RESUMO
BACKGROUND: With the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma. METHODS: The guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management. RESULTS: The selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference - all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6-11 years and ≥12 years. CONCLUSIONS: For the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.
Assuntos
Asma/diagnóstico , Asma/prevenção & controle , Criança , Pré-Escolar , Feminino , Humanos , Masculino , MéxicoRESUMO
Fifteen patients diagnosed with bronchial asthma were examined to evaluate the cardiotoxicity caused by the combined intravenous treatment using methylxanthine-aminophylline 250 mg and a beta agonist: salbutamol 0.5 mg. The following observations were made: four patients had sinus tachycardia and another suffered from ventricular extrasystoles as seen in the electrocardiographic register; another two patients had sinus tachycardia when the bronchial dilator dosage was doubled. From a clinical and electrocardiographic standpoint, arrhythmias do not seem to be a grave problem among the population studied.