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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Three types of asthmatic patients can be identified during periods of clinical stability&#58; &#8220;poor perceivers&#44;&#8221; &#8220;normal perceivers&#44;&#8221; and &#8220;over perceivers&#46;&#8221; When asthmatics undergo bronchial challenge in the laboratory&#44; the same distinctions in type of perception can be observed&#46; The aim of the present study was to determine the level of agreement between the 2 situations&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 93 patients with persistent moderate asthma &#40;36 men and 57 women&#59; mean age 40 years&#41; were studied&#46; We asked them to assess their dyspnea on a modified Borg scale when stable and after each histamine dose in a bronchial provocation test&#46; When a patient&#39;s Borg scale assessment in stable situation was below the 25th percentile&#44; that patient was classified as a poor perceiver&#46; Patients were considered over perceivers if their score in stable situation was in the 75th percentile&#46; Others were labeled normal perceivers&#46; Type of perception during acute bronchoconstriction was defined in function of the change in Borg assessment once forced expiratory volume in the first second had decreased 20&#37;&#58; poor perceivers were those whose change in Borg assessment was in the 25th percentile&#44; over perceivers were in the 75th percentile&#44; and normal perceivers in the middle percentiles&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">In stable situation&#44; 23 patients were poor perceivers&#44; 58 were normal perceivers&#44; and 12 were over perceivers&#46; During bronchoconstriction&#44; there were 23 poor perceivers&#44; 47 normal perceivers&#44; and 23 over perceivers&#46; Agreement was estimated by a kappa index of 0&#46;0574 for poor perception&#44; 0&#46;1521 for over perception&#44; and 0&#46;3980 for normal perception&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Asthmatics&#39; perception of dyspnea during periods of stability and during acute bronchoconstriction are independent phenomena&#46; It is therefore not possible to infer how a patient will perceive an asthmatic attack by evaluating only how he or she perceives breathlessness during stable periods&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Durante la estabilidad cl&#237;nica se pueden distinguir 3 tipos de asm&#225;ticos&#58; hipoperceptores&#44; normoperceptores e hiperperceptores&#46; Cuando a esos mismos pacientes se les provoca una broncoconstricci&#243;n aguda&#44; tambi&#233;n existen hipo&#44; normo e hiperperceptores de disnea&#46; El objetivo del presente trabajo ha sido comprobar la concordancia entre ambas situaciones&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha estudiado a 93 pacientes con asma persistente moderada &#40;36 varones y 57 mujeres&#59; edad media de 40 a&#241;os&#41;&#46; Se les pidi&#243; que estimaran su disnea &#40;es-cala modificada de Borg&#41; en situaci&#243;n de estabilidad y despu&#233;s de cada dosis de histamina en una prueba de broncoprovocaci&#243;n&#46; Cuando la puntuaci&#243;n de Borg en situaci&#243;n estable era menor del percentil 25&#44; se consider&#243; hipoperceptor&#59; si era superior al percentil 75&#44; hiperperceptor&#44; y normoperceptor al grupo restante&#46; En funci&#243;n del cambio de disnea al descender un 20&#37; el volumen espiratorio forzado en el primer segundo se distinguieron los perceptores agudos&#58; hipoperceptores &#40;cambio en Borg inferior al percentil 25&#41;&#44; hiperperceptores &#40;cambio superior al percentil 75&#41; y normoperceptores &#40;cambio entre los percentiles 25 y 75&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">En situaci&#243;n estable 23 pacientes fueron hipoperceptores&#44; 58 normoperceptores y 12 hiperperceptores&#44; mientras que durante la broncoconstricci&#243;n hubo 23 hipoperceptores&#44; 47 normoperceptores y 23 hiperperceptores&#46; El an&#225;lisis de concordancia mostr&#243; un &#237;ndice kappa de 0&#44;0574 para la hipopercepci&#243;n&#44; de 0&#44;1521 para la hiperpercepci&#243;n y de 0&#44;3980 para la normopercepci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Las percepciones de disnea de los asm&#225;ticos en situaci&#243;n estable y durante una broncoconstricci&#243;n aguda son fen&#243;menos independientes&#46; Por ello&#44; no es posible inferir c&#243;mo un paciente va a percibir una crisis de asma va-lorando &#250;nicamente c&#243;mo percibe su enfermedad durante la estabilidad cl&#237;nica&#46;</p>"
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Original Articles
Agreement in Asthmatics' Perception of Dyspnea During Acute and Chronic Obstruction
E. Martínez-Moragóna,
Corresponding author
emm01v@saludalia.com

Correspondence: Dra. E. Martínez-Moragón. Servicio de Neumología (Medicina Interna). Hospital de Sagunto. Avda. Ramón y Cajal, s/n. 46520 Port de Sagunt. Valencia. España
, M. Perpiñáb, A. Bellochc, A. de Diegob, M.E. Martínez-Francésb
a Servicio de Neumología, Hospital de Sagunto, Port de Sagunt, Valencia, Spain
b Servicio de Neumología, Hospital Universitario La Fe, Valencia, Spain
c Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universidad de Valencia, Valencia, Spain
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">Three types of asthmatic patients can be identified during periods of clinical stability&#58; &#8220;poor perceivers&#44;&#8221; &#8220;normal perceivers&#44;&#8221; and &#8220;over perceivers&#46;&#8221; When asthmatics undergo bronchial challenge in the laboratory&#44; the same distinctions in type of perception can be observed&#46; The aim of the present study was to determine the level of agreement between the 2 situations&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 93 patients with persistent moderate asthma &#40;36 men and 57 women&#59; mean age 40 years&#41; were studied&#46; We asked them to assess their dyspnea on a modified Borg scale when stable and after each histamine dose in a bronchial provocation test&#46; When a patient&#39;s Borg scale assessment in stable situation was below the 25th percentile&#44; that patient was classified as a poor perceiver&#46; Patients were considered over perceivers if their score in stable situation was in the 75th percentile&#46; Others were labeled normal perceivers&#46; Type of perception during acute bronchoconstriction was defined in function of the change in Borg assessment once forced expiratory volume in the first second had decreased 20&#37;&#58; poor perceivers were those whose change in Borg assessment was in the 25th percentile&#44; over perceivers were in the 75th percentile&#44; and normal perceivers in the middle percentiles&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">In stable situation&#44; 23 patients were poor perceivers&#44; 58 were normal perceivers&#44; and 12 were over perceivers&#46; During bronchoconstriction&#44; there were 23 poor perceivers&#44; 47 normal perceivers&#44; and 23 over perceivers&#46; Agreement was estimated by a kappa index of 0&#46;0574 for poor perception&#44; 0&#46;1521 for over perception&#44; and 0&#46;3980 for normal perception&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Asthmatics&#39; perception of dyspnea during periods of stability and during acute bronchoconstriction are independent phenomena&#46; It is therefore not possible to infer how a patient will perceive an asthmatic attack by evaluating only how he or she perceives breathlessness during stable periods&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Durante la estabilidad cl&#237;nica se pueden distinguir 3 tipos de asm&#225;ticos&#58; hipoperceptores&#44; normoperceptores e hiperperceptores&#46; Cuando a esos mismos pacientes se les provoca una broncoconstricci&#243;n aguda&#44; tambi&#233;n existen hipo&#44; normo e hiperperceptores de disnea&#46; El objetivo del presente trabajo ha sido comprobar la concordancia entre ambas situaciones&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha estudiado a 93 pacientes con asma persistente moderada &#40;36 varones y 57 mujeres&#59; edad media de 40 a&#241;os&#41;&#46; Se les pidi&#243; que estimaran su disnea &#40;es-cala modificada de Borg&#41; en situaci&#243;n de estabilidad y despu&#233;s de cada dosis de histamina en una prueba de broncoprovocaci&#243;n&#46; Cuando la puntuaci&#243;n de Borg en situaci&#243;n estable era menor del percentil 25&#44; se consider&#243; hipoperceptor&#59; si era superior al percentil 75&#44; hiperperceptor&#44; y normoperceptor al grupo restante&#46; En funci&#243;n del cambio de disnea al descender un 20&#37; el volumen espiratorio forzado en el primer segundo se distinguieron los perceptores agudos&#58; hipoperceptores &#40;cambio en Borg inferior al percentil 25&#41;&#44; hiperperceptores &#40;cambio superior al percentil 75&#41; y normoperceptores &#40;cambio entre los percentiles 25 y 75&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">En situaci&#243;n estable 23 pacientes fueron hipoperceptores&#44; 58 normoperceptores y 12 hiperperceptores&#44; mientras que durante la broncoconstricci&#243;n hubo 23 hipoperceptores&#44; 47 normoperceptores y 23 hiperperceptores&#46; El an&#225;lisis de concordancia mostr&#243; un &#237;ndice kappa de 0&#44;0574 para la hipopercepci&#243;n&#44; de 0&#44;1521 para la hiperpercepci&#243;n y de 0&#44;3980 para la normopercepci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Las percepciones de disnea de los asm&#225;ticos en situaci&#243;n estable y durante una broncoconstricci&#243;n aguda son fen&#243;menos independientes&#46; Por ello&#44; no es posible inferir c&#243;mo un paciente va a percibir una crisis de asma va-lorando &#250;nicamente c&#243;mo percibe su enfermedad durante la estabilidad cl&#237;nica&#46;</p>"
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