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        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">A study has been carried out on the incidence and clinical characteristics of asthma exacerbations &#40;AE&#41; seen in hospital accident and emergency departments &#40;HA&#38;ED&#41; and domiciliary services &#40;DS&#41; in Barcelona&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">AEs were identified over a 56-day-period during the October and November 2003 and the patients seen in university hospitals were interviewed&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 262 AE were identified&#44; 188 in hospital accident and emergency departments and 82 in domiciliary care&#44; which was a mean of 4&#46;6 AE&#47;day&#44; giving an incidence of 0&#46;37 AE&#47;10<span class="elsevierStyleSup">5</span> inhabitants&#46; This incidence was no different from that obtained in the same months in 2002 &#40;<span class="elsevierStyleItalic">P</span> &#62; 0&#46;05&#41;&#46; The mean age &#40;&#177;standard deviation&#41; of the143 cases of AE seen in university hospitals was 41&#177;17 years&#59; 87&#47;143 &#40;60&#37;&#41; were women and 57&#47;138 &#40;41&#37;&#41; smokers&#46; In 36&#47;61 &#40;59&#37;&#41; the AE started in the home&#59; in 88&#47;132 &#40;61&#37;&#41; it began 24 hours before arriving at the hospital centre&#46; In 78&#47;123 cases &#40;63&#37;&#41; slow onset of nasal cold was noted before the AE and a viral infection was suspected&#46; Inhaled corticosteroids were administered to 45&#47;112 patients &#40;40&#37;&#41;&#44; and only one was also given oral corticosteroids 12 hours before admission&#46; The AEs were mild in 38&#47;75 cases &#40;51&#37;&#41;&#44; moderate in 28&#47;75 &#40;37&#37;&#41;&#44; severe in 8&#47;75 &#40;11&#37;&#41; and almost fatal in one patient &#40;1&#46;3&#37;&#41;&#46; Around 10&#37; &#40;13&#47;137&#41; of patients &#40;10&#37;&#41; were readmitted&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The daily incidence of AE is 0&#46;37&#47;10<span class="elsevierStyleSup">5</span> inhabitants&#46; More than half of the exacerbations started after nasal cold and 11&#37; of the AEs were severe&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha estudiado la tasa de agudizaciones asm&#225;ticas &#40;AA&#41; atendidas en los servicios de urgencias hospitalarios &#40;SUH&#41; y domiciliarios &#40;SEM&#41;&#44; as&#237; como sus caracter&#237;sticas cl&#237;nicas&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Durante los meses de octubre y noviembre de 2003 se identificaron durante 56 d&#237;as las AA y se entrevist&#243; a los pacientes atendidos en los hospitales universitarios&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se identificaron 262 AA&#44; 188 en los servicios de urgencias hospitalarios y 82 en los domiciliarios&#44; es decir&#44; una media de 4&#44;6 AA&#47;d&#237;a&#44; lo que significa una tasa de 0&#44;37 AA&#47;10<span class="elsevierStyleSup">5</span> habitantes&#44; incidencia no diferente de la obtenida en los mismos meses de 2002 &#40;p &#62; 0&#44;05&#41;&#46; La edad media &#40;&#177; desviaci&#243;n est&#225;ndar&#41; de los 143 casos de AA atendidas en los hospitales universitarios era de 41 &#177; 17 a&#241;os&#59; 87&#47;143 &#40;60&#37;&#41; eran mujeres y 57&#47;138 &#40;41&#37;&#41;&#44; fumadores&#46; En 36&#47;61 &#40;59&#37;&#41; la AA se inici&#243; en el domicilio&#59; en 88&#47;132 &#40;61&#37;&#41; comenz&#243; 24 h antes de la llegada al centro hospitalario&#46; En 78&#47;123 casos &#40;63&#37;&#41; se registr&#243; catarro nasal de instauraci&#243;n lenta antes de la AA y se sospech&#243; una infecci&#243;n v&#237;rica&#46; Recib&#237;an corticosteroides inhalados 45&#47;112 pacientes &#40;40&#37;&#41;&#44; y &#250;nicamente uno a&#241;adi&#243; corticosteroides orales en las 12h previas al ingreso&#46; La AA era leve en 38&#47;75 casos &#40;51&#37;&#41;&#44; moderada en 28&#47;75 &#40;37&#37;&#41;&#44; grave en 8&#47;75 &#40;11&#37;&#41; y casi fatal en un paciente &#40;1&#44;3&#37;&#41;&#46; Fueron readmitidos 13&#47;137 pacientes &#40;10&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La incidencia diaria de AA es de 0&#44;37&#47;10<span class="elsevierStyleSup">5</span> habitantes&#46; M&#225;s de la mitad de las agudizaciones se hab&#237;an iniciado tras un catarro nasal&#46; Un 11&#37; de las AA eran graves&#46;</p>"
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                          "autores" => array:4 [
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                          "autores" => array:5 [
                            0 => "J&#46; Serra-Batlles"
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                            2 => "E&#46; Morejon"
                            3 => "A&#46; Comella"
                            4 => "J&#46; Bugues"
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                        "paginaFinal" => "1326"
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                            3 => "J&#46; Garcia-Aymerich"
                            4 => "J&#46; Ferrer"
                            5 => "M&#46;J&#46; Cruz"
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            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asthma severity and adequacy of management in accident and emergency departments in Fran a prospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Salmeron"
                            1 => "R&#46; Liard"
                            2 => "D&#46; Elkharrat"
                            3 => "J&#46; Muir"
                            4 => "F&#46; Neukirch"
                            5 => "A&#46; Ellrodt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2001"
                        "volumen" => "358"
                        "paginaInicial" => "629"
                        "paginaFinal" => "635"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11530150"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Global Initiative for Asthma &#40;GINA&#41;&#46; Available at&#58; <a class="elsevierStyleInterRef" href="http://www.ginasthma.com/">www&#46;ginasthma&#46;com</a>&#46; p&#46; 68&#46;"
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Departament d&#8217;Estad&#237;stica&#46; Ajuntament de Barcelona&#46; Available at&#58; <a class="elsevierStyleInterRef" href="http://www.bcn.es/estadistica/">www&#46;bcn&#46;es&#47;estadistica&#47;</a>&#46;"
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estudio Europeo del Asma&#46; Prevalencia de s&#237;ntomas relacionados con el asma en cinco &#225;reas espa&#241;olas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Grupo Espa&#241;ol del Estudio Europeo del Asma"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "1995"
                        "volumen" => "104"
                        "paginaInicial" => "487"
                        "paginaFinal" => "492"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute asthma in adult"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46;J&#46; Rodrigo"
                            1 => "C&#46; Rodrigo"
                            2 => "J&#46;B&#46; Hall"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2004"
                        "volumen" => "125"
                        "paginaInicial" => "1081"
                        "paginaFinal" => "1102"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15006973"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency and clinical characteristics of rapid-onset fatal and near-fatal asthma"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "High Risk Asthma Research Group"
                          "etal" => false
                          "autores" => array:4 [
                            0 => "V&#46; Plaza"
                            1 => "J&#46; Serrano"
                            2 => "C&#46; Picado"
                            3 => "J&#46; Sanchis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2002"
                        "volumen" => "19"
                        "paginaInicial" => "846"
                        "paginaFinal" => "852"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12030723"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden-onset asthma exacerbations&#58; clinical features response to therapy&#44; and 2-week follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;G&#46; Barr"
                            1 => "P&#46;G&#46; Woodruff"
                            2 => "S&#46; Clark"
                            3 => "C&#46;A&#46; Camargo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2000"
                        "volumen" => "15"
                        "paginaInicial" => "266"
                        "paginaFinal" => "273"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10706490"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Global Initiative for Asthma &#40;GINA&#41;&#44; 2002&#46; Available at&#58; <a class="elsevierStyleInterRef" href="http://www.ginasthma.com/">www&#46;ginasthma&#46;com</a>&#46; p&#46; 134&#46;"
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of a combined comorbidity index"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Charlson"
                            1 => "T&#46;P&#46; Szatrowski"
                            2 => "J&#46; Peterson"
                            3 => "J&#46; Gold"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Epidemiol"
                        "fecha" => "1994"
                        "volumen" => "47"
                        "paginaInicial" => "1245"
                        "paginaFinal" => "1251"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7722560"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thunderstorm outflows preceding epidemics of asthma during spring and summer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;B&#46; Marks"
                            1 => "J&#46;R&#46; Colquhoun"
                            2 => "S&#46;T&#46; Girgis"
                            3 => "M&#46;H&#46; Koski"
                            4 => "A&#46;B&#46; Treloar"
                            5 => "P&#46; Hansen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2001"
                        "volumen" => "56"
                        "paginaInicial" => "468"
                        "paginaFinal" => "471"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11359963"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preventing asthma epidemics due to soybeans by dust-control measures"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Ant&#243;"
                            1 => "J&#46; Sunyer"
                            2 => "C&#46;E&#46; Reed"
                            3 => "J&#46; Sabria"
                            4 => "F&#46; Mart&#237;nez"
                            5 => "F&#46; Morell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199312093292402"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1993"
                        "volumen" => "329"
                        "paginaInicial" => "1760"
                        "paginaFinal" => "1763"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8232484"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Allergens&#44; viruses&#44; and asthma exacerbations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;S&#46; Murray"
                            1 => "A&#46; Simpson"
                            2 => "A&#46; Custovic"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1513/pats.2306027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc Am Thorac Soc"
                        "fecha" => "2004"
                        "volumen" => "1"
                        "paginaInicial" => "99"
                        "paginaFinal" => "104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16113420"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory virus and exacerbations of asthma in adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;G&#46; Nicholson"
                            1 => "J&#46; Kent"
                            2 => "D&#46;C&#46; Ireland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1993"
                        "volumen" => "307"
                        "paginaInicial" => "982"
                        "paginaFinal" => "986"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8241910"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0210570510002608"
                          "estado" => "S300"
                          "issn" => "02105705"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short-term respiratory effects of cleaning exposures in female domestic cleaners"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Medina-Ram&#243;n"
                            1 => "J&#46;P&#46; Zock"
                            2 => "M&#46; Kogevinas"
                            3 => "J&#46; Sunyer"
                            4 => "X&#46; Basaga&#241;a"
                            5 => "J&#46; Schwartz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.06.00085405"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2006"
                        "volumen" => "27"
                        "paginaInicial" => "1196"
                        "paginaFinal" => "1203"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16510456"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Bellido-Casado J&#44; Plaza V&#44; Rodrigo GJ&#44; Neffen H&#44; Baz&#250;s MT&#44; Levy G&#44; et al &#40;en representaci&#243;n de las &#193;reas de Asma de ALAT y SEPAR&#41;&#46; Agudizaci&#243;n grave de asma y prescripci&#243;n previa de corticosteroides inhalados en Espa&#241;a y Latinoam&#233;rica&#58; Proyecto EAGLE&#46; 40&#46;&#176; Congreso Nacional de la Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41;&#46; Barcelona&#44; 1&#8211;4 de junio de 2007&#46; Arch Bronconeumol&#46; 2007&#59;43 Especial Congreso&#58; 2&#46;"
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid effects of inhaled corticosteroids in acute asthma&#58; an evidencebased evaluation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;J&#46; Rodrigo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.130.5.1301"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2006"
                        "volumen" => "130"
                        "paginaInicial" => "1301"
                        "paginaFinal" => "1311"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17099004"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Addition of intravenous aminophylline to beta2-agonists in adults with acute asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Parameswaran"
                            1 => "J&#46; Belda"
                            2 => "B&#46;H&#46; Rowe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2000"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Grupo Espa&#241;ol para el Manejo del Asma &#40;GEMA&#41;&#46; Gu&#237;a espa&#241;ola para el manejo del asma&#46; 2009&#46; Available at&#58; <a class="elsevierStyleInterRef" href="http://www.gemasma.com/">www&#46;gemasma&#46;com</a>&#46;"
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Global Initiative for Asthma &#40;GINA&#41;&#46; Disponible en&#58; <a class="elsevierStyleInterRef" href="http://www.ginasthma.com/">www&#46;ginasthma&#46;com</a>&#46;"
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management according to the Global Initiative for Asthma guidelines of patients with near-fatal asthma reduces morbidity and mortality"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Rodr&#237;guez-Trigo"
                            1 => "V&#46; Plaza"
                            2 => "C&#46; Picado"
                            3 => "J&#46; Sanchis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2008"
                        "volumen" => "44"
                        "paginaInicial" => "192"
                        "paginaFinal" => "196"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18423180"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
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Vol. 45. Issue 11.
Pages 550-555 (November 2009)
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Vol. 45. Issue 11.
Pages 550-555 (November 2009)
Original article
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Incidence and Characteristics of Asthma Exacerbations in Barcelona (ASMAB II)
Incidencia y características de las agudizaciones asmáticas en Barcelona (ASMAB II)
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Ferran Morella,
Corresponding author
fmorell@vhebron.net

Corresponding author.
, Ferran Morellb, Teresa Genoverb, Teresa Genoverc, Esther Benaqued, César Picadob, César Picadoe, Xavier Muñoza, Xavier Muñozb, María Jesús Cruza, María Jesús Cruzb
a Servei de Pneumologia, Hospital Universitari Vall d’Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
b CIBER de Enfermedades Respiratorias (CibeRes)
c Centro de Asistencia Primaria Sant Rafael, Barcelona, Spain
d Centro de Asistencia Primaria Río de Janeiro, SAP Muntanya, Institut Català de la Salut, Barcelona, Spain
e Servei de Pneumologia i Al lèrgia Respiratoria, Hospital Clínic, IDIBAPS, Departament de Medicina, Universitat de Barcelona, Barcelona, Spain
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Article information
Abstract
Introduction

A study has been carried out on the incidence and clinical characteristics of asthma exacerbations (AE) seen in hospital accident and emergency departments (HA&ED) and domiciliary services (DS) in Barcelona.

Patients and methods

AEs were identified over a 56-day-period during the October and November 2003 and the patients seen in university hospitals were interviewed.

Results

A total of 262 AE were identified, 188 in hospital accident and emergency departments and 82 in domiciliary care, which was a mean of 4.6 AE/day, giving an incidence of 0.37 AE/105 inhabitants. This incidence was no different from that obtained in the same months in 2002 (P > 0.05). The mean age (±standard deviation) of the143 cases of AE seen in university hospitals was 41±17 years; 87/143 (60%) were women and 57/138 (41%) smokers. In 36/61 (59%) the AE started in the home; in 88/132 (61%) it began 24 hours before arriving at the hospital centre. In 78/123 cases (63%) slow onset of nasal cold was noted before the AE and a viral infection was suspected. Inhaled corticosteroids were administered to 45/112 patients (40%), and only one was also given oral corticosteroids 12 hours before admission. The AEs were mild in 38/75 cases (51%), moderate in 28/75 (37%), severe in 8/75 (11%) and almost fatal in one patient (1.3%). Around 10% (13/137) of patients (10%) were readmitted.

Conclusions

The daily incidence of AE is 0.37/105 inhabitants. More than half of the exacerbations started after nasal cold and 11% of the AEs were severe.

Keywords:
Bronchial asthma
Asthma exacerbations
Epidemiology of asthma
Resumen
Introducción

Se ha estudiado la tasa de agudizaciones asmáticas (AA) atendidas en los servicios de urgencias hospitalarios (SUH) y domiciliarios (SEM), así como sus características clínicas.

Pacientes y métodos

Durante los meses de octubre y noviembre de 2003 se identificaron durante 56 días las AA y se entrevistó a los pacientes atendidos en los hospitales universitarios.

Resultados

Se identificaron 262 AA, 188 en los servicios de urgencias hospitalarios y 82 en los domiciliarios, es decir, una media de 4,6 AA/día, lo que significa una tasa de 0,37 AA/105 habitantes, incidencia no diferente de la obtenida en los mismos meses de 2002 (p > 0,05). La edad media (± desviación estándar) de los 143 casos de AA atendidas en los hospitales universitarios era de 41 ± 17 años; 87/143 (60%) eran mujeres y 57/138 (41%), fumadores. En 36/61 (59%) la AA se inició en el domicilio; en 88/132 (61%) comenzó 24 h antes de la llegada al centro hospitalario. En 78/123 casos (63%) se registró catarro nasal de instauración lenta antes de la AA y se sospechó una infección vírica. Recibían corticosteroides inhalados 45/112 pacientes (40%), y únicamente uno añadió corticosteroides orales en las 12h previas al ingreso. La AA era leve en 38/75 casos (51%), moderada en 28/75 (37%), grave en 8/75 (11%) y casi fatal en un paciente (1,3%). Fueron readmitidos 13/137 pacientes (10%).

Conclusiones

La incidencia diaria de AA es de 0,37/105 habitantes. Más de la mitad de las agudizaciones se habían iniciado tras un catarro nasal. Un 11% de las AA eran graves.

Palabras clave:
Asma bronquial
Exacerbaciones del asma
Epidemiología del asma
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References
[1.]
K.F. Rabe, P.A. Vermeire, J.B. Soriano, W.C. Maier.
Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) study.
Eur Respir J, 16 (2000), pp. 802-807
[2.]
Global Initiative for Asthma (GINA). Available at: www.ginasthma.com. p. 85.
[3.]
J. Serra-Batlles, V. Plaza, E. Morejon, A. Comella, J. Bugues.
Cost of asthma according to the degree of severity.
Eur Respir J, 12 (1998), pp. 1322-1326
[4.]
F. Morell, T. Genover, X. Muñoz, J. Garcia-Aymerich, J. Ferrer, M.J. Cruz.
Rate and characteristics of asthma exacerbations: the ASMAB I study.
Arch Bronconeumol, 44 (2008), pp. 303-311
[5.]
S. Salmeron, R. Liard, D. Elkharrat, J. Muir, F. Neukirch, A. Ellrodt.
Asthma severity and adequacy of management in accident and emergency departments in Fran a prospective study.
Lancet, 358 (2001), pp. 629-635
[6.]
Global Initiative for Asthma (GINA). Available at: www.ginasthma.com. p. 68.
[7.]
Departament d’Estadística. Ajuntament de Barcelona. Available at: www.bcn.es/estadistica/.
[8.]
Grupo Español del Estudio Europeo del Asma.
Estudio Europeo del Asma. Prevalencia de síntomas relacionados con el asma en cinco áreas españolas.
Med Clin (Barc), 104 (1995), pp. 487-492
[9.]
G.J. Rodrigo, C. Rodrigo, J.B. Hall.
Acute asthma in adult.
Chest, 125 (2004), pp. 1081-1102
[10.]
V. Plaza, J. Serrano, C. Picado, J. Sanchis, High Risk Asthma Research Group.
Frequency and clinical characteristics of rapid-onset fatal and near-fatal asthma.
Eur Respir J, 19 (2002), pp. 846-852
[11.]
R.G. Barr, P.G. Woodruff, S. Clark, C.A. Camargo.
Sudden-onset asthma exacerbations: clinical features response to therapy, and 2-week follow-up.
Eur Respir J, 15 (2000), pp. 266-273
[12.]
Global Initiative for Asthma (GINA), 2002. Available at: www.ginasthma.com. p. 134.
[13.]
M. Charlson, T.P. Szatrowski, J. Peterson, J. Gold.
Validation of a combined comorbidity index.
J Clin Epidemiol, 47 (1994), pp. 1245-1251
[14.]
G.B. Marks, J.R. Colquhoun, S.T. Girgis, M.H. Koski, A.B. Treloar, P. Hansen, et al.
Thunderstorm outflows preceding epidemics of asthma during spring and summer.
Thorax, 56 (2001), pp. 468-471
[15.]
J.M. Antó, J. Sunyer, C.E. Reed, J. Sabria, F. Martínez, F. Morell, et al.
Preventing asthma epidemics due to soybeans by dust-control measures.
N Engl J Med, 329 (1993), pp. 1760-1763
[16.]
C.S. Murray, A. Simpson, A. Custovic.
Allergens, viruses, and asthma exacerbations.
Proc Am Thorac Soc, 1 (2004), pp. 99-104
[17.]
K.G. Nicholson, J. Kent, D.C. Ireland.
Respiratory virus and exacerbations of asthma in adults.
BMJ, 307 (1993), pp. 982-986
[18.]
M. Medina-Ramón, J.P. Zock, M. Kogevinas, J. Sunyer, X. Basagaña, J. Schwartz, et al.
Short-term respiratory effects of cleaning exposures in female domestic cleaners.
Eur Respir J, 27 (2006), pp. 1196-1203
[19.]
Bellido-Casado J, Plaza V, Rodrigo GJ, Neffen H, Bazús MT, Levy G, et al (en representación de las Áreas de Asma de ALAT y SEPAR). Agudización grave de asma y prescripción previa de corticosteroides inhalados en España y Latinoamérica: Proyecto EAGLE. 40.° Congreso Nacional de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Barcelona, 1–4 de junio de 2007. Arch Bronconeumol. 2007;43 Especial Congreso: 2.
[20.]
G.J. Rodrigo.
Rapid effects of inhaled corticosteroids in acute asthma: an evidencebased evaluation.
Chest, 130 (2006), pp. 1301-1311
[21.]
K. Parameswaran, J. Belda, B.H. Rowe.
Addition of intravenous aminophylline to beta2-agonists in adults with acute asthma.
Cochrane Database Syst Rev, (2000),
[22.]
Grupo Español para el Manejo del Asma (GEMA). Guía española para el manejo del asma. 2009. Available at: www.gemasma.com.
[23.]
Global Initiative for Asthma (GINA). Disponible en: www.ginasthma.com.
[24.]
G. Rodríguez-Trigo, V. Plaza, C. Picado, J. Sanchis.
Management according to the Global Initiative for Asthma guidelines of patients with near-fatal asthma reduces morbidity and mortality.
Arch Bronconeumol, 44 (2008), pp. 192-196
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