Abstract Objective To compare the effectiveness of inhaled Magnesium Sulfate associated with Salbutamol versus Inhaled Salbutamol alone in patients with moderate and severe asthma exacerbations. Method Clinical, prospective and randomized study with patients between 3 and 14 years of age divided into two groups: one to receive inhaled salbutamol associated with magnesium sulfate (GSM), the other to receive inhaled salbutamol alone (GS). The sample consisted of 40 patients, 20 patients in each group. Severity was classified using the modified Wood-Downes score, with values between 4 and 7 classified as moderate and 8 or more classified as severe. Results Post-inhalation scores decreased both in patients who received salbutamol and magnesium and in those who received salbutamol alone, with no statistically significant difference between the groups. Conclusions Despite the benefits when administered intravenously, inhalation of the drug alone or in combination did not reduce the severity of the exacerbation. exacerbations Clinical 1 groups GSM, GSM , (GSM) GS. GS . (GS) 2 group WoodDownes Wood Downes score Postinhalation Post intravenously exacerbation (GSM (GS

Respiratory syncytial virus (RSV) is the commonest cause of lower respiratory tract infection (LRTI) in children, particularly those aged <1 year. In South Africa (SA), increased hospitalisation rates during the RSV season, including access to intensive care facilities, place a huge burden on the healthcare system. Furthermore, RSV-LRTI during early childhood may lead to long-term respiratory sequelae, including recurrent wheezing, asthma, and impairment of lung function. Recently, two new RSV prevention strategies have emerged: nirsevimab, a long-acting monoclonal antibody, and a maternal RSV vaccine. Both strategies have shown high efficacy in reducing RSV-LRTI hospitalisation in infants and are being considered for licensure in SA. Implementation of these prevention strategies, combined with public engagement and collaboration between stakeholders, could significantly reduce RSV-related morbidity and mortality in SA.

BACKGROUND: Smoking and alcohol misuse are lifestyle factors that can be controlled and have significant health effects. Both these factors increase the risk of developing conditions such as diabetes mellitus because they affect glucose metabolism and can interfere with blood glucose control in individuals with diabetes. Research on tobacco and alcohol use and specific health outcomes among adults with prediabetes or type 2 diabetes mellitus (T2DM) could provide valuable information leading to more efficient treatment and management of this disease OBJECTIVES: To assess the association between tobacco and alcohol use and specific health outcomes among South African adults with prediabetes or T2DM METHODS: Data from the 2016 South African Demographic and Health Survey were analysed using Stata vl7. Participants were classified into prediabetes or T2DM groups, based on a glycated haemoglobin cut-off of 5.7% or self-report of a previous diagnosis of T2DM. Exposures of interest were self-reported current tobacco smoking and problem/risky alcohol use. The associations between these exposures and health outcomes in the different groups were assessed using multivariable logistic regression analysis. We adjusted for specific confounders in the regression models RESULTS: Of a total of 6 108 participants (mean (standard deviation) age 41 (19) years), 72.2% (n=4 409) had prediabetes and 27.8% (n=1 699) T2DM; 17.7% (n=1 084) were current smokers and 9.3% (n=565) reported problem/risky alcohol use. Current smoking was significantly associated with 40% increased odds of shortness of breath (adjusted odds ratio (aOR) 1.40; 95% confidence interval (CI) 1.1 - 1.7; p<0.001) and 67% increased odds of chronic obstructive pulmonary disease (COPD)/asthma (aOR 1.67; 95% CI 1.2 - 2.2; p<0.001). Problem/risky alcohol use was significantly associated with 40% increased odds of COPD/asthma (aOR 1.40; 95% CI 1.1 - 1.7; p=0.001) and 92% increased odds of having cancer (aOR 1.92; 95% CI 1.5 - 2.5; p<0.001 CONCLUSION: There is a need for targeted smoking cessation programmes and alcohol misuse counselling among individuals living with diabetes and prediabetes

ABSTRACT Exposure to airborne pollen allergens is an important environmental factor in triggering respiratory allergic diseases, such as rhinitis and asthma. These diseases lead to a reduction in patients’ quality of life and an increase in socioeconomic costs throughout Europe, including Portugal. One of the most common information available to patients with pollinosis and their clinicians is the concentration of pollen grains present in the atmosphere of outdoor environments, bioaerosols whose temporal distribution is contained in the pollen calendars. Another fundamental instrument is the Pollen Bulletin, which provides pollen forecasts. Given the scientific evidence of the relationship between pollen concentrations and allergic symptoms, such information and prevention tools have been essential for the general population and the medical community assisting in these pathologies. The aeropalynological information disclosed is only possible with the continuous environmental monitoring carried out by the Portuguese Aerobiology Network for more than two decades in Portugal. The Pollen incidence maps presented here, constructed based on the information that gave rise to the pollen calendars, show the incidence of the main allergenic pollen types to which the populations of each region of the country are exposed and shall constitute an essential tool in the clinical practice in the allergic disease field in Portugal.

RESUMO A exposição a aeroalergénios polínicos é um importante fator ambiental desencadeante de doenças alérgicas respiratórias, tais como a rinite e a asma. Estas patologias conduzem a uma redução da qualidade de vida dos doentes e a um aumento dos custos socioeconómicos por toda a Europa, incluindo em Portugal. Uma das informações mais comuns disponíveis para os doentes com polinose e seus clínicos é a concentração de grãos de pólen presentes na atmosfera dos ambientes exteriores, bioaerossóis cuja distribuição temporal se encontra contida nos calendários polínicos. Outro instrumento fundamental é o “Boletim Polínico”, instrumento que informa as previsões de grãos de pólen na atmosfera. Dada a evidência cientificamente comprovada da relação entre concentrações de pólen e sintomatologia alérgica, tais ferramentas de informação e de prevenção têm sido imprescindíveis quer para a população em geral, quer para a comunidade médica que a assiste nestas patologias. As informações aeropalinológicas divulgadas só são possíveis com a monitorização ambiental contínua que tem sido feita pela Rede Portuguesa de Aerobiologia há mais de duas décadas em Portugal. Os mapas de incidência polínica aqui apresentados, construídos com base na informação que deu origem aos calendários polínicos, mostram a incidência dos principais tipos polínicos alergizantes a que as populações de cada região do país estão expostas e constituirão um instrumento essencial na prática clínica no domínio da doença alérgica em Portugal.

Resumen El aparato respiratorio, desde la nariz al pulmón, se comporta como una unidad anatómica y fisiopatológica bajo un modelo holístico. Se han observado alteraciones pulmonares sin traducción clínica en pacientes con rinitis sin asma, que se manifiestan como hiperreac tividad bronquial, reducción de la función pulmonar e inflamación bronquial. Estas serían consecuencia de un fenómeno inflamatorio sistémico con impacto simultá neo en nariz y pulmón, que por razones desconocidas no tiene una expresión clínica completa, pero que podrían significar un mayor riesgo de desarrollo de asma. En esta revisión abordamos la frecuencia y caracte rísticas de las anormalidades pulmonares existentes en niños y adolescentes con rinitis crónica derivadas de nuestras investigaciones previas y, más recientemente, del proyecto “Enfermedad Alérgica Respiratoria: El Con cepto de Unidad de la Vía Aérea”, línea de investigación acreditada por la Universidad Católica de Córdoba y un análisis comparativo con las evidencias aportadas por otros autores en la literatura médica.

Abstract The respiratory tract, from the nose to the lung, behaves as an anatomical and pathophysiological unit under a holistic model. Lower airway abnormalities, such as bronchial hyperresponsiveness, reduced lung function and inflammation of the bronchial mucosa without clinical expression, have been observed in pa tients with rhinitis without asthma. These would be the consequence of a common systemic inflammatory phenomenon with simultaneous impact on the nose and lung. For unknown reasons, these patients do not exhibit a full clinical expression, which could mean an increased risk of developing asthma. In this review we address the frequency and charac teristics of existing pulmonary abnormalities in children and adolescents with chronic rhinitis that derive from our previous research and, more recently, within the project “Allergic Respiratory Disease: The United Airway Con cept” supported by the Universidad Católica de Córdoba, and a comparative analysis with the evidence provided by other authors in the medical literature.

Resumen Introducción: La menarquia temprana se asocia con la salud general, como el aumento del riesgo de cáncer, obesidad, enfermedad cardiovascular y función pulmonar más baja. Sin embargo, pocos estudios han investigado la relación entre la fuerza de los músculos respiratorios y la menarquia temprana. Objetivo: Comparar las medias de las presiones máximas inspiratoria y espiratoria (PIM/PEM), considerando la edad de la menarquia de mujeres de mediana edad y mayores residentes en la comunidad de Temuco - Chile. Material y métodos: Se incluyeron en la muestra mujeres de 41-80 años, residentes de Temuco. Se dividieron en dos grupos en relación a la edad de la menarquia (< 13 años; ≥ 13 años), y se evaluaron en relación con la PIM/MEP mediante un manómetro. Resultados: Estudio transversal con 41 mujeres (edad media = 53,7). 18 mujeres fueron consideradas con menarquia temprana (valor medio de PIM = 90,05 cmH2O, PEM = 119,2 cmH2O) y 23 mujeres fueron con edad de menarquia ≥ 13 años (PIM media de 95,17 cmH2O, MEP de 122,4 cmH2). Conclusiones: El grupo con menarquia precoz presentó presiones respiratorias máximas inferiores al grupo considerado con menarquia no precoz entre mujeres de mediana edad y mayores residentes en la comunidad de Temuco - Chile.

Abstract Introduction: Early menarche is associated with general health, such as the increased risk of cancer, obesity, cardiovascular diseases, asthma, and lower lung function in adult women. However, few studies have investigated the relationship between respiratory muscle strength and early menarche. Objective: The objective of this study was to compare the means of maximal inspiratory and expiratory pressures (MIP/MEP) considering the age of the menarche of middle-aged and older women residents of Temuco - Chile. Materials and methods: Women aged 41-80 years, residents of Temuco, were included in the sample. They were divided into two groups in relation to their menarche age (< 13 years old; ≥ 13 years old), and they were evaluated in relation to MIP/MEP using a manometer. We conducted the independent samples t-test to compare MIP/MEP means between the menarche groups. Results: This was a cross-sectional study, with 41 women (mean age = 53.7; SD = 9.06). Eighteen women were considered in the group of with early menarche (mean MIP = 90.05 cmH2O, MEP = 119.2 cmH2O, and 23 women were categorized with menarche age ≥ 13 years old (mean MIP = 95.17 cmH2O, MEP = 122.4 cmH20). Conclusion: The early menarche group presented maximal respiratory pressures lower than the group considered with non-early menarche among middle-aged and older women residents of Temuco - Chile.

RESUMEN Introducción: la sensibilización a Blomia tropicalis resulta elevada entre los asmáticos y compite en importancia en cuanto a sensibilización alérgica. Objetivo: caracterizar la respuesta cutánea positiva al ácaro Blomia tropicalis en la población alérgica. Métodos: se realizó un estudio observacional, descriptivo, transversal, desde enero-junio de 2023 en un universo de 187 pacientes de cinco-59 años con pruebas positivas al ácaro, atendidos en la consulta de Alergología del Policlínico Docente “Ernesto Guevara de la Serna” de Niquero, que coincidió con la muestra. Los resultados fueron procesados con el programa Statistical Package for Social Science, versión 26.0. Se aplicaron distribuciones de frecuencia absoluta y porcientos. Se calculó la media geométrica ± la desviación estándar del área del habón. Para las variables cuantitativas y cualitativas se utilizó la prueba de Chi-cuadrado con un nivel de significación p≤0.05. Resultados: predominaron los pacientes de cinco-15 años (46,52 %) y del sexo femenino (56,8 %). El asma bronquial y la rinitis fueron las enfermedades alérgicas con mayor sensibilización (52,41 % y 28,34 %), respectivamente. Prevaleció la intensidad de la reacción ligera (44,39 %) con un diámetro promedio del habón de 3,50±0,47. El perfil de sensibilización más frecuente fue la polisensibilización (71,66 %). Conclusiones: la respuesta cutánea al ácaro Blomia tropicalis en la población alérgica de Niquero obedece a perfiles de polisensibilización en enfermedades de índole respiratoria. La intensidad de la reacción detectada sugiere que existe una relación directa de este alergeno con el daño a la salud expresado principalmente en el asma bronquial y la rinitis.

ABSTRACT Introduction: in Cuba the sensitization to Blomia tropicalis it can catch up with numbers lifted between the asthmatic. At tropical humid regions this sort, compete in importance or even the first place as to allergic sensitization can occupy population. Objective: characterize the cutaneous positive answer to the acarus Blomia tropicalis in the allergic population. Methods: an observational, descriptive, cross-sectional study was carried out from January-June 2023 in a universe of 187 patients aged 5-59 years with positive tests for the mite, treated in the Allergology consultation of the “Ernesto Guevara of the Serna” Teaching Polyclinic of Niquero, who coincided with the sample. The results were processed with the Statistical Package for Social Science program, version 26.0. Absolute frequency and percentage distributions were applied. The geometric mean ± standard deviation of the wheal area was calculated. For the quantitative and qualitative variables, the Chi-square test was used with a significance level of p≤0.05. Results: the patients of the group of 5 to 15 years (46,52 %) and of the female sex predominated in the series (56,68 %). Spasmodic asthma and rhinitis were the allergic diseases with bigger sensitization to the acarus Bt (52,41 % and 28,34 %), respectively. The intensity of the reaction that prevailed was the light (44,39 %) with an average diameter of 3,50±0,47's habón. The profile of more frequent sensitization turned out to be the poly-sensitization (71,66 %). Conclusions: the cutaneous answer to the acarus Blomia tropicalis in Niquero's allergic population to obeys profiles of poly-sensitization most of all in diseases of respiratory nature. The intensity of the reaction detected suggests that there is a direct relationship between this allergen and health damage expressed mainly in bronchial asthma and rhinitis.

Abstract Severe asthma is an entity with a complex diagnosis, requiring an adequate differential diagnosis and identification of endotypes for a correct approach and therapeutic process. In the present review, we show a synthesis of the current literature on the diagnosis, pathophysiology, and management of severe asthma, having critically analyzed the evidence in search engines such as Medline, Scopus, and Embase.

Resumen El asma grave es una enfermedad compleja, que requiere un enfoque y diagnóstico diferencial ordenado e identificación de endotipos para el correcto abordaje y tratamiento. El tratamiento farmacológico cuenta cada vez con más moléculas a disposición del personal médico para el control efectivo de los síntomas. Esta revisión muestra una síntesis de la bibliografía actual acerca del diagnóstico, fisiopatología y tratamiento del asma grave, mediante la lectura crítica previa de la evidencia científica en buscadores como Medline, Scopus y Embase.

Abstract Objectives: Report the prevalence and severity of the most common allergic diseases in children living in Monterrey, México Methods: Cross-sectional multi-center survey on the most common allergic diseases, completed by parents of 6-7-year-old children and by 13-14- year-old adolescents in the Monterrey metropolitan area, between January 2018 and December 2019. Results: A total of 3,044 questionnaires were eligible for the analysis. Among children between 6-7 years old, 30.2% (n = 143/473) presented wheezing at any time in their life; with a higher prevalence in the male population. In the adolescent group, 26.4% reported having experienced wheezing at some point in their life, with aslight predominance in the female group (54.9%). Conclusions: Knowing the prevalence of allergic diseases in our population gives us tools to generate strategies that allow us to provide the best quality healthcare to our patients.

Resumen Objetivo: Reportar la prevalencia y gravedad de las enfermedades alérgicas más comunes en niños residentes en Monterrey, México. Métodos: Encuesta multicéntrica transversal, acerca de las enfermedades alérgicas más comunes, completada por padres de niños de 6 aa 7 años y por adolescentes de 13 a 14 años del área metropolitana de Monterrey, entre enero de 2018 y diciembre de 2019. Resultados: Un total de 3044 cuestionarios fueron elegibles para el análisis. Entre los niños de 6-7 años, 30.2% (n = 143/473) manifestaron sibilancias en algún momento de su vida; con mayor prevalencia en la población masculina. En el grupo de adolescentes el 26.4% refirió haber tenido sibilancias alguna vez en su vida, con un ligero predominio en el grupo femenino (54.9%). Conclusiones: Conocer la prevalencia de las enfermedades alérgicas en la población brinda herramientas para generar estrategias para la mejor calidad asistencial en los pacientes.

Abstract: Respiratory diseases are one of the main causes of morbidity and mortality in children under 5 years of age. The acute respiratory disease (ERA in Spanish) room strategy implemented in Colombia is an important tool to reduce hospitalization and mortality rates in this population. Objective: To describe the health outcomes of the implementation of the ERA room strategy in two health institutions in Bogota. Patients and Method: Multicenter descriptive study including 1785 patients admitted to the ERA rooms of two institutions in Bogota, between December 2019 and 2022. Data on sex, age, admission diagnosis, length of stay in ERA room, education provided, and post discharge follow-up were collected. The main outcomes were evaluated through hospitalization requirement, ICU requirement, and post discharge improvement. Results: 1785 patients were included during the study period. 57% were male; median age was 26.6 months (IQR: 11.8 to 40.6); length of stay in ERA room was 2.62 hours (IQR: 1.73 to 4.88); 91.65% of family members and/or caregivers received educational measures. Conclusions: This study describes the results of the implementation of the ERA room strategy; the low proportion of patients requiring hospitalization is evident. Additionally, the education provided to parents and caregivers on home management is relevant, as well as the post discharge follow-up of this cohort of patients with acute respiratory disease.

Resumen: Las enfermedades respiratorias son una de las principales causas de morbilidad y mortalidad en los niños menores de 5 años. La estrategia de una sala de enfermedad respiratoria aguda (ERA) implementada en Colombia, es una importante herramienta para contribuir a la disminución de los índices de hospitalización y mortalidad en esta población. Objetivo: Describir los resultados en salud de la implementación de la estrategia de sala ERA en dos instituciones de salud en la ciudad de Bogotá. Pacientes y Método: Estudio descriptivo multicéntrico que incluyó 1.785 pacientes ingresados a las salas ERA de dos instituciones de la ciudad de Bogotá, atendidos entre diciembre de 2019 y de 2022. Se recolectaron datos como sexo, edad, diagnóstico de ingreso, tiempo de estancia en sala ERA, educación brindada y seguimiento post egreso. Los principales resultados se evaluaron a través del requerimiento de hospitalización, requerimiento de UCI y la mejoría post egreso. Resultados: Se incluyeron 1785 pacientes durante el periodo de estudio. El 57% corresponde al sexo masculino; la mediana de edad fue de 26,6 meses (RIC: 11,8 a 40,6); el tiempo de estancia en sala ERA fue de 2,62 horas (RIC: 1,73 a 4,88); el 91,65% de los familiares y/o cuidadores recibieron acciones educativas. Conclusiones: Este estudio describe los resultados de la implementación de la estrategia sala ERA, se evidencia la baja proporción de pacientes que requirieron hospitalización. Adicionalmente, es relevante la educación brindada a los padres y cuidadores del manejo en casa; así como, el seguimiento post egreso realizado en esta cohorte de pacientes con ERA.

Abstract Neuroendocrine tumors (NETs) are the most common primary lung neoplasms. Clinical manifestations can be subtle, and chest radiograph usually shows non-specific findings, often leading to delayed or inaccurate diagnosis. Despite their indolent nature, NETs have metastatic potential and can cause significant morbidity. Early diagnosis is critical for optimal management, as surgical resection can be curative. The challenge is to correctly diagnose this rare entity while avoiding unnecessary testing. Patients with suspected NETs should be referred to a tertiary hospital for multidisciplinary evaluation, and bronchoscopy should not be delayed. Herein is reported the case of an adolescent with asthma who presented with nonspecific respiratory and constitutional symptoms. The persistence of symptoms and imaging alterations despite multiple treatments for recurrent pneumonia raised clinical suspicion of a more serious underlying condition, leading to the diagnosis of bronchial NET.

Resumo Os tumores neuroendócrinos (TNEs) são as neoplasias pulmonares primárias mais comuns. O diagnóstico pode ser desafiante, pois as manifestações clínicas são geralmente subtis e as alterações imagiológicas inespecíficas. Apesar da sua natureza indolente, os TNEs têm potencial metastático e podem causar morbilidade significativa. O diagnóstico precoce é fundamental para uma abordagem otimizada, uma vez que a ressecção cirúrgica pode ser curativa. O desafio é estabelecer o diagnóstico desta entidade rara evitando avaliações e exames complementares desnecessários. Perante suspeita de TNE, o doente deve ser referenciado para um hospital terciário para avaliação multidisciplinar e realização de broncoscopia. É descrito o caso de um adolescente com asma que se apresentou com sintomas respiratórios e constitucionais inespecíficos. A persistência dos sintomas e alterações imagiológicas apesar da realização de múltiplos tratamentos por pneumonia recorrente motivou a continuação da investigação etiológica e possibilitou o estabelecimento do diagnóstico de TNE endobrônquico.

ABSTRACT Digital health can effectively engage patients in the self-management of their asthma. Still, it will only reach its full potential when apps are aligned with patients’ needs and are integrated into clinical practice. We aim to test a framework for the involvement of patients/carers in all phases of developing and implementing an app for asthma. This protocol was co-designed with six asthma patients/carers and includes 5 tasks. Regular interactions among patients, developers and healthcare professionals will be a priority for user requirements definition (task 1) and iterative development and testing until the app’s initial version (tasks 2-3). Patients/carers and healthcare professionals will be fully engaged in the real-life feasibility study (task 4) and management and dissemination activities (task 5). The eligibility criteria to participate in tasks 2-4 are 1) diagnosis of asthma or carer of a person with asthma; 2) ≥18 years; 3) ability to use apps and access a mobile device with Internet. We anticipate applying questionnaires such as the User Experience Questionnaire and the System Usability Scale in all app testing tasks. We expect to have a final version of the asthma app that meets patients’/carers’ needs and experiences and healthcare professionals’ concerns. This will be an attractive app to support patients in self-management of their disease, keeping their asthma in control, having fewer asthma symptoms, and enjoying life. This study will be a framework for fully involving patients, carers and citizens in the iterative co-production development and implementation of an asthma app.

RESUMO A saúde digital pode envolver efetivamente os doentes no controlo da sua doença, mas só alcançará o seu potencial quando as aplicações móveis desenvolvidas estiverem alinhadas com as necessidades percebidas pelos doentes e integradas na prática clínica. O nosso objetivo é testar uma abordagem para o envolvimento de doentes/cuidadores em todas as fases de desenvolvimento e implementação de uma aplicação móvel para a autogestão da asma. Este protocolo foi codesenvolvido com seis pessoas com asma/cuidadores e contempla cinco tarefas. Interações regulares entre doentes, investigadores, programadores e profissionais de saúde serão uma prioridade para a definição dos requisitos do utilizador (tarefa 1) e para o desenvolvimento iterativo até a versão inicial da aplicação (tarefas 2-3). Doentes/cuidadores e profissionais de saúde estarão ativamente envolvidos no estudo observacional sobre o uso da app na vida real (tarefa 4) e nas atividades de gestão/disseminação (tarefa 5). Os critérios de elegibilidade para participar nas tarefas 2-4 são: diagnóstico médico de asma ou cuidador de pessoa com este diagnóstico; pelo menos 18 anos; capacidade de usar aplicações e acesso a um dispositivo móvel com Internet. Antecipamos o uso de questionários como o Questionário de Experiência do Utilizador e a Escala de Usabilidade do Sistema em todas as tarefas que envolvem teste da aplicação. No final do estudo esperamos ter uma versão final da aplicação para a asma que atenda às necessidades e experiência dos doentes/cuidadores e às preocupações dos profissionais de saúde. Esta será uma aplicação atrativa para apoiar os doentes na autogestão da sua doença, ajudando a manter a sua asma controlada, com menos sintomas e melhor qualidade de vida. Este estudo fornecerá uma abordagem para envolver os doentes, cuidadores e cidadãos no desenvolvimento iterativo e coprodução de uma aplicação móvel de saúde para pessoas com asma.

ABSTRACT Objective: To compare revisits for asthma to the emergency department (ED) during the week following discharge and describe associated factors before and after the implementation of an assistance protocol. Materials y methods: A retrospective cohort study was conducted, including visits for asthma exacerbations in adults to the ED of a university hospital during the periods 2016-2018 (pre-protocol) and 2019-2020 (post-protocol). A multivariate logistic regression model was used, and the odds ratios (OR) with their 95% confidence intervals (95 % CI) were reported. A p-value < 0.05 was considered significant. Results: Revisits were 38 (31.40 %) for the pre-protocol period and 33 (26.61%) for the post-protocol period. In the multivariate regression model, no differences were found in early revisits when comparing the post-protocol period with the pre-protocol period (OR 0.68; 95 % CI: 0.26-1.74; p = 0.421). Factors associated with early revisits were age (OR: 1.02; 95 % CI: 1.00-1.04; p = 0.017), male sex (OR: 0.21; 95 % CI: 0.08-0.59: p = 0.003), and having had more than one visit to the ED in the last year (OR: 6.19; 95 % CI: 2.48-15.46; p < 0.001). Conclusion: Although early revisits did not decrease after the protocol implementation, age and having had more than one visit for asthma to the ED in the last year were identified as risk factors for revisits within the week, while male sex was a protective factor.

RESUMEN Objetivo: Comparar las reconsultas por asma al servicio de urgencias (SU) durante la semana posterior al alta y explorar los factores asociados antes y después de la implementación de un protocolo asistencial. Materiales y métodos: Se realizó un estudio de cohorte retrospectivo que incluyó las consultas por crisis asmática de adultos al SU de un hospital universitario en los períodos 2016-2018 (preprotocolo) y 2019-2020 (posprotocolo). Se utilizó un modelo de regresión logística multivariado y se reportaron odds ratios (OR) e intervalo de confianza del 95 % (IC 95 %). Se consideró significativo un valor p < 0,05. Resultados: Las reconsultas fueron 38 (31,40 %) para el período preprotocolo y 33 (26,61 %) para el período posprotocolo. En el modelo de regresión multivariable, no se encontraron diferencias en las reconsultas tempranas al comparar el período posprotocolo con el período preprotocolo (OR 0,68; IC 95 %: 0,26-1,74; p = 0,421). Los factores asociados a las reconsultas tempranas fueron la edad (OR: 1,02; IC 95 %: 1,00-1,04; p = 0,017), el sexo masculino (OR 0,21 IC 95 %: 0,08-0,59; p = 0,003) y el haber tenido más de una consulta al SU en el último año (OR 6,19 IC 95 %: 2,48-15,46; p < 0,001). Conclusión: Aunque las reconsultas tempranas no disminuyeron luego de la aplicación del protocolo, se identificaron la edad y el haber tenido más de una visita al SU por asma dentro del último año como factores de riesgo para las reconsultas dentro de la semana, mientras que el sexo masculino resultó ser un factor protector.