Consuelo Cárdenas

Effectiveness of Asthma Education with and Without a Self-Management Plan in Hospitalized Children

Background. Formal education in primary care can reduce asthma exacerbations. However, there are few studies in hospitalized children, with none originating in Latin America. Methods. A prospective randomized study was designed to evaluate whether a full education with self-management plan (ESM) was more effective than an education without self-management plan (E) in reducing asthma hospitalization. Children (5 to 15 years of age) who were hospitalized for an asthma attack were divided in two groups. Children in the E group received general instructions based on a booklet. Those in the ESM group received the same booklet plus a self-management guide and a puzzle game that reinforces the lessons learned in the booklet. Patients were interviewed every 3 months, by telephone, for one year. Interviewers recording the number of hospitalizations, exacerbations, and emergency visits for asthma and oral steroid burst uses. Results. From 88 children who met the inclusion criteria, 77 (86%) completed one year of follow-up (41 from E and 36 from ESM group). Overall, after one year, the hospitalization decreased by 66% and the inhaled corticosteroids therapy increased from 36% to 79%. At the end of the study, there was no difference in exacerbations, emergency visits, oral steroid burst uses, or hospitalizations between the two groups. Conclusions. Asthma education with or without a self-management plan during asthma hospitalization were effective in reducing exacerbations, emergency visits, oral steroid burst uses, and future rehospitalizations. This evidence supports the importance of providing a complete asthma education plan in any patient who is admitted for asthma exacerbation.

Oral and written counseling is a useful instrument to improve short-term adherence to treatment in acne patients: a randomized controlled trial.

Background: Therapeutic success in acne patients not only depends on the appropriate selection of drugs but also on the patient’s treatment adherence or compliance. Lack of adherence is an important problem both in general medicine and in dermatologic practice. Objective: To evaluate the impact of oral and written counseling on treatment adherence among acne patients. Patients and Methods: Eighty patients were randomized into two groups of 40 patients each. The intervention group received a patient information leaflet (apart from oral counseling), and instructions were reinforced by a telephone call within 15 days of treatment onset. The second group (control group) received treatment indications as usual (oral counseling in-office only). Both groups were followed up with a phone call, evaluating adherence to treatment according to self-reporting of patients at 30, 60, 90 days, and 6 months. Results: Better adherence to treatment was observed in the intervention group. This difference was significant only within the first month of treatment (80% versus 62%, p = 0.043). The beneficial effect of written counseling plus a phone call decreased in subsequent months. Conclusion: Written counseling significantly improves adherence within the first month of treatment. These results suggest that it is reasonable to spend time and resources in written counseling in order to optimize adherence to treatment.

Angiomatosis bacilar por Bartonella quintana como primera manifestación de infección por VIH: Report of one case

Bacillary angiomatosis is an unusual infectious disease, with angioproliferative lesions, typical of immunocompromised patients. It is caused by Bartonella quintana and Bartonella henselae, two infectious agents of the genus Bartonella, which trigger variable clinical manifestations, including cutaneous vascular and purpuric lesions, and regional lymphadenopathy, and even a systemic disease with visceral involvement. We report a 38-year-old HIV positive male presenting with a history of six months of cutaneous growing purple angiomatous lesions, located also in nasal fossae, rhinopharynx and larynx. The skin biopsy was compatible with bacillary angiomatosis. Polymerase chain reaction of a tissue sample showed homology with B. quintana strain Toulouse. The patient was treated with azithromycin and ciprofl oxacin with a favorable evolution. (Rev Med Chile 2012; 140: 910-914).

Comparison of efficacy of aminolaevulinic acid photodynamic therapy vs. adapalene gel plus oral doxycycline for treatment of moderate acne vulgaris-A simple, blind, randomized, and controlled trial

Although progress has been made in the study of photodynamic therapy for acne, studies using current recommended therapies as active comparators are lacking.

Manifestaciones cutáneas en donantes de sangre portadores de HTLV-1 en comparación con donantes de sangre no portadores de HTLV-1

Background: Most human T cell lymphotropic virus type 1 (HTLV-1) infected individuals are asymptomatic, but they commonly present cutaneous lesions that could be considered warning signs of the disease. Aim: To identify the main cutaneous manifestations present in HTLV-1 infected blood donors and compare them with healthy donors. Materials and methods: Two blood donor groups from the blood bank of an emergency hospital were matched according to gender and age. One group was formed by HTLV-1 (+) (cases) and the other by HTLV-1 (-) donors (controls). A blind examiner to the serologic condition, evaluated their cutaneous manifestations. Results: Twenty five cases and 25 controls aged 18 to 60 years (24 females) were evaluated. One or more cutaneous manifestations were found in 24 (96%) cases and in 15 (60%) controls (p< 0.01). Inflammatory cutaneous diseases were found in 19 (76%) cases and in 9 (36%) controls (p< 0.01). Dermatophytosis was found in 18 (72%) cases and in 12 (48%) controls (NS). Conclusions: HTLV-1 infected Chilean subjects have a higher frequency of dermatoses than their healthy counterparts.