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Publications (3)3.09 Total impact

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    ABSTRACT: Introduction. Poor inhaler technique is common in real life and often cause of uneffective drug delivery in the lungs. To the aim of solving this problem, the pharmaceutical industry has recently introduced some newer user-friendly inhalers. However, it is not clear whether proper inhaler use is effectively improving in real life. Materials and methods. Comparison of two multicenter, cross-sectional, observational surveys performed on 2001 and 2008. Both studies included a large population of Italian patients, mostly suffering from asthma or COPD and experienced in the use of the most commonly inhalers. All enrolled subjects were assessed during scheduled pulmonary visits in an outpatient setting. They gave information about their inhalation treatment at home by a standardised questionnaire and showed their inhalation technique with the used devices to the investigator who completed a standardised step-by-step checklist. Results. The 1st study included 1.404 subjects (mean age 57 years; males 45%, females 55%; asthmatics 48%, COPD 39%); 1.056 and 721 patients were respectively using Metered Dose Inhalers (MDIs) and Dry Powder Inhalers (DPIs). The 2nd study enrolled 1.664 patients (mean age 62 years; males 58%, females 42%; asthmatics 42%, COPD 52%); 843 and 1.113 were respectively using MDIs and DPIs. We found high rates of misuse for all evaluated inhalers in both studies. Critical mishandlings for the different devices ranged from 17% to 24% for the 1st study and from 12% to 43% for the 2nd study. Education by health care givers was the only modifiable factor associated with reduced misuse for all the studied inhalers in both studies. Importantly, most subjects were not trained in inhaler technique by health care givers and this problem seems to be increasing. Conclusions. Poor inhaler use remains common in Italian real life despite the introduction of newer userfriendly devices. Education by health care givers may improve inhaler technique, but it is not ubiquitously performed.
    Rassegna di Patologia dell'Apparato Respiratorio 08/2012; 27(4):211-218.
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    ABSTRACT: Inhalers and nebulisers are devices used for delivering aerosolised drugs in subjects with Chronic Airflow Obstruction (CAO). This multicentre, cross-sectional observational study was performed in a large population of outpatients with CAO regularly using home aerosol therapy and referring to chest clinics. The aims of the study were to compare the characteristics of the group of subjects with CAO who were using home nebulisers but also experienced with inhalers vs. those only using inhalers and to investigate whether the first group of subjects was particularly prone to inhaler misuse. Information was gained evaluating the responses to a standardised questionnaire on home aerosol therapy and the observations of inhaler technique. We enrolled 1527 patients (58% males; mean ± SE; aged 61.1 ± 0.4 years; FEV1% pred 69.9 ± 0.6; 51% and 44% respectively suffering from COPD and asthma) who were only inhaler users (OIU group) and 137 (85% males; aged 67.7 ± 1.3 years; FEV1% pred 62.3 ± 2.9; 60% and 23% respectively suffering from COPD and asthma) who were using both nebulisers and inhalers (NIU group). Nebuliser users were older, had more severe obstruction, related symptoms and health care resources utilisation. Nebulisers users performed more critical inhalers errors than those of the OIU group (49% vs. 36%; p = 0.009). We conclude that our patients with CAO and regular nebuliser treatment had advanced age, severe respiratory conditions and common inhaler misuse.
    Respiratory medicine 01/2012; 106(5):668-76. DOI:10.1016/j.rmed.2011.11.016 · 3.09 Impact Factor
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    Inés Scarlato
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    ABSTRACT: Resumen El presente trabajo procede de la investigación titulada "Tiempo libre, espacio público e identidad. Análisis del caso Parque Plaza Líber Seregni" 2 . El mismo pretende problematizar las nociones de tiempo libre y espacio público, y su papel en los procesos civilizatorios de Uruguay moderno, para pensar las configuraciones que adquieren tales conceptos en la actualidad y el papel que juegan en la conformación de ciudadanía uruguaya. Para tal cometido se realizará aproximaciones teóricas desde la perspectiva de Milner 3 , así como desde el abordaje histórico que propone Barrán 4 . Uruguay, entre fines del siglo XIX y principios del XX, experimenta una serie de transformaciones políticas, económicas, sociales y culturales propias de la "modernización". Un proyecto civilizador reorganizaría la vida social de la población, en relación a un territorio y una producción. La aprobación de la ley de las 8 horas, como señal de establecimiento de la frontera entre un tiempo de trabajo y un tiempo libre; así como la invención y fomento de los espacios públicos, dan lugar a las dicotomías tiempo de trabajo / tiempo libre y espacio público / espacio privado. Cabe preguntarse, ¿qué configuraciones adquieren estos binomios en la actualidad? ¿Bajo qué supuestos se asienta la popularización de estos términos? Palabras claves: Tiempo libre, espacio público, civilización.