Eduardo Ponte

• Professor at Faculdade de Medicina de Jundiaí

We hypothesize that green areas within cities affect the respiratory symptoms of individuals with asthma, but this effect may not be the same for all age groups, because the immunopathology of asthma in children-adolescents is different from the immunopathology of asthma in adults. The objective of this study is to evaluate whether there is an asso...

Introduction In spite of difficulties in differentiating asthma from COPD, physicians should strive for accurate diagnosis because outcomes may be different. Objectives Our aims were to compare the frequency of hospital admissions (HA) between severe asthmatic (SA) and Gold III-IV COPD subjects receiving disease specific guideline recommended ther...

Introduction The health and financial burden of mild‐persistent asthma has been poorly investigated. Objective Our aim was to compare the rate of hospital admissions that have occurred during the preceding year between children and adolescents with current mild‐persistent (MP) and moderate‐severe (MS) asthma. Methods We screened children and adol...

Lung-cancer screening with chest computerized tomography (CT) is not easy to introduce in low-medium resource countries due to cost issues. We investigated whether the increasing availability of chest CT exams in Brazil, in spite of no lung-cancer screening protocol, was associated with lung-cancer death rate along 10-year follow-up. We performed r...

Background Improved understanding of the normal range of blood eosinophil counts (BEC) and conditions that influence them in non-asthmatic individuals should allow more accurate estimation of the threshold at which eosinophilic disease should be considered, diagnosed, and treated. This analysis investigated the impact of atopy, smoking, and parasit...

Objective: This study aims to describe the eligibility for biologic therapies for severe asthma (SA) in a cohort of patients attending the Program for Control of Asthma (ProAR) in Bahia, Brazil. Methods: Data from SA patients (≥18 years old) attending the ProAR, that were included in a case-control study conducted from 2013 to 2015, were used to re...

Objective To describe trends of hospital admissions due to asthma from 2008 to 2015 and to evaluate their relationship with trends of inhaled corticosteroids (ICS) provision by the government in Brazil. Methods We used Brazilian Government data to calculate hospital admission rates due to asthma, number of physicians, number of hospital beds, numb...

Background: We should continually improve tools for evaluating asthma. The aim of this study was to evaluate whether the FEV1/FVC ratio in the lower range of normality is associated with worse outcomes in asthmatics without airway obstruction. Methods: We screened asthmatics at eight clinics. Subjects answered the Asthma Control Questionnaire an...

Introduction: It is unknown whether rural-urban migration contributes to worse the burden of asthma in the cities. Objectives: The aim of this study was to evaluate whether subjects with asthma that migrated from rural areas to a large urban center in Brazil have more severe disease than asthmatic subjects that was born and always lived in the u...

Objective: To determine whether a low level of education is a risk factor for uncontrolled asthma in a population of patients who have access to pulmonologists and to treatment. Methods: This was a cross-sectional study involving outpatients > 10 years of age diagnosed with asthma who were followed by a pulmonologist for at least 3 months in the...

Purpose Long Acting Beta2 Agonists (LABA) prevent COPD exacerbations in strictly standardized clinical trials. Our aim was to evaluate the relationship between the amount of LABA provided by the government and the trend in COPD hospital admission (HA) rate in Brazil. Methods This is a longitudinal large-scale real-life study. We calculated COPD HA...

Background: Asthma is a syndrome with multiple phenotypes. Peripheral blood eosinophil counts might be the ideal biomarker to identify subjects with eosinophilic asthma. It is available, inexpensive, and it is associated with eosinophilia in sputum. Objective: The aim of this study was to evaluate whether blood eosinophilia is associated with as...

Unbiased clustering of severe asthmatics in ProAR and replication in ProAR plus U-BIOPRED

● To compare the eosinophil levels(EOS) in asthmatic patients and controls from Brazil (ProAR) and Europe (U-BIOPRED), and to estimate the proportion of patients meeting pre-determined cut-offs in blood eosinophils (EOS) counts proposed as indicators of response to treatment with various immuno-biologics. ● To determine the effect of IgE, Atopic st...

This study aimed to search for risk factors and biomarkers of severe asthma according to the most common phenotypes in Brazil. This is a preliminary report on general characteristics of subjects evaluated.

Objective: To evaluate the relationship between obesity and asthma. Methods: This was a preliminary cross-sectional analysis involving 925 subjects with mild-to-moderate or severe asthma evaluated between 2013 and 2015. Obesity was defined on the basis of body mass index (BMI) and abdominal circumference. We collected clinical, laboratory, and a...

Background and objective: The relationship between age and asthma phenotypes is important as population is ageing, asthma is becoming common in older ages and recently developed treatments for asthma are guided by phenotypes. The aim of this study is to evaluate whether age is associated with specific asthma phenotypes. Methods: This is a cross-...

Purpose of review: The prevalence of asthma was thought to be low in most low-income countries, but several reports have indicated this is not always true. This is a narrative review of recent publications on the burden of asthma in low and middle-income countries (LMIC) and underprivileged communities from developed countries. Recent findings:...

Background The structural changes of the respiratory system related to ageing determine lung function decline in healthy subjects after 25 years of age. An annual reduction of 25 ml in Forced Expiratory Volume in 1 s (FEV1) is expected. We aimed to describe the longitudinal lung function variation of subjects with severe asthma receiving appropriat...

Introduction: Previous cross sectional studies could establish an association between prevalence of self reported wheeze and urban-rural environment, but the impact of urbanization on meaningful outcomes of asthma for public health is not established yet. Objectives: Evaluate the effect of urbanization on asthma burden. Methods: A time series...

Objectives: To evaluate whether irreversible airway obstruction (IAO) related to asthma is a risk factor for lack of symptoms control, poor quality of life and exacerbations. Methods: We evaluated consecutive outpatients with asthma in a one-year cohort study. We excluded subjects with smoke history > 9 pack-years. Definition of IAO was post bro...

Introduction: fix airflow obstruction has been observed in asthma, but little is known about its risk factors from longitudinal studies. Objectives: to describe trends of FEV1 in patients with previously untreated severe asthma, following long term treatment; and to identify predictors of a steeper decline in FEV1. Methods: A cohort study of an ave...

To report the results of a workshop regarding asthma management programs and centers (AMPCs) in Brazil, so that they can be used as a tool for the improvement and advancement of current and future AMPCs. The workshop consisted of five presentations and the corresponding group discussions. The working groups discussed the following themes: implement...

Background: Aging modifies immune response and respiratory physiology. Few studies evaluate the effect of age on asthma. The aim of our study was to evaluate whether age is associated with uncontrolled symptoms and hospital admissions due to asthma in a setting where patients were receiving proper treatment. Methods: We enrolled 401 patients wit...

Objective: The aim of this study was to evaluate whether endemic areas for helminth infections in Brazil have lower rates of hospital admission due to asthma and whether reduction in helminth endemicity impacts on asthma morbidity. Methods: This was a country-wide ecological study in Brazil. Government databases were the source of information. A...

Introduction: Atopy is part of the immunopathology of allergic diseases; however, the effect of atopy on the prognosis of asthma in adult patients is not established yet. The aim of this study is to investigate whether there is an association between lack of control of asthma and sensitization to aeroallergens. The relation between rhinitis severi...

IL-13 is a signature cytokine of the helper T cell type 2 (TH2) pathway which underlies host defense to helminthic infection and activates production of IgE in both parasitized populations and in urban settings after allergen exposure. Two functional polymorphisms in IL13, rs1800925 (or c.1-1111C>T) and rs20541 (or R130Q) were previously found to b...

To determine the frequency of near-fatal asthma in a group of severe asthma patients, as well as the clinical characteristics and prognosis of these patients within a one-year follow-up period. A prospective study involving 731 low-income patients with severe asthma treated at a referral outpatient clinic located in the city of Salvador, Brazil. Th...

Interleukin (IL)-10 is a regulatory cytokine of the helper T cell type 2 (TH2) pathway, which underlies both the host defense to helminthic infection and atopic diseases, including asthma. Although IL10 promoter polymorphisms are associated with increased atopy risk, IL10 variation has not been thoroughly explored in schistosomiasis-endemic populat...

Sialic acid-binding immunoglobulin-like lectin-8 (Siglec-8) promotes the apoptosis of eosinophils and inhibits FcvarepsilonRI-dependent mediator release from mast cells. We investigated the genetic association between sequence variants in Siglec-8 and diagnosis of asthma, total levels of serum IgE (tIgE), and diagnosis of eosinophilic esophagitis (...

The prevalence of asthma is increasing in developing countries and the burden of uncontrolled asthma affects patients, families, and the health system. This is to summarize, evaluate, and discuss previous reports on the impact of a targeted and comprehensive approach to the most severe cases of asthma in a low-income setting. A Program for Control...

OBJETIVO: Desenvolver e validar uma versão do Asthma Control Test (ACT, Teste de Controle da Asma) em português para uso no Brasil. MÉTODOS: Foram estudados 290 pacientes ambulatoriais com asma maiores que 12 anos. Os pacientes responderam ao ACT e foram examinados por um pneumologista para avaliar o controle da asma em duas visitas. Na primeira vi...

Objective: To develop and validate a Portuguese-language version of the Asthma Control Test (ACT) for use in Brazil Methods: The study comprised 290 asthma outpatients over 12 years of age. The patients completed the ACT questionnaire and had an appointment with a pulmonologist in order to assess asthma control in two visits in the first visit, the...

To develop and validate a Portuguese-language version of the Asthma Control Test (ACT) for use in Brazil. The study comprised 290 asthma outpatients over 12 years of age. The patients completed the ACT questionnaire and had an appointment with a pulmonologist in order to assess asthma control in two visits. In the first visit, the patients also und...

Objective: To evaluate the impact of the Programa de Controle da Asma e Rinite Alérgica em Feira de Santana (ProAR-FS, Program for the Control of Asthma and Allergic Rhinitis in Feira de Santana) on the frequency of hospitalizations for asthma in patients monitored at a referral center for one year. Methods: This was a historical control study invo...

To evaluate the impact of the Programa de Controle da Asma e Rinite Alérgica em Feira de Santana (ProAR-FS, Program for the Control of Asthma and Allergic Rhinitis in Feira de Santana) on the frequency of hospitalizations for asthma in patients monitored at a referral center for one year. This was a historical control study involving 253 consecutiv...

Asthma is the third cause of hospitalisations due to clinical illnesses in Brazil. The Programme for Control of Asthma in Bahia (ProAR) leads an initiative in Salvador City (Brazil) to manage severe asthma for free. The aim of this study was to identify trends in asthma hospitalisation in the entire city and to evaluate the impact of ProAR. Informa...

To estimate the direct and indirect costs of severe asthma and the economic impact of its management to low-income families in Salvador, Brazil. One hundred and ninety-seven patients with severe asthma and referred to a state-funded asthma center providing free treatment were evaluated. At registration, they were asked about family cost-events in t...

To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ) is a valid instrument to measure asthma control in adult outpatients in Brazil. We selected 278 outpatients diagnosed with asthma. All of the patients completed the questionnaire, underwent spirometry and were clinically evaluated by a physician in order to charact...

Asthma prevalence and severity are high among underserved minorities, including those of African descent. The Duffy antigen/receptor for chemokines is the receptor for Plasmodium vivax on erythrocytes and functions as a chemokine-clearing receptor. Unlike European populations, decreased expression of the receptor on erythrocytes is common among pop...

OBJECTIVE: To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ) is a valid instrument to measure asthma control in adult outpatients in Brazil. METHODS: We selected 278 outpatients diagnosed with asthma. All of the patients completed the questionnaire, underwent spirometry and were clinically evaluated by a physician...

Retrospective studies provide evidence that rhinitis is associated with more severe asthma. The aim of this study was to evaluate prospectively whether rhinitis is a predictor of increased asthma severity. Five hundred and fifty-seven patients with severe asthma were enrolled. During 1 year of follow-up, each patient was evaluated every 3 months wi...

Geohelminth infections are major parasitic infections with a worldwide distribution. Immunoglobulin E (IgE) is considered to play a central role in protective immunity against these parasites although the evidence from experimental animal models infected with helminth parasites and treated with anti-IgE antibodies and from observational studies in...

To determine the proportion of asthma patients with poor perception of asthma control and to evaluate the characteristics of this subgroup. A cross-sectional study in which consecutive outpatients (over the age of 12) with mild, moderate, or severe asthma were selected. The patients underwent clinical examination and pulmonary function tests, as we...

Objective: To determine the proportion of asthma patients with poor perception of asthma control and to evaluate the characteristics of this subgroup. Methods: A cross-sectional study in which consecutive outpatients (over the age of 12) with mild, moderate, or severe asthma were selected. The patients underwent clinical examination, and pulmonary...

Critical review of the literature to investigate the relationship between asthma and type 1 diabetes mellitus (DM1). Bibliography search in MEDLINE and LILACS databases in the last twenty years. SUMMARY OF DATA: Several studies demonstrate an inverse relationship between asthma, atopic diseases and the risk to develop DM1. According to the "Hygiene...

OBJETIVO: Descrever características demográficas e clínicas de asmáticos que apresentaram como desfecho a morte e relatar as condições que concorreram para o óbito entre admitidos no Programa de Controle da Asma e da Rinite Alérgica na Bahia (ProAR). MÉTODOS: Estudo observacional retrospectivo e descritivo. Foram coletadas informações de atestados...

To report demographic and clinical characteristics of patients with asthma who evolved to death, as well as to describe the conditions related to this outcome in a subgroup of patients admitted to the Program for the Control of Asthma and Rhinitis in Bahia (ProAR). A descriptive, retrospective, observational study. Data from clinical charts and dea...

To describe the principal evidence in the literature regarding the interrelationship among helminth infections, atopy, and asthma, a nonsystematic review of the literature was conducted. Among the publications on the subject, we found a number in which there was controversy regarding the capacity of geohelminth infections to inhibit responsiveness...

Este estudo teve como objetivo descrever as principais evidências encontradas na literatura acerca da inter-relação entre infecções helmínticas, atopia e asma. Foi feita uma revisão não sistemática da literatura. Encontramos numerosas publicações sobre o tema nas quais se verifica controvérsia quanto à capacidade das infecções por geohelmintos de i...

To quantify the use of health care resources among patients enrolled in the Bahia State Asthma and Allergic Rhinitis Control Program. As of January of 2006, 1405 patients had enrolled in the program, which is carried out in four referral centers in the city of Salvador. These patients formed the basis of this retrospective/prospective, observationa...

An unusual association of asthma and myasthenia gravis (MG) complicated by tracheal stenosis is reported. The patient was a 35-year-old black woman with a history of severe asthma and rhinitis over 30 years. A respiratory tract infection triggered a life-threatening asthma attack whose treatment required orotracheal intubation and mechanical ventil...

Asthma is one of the most common chronic diseases and a major economical burden to families and health systems. Whereas efficacy of current therapeutical options has been clearly established, cost-effectiveness analysis of public health interventions for asthma control are scarce. 81 patients with severe asthma (12-75 years) joining a programme in...

Helminth infections have been associated with reduced reactivity to aeroallergens, which could be related to interleukin 10 (IL-10) production, as reported in schistosomiasis. To compare skin responses to aeroallergens with Der p specific IL-10 production in patients with asthma or rhinitis according to Ascaris infection status. Cross-sectional stu...

OBJETIVO: Determinar, através de análise de tomografia computadorizada, a freqüência de envolvimento dos seios paranasais em pacientes com rinite alérgica. MÉTODOS: Foram selecionados 60 pacientes ambulatoriais com diagnóstico de rinite alérgica e queixa de obstrução nasal. Os pacientes foram submetidos a rinoscopia anterior, aplicação de questioná...

OBJETIVO: Determinar, através de análise de tomografia computadorizada, a freqüência de envolvimento dos seios paranasais em pacientes com rinite alérgica. MÉTODOS: Foram selecionados 60 pacientes ambulatoriais com diagnóstico de rinite alérgica e queixa de obstrução nasal. Os pacientes foram submetidos a rinoscopia anterior, aplicação de questioná...

INTRODUÇÃO: A cirurgia redutora de volume pulmonar é uma alternativa terapêutica para o enfisema pulmonar avançado. A avaliação radiológica do tipo e distribuição do enfisema parece ser o principal critério de indicação cirúrgica, além da função pulmonar. OBJETIVO: Determinar o nível de evidência científica referente ao padrão radiológico do candid...

Asthma is a disease of high morbidity and and costs for the patients and the government. In Brazil asthma is the third cause of hospital admissions in public facilities. Adequate therapy can control symptoms, avoid hospitalizations and preventable deaths. Based upon these premises, programs to control asthma have been created in several cities, wit...

Objective: To evaluate whether the Portuguese version of the Asthma Control Questionnaire (ACQ) is a valid instrument to measure asthma control in adult outpatients in Brazil. Methods: We selected 278 outpatients diagnosed with asthma. All of the patients completed the questionnaire, underwent spirometry and were clinically evaluated by a physician...