Mise à jour dans le traitement de l’asthme chez l’adulte
Bibliographic record
Abstract
Resume Objectif : Discuter des nouveautes relatives au traitement de l’asthme, presentees depuis 2003. Discuter des nouvelles molecules et strategies de traitement approuvees au Canada dans cette indication. Sources des donnees : Une recherche dans PubMed entre 1999 et 2006 a ete effectuee avec les mots cles : asthme, traitement, corticosteroides, β 2 -agonistes, antagonistes des recepteurs des leucotrienes, ciclesonide, omalizumab. Des references secondaires et tertiaires ont ete consultees pour completer cette recherche. Analyse des donnees : L’education, l’assainissement de l’environnement et un suivi medical adequat sont essentiels a la maitrise de l’asthme. De plus, toute personne asthmatique devrait beneficier d’un plan d’action ecrit en cas d’exacerbation. Les corticosteroides inhales a faible dose pris regulierement devraient etre envisages precocement comme premier traitement d’entretien de l’asthme. Lorsque l’asthme chez l’adulte demeure symptomatique malgre de faibles doses de corticosteroides inhales, l’ajout d’un β 2 -agoniste a longue duree d’action comme traitement d’appoint s’avere efficace. Actuellement, l’omalizumab est reserve au traitement de l’asthme grave allergique, non maitrise par la pharmacotherapie classique, de patients qui ont une concentration serique elevee d’IgE. Le ciclesonide est un nouveau corticosteroide inhale etudie dans le traitement d’entretien de l’asthme chez les adultes. Cependant, il n’a pas demontre une efficacite superieure par rapport aux autres corticosteroides inhales. Conclusion : Des recommandations claires et completes concernant le traitement de l’asthme chez l’adulte sont presentement disponibles. Il est cependant necessaire d’ameliorer leur mise en application en milieu clinique. Abstract Objective : To discuss the changes in the treatment of asthma since 2003. To discuss new therapeutic options and treatment strategies approved in Canada for asthma. Data source : A review of the scientific literature from 1999 to 2006 was done on Pubmed using the following key words: asthma, treatment, corticosteroids, β 2 -agonists, leukotriene receptor antagonists, cicleso - nide, omalizumab. Secondary and tertiary references were also consulted to complete the search. Data analysis : Education, a healthy environment, and medical follow-up are essential to the control of asthma. In addition, any asthmatic person should benefit from an action plan to be used in the case of an exacerbation. Regular administration of low-dose inhaled corticosteroids should be considered early-on as a firstline option for asthma maintenance control. In adults, when asthma remains symptomatic despite low doses of inhaled corticosteroids, the addition of a long-acting β 2 -agonist is effective. Currently, omalizumab is used only for the treatment of severe allergic asthma after failure of classic pharmacotherapy in patients with high serum concentrations of IgE. Ciclesonide is a new inhaled corticosteroid evaluated for the maintenance treatment phase of asthma in adults. It has, however, not shown superior efficacy with regard to other inhaled corticosteroids. Conclusion : Comprehensive and clear recommendations for the treatment of asthma in adults are currently available. However, it is necessary to improve their clinical application. Key Words : asthma; inhaled corticosteroids; long-acting inhaled β 2 -agonists; leukotriene receptor antagonists; ciclesonide; omalizumab.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.021 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".