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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Allergic Rhinitis and its Impact on Asthma &#40;ARIA&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Bousquet"
                            1 => "P&#46; Van Cauwenberge"
                            2 => "N&#46; Khaltaev"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Allergy Clin Immunol"
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                        "paginaInicial" => "5174"
                        "paginaFinal" => "5334"
                      ]
                    ]
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              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rhinitis and Asthma&#58; One Airway One Disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Serrano"
                            1 => "A&#46; Valero"
                            2 => "C&#46; Picado"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "numero" => "10"
                        "paginaInicial" => "569"
                        "paginaFinal" => "578"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16266671"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perennial Rhinitis&#58; An independent risk factor for asthma in nonatopic subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
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                            2 => "Neukirch Catherine"
                            3 => "Liard Renata"
                            4 => "Neukirch Fran&#231;oise"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "1999"
                        "volumen" => "104"
                        "paginaInicial" => "301"
                        "paginaFinal" => "304"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10452748"
                            "web" => "Medline"
                          ]
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                ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Changes in bronchial responsiveness following nasal provocation allergen"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Corren"
                            1 => "A&#46; Adinoff"
                            2 => "C&#46; Irvin"
                          ]
                        ]
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                  ]
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                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "1992"
                        "volumen" => "89"
                        "paginaInicial" => "611"
                        "paginaFinal" => "618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1740589"
                            "web" => "Medline"
                          ]
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                ]
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                    0 => array:2 [
                      "titulo" => "Pulmonary response to nasal-challenge testing of athopic subject with stable asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Schumaker"
                            1 => "K&#46; Cora"
                            2 => "L&#46; Taussig"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "1986"
                        "volumen" => "78"
                        "paginaInicial" => "30"
                        "paginaFinal" => "35"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3722633"
                            "web" => "Medline"
                          ]
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                  ]
                ]
              ]
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                      "titulo" => "Changes in airway resistance following nasal provocation"
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Littell"
                            1 => "C&#46; Carlisle"
                            2 => "R&#46; Millman"
                            3 => "S&#46; Braman"
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                      "doi" => "10.1164/ajrccm/141.3.580"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Resp Dis"
                        "fecha" => "1990"
                        "volumen" => "141"
                        "paginaInicial" => "580"
                        "paginaFinal" => "583"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2178523"
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                      "titulo" => "Systemic immunologic and inflammatory aspects of allergic rhinitis"
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                          "autores" => array:1 [
                            0 => "A&#46; Togias"
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                        "fecha" => "2000"
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                        "paginaFinal" => "S250"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11080739"
                            "web" => "Medline"
                          ]
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                  ]
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              ]
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                    0 => array:2 [
                      "titulo" => "Sitespecific sensitisation in a murine model of allergic rhinitis&#58; role of the upper airway in lower airway disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; McCusker"
                            1 => "M&#46; Chicoine"
                            2 => "D&#46; Hamid"
                            3 => "B&#46; Mazer"
                          ]
                        ]
                      ]
                    ]
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                        "tituloSerie" => "J&#46; Allergy Clin Immunol"
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                        "paginaInicial" => "891"
                        "paginaFinal" => "898"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12464956"
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                      "titulo" => "Nasal allergen provocation induces adhesion molecule expression and tissue eosinophilia in upper and lower airways"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46;J&#46; Braunstahl"
                            1 => "S&#46;E&#46; Overbeek"
                            2 => "A&#46; KleinJan"
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                            4 => "H&#46;C&#46; Hoogsteden"
                            5 => "W&#46;J&#46; Fokkens"
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                        "fecha" => "2001"
                        "volumen" => "107"
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                      "titulo" => "A single nasal allergen challenge increases induced sputum inflammatory markers in nonasthmatic subjects with seasonal allergic rhinitis&#58; correlation with plasma interleukin-5"
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                            2 => "O&#46; Kornmann"
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                            4 => "T&#46; Taeumer"
                            5 => "R&#46; Buhl"
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                        "tituloSerie" => "Clin Exp Allergy"
                        "fecha" => "2003"
                        "volumen" => "33"
                        "paginaInicial" => "475"
                        "paginaFinal" => "482"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12680863"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Segmental bronchial provocation induces nasal inflammation in allergic rhinitis patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46;J&#46; Braunstahl"
                            1 => "A&#46; KleinJan"
                            2 => "S&#46;E&#46; Overbeek"
                            3 => "J&#46;B&#46; Prins"
                            4 => "H&#46;C&#46; Hoogsteden"
                            5 => "W&#46;J&#46; Fokkens"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.161.6.9906121"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Resp Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "161"
                        "paginaInicial" => "2051"
                        "paginaFinal" => "2057"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10852787"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Segmental bronchoprovocation in allergic rhinitis affects mast cell and basophil numbers in nasal and bronchial mucosa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;J&#46; Braunstahl"
                            1 => "S&#46;E&#46; Overbeek"
                            2 => "W&#46;J&#46; Fokkens"
                            3 => "A&#46; KleinJan"
                            4 => "A&#46;R&#46; McEuen"
                            5 => "A&#46;F&#46; Walls"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Resp Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "161"
                        "paginaInicial" => "858"
                        "paginaFinal" => "865"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An update on the asthma &#8211; rhinitis link"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Passalacqua Giovanni"
                            1 => "Ciprandi Giorgio"
                            2 => "Pasquali Mercedes"
                            3 => "Guerra Laura"
                            4 => "Canonica Giogio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Allergy Clin Immunol"
                        "fecha" => "2004"
                        "volumen" => "4"
                        "paginaInicial" => "177"
                        "paginaFinal" => "183"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15126938"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Durham SR&#44; Mackay S&#46; Diseases of the nose&#46; In Respiratory Medicine&#46; Volume 2&#46; Third Edition&#46; 43&#58;1035- -47&#46; Gibson GJ&#44; Geddes DM&#44; Costabel U&#44; Sterk PJ&#44; Corrin B&#44; editors&#46; Saunders&#46;"
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis&#58; systematic review of randomised controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "John Weiner"
                            1 => "Michael Abramson"
                            2 => "Puy&#46; Robert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1998"
                        "volumen" => "317"
                        "paginaInicial" => "1624"
                        "paginaFinal" => "1629"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9848901"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of montelukast on rhinitis symptoms in patients with asthma and seasonal allergic rhinitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "George Philip"
                            1 => "Anjuli&#46;S&#46; Nayak"
                            2 => "Berger William"
                            3 => "Leynadier Francisque"
                            4 => "S&#46; France Vrijens"
                            5 => "Dass Balachandra"
                            6 => "Reiss Theodore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Med Res"
                        "fecha" => "2004"
                        "volumen" => "20"
                        "numero" => "10"
                        "paginaInicial" => "1549"
                        "paginaFinal" => "1558"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunologic changes associated with allergen imunotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Stephan Durham"
                            1 => "Till&#46; Stephan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "1998"
                        "volumen" => "102"
                        "paginaInicial" => "157"
                        "paginaFinal" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9723654"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Samantha M&#46; Mucha&#44; Fuad M&#46; Baroody&#46; Sinusitis Update&#46; Curr Opin Allergy Clin Immunol 3&#58;33-38&#46;"
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adult rhinosinusitis defined"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Donald"
                            1 => "Lanza"
                            2 => "W&#46; David"
                            3 => "Kennedy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Otoryngol Head Neck Surg"
                        "fecha" => "1997"
                        "volumen" => "117"
                        "paginaInicial" => "S1"
                        "paginaFinal" => "S7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Carlos Lucas&#46; Asma de dif&#237;cil controlo&#46; In Tratado de Pneumologia&#46; Vol&#46; I&#46; 66&#46;5&#58; 909-920&#46; Gomes MJ&#44; Sotto-Mayor R &#40;eds&#46;&#41;&#46; Sociedade Portuguesa de Pneumologia&#46;"
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rhinosinusitis in severe asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46; Bresiani"
                            1 => "L&#46; Paradis"
                            2 => "A&#46; Des Roches"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mai.2001.111593"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2001"
                        "volumen" => "107"
                        "paginaInicial" => "73"
                        "paginaFinal" => "80"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11149994"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nasal endoscopy in asthmatic childr assessment of rhinosinusitis adenoiditis incidence correlations with cytology F microbiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Tosca"
                            1 => "A&#46;M&#46; Riccio"
                            2 => "G&#46;L&#46; Marseglia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Allergy"
                        "fecha" => "2001"
                        "volumen" => "31"
                        "paginaInicial" => "609"
                        "paginaFinal" => "615"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11359430"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chronic sinusitis in severe asthma is related to sputum eosinophilia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;T&#46; Brinke"
                            1 => "D&#46;C&#46; Grootendorst"
                            2 => "J&#46;T&#46; Schmidt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2002"
                        "volumen" => "109"
                        "paginaInicial" => "621"
                        "paginaFinal" => "626"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11941310"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:7 [
                            0 => "J&#46; Mensa"
                            1 => "J&#46;M&#46; Gatell"
                            2 => "J&#46;R&#46; Azanza"
                            3 => "A&#46; Dominguez-Gil"
                            4 => "J&#46;E&#46; Garcia"
                            5 => "M&#46;T&#46; Jiminez de Anta"
                            6 => "G&#46; Prats"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gu&#237;a de Terap&#234;utica Antimicrobiana"
                        "fecha" => "2005"
                        "volumen" => "3"
                        "paginaInicial" => "407"
                        "paginaFinal" => "410"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Cori Copilevitz&#44; Raymond Slavin&#46; Sinusitis and asthma&#46; <span class="elsevierStyleItalic">In</span> Current Review of Asthma 2003&#59; 7&#58;61-5&#46; Kaliner MA &#40;ed&#46;&#41;&#46; Current Medicine&#46;"
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intrasinus administration of topical budesonide to allergic patients with chronic sinusitis following surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "F&#46; Lavigne"
                            1 => "L&#46; Cameron"
                            2 => "P&#46;M&#46; Renzi"
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00005537-200205000-00015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "2002"
                        "volumen" => "112"
                        "paginaInicial" => "858"
                        "paginaFinal" => "864"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12150618"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The link between the nose and lung&#44; perennial rhinitis and asthma-is it the same disease&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;M&#46; Rowe-Jones"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "1997"
                        "volumen" => "52"
                        "numero" => "Suppl 36"
                        "paginaInicial" => "20"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12598719"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;-J&#46; Dhong"
                            1 => "Y&#46;S&#46; Jung"
                            2 => "S&#46;K&#46; Chung"
                            3 => "D&#46;C&#46; Choi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Otolaryngol Head Neck Surg"
                        "fecha" => "2001"
                        "volumen" => "124"
                        "paginaInicial" => "99"
                        "paginaFinal" => "104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11228462"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of endoscopic surgery in the management of patients with asthma and chronic sinusitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;N&#46; Palmer"
                            1 => "D&#46;B&#46; Conley"
                            2 => "R&#46;G&#46; Dong"
                            3 => "A&#46;M&#46; Ditto"
                            4 => "P&#46;R&#46; Yamold"
                            5 => "R&#46;C&#46; Kern"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Rhinol"
                        "fecha" => "2001"
                        "volumen" => "15"
                        "numero" => "1"
                        "paginaInicial" => "49"
                        "paginaFinal" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11258656"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of endoscopic sinus surgery asthma&#58; management of patients with chronic rhinosinusitis&#44; nasal polyposis&#44; and asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Dunlop"
                            1 => "G&#46;K&#46; Scadding"
                            2 => "V&#46;J&#46; Lund"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Rhinol"
                        "fecha" => "1999"
                        "volumen" => "13"
                        "paginaInicial" => "261"
                        "paginaFinal" => "265"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10485011"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nasal polyposis&#58; an update"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Ruby"
                            1 => "Pawanker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Cur Opin Allergy Clin Immunol"
                        "fecha" => "2003"
                        "volumen" => "3"
                        "paginaInicial" => "1"
                        "paginaFinal" => "6"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pathogenesis of nasal polyps&#58; an update"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Pawliczak"
                            1 => "A&#46; Lewandowska-Polak"
                            2 => "M&#46;L&#46; Kowalski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Curr Allergy Asthma Rep"
                        "fecha" => "2005"
                        "volumen" => "5"
                        "numero" => "6"
                        "paginaInicial" => "463"
                        "paginaFinal" => "471"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16216171"
                            "web" => "Medline"
                          ]
                        ]
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Vol. 12. Issue 5.
Pages 563-579 (September - October 2006)
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Vol. 12. Issue 5.
Pages 563-579 (September - October 2006)
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Doenças inflamatórias alérgicas das vias aéreas superiores e suas implicações na asma brônquica – A propósito de um caso clínico
Allergic inflammatory diseases of the upper airways and their impact on asthma – Following on from a case report
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Ana L. Fonseca1, Ana M. Arrobas2
1 Interna do Complementar de Pneumologia, Serviço de Pneumologia. Director: Dr. Jorge Pires Hospital Geral do Centro Hospitalar de Coimbra Quinta dos Vales Coimbra
2 Assistente Hospitalar Graduada de Pneumologia, Serviço de Pneumologia. Director: Dr. Jorge Pires Hospital Geral do Centro Hospitalar de Coimbra Quinta dos Vales Coimbra
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Resumo

Os autores apresentam o caso clínico de uma doente referenciada à consulta de alergologia respiratória por “asma de difícil controlo”. A investigação clínica conduziu à identificação de patologia inflamatória crónica das vias aéreas superiores de carácter grave, como factor de agravamento da asma brônquica. Após terapêutica, que no referido caso implicou abordagem cirúrgica dos seios perinasais, houve melhoria franca do controlo da asma. A propósito do caso, é efectuada uma revisão das principais patologias inflamatórias alérgicas das vias aéreas superiores (rinite, sinusite e polipose nasal) e abordadas as suas principais implicações no controlo da asma brônquica.

Palavras-chave:
Asma brônquica
rinite alérgica
sinusite crónica
polipose nasal
Abstract

The authors present a case report of a patient refered to physician for “difficult-to-treat asthma”. Clinical evaluation concluded that severe chronic inflammatory upper airway disease was an asthma worsening factor. Patient demonstrated improvement in asthma control, after surgery.

In the context of the clinical study, the authors present a review of the most common allergic inflammatory diseases of the upper airways (allergic rhinitis, chronic sinusitis and nasal polyposis) and reflect on their impact on asthma.

Key-words:
Asthma
allergic rhinitis
chronic sinusitis
nasal polyposis
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Bibliografia
[1.]
Nutku E, Toda M, Hamid Q A. Rhinitis, nasal polyposis and asthma: pathological aspects. In The Nose and Lung Diseases. European Respiratory Monograph. Vol. 6. Monograph 18. 2001; 9:115-32.
[2.]
Global Strategy for Asthma Management and Prevention. National Institutes of Health. National Heart, Lung and Blood Institute. Revised 2005.
[3.]
J. Bousquet, P. Van Cauwenberge, N. Khaltaev.
Allergic Rhinitis and its Impact on Asthma (ARIA).
J Allergy Clin Immunol, 108 (2001), pp. 5174-5334
[4.]
C. Serrano, A. Valero, C. Picado.
Rhinitis and Asthma: One Airway One Disease.
Arch Bronconeumol, 41 (2005), pp. 569-578
[5.]
Leynaert Bénédicte, Bousquet Jean, Neukirch Catherine, Liard Renata, Neukirch Françoise.
Perennial Rhinitis: An independent risk factor for asthma in nonatopic subjects.
J Allergy Clin Immunol, 104 (1999), pp. 301-304
[6.]
J. Corren, A. Adinoff, C. Irvin.
Changes in bronchial responsiveness following nasal provocation allergen.
J Allergy Clin Immunol, 89 (1992), pp. 611-618
[7.]
M. Schumaker, K. Cora, L. Taussig.
Pulmonary response to nasal-challenge testing of athopic subject with stable asthma.
J Allergy Clin Immunol, 78 (1986), pp. 30-35
[8.]
N. Littell, C. Carlisle, R. Millman, S. Braman.
Changes in airway resistance following nasal provocation.
Am Rev Resp Dis, 141 (1990), pp. 580-583
[9.]
A. Togias.
Systemic immunologic and inflammatory aspects of allergic rhinitis.
J Allergy Clin Immunol, 106 (2000), pp. S247-S250
[10.]
C. McCusker, M. Chicoine, D. Hamid, B. Mazer.
Sitespecific sensitisation in a murine model of allergic rhinitis: role of the upper airway in lower airway disease.
J. Allergy Clin Immunol, 110 (2002), pp. 891-898
[11.]
G.J. Braunstahl, S.E. Overbeek, A. KleinJan, J.B. Prins, H.C. Hoogsteden, W.J. Fokkens.
Nasal allergen provocation induces adhesion molecule expression and tissue eosinophilia in upper and lower airways.
J Allergy Clin Immunol, 107 (2001), pp. 469-476
[12.]
K.M. Beeh, J. Beier, O. Kornmann, C. Meier, T. Taeumer, R. Buhl.
A single nasal allergen challenge increases induced sputum inflammatory markers in nonasthmatic subjects with seasonal allergic rhinitis: correlation with plasma interleukin-5.
Clin Exp Allergy, 33 (2003), pp. 475-482
[13.]
G.J. Braunstahl, A. KleinJan, S.E. Overbeek, J.B. Prins, H.C. Hoogsteden, W.J. Fokkens.
Segmental bronchial provocation induces nasal inflammation in allergic rhinitis patients.
Am J Resp Crit Care Med, 161 (2000), pp. 2051-2057
[14.]
G.J. Braunstahl, S.E. Overbeek, W.J. Fokkens, A. KleinJan, A.R. McEuen, A.F. Walls, et al.
Segmental bronchoprovocation in allergic rhinitis affects mast cell and basophil numbers in nasal and bronchial mucosa.
Am J Resp Crit Care Med, 161 (2001), pp. 858-865
[15.]
Passalacqua Giovanni, Ciprandi Giorgio, Pasquali Mercedes, Guerra Laura, Canonica Giogio.
An update on the asthma – rhinitis link.
Curr Opin Allergy Clin Immunol, 4 (2004), pp. 177-183
[16.]
Durham SR, Mackay S. Diseases of the nose. In Respiratory Medicine. Volume 2. Third Edition. 43:1035- -47. Gibson GJ, Geddes DM, Costabel U, Sterk PJ, Corrin B, editors. Saunders.
[17.]
John Weiner, Michael Abramson, Puy. Robert.
Intranasal corticosteroids versus oral H1 receptor antagonists in allergic rhinitis: systematic review of randomised controlled trials.
BMJ, 317 (1998), pp. 1624-1629
[18.]
George Philip, Anjuli.S. Nayak, Berger William, Leynadier Francisque, S. France Vrijens, Dass Balachandra, Reiss Theodore.
The effect of montelukast on rhinitis symptoms in patients with asthma and seasonal allergic rhinitis.
Curr Med Res, 20 (2004), pp. 1549-1558
[19.]
J. Stephan Durham, Till. Stephan.
Immunologic changes associated with allergen imunotherapy.
J Allergy Clin Immunol, 102 (1998), pp. 157-164
[20.]
Samantha M. Mucha, Fuad M. Baroody. Sinusitis Update. Curr Opin Allergy Clin Immunol 3:33-38.
[21.]
C. Donald, Lanza, W. David, Kennedy.
Adult rhinosinusitis defined.
Otoryngol Head Neck Surg, 117 (1997), pp. S1-S7
[22.]
Carlos Lucas. Asma de difícil controlo. In Tratado de Pneumologia. Vol. I. 66.5: 909-920. Gomes MJ, Sotto-Mayor R (eds.). Sociedade Portuguesa de Pneumologia.
[23.]
M. Bresiani, L. Paradis, A. Des Roches, et al.
Rhinosinusitis in severe asthma.
J Allergy Clin Immunol, 107 (2001), pp. 73-80
[24.]
A. Tosca, A.M. Riccio, G.L. Marseglia, et al.
Nasal endoscopy in asthmatic childr assessment of rhinosinusitis adenoiditis incidence correlations with cytology F microbiology.
Clin Exp Allergy, 31 (2001), pp. 609-615
[25.]
A.T. Brinke, D.C. Grootendorst, J.T. Schmidt, et al.
Chronic sinusitis in severe asthma is related to sputum eosinophilia.
J Allergy Clin Immunol, 109 (2002), pp. 621-626
[26.]
J. Mensa, J.M. Gatell, J.R. Azanza, A. Dominguez-Gil, J.E. Garcia, M.T. Jiminez de Anta, G. Prats.
Guía de Terapêutica Antimicrobiana, 3 (2005), pp. 407-410
[27.]
Cori Copilevitz, Raymond Slavin. Sinusitis and asthma. In Current Review of Asthma 2003; 7:61-5. Kaliner MA (ed.). Current Medicine.
[28.]
F. Lavigne, L. Cameron, P.M. Renzi, et al.
Intrasinus administration of topical budesonide to allergic patients with chronic sinusitis following surgery.
Laryngoscope, 112 (2002), pp. 858-864
[29.]
J.M. Rowe-Jones.
The link between the nose and lung, perennial rhinitis and asthma-is it the same disease?.
Allergy, 52 (1997), pp. 20-28
[30.]
H.-J. Dhong, Y.S. Jung, S.K. Chung, D.C. Choi.
Effect of endoscopic sinus surgery on asthmatic patients with chronic rhinosinusitis.
Otolaryngol Head Neck Surg, 124 (2001), pp. 99-104
[31.]
J.N. Palmer, D.B. Conley, R.G. Dong, A.M. Ditto, P.R. Yamold, R.C. Kern.
Efficacy of endoscopic surgery in the management of patients with asthma and chronic sinusitis.
Am J Rhinol, 15 (2001), pp. 49-53
[32.]
G. Dunlop, G.K. Scadding, V.J. Lund.
The effect of endoscopic sinus surgery asthma: management of patients with chronic rhinosinusitis, nasal polyposis, and asthma.
Am J Rhinol, 13 (1999), pp. 261-265
[33.]
Ruby, Pawanker.
Nasal polyposis: an update.
Cur Opin Allergy Clin Immunol, 3 (2003), pp. 1-6
[34.]
R. Pawliczak, A. Lewandowska-Polak, M.L. Kowalski.
Pathogenesis of nasal polyps: an update.
Curr Allergy Asthma Rep, 5 (2005), pp. 463-471
[35.]
C. Bachert, T. Van Zele, P. Gevaert, L. De Schrijver, P. Van Cauwenberge.
Superantigens and nasal polyps.
Curr Allergy Asthma Rep, 3 (2003), pp. 523-531
[36.]
Drake-Lee.
Nasal polyps.
Hosp Med, 65 (2004), pp. 264-267
[37.]
R. Wynn, G. Har-El.
Recorrence rates after endoscopic sinus surgery for massive sinus polyposis.
Laryngoscope, 114 (2004), pp. 811-813
[38.]
G.M. English.
Nasal polypectomy and sinus surgery in patients with asthma and aspirin idiosyncrasy.
Laryngoscope, 96 (1986), pp. 374-380
Copyright © 2006. Sociedade Portuguesa de Pneumologia
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