Obstructive sleep apnoea syndrome is an under-recognized cause of uncontrolled asthma across the life cycle
a University Hospital, Montpellier, France
b MACVIA-LR, Contre les Maladies Chroniques pour un VIeillissement Actif en Languedoc Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, France
c INSERM, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, U1168, Paris, and UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France
d Global Alliance against Chronic Respiratory Diseases (GARD), Turkey
e ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Brazil
f Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal
Read
1793
Timeswas read the article
724
Total PDF
1069
Total HTML
Share statistics
array:19 [ "pii" => "X0873215916479400" "issn" => "08732159" "doi" => "10.1016/j.rppnen.2015.12.006" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2016;22:1-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 699 "formatos" => array:2 [ "HTML" => 440 "PDF" => 259 ] ] "itemSiguiente" => array:16 [ "pii" => "X0873215916479419" "issn" => "08732159" "doi" => "10.1016/j.rppnen.2015.12.007" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Port Pneumol. 2016;22:4-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 519 "formatos" => array:2 [ "HTML" => 319 "PDF" => 200 ] ] "en" => array:8 [ "idiomaDefecto" => true "titulo" => "Limitations of evidence-based medicine" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "4" "paginaFinal" => "5" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.R. Bach, M. Chiou" "autores" => array:2 [ 0 => array:2 [ "Iniciales" => "J.R." "apellidos" => "Bach" ] 1 => array:2 [ "Iniciales" => "M." "apellidos" => "Chiou" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0873215916479419?idApp=UINPBA00004E" "url" => "/08732159/0000002200000001/v0_201604141139/X0873215916479419/v0_201604141139/en/main.assets" ] "en" => array:9 [ "idiomaDefecto" => true "titulo" => "Obstructive sleep apnoea syndrome is an under-recognized cause of uncontrolled asthma across the life cycle" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1" "paginaFinal" => "3" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Bousquet, A.A. Cruz, C. Robalo-Cordeiro" "autores" => array:3 [ 0 => array:4 [ "Iniciales" => "J." "apellidos" => "Bousquet" "email" => array:1 [ 0 => "jean.bousquet@orange.fr" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] ] ] 1 => array:3 [ "Iniciales" => "A.A." "apellidos" => "Cruz" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "affd" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "affe" ] ] ] 2 => array:3 [ "Iniciales" => "C." "apellidos" => "Robalo-Cordeiro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "afff" ] ] ] ] "afiliaciones" => array:6 [ 0 => array:3 [ "entidad" => "University Hospital, Montpellier, France" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "affa" ] 1 => array:3 [ "entidad" => "MACVIA-LR, Contre les Maladies Chroniques pour un VIeillissement Actif en Languedoc Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, France" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "affb" ] 2 => array:3 [ "entidad" => "INSERM, VIMA: Ageing and chronic diseases Epidemiological and public health approaches, U1168, Paris, and UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, France" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "affc" ] 3 => array:3 [ "entidad" => "Global Alliance against Chronic Respiratory Diseases (GARD), Turkey" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "affd" ] 4 => array:3 [ "entidad" => "ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Brazil" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "affe" ] 5 => array:3 [ "entidad" => "Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal" "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "afff" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "correspondencia" => "Corresponding author. jean.bousquet@orange.fr" ] ] ] ] "textoCompleto" => "<p class="elsevierStylePara">Obstructive sleep apnoea syndrome (OSA) is a clinical syndrome marked by recurring episodes of upper airway obstruction that lead to markedly reduced (hypopnoea) or absent (apnoea) airflow at the nose/mouth. These episodes of impaired ventilation are usually accompanied by loud snoring and hypoxemia, and are typically terminated by brief arousals.<a href="#bib1" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">1</span></a> However, despite having significant breathing problems during sleep, most patients have no readily detectable respiratory abnormality while awake. OSA is a very common yet underdiagnosed disorder often occurring in a context of multimorbidity.<a href="#bib2" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">2</span></a></p><p class="elsevierStylePara">The pathophysiological mechanisms involved in OSA are complex and not fully understood. Critical upper airway narrowing/collapse usually occurs in the oropharynx, between the nasal choanae and epiglottis, an area lacking rigid structural support. Patency of this vulnerable segment is dependent on the action of pharyngeal dilator and abductor muscles that are normally activated in a rhythmic fashion during each inspiration. Collapse of the upper airway occurs if the negative upper airway pressure generated by inspiratory pump muscles exceeds the dilating force of these upper airway muscles.<a href="#bib3" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">3</span></a></p><p class="elsevierStylePara">A variety of factors contribute to upper airway narrowing in patients with OSA. Obesity contributes to OSA pathogenesis in multiple ways including altering upper airway anatomy and collapsibility, ventilatory control and increasing respiratory work load. OSA itself contributes to the development of obesity. Moreover, both OSA and obesity promote the activation of inflammatory pathways, which is likely a key mechanism in cardiovascular and metabolic disease processes.<a href="#bib4" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">4</span></a> Anatomical factors that predispose to upper airway narrowing should be sought in the physical examination of a patient suspected of having OSA, which, in addition to tonsillar hypertrophy, include retrognathia, micrognathia, and macroglossia.<a href="#bib5" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">5</span></a> However, the most common physical finding is a non-specific narrowing of the pharyngeal airway with reduced visualization of the posterior pharyngeal wall. The etiology of OSA in children differs from adults in that adenotonsillar hypertrophy is the most common cause of the disorder although the increasing prevalence of obesity among children in recent years represents an important contributing factor in many cases.<a href="#bib6" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">6</span></a></p><p class="elsevierStylePara">OSA is a unique physiologic stressor that contributes to the development or progression of many other disorders, particularly cardiovascular diseases and hypertension.<a href="#bib7" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">7</span></a><span class="elsevierStyleSup">, </span><a href="#bib8" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">8</span></a> OSA is also associated with metabolic, and neurocognitive disease, increased cancer-related deaths,<a href="#bib9" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">9</span></a> and COPD.<a href="#bib10" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">10</span></a> Treatment with continuous positive airways pressure (CPAP) to reverse OSA-related symptoms and multimorbidities provides variable benefit in some but not all patients.</p><p class="elsevierStylePara">OSA is also frequent among subjects with asthma.<a href="#bib11" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a><span class="elsevierStyleSup">, </span><a href="#bib12" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">12</span></a> In population based studies, patients with asthma have a significantly higher risk of developing OSA than the general population.<a href="#bib13" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">13</span></a> The increased risk of OSA may be associated with the concomitant presence of rhinitis<a href="#bib14" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">14</span></a><span class="elsevierStyleSup">, </span><a href="#bib15" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">15</span></a> or obesity.<a href="#bib16" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">16</span></a> The potential contribution of nasal obstruction to OSA has been debated. While many reports have shown a relationship between nasal obstruction and OSA,<a href="#bib17" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">17</span></a><span class="elsevierStyleSup">, </span><a href="#bib18" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">18</span></a> other reports have failed to find a relationship.<a href="#bib19" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">19</span></a><span class="elsevierStyleSup">, </span><a href="#bib20" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">20</span></a> The paper of Madama et al published in this journal raises two important issues in multimorbid asthma and OSA<a href="#bib11" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a>:</p><ul><li><p class="elsevierStylePara">1. Asthma in old age adults: Asthma is common in old age adults<a href="#bib21" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">21</span></a> and there are overlaps with other diseases such as COPD. The overall management of asthma in the elderly population is also complicated by specific features that the disease develops in the most advanced ages, and by the difficulties that the physician encounters when approaching the older asthmatic subjects.<a href="#bib22" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">22</span></a> OSA increases in prevalence in old age adults and those with obesity. The overlap between asthma, OSA and obesity needs a careful attention<a href="#bib23" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">23</span></a> since the treatment differs from asthma alone. This syndrome is usually not considered in guidelines.<a href="#bib24" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">24</span></a> AIRWAYS ICPs will approach this problem in depth in order to provide some recommendations for this new overlap syndrome in old age adults.<a href="#bib11" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a> The initiative AIRWAYS ICPs (Integrated care pathways for airway diseases)<a href="#bib25" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">25</span></a> has launched a collaboration to develop practical multisectoral care pathways (ICPs) to reduce the burden of chronic respiratory diseases, their mortality and multimorbidity. AIRWAYS-ICPs proposes a feasible, achievable and manageable pathway from science to guidelines and policies using existing networks and stakeholders committed to the Action Plan B3 of the European Innovation Partnership on Active and Healthy Aging (EIP on AHA)<a href="#bib26" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">26</span></a> and the WHO Global Alliance against Chronic Respiratory Diseases (GARD).<a href="#bib27" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">27</span></a><span class="elsevierStyleSup">, </span><a href="#bib28" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">28</span></a> It is implemented in European countries and regions, as part of the EIP on AHA, and is scaled up globally with GARD. The Renovated Action Plan of the EIP on AHA has a synergy on chronic respiratory diseases in old age people, an under-recognized societal problem.</p></li><li><p class="elsevierStylePara">2. Uncontrolled asthma: The risk of OSA is associated with poor asthma control. Patients with inhaled steroid treatment have a higher risk for OSA than those without steroid treatment.<a href="#bib13" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">13</span></a> In the SARP-II (Severe Asthma Research Program), OSA risk is associated with a neutrophilic airway inflammation in asthma, which suggests that OSA may be an important contributor to the neutrophilic asthma.<a href="#bib29" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">29</span></a> Unrecognized OSA may be a reason for poor asthma control, particularly among older patients. In one study, CPAP use attenuated the likelihood of severe asthma in older subjects by 91%.<a href="#bib23" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">23</span></a> Sleep disordered breathing are also increased in asthmatic children and the prevalence of sleep disordered breathing increased with increasing asthma severity.<a href="#bib30" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">30</span></a> Overal, recent studies indicate that OSA and asthma are closely associated in pathogenesis, symptoms, and therapies, and there is a coexistence of OSA in difficult-to-control asthmatic patients.<a href="#bib31" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">31</span></a> Thus, as proposed by Madama et al.,<a href="#bib11" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">11</span></a> in asthmatic patients with uncontrolled disease, symptoms suggestive of OSA should be investigated (e.g. daytime sleepiness, snoring, chocking or gasping during sleep, recurrent awakenings) and polysomnography readily performed if needed. OSA should therefore be considered in patients with severe asthma either as a differential diagnosis<a href="#bib32" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">32</span></a> or as a multimorbidity that prevents asthma control. Guidelines should consider this new overlap syndrome since the treatment of OSA was shown to improve asthma control in these patients.</p></li></ul><p class="elsevierStylePara">In patients with asthma, OSA should be investigated whenever there is inadequate control of symptoms of nocturnal asthma despite the treatment recommended by guidelines having been administered. There is evidence in the literature that the use of CPAP contributes to asthma control in asthma patients with OSA and uncontrolled asthma.<a href="#bib24" class="elsevierStyleCrossRefs"><span class="elsevierStyleSup">24</span></a></p><p class="elsevierStylePara">Corresponding author. jean.bousquet@orange.fr</p>" "pdfFichero" => "320v22n01a90447940pdf001.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliography" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Sleep apnea syndrome due to upper airway obstruction: a review of 25 cases. Arch Intern Med. 1977; 137:296-300." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Sleep apnea syndrome due to upper airway obstruction: a review of 25 cases." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Guilleminault C" 1 => "Eldridge FL" 2 => "Tilkian A" 3 => "Simmons FB" 4 => "Dement WC." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Intern Med. " "fecha" => "1977" "volumen" => "137" "paginaInicial" => "296" "paginaFinal" => "300" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/557314" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Epidemiological aspects of obstructive sleep apnea. J Thorac Dis. 2015; 7:920-9." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Epidemiological aspects of obstructive sleep apnea." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Garvey JF" 1 => "Pengo MF" 2 => "Drakatos P" 3 => "Kent BD." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3978/j.issn.2072-1439.2015.04.52" "Revista" => array:6 [ "tituloSerie" => "J Thorac Dis. " "fecha" => "2015" "volumen" => "7" "paginaInicial" => "920" "paginaFinal" => "929" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26101650" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The pathogenesis of obstructive sleep apnea. J Thorac Dis. 2015; 7:1358-72." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The pathogenesis of obstructive sleep apnea." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Pham LV" 1 => "Schwartz AR." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3978/j.issn.2072-1439.2015.07.28" "Revista" => array:6 [ "tituloSerie" => "J Thorac Dis. " "fecha" => "2015" "volumen" => "7" "paginaInicial" => "1358" "paginaFinal" => "1372" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26380762" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Obesity and sleep-disordered breathing – when two ‘bad guys’ meet. QJM. 2014; 107:949-54." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Obesity and sleep-disordered breathing – when two ‘bad guys’ meet." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Ryan S" 1 => "Crinion SJ" 2 => "McNicholas WT." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/qjmed/hcu029" "Revista" => array:6 [ "tituloSerie" => "QJM. " "fecha" => "2014" "volumen" => "107" "paginaInicial" => "949" "paginaFinal" => "954" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24509235" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Pathophysiology of obstructive sleep apnoea. Eur Respir J. 1995; 8:1161-78." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Pathophysiology of obstructive sleep apnoea." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Deegan PC" 1 => "McNicholas WT." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "1995" "volumen" => "8" "paginaInicial" => "1161" "paginaFinal" => "1178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7589402" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Sleep-disordered breathing in children. Am J Respir Crit Care Med. 2001; 164:16-30." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Sleep-disordered breathing in children." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Marcus CL." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm.164.1.2008171" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med. " "fecha" => "2001" "volumen" => "164" "paginaInicial" => "16" "paginaFinal" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11435234" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The different clinical faces of obstructive sleep apnoea: a cluster analysis. Eur Respir J. 2014; 44:1600-7." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The different clinical faces of obstructive sleep apnoea: a cluster analysis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Ye L" 1 => "Pien GW" 2 => "Ratcliffe SJ" 3 => "Bjornsdottir E" 4 => "Arnardottir ES" 5 => "Pack AI" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00032314" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2014" "volumen" => "44" "paginaInicial" => "1600" "paginaFinal" => "1607" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25186268" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "OSA and pulmonary hypertension: time for a new look. Chest. 2015; 147:847-61." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "OSA and pulmonary hypertension: time for a new look." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Ismail K" 1 => "Roberts K" 2 => "Manning P" 3 => "Manley C" 4 => "Hill NS." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.14-0614" "Revista" => array:6 [ "tituloSerie" => "Chest. " "fecha" => "2015" "volumen" => "147" "paginaInicial" => "847" "paginaFinal" => "861" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25732450" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Intermittent hypoxemia and OSA: implications for comorbidities. Chest. 2015; 147:266-74." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Intermittent hypoxemia and OSA: implications for comorbidities." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Dewan NA" 1 => "Nieto FJ" 2 => "Somers VK." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.14-0500" "Revista" => array:6 [ "tituloSerie" => "Chest. " "fecha" => "2015" "volumen" => "147" "paginaInicial" => "266" "paginaFinal" => "274" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25560865" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Sleep-related disorders in chronic obstructive pulmonary disease. Expert Rev Respir Med. 2014; 8:79-88." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Sleep-related disorders in chronic obstructive pulmonary disease." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Crinion SJ" 1 => "McNicholas WT." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1586/17476348.2014.860357" "Revista" => array:6 [ "tituloSerie" => "Expert Rev Respir Med. " "fecha" => "2014" "volumen" => "8" "paginaInicial" => "79" "paginaFinal" => "88" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24378218" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Overlap syndrome – asthma and obstructive sleep apnea. Rev Port Pneumol. 2016; 22:6-10." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Overlap syndrome – asthma and obstructive sleep apnea." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Madama D" 1 => "Silva A" 2 => "Matos MJ." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rppnen.2015.08.005" "Revista" => array:6 [ "tituloSerie" => "Rev Port Pneumol. " "fecha" => "2016" "volumen" => "22" "paginaInicial" => "6" "paginaFinal" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26603307" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Association between asthma and risk of developing obstructive sleep apnea. JAMA. 2015; 313:156-64." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Association between asthma and risk of developing obstructive sleep apnea." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Teodorescu M" 1 => "Barnet JH" 2 => "Hagen EW" 3 => "Palta M" 4 => "Young TB" 5 => "Peppard PE." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2014.17822" "Revista" => array:6 [ "tituloSerie" => "JAMA. " "fecha" => "2015" "volumen" => "313" "paginaInicial" => "156" "paginaFinal" => "164" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25585327" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Risk of obstructive sleep apnea in adult patients with asthma: a population-based Cohort Study in Taiwan. PLOS ONE. 2015; 10:e0128461." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Risk of obstructive sleep apnea in adult patients with asthma: a population-based Cohort Study in Taiwan." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Shen TC" 1 => "Lin CL" 2 => "Wei CC" 3 => "Chen CH" 4 => "Tu CY" 5 => "Hsia TC" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0128461" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE. " "fecha" => "2015" "volumen" => "10" "paginaInicial" => "e0128461" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26067280" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Sleep apnea risk in subjects with asthma with or without comorbid rhinitis. Respir Care. 2014; 59:1851-6." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Sleep apnea risk in subjects with asthma with or without comorbid rhinitis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Braido F" 1 => "Baiardini I" 2 => "Lacedonia D" 3 => "Facchini FM" 4 => "Fanfulla F" 5 => "Molinengo G" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4187/respcare.03084" "Revista" => array:6 [ "tituloSerie" => "Respir Care. " "fecha" => "2014" "volumen" => "59" "paginaInicial" => "1851" "paginaFinal" => "1856" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24917451" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The nose, upper airway, and obstructive sleep apnea. Ann Allergy Asthma Immunol. 2015; 115:96-102." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The nose, upper airway, and obstructive sleep apnea." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Wilhelm CP" 1 => "deShazo RD" 2 => "Tamanna S" 3 => "Ullah MI" 4 => "Skipworth LB." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.anai.2015.06.011" "Revista" => array:6 [ "tituloSerie" => "Ann Allergy Asthma Immunol. " "fecha" => "2015" "volumen" => "115" "paginaInicial" => "96" "paginaFinal" => "102" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26250769" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Abdominal and general adiposity and level of asthma control in adults with uncontrolled asthma. Ann Am Thorac Soc. 2014; 11:1218-24." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Abdominal and general adiposity and level of asthma control in adults with uncontrolled asthma." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Lv N" 1 => "Xiao L" 2 => "Camargo CA" 3 => "Wilson SR" 4 => "Buist AS" 5 => "Strub P" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1513/AnnalsATS.201405-214OC" "Revista" => array:6 [ "tituloSerie" => "Ann Am Thorac Soc. " "fecha" => "2014" "volumen" => "11" "paginaInicial" => "1218" "paginaFinal" => "1224" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25343191" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Obstructive apneas during sleep in patients with seasonal allergic rhinitis. Am Rev Respir Dis. 1982; 126:625-8." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Obstructive apneas during sleep in patients with seasonal allergic rhinitis." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "McNicholas WT" 1 => "Tarlo S" 2 => "Cole P" 3 => "Zamel N" 4 => "Rutherford R" 5 => "Griffin D" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/arrd.1982.126.4.625" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis. " "fecha" => "1982" "volumen" => "126" "paginaInicial" => "625" "paginaFinal" => "628" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7125355" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Nasal obstruction as a risk factor for sleep apnoea syndrome. Eur Respir J. 2000; 16:639-43." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Nasal obstruction as a risk factor for sleep apnoea syndrome." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Lofaso F" 1 => "Coste A" 2 => "d’Ortho MP" 3 => "Zerah-Lancner F" 4 => "Delclaux C" 5 => "Goldenberg F" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2000" "volumen" => "16" "paginaInicial" => "639" "paginaFinal" => "643" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11106205" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Nasal resistance in obstructive sleep apnea. Chest. 1994; 105:1133-5." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Nasal resistance in obstructive sleep apnea." "idioma" => "ro" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Atkins M" 1 => "Taskar V" 2 => "Clayton N" 3 => "Stone P" 4 => "Woodcock A." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest. " "fecha" => "1994" "volumen" => "105" "paginaInicial" => "1133" "paginaFinal" => "1135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8162738" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The importance of nasal resistance in obstructive sleep apnea syndrome: a study with positional rhinomanometry. Sleep Breath. 2001; 5:3-11." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The importance of nasal resistance in obstructive sleep apnea syndrome: a study with positional rhinomanometry." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "De Vito A" 1 => "Berrettini S" 2 => "Carabelli A" 3 => "Sellari-Franceschini S" 4 => "Bonanni E" 5 => "Gori S" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11325-001-0003-y" "Revista" => array:6 [ "tituloSerie" => "Sleep Breath. " "fecha" => "2001" "volumen" => "5" "paginaInicial" => "3" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11868135" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Asthma in the elderly: current understanding and future research needs – a report of a National Institute on Aging (NIA) workshop. J Allergy Clin Immunol. 2011; 128(3 Suppl):S4-S24." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Asthma in the elderly: current understanding and future research needs – a report of a National Institute on Aging (NIA) workshop." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Hanania NA" 1 => "King MJ" 2 => "Braman SS" 3 => "Saltoun C" 4 => "Wise RA" 5 => "Enright P" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaci.2011.06.048" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol. " "fecha" => "2011" "volumen" => "128" "paginaInicial" => "S4" "paginaFinal" => "S24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21872730" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Asthma in the older adult: presentation, considerations and clinical management. Expert Rev Clin Immunol. 2015; 11:1297-308." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Asthma in the older adult: presentation, considerations and clinical management." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Battaglia S" 1 => "Benfante A" 2 => "Scichilone N." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1586/1744666X.2015.1087850" "Revista" => array:6 [ "tituloSerie" => "Expert Rev Clin Immunol. " "fecha" => "2015" "volumen" => "11" "paginaInicial" => "1297" "paginaFinal" => "1308" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26358013" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Asthma control and its relationship with Obstructive Sleep Apnea (OSA) in older adults. Sleep Disord. 2013; 2013:251567." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Asthma control and its relationship with Obstructive Sleep Apnea (OSA) in older adults." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Teodorescu M" 1 => "Polomis DA" 2 => "Gangnon RE" 3 => "Fedie JE" 4 => "Consens FB" 5 => "Chervin RD" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2013/251567" "Revista" => array:5 [ "tituloSerie" => "Sleep Disord. " "fecha" => "2013" "volumen" => "2013" "paginaInicial" => "251567" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24307949" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Obstructive sleep apnea and asthma. J Bras Pneumol. 2013; 39:604-12." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Obstructive sleep apnea and asthma." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Salles C" 1 => "Terse-Ramos R" 2 => "Souza-Machado A" 3 => "Cruz AA." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/S1806-37132013000500011" "Revista" => array:6 [ "tituloSerie" => "J Bras Pneumol. " "fecha" => "2013" "volumen" => "39" "paginaInicial" => "604" "paginaFinal" => "612" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24310634" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Integrated care pathways for airway diseases (AIRWAYS-ICPs). Eur Respir J. 2014; 44:304-23." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Integrated care pathways for airway diseases (AIRWAYS-ICPs)." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Bousquet J" 1 => "Addis A" 2 => "Adcock I" 3 => "Agache I" 4 => "Agusti A" 5 => "Alonso A" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00014614" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J. " "fecha" => "2014" "volumen" => "44" "paginaInicial" => "304" "paginaFinal" => "323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24925919" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The European innovation partnership on active and healthy ageing: the European geriatric medicine introduces the EIP on AHA column. Eur Geriatr Med. 2014; 5:361-2." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The European innovation partnership on active and healthy ageing: the European geriatric medicine introduces the EIP on AHA column." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Bousquet J" 1 => "Michel J" 2 => "Standberg T" 3 => "Crooks G" 4 => "Iakovidis I" 5 => "Gomez M." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Geriatr Med. " "fecha" => "2014" "volumen" => "5" "paginaInicial" => "361" "paginaFinal" => "362" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Global alliance against chronic respiratory diseases. Allergy. 2007; 62:216-23." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Global alliance against chronic respiratory diseases." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Bousquet J" 1 => "Dahl R" 2 => "Khaltaev N." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2007.01307.x" "Revista" => array:6 [ "tituloSerie" => "Allergy. " "fecha" => "2007" "volumen" => "62" "paginaInicial" => "216" "paginaFinal" => "223" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17298337" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib28" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Global surveillance, prevention and control of chronic respiratory diseases. A comprehensive approach. Global alliance against chronic respiratory diseases. World Health Organization; 2007. ISBN 978 92 4 156346 8, 148 pp." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Global surveillance, prevention and control of chronic respiratory diseases. A comprehensive approach. Global alliance against chronic respiratory diseases." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Bousquet J" 1 => "Khaltaev N." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "titulo" => "Global surveillance, prevention and control of chronic respiratory diseases. A comprehensive approach. Global alliance against chronic respiratory diseases." "fecha" => "2007" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib29" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Obstructive sleep apnea risk, asthma burden, and lower airway inflammation in adults in the Severe Asthma Research Program (SARP) II. J Allergy Clin Immunol Pract. 2015; 3:. 566–575e1" "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Obstructive sleep apnea risk, asthma burden, and lower airway inflammation in adults in the Severe Asthma Research Program (SARP) II." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Teodorescu M" 1 => "Broytman O" 2 => "Curran-Everett D" 3 => "Sorkness RL" 4 => "Crisafi G" 5 => "Bleecker ER" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "J Allergy Clin Immunol Pract. " "fecha" => "2015" "volumen" => "3" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib30" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects. Pediatr Pulmonol. 2015; 50:1128-36." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Goldstein NA" 1 => "Aronin C" 2 => "Kantrowitz B" 3 => "Hershcopf R" 4 => "Fishkin S" 5 => "Lee H" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ppul.23120" "Revista" => array:6 [ "tituloSerie" => "Pediatr Pulmonol. " "fecha" => "2015" "volumen" => "50" "paginaInicial" => "1128" "paginaFinal" => "1136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25461921" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib31" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Asthma and obstructive sleep apnea. Chin Med J (Engl). 2015; 128:2798-804." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Asthma and obstructive sleep apnea." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Qiao YX" 1 => "Xiao Y." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0366-6999.167361" "Revista" => array:6 [ "tituloSerie" => "Chin Med J (Engl). " "fecha" => "2015" "volumen" => "128" "paginaInicial" => "2798" "paginaFinal" => "2804" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26481749" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib32" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:3 [ "referenciaCompleta" => "Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma. J Allergy Clin Immunol. 2010; 126:926-38." "contribucion" => array:1 [ 0 => array:3 [ "titulo" => "Uniform definition of asthma severity, control, and exacerbations: document presented for the World Health Organization Consultation on Severe Asthma." "idioma" => "en" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "Bousquet J" 1 => "Mantzouranis E" 2 => "Cruz AA" 3 => "Ait-Khaled N" 4 => "Baena-Cagnani CE" 5 => "Bleecker ER" 6 => "et-al." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaci.2010.07.019" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol. " "fecha" => "2010" "volumen" => "126" "paginaInicial" => "926" "paginaFinal" => "938" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20926125" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/08732159/0000002200000001/v0_201604141139/X0873215916479400/v0_201604141139/en/main.assets" "Apartado" => array:4 [ "identificador" => "50811" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Editorials" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/08732159/0000002200000001/v0_201604141139/X0873215916479400/v0_201604141139/en/320v22n01a90447940pdf001.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0873215916479400?idApp=UINPBA00004E" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 8 | 15 |
| 2024 October | 45 | 27 | 72 |
| 2024 September | 62 | 24 | 86 |
| 2024 August | 67 | 28 | 95 |
| 2024 July | 45 | 26 | 71 |
| 2024 June | 59 | 38 | 97 |
| 2024 May | 36 | 18 | 54 |
| 2024 April | 33 | 20 | 53 |
| 2024 March | 26 | 19 | 45 |
| 2024 February | 49 | 24 | 73 |
| 2024 January | 39 | 19 | 58 |
| 2023 December | 13 | 24 | 37 |
| 2023 November | 18 | 34 | 52 |
| 2023 October | 18 | 31 | 49 |
| 2023 September | 20 | 36 | 56 |
| 2023 August | 10 | 10 | 20 |
| 2023 July | 16 | 25 | 41 |
| 2023 June | 18 | 20 | 38 |
| 2023 May | 48 | 34 | 82 |
| 2018 February | 0 | 1 | 1 |
| 2017 December | 0 | 1 | 1 |
| 2017 July | 1 | 0 | 1 |
| 2017 June | 0 | 1 | 1 |
| 2017 February | 1 | 1 | 2 |
| 2017 January | 3 | 1 | 4 |
| 2016 November | 2 | 1 | 3 |
| 2016 October | 2 | 7 | 9 |
| 2016 September | 7 | 0 | 7 |
| 2016 August | 13 | 0 | 13 |
| 2016 July | 9 | 4 | 13 |
| 2016 April | 65 | 19 | 84 |
| 2016 March | 136 | 78 | 214 |
| 2016 February | 201 | 145 | 346 |
Show all
