Previous studies suggest that chest radiography is improperly and

Previous studies suggest that chest radiography is improperly and unnecessarily used in children and adults with acute asthma treated in emergency rooms.50 Due to the alterations that are usually found in patients during asthmatic crises, such as hyperinsufflation, fluid extravasation, and atelectasis associated with hypoxemia,51 the misinterpretation of these findings as a sign of pneumonia is common and, consequently, unnecessary prescription of antibiotics. A multicenter study of 734 asthmatic patients treated in emergency rooms evaluated the request for additional tests, in this case, chest radiography and blood tests. Severely ill patients, those under 1 year, and those with a comorbidity

were excluded. A total of 302 (41.0%) children underwent buy Trichostatin A additional tests, such as chest radiography (27.0%) and Selleckchem Adriamycin blood tests (14.0%). After excluding febrile

or hypoxic patients, 32.0% were still subjected to at least one of the exams.50 Despite the lack of Brazilian data, the routine of pediatric emergency care services in the country appears to adhere to this rule. In order to prevent the dissemination of viral agents, due to the high capacity of viral spread through droplets and fomites, hand washing, and the use of respiratory masks are simple strategies that have been proven to be effective.52 Staying away from situations that favor clusters of people during periods of increased viral circulation has been recommended, although there are no studies that proved the effectiveness of this strategy.52 and 53 The use of substances such as herbal preparations including Echinacea and vitamin C has been evaluated, but double-blind, placebo-controlled studies failed to demonstrate their benefit. 54 The prevention of viral infections through vaccines has

been the most effective way to control diseases caused by viruses. In the case of respiratory viruses, the only vaccine available is for Flu, although there are ongoing studies for the development of vaccines Rucaparib clinical trial for other respiratory viruses, especially HRV. However, their great antigenic diversity hinders research success; recent studies have tried to establish a more adequate antigenic target in the viral structure.54 and 55 Specific RSV immunoglobulin has been successfully used in reducing hospitalizations for viral bronchiolitis, and new perspectives for the treatment of exacerbations triggered by viral infections have emerged from studies directed to synthetic agonists of TLR3 receptor, IFN-β agonist, and IL33- and IL25-antagonists, among others.56 and 57 There is no specific treatment for most respiratory viruses. Some antivirals have been successfully used, as in the case of Flu infection, such as amantadine, rimantadine, oseltamivir phosphate, and zanamivir; the latter is not indicated for patients with asthma. Ribavirin is indicated for the treatment of severe infections caused by RSV.

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