RESUMEN
BACKGROUND: Asthma prevalence in adolescents appears to be increasing and determinants are not well established. OBJECTIVE: To determine the association between sex and active smoking with asthma prevalence in adolescents. PARTICIPANTS AND METHOD: In this cross-sectional study 6,922 students, ages 12 to 18 years, residents in an area of northeastern Mexico, were included. We developed a questionnaire based on The International Study of Asthma and Allergies in Childhood (ISAAC) and on The European Community Respiratory Health Survey (ECRHS). The association between sex and active smoking with asthma prevalence was determined using a logistic regression model. RESULTS: Of the total population, 46.3% were males, 7.3% suffered from asthma and 17.3% were cigarette smokers. We found that sex (OR = 0.55; CI 95%: 0.48-0.63) and active smoking (adjusted OR = 1.12; CI 95%: 0.89-1.42) were not associated with asthma prevalence. Females (OR = 1.44; CI 95%: 1.13-1.84) and active smoking (adjusted OR = 1.38; CI 95%: 1.15-1.67) were associated with prevalence of wheezing in the last 12 months, and with prevalence of dry cough at night (OR = 1.53; CI 95%: 1.34-1.76). CONCLUSIONS: Teenager males and active smoking were not associated with asthma prevalence. Females had an association with wheezing in the last 12 months and dry cough at night.
Asunto(s)
Asma , Fumar , Adolescente , Asma/epidemiología , Estudios Transversales , Humanos , Prevalencia , Ruidos RespiratoriosRESUMEN
Asthma, as chronic inflammatory disease, shows variations in clinical manifestations and the degree of airflow obstruction, so its severity may change over time in the same patient. The Global Initiative for Asthma (GINA) established a practical system of classification, considering clinical and functional aspects as frequency of diurnal and nocturnal respiratory symptoms and lung function, their combination allows for classifying asthma severity as intermittent and persistent ( mild, moderate and severe). Recently, it has been proposed to classify the asthma according to degree of control: controlled, partly controlled and uncontrolled. The parameters used in this system are: frequency of diurnal and nocturnal respiratory symptoms, activity limitation, use of rescue therapy, determining the forced expiratory volume in one second (FEV1) or peak expiratory flow (PEF) and the exacerbations. The patient's participation on the asthma classification has also been considered through the self application of asthma control questionnaire (ACT). Patients with high risk of death are classified in the group of difficult asthma control (ADC), requiring major and minor criteria to define it; the common denominator is the decontrol of the disease, high dose steroids and appropriate treatment previously established. Sort asthma with any of these systems, information about its impact on the patient's life and thus establish the recommended treatment schedule for each patient group.
Asunto(s)
Asma/clasificación , Asma/diagnóstico , Algoritmos , Humanos , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: The prevalence of asthma and obesity has increased last years implying important economical and social consequences. A relationship between asthma severity and obesity grade has been found. Therefore, it is necessary to evaluate if obesity decline has a beneficial impact on asthma severity. OBJECTIVE: To evaluate the effect of obesity decline on control symptoms and asthma severity. PATIENTS AND METHODS: Ninety-six patients with obesity and moderate chronic asthma were randomized to group A or B and were maintained for 40 days on a low calorie diet. At baseline and at the end of the study, symptoms, measurement of obesity, spirometry, inflammatory cytokines and immunoglobulin's levels were assessed. Diets' safety was evaluated based on laboratory test. Data were analyzed with Student's t test. RESULTS: After 40 days on a low calorie diet, in group A, there were significant decreases of obesity (p < 0.001) and IgE, symptoms almost disappeared (cough persisted in 20%) and medication was suspended in 80%. Group B had obesity decline but IgE levels remained (> 100 UI/mL), symptoms and drug regimen remained unchanged. Both diets were not harmful for patients. CONCLUSION: These results show that asthmatic obese patients maintained for 40 days on low calorie diet A, had obesity and IgE levels decrease and symptoms and asthma severity relief.
Asunto(s)
Asma/terapia , Dieta Reductora , Obesidad/dietoterapia , Pérdida de Peso , Adolescente , Adulto , Anciano , Antiasmáticos/uso terapéutico , Asma/complicaciones , Asma/tratamiento farmacológico , Asma/fisiopatología , Citocinas/sangre , Ingestión de Energía , Femenino , Humanos , Inmunoglobulina E/sangre , Inmunoglobulinas/análisis , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/fisiopatología , Estudios Prospectivos , EspirometríaRESUMEN
OBJECTIVE: To determine the effect of allergic rhinitis (AR), asthma, rhinobronchitis (ARB) on dental malocclusion in adolescents. METHOD: This is a cross-sectional, observational, retrospective and sample descriptive study of 2556 adolescents aged 14-20 years. AR, asthma and ARB were defined by self-reported. Malocclusion was identified by direct physical examination. Data were analyzed by the SPSS 10.0 version statistical program, adjusted OR value (Odds Ratio) using a logistic regression model was determined, ji square was calculated, an 95% Confidence Intervals was used. Equal or smaller values of p < 0.05 were considered statistically significant. RESULTS: Percentage of male sex was 42.7% and female 57.3%. Prevalence of AR was 39.3%, asthma 6.9%, ARB 4.5%, and malocclusion, 37.2%. A higher percentage of malocclusion was found in adolescents with asthma (48.3% vs 36.3%). For the groups of asthma (adjusted OR = 1.78; p = 0.017) and RA (fit OR = 1.20, p = 0.032) were inferred that these pathologies to favor the malocclusion in adolescents, this did not happen with the group of RBA (OR fit = 0.81; p = 0.511). The prevalence of open bite was greater in adolescents with asthma (44.3% vs. 31.3%). For the asthma group (OR fit = 1.66; p = 0.037) we deduced that the development of anterior open bite is favored, this was not thus for the groups of RBA (OR fit = 1.01; p = 0.956) and RA (OR fit = 1.17; p = 0.071). Nor AR, asthma orARB have any effect on posterior open bite. CONCLUSIONS: Asthma is related to malocclusion in adolescents, particularly to anterior open bite. AR and ARB do not favor the development of malocclusion.
Asunto(s)
Asma/epidemiología , Bronquitis/epidemiología , Maloclusión/epidemiología , Rinitis Alérgica Perenne/epidemiología , Sinusitis/epidemiología , Adolescente , Comorbilidad , Femenino , Humanos , Masculino , PrevalenciaRESUMEN
Among the allergic disorders we emphasize the inflammatory diseases of the inferior respiratory tract by their incidence, repercussion in daily activities, and by their high cost of medical attention. For their treatment, they require more than one inhaled or systemic drug. Current medicines tend to have adverse or secondary effects, such as: osteoporosis, type 3 diabetes mellitus, tremor or tachycardia. New medicines are being developed with less adverse or secondary effects, and much more selective and specific in the molecules involved in the allergic disease's physiopathology. Among them we find pascolizumab, which inhibits the differentiation made to Th2, as well as the citokines production. Other drugs are: mepolizumab, monoclonal antibody antiCD23, and the selective inhibitor of IgE (AJP13358) Rhu-Mab-E25. Currently, they are being developed some new drugs, such as SB-207499 (SKB) and LAS 31025, which are selective inhibitors of fosfodiesterase. Within the currently studied medicines that offer high specificity to inhibit the synthesis of interleukines we emphasize the presence of humanized monoclonal antibodies antireceptor IL-4. The anti IL-5 (SB-240563) is administered in asthmatic patients to reduce eosinofilia in expectoration. Tosilate of suplatast is a selective IL-4 and IL-5 inhibitor. Ramatroban (BAY or 3405) is an antagonist of the tromboxane A2 receptor, which reduces the inflammatory process of the nasal mucose without hemodynamic effects. Immunotherapy with peptides avoids the response of IgE by the allergen, without mast cell degranulation.
Asunto(s)
Hipersensibilidad Respiratoria/terapia , Anticuerpos Monoclonales/uso terapéutico , Predicción , Humanos , InmunoterapiaRESUMEN
Adverse drug reactions are originated by immunological and non-immunological mechanisms. Estimated incidence is of 6.7%, and the incidence of mortal reactions is of 0.32%. In women, skin reaction incidence is 35% higher than in men, and it is 20 times higher than presenting contrast medium-related reactions. Allergic reaction is classified accordingly to Gell and Coombs criteria. It is unknown the pathogenic mechanism of the drug-induced fever. Predictable reaction depends on the dose and it is frequently related to the drug. Unpredictable reaction depends on the individual and pseudoallergic features of each patient; no immunological mechanism is involved. For diagnosis, lymphocyte transformation test measures the T cell proliferation to an in vitro drug; furthermore, it is the most sensitive. There are just a few options to evaluate and manage those patients. When it is impossible to make the exposition test the alternative is to withdraw the drug and try another treatment option. If there is no other available drug, desensitization must be considered.
Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Relación Dosis-Respuesta a Droga , Hipersensibilidad a las Drogas/diagnóstico , Hipersensibilidad a las Drogas/epidemiología , Hipersensibilidad a las Drogas/inmunología , Hipersensibilidad a las Drogas/fisiopatología , Femenino , Fiebre/inducido químicamente , Humanos , Incidencia , Activación de Linfocitos/efectos de los fármacos , Masculino , Distribución por Sexo , Linfocitos T/efectos de los fármacosRESUMEN
Occupational asthma could be defined as a reversible lung disorder characterized by attacks of breathing difficulty, wheezing, and cough, which are caused by various agents found in the workplace. Incidence varies from 2 to 15% in adult work population; actually there is no data for the child population. Allergic occupational asthma is due to allergic sensitization to a specific substance or material present at the workplace; non-allergic occupational asthma occurs because of the high exposure to an irritant also at the workplace. Over the past few years, more people have been diagnosed as having asthma because of some workplace exposure. The identification of occupational asthma in workers is important because early detection may lead to the control of the worker's symptoms and control of the chemicals in the workplace. In Latin America there is no data about occupational asthma, maybe for the scarce information about it or for its difficult diagnosis.
Asunto(s)
Asma/inmunología , Enfermedades Profesionales/inmunología , Asma/diagnóstico , Asma/fisiopatología , Humanos , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/fisiopatología , SíndromeRESUMEN
BACKGROUND: Urticaria and angioedema are illnesses of easy diagnosis, but to solve them or to determine their cause is complex, as well as the therapeutic management of chronic cases. OBJECTIVE: To determine the prevalence, possible precipitating factors and chronic urticaria characteristics. MATERIAL AND METHODS: A questionnaire was applied to 4,000 persons selected at random, from the ages of 18-50 years, women and men. We made up simple frequencies, odds ratio, confidence interval at 95%. Possible interventions from the some variables were determined through regression logistic model. RESULTS: Chronic urticaria and angioedema prevalence was 4.8%. From the 147 sick persons, 71.4% were women (p = 0.00) 51.70% had only wheals, 10.88% angioedema alone and 37.41% of the patients with chronic urticaria also have angioedema. Potential triggering factors that we found were 18.36% drugs (p = 0.00) and 4.08% foods (p = 0.00). Family (p = 0.00) and personal allergy (p = 0.00) antecedents were documented in 55.8% and 68.70%, respectively. In 40.1% symptoms interfere with daily activities of the patients and 53.1% of patients had symptoms at night. CONCLUSIONS: Despite of being a retrospective study, the results show us that the chronic urticaria and angioedema are important health problems in the northeastern of Mexico. We can not identify the etiology, and the symptoms can disturb quality of life of the patients. Female sex, family and personal allergy antecedent could be important for these pathology presentations.
Asunto(s)
Angioedema/epidemiología , Urticaria/epidemiología , Adolescente , Adulto , Angioedema/tratamiento farmacológico , Angioedema/etiología , Antialérgicos/uso terapéutico , Enfermedad Crónica , Comorbilidad , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Hipersensibilidad Respiratoria/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Muestreo , Fumar/epidemiología , Encuestas y Cuestionarios , Población Urbana , Urticaria/tratamiento farmacológico , Urticaria/etiologíaRESUMEN
Se comunica un caso clínico de angioedema heredofamiliar de Osler, que presentó edema de cara, cuello, manos y pies, dificultad respiratoria, náuseas, vómito, diarrea y dolor abdominal cólico, desde los siete años de edad.