RESUMEN
STUDY OBJECTIVE: To examine in children the relationship of wheezing to measurable environmental factors. STUDY DESIGN: Multiple regression analysis was used to measure correlation with air quality, weather, and seasonal and infection-related variables. RESULTS: Daily wheezing census was significantly correlated with weather and seasonal variables and the daily infection census. We are not certain which weather variable is the dominant factor in the weather association because all of the weather variables have some degree of colinearity. Air quality as measured by carbon monoxide and airborne particles was not shown to be associated with wheezing. CONCLUSION: A high incidence of pediatric emergency department presentations for wheezing are associated with weather, infections, and months of the year.
Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Ambiente , Ruidos Respiratorios/etiología , Adolescente , Contaminantes Atmosféricos/análisis , Monóxido de Carbono , Niño , Preescolar , Hawaii , Humanos , Humedad , Lactante , Infecciones del Sistema Respiratorio/complicaciones , Dióxido de Azufre , Temperatura , Tiempo (Meteorología)RESUMEN
Although thrombotic thrombocytopenic purpura (TTP) has been described in patients with systemic lupus erythematosus (SLE), the relationship between these 2 diseases is controversial. We recently treated a patient with longstanding SLE who developed TTP. The patient responded to therapy with aggressive plasmapheresis. Review of the literature revealed that TTP may occur in the setting of either active or inactive SLE. Survival in SLE associated TTP correlated with the use of plasma therapy (plasma infusion or plasmapheresis) rather than with the activity of the underlying autoimmune disease. We conclude that TTP and SLE represent distinct clinical entities that may occur together in an immunologically predisposed host. The use of plasma therapy appears to have had a significant impact on survival in these patients.