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INTRODUCTION: The increase in the number of people with upper limb spasticity as a sequela of cerebrovascular disease, which negatively impacts their autonomy, functional independence and participation, and affects their quality of life, calls for the application of precise and objective instruments for its measurement and evaluation. OBJECTIVE: To assess the validity and reliability of the Tardieu scale in the evaluation of upper extremity spasticity in adults with cerebrovascular disease. MATERIALS AND METHODS: The search strategy was implemented in eight databases; the systematic review protocol was registered beforehand in INPLASY (with registration no. 2023110076). The evidence was synthesised in three phases: a tabular presentation of results, an evaluation of the quality of the articles, and a narrative synthesis of the findings. RESULTS: Only three of the 33 articles identified fulfilled the variables that enable the validity and reliability of the Tardieu scale to be established. The measurements of angles and velocities R1, R2 and R2-R1 were analysed. Student's t-test to assess the reliability between the measurements of R1 and R2; and angles R2 and R2-R1 showed statistical significance, which confirmed the reliability of the scale. CONCLUSIONS: The Tardieu scale proved robust. It is important to note that the sample size, the time of evolution of the disease and the age of the patients may influence the results of the scale.
TITLE: Validez y fiabilidad de la escala de Tardieu para evaluar la espasticidad en miembro superior en adultos con enfermedad cerebrovascular. Revisión sistemática.Introducción. El incremento en el número de personas con espasticidad en los miembros superiores como secuela de una enfermedad cerebrovascular, que impacta negativamente en la autonomía, la independencia funcional y la participación, y afecta a la calidad de vida de las personas, demanda la aplicación de herramientas clínicas precisas y objetivas para su medición y evaluación. Objetivo. Evaluar la validez y la fiabilidad de la escala de Tardieu en la evaluación de la espasticidad en las extremidades superiores de adultos con enfermedad cerebrovascular. Materiales y métodos. La estrategia de búsqueda se implementó en ocho bases de datos; el protocolo de revisión sistemática se registró previamente en INPLASY (registro n.o 2023110076). La síntesis de la evidencia se llevó a cabo en tres fases: presentación tabular de resultados, evaluación de la calidad de los artículos y síntesis narrativa de los hallazgos. Resultados. De los 33 artículos identificados, sólo tres cumplieron con las variables que permiten establecer la validez y la fiabilidad de la escala de Tardieu. Se analizaron las medidas de los ángulos y velocidades R1, R2 y R2-R1. La prueba de la t de Student para evaluar la fiabilidad entre las medidas de R1 y R2; los ángulos R2 y R2-R1 mostraron significancia estadística, lo que confirmó la confiabilidad de la escala. Conclusiones. La escala de Tardieu demostró robustez. Es importante considerar que el tamaño de la muestra, el tiempo de evolución de la enfermedad y la edad de los pacientes pueden influir en los resultados de la escala.
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Transtornos Cerebrovasculares , Espasticidade Muscular , Extremidade Superior , Humanos , Espasticidade Muscular/etiologia , Espasticidade Muscular/diagnóstico , Espasticidade Muscular/fisiopatologia , Reprodutibilidade dos Testes , Transtornos Cerebrovasculares/complicações , Extremidade Superior/fisiopatologia , AdultoRESUMO
Traumatic brain injury (TBI) represents a significant public health concern and has been associated with high rates of morbidity and mortality. TBI generates two types of brain damage: primary and secondary. Secondary damage originates a series of pathophysiological processes, which include metabolic crisis, excitotoxicity, and neuroinflammation, which have deleterious consequences for neuronal function. However, neuroprotective mechanisms are also activated. The balance among these tissue responses, and its variations throughout the day determines the fate of the damage tissue. We have demonstrated less behavioral and morphological damage when a rat model of TBI was induced during the light hours of the day. Moreover, here we show that rats subjected to TBI in the dark lost less body weight than those subjected to TBI in the light, despite no change in food intake. Besides, the rats subjected to TBI in the dark had better performance in the beam walking test and presented less histological damage in the corpus callosum and the cingulum bundle, as shown by the Klüver-Barrera staining. Our results suggest that the time of day when the injury occurs is important. Thus, this data should be used to evaluate the pathophysiological processes of TBI events and develop better therapies.
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BACKGROUND: The purpose of this study was to compare jaw and cervical vertebrae bone density in computed tomography (CT) analyses of oncological patients undergoing antiresorptive medication with control patients, aiming to find information that may assist the radiologist and clinician in predicting risks and monitoring osteonecrosis in the jaw. MATERIAL AND METHODS: Thirty-one patients treated with zoledronic acid and 37 control were included in the study. Two areas in regions of interest were chosen and standardized, one in the lower portion of the mandible and another in the axial cervical vertebra (C2) of patients undergoing antiresorptive drug treatment (experimental group) and the control group. Density analysis was performed using Hounsfield scale grayscale values obtained from multislice CT exams. Interclass correlation coefficient test (ICC) was performed to assess reproducibility and repeatability. The test of normality of the samples was demonstrated using the Shapiro-Wilk test and the comparison performed using Mann-Whitney U non-parametric test. RESULTS: When compared to patients in the control group, patients undergoing antiresorptive medication depicted an increase in bone density in both jaw bone (p=0.021) and cervical vertebrae (p=0.002). The same pattern could be observed in patients who used the medication on a monthly basis for analysis of jaw bone (p=0.021), the cervical vertebrae (p=0.002), and the cervical vertebrae of the patients who used the medication on a quarterly basis (p=0.003). CONCLUSIONS: CT can be a potentially useful method for detecting alterations associated with antiresorptive therapy, serving as a possible tool in the prediction of the disease progression.
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Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Humanos , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Densidade Óssea , Reprodutibilidade dos Testes , Conservadores da Densidade Óssea/uso terapêutico , Tomografia Computadorizada por Raios X/métodos , Difosfonatos/uso terapêuticoRESUMO
OBJECTIVE: This study evaluated the effectiveness of class II restorations, in permanent teeth, through the ART technique in comparison to composite resin. MATERIALS AND METHODS: Participants (154), aged 8 to 19 years, with good general health, with class II cavities in permanent teeth, and without pulp involvement and tooth pain were included in this parallel and randomized clinical trial. The Ethics Committee approval number was CAAE: 24012913.0.1001.5417. Seventy-seven restorations were made with each restorative material (Equia Fil-GC Corporation and Z350-3M). Evaluations occurred at 6 and 12 months by the criteria of ART and the USPHS modified. Data were analyzed by Mann-Whitney, chi-square, Fisher's exact, chi-square tests with linear trend and logistic regression by enter method (p < 0.050). The Kaplan-Meier test evaluated the survival rates of the restorations. The log-rank test compared the survival curves. RESULTS: Regardless of the evaluation criteria used, the success rates of ART restorations were 98.7% (6 months) and 95.8% (12 months) and for composite resins were 100% (6 months) and 98.7% (12 months), with no statistical difference of restoration groups (p > 0.050). Survival rates for restorations, regardless of the evaluation criteria used, are the same as the success rates, with the exception of ART restorations at 12 months of follow-up (94.8%). CONCLUSION: No differences in the success rates of class II restorations of ART compared to resin composite, in permanent teeth, were observed after 12 months. CLINIC SIGNIFICANT: HVGIC can safely be used to restore proximal cavities in permanent teeth up to 12 months.
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Resinas Compostas , Tratamento Dentário Restaurador sem Trauma , Cárie Dentária , Restauração Dentária Permanente , Adolescente , Criança , Falha de Restauração Dentária , Dentição Permanente , Feminino , Cimentos de Ionômeros de Vidro , Humanos , Masculino , Adulto JovemRESUMO
ABSTRACT In the last decade, the risk benefits ratio of MHT has been evaluated mainly in terms of cardiovascular risk. Present Consensus Statement is largely inspired by the Global Consensus on Menopausal Hormone Therapy in 2013 and 2016 by leading global menopause societies (The American Society for Reproductive Medicine, The Asia Pacific Menopause Federation, The Endocrine Society, The European Menopause and Andropause Society, The International Menopause Society, The International Osteoporosis Foundation and The North American Menopause Society). The aim of these Recommendations is to provide a simple and updated reference on postmenopausal MHT. The term MHT typically includes estrogen replacement therapy (ERT) and estrogen-progestogen therapy (EPT). EPT can be sequential (Seq) when progestogen is added to ERT for 10-14 days a month, or continuous combined (CC) when progestogen is administered continuously every day along with a fixed amount of estrogen. MHT also includes Tibolone and the Tissue Selective Estrogen Complex (TSEC).
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Humanos , Feminino , Sociedades Médicas/tendências , Menopausa , Terapia de Reposição de Estrogênios , Terapia de Reposição de Estrogênios/efeitos adversos , Fatores de Risco , Estrogênios/administração & dosagemRESUMO
Our aim is to illustrate how the thermodynamics-based concept of entropy has spread across different areas of knowledge by analyzing the distribution of papers, citations and the use of words related to entropy in the predefined Scopus categories. To achieve this, we analyze the Scopus papers database related to entropy research during the last 20 years, collecting 750 K research papers which directly contain or mention the word entropy. First, some well-recognized works which introduced novel entropy-related definitions are monitored. Then we compare the hierarchical structure which emerges for the different cases of association, which can be in terms of citations among papers, classification of papers in categories or key words in abstracts and titles. Our study allowed us to evaluate, to some extent, the utility and versatility of concepts such as entropy to permeate in different areas of science. Furthermore, the use of specific terms (key words) in titles and abstracts provided a useful way to account for the interaction between areas in the category research space.
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OBJETIVO: Describir los efectos de la restricción moderada del sueño en las regiones cerebrales involucradas en los procesos de inhibición cognitiva, función motora y fluidez fonológica, utilizando imágenes por resonancia magnética funcional (RMf). Materiales y métodos: Se estableció una condición de sueño habitual y otra de restricción moderada en 12 estudiantes diestros de pre y posgrado de Medicina, de entre 20 y 40 años. En ambos estados se utilizó la prueba psicológica de atención d2 e imágenes de RMf con paradigmas de función motora, fluencia fonológica y atención del tipo inhibición de la función ejecutiva Stroop. La restricción moderada de sueño fue de al menos el 63% con respecto al sueño habitual. Resultados: Se encontraron diferencias significativas en la activación cerebral con RMf para la función motora (p<0,05) entre el ciclo de sueño regular y el de restricción moderada. La actividad cerebral en RMf con los paradigmas de atención Stroop y fluidez fonológica no mostró diferencias significativas, así como tampoco la prueba psicológica de atención d2. Discusión: Se encontró interferencia en las activaciones cerebrales de representación motora con la restricción moderada de sueño, pero no se hallaron diferencias significativas en las activaciones de atención tipo Stroop, ni en la tarea de fluencia fonológica o las pruebas de atención d2. Esto podría deberse a una insuficiente restricción del sueño o a eficientes mecanismos de compensación en los sujetos de este estudio. Conclusión: Existen diferencias en las activaciones cerebrales de representación motora en la restricción moderada del sueño medidas con RMf
OBJECTIVE: To describe the effects of moderate sleep deprivation in brain regions involved in cognitive inhibition processes, motor function, and phonological fluency using functional Magnetic Resonance Imaging (fMRI). Materials and methods: A sample of 12 under-graduate and post-graduate medical students, between 20 and 40 years, were subjected to a follow-up of the number of hours of regular sleep in order compare to a moderate sleep deprivation after a nightshift. The d2 attention test and fMRI studies were used in both groups in order to evaluate motor function, verbal fluency and cognitive inhibition, or Stroop paradigms. The moderate sleep deprivation was at least 63% with respect to the regular sleep pattern during the previous week. Results: Significant differences in brain activity were found in fMRI to measure motor function (P<0.05) comparing regular sleep cycle and moderate sleep deprivation. The brain activity with fMRI Stroop paradigms and phonological fluency showed no significant differences between the two conditions, likewise with the psychological attention test d2. Discussion: The fMRI showed interference on motor representation activations in moderate sleep deprivation. No significant differences in fMRI were found in the processes of cognitive inhibition or Stroop paradigms, in phonological fluency, or in the psychological attention test d2. These could be attributed to inadequate sleep deprivation or efficient compensation mechanisms in the subjects of this study. Conclusión: There is a difference showed in fMRI on motor representation activations in moderate sleep deprivation
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Humanos , Masculino , Feminino , Adulto , Transtornos do Sono do Ritmo Circadiano , Sono , Privação do Sono , Imageamento por Ressonância Magnética , PolissonografiaRESUMO
INTRODUCTION: Smoking and depression have a long-history documented of comorbidity. OBJECTIVE: The objective of this study was to develop and test a treatment that could simultaneously achieve smoking abstinence and decrease depressive symptoms in a group of heavy smokers with minimal/mild depressive symptomatology. METHOD: Sixty smokers were randomly assigned to three different treatment settings. Treatment included a pre-abstinence phase, a psychological treatment phase, a pharmacotherapy phase and a follow-up stage. Smokers began the psychological treatment and the pharmacotherapy two weeks before the day they chosen to quit smoking, and monitoring was conducted over a year. Abstinence was confirmed by assessing the levels of urinary cotinine. RESULTS: Using a linear mixed model with individual random effect, baseline data was compared with subsequent assessments; 46% of the patients achieved abstinence. For men, the three treatment settings significantly reduced depressive symptoms and helped smokers to achieve abstinence. For women, only the nicotine patch showed to be effective in the reducing depressive symptoms. DISCUSSION AND CONCLUSION: Integral pre-abstinence treatment is effective in aiding smokers to achieve smoking abstinence and improve depressive symptoms.
INTRODUCCIÓN: El fumar y la depresión tienen una larga y documentada historia de comorbilidad. OBJETIVO: El objetivo de este estudio fue desarrollar y probar un tratamiento que lograra, simultáneamente, la abstinencia del consumo de tabaco y los síntomas depresivos en un grupo de fumadores graves con sintomatología depresiva mínima/leve. MÉTODO: Sesenta fumadores fueron asignados al azar a tres diferentes situaciones de tratamiento. El tratamiento incluyó una fase de preabstinencia, una fase de tratamiento psicológico, una fase de farmacoterapia y una fase de seguimiento. Los fumadores comenzaron el tratamiento psicológico y farmacológico dos semanas antes de iniciar la abstinencia y el seguimiento se realizó durante un año. La abstinencia se confirmó evaluando los niveles de cotinina en orina. RESULTADOS: Por medio de un modelo lineal mixto con efecto aleatorio individual, los datos de la línea base se compararon con las evaluaciones subsequentes; el 46% de los pacientes lograron la abstinencia. Para los hombres, las tres situaciones de tratamiento redujeron significativamente sus síntomas de depresión y les ayudaron a lograr la abstinencia, mientras que en las mujeres sólo el parche de nicotina mostró ser efectivo para reducir de los síntomas depresivos. DISCUSIÓN Y CONCLUSIÓN: El tratamiento integral de preabstinencia es efectivo para ayudar a los fumadores a lograr la abstinencia y mejorar los síntomas depresivos.
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OBJECTIVE: To compare and quantify the retinal vascular changes induced by non-intentional pressure contact by digital handheld camera during retinopathy of prematurity (ROP) imaging by means of a computer-based image analysis system, Retinal Image multiScale Analysis. METHODS: A set of 10 wide-angle retinal pairs of photographs per patient, who underwent routine ROP examinations, was measured. Vascular trees were matched between 'compression artifact' (absence of the vascular column at the optic nerve) and 'not compression artifact' conditions. Parameters were analyzed using a two-level linear model for each individual parameter for arterioles and venules separately: integrated curvature (IC), diameter (d), and tortuosity index (TI). RESULTS: Images affected with compression artifact showed significant vascular d (P<0.01) changes in both arteries and veins, as well as in artery IC (P<0.05). Vascular TI remained unchanged in both groups. CONCLUSIONS: Non-adverted corneal pressure with the RetCam lens could compress and decrease intra-arterial diameter or even collapse retinal vessels. Careful attention to technique is essential to avoid absence of the arterial blood column at the optic nerve head that is indicative of increased pressure during imaging.
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Competência Clínica , Diagnóstico por Computador/efeitos adversos , Processamento de Imagem Assistida por Computador , Disco Óptico/patologia , Artéria Retiniana/patologia , Retinopatia da Prematuridade/patologia , Competência Clínica/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Disco Óptico/fisiopatologia , Fotografação , Artéria Retiniana/fisiopatologia , Retinopatia da Prematuridade/diagnóstico , Retinopatia da Prematuridade/fisiopatologia , TelemedicinaRESUMO
The efficiency of four different and representative models of heat engines under maximum conditions for a figure of merit representing a compromise between useful energy and lost energy (the Ω criterion) is investigated and compared with previous results for the same models where the efficiency is considered at maximum power conditions. It is shown that the maximum Ω regime is more efficient and, additionally, that the resulting efficiencies present a similar behavior. For each performance regime we obtain explicit equations accounting for lower and upper bounds. The optimization of refrigeration devices is far from being as clear as heat engines, and some remarks on it are finally considered.
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Optical brighteners have attracted interest as adjuvant's in baculovirus-based biological insecticides due to their ability enhance the insecticidal properties of these viruses and protect virus particles from the degrading effects of ultraviolet (UV) radiation. The effects of two types of optical brighteners, Tinopal CBS (a distyryl-biphenyl derivative) and Tinopal C1101 (an ethenediyl benzenesulfonic derivative) at 1 or 3% (wt./vol.), on growth of different crOPs [maize, Zea mays L. (var. HY-311), sorghum, Sorghum vulgare Pers. (var. Silo), tomato, Lycopersicum esculentum L. (var. Floradade IT), or pepper, Capsicum annum L. (var. Cal Won 300)] were examined after once a week application during four weeks. Both compounds significantly affected the growth of maize plants, whereas sorghum plants were affected only at the highest concentration of Tinopal C1101. Neither brightener had negative effects on tomato or peppers plants. Both compounds increased the percentage of reflectance of maize and tomato leaves when analyzed using laboratory and field spectrophotometers. A greenhouse experiment involving single application of 1 and 3% Tinopal C1101 indicated that the stomatal conductance and photosynthetic rate of maize and tomato plants were not significantly affected. We conclude that the effects of optical brighteners on plant growth are more likely to be influenced by differences between plant species than differences between brightener compounds.
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Adjuvantes Farmacêuticos/farmacologia , Agricultura/métodos , Produtos Agrícolas/efeitos dos fármacos , Controle Biológico de Vetores/métodos , Praguicidas/química , Praguicidas/farmacologia , Adjuvantes Farmacêuticos/química , Benzenossulfonatos , Relação Dose-Resposta a Droga , Fotossíntese/efeitos dos fármacos , Estômatos de Plantas/efeitos dos fármacosRESUMO
The performance of an anaerobic mesophilic packed bed reactor, with a mixture of GAC and tezontle, followed by an aerobic suspended growth system was studied for the treatment of organic chemical wastewater with a high COD concentration (22-29 g/L). The testing of the anaerobic-aerobic system was conducted in an experimental set-up for almost 2.5 years. Different operational conditions were evaluated. The anaerobic reactor showed performance stability and COD removals higher than 80% were obtained with loads up to 16.6 kg x m(-3) x d(-1). The acclimation of the aerobic biomass to the substrate in the anaerobic effluent was very quick and COD removals higher than 94% were obtained even at high organic loads. The combined anaerobic-aerobic system allowed total COD removals higher than 99.5% and the accomplishment of the discharge requirements of 200 mgCOD/L when the anaerobic reactor was operated with loads of 8-11 kg x m(-3)x d(-1) and the aerobic reactor with 0.33 kg x kg(-1) x d(-1), being the total HRT of 4.4. The average TKN removal in the anaerobic-aerobic system was 97%, the average for the anaerobic reactor being 52% and that one for the aerobic system being 94%.
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Reatores Biológicos , Compostos Orgânicos/isolamento & purificação , Poluentes Químicos da Água/isolamento & purificação , Purificação da Água/métodos , Aerobiose , Anaerobiose , Biofilmes , Filtração , Nitrogênio/isolamento & purificação , OxigênioRESUMO
The studied organic chemical wastewater had a high COD, 20-45g/L, and low TSS, less than 200 mg/L, making anaerobic bio-filtration a suitable treatment method. The organic matter consisted of alcohols, amines, ketones and aromatic compounds, such as toluene and phenol. Granulated activated carbon (GAC) and a porous stone called tezontle, widely available in Mexico, were used as a bio-film support. Once inoculated, the mesophilic reactors with granulated activated carbon (GAC-BFs) reached stability with 80% COD removal in 40 days, while the reactors with tezontle material (tezontle-BF) required 145 days. Biodegradation of more than 95% was obtained with both support media: at organic loads less than 1.7 kg m(-3) d (-1) in tezontle-BF and with loads of up to 13.3 kg m(-3) d(-1) in GAC-BFs. The bio-filters with GAC allowed COD removal efficiency of 80% at a load as high as 26.3 kg m (-3) d(-1), while the same efficiency with tezontle was obtained at loads up to 4.45 kgm (-3d) (-1). The use of GAC as support material allows greater biodegradation rates than tezontle and it makes the bio-filters more resistant to organic increases, inhibition effects and toxicity. Methanogenic activity was inhibited at loads higher than 1.7 kg m(-3) d(-1) in bio-filters with tezontle and 22.8 kg m(-3) d(-1 ) in bio-filters with GAC. At loads lower than the previously mentioned, high methane production yield was obtained, 0.32-0.35 m(3) CH4/kg COD removed. The biomass growth rates were low in the bio-filters with both kinds of material; however, a sufficiently high biomass holdup was obtained.
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Reatores Biológicos , Resíduos Industriais , Poluentes Químicos da Água/metabolismo , Anaerobiose , Biodegradação Ambiental , Carbono/química , Carbono/metabolismo , México , Poluentes Químicos da Água/químicaRESUMO
A clinical, descriptive, and transversal study was conducted in a group of patients with chronic anovulation and sterility, to correlate insulin resistance, determined by the fasting glucose/insulin ratio, with body fat composition using anthropometrics parameters and the interaction of light near infrared region method, we studied 41 young patients with chronic anovulation and sterility. Based on their body mass index, all patients had obesity or overweight. Similarly, most of them presented with a percentage of body fat over the recommended limits. Forty percent of all studied patients had a fasting glucose/insulin ratio below 4.5, which corresponds to insulin resistance. The correlation between the percentage of body fat and fasting glucose/insulin ratio was significant, as was the correlation between body mass index and the percentage of body fat. We found overweight or obesity in the majority of our patients, and insulin resistance in almost half of them. Such disturbances were positively associated with the percentage of body fat and android distribution. Therefore, we recommend a routinely anthropometrics evaluation in these patients as well as fasting glucose/insulin ratio determination in order to act in an early stage over the natural history of metabolic syndrome, whose common denominator is insulin resistance.
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Tecido Adiposo , Anovulação/metabolismo , Glicemia/análise , Composição Corporal , Infertilidade Feminina/metabolismo , Insulina/sangue , Adulto , Doença Crônica , Estudos Transversais , Feminino , HumanosRESUMO
Apoptosis, or programmed cell-dead is one of the main mechanisms in the process of tissular loss. This is an active process of cellular depletion that participates in a direct manner in tissular homeostasis during the life span. This apoptotic process is a key event on the pathology of tumors development. The nature of apoptosis is genetic, but it is triggered by external factors. The caspases are been mentioned as responsible of the specific cellular lost, which is the final outcome. The equilibrium between proliferation and cellular death is determined by a balance of survival factors and death promoters such as genic regulators, hormones, cytokines and growth factors among others. In the ovary, apoptosis regulates follicular proliferation and differentiation. During embryogenesis the magnitude of the population of oogonias is mediated by apoptosis. During the ovarian cycle, apoptosis participates also in the follicular atresia process. It is probable that apoptosis is participating also directly in the accelerated follicular atresia. This mechanism has been hypothesized to be involved in the pathophysiology of premature ovarian failure. The role of apoptosis is some reproductive pathological events such as chronic anovulation, low ovarian reserve and early ovarian dysfunction is still not known. The knowledge of the role of apoptosis in such pathological conditions will contribute to the understanding of the ovarian physiology and will permit to intervene early during the natural history of the disease.
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Apoptose , Ovário/fisiologia , Feminino , HumanosRESUMO
We examined the association of breastfeeding and the presence of chronic respiratory symptoms among 5,182 Brazilian schoolchildren 7-14 years of age who were participants in the International Study on Asthma and Allergies in Childhood (ISAAC). The prevalence of medically diagnosed asthma and current wheeze were respectively 4.6% (95% confidence interval [CI] 4.0%-5.2%) and 11.9% (95% CI 11.0%-12.8%). Ninety percent of the mothers in our study population had breastfed their child. After adjusting for potential confounding factors, we found that children who had not been breastfed were more likely to have a medical diagnosis of asthma (odds ration [OR] = 1 .51, 95% CI 1.00-2.51), experience current wheeze (OR = 1.29, 95% CI 0.96-1.74), and wheeze after exercise (OR = 1.51, 95% CI 1.01-2.27) than children who had been breastfed for more than 6 months. This effect was only present among children with no family history of asthma (OR = 1.54, 95% CI 0.90-2.42 for medical diagnosis of asthma; OR = 1.27, 95% CI 0.93-1.75 for current wheezing; and OR = 1.74, 95% CI 1.12-2.6 for wheeze after exercise). We conclude that the low prevalence of asthma and wheeze observed in our population may be partly related to the high level of breastfeeding.