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1.
Pediatr Pulmonol ; 58(1): 297-305, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36263459

RESUMO

OBJECTIVE: Sufficient vitamin D (25-hydroxyvitamin D [25(OH)D]) serum levels are associated with decreased asthma symptoms. Our aim was to investigate associations between vitamin D and atopy, asthma, asthma severity, and asthma phenotypes in Brazilian teenagers. METHODS: This cross-sectional study involved 942 individuals (11-19 years old) engaged in an asthma cohort. The ISAAC questionnaire was employed to diagnosis asthma and asthma severity. Serum allergen-specific immunoglobulin E (sIgE) was measured by ImmunoCap and serum 25(OH)D was measured by ELISA. We calculated the correlation between sIgE and 25(OH)D. We used multivariate logistic regression analysis to assess associations of interest. RESULTS: We found that 25(OH)D deficiency was positively associated with atopy (OR 1.45, confidence interval [CI] 1.05-2.00) and high levels of this vitamin negatively correlated with sIgE to Dermatophagoides pteronyssinus (r = -0.11, p = 0.019). The average 25(OH)D serum level was 27.0 ± 9.5 ng/ml; 366 individuals (38.8%) had a sufficient level. There was no association between 25(OH)D and asthma, asthma severity or asthma phenotypes in the population. However, sex was a possible effect modifier of the association between vitamin D and asthma: insufficiency in asthmatic women (86%) was higher than in asthmatic men (42%), and there was an association between insufficient vitamin D levels and greater asthma risk only in women (OR = 3.06, 95% CI 1.16-8.07). CONCLUSION: We have shown that vitamin D deficiency was associated with greater risk of atopy in both sexes and vitamin D insufficiency was associated with asthma only in women. There was no association between vitamin D levels and asthma phenotypes or asthma severity.


Assuntos
Asma , Hipersensibilidade Imediata , Deficiência de Vitamina D , Masculino , Feminino , Humanos , Estudos Transversais , Brasil/epidemiologia , Vitamina D , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia , Calcifediol , Hipersensibilidade Imediata/complicações , Hipersensibilidade Imediata/epidemiologia , Asma/complicações , Imunoglobulina E , Vitaminas
2.
Rev Alerg Mex ; 68(1): 26-34, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34148326

RESUMO

BACKGROUND: The impact of obesity on the severity of asthma continues to be a cause of controversy. OBJECTIVE: To compare the severity of asthma and asthma control in obese patients with non-obese patients. METHODS: A cross-sectional study which included 188 patients with asthma, of ≥ 18 years of age, who were selected consecutively. The patients were categorized and compared based on the presence or absence of obesity. In order to establish an association between variables, logistic regression analyses were performed. RESULTS: In total, 111/188 of the patients had obesity; these patients were older than those without obesity (35.9 ± 15.3 years vs. 44.4 ± 13.8 years, p <0.001). No significant difference was observed in the groups regarding sex, total IgE serum concentration, peripheral blood eosinophil count, personal history of atopic diseases, frequency of allergic sensitization, hospitalization for asthma, and asthma control. Overall, obesity was significantly associated with moderate-severe asthma (OR = 1.82, p = 0.047), but not with asthma control (p = 0.094). CONCLUSIONS: Our results suggest that patients with asthma and obesity are older and that their pulmonary function is worse, which is reflected in a greater level of severity of asthma.


Antecedentes: El impacto de la obesidad sobre la gravedad del asma contiúa siendo motivo de controversia. Objetivo: Comparar la gravedad y el control del asma entre pacientes con obesidad y sin obesidad. Métodos: Estudio transversal que incluyó a 188 pacientes con asma, con edad ≥ 18 años, seleccionados consecutivamente. Los pacientes fueron categorizados y comparados de acuerdo con la presencia de obesidad o no. Para establecer asociación entre variables se realizó análisis de regresión logística. Resultados: En total, 111 pacientes tenían obesidad; su edad fue mayor que la de los pacientes sin obesidad (35.9 ± 15.3 años versus 44.4 ± 13.8 años, p < 0.001). No se observó diferencia significativa entre los grupos respecto a sexo, concentración sérica total de IgE, número de eosinófilos en sangre periférica, historia personal de enfermedad atópica, frecuencia de sensibilización alérgica, hospitalización por asma y control del asma. En general, la obesidad se asoció significativamente con el asma moderada o grave (RM = 1.82, p = 0.047), pero no lo hizo con el control del asma (p = 0.094). Conclusiones: Nuestros resultados sugieren que los pacientes con asma y obesidad tienen mayor edad y peor función pulmonar, la cual se reflejada en mayor gravedad del asma.


Assuntos
Asma , Adulto , Asma/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Humanos , Pulmão , Obesidade/complicações , Obesidade/epidemiologia
3.
Neumol. pediátr. (En línea) ; 14(4): 205-209, dic. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1087949

RESUMO

The main source of Vitamin D is the bioconversion of 7-dehydrocholesterol to cholecalciferol, however, the level of sun exposition has been drastically reduced during the last decades, so it is not unusual to find a high deficit of Vitamin D in the population. There is evidence to suggest that the deficit of Vitamin D is associated with a worse evolution of asthma and a greater risk of serious exacerbations. Possibly prenatal Vitamin D supplementation to pregnant mothers reduces the risk of wheezing and asthma in the offspring, and supplementation to asthmatic children could improve the evolution of the disease.


La principal fuente de Vitamina D es la bioconversión del 7-dehidrocolesterol a colecalciferol, sin embargo, el nivel de exposición solar se ha reducido drásticamente durante las últimas décadas, por lo que no es extraño encontrar un déficit elevado de Vitamina D en la población. Existe evidencia que sugiere que el déficit de Vitamina D se asocia a peor evolución del asma y mayor riesgo de exacerbaciones graves. Posiblemente la suplementación prenatal de Vitamina D a madres embarazadas reduzca el riesgo de sibilancias y asma en los hijos que nacerán, y la suplementación a niños asmáticos podría mejorar la evolución de la enfermedad.


Assuntos
Humanos , Criança , Asma/terapia , Vitamina D/administração & dosagem , Asma/etiologia , Asma/prevenção & controle , Deficiência de Vitamina D/complicações , Suplementos Nutricionais
4.
Rev. cuba. med ; 58(4): e508, oct.-dic. 2019. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1139030

RESUMO

Introducción: Los síntomas nocturnos son frecuentes en asmáticos y pueden relacionarse con la gravedad, el grado de control del asma y la función pulmonar. Objetivos: Determinar las características demográficas, clínicas y espirométricas de pacientes asmáticos con síntomas nocturnos, que acuden a consulta externa de neumología. Métodos: Se realizó un estudio descriptivo transversal en 50 pacientes asmáticos con síntomas nocturnos, atendidos por consulta externa en el Hospital Neumológico Benéfico Jurídico, en el período comprendido de mayo de 2017 a mayo de 2018. Resultados: Predominó el sexo femenino (74,0 por ciento), la edad entre 40 y 59 años (52,0 por ciento), los antecedentes familiares de asma o alergia (60,0 por ciento) y múltiples comorbilidades asociadas (78,0 por ciento). La hipersomnia diurna estuvo presente en 80,0 por ciento de los casos, con una frecuencia significativamente elevada en pacientes con asma persistente moderada y severa, disminución de la reversibilidad aguda al broncodilatador, mal control de la enfermedad y limitación de la actividad física. Conclusiones: Los síntomas nocturnos en los pacientes asmáticos son frecuentes y se relacionan con la hipersomnia diurna, la gravedad del asma, el grado de control, la respuesta al broncodilatador y limitación de la actividad física(AU)


Introduction: Nighttime symptoms are frequent in asthmatics and can be related to severity, degree of asthma control and lung function. Objectives: To determine the demographic, clinical and spirometric characteristics of asthmatic patients with nocturnal symptoms, who go to an outpatient pulmonology clinic. Methods: A descriptive cross-sectional study was conducted in 50 asthmatic patients with nocturnal symptoms, they were assisted in the outpatient consultation at the Hospital Neumológico Benéfico Jurídico, from May 2017 to May 2018. Results: Female sex (74.0 percent), age ranging 40 and 59 years (52.0 percent), family history of asthma or allergy (60.0 percent) and multiple associated comorbidities (78.0 percent) predominated. Daytime hypersomnia was present in 80.0 percent of cases, with significantly elevated frequency in patients with moderate and severe persistent asthma, decreased acute reversibility to the bronchodilator, poor disease control, and limited physical activity. Conclusions: Nocturnal symptoms in asthmatic patients are frequent and are related to daytime hypersomnia, asthma severity, degree of control, response to the bronchodilator and limitation of physical activity(AU)


Assuntos
Humanos , Masculino , Feminino , Espirometria/métodos , Estado Asmático/complicações , Distúrbios do Sono por Sonolência Excessiva/etiologia , Narcolepsia/complicações , Transtornos Respiratórios/complicações , Epidemiologia Descritiva , Estudos Transversais
5.
Arch. argent. pediatr ; 115(4): 336-342, ago. 2017. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-887344

RESUMO

Objetivo. Determinar la concentración de vitamina D en pacientes de entre 6 y 18 años de edad sometidos a un seguimiento por asma y la relación entre la concentración de vitamina D y el control y la gravedad del asma. Materiales y métodos. Se inscribió en el estudio a pacientes con asma y voluntarios sanos de entre 6 y 18 años de edad, asignados al grupo de pacientes y al grupo de referencia, respectivamente. Se registraron las características demográficas y los hallazgos clínicos de los pacientes, y se les realizó una prueba funcional respiratoria. Se estimaron el índice de masa corporal (IMC) y la concentración de 25-hidroxi vitamina D (25(OH)D), calcio, fósforo, fosfatasa alcalina, inmunoglobulina E total y eosinófilos de todos los pacientes. La gravedad del asma y las condiciones de control se determinaron según los criterios de la Iniciativa Global para el Asma (Global Initiative for Asthma, GINA). Resultados. Se incluyó a 72 pacientes con asma y a 66 niños sanos. En comparación con el grupo de referencia, en el grupo de pacientes se detectó una menor concentración de vitamina D. En 38 (52,8%) niños del grupo de pacientes con asma se observó deficiencia de vitamina D; en este grupo, el control del asma era deficiente y la gravedad, significativamente mayor. No se observó una correlación significativa entre la concentración de vitamina D y el sexo, la obesidad, las pruebas funcionales respiratorias, las pruebas cutáneas, la concentración sérica de eosinófilos e inmunoglobulina E (IgE) total. Conclusión. La deficiencia y la insuficiencia de vitamina D fueron más frecuentes en los niños con asma, en comparación con los niños del grupo de referencia. Una menor concentración de vitamina D se asocia con un control deficiente del asma y una mayor gravedad de esta.


Background. The objective was to determine vitamin D levels in patients between the ages 6 and 18 years, followed for asthma, and the relation between vitamin D levels and asthma control and severity. Materials and Methods. Patients with asthma and healthy volunteers between the ages 6 and 18 years were enrolled into the study as patient and control groups, respectively. Patient demographic information and clinical findings were recorded; a respiratory function test was performed. Body mass index (BMI), 25(OH) D,calcium, phosphorus, alkaline phosphatase, total IgE and eosinophil levels were determined for all patients. Asthma severity and control conditions were established based on GINA (Global Initiative for Asthma) criteria. Results. Seventy two patients with asthma and 66 healthy children were included. Compared to the control group, decreased serum vitamin D levels were detected in patient group. Thirty eight (52.8%) patients in asthma patient group had vitamin D defficiency; in this group, asthma control was poor and asthma severity was significantly higher. No significant correlation was found between vitamin D levels and gender, obesity, respiratory functions, skin test, serum eosinophil and total IgE levels. Conclusion. The frequency of vitamin D deficiency and insufficiency was higher in children with asthma, compared to the controls. Lower levels of vitamin D are associated with poor asthma control and increased asthma severity.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Asma/complicações , Vitamina D/análogos & derivados , Asma/sangue , Asma/terapia , Vitamina D/sangue , Deficiência de Vitamina D/complicações , Índice de Gravidade de Doença , Estudos Transversais
6.
Arch. argent. pediatr ; 115(4): 343-349, ago. 2017. graf, tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-887345

RESUMO

Introducción. La mortalidad neonatal (MN) comprende las defunciones ocurridas los primeros 27 días de vida. Es el componente de la mortalidad infantil que disminuyó menos en los últimos 50 años. El objetivo fue analizar la evolución y las características de la MN en Argentina. Población y métodos. Estudio descriptivo, ecológico de MN en Argentina entre 2005 y 2014, en el que se analizaron la evolución, las causas y la importancia de la prematurez y el bajo peso al nacer. Se utilizaron registros de la Dirección de Estadísticas e Información de Salud del Ministerio de Salud de la Nación. Resultados. La tasa de mortalidad neonatal descendió 19,2% (2005: 8,9%% 2014: 7,2%); su componente precoz (de 0 a 6 días), 20% (2005: 6,5%; 2014: 5,2%); y el tardío (de 7 a 27 días), 13% (2005: 2,3%; 2014: 2%). Las afecciones perinatales y las malformaciones congénitas fueron la causa de más del 95% de las defunciones neonatales en el período. El peso relativo de las primeras disminuyó; el de las segundas aumentó. Los nacidos vivos pretérmino y con bajo peso presentaron mayor riesgo de muerte neonatal. Se observó menor descenso de la tasa de mortalidad neonatal específica cuanto menor era la edad gestacional y el peso al nacer. Conclusión. En los últimos 10 años, se observó un importante descenso en la MN. Las afecciones perinatales y las malformaciones congénitas fueron la causa de casi todas las defunciones en este grupo etario. La MN estuvo asociada al bajo peso al nacer y la prematurez.


Background. The objective was to determine vitamin D levels in patients between the ages 6 and 18 years, followed for asthma, and the relation between vitamin D levels and asthma control and severity. Materials and Methods. Patients with asthma and healthy volunteers between the ages 6 and 18 years were enrolled into the study as patient and control groups, respectively. Patient demographic information and clinical findings were recorded; a respiratory function test was performed. Body mass index (BMI), 25(OH) D,calcium, phosphorus, alkaline phosphatase, total IgE and eosinophil levels were determined for all patients. Asthma severity and control conditions were established based on GINA (Global Initiative for Asthma) criteria. Results. Seventy two patients with asthma and 66 healthy children were included. Compared to the control group, decreased serum vitamin D levels were detected in patient group. Thirty eight (52.8%) patients in asthma patient group had vitamin D defficiency; in this group, asthma control was poor and asthma severity was significantly higher. No significant correlation was found between vitamin D levels and gender, obesity, respiratory functions, skin test, serum eosinophil and total IgE levels. Conclusion. The frequency of vitamin D deficiency and insufficiency was higher in children with asthma, compared to the controls. Lower levels of vitamin D are associated with poor asthma control and increased asthma severity.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Mortalidade Infantil/tendências , Argentina/epidemiologia , Fatores de Tempo , Recém-Nascido de Baixo Peso , Recém-Nascido Prematuro , Epidemiologia Descritiva , Causas de Morte
7.
Arch Argent Pediatr ; 115(4): 336-342, 2017 Aug 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28737861

RESUMO

BACKGROUND: The objective was to determine vitamin D levels in patients between the ages 6 and 18 years, followed for asthma, and the relation between vitamin D levels and asthma control and severity. MATERIALS AND METHODS: Patients with asthma and healthy volunteers between the ages 6 and 18 years were enrolled into the study as patient and control groups, respectively. Patient demographic information and clinical findings were recorded; a respiratory function test was performed. Body mass index (BMI), 25(OH) D,calcium, phosphorus, alkaline phosphatase, total IgE and eosinophil levels were determined for all patients. Asthma severity and control conditions were established based on GINA (Global Initiative for Asthma) criteria. RESULTS: Seventy two patients with asthma and 66 healthy children were included. Compared to the control group, decreased serum vitamin D levels were detected in patient group. Thirty eight (52.8%) patients in asthma patient group had vitamin D defficiency; in this group, asthma control was poor and asthma severity was significantly higher. No significant correlation was found between vitamin D levels and gender, obesity, respiratory functions, skin test, serum eosinophil and total IgE levels. CONCLUSION: The frequency of vitamin D deficiency and insufficiency was higher in children with asthma, compared to the controls. Lower levels of vitamin D are associated with poor asthma control and increased asthma severity.


OBJETIVO: Determinar la concentración de vitamina D en pacientes de entre 6 y 18 años de edad sometidos a un seguimiento por asma y la relación entre la concentración de vitamina D y el control y la gravedad del asma. MATERIALES Y MÉTODOS: Se inscribió en el estudio a pacientes con asma y voluntarios sanos de entre 6 y 18 años de edad, asignados al grupo de pacientes y al grupo de referencia, respectivamente. Se registraron las características demográficas y los hallazgos clínicos de los pacientes, y se les realizó una prueba funcional respiratoria. Se estimaron el índice de masa corporal (IMC) y la concentración de 25-hidroxi vitamina D (25(OH)D), calcio, fósforo, fosfatasa alcalina, inmunoglobulina E total y eosinófilos de todos los pacientes. La gravedad del asma y las condiciones de control se determinaron según los criterios de la Iniciativa Global para el Asma (Global Initiative for Asthma, GINA). RESULTADOS: Se incluyó a 72 pacientes con asma y a 66 niños sanos. En comparación con el grupo de referencia, en el grupo de pacientes se detectó una menor concentración de vitamina D. En 38 (52,8%) niños del grupo de pacientes con asma se observó deficiencia de vitamina D; en este grupo, el control del asma era deficiente y la gravedad, significativamente mayor. No se observó una correlación significativa entre la concentración de vitamina D y el sexo, la obesidad, las pruebas funcionales respiratorias, las pruebas cutáneas, la concentración sérica de eosinófilos e inmunoglobulina E (IgE) total. CONCLUSIÓN: La deficiencia y la insuficiencia de vitamina D fueron más frecuentes en los niños con asma, en comparación con los niños del grupo de referencia. Una menor concentración de vitamina D se asocia con un control deficiente del asma y una mayor gravedad de esta.


Assuntos
Asma/sangue , Vitamina D/análogos & derivados , Adolescente , Asma/complicações , Asma/terapia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Vitamina D/sangue , Deficiência de Vitamina D/complicações
8.
J Pediatr ; 185: 149-154.e2, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28284473

RESUMO

OBJECTIVES: To evaluate the efficacy of brief, single administration of positive expiratory pressure (PEP) therapy in reducing clinical severity and need for additional second-line therapies and hospitalization in children presenting to the emergency department (ED) with acute asthma. STUDY DESIGN: This was a prospective randomized controlled trial of children 2-18 years of age presenting to a tertiary-care academic pediatric ED with moderate-to-severe asthma exacerbations from December 2014 to June 2016. Children who continued to have moderate asthma severity after completion of initial therapies (albuterol/ipratropium bromide and corticosteroids) were randomized to receive PEP therapy or standard of care. The primary outcome was change in pulmonary asthma score before and after intervention, as assessed by a blinded physician. Secondary outcomes included need for additional therapies, ED length of stay, and disposition. RESULTS: A total of 52 patients were randomized to receive either PEP (n?=?26) or standard therapy (n?=?26). Study groups were similar in demographics and baseline characteristics. There was no significant difference in primary outcome between groups with a mean change in Pulmonary Asthma Score of 0.92 (±1.2) in the PEP group and 0.40 (±1.2) in the standard group (P?=?.12). There also was no significant difference in need for additional therapies, ED length of stay, and disposition. Mild, self-resolving side effects were observed in 3 subjects receiving PEP therapy. CONCLUSION: Single, brief, administration of PEP therapy after completion of first-line therapies does not improve clinical severity in children presenting to the ED with acute asthma. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02494076.


Assuntos
Asma/terapia , Respiração com Pressão Positiva , Albuterol/uso terapêutico , Broncodilatadores/uso terapêutico , Criança , Terapia Combinada , Serviço Hospitalar de Emergência , Feminino , Glucocorticoides/uso terapêutico , Humanos , Ipratrópio/uso terapêutico , Masculino , Nebulizadores e Vaporizadores , Prednisona/uso terapêutico , Estudos Prospectivos , Índice de Gravidade de Doença , Método Simples-Cego
9.
J Allergy Clin Immunol ; 136(4): 885-92.e2, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25913104

RESUMO

BACKGROUND: Gene-environment interaction studies using genome-wide association study data are often underpowered after adjustment for multiple comparisons. Differential gene expression in response to the exposure of interest can capture the most biologically relevant genes at the genome-wide level. OBJECTIVE: We used differential genome-wide expression profiles from the Epidemiology of Home Allergens and Asthma birth cohort in response to Der f 1 allergen (sensitized vs nonsensitized) to inform a gene-environment study of dust mite exposure and asthma severity. METHODS: Polymorphisms in differentially expressed genes were identified in genome-wide association study data from the Childhood Asthma Management Program, a clinical trial in childhood asthmatic patients. Home dust mite allergen levels (<10 or ≥10 µg/g dust) were assessed at baseline, and (≥1) severe asthma exacerbation (emergency department visit or hospitalization for asthma in the first trial year) served as the disease severity outcome. The Genetics of Asthma in Costa Rica Study and a Puerto Rico/Connecticut asthma cohort were used for replication. RESULTS: IL9, IL5, and proteoglycan 2 expression (PRG2) was upregulated in Der f 1-stimulated PBMCs from dust mite-sensitized patients (adjusted P < .04). IL9 polymorphisms (rs11741137, rs2069885, and rs1859430) showed evidence for interaction with dust mite in the Childhood Asthma Management Program (P = .02 to .03), with replication in the Genetics of Asthma in Costa Rica Study (P = .04). Subjects with the dominant genotype for these IL9 polymorphisms were more likely to report a severe asthma exacerbation if exposed to increased dust mite levels. CONCLUSIONS: Genome-wide differential gene expression in response to dust mite allergen identified IL9, a biologically plausible gene target that might interact with environmental dust mite to increase severe asthma exacerbations in children.


Assuntos
Antígenos de Dermatophagoides/imunologia , Proteínas de Artrópodes/imunologia , Asma/genética , Asma/imunologia , Cisteína Endopeptidases/imunologia , Dermatophagoides farinae/imunologia , Interação Gene-Ambiente , Interleucina-9/genética , Leucócitos Mononucleares/fisiologia , Animais , Células Cultivadas , Criança , Pré-Escolar , Estudos de Coortes , Costa Rica , Progressão da Doença , Serviços Médicos de Emergência , Exposição Ambiental/efeitos adversos , Proteína Básica Maior de Eosinófilos/genética , Proteína Básica Maior de Eosinófilos/metabolismo , Feminino , Seguimentos , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Genótipo , Humanos , Interleucina-5/genética , Interleucina-5/metabolismo , Masculino , Polimorfismo de Nucleotídeo Único , Proteoglicanas/genética , Proteoglicanas/metabolismo , Porto Rico , Transcriptoma , Estados Unidos , Regulação para Cima
10.
World Allergy Organ J ; 8(1): 8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25780492

RESUMO

BACKGROUND: Asthma is a common chronic disease worldwide and Ascaris lumbricoides infection (ascariasis) is frequent in tropical regions. However, the effect of ascariasis on asthma severity has not been sufficiently explored. We sought to evaluate the influence of the IgE immune response to Ascaris extract and purified house dust mites (HDM) and Ascaris allergens on indicators of asthma severity in patients living in the tropics. METHODS: Asthmatic patients from Cartagena, Colombia were recruited. Clinical assessment included questionnaires, physical examination, allergy skin tests, spirometry, parasite stool examination and IgE antibody measurements. Asthma was diagnosed by a physician according to validated criteria. Indicators of severity were occurrence of severe dyspnea episodes, night awakenings events, > 4 emergency room (ER) visits and hospitalizations during the last year. Specific IgE to Der p 2, Ascaris spp., Blomia tropicalis and Dermatophagoides pteronyssinus extracts was determined by ImmunoCap. IgE to tropomyosins (Asc l 3, Blo t 10 and Der p 10), Blo t 5 and Asc s 1 was detected by ELISA. Logistic regression analyses were used to explore the relationships between sensitization and indicators of asthma severity. RESULTS: After adjustment for HDM sensitization, Ascaris sensitization remained associated with severe dyspnea (aOR: 1.90, 95% CI: 1.08 - 3.34, p = 0.03) and > 4 ER visits (aOR: 2.23, 95% CI: 1.15 - 4.30, p = 0.02). We also found that sensitization to the species specific markers Blo t 5 and Asc s 1, as well as the cross-reactive tropomyosins of D. pteronyssinus and Ascaris were associated with > 4 ER visits. Der p 2 sensitization was associated with bronchodilator responsiveness (aOR: 2.24: 1.25-4.02, p = 0.01). Remarkably, significantly higher IgE levels to HDM species specific allergens were found in Ascaris sensitized patients. CONCLUSIONS: In this tropical population, IgE sensitization to Ascaris and the cross-reactive tropomyosins was frequent and associated with clinical indicators of asthma severity. The significant relationship between sensitization to the nematode-specific marker Asc s 1 and ER attendance supports these findings. Moreover, ascariasis increases the human IgE responses to HDM specific allergens.

11.
Alerg. inmunol. clin ; 32(1-2): 11-17, 2013. tab
Artigo em Espanhol | BINACIS | ID: bin-130032

RESUMO

Este es el primer estudio de la calidad de vida (CV) de los niños asmáticos y sus cuidadores en Córdoba, Argentina.Se evaluó la relación entre la calidad de vida del niño, el grado de severidad del asma y la calidad de vida del padre. Se aplicaron los cuestionarios: Pediatric Asthma Quality of Life Questionnaire (PAQLQ) y Pediatric Asthma CaregiverÆs Quality of Lifenaire (PAQLQ) de la profesora Juniper a 60 binomios Questionnaire padre ûniño asmático en el Servicio de Alergia e InmunologIa Clínica del Hospital de Niños de la Santísima Trinidad de Córdoba, Argentina.Para el estudio, los datos fueron obtenidos de las historias clínicas, valoración GINA, espirometría realizada en el día de la aplicación de los cuestionarios.La severidad del asma del niño y la calidad de vida del mismo influyen en la calidad de vida de los padres. El dominio emocional de los niños es la variable más importante en la calidad de los respectivos padres. El promedio de la CV de los niños fue 5,63±1,47. La severidad del asma afectan tanto a la CV de los niños como la de sus padres. La CV de los padres estuvo más disminuida que en la de sus niños. (AU)


This is the first study of Quality of Life both asthmatic children and their caregivers in Córdoba, Argentina. The relationship between severity of childrenÆs asthma and the quality of life of children with this disease and their caregivers were evaluated. The Pediatric Asthma Quality of Life Questionaire (PAQLQ) and Pediatric Asthma CaregiverÆs Quality of Life Questionnaire (PACQLQ) were administered to 60 pediatric asthmatic patients and caregivers in the Allergy and Clinical Immunology Service of the Hospital de Niños de la Santísima Trinidad de Córdoba, Argentina.Data was obtained from medical records, spirometry, GINAÆs valuation and two quality of life (QL) questionnaires. The relationship between severity of childrenÆs asthma and quality of life of the children and their caregivers were determined using PearsonÆs correlation. The mean of patientÆs QL was 5,91±1,17; the mean of caregiversÆ QL was 5,63±1,47. The severity of asthma of the children impaired both the QL the children and their fathers. The fathersÆQL was more impaired than their children. The emotional domain of the children was the most influential variable in the QL of their caregivers. (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Asma , Criança , Qualidade de Vida , Cuidadores , Hospitais Pediátricos/estatística & dados numéricos , Hospitais Pediátricos/tendências
12.
Alerg. inmunol. clin ; 32(1-2): 11-17, 2013. tab
Artigo em Espanhol | LILACS | ID: lil-719893

RESUMO

Este es el primer estudio de la calidad de vida (CV) de los niños asmáticos y sus cuidadores en Córdoba, Argentina.Se evaluó la relación entre la calidad de vida del niño, el grado de severidad del asma y la calidad de vida del padre. Se aplicaron los cuestionarios: Pediatric Asthma Quality of Life Questionnaire (PAQLQ) y Pediatric Asthma Caregiver’s Quality of Lifenaire (PAQLQ) de la profesora Juniper a 60 binomios Questionnaire padre –niño asmático en el Servicio de Alergia e InmunologÍa Clínica del Hospital de Niños de la Santísima Trinidad de Córdoba, Argentina.Para el estudio, los datos fueron obtenidos de las historias clínicas, valoración GINA, espirometría realizada en el día de la aplicación de los cuestionarios.La severidad del asma del niño y la calidad de vida del mismo influyen en la calidad de vida de los padres. El dominio emocional de los niños es la variable más importante en la calidad de los respectivos padres. El promedio de la CV de los niños fue 5,63±1,47. La severidad del asma afectan tanto a la CV de los niños como la de sus padres. La CV de los padres estuvo más disminuida que en la de sus niños.


This is the first study of Quality of Life both asthmatic children and their caregivers in Córdoba, Argentina. The relationship between severity of children’s asthma and the quality of life of children with this disease and their caregivers were evaluated. The Pediatric Asthma Quality of Life Questionaire (PAQLQ) and Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) were administered to 60 pediatric asthmatic patients and caregivers in the Allergy and Clinical Immunology Service of the Hospital de Niños de la Santísima Trinidad de Córdoba, Argentina.Data was obtained from medical records, spirometry, GINA’s valuation and two quality of life (QL) questionnaires. The relationship between severity of children’s asthma and quality of life of the children and their caregivers were determined using Pearson’s correlation. The mean of patient’s QL was 5,91±1,17; the mean of caregivers’ QL was 5,63±1,47. The severity of asthma of the children impaired both the QL the children and their fathers. The fathers’QL was more impaired than their children. The emotional domain of the children was the most influential variable in the QL of their caregivers.


Assuntos
Humanos , Masculino , Feminino , Criança , Asma , Cuidadores , Criança , Hospitais Pediátricos/estatística & dados numéricos , Hospitais Pediátricos/tendências , Qualidade de Vida
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