RESUMO
OBJECTIVE: To evaluate the quality of life and its association with disease control, severity, allergic comorbidities and adherence to treatment in children and adolescents with asthma. METHODS: A cross-sectional study that included children and adolescents aged seven to 17. The Paediatric Asthma Quality of Life Questionnaire (PAQLQ) was used to assess their quality of life. Sociodemographic and clinical data were obtained from the chart and from a questionnaire. Descriptive statistics were performed and chi-square or Fisher's exact tests were used to verify the existence of associations between quality of life and disease control, severity, comorbidities and adherence to treatment. The level of statistical significance was set at p<0.05. RESULTS: 101 children/adolescents were evaluated (62.4% boys), with a mean age of 10.1 years. On average, the PAQLQ score was ≤5.9 points, indicating moderate / severe quality of life impairment. Higher levels of control, as well as higher disease severity, were associated with higher quality of life impairment, both in total PAQLQ score and domains (p<0.05). The presence of comorbidities was also associated with higher quality of life impairment (p=0.01), except in the emotional function domain. Adherence to treatment showed no association with quality of life. CONCLUSIONS: Children and adolescents with asthma present impairment in their quality of life, and this is related to poorer control and severity of the disease, as well as to the presence of allergic comorbidities.
Assuntos
Asma/tratamento farmacológico , Asma/psicologia , Hipersensibilidade/psicologia , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Adolescente , Instituições de Assistência Ambulatorial/organização & administração , Asma/diagnóstico , Brasil/epidemiologia , Broncodilatadores/uso terapêutico , Criança , Comorbidade , Estudos Transversais , Feminino , Humanos , Hipersensibilidade/epidemiologia , Masculino , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e QuestionáriosRESUMO
ABSTRACT Objective: To evaluate the quality of life and its association with disease control, severity, allergic comorbidities and adherence to treatment in children and adolescents with asthma. Methods: A cross-sectional study that included children and adolescents aged seven to 17. The Paediatric Asthma Quality of Life Questionnaire (PAQLQ) was used to assess their quality of life. Sociodemographic and clinical data were obtained from the chart and from a questionnaire. Descriptive statistics were performed and chi-square or Fisher's exact tests were used to verify the existence of associations between quality of life and disease control, severity, comorbidities and adherence to treatment. The level of statistical significance was set at p<0.05. Results: 101 children/adolescents were evaluated (62.4% boys), with a mean age of 10.1 years. On average, the PAQLQ score was ≤5.9 points, indicating moderate / severe quality of life impairment. Higher levels of control, as well as higher disease severity, were associated with higher quality of life impairment, both in total PAQLQ score and domains (p<0.05). The presence of comorbidities was also associated with higher quality of life impairment (p=0.01), except in the emotional function domain. Adherence to treatment showed no association with quality of life. Conclusions: Children and adolescents with asthma present impairment in their quality of life, and this is related to poorer control and severity of the disease, as well as to the presence of allergic comorbidities.
RESUMO Objetivo: Avaliar a qualidade de vida e sua associação com controle da doença, gravidade, comorbidades alérgicas e adesão ao tratamento em crianças e adolescentes com asma. Métodos: Estudo transversal que incluiu crianças e adolescentes com idade entre sete e 17 anos. O Paediatric Asthma Quality of Life Questionary (PAQLQ) foi utilizado para avaliar a qualidade de vida. Dados sociodemográficos e clínicos foram obtidos a partir do prontuário e de um questionário. Foi realizada estatística descritiva e o teste do qui-quadrado ou o teste exato de Fisher foi utilizado para verificar existência de associações entre qualidade de vida e controle da doença, gravidade, comorbidades e adesão ao tratamento. O nível de significância estatística adotado foi de p<0,05. Resultados: 101 adolescentes/crianças foram avaliados (62,4% meninos), com média de idade de 10,1 anos. Em média, a pontuação do PAQLQ foi ≤5,9 pontos, indicando comprometimento moderado/grave da qualidade de vida. Piores níveis de controle e a maior gravidade da doença estiveram associados ao maior comprometimento da qualidade de vida, tanto no escore total do PAQLQ quanto por domínios (p<0,05). A presença de comorbidades também esteve associada ao maior comprometimento da qualidade de vida (p=0,01), exceto no domínio função emocional. A adesão ao tratamento não demonstrou associação com a qualidade de vida. Conclusões: Crianças e adolescentes com asma apresentam prejuízo na qualidade de vida, e este está relacionado com pior controle e maior gravidade da doença, assim como com a presença de comorbidades alérgicas.
Assuntos
Asma/psicologia , Asma/tratamento farmacológico , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Hipersensibilidade/psicologia , Qualidade de Vida , Asma/diagnóstico , Índice de Gravidade de Doença , Brasil/epidemiologia , Broncodilatadores/uso terapêutico , Comorbidade , Estudos Transversais , Inquéritos e Questionários , Instituições de Assistência Ambulatorial/organização & administração , Hipersensibilidade/epidemiologiaRESUMO
Opioids are addictive drugs, whose misuse evoke withdrawal and relapse. Mediterranean-based diet (MBD) is rich in n-3 polyunsaturated fatty acids (PUFA), while Western based diets (WBDs) contain saturated fatty acids including interesterified fat (IF) and palm oil (PO), influencing neural functions. We compared MBD and WBDs on morphine-induced addiction parameters. Rats fed with MBD (chow plus 20% soybean- and fish-oil- n-6/n-3 PUFA 1:1) or WBD (WBD- PO or WBD-IF: chow plus 20% of palm oil or interesterified fat, respectively; high n-6/n-3 PUFA ratio) were exposed to morphine in conditioned place preference (CPP) paradigm. Anxiety-like behavior, locomotion and thermal sensitivity were evaluated during withdrawal. After morphine-CPP extinction, animals were challenged to morphine-reinstatement to induce relapse. All groups showed morphine-CPP, WBDs favored anxiety-like behaviors per se, locomotor sensitization and thermal hipersensitivity during withdrawal, resulting in increased morphine-reinstatement in comparison to MBD, which did not show relapse. WBDs increased glucocorticoid receptor immunoreactivity in the pre-frontal cortex, increasing corticosterone (CORT) and adrenocorticotrophic hormone (ACTH) per se and after morphine-reinstatement. In the nucleus accumbens, WBDs increased dopamine transporter (DAT) and dopamine receptor-2 (D2R) immunoreactivity and decreased dopamine receptor-1 (D1R). These findings indicate that WBDs facilitate morphine-reinstatement, unlike MBD, preserving the DA system mesolimbic neuroplasticity.
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Dieta Mediterrânea , Dieta Ocidental/efeitos adversos , Dependência de Morfina/dietoterapia , Síndrome de Abstinência a Substâncias/prevenção & controle , Animais , Ansiedade/prevenção & controle , Ansiedade/psicologia , Comportamento Animal/efeitos dos fármacos , Dieta Mediterrânea/psicologia , Dieta Ocidental/psicologia , Modelos Animais de Doenças , Hipersensibilidade/prevenção & controle , Hipersensibilidade/psicologia , Masculino , Morfina/administração & dosagem , Dependência de Morfina/psicologia , Atividade Motora/efeitos dos fármacos , Ratos Wistar , RecidivaRESUMO
OBJECTIVE: To explore psychological distress in Korean adolescents having allergic disease comorbid with obesity. STUDY DESIGN: A total of 703 869 adolescents who completed the Korean Youth Risk Behavior Web-based Survey between 2007 and 2016 were analyzed. Participants were divided into 4 groups-healthy control, allergic disease only, obesity only, and comorbidity of allergic disease and obesity-and compared them to determine whether they showed differences in mental health. RESULTS: Adolescents with both atopic dermatitis and obesity had significantly greater odds of experiencing unhappiness (OR, 1.17), stress (OR, 1.32), and suicidal ideation (OR, 1.25) than those without both conditions. The same was true of adolescents with obesity and allergic rhinitis (OR, 1.21, 1.37, and 1.27, respectively) or bronchial asthma (OR, 1.37, 1.39, and 1.37). The comorbidity groups also showed significantly greater odds of stress and suicidal ideation than the allergic disease-only (atopic dermatitis with obesity, 1.21 and 1.15, respectively; allergic rhinitis with obesity, 1.11 and 1.09; bronchial asthma with obesity, 1.17 and 1.14) and obesity-only groups (atopic dermatitis with obesity, 1.13 and 1.09; allergic rhinitis with obesity, 1.18 and 1.10; bronchial asthma with obesity, 1.18 and 1.21). CONCLUSIONS: Allergic disease and obesity negatively and additively influence mental health in adolescents.
Assuntos
Hipersensibilidade/complicações , Hipersensibilidade/psicologia , Obesidade/complicações , Obesidade/psicologia , Estresse Psicológico/epidemiologia , Adolescente , Asma/complicações , Asma/epidemiologia , Asma/psicologia , Comorbidade , Estudos Transversais , Bases de Dados Factuais , Dermatite Atópica/complicações , Dermatite Atópica/epidemiologia , Dermatite Atópica/psicologia , Feminino , Humanos , Hipersensibilidade/epidemiologia , Internet , Coreia (Geográfico)/epidemiologia , Masculino , Obesidade/epidemiologia , Ideação Suicida , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To determine whether maternal mental health mediates the relationship between eczema or asthma symptoms and mental well-being in children. STUDY DESIGN: Analysis of 7250 children from the Avon Longitudinal Study of Parents and Children. Child mental well-being at 8 years was measured by the Strengths and Difficulties Questionnaire. Binary outcomes were high 'internalizing' (anxious/depressive) and 'externalizing' (oppositional/hyperactive) problems (high was >90th percentile). Child rash and wheeze categories were 'none'; 'early onset transient' (infancy/preschool only); 'persistent' (infancy/preschool and at school age); and 'late onset' (school age only). Maternal anxiety and depression were reported during pregnancy and when child was 8 years old. RESULTS: Persistent wheezing symptoms were associated with high externalizing (OR 1.74, 95% CI, 1.41-2.15) and internalizing (1.67, 1.35-2.06) problems compared with never wheeze. Maternal anxiety and depression, and disrupted child sleep, attenuated these associations. Persistent rash (externalizing: 1.74, 1.40-2.15; internalizing: 1.42, 1.16-1.74) and late onset rash (externalizing: 1.62, 1.17-2.25; internalizing: 1.46, 1.07-1.99) symptoms were associated with poorer mental well-being compared with no rash at any age. Maternal anxiety and depression, particularly when child was aged 8 years rather than during pregnancy, accounted for the association with internalizing symptoms and partly for externalizing symptoms. Sleep disruption did not mediate the association. CONCLUSIONS: Maternal anxiety and depression may mediate the association between child rash and wheeze and child mental well-being.
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Ansiedade , Depressão , Exantema/diagnóstico , Hipersensibilidade/diagnóstico , Saúde Mental , Mães/psicologia , Sons Respiratórios/diagnóstico , Criança , Exantema/epidemiologia , Exantema/psicologia , Feminino , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/psicologia , Estudos Longitudinais , Masculino , Inquéritos e QuestionáriosRESUMO
This paper reports the role of children with some chronic disease, particularly allergic, into his/her familial system about the control of the disease (emphasizing the role of symptoms). Approach is done since a systemic perspective, where vision of isolated individual losses preponderance and the phenomenon is studied in its relational context. When family does not have the necessary resources to effectively confront a crisis, how familial functioning influences the appearing or disappearing of situations of personal and familiar risk should be explored. The symptom is the expression of some general dysfunction in familial organization and actively represents the most powerful reinforcement of the rigid familial homeostasia. Interpretation and treatment of allergic symptoms depend greatly on the form family interprets and understands its recurrence. Impact of family on chronicity of its child's allergic diseases, exacerbations and repercussions in the degree of illness' control should be studied. In cases of difficult control of the disease and when environmental control measurements, immunotherapy and pharmacological treatment do not offer the expected advantages, the family should be studied and psycotherapeutic support with trained personnel must be given.
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Relações Familiares , Hipersensibilidade/psicologia , Atitude Frente a Saúde , Doença Crônica , Cultura , Humanos , Hipersensibilidade/terapia , Relações Pais-Filho , Papel do DoenteRESUMO
The influence of stress on total leukocyte count from bronchoalveolar lavage (BAL) was investigated in rats sensitized and challenged with ovalbumin (OVA). The animals were injected intraperitoneally with a suspension of OVA plus aluminum hydroxide in 0.9% NaCl (Day 0) and boosted at Day 7 with an identical OVA solution, administered subcutaneously. From the first to the 13th day after sensitization, rats were placed individually in a shuttle box where they received 50 escapable footshocks per day, always preceded by a sound signal (S); the responses that occurred during both S and shocks canceled the stressful stimulation. On Day 14, animals were submitted to a single session of 50 inescapable footshocks, preceded by the same S; immediately after, the animals were submitted to a 1% OVA-inhalation challenge. Results showed high levels of stress in the shocked animals as detected through both ultrasonic vocalizations (UVs) and social interaction test in an open field. Total leukocyte count in BAL from stressed animals (24 h post-OVA challenge) revealed a significant increase in the number of inflammatory cells in comparison to that measured in sensitized, nonstressed challenged rats. These data demonstrate that stress plays a relevant and important role on total bronchoalveolar cell count in OVA-sensitized rats.
Assuntos
Líquido da Lavagem Broncoalveolar/citologia , Hipersensibilidade/patologia , Ovalbumina/imunologia , Estresse Psicológico/patologia , Animais , Contagem de Células , Eletrochoque , Hipersensibilidade/psicologia , Relações Interpessoais , Contagem de Leucócitos , Masculino , Ratos , Ratos Wistar , Estresse Psicológico/psicologia , Vocalização AnimalRESUMO
The role of psychosocial factors in the development of wheezing was studied prospectively in 100 infants with a strong family history of allergy. The entire family participated in a standardized family test when the children were 3 and 18 months of age. The ability to adjust to demands of the situation ("adaptability") and the balance between emotional closeness and distance ("cohesion") were assessed from videotapes by independent raters. Families rated as functional in both aspects were classified as "functional" and otherwise as "dysfunctional." Based on records of symptoms kept by the parents and on results of physical examinations at 6 and 18 months of age, the children were classified as healthy or as having recurrent wheezing, recurrent infections, or eczema. An unbalanced family interplay was common (37%) at 3 months but did not predict development of illness. If the child remained healthy and the family did not experience any further stress, family interaction was functional 15 months later. If, however, the child acquired anxiety-provoking symptoms, such as wheezing, a high proportion of families continued or began to have dysfunctional interaction patterns. When the healthy children were 18 months of age, only 12% of their families were dysfunctional, compared with 26%, 46%, and 52%, respectively, of the families of children with eczema, recurrent infections, and obstructive symptoms (p < 0.01). We conclude that dysfunctional family interaction seems to be a result rather than the cause of wheezing in infancy.
Assuntos
Asma/psicologia , Saúde da Família , Família , Adaptação Psicológica , Asma/fisiopatologia , Infecções Bacterianas/fisiopatologia , Infecções Bacterianas/psicologia , Eczema/fisiopatologia , Eczema/psicologia , Feminino , Seguimentos , Humanos , Hipersensibilidade/fisiopatologia , Hipersensibilidade/psicologia , Lactente , Acontecimentos que Mudam a Vida , Masculino , Relações Pais-Filho , Estudos Prospectivos , Recidiva , Sons Respiratórios/etiologia , Sons Respiratórios/fisiopatologia , Fatores de Risco , Classe Social , Estresse Fisiológico/fisiopatologia , Estresse Psicológico/fisiopatologiaRESUMO
This study evaluated the self-reported patterns of handedness among a large subsample (n = 1612) of the gay/bisexual men comprising the Multicenter AIDS Cohort Study (MACS). There was a small but significant elevation in left-handedness among gay/bisexual men compared to available normative data. However, there were no differences within the cohort in measures of immune function, self-reported autoimmune disorders, asthma, or hay fever, although there was an association between handedness and allergy. Performance on neuropsychological tests also did not differ as a function of handedness.
Assuntos
Síndrome da Imunodeficiência Adquirida/fisiopatologia , Doenças Autoimunes/fisiopatologia , Bissexualidade , Lateralidade Funcional/fisiologia , Homossexualidade , Hipersensibilidade/fisiopatologia , Testes Neuropsicológicos , Síndrome da Imunodeficiência Adquirida/psicologia , Adulto , Doenças Autoimunes/psicologia , Bissexualidade/psicologia , Estudos de Coortes , Suscetibilidade a Doenças/fisiopatologia , Suscetibilidade a Doenças/psicologia , Soropositividade para HIV/fisiopatologia , Soropositividade para HIV/psicologia , Homossexualidade/psicologia , Humanos , Hipersensibilidade/psicologia , Masculino , Fatores de RiscoRESUMO
La corriente psiquiátrica que explica las enfermedades alérgicas como padecimientos de origen psicosomático considera dos aspectos principales: 1) las emociones se expresan en sintomas alérgicos a través del hipotálamo y el Sistema Nervioso Autónomo y 2) ciertas manaipulaciones conductuales, como el aprendizaje y el condicionamiento, alteran la respuesta inmune y producen manifestaciones alérgicas. Los estudios de pacientes psiquiátricos para investigar atopias, asís como los realizados en alérgicos buscando alteraciones psiquiátricas previas, no son concluyentes. La enfermedad alérgica es una alteración inmunológica específicamfica aunque es susceptibel a factores no específicos como las emociones. Alteraciones psiquiátricas más frecuentes en los apcientes alérgicos son la depresión y la ansiedad. En la depresión existe un desbalance nervioso autónomo, que también se refiere en las enfermedades alergicas; la combinación de depresión y alergia agrava la situación del paciente. Es importante que el alergólogo reconozca y trate algunos problemas psiquiátricos de sus enfermos, sólo una minoria de sus casos deberá acudir al psiquiatra. Se muestran interesantes propiedades antialérgicas de los medicamentos antidepresivos
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Humanos , Masculino , Feminino , Hipersensibilidade/psicologia , Ansiedade , Depressão , Hipersensibilidade/terapiaRESUMO
The potential impact of an ill child on other siblings in the family was examined by comparing 72 siblings of children with rheumatic disease with 60 siblings of healthy children from demographically matched families. Psychosomatic, behavioral, emotional, and social problems, as reported by both the parents and the siblings, were investigated. Although siblings of patients with rheumatic disease generally were functioning as well as siblings of healthy children, they reported having more allergies and asthma. A set of vulnerability and protective factors was tested as predictors of sibling functioning. Cohesive and expressive family environments in which mothers and patients with rheumatic disease were functioning adequately promoted better adaptation among the siblings.