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do Nascimento Maia P, Bazhuni Pombo Sant'Anna MDF, Parente AAAI, Baroni Aurilio R, Albino Servilha Silva B, Luiz RR, Sant'Anna CC. Correlation of digital flow peak with spirometry in children with and without asthma. J Asthma 2023; 60:270-276. [PMID: 35188448 DOI: 10.1080/02770903.2022.2045308] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Spirometry and peak expiratory flow measurement (PEF) are combined during functional respiratory assessments. The new digital peak flow meter (DPM) evaluates the forced expiratory volume in the first second (FEV1) and PEF. OBJECTIVE To compare lung function measurements using spirometry and DPM. METHODS This cross-sectional analytical study assessed FEV1 and PEF in children with and without asthma. Statistical analysis was performed to assess the agreement between the measures using the intraclass correlation coefficient (ICC), Bland-Altman, and survival agreement plot. RESULTS 125 (3-12 y) and 196 (6-18 y) children without and with asthma, respectively, were studied. In children without asthma, the ICC for FEV1 and PEF were 0.89 and 0.86, respectively, while the corresponding values were 0.87 and 0.79, respectively, in patients with asthma. The Bland-Altman method showed a difference of -0.4 to 0.5 for FEV1 in patients without asthma, with a tendency to increase as the FEV1 increased to a certain extent. In patients with asthma, the pattern was similar for FEV1, and the PEF had a greater dispersion than among those without asthma; however, a good agreement pattern was maintained. In the survival agreement plot, when accepting a tolerance of 0.150 mL for FEV1, there was an agreement of close to 55% in both groups. Likewise, when accepting a tolerance of 0.5 L/s for PEF, an agreement of close to 60% and 50% was observed in patients without and with asthma, respectively. CONCLUSION DPM was effective as a measure of lung function in pediatric patients with and without asthma.
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Affiliation(s)
- Paula do Nascimento Maia
- Universidade Federal do Rio de Janeiro Instituto de Puericultura e Pediatria Martagão Gesteira, pediatric pneumology, Rio de Janeiro, Brazil
| | | | - Ana Alice Amaral Ibiapina Parente
- Universidade Federal do Rio de Janeiro Instituto de Puericultura e Pediatria Martagão Gesteira, pediatric pneumology, Rio de Janeiro, Brazil
| | - Rafaela Baroni Aurilio
- Universidade Federal do Rio de Janeiro Instituto de Puericultura e Pediatria Martagão Gesteira, pediatric pneumology, Rio de Janeiro, Brazil
| | - Beatriz Albino Servilha Silva
- Universidade Federal do Rio de Janeiro Instituto de Puericultura e Pediatria Martagão Gesteira, pediatric pneumology, Rio de Janeiro, Brazil
| | - Ronir Raggio Luiz
- Universidade Federal do Rio de Janeiro Instituto de Puericultura e Pediatria Martagão Gesteira, pediatric pneumology, Rio de Janeiro, Brazil
| | - Clemax Couto Sant'Anna
- Universidade Federal do Rio de Janeiro Instituto de Puericultura e Pediatria Martagão Gesteira, pediatric pneumology, Rio de Janeiro, Brazil
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Fernandes SDSC, Solé D, Camargos P, Andrade CRD, Ibiapina CDC. Factors associated with asthma expression in adolescents. ACTA ACUST UNITED AC 2019. [PMID: 29538537 PMCID: PMC6104536 DOI: 10.1590/s1806-37562017000000078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: To evaluate risk factors associated with asthma symptoms in adolescents in the 13- to 14-year age bracket. Methods: This was a cross-sectional study involving adolescents enrolled in randomly selected public schools in the city of Belo Horizonte, Brazil, and conducted with the use of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and its supplementary module for risk factor assessment. The ISAAC questionnaire was completed by the students themselves, whereas the supplementary questionnaire was completed by their parents or legal guardians. Variables showing p ≤ 0.25 in the univariate analysis were included in the multivariate analysis. Stepwise regression with backward elimination was used for variable selection. Results: We evaluated 375 adolescents, 124 (33.1%) of whom had asthma symptoms. The final multivariate analysis model revealed that asthma symptoms were associated with birth weight < 2,500 g (p < 0.001), day care center or nursery attendance (p < 0.002), maternal history of asthma (p < 0.001), contact with animals during the first year of life (p < 0.027), current contact with animals outside the home (dogs, cats, or farm animals; p < 0.005), and more than 20 cigarettes per day smoked by parents or other household members (p < 0.02). Conclusions: Exposure to animals in and outside the home is associated with asthma symptoms, as is environmental tobacco smoke exposure. Families, health professionals, and administrators of health care facilities should take that into account in order to prevent asthma and reduce asthma morbidity.
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Affiliation(s)
| | - Dirceu Solé
- . Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo - Unifesp - São Paulo (SP) Brasil
| | - Paulo Camargos
- . Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
| | - Cláudia Ribeiro de Andrade
- . Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
| | - Cássio da Cunha Ibiapina
- . Departamento de Pediatria, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG) Brasil
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Ardura-Garcia C, Garner P, Cooper PJ. Is childhood wheeze and asthma in Latin America associated with poor hygiene and infection? A systematic review. BMJ Open Respir Res 2018. [PMID: 29531744 PMCID: PMC5844372 DOI: 10.1136/bmjresp-2017-000249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Introduction High asthma prevalence in Latin-American cities is thought to be caused by poor hygiene and infections. This contradicts the widely accepted 'hygiene hypothesis' for asthma aetiology. Methods Systematic review of observational studies evaluating the association between poor hygiene exposures or infections and asthma/wheeze among Latin-American children aged 4-16 years. MEDLINE, EMBASE, LILACS and CINAHL electronic databases were searched following a predefined strategy to 18 December 2017. We quantified outcomes measured and reported, assessed risk of bias and tabulated the results. Results Forty-five studies included: 6 cohort, 30 cross-sectional and 9 case-control studies. 26 cross-sectional studies were school-based surveys (14 of over 3000 children), whereas 5 case-control studies were hospital/health centre-based. Exposures measured and reported varied substantially between studies, and current wheeze was the most common outcome reported. Data showed selective reporting based on statistical significance (P value <0.05): 17/45 studies did not clearly describe the number of exposures measured and 15/45 studies reported on less than 50% of the exposures measured. Most exposures studied did not show an association with wheeze or asthma, except for a generally increased risk associated with acute respiratory infections in early life. Contradictory associations were observed frequently between different studies. Conclusion Selective reporting is common in observational studies exploring the association between environmental exposures and risk of wheeze/asthma. This, together with the use of different study outcomes (wheeze/asthma) associated with possibly distinct causal mechanisms, complicates inferences about the role of poor hygiene exposures and childhood infections in explaining asthma prevalence in Latin-American children.
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Affiliation(s)
| | - Paul Garner
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Philip J Cooper
- Facultad de Ciencias Medicas, de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.,Institute of Infection and Immunity, St George's, University of London, London, UK
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Mascarenhas JMO, Silva RDCR, Assis AMOD, Pinto EDJ, Conceição JS, Barreto ML. Symptoms of asthma and associated factors in adolescents from Salvador, Bahia. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 19:181-93. [PMID: 27167659 DOI: 10.1590/1980-5497201600010016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 04/08/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Identify the factors associated with asthma symptoms in adolescents. METHODS Cross-sectional study with the participation of 1,176 students between the ages of 11 and 17 years old, in Salvador, Bahia, Brazil. The asthma symptoms were identified by using the standardized questionnaire from The International Study of Asthma and Allergies in Childhood Program (ISAAC), phase III. The subjects' food intake data were collected by a semiquantitative food frequency questionnaire (FFQ) comprised of 97 food items. All of the information was collected during a single interview. Anthropometric, socioeconomic, and demographic data were collected from the study population. The robust Poisson model was adopted to obtain the raw and adjusted PR (prevalence ratio). RESULTS From the total number of adolescents, 57.6% are female and 83.71% of them were between 13 and 17 years old. The prevalence of asthma symptoms was of 7.6%, being higher among males (9.62%). The prevalence of wheezing in the last 12 months was 8.6%. Among the adolescents with rhinitis and eczema, the prevalence of asthma symptoms was of 15.2 and 14.3%, respectively. After an adjusted analysis, the following factors were identified: females PR = 0.64 (95%CI 0.42 - 0.96), rhinitis PR = 3.23 (95%CI 2.17 - 4.83) and the 2nd tertile of the healthy pattern (moderate consumption) PR = 0.61 (95%CI 0.37 - 0.99). CONCLUSION Rhinitis and eczema were presented as risk factors for asthma symptoms. The healthy food intake pattern that had been stratified in tertiles, presented the 2nd tertile as a protector for asthma symptoms.
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Affiliation(s)
| | | | | | - Elizabete de Jesus Pinto
- Departamento de Ciência da Nutrição, Escola de Nutrição, Universidade Federal da Bahia, Salvador, BA, Brazil
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Coelho MADQ, de Pinho L, Marques PQ, Silveira MF, Solé D. Prevalence and factors associated with asthma in students from Montes Claros, Minas Gerais, Brazil. CIENCIA & SAUDE COLETIVA 2017; 21:1207-16. [PMID: 27076019 DOI: 10.1590/1413-81232015214.04572015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 07/18/2015] [Indexed: 10/23/2023] Open
Abstract
We investigated the prevalence of asthma and factors related to asthma development in schoolchildren aged 6 to 14, living in central and peripheral areas of the city of Montes Claros, Minas Gerais and who were registered with the Family Health Strategy program. Initially, a standard written questionnaire, based on ISAAC (International Study of Asthma and Allergies in Childhood), was administered to collect personal data, information regarding income, asthma prevalence, allergic rhinitis and eczema (N = 1,131). Secondly, a case-control study was performed by grouping the patients as either asthmatic (A; N = 172) or non-asthmatic (NA; N = 379). Potential factors associated with the occurrence of asthma were evaluated using the complementary questionnaire from ISAAC phase II. Skin tests for immediate hypersensitivity (STIH) and parasitological tests were also performed. The odds ratio, estimated by multivariate analysis, indicated that asthma cases were related to kindergarten attendance, household smoking, family history of asthma, rhinitis and positive STIH. It was concluded that, in the studied population, the prevalence of asthma was related to genetic predisposition, in addition to individual history, social demographics, exposure to pollutants such as tobacco smoke and a positive response to allergy testing.
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Affiliation(s)
| | - Lucinéia de Pinho
- Departamento de Fisiopatologia, Universidade Estadual de Montes Claros, Montes Claros, MG, Brasil,
| | | | | | - Dirceu Solé
- Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Moraes LSL, Takano OA, Mallol J, Solé D. [Prevalence and clinical characteristics of wheezing in children in the first year of life, living in Cuiabá, Mato Grosso, Brazil]. REVISTA PAULISTA DE PEDIATRIA 2016; 32:313-9. [PMID: 25510994 PMCID: PMC4311784 DOI: 10.1016/j.rpped.2014.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 06/08/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE: To evaluate the prevalence and the clinical characteristics of wheezing in
infants aged 12 to 15 months in the city of Cuiabá, Mato Grosso State, Midwest
Brazil. METHODS: Parents and/or guardians of infants were interviewed and completed a written
standardized questionnaire of the Estudio Internacional de Sibilancia en Lactantes
(EISL) - phase 3 at primary healthcare clinics at the same day of children
vaccination or at home, from August of 2009 to November of 2010. RESULTS: 1,060 parents and/or guardians completed the questionnaire, and 514 (48.5%)
infants were male. Among the studied infants, 294 (27.7%) had at least one episode
of wheezing during the first year of life, beggining at 5.8±3.0 months of age,
with a predominance of male patients. The prevalence of occasional wheezing (<3
episodes of wheezing) was 15.0% and recurrent wheezing (≥3 episodes) was 12.7%.
Among the infants with recurrent wheezing, the use of inhaled β2-agonist, oral
corticosteroid, leukotriene receptor antagonist, as well as night symptoms,
respiratory distress, and hospitalization due to severe episodes were
significantly more frequent. Physician-diagnosed asthma was observed in 28 (9.5%)
of the wheezing infants. Among the wheezing infants, 80 (27.7%) were diagnosed
with pneumonia, of whom 33 (11.2%) required hospitalization; neverthless, no
differences between occasional and recurrent wheezing infants were found. CONCLUSIONS: The prevalence of recurrent wheezing and physician-diagnosed asthma in infants
were lower compared with those observed in other Brazilian studies. Recurrent
wheezing had early onset and high morbity.
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Affiliation(s)
| | | | | | - Dirceu Solé
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil
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Solé D, Camelo-Nunes IC, Wandalsen GF, Mallozi MC. Asthma in children and adolescents in Brazil: contribution of the International Study of Asthma and Allergies in Childhood (ISAAC). ACTA ACUST UNITED AC 2015; 32:114-25. [PMID: 24676199 PMCID: PMC4182995 DOI: 10.1590/s0103-05822014000100018] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 05/22/2013] [Indexed: 11/23/2022]
Abstract
Objective: To assess asthma among Brazilian pediatric population applying the International
Study of Asthma and Allergies in Childhood (ISAAC), an internationally
standardized and validated protocol. Data sources: ISAAC was conceived to maximize the value of epidemiologic studies on asthma and
allergic diseases, establishing a standardized method (self-applicable written
questionnaire and/or video questionnaire) capable to facilitate the international
collaboration. Designed to be carried out in three successive and dependent
phases, the ISAAC gathered a casuistic hitherto unimaginable in the world and in
Brazil. This review included data gathered from ISAAC official Brazilian centers
and others who used this method. Data synthesis: At the end of the first phase, it has been documented that the prevalence of
asthma among Brazilian schoolchildren was the eighth among all centers
participating all over the world. Few centers participated in the second phase and
investigated possible etiological factors, especially those suggested by the first
phase, and brought forth many conjectures. The third phase, repeated seven years
later, assessed the evolutionary trend of asthma and allergic diseases prevalence
in centers that participated simultaneously in phases I and III and in other
centers not involved in phase I. Conclusions: In Brazil, the ISAAC study showed that asthma is a disease of high prevalence and
impact in children and adolescents and should be seen as a Public Health problem.
Important regional variations, not well understood yet, and several risk factors
were found, which makes us wonder: is there only one or many asthmas in Brazil?
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Affiliation(s)
- Dirceu Solé
- Departamento de Pediatria, Escola Paulista de Medicina, Unifesp, Sao Paulo, SP, Brasil
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Sá-Sousa A, Jacinto T, Azevedo LF, Morais-Almeida M, Robalo-Cordeiro C, Bugalho-Almeida A, Bousquet J, Fonseca JA. Operational definitions of asthma in recent epidemiological studies are inconsistent. Clin Transl Allergy 2014; 4:24. [PMID: 25136441 PMCID: PMC4136946 DOI: 10.1186/2045-7022-4-24] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 07/15/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The best combination of questions to define asthma in epidemiological asthma studies is not known. We summarized the operational definitions of asthma used in prevalence studies and empirically assess how asthma prevalence estimates vary depending on the definition used. METHODS We searched the Thomson Reuters ISI Web of knowledge and included (1) cross-sectional studies (2) on asthma prevalence (3) conducted in the general population and (4) containing an explicit definition of asthma. The search was limited to the 100 most-cited papers or published since January 2010. For each paper, we recorded the asthma definition used and other variables. Then we applied the definitions to the data of the Portuguese National Asthma survey (INAsma) and of the 2005-2006 National Health and Nutrition Examination Survey (NHANES) computing asthma prevalence estimates for the different definitions. RESULTS Of 1738 papers retrieved, 117 were included for analysis. Lifetime asthma, diagnosed asthma and current asthma were defined in 8, 12 and 29 different ways, respectively. By applying definitions of current asthma on INAsma and NHANES data, the prevalence ranged between 5.3%-24.4% and 1.1%-17.2%, respectively. CONCLUSIONS There is considerable heterogeneity in the definitions of asthma used in epidemiological studies leading to highly variable estimates of asthma prevalence. Studies to inform a standardized operational definition are needed. Meanwhile, we propose a set of questions to be reported when defining asthma in epidemiological studies.
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Affiliation(s)
- Ana Sá-Sousa
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
| | - Tiago Jacinto
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal
| | - Luís Filipe Azevedo
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Health Information and Decision Sciences Department – CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Mário Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - Carlos Robalo-Cordeiro
- Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | | | - Jean Bousquet
- Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire Montpellier, Montpellier, France
- Centre de recherche en Epidémiologie et Santé des Populations, CESP Inserm U1018, Villejuif, France
| | - João Almeida Fonseca
- Center for research in health technologies and information systems.– CINTESIS, Universidade do Porto, Porto, Portugal
- Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal
- Health Information and Decision Sciences Department – CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Faculdade de Medicina da Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
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Luna MDFGD, Fischer GB, Luna JRGD, Silva MGCD, Almeida PCD, Chiesa D. Prevalences of asthma and rhinitis among adolescents in the city of Fortaleza, Brazil: temporal changes. J Bras Pneumol 2013; 39:128-37. [PMID: 23670497 PMCID: PMC4075819 DOI: 10.1590/s1806-37132013000200003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 03/04/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the prevalences of asthma and rhinitis in adolescents (13-14 years of age) in the city of Fortaleza, Brazil, in 2010, comparing the results with those obtained in a prevalence survey conducted in 2006-2007. METHODS This was a cross-sectional study involving probabilistic samples of 3,015 and 3,020 adolescents in surveys conducted in 2006-2007 and 2010, respectively. The International Study of Asthma and Allergies in Childhood protocol was used on both occasions. RESULTS Comparing the two periods, there were no significant differences regarding cumulative wheezing, active asthma, four or more wheezing attacks within the last year, sleep disturbed by wheezing more than one night per week, and speech-limiting wheezing. The prevalences of exercise-induced wheezing, dry cough at night, and physician-diagnosed asthma were significantly higher in 2010 than in the 2006-2007 period (p < 0.01 for all). The prevalence of physician-diagnosed rhinitis was significantly lower in 2010 (p = 0.01), whereas there were no significant differences between the two periods regarding cumulative rhinitis, current rhinitis, and rhinoconjunctivitis. In both periods, dry cough at night, current rhinitis, and rhinoconjunctivitis were significantly more prevalent in females than in males (p < 0.01 for all). Also in both periods, active asthma, current rhinitis, and rhinoconjunctivitis were more prevalent in private school students than in public school students (p < 0.01 for all). CONCLUSIONS Our data show that the prevalences of asthma and rhinitis symptoms remain high among 13- and 14-year-olds in Fortaleza, predominantly among females and private school students.
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