1
|
Mallol J, Solé D, Garcia-Marcos L, Rosario N, Aguirre V, Chong H, Urrutia-Pereira M, Szulman G, Niederbacher J, Arruda-Chavez E, Toledo E, Sánchez L, Pinchak C. Prevalence, Severity, and Treatment of Recurrent Wheezing During the First Year of Life: A Cross-Sectional Study of 12,405 Latin American Infants. Allergy Asthma Immunol Res 2015; 8:22-31. [PMID: 26540498 PMCID: PMC4695404 DOI: 10.4168/aair.2016.8.1.22] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/15/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE This study aimed to determine the prevalence and severity of recurrent wheezing (RW) defined as ≥3 episodes of wheezing, risk factors, and treatments prescribed during the first year of life in Latin American infants. METHODS In this international, cross-sectional, and community-based study, parents of 12,405 infants from 11 centers in 6 South American countries (Argentina, Brazil, Chile, Colombia, Peru, and Uruguay) completed a questionnaire about wheezing and associated risk/protective factors, asthma medications, and the frequency of and indications for the prescription of antibiotics and paracetamol during the first year of life. RESULTS The prevalence of RW was 16.6% (95% CI 16.0-17.3); of the 12,405 infants, 72.7% (95% CI 70.7-74.6) visited the Emergency Department for wheezing, and 29.7% (27.7-31.7) was admitted. Regarding treatment, 49.1% of RW infants received inhaled corticosteroids, 55.7% oral corticosteroids, 26.3% antileukotrienes, 22.9% antibiotics ≥4 times mainly for common colds, wheezing, and pharyngitis, and 57.5% paracetamol ≥4 times. Tobacco smoking during pregnancy, household income per month <1,000 USD, history of parental asthma, male gender, and nursery school attendance were significant risk factors for higher prevalence and severity of RW, whereas breast-feeding for at least 3 months was a significant protective factor. Pneumonia and admissions for pneumonia were significantly higher in infants with RW as compared to the whole sample (3.5-fold and 3.7-fold, respectively). CONCLUSIONS RW affects 1.6 out of 10 infants during the first year of life, with a high prevalence of severe episodes, frequent visits to the Emergency Department, and frequent admissions for wheezing. Besides the elevated prescription of asthma medications, there is an excessive use of antibiotics and paracetamol in infants with RW and also in the whole sample, which is mainly related to common colds.
Collapse
Affiliation(s)
- Javier Mallol
- Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile.
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Luis Garcia-Marcos
- Pediatric Respiratory and Allergy Units, "Virgen de la Arrixaca" University Children's Hospital, University of Murcia, and IMIB Research Institute, Murcia, Spain
| | - Nelson Rosario
- Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Viviana Aguirre
- Department of Pediatric Respiratory Medicine, Hospital El Pino, University of Santiago de Chile (USACH), Santiago, Chile
| | - Herberto Chong
- Department of Pediatrics, Hospital de Clínicas, Federal University of Paraná (UFPR), Curitiba, Brazil
| | | | | | - Jurg Niederbacher
- Escuela de Medicina, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Erika Arruda-Chavez
- Section of Allergy and Clinical Immunology, British American Hospital, Lima, Peru
| | - Eliana Toledo
- Hospital de Base de São José do Rio Preto, Faculty of Medicine of Sao José do Rio Preto, São Paulo, Brazil
| | - Lillian Sánchez
- Department of Pediatrics, Federal University of Mato Grosso, Cuiaba, Brazil
| | - Catalina Pinchak
- Clínica Pediátrica "B". Hospital Pereira Rossell, Facultad Medicina, Universidad de la Republica, Montevideo, Uruguay
| | | |
Collapse
|
2
|
Montenegro-Medina YM, Rey-Caro LA, Niederbacher J, Martínez-Vega RA, Díaz-Quijano FA, Villar-Centeno LÁ. [Roll of antibodies antiplatelets in viral infection: a systematic review of literature]. Biomedica 2011; 31:35-43. [PMID: 22159482 DOI: 10.1590/s0120-41572011000100006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 04/10/2010] [Accepted: 09/25/2010] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Thrombocytopenia is a frequent phenomenon in viral infections. Peripheral platelet destruction mediated by anti-platelet antibodies has been one of the proposed causal mechanisms. OBJECTIVE Results were collected and analyzed from published studies on associations of human viral infections on anti-platelet antibodies and total platelet counts. MATERIALS AND METHODS A PubMed search was conducted using the following terms: Viral infection (OR Virus diseases) AND antiplatelet antibody (OR thrombocytopenia) AND HIV (OR measles OR dengue OR chickenpox OR varicella OR Epistein Barr OR mumps OR rubella). Two hundred eighteen reference hits were obtained, 65 of which were relevant to this review. RESULTS Antiplatelet antibody-mediated thrombocytopenia has been documented in cases of HIV, measles, dengue, chickenpox, Epstein-Barr, mumps and rubella. Moreover, the presence of these antibodies has been associated with severity the disease and thrombocytopenia in viral infections. CONCLUSIONS Although the presence of antiplatelet antibodies was not the only mechanism for explaining the thrombocytopenia developed in these viral infections, their presence was associated with severity of thrombocytopenia and with the clinical presentation of these patients.
Collapse
|
3
|
Ospina S, Gabriela Becerra M, Aguirre C, Cristina Mariño A, Esperanza Galvis C, Inés Villarreal M, De la Hoz F, Méndez H, Sierra A, López P, Pérez J, Niederbacher J, Espinal C, Mojica A. Seroprevalencia del virus de la hepatitis A en niños de 1 a 15 años en un hospital universitario. Infectio 2011. [DOI: 10.1016/s0123-9392(11)70070-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
4
|
Rodríguez LA, Rey JJ, Herrera AB, Castro H, Niederbacher J, Vera LM, Cala LL, Bolívar F. [Respiratory symptoms associated with asthma prevalence and air pollution in preschool children]. Biomedica 2010; 30:15-22. [PMID: 20890545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Accepted: 07/27/2009] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Increases in the air pollution levels has well-documented harmful effects on human health, especially exacerbating problems of asthma and other allergies. OBJECTIVE The prevalence of symptoms associated with asthma was determined in preschool populations in zones with differing levels of air pollution. MATERIALS AND METHODS A cross-sectional study was conducted in Bucaramanga, Colombia, comparing respiratory symptoms in 768 children under seven years in two urban zones with different pollution levels of particulate matter and ozone. Morbidity was evaluated for respiratory indicators of asthma by means of a questionnaire version previously validated in Spanish. RESULTS The use of cigarettes (27.5%) and aerosols (22.7%) were the most frequent source of indoor air pollution. Wheezing prevalence was 25.6% (95% CI 23.2-29.8%) and diagnosis of asthma was 8.4% (95% CI 6.2-11.5%), with no differences between zones. The final multivariate model did not show an association between outdoor pollution and symptoms related with asthma. However, concrete flooring and presence of mold did show an association with these symptoms. CONCLUSIONS Indoor air quality rather than outdoor air pollution may play a more important role in producing respiratory symptoms related with asthma in preschool children in the city of Bucaramanga, Colombia.
Collapse
|