Cat ownership is associated with increased asthma prevalence and dog ownership with decreased spirometry values

The association between pet ownership and the development of allergic and respiratory diseases has been the aim of several studies, however, the effects of exposure in adults remain uncertain. The aims of the present study were to investigate the prevalence of asthma and lung function status among dog and cat owners. This cross-sectional study was performed at two universities with students and workers who were allocated into 3 groups according to pet ownership in the previous year: cat owners, dog owners, and no pets (control group). Subjects underwent spirometry, bronchial challenge test with mannitol, skin prick tests, and questionnaires about animal exposures and respiratory symptoms. Control group comprised 125 subjects; cat owner group, 51 subjects; and dog owner group, 140 subjects. Cat owners had increased asthma prevalence (defined by symptoms and positive bronchial challenge test), but no changes in lung function compared to the control group. The dog owner group had lower spirometry values (forced expiratory volume in one second and lower forced vital capacity), but similar asthma prevalence, compared to the control group. In the cat owner group, excess of asthma may have an immunological basis, since we found an association with atopy. Although we did not have endotoxin data from volunteers' households, we postulated that low values of lung function were associated to exposure to endotoxins present in environments exposed to dogs.

Sensitization to cat allergen and its association with respiratory allergies: cross-sectional study

ABSTRACT Cats are a significant source of allergens that contribute towards worsening of allergic diseases. The aim of this study was to investigate the association between sensitization to cat allergens and allergic respiratory diseases.This was an observational retrospective study based on the skin pricktests results of patients at a tertiary-level hospital in São Paulo. A total of 1,985 test results were assessed. The prevalence of sensitization to cat allergen was 20% (399 patients). Our data indicated that in this population of atopic patients, a positive skin prick test result for cat allergen was not associated significantly with a diagnosis of respiratory allergy.

Factores asociados a la sibilancia recurrente en lactantes de La Habana, Cuba / Factors associated to the recurrent wheezing in nurslings of Havana, Cuba

Introducción: en Cuba la prevalencia de sibilancia recurrente a nivel poblacional a edades tempranas es desconocida. Objetivo: identificar la magnitud y factores asociados en el lactante con sibilancia recurrente. Método: diseño epidemiológico transversal. Una muestra de 1956 niños entre las edades de 12 a 15 meses que viven en 4 municipios de La Habana fue seleccionada para su inclusión en el estudio. A los que se les aplicó por los investigadores un cuestionario validad internacionalmente y aplicado en el territorio nacional (ISAAC), con vista a obtener datos del primer año de vida. La sibilancia recurrente fue definida por la presencia de 3 ó más episodios. Resultados: la prevalencia de sibilancia recurrente fue de 20 por ciento. Los factores de riesgo de mayor importancia fueron: historia familiar de asma OR 1,89 (IC 95%:1,09-3,27), sospecha de alergia a picadura de insectos OR 1,75 (IC 95 por ciento: 1,09-2,80), antecedente de distress respiratorio al nacimiento OR 1,74 (IC 95 por ciento: 1,36-2,22) y el uso del paracetamol incluido el kogrip OR 1,40 (IC 95 por ciento: 1,14-1,73). Presencia de diferencias significativas del riesgo de sibilancia recurrente entre los 4 municipios luego del ajuste de factores de confusión. Conclusiones: la sibilancia recurrente fue identificada como un problema de salud en La Habana. Factores de riesgo modificables para la sibilancia recurrente fueron detectados en el grupo estudio, al igual que diferencias del riesgo entre los municipios. Hechos que debe tenerse en cuenta para la elaboración de futuras intervenciones(AU)

Introduction: prevalence of recurrent wheezing among Cuban infants is not known. Objective: Identify the magnitude and factors associated to recurrent wheezing in infants. Method: across-sectional epidemiological study was conducted of a sample of 1 956 children aged 12-15 months from four Havana municipalities randomly selected for inclusion in the research. A questionnaire validated internationally and used in the national territory (ISAAC) was applied to collect data about the first year of life. Recurrent wheezing was defined by the presence of three or more episodes. Results: prevalence of recurrent wheezing was 20 percent. The most important risk factors were a family history of asthma OR 1.89 (CI 95 percent:1.09-3.27), suspected allergy to insect bites OR 1.75 (CI 95 percent: 1.09-2.80), a history of respiratory distress at birth OR 1.74 (CI 95 percent: 1.36-2.22) and the use of paracetamol including Kogrip OR 1.40 (CI 95 percent: 1.14-1.73). Risk for recurrent wheezing showed significant differences between the four municipalities after adjustment for confounding factors. Conclusions: recurrent wheezing was identified as a health problem in Havana. Modifiable risk factors for recurrent wheezing were detected in the study sample. Risk differences were found between the municipalities. These facts should be considered when planning future interventions(AU)

Efeito da toxina botulínica tipo A sobre a expressão de neuropeptídeos e o transporte mucociliar nasal em coelhos / Effect of botulinum toxin type A on nasal neuropeptides and mucociliary clearance in rabbits

INTRODUÇÃO: A toxina botulínica tipo A (TXB-A) tem sido testada no tratamento da rinite, principalmente nos casos de rinite idiopática. Sugere-se que um estado de hiper-reatividade do nervo trigêmeo esteja envolvido na fisiopatologia da rinite idiopática. O nervo trigêmeo possui fibras sensitivas não mielinizadas tipo C (FSNMT-C) que contém os neuropeptídeos substância P (SP) e peptídeo relacionado ao gene da calcitonina (CGRP). O óxido nítrico (NO) produzido pelas enzimas óxido nítrico sintase (NOS) também está envolvido nesse processo de neurorregulação nasal. O transporte mucociliar, mecanismo primário de defesa do sistema respiratório, é formado pelo batimento ciliar e muco nasal, e esses componentes podem ser influenciados por diferentes neuropeptídeos e neurotransmissores presentes na mucosa nasal. OBJETIVO: O objetivo deste estudo foi avaliar o efeito da TXB-A sobre a expressão da SP, CGRP e óxido nítrico sintase neural (nNOS), além de sua influência sobre o transporte mucociliar nasal em coelhos. MÉTODOS: Coelhos machos saudáveis da linhagem Nova Zelândia foram divididos em dois grupos: o grupo tratamento recebeu TXB-A (25UI) na concha nasomaxilar (CNM) do lado direito e soro fisiológico a 0,9% (SF0,9%) na CNM esquerda. O grupo controle recebeu SF0,9% na CNM direita e nenhuma intervenção na CNM esquerda. Foram investigados os efeitos da TXB-A sobre a expressão da SP, CGRP e nNOS no tecido de CNM por meio da imuno-histoquímica. Para esta análise, dividiu-se o tecido em camada externa (CE, acima da membrana basal) e camada interna (CI, abaixo da membrana basal). Avaliou-se também a presença de apoptose celular, a frequência de batimento ciliar (FBC), o perfil histoquímico do muco nasal (glicoproteínas ácidas e neutras) e a espessura do epitélio (ESP-CE). RESULTADOS: Foi observado um aumento significativo na quantidade de células apoptóticas na CNM do grupo tratamento que recebeu TXB-A em comparação aos controles (p <= 0,001). A CNM do grupo tratamento...(au)

INTRODUCTION: Botulinum toxin type A (BoNT-A) has been assessed in the treatment of rhinitis, especially in cases of idiopathic rhinitis. Trigeminal hyper-responsiveness appears to be involved in the pathological process of idiopathic rhinitis. Trigeminal nociceptive type C unmyelinated sensory fibers contain the neuropeptides calcitonin gene-related peptide (CGRP) and substance P (SP). Nitric oxide (NO) produced by the enzyme nitric oxide synthase (NOS) are also involved in this nasal neurorregulation process. The mucociliary clearance, primary defense system of the respiratory system, is composed by the ciliary beat and nasal mucus. These components can be influenced by different nasal neuropeptides and neurotransmitters. OBJECTIVE: The aim of this study was to evaluate the effect of BoNT-A on the expression of SP, CGRP and neural nitric oxide synthase (nNOS), and its influence on nasal mucociliary clearance in rabbits. METHODS: Healthy New Zealand male rabbits were divided into two groups: the treatment group was challenged with BoNT-A (25UI) in the right nasomaxillary turbinate (NMT) and saline (SF0.9%) in the left NMT. The control group received SF0.9% in the right NMT and no-intervention in the left NMT. We investigated the effects of BoNT-A on SP, CGRP and nNOS expression in the NMT tissue by immunohistochemistry. Each area of interest was subdivided into an internal layer (IL: below the basement membrane) and outer layer (OL: above the basement membrane) for analysis. It was also assessed signs of cellular apoptosis, ciliary beat frequency (CBF), mucus histochemical profile (acidic and neutral glycoproteins) and epithelial thickness (EP-TH). RESULTS: It was observed a significant increase in the amount of apoptotic cells in the BoNT-A-challanged NMT compared with controls (p <= 0.001). The NMT of treatment group which received only SF0.9% showed an increase in the amount of apoptotic cells in the IL compared with controls (NMT SF0.9%, p = 0.035)...

Factores asociados a morbimortalidad en pacientes pediátricos asmáticos atendidos en el Hospital Nacional Docente Madre Niño San Bartolomé 2014 / Factors associated with mortality and morbidity in asthmatic pediatric patients treated at the Teaching National Hospital Mother Child San Bartolome 2014

Objetivo: Determinar los factores asociados a morbimortalidad en pacientes pediátricos asmáticos atendidos en el Hospital Nacional Docente Madre Niño "San Bartolomé" 2014. Metodología: Estudio observacional, analítico-comparativo, prospectivo de corte transversal. La muestra estuvo constituida por 120 pacientes pediátricos asmáticos menores de 4 años atendidos en el Hospital Nacional Docente Madre Niño "San Bartolomé", los cuales se dividieron en dos grupos: grupo de estudio: pacientes con morbimortalidad y grupo comparativo: pacientes sin morbimortalidad. Para el análisis descriptivo de las variables cuantitativas se estimó medidas de tendencia central y de dispersión, para las variables cualitativas se utilizó frecuencias absolutas y relativas. Además, para el análisis inferencial se emplearon las pruebas Chi-cuadrado y t de student, con un nivel de significancia del 5 por ciento. Resultados: Dentro de las características de los pacientes pediátricos asmáticos menores de 4 años, se encontró que el 28,3 por ciento presentó alguna morbimortalidad, entre ellas la más frecuente fue neumonía (27,5 por ciento), seguido de insuficiencia respiratoria (9,2 por ciento), crisis asmática severa (5,8 por ciento), entre otras. La edad media de los pacientes con morbimortalidad fue 2,24±0,61 años con predominio del sexo masculino (55,9 por ciento), similar característica se encontró en los pacientes sin morbimortalidad. Respecto a los antecedentes personales, se comprobó que los pacientes con morbimortalidad presentaron menor periodo de lactancia que los niños sin morbimortalidad, siendo esta diferencia significativa (p=0,001); además respecto a los antecedentes se observó asociación entre el antecedente familiar de asma y la presencia de morbimortalidad en el niño (p=0,002). Un hallazgo importante a mencionar fue que solo los pacientes asmáticos con morbimortalidad estuvieron expuestos a cambios climáticos (20 por ciento) y presencia de animales domésticos (35,3...

Objective: To determine the factors associated with morbimortality in pediatric patients with asthma treated at the "San Bartolome" Teaching Mother Child National Hospital. Methodology: Observational, analytical-comparative, prospective and cross-sectional study. The sample consisted of 120 asthmatic pediatric patients under 4 years treated at the "San Bartolome" Teaching Mother Child National Hospital, which were divided into two groups: group study: patients with morbidity and comparison group: patients without mortality. For the descriptive analysis of quantitative variables were estimated measures of central tendency and dispersion, for qualitative variables were used absolute and relative frequencies. Also, for the inferential analysis, the Chi-square and t student test, with a significance level of 5 per cent was used. Results: Among characteristics of asthmatic pediatric patients under 4 years, was observed that 28.3 per cent had some morbimortality between the most frequent were pneumonia (27.5 per cent), followed by acute respiratory failure (9.2 per cent), severe asthma attack (5.8 per cent), among others. The mean age of patients with morbimortality was 2.24±0.61 years old with predominance of males (55.9 per cent), similar characteristic was found in patients without morbimortality. Regarding personal history, it was found that patients with morbimortality had lower breastfeeding than children without morbimortality, with significant difference (p=0.001), also about history, was observed association between family history of asthma and presence of morbimortality in child (p=0.002). An important finding was that only asthmatic patients with morbimortality were exposed to climate change (20 per cent) and domestic animals (35.3 per cent). When analyzing the clinical features of asthma was found that sneezing (p=0.001), nasal congestion (p=0.010), fever (p=0.002), vomiting (p=0.018) and previous hospitalizations (p<0.001) were significantly associated...

Murciélagos y ácaros en la alergia respiratoria / Bats and house-dust mites in respiratory allergy

Se valoró la posibilidad de que estos mamíferos ingirieron ácaros del hábitat (dermatophagoides pteronyssinus), y que sus antígenos formaran parte de las heces del murciélago (murcielaquina), y resultaren indirectamente alergénicos para los pacientes atópicos que habían revelado hipersensibilidad a dichas heces...

The possibility that house-dust mite antigens coming from dermatophagoides pteronyssinus were hidden in bat feces was studied in those atopic patients suffering rhinitis and asthma that revealed hypersensibility to bat feces...

Avaliação da resposta IgE para o entendimento do papel de fungos do ar na alergia respiratória em crianças / Evaluation of IgE responses for a better understanding of the role of airborne fungi in respiratory allergy in children

Este estudo realizou-se na cidade de São Luis, Maranhão, com a finalidade de investigar possível relação entre alergia respiratória e elevação sérica de IgE total e IgE específica para fungos isolados de ambientes externos. Métodos: Fizeram parte deste estudo 98 crianças com diagnóstico clínico de asma e/ou rinite alérgica, com idades entre 4 e 12 anos, sendo 65(66,3%) do sexo masculino e 33 (33,7%) do sexo feminino. Quantificaram-se no soro dessas crianças os níveis de IgE total e IgE específica para Aspergillus spp e Penicillium spp, pelo método de ELISA. Resultados: IgE total foi detectada em 95 crianças (96,9%); 73 (74,5%) apresentaram níveis detectáveis de IgE anti-Aspergillus spp e 85 (86,7%) de IgE anti-Penicillium spp. Não houve significância estatística quando foram correlacionados níveis de IgE total, sexo e área de residência das crianças estudadas (p = 0,88). Na correlação entre IgE total e faixa etária verificou-se distribuição não normal dos dados, com destaque à faixa etária de 11 anos, onde os níveis deIgE total foram mais elevados (Teste de Shapiro p < 0,05). Não houve correlação entre IgE anti-Aspergilluse IgE anti-Penicillium com idade, sexo e área de residência. Conclusão: Anticorpos IgE contra os fungos estudados possivelmente fazem parte de uma polissensibilização, já que os fungos estão presentes em todas as áreas e durante todo o ano na cidade de São Luis, Maranhão, Brasil. Serão necessários mais estudos para o entendimento da alergia respiratória por fungos do ar em São Luis, Maranhão...

The present study was carried out in the city of São Luís, capital of the state of Maranhão, northeastern Brazil, with the aim of investigating a possible relationship between respiratory allergies and high serum levels of total IgE and specific IgE for fungi isolated in outdoor environments. Methods: The study included 98 children with a clinical diagnosis of asthma and/or allergic rhinitis, aged 4 to 12 years. Sixty-five (66.3%) were male and 33 (33.7%) female. Total IgE, Aspergillus spp-specific IgE, and Penicillium spp-specific IgE were quantified in the serum of the children using the ELISA method. Results: Total IgE was detected in 95 children (96.9%). Seventy-three (74.5%) showed detectable levels of Aspergillus spp-specific IgE, and 85 (86.7%), of Penicillium spp-specific IgE. There was no significant correlation between total IgE levels, sex, and area of residence among the children assessed (p = 0.88). When assessing the correlation between total IgE levels and age, data were found to have a non-normal distribution, especially in the 11-year old age group, where total IgE levels were higher than in the other ages (Shapiro test, p < 0.05). There was no significant correlation of Aspergillus spp- and Penicillium spp-specific IgE with age, gender, and area of residence. Conclusion: IgE antibodies against the fungi investigated are possibly a part of polysensitization, as these fungi are present in all areas and throughout the year in the city investigated. Further studies are necessary for a better understanding of the role played by fungal sensitization in respiratory allergy in São Luís, Maranhão...

The putative role of ovary removal and progesterone when considering the effect of formaldehyde exposure on lung inflammation induced by ovalbumin

OBJECTIVE: Formaldehyde exposure during the menstrual cycle is known to affect the course of allergic lung inflammation. Because our previous data demonstrated that formaldehyde combined with an ovariectomy reduced allergic lung inflammation, we investigated the putative role of ovary removal and progesterone treatment when considering the effect of formaldehyde on allergic lung inflammation. METHOD: Ovariectomized rats and their matched controls were exposed to formaldehyde (1%, 3 days, 90 min/day) or vehicle, and immediately after exposure, the rats were sensitized to ovalbumin by a subcutaneous route. After 1 week, the rats received a booster by the same route, and after an additional week, the rats were challenged with ovalbumin (1%) by an aerosol route. The leukocyte numbers, interleukin-10 (IL-10) release, myeloperoxidase activity, vascular permeability, ex vivo tracheal reactivity to methacholine and mast cell degranulation were determined 24 h later. RESULTS: Our results showed that previous exposure to formaldehyde in allergic rats decreased lung cell recruitment, tracheal reactivity, myeloperoxidase activity, vascular permeability and mast cell degranulation while increasing IL-10 levels. Ovariectomy only caused an additional reduction in tracheal reactivity without changing the other parameters studied. Progesterone treatment reversed the effects of formaldehyde exposure on ex vivo tracheal reactivity, cell influx into the lungs and mast cell degranulation. CONCLUSION: In conclusion, our study revealed that formaldehyde and ovariectomy downregulated allergic lung inflammation by IL-10 release and mast cell degranulation. Progesterone treatment increased eosinophil recruitment and mast cell degranulation, which in turn may be responsible for tracheal hyperreactivity and allergic lung inflammation. .

Sensibilización a ácaros domésticos en niños asmáticos severos / Sensitization to domestic mites identified in severe asthmatic patients

Introducción: las enfermedades alérgicas y el asma incrementan su prevalencia en Cuba y a nivel mundial. Los ácaros del polvo se encuentran entre los alérgenos perennes más prevalentes en todo el mundo. Objetivo: determinar la sensibilización a 3 especies de ácaros domésticos en los niños asmáticos severos de la Escuela Especial Celia Sánchez Manduley, de Tarará, provincia La Habana. Métodos: se realizó un estudio descriptivo transversal en 91 alumnos, durante el curso escolar 2011-2012, y a toda la muestra se le realizaron pruebas cutáneas por punción (prick test), utilizando extractos Vallergen-BT (Blomia tropicalis), Vallergen-DS (Dermatophagoides siboney) y Vallergen-DP (Dermatophagoides pteronyssinus) confeccionados por el Centro de Biopreparados, en Cuba; además se determinó IgE sérica total. Resultados: la rinitis alérgica resultó la comorbilidad alérgica más frecuente. El total de los pacientes presentó reactividad cutánea positiva a los ácaros, así como IgE sérica total elevada. La sensibilización frente al D. pteronyssinus se reportó en el 93,4 por ciento de los pacientes. No existió diferencia estadísticamente significativa en el diámetro del habón. Existió correlación entre la positividad de la IgE sérica total y la sensibilización cutánea a los 3 ácaros del polvo estudiado. Conclusiones: existe una estrecha relación entre el asma bronquial y la sensibilización a ácaros, con predominio de la especie D. Pteronyssinus

Introduction: the prevalence of allergic diseases and asthma grows in Cuba and worldwide. Dust mites are one of the most prevailing perennial allergens throughout the world. Objective: to determine the sensitization to 3 domestic mite species of severe asmathic children from Celia Sanchez Manduley special school located in Tarara, Havana province. Methods: a cross-sectional descriptive study was carried out in 91 students during the 2011-2012 academic year. The whole sample was performed prick tests using Vallergen-BT (Blomia tropicalis), Vallergen-DS (Dermatophagoides siboney) and Vallergen-DP (Dermatophagoides pteronyssinus) extracts prepared by the National Center of Biopreparations and their total serum IgE were additionally estimated. Results: allergic rhinitis proved to be the most frequent comorbidity. All the patients showed positive skin reactivity to mites as well as increased total serum IgE. Sensitization to D. pteronyssinus was reported in 93.4 percent of patients. There was no statistically significant difference in the habon diameter, but total serum IgE positivity and skin sensitization to the three dust mites under study were correlated. Conclusions: there is close association between bronchial asthma and sensitization to mites, being D. Pteronyssinus predominant

Laboratory animals and respiratory allergies: The prevalence of allergies among laboratory animal workers and the need for prophylaxis

OBJECTIVE: Subjects exposed to laboratory animals are at a heightened risk of developing respiratory and allergic diseases. These diseases can be prevented by simple measures such as the use of personal protective equipment. We report here the primary findings of the Laboratory Animals and Respiratory Allergies Study regarding the prevalence of allergic diseases among laboratory animal workers, the routine use of preventive measures in laboratories and animal facilities, and the need for prevention programs. METHODS: Animal handlers and non-animal handlers from 2 Brazilian universities (University of São Paulo and State University of Campinas) answered specific questionnaires to assess work conditions and symptoms. These subjects also underwent spirometry, a bronchial challenge test with mannitol, and skin prick tests for 11 common allergens and 5 occupational allergens (rat, mouse, guinea pig, hamster, and rabbit). RESULTS: Four hundred fifty-five animal handlers (32±10 years old [mean±SD], 209 men) and 387 non-animal handlers (33±11 years old, 121 men) were evaluated. Sensitization to occupational allergens was higher among animal handlers (16%) than non-animal handlers (3%, p<0.01). Accessibility to personal protective equipment was measured at 85% (median, considering 73 workplaces of the animal handler group). Nineteen percent of the animal handlers indicated that they wear a respirator at all times while handling animals or working in the animal room, and only 25% of the animal handlers had received an orientation about animal-induced allergies, asthma, or rhinitis. CONCLUSION: In conclusion, our data indicate that preventive programs are necessary. We suggest providing individual advice to workers associated with institutional programs to promote a safer work environment. .

Asma na gravidez: atualização no manejo / Asthma in pregnancy: current management

A asma é doença crônica frequente na gestação, cujo descontrole encontra-se associado a desfechos maternos e perinatais desfavoráveis. O manejo da doença apresenta desafios, tais como a resistência das pacientes em utilizar medicações durante a gravidez, além de queixas frequentes de dispneia associada ao estado gravídico, não relacionada à asma. O objetivo do presente trabalho foi revisar os conhecimentos atuais sobre asma na gravidez. As fontes de dados foram revisões e artigos originais publicados nos últimos 12 anos e indexados nas bases de dados PubMed, SciELO e Lilacs. As conclusões deste artigo de revisão indicam que o controle adequado da asma juntamente com a vigilância obstétrica cuidadosa devem ser integrados e constituir objetivo global do tratamento de gestantes asmáticas. O tratamento medicamentoso permite o uso de algumas medicações utilizadas em pacientes não gestantes.

Asthma is a common chronic disease during pregnancy, and inappropriate control of this conditionis associated with unfavorable maternal and perinatal outcomes. Management of asthma duringpregnancy presents challenges, including the patients’ resistance to use medications duringpregnancy and frequent complaints of dyspnea associated with pregnancy but not related toasthma. The objective of the present study was to review the current knowledge about asthmain pregnancy. Data sources included reviews and original articles published in the past 12 yearsand indexed in PubMed, SciELO, and Lilacs databases. Our findings indicate that adequate controlof asthma and careful obstetric follow-up should be integrated and constitute a global goal intreating pregnant women with asthma. Pharmacologic treatment allows for the use of somemedications that are used in non-pregnant patients.

Giardia lamblia e alergia respiratória: estudo em uma amostra de crianças de área urbana com frequência elevada da protozoose / Giardia lamblia and respiratory allergies: a study of children from an urban area with a high incidence of protozoan infections

OBJETIVO: Uma elevada incidência de enteroparasitoses é encontrada em regiões urbanas do nordeste brasileiro. As infecções por Giardia lamblia têm sido relacionadas com aumento da prevalência de alergias cutâneas e gastrointestinais. Contudo, ainda existe pouca informação sobre a associação entre a giardíase e doenças alérgicas das vias aéreas. Diante disso, o presente estudo se propôs a verificar a relação entre a infecção por G. lamblia em crianças de área urbana e reatividade alérgica respiratória. MÉTODOS: O estudo incluiu 110 pacientes, de ambos os sexos e idades, entre 5 e 15 anos. Os pacientes foram submetidos a questionários de avaliação dos sintomas clínicos, testes cutâneos de leitura imediata e exames coproparasitológicos e sorológicos. RESULTADOS: Foi verificada uma frequência elevada de crianças infectadas por G. lamblia (45%, 50/110). A infecção pelo protozoário não foi associada com maior risco de alergias respiratórias (p = 0,075), elevação de IgE total (p = 0,701), IgE específica (p = 0,250) ou teste cutâneo positivo para diferentes alérgenos ambientais (p = 0,239). CONCLUSÃO: O estudo demonstrou que a presença dos sintomas de asma, atopia cutânea e marcadores sorológicos não foram associados com a presença de infecção pela G. lamblia nessa amostra de crianças.

OBJECTIVES: There is a high incidence of intestinal parasite infection in urban areas in the Northeast of Brazil. Giardia lamblia infections have been associated with increased prevalence of cutaneous allergies and gastrointestinal disorders. However, little is known about the relationship between giardiasis and allergic diseases of the airways. The present study aimed to investigate the possible association between respiratory allergic diseases and infections by G. lamblia in children from urban areas. METHODS: This study recruited 110 patients of both sexes aged 5-15 years. Patients were administered a questionnaire evaluating clinical symptoms and were given skin tests, parasite tests and serum tests. RESULTS: A high incidence of G. lamblia was observed (45%, 50/110). Infections by this protozoan were not associated with increased risk of respiratory allergy (p = 0.075), high total IgE levels (p = 0.701), positive specific IgE tests (p = 0.250), or positive skin tests for a range of environmental allergens (p = 0.239). CONCLUSION: This study demonstrated that symptoms of asthma, skin allergy and serum markers were not associated with G. lamblia infections in this sample of children from urban areas.

Asma: a arte do encontro / Asthma: the art of meeting

A asma é um importante problema de Saúde Pública. Estima-se que ela comprometa cerca de 300 milhões de pessoas e mate 250 mil a cada ano, em todo o mundo. Trata-se de uma alteração inflamatória crônica das vias aéreas, cujas principais características incluem, também, grau variável de obstrução ao fluxo aéreo e hiper-responsividade brônquica. O tratamento é baseado em fármacos anti-inflamatórios e broncodilatadores. Para pacientes que permanecem sintomáticos vêm sendo desenvolvidas novas terapias, desenhadas para atingir alvos-chaves na patogenia.

Asthma is a serious health problem throughout the world. It is estimated that 300 million people are affected and 250 thousands are killed by asthma worldwide. Asthma is a multifactorial chronic inflammatory disorder of the airway in which the chief features include a variable degree of airflow obstruction and bronchial hyper-responsiveness, in addition to the underlying chronic airway inflammation. Asthma's treatment is based on anti-inflammatory and bronchodilator drugs. For patients who remain symptomatic new therapies tailored to target key pathways in asthma pathology are being developed.

Evidence of an association between the O blood group and allergic rhinitis

OBJECTIVE: The aim of this study was to verify if ABO phenotypes are associated with allergic rhinitis. METHODS: 168 patients with allergic rhinitis and 168 control individuals from the same geographical region and paired by gender and age were enrolled in the study. ABO phenotypes were identified in red blood cells using the hemagglutination technique. The Fisher exact and chi-squared tests were employed to compare proportions. Statistical significance was set for an alpha error of 5 percent (p-value < 0.05). RESULTS: The overall differences in the frequencies of the ABO phenotypes of patients and controls were marginal (χ2: 7.569; degrees of freedom (DF): 3; p-value = 0.055) however the O blood group was associated with allergic rhinitis (χ2: 5.764; DF: 1; p-value = 0.016; OR: 1.735; CI 95 percent: 1.127-2.673). The differences in the frequencies of the O phenotype in patients and controls were statistically different for men (χ2: 8.520; DF: 1; p-value = 0.003) but not for women (χ2: 0.6375; DF: 1; p-value = 0.4246). The A phenotype was associated with protection (OR: 0.4385; CI 95 percent: 0.2043-0.9415; p-value = 0.049) and the O phenotype was associated with susceptibility (OR = 2.789; CI 95 percent: 1.385-5.616; p-value = 0.005) to allergic rhinitis only for men. CONCLUSION: The O blood group phenotype is associated with allergic rhinitis in male but not in female patients.

Doença do refluxo gastroesofágico e hiperresponsividade das vias aéreas: coexistência além da chance? / Gastroesophageal reflux disease and airway hyperresponsiveness: concomitance beyond the realm of chance?

A doença do refluxo gastroesofágico e a asma são duas condições mundialmente comuns e podem coexistir. Contudo, a natureza da relação entre essas duas doenças ainda não é bem compreendida. Neste artigo, revisamos alguns aspectos controversos da relação entre asma, hiperresponsividade das vias aéreas e refluxo gastroesofágico, tanto em adultos, quanto em crianças.

Gastroesophageal reflux disease and asthma are both quite common the world over, and they can coexist. However, the nature of the relationship between these two diseases remains unclear. In this study, we review controversial aspects of the relationships among asthma, airway hyperresponsiveness, and gastroesophageal reflux disease in adults and in children.

Alergia, pólenes y medio ambiente / Allergy, pollen and the environment

Las enfermedades respiratorias como el asma y la rinitis, de origen predominantemente alérgico, constituyen un problema de salud pública para México, ya que son causas importantes de morbilidad hospitalaria y de ingresos a urgencias pediátricas. Los pólenes son transportados por el viento y se impactan en las vías aéreas causando enfermedad respiratoria alérgica en personas susceptibles. Estudios aerobiológicos en México muestran que en la temporada de secas se encuentra una mayor abundancia y diversidad de pólenes, siendo los árboles la fuente principal. Los tipos polínicos de árboles que sobresalen por su abundancia son Pinus, Fraxinus, Cupressaseae, Alnus, Liquidambar, Callistemon y Casuarina. Interesantemente, el polen de malezas y pastos alcanza su pico máximo de producción durante la temporada de lluvias. Los taxa de malezas y pastos que han sido encontrados de manera más numerosa son Compositae, Cheno-Am, Ambrosia y Gramineae, correspondiendo los primeros tres a malezas y el último a pastos. En la ciudad de México, la contaminación es un factor que exacerba la alergenicidad de los pólenes, ya que los contaminantes causan un efecto directo sobre el propio grano al liberar sus antígenos. En el mundo, el calentamiento global ha favorecido el desarrollo de alergias respiratorias debido a que las etapas de floración son más prolongadas. Todo esto en conjunto representa una amenaza para la salud de los pacientes alérgicos.

Allergic respiratory diseases such asthma and allergic rhinitis are a health problem throughout the world. In Mexico City, pollens are an important cause of allergic respiratory disease. Both, the geographic location- and the vegetation surrounding this City favor the distribution of pollens leading to respiratory disease in susceptible patients. Aerobiological studies have shown that during the mild dry winter there is a large amount of pollens in the environment with tree pollens being the most abundant of all. The most frequent tree pollens found in Mexico City include Fraxinus, Cupressaseae, Alnus, Liquidambar, Callistemon, Pinus, and Casuarina. In contrast, grass- and weed pollens predominate during the summer (rainy season) including Compositae, Cheno-Am, Ambrosia and Gramineae. An additional health problem in Mexico City is the air pollution that exerts a direct effect on individuals. This in turn increases pollen allergenicity by disrupting them leading to the release of their particles which then penetrate the human airways causing disease. Thus, the polluted environment along with global warming which is also known to increase pollen quantities by inducing longer pollen seasons may represent a health risk to Mexico City inhabitants.

Fatores preditivos para realização de cirurgia nasal em uma clínica de otorrinolaringologia no sul do Brasil, no ano de 2007 / Predictive factors for doing nasal surgery in an otolaryngology clinic of in southern Brazil, in 2007

Introdução: Avaliar os principais fatores de risco para realização de cirurgia nasal e relacionar a sensibilidade aos alérgenos inalatórios testados através do RAST e a necessidade dessa cirurgia. Métodos: Foi realizado estudo observacional, longitudinal do tipo coorte retrospectiva, de 155 pacientes que realizaram o RAST no ano de 2007, onde foram analisados sexo, idade, sintomas alérgicos (espirros, obstrução nasal, prurido ocular, prurido nasal e prurido otológico), perfil do RAST, IgE total, IgA, tipo de cirurgia, realização de cirurgia, número de cirurgias, melhora dos sintomas e recidiva dos sintomas clínicos obstrutivos. Resultados: Foi observado como fator de risco para cirurgia nasal: obstrução nasal (RR:2,38~ p<0,001), hipertrofia dos cornetos nasais (RR:2,66~ p<0,001), desvio de septo nasal (RR:2,66~ p<0,001), amigdalites de repetição (RR1,41~ p=0,02), sinusite crônica (RR:1,37~ p=0,02) e sensibilidade a fungos testada do RAST (RR:1,62~ p=0,14). Conclusão: Obstrução nasal, hipertrofia dos cornetos, desvio de septo nasal, amigdalites de repetição, sinusite crônica e sensibilidade a fungos foram fatores de risco para realização de cirurgia nasal. A sensibilidade aos alérgenos testados através RAST grupo específico não se relacionou de forma estatisticamente significativa com a realização de cirurgia nasal, mas sim com as condições clínicas que levam ao tratamento cirúrgico (AU)

Introduction: To evaluate the main risk factors for performing nasal surgery and to relate sensitivity to inhalatory allergens as tested through RAST to the need for this surgery. Methods: An observational longitudinal study was performed with a retrospective cohort of 155 patients who underwent RAST in 2007, in which the following factors were analyzed: sex, age, allergic symptoms (sneezing, nasal obstruction, eye pruritus, ear pruritus) RAST profile, total IgE, IgA, surgery type, surgery performance, number of surgeries, improvement of symptoms, and relapse of obstructive clinical symptoms. Results: The following were identified as risk factors for nasal surgery: nasal obstruction (RR:2.38~ p<0.001), hypertrophy of the nasal cornets (RR:2.66~ p<0.001), nasal septum deviation (RR:2.66~ p<0.001), repetition amygdalitis (RR1.41~ p=0.02), chronic sinusitis (RR:1.37~ p=0.02) and sensitivity to fungi as tested by the RAST (RR:1.62~ p=0.14). Conclusion: Nasal obstruction, cornets hypertrophy, nasal septum deviation, repetition amygdalitis, chronic sinusitis, and sensitivity to fungi were risk factors for the performance of nasal surgery. Although the sensitivity to allergens tested through group-specific RAST was not significantly related to nasal surgery performance, it was significantly related to the clinical conditions that lead to the surgical approach (AU)