RESUMO
BACKGROUND: Inuit children in Nunavut, Canada, have high rates of lower respiratory tract infection (LRTI) early in life. Whether this commonly results in chronic respiratory symptoms later in life is unknown. METHODS: A cross-sectional survey of 3- to 5-years-old Inuit children was conducted in all three regions of Nunavut, as part of the "Qanuippitali, what about us, how are we?" survey. RESULTS: Reported chronic cough and wheezing were common in preschool Inuit children, although reported asthma diagnosed by a healthcare professional was uncommon. The presence of smokers in the home tended to be associated with severe LRTI in the first 2 years of life. Reported wheezing as well as reported bronchitis or pneumonia in the previous 12 months was significantly associated with severe LRTI in the first 2 years of life. Reported wheezing was also strongly associated with reported bronchitis or pneumonia in the past 12 months. The prevalence of chronic moist cough could not be clearly assessed, due to limitations in the questionnaire. INTERPRETATION: Severe LRTI in the first 2 years of life was associated with ongoing respiratory morbidity in preschool Inuit children, although symptoms appeared to lessen in severity over time.
Assuntos
Inuíte/estatística & dados numéricos , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/etiologia , Infecções Respiratórias/complicações , Assistência Ambulatorial/estatística & dados numéricos , Asma/epidemiologia , Asma/etiologia , Aleitamento Materno/estatística & dados numéricos , Bronquiolite/complicações , Bronquiolite/epidemiologia , Bronquiolite/etiologia , Canadá/epidemiologia , Pré-Escolar , Centros Comunitários de Saúde , Tosse/epidemiologia , Tosse/etiologia , Estudos Transversais , Feminino , Hospitalização/estatística & dados numéricos , Habitação/estatística & dados numéricos , Humanos , Masculino , Morbidade , Pneumonia/complicações , Pneumonia/epidemiologia , Pneumonia/etiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/etiologia , Prevalência , Sons Respiratórios/etiologia , Doenças Respiratórias/complicações , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/etiologia , Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Inquéritos e Questionários , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/estatística & dados numéricosRESUMO
BACKGROUND: Adrenal suppression secondary to high-dose inhaled corticosteroid use has been reported in children. METHODS: The authors report the use of ciclesonide to reverse adrenal suppression secondary to inhaled fluticasone use in four pediatric patients. RESULTS: In these four children, hypothalamic-pituitary-adrenal axis function normalized after the patients were changed to ciclesonide, while good asthma control was maintained. CONCLUSIONS: Ciclesonide should be considered for the reversal of adrenal suppression secondary to the use of fluticasone, and perhaps other older inhaled corticosteroids as well.