Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 13 de 13
Filtrar
1.
Immun Ageing ; 21(1): 17, 2024 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-38454515

RESUMEN

BACKGROUND: Several risk factors have been involved in the poor clinical progression of coronavirus disease-19 (COVID-19), including ageing, and obesity. SARS-CoV-2 may compromise lung function through cell damage and paracrine inflammation; and obesity has been associated with premature immunosenescence, microbial translocation, and dysfunctional innate immune responses leading to poor immune response against a range of viruses and bacterial infections. Here, we have comprehensively characterized the immunosenescence, microbial translocation, and immune dysregulation established in hospitalized COVID-19 patients with different degrees of body weight. RESULTS: Hospitalised COVID-19 patients with overweight and obesity had similarly higher plasma LPS and sCD14 levels than controls (all p < 0.01). Patients with obesity had higher leptin levels than controls. Obesity and overweight patients had similarly higher expansions of classical monocytes and immature natural killer (NK) cells (CD56+CD16-) than controls. In contrast, reduced proportions of intermediate monocytes, mature NK cells (CD56+CD16+), and NKT were found in both groups of patients than controls. As expected, COVID-19 patients had a robust expansion of plasmablasts, contrasting to lower proportions of major T-cell subsets (CD4 + and CD8+) than controls. Concerning T-cell activation, overweight and obese patients had lower proportions of CD4+CD38+ cells than controls. Contrasting changes were reported in CD25+CD127low/neg regulatory T cells, with increased and decreased proportions found in CD4+ and CD8+ T cells, respectively. There were similar proportions of T cells expressing checkpoint inhibitors across all groups. We also investigated distinct stages of T-cell differentiation (early, intermediate, and late-differentiated - TEMRA). The intermediate-differentiated CD4 + T cells and TEMRA cells (CD4+ and CD8+) were expanded in patients compared to controls. Senescent T cells can also express NK receptors (NKG2A/D), and patients had a robust expansion of CD8+CD57+NKG2A+ cells than controls. Unbiased immune profiling further confirmed the expansions of senescent T cells in COVID-19. CONCLUSIONS: These findings suggest that dysregulated immune cells, microbial translocation, and T-cell senescence may partially explain the increased vulnerability to COVID-19 in subjects with excess of body weight.

2.
Sleep Breath ; 2023 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-38062225

RESUMEN

PURPOSE: To describe sleep and quality of life of pediatric patients with chronic obstructive respiratory diseases and to ascertain whether or not sleep quality correlates with quality of life in this population. METHODS: Participants aged 5 to 18 years with cystic fibrosis (CF), severe asthma, or postinfectious bronchiolitis obliterans (PIBO) receiving regular follow-up at a pediatric respiratory medicine center were recruited. Two questionnaires were used: the Brazilian version of the Sleep Disturbance Scale for Children (SDSC) and the Pediatric Quality of Life Inventory (Peds-QL). RESULTS: A total of 46 individuals were included: 30 with CF, 9 with severe asthma, and 7 with PIBO. Almost two-thirds of the patients and their parents or guardians scored at least 39 points on the SDSC, suggesting poor sleep quality. Significantly higher overall median scores were observed in those with severe asthma. Patients and their parents or guardians scored a median of 77 and 80 points respectively on the Peds-QL, with parents of patients with CF scoring higher than any other group. There was a moderate inverse correlation between sleep disorders and quality of life (r = - 0.532 for patients and r = - 0.606 for parents; p < 0.001). CONCLUSION: Children and adolescents with chronic obstructive respiratory diseases experience impairment in their sleep quality and quality of life. Sleep disorders and quality of life have a moderate negative correlation.

3.
J Am Heart Assoc ; 12(23): e029627, 2023 12 05.
Artículo en Inglés | MEDLINE | ID: mdl-38014655

RESUMEN

BACKGROUND: Arterial hypertension is the greatest cause of morbidity and mortality worldwide. Our aim was to investigate the prevalence of and factors associated with high blood pressure (HBP) among adolescents. METHODS AND RESULTS: The Pelotas 2004 Birth Cohort included 4231 newborns from hospital births in Pelotas, Brazil. A digital automatic OMRON sphygmomanometer (model HEM 742) was used to measure blood pressure on 3 occasions (at 6, 11, and 15 years of age). Those with blood pressure ≥95th percentile for age, height, and sex on each of the 3 occasions were considered as presenting HBP. Independent variables included family (income and history of arterial hypertension), maternal (schooling, age, pregestational body mass index, and smoking during pregnancy), and adolescent characteristics at birth (sex, skin color, gestational age, intrauterine growth, and systolic and diastolic genetic factors), and at 15 years (sleep, physical activity, sodium intake, screen time, work, body mass index, fat mass index, fat-free mass index, growth pattern, and puberty status). The prevalence of HBP (95% CI) was calculated. Crude and adjusted odds ratios (ORs) stratified by sex were obtained by logistic regression. A total of 1417 adolescents with complete information on blood pressure on the 3 occasions were analyzed. The prevalence of HBP was 3.2% (95% CI, 1.9%-4.5%) in female adolescents and 4.3% (95% CI, 2.8%-5.8%) in male adolescents. Female adolescents with a family history of arterial hypertension had a 3 times higher chance of HBP than their counterparts (OR, 3.1 [95% CI, 1.26-7.54]). In male adolescents, excessive maternal pregestational weight was associated with a 2.3-fold increase in the chance of HBP. In both sexes, excessive adolescent weight was associated with HBP (ORs, 3.5 and 5.0, for female and male adolescents, respectively). A higher fat mass index and fat-free mass index in female (ORs, 1.4 and 1.2, respectively) and male adolescents (ORs, 2.5 and 3.0, respectively) increased the chance of HBP. Among male adolescents, the chance of HBP was higher among those with rapid weight gain between 48 months and 6 years and between 6 and 11 years and rapid height gain between 6 and 11 years. CONCLUSIONS: Higher fat mass in both sexes and rapid weight gain in male adolescents are risk factors for HBP in adolescents aged 15 years, potentially amenable to prevention.


Asunto(s)
Hipertensión , Embarazo , Adolescente , Humanos , Masculino , Recién Nacido , Femenino , Estudios de Cohortes , Prevalencia , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/etiología , Factores de Riesgo , Presión Sanguínea/fisiología , Índice de Masa Corporal , Aumento de Peso
4.
J Bras Pneumol ; 48(1): e20210290, 2022.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-35137869

RESUMEN

OBJECTIVE: To assess respiratory system impedance (Zrs) and spirometric parameters in children and adolescents with and without a history of preterm birth. METHODS: We evaluated a sample of 51 subjects between 11 and 14 years of age: 35 who had a history of preterm birth (preterm group) and 16 who had been born at term (full-term group). Lung function was measured by spirometry, spectral oscillometry, and intra-breath oscillometry. RESULTS: Neither spirometry nor spectral oscillometry revealed any statistically significant differences between the preterm and full-term groups. However, intra-breath oscillometry demonstrated significant differences between the two groups in terms of the change in resistance, reactance at end-inspiration, and the change in reactance (p < 0.05 for all). CONCLUSIONS: Our findings suggest that abnormalities in Zrs persist in children and adolescents with a history of preterm birth and that intra-breath oscillometry is more sensitive than is spectral oscillometry. Larger studies are needed in order to validate these findings and to explore the impact that birth weight and gestational age at birth have on Zrs later in life.


Asunto(s)
Nacimiento Prematuro , Adolescente , Adulto , Niño , Femenino , Volumen Espiratorio Forzado , Humanos , Recién Nacido , Pulmón , Oscilometría , Embarazo , Nacimiento Prematuro/diagnóstico , Espirometría
5.
J. bras. pneumol ; 48(1): e20210290, 2022. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1360539

RESUMEN

ABSTRACT Objective: To assess respiratory system impedance (Zrs) and spirometric parameters in children and adolescents with and without a history of preterm birth. Methods: We evaluated a sample of 51 subjects between 11 and 14 years of age: 35 who had a history of preterm birth (preterm group) and 16 who had been born at term (full-term group). Lung function was measured by spirometry, spectral oscillometry, and intra-breath oscillometry. Results: Neither spirometry nor spectral oscillometry revealed any statistically significant differences between the preterm and full-term groups. However, intra-breath oscillometry demonstrated significant differences between the two groups in terms of the change in resistance, reactance at end-inspiration, and the change in reactance (p < 0.05 for all). Conclusions: Our findings suggest that abnormalities in Zrs persist in children and adolescents with a history of preterm birth and that intra-breath oscillometry is more sensitive than is spectral oscillometry. Larger studies are needed in order to validate these findings and to explore the impact that birth weight and gestational age at birth have on Zrs later in life.


RESUMO Objetivo: Avaliar a impedância do sistema respiratório (Zsr) e parâmetros espirométricos em crianças e adolescentes com e sem história de prematuridade. Métodos: Foi analisada uma amostra de 51 indivíduos entre 11 e 14 anos de idade: 35 com história de prematuridade (grupo pré-termo) e 16 nascidos a termo (grupo a termo). A função pulmonar foi medida por meio de espirometria, oscilometria espectral e oscilometria intra-breath. Resultados: A espirometria e a oscilometria espectral não revelaram diferenças estatisticamente significativas entre os grupos pré-termo e a termo. No entanto, a oscilometria intra-breath demonstrou diferenças significativas entre os dois grupos quanto à alteração da resistência, à reatância ao final da inspiração e à alteração da reatância (p < 0,05 para todas). Conclusões: Nossos achados sugerem que as anormalidades na Zsr persistem em crianças e adolescentes com história de prematuridade e que a oscilometria intra-breath é mais sensível do que a oscilometria espectral. São necessários estudos maiores para validar esses achados e para explorar o impacto do peso e idade gestacional ao nascer na Zsr mais tarde na vida.

6.
J Bras Pneumol ; 47(6): e20210229, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34909923

RESUMEN

OBJECTIVE: The objective of this study is to evaluate the impact of social distancing resulting from COVID-19 in hospitalizations for infections of the upper airways (URTI), such as acute laryngitis, tracheitis, and otitis media in children aged 0 to 9 years in Brazil, considering that they share the same forms of transmission. METHODS: Data on hospitalizations for acute airway changes and their complications in children <9 years old were obtained from the Database of the Brazilian Department of Public Health Informatics for the period 2015 to 2020. These data were also analyzed by macroregions of Brazil (North, Northeast, Southeast, South, and Midwest). The effect of the social distancing strategy on the increase of acute laryngitis, tracheitis, otitis media, and mastitis, as absolute and relative reductions, was calculated by analyzing the annual calculation of 2015-2019 vs 2020. RESULTS: All the hospitalizations compared in the Unified Health System (SUS) for laryngitis and acute tracheitis and otitis media decreased, considering all states of Brazil. The largest reduction in hospitalization reduction was in the North, with -94% in 2015-2019 vs 2020 in cases of laryngitis and acute tracheitis, and in the Midwest, with - 85% in 2015-2019 vs 2020 in cases of otitis media. CONCLUSION: Hospitalizations for laryngitis, acute tracheitis, and acute otitis media in children <9 years old decreased between March and July 2020 in Brazil, when social distancing measures were adopted due to the COVID-19 pandemic.


Asunto(s)
COVID-19 , Laringitis , Mastoiditis , Otitis Media , Traqueítis , Brasil/epidemiología , Niño , Femenino , Hospitalización , Humanos , Laringitis/epidemiología , Otitis Media/epidemiología , Pandemias , Distanciamiento Físico , SARS-CoV-2 , Traqueítis/epidemiología
7.
Ann Allergy Asthma Immunol ; 127(3): 372-377, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34146698

RESUMEN

BACKGROUND: Asthma control is not well reflected by spirometry, yet this is the most frequently used measure of lung function in asthma clinics. Oscillometry is an alternative technique suitable for those with severe asthma. OBJECTIVE: To investigate usefulness of oscillometry in subjects with severe asthma to determine which outcome variables best reflected asthma control. METHODS: Adults with severe asthma were recruited from a severe asthma clinic in Brazil. Oscillometry (conventional multifrequency measurements between 6 and 32 Hz; intrabreath tracking at 8 Hz) and spirometry were performed. Asthma control was determined by the asthma control test. RESULTS: A total of 60 adults were evaluated; mean age was 56.7 years. There was predominance of women (82%), and most patients (63%) reported onset of asthma symptoms in childhood or adolescence. There were no differences between controlled and uncontrolled asthma in spirometry. Uncontrolled asthma was associated with higher resistance (at 8 and 10 Hz) and more negative reactance (for 6, 8, and 10 Hz) (P < .05) on conventional oscillometry. Intrabreath oscillometry revealed significant differences between controlled and uncontrolled patients with asthma (P < .01 for changes in resistance and reactance between end expiration and end inspiration). The accuracy of the lung function tests in discriminating between controlled and uncontrolled asthma was higher for intrabreath variables (area under the curve = 0.65-0.72). CONCLUSION: Oscillometry, particularly the intrabreath technique, better reflected asthma control than spirometry measures. Our findings suggest that oscillometry may be a useful technique to aid management of severe asthma, with a potential to reflect loss of disease control.


Asunto(s)
Asma/diagnóstico , Oscilometría/métodos , Pruebas de Función Respiratoria/métodos , Adulto , Anciano , Antiasmáticos/uso terapéutico , Asma/tratamiento farmacológico , Asma/fisiopatología , Femenino , Humanos , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad
8.
Respir Med ; 164: 105915, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32217290

RESUMEN

BACKGROUND: Asthma is a common chronic disease in childhood, resulting in high costs for health care systems and society. As of June 2011, the Brazilian Unified Health System (SUS) provides free asthma medications for the population. This study evaluated the impact of this program on asthma admissions in the population aged 1-19 years. In addition, a cost-benefit analysis compared data before and after the introduction of the program. METHODS: This descriptive study was based on information from SUS Information Technology Department (DATASUS). Admission rates and costs of patients aged 1-19 years with diagnosed asthma were compared before (2008-2010) and after (2012-2017) the provision of free inhaled corticosteroid. RESULTS: The asthma admission rate reduced by 28.4% when comparing the two periods (OR 0.71; 95% CI 0.64-0.79). Children aged 1-4 years had a 27.3% reduction in asthma admissions (OR 0.72; 95% CI 0.63-0.82), while those aged 15-19 years had a 39.65% decrease (OR 0.59; 95% CI 0.37-0.95). Asthma admission costs decreased when comparing the two periods (OR 0.68; 95% CI 0.62-0.74). After the introduction of the program, mean cost savings reached US $27,865,905.08 in children aged 1-4 years and US $21,350,660.63 in those aged 5-19 years. CONCLUSION: The economic burden of pediatric asthma on Brazil's public health care system is significant. From 2012 to 2015, free provision of inhaled corticosteroid was cost-effective in all age groups. In 2017, no cost-benefit effect was observed in this population, but asthma admission rate decreased.


Asunto(s)
Corticoesteroides/administración & dosificación , Antiasmáticos/economía , Asma/tratamiento farmacológico , Asma/economía , Análisis Costo-Beneficio , Atención a la Salud/economía , Programas de Gobierno/economía , Admisión del Paciente/economía , Admisión del Paciente/estadística & datos numéricos , Administración por Inhalación , Adolescente , Adulto , Brasil , Niño , Preescolar , Ahorro de Costo/estadística & datos numéricos , Costo de Enfermedad , Femenino , Humanos , Lactante , Masculino , Pediatría , Adulto Joven
9.
Einstein (Sao Paulo) ; 18: eAO5262, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32130328

RESUMEN

OBJECTIVE: To compare the frequency of respiratory tract infections in children treated with OM-85 BV and placebo during the 3-month therapy period, and observation for a further 3 months after treatment. METHODS: A randomized, double-blind, placebo-controlled trial was conducted with 54 children (6 months to 5 years old) with no past history of recurrent respiratory infections attending daycare center. Family members were instructed to administer one capsule per day for 10 consecutive days, for 3 months of OM-85 BV or placebo. Telephone interviews were conducted every 30 days. RESULTS: There was no significant difference in the number of respiratory infections between the groups. The mean number of respiratory tract infection in the OM-85 BV Group in the first 3 months was 0.92±0.87, and in the Placebo Group was 0.74±1.02, and at 6 months it was 1.62±1.47 and 1.03±1.34, respectively. CONCLUSION: OM-85 BV was not effective in the primary prevention of respiratory tract infections. Although most authors recommend the use of this immunostimulant in children with a history of recurrent respiratory infections, more studies are needed to define its usefulness in the primary prevention of respiratory infections in healthy children exposed to few risk factors.


Asunto(s)
Adyuvantes Inmunológicos/uso terapéutico , Extractos Celulares/uso terapéutico , Prevención Primaria/métodos , Lactancia Materna , Guarderías Infantiles , Preescolar , Método Doble Ciego , Femenino , Humanos , Lactante , Masculino , Proyectos Piloto , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Contaminación por Humo de Tabaco , Resultado del Tratamiento
10.
Einstein (Säo Paulo) ; 18: eAO5262, 2020. tab
Artículo en Inglés | LILACS | ID: biblio-1090059

RESUMEN

ABSTRACT Objective To compare the frequency of respiratory tract infections in children treated with OM-85 BV and placebo during the 3-month therapy period, and observation for a further 3 months after treatment. Methods A randomized, double-blind, placebo-controlled trial was conducted with 54 children (6 months to 5 years old) with no past history of recurrent respiratory infections attending daycare center. Family members were instructed to administer one capsule per day for 10 consecutive days, for 3 months of OM-85 BV or placebo. Telephone interviews were conducted every 30 days. Results There was no significant difference in the number of respiratory infections between the groups. The mean number of respiratory tract infection in the OM-85 BV Group in the first 3 months was 0.92±0.87, and in the Placebo Group was 0.74±1.02, and at 6 months it was 1.62±1.47 and 1.03±1.34, respectively. Conclusion OM-85 BV was not effective in the primary prevention of respiratory tract infections. Although most authors recommend the use of this immunostimulant in children with a history of recurrent respiratory infections, more studies are needed to define its usefulness in the primary prevention of respiratory infections in healthy children exposed to few risk factors.


RESUMO Objetivo Comparar a frequência de infecções do trato respiratório em crianças tratadas com OM-85 BV e placebo durante o período de terapia de 3 meses, e observação por mais 3 meses após o tratamento. Métodos Foi realizado estudo randomizado, duplo-cego, controlado por placebo com 54 crianças (6 meses a 5 anos) sem história prévia de infecções respiratórias recorrentes, que frequentavam creches. Os membros da família foram instruídos a administrar uma cápsula por dia durante 10 dias consecutivos, durante 3 meses, de OM-85 BV ou placebo. Entrevistas telefônicas foram realizadas a cada 30 dias. Resultados Não houve diferença significativa no número de infecções respiratórias entre os grupos. O número médio de infecções do trato respiratório no Grupo OM-85 BV nos primeiros 3 meses foi de 0,92±0,87 e, no Grupo Placebo, de 0,74±1,02, e aos 6 meses foi de 1,62±1,47 e 1,03±1,34, respectivamente. Conclusão O OM-85 BV não foi eficaz na prevenção primária de infecções do trato respiratório. Embora a maioria dos autores recomende o uso deste imunoestimulante em crianças com história de infecções respiratórias recorrentes, mais estudos são necessários para definir sua utilidade na prevenção primária de infecções respiratórias em crianças saudáveis expostas a poucos fatores de risco.


Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Prevención Primaria/métodos , Extractos Celulares/uso terapéutico , Adyuvantes Inmunológicos/uso terapéutico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Contaminación por Humo de Tabaco , Lactancia Materna , Guarderías Infantiles , Proyectos Piloto , Método Doble Ciego , Resultado del Tratamiento
11.
Artículo en Portugués | LILACS | ID: biblio-1117501

RESUMEN

Objetivos: verificar o número e as causas de hospitalizações por quedas em idosos brasileiros, além dos gastos federais do Sistema Único de Saúde (SUS), no período de 2000 a 2018. Métodos: trata-se de um estudo ecológico, utilizando informações disponíveis na base de dados do Departamento de Informática do SUS. Foram coletados dados de idosos (≥60 anos) que internaram no SUS devido às quedas no período de 2000 a 2018 no Brasil. Extraíram-se o número de hospitalizações no País e nas regiões (Norte, Nordeste, Sul, Sudeste e Centro-Oeste), as causas das quedas (Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde ­ 10) e o valor de gastos federais. Para fins estatísticos, utilizou-se análise descritiva. Resultados: totalizaram-se 1,48 milhões de hospitalizações por quedas em idosos no Brasil, com uma taxa de 38,6 a cada 10 mil. As principais causas desses registros no DATASUS foram as "quedas sem especificações", as "outras quedas no mesmo nível" e as "quedas no mesmo nível por escorregão, tropeção ou passos em falsos". Em relação às localidades, os idosos pertencentes às regiões Sudeste (47,1), Sul (44,1) e Centro-Oeste (40,4) foram aqueles que apresentaram maiores medianas das taxas de hospitalizações por quedas no período analisado. Entretanto, o Nordeste (variação%=0,4), o Sul (variação%=0,2) e o Centro-Oeste (variação%=0,2) demonstraram maiores elevações desse indicador ao longo dos 18 anos, enquanto apenas a região Norte apresentou redução (variação%=-0,5). A mediana de gastos hospitalares federais (milhões) foi de R$135,58, variando de R$112,89 até R$194,98. Conclusões: houve aumento das taxas de hospitalizações por quedas em idosos no SUS em quase todas as unidades federativas. As causas mais frequentes foram as "quedas sem especificações", as "outras quedas no mesmo nível" e as "quedas no mesmo nível por escorregão, tropeção ou passos em falsos". Além disso, ocorreu elevação dos gastos hospitalares federais ao longo do período no País.


Aims: to verify the number and causes of hospitalizations for falls in Brazilian elderly, in addition to the federal expenses of the Unified Health System (SUS), in the period from 2000 to 2018. Methods: this is an ecological study, using information available in the database of the SUS Department of Informatics. Data were collected from elderly (≥60 years) who were admitted to SUS due to falls in the period from 2000 to 2018 in Brazil. The number of hospitalizations in the country and in the regions (North, Northeast, South, Southeast and Midwest), the causes of falls (International Statistical Classification of Diseases and Related Health Problems ­ 10) and the amount of federal spending were extracted. For statistical purposes, descriptive analysis was used. Results: there were 1.48 million hospitalizations for falls in the elderly in Brazil, with a rate of 38.6 per 10,000. The main causes of these records in DATASUS were "falls without specifications", "other falls on the same level" and "falls on the same level due to slips, trips or false steps". Regarding the locations, the elderly belonging to the Southeast (47.1), South (44.1) and Midwest (40.4) regions were those who had the highest median hospitalization rates for falls in the analysed period. However, the Northeast (variation%=0.4), the South (variation%=0.2) and the Midwest (variation%=0.2) showed greater increases in this indicator over the age of 18, while only the North region showed a reduction (variation%=-0.5). The median federal hospital expenses (million) was R$135.58, ranging from R$112.89 to R$194.98. Conclusions: there was an increase in hospitalization rates due to falls in the elderly in SUS, in almost all federative units. The most frequent causes were "falls without specifications", "other falls on the same level" and "falls on the same level due to slips, trips or false steps". In addition, there was an increase in federal hospital spending over the period in the country.


Asunto(s)
Accidentes por Caídas , Sistema Único de Salud , Anciano , Indicadores de Salud , Costos de Hospital , Geriatría , Hospitalización , Medicina
12.
Respir Med ; 121: 21-25, 2016 12.
Artículo en Inglés | MEDLINE | ID: mdl-27888987

RESUMEN

BACKGROUND: Since June 2011, the Brazilian health system started providing asthma medications (beclomethasone and salbutamol), totally free of charge to patients with asthma. The aim of this study was to evaluate the impact of the provision of free asthma medications on hospital admissions for asthma in Brazil, using a national hospitalization database (DATASUS), comparing the incidence of hospital admissions before and after the free supply of these drugs. METHODS: Admissions of patients with 1-49 years of age by the Brazilian public health system with the diagnosis of asthma were compared pre (2008-2010) and post (2012-2014) provision of free medicines (beclomethasone and salbutamol). The number of hospital admissions due to asthma and non-respiratory diseases, as well as the amount spent with asthma hospitalization, were obtained from DATASUS, the Brazilian government open-access public health database system. RESULTS: Admission rates for asthma significantly decreased from 90.09/100.000 (2008-2010) to 59.85/100.000 (2012-2014), when the period pre and post provision of free medicines were compared [OR 0.67 (CI 0.48-0.92)]. Non-respiratory admission rates remained stable, when both periods were also compared. CONCLUSION: Asthma hospitalization rates significantly decreased in the three-year period after the provision of free medicines to treat asthma. Our findings suggest that the provision of free medications for asthma may have a particular public health impact by its own in developing countries.


Asunto(s)
Antiasmáticos/economía , Asma/tratamiento farmacológico , Costos de los Medicamentos/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Albuterol/economía , Albuterol/uso terapéutico , Antiasmáticos/uso terapéutico , Asma/economía , Asma/epidemiología , Beclometasona/economía , Beclometasona/uso terapéutico , Brasil/epidemiología , Niño , Preescolar , Bases de Datos Factuales , Femenino , Glucocorticoides/economía , Glucocorticoides/uso terapéutico , Costos de la Atención en Salud/estadística & datos numéricos , Costos de la Atención en Salud/tendencias , Hospitalización/tendencias , Humanos , Lactante , Masculino , Persona de Mediana Edad
13.
Fisioter. pesqui ; 23(2): 193-200, abr.-jun. 2016. tab, graf
Artículo en Portugués | LILACS | ID: lil-795196

RESUMEN

RESUMO O objetivo deste estudo foi avaliar a frequência de sucesso de pré-escolares e escolares com e sem sintomas respiratórios nos testes de função pulmonar. Foram incluídas crianças e adolescentes com idade entre quatro e 12 anos com e sem sintomas respiratórios, baseados no questionário de doenças respiratórias. Os participantes foram recrutados em duas escolas e classificados, de acordo com sua faixa etária, em pré-escolares (4-6 anos) e escolares (7-12 anos). Foram coletados dados demográficos e antropométricos, além das variáveis dos testes de manovacuometria (PIMAX e PEMAX) e de espirometria (VEF1, CVF, VEF1/CVF e FEF25-75%). Os testes de função pulmonar foram considerados bem-sucedidos quando os participantes preenchiam os critérios de aceitabilidade e reprodutibilidade das diretrizes nacionais e internacionais. Para fins estatísticos, utilizou-se o teste de qui-quadrado e correlação de Pearson. Foram incluídos 148 participantes, com média de idade de 8,1±1,7 anos, sendo 51,4% do sexo feminino e 85,1% saudáveis. A taxa de sucesso no teste de manovacuometria e de espirometria foi de 91,9% e 91,2%, respectivamente. Houve uma taxa de sucesso significativamente menor no grupo de pré-escolares em comparação aos escolares, tanto para o teste de manovacuometria (p=0,044) como para o exame espirométrico (p=0,015). As correlações entre as variáveis do teste de manovacuometria e do exame espirométrico mostraram-se positivas e moderadas entre a PIMAX e a CVF, e a PEMAX e o VEF1 e FEF25-75%. Os achados demonstram uma frequência de sucesso significativamente menor no grupo etário pré-escolar em comparação com os sujeitos escolares em ambos os testes de função pulmonar avaliados.


RESUMEN Este estudio tiene por objeto evaluar la frecuencia de éxito en los preescolares y escolares con y sin síntomas respiratorios en pruebas de función pulmonar. Del estudio, participaron niños y adolescentes de 4 a 12 años de edad con y sin síntomas respiratorios, con base en el cuestionario de enfermedades respiratorias. Se les invitaron a los participantes de dos escuelas, y se los clasificaron según el rango etario en preescolares (4-6 años) y escolares (7-12 años). Se recolectaron datos demográficos y antropométricos, además de las variables de la prueba de presión inspiratoria y presión espiratoria máximas (PImáx y PEmáx) y espirometría (VEF1, CVF, VEF1/CVF y FEF25-75%). Se consideraron las pruebas de función pulmonar exitosas cuando los participantes rellenaban los criterios de aceptación y reproducción de las directrices nacional e internacional. Para análisis estadístico, se empleó la prueba Chi-cuadrado y la correlación de Pearson. Se incluyeron 148 participantes, con promedio de edad de 8,1±1,7 años, siendo el 51,4% del género femenino y el 85,1% saludables. Las tasas de éxito en la prueba de presión inspiratoria y presión espiratoria máximas y de espirometría fueron de 91,9% y 91,2%, respectivamente. Hubo una tasa de éxito significativamente menor en el grupo preescolar en comparación con el escolar, tanto en la prueba de presión inspiratoria y presión espiratoria máximas (p=0,044) como para la de espirometría (p=0,015). Las correlaciones entre las variables de la prueba de presión inspiratoria y presión espiratoria máximas y la de la espirometría presentaron valores positivos y moderados entre la PImáx y la CVF, y la PEmáx y VEF1 y FEF25-75%. Los resultados mostraron una frecuencia de éxito significativamente menor para el grupo preescolar en comparación con el escolar en ambas pruebas de función pulmonar evaluadas.


ABSTRACT The aim of this study was to evaluate the success rate of preschool and school children with/without respiratory symptoms in pulmonary function tests. Children and adolescents, aged 4 to 12 years, with/without respiratory symptoms based on the questionnaire of respiratory diseases were included. Participants were recruited from two schools and classified according to their age group in preschool children (4-6 years) and school children (7-12 years). We collected demographic and anthropometric data, and the variables of the manovacuometry test (MIP and MEP) and spirometry test (FEV1, FVC, FEV1/FVC, and FEF25-75%). Pulmonary function tests were considered successful when the participants reached acceptability and reproducibility criteria established by national and international guidelines. In the statistical analysis, we used the chi-square test and Pearson correlation test. We included 148 participants, mean age of 8.1±1.7 years, being 51.4% female and 85.1% healthy. The success rate for the manovacuometry test and spirometry was 91.9% and 91.2%, respectively. There was a significantly lower success rate in the preschool group, compared to school children for both manovacuometry (p=0.044) and spirometry (p=0.015) tests. We found positive correlations between the MIP and FEV1 and MEP and FEF25-75%. The findings demonstrated a significantly lower success rate in preschool age group, compared to pre-school subjects in both pulmonary function tests evaluated.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...