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1.
Environ Monit Assess ; 193(4): 198, 2021 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-33730196

RESUMEN

We investigated the association between air pollution and asthma and bronchitis hospital admissions in Algiers city (Algeria). In addition, we used geographic information systems (GIS) and statistical methods to evaluate their correlation with the atmospheric pollution estimated by the lichen biomonitoring method of the index of atmospheric purity (IAP), the index of human impact (IHI) and environmental parameters. Thus, we georeferenced 976 local patients (including 771 patients with asthma and 205 patients with bronchitis). Then, we compared the patients to the spatial distribution of IAP in thirty-five areas (communities). The results revealed a significant difference in the mean spatial variation in the diseases among those areas. In fact, maps and generalized linear models (GLMs) revealed a significant negative correlation between IAP and diseases. Therefore, redundancy analysis (RDA) and Monte Carlo tests described a significant effect of IAP, urbanization and the number of roads on the distribution of diseases. We hope our findings contribute to enriching the literature on health research with a low-cost method of monitoring outdoor air pollution.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Asma , Bronquitis , Líquenes , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Argelia , Asma/epidemiología , Bahías , Monitoreo Biológico , Ciudades , Monitoreo del Ambiente , Sistemas de Información Geográfica , Humanos
3.
Pneumologie ; 75(3): 191-200, 2021 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-33728628

RESUMEN

The present addendum of the guideline for the diagnosis and treatment of asthma (2017) complements new insights into the diagnosis and management of asthma as well as for the newly approved drugs for the treatment of asthma. Current, evidence-based recommendations on diagnostic and therapeutic approaches are presented for children and adolescents as well as for adults with asthma.


Asunto(s)
Asma , Neumología , Adolescente , Adulto , Asma/diagnóstico , Asma/tratamiento farmacológico , Asma/epidemiología , Austria , Niño , Humanos , Sociedades Médicas
6.
Sci Rep ; 11(1): 5895, 2021 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-33723342

RESUMEN

Between March and April 2020, Cyprus and Greece health authorities enforced three escalated levels of public health interventions to control the COVID-19 pandemic. We quantified compliance of 108 asthmatic schoolchildren (53 from Cyprus, 55 from Greece, mean age 9.7 years) from both countries to intervention levels, using wearable sensors to continuously track personal location and physical activity. Changes in 'fraction time spent at home' and 'total steps/day' were assessed with a mixed-effects model adjusting for confounders. We observed significant mean increases in 'fraction time spent at home' in Cyprus and Greece, during each intervention level by 41.4% and 14.3% (level 1), 48.7% and 23.1% (level 2) and 45.2% and 32.0% (level 3), respectively. Physical activity in Cyprus and Greece demonstrated significant mean decreases by - 2,531 and - 1,191 (level 1), - 3,638 and - 2,337 (level 2) and - 3,644 and - 1,961 (level 3) total steps/day, respectively. Significant independent effects of weekends and age were found on 'fraction time spent at home'. Similarly, weekends, age, humidity and gender had an independent effect on physical activity. We suggest that wearable technology provides objective, continuous, real-time location and activity data making possible to inform in a timely manner public health officials on compliance to various tiers of public health interventions during a pandemic.


Asunto(s)
Asma/epidemiología , Monitoreo Fisiológico/métodos , Dispositivos Electrónicos Vestibles , Adolescente , Asma/diagnóstico , Niño , Preescolar , Chipre , Femenino , Grecia , Humanos , Masculino , Monitoreo Fisiológico/instrumentación , Vigilancia en Salud Pública , Índice de Severidad de la Enfermedad , Movilidad Social
7.
Medicine (Baltimore) ; 100(11): e25214, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33726017

RESUMEN

ABSTRACT: The purpose of this study was to evaluate the association between asthma and benign prostatic hyperplasia (BPH) in an adult Korean population and to evaluate this association based on the treatment status of asthmatics.We utilized the Korean genome and epidemiology study health examinee 2004 to 2016 database. A total of 47,186 participants (825 asthmatics and 46,361 controls) were selected and their BPH histories were analyzed. We categorized the participants according to their asthma treatment status: "well controlled"; "being treated"; and "not being treated". The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for BPH were analyzed using multiple logistic regression. Subgroup analyses were performed according to age (60 years).The results showed that the prevalence of BPH was higher among asthma patients (17.1%) than among controls (8.7%, P < .001). Asthma patients had a higher risk of having BPH (OR = 1.64, 95% CI = 1.37-2.01, P < .001) than controls, after adjustment for age, income, body mass index (BMI), smoking, alcohol consumption, frequency of physical activity, and the past medical diseases. The ORs for BPH were 1.35 (95% CI = 1.04-1.76) in those aged >60 years and 2.24 (95% CI = 1.70-2.96) in those aged ≤60 years. The ORs for BPH were 1.82 (95% CI = 1.16-2.87, P = .009) in the "well-controlled" group, 1.05 (95% CI = 0.74-1.49, P = .794) in the "being treated" group, and 2.24 (95% CI = 1.69-2.97, P < .001) in the "not being treated" group.We found that there is a correlation between asthma and BPH in the adult Korean population. There is a stronger association between asthma and BPH in younger adults and in those who are not receiving treatment for asthma.


Asunto(s)
Asma/epidemiología , Hiperplasia Prostática/epidemiología , Antiasmáticos/uso terapéutico , Asma/complicaciones , Asma/terapia , Estudios Transversales , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Estudios Prospectivos , Hiperplasia Prostática/complicaciones , República de Corea/epidemiología
8.
Sci Total Environ ; 770: 144746, 2021 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-33736384

RESUMEN

OBJECTIVES: Few studies have comprehensively assessed multiple environmental exposures affecting children's health. This study applied machine-learning methods to evaluate how indoor environmental conditions at home and school contribute to asthma and allergy-related symptoms. METHODS: We randomly selected 10 public schools representing different socioeconomic statuses in New York State (2017-2019) and distributed questionnaires to students to collect health status and home-and school-environmental exposures. Indoor air quality was measured at school, and ambient particle exposures (PM2.5 and components) were measured using real-time personal monitors for 48 h. We used random forest model to identify the most important risk factors for asthma and allergy-related symptoms, and decision tree for visualizing the inter-relationships among the multiple risk factors with the health outcomes. RESULTS: The top contributing factors identified for asthma were family rhinitis history (relative importance: 10.40%), plant pollen trigger (5.48%); bedroom carpet (3.58%); environmental tobacco smoke (ETS) trigger symptom (2.98%); and ETS exposure (2.56%). For allergy-related symptoms, plant pollen trigger (10.88%), higher paternal education (7.33%), bedroom carpet (5.28%), family rhinitis history (4.78%), and higher maternal education (4.25%) were the strongest contributing factors. Conversely, primary heating with hot water radiator was negatively (-6.86%) associated with asthma symptoms. Younger children (<9 years old) with family history of rhinitis and carpeting in the bedroom were the prominent combined risk factors for asthma. Children jointly exposed to pollen, solvents, and carpeting in their home tended to have greater risks of allergy-related symptoms, even without family history of rhinitis. CONCLUSION: Family rhinitis history, bedroom carpet, and pollen triggers were the most important risk factors for both asthma and allergy-related symptoms. Our new findings included that hot-water radiator was related to reduced asthma symptoms, and the combination of young age, rhinitis history, and bedroom carpeting was related to increased asthma symptoms. Further studies are needed to confirm our findings.


Asunto(s)
Contaminación del Aire Interior , Asma , Asma/epidemiología , Niño , Ciencia de los Datos , Exposición a Riesgos Ambientales , Humanos , New York/epidemiología , Factores de Riesgo , Instituciones Académicas
9.
Allergol. immunopatol ; 49(1): 1-10, ene.-feb. 2021. tab, graf
Artículo en Inglés | IBECS | ID: ibc-199219

RESUMEN

BACKGROUND: The Global Asthma Network (GAN) builds on the International Study of Asthma and Allergies in Childhood (ISAAC). OBJECTIVE: To compare asthma prevalence time trends in primary and secondary school children in four Mexican centers participating in ISAAC and GAN. METHODS: GAN is a cross-sectional, multicenter, epidemiological methodology carried out in groups of primary school children aged 6-7 and adolescents aged 13-14 following the ISAAC Phase Three protocol, with additional questions on risk factors and asthma management. RESULTS: Overall, the prevalence of asthma symptoms and diagnosis in primary school children was higher in males than in females both in ISAAC (p < 0.05) and in GAN (p < 0.01), while adolescent females had a higher prevalence, also both in ISAAC (p < 0.001) and in GAN (p < 0.001). CONCLUSION: The prevalence of asthma and its symptoms has increased from ISAAC Phase Three since 2003 to GAN Phase I in Mexico in 2019. These findings are in line with the increases observed in the centers with low asthma baseline prevalence in ISAAC Phase One in comparison with ISAAC Phase Three


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Asma/epidemiología , Asma/diagnóstico , Hipersensibilidad/epidemiología , Monitoreo Epidemiológico , Cooperación Internacional , México/epidemiología , Estudios Transversales , Encuestas y Cuestionarios
10.
Allergol. immunopatol ; 49(1): 17-24, ene.-feb. 2021. tab
Artículo en Inglés | IBECS | ID: ibc-199221

RESUMEN

OBJECTIVES: The main objective was to determine the prevalence of recurrent wheezing (RW) among infants and toddlers as well as the prevalence of asthma predictive risk factors among those with RW. MATERIALS AND METHODS: A prospective study of a cohort of babies recruited after their birth during July 2015-June 2017. Mothers were contacted using the WhatsApp messaging system for digital follow-up on their baby's condition at 3-monthly intervals until they were 18 months old. Information on wheezing and its correlates were collected by digital follow-up and corroborated at an in-person interview and examination of their baby at 18 months of age. Recurrent wheezing was defined as more than three episodes of wheezing or its correlates during the follow-up period. RESULTS: There were 338 males (41.5%) and 476 (58.5%) females. Overall, 31.1% (95% CI = 27.9%, 34.4%) had RW by 18 months and the same number had RW during their first year of life. Of the infants with RW, 121 (47.8%; 95% CI = 41.6, 54.2) had at least one or both of the major criteria and/or at least two minor criteria of the stringent Asthma Predictive Index (API). Of those with RW, 32.0% received antihistamine and 20% had received antibiotics on their last visit to a physician for wheezing or symptoms of cough, cold, and/or breathing difficulty. CONCLUSIONS: Nearly a third of infants and toddlers had RW and nearly half of the infants with RW had risk factors fulfilling the criteria of the stringent API


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Ruidos Respiratorios/diagnóstico , Estudios de Cohortes , Recurrencia , Asma/epidemiología , Estudios Prospectivos , Barbados/epidemiología , Factores de Riesgo , Encuestas y Cuestionarios , Estudios Longitudinales
11.
Allergol. immunopatol ; 49(1): 25-31, ene.-feb. 2021. tab
Artículo en Inglés | IBECS | ID: ibc-199222

RESUMEN

BACKGROUND: Besides the well-known risk factors, Toxocara infection is thought to play a signif­icant etiological role in the development of childhood asthma. To further explore this associa­tion, the prevalence of Toxocara infection in sera of asthmatic children and healthy controls in northern Iran was investigated. METHODS: In this case-control study, cases were 145 physician-confirmed asthmatic children diag­nosed according to the Global Initiative for Asthma (GINA) guidelines. Controls were 115 age- sex-residence-matched children who did not have physician-diagnosed asthma. The presence of anti-Toxocara immunoglobulin G (IgG) was tested using enzyme-linked immunosorbent assay. Univariate and multivariate logistic regression methods were used for case-control comparisons. RESULTS: Seropositivity rate was 4.1% (95% CI, 3.4-4.7%) in asthmatic children and 0.86% (95% CI, 0.71-1.0%) in controls, suggesting a strong association (P-value < 0.02). Moreover, Toxocara infection was not significantly more prevalent (P-value = 0.12) in children with moderate sus­tainable asthma (9.3%, 3/32) than in children with mild sustainable asthma (2.3%, 3/113). Mean total immunoglobulin E (IgE) level was significantly higher in Toxocara-infected children (222.3 ± 367.1) than in non-infected children (143.19 ± 218.05) in the case group (P-value < 0.05). CONCLUSIONS: Our findings indicated that Toxocara infection can play an important role in child­hood asthma. Further experimental and epidemiological studies are needed to clarify this hypothesis


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Toxocariasis/diagnóstico , Asma/epidemiología , Asma/parasitología , Toxocara/patogenicidad , Hipersensibilidad Inmediata/epidemiología , Asma/diagnóstico , Estudios Seroepidemiológicos , Toxocara/inmunología , Ruidos Respiratorios/etiología , Estudios de Casos y Controles , Ensayo de Inmunoadsorción Enzimática , Modelos Logísticos , Inmunoglobulina E/sangre , Inmunoglobulina G/sangre
12.
Allergol. immunopatol ; 49(1): 32-39, ene.-feb. 2021. tab
Artículo en Inglés | IBECS | ID: ibc-199223

RESUMEN

BACKGROUND: Asthma control is the goal of asthma management. A nationwide study on this aspect was launched by the Italian Society of Paediatric Allergy and Immunology (ControL'Asma study). OBJECTIVE: To define variables associated with different asthma control grades in a nationwide population of asthmatic children and adolescents. METHODS: This cross-sectional real-world study included 480 asthmatic children and adoles­cents (333 males, median age 11.2 years) consecutively enrolled in 10 third level pediatric allergy clinics. According to the Global Initiative for Asthma (GINA) document, history, med­ication use, perception of asthma symptoms assessed by visual analog scale (VAS), clinical examination, lung function, childhood asthma control test (cACT)/asthma control test (ACT), and asthma control level were evaluated. RESULTS: Considering GINA criteria, asthma was well controlled in 55% of patients, partly con­trolled in 32.4%, and uncontrolled in 12.6%. Regarding cACT/ACT, asthma was uncontrolled in 23.2%. Patients with uncontrolled asthma had the lowest lung function parameters and VAS scores, more frequent bronchial obstruction and reversibility, and used more oral and inhaled corticosteroids (CS). CONCLUSIONS: The ControL'Asma study, performed in a real-world setting, showed that asthma in Italian children and adolescents was usually more frequent in males. Asthmatic patients had an early onset and allergic phenotype with very frequent rhinitis comorbidity. Uncontrolled and partly controlled asthma affected about half of the subjects, and the assessment of asthma symptom perception by VAS could be a reliable tool in asthma management


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Asma/epidemiología , Asma/prevención & control , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/prevención & control , Escala Visual Analógica , Sociedades Médicas/normas , Estudios Transversales , Consentimiento Informado/normas , Encuestas y Cuestionarios , Rinitis/epidemiología , Guías de Práctica Clínica como Asunto
13.
Allergol. immunopatol ; 49(1): 40-49, ene.-feb. 2021. tab, grab
Artículo en Inglés | IBECS | ID: ibc-199224

RESUMEN

OBJECTIVES: The Asthma Risk Factor Scale (ARFS) is used to screen for asthma in Lebanese pre-school children (aged 3-16 years). The study objective was to describe factors associated with asthma, confirm ARFS score validity among Lebanese preschool children, and develop a risk score for asthma diagnosis in this age group (Pre-School Asthma Risk Factor Scale [PS-ARFS]).METHODS: A cross-sectional study enrolled 515 preschool children (November 2018 and March 2019). The ARFS is a 15-item tool that assesses children's environmental exposure, parental history of asthma, and dietary habits. RESULTS: The percentage of asthmatic children was 8.2%. Higher odds of asthma in children were associated with living near a prairie sprayed with pesticides (odds ratio [OR] = 2.33), playing out-doors (OR = 2.89), having a heater in the bedroom (OR = 10.73), attending a nursery (OR = 2.91), having a mother who smokes cigarettes (OR = 3.35) or water pipe (OR = 2.46), a sister with a history of seasonal allergy (OR = 6.81), and a parental history (mother and father) of asthma (OR = 6.15 a n d OR = 9.83, respectively). Higher ARFS scores (OR = 1.144) were associated with higher odds of asthma. Accordingly, the PS-ARFS was created according to the following formula: ARFS score + (playing out-door × 2.4) + (heating system in the bedroom × 12.9) + (having attended a nursery × 2.5) (area under the curve = 0.908 [0.860-0.957]; P< 0.001); at value: 14.20, Se = 84.3% and Sp = 90.9%.CONCLUSION: PS-ARFS is suggested for screening of asthma in preschool children in an epidemio-logical setting and in the absence of spirometry


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Asma/epidemiología , Medición de Riesgo , Factores de Riesgo , Líbano/epidemiología , Conducta Alimentaria , Estudios Transversales , Encuestas y Cuestionarios , Ruidos Respiratorios/diagnóstico , Análisis Multivariante , Valor Predictivo de las Pruebas
14.
Allergol. immunopatol ; 49(1): 135-145, ene.-feb. 2021. tab, graf
Artículo en Inglés | IBECS | ID: ibc-199235

RESUMEN

OBJECTIVES: To validate a scale to assess the hygiene hypothesis and the association between hygiene and asthma among Lebanese preschool children aged 3-5 years. METHODS: This cross-sectional study, conducted between November 2018 and March 2019, enrolled 515 preschool children. Asthma and potential risk factors, including hygiene, were assessed using a standardized questionnaire. A specific hygiene hypothesis scale has been gen­erated and validated for this purpose. RESULTS: The hygiene hypothesis scale items converged over a solution of nine factors that had an Eigenvalue over 1, explaining a total of 65.86% of the variance. An acceptable Cronbach's alpha value was recorded for the hygiene hypothesis scale (0.696). Variables correlated with higher odds of asthma were male gender (ORa = 0.41 for females), living near a prairie sprayed with pesticides (ORa = 3.09), having a heating system in the bedroom compared to the sitting room (ORa = 9.97), attending kindergarten (ORa = 2.80), having a mother who smokes water­pipe compared to not smoking (ORa = 3.34), having a mother with a history of asthma (ORa = 5.50), and having respiratory infections (ORa = 14.72). However, the hygiene hypothesis score was not associated with higher odds of asthma (p = 0.881). CONCLUSIONS: The current results suggested that neither home cleaning nor personal cleanliness was correlated with asthma in preschool children. Larger prospective studies that measure the intensity and duration of exposure to each toxicant are suggested to better assess the hygiene hypothesis items and their association with asthma


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Asma/etiología , Hipótesis de la Higiene , Asma/epidemiología , Polvo/inmunología , Líbano , Estudios Transversales , Factores de Riesgo , Encuestas y Cuestionarios , Análisis Factorial , Modelos Logísticos , Hipersensibilidad/inmunología , Asma/inmunología , Polvo/análisis , Polvo/prevención & control
16.
Artículo en Inglés | MEDLINE | ID: mdl-33525356

RESUMEN

Asthma is a widespread respiratory disease caused by complex contribution from genetic, environmental and behavioral factors. For several decades, its sensitivity to environmental factors has been investigated in single exposure (or single family of exposures) studies, which might be a narrow approach to tackle the etiology of such a complex multifactorial disease. The emergence of the exposome concept, introduced by C. Wild (2005), offers an alternative to address exposure-health associations. After presenting an overview of the exposome concept, we discuss different statistical approaches used to study the exposome-health associations and review recent studies linking multiple families of exposures to asthma-related outcomes. The few studies published so far on the association between the exposome and asthma-related outcomes showed differences in terms of study design, population, exposome definition and statistical methods used, making their results difficult to compare. Regarding statistical methods, most studies applied successively univariate (Exposome-Wide Association Study (ExWAS)) and multivariate (adjusted for co-exposures) (e.g., Deletion-Substitution-Addition (DSA) algorithm) regression-based models. This latest approach makes it possible to assess associations between a large set of exposures and asthma outcomes. However, it cannot address complex interactions (i.e., of order ≥3) or mixture effects. Other approaches like cluster-based analyses, that lead to the identification of specific profiles of exposure at risk for the studied health-outcome, or mediation analyses, that allow the integration of information from intermediate biological layers, could offer a new avenue in the understanding of the environment-asthma association. European projects focusing on the exposome research have recently been launched and should provide new results to help fill the gap that currently exists in our understanding of the effect of environment on respiratory health.


Asunto(s)
Asma , Contaminantes Ambientales , Exposoma , Asma/epidemiología , Asma/etiología , Exposición a Riesgos Ambientales/efectos adversos , Humanos , Estilo de Vida
17.
Pediatr Rheumatol Online J ; 19(1): 21, 2021 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-33627147

RESUMEN

IMPORTANCE: Active pediatric COVID-19 pneumonia and MIS-C are two disease processes requiring rapid diagnosis and different treatment protocols. OBJECTIVE: To distinguish active pediatric COVID-19 pneumonia and MIS-C using presenting signs and symptoms, patient characteristics, and laboratory values. DESIGN: Patients diagnosed and hospitalized with active COVID-19 pneumonia or MIS-C at Children's of Alabama Hospital in Birmingham, AL from April 1 through September 1, 2020 were identified retrospectively. Active COVID-19 and MIS-C cases were defined using diagnostic codes and verified for accuracy using current US Centers for Disease Control case definitions. All clinical notes were reviewed for documentation of COVID-19 pneumonia or MIS-C, and clinical notes and electronic medical records were reviewed for patient demographics, presenting signs and symptoms, prior exposure to or testing for the SARS-CoV-2 virus, laboratory data, imaging, treatment modalities and response to treatment. FINDINGS: 111 patients were identified, with 74 classified as mild COVID-19, 8 patients as moderate COVID-19, 8 patients as severe COVID-19, 10 as mild MIS-C and 11 as severe MIS-C. All groups had a male predominance, with Black and Hispanic patients overrepresented as compared to the demographics of Alabama. Most MIS-C patients were healthy at baseline, with most COVID-19 patients having at least one underlying illness. Fever, rash, conjunctivitis, and gastrointestinal symptoms were predominant in the MIS-C population whereas COVID-19 patients presented with predominantly respiratory symptoms. The two groups were similar in duration of symptomatic prodrome and exposure history to the SARS-CoV-2 virus, but MIS-C patients had a longer duration between presentation and exposure history. COVID-19 patients were more likely to have a positive SAR-CoV-2 PCR and to require respiratory support on admission. MIS-C patients had lower sodium levels, higher levels of C-reactive protein, erythrocyte sedimentation rate, d-dimer and procalcitonin. COVID-19 patients had higher lactate dehydrogenase levels on admission. MIS-C patients had coronary artery changes on echocardiography more often than COVID-19 patients. CONCLUSIONS AND RELEVANCE: This study is one of the first to directly compare COVID-19 and MIS-C in the pediatric population. The significant differences found between symptoms at presentation, demographics, and laboratory findings will aide health-care providers in distinguishing the two disease entities.


Asunto(s)
/fisiopatología , Síndrome de Respuesta Inflamatoria Sistémica/fisiopatología , Dolor Abdominal/fisiopatología , Adolescente , Afroamericanos , Asma/epidemiología , Proteína C-Reactiva/metabolismo , /metabolismo , Estudios de Casos y Controles , Niño , Preescolar , Comorbilidad , Conjuntivitis/fisiopatología , Enfermedad de la Arteria Coronaria , Diabetes Mellitus/epidemiología , Diarrea/fisiopatología , Dilatación Patológica , Ecocardiografía , Exantema/fisiopatología , Femenino , Fiebre/fisiopatología , Cardiopatías Congénitas/epidemiología , Hispanoamericanos , Humanos , Hiponatremia/metabolismo , Masculino , Náusea/fisiopatología , Neoplasias/epidemiología , Trastornos del Neurodesarrollo/epidemiología , Obesidad/epidemiología , Índice de Severidad de la Enfermedad , Distribución por Sexo , Volumen Sistólico , Síndrome de Respuesta Inflamatoria Sistémica/epidemiología , Síndrome de Respuesta Inflamatoria Sistémica/metabolismo , Factores de Tiempo , Vómitos/fisiopatología
18.
Artículo en Inglés | MEDLINE | ID: mdl-33530624

RESUMEN

Asthma is the most frequent chronic condition in childhood and a current concern exists about asthma in the pediatric population and its risk for severe SARS-CoV-2 infection. Although all ages can be affected, SARS-CoV-2 infection has lower clinical impact on children and adolescents than on adults. Fever, cough and shortness of breath are the most common symptoms and signs in children; wheezing has not been frequently reported. Published studies suggest that children with asthma do not appear to be disproportionately more affected by COVID-19. This hypothesis raises two issues: is asthma (and/or atopy) an independent protective factor for COVID-19? If yes, why? Explanations for this could include the lower IFN-α production, protective role of eosinophils in the airway, and antiviral and immunomodulatory proprieties of inhaled steroids. Additionally, recent evidence supports that allergic sensitization is inversely related to ACE2 expression. Obesity is a known risk factor for COVID-19 in adults. However, in the childhood asthma-obesity phenotype, the classic atopic Th2 pattern seems to predominate, which could hypothetically be a protective factor for severe SARS-CoV-2 infection in children with both conditions. Finally, the return to school activities raises concerns, as asymptomatic children could act as vectors for the spread of the disease. Although this is still a controversial topic, the identification and management of asymptomatic children is an important approach during the SARS-CoV-2 epidemic. Focus on asthma control, risk stratification, and medication adherence will be essential to allow children with asthma to return safely to school.


Asunto(s)
Asma , Asma/epidemiología , Asma/terapia , Niño , Humanos , Factores de Riesgo
19.
Artículo en Inglés | MEDLINE | ID: mdl-33535701

RESUMEN

Asthma is one of the most common chronic diseases worldwide affecting all age groups from children to the elderly. In addition to other factors such as smoking, air pollution and atopy, some environmental chemicals are shown or suspected to increase the risk of asthma, exacerbate asthma symptoms and cause other respiratory symptoms. In this scoping review, we report environmental chemicals, prioritized for investigation in the European Human Biomonitoring Initiative (HBM4EU), which are associated or possibly associated with asthma. The substance groups considered to cause asthma through specific sensitization include: diisocyanates, hexavalent chromium Cr(VI) and possibly p-phenylenediamine (p-PDA). In epidemiological studies, polyaromatic hydrocarbons (PAHs) and organophosphate insecticides are associated with asthma, and phthalates, per- and polyfluoroalkyl substances (PFASs), pyrethroid insecticides, mercury, cadmium, arsenic and lead are only potentially associated with asthma. As a conclusion, exposure to PAHs and some pesticides are associated with increased risk of asthma. Diisocyanates and Cr(VI) cause asthma with specific sensitization. For many environmental chemicals, current studies have provided contradicting results in relation to increased risk of asthma. Therefore, more research about exposure to environmental chemicals and risk of asthma is needed.


Asunto(s)
Arsénico , Asma , Contaminantes Ambientales , Hidrocarburos Aromáticos , Plaguicidas , Anciano , Asma/inducido químicamente , Asma/epidemiología , Monitoreo Biológico , Niño , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Monitoreo del Ambiente , Contaminantes Ambientales/análisis , Contaminantes Ambientales/toxicidad , Humanos
20.
Medicine (Baltimore) ; 100(4): e23858, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530179

RESUMEN

BACKGROUND: This meta-analysis aimed to systematically estimate the prevalence of comorbid bronchiectasis in patients with asthma and to summarize its clinical impact. METHODS: Embase, PubMed, and Cochrane Library electronic databases were searched to identify relevant studies published from inception until March 2020. STUDY SELECTION: Studies were included if bronchiectasis was identified by high-resolution computed tomography. Outcomes included the prevalence of bronchiectasis and its association with demographic characteristics and indicators of asthma severity, including results of lung function tests and the number of exacerbations. RESULTS: Five observational studies with 839 patients were included. Overall, the mean prevalence of bronchiectasis in patients with asthma was 36.6% (307/839). Patients with comorbid bronchiectasis had lower forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) (MD: -2.71; 95% CI: -3.72 to -1.69) and more frequent exacerbations (MD: 0.68; 95% CI: 0.03 to 1.33) than those with asthma alone, and there was no significant difference of sex, duration of asthma and serum levels of immunoglobulin(Ig)Es between asthmatic patients with or without bronchiectasis. CONCLUSION: The presence of bronchiectasis in patients with asthma was associated with greater asthma severity. There are important therapeutic implications of identifying bronchiectasis in asthmatic patients.


Asunto(s)
Asma/complicaciones , Bronquiectasia/complicaciones , Asma/epidemiología , Asma/fisiopatología , Biomarcadores/sangre , Bronquiectasia/epidemiología , Bronquiectasia/fisiopatología , Comorbilidad , Eosinófilos/metabolismo , Volumen Espiratorio Forzado , Humanos , Prevalencia , Factores de Riesgo , Índice de Severidad de la Enfermedad , Capacidad Vital
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