[Asthma incidence in Huelva, Spain at 2 stages of life: childhood and young adulthood]. / Incidencia de asma en 2 etapas de la vida: niños y adultos jóvenes de la ciudad de Huelva.

OBJECTIVE: Few studies have evaluated the incidence of asthma in Spain. Although more children than adults develop asthma every year, no study to date has analyzed the differences in incidence by following 2 age cohorts in the same geographical area. The aim of this study was to determine changes in wheezing, bronchial hyperreactivity, and asthma (in terms of onset, persistence, and remission), changes in forced expiratory volume in 1 second (FEV(1)), and asthma incidence in children (11-16 years) and young adults (20-44 years) in the city of Huelva, Spain. PATIENTS AND METHODS: We analyzed data from 2 groups studied for the first time between 1991 and 1993 and for the second time after an average follow-up period of 9 years. In the first period, data came from the Study of Respiratory Diseases in Huelva (714 children) and the European Community Respiratory Health Survey conducted in the city (271 adults). Both groups answered a respiratory symptom questionnaire, underwent spirometry testing, and completed a nonspecific bronchial challenge test with methacholine. RESULTS: In adults, onset was more common than remission for both wheezing (15.7% vs 6.9%, P=.011) and bronchial hyperreactivity (10.1% vs 3%, P=.017), and asthma incidence was 4.76 cases/1000 person-years. In children, there were more new cases than remissions for wheezing, (24.2% vs 4.3%, P=.001), bronchial hyperreactivity (13.9% vs 5.4%, P=.02), and asthma (9.3% vs 3%, P=.004). The incidence rate for asthma was 15.69 cases/1000 person-years in this age group. The annual decrease in lung function (FEV(1)) was highest in adults with wheezing (34.3 mL) and asthma (54.8 mL). CONCLUSIONS: There were more new cases of wheezing and bronchial hyperreactivity than remissions in both children and young adults. Children had a 3.3-fold higher incidence of asthma than adults in Huelva.

Incidencia de asma en 2 etapas de la vida: niños y adultos jóvenes de la ciudad de Huelva / Asthma incidence in Huelva, Spain at 2 stages of life: childhood and young adulthood

OBJETIVO: Hay pocos estudios que valoren la incidencia de asma en nuestro país. Se sabe que es mayor en niños que en adultos, pero esta diferente incidencia no se ha comprobado mediante el seguimiento de 2 poblaciones de diferente edad en el mismo ámbito geográfico. El propósito de este trabajo ha sido determinar los cambios (aparición, persistencia y remisión) de sibilancias, hiperreactividad bronquial (HB) y asma, la evolución del volumen espiratorio forzado en el primer segundo y la incidencia anual de asma en niños (11-16 años) y adultos jóvenes (20-44 años) en la ciudad de Huelva. PACIENTES Y MÉTODOS: Se ha realizado una segunda evaluación en el seguimiento de 2 grupos estudiados entre 1991 y 1993 (714 niños del Estudio de Enfermedades Respiratorias de Huelva y 271 adultos del Estudio Europeo de Enfermedades Respiratorias), con un promedio de tiempo de 9 años. Se pasó a ambos grupos un cuestionario sobre síntomas respiratorios, además de efectuar una espirometría y una prueba de provocación bronquial inespecífica con metacolina. RESULTADOS: En los adultos se encontraron más nuevas apariciones (15,7%) que remisiones (6,9%) de sibilancias (p = 0,011) e HB (apariciones: 10,1%; remisiones: 3%; p = 0,017), con una incidencia anual de asma de 4,76 casos/1.000 personas-año. Los niños mostraron más nuevas apariciones (24,2%) que remisiones (4,3%) de sibilancias (p < 0,001), HB (un 13,9% de apariciones y un 5,4% de remisiones; p = 0,02) y asma (un 9,3% de apariciones y un 3% de remisiones; p = 0,004), con una incidencia anual de asma de 15,69 casos/1.000 personas-año. La pérdida anual de función pulmonar (volumen espiratorio forzado en el primer segundo) fue más elevada en los adultos en los que aparecieron sibilancias (34,3 ml) y asma (54,8 ml). CONCLUSIONES: En ambas poblaciones, hay más nuevos casos de sibilancias e HB que remisiones. La incidencia anual de asma es 3,3 veces mayor en niños que en adultos en la ciudad de Huelva

OBJECTIVE: Few studies have evaluated the incidence of asthma in Spain. Although more children than adults develop asthma every year, no study to date has analyzed the differences in incidence by following 2 age cohorts in the same geographical area. The aim of this study was to determine changes in wheezing, bronchial hyperreactivity, and asthma (in terms of onset, persistence, and remission), changes in forced expiratory volume in 1 second (FEV1), and asthma incidence in children (11-16 years) and young adults (20-44 years) in the city of Huelva, Spain. PATIENTS AND METHODS: We analyzed data from 2 groups studied for the first time between 1991 and 1993 and for the second time after an average follow-up period of 9 years. In the first period, data came from the Study of Respiratory Diseases in Huelva (714 children) and the European Community Respiratory Health Survey conducted in the city (271 adults). Both groups answered a respiratory symptom questionnaire, underwent spirometry testing, and completed a nonspecific bronchial challenge test with methacholine. RESULTS: In adults, onset was more common than remission for both wheezing (15.7% vs 6.9%, P=.011) and bronchial hyperreactivity (10.1% vs 3%, P=.017), and asthma incidence was 4.76 cases/1000 person-years. In children, there were more new cases than remissions for wheezing, (24.2% vs 4.3%, P=.001), bronchial hyperreactivity (13.9% vs 5.4%, P=.02), and asthma (9.3% vs 3%, P=.004). The incidence rate for asthma was 15.69 cases/1000 person-years in this age group. The annual decrease in lung function (FEV1) was highest in adults with wheezing (34.3 mL) and asthma (54.8 mL). CONCLUSIONS: There were more new cases of wheezing and bronchial hyperreactivity than remissions in both children and young adults. Children had a 3.3-fold higher incidence of asthma than adults in Huelva

Bronchial hyperreactivity in patients who inhale heroin mixed with cocaine vaporized on aluminum foil.

BACKGROUND: In our area, inhaling heroin mixed with cocaine vaporized on aluminum foil, known as rebujo, is becoming more and more common. AIM: To define the prevalence and the characteristics of bronchial disease (wheezing, bronchial hyperreactivity [BHR], and asthma) present in subjects inhaling heroin mixed with cocaine vaporized on aluminum foil. MATERIALS AND METHODS: Ninety-one subjects who inhaled the drug mixture were included in the study: 62 subjects were from a drug rehabilitation center (INH-I group), and 29 subjects were among patients admitted to our hospital for a variety of reasons (INH-II group). A questionnaire was completed in both groups, as well as IgE determination and lung function tests (spirometry and methacholine challenge). The control group consisted of 122 individuals who did not inhale the drug mixture, and were chosen randomly from the general population (NO-INH group). All subjects were tobacco smokers. RESULTS: In the INH-I group, there was a 41.9% prevalence of wheezing over the past 12 months, a 44.4% prevalence of BHR, and a 22.02% prevalence of asthma, defined as wheezing plus BHR. In the NO-INH group, these values were 32.78% (p = 0.22), 15.57% (p < 0.0001), and 8.19% (p < 0.01), respectively. Of the subjects who inhaled the drug mixture and denied having symptoms prior to the use of the drug mixture, 31.4% had wheezing develop after commencing use of the drug, following a mean latency of 4.09 months. Wheezing remitted in only 7.6% after discontinuation of the drug. CONCLUSIONS: (1) There is a real increase in BHR in subjects who inhale heroin mixed with cocaine vaporized on aluminum foil; and (2) this BHR is associated with wheezing that develops after a variable period of latency, once drug inhalation begins, and persists despite discontinuation of the drug.