Aeroallergen sensitization patterns among patients with chronic rhinitis with or without concomitant asthma.

OBJECTIVES: The aim of this study was to explore the differences in the pattern of allergen sensitization in CR individuals without or with asthma, according to asthma severity. METHODS: A total of 1066 adults were evaluated. Asthma and chronic/allergic rhinits were identified by specialists, questionnaries and skin-prick test. The phenotypic characterization was avaliable from skin-prick test to an aeroallergen extended panel, total IgE and pulmonary function. Using questionnaires and clinical evaluation, participants were classified into the groups: chronic rhinitis alone (CRA) and chronic rhinitis + asthma, the latter subdivided into CR + mild asthma (CRMA) and CR + moderate to severe asthma (CRMSA). Aerollergen sensitization was defined by a positive prick test to one or more allergens associated with nasal symptoms and/or asthma. The association between CR and asthma was evaluated by multivariable logistic regression. The evidence of effect modification of pattern of sensitization in CR on the association with asthma severity and outcomes was examined by introducing interactions terms in the logistic regression models adjusting for confounders. RESULTS: Frequency of sensitization to aeroallergens was higher in association with asthma in comparison to CRA (CRMA 70.4%; CRMSA 65.0%; CRA 47.0%; p = 0.000). Similarly, the presence of asthma was associated to aeroallergen multiple sensitization (51.5%) (OR = 2.10, 95% CI 1.27-3.50). Additionally, the sensitization to mites, cockroaches, animal epithelium, grasses, and molds, were higher in asthma (56.8%, 24.3%, 12%, 7.13% and 10.3%, respectively). Sensitization to Alternaria alternata, Cladosporium herbarum and dog epithelium was exclusive in asthma groups. A concomitant asthma diagnosis was directly associated with a positive allergen sensitization at least one allergen (62.7%, OR = 2.45, 95% CI 1.80-3.34) and polissensitization (51.5%, OR = 2.10, 95% CI 1.27-3.50). CONCLUSION: Asthma is associated with multiple allergen sensitization among patients with CR. Some unique profiles of aeroallergen sensitization were observed in patients with CR and asthma. Nevertheless, no difference was found in the sensitization in relation to asthma severity, which suggest atopy is not the main underlying mechanism for asthma severity among patients with CR. LEVEL OF EVIDENCE: Level 3.

Qualidade de vida e do sono em pacientes com rinite no Oeste da Bahia / Quality of life and sleep in patients with rhinitis in the Western Bahia

Introdução: a rinite é um distúrbio respiratório crônico comum, de alta prevalência no Brasil e no mundo, que representa um fardo considerável para os portadores. Está associada a sintomas incômodos, que reduzem a qualidade de vida e do sono, acarretando em prejuízos sociais, emocionais e funcionais. Objetivo: avaliar a qualidade de vida e do sono conforme o grau de incômodo dos sintomas dos pacientes com rinite, acompanhados no Sistema Único de Saúde da região Oeste da Bahia. Metodologia: um estudo de corte transversal que avaliou 169 pacientes entre 12 e 90 anos diagnosticados clinicamente com rinite, atendidos em ambulatório de Otorrinolaringologia no município de Barreiras (Bahia), entre novembro de 2018 a setembro de 2019, através do Questionário Modificado de Qualidade de Vida em Rinoconjuntivite, Escala de Sonolência de Epworth e Índice de Qualidade do Sono de Pittsburgh. Resultados: a qualidade de vida e do sono foram significantemente afetadas pela rinite, sendo os piores índices relacionados aos pacientes que atribuíram maior gravidade à doença. Ainda, limitações em atividades recreativas e domésticas devido à rinite se associaram a um sono de má qualidade. Não foi encontrada relação significativa entre sonolência diurna e qualidade de vida. Conclusão: os achados sinalizam a necessidade de orientar os pacientes quanto à higiene do sono, medidas de controle do ambiente e o efetivo tratamento medicamentoso. Também enfatizam a necessidade de avaliar as percepções singulares dos pacientes quanto à sua qualidade de vida para direcionar as estratégias de cuidado e monitorizar o tratamento e o controle da doença.

Introduction: the rhinitis is a common chronic respiratory disorder, highly prevalent in Brazil and worldwide, that mean a considerable onus for patients. It is associated with uncomfortable symptoms, wich reduce the quality of life and sleep, resulting in social, emotional and functional losses. Objective: to evaluate the quality of life and sleep according to degree of nuisance of patients with rhinitis being followed up in the Brazilian Unified National Health System (SUS) in the Western Bahia. Methods: a cross-sectional study that evaluated 169 patients between 12 and 90 years old diagnosed clinically with rhinitis, seen at an Otorhnolaryngology service in Barreiras (Bahia), between November 2018 and September 2019, through the Rhinoconjunctivitis Quality of Life Modified Questionnaire, Epworth Slipness Scale and Pittsburgh Sleep Quality Index. Results: quality of life and sleep were significantly affected by rhinitis, with the worst rates related to patients who attributed greater severity to the disease. Also, limitations in recreational and domestic activities due to rhinitis were associated with poor sleep. No significant relationship was found between daytime sleepiness and quality of life. Conclusion: the findings signal the need to guide patients on sleep hygiene, environmental control measures and effective pharmacological management. They also emphasize the need to assess patients' unique perceptions of their quality of life to guide care strategies and monitor the disease treatment and control.

Programa de educação pelo trabalho para a saúde nas escolas: oficina sobre sexualidade / The educational program for health work in schools: workshop on sexuality

Este artigo relata uma experiência de educação em saúde sobre sexualidade, conduzida por monitores do PET-Saúde, da Universidade de Brasília, do subgrupo de Planejamento Familiar. As oficinas foram realizadas com adolescentes de escolas públicas de ensino fundamental e médio dos municípios de Ceres e Santa Isabel, em Goiás. Foram abordadas questões sobre sexualidade; gravidez; métodos anticoncepcionais; doenças sexualmente transmissíveis. Os alunos, divididos em grupos, formularam as perguntas anonimamente e as responderam, por sorteio. Os monitores coordenaram as atividades, orientaram os alunos na elaboração das respostas e simularam o uso de métodos contraceptivos (preservativos masculino e feminino). A experiência evidenciou a importância do desenvolvimento de uma ação crítica, reflexiva e participativa para a promoção da saúde dos adolescentes, abordando-se o tema sexualidade dentro da realidade local. A intenção do trabalho foi estabelecer um meio eficaz e criativo de abordagem dessa temática no âmbito escolar em conjunto com o serviço de atenção básica desses municípios, favorecendo a integração ensino-serviço-comunidade, que é um dos objetivos principais do programa PET-Saúde.

This article reports on an experience in health education on sexuality led by monitors from the Educational Program for Health Work from the University of Brasília, belonging to the Family Planning subgroup. The workshops included teenagers from public elementary and secondary schools in the municipalities of Ceres and Santa Isabel, Goiás State. The workshops discussed issues on sexuality, pregnancy, contraceptive methods, and sexually transmitted diseases. The students, divided into groups, prepared the questions anonymously and answered them by random selection. The monitors coordinated the activities, oriented the students in elaborating the answers, and simulated the use of contraceptive methods (male and female condoms). The experience showed the importance of developing critical, reflexive, and participatory action for health promotion with teenagers, approaching the theme of sexuality within the local reality. The project's goal was to establish an effective and creative means for approaching this topic within the school setting, together with the primary care service in these communities, favoring integration between teaching, health services, and the community, one of the principal objectives of the Educational Program for Health Work.