Prevalence and associated factors for asthma in adults in Quito: a cross-sectional study.

Background: Although several epidemiological studies of asthma have been carried out in Ecuador in the last two decades, none of these has estimated the prevalence of asthma in adult populations. Objective: To estimate the prevalence of asthma symptoms in adults in the city of Quito and to identify possible associated factors. Methods: A cross-sectional study was conducted on subjects older than 18 years residing in the Metropolitan District of Quito. The Global Asthma Network (GAN) questionnaire was applied to collect information on asthma symptoms and sociodemographic and lifestyle data. Bivariate and multivariate analyses with logistic regression were used to identify asthma-related factors. Results: 2,476 subjects answered the questionnaire (80.9% women, mean age 40 years). The prevalence of wheezing in the last 12 months, asthma ever, and asthma diagnosed by a doctor were 6.3%, 1.9% and 1.6%, respectively. The prevalence of rhinitis ever and eczema ever was 13.7% and 5.5%. The presence of mould at home (OR: 2.13; 95% CI: 1.48 -3.06; p <0.001), cat at home (OR: 1.06; 95% CI: 1.06 -2.13; p <0.022) and rhinitis at some time (OR: 3.65; 95% CI: 2.53 - 5.29; p <0.022) were associated with the presence of wheezing in the last 12 months. Conclusions: Our study shows that, compared to other cities in Latin America, the prevalence of asthma in adults in Quito is relatively low. Along with the presence of rhinitis, factors related to housing quality are closely linked to the occurrence of asthma in adult populations.

Antecedentes: Aunque en el Ecuador se han realizado varios estudios epidemiológicos de asma en las dos últimas décadas, ninguno de estos ha estimado la prevalencia de asma en poblaciones adultas. Objetivo: Estimar la prevalencia de síntomas de asma en adultos en Quito e identificar posibles factores asociados. Métodos: Se realizó un estudio transversal en sujetos mayores a 18 años residentes en la ciudad de Quito-Ecuador. Se aplicó el cuestionario Global Asthma Network para recolectar información sobre síntomas de asma y datos sociodemográficas y de estilo de vida. Para la identificación de factores asociados con asma se utilizó análisis bivariados y multivariados con regresión logística. Resultados: Un total de 2,476 sujetos respondieron el cuestionario (80.9% mujeres, edad media 40 años). La prevalencia de sibilancias en los últimos 12 meses, asma alguna vez y asma diagnosticado por un médico fue de 6.3%; 1.9% y 1.6%, respectivamente. La prevalencia de rinitis y eczema alguna vez fue de 13.7% y 5.5%. La presencia de moho en el hogar (OR: 2.13; 95% IC: 1.48-3.06; p <0.001), gato en casa (OR: 1.06; 95% IC: 1.06-2.13; p <0.022) y rinitis alguna vez (OR: 3.65; 95% IC: 2.53-5.29; p <0.022) estaban asociados con la presencia de sibilancias en los últimos 12 meses. Conclusiones: Nuestro estudio muestra que, en comparación con otras ciudades de América Latina, la prevalencia de asma en adultos en Quito es relativamente baja. Junto con la presencia de rinitis, factores relacionados con la calidad de la vivienda están estrechamente ligados con la ocurrencia de asma en poblaciones adultas.

Prevalence and associated factors for asthma in adults in Quito: a cross-sectional study / Prevalencia y factores asociados para asma en adultos en Quito: un estudio transversal

Abstract Background: Although several epidemiological studies of asthma have been carried out in Ecuador in the last two decades, none of these has estimated the prevalence of asthma in adult populations. Objective: To estimate the prevalence of asthma symptoms in adults in the city of Quito and to identify possible associated factors. Methods: A cross-sectional study was conducted on subjects older than 18 years residing in the Metropolitan District of Quito. The Global Asthma Network (GAN) questionnaire was applied to collect information on asthma symptoms and sociodemographic and lifestyle data. Bivariate and multivariate analyses with logistic regression were used to identify asthma-related factors. Results: 2,476 subjects answered the questionnaire (80.9% women, mean age 40 years). The prevalence of wheezing in the last 12 months, asthma ever, and asthma diagnosed by a doctor were 6.3%, 1.9% and 1.6%, respectively. The prevalence of rhinitis ever and eczema ever was 13.7% and 5.5%. The presence of mould at home (OR: 2.13; 95% CI: 1.48 -3.06; p <0.001), cat at home (OR: 1.06; 95% CI: 1.06 -2.13; p <0.022) and rhinitis at some time (OR: 3.65; 95% CI: 2.53 - 5.29; p <0.022) were associated with the presence of wheezing in the last 12 months. Conclusions: Our study shows that, compared to other cities in Latin America, the prevalence of asthma in adults in Quito is relatively low. Along with the presence of rhinitis, factors related to housing quality are closely linked to the occurrence of asthma in adult populations.

Resumen Antecedentes: Aunque en el Ecuador se han realizado varios estudios epidemiológicos de asma en las dos últimas décadas, ninguno de estos ha estimado la prevalencia de asma en poblaciones adultas. Objetivo: Estimar la prevalencia de síntomas de asma en adultos en Quito e identificar posibles factores asociados. Métodos: Se realizó un estudio transversal en sujetos mayores a 18 años residentes en la ciudad de Quito-Ecuador. Se aplicó el cuestionario Global Asthma Network para recolectar información sobre síntomas de asma y datos sociodemográficas y de estilo de vida. Para la identificación de factores asociados con asma se utilizó análisis bivariados y multivariados con regresión logística. Resultados: Un total de 2,476 sujetos respondieron el cuestionario (80.9% mujeres, edad media 40 años). La prevalencia de sibilancias en los últimos 12 meses, asma alguna vez y asma diagnosticado por un médico fue de 6.3%; 1.9% y 1.6%, respectivamente. La prevalencia de rinitis y eczema alguna vez fue de 13.7% y 5.5%. La presencia de moho en el hogar (OR: 2.13; 95% IC: 1.48-3.06; p <0.001), gato en casa (OR: 1.06; 95% IC: 1.06-2.13; p <0.022) y rinitis alguna vez (OR: 3.65; 95% IC: 2.53-5.29; p <0.022) estaban asociados con la presencia de sibilancias en los últimos 12 meses. Conclusiones: Nuestro estudio muestra que, en comparación con otras ciudades de América Latina, la prevalencia de asma en adultos en Quito es relativamente baja. Junto con la presencia de rinitis, factores relacionados con la calidad de la vivienda están estrechamente ligados con la ocurrencia de asma en poblaciones adultas.

Characterization of Collagen from Three Genetic Lines (Gray, Red and F1) of Oreochromis niloticus (Tilapia) Skin in Young and Old Adults.

From tilapia (Oreochromis niloticus) farming, the by-products have been identified as a source of collagen that could be used for the development of dermocosmetics or pharmaceutical products. However, the characteristics of collagen related to a specific strain or culture must be well defined prior to its application. Collagen was extracted from the skin of three strains of tilapia: red YY males (YY: two Y-type sex chromosomes), XX gray females, and the F1: offspring of crossing red YY males with XX gray females; at different ages in the adult phase, using acetic acid and pepsin enzyme. The characteristics of acid-soluble collagen (ASC) and pepsin-soluble collagen (PSC) were shown by SDS-PAGE band profiles to be similar to bovine collagen type I (SIGMA), the PSC of gray tilapia being more fragile to temperature changes, consistent with the results of fractional viscosity. The characteristics of the F1 progeny were prioritized for being a commercially productive and sustainable source for the extraction of collagen, and the ASC form, being the one with the greatest stability and advantage over PSC, of importance to our investigations, leads to a controlled digestion as in the case of peptide induction, and also in the development of natural products in the pharmaceutical and/or dermocosmetic industry. Evaluations of the triple helix structure by FT-IR, X-ray diffraction and UV-visible spectroscopy give similar results between the strains: red, gray, and F1, and between ages in the adult form F1 (15, 24, and 36 months of age). Consequently, the skin of tilapia in adult form is recommended sustainably for up to 24 months of age where the collagen is obtained with the use of acetic acid without enzymatic treatment.

Asthma, rhinitis and eczema symptoms in Quito, Ecuador: a comparative cross-sectional study 16 years after ISAAC.

BACKGROUND: In 2003, the International Study of Asthma and Allergies in Childhood (ISAAC) estimated the prevalence of asthma, rhinitis and eczema symptoms in Quito, Ecuador. Since then, no update of this study has been done in the last years. This study examined changes in the prevalence of asthma-rhinitis-eczema symptoms over a 16 years period in Quito and explored possible risk factors. METHODS: We conducted a comparative cross-sectional study in an adolescent population following the Global Asthma Network (GAN) methodology. A written questionnaire was used to explore symptoms of asthma-rhinitis-eczema. We calculated the prevalence and 95% CIs for each of the symptoms and compared them with the ISAAC results. We conducted bivariate and multivariate analysis using logistic regression to identify possible risk factors for recent wheeze, rhinitis and eczema. RESULTS: A total of 2380 adolescents aged between 13 and 14 years were evaluated. The prevalence of doctor diagnosis for asthma, rhinitis and eczema was 3.4%, 8.5% and 2.2%, respectively. Compared with ISAAC results, we found a lower prevalence of wheeze and eczema symptoms: wheeze ever (37.6% vs 12.7%), recent wheeze (17.8% vs 6.5%), asthma ever (6.9% vs 4.6%), recent rush (22.4% vs 13.9%) and eczema ever (11.7% vs 3.6%). The prevalence of rhinitis symptoms in the GAN study was higher than the ISAAC results: nose symptoms in the past 12 months (36.6% vs 45.8%) and nose and eye symptoms in the past 12 months (23.1% vs 27.9). Significant associations were observed between symptoms of asthma-rhinitis-eczema and sex, race/ethnicity, smoking habit, physical exercise and sedentary activities. CONCLUSIONS: In the last two decades, the prevalence of asthma and eczema symptoms in adolescent population in the city of Quito has significantly declined; however, the prevalence of rhinitis symptoms has increased. The reduction in asthma symptoms could be related to better managing the disease and changes in local environmental risk factors in the last years. Further studies must be conducted in the country to evaluate the change in trends in asthma and other related allergic diseases.

Trends in hospital admissions and mortality rates for asthma in Ecuador: a joinpoint regression analysis of data from 2000 to 2018.

BACKGROUND: Although asthma has emerged as an important public health problem over recent decades in Latin America, there are limited published data on national hospital admission and mortality rates for asthma from countries in the region. OBJECTIVE: To analyse trends in asthma hospitalisation and mortality rates in Ecuador over a 19-year period from 2000 to 2018. METHODS: Hospital discharge and death certificates listing asthma, as defined in the International Classification of Diseases 10th Revision codes (J45 and J46), were used to analyse time trends in rates of hospital admissions and mortality for asthma. The data were obtained from the Ecuadorian National Institute of Statistics and Census. Crude and age-standardised rates were estimated for the entire population. Additionally, specific rates by sex, age and region were estimated. We used joinpoint analysis to identify national trends. RESULT: During 2000-2018, a total of 58 250 hospitalisations and 1328 deaths due to asthma were identified. The average annual rates for hospitalisation and mortality attributed to asthma were estimated to be 21 (95% CI 19.3 to 22.8) and 5.2 (95% CI 4.4 to 6.0) per 100 000 population, respectively, over this period. Asthma hospital admissions decreased from 28 to 13.7 per 100 000 population between 2000 and 2018, and asthma mortality decreased from 0.8 to 0.3 per 100 000 population over the same period. Based on jointpoint analysis, two temporal trends were identified for hospital admissions. Between 2000 and 2011, hospital admissions decreased 0.8% per year and between 2011 and 2018 decreased 6.6% per year (p<0.05). On average, hospitalisation rates decreased 3.1% per year (p<0.05) over the entire study period. Mortality rate decreased 5.6% per year (p<0.05) over the 19-year period. Hospitalisation rates were higher among females, those aged 5 to 19 years and those living in the Coast region. CONCLUSIONS: Our analysis shows a temporal trend of reduction in rates of hospitalisations and deaths attributed to asthma between 2000 and 2018 in Ecuador, consistent with similar trends elsewhere in the Latin American region. Health registration systems in Latin America need to be improved to provide reliable data for future between and within country comparisons of trends in asthma hospitalisations and deaths.

Enfermedad de Gaucher: caso clínico / Gaucher's disease: a clinical case

La enfermedad de Gaucher es una patología de depósito lisosomal, autosómica recesiva, con mutación en el gen GBA, que afecta principalmente al hígado, bazo, huesos y a la médula ósea. Es una enfermedad rara con baja incidencia mundial. Existen 3 tipos; el tipo I es el más frecuente en la población pediátrica, y el tipo III es el de peor pronóstico y presenta manifestaciones neurológicas. El diagnóstico se realiza con el tamizaje prenatal de enfermedades de depósito, más específicamente de mutaciones GBA. El diagnóstico definitivo se realiza al detectar ß-glucocerebrosidasa, y los estudios genéticos para la tipificación del gen afectado: en el tipo 1 mutación N370S y mutaciones L444P o D409H en tipo 2 y 3. El tratamiento se realiza con terapia de reemplazo enzimático o con la terapia de reducción de sustrato. Describimos en este artículo a un paciente preescolar del Hospital Enrique Garcés, con cuadro respiratorio, hepato-esplenomegalia y afectación de las tres líneas celulares sanguíneas.

Gaucher's disease is an autosomal recessive lysosomal storage pathology, with mutation in the GBA gene, which mostly affects the liver, spleen, bone and bone marrow. It is a rare disease with low global incidence. There are 3 types: type I is the most frequent in the pediatric population, and type III has the worst prognosis and presents neurological manifestations. Diagnosis is made with prenatal screening of storage diseases, and more specifically GBA1 mutations. The definitive diagnosis is made by detecting ß-glucocerebrosidase, and genetic studies for the detarmination of the affected gene, in type 1 mutation N370S and L444P mutations or D409H in type 2 and 3. The treatment is enzyme replacement therapy or substrate reduction therapy. This article describes a preschool patient of Enrique Garcés Hospital, with respiratory symptoms, hepato-splenomegaly and involvement of the three blood cell lines.