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1.
Allergol. immunopatol ; 47(2): 107-121, mar.-abr. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-180798

RESUMO

Background and aim: The definition and diagnosis of asthma are the subject of controversy that is particularly intense in the case of individuals in the first years of life, due to reasons such as the difficulty of performing objective pulmonary function tests or the high frequency with which the symptoms subside in the course of childhood. Since there is no consensus regarding the diagnosis of asthma in preschool children, a systematic review has been carried out. Materials and methods: A systematic search was made of the clinical guidelines published in the last 10 years and containing information referred to the concept or diagnosis of asthma in childhood - including the first years of life (infants and preschool children). A series of key questions were established, and each selected guide was analyzed in search of answers to those questions. The review protocol was registered in the international prospective register of systematic reviews (PROSPERO), with registration number CRD42017074872. Results: Twenty-one clinical guidelines were selected: 10 general guides (children and adults), eight pediatric guides and three guides focusing on preschool children. The immense majority accepted that asthma can be diagnosed from the first years of life, without requiring pulmonary function tests or other complementary techniques. The response to treatment and the exclusion of other alternative diagnoses are key elements for establishing the diagnosis. Only one of the guides denied the possibility of diagnosing asthma in preschool children. Conclusions: There is generalized although not unanimous agreement that asthma can be diagnosed in preschool children


No disponible


Assuntos
Humanos , Lactente , Pré-Escolar , Antiasmáticos/uso terapêutico , Asma/diagnóstico , Asma/tratamento farmacológico , Testes de Função Respiratória
2.
Artigo em Inglês | MEDLINE | ID: mdl-30193886

RESUMO

BACKGROUND AND AIM: The definition and diagnosis of asthma are the subject of controversy that is particularly intense in the case of individuals in the first years of life, due to reasons such as the difficulty of performing objective pulmonary function tests or the high frequency with which the symptoms subside in the course of childhood. Since there is no consensus regarding the diagnosis of asthma in preschool children, a systematic review has been carried out. MATERIALS AND METHODS: A systematic search was made of the clinical guidelines published in the last 10 years and containing information referred to the concept or diagnosis of asthma in childhood - including the first years of life (infants and preschool children). A series of key questions were established, and each selected guide was analyzed in search of answers to those questions. The review protocol was registered in the international prospective register of systematic reviews (PROSPERO), with registration number CRD42017074872. RESULTS: Twenty-one clinical guidelines were selected: 10 general guides (children and adults), eight pediatric guides and three guides focusing on preschool children. The immense majority accepted that asthma can be diagnosed from the first years of life, without requiring pulmonary function tests or other complementary techniques. The response to treatment and the exclusion of other alternative diagnoses are key elements for establishing the diagnosis. Only one of the guides denied the possibility of diagnosing asthma in preschool children. CONCLUSIONS: There is generalized although not unanimous agreement that asthma can be diagnosed in preschool children.

5.
An. pediatr. (2003. Ed. impr.) ; 84(2): 122.e1-122.e11, feb. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-147731

RESUMO

Introducción: La identificación adecuada del paciente pediátrico con asma grave es esencial para su correcto manejo. Sin embargo, los criterios para definir el asma grave y las recomendaciones para su control varían mucho entre las distintas guías. Material y métodos: Se elaboró una encuesta telemática para analizar las opiniones relativas a la definición y control del asma grave pediátrica. Para lograr un consenso se siguió una metodología Delphi modificada. Con los resultados se elaboraron recomendaciones prácticas. Resultados: El cuestionario fue respondido por 11 neumólogos y alergólogos pediátricos expertos en asma grave. Hubo consenso en 50 de los 65 ítems planteados (76,92%). Se consideró que un paciente tiene asma grave si en el último año ha requerido 2 o más ciclos de corticoides orales, si requiere tratamiento diario con corticoides inhalados a dosis medias (con otra medicación controladora) o dosis altas (con o sin otra medicación controladora), si no responde a un tratamiento convencional optimizado, o si la enfermedad pone en riesgo su vida o deteriora gravemente su calidad de vida. La definición de asma grave también podría incluir a los pacientes que consumen recursos sanitarios de manera regular y justificada, o tienen factores psicosociales o ambientales que impiden su control. Para la monitorización, se recomienda usar cuestionarios específicos de población pediátrica (CAN o ACT). Respecto al tratamiento, se debería considerar el uso de omalizumab en un escalón anterior al de los corticoides orales. Conclusiones: El presente trabajo ofrece recomendaciones consensuadas que pueden ser de utilidad en el manejo del asma grave pediátrica (AU)


Introduction: Accurate identification of paediatric patients with severe asthma is essential for an adequate management of the disease. However, criteria for defining severe asthma and recommendations for control vary among different guidelines. Material and methods: An online survey was conducted to explore expert opinions about the definition and management of severe paediatric asthma. To reach a consensus agreement, a modified Delphi technique was used, and practice guidelines were prepared after the analysis of the results. Results: Eleven paediatric chest disease physicians and allergy specialists with wide expertise in severe asthma responded to the survey. Consensus was reached in 50 out of 65 questions (76.92%). It was considered that a patient has severe asthma if during the previous year they have required 2 or more cycles of oral steroids, required daily treatment with medium doses of inhaled corticosteroids (with other controller medication) or high doses (with or without other controller medication), did not respond to optimised conventional treatment, or if the disease threatened the life of the patient or seriously impairs their quality of life. The definition of severe asthma may also include patients who justifiably use health resources on a regular basis, or have psychosocial or environmental factors impeding control. For monitoring, the use of questionnaires designed specifically for paediatric population, such as CAN or ACT, is recommended. As regards treatment, the use of omalizumab should be considered prior to the use of oral corticosteroids. Conclusions: This paper provides consensus recommendations that may be useful in the management of severe paediatric asthma (AU)


Assuntos
Humanos , Masculino , Feminino , Asma/epidemiologia , Asma/prevenção & controle , Conferências de Consenso como Assunto , Monitorização Ambulatorial/estatística & dados numéricos , Monitoramento Epidemiológico , Inquéritos e Questionários , Pediatria , Pediatria/estatística & dados numéricos , Avaliação de Resultado de Ações Preventivas/métodos , Avaliação de Resultado de Intervenções Terapêuticas/métodos
6.
An Pediatr (Barc) ; 84(2): 122.e1-122.e11, 2016 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-26515042

RESUMO

INTRODUCTION: Accurate identification of paediatric patients with severe asthma is essential for an adequate management of the disease. However, criteria for defining severe asthma and recommendations for control vary among different guidelines. MATERIAL AND METHODS: An online survey was conducted to explore expert opinions about the definition and management of severe paediatric asthma. To reach a consensus agreement, a modified Delphi technique was used, and practice guidelines were prepared after the analysis of the results. RESULTS: Eleven paediatric chest disease physicians and allergy specialists with wide expertise in severe asthma responded to the survey. Consensus was reached in 50 out of 65 questions (76.92%). It was considered that a patient has severe asthma if during the previous year they have required 2 or more cycles of oral steroids, required daily treatment with medium doses of inhaled corticosteroids (with other controller medication) or high doses (with or without other controller medication), did not respond to optimised conventional treatment, or if the disease threatened the life of the patient or seriously impairs their quality of life. The definition of severe asthma may also include patients who justifiably use health resources on a regular basis, or have psychosocial or environmental factors impeding control. For monitoring, the use of questionnaires designed specifically for paediatric population, such as CAN or ACT, is recommended. As regards treatment, the use of omalizumab should be considered prior to the use of oral corticosteroids. CONCLUSIONS: This paper provides consensus recommendations that may be useful in the management of severe paediatric asthma.


Assuntos
Antiasmáticos/uso terapêutico , Asma/tratamento farmacológico , Corticosteroides/uso terapêutico , Criança , Consenso , Humanos , Guias de Prática Clínica como Assunto , Qualidade de Vida
7.
Allergol. immunopatol ; 43(3): 264-271, mayo-jun. 2015. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-136333

RESUMO

Background: Respiratory syncytial virus acute bronchiolitis (RSV-AB) is a major cause of hospital admission among our infants. The immune and inflammatory mechanisms involved in the RSV-AB and factors influencing severity have not been clearly established, although an imbalanced Th1 and Th2 response seems to be crucial. Objectives: To assess the local and systemic inflammatory response in RSV-AB. To find a possible marker of clinical severity and/or oxygen requirements. Patients and methods: Levels of nine cytokines were measured in nasopharyngeal aspirate (NPA) and peripheral blood (PB) of 45 infants with RSV-AB and 27 peer controls, including IFNγ, TNFα, VEGF, interleukins 4, 6 and 10, and chemokines (IL-8 and macrophage inflammatory proteins 1-α and 1-β). Results: The levels of the analyzed cytokines and chemokines were significantly higher in the NPA of RSV-AB group, with a decrease in IL-4/IFNγ ratio. IL-6 and MIP-1β levels in NPA were directly correlated to oxygen therapy. PB showed an increase in IL-8 and a decrease in MIP-1α and MIP-1β in the RSV-AB group (only MIP-1β associated to the need for oxygen therapy). No correlation was found between cytokines and chemokines levels in NPA and PB. Conclusions: This study shows that RSV triggers an inflammatory response fundamentally at the respiratory level, with scant systemic repercussion. This local response is characterized by an increase in Th1 and Th2 cytokines, although with a relative predominance of Th1. The determination upon patient admission of IL-6 and MIP-1β levels in NPA, and of MIP-1β in PB could help predict severe forms and the need for oxygenotherapy (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Vírus Sinciciais Respiratórios/imunologia , Vírus Sinciciais Respiratórios/patogenicidade , Vacinas contra Vírus Sincicial Respiratório/imunologia , Bronquiolite/imunologia , Oxigenoterapia , Células Th1/imunologia , Equilíbrio Th1-Th2 , Células Th2/imunologia , Citocinas/imunologia , Hospitalização/tendências
8.
Allergol Immunopathol (Madr) ; 43(3): 264-71, 2015 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24985791

RESUMO

BACKGROUND: Respiratory syncytial virus acute bronchiolitis (RSV-AB) is a major cause of hospital admission among our infants. The immune and inflammatory mechanisms involved in the RSV-AB and factors influencing severity have not been clearly established, although an imbalanced Th1 and Th2 response seems to be crucial. OBJECTIVES: To assess the local and systemic inflammatory response in RSV-AB. To find a possible marker of clinical severity and/or oxygen requirements. PATIENTS AND METHODS: Levels of nine cytokines were measured in nasopharyngeal aspirate (NPA) and peripheral blood (PB) of 45 infants with RSV-AB and 27 peer controls, including IFNγ, TNFα, VEGF, interleukins 4, 6 and 10, and chemokines (IL-8 and macrophage inflammatory proteins 1-α and 1-ß). RESULTS: The levels of the analyzed cytokines and chemokines were significantly higher in the NPA of RSV-AB group, with a decrease in IL-4/IFNγ ratio. IL-6 and MIP-1ß levels in NPA were directly correlated to oxygen therapy. PB showed an increase in IL-8 and a decrease in MIP-1α and MIP-1ß in the RSV-AB group (only MIP-1ß associated to the need for oxygen therapy). No correlation was found between cytokines and chemokines levels in NPA and PB. CONCLUSIONS: This study shows that RSV triggers an inflammatory response fundamentally at the respiratory level, with scant systemic repercussion. This local response is characterized by an increase in Th1 and Th2 cytokines, although with a relative predominance of Th1. The determination upon patient admission of IL-6 and MIP-1ß levels in NPA, and of MIP-1ß in PB could help predict severe forms and the need for oxygenotherapy.


Assuntos
Bronquiolite/diagnóstico , Infecções por Vírus Respiratório Sincicial/diagnóstico , Vírus Sinciciais Respiratórios/imunologia , Células Th1/imunologia , Bronquiolite/imunologia , Bronquiolite/terapia , Citocinas/metabolismo , Progressão da Doença , Feminino , Hospitalização , Humanos , Oxigenação Hiperbárica , Lactente , Mediadores da Inflamação/metabolismo , Masculino , Prognóstico , Infecções por Vírus Respiratório Sincicial/imunologia , Infecções por Vírus Respiratório Sincicial/terapia , Equilíbrio Th1-Th2
12.
An. pediatr. (2003, Ed. impr.) ; 79(3): 188-188[e1-e5], sept. 2013.
Artigo em Espanhol | IBECS | ID: ibc-116573

RESUMO

La prevalencia del asma ha aumentado en las últimas décadas, especialmente en los países desarrollados, por motivos no bien esclarecidos. En los últimos años se ha observado una asociación entre el uso de paracetamol en distintas etapas de la vida, incluyendo la gestación y la infancia, y la prevalencia de asma. El carácter observacional de los estudios publicados no permite establecer una relación causal. Sería necesario realizar ensayos clínicos para comprobar la naturaleza de la asociación, que podría deberse a la presencia de diversos factores de confusión. Las sociedades pediátricas españolas firmantes de este artículo consideran que los datos disponibles hasta la fecha no son suficientes para desaconsejar el uso de paracetamol durante la gestación ni en niños asmáticos o con riesgo de asma (AU)


Asthma prevalence has increased over the last few decades, especially in developed countries, and possibly due to different reasons. An association between paracetamol use or exposure at different periods of life, including gestation and childhood, and asthma prevalence has been observed in the last few years. Causality can not be established from observational reports, due to the arguable presence of many confounding factors and biases. Randomised trials are needed to elucidate the nature of this association. The Spanish Paediatric societies subscribing to this paper consider that current evidence is insufficient to discourage the use of paracetamol during gestation or in children with or at risk of asthma (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Acetaminofen/efeitos adversos , Asma/induzido quimicamente , Fatores de Risco , Exposição Materna
13.
An Pediatr (Barc) ; 79(3): 188.e1-5, 2013 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-23462095

RESUMO

Asthma prevalence has increased over the last few decades, especially in developed countries, and possibly due to different reasons. An association between paracetamol use or exposure at different periods of life, including gestation and childhood, and asthma prevalence has been observed in the last few years. Causality can not be established from observational reports, due to the arguable presence of many confounding factors and biases. Randomised trials are needed to elucidate the nature of this association. The Spanish Paediatric societies subscribing to this paper consider that current evidence is insufficient to discourage the use of paracetamol during gestation or in children with or at risk of asthma.


Assuntos
Acetaminofen/efeitos adversos , Analgésicos não Entorpecentes/efeitos adversos , Antipiréticos/efeitos adversos , Asma/induzido quimicamente , Asma/prevenção & controle , Acetaminofen/uso terapêutico , Analgésicos não Entorpecentes/uso terapêutico , Antipiréticos/uso terapêutico , Criança , Humanos
16.
An. pediatr. (2003, Ed. impr.) ; 77(2): 130-135, ago. 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-102755

RESUMO

La microdeleción 22q11 es una deleción genética frecuente con variabilidad fenotípica amplia. Engloba una serie de síndromes, entre los que destaca el síndrome de DiGeorge. Las manifestaciones clínicas más frecuentemente descritas son malformaciones cardiacas, una facies característica, malformaciones palatinas, hipoparatiroidismo, inmunodeficiencia secundaria a hipoplasia tímica, retraso psicomotor y alteraciones psiquiátricas. Dentro de los signos producidos por la enfermedad, es frecuente la insuficiencia respiratoria de causa multifactorial. Las malformaciones de la vía aérea son frecuentes, aunque en la mayoría de los pacientes son leves, por lo que no suelen producir sintomatología. Sin embargo, en algunos casos pueden condicionar clínica respiratoria grave. Los casos clínicos presentados ilustran la importancia de la valoración precoz de la vía aérea mediante fibrobroncoscopia en pacientes con microdeleción 22q11 que presentan dificultad respiratoria recurrente(AU)


The 22q11 deletion syndrome is a frequent contiguous-gene deletion syndrome. This disorder has a broad spectrum of phenotypic manifestations. It includes various syndromes such as DiGeorge syndrome. The most frequent clinical manifestations are congenital cardiac defects, characteristic facies, palate malformations, hypoparathyroidism, immunodeficiency due to thymic hypoplasia, growth retardation, and behavioural and psychiatric problems. Among the symptoms observed, many patients suffer from respiratory insufficiency or failure. The origin is often multifactorial. Structural airway abnormalities are frequently found in this syndrome. In many of these patients the malformation is mild or non-existent, and remains asymptomatic. However, in some cases it can cause a severe respiratory insufficiency, being diagnosed when other disorders are ruled out. These cases illustrate the importance of early visualisation of the airway by fibrobronchoscopy in the management of the patient with 22q11 deletion syndrome who has recurrent respiratory difficulties(AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Criança , Síndrome da Deleção 22q11/complicações , Síndrome da Deleção 22q11/diagnóstico , Doenças Cardiovasculares/complicações , Broncoscopia/métodos , Broncoscopia , Oxigenoterapia , Espasmo Brônquico/complicações , Espasmo Brônquico/diagnóstico , Pneumonia/complicações , Síndrome da Deleção 22q11/fisiopatologia , Síndrome da Deleção 22q11 , Causalidade , Hipercapnia/complicações , Espasmo Brônquico/terapia , Espasmo Brônquico , Radiografia Torácica/métodos , Corticosteroides/uso terapêutico , Broncodilatadores/uso terapêutico , Azitromicina/uso terapêutico
17.
An Pediatr (Barc) ; 77(2): 130-5, 2012 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-22459608

RESUMO

The 22q11 deletion syndrome is a frequent contiguous-gene deletion syndrome. This disorder has a broad spectrum of phenotypic manifestations. It includes various syndromes such as DiGeorge syndrome. The most frequent clinical manifestations are congenital cardiac defects, characteristic facies, palate malformations, hypoparathyroidism, immunodeficiency due to thymic hypoplasia, growth retardation, and behavioural and psychiatric problems. Among the symptoms observed, many patients suffer from respiratory insufficiency or failure. The origin is often multifactorial. Structural airway abnormalities are frequently found in this syndrome. In many of these patients the malformation is mild or non-existent, and remains asymptomatic. However, in some cases it can cause a severe respiratory insufficiency, being diagnosed when other disorders are ruled out. These cases illustrate the importance of early visualisation of the airway by fibrobronchoscopy in the management of the patient with 22q11 deletion syndrome who has recurrent respiratory difficulties.


Assuntos
Síndrome da Deleção 22q11/diagnóstico , Broncoscopia , Broncoscopia/métodos , Pré-Escolar , Feminino , Tecnologia de Fibra Óptica , Humanos , Lactente , Recém-Nascido
18.
Allergol. immunopatol ; 38(4): 174-180, jul.-ago. 2010. graf, tab
Artigo em Inglês | IBECS | ID: ibc-86413

RESUMO

Background: Atopic eczema affects 5–10% of the Spanish paediatric population, and has increased in frequency over the last few decades, probably due to changes in the environment and lifestyle. Phase II of the ISAAC (International Study of Asthma and Allergies in Childhood) uses a standardised methodology to establish the prevalence of allergic disorders and factors linked to them in each centre. Objectives: To assess the prevalence and severity of atopic eczema, and to establish factors linked to atopic eczema in 10–11 year-old school children in the city of Almeria (South-East coast of Spain). Material and methods: An ecological study was carried out as part of ISAAC II, using homologated questionnaires and allergic tests in 1143 schoolchildren. Statistic association was assessed by means of ÷2 test, and then logistic regression analysis was performed with the most significant variables from the univariant analysis. Results: The prevalence of atopic eczema was 11.4%. The risk factors found in the multiple logistic regression analysis were: personal antecedents of severe asthma (OR 19 CI 95% 1.35–266) and severe rhinitis (OR 7.7 CI 95% 1.79–33), fungi in bedroom during the first year of life (OR 4.2 CI 95% 1.17–15.1) and atopic eczema in one parent (OR 5.2 CI 95% 2.69–10.1). Conclusions: The prevalence of atopic eczema is similar to that found in other studies within ISAAC Phase I. The most important risk factors for atopic eczema are family and personal history of other atopic diseases and the presence of fungi in the home (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Dermatite Atópica/epidemiologia , Rinite/complicações , Rinite/epidemiologia , Asma/diagnóstico , Dermatite Atópica/prevenção & controle , Dermatite Atópica/fisiopatologia , Rinite/prevenção & controle , Asma/epidemiologia , Modelos Logísticos , Fatores de Risco
19.
Allergol. immunopatol ; 38(3): 135-141, jun. 2010. graf, tab
Artigo em Inglês | IBECS | ID: ibc-86379

RESUMO

Background: Allergic rhinitis affects 10–30% of children in developed countries and has increased in frequency over the last few decades, probably due to changes in the environment and life style. Aim: To assess the prevalence, severity, and factors linked to rhinitis in 10 and 11-year-old children from Almeria (Spain). Methods: As part of ISAAC II, a cross-sectional survey was conducted among a representative sample of 1143 schoolchildren in spring and autumn of 2001, using homologated questionnaires and skin-prick testing. Results: The overall prevalence of rhinitis and rhinoconjunctivitis were 38.9% and 24.8%, respectively, 17.9% had medically diagnosed rhinitis. During the previous year symptoms disturbed daily activities and school attendance in some measure in 40% and 26% of children with rhinitis, respectively. Results: The risk factors found in the multiple logistic regression analysis were atopy (OR 2.57; 95% CI 1.92–3.42); cat contact at home during first year of life (OR 2.4 95% CI 1.13–5.12); prior medical diagnosis of asthma (OR 2.2; 95% CI 1.22–4.02); nocturnal cough in absence of colds (OR 1.9; 95% CI 1.25–2.97); diagnosis of rhinitis in one of the parents (OR 1.8; 95% CI 1.31–2.59); wheezing at any time (OR 1.6; 95% CI 1.18–2.28); and nursery school attendance (OR 1.5; 95% CI 1.21–2.5). Conclusions: The prevalence of rhinitis found is superior to that of other centres participating in the ISAAC Phases I and II, and coexists with asthma and eczema in many children. The independent risk factors associated to rhinitis are in accordance with previous reports (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Rinite/epidemiologia , Rinite Alérgica Sazonal/epidemiologia , Conjuntivite/complicações , Conjuntivite/epidemiologia , Dermatite Atópica/complicações , Dermatite Atópica/epidemiologia , Sons Respiratórios/fisiopatologia , Dermatite Atópica/fisiopatologia , Sons Respiratórios/diagnóstico , Inquéritos e Questionários , Modelos Logísticos
20.
Allergol Immunopathol (Madr) ; 38(3): 135-41, 2010 May-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20462685

RESUMO

BACKGROUND: Allergic rhinitis affects 10-30% of children in developed countries and has increased in frequency over the last few decades, probably due to changes in the environment and life style. AIM: To assess the prevalence, severity, and factors linked to rhinitis in 10 and 11-year-old children from Almeria (Spain). METHODS: As part of ISAAC II, a cross-sectional survey was conducted among a representative sample of 1143 schoolchildren in spring and autumn of 2001, using homologated questionnaires and skin-prick testing. RESULTS: The overall prevalence of rhinitis and rhinoconjunctivitis were 38.9% and 24.8%, respectively, 17.9% had medically diagnosed rhinitis. During the previous year symptoms disturbed daily activities and school attendance in some measure in 40% and 26% of children with rhinitis, respectively. The risk factors found in the multiple logistic regression analysis were atopy (OR 2.57; 95% CI 1.92-3.42); cat contact at home during first year of life (OR 2.4 95% CI 1.13-5.12); prior medical diagnosis of asthma (OR 2.2; 95% CI 1.22-4.02); nocturnal cough in absence of colds (OR 1.9; 95% CI 1.25-2.97); diagnosis of rhinitis in one of the parents (OR 1.8; 95% CI 1.31-2.59); wheezing at any time (OR 1.6; 95% CI 1.18-2.28); and nursery school attendance (OR 1.5; 95% CI 1.21-2.5). CONCLUSIONS: The prevalence of rhinitis found is superior to that of other centres participating in the ISAAC Phases I and II, and coexists with asthma and eczema in many children. The independent risk factors associated to rhinitis are in accordance with previous reports.


Assuntos
Asma/epidemiologia , Dermatite Atópica/epidemiologia , Rinite Alérgica Perene/epidemiologia , Rinite Alérgica Sazonal/epidemiologia , Atividades Cotidianas , Animais , Asma/fisiopatologia , Gatos , Criança , Estudos Transversais , Dermatite Atópica/fisiopatologia , Progressão da Doença , Feminino , Humanos , Masculino , Prevalência , Rinite Alérgica Perene/fisiopatologia , Rinite Alérgica Sazonal/fisiopatologia , Fatores de Risco , Testes Cutâneos , Espanha , Inquéritos e Questionários
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