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1.
Georgian Med News ; (292-293): 68-71, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31560666

RESUMO

The aim of our study was a comparative description of the state of bronchial sensitivity to nonspecific stimuli in respiratory asymptomatic children and children with bronchial asthma. We investigated a total of 242 children aged between 7 and 14 years. The group of respiratory asymptomatic children included 100 examined and 142 had an established diagnosis of atopic bronchial asthma at the I, II, and III stages in the phase of remission. The study was conducted in accordance with the principles of bioethics. In order to investigate the nature of the reaction, bronchoprovocation test with the acetylcholine (bronchoconstrictor) was conducted in children. The test involved monitoring the state of bronchial patency under the effect of increasing concentrations of the stimulus. The acetylcholine test showed that the state of nonspecific bronchial hypersensitivity was expressed in the most of patients with asthma and in 5% of respiratory asymptomatic children. Comparison of the results of the nonspecific bronchial sensitivity and diagnosed airway obstruction did not reveal the relationship between these characteristics. The findings suggest that the presence of nonspecific bronchial hypersensitivity is a congenital and not an acquired phenomenon.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Asma/fisiopatologia , Brônquios/fisiopatologia , Hiper-Reatividade Brônquica/fisiopatologia , Hipersensibilidade Imediata/complicações , Adolescente , Obstrução das Vias Respiratórias/diagnóstico , Obstrução das Vias Respiratórias/fisiopatologia , Asma/etiologia , Hiper-Reatividade Brônquica/diagnóstico , Testes de Provocação Brônquica , Criança , Humanos
2.
Artigo em Japonês | MEDLINE | ID: mdl-31434811

RESUMO

Recently, the main air pollutant has been fine particulate matter (PM2.5), which is taken up by the whole body with severe adverse health effects. The main chemical components of PM2.5 are salts of sulfate (and nitrate) and carbons. However, it remains unknown which components are toxic. Here, the author reviewed the literatures to determine which components are toxic and the main mechanisms underlying their toxicity. Many epidemiological studies have shown that sulfate concentration is strongly related to mortality. However, there is no experimental evidence showing that sulfate at environmental concentrations of PM2.5 causes cardiovascular disease or other disease. On the other hand, carbon components such as elementary carbon (EC) produces high concentrations of reactive oxygen species (ROS) via its phagocytosis by macrophages, and organic carbon (OC) also produces high concentrations of ROS during its metabolic processes, and the ROS cause acute and chronic inflammation. They cause many diseases including cardiovascular disease, asthma and cancer. Furthermore, there are many lines of evidence showing that epigenetic changes such as DNA methylation or microRNA expression induced by particulate matters also induce the development of many diseases such as those mentioned above. It has been reported that carbon components are incorporated into the brain and produce ROS, and that the ROS cause damage to brain cells and Alzheimer's disease and cognitive disorders in the elderly.From these lines of evidence, the author would like to emphasize that the main toxicity of PM2.5 is due to carbon components, and it is important to take countermeasures to decrease the concentration of carbon components in ambient air.


Assuntos
Poluentes Atmosféricos/toxicidade , Carbono/toxicidade , Material Particulado/toxicidade , Sulfatos/toxicidade , Doença de Alzheimer/etiologia , Animais , Asma/etiologia , Doenças Cardiovasculares/etiologia , Epigênese Genética , Cobaias , Humanos , Camundongos , Neoplasias/etiologia , Estresse Oxidativo , Espécies Reativas de Oxigênio/metabolismo
3.
Medicine (Baltimore) ; 98(35): e16540, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464891

RESUMO

Antibiotics during infancy, delivery, and breastfeeding affect the intestinal microbiota in early life and is associated with allergic disease. Gastroenteritis (GE) during infancy also affects intestinal microbiota in early life, however, its relationship to allergic disease has not been investigated.Data of 45,499 males and 49,430 females, from birth to 5 years of age, were collected from a national database in Taiwan. Subjects were categorized into early GE (GE within 0-6 months) and non-early GE group (no GE within 0-6 months). The rates of asthma (AS), allergic rhinitis (AR), and atopic dermatitis (AD) over 5 years were evaluated and compared between the groups. In patients with AS, AR, and AD, the number of clinical visits and drug prescriptions for the allergic disease was also evaluated to assess the effect of early GE on allergic disease.After adjusting for the effect of GE in later life and other factors, the rates of AS [OR (odds ratio) 1.54, 95% confidence interval (CI) 1.48-1.60], AR [OR 1.49, 95% CI 1.45-1.54], and AD [OR 1.40, 95% CI 1.33-1.47] were higher in the early GE group than in the non-early GE group. The magnitude of the increase was higher in females than in males. In those with AS, AR, and AD, the number of clinical visits and drug prescriptions was not different between the early GE and non-early GE groups. In children with early GE, good control of GE in the following years lowered the rate of allergic disease.Early-life GE was associated with increased rates of AS, AR, and AD in later life and this was trend more prominent in females.


Assuntos
Asma/epidemiologia , Dermatite Atópica/epidemiologia , Gastroenterite/complicações , Rinite Alérgica/epidemiologia , Asma/etiologia , Estudos de Casos e Controles , Pré-Escolar , Dermatite Atópica/etiologia , Feminino , Gastroenterite/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Rinite Alérgica/etiologia , Caracteres Sexuais , Taiwan/epidemiologia
4.
J Bras Pneumol ; 45(3): e20180138, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31271601

RESUMO

OBJECTIVE: To estimate the evolution of the prevalence of asthma and wheezing among schoolchildren in Brazil from 2012 to 2015, as well as to identify factors associated with both conditions. METHODS: This was a cross-sectional study using data from the Brazilian National School-Based Adolescent Health Survey for 2012 and 2015. To characterize the evolution of the prevalence of asthma and wheezing, we used linear regression with weighted-least-squares estimation and presented the annual percent change (APC). RESULTS: During the study period, there was a reduction in the prevalence of wheezing, from 23.2% in 2012 to 22.4% in 2015 (APC, -0.27). The prevalence of asthma increased from 12.4% in 2012 to 16.0% in 2015 (APC, 1.20). The increase in the prevalence of asthma was greatest in the southern region of the country (APC, 2.17). Having any history of smoking and having consumed alcohol in the last 30 days were factors that influenced the prevalence of wheezing and the prevalence of a self-reported diagnosis of asthma during the two years evaluated. CONCLUSIONS: There has been an increase in the prevalence of asthma in recent years in Brazil. Our data underscore the importance of improving health strategies and policies aimed at the control of asthma.


Assuntos
Asma/epidemiologia , Asma/etiologia , Sons Respiratórios/etiologia , Adolescente , Saúde do Adolescente/estatística & dados numéricos , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Prevalência , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Fatores Socioeconômicos , Inquéritos e Questionários , Fatores de Tempo
5.
Environ Monit Assess ; 191(Suppl 2): 269, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31254073

RESUMO

Asthma is the most common pediatric disease in the USA. It has been consistently demonstrated that asthma symptoms are exacerbated by exposure to ozone. Ozone (O3) is a secondary pollutant produced when volatile organic compounds (VOCs) are oxidized in the atmosphere in the presence of nitrogen oxides (NOx). At ground level, elevated ozone is typically formed as a result of human activities. However, wildfires represent an additional source of ozone precursors. Recent evidence suggests that smoke can increase ozone concentrations. We estimated the number of excess asthma-related emergency department (ED) visits in children with asthma that may be attributed to elevated ozone associated with smoke (EOAS) in the USA. We conducted a quantitative burden assessment (BA) using a Monte Carlo approach to estimate the median number of excess pediatric asthma ED visits that may be attributed to EOAS among children with asthma in the continental USA between 2005 and 2014, as well as 95% confidence bounds (95% CB). We estimated that a median of 2403 (95% CB 235-5382) pediatric asthma ED visits could be attributed to EOAS exposure between 2005 and 2014 in the continental USA. Furthermore, the impact of EOAS on estimated asthma ED visits was greatest in the eastern half of the continental USA. We found a significant increase in pediatric asthma ED visits that may be attributed to exposure to EOAS. EOAS may have a measurable negative impact on children with asthma in the USA.


Assuntos
Poluentes Atmosféricos/análise , Asma/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Ozônio/análise , Fumaça/análise , Compostos Orgânicos Voláteis/química , Adolescente , Poluentes Atmosféricos/efeitos adversos , Asma/etiologia , Atmosfera , Criança , Pré-Escolar , Monitoramento Ambiental , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Oxirredução , Ozônio/efeitos adversos , Pediatria , Fumaça/efeitos adversos , Estados Unidos/epidemiologia , United States Environmental Protection Agency , Incêndios Florestais
6.
Lancet ; 394(10196): 407-418, 2019 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-31230828

RESUMO

BACKGROUND: Asthma is a common chronic airway disease worldwide. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of asthma. We therefore aimed to estimate the national prevalence of asthma in a representative sample of the Chinese population. METHODS: A representative sample of 57 779 adults aged 20 years or older was recruited for the national cross-sectional China Pulmonary Health (CPH) study using a multi-stage stratified sampling method with parameters derived from the 2010 census. Ten Chinese provinces, representative of all socioeconomic settings, from six geographical regions were selected, and all assessments were done in local health centres. Exclusion criteria were temporary residence, inability to take a spirometry test, hospital treatment of cardiovascular conditions or tuberculosis, and pregnancy and breastfeeding. Asthma was determined on the basis of a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. All participants were assessed with a standard asthma questionnaire and were classed as having or not having airflow limitation through pulmonary function tests before and after the use of a bronchodilator (400 µg of salbutamol). Risk factors for asthma were examined by multivariable-adjusted analyses done in all participants for whom data on the variables of interest were available. Disease management was assessed by the self-reported history of physician diagnosis, treatments, and hospital visits in people with asthma. FINDINGS: Between June 22, 2012, and May 25, 2015, 57 779 participants were recruited into the CPH study. 50 991 (21 446 men and 29 545 women) completed the questionnaire survey and had reliable post-bronchodilator pulmonary function test results and were thus included in the final analysis. The overall prevalence of asthma in our sample was 4·2% (95% CI 3·1-5·6), representing 45·7 million Chinese adults. The prevalence of asthma with airflow limitation was 1·1% (0·9-1·4), representing 13·1 million adults. Cigarette smoking (odds ratio [OR] 1·89, 95% CI 1·26-2·84; p=0·004), allergic rhinitis (3·06, 2·26-4·15; p<0·0001), childhood pneumonia or bronchitis (2·43, 1·44-4·10; p=0·002), parental history of respiratory disease (1·44, 1·02-2·04; p=0·040), and low education attainment (p=0·045) were associated with prevalent asthma. In 2032 people with asthma, only 28·8% (95% CI 19·7-40·0) reported ever being diagnosed by a physician, 23·4% (13·9-36·6) had a previous pulmonary function test, and 5·6% (3·1-9·9) had been treated with inhaled corticosteroids. Furthermore, 15·5% (11·4-20·8) people with asthma reported at least one emergency room visit and 7·2% (4·9-10·5) at least one hospital admission due to exacerbation of respiratory symptoms within the preceding year. INTERPRETATION: Asthma is prevalent but largely undiagnosed and undertreated in China. It is crucial to increase the awareness of asthma and disseminate standardised treatment in clinical settings to reduce the disease burden. FUNDING: National Key R&D Program of China, Ministry of Science and Technology of China; the Special Research Foundation for Public Welfare of Health, Ministry of Health of China; the Chinese National Research Program for Key Issues in Air Pollution Control; and the National Natural Science Foundation of China.


Assuntos
Asma/tratamento farmacológico , Asma/epidemiologia , Bronquite/epidemiologia , Fumar Cigarros/epidemiologia , Pneumonia/epidemiologia , Rinite Alérgica/epidemiologia , Administração por Inalação , Corticosteroides/uso terapêutico , Adulto , Asma/etiologia , Bronquite/complicações , China/epidemiologia , Fumar Cigarros/efeitos adversos , Estudos Transversais , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia/complicações , Prevalência , Rinite Alérgica/complicações , Fatores de Risco , Inquéritos e Questionários
7.
Environ Sci Pollut Res Int ; 26(23): 24262-24271, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31228070

RESUMO

Modern lifestyle with the increasing use of air conditioner (AC) has been linked with breathing difficulties, irritation, dryness, and other symptoms. Hence, dust mites were isolated from AC filters, which causes allergic diseases. A total of 95 dust samples were collected from AC filters from hospitals, guest house, office, school, and homes in Chandigarh, India. The highest concentration of dust mites was detected from hospitals (9/g), offices (7/g), households (6/g), guest houses (3/g), and schools (0/g). Based on the morphology of dust mites observed under a light microscope, Dermatophagoides and Acarus species were found most common. Indoor air quality was also monitored to find out their relation with dust mites present in AC filters. Further, the respiratory health status of indoor facility users was also assessed using a standard questionnaire as a study tool. It was seen that 55.3% of male among the total respondents were having an allergy and only 44.7% of the females had an allergy. The allergy among the male respondents (55.3%) was significantly more (p < 0.05) in comparison with female respondents (44.7%). Some of the respondents also reported a family history of rhinitis (31.9%), asthma (12.8%), recurrent urticaria (6.4%), and conjunctivitis (6.4%). Interestingly, 23.4% of study participants reported that they get disturbed by the use of AC and house dust was found to be the most triggering factor in enhancing the symptoms of allergy. Thus, it is recommended that air conditioner filters should be cleaned regularly to prevent the accumulation of the dust mites and related allergens on filter dust.


Assuntos
Ar Condicionado , Filtros de Ar , Poluição do Ar em Ambientes Fechados/análise , Alérgenos/análise , Ácaros/crescimento & desenvolvimento , Animais , Antígenos de Dermatophagoides , Asma/etiologia , Poeira/análise , Feminino , Humanos , Índia , Masculino
8.
BMC Public Health ; 19(1): 723, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31182075

RESUMO

BACKGROUND: Indoor environmental quality significantly influences the occurrence of asthma attack. Zunyi District has abundant coal reserves and is regarded as one of the cities that are most severely polluted by high levels of particulate matter in China. This study aimed to examine the correlation of indoor exposure with adult respiratory health, as well as the differences in effect between winter and summer. METHODS: A cross-sectional epidemiological study was conducted among 1207 adult residents in Zunyi, Guizhou Province of Southwest China in winter and summer. Data on health variables related to asthma and home environmental factors were collected using a modified European Community Respiratory Health Survey II questionnaire. The following data were obtained: samples of particulate matter 2.5 (PM2.5) inside and outside the households under study (n = 20); lung function status, including peak expiratory flow rate, forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC ratio. RESULT: The odds ratio (OR) for asthma-like symptoms and asthma in adults using coal stove for cooking or warming, relative to non-users, was 1.73 (95% CI, 1.11-2.69) in winter vs. 1.30 (95% CI, 0.79-2.14) in summer. Adult residents with exposure to cooking oil fumes were at a considerably higher risk of asthma-like symptoms and asthma [OR = 2.65 (95% CI, 1.25 to 5.61) in winter vs. OR = 7.93 (95% CI, 2.54 to 24.75] in summer] than those without such exposure. The prevalence of asthma-like symptoms and asthma was significantly higher in adults with high kitchen risk scores or high sleeping-area risk scores than in those with low scores in both seasons (p < 0.05). The relative kitchen and sleeping area PM2.5 concentrations were higher in winter than in summer (p < 0.05). Lung function was negatively associated with indoor kitchen and sleeping area relative PM2.5 concentration in winter rather than summer (p < 0.001). The effect of exposure to indoor risk factors on lung function among the residents was greater in winter than in summer (p < 0.001). CONCLUSION: Exposure to indoor risk factors, such as aerocontaminants from coal combustion, causes asthma symptoms and reduces pulmonary function. The effect of indoor risk factors on respiratory health among adults with such exposure was greater in winter than in summer.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar em Ambientes Fechados/análise , Asma/epidemiologia , Exposição Ambiental/efeitos adversos , Material Particulado/análise , Adulto , Asma/etiologia , China/epidemiologia , Cidades , Carvão Mineral , Culinária , Estudos Transversais , Feminino , Humanos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Fatores de Risco , Estações do Ano
9.
JAMA ; 321(19): 1906-1915, 2019 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-31112259

RESUMO

Importance: Exposure to air pollutants is a well-established cause of asthma exacerbation in children; whether air pollutants play a role in the development of childhood asthma, however, remains uncertain. Objective: To examine whether decreasing regional air pollutants were associated with reduced incidence of childhood asthma. Design, Setting, and Participants: A multilevel longitudinal cohort drawn from 3 waves of the Southern California Children's Health Study over a period of air pollution decline. Each cohort was followed up from 4th to 12th grade (8 years): 1993-2001, 1996-2004, and 2006-2014. Final follow-up for these data was June 2014. Population-based recruitment was from public elementary schools. A total of 4140 children with no history of asthma and residing in 1 of 9 Children's Health Study communities at baseline were included. Exposures: Annual mean community-level ozone, nitrogen dioxide, and particulate matter less than 10 µm (PM10) and less than 2.5 µm (PM2.5) in the baseline year for each of 3 cohorts. Main Outcomes and Measures: Prospectively identified incident asthma, collected via questionnaires during follow-up. Results: Among the 4140 children included in this study (mean [SD] age at baseline, 9.5 [0.6] years; 52.6% female [n = 2 179]; 58.6% white [n = 2273]; and 42.2% Hispanic [n = 1686]), 525 incident asthma cases were identified. For nitrogen dioxide, the incidence rate ratio (IRR) for asthma was 0.80 (95% CI, 0.71-0.90) for a median reduction of 4.3 parts per billion, with an absolute incidence rate decrease of 0.83 cases per 100 person-years. For PM2.5, the IRR was 0.81 (95% CI, 0.67-0.98) for a median reduction of 8.1 µg/m3, with an absolute incidence rate decrease of 1.53 cases per 100 person-years. For ozone, the IRR for asthma was 0.85 (95% CI, 0.71-1.02) for a median reduction of 8.9 parts per billion, with an absolute incidence rate decrease of 0.78 cases per 100 person-years. For PM10, the IRR was 0.93 (95% CI, 0.82-1.07) for a median reduction of 4.0 µg/m3, with an absolute incidence rate decrease of 0.46 cases per 100 person-years. Conclusions and Relevance: Among children in Southern California, decreases in ambient nitrogen dioxide and PM2.5 between 1993 and 2014 were significantly associated with lower asthma incidence. There were no statistically significant associations for ozone or PM10.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Asma/epidemiologia , Dióxido de Nitrogênio/efeitos adversos , Material Particulado/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Asma/etiologia , California/epidemiologia , Criança , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Dióxido de Nitrogênio/análise , Ozônio/efeitos adversos , Ozônio/análise , Material Particulado/análise
10.
Medicina (B Aires) ; 79(2): 123-136, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31048278

RESUMO

In recent years there has been a significant increase in the prevalence of allergic diseases despite advances in the understanding of the pathogenesis, the dissemination of guidelines for its management and the emergence of new drugs. The reasons for this increase are not fully established, but it is suggested that multiple environmental factors may be involved. Inhaled air contains numerous harmful agents in addition to environmental allergens. The main immediate respiratory clinical expression after inhaling this contaminated air is asthma and rhinitis. The activity of human beings has altered the outdoor environment by the emission of multiple pollutants and has produced an increasing climate change. It also has a notable impact on the development of respiratory pathology and the modification of air quality. The bibliography on the subject of environmental control is very broad and sometimes difficult to interpret. In order to be able to make precise, valid and simple indications for patients to accomplish with, four scientific societies of the Argentine Republic that deal with this type of diseases, have elaborated a document that contains information of easy access to all medical personal involved in the treatment of patients with asthma and / or rhinitis, that provides practical measures for the patients and the different public health systems about unmet needs in this complex issue.


Assuntos
Alérgenos/efeitos adversos , Exposição Ambiental/efeitos adversos , Doenças Respiratórias/etiologia , Poluentes Atmosféricos/efeitos adversos , Asma/etiologia , Mudança Climática , Humanos , Fatores de Risco
11.
Int J Mol Sci ; 20(10)2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31137771

RESUMO

Extracellular vesicles (EVs) are circulating vesicles secreted by various cell types. EVs are classified into three groups according to size, structural components, and generation process of vesicles: exosomes, microvesicles, and apoptotic bodies. Recently, EVs have been considered to be crucial for cell-to-cell communications and homeostasis because they contain intracellular proteins and nucleic acids. Epithelial cells from mice suffering from bronchial asthma (BA) secrete more EVs and suppress inflammation-induced EV production. Moreover, microarray analyses of bronchoalveolar lavage fluid have revealed that several microRNAs are useful novel biomarkers of BA. Mesenchymal stromal cell-derived EVs are possible candidates of novel BA therapy. In this review, we highlight the biologic roles of EVs in BA and review novel EV-targeted therapy to help understanding by clinicians and biologists.


Assuntos
Asma/metabolismo , Vesículas Extracelulares/metabolismo , Animais , Asma/etiologia , Biomarcadores/metabolismo , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo
12.
Int J Mol Sci ; 20(8)2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30991656

RESUMO

Dipsacus asperoides C. Y. Cheng et T. M. Ai (DA) has been used in China as a traditional medicine to treat lumbar and knee pain, liver dysfunction, and fractures. We explored the suppressive effect of DA on allergic asthma using an ovalbumin (OVA)-induced asthma model. In the asthma model, female Balb/c mice were sensitized to OVA on day 0 and 14 to boost immune responses and then exposed to OVA solution by using an ultrasonic nebulizer on days 21 to 23. DA (20 and 40 mg/kg) was administered to mice by oral gavage on days 18 to 23. Methacholine responsiveness was determined on day 24 using a plethysmography. On day 25, we collected bronchoalveolar lavage fluid, serum, and lung tissue from animals under anesthesia. DA treatment effectively inhibited methacholine responsiveness, inflammatory cell infiltration, proinflammatory cytokines such as interleukin (IL)-5 and IL-13, and immunoglobulin (Ig) E in OVA-induced asthma model. Reductions in airway inflammation and mucus hypersecretion, accompanied by decreases in the expression of inducible nitric oxide synthase (iNOS) and the phosphorylation of nuclear factor kappa B (NF-κB), were also observed. Our results indicated that DA attenuated the asthmatic response, and that this attenuation was closely linked to NF-κB suppression. Thus, this study suggests that DA is a potential therapeutic for allergic asthma.


Assuntos
Anti-Inflamatórios/uso terapêutico , Asma/tratamento farmacológico , Dipsacaceae , Medicamentos de Ervas Chinesas/uso terapêutico , Animais , Anti-Inflamatórios/química , Asma/etiologia , Asma/imunologia , Dipsacaceae/química , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/química , Feminino , Imunoglobulina E/imunologia , Interleucina-13/imunologia , Interleucina-5/imunologia , Camundongos Endogâmicos BALB C , NF-kappa B/imunologia , Ovalbumina/imunologia
13.
Environ Int ; 127: 858-867, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30954275

RESUMO

BACKGROUND: Asthma is one of the leading chronic airway diseases among children in the United States (US). Emerging evidence indicates that Traffic Related Air Pollution (TRAP), as opposed to ambient air pollution, leads to the onset of childhood asthma. We estimated the number of incident asthma cases among children attributable to TRAP in the contiguous US, for the years 2000 and 2010. METHODS: The number of incident childhood asthma cases and percentage due to TRAP were estimated using standard burden of disease assessment methods. We combined children (<18 years) counts and pollutant exposures at populated US census blocks with a national asthma incidence rate and meta-analysis derived concentration response functions (CRF). NO2, PM2.5 and PM10 were used as surrogates of TRAP exposures, with NO2 being most specific. Annual average concentrations were obtained from previously validated land-use regression (LUR) models. Asthma incidence rate and a CRF for each pollutant were obtained from the literature. Estimates were stratified by urban or rural living and by median household income. We also estimated the number of preventable cases among blocks that exceeded the limit for two counterfactual scenarios. The first scenario used the recommended air quality annual averages from the World Health Organization (WHO) as a limit. The second scenario used the minimum modeled concentration for each pollutant, in either year, as a limit. RESULTS: Average concentrations in 2000 and 2010, respectively, were 20.6 and 13.2 µg/m3 for NO2, 12.1 and 9 µg/m3 for PM2.5 and 21.5 and 17.9 µg/m3 for PM10. Attributable number of cases ranged between 209,100-331,200 for the year 2000 and 141,900-286,500 for 2010, depending on the pollutant. Asthma incident cases due to TRAP represented 27%-42% of all cases in 2000 and 18%-36% in 2010. Percentage of cases due to TRAP were higher (1) in urban areas than rural areas, and (2) in block groups with lowest median household income. Online open-access interactive maps and tables summarizing findings at the county level and 498 major US cities, are available at [https://carteehdata.org/l/s/TRAP-burden-of-childhood-asthma]. Assuming that pollutants did not exceed WHO air quality recommendations, the number of incident cases that could have been prevented ranged between 300 and 53,400, depending on the pollutant and year. Assuming that pollutant levels were limited to the minimum modeled concentration, the number of childhood asthma incident cases that could have been prevented ranged between 127,700 and 317,600, depending on the pollutant and year. CONCLUSION: This is the first study to estimate the burden of incident childhood asthma attributable to TRAP at a national scale in the US. The attributable burden of childhood asthma dropped by 33% between 2000 and 2010. However, a significant proportion of cases can be prevented.


Assuntos
Poluentes Atmosféricos/análise , Asma/epidemiologia , Asma/etiologia , Exposição Ambiental/análise , Poluição Relacionada com o Tráfego/efeitos adversos , Poluição do Ar/análise , Criança , Pré-Escolar , Humanos , Lactente , Poluição Relacionada com o Tráfego/estatística & dados numéricos , Estados Unidos/epidemiologia
14.
Med Clin North Am ; 103(3): 435-452, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30955512

RESUMO

Asthma is one of the commonest respiratory diseases in the United States, affecting approximately 8% of adults. This article reviews the epidemiology, diagnosis, and treatment of asthma, with integration of recommendations from professional societies, with special attention to differential diagnosis. A framework for outpatient management of patients with asthma is presented, including indications for subspecialist referral. With integration of objective diagnostic information, systematic approach through modification of disease triggers and adjustment of controller medications, and patient empowerment to respond to varying symptoms using an asthma action plan, most individuals with asthma are successfully managed in the primary care setting.


Assuntos
Asma/diagnóstico , Asma/terapia , Atenção Primária à Saúde/métodos , Asma/epidemiologia , Asma/etiologia , Humanos , Encaminhamento e Consulta
15.
Tokai J Exp Clin Med ; 44(1): 1-4, 2019 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-30963521

RESUMO

INTRODUCTION: Sweet potato may contain furanoterpenoids, including ipomeamarone, which cause lung edema. CASE PRESENTATION: A 10-year-old schoolgirl was hospitalized with asthma exacerbation and acute pneumonia. Chest radiographs showed a diffuse opacity of the left lung and hyperpermeability of the right lung. Computed tomography indicated foreign-body aspiration. Flexible bronchoscopy revealed an inhaled piece of sweet potato obstructing the left main bronchus. Although the patient's dyspnea worsened after removal of the sweet potato, she recovered with the treatment based on the 2014 Japanese Childhood Asthma Guidelines. CONCLUSION: Cases of sweet potato aspiration need careful treatment after removal of the foreign body.


Assuntos
Asma/etiologia , Corpos Estranhos/complicações , Corpos Estranhos/cirurgia , Pneumonia Aspirativa/complicações , Solanum tuberosum/efeitos adversos , Doença Aguda , Asma/terapia , Broncoscopia , Criança , Progressão da Doença , Feminino , Corpos Estranhos/diagnóstico por imagem , Humanos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X , Resultado do Tratamento
16.
Presse Med ; 48(5): 488-502, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-31005500

RESUMO

INTRODUCTION: Exposure to a traumatic event may not only lead to a large variety of mental disorders, such as post-traumatic stress disorder (PTSD) but also respiratory symptoms and/or respiratory diseases, as asthma. OBJECTIVES: Systematic literature review of data on the impact of post-traumatic stress disorder on asthma. DOCUMENTARY SOURCES: Medline, on the period 1980-2018 with the following keywords: "PTSD" or "post-traumatic stress disorder" or "post-traumatic stress disorder" and "asthma", limits "title/abstract"; the selected languages were English or French. Among 141 articles, 23 abstracts have given use to a dual reading to select 14 studies. RESULTS: While PTSD may develop 4 weeks after being exposed to a traumatic event during which the physical integrity of the person has been threatened, it might also develop several months or years later. PTSD has been reported to be a risk factor for asthma and also a factor that might enhance a preexisting asthma. It is also important to note that this relation has been highlighted among several populations, traumatic events and regardless the gender and/or cultural factors. Despite its impact on the development of asthma, in asthmatic patients, PTSD may be responsible for poor asthma control, increased rates of healthcare use (visit in the emergency department and/or hospitalization for asthma) and poor asthma-related quality of life. The study of the association between PTSD and asthma have to take into account some potentially confounding factors, such as smoking status and dust exposure (e.g.: asthma following the terrorist attacks of the World Trade Center). Less is known regarding the potential mechanisms involved in the association between PTSD and asthma. Several factors including the nervous system, the hypothalamo-pituitary-adrenal axis, the inflammatory response and the immune system may explain the association. CONCLUSION: PTSD is a risk factor for the development of asthma and for the worsening of preexisting asthma. In asthmatic patients, it is of primary importance to systematically screen potential PTSD that might be developed after a traumatic event or a preexisting traumatic condition. Moreover, after exposure to a traumatic event, a special attention needs to be paid to somatic reactions such as asthma. The majority of studies having been conducted on American samples, replicating studies among European samples appears of prime importance in order to add a body of knowledge on the association between somatic and psychiatric conditions.


Assuntos
Asma/etiologia , Transtornos de Estresse Pós-Traumáticos/complicações , Progressão da Doença , Humanos
18.
Med Clin North Am ; 103(3): 535-548, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30955520

RESUMO

Occupational exposures are a major cause of lung disease and disability worldwide. This article reviews the broad range of types of occupational lung diseases, including airways disease, pneumoconioses, and cancer. Common causes of occupational lung disease are reviewed with specific examples and clinical features. Emphasis on the importance of a detailed history to make an accurate diagnosis of an occupational lung disease is discussed.


Assuntos
Pneumopatias/diagnóstico , Doenças Profissionais/diagnóstico , Exposição Ocupacional/efeitos adversos , Asma/diagnóstico , Asma/etiologia , Humanos , Pneumopatias/etiologia , Doenças Profissionais/etiologia , Pneumoconiose/diagnóstico , Pneumoconiose/etiologia
19.
Environ Int ; 126: 735-746, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30878869

RESUMO

During 2010-2012, we conducted an observational study on household environment and health outcomes among 40,010 preschool children from seven cities of China. Here we examined associations of six dampness-related indicators (visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on windowpane, moldy odor) in the current residence and three dampness-related indicators (visible mold spots, condensation on windowpane, moldy odor) in the early residence with childhood asthma and rhinitis. In the multi-level logistic regression analyses, visible mold spots and visible damp stains in the current residence were significantly associated with the increased odds of doctor-diagnosed asthma and allergic rhinitis during lifetime-ever (adjusted odd ratios (AORs) range: 1.18-1.35). All dampness-related indicators were significantly associated with increased odds of wheeze and rhinitis during lifetime-ever and in the past 12 months (AORs range: 1.16-2.64). The cumulative numbers of damp indicators had positively dose-response relationships with the increased odds of the studied diseases. These associations for wheeze and rhinitis were similar between northern children and southern children. Similar results were found in the sensitive analyses among children without a family history of allergies and among children without asthma and allergic rhinitis. For 3-6 years-old children in mainland of China in 2011, we speculated that about 90,000 (2.02%) children with asthma and about 59,000 (1.09%) children with allergic rhinitis could be attributable to exposing to visible mold spots in the current residence. Our results suggested that early and lifetime exposures to household dampness indicators are risk factors for childhood asthma and rhinitis.


Assuntos
Asma/epidemiologia , Habitação , Umidade/efeitos adversos , Rinite Alérgica/epidemiologia , Asma/etiologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Rinite Alérgica/etiologia , Fatores de Risco
20.
Artigo em Inglês | MEDLINE | ID: mdl-30823641

RESUMO

A large number of World Trade Center (WTC) rescue and recovery workers are affected by asthma. While physical and mental health comorbidities have been associated with poor asthma control in this population, the potential role of allergen sensitization is unknown. This study examined the association of indoor sensitization and exposure as a risk factor for increased asthma morbidity in WTC workers. We used data from a prospective cohort of 331 WTC workers with asthma. Sensitization to indoor allergens was assessed by measurement of antigen-specific serum immunoglobulin E (IgE) levels. We used validated tools to evaluate the exposure to indoor allergens. Asthma morbidity outcomes included level of control (Asthma Control Questionnaire, ACQ), quality of life (Asthma Quality of Life Questionnaire, AQLQ) and acute resource utilization. The prevalence of sensitization to cat, dog, mouse, dust mite, cockroach, and mold allergens were 33%, 21%, 17%, 40%, 17%, and 17%, respectively. Unadjusted and regression analyses showed no significant relationship between sensitization and increased asthma morbidity (p > 0.05 for all comparisons), except for sensitization to Aspergillus Fumigatus, cat and mouse epithelium, which were associated with decreased morbidity.


Assuntos
Alérgenos/imunologia , Asma/etiologia , Exposição Ambiental , Trabalho de Resgate , Ataques Terroristas de 11 de Setembro , Animais , Asma/epidemiologia , Baratas/imunologia , Estudos de Coortes , Feminino , Recursos em Saúde , Humanos , Masculino , Morbidade , Prevalência , Estudos Prospectivos , Pyroglyphidae/imunologia , Qualidade de Vida , Fatores de Risco
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