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1.
Curr Opin Allergy Clin Immunol ; 21(2): 159-165, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33534416

RESUMO

PURPOSE OF REVIEW: To summarize the impact of the COVID-19 pandemic on the practice of paediatric allergy. RECENT FINDINGS: Given significant overlap in symptoms, care must be taken to differentiate routine allergic conditions from COVID-19 infection but it appears that most allergic diseases are not risk factors for a severe COVID-19 course. The full impact of restricted allergy/immunology ambulatory services will take months to years to fully understand. One benefit of having to adapt practice style is greater awareness and acceptance of shared decision-making and recognition of preference-sensitive care options in food allergy, in particular for approaches towards allergy prevention, treatment, and anaphylaxis care. Social distancing and masks have helped reduce spread of common respiratory viruses, which may be helping to lower the incidence of viral-associated wheezing episodes, enhancing evidence of the effects of preventing exposure of young children to respiratory viruses on asthma pathogenesis, as well as on allergic rhinitis. There has been a revolution in the rise of telemedicine to increase access to high-quality allergy/immunology specialty care. SUMMARY: Although the field has adapted to remain operational in the face of a significant challenge, it is important to apply lessons learned to evolve patient care and optimize treatment in the aftermath of the pandemic.


Assuntos
Asma/epidemiologia , Dermatite Atópica/epidemiologia , Eczema/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Pandemias , Rinite Alérgica/epidemiologia , Asma/terapia , Criança , Pré-Escolar , Comorbidade , Dermatite Atópica/terapia , Gerenciamento Clínico , Eczema/terapia , Hipersensibilidade Alimentar/terapia , Humanos , Rinite Alérgica/terapia , Telemedicina
3.
Acta Dermatovenerol Alp Pannonica Adriat ; 29(3): 115-122, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32975297

RESUMO

INTRODUCTION: This questionnaire study evaluates dermatological complaints that may arise due to hygiene measures and anxiety among healthcare professionals (HCPs) during the COVID-19 outbreak. METHODS: A total of 526 volunteers, consisting of doctors and nurses, participated. Demographic features, personal hygiene behavior, personal protective equipment (PPE) use, Hospital Anxiety and Depression Scale-Anxiety (HADS-A) parameters, and symptoms of various dermatological diseases (xerosis, eczema, acne, hair loss, palmar hyperhidrosis, xeromycteria, urticaria, aphthous stomatitis, and seborrheic dermatitis) were investigated. RESULTS: Although the frequency and severity of many dermatological complaints increased during the pandemic period, the most frequent increase was observed in the frequency of complaints suggesting xerosis and eczema. We found that complaints suggesting xerosis and eczema were seen on the hands 2.44 and 3.57 times, respectively, as a result of washing hands 10 times/day, and that handwashing times of 10 seconds or more significantly increased the risk of eczema (5.44 times). Another remarkable result was a fivefold increase in acne complaints among those using any mask. The severity of all complaints except hair loss and seborrheic dermatitis correlated significantly with HADS-A. CONCLUSIONS: Our study showed that the frequency and severity of some dermatological complaints increased in HCPs.


Assuntos
Infecções por Coronavirus/epidemiologia , Eczema/epidemiologia , Dermatoses da Mão/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Corpo Clínico Hospitalar/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Feminino , Luvas Protetoras/estatística & dados numéricos , Humanos , Higiene , Masculino , Exposição Ocupacional/efeitos adversos , Pandemias , Inquéritos e Questionários , Turquia
4.
Ann Allergy Asthma Immunol ; 125(4): 481-483, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32717301
5.
PLoS One ; 15(7): e0234633, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649729

RESUMO

BACKGROUND: Limited data are available on prevalence and associated risk factors for atopy and allergic diseases from high-altitude urban settings in Latin America. OBJECTIVE: To estimate the prevalence of atopy, asthma, rhinitis, and eczema, and associations with relevant risk factors in preschool children in the Andean city of Cuenca. METHODS: A cross-sectional study was undertaken using a representative sample of 535 children aged 3-5 years attending 30 nursery schools in the city of Cuenca, Ecuador. Data on allergic diseases and risk factors were collected by parental questionnaire. Atopy was measured by skin prick test (SPT) reactivity to a panel of relevant aeroallergens. Associations between risk factors and the prevalence of atopy and allergic diseases were estimated using multivariable logistic regression. RESULTS: Asthma symptoms were reported for 18% of children, rhinitis for 48%, and eczema for 28%, while SPT reactivity was present in 33%. Population fractions of asthma, rhinitis, and eczema attributable to SPT were 3.4%, 7.9%, and 2.9%, respectively. In multivariable models, an increased risk of asthma was observed among children with a maternal history of rhinitis (OR 1.85); rhinitis was significantly increased in children of high compared to low socioeconomic level (OR 2.09), among children with a maternal history of rhinitis (OR 2.29) or paternal history of eczema (OR 2.07), but reduced among children attending daycare (OR 0.64); eczema was associated with a paternal history of eczema (OR 3.73), and SPT was associated with having a dog inside the house (OR 1.67). CONCLUSIONS: A high prevalence of asthma, rhinitis, and eczema symptoms were observed among preschool children in a high-altitude Andean setting. Despite a high prevalence of atopy, only a small fraction of symptoms was associated with atopy. Parental history of allergic diseases was the most consistent risk factor for symptoms in preschool children.


Assuntos
Asma/epidemiologia , Eczema/epidemiologia , Rinite/epidemiologia , Alérgenos , Pré-Escolar , Estudos Transversais , Equador/epidemiologia , Feminino , Humanos , Hipersensibilidade/epidemiologia , Masculino , Prevalência , Fatores de Risco , Testes Cutâneos , Inquéritos e Questionários
9.
PLoS One ; 15(6): e0233890, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32542014

RESUMO

BACKGROUND: Allergic conditions and respiratory tract infections (RTIs) are common causes of morbidity and mortality in childhood. The relationship between vitamin D status in pregnancy (mothers), early life (infants) and health outcomes such as allergies and RTIs in infancy is unclear. To date, studies have shown conflicting results. OBJECTIVE: This systematic review aims to gather and appraise existing evidence on the associations between serum vitamin D concentrations during pregnancy and at birth and the development of eczema, wheezing, and RTIs in infants. DATA SOURCES: PubMed, MEDLINE, ProQuest, Scopus, CINAHL, Cochrane Library and Academic Search Premier databases were searched systematically using specified search terms and keywords. STUDY SELECTION: Articles on the associations between serum vitamin D concentrations during pregnancy and at birth and eczema, wheezing, and RTIs among infants (1-year-old and younger) published up to 31 March 2019 were identified, screened and retrieved. RESULTS: From the initial 2678 articles screened, ten met the inclusion criteria and were included in the final analysis. There were mixed and conflicting results with regards to the relationship between maternal and cord blood vitamin D concentrations and the three health outcomes-eczema, wheezing and RTIs-in infants. CONCLUSION: Current findings revealed no robust and consistent associations between vitamin D status in early life and the risk of developing eczema, wheezing and RTIs in infants. PROSPERO registration no. CRD42018093039.


Assuntos
Eczema/epidemiologia , Hipersensibilidade/epidemiologia , Complicações na Gravidez/epidemiologia , Sons Respiratórios , Infecções Respiratórias/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Adulto , Estudos de Coortes , Bases de Dados como Assunto , Feminino , Humanos , Lactente , Recém-Nascido , Morbidade , Gravidez , Complicações na Gravidez/sangue , Deficiência de Vitamina D/sangue
11.
Medicine (Baltimore) ; 99(21): e20327, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481318

RESUMO

BACKGROUND: Eczema is a relapsing and persistent inflammatory skin disease affecting about one-fifth of children worldwide. As in other developed countries, the prevalence of this chronic disease in Hong Kong is approximately 30%. Moreover, the number of local cases reported has been on a rising trend since 1995. Eczema frequently starts in early infancy. A total of 45% of all cases begin within the first six months of life, 60% during the first year and 85% before the age of 5. The pathophysiology of eczema is multi-factorial and is a complex inter-relationship between skin barrier, genetic predisposition, immunologic development, microbiome, environment, nutrition, and pharmacological and psychological factors. OBJECTIVE: To characterize the longitudinal changes of gut microbial profile in early childhood and to examine the association between gut microbiome diversity, environmental factors and the development of eczema in early childhood. METHOD: We will conduct a longitudinal cohort study that follows 1250 Hong Kong Chinese infants for 2 years and assess the gut microbiome and other potential environmental factors in the aetiology of eczema. Parents will be asked to provide demographic data, their infant birth data, allergy condition, diet, environmental conditions as well as the data on maternal stress. Stool specimen will be collected for gut microbiome diversity analysis. We will examine newborn infants at enrollment, at 4 months, 1 year and 2 years after birth. EXPECTED RESULTS: This study will evaluate the association between gut microbiome, environmental factors and the development of eczema in Chinese infants. Findings from this study may be used to develop a predictive path model to guide effective health promotion, disease prevention and management.


Assuntos
Eczema/etiologia , Microbioma Gastrointestinal/fisiologia , Pré-Escolar , Eczema/epidemiologia , Eczema/microbiologia , Feminino , Seguimentos , Hong Kong/epidemiologia , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos , Fatores de Tempo
12.
Contact Dermatitis ; 83(2): 108-114, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32452036

RESUMO

BACKGROUND: As a result of the COVID-19 outbreak, hygiene regulations have been revised and hand sanitation has been intensified. OBJECTIVE: To investigate the onset of hand eczema during the COVID-19 pandemic in healthcare workers (HCWs) directly involved in intensive care of COVID-19 patients and HCWs without direct contact with COVID-19 patients. Hereby, we aim at increasing awareness about occupational hand eczema and preventive measures that can be adopted. METHOD: A survey was distributed amongst 114 HCWs at a single surgical centre and at a COVID-19 intensive care unit of the university hospital Ludwig Maximilian University Munich, Germany. Participants were questioned about the daily frequency of hand hygiene prior to and during the pandemic. Participants self-reported the onset of hand eczema and associated symptoms. RESULTS: Our study revealed a significant increase in hand washing, disinfection, and use of hand cream across all participants (P-value <.001), regardless of having direct contact with COVID-19 patients. A high prevalence of symptoms associated with acute hand dermatitis of 90.4% was found across all HCWs, whereas hand eczema itself was underreported (14.9%). CONCLUSION: The increase in hand sanitation during the COVID-19 pandemic impairs the skin of the hands across all HCWs, independent of direct intensive care of affected patients.


Assuntos
Infecções por Coronavirus/prevenção & controle , Dermatite Ocupacional/epidemiologia , Eczema/epidemiologia , Dermatoses da Mão/epidemiologia , Desinfecção das Mãos/tendências , Higienizadores de Mão/uso terapêutico , Pessoal de Saúde/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Creme para a Pele/uso terapêutico , Adulto , Asma/epidemiologia , Betacoronavirus , Comorbidade , Infecções por Coronavirus/terapia , Dermatite Atópica/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Hipersensibilidade Tardia/epidemiologia , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Médicos/estatística & dados numéricos , Pneumonia Viral/terapia , Prevalência , Rinite Alérgica/epidemiologia
15.
PLoS One ; 15(5): e0231818, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32401757

RESUMO

BACKGROUND: It is challenging to define likely food allergy (FA) in large populations which limited the number of large studies regarding risk factors for FA. OBJECTIVE: We studied the prevalence and characteristics of self-reported FA (s-rFA) in the large, population-based Dutch Lifelines cohort and identified associated risk factors. METHODS: Likely food allergic cases (LikelyFA) were classified based on questionnaire reported characteristics consistent with FA. Subjects with atypical characteristics were classified as Indeterminate. We investigated 13 potential risk factors for LikelyFA such as birth mode and living on a farm and addressed health-related quality of life (H-RQOL). RESULTS: Of the 78, 890 subjects, 12.1% had s-rFA of which 4.0% and 8.1% were classified as LikelyFA and Indeterminate, respectively. Younger age, female sex, asthma, eczema and nasal allergy increased the risk of LikelyFA (p-value range <1.00*10-250-1.29*10-7). Living in a small city/large village or suburb during childhood was associated with a higher risk of LikelyFA than living on a farm (p-value = 7.81*10-4 and p = 4.84*10-4, respectively). Subjects classified as Indeterminate more often reported depression and burn-out compared to those without FA (p-value = 1.46*10-4 and p = 8.39*10-13, respectively). No association was found with ethnicity, (duration of) breastfeeding, birth mode and reported eating disorder. Mental and physical component scores measuring H-RQOL were lower in both those classified as LikelyFA and Indeterminate compared to those without FA. CONCLUSION: The prevalence of s-rFA among adults is considerable and one-third reports characteristics consistent with LikelyFA. Living on a farm decreased the risk of LikelyFA. The association of poorer H-RQOL as well as depression and burn-out with questionable self-perceived FA is striking and a priority for future study.


Assuntos
Hipersensibilidade Alimentar/epidemiologia , Adulto , Alérgenos , Asma/epidemiologia , Estudos de Coortes , Eczema/epidemiologia , Feminino , Alimentos , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Prevalência , Qualidade de Vida , Rinite Alérgica Sazonal/epidemiologia , Fatores de Risco , Inquéritos e Questionários
16.
Environ Health ; 19(1): 32, 2020 03 13.
Artigo em Inglês | MEDLINE | ID: mdl-32169083

RESUMO

BACKGROUND: Prenatal phthalate exposure has been suggested to alter immune responses and increase the risk of asthma, eczema and rhinitis. However, few studies have examined the effects in prospective cohorts and only one examined rhinitis. We therefore studied associations between maternal urinary concentrations of phthalate metabolites and asthma, eczema and rhinitis in offspring aged 5 years. METHODS: From 552 pregnant women in the Odense Child Cohort, we quantified urinary concentrations of 12 phthalate metabolites in third trimester. We assessed asthma, rhinitis and eczema in their offspring at age 5 years with a questionnaire based on the International Study of Asthma and Allergies in Childhood (ISAAC), and conducted logistic regression adjusting for relevant confounders. RESULTS: 7.4% of the children had asthma, 11.7% eczema and 9.2% rhinitis. Phthalate exposure was low compared to previous cohorts. No significant associations between prenatal phthalate exposure and asthma were found. Odds ratios (ORs) of child rhinitis with a doubling in ΣDiNPm and di-2-ethylhexyl phthalate metabolite (ΣDEHPm) concentrations were, respectively, 1.15 (95% confidence interval (CI) 0.97,1.36) and 1.21 (CI 0.93,1.58). The OR of eczema when doubling ΣDiNPm was 1.24 (CI 1.00,1.55), whereas the OR of using medicine against eczema when doubling a di-ethyl phthalate (DEP) metabolite was 0.81 (CI 0.68,0.96). CONCLUSION: The lack of association between maternal phthalate exposure and asthma in the offspring may be due to low exposure and difficulties in determining asthma in 5-year-olds. The higher odds of rhinitis may raise public concern but further research in larger cohorts of older children is warranted.


Assuntos
Asma/epidemiologia , Eczema/epidemiologia , Exposição Materna/efeitos adversos , Ácidos Ftálicos/urina , Plastificantes/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Rinite/epidemiologia , Asma/induzido quimicamente , Criança , Dinamarca/epidemiologia , Eczema/induzido quimicamente , Poluentes Ambientais/efeitos adversos , Feminino , Humanos , Masculino , Ácidos Ftálicos/efeitos adversos , Gravidez , Terceiro Trimestre da Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Prevalência , Estudos Prospectivos , Rinite/induzido quimicamente
17.
Georgian Med News ; (298): 53-57, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32141849

RESUMO

Atopic dermatitis represents one of the most prevalent manifestations of atopy in children, which is distinguished by the early onset and high frequency of chronicity. The aim of this study was to study the clinical features of atopic dermatitis in early childhood and to evaluate comorbid conditions. The prospective research was conducted to study the cohort of 68 patients, who were developed the atopic dermatitis under 2 years of age. It was revealed, that the age of onset of the disease and the clinical severity was determined by the genetic predisposition on the mother's side. According to the clinical severity of the disease there were revealed the series of peculiarities especially in the case of moderate course: the high frequency of comorbid allergic pathology (rhinitis, conjunctivitis, urticaria, allergic gastritis) and the co-existing gastroenterological disorders (colic, constipation and foaming). The use of CoMISSas a non-invasive tool assumes the great importance in respect of making timely diagnosis of the allergy to cow's milk protein.


Assuntos
Conjuntivite/epidemiologia , Dermatite Atópica/epidemiologia , Hipersensibilidade Alimentar/complicações , Urticária/epidemiologia , Idade de Início , Criança , Pré-Escolar , Comorbidade , Eczema/epidemiologia , Feminino , Gastrite/epidemiologia , Humanos , Imunoglobulina E , Lactente , Estudos Prospectivos , Rinite/epidemiologia
18.
Adv Ther ; 37(2): 692-706, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31956966

RESUMO

INTRODUCTION: Chronic hand eczema (CHE) is a relapsing inflammatory dermatologic disease. Signs and symptoms can have a significant impact on patients' health-related quality of life (HRQoL). The aim of this study is to characterize the core signs, symptoms and impacts of CHE to develop a conceptual model. METHODS: A structured literature search and qualitative interviews with 20 adult CHE patients in the US and 5 expert dermatologists were conducted to explore the patient experience of CHE signs, symptoms and impacts. Findings were used to support the development of a conceptual model. RESULTS: There was a paucity of CHE qualitative research in the literature, supporting the need for the prospective qualitative research. The primary signs and symptoms identified from the literature review and interviews included itch, dryness, cracking, pain, thickened skin and bleeding. The most salient impacts included embarrassment and appearance concerns, frustration, impacts on work and sleep disturbance. Saturation was achieved for all signs, symptoms and impact concepts. CONCLUSIONS: Findings from this literature review and in-depth qualitative interviews supported the development of a comprehensive conceptual model documenting the signs, symptoms and impacts relevant to CHE patients. Such a model is of considerable value given the lack of existing studies in the literature focused on the qualitative exploration of the CHE patient experience. Limitations included the patient sample being only from the US and not including some CHE subtypes.


Assuntos
Eczema/classificação , Eczema/diagnóstico , Eczema/fisiopatologia , Mãos/fisiopatologia , Avaliação de Sintomas , Adulto , Idoso , Doença Crônica/epidemiologia , Eczema/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Estudos Prospectivos , Pesquisa Qualitativa , Estados Unidos/epidemiologia , Adulto Jovem
19.
Environ Int ; 136: 105474, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31962272

RESUMO

BACKGROUND: Uncertainly continues to exist regarding the role of air pollution on pediatric asthma and allergic conditions, especially as air pollution levels have started to decrease in recent decades. OBJECTIVE: We examined associations of long-term air pollution levels at the home address with pediatric eczema, rhinoconjunctivitis and asthma prevalences in five birth cohorts (BIB, EDEN, GASPII, RHEA and INMA) from seven areas in five European countries. METHODS: Current eczema, rhinoconjunctivitis and asthma were assessed in children aged four (N = 6527) and eight years (N = 2489). A multi-morbidity outcome (≥2 conditions versus none) was also defined. Individual outdoor levels of nitrogen dioxide (NO2), nitrogen oxides, mass of particulate matter with an aerodynamic diameter <10 µm (PM10), 10-2.5 µm (PMcoarse) and <2.5 µm (PM2.5), and PM2.5 absorbance were assigned to the birth, four- and eight-year home addresses using highly defined spatial air pollution exposure models. Cohort-specific cross-sectional associations were assessed using logistic regression models adjusted for demographic and environmental covariates and combined in a random effects meta-analysis. RESULTS: The overall prevalence of pediatric eczema, rhinoconjunctivitis and asthma at four years was 15.4%, 5.9% and 12.4%. We found no increase in the prevalence of these outcomes at four or eight years with increasing air pollution exposure. For example, the meta-analysis adjusted odds ratios (95% confidence intervals) for eczema, rhinoconjunctivitis and asthma at four years were 0.94 (0.81, 1.09), 0.90 (0.75, 1.09), and 0.91 (0.74, 1.11), respectively, per 10 µg/m3 increase in NO2 at the birth address, and 1.00 (0.81, 1.23), 0.70 (0.49, 1.00) and 0.88 (0.54, 1.45), respectively, per 5 µg/m3 increase in PM2.5 at the birth address. DISCUSSION: In this large meta-analysis of five birth cohorts, we found no indication of adverse effects of long-term air pollution exposure on the prevalence of current pediatric eczema, rhinoconjunctivitis or asthma.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Asma , Conjuntivite , Eczema , Rinite , Poluentes Atmosféricos/toxicidade , Criança , Conjuntivite/epidemiologia , Estudos Transversais , Eczema/epidemiologia , Exposição Ambiental , Europa (Continente)/epidemiologia , Humanos , Material Particulado , Rinite/epidemiologia
20.
Arch Dis Child ; 105(7): 664-670, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31980422

RESUMO

BACKGROUND AND OBJECTIVE: As caesarean delivery and childhood allergy continue to rise, their inter-relationships may change. We examined whether caesarean delivery predicts allergic disease and impaired lung function in two contemporary harmonised population-based cohorts. METHODS: Parent-reported asthma and eczema data were drawn from two prospective Australian infant cohorts, HealthNuts (n=5276, born 2006-2010) and the Longitudinal Study of Australian Children (LSAC, n=5107, born 2003-2004) at age 6-7 years, and spirometric lung function from LSAC's Child Health CheckPoint (n=1756) at age 11-12 years. Logistic regression estimated associations between delivery mode and current asthma and eczema at 6-7 years, and linear regression examined lung function at 11-12 years. Models were adjusted for potential confounding factors. RESULTS: Complete case analysis included 3135 HealthNuts and 3654 LSAC children (32.2% and 30.9% born by caesarean, respectively). An association was evident between caesarean delivery and asthma at age 6-7 years in HealthNuts (adjusted OR (aOR) 1.25, 95% CI 1.00 to 1.57) but not in LSAC (aOR 1.05, 95% CI 0.86 to 1.28), while neither study showed clear associations with eczema (HealthNuts: aOR 1.09, 95% CI 0.88 to 1.35; LSAC: aOR 0.89, 95% CI 0.69 to 1.15). Spirometric lung function parameters at age 11-12 years were similar by delivery mode. Associations were not modified by duration of breast feeding, maternal history of asthma/eczema, childcare attendance, number of older siblings or pet exposure. CONCLUSIONS: In two unselected populations using harmonised protocols, the likely association of caesarean delivery with developing childhood allergy was small.


Assuntos
Asma/epidemiologia , Cesárea/estatística & dados numéricos , Eczema/epidemiologia , Pulmão/fisiologia , Asma/fisiopatologia , Austrália/epidemiologia , Criança , Feminino , Volume Expiratório Forçado , Humanos , Estudos Longitudinais , Masculino , Prevalência , Estudos Prospectivos , Espirometria , Capacidade Vital
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