Prevalence of recurrent wheezing and its risk factors

OBJECTIVE: analyze the prevalence of recurrent wheezing and its risk factors. METHOD: systematic literature review, guided by the research question "what is the prevalence of recurrent wheezing and its risk factors?". The search was performed in the databases MedLine and LILACS, in April and May 2013. The inclusion criteria were: scientific study, fully available, published between 2002 and 2013, with free access. RESUMO: wheezing presents a higher prevalence in developing countries, possibly due to poor socioeconomic conditions. Among its risk factors, we find heredity, mother's education level, attendance of day nursery, smoking during pregnancy, breastfeeding for < 3 months, animals in the household of children, among others. CONCLUSION: in Latin America, the prevalence of wheezing shows to be high and the use of non-standardized instruments hampers its treatment...

OBJETIVO: analisar a prevalência de sibilância recorrente e seus fatores de risco. MÉTODO: revisão integrativa, norteada pela questão de pesquisa "qual é a prevalência da sibilância recorrente e seus fatores de risco?". A busca foi realizada nas bases de dados MedLine e Lilacs em abril e maio de 2013. Os critérios de inclusão foram: estudo científico, disponível na íntegra, publicado entre 2002 e 2013, com acesso livre e gratuito e os resultados foram apresentados em tabela. RESULTADOS: a sibilância apresenta uma maior prevalência em países em desenvolvimento, possivelmente devido a baixas condições socioeconômicas. Dentre seus fatores de risco encontram-se a hereditariedade, o grau de escolaridade materna, a frequência em creche, o tabagismo durante a gravidez, a amamentação por > 3 meses, animais no domicílio de crianças, dentre outros. CONCLUSÃO: na América Latina, a prevalência da sibilância mostra-se elevada e o uso de instrumentos não padronizados dificulta seu tratamento...

The Effect of Level of Exposure to House Dust Mites on the Development of Asthma after Early Childhood Wheezing / 소아알레르기및호흡기학회지

PURPOSE: Many young children suffer from wheezing illness during infancy, and some of them experience wheezing frequently and develop bronchial asthma ultimately. It is not clear whether the level of exposure to allergens in the environment is a significant risk factor for asthma in this clinical setting. The aim of this study was to examine the effect of level of exposure to house dust mites on the development of asthma after early childhood wheezing. METHODS: Asthmatic children(n=21) and nonasthmatic children(n=19) with the past history of wheezing illness during the first three years of age were recruited. Samples of house dusts were collected from the bedclothes in their bedrooms. We measured the amount of group I allergens from Dermatophagoides spp., Der f I and Der p I in house dusts by ELISA using monoclonal antibodies. RESULTS: In asthmatic and nonasthmatic groups, the level of Der f I was higher than that of Der p I, although the difference was not statistically significant. The level of Der f I was 4.32 microgram/gm of dust(geometric mean; range of 1 SD : 0.61-30.48) in asthmatic group and 3.72 microgram/gm(0.50-27.42) in nonasthmatic group. The level of Der p I was 2.22 microgram/gm(0.33-14.96) in asthmatic group and 2.07 microgram/gm(0.31-13.77) in nonasthmatic group. The difference between the two groups was not significant for both allergens. When the total subjects were divided into atopic(n=21) and nonatopic(n=19) groups, there was significant difference in neither Der f I nor Der p I level between atopic and nonatopic groups. CONCLUSION: Although personal atopy is important in the development of asthma after early childhood wheezing, the level of exposure to allergens in the environment may not be a significant risk factor for the development of asthma in this clinical setting.

Tthe influences of parental atopy and bronchial hyperresponsiveness on the development of asthma agter early childhood wheezing / 천식및알레르기

BACKGROUND: Many young children suffer from wheezing illness during viral respiratory infection, and some of them experience wheezing many years later and ultimately develop bronchial asthma. It is not clear whether atopy or bronchial hyperresponsiveness in the family is a significant risk factor for asthma in this clinical setting. Objective : To examine the genetic basis for the development of asthma after early childhood wheezing. Materials and METHODS: A measurement of serum total IgE concentration, skin prick test to common inhalant allergens, and methacholine bronchial provocation test were performed in 29 asthmatic children and their parents, and 22 non-asthmatic children with the past history of wheezing illness during the first three years of age and their parents. A questionnaire was performed to assess the presence of asthma and allergic rhinitis in the parents. RESULTS: Positive skin test response to common inhalant allergens was more prevalent in asthmatics than in non-asthmatics(67.8% vs. 27.2%). Serum total IgE concentration was significantly higher in asthmatics than in non-asthmatics(geometric mean: 173 vs. 83 IU/ ml). Positive skin test response to comman inhalant allergens was more prevalent in parents of asthmatics than in thoae of non-asthmatics(51.7% vs. 25.0%), but serum total IgE level was not different between the two groups(geometric mean: 132 vs. 120 IU/ml). Positive rate of methacholine bronchial provocation test, geometric mean of PC20-methacholine, and BR index were not different between the parents of asthmatics and non-asthmatics (18.1% vs. 13.9%; 164 vs. 180 mg/ml; 1.154+-0.077 vs. 1.055+-0.068, respectively). CONCLUSION: It is suggested that personal atopy is important in the development of asthma after early childhood wheezing, and parental atopy rather than bronchial hyperresponsiveness is a risk factor for the development of childhood asthma in this clinical setting.