ABSTRACT
SUMMARY BACKGROUND: There is very limited information on how the risk of persistent asthma in recurrent wheezing (RW) infants modifies their lung function early in life. The aim of this study is to compare lung function of RW infants and young children with a positive or negative asthma predictive index (API), an index previously used to anticipate asthma persistence into childhood and adolescence. METHODS: Two groups of RW infants and young children were recruited in two centres in Spain (Palma de Mallorca and Murcia). Lung function was measured according to the thoracho-abdominal compression technique (RCT), and values of the maximal flow at functional residual capacity (V'FRC) were expressed as Z-scores. Other variables included in the study, as independent factors, were: gender, age, length, weight, and parental smoking habits together with information regarding API. RESULTS: Expressed as mean +/- SD, API+ RW infants (n = 50; age in months 11.9 +/- 4.9) had a lower V'FRC Z-score than API- RW ones (n = 41; age in months 12.3 +/- 6.2; -2.01 +/- 0.79 vs. -1.64 +/- 0.77, P = 0.026, respectively). Centre and tobacco exposition did not have an effect on lung function. CONCLUSION: Among RW infants and young children, those having a positive API have a significant lower lung function as measured by V'FRC at an early age.
Subject(s)
Asthma/diagnosis , Asthma/physiopathology , Lung/physiopathology , Respiratory Mechanics/physiology , Respiratory Sounds/physiopathology , Female , Functional Residual Capacity , Humans , Infant , Male , Risk FactorsABSTRACT
BACKGROUND: While the Northern Hemisphere experiences the effects of the 2009 pandemic influenza A (H1N1) virus, data from the recent influenza season in the Southern Hemisphere can provide important information on the burden of disease in children. METHODS: We conducted a retrospective case series involving children with acute infection of the lower respiratory tract or fever in whom 2009 H1N1 influenza was diagnosed on reverse-transcriptase polymerase-chain-reaction assay and who were admitted to one of six pediatric hospitals serving a catchment area of 1.2 million children. We compared rates of admission and death with those among age-matched children who had been infected with seasonal influenza strains in previous years. RESULTS: Between May and July 2009, a total of 251 children were hospitalized with 2009 H1N1 influenza. Rates of hospitalization were double those for seasonal influenza in 2008. Of the children who were hospitalized, 47 (19%) were admitted to an intensive care unit, 42 (17%) required mechanical ventilation, and 13 (5%) died. The overall rate of death was 1.1 per 100,000 children, as compared with 0.1 per 100,000 children for seasonal influenza in 2007. (No pediatric deaths associated with seasonal influenza were reported in 2008.) Most deaths were caused by refractory hypoxemia in infants under 1 year of age (death rate, 7.6 per 100,000). CONCLUSIONS: Pandemic 2009 H1N1 influenza was associated with pediatric death rates that were 10 times the rates for seasonal influenza in previous years.
Subject(s)
Disease Outbreaks , Hospitalization/statistics & numerical data , Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Adolescent , Age Distribution , Argentina/epidemiology , Child , Child, Preschool , Comorbidity , Female , Humans , Hypoxia/etiology , Hypoxia/mortality , Infant , Infant, Newborn , Influenza, Human/classification , Influenza, Human/complications , Influenza, Human/mortality , Male , Pneumonia, Bacterial/epidemiology , Pneumonia, Bacterial/etiology , Severity of Illness Index , Staphylococcus/isolation & purification , Streptococcus pneumoniae/isolation & purificationABSTRACT
Se analizó y comparó la curva flujo/volumen (F/V) de 17 niños asmáticos asintomáticos y 22 niños sanos sin antecedentes respiratorios. Se tomaron las medias de los flujos espiratorios e inspiratorios en el pico y en el 75%, 50% de la capacidad vital (VC), y sus cocientes, en ambos grupos, antes y después de la aplicación de un broncodilatador aerosolizado. Las medias (X) de los flujos medios forzados (FMF), flujo espiratorio máximo al 50/flujo inspiratorio máximo al 50 (FEM 50/FIM 50) y flujo espiratorio máximo al 25/flujo inspiratorio máximo al 25 (FEM 25/FIM 25) fueron significativamente más hajas en los niños asmáticos. El coeficiente FEM 25/FIM 25 fue menor o igual a 0,3 en todos los asmáticos, aun en aquellos asintomáticos y sin tratamiento con valores espirométricos normales. No se encontró relación entre FMF y FEM 25/FIM 25 mediante la curva de regresión. Todos los niños sanos tuvieron FEM 25/FIM 25 mayor de 0,3. El FMF y los flujos de volúmenes bajos son los parámetros más confiables para el seguimiento de niños asmáticos. El 13% de los niños sanos tuvo prueba broncodilatadora positiva. Se supone que existe compromiso de la pequeña vía aérea y de la distensibilidad dinámica cuando el coeficiente FEM 25/FIM 25 es menor o igual a 0,3 (AU)
Subject(s)
Child , Adolescent , Humans , Male , Female , Pulmonary Ventilation , Asthma/physiopathologyABSTRACT
Se analizó y comparó la curva flujo/volumen (F/V) de 17 niños asmáticos asintomáticos y 22 niños sanos sin antecedentes respiratorios. Se tomaron las medias de los flujos espiratorios e inspiratorios en el pico y en el 75%, 50% de la capacidad vital (VC), y sus cocientes, en ambos grupos, antes y después de la aplicación de un broncodilatador aerosolizado. Las medias (X) de los flujos medios forzados (FMF), flujo espiratorio máximo al 50/flujo inspiratorio máximo al 50 (FEM 50/FIM 50) y flujo espiratorio máximo al 25/flujo inspiratorio máximo al 25 (FEM 25/FIM 25) fueron significativamente más hajas en los niños asmáticos. El coeficiente FEM 25/FIM 25 fue menor o igual a 0,3 en todos los asmáticos, aun en aquellos asintomáticos y sin tratamiento con valores espirométricos normales. No se encontró relación entre FMF y FEM 25/FIM 25 mediante la curva de regresión. Todos los niños sanos tuvieron FEM 25/FIM 25 mayor de 0,3. El FMF y los flujos de volúmenes bajos son los parámetros más confiables para el seguimiento de niños asmáticos. El 13% de los niños sanos tuvo prueba broncodilatadora positiva. Se supone que existe compromiso de la pequeña vía aérea y de la distensibilidad dinámica cuando el coeficiente FEM 25/FIM 25 es menor o igual a 0,3
