Diversos metales pueden ser biomarcadores precoces de cáncer de pulmón / Different metals can be early biomarkers for lung cancer x

FUNDAMENTO Y OBJETIVOS: el cáncer de pulmón (CP) es el que provoca mayor mortalidad, especialmente por su frecuente diagnóstico tardío, con menos posibilidades de curación. En el inicio del proceso carcinogénico, previo al diagnóstico clínico, los oligoelementos (metales o metaloides), desempeñan un papel importante al activar o inhibir las reacciones enzimáticas y las metaloproteínas. El objetivo de nuestro estudio es analizar la utilidad de diversos metales como biomarcadores (BM) precoces de CP, obtenidos en muestras de suero, orina, y lavado broncoalveolar (LBA)MATERIAL Y MÉTODOS: hemos analizado las concentraciones totales, incluyendo fracciones de alto y bajo peso molecular, de 11 metales en muestras de suero, orina y LBA de pacientes CP, controles sanos (CS) y pacientes con patología respiratoria no cáncer (NCP) empleando una técnica de análisis basada en un plasma de acoplamiento inductivo-espectrometría de masas (ICP-QQQ-MS). RESULTADOS: obtuvimos una clara discriminación entre los grupos en las tres muestras analizadas. Hemos obtenido metales sobreexpresados o reducidos en el CP que podrían utilizarse como BM. La concentración de vanadio (V) y cromo (Cr) en suero es claramente mayor en pacientes con CP. Hemos demostrado que varios metales (V, Cr y cobre), relacionados con procesos metabólicos alterados en CP como estrés oxidativo y homeostasis, y/o sus relaciones podrían ser buenos BM de CP. CONCLUSIONES: diversos metales, y sus relaciones y correlaciones, en la población estudiada diferencian claramente a los pacientes con cáncer de pulmón de los CS y NCP y parecen ser buenos biomarcadores en el diagnóstico precoz del cáncer de pulmón

BACKGROUND AND OBJECTIVES: Lung cancer (LC) has the highest mortality rate, especially due to its late diagnosis, with a lower chance of recovery. At the start of the carcinogenic process, before a clinical diagnosis, trace elements (metals or metalloids) play an important role by activating or inhibiting enzymatic reactions and metalloproteins. The objective of our study is to analyze the utility of different metals as early biomarkers (BM) for LC which are obtained in serum, urine and bronchoalveolar lavage (BAL) samples. MATERIAL AND METHODS: We analyzed the total concentrations, including fractions of high and low molecular weight, of 11 metals in serum, urine and BAL samples from patients with LC, healthy controls (HC) and patients with non-cancerous respiratory pathology (NCP) using an analysis technique based on inductively coupled plasma mass spectrometry (ICP-QQQ-MS).RESULTS: We obtained a clear discrimination between groups for the three samples analyzed. We obtained overexpressed or reduced metals in LC that could be used as BM. The concentration of vanadium (V) and chromium (Cr) in serum is clearly higher in patients with LC. We have shown that several metals (V, Cr and copper) related to the altered metabolic processes in LC such as oxidative stress and homeostasis and/or their connections could be good BM for LC. CONCLUSIONS: in the population studied, several metals and their connections and correlations were clearly differentiated in the patients with lung cancer compared to the HC and NCP groups and they appear to be good biomarkers for the early diagnosis of lung cancer

Study of the metabolomic relationship between lung cancer and chronic obstructive pulmonary disease based on direct infusion mass spectrometry.

The high prevalence of lung cancer (LC) has triggered the search of biomarkers for early diagnosis of this disease. For this purpose the study of metabolic changes related to the development of lung cancer could provide interesting information about its early diagnosis. In this sense, chronic obstructive pulmonary disease (COPD), a disease associated with tumor development, is a comorbidity that increases the risk of onset and progression of lung neoplasia and has also to be considered in the study of pathology related to lung cancer. This work develop a metabolomic approach based on direct infusion mass spectrometry using a hybrid triple quadrupole-time of flight mass spectrometer (DI-ESI-QqQ-TOF-MS) in order to identify altered metabolites from serum of LC and COPD patients and evaluate its relationship and implication in the progression of LC. This methodology has been applied to 30 serum samples from LC, 30 healthy patients used as controls (HC) and 30 serum samples from COPD to found altered metabolites from both LC and COPD diseases. In addition, some metabolic differences and similarities were found in Pulmonary Emphysema and Chronic Bronchitis patients. On the other hand, altered metabolites were studied in different stages of LC (II, III and IV) to evaluate the perturbation of them throughout the progression of disease. The sample treatment consisted of the extraction of polar and non-polar metabolites from serum that was later infused into the mass spectrometer using an electrospray ionization source in positive and negative mode. Partial least squares discriminant analysis (PLS-DA) allowed a classification between LC, HC and COPD groups in all acquisition modes. A total of 35 altered and common metabolites between LC and COPD, including amino acids, fatty acids, lysophospholipids, phospholipids and triacylglycerides were identified, being alanine, aspartate and glutamate metabolism the most altered. Finally, ROC curves were applied to the dataset and metabolites with AUC value higher than 0.70 were considered as relevant in the progression of LC.

Seguridad vial, asma y rinitis: reflexiones / Road safety, asthma and rhinitis: reflections

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Tos crónica invalidante e infecciones de repetición / Chronic, disabling cough and repeated infections

La tos crónica, o tos que perdura más de 8 semanas, es un síntoma muy habitual en la práctica clínica médica. Existen numerosas etiologías que se manifiestan con tos crónica, por tanto, es fundamental para el médico realizar un enfoque sistemático que le permita hacer un correcto diagnóstico diferencial. Es muy inusual encontrar como origen de tos crónica la presencia de anomalías traqueales, como es el caso de la traqueomalacia. Esta comprende diferentes condiciones de la tráquea, que tienen en común la mayor proximidad de las paredes traqueales. Habitualmente, la tráquea cambia su morfología de manera fisiológica durante el ciclo respiratorio, dependiendo del impacto producido por la presión del aire. El colapso dinámico de la vía aérea puede conducir a una obstrucción casi completa de la misma durante la espiración produciendo, entre otros síntomas, tos. Para su manejo se pueden emplear stents de silicona en Y, como tratamiento sintomático definitivo, en pacientes con riesgo quirúrgico alto

Chronic cough or a cough that lasts more than eight weeks is a common symptom in medical practice. A large number of etiologies are expressed with chronic cough; therefore, it is essential that the doctor carries out a systematic focus that leads to a correct, differential diagnosis. It is most unusual that chronic cough originates from tracheal abnormality, as in the case of tracheomalacia. This includes a variety of tracheal conditions that all share greater proximity of the tracheal walls. Usually, the trachea alters its physiological morphology when breathing, depending on the impact of air pressure. The dynamic collapse of the airway could lead to an almost complete obstruction of the airway during expiration, thus causing, among other symptoms, cough. Silicone Y stents may be used to treat the symptoms in patients with high surgical risk

Perfiles metabolómicos de sujetos sanos y con cáncer de pulmón. Influencia de la carga tabáquica / The metabolomics of healthy subjects and those with lung cancer: the influence of smoking

INTRODUCCIÓN: la aplicación de técnicas metabolómicas presenta un gran potencial para la búsqueda de posibles biomarcadores de diagnóstico precoz en numerosas enfermedades. El empleo de procedimientos metabolómicos basados en espectrometría de masas permite estudiar las modificaciones metabólicas subyacentes al cáncer de pulmón (CP) y la influencia de la carga tabáquica (CT), medida en paquetes-año, en los correspondientes perfiles metabólicos. METODOLOGÍA: se estudió el suero de 9 controles sanos (no fumadores), 6 enfermos de CP con carga tabáquica moderada (CT 70). Se analizaron los metabolitos mediante técnicas de espectrometría de masas de alta resolución (DI-ESI-QTOFMS). Los perfiles metabólicos obtenidos se sometieron a análisis estadístico multivariante (PCA, PLS-DA). RESULTADOS: los tres grupos de estudio mostraron perfiles metabólicos claramente diferentes, lo que permitió identificar algunos posibles biomarcadores. Los niveles de glutatión se encontraron disminuidos en muestras de suero de pacientes con CP, mientras que se incrementó el contenido de distintos fosfolípidos de membrana (PL). La mayoría de estas anormalidades metabólicas se acentuó en pacientes con una CT elevada. CONCLUSIONES: el análisis metabolómico en muestras de suero permitió diferenciar claramente entre sujetos sanos y pacientes con CP. Así mismo, se identificaron posibles biomarcadores para el diagnóstico del CP (relacionados con rutas previamente conocidas en el proceso del cáncer). Además, estas alteraciones se vieron influenciadas por la carga tabáquica, confirmando la importancia del tabaquismo como factor de riesgo primario en el desarrollo del CP

By using high resolution metabolomics, we obtained the metabolomic profiles for patients who smoked and had lung cancer (LC) and a healthy, non-smoker control (HC) group; we assessed the influence of smoking on said profiles. The results show a clear discrimination between the metabolomic profiles of both groups studied; the metabolites causing said difference could be determined. Moreover, differences were encountered between the metabolomic profiles of heavy smokers with lung cancer compared to moderate smokers. INTRODUCTION: theapplicationof metabolomic techniques offers extensive potential to search for possible biomarkers in the early detection of several diseases. Using metabolomic procedures based on mass spectrometry allow us to study underlying metabolic changes in lung cancer and the influence of smoking, measured as packets/year, in the corresponding metabolic profiles. METHOD: the serum from 9 healthy control subjects (nonsmokers) was studied, as well as that of 6 patients with lung cancer who were moderate smokers (CT 70). The metabolites were analyzed using high resolution mass spectrometer techniques (DI-ESI-QTOF-MS). The metabolic profiles obtained were subject to multivariate statistical analysis (PCA, PLS-DA). RESULTS: the three groups studied showed clearly differentiated metabolic profiles, which facilitated the identification of certain biomarkers. Glutathione levels were found to be decreased in the sample from patients with lung cancer, while the content of various membrane phospholipids increased. Most of these metabolic abnormalities were heightened in patients who were heavy smokers. CONCLUSIONS: the metabolomics analysis in serum samples clearly differentiated healthy subjects from patients with lung cancer. Also, possible biomarkers were identified to diagnose lung cancer (linked to previously known routes in the cancer process. Moreover, these alterations were influenced by the amount smoked, thus confirming the importance of smoking as a primary risk factor in developing lung cáncer

Asma premenstrual: concepto, prevalencia y su relación con el síndrome premenstrual / Prevalence of premenstrual asthma and its relationship with premenstrual syndrome

Se considera asma premenstrual (APM) al deterioro cíclico del asma durante la fase premenstrual y/o los primeros días de la menstruación que experimentan algunas mujeres en edad fértil. Afecta, según diversos estudios, a más del 30 % de asmáticas. No existen criterios unánimes para su definición. Por otra parte, algunas mujeres experimentan cambios físicos y psíquicos en el periodo premenstrual, trastorno denominado síndrome premenstrual (SPM). Respecto al APM, hemos evaluado las distintas definiciones aceptadas y consideramos el criterio semi-objetivo en un ciclo menstrual (deterioro clínico > 20% en el periodo premenstrual, determinado por una metodología específica) como el que mejor refleja la realidad del APM. La prevalencia que hemos obtenido en nuestro medio con esta definición es del 44,7 % (46/103) (IC 95 %: 35,3 - 54,3 %). Las mujeres con APM presentan más síntomas relacionados con SPM, especialmente los de componente edematoso

Premenstrual asthma (PMA) is considered the cyclical deterioration of asthma during the premenstrual phaseand/or the first days of menstruation in some women during the fertile period. According to several studies, PMA affects over 30 % of asthmatic women. There are not unanimous criteria to define it. Moreover some women during premenstrual phase sufferphysical and psychological premenstrual changes known as premenstrual syndrome (PMS). We evaluated different definitions for the PMA and we have considered semi-objective criteria for a complete menstrual cycle -clinical deterioration exceeded 20% in the premenstrual period, determined by a specific methodology- as the criteria that best reflect the reality of this pathology. The prevalence obtained was 44.7 % % (46/103) (IC 95 %: 35.3 - 54.3 %). Women with PMA have more symptoms associated with PMS, especially edematous component

Premenstrual asthma and leukotriene variations in the menstrual cycle

Background: Several authors have reported an increase in leukotriene C4 in the premenstrual phase in women with severe premenstrual asthma, indicating that antileukotrienes could be used in treatment. Objective: To analyse the role of leukotrienes in premenstrual asthma. Methods: A questionnaire on respiratory symptoms and peak flow during one complete menstrual cycle was given to women of fertile age to define them as asthmatics who suffered from premenstrual asthma or not. Premenstrual asthma (PMA) was defined as a clinical or functional deterioration (major=20%) in the premenstrual phase compared with the preovulatory phase. Blood samples to measure leukotriene C4 were taken during the preovulatory and premenstrual phases. Results: Blood samples were taken in 62 asthmatic women, 34 of whom (54.3%) presented PMA criteria, all with a premenstrual deterioration of between 20 and 40%. There was no difference in leukotriene C4 levels between the preovulatory and premenstrual phases in the women who suffered from PMA (1.50ng/mL vs. 1.31ng/mL; p=0.32) and those who did not (1.40ng/mL vs. 1.29ng/mL; p=0.62). Neither were there any differences in leukotriene levels between women with or without PMA. The results were similar for each category of asthma severity. Conclusions: Our data show that leukotriene C4 does not appear to be involved in the pathogenesis of premenstrual asthma, or support the use of anti-leukotrienes in the specific treatment of premenstrual asthma, at least in women with a moderate premenstrual deterioration. No differences appeared in any of the categories of asthma severity(AU)

Estudio epidemiológico de seguimiento de asma en adolescentes de la ciudad de huelva / Epidemiological study of the follow up of asthma in adolescents of Huelva city

Objetivo: Analizar y comparar la incidencia de asma en adolescentes y adultos de Huelva. Determinar los cambios (aparición, persistencia y remisión) de sibilancias, hiperreactividad bronquial (HB) y asma, así como esclarecer los posibles factores de riesgo de asma incidente. Metodología: Seguimiento de 9 años de la cohorte original tras el estudio transversal inicial. Se realizó una segunda evaluación de los 2 grupos analizados, 401 niños del Estudio de Enfermedades Respiratorias y 204 adultos del Estudio Europeo de Enfermedades Respiratorias. Ambos realizaron un cuestionario sobre síntomas respiratorios, una espirometría y una prueba de metacolina. Resultados: La incidencia anual acumulada de asma en los niños (15,69/1000 personas-año) fue tres veces superior a la de los adultos (4,76/1000 personas-año). En los niños hubo un 24,2% de apariciones y un 4,3% de remisiones de sibilancias en los últimos 12 meses. De esta forma, las apariciones superaban a las remisiones (p < 0.001). También se produjeron más apariciones que remisiones en HB (13,9% vs 5,4%;p = 0,02) y asma (9,3% vs 3%; p = 0,004). En los adultos se encontraron más apariciones que remisiones (15,7%vs6,9%;p= 0,011)de sibilancias e HB (10,1% vs3% ; p =0,017) no se hallaron cambios significativos en el seguimiento de asma. Los factores de riesgo más importantes relacionados con asma incidente fueron: tener sibilancias (RR: 8,12) y opresión torácica(RR: 9,17) al estar cerca de un animal. Conclusiones: La incidencia de asma en adolescentes es tres veces superior a la de los adulto (AU)

Objective: To analyse and to compare the incidence of asth main adolescents and adults of Huelva. To determine the changes (appearance, persistence and remission) of wheezing, bronchialhyper-responsiveness(BH) and asthma, as well as to clarify the potential risk factors for incidence of asthma. Methodology: Nine year follow-up of the original cohort after the initial cross-sectional study. A second evaluation was made of the 2 analysed groups, 401 children of the Respiratory Diseases Study and 204 adults of the European Respiratory Diseases Study. Both groups completed a questionnaire on respiratory symptoms, spirometry and methacholine challenge test. Results: The accumulated annual incidence of asthma in children(15.69/1000 persons / year) was three times higher than in adults (4.76/1000 persons / year). In children there were24.2% of occurrences and 4.3% of remissions of wheezing in the last 12 months. Thus, the occurrences exceeded remissions(p < 0.001). There were also more occurrences than remissions in BH (13.9% vs. 5.4%; p = 0.02) and asthma (9.3%vs. 3%; p = 0.004). In adults, there were more occurrences than remissions (15.7% vs. 6.9%; p= 0.011) of wheezing and BH (10.1% vs. 3%; p =0,017) with no significant changes found in the asthma follow-up. The most important risk factors associated with incident asthma were presence of wheezing (RR: 8.12) and thoracic oppression (RR: 9.17) when being near an animal. Conclusions: The incidence of asthma in adolescents is three times higher than in adults (AU)

Premenstrual asthma and leukotriene variations in the menstrual cycle.

BACKGROUND: Several authors have reported an increase in leukotriene C4 in the premenstrual phase in women with severe premenstrual asthma, indicating that antileukotrienes could be used in treatment. OBJECTIVE: To analyse the role of leukotrienes in premenstrual asthma. METHODS: A questionnaire on respiratory symptoms and peak flow during one complete menstrual cycle was given to women of fertile age to define them as asthmatics who suffered from premenstrual asthma or not. Premenstrual asthma (PMA) was defined as a clinical or functional deterioration (≥20%) in the premenstrual phase compared with the preovulatory phase. Blood samples to measure leukotriene C4 were taken during the preovulatory and premenstrual phases. RESULTS: Blood samples were taken in 62 asthmatic women, 34 of whom (54.3%) presented PMA criteria, all with a premenstrual deterioration of between 20 and 40%. There was no difference in leukotriene C4 levels between the preovulatory and premenstrual phases in the women who suffered from PMA (1.50ng/mL vs. 1.31ng/mL; p=0.32) and those who did not (1.40ng/mL vs. 1.29ng/mL; p=0.62). Neither were there any differences in leukotriene levels between women with or without PMA. The results were similar for each category of asthma severity. CONCLUSIONS: Our data show that leukotriene C4 does not appear to be involved in the pathogenesis of premenstrual asthma, or support the use of anti-leukotrienes in the specific treatment of premenstrual asthma, at least in women with a moderate premenstrual deterioration. No differences appeared in any of the categories of asthma severity.

Relación entre asma premenstrual y empeoramiento de síntomas otorrinolaringológicos en mujeres con asma / Relationship between premenstrual asthma and premenstrual worsening of otorhinolaryngological symptoms in women asthma

Objetivo: Analizar si existe empeoramiento de síntomas otorrinolaringológicos (rinorrea, obstrucción nasal y disfonía) en (..) (AU)

Objective: To analyse if there is worsening of several otorhinolaryngological sypmtoms (..) (AU)

Utilidad del omalizumab en un paciente con asma grave y aspergilosis broncopulmonar alérgica / Use of omalizumab in a patient with severe asthma and allergic bronchopulmonary aspergilosis

Mujer de 64 años diagnositicada de asma bronquial en la juventud, catalogada como asma de difícil control y corticode pendiente. En las pruebas complementarias se ha objetivado una eosinofilia mantenida (>7%), IgE total elevada con un pico (..) (AU)

A 64 year-old woman diagnosed with bronchial asthma, proven difficult to control and corticoid-dependent since an early age, was studied. Complementary test performed demonstrated (..) (AU)

Variability in the prevalence of premenstrual asthma.

Our aim is to analyse the differences in the prevalence of premenstrual asthma (PMA) according to a set of criteria, the relationship between them and the influence of asthma severity. The answer "Yes" to "Does your asthma get worse before menstruation?" was considered subjective PMA. A daily respiratory symptoms register of fertile asthmatic females was taken during two consecutive menstrual cycles. For the semi-objective diagnosis, an exacerbation of > or =20% was required in the symptoms register. Objective diagnosis was a premenstrual worsening of > or =20% of peak flow. We selected 103 patients. Subjective premenstrual deterioration was perceived in 43.7%. The semi-objective deterioration of symptoms in the first cycle occurred in 44.7%, and in 22.3% in both cycles. A total of 54.3% of females with semi-objective criteria in the first cycle perceived a subjective deterioration of symptoms, versus 35.1% of those without semi-objective criteria (p = 0.05). PMA was present at all levels of asthma severity, with no clear link to the degree of severity. The detection of PMA prevalence, the subjective perception of this deterioration and its presence at all levels of asthma severity lead us to urge research into possible premenstrual deterioration in all fertile asthmatic females.

Documento de consenso sobre asma bronquial en Andalucía / No disponible

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Asma premenstrual, relación con la severidad del asma y su apreciación subjetiva / Premenstrual Asthma, relation between the severity of the asthma and its subjective appreciation

Introducción: diversos estudios, aunque con resultados dispares, han relacionado el asma premenstrual (AP) con la severidad delasma. Por otra parte, no existe uniformidad respecto al hecho de que las pacientes con AP manifiesten una percepción subjetiva de empeoramiento de su asma en el periodo premenstrual. Objetivo: estudiar en mujeres asmáticas, con o sin criterios de AP, la relación con la clasificación del asma (GINA 2005) y el hecho de manifestar un empeoramiento de su asma en el periodo premenstrual. Material y método: se ha realizado un estudio observacional trasversal sobre una población de mujeres asmáticas en edad fértil en las que se realizó un cuestionario en el que se recogía, entre otros aspectos, la clasificación del asma (GINA 2005) y el hecho de manifestar un empeoramiento de los síntomas asmáticos en el periodo premenstrual. Por otra parte, se recogía diariamente durante un ciclo menstrual completo un cuestionario de síntomas respiratorios–SR– (tos, disnea, sibilancias y opresión torácica) y los valores depeak flow (PF) matutino y vespertino durante dicho ciclo. Se considera AP al empeoramiento > 20% en el PF y/o en los síntomas asmáticos (>20%) en el periodo premenstrual. Resultados: hasta el momento, han completado la recogida de los cuestionarios y los valores de PF, en los distintos hospitales participantes,82 pacientes. (6 graves, 29 moderados, 26 persistentes leves y 21 intermitentes leves). De ellas, 35 (42,7%; IC 95%: 31,96-53,41) presentaban criterios clínicos de asma premenstrual. Presentaban criterios funcionales 3 de las mujeres (3,7%), cumpliendo todas ellas también criterios clínicos. El asma premenstrual se distribuyó con frecuencia similar en los distintos grupos de gravedad(p=0,98). Las mujeres con AP reconocían con mayor frecuencia(61,8% frente a 40,4%) el empeoramiento premenstrual de sus síntomas (p=0,06).(..) (AU)

Introduction: A number of studies, although with incongruent results, have related premenstrual asthma (PA) to the severity of the asthma. On the other hand, there is no uniformity regarding the fact that patients with PA express a subjective perception of a worsening of their asthma during the premenstrual period. Objective: To study asthmatic women with/without PA criteria, the relationship between the classification of the asthma (GINA2005) and whether there is a worsening of their asthma during the premenstrual period. Materials and method: A transverse observational study was carried out on a population of fertile, asthmatic women, who completed a questionnaire in which included, amongst other aspects, the asthma classification (GINA 2005) and whether there was a manifest worsening of the asthmatic symptoms during the premenstrual period. On the other hand, a questionnaire of respiratory symptoms (RS), including cough, dyspnea, sibilance and thoracic oppression, was completed daily, during a complete menstrual cycle, plus the Peak Flow values in the morning and evening during this cycle. PA is consider edif there is a worsening >20% during the PF and/or in the asthmatic symptoms (>20%) during the premenstrual period. Results: Up to now, the completed questionnaires have been collected and the values of the Peak Flow (PF), at the different participating hospitals, 82 patients (6 serious, 29 moderate, 26 persistent light and21 intermittent light). Of these, 35 (42.7%; IC95%: 31.96-53.41) presented clinical criteria of Premenstrual Asthma. Three of the women presented functional criteria (3.7%), all them also fulfilling clinical criteria. Premenstrual asthma was distributed with a similar frequently in the different groups of seriousness (p=0.98). The women with PA recognized with more frequency (61.8% as against 40.4%) the premenstrual worsening of their symptoms (p=0.06). (..) (AU)

Utilidad e indicaciones de Omaluzumab en el asma bronquia / No disponible

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Situación actual en el manejo del asma en Andalucía y Extremadura. Posibles líneas de mejora / No disponible

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Cambios en la prevalencia de síntomas de asma e hiperreactividad bronquial en el seguimiento de dos cohortes poblacionales de la ciudad de Huelva / Changes in the prevalence of asthma symptoms and bronchial hyper-reactivity in the follow-up of two population groups of the Huelva city

Objetivo: Analizar los cambios en la prevalencia de síntomas asmáticos e hiperreactividad bronquial (HB) que ocurren con la edad en dos cohortes de adolescentes y adultos jóvenes de la ciudad de Huelva. Material y métodos: Se ha realizado una segunda evaluación en el seguimiento de las dos poblaciones estudiadas entre 1991 y1993: jóvenes adolescentes de 11 a 16 años (n= 714), incluidos en el Estudio de Enfermedades Respiratorias de Huelva (EERH-I), y adultos jóvenes de 20-44 años (n=271), incluida en el Estudio Europeo de Enfermedades Respiratorias (ECRHS-I) de la ciudad de Huelva, a las que se realizaron cuestionario de síntomas respiratorios(SR) y prueba de hiperreactividad bronquial inespecífica con metacolina (MT). En la segunda evaluación, realizada con un seguimiento promedio de 9 años, se consiguió estudiar a 401 de los “niños - adolescentes” y 204 de los “adultos jóvenes”. Al igual que en la fase previa, se ha realizado en ambas población es el mismo cuestionario sobre síntomas respiratorios, una espirometría y una prueba de provocación bronquial inespecífica con metacolina. Se comparan las prevalencias de sibilancias (Sib), HB y asma encontradas en la misma población (niños o adultos), en ambos cortes trasversales (1991 y 2.001). Se comparan los resultados obtenidos entre ambas poblaciones. Resultados: Entre los años 1991 a 2001, tanto en jóvenes como en adultos, se incrementan los síntomas respiratorios, especialmente las sibilancias y la disnea, en reposo y al ejercicio. La hiperreactividad bronquial se incrementa claramente en los jóvenes(p<0.001) y sólo ligeramente en los adultos (NS). Como consecuencia de lo anterior, el diagnóstico epidemiológico de asma (sibilancias+ HB) se incrementó de forma significativa sólo en los jóvenes. Otro dato destacable en los niños era que recibían tratamiento para el asma sólo la mitad de los que estaban diagnosticados de asma por un médico y que éstos eran menos que los que referían haber tenido sibilancias en los últimos 12 meses. La discrepancia entre sibilancias y diagnóstico de asma era más evidente en adultos. Conclusiones: En la década de los 90 y en la ciudad de Huelva, una ciudad con elevada prevalencia de sibilancias (Sib) y nivel medio-bajo de hiperreactividad bronquial (HB) y asma, los SR y la HB se van incrementando durante la adolescencia y se estabilizan en la edad adulta. Esto podría explicarse tanto por la historia natural de la enfermedad como por la diferente influencia de las condiciones ambientales en las diferentes edades

Objective: To analyze the changes in the prevalence of asthmatic symptoms and bronchial hyper-reactive (BHR) conditions, which occur with age, in two groups of adolescents and young adults from the city of Huelva. Material and Methods: A second follow-up evaluation was performed on the two populations studied between 1991 and 1993:adolescents between 11 and 16 years of age (n = 714), included in the Study of Breathing Illnesses of Huelva (EERH-I), and young adults 20-44 years old (n=271), included in the European Study of Breathing Illnesses (ECRHS-I) of the city of Huelva. A questionnaire about breathing symptoms (BS) and a non-specific test of bronchial hyper-reactivity with methacholine (MT) were administered. In the second evaluation, carried out with an average follow up of 9 years, it was possible to study 401 of those “child-adolescents” and 204 of those “young adults.” The same as in the previous phase, both populations were administered the same questionnaire about breathing symptoms, aspirometry and a non-specific bronchial provocation test with methacholine was performed. The prevalence of wheezing, BHR and asthma found in the same population (children or adults) was compared in both cross samples (1991 and 2001). The results obtained were compared between both populations. Results: Between the years 1991 and 2001, both in adolescents and adults, the breathing symptoms increased, especially wheezing and dyspnea, at rest and at exercise. Bronchial hyper-reactivity had a clear increase in the adolescents (p < 0.001) and only a slight increase in the adults (NS). As a consequence of the above, the epidemiologic diagnosis of asthma (wheezing + BHR) increased significantly in adolescents. Another outstanding fact in the children was that only half of those medically diagnosed with asthma received treatment for their asthma, and amongst these, there were fewer that said they had experienced wheezing in the last 12 months. The discrepancy between wheezing and the diagnosis of asthma was more evident in adults. Conclusions: In the 90s and in the city of Huelva, a city with a high prevalence of wheezing and medium-low level of bronchial hyper-reactivity (BHR) and asthma, BS and the HR have increased during adolescence and stabilized in adulthood. This could be explained both by the natural evolution of the disease and by the different influences of the environmental conditions at the different ages

Inmunoterapia y asma / No disponible

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