ABSTRACT
The Phadiatop Infant® (PhInf) is a panel developed to assess allergic sensitization (immunoglobulin E [IgE]) in children aged <5 years and combines inhalant and food allergens. The test has not been evaluated outside Europe. This is a cross-sectional study conducted at 11 pediatric allergy centers to evaluate PhInf as an allergic disease screening method in Brazilian children. Children as controls and patients (aged 6 months18 years) were grouped according to their primary disease and age group. PhInf and specific serum IgE (sIgE) screening was performed for Dermatophagoides pteronyssinus (DP), cat and dog epithelia, a mix of grasses and pollens, eggs, cows milk, peanuts, and shrimp. Values ≥ 0.35 kUA/L (or PAU/L) were considered positive. A total of 470 children and adolescents, which included 385 patients and 85 controls, participated in the study (47.7% boys, average age: 6.3 years). In all, 72.6% of the participants had positive PhInf test (n = 341), with a higher proportion of those having food allergy (92.6%), atopic dermatitis (91.9%), and those aged >13 years having allergy (95%). The PhInf and sIgE agreement between patients (Kappa = 0.94, P < 0.001) and controls (Kappa = 0.84, P < 0.001) was high. PhInf and DP agreement in patients aged >13 years was excellent (Kappa = 0.936, P < 0.001). Compared with sIgE dosage, PhInf had high sensitivity (97%) and specificity (93%). Positivity of PhInf test in this population was high and had an excellent correlation with the allergens comprising the panel. It is a useful method for screening children suspected of having allergic diseases in a non-European country (AU)
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Hypersensitivity/diagnosis , Allergens , Food Hypersensitivity/diagnosis , Case-Control Studies , Cross-Sectional Studies , Immunoglobulin E , LaboratoriesABSTRACT
BACKGROUND: Due to the high prevalence of recurrent wheezing in the pediatric population, it is important to be able to identify environmental risk factors that may affect the etiology of asthma in several regions. OBJECTIVE: to identify possible risk factors associated with asthma in children (9-12 years old) in Passo Fundo, Rio Grande do Sul, Brazil. MATERIAL AND METHODS: A total of 1003 school-age children were selected for the cross-sectional study by applying a standardized written questionnaire from the International Study of Asthma and Allergy, and a supplementary questionnaire (ISAAC phase II) was added to address personal, family and environmental factors. Of these, 125 children were excluded because they did not accept to do the skin prick test, resulting in a sample of 878. RESULTS: Independent risk factors associated with asthma were bronchiolitis before two years old [OR] = 3.11; 2.23-4.33, current rhinitis [0R] = 2.07; 1.43-3.0; sharing bedroom during the first year of life [OR] = 2.03; 1.36-3.04; atopy [OR] = 1,82; 1.26-2.50; use of paracetamol more than 12 times a year [OR] = 1.68; 1.20-2.31; use of antibiotics in the first six months of life [OR]=1,57 1;13-2.17; maternal asthma [OR] = 1.75; 1.05-2.78, having an indoor cat during the first year of life [OR] = 1.73, 1.07-2.78; premature birth [OR] = 1.60,1.02-2.50. CONCLUSIÓN: our results show that genetic backgrounds, environmental factors, premature birth, use of antibiotics before six months of life, using paracetamol once per month and the presence of co-morbidities such as rhinitis are the risk factors associated with asthma in Brazilian children
No disponible
Subject(s)
Humans , Male , Child , Asthma/epidemiology , Schools/statistics & numerical data , Risk Factors , Brazil/epidemiology , Asthma/etiology , Surveys and Questionnaires , Rhinitis/complications , Cross-Sectional Studies , Logistic ModelsABSTRACT
OBJECTIVE: Migraine is a chronic condition with complex pathophysiology. Although immunologic disturbances have been linked to migraine, only few attempts have been made to assess the possibility of allergic rhinitis as a worsening factor of migraine in adults. This survey aimed to compare migraine disability between adult migraineurs with and without current allergic rhinitis. METHODS: This cross-sectional study comprised 118 adult migraineurs who were consecutively assisted at an outpatient clinic. After ordinary neurological evaluation, participants were evaluated for headache disability using the Migraine Disability Assessment (MIDAS). The presence of current allergic rhinitis, allergic rhinoconjunctivitis and seasonal allergic rhinitis was scored for each participant according to the International Study of Asthma and Allergies in questionnaire. RESULTS: There was no significant difference between the MIDAS scores of those with current allergic rhinitis, allergic rhinoconjunctivitis, or seasonal allergic rhinitis and nonatopic migraineurs. The disability caused by allergic symptoms also did not influence the MIDAS scores of patients with allergic rhinitis. The frequency of headache days during the last three months was higher in the subset of patients without allergic rhinitis (median and interquartile range 12 [8-19.2] vs. 8 [4-14]; p = 0.03). CONCLUSIONS: Our results suggest that current allergic rhinitis, allergic rhinoconjunctivitis, and seasonal allergic rhinitis are not related to headache disability in adults with episodic migraine.
Subject(s)
Migraine Disorders/etiology , Rhinitis, Allergic/complications , Adult , Body Mass Index , Cross-Sectional Studies , Disability Evaluation , Female , Humans , Male , Middle Aged , Migraine Disorders/physiopathology , Regression Analysis , Rhinitis, Allergic/physiopathology , Severity of Illness Index , Statistics, Nonparametric , Surveys and Questionnaires , Time FactorsABSTRACT
ABSTRACT Migraine is a chronic condition with complex pathophysiology. Although immunologic disturbances have been linked to migraine, only few attempts have been made to assess the possibility of allergic rhinitis as a worsening factor of migraine in adults. Objective This survey aimed to compare migraine disability between adult migraineurs with and without current allergic rhinitis. Methods This cross-sectional study comprised 118 adult migraineurs who were consecutively assisted at an outpatient clinic. After ordinary neurological evaluation, participants were evaluated for headache disability using the Migraine Disability Assessment (MIDAS). The presence of current allergic rhinitis, allergic rhinoconjunctivitis and seasonal allergic rhinitis was scored for each participant according to the International Study of Asthma and Allergies in questionnaire. Results There was no significant difference between the MIDAS scores of those with current allergic rhinitis, allergic rhinoconjunctivitis, or seasonal allergic rhinitis and nonatopic migraineurs. The disability caused by allergic symptoms also did not influence the MIDAS scores of patients with allergic rhinitis. The frequency of headache days during the last three months was higher in the subset of patients without allergic rhinitis (median and interquartile range 12 [8-19.2] vs. 8 [4-14]; p = 0.03). Conclusions Our results suggest that current allergic rhinitis, allergic rhinoconjunctivitis, and seasonal allergic rhinitis are not related to headache disability in adults with episodic migraine.
RESUMO A migrânea é uma condição dolorosa crônica com fisiopatologia complexa. Apesar de disfunções imunológicas já terem sido ligadas à migrânea, poucas foram as tentativas, na literatura, de se avaliar a possibilidade da rinite alérgica como um fator agravante da migrânea em adultos, tornando a questão ainda não esclarecida. Objetivo Esta pesquisa visou comparar a incapacidade da migrânea em adultos com e sem rinite alérgica. Métodos Este estudo transversal incluiu 118 adultos com migrânea consecutivamente atendidos em uma clínica ambulatorial. Após o exame neurológico usual, os participantes foram avaliados com relação à incapacidade gerada pela cefaleia com o Migraine Disability Assessment (MIDAS), assim como para a presença atual de rinite alérgica, rinoconjuntivite alérgica e rinite alérgica sazonal de acordo com o questionário do International Study of Asthma and Allergies in Childhood (ISAAC). Resultados Não houve diferença nos escores do MIDAS entre migranosos com e sem alérgica, rinoconjuntivite alérgica e rinite alérgica sazonal. A incapacidade causada pelos sintomas alérgicos também não influenciou os escores do MIDAS dos pacientes com rinite alérgica. A frequência de dias com cefaleia durante os últimos 3 meses foi maior no subgrupo de pacientes sem rinite alérgica (mediana e intervalo interquartil 12 [8-19,2] vs. 8 [4-14]; p = 0,03). Conclusões Os resultados sugerem que rinite alérgica, rinoconjuntivite alérgica e rinite alérgica sazonal não estão relacionadas à incapacidade por cefaleia em pacientes adultos com migrânea episódica.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Rhinitis, Allergic/complications , Migraine Disorders/etiology , Time Factors , Severity of Illness Index , Body Mass Index , Cross-Sectional Studies , Surveys and Questionnaires , Regression Analysis , Statistics, Nonparametric , Disability Evaluation , Rhinitis, Allergic/physiopathology , Migraine Disorders/physiopathologyABSTRACT
OBJETIVO: Avaliar o conhecimento de pediatras sobre alergia alimentar. MÉTODOS: Dados obtidos de questionário padronizado, postado e respondido por pediatras filiados à Sociedade Brasileira de Pediatria (SBP). Digitação dos dados em planilha Excel e análise de freqüência de respostas afirmativas em porcentagem. RESULTADOS: Foram analisados 895 questionários preenchidos por pediatras de todo o país, com predomínio da região Sudeste (61,6 por cento). Segundo os pediatras entrevistados, as manifestações diagnósticas de alergia alimentar são: respiratórias, cutâneas e sistêmicas, em iguais proporções. Ainda segundo estes pediatras, leite de vaca (98,9 por cento), clara de ovo (58,7 por cento) e amendoim (50,9 por cento) são os principais alimentos associados a essas manifestações. Embora 74,8 por cento dos respondedores tivessem identificados os corantes e aditivos alimentares como responsáveis pela alergia alimentar, apenas 19,4 por cento conheciam o código de identificação da tartrazina. CONCLUSÕES: Os dados apresentados reforçam a necessidade de ampliação dos conhecimentos dos profissionais de saúde sobre o diagnóstico e tratamento da alergia alimentar, com o objetivo de garantir o uso de critérios diagnósticos e terapêuticos mais adequados.
OBJECTIVE: To evaluate the knowledge of Brazilian pediatricians about food allergy. METHODS: Data was obtained from a sent back posted written questionnaire. It was filled in by Brazilian pediatricians, affiliated to the Brazilian Society of Pediatrics. Data was transcript to an Excel spread sheet and the frequency of affirmative responses was reported as percentages. RESULTS: Data from 895 written questionnaire of pediatricians from all over Brazil, (mainly from the southeastern region - 61.6 percent), were analyzed. The main clinical expressions of food allergy determined by the pediatricians were: respiratory, cutaneous and systemic symptoms (equal proportions). According to these pediatricians, cow's milk (98.9 percent), egg white (58.7 percent) and peanuts (50.9 percent) were the main allergens related to food allergy symptoms. Although 74.8 percent of the responders have indicated food dyes and food additives as associated to food allergies, only 19.4 percent of them knew the identification code of tartrarzine. CONCLUSIONS: The presented data reinforce the need to improve the pediatricians' knowledge about the diagnosis and treatment of food allergy, in order to assure the use of appropriate diagnostic and treatment criteria.
Subject(s)
Humans , Food Additives , Food , Health Knowledge, Attitudes, Practice , Child , Food Hypersensitivity/diagnosis , Arachis , Egg White , Milk Substitutes , TartrazineABSTRACT
Relata-se três casos de angioedema hereditário tipo I. O angioedema hereditário caracteriza-se por edema recorrente näo pruriginoso sem cacifo ou urticária em qualquer parte do corpo, com predomínio pela face, mäos e pés, acompanhado ou näo de dor abdominal. Incidência de aproximadamente 1:150.000. Quanto ao tratamento em casos severos e/ou crises frequentes, utiliza-se medicaçäo antifibrinolítica ou androgênios
Subject(s)
Humans , Angioedema/diagnosis , Angioedema/etiology , Chromosome Aberrations , Genetic Diseases, InbornABSTRACT
A Síndrome de Kartagener é determinada pela tríade de situs inversus bronquiectasia e sinusite. Seu substrato anatomo-funcional é uma alteraçäo na ultra-estrutura dos cílio e flagelos, que se tornam discinéticos. Como resultados, todos os epitélios ciliados, bem como os espermatozóides têm sua funçäo prejudicada. Faz-se uma revisäo sobre a Síndrome de Kartagener, com ênfase especial nos aspectos de etiopatogenia e apresentaçäo clínica em conjunto ao relato de um caso
Subject(s)
Humans , Female , Adolescent , Kartagener Syndrome/diagnosis , Kartagener Syndrome/complications , Kartagener Syndrome/geneticsABSTRACT
A doença de Kawasaki (DK) é uma entidade que envolve múltiplos sistemas, afetando principalmente crianças menores de cinco anos, sendo caracterizada clinicamente por febre, alteraçöes cutaneomucosas e linfonodomegalia. Sua etiologia é desconhecida. Foi descrita em 1967 no Japäo, onde já existem milhares de casos diagnosticados. No Brasil, os relatos säo escassos e parecem refletir um problema de subdiagnóstico, mais do que incidência verdadeiramente baixa da doença. Relatamos um caso da DK diagnosticado no Hospital de Caridade de Erichim (RS), cujo quadro clínico foi típico e a evoluçäo favorável após tratamento com ácido acetilsalicílico (AAS). O caso é discutido e a literatura revista, no intuito de divulgar a DK no Brasil
