Asthma and vitamin D in Brazilian adolescents: Study of Cardiovascular Risks in Adolescents (ERICA).

OBJECTIVE: To evaluate the association between asthma prevalence and serum levels of vitamin D in Brazilian adolescents. METHODS: This was a cross-sectional, school-based study involving adolescents between 12-17 years of age from four large Brazilian cities located at different latitudes (Fortaleza, Rio de Janeiro, Brasília, and Porto Alegre). Information on asthma diagnosis, lifestyle, and sociodemographic characteristics was collected by means of self-administered questionnaires. Serum concentrations of calcifediol were dichotomized as sufficient (≥ 20 ng/mL) or insufficient/deficient (< 20 ng/mL) levels. Bivariate analyses were carried out between vitamin D levels and prevalence of active asthma (AA), as well as other variables in study, using the chi-square test. Generalized linear models were configured to analyze potential confounding factors (p < 0.20). RESULTS: Between 2013 and 2014, 1,053 adolescents were evaluated. The prevalences of AA and insufficient/deficient levels of calcifediol were 15.4% and 21%, respectively. There were no statistically significant associations between AA and hypovitaminosis D. The prevalences of AA and vitamin D insufficiency were, respectively, 2.34 (95% CI, 1,28-4.30) and 3.22 (95% CI, 1.75-5.95) times higher in Porto Alegre than in Rio de Janeiro, regardless of possible confounding factors. However, no significant associations were found between the prevalence of AA and vitamin-D-related variables in any of the cities. CONCLUSIONS: No association was found between AA and low levels of vitamin D in adolescents living at different latitudes in Brazil.

Ferramentas para avaliação e acompanhamento da urticária crônica / Patient-reported outcomes for the evaluation and follow-up of chronic urticaria

Urticária é uma doença pruriginosa da pele na qual ocorrem urticas e/ou angioedema. A urticária é definida como crônica quando persiste por 6 semanas ou mais. A urticária crônica tem um grande impacto na vida diária do paciente. Atualmente, não há biomarcadores confiáveis para identificar e medir a atividade da doença na urticária crônica espontânea. Consequentemente, o uso de ferramentas conhecidas por patient-reported outcomes (PROs) é crucial ao avaliar e monitorar diferentes aspectos da urticária crônica, como atividade/gravidade da doença, controle da doença e qualidade de vida. Apresentamos uma visão geral de cinco PROs usados na avaliação da urticária crônica, e destacamos suas vantagens, limitações e uso na prática clínica e pesquisa.

Urticaria is an itching skin disease characterized by the presence of wheals and/or angioedema. Urticaria is defined as chronic when it persists for 6 weeks or more. Chronic urticaria has great impact on the daily lives of patients. Currently, there are no reliable biomarkers to identify and measure disease activity in chronic spontaneous urticaria. Consequently, the use of tools known as patient-reported outcomes (PROs) is crucial when evaluating and monitoring different aspects of chronic urticaria such as disease activity/severity, disease control, and quality of life. We present an overview of the five PROs used in the evaluation of chronic urticaria, highlighting their advantages, limitations, and use in clinical practice and research.

Quality of life in children and teenagers with atopic dermatitis.

BACKGROUND: Atopic Dermatitis is a disease which has increased during the past years despite our improved understanding of it. OBJECTIVE: To assess the impact of Atopic Dermatitis in the quality of life of children and teenagers and their family. METHOD: A descriptive cross-sectional method with prospective data collection of 50 children and teenagers diagnosed with Atopic Dermatitis ranging in age from 5-16 years. Fifty parents and/or guardians answered the quality of life questionnaires The Children's Dermatology Life Quality Index and Family Dermatitis Impact Questionnaire. The socio-demographic and clinical variables were evaluated by a clinical record chart designed specifically for the research and socioeconomic standardized questionnaire by the Brazilian Association of Research Enterprises, which evaluates assets acquired and the educational level of the head of the household. RESULTS: Thirty-five out of the 50 patients were female (70%), and 28 (56%) of them were from social class C. The Questionnaire Children's Dermatology Life Quality Index showed that 19 (38%) patients ranged from 7 to 12 points (moderate impact of atopic dermatitis) and 17 patients (34%) ranged from 13 to 30 points (high impact of atopic dermatitis). The Family Dermatitis Impact Questionnaire revealed that 15 (30%) families had scores between 7 and 12 points and 22 families (44%) scored between 13 and 30 points. CONCLUSION: The results show that there is a very high impact on the QoL for atopic dermatitis patients and their families. This makes us suggest the importance of including the quality of life study in clinical evaluations.

Quality of life in children and teenagers with atopic dermatitis / Qualidade de vida das crianças e adolescentes com dermatite atópica

BACKGROUND: Atopic Dermatitis is a disease which has increased during the past years despite our improved understanding of it. OBJECTIVE: To assess the impact of Atopic Dermatitis in the quality of life of children and teenagers and their family. METHOD: A descriptive cross-sectional method with prospective data collection of 50 children and teenagers diagnosed with Atopic Dermatitis ranging in age from 5-16 years. Fifty parents and/or guardians answered the quality of life questionnaires The Children's Dermatology Life Quality Index and Family Dermatitis Impact Questionnaire. The socio-demographic and clinical variables were evaluated by a clinical record chart designed specifically for the research and socioeconomic standardized questionnaire by the Brazilian Association of Research Enterprises, which evaluates assets acquired and the educational level of the head of the household. RESULTS: Thirty-five out of the 50 patients were female (70%), and 28 (56%) of them were from social class C. The Questionnaire Children's Dermatology Life Quality Index showed that 19 (38%) patients ranged from 7 to 12 points (moderate impact of atopic dermatitis) and 17 patients (34%) ranged from 13 to 30 points (high impact of atopic dermatitis). The Family Dermatitis Impact Questionnaire revealed that 15 (30%) families had scores between 7 and 12 points and 22 families (44%) scored between 13 and 30 points. CONCLUSION: The results show that there is a very high impact on the QoL for atopic dermatitis patients and their families. This makes us suggest the importance of including the quality of life study in clinical evaluations.

FUNDAMENTOS: A dermatite atópica é uma doença cuja prevalência vem aumentando nos últimos anos apesar do conhecimento crescente sobre a mesma. OBJETIVO: Avaliar a qualidade de vida das crianças e adolescentes com dermatite atópica e de suas famílias. MÉTODO: Estudo transversal descritivo com coleta prospectiva de dados de 50 crianças e adolescentes de 5 a 16 anos, com diagnóstico de DA e 50 pais ou responsáveis dos mesmos através da utilização de dois questionários de qualidade de vida, o Qualidade de Vida na Dermatologia Infantil e o Impacto da Dermatite Atópica na Família. As variáveis sócio-demográficas e clínicas foram avaliadas por uma ficha clínica elaborada especificamente para a pesquisa, os aspectos socioeconômicos, pelo questionário padronizado da Associação Brasileira de Empresas de Pesquisa, que avalia bens adquiridos e o grau de instrução do chefe da família. RESULTADOS: Havia 35/50 (70%) pacientes do sexo feminino; 28(56%) da classe social C. Através do questionário Qualidade de Vida na Dermatologia Infantil observou-se que: 19 (38%) pacientes ficaram na faixa de 7 a 12 pontos (impacto moderado da dermatite atópica) e 17 (34%), na faixa de 13 a 30 pontos (impacto elevado da dermatite atópica). Pelo questionário Impacto da Dermatite Atópica na Família observou-se: 15 (30%) famílias apresentaram escores entre 7 e 12 pontos e 22 (44%) entre 13 e 30 pontos. CONCLUSÃO: Os resultados mostram que a repercussão da doença na vida dos pacientes com dermatite atópica e de suas famílias é alta, o que nos faz sugerir que seria importante inserir o estudo da qualidade de vida na avaliação clínica dos mesmos.

Potencial de sensibilizaçäo cutânea de duas formulaçöes de um creme básico em pacientes com dermatoses alérgicas / Skin sensitization potential of two formulas of a basic cream in patients with allergic dermatoses

Objetivos. Avaliar se a formulação de um crème básico cosmético (Crème Universal© acrescida de uma essência A ou B aumentaria o potencial de sensibilização em uma população suscetível. Métodos: Estudo multicêntrico, comparativo, simples-cego, randomizado, conduzido em 179 pacientes adultos portadores de pele xerótica e dermatite de contato e/ou atópica, distribuídos em 2 grupos parcelados A e B que utilizaram crème com essência A ou B respectivamente. Após 14 dias de uso contínuo de crème todos os pacientes foram submetidos a teste de contato com uma bateria padrão e mais os componentes do crème. Resultados: O teste de contato foi positivo para algum dos componentes do crème em apenas três (1,7 por cento) casos do total de pacientes e o índice geral de reação adversa foi de 8 por cento no Grupo A e 7,6 por cento no Grupo B. Não houve diferença estatisticamente significantes entre os dois grupos. Conlusão: A utilização do Crème Universal© associado a uma essência A ou B resultou num índice de sensibilização extremamente baixo numa população especialmente susceptível. Não houve diferença de reações com o acréscimo de essência A ou B.