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- ItemAcesso aberto (Open Access)Prevalence and clinical characteristics of wheezing in children in thefirst year of life, living in Cuiabá, Mato Grosso, Brazil(Sociedade de Pediatria de São Paulo, 2014-12-01) Moraes, Lillian Sanchez Lacerda; Takano, Olga Akiko; Mallol, Javier; Solé, Dirceu [UNIFESP]; Universidade Federal de Mato Grosso; Universidade de Santiago; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate the prevalence and the clinical characteristics of wheezing in infants aged 12 to 15 months in the city of Cuiabá, Mato Grosso State, Midwest Brazil. METHODS: Parents and/or guardians of infants were interviewed and completed a written standardized questionnaire of the Estudio Internacional de Sibilancia en Lactante (EISL) - phase 3 at primary healthcare clinics at the same day of children vaccination or at home, from August of 2009 to November of 2010. RESULTS: 1,060 parents and/or guardians completed the questionnaire, and 514 (48.5%) infants were male. Among the studied infants, 294 (27.7%) had at least one episode of wheezing during the first year of life, beggining at 5.8±3.0 months of age, with a predominance of male patients. The prevalence of occasional wheezing (<3 episodes of wheezing) was 15.0% and recurrent wheezing (≥3 episodes) was 12.7%. Among the infants with recurrent wheezing, the use of inhaled β2-agonist, oral corticosteroid, leukotriene receptor antagonist, as well as night symptoms, respiratory distress, and hospitalization due to severe episodes were significantly more frequent. Physician-diagnosed asthma was observed in 28 (9.5%) of the wheezing infants. Among the wheezing infants, 80 (27.7%) were diagnosed with pneumonia, of whom 33 (11.2%) required hospitalization; neverthless, no differences between occasional and recurrent wheezing infants were found. CONCLUSIONS: The prevalence of recurrent wheezing and physician-diagnosed asthma in infant were lower compared with those observed in other Brazilian studies. Recurrent wheezing had early onset and high morbity.
- ItemEmbargoPrevalência e fatores de risco associados à sibilância em lactentes no primeiro ano de vida em Belém - Pará - Brasil(Universidade Federal de São Paulo (UNIFESP), 2011-01-26) Prestes, Elaine Xavier [UNIFESP]; Solé, Dirceu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objetivo: determinar a prevalência e fatores de risco para sibilância, sibilância recorrente e asma em lactentes de Belém, Pará, Brasil. Métodos: estudo transversal que utilizou o questionário escrito do Estudio Internacional de Sibilancias en Lactentes (EISL) para pais de lactentes de 12 a 15 meses, nas Unidades Básicas de Saúde de Belém, por ocasião de vacinação, entre maio e agosto de 2006. Utilizou-se o Teste t de Student ou Mann-Whitney para variáveis contínuas e teste Qui-quadrado para as categóricas, estimação da razão de chances (RC), com intervalo de confiança de 95%, e ajuste de modelo de regressão logística para avaliar fatores de risco com nível de significância de 5%. Resultados: participaram do estudo 3.024 crianças. A prevalência de sibilância foi 46,1%, de sibilância recorrente 21,9% e asma 10,1%. Os fatores de risco para sibilância no primeiro ano de vida foram: ter infecções de vias aéreas; ser exposto ao fumo na gestação; ser do gênero masculino; ter história familiar de asma, rinite e dermatite atópica; ter tido o primeiro resfriado antes dos cinco meses de idade; ter dermatite atópica; morar em local com poluição atmosférica. Ter o esquema de vacinação atualizado e maior número de pessoas em casa foi identificado como fator de proteção. Os fatores de risco para sibilância recorrente foram: gênero masculino, infecção de vias aéreas, infecção de vias aéreas antes dos cinco meses de idade, ser da raça negra, exposição à poluição atmosférica, história familiar de asma e rinite, dermatite atópica pessoal. Ter o calendário vacinal atualizado e ter seis meses de idade ou mais na primeira infecção foram fatores de proteção. Os fatores de risco para asma foram: ter mais de três episódios de infecções de vias aéreas; ser exposto ao fumo na gestação; ter história familiar de asma; morar em local com poluição atmosférica. Conclusão: a prevalência de sibilância, sibilância recorrente e asma em lactentes de Belém são elevadas e os fatores de risco associados a elas apontam para fatores genéticos, exposição a infecções de vias aéreas, fumo e poluição do ar. A educação dos pais em relação à sibilância e a capacitação de pediatras poderão diminuir a morbidade da doença sibilante e os custos com serviços de saúde.
- ItemAcesso aberto (Open Access)Prevalência e fatores de risco para sibilância no primeiro ano de vida(Sociedade Brasileira de Pneumologia e Tisiologia, 2010-10-01) Lima, João Antonio Bonfadini; Fischer, Gilberto Bueno; Sarria, Edgar Enrique; Mattiello, Rita; Solé, Dirceu [UNIFESP]; Universidade Federal do Rio Grande do Sul; Universidade Federal de Ciências da Saúde de Porto Alegre; Indiana University; Universidade Federal do Rio Grande do Sul Faculdade de Medicina; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To determine the prevalence of and the risk factors for wheezing in infants under one year of age and residing in the city of Porto Alegre, Brazil. METHODS: This was a cross-sectional study and is part of a multicenter, multinational project. The parents or legal guardians of the infants were interviewed at primary health care clinics or during home visits. We used a standardized questionnaire, validated for use in Brazil. Potential risk factors were assessed by means of a Poisson regression model with robust variance estimation, using the Wald test to determine the significance of each variable in the model. RESULTS: The sample comprised 1,013 infants. The majority of those were male (53%), and the mean age was 13.5 ± 1.2 months. In 61% of the infants, there had been at least one episode of wheezing, which had recurred at least three times in one third of those infants. The mean age at the first episode of wheezing was 5.16 months (median, 5 months). Over 40% of the infants with wheezing visited emergency rooms due to wheezing, and 17% of those were hospitalized at least once in the first year of life because of this symptom. In the multivariate analysis, the risk factors for wheezing were as follows: male gender; history of pneumonia; maternal smoking during pregnancy; day care center attendance; low maternal level of education; early weaning; multiple episodes of cold; first viral infection prior to 3 months of age; existence of siblings; and history of asthma in the nuclear family. CONCLUSIONS: The prevalence of wheezing is high among infants in the city of Porto Alegre. We identified various risk factors for wheezing in infants.
- ItemAcesso aberto (Open Access)Prevalência e gravidade da sibilância no primeiro ano de vida(Sociedade Brasileira de Pneumologia e Tisiologia, 2010-08-01) Dela Bianca, Ana Caroline Cavalcanti [UNIFESP]; Wandalsen, Gustavo Falbo [UNIFESP]; Mallol, Javier; Solé, Dirceu [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Santiago do Chile Departamento de Medicina Respiratória InfantilOBJECTIVE: To determine the prevalence and severity of wheezing in infants, using the standardized protocol devised for the Estudio Internacional de Sibilancias en Lactantes (EISL, International Study of Wheezing in Infants), as well as to determine the relationship between such wheezing and physician-diagnosed asthma, in the first year of life. METHODS: Between March of 2005 and August of 2006, the EISL questionnaire was administered to the parents or legal guardians of infants undergoing routine procedures or immunization at public primary health care clinics in the southern part of the city of São Paulo, Brazil. RESULTS: Our sample comprised 1,014 infants (mean age = 5.0 ± 3.0 months), 467 (46.0%) of whom had at least one wheezing episode, 270 (26.6%) having three or more such episodes, in their first year of life. The use of inhaled β2 agonists, inhaled corticosteroids, or antileukotrienes, as well as the occurrence of nocturnal symptoms, difficulty breathing, pneumonia, emergency room visits, and hospitalization due to severe wheezing, was significantly more common among those with recurrent wheezing (p < 0.05). Physician-diagnosed asthma was reported for 35 (7.5%) of the 467 wheezing infants and was found to be associated with the use of inhaled corticosteroids, difficulty breathing during the attacks, and six or more wheezing episodes in the first year of life. However, less than 40% of those infants were treated with inhaled corticosteroids or antileukotrienes. CONCLUSIONS: In this study, the prevalence of wheezing episodes among infants in their first year of life was high and had an early onset. The proportion of infants diagnosed with and treated for asthma was low.
- ItemSomente MetadadadosPrevalência, gravidade, fatores de risco e seguimento da sibilância em lactentes da regiao Centro-Sul de São Paulo(Universidade Federal de São Paulo (UNIFESP), 2010) Dela Bianca, Ana Caroline Cavalcanti [UNIFESP]; Solé, Dirceu [UNIFESP]