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Marín D, Basagaña X, Amaya F, Aristizábal LM, Muñoz DA, Domínguez A, Molina F, Ramos CD, Morales-Betancourt R, Hincapié R, Rodríguez-Villamizar L, Rojas Y, Morales O, Cuellar M, Corredor A, Villamil-Osorio M, Bejarano MA, Vidal D, Narváez DM, Groot H, Builes JJ, López L, Henao EA, Lopera V, Hernández LJ, Bangdiwala SI, Marín-Ochoa B, Oviedo AI, Sánchez-García OE, Toro MV, Riaño W, Rueda ZV. Early-life external exposome in children 2-5 years old in Colombia. Environ Res 2024; 252:118913. [PMID: 38643821 DOI: 10.1016/j.envres.2024.118913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 04/07/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024]
Abstract
Exposome studies are advancing in high-income countries to understand how multiple environmental exposures impact health. However, there is a significant research gap in low- and middle-income and tropical countries. We aimed to describe the spatiotemporal variation of the external exposome, its correlation structure between and within exposure groups, and its dimensionality. A one-year follow-up cohort study of 506 children under 5 in two cities in Colombia was conducted to evaluate asthma, acute respiratory infections, and DNA damage. We examined 48 environmental exposures during pregnancy and 168 during childhood in eight exposure groups, including atmospheric pollutants, natural spaces, meteorology, built environment, traffic, indoor exposure, and socioeconomic capital. The exposome was estimated using geographic information systems, remote sensing, spatiotemporal modeling, and questionnaires. The median age of children at study entry was 3.7 years (interquartile range: 2.9-4.3). Air pollution and natural spaces exposure decreased from pregnancy to childhood, while socioeconomic capital increased. The highest median correlations within exposure groups were observed in meteorology (r = 0.85), traffic (r = 0.83), and atmospheric pollutants (r = 0.64). Important correlations between variables from different exposure groups were found, such as atmospheric pollutants and meteorology (r = 0.76), natural spaces (r = -0.34), and the built environment (r = 0.53). Twenty principal components explained 70%, and 57 explained 95% of the total variance in the childhood exposome. Our findings show that there is an important spatiotemporal variation in the exposome of children under 5. This is the first characterization of the external exposome in urban areas of Latin America and highlights its complexity, but also the need to better characterize and understand the exposome in order to optimize its analysis and applications in local interventions aimed at improving the health conditions and well-being of the child population and contributing to environmental health decision-making.
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Affiliation(s)
- Diana Marín
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia.
| | - Xavier Basagaña
- ISGlobal, Barcelona, 08003, España, Spain; Universitat Pompeu Fabra (UPF), Barcelona, 08003, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain
| | - Ferney Amaya
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - Diego Alejandro Muñoz
- Department of Mathematics, National University of Colombia, Medellín, 050034, Colombia
| | - Alan Domínguez
- ISGlobal, Barcelona, 08003, España, Spain; Universitat Pompeu Fabra (UPF), Barcelona, 08003, Spain; CIBER Epidemiology and Public Health (CIBERESP), Spain
| | - Francisco Molina
- Environmental School, School of Engineering, Universidad de Antioquia UdeA, Medellin, 050010, Colombia
| | - Carlos Daniel Ramos
- Environmental School, School of Engineering, Universidad de Antioquia UdeA, Medellin, 050010, Colombia
| | | | - Roberto Hincapié
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Laura Rodríguez-Villamizar
- Department of Public Health, School of Medicine, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Yurley Rojas
- School of Engineering, Universidad Industrial de Santander, Bucaramanga, 680002, Colombia
| | - Olga Morales
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia; Department of Pediatrics, Hospital San Vicente Fundación, Medellín, 050010, Colombia
| | - Martha Cuellar
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia; Department of Pediatrics, SOMER Clinic, Medellín, Colombia
| | - Andrea Corredor
- Department of Pediatrics, ONIROS Centro Especializado en Medicina Integral del Sueño, Bogotá, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatrics, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
| | | | - Dolly Vidal
- Department of Pediatrics, Hospital Universitario San José, Popayán, 190003, Colombia
| | - Diana M Narváez
- Human Genetics Laboratory, Universidad de los Andes, Bogotá, 111711, Colombia
| | - Helena Groot
- Human Genetics Laboratory, Universidad de los Andes, Bogotá, 111711, Colombia
| | - Juan José Builes
- Department of Paternity Testing. GENES Laboratory, Medellín, 050024, Colombia
| | - Lucelly López
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - Verónica Lopera
- Secretariat of Health, Medellin Mayor's Office, Medellin, 050015, Colombia
| | | | - Shrikant I Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, L8S 4K1, Canada; Statistics Department, Population Health Research Institute, McMaster University, Hamilton, ON, L8L 2X2, Canada
| | - Beatriz Marín-Ochoa
- School of Social Sciences, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Ana Isabel Oviedo
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | | | - María Victoria Toro
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia
| | - Will Riaño
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia; School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic Medellin, 050010, Colombia
| | - Zulma Vanessa Rueda
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, 050034, Colombia; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, R3E 0J9, Canada
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Gutierrez-Marin PA, Castano-Jaramillo LM, Velez-Tirado N, Villamil-Osorio M, Patiño E, Reina MF, Hernandez MT. STK4 deficiency and epidermodysplasia verruciformis-like lesions: A case report. Pediatr Dermatol 2024; 41:96-99. [PMID: 37515487 DOI: 10.1111/pde.15400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/02/2023] [Indexed: 07/31/2023]
Abstract
Serine/threonine kinase 4 deficiency (STK4 or MST1, OMIM:614868) is an autosomal recessive (AR) combined immunodeficiency that can present with skin lesions such as epidermodysplasia verruciformis-like lesions (EVLL). Herein, we describe a 17-year-old male patient born from consanguineous parents presenting with recurrent respiratory infections, verruciform plaques, poikiloderma, chronic benign lymphoproliferation, and Sjögren syndrome with suspected interstitial lymphocytic pneumonia.
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Affiliation(s)
| | - Lina M Castano-Jaramillo
- Department of Pediatric Clinical Immunology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Natalia Velez-Tirado
- Department of Pediatric Clinical Immunology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatric Pulmonology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Esteban Patiño
- Department of Pathology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Maria Fernanda Reina
- Department of Pediatric Rheumatology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
| | - Maribel Trujillo Hernandez
- Department of Pediatric Dermatology, HOMI Fundacion Hospital Pediatrico la Misericordia, Bogota, Colombia
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Villamil-Osorio M, Moyano-Ariza LF, Camacho-Moreno G, Restrepo-Gualteros SM, Sossa-Briceño MP, Rodriguez-Martinez CE. Multilevel analysis identifying the factors associated with RSV detection in infants admitted for viral bronchiolitis in the era of the COVID-19 pandemic. Pediatr Pulmonol 2023; 58:2795-2803. [PMID: 37449772 DOI: 10.1002/ppul.26590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/29/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVES To identify factors independently associated with respiratory syncytial virus (RSV) detection in infants admitted for viral bronchiolitis during 3 consecutive years, before and during the COVID-19 pandemic, in Bogota, Colombia, a middle-income country with a subtropical highland climate. METHODS An analytical cross-sectional study was conducted before and during the COVID-19 pandemic, including patients with a diagnosis of viral bronchiolitis admitted to all the hospitals of the city between January 2019 and November 2021. We evaluated a set of a priori-selected predictor variables that included individual, healthcare system, meteorological, air pollutant, and COVID-19 variables. Since the variables analyzed are hierarchical in nature, multilevel modeling was used to identify factors independently associated with detection of RSV as the causative agent of viral bronchiolitis. RESULTS A total of 13,177 patients were included in the study. After controlling for potential confounders, it was found that age (odds ratio [OR] 0.86; 95% confidence interval [CI] 0.76-0.97), a third level of medical care institution (OR 3.05; 95% CI 1.61-5.76), temperature (OR 1.60; 95% CI 1.24-2.07), rainfall (OR 1.003, 95% CI 1.001, 1.005), NO2 (OR 0.97; 95% CI 0.95-0.99), CO (OR 0.99; 95% CI 0.99-0.99), and COVID-19 pandemic period (OR 0.84, 95% CI 0.71-0.99) were independently associated with RSV detection in our sample of patients. CONCLUSIONS The identified factors associated with RSV detection provide additional scientific evidence that may be useful in the development of specific interventions aimed at ameliorating or preventing the impact of RSV in Bogota and probably other similar low- to middle-income countries in high-risk infants.
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Affiliation(s)
- Milena Villamil-Osorio
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia
- Department of Pediatric Pulmonology, HOMI, Fundación Hospital Pediátrico la Misericordia, Bogota, Colombia
| | - Luisa F Moyano-Ariza
- Ministry of Health and Social Protection, Investigation Group Epidemiology and Evaluation in Public Health, Universidad Nacional de Colombia, Bogota, Colombia
| | - Germán Camacho-Moreno
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Pediatric Infectious Diseases, HOMI, Fundación hospital pediátrico la Misericordia, Bogota, Colombia
- Department of Infectious Diseases, Fundación Hospital Infantil Universitario de San José, Bogota, Colombia
| | - Sonia M Restrepo-Gualteros
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia
- Department of Pediatric Pulmonology, HOMI, Fundación Hospital Pediátrico la Misericordia, Bogota, Colombia
| | - Monica P Sossa-Briceño
- Department of Internal Medicine, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
| | - Carlos E Rodriguez-Martinez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia
- Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia
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Marín D, Orozco LY, Narváez DM, Ortiz-Trujillo IC, Molina FJ, Ramos CD, Rodriguez-Villamizar L, Bangdiwala SI, Morales O, Cuellar M, Hernández LJ, Henao EA, Lopera V, Corredor A, Toro MV, Groot H, Villamil-Osorio M, Muñoz DA, Hincapié RC, Amaya F, Oviedo AI, López L, Morales-Betancourt R, Marín-Ochoa BE, Sánchez-García OE, Marín JS, Abad JM, Toro JC, Pinzón E, Builes JJ, Rueda ZV. Characterization of the external exposome and its contribution to the clinical respiratory and early biological effects in children: The PROMESA cohort study protocol. PLoS One 2023; 18:e0278836. [PMID: 36662732 PMCID: PMC9858469 DOI: 10.1371/journal.pone.0278836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 11/01/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Air pollution contains a mixture of different pollutants from multiple sources. However, the interaction of these pollutants with other environmental exposures, as well as their harmful effects on children under five in tropical countries, is not well known. OBJECTIVE This study aims to characterize the external exposome (ambient and indoor exposures) and its contribution to clinical respiratory and early biological effects in children. MATERIALS AND METHODS A cohort study will be conducted on children under five (n = 500) with a one-year follow-up. Enrolled children will be followed monthly (phone call) and at months 6 and 12 (in person) post-enrolment with upper and lower Acute Respiratory Infections (ARI) examinations, asthma development, asthma control, and genotoxic damage. The asthma diagnosis will be pediatric pulmonologist-based and a standardized protocol will be used. Exposure, effect, and susceptibility biomarkers will be measured on buccal cells samples. For environmental exposures PM2.5 will be sampled, and questionnaires, geographic information, dispersion models and Land Use Regression models for PM2.5 and NO2 will be used. Different statistical methods that include Bayesian and machine learning techniques will be used for the ambient and indoor exposures-and outcomes. This study was approved by the ethics committee at Universidad Pontificia Bolivariana. EXPECTED STUDY OUTCOMES/FINDINGS To estimate i) The toxic effect of particulate matter transcending the approach based on pollutant concentration levels; ii) The risk of developing an upper and lower ARI, based on different exposure windows; iii) A baseline of early biological damage in children under five, and describe its progression after a one-year follow-up; and iv) How physical and chemical PM2.5 characteristics influence toxicity and children's health.
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Affiliation(s)
- Diana Marín
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Luz Yaneth Orozco
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia
- School of Engineering, Universidad de Antioquia, Medellín, Colombia
| | | | | | | | | | - Laura Rodriguez-Villamizar
- Department of Public Health, School of Health, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Shrikant I. Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
- Statistics Department, Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Olga Morales
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic, Medellín, Colombia
- Department of Pediatrics, Hospital San Vicente Fundación, Medellín, Colombia
| | - Martha Cuellar
- School of Medicine, Pediaciencias Group, Universidad de Antioquia, Noel Clinic, Medellín, Colombia
- Department of Pediatrics, SOMER Clinic, Medellín, Colombia
| | | | | | - Verónica Lopera
- Secretaría de Salud, Alcaldía de Medellín, Medellín, Colombia
| | - Andrea Corredor
- Department of Pediatrics, ONIROS Centro Especializado en Medicina Integral del Sueño, Bogotá, Colombia
| | - María Victoria Toro
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Helena Groot
- Human Genetics Laboratory, Universidad de los Andes, Bogotá, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatrics, Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
| | | | | | - Ferney Amaya
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Ana Isabel Oviedo
- School of Engineering, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Lucelly López
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | - Beatriz Elena Marín-Ochoa
- School of Social Communications and Journalism, Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | | | | | | | - Eliana Pinzón
- Secretaria distrital de Salud, Alcaldia de Bogota, Bogota, Colombia
| | | | - Zulma Vanessa Rueda
- School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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Villamil-Osorio M, Yunis LK, Quintero L, Restrepo-Gualteros S, Yunis JJ, Jaramillo L, Agudelo BI, Ladino Y. [Brain-lung-thyroid syndrome in a newborn with deletion 14q12-q21.1]. Andes Pediatr 2021; 92:930-936. [PMID: 35506806 DOI: 10.32641/andespediatr.v92i6.3287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 06/07/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION In newborns with respiratory failure and interstitial lung disease, it should be approached as chILD (Childhood Interstitial Lung Disease) syndrome to rule out alterations in surfactant metabolism and brain-lung-thyroid syndrome caused by pathogenic variants in the NKX2-1 gene. OBJECTIVE To pre sent a newborn with chILD syndrome and a large deletion in chromosome 14q12-q21.1. CLINICAL CASE Newborn patient with respiratory distress since birth, chILD syndrome, and hypothyroidism, in which brain-lung-thyroid syndrome was suspected. He also presented seizures, minor and ma jor abnormalities on physical examination. Microarray analysis revealed a 14.7 Mb deletion in the chromosome 14q12-q21.1, which includes the NKX2-1 gene. CONCLUSION The brain-lung-thyroid syndrome should be considered in newborns with respiratory distress syndrome and diffuse lung disease (chILD syndrome), especially if they present hypotonia, choreoathetosis, or hypothyroidism. Diagnosis confirmation requires genetic analysis, even more, when there are other abnormalities not explained by the suspected syndrome.
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Affiliation(s)
| | | | - Ligia Quintero
- HOMI Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
| | | | | | - Lina Jaramillo
- HOMI Fundación Hospital Pediátrico la Misericordia, Bogotá, Colombia
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Restrepo-Gualteros S, Villamil-Osorio M, Rodríguez-Martínez CE. To the Editor. Sleep Med 2021; 86:124. [PMID: 34103265 DOI: 10.1016/j.sleep.2021.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 05/14/2021] [Accepted: 05/15/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Sonia Restrepo-Gualteros
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Department of Pediatric Pulmonology, Fundacion Hospital de La Misericordia, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Department of Pediatric Pulmonology, Fundacion Hospital de La Misericordia, Colombia
| | - Carlos E Rodríguez-Martínez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia.
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Peña-Cruz J, Correa-Jiménez Ó, Aponte-Barrios N, Molina-Ramírez I, Olaya-Morales N, Restrepo-Gualteros S, Villamil-Osorio M. Pulmonary nodule in pediatrics: Beyond the infection. ACTA ACUST UNITED AC 2021; 92:110-116. [PMID: 34106191 DOI: 10.32641/andespediatr.v92i1.2478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 08/23/2020] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The study of a pulmonary nodule in pediatrics is a diagnostic challenge where multiple pathologies must be taken into account, especially infections. In developing countries, where tuberculosis infec tion is endemic, it is one of the most likely diagnoses; however, the diagnostic possibility of malig nancy should never be overlooked. OBJECTIVE To describe a case report of a patient with a pulmonary nodule, that after ruling out the most frequent causes, a primary malignant tumor was diagnosed. CLINICAL CASE 17-year-old female patient with a one-month history of cough, dyspnea, and hemop tysis, without other symptoms. Since she did not respond to conventional antibiotic management, a chest CT scan with contrast was performed which showed a pulmonary nodule with irregular con tours, and with the bronchoalveolar lavage pulmonary infections were ruled out (pulmonary tuber culosis, fungal infection, and others bacteria). Biopsy of the lesion was performed to complete the study which histopathology was compatible with a mucoepidermoid carcinoma (MEC). The patient underwent right low lobectomy and lymph node resection with good clinical response during three years of follow-up. CONCLUSION Pulmonary nodule in pediatrics is a finding usually associated with infection, nevertheless, neoplastic conditions have to be considered, not only metastasis but also pri mary pulmonary malignant lesions due to prognosis implications.
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Affiliation(s)
- Juan Peña-Cruz
- Facultad de Medicina, Universidad Nacional de Colombia, Bogotá D.C., Colombia
| | - Óscar Correa-Jiménez
- División de Inmunología, Fundación Hospital Pediátrico la Misericordia, Bogotá D.C., Colombia
| | - Nelson Aponte-Barrios
- División de Hematología y Oncología Pediátrica, Fundación Hospital Pediátrico la Misericordia, Bogotá D.C., Colombia
| | - Iván Molina-Ramírez
- Facultad de Medicina, Universidad Nacional de Colombia, Bogotá D.C., Colombia
| | | | | | - Milena Villamil-Osorio
- División de Neumología Pediátrica, Fundación Hospital Pediátrico la Misericordia, Bogotá D.C., Colombia
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Restrepo-Gualteros SM, Villamil-Osorio M, Rodriguez-Martinez CE. Prediction of normal values for central apnea-hypopnea index at different ages and altitudes above sea level in healthy children. Sleep Med 2020; 78:182-188. [PMID: 33454450 DOI: 10.1016/j.sleep.2020.12.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/25/2020] [Accepted: 12/28/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is a critical need for studies aimed to help clinicians to establish the normal/expected central apnea-hypopnea index (CAHI) at altitudes above sea level and ages other than those reported in the current available studies. The aim of the present study was to develop predictive models useful for determining the normal/expected CAHI in children of different ages born and living at various altitudes above sea level. METHODS A systematic review of the literature was performed in order to identify all available studies that reported on CAHI values measured in healthy children of different ages and living at various levels above sea level. In order to identify factors independently associated with CAHI values, they were fit to multiple linear and quantile regression models. RESULTS A total of 16 studies that reported on CAHI values measured in healthy children living at various levels above sea level were included in the analyses. Out of the 16 studies, 12 (75%) were conducted in low-altitude cities, 1 (6.2%) was conducted in a medium-altitude city, 2 (12.5%) in high-altitude cities, and 1 (6.2%) in both low- and high-altitude cities. Age and altitude above sea level are independent predictors of CAHI values in the linear regression analysis and in the quantile regression at the ninetieth percentile. CONCLUSIONS The best-fitting prediction equations were obtained with linear regression and quantile regression at the ninetieth percentile analyses, and either of the two models could be used to predict the normal/expected CAHI values in healthy children.
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Affiliation(s)
- Sonia M Restrepo-Gualteros
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Department of Pediatric Pulmonology, Fundacion Hospital de La Misericordia, Bogota, Colombia
| | - Milena Villamil-Osorio
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Department of Pediatric Pulmonology, Fundacion Hospital de La Misericordia, Bogota, Colombia
| | - Carlos E Rodriguez-Martinez
- Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia; Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogota, Colombia.
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Villamil-Osorio M, Bejarano-Melo MA, Correa-Jimenez O, Gutierrez MJ, Ramirez-Camacho O, Caceres-Montejo J, Rodríguez-Martínez C, Restrepo-Gualteros S. Bronchoalveolar Lavage Findings In Patients With Asthma, Wheezing Or Chronic Pneumopathy At A Pediatric Referral Center In Colombia. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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