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Abstract
Summary Although allergic diseases have become increasingly prevalent in the elderly, there are few data on this population. Through a retrospective analysis of the electronic medical records of patients aged 65 years and above followed in our Immunoallergology Unit, we aimed to characterize the immunoallergic diseases of the elderly. The most common disorders were respiratory diseases (n = 185; 50%), mucocutaneous diseases (n = 113; 31%), drug allergy (n = 31; 8%), food allergy (n = 9; 2%), and anaphylaxis (n = 9; 2%). Use of specific immunotherapy was residual (n = 2; 1%). There was an association between anaphylaxis and both, drug (p = 0.004) and food (p = 0.013) allergies. Non-allergic rhinitis and bronchial asthma were more frequent in females, and ACE inhibitors/ARB induced-angioedema in males. Recognizing the characteristics of immunoallergic diseases in the elderly and the specificities of this age group is paramount in providing these patients with the best possible care.
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Affiliation(s)
- G Martins-Dos-Santos
- Department of Immunoallergology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - M Araújo
- Department of Immunoallergology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - S Prates
- Department of Immunoallergology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
| | - P Leiria-Pinto
- Department of Immunoallergology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
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2
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Leiria-Pinto P, Marques J, Finelli E, Alves C, Alves M, Trincão D, Pinto N, Carreiro-Martins P, Papoila AL, Neuparth N. Cross-cultural validation of the Portuguese from Portugal version of the test for respiratory and asthma control in kids questionnaire. Eur Ann Allergy Clin Immunol 2020; 53:214-220. [PMID: 33182989 DOI: 10.23822/eurannaci.1764-1489.174] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Objective. The Test for Respiratory and Asthma Control in Kids (TRACK) is a tool to assess asthma control in preschool children. This study aims to validate the Portuguese from Portugal version of the TRACK questionnaire. Methods. A prospective cohort study was carried out to assess their psychometric characteristics. Caregivers of 141 children under age 5 with asthma symptoms were enrolled. Results. Internal reliability was close to 0.70 (Cronbach's α). The test-retest reliability was 0.87. TRACK scores were different between well, partially, and non-controlled asthma groups (p less than 0.001). Patients rated as having better control showed an increase in TRACK scores. Conclusions. The Portuguese version of the TRACK questionnaire is accurate and reliable for monitoring asthma control. Its use may help to overcome challenges with the management of this age group.
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Affiliation(s)
- P Leiria-Pinto
- Department of Immunoallergology, Hospital Dona Estefânia, University Hospital of Central Lisbon (CHULC), EPE, Lisbon, Portugal.,CHRC/CEDOC, Integrated Pathophysiological Mechanisms Research Group, Comprehensive Health Research Center/Chronic Diseases Research Center, Nova Medical School, Lisbon, Portugal
| | - J Marques
- Department of Immunoallergology, Hospital Dona Estefânia, University Hospital of Central Lisbon (CHULC), EPE, Lisbon, Portugal.,CHRC/CEDOC, Integrated Pathophysiological Mechanisms Research Group, Comprehensive Health Research Center/Chronic Diseases Research Center, Nova Medical School, Lisbon, Portugal
| | - E Finelli
- Department of Immunoallergology, Hospital Dona Estefânia, University Hospital of Central Lisbon (CHULC), EPE, Lisbon, Portugal
| | - C Alves
- Department of Immunoallergology, Hospital Dona Estefânia, University Hospital of Central Lisbon (CHULC), EPE, Lisbon, Portugal
| | - M Alves
- Research Centre (CHULC), EPE, Lisbon, Portugal.,Centre of Statistics and its Applications (CEAUL), Lisbon, Portugal
| | - D Trincão
- Department of Immunoallergology, Hospital Dona Estefânia, University Hospital of Central Lisbon (CHULC), EPE, Lisbon, Portugal
| | - N Pinto
- Department of Immunoallergology, Hospital Dona Estefânia, University Hospital of Central Lisbon (CHULC), EPE, Lisbon, Portugal
| | - P Carreiro-Martins
- Department of Immunoallergology, Hospital Dona Estefânia, University Hospital of Central Lisbon (CHULC), EPE, Lisbon, Portugal.,CHRC/CEDOC, Integrated Pathophysiological Mechanisms Research Group, Comprehensive Health Research Center/Chronic Diseases Research Center, Nova Medical School, Lisbon, Portugal
| | - A L Papoila
- Research Centre (CHULC), EPE, Lisbon, Portugal.,Centre of Statistics and its Applications (CEAUL), Lisbon, Portugal
| | - N Neuparth
- Department of Immunoallergology, Hospital Dona Estefânia, University Hospital of Central Lisbon (CHULC), EPE, Lisbon, Portugal.,CHRC/CEDOC, Integrated Pathophysiological Mechanisms Research Group, Comprehensive Health Research Center/Chronic Diseases Research Center, Nova Medical School, Lisbon, Portugal
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3
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Leiria-Pinto P, Carreiro-Martins P, Peralta I, Marques J, Finelli E, Alves C, Belo J, Alves M, Papoila AL, Neuparth N. Factors associated with asthma control in 121 preschool children. J Investig Allergol Clin Immunol 2020; 31:471-480. [PMID: 32694095 DOI: 10.18176/jiaci.0630] [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] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVE There are controversial data about risk factors for uncontrolled asthma in preschool children. Objective: This study aims to explore the association between clinical and functional parameters and the lack of asthma control in preschool children. METHODS Children 3-5 years-old with asthma and healthy controls were recruited. A questionnaire was used to identify the potential risk factors of uncontrolled asthma as defined by GINA (Global INitiative for Asthma) criteria. Lung function and bronchial reversibility were evaluated through impulse oscillometry (IOS) and spirometry. Adjusted odds ratios (OR) were estimated based on multivariable generalized additive regression models. The discriminative ability of the models was measured by the area under the receiver operating characteristic curve (AUC). RESULTS 121 children were included, 107 of which had asthma and 14 were healthy controls. Fifty-three patients (50%) had uncontrolled asthma. After adjustment, the variables associated with an increased risk of lack of control were: "More than 3 flare-ups in last 12 months", "moderate to severe rhinitis", "relative variation in post-bronchodilator FVC and FEV1". The AUC of the final models that included variation of FVC or FEV1 were 0.82 and 0.81, respectively. R5-20, R5-20% and AX z-score values of the healthy group were lower than those of children with asthma. CONCLUSION In preschool children, clinical and functional parameters are associated with uncontrolled asthma. More studies are needed to confirm usefulness of the IOS.
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Affiliation(s)
- P Leiria-Pinto
- Immunoallergology Department, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal.,NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - P Carreiro-Martins
- Immunoallergology Department, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal.,NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - I Peralta
- Immunoallergology Department, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal
| | - J Marques
- Immunoallergology Department, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal.,NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon, Portugal
| | - E Finelli
- Immunoallergology Department, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal
| | - C Alves
- Immunoallergology Department, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal
| | - J Belo
- Centro Hospitalar Universitário Cova da Beira
| | - M Alves
- Centro de Investigação, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal
| | - A L Papoila
- NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon, Portugal.,Centro de Investigação, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal
| | - N Neuparth
- Immunoallergology Department, Hospital Dona Estefânia - CHULC, EPE, Lisbon, Portugal.,NOVA Medical School/Comprehensive Health Research Center (CHRC), Lisbon, Portugal
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4
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Affiliation(s)
- C Alves
- Dona Estefânia Hospital, Immunoallergology department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - I Afonso
- Dona Estefânia Hospital, Pediatric Gastroenterology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - P Leiria-Pinto
- Dona Estefânia Hospital, Immunoallergology department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.,CEDOC, Respiratory Research Group, Nova Medical School, Lisbon, Portugal
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5
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Finelli E, Custódio P, Porovska O, Prates S, Leiria-Pinto P. Patch testing in a case of eslicarbazepine and carbamazepine induced cutaneous reaction. Eur Ann Allergy Clin Immunol 2017; 50:229-231. [PMID: 29384108 DOI: 10.23822/eurannaci.1764-1489.37] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Anticonvulsants are among the drugs most commonly involved in cutaneous adverse drug reactions (CADRs). Eslicarbazepine is a new anti-epileptic drug, chemically related to carbamazepine but with a more favorable safety profile. We report the clinical case of a woman who developed a skin rash on day 10 of eslicarbazepine with further exacerbation with eosinophilia on day 2 of carbamazepine. Epicutaneous tests were positive with eslicarbazepine.
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Affiliation(s)
- E Finelli
- Immunoallergology Department, Dona Estefânia Hospital, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - P Custódio
- Immunoallergology Department, Dona Estefânia Hospital, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - O Porovska
- Occupational Health Department, São José Hospital, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - S Prates
- Immunoallergology Department, Dona Estefânia Hospital, Centro Hospitalar Lisboa Central, Lisbon, Portugal
| | - P Leiria-Pinto
- Immunoallergology Department, Dona Estefânia Hospital, Centro Hospitalar Lisboa Central, Lisbon, Portugal
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6
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Gaspar-Marques J, Finelli E, Martins PC, Prates S, Leiria-Pinto P. Piperacillin-tazobactam anaphylaxis: a rare cause of occupational disease. Eur Ann Allergy Clin Immunol 2017; 50:89-91. [PMID: 29383926 DOI: 10.23822/eurannaci.1764-1489.29] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Piperacillin is a beta-lactam antibiotic of penicillin family. Some penicillins were report-ed as occupational diseases cause, but piperacillin anaphylaxis with occupational sensi-tization is rare. We describe the case of a female nurse with recurrent anaphylaxis in last few months without apparent cause, only in work environment. Latex allergy was excluded after negative latex glove provocation. Later during diagnostic workup, the patient reported a similar reaction minutes after piperacillin preparation. She denied any previous antibiotic therapeutic exposure. Skin prick tests (SPT) to beta-lactams were positive to piperacillin, penicillin G and major and minor determinants. SPT to cefuroxime was negative but intradermic test was positive. The patient has indication for beta-lactams eviction and for adrenaline auto-injector kit. No further reactions occurred after patient's transfer to another department with minimum possible exposure. Allergic risk prevention is essential and must be rapidly implemented to avoid incapacitating occupational diseases development.
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Affiliation(s)
- J Gaspar-Marques
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisbon, Portugal
| | - E Finelli
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - P C Martins
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisbon, Portugal
| | - S Prates
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
| | - P Leiria-Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, Lisbon, Portugal; CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Lisbon, Portugal
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7
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Alves C, Romeira A, Abreu C, Carreiro-Martins P, Gomes E, Leiria-Pinto P. Non-steroidal anti-inflammatory drug hypersensitivity in children. Allergol Immunopathol (Madr) 2017; 45:40-47. [PMID: 27475775 DOI: 10.1016/j.aller.2016.04.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/12/2016] [Accepted: 04/01/2016] [Indexed: 12/29/2022]
Abstract
INTRODUCTION There are rather few publications about hypersensitivity reactions to non-steroidal anti-inflammatory drugs (NSAID) in the paediatric age. In this study, we aimed to assess the frequency of confirmed NSAID hypersensitivity in children with a previous reported reaction to NSAID in order to investigate the role of the drug provocation test (DPT) in the diagnostic workup and to explore the factors associated with confirmed NSAID hypersensitivity. METHODS We conducted a retrospective analysis of the clinical files from every patient under 18 years old who attended two Portuguese paediatric allergy outpatient clinics, from January 2009 to August 2014, due to a suspected NSAID hypersensitivity. RESULTS We included 119 patients, with a median age of nine years (P25-P75: 5-14). Ibuprofen was the commonest implicated NSAID in the patients' reports (n=94-79%). After DPT, NSAID hypersensitivity was confirmed in nine (7.6%) patients, excluded in 93 (78.2%) and was inconclusive in 17 (14.3%). In the majority (n=95-79.8%), the reaction occurred in the first 24h after intake. Eighty-four patients (70.6%) reported only cutaneous manifestations and 18 (15.1%) had systemic symptoms. Anaphylaxis represented a relative risk to NSAID hypersensitivity confirmation. No association was found for atopy and the number of previous reactions. CONCLUSION In our study, NSAID hypersensitivity was confirmed in a small proportion of the patients with a previous reported reaction. Ibuprofen was the most implicated drug with urticaria/angio-oedema as the commonest manifestation. Anaphylaxis was associated with confirmed drug hypersensitivity. The drug provocation test was essential to establish the diagnosis.
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Gaspar Marques J, Carreiro Martins P, Belo J, Alves C, Paiva M, Caeiro E, Leiria-Pinto P. Pollen Counts Influence Web Searches for Asthma and Rhinitis. J Investig Allergol Clin Immunol 2016; 26:192-4. [PMID: 27326989 DOI: 10.18176/jiaci.0047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J Gaspar Marques
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal.,CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
| | - P Carreiro Martins
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal.,CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal.,Epidemiology and Statistics Analysis Unit, Research Centre, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045, Lisbon, Portugal.,Portuguese Society of Allergy and Clinical Immunology, Portugal
| | - J Belo
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - C Alves
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - M Paiva
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - E Caeiro
- Portuguese Society of Allergy and Clinical Immunology, Portugal.,Instituto de Ciências Agrárias e Ambientais Mediterrânicas, Universidade de Évora, Évora, Portugal
| | - P Leiria-Pinto
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal.,CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
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9
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Antunes J, Prates S, Leiria-Pinto P. Fixed drug eruption due to etoricoxibe - a case report. Allergol Immunopathol (Madr) 2014; 42:623-4. [PMID: 23972405 DOI: 10.1016/j.aller.2013.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 06/05/2013] [Accepted: 06/19/2013] [Indexed: 11/26/2022]
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Araújo-Martins J, Carreiro Martins P, Viegas J, Aelenei D, Cano M, Teixeira J, Paixão P, Papoila A, Leiria-Pinto P, Pedro C, Rosado-Pinto J, Annesi-Maesano I, Neuparth N. Environment and Health in Children Day Care Centres (ENVIRH) - Study rationale and protocol. Rev Port Pneumol (2006) 2014; 20:311-323. [PMID: 32288977 PMCID: PMC7110969 DOI: 10.1016/j.rppnen.2014.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 02/01/2014] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Indoor air quality (IAQ) is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC) is not completely clear. The aim of this project was to study these effects. METHODS – STUDY DESIGN This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children). In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children) was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children). In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. RESULTS In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children).Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. DISCUSSION This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC.
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Affiliation(s)
- J. Araújo-Martins
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - P. Carreiro Martins
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - J. Viegas
- Laboratório Nacional de Engenharia Civil, Avenida do Brasil, 101, 1700-066 Lisbon, Portugal
| | - D. Aelenei
- Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus da Caparica, 2829-516 Caparica, Portugal
| | - M.M. Cano
- Instituto Nacional de Saúde Dr. Ricardo Jorge – Lisboa, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - J.P. Teixeira
- Instituto Nacional de Saúde Dr. Ricardo Jorge – Porto, Rua Alexandre Herculano, 321, 4000-055 Oporto, Portugal
| | - P. Paixão
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - A.L. Papoila
- Departamento de Bioestatística e Informática, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Ceaul, Portugal
- Centro de Investigação, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - P. Leiria-Pinto
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - C. Pedro
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - J. Rosado-Pinto
- Hospital da Luz, Avenida Lusíada, 100, 1500-650 Lisbon, Portugal
| | - I. Annesi-Maesano
- INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe EPAR (Epidemiology of Allergic and Respiratory Diseases), F-75013 Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe EPAR, F-75013 Paris, France
| | - N. Neuparth
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
- Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
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11
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Araújo-Martins J, Carreiro Martins P, Viegas J, Aelenei D, Cano MM, Teixeira JP, Paixão P, Papoila AL, Leiria-Pinto P, Pedro C, Rosado-Pinto J, Annesi-Maesano I, Neuparth N. Environment and Health in Children Day Care Centres (ENVIRH) - Study rationale and protocol. Rev Port Pneumol 2014; 20:311-23. [PMID: 24746462 PMCID: PMC7126211 DOI: 10.1016/j.rppneu.2014.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/06/2014] [Accepted: 02/01/2014] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Indoor air quality (IAQ) is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC) is not completely clear. The aim of this project was to study these effects. METHODS - STUDY DESIGN This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children). In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children) was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children). In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. RESULTS In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children). Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. DISCUSSION This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC.
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Affiliation(s)
- J Araújo-Martins
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal.
| | - P Carreiro Martins
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - J Viegas
- Laboratório Nacional de Engenharia Civil, Avenida do Brasil, 101, 1700-066 Lisbon, Portugal
| | - D Aelenei
- Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Campus da Caparica, 2829-516 Caparica, Portugal
| | - M M Cano
- Instituto Nacional de Saúde Dr. Ricardo Jorge - Lisboa, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
| | - J P Teixeira
- Instituto Nacional de Saúde Dr. Ricardo Jorge - Porto, Rua Alexandre Herculano, 321, 4000-055 Oporto, Portugal
| | - P Paixão
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - A L Papoila
- Departamento de Bioestatística e Informática, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Ceaul, Portugal; Centro de Investigação, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - P Leiria-Pinto
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
| | - C Pedro
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal
| | - J Rosado-Pinto
- Hospital da Luz, Avenida Lusíada, 100, 1500-650 Lisbon, Portugal
| | - I Annesi-Maesano
- INSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR (Epidemiology of Allergic and Respiratory Diseases), F-75013 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, F-75013 Paris, France
| | - N Neuparth
- CEDOC, Faculdade de Ciências Médicas (FCM), Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal; Serviço de Imunoalergologia, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
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Martinho A, Mendes J, Simões O, Nunes R, Gomes J, Castro ED, Leiria-Pinto P, Ferreira M, Pereira C, Castel-Branco M, Pais L. Mutations analysis of C1 inhibitor coding sequence gene among Portuguese patients with hereditary angioedema. Mol Immunol 2013; 53:431-4. [DOI: 10.1016/j.molimm.2012.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 09/05/2012] [Indexed: 10/27/2022]
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13
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Pite H, Prates S, Borrego LM, Matos V, Loureiro V, Leiria-Pinto P. Resolution of IgE-mediated fish allergy. Allergol Immunopathol (Madr) 2012; 40:195-7. [PMID: 21640463 DOI: 10.1016/j.aller.2011.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Revised: 02/16/2011] [Accepted: 03/03/2011] [Indexed: 11/30/2022]
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14
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Antunes J, Fernandes A, Borrego LM, Leiria-Pinto P, Cavaco J. Cystic fibrosis, atopy, asthma and ABPA. Allergol Immunopathol (Madr) 2010; 38:278-84. [PMID: 20675033 DOI: 10.1016/j.aller.2010.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 06/10/2010] [Accepted: 06/16/2010] [Indexed: 11/19/2022]
Abstract
The role of atopy on cystic fibrosis (CF) progression remains unclear but evidence suggests that it may influence the appearance of co-morbid conditions such as CF asthma or allergic bronchopulmonary aspergillosis (ABPA). Recognising asthma in patients with CF is not always easy but the identification of atopic markers favours the diagnosis. Physicians should be aware of this fact in order to achieve a better control of respiratory symptoms in patients with CF. Bronchial mucosa inflammation and abnormal mucus predispose to mould colonisation. These patients are at higher risk of allergic sensitisation, especially when atopic susceptibility is present. In the particular case of A. fumigatus, allergic sensitisation precedes ABPA development, which occurs in up to 10% of CF patients. Progression of lung function deterioration is most strikingly pronounced in patients with ABPA. Therefore, sensitisation with A. fumigatus should be regularly tested in patients with CF, especially those at higher risk. Recombinant allergens constitute an important advance in differentiating Aspergillus sensitisation from ABPA itself.
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Affiliation(s)
- J Antunes
- Serviço de Imunoalergologia, Hospital Dona Estefânia, Lisboa, Portugal.
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15
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Rodrigues Carvalho S, Silva I, Leiria-Pinto P, Rosado-Pinto J. Rapid oral tolerance induction to isoniazid and pyrazinamide and controlled administration of ethambutol: clinical case. Allergol Immunopathol (Madr) 2009; 37:336-8. [PMID: 19875222 DOI: 10.1016/j.aller.2009.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 05/26/2009] [Indexed: 10/20/2022]
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16
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Borrego LM, Stocks J, Leiria-Pinto P, Peralta I, Romeira AM, Neuparth N, Rosado-Pinto JE, Hoo AF. Lung function and clinical risk factors for asthma in infants and young children with recurrent wheeze. Thorax 2008; 64:203-9. [PMID: 19008296 DOI: 10.1136/thx.2008.099903] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Although several risk factors for asthma have been identified in infants and young children with recurrent wheeze, the relevance of assessing lung function in this group remains unclear. Whether lung function is reduced during the first 2 years in recurrently wheezy children, with and without clinical risk factors for developing subsequent asthma (ie, parental asthma, personal history of allergic rhinitis, wheezing without colds and/or eosinophil level >4%) compared with healthy controls was assessed in this study. METHODS Forced expiratory flows and volumes in steroid naïve young children with >or=3 episodes of physician confirmed wheeze and healthy controls, aged 8-20 months, were measured using the tidal and raised volume rapid thoracoabdominal compression manoeuvres. RESULTS Technically acceptable results were obtained in 50 wheezy children and 30 controls using tidal rapid thoracoabdominal compression, and 44 wheezy children and 29 controls with the raised volume technique. After adjustment for sex, age, body length at test and maternal smoking, significant reductions in z scores for forced expiratory volume at 0.5 s (mean difference (95% CI) -1.0 (-1.5 to -0.5)), forced expired flow after 75% forced vital capacity (FVC) has been exhaled (FEF(25)) (-0.6 (-1.0 to -0.2)) and average forced expired flow over the mid 50% of FVC (FEF(25-75)) (-0.8 (-1.2 to -0.4)) were observed in those with recurrent wheeze compared with controls. Wheezy children with risk factors for asthma (n = 15) had significantly lower z scores for FVC (-0.7 (-1.4 to -0.04)) and FEF(25-75) (-0.6 (-1.2 to -0.1)) than those without such risk factors (n = 29). CONCLUSIONS Compared with healthy controls, airway function is reduced in young children with recurrent wheeze, particularly those at risk for subsequent asthma. These findings provide further evidence for associations between clinical risk factors and impaired respiratory function in early life.
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Affiliation(s)
- L M Borrego
- Serviço de Imunoalergologia, Centro Hospitalar Lisboa Central-Hospital de Dona Estefania, Lisboa, Portugal.
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Borrego LM, César M, Leiria-Pinto P, Rosado-Pinto JE. Prevalence of asthma in a Portuguese countryside town: repercussions on absenteeism and self-concept. Allergol Immunopathol (Madr) 2005; 33:93-9. [PMID: 15808116 DOI: 10.1157/13072920] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Childhood asthma represents an increasing health problem and is the leading cause of hospital admission and absenteeism in children with chronic disease. It also compromises quality of life, eventually contributing to disturbances in self-concept. Self-concept is a recent and global perspective of "the self" and relates to skills, self-image and self-esteem. Little information is available on this topic and there are no data from Portuguese countryside towns. OBJECTIVE The aim of this study was to determine the prevalence of asthma among all school children in the 5th and 6th grades in a Portuguese countryside town and to establish its possible correlation with absenteeism and self-concept. METHODS In April 2002, two questionnaires were administered in the presence of the researcher to a group of 950 children attending different schools. The children completed the internationally renowned questionnaires: ISAAC and the Self-Concept Scale by Susan Harter. RESULTS Our sample (n = 818) had a mean age of 11 years (10-15 years) and a male-to-female ratio of 1/1. The cumulative prevalence of asthma was 11.9 % and that of active asthma was 8.8 %; 63.9 % of asthmatics were male and 36.1 % were female. The mean age of asthmatics was 11.34 years and 74 % had active symptoms. Comparison of this group of 97 asthmatic children with the remaining children revealed a statistically significant correlation between the presence of asthma and school absenteeism (global: p = 0.04; gymnastics: 0.05). Regarding the Self-Concept Scale a statistically significant association was found between the presence of asthma and school achievement (p = 0.027), physical appearance (p = 0.015), behavior (p < 0.000) and self-esteem (p < 0.000). No statistically significant correlations were found in social acceptance (p = 0.289) or athletic competence (p = 0.085). Asthmatic boys had higher self-concept scores than girls, except in the domain of behavior. CONCLUSIONS Twelve percent of the population studied was asthmatic. In asthmatic children, absenteeism was higher and self-concept was lower for almost all domains, except social acceptance and athletic achievement, probably due to overprotection.
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Affiliation(s)
- L M Borrego
- Immunoallergy Department, Dona Estefânia Hospital, Rua Jacinta Marto, 1169-045 Lisbon, Portugal.
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