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Roncada C, Souza RGD, Costa DD, Pitrez PM. PEDIATRIC ASTHMA: IMPACT OF THE DISEASE IN CHILDREN RECEIVING OUTPATIENT TREATMENT IN SOUTHERN BRAZIL. ACTA ACUST UNITED AC 2020; 38:e2018398. [PMID: 32667472 PMCID: PMC7357598 DOI: 10.1590/1984-0462/2020/38/2018398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/10/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the impact of pediatric asthma on patients of a specialized outpatient clinic in Southern Brazil. METHODS The study included children aged 8 to 17 years old with asthma diagnosis (mild, moderate and severe) under treatment at the asthma clinic of Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brazil. Measurements of spirometry, quality of life, disease control and atopy tests were applied. RESULTS A total of 66 children were included in the study and divided into groups, according to the severity of the disease: mild, moderate or severe asthma. The results showed similarities in both the treatment and the impact of asthma between groups, except for adherence to treatment: the group with mild asthma showed least adherence to treatment, and the group with severe asthma, greater adherence (p=0.011). As to school absenteeism, the group with severe asthma showed higher frequency (p=0.012), with over 10 days per year (p=0.043). Spirometry showed lower volume/capacity for the group with moderate asthma, followed by the groups with severe and mild asthma. All groups had a high prevalence of allergic asthma, with mites as the main allergens. For quality of life (QOL), and health-related quality of life (HRQOL) levels, there were no differences between groups. In addition, the values were close to the acceptable levels for the total score and for each one of the six domains. The same occurred for the HRQOL-asthma module. CONCLUSIONS QOL and HRQOL present acceptable levels regardless of the severity of the disease.
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Affiliation(s)
- Cristian Roncada
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Paulo Márcio Pitrez
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Zacaron D, Roncada C, Molin RSD, Jones MH, Pitrez PC. Prevalence and impact of asthma in schoolchildren in the city of Caxias do Sul-RS. J Pediatr (Rio J) 2020; 96:479-486. [PMID: 30898494 PMCID: PMC9432107 DOI: 10.1016/j.jped.2019.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/21/2018] [Accepted: 01/28/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To analyze the prevalence and impact of asthma in schoolchildren from the city of Caxias do Sul, RS, Brazil. METHODS Cross-sectional observational and case-control study with children and adolescents between 7 and 15 years old, from public schools in Caxias do Sul, RS. The study is composed of two phases: Phase I analyzed the prevalence of asthma in the delimited population, investigating 1915 schoolchildren; Phase II quality of life questionnaires, asthma control and classification (for the asthmatic group), physical activity, school performance, pulmonary function tests and anthropometric measures were applied to 266 asthmatics and 288 controls. RESULTS The estimated prevalence of asthma was 16.1%. In the comparison between asthmatics and nonasthmatics premature birth (p<0.001) and diagnosis of another chronic disease at birth (p<0.001) were found. Regarding pulmonary function, significant differences were found in the values between groups in FEV1, FEV1/FVC and forced expiratory flow in the 25 and 75% (FEF25-75%), being that asthmatics presented lower values. Among asthmatics, 133 (50.8%) did not have the disease controlled. In the anthropometric variables, significant differences were observed, with higher values in controls, in the the waist-to-height ratio (p=0.009) and in the perception of health (p<0.001). Quality of life is lower in asthmatics in the physical well-being domain (p=0.001) and in the total score (p=0.016). The total school performance score did not present a statistically significant difference between the groups. CONCLUSION The prevalence of asthma is similar to that of other industrialized urban centers and may negatively affect some areas of the development of schoolchildren.
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Affiliation(s)
- Daniel Zacaron
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Saúde da Criança, Porto Alegre, RS, Brazil; Centro Universitário da Serra Gaúcha (FSG), Educação Física, Caxias do Sul, RS, Brazil.
| | - Cristian Roncada
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Saúde da Criança, Porto Alegre, RS, Brazil; Centro Universitário da Serra Gaúcha (FSG), Grupo de Pesquisa e Estudo em Saúde e Performance (GEPESP), Caxias do Sul, RS, Brazil
| | - Rossano Sartori Dal Molin
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Saúde da Criança, Porto Alegre, RS, Brazil
| | - Marcus Herbert Jones
- Universidade Federal do Rio Grande do Sul (UFRGS), Pneumologia Pediátrica, Porto Alegre, RS, Brazil; Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Medicina, Porto Alegre, RS, Brazil
| | - Paulo Condessa Pitrez
- Universidade Católica do Rio Grande do Sul (PUCRS), Escola de Medicina, Porto Alegre, RS, Brazil
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Zacaron D, Roncada C, Molin RSD, Jones MH, Pitrez PC. Prevalence and impact of asthma in schoolchildren in the city of Caxias do Sul‐RS. Jornal de Pediatria (Versão em Português) 2020. [DOI: 10.1016/j.jpedp.2019.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Pazini F, Pietta-Dias C, Roncada C. RELATIONSHIP BETWEEN SCHOOLCHILDREN'S LEVELS OF PHYSICAL ACTIVITY, ANTHROPOMETRIC INDICES AND PULMONARY FUNCTION. ACTA ACUST UNITED AC 2020; 39:e2019189. [PMID: 32578668 PMCID: PMC7309578 DOI: 10.1590/1984-0462/2021/39/2019189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/20/2019] [Indexed: 11/21/2022]
Abstract
Objective: To evaluate and to correlate levels of physical activity with the pulmonary
function of children with and without a diagnosis of asthma. Methods: This study was conducted in two phases with schoolchildren aged between
eight and 16 years old in Porto Alegre/RS. In the first phase (cross
sectional), the sample was classified as asthmatic if a physician had ever
diagnosed them with asthma and if they reported symptoms and treatment for
the disease in the past 12 months. In the second phase (control-case), the
following were measured: anthropometry, physical activity levels, time spent
in front of screens, and lung function (spirometry). Data are presented in
mean and standard deviation or median and interquartile interval and by
absolute and relative values. Chi-square, Student’s t-test or Mann-Whitney
test and Spearman correlation were applied, with p<0.05 being
significant. Results: 605 students participated in the study, 290 children with a clinical
diagnosis of asthma and 315 classified as a control. 280 (47.3%) were male
children, with an average age of 11.0±2.3 years old. The spirometric values
showed differences in the classifications of airway obstruction levels
between the asthma and control groups (p=0.005), as well as in the response
to bronchodilator use for FEV1/FVC (p=0.023). In the correlation assessment,
there was no correlation between physical activity with anthropometric
values, nor with pulmonary function, pre-and post-bronchodilator. Conclusions: The study demonstrates that there is no relationship between either
anthropometric values or physical activity levels with pulmonary function of
asthmatic children.
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Affiliation(s)
- Fernanda Pazini
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Cristian Roncada
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Fantinelli AA, Borges RF, Stein RT, Molin RSD, Roncada C. Development and validation of the specific instrument for assistance complexity of puerperal and newborns: Fantinelli Scale. Rev Bras Saude Mater Infant 2020. [DOI: 10.1590/1806-93042020000200006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to develop and validate a care complexity assessment system adapted for mothers and newborns, based on two pre-existing scales. Methods: this is a cross-sectional study of psychometric validation of instruments, applied in a roomming-in, in 2016. The instrument has 13 indicators, submitted to the evaluation of a panel of judges for validation. For the psychometric analysis of the instrument, five criteria were adopted: a) internal consistency through Cronbach's alpha (αC); (b) intraclass correlation coefficient (ICC); c) correlation between categorical items, mediating Kendall correlation; d) ceiling and floor effect; e) Kaiser-Meyer-Olkin test. Results: after evaluating the judges on the categories, the agreement was satisfactory, being equal to or greater than 80%. The mean total score of the 13 items was 22.5 ± 4.2, with an intermediate level score of 52.9%. For psychometric validation purposes, the instrument presented αC scores of 0.73 points, between minimum items of 0.70 and maximum of 0.74 points. In the correlation of αC by items and the total score, the instrument showed high relationships (r2: 0.84). In the ICC assessment of 0.73 points (CI95%= 0.71-0.75; p<0.001). Conclusion: the questionnaire presented psychometric indicators of acceptable content validity, with statistical evidence of reliability, obtained by satisfactory inter-rateragreement.
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Roncada C, Medeiros TM, Strassburger MJ, Strassburger SZ, Pitrez PM. Comparison between the health-related quality of life of children/adolescents with asthma and that of their caregivers: a systematic review and meta-analysis. ACTA ACUST UNITED AC 2020; 46:e20190095. [PMID: 32321034 PMCID: PMC7572293 DOI: 10.36416/1806-3756/e20190095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/18/2019] [Indexed: 12/03/2022]
Abstract
Objective: To evaluate the health-related quality of life (HRQoL) of children/adolescents with asthma and that of their caregivers, comparing the two. Methods: This was a systematic review and meta-analysis based on the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, with a strategy of searching five health-related databases (MEDLINE/PubMed, EMBASE, ScienceDirect, SciELO, and LILACS). We included studies that evaluated the HRQoL of children/adolescents with asthma and that of their caregivers with the Pediatric Asthma Quality of Life Questionnaire and the Pediatric Asthma Caregiver’s Quality of Life Questionnaire, respectively, using the total scores and the scores on the domains activity limitation, symptoms (children/adolescents only), and emotional function. Results: We identified 291 articles, and we evaluated 133 of those. A total of 33 articles, collectively including 4,101 subjects, were included in the meta-analysis. An analysis stratified by study design showed no differences between the HRQoL of the caregivers and that of the children/adolescents in the activity limitation domain and in the total score. However, the mean emotional function domain scores were significantly higher (better) among children/adolescents with asthma than among their caregivers in longitudinal studies-Δ = 0.82 (0.21-1.44)-and randomized clinical trials-Δ = 0.52 (0.29-0.79)-although not in cross-sectional studies-Δ = −0.20 (−0.03 to 0.43). Conclusions: The total HRQoL scores proved to be similar between children/adolescents with asthma and their caregivers. However, the two groups differed in their perception of their emotional function, the caregivers scoring significantly lower than the children/adolescents in that domain.
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Affiliation(s)
- Cristian Roncada
- . Centro Universitário da Serra Gaúcha - FSG - Porto Alegre (RS) Brasil
| | - Tássia Machado Medeiros
- . Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil.,. Serviço de Radiologia, Hospital Unimed Noroeste Ijuí, Ijuí (RS) Brasil
| | - Márcio Júnior Strassburger
- . Departamento de Ciências da Vida, Universidade Regional do Noroeste do Estado do Rio Grande do Sul - UNIJUI - Ijuí (RS) Brasil
| | - Simone Zeni Strassburger
- . Departamento de Ciências da Vida, Universidade Regional do Noroeste do Estado do Rio Grande do Sul - UNIJUI - Ijuí (RS) Brasil
| | - Paulo Márcio Pitrez
- . Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
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Santos APD, Strassburger MJ, Roncada C, Stein RT, Pitrez PM, Strassburger SZ. Effect of physical activity on asthma control in schoolchildren. Einstein (Sao Paulo) 2019; 18:eAO4936. [PMID: 31721896 PMCID: PMC6896598 DOI: 10.31744/einstein_journal/2020ao4936] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/25/2019] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To investigate the effect of levels of physical activity on asthma control in children. METHODS A cross-sectional study, including public school students aged 8 to 12 years, of both sexes, with asthma, from a capital and a medium-sized cities in Southern Brazil. At home, the students answered the questionnaire on levels of physical activity and disease control. RESULTS A total of 482 schoolchildren with asthma participated in the study, with mean age of 10.9±2.2 years, and 253 (52%) were girls. Regarding disease control, 50% had controlled asthma, and 67% were considered sedentary. Schoolchildren with controlled asthma were more active than those with uncontrolled asthma (p=0.032). Active schoolchildren were more likely to have asthma controlled (OR=1.5; 95%CI: 1.04-2.25). CONCLUSION The results demonstrated an association between physical activity levels and asthma control. More active schoolchildren were more likely to have asthma controlled.
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Affiliation(s)
- Ana Paula Dos Santos
- Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Ijuí, RS, Brazil
| | | | | | | | - Paulo Márcio Pitrez
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Pietta-Dias C, Bello MD, da Silva R, Vargas C, Machado GDB, Roncada C, Tiggemann CL, Schröder N. Differential impact of endurance, strength, or combined training on quality of life and plasma serotonin in healthy older women. Aging Clin Exp Res 2019; 31:1573-1581. [PMID: 30656562 DOI: 10.1007/s40520-019-01120-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/03/2019] [Indexed: 12/31/2022]
Abstract
Aging is associated with a progressive decline in physical and neurophysiological functions, and some studies suggest that cerebral serotonin is decreased in older adults. These factors contribute to reduced ability to perform daily activities, influencing quality of life (QoL). Regular physical activity has demonstrated important benefits in reversing ageing effects; however, little is known whether different training protocols might induce differential effects on QoL. The aim of this study was to verify the effects of different types of training on QoL and its relation with plasma serotonin in healthy older women. Forty-eight older women were randomly assigned in four groups: Strength Training (ST), Endurance Training (ET), Combined Training (CT), and Control Group (CG) which was instructed not to engage in any physical exercise during the study time. Participants underwent 12 weeks of training twice a week. Plasma serotonin and a scoring system questionnaire SF-36 for evaluation of QoL were assessed at baseline and after the completion of training protocols. When comparing pre- and post-training periods all trained groups showed improvement in QoL, but the CT improved more domains. Plasma serotonin was significantly lower in the ST and in the CT groups in comparison with controls after the 12-week training. Significant correlations of plasma serotonin with physical functioning, role-physical, general health, vitality, and mental health were observed. CT resulted in higher amelioration in QoL, in comparison with ET or ST only. All training protocols induced significant reductions in peripheral serotonin levels, which were negatively correlated with improvements in QoL.
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Affiliation(s)
- Caroline Pietta-Dias
- Exercise Research Laboratory, School of Physical Education, Physical Therapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Maqueli Dal Bello
- Department of Sports, School of Physical Education, Centro Universitário da Serra Gaúcha, Caxias do Sul, Brazil
| | - Rogeane da Silva
- Department of Sports, School of Physical Education, Centro Universitário da Serra Gaúcha, Caxias do Sul, Brazil
| | - Carol Vargas
- Department of Sports, School of Physical Education, Centro Universitário da Serra Gaúcha, Caxias do Sul, Brazil
| | - Gustavo Dalto Barroso Machado
- Neurobiology and Developmental Biology Laboratory, Faculty of Biosciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristian Roncada
- Department of Sports, School of Physical Education, Centro Universitário da Serra Gaúcha, Caxias do Sul, Brazil
| | - Carlos Leandro Tiggemann
- Department of Sports, School of Physical Education, Centro Universitário da Serra Gaúcha, Caxias do Sul, Brazil
| | - Nadja Schröder
- National Institute of Science and Technology for Translational Medicine (INCT-TM), Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq), Brasília, Brazil.
- Physiology Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Rua Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil.
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Banhos CCD, Roncada C, Pinto LA, Pitrez PM. Assessment of theoretical and practical knowledge of asthma among guardians of children treated in primary care. ACTA ACUST UNITED AC 2019; 46:e20190147. [PMID: 31644701 PMCID: PMC7462671 DOI: 10.1590/1806-3713/e20190147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Cathiana Carmo Dalto Banhos
- . Programa de Pós-Graduação em Pediatria e Saúde da Criança, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Cristian Roncada
- . Grupo de Estudo e Pesquisa em Saúde e Performance - GEPESP - Centro Universitário da Serra Gaúcha, Caxias do Sul (RS) Brasil
| | - Leonardo Araújo Pinto
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Paulo Márcio Pitrez
- . Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil.,. Hospital Moinhos de Vento, Porto Alegre (RS) Brasil
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Roncada C, Soldera K, Andrade J, Bischoff LC, Bugança BM, Cardoso TDA, Pitrez PM. EVALUATION OF QUALITY OF LIFE OF PARENTS AND CAREGIVERS OF ASTHMATIC CHILDREN. Rev Paul Pediatr 2018; 36:451-456. [PMID: 30540110 PMCID: PMC6322800 DOI: 10.1590/1984-0462/;2018;36;4;00012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/08/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate and compare the levels of quality of life of parents/caregivers of children with and without diagnosis of asthma. METHODS Parents of children with asthma (asthma group) undergoing outpatient care and parents of children without asthma or asthma in remission (control group) were selected from public schools. They answered a questionnaire about quality of life (The World Health Organization Quality of Life- WHOQOL-BREF), previously validated for the study population. Domains (physical, psychological, social relations, environment and total score) were compared between groups, as well as the levels of correlation of self-perceived quality of life and satisfaction with health. RESULTS 101 parents/caregivers were included in the sample, that is, 50 (49.5%) parents of asthmatic children and 51 (50.5%) in the control group. Most parents included in the sample were females (n=89; 88.1%), with mean age of 33.5±10.4 years. When assessing quality of life, the overall score of domains was considered satisfactory, both in general evaluation (68.6±13.4) and in each group (asthma: 62.8±10.7; control: 74.3±13.4; p-value<0.001). Comparison of asthma and control groups showed significant differences in total score and in scores of all domains (p<0.001). CONCLUSIONS Parents/caregiversof children with asthma have a lower quality of life compared to parents/caregivers of healthy children.
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Affiliation(s)
- Cristian Roncada
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre,
RS, Brasil
- Centro Universitário da Serra Gaúcha, Caxias do Sul, RS,
Brasil
| | - Karina Soldera
- Centro Universitário da Serra Gaúcha, Caxias do Sul, RS,
Brasil
| | - Julia Andrade
- Centro Universitário da Serra Gaúcha, Caxias do Sul, RS,
Brasil
| | | | | | | | - Paulo Márcio Pitrez
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre,
RS, Brasil
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Roncada C, Andrade J, Bischoff LC, Pitrez PM. COMPARISON OF TWO INHALATIONAL TECHNIQUES FOR BRONCHODILATOR ADMINISTRATION IN CHILDREN AND ADOLESCENTS WITH ACUTE ASTHMA CRISIS: A META-ANALYSIS. ACTA ACUST UNITED AC 2018; 36:364-371. [PMID: 29995144 PMCID: PMC6202895 DOI: 10.1590/1984-0462/;2018;36;3;00002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/12/2017] [Indexed: 01/30/2023]
Abstract
Objective: To compare the efficacy of pediatric asthma treatment by nebulizer and
metered-dose inhaler with the use of a spacer (MDI-spacer) in rescue
techniques for asthmatic patients assisted at pediatric emergency units. Data sources: A systematic review was conducted to identify the most relevant randomized
controlled trials comparing the administration of a bronchodilator (β-2
agonist) by two inhalation techniques (nebulization and MDI-spacer) to treat
asthma in children at pediatric emergency units. The following databases
were searched: PubMed, Scientific Electronic Library Online (SciELO), and
ScienceDirect. Two researchers independently applied the eligibility
criteria, and only randomized controlled trials that compared both
inhalation techniques (nebulization and MDI-spacer) for asthma treatment at
pediatric emergency units were included. Data synthesis: 212 articles were pre-selected, of which only nine met the eligibility
criteria and were included in meta-analysis. Results show no differences
between inhalation techniques for any of the four outcomes analyzed: heart
rate (difference - Df: 1.99 [95% confidence interval - 95%CI -2.01-6.00]);
respiratory rate (Df: 0.11 [95%CI -1.35-1.56]); O2 saturation
(Df: -0.01 [95%CI -0.50-0.48]); and asthma score (Df: 0.06 [95%CI
-0,26-0.38]). Conclusions: The findings demonstrate no differences in cardiorespiratory frequency,
O2 saturation, and asthma scores upon administration of β-2
agonist by both inhalation techniques (nebulization and MDI-spacer) to
asthmatic patients assisted at pediatric emergency units.
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Affiliation(s)
- Cristian Roncada
- Centro Universitário da Serra Gaúcha, Caxias do Sul, RS, Brasil.,Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Julia Andrade
- Centro Universitário da Serra Gaúcha, Caxias do Sul, RS, Brasil
| | | | - Paulo Márcio Pitrez
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Roncada C, Cardoso TDA, Bugança BM, Bischoff LC, Soldera K, Pitrez PM. Levels of knowledge about asthma of parents of asthmatic children. ACTA ACUST UNITED AC 2018; 16:eAO4204. [PMID: 29898088 PMCID: PMC6063748 DOI: 10.1590/s1679-45082018ao4204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/09/2018] [Indexed: 11/22/2022]
Abstract
Objective To evaluate the levels of knowledge about asthma of parents of school children. Methods A cross-sectional study was carried out with parents of children with medical diagnosis of asthma (mild, moderate and severe), followed up at an outpatient referral center for childhood asthma in the Southern region of Brazil (Asthma Group). Parents of children with asthma in remission and healthy children were also selected (Control Group). The Newcastle Asthma Knowledge Questionnaire (NAKQ) questionnaire was applied in both groups. Results A total of 154 parents of children participated in the study; in that, 62 (40.26%) in the Asthma Group, and 92 (59.74%) in the Control Group, with a mean age of 35.60±10.03 years. Of these, 132 (85.7%) were female, and 72 (46.8%) parents studied up to high school. The average score of level of knowledge was 18.06±4.11 points. Only 30.5% parents had acceptable levels of knowledge about asthma, which were more prevalent in the Asthma Group than in the Control Group (41.9% versus 22.8%, p=0.01). The mean score in Newcastle Asthma Knowledge Questionnaire (NAKQ) was higher in the Asthma Group (19.32±3.92 versus 17.21±4.03, p=0.001), respectively. The parents with mild and moderate asthmatic children scored more than those of severe asthma (19.5 and 19.9 versus 18.2 points, p=0.02). Conclusion Most parents had an unsatisfactory level of knowledge about asthma, which reinforces the need for changes in public asthma management programs.
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Affiliation(s)
- Cristian Roncada
- Faculdade de Educação Física, Centro Universitário da Serra Gaúcha, Caxias do Sul, RS, Brazil
| | - Thiago de Araujo Cardoso
- Núcleo de Educação em Saúde da Criança, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Karina Soldera
- Faculdade de Biomedicina, Centro Universitário da Serra Gaúcha, Caxias do Sul, RS, Brazil
| | - Paulo Márcio Pitrez
- Núcleo de Educação em Saúde da Criança, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Dutra MS, Roncada C, da Silva GL, Ferla NJ, Pitrez PM. Mite Fauna Assessment in Houses of Two distinct Socioeconomic Groups From Southern Brazil. J Med Entomol 2018; 55:620-625. [PMID: 29281052 DOI: 10.1093/jme/tjx239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Indexed: 06/07/2023]
Abstract
House dust mites (HDM) are the main source of aeroallergens worldwide, yet epidemiological differences between socioeconomic factors in association with this medical condition have not been studied in the south region of Brazil. To assess the prevalence of HDM in two socioeconomically distinct populations of patients with allergic asthma or rhinitis, the differences between samples from houses of high-income families and low-income families were analyzed. Mite samples were collected between July and December 2015, in Porto Alegre, Brazil. The HDM were Dermatophagoides pteronyssinus and Dermatophagoides farinae (Hughes; Acari: Pyroglyphidae). Also, other non-pyroglyphid house mites were identified in dust samples: Tyrophagus putrescentiae (Schrank; Acari: Acaridae), Chortoglyphus arcuatus, and Cheyletus malaccensis. Identification of species was performed through morphological keys with a stereomicroscope and a phase optical microscope. A total of 104 homes was evaluated (low-income group: n = 53; high-income group, n = 51). We found a total of 721 mites, representing 11 species, in 93 (89%) houses. In the remaining houses, no mites were found. We observed no significant differences of species composition between the groups studied. However, the number of mites was significantly higher in the low-income group (P < 0.001). D. pteronyssinus was the predominant species detected, with 286 mites (39.6%). D. farinae was not detected in any sample. Our results show that living-rooms from low-income families present higher numbers of HDM.
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Affiliation(s)
- Moisés S Dutra
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Infant Center, Institute for Biomedical Research (IPB), Porto Alegre, Brazil
| | - Cristian Roncada
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Infant Center, Institute for Biomedical Research (IPB), Porto Alegre, Brazil
| | - Guilherme L da Silva
- Laboratory of Acarology (TECNOVATES), University of Taquari Valley (UNIVATES), Lajeado, Brazil
| | - Noeli J Ferla
- Laboratory of Acarology (TECNOVATES), University of Taquari Valley (UNIVATES), Lajeado, Brazil
| | - Paulo M Pitrez
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Infant Center, Institute for Biomedical Research (IPB), Porto Alegre, Brazil
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Pitrez PM, de Souza RG, Roncada C, Heinzmann-Filho JP, Santos G, Pinto LA, Jones MH, Stein RT. Impact of omalizumab in children from a middle-income country with severe therapy-resistant asthma: A real-life study. Pediatr Pulmonol 2017; 52:1408-1413. [PMID: 29027379 DOI: 10.1002/ppul.23845] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [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: 03/02/2017] [Accepted: 09/01/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Severe asthma in children is a global health problem. Severe therapy-resistant asthma (STRA) in children is a major clinical challenge due to persistent symptoms despite high doses of corticosteroids and results in high public health costs. Omalizumab (anti-IgE monoclonal antibody) has been described as an effective add-on therapy in these patients. The characteristics of children with STRA from low- and middle-income countries have scarcely been reported, and no real-life study has been published on the effects of omalizumab in this group of patients. The aim of our study is to report the first clinical real-life experiences with omalizumab in Brazilian children with STRA. METHODS Children (6-18 years old) from a referral center who were diagnosed with STRA were included in this retrospective study based on our clinical databases. The included children had undergone at least 6 months of omalizumab treatment and fulfilled the following initial criteria: 1) >6 years old; 2) a positive skin-prick test for at least one aeroallergen; and 3) a serum total IgE level between 30 and 1500 IU/mL. Clinical and lung function variables were analyzed before and after treatment. RESULTS Fourteen children (mean age: 11.9 years; percentage female: 72%) were included in this study. Omalizumab treatment significantly increased control of the disease according to a standardized questionnaire administered at every visit (P < 0.0001), ceased hospitalizations in 70% (P = 0.02) of patients, and allowed 8/9 (89%) patients to be weaned off oral steroids (P = 0.004). CONCLUSIONS In this retrospective report, the use of omalizumab in Brazilian children with STRA significantly improved disease control, decreased hospitalizations, and allowed suspension of continuous oral corticosteroids.
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Affiliation(s)
- Paulo M Pitrez
- Laboratory of Pediatric Respirology, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo G de Souza
- Laboratory of Pediatric Respirology, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristian Roncada
- Laboratory of Pediatric Respirology, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Joao P Heinzmann-Filho
- Laboratory of Pediatric Respirology, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giovana Santos
- Laboratory of Pediatric Respirology, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo A Pinto
- Laboratory of Pediatric Respirology, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcus H Jones
- Laboratory of Pediatric Respirology, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Renato T Stein
- Laboratory of Pediatric Respirology, Infant Center, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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Cardoso TDA, Roncada C, Silva ERD, Pinto LA, Jones MH, Stein RT, Pitrez PM. The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system. J Bras Pneumol 2017; 43:163-168. [PMID: 28746526 PMCID: PMC5687945 DOI: 10.1590/s1806-37562016000000352] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 04/14/2017] [Indexed: 11/21/2022] Open
Abstract
Objective: To present official longitudinal data on the impact of asthma in Brazil between 2008 and 2013. Methods: This was a descriptive study of data collected between 2008 and 2013 from an official Brazilian national database, including data on asthma-related number of hospitalizations, mortality, and hospitalization costs. A geographical subanalysis was also performed. Results: In 2013, 2,047 people died from asthma in Brazil (5 deaths/day), with more than 120,000 asthma-related hospitalizations. During the whole study period, the absolute number of asthma-related deaths and of hospitalizations decreased by 10% and 36%, respectively. However, the in-hospital mortality rate increased by approximately 25% in that period. The geographic subanalysis showed that the northern/northeastern and southeastern regions had the highest asthma-related hospitalization and in-hospital mortality rates, respectively. An analysis of the states representative of the regions of Brazil revealed discrepancies between the numbers of asthma-related hospitalizations and asthma-related in-hospital mortality rates. During the study period, the cost of asthma-related hospitalizations to the public health care system was US$ 170 million. Conclusions: Although the numbers of asthma-related deaths and hospital admissions in Brazil have been decreasing since 2009, the absolute numbers are still high, resulting in elevated direct and indirect costs for the society. This shows the relevance of the burden of asthma in middle-income countries.
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Affiliation(s)
- Thiago de Araujo Cardoso
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Cristian Roncada
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | | | - Leonardo Araujo Pinto
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Marcus Herbert Jones
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Renato Tetelbon Stein
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Paulo Márcio Pitrez
- . Centro Infant, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
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Roncada C, Oliveira SGD, Cidade SF, Rafael JG, Ojeda BS, Santos BRLD, Gustavo ADS, Pitrez PM. Asthma treatment in children and adolescents in an urban area in southern Brazil: popular myths and features. J Bras Pneumol 2017; 42:136-42. [PMID: 27167435 PMCID: PMC4853067 DOI: 10.1590/s1806-37562015000000166] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/03/2015] [Indexed: 11/22/2022] Open
Abstract
Objective: To describe the frequency of popular myths about and features of asthma treatment in children and adolescents in an urban area in southern Brazil. Methods: The parents or legal guardians of public school students (8-16 years of age) completed a specific questionnaire regarding their understanding of asthma, asthma control, and treatment characteristics. The sample included parents or legal guardians of students with asthma (n = 127) and healthy controls (n = 124). Results: The study involved 251 parents or legal guardians, of whom 127 (68.5%) were the mothers and 130 (51.8%) were White. The mean age of these participants was 38.47 ± 12.07 years. Of the participants in the asthma and control groups, 37 (29.1%) and 26 (21.0%), respectively, reported being afraid of using asthma medications, whereas 61 (48%) and 56 (45.2%), respectively, believed that using a metered dose inhaler can lead to drug dependence. However, only 17 (13.4%) and 17 (13.7%) of the participants in the asthma and control groups, respectively, reported being afraid of using oral corticosteroids. In the asthma group, 55 students (43.3%) were diagnosed with uncontrolled asthma, only 41 (32.3%) had a prescription or written treatment plan, and 38 (29.9%) used asthma medications regularly. Conclusions: Popular myths about asthma treatment were common in our sample, as were uncontrolled asthma and inappropriate asthma management. Further studies in this field should be conducted in other developing countries, as should evaluations of pediatric asthma treatment programs in public health systems.
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Affiliation(s)
- Cristian Roncada
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | | | | | | | | | | | - Paulo Márcio Pitrez
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Jones MH, Roncada C, Fernandes MTC, Heinzmann-Filho JP, Sarria Icaza EE, Mattiello R, Pitrez PMC, Pinto LA, Stein RT. Asthma and Obesity in Children Are Independently Associated with Airway Dysanapsis. Front Pediatr 2017; 5:270. [PMID: 29326908 PMCID: PMC5741591 DOI: 10.3389/fped.2017.00270] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 12/04/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND An increase in the prevalence of overweight and asthma has been observed. Both conditions affect negatively lung function in adults and children. The aim of this study was to analyze the effect of overweight and asthma on lung function in children. METHODS We designed a case-control study of healthy and asthmatic subjects nested within an epidemiological asthma prevalence study in children between 8 and 16 years of age. The effect of asthma and overweight on lung function was assessed by impulse oscillometry and spirometry obtained at baseline and 10-15 min after salbutamol. RESULTS 188 children were recruited, 114 (61%) were asthmatics and 72 (38%) were overweight or obese. Children with asthma and overweight had a higher FVC (+1.16 z scores, p < 0.001) and higher FEV1 (+0.79 z scores, p = 0.004) and lower FEV1/FVC (-0.54 z scores, p = 0.008) when compared to healthy controls. Compared to normal weight asthmatics, the overweight had higher FVC (+0.78 z scores, p = 0.005) and lower FEV1/FVC (-0.50 z scores, p = 0.007). In the multivariate analysis, overweight was associated with an increase of 0.71 and 0.44 z scores in FVC and FEV1, respectively, and a reduction in FEV1/FVC by 0.40 z scores (p < 0.01 for all). Overweight had no effect on maximal flows and airway resistance at baseline, and this was not modified by inhalation of a bronchodilator. Asthma was also associated with higher post-BD FVC (0.45 z scores, p = 0.012) and FEV1 (0.35 z scores, p = 0.034) but not with FEV1/FVC and FEF25-75%. Two-way analysis of variance did not detect any interaction between asthma and overweight on lung function variables before or after bronchodilator. CONCLUSION Our results suggest that asthma and overweight are independently associated with airway dysanaptic growth in children which can be further scrutinized using impulse oscillometry. Overweight contributed more to the reduction in FEV1/FVC than asthma in children without increasing airway resistance. Spirometry specificity and sensitivity for obstructive diseases may be reduced in populations with high prevalence of overweight. Adding impedance oscillometry to spirometry improves our understanding of the ventilatory abnormalities in overweight children.
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Affiliation(s)
- Marcus H Jones
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Cristian Roncada
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Morgana Thais Carollo Fernandes
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,School of Nursing, Centro Universitário Ritter dos Reis, Porto Alegre, Brazil
| | - João Paulo Heinzmann-Filho
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Rita Mattiello
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Paulo Marcio C Pitrez
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Leonardo A Pinto
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Renato T Stein
- Laboratory of Respiratory Physiology, Infant Center, School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Pelizzer T, Dias CP, Poeta J, Torriani T, Roncada C. Prevalência de câncer colorretal associado ao papilomavírus humano: uma revisão sistemática com metanálise. Rev bras epidemiol 2016; 19:791-802. [DOI: 10.1590/1980-5497201600040009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 08/31/2016] [Indexed: 01/05/2023] Open
Abstract
RESUMO: Introdução: O câncer colorretal é um dos tipos de tumor mais prevalentes na população mundial. A mortalidade causada por esses tumores malignos continua elevada e mantém-se praticamente no mesmo nível nas últimas décadas. Entre os fatores de risco já estabelecidos para o desenvolvimento do câncer estão as infecções por patógenos ou vírus. Entre os vírus, o papilomavírus humano (HPV) é o mais prevalente, tendo mais de 180 cepas, das quais 40 estão diretamente relacionadas com infecções anogenitais. Objetivo: Avaliar de forma sistemática, com metanálise, os principais estudos que associam o HPV ao câncer colorretal. Métodos: Como estratégia de busca foi adotada a lógica baseada em descritores específicos (idioma inglês), vinculados aos operadores booleanos (AND/OR). As buscas foram aplicadas nas bases de dados PubMed, ScienceDirect e Scientific Electronic Library Online (SciELO), no período de abril e maio de 2015. Resultados: Foram avaliadas 1.549 amostras, sendo 956 (61,7%) do sexo masculino. Foram diagnosticados 630/1.358 casos de câncer colorretal por HPV (51,9%). Destes, 408/767 (51,9%) eram do sexo masculino e 404/598 (67,5%) foram associados aos HPVs 16 e 18, com prevalência tumoral na região do colo (253/411; 61,3%). Do total de 598 amostras para estimativa das prevalências de HPV-16 e HPV-18, a quantidade de casos com valores muito semelhantes foi de 204 (31,7%) e 200 (35,8%), respectivamente. Foram verificados valores relativamente expressivos na região do colo, 253 (61,3%), e na região retal, 158 (38,7%). Conclusão: Após a realização do presente estudo, a associação entre HPV e câncer colorretal ficou evidente, não havendo distinção entre gêneros, com valores muito semelhantes entre o HPV-16 e o HPV-18.
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Affiliation(s)
| | | | - Julia Poeta
- Faculdade da Serra Gaúcha, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | - Tânia Torriani
- Faculdade da Serra Gaúcha, Brazil; Universidade Feevale, Brazil
| | - Cristian Roncada
- Faculdade da Serra Gaúcha, Brazil; Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
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Oliveira SG, Sarria EE, Roncada C, Stein RT, Pitrez PM, Mattiello R. Validation of the Brazilian version of the childhood asthma control test (c-ACT). Pediatr Pulmonol 2016; 51:358-63. [PMID: 26422330 DOI: 10.1002/ppul.23318] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 01/28/2015] [Revised: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Children's perception of their symptoms has proved reliable and relevant to disease management and should be considered when assessing their asthma control. The aim of the study is to validate the Brazilian Portuguese version of the Childhood Asthma Control Test (c-ACT) in children aged 4-11 years. METHODS This is a cross-sectional study in children diagnosed with asthma undergoing treatment in a pediatric pulmonology outpatient clinic in Porto Alegre, Brazil. The translation and linguistic adaptation of the instrument were performed in accordance with international recommendations for questionnaire validation. RESULTS A total of 105 participants were included, aged 4-11 years. VALIDITY all correlations between the total score and items on the questionnaire were significant and obtained values of r ≥ 0.3, and c-ACT means showed statistically significant differences between the GINA categories (P < 0.01). The controlled asthma group showed significantly higher c-ACT scores than those of uncontrolled asthma group (controlled 22.0 ± 2.9 vs. uncontrolled 16.3 ± 5.3 P < 0.01); and partially controlled asthma group showed significantly higher c-ACT scores than those of uncontrolled asthma group (partially controlled 20.0 ± 4.0 vs. uncontrolled 16.3 ± 5.3 P = 0.03). Correlations between the c-ACT total score and spirometry and nitric oxide were poor (r = 0.020; P = 0.866 and r = 0.035; P = 0.753, respectively). Reliability: the α-C coefficient for the c-ACT total score was 0.677 (95%CI 0.573-0763). Sensitivity to change had an effect size of 0.8 and an intraclass correlation coefficient of 0.598. No floor or ceiling effects were observed. CONCLUSION The Brazilian version of the Childhood Asthma Control Test proved to be valid and reliable in children aged 4-11 years.
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Affiliation(s)
- Suelen G Oliveira
- Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande (PUCRS), Porto Alegre, Brazil
| | - Edgar E Sarria
- Department of Biology and Pharmacy, School of Medicine, Universidade de Santa Cruz do Sul (UNISC), Santa Cruz do Sul, Brazil
| | - Cristian Roncada
- Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande (PUCRS), Porto Alegre, Brazil
| | - Renato T Stein
- Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande (PUCRS), Porto Alegre, Brazil
| | - Paulo M Pitrez
- Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande (PUCRS), Porto Alegre, Brazil
| | - Rita Mattiello
- Centro Infant, Biomedical Research Institute, Pontifícia Universidade Católica do Rio Grande (PUCRS), Porto Alegre, Brazil
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Roncada C, de Oliveira SG, Cidade SF, Sarria EE, Mattiello R, Ojeda BS, Dos Santos BRL, Gustavo ADS, Pinto LA, Jones MH, Stein RT, Pitrez PM. Burden of asthma among inner-city children from Southern Brazil. J Asthma 2016; 53:498-504. [PMID: 26787296 DOI: 10.3109/02770903.2015.1108438] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the impact of asthma in a population of inner-city Brazilian children. METHODS In a cross-sectional study, we selected children with asthma and healthy controls from public schools (8-16 years) from a capital city of Southern Brazil. Divided into three phases, questionnaires were administered, assessing lung function, body mass index and allergic sensitization. RESULTS From 2500 children initially included in the study (48.4% males; mean age of 11.42 ± 2.32 years), asthma prevalence was detected in 28.6% (715/2500). The disease was not controlled in 42.7% (305/715) of the children, with 7.6% of hospitalization rate. School absenteeism (at least one day of missing school because of asthma) and sedentary behavior were high (57.1 and 67.2%, respectively), with 47.9% of subjects requiring oral steroids in the previous year, and physical well-being significantly lower than controls, directly interfering with quality of life, and therefore in the daily activities of these students. Moreover, 38% of the parents admitted to being non-adherent to treatment with their children and 31.1 and 53.6%, respectively, believed that rescue medication and exercise might be harmful. CONCLUSIONS The burden of asthma in Brazilian children seems to be substantial. New international guidelines with a special focus in developing countries settings, with more pragmatic approaches, should be a priority for discussion and implementation actions.
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Affiliation(s)
- Cristian Roncada
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
| | - Suelen Goecks de Oliveira
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
| | - Simone Falcão Cidade
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
| | - Edgar Enrique Sarria
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
| | - Rita Mattiello
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
| | - Beatriz Sebben Ojeda
- b School of Nursery, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil
| | - Beatriz Regina Lara Dos Santos
- b School of Nursery, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil
| | - Andréia da Silva Gustavo
- b School of Nursery, Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil
| | - Leonardo Araújo Pinto
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
| | - Marcus Herbert Jones
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
| | - Renato Tetelbom Stein
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
| | - Paulo Márcio Pitrez
- a Infant Center, Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre - RS , Brazil , and
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Roncada C, Dias CP, Goecks S, Cidade SEF, Pitrez PMC. Usefulness of the WHOQOL-BREF questionnaire in assessing the quality of life of parents of children with asthma. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rppede.2015.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rodrigues AM, Roncada C, Santos G, Heinzmann-Filho JP, de Souza RG, Vargas MHM, Pinto LA, Jones MH, Stein RT, Pitrez PM. Clinical characteristics of children and adolescents with severe therapy-resistant asthma in Brazil. J Bras Pneumol 2015; 41:343-50. [PMID: 26398754 PMCID: PMC4635954 DOI: 10.1590/s1806-37132015000004462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 10/27/2014] [Accepted: 02/25/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the clinical characteristics, lung function, radiological findings, and the inflammatory cell profile in induced sputum in children and adolescents with severe therapy-resistant asthma (STRA) treated at a referral center in southern Brazil. METHODS We retrospectively analyzed children and adolescents (3-18 years of age) with uncontrolled STRA treated with high-dose inhaled corticosteroids and long-acting β2 agonists. We prospectively collected data on disease control, lung function, skin test reactivity to allergens, the inflammatory cell profile in induced sputum, chest CT findings, and esophageal pH monitoring results. RESULTS We analyzed 21 patients (mean age, 9.2 ± 2.98 years). Of those, 18 (86%) were atopic. Most had uncontrolled asthma and near-normal baseline lung function. In 4 and 7, induced sputum was found to be eosinophilic and neutrophilic, respectively; the inflammatory cell profile in induced sputum having changed in 67% of those in whom induced sputum analysis was repeated. Of the 8 patients receiving treatment with omalizumab (an anti-IgE antibody), 7 (87.5%) showed significant improvement in quality of life, as well as significant reductions in the numbers of exacerbations and hospitalizations. CONCLUSIONS Children with STRA present with near-normal lung function and a variable airway inflammatory pattern during clinical follow-up, showing a significant clinical response to omalizumab. In children, STRA differs from that seen in adults, further studies being required in order to gain a better understanding of the disease mechanisms.
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Affiliation(s)
- Andrea Mendonça Rodrigues
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Cristian Roncada
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Giovana Santos
- Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - João Paulo Heinzmann-Filho
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Rodrigo Godinho de Souza
- Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Mauro Henrique Moraes Vargas
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Leonardo Araújo Pinto
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Marcus Herbert Jones
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Renato Tetelbom Stein
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| | - Paulo Márcio Pitrez
- Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
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Roncada C, Dias CP, Goecks S, Cidade SEF, Pitrez PMC. [Usefulness of the WHOQOL-BREF questionnaire in assessing the quality of life of parents of children with asthma]. Rev Paul Pediatr 2015; 33:268-74. [PMID: 26137868 PMCID: PMC4620952 DOI: 10.1016/j.rpped.2015.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 01/22/2015] [Accepted: 01/23/2015] [Indexed: 11/25/2022]
Abstract
Objective:: To evaluate the quality of life (QOL) of parents of children with asthma and to
analyze the internal consistency of the generic QOL tool World Health Organization
Quality of Life, abbreviated version (WHOQOL-BREF). Methods:: We evaluated the QOL of parents of asthmatic and healthy children aged between 8
and 16, using the generic WHOQOL-BREF questionnaire. We also evaluated the
internal consistency using Cronbach's alpha (αC), in order to
determine whether the tool had good validity for the target audience. Results:: The study included 162 individuals with a mean age of 43.8±13.6 years, of which
104 were female (64.2%) and 128 were married (79.0%). When assessing the QOL, the
group of parents of healthy children had higher scores than the group of parents
of asthmatic children in the four areas evaluated by the questionnaire (Physical,
Psychological Health, Social Relationships and Environment), indicating a better
quality of life. Regarding the internal consistency of the WHOQOL-BREF, values of
˛C were 0.86 points for the group of parents of asthmatic children, and 0.88 for
the group of parents of healthy children. Conclusions:: Parents of children with asthma have impaired quality of life due to their
children's disease. Furthermore, the WHOQOL-BREF, even as a generic tool, showed
to be practical and efficient to evaluate the quality of life of parents of
asthmatic children. © 2015 Sociedade de Pediatria de São Paulo. Published by
Elsevier Editora Ltda. All rights reserved.
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Affiliation(s)
- Cristian Roncada
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil.
| | | | - Suelen Goecks
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brasil
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Andrea R, Santos G, Souza R, Vargas M, Roncada C, Pinto L, Jones M, Stein R, Pitrez P. Clinical characteristics, lung function and airway inflammatory patterns of Brazilian children with severe therapy‐resistant asthma. Clin Transl Allergy 2015. [PMCID: PMC4407148 DOI: 10.1186/2045-7022-5-s2-p5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Coelho BDS, Souza LKD, Bortoluzzi R, Roncada C, Tiggemann CL, Dias CP. Comparação da força e capacidade funcional entre idosos praticantes de musculação, hidroginástica e não praticantes de exercícios físicos. Rev bras geriatr gerontol 2014. [DOI: 10.1590/1809-9823.2014.13046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUÇÃO: As mudanças na força e na capacidade funcional decorrentes do envelhecimento podem ser melhoradas mediante a prática de exercícios físicos como a musculação e a hidroginástica. OBJETIVO: Comparar a força e a capacidade funcional entre idosos praticantes de musculação, hidroginástica e não praticantes de exercícios físicos. MÉTODOS: Estudo descritivo de corte transversal com amostragem não probabilística voluntária. Participaram do estudo 36 idosos (63,6±4,1 anos), sendo 12 praticantes de musculação, 12 praticantes de hidroginástica e 12 não praticantes de exercícios físicos. O nível de atividade física foi avaliado pelo Questionário Internacional de Atividade Física (IPAQ). A avaliação da força máxima foi realizada pelo teste de uma repetição máxima (1RM) em membros superiores e inferiores. A capacidade funcional foi avaliada pelos testes de levantar da cadeira em 30 segundos e velocidade de caminhada habitual e máxima. Foi utilizada Anova One Way com post-hoc de Bonferroni para comparação das variáveis dependentes entre os grupos com α=0,05. RESULTADOS: Todos os grupos foram classificados como ativos. O grupo praticante de musculação apresentou os maiores valores de força máxima, quando comparado ao praticante de hidroginástica e não praticante de exercícios físicos (p≤0,01). Além disso, os grupos praticante de hidroginástica e não praticante de exercícios físicos não apresentaram diferenças na força máxima (p=1,0). Já para o teste de levantar da cadeira, não foram observadas diferenças entre os grupos (p=0,07), o mesmo sendo observado no teste de velocidade de caminhada habitual (p=0,06) e máxima (p=0,22). CONCLUSÃO: A musculação mostrou-se mais eficaz para o aumento de força, mas o estilo de vida ativo é suficiente para a manutenção da capacidade funcional.
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Affiliation(s)
| | | | | | | | | | - Caroline Pieta Dias
- Faculdade da Serra Gaúcha, Brasil; Universidade Federal do Rio Grande do Sul, Brasil
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Roncada C, Mattiello R, Pitrez PM, Sarria EE. Specific instruments to assess quality of life in children and adolescents with asthma. J Pediatr (Rio J) 2013; 89:217-25. [PMID: 23669217 DOI: 10.1016/j.jped.2012.11.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 11/21/2012] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify and describe specific instruments to assess health-related quality of life (HRQoL) in children and adolescents with asthma. DATA SOURCE Searches were performed in the PubMed, Ovid, and LILACS databases using different combinations of key words (MeSH terms), selecting original articles on the development of specific HRQoL questionnaires, published in English, Portuguese, or Spanish, between 1990 and 2012. DATA SYNTHESIS A total of 15 instruments that met the inclusion criteria were identified. Most studies assessed reliability through internal consistency, reproducibility, and/or sensitivity to changes. Validity was assessed by comparison with healthy controls (discordant validity) or factorial analysis. CONCLUSIONS Of the 15 instruments, three are the most frequently used: Pediatric Asthma Quality of Life Questionnaire (PAQLQ), Pediatric Quality of Life Inventory 4.0 (PedsQL-Asthma), and Disability Kids (DISABKIDS). In general, these three tools have adequate psychometric characteristics and are practical to implement, but only PAQLQ has been culturally adapted to Brazil.
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Affiliation(s)
- Cristian Roncada
- Programa de Pós-Graduação em Pediatria e Saúde da Criança, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
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