Biomedical subjects

Claudia Galassi

Publications and source records attributed to Claudia Galassi.

13 recordsLinked to original sources

PubMed2006

Maternal complications and procedures in pregnancy and at birth and wheezing phenotypes in children.

RATIONALE: There is increasing interest in the potential influence of fetal and early life conditions on childhood wheezing. OBJECTIVES: To investigate the associations between maternal complications and procedures in pregnancy and at birth and the risk of various wheezing phenotypes in young children. METHODS: We studied 15,609 children, aged 6-7 yr, enrolled in a population-based study. Standardized questionnaires were completed by the children's mothers. RESULTS: Of the children, 9.5% (1,478) had transient early wheezing, 5.4% (884) had persistent wheezing, and 6.1% (948) had late-onset wheezing. Maternal hypertension or preeclampsia was associated with an increased risk of all three wheezing phenotypes (for transient early wheezing: odds ratio [OR], 1.40; 95% confidence interval [95% CI], 1.08-1.82; for persistent wheezing: OR, 1.59; 95% CI, 1.15-2.19; and for late-onset wheezing: OR, 1.47; 95% CI, 1.06-2.01). Use of antibiotics for urinary tract infections was associated with transient early wheezing (OR, 1.52; 95% CI, 1.16-2.00), whereas antibiotic administration at delivery was associated with both transient early wheezing (OR, 1.21; 95% CI, 1.01-1.46) and persistent wheezing (OR, 1.39; 95% CI, 1.10-1.75). Children who had a mother with diabetes were also more likely to have persistent wheezing (OR, 1.72; 95% CI, 0.99-3.00). Neither amniocentesis/chorionic villus sampling, nor weight gain in pregnancy, nor cesarean section was associated with the subsequent development of wheezing. Maternal asthma or atopy was not an effect modifier of the associations found. CONCLUSIONS: Some maternal complications during pregnancy and at delivery may increase the risk of developing different phenotypes of wheezing in childhood.

Child↗

PubMed2006

Changes in prevalence of asthma and allergies among children and adolescents in Italy: 1994-2002.

BACKGROUND: Several studies conducted during the 1990s indicated an increase in the prevalence of symptoms of asthma; more recent investigations suggest that the trend is stabilizing or may even be reversing. OBJECTIVE: We compared 2 cross-sectional surveys conducted in 1994 and 2002 in 8 areas in northern and central Italy, to evaluate prevalence changes for asthma, allergic rhinitis, and eczema. METHODS: The International Study of Asthma and Allergies in Childhood methods and questionnaires were used to investigate 6- to 7-year-old children (16,115 and 11,287 questionnaires completed by parents in 1994-1995 and 2002, respectively) and 13- to 14-year-old adolescents (19,723 and 10,267 questionnaires completed by adolescents in 1994-1995 and 2002, respectively). In each phase, the overall response rate was >90%. Prevalence changes were calculated as the absolute difference between the prevalence recorded on the 2 occasions. RESULTS: The prevalence of wheeze (past 12 months) increased slightly among children (change: 0.8%; 95% confidence interval [CI]: 0.0% to 1.6%) and was rather stable among adolescents. Symptoms of allergic rhinitis (children: change: 5.2%; 95% CI: 4.0% to 6.4%; adolescents: change: 4.1%; 95% CI: 1.9% to 6.3%) and symptoms of atopic eczema (children: change: 4.4%; 95% CI: 3.6% to 5.2%; adolescents: change: 2.1%; 95% CI: 1.2% to 3.0%) increased clearly in both age groups. There was some heterogeneity across the centers among adolescents, especially for allergic rhinitis, with larger increases seen in the 3 metropolitan areas. The changes observed paralleled profound family changes, ie, better parental education, higher rates of maternal employment, and lower rates of exposure to parental smoke. These factors, however, do not explain all of the observed changes in prevalence. CONCLUSIONS: The results indicate that the epidemiologic features of asthma and allergies in Italy are changing rapidly, although the causes are still uncertain.

Adolescent↗

PubMed2004

Air pollution and respiratory status in asthmatic children: hints for a locally based preventive strategy. AIRE study.

Respiratory health effects of short-term exposure to ambient air pollution have been examined in 120 'asthma-like' school-aged children in some areas of Emilia-Romagna (urban-industrial and rural area). They kept a daily diary, through 12 weeks, for respiratory symptoms, PEF measurements, drug consumption and daily activity. The average daily concentrations of air pollutants in the same period (TSP, NO2, CO, PM2.5) were higher in the industrial than the rural area. Asthma was diagnosed in 77% of cases, 85% of subjects took medical treatments for respiratory disease in the last year and 90% used medicine for respiratory diseases. Significantly lower variations in PEF, between morning and evening, were observed in the rural area, considering only the asthmatic or cough subsets of children. Symptom prevalence was higher in the urban-industrial area than the rural area; the most frequent symptoms were cough, phlegm and stuffed nose. The two area populations are homogeneous in individual features, family susceptibility, passive smoking exposure and atopy. The differences observed in the frequency of daily reported symptoms could be attributed to external situations like the different reported exposures to pollutants. Although most analyses revealed non-significant associations, panel analysis showed a significant statistical risk for the cough and phlegm group by an increase of 10 microg of TSP (RR 1.0017, 95% CI: 1.0002-1.0033) in the entire group. In the urban-industrial panel we observed a significant association between cough and phlegm together and PM2.5 (RR 1.0044, 95% CI: 1.0011-1.0077). The results of this investigation should be used in orienting local political decisions.

Air Pollution↗

PubMedDate not supplied

Environment and respiratory diseases in childhood: the Italian experience.

To estimate the prevalence of respiratory disorders in children, and to investigate the roles of potential environmental risk factors, including exposure to outdoor air pollution, a large multicenter, population based survey (SIDRIA) was conducted in Italy in 1994-1995. The study enrolled more than 40,000 children. Results allowed international comparisons of the prevalences of asthma and allergies in childhood in the framework of the ISAAC (International Study of Asthma and Allergies in Childhood) study, and supplied further evidence of the adverse respiratory effects of many environmental factors. The methods and main findings of the SIDRIA study are presented, focusing on the role of outdoor risk factors.

Adolescent↗

PubMedDate not supplied

[SIDRIA second phase: objectives, study design and methods].

The SIDRIA project (Italian Studies on Respiratory Disorders in Children and the Environment) is aimed at evaluating the prevalence of respiratory and allergic disorders, and their geographic and temporal variations, in the context of the ISAAC study (International study of asthma and allergies in Childhood). The SIDRIA study was specifically designed to evaluate the prevalence of a variety of environmental, social, behavioural and familiar risk factors, and to examine the association between these socio-environmental factors and asthma as well as other respiratory disorders in children. The first phase of SIDRIA was conducted in 1994-1995 in 10 areas of Northern and Central Italy. The 2nd phase took place in 2002, in 13 Italian areas, and included 20,016 children (6-7 years old) and 16,175 adolescents (13-14 years old), with a response rate of 89% and 93%, respectively.

Adolescent↗

PubMedDate not supplied

[Respiratory and allergic disorders in children: differences in socio-economic status].

The association between socio-economic status (SES) and respiratory and allergic disorders is controversial, and conflicting results are reported in literature. We examined this association using as indicators of SES parental education and occupation. Persistent cough resulted inversely associated with SES, while current wheezing and atopic dermatitis were directly associated with SES. The role of SES on frequency of respiratory and allergic conditions in Italy needs to be further investigated, although our results confirm a higher frequency of allergic dermatitis and a lower frequency of persistent cough in more advantaged families.

Adolescent↗

PubMedDate not supplied

[Prevalence of asthma and allergies among migrant children and adolescents in Italy].

Prevalence of asthma and allergies in children shows large variations among different populations, but there is limited evidence about these conditions in immigrants from developing countries. The aim of this study was to evaluate the prevalence of asthma symptoms and allergies in immigrant children and adolescents living in Italy and to investigate the possible role of genetic and environmental factors in the development of such diseases. There were 1340 (4.0%) immigrants in Italy, mainly from East Europe (31.7%); 532 were born in Italy to foreign parents and 808 were born abroad. Asthma and other atopic diseases were on the whole significantly less common among immigrant children than among Italians, while some infectious diseases in the first two years of life resulted more present in immigrant children than in Italians.

Adolescent↗

PubMedDate not supplied

[Risk factors in the pre-, perinatal and early life (first year) for wheezing in young children].

In recent years some studies have focused attention on the contribution of early life risk factors in the pathogenesis of asthma and wheezing. In our study we tested the hypothesis that wheezing in childhood is not a single disorder and that different wheezing phenotypes (called transient early wheezing, persistent wheezing and late-onset wheezing) are associated with different risk factors. We evaluated the association between pre, perinatal and early life (1st year) risk factors and different wheezing phenotypes in children 6-7 years old enrolled in the SIDRIA-2 project. Maternal smoking in pregnancy is associated with early and persistent wheezing; prematurity, child's admission to hospital shortly after birth for respiratory problems, indicators of respiratory infections during the child's first year of life are associated with early wheezing. An increase in childhood infections from contact with siblings or day care attendance is a risk factor for early wheezing but protective against late-onset wheezing, while an opposite pattern was observed for breastfeeding. Finally, mould or dampness in the child's bedroom during his first year of life is associated with all wheezing phenotypes. The risk factors studied are differently associated with different wheezing phenotypes.

Asthma↗

PubMedDate not supplied

[Effects of indoor exposures on respiratory and allergic disorders].

Several studies have shown that indoor pollution increases the risk for chronic pulmonary diseases and acute respiratory symptoms in children/adolescents. Some associations have been confirmed by studies. Other relations are still unclear, such as those regarding dog and cat ownership. In this study we assessed the relationships of the exposure to mould and dog/cat ownership with respiratory/allergic symptoms/diagnoses, such as wheezing, asthma, rhinoconjunctivitis, eczema, and cough/phlegm in 20,016 children (6-7 yrs old) and 13,266 adolescents (13-14 yrs old) from 12 Italian areas. Early mould exposure (in the first year of life) was positively related to all considered symptoms/diagnoses (significantly for wheezing, asthma, rhinoconjunctivitis in both children and adolescents, and for cough/phlegm among children); current exposure (in the last year) was a significant risk factor for wheeze, among children. In the latter, dog exposure only in the first year of life increased the risk for wheezing and cough/phlegm, whereas the presence of a dog lifetime seemed a protective factor (though not significant) for all symptoms/diagnoses; negative relations (but not significant) suggested a protective effect by the cat for asthma, independently of exposure period. Among adolescents, the presence of a dog both lifetime and only in the first year of life was significantly related to cough/phlegm; except for rhino-conjunctivitis, all symptoms/diagnoses were negatively related to the presence of a cat lifetime (though not significantly). In conclusion, our results confirmed the effects of mould exposure, especially when it occurs early, on the prevalence of respiratory disorders such as asthma, rhinitis and cough in the pediatric age. The complex relations between keeping a dog or cat at home and respiratory/allergic symptoms/diseases in childhood warrants further studies.

Adolescent↗

PubMedDate not supplied

[Outdoor risk factors and adverse effects on respiratory health in childhood].

Several epidemiological studies have provided evidence that exposure to auto vehicular traffic increases the prevalence of bronchitis, cough and deficits in lung function and may exacerbate pre-existing asthma, especially in children. The aim of this study was to investigate the role of road traffic pollution on respiratory health in a large sample of Italian school children. Eighteen percent of the SIDRIA-2 sample reported high traffic density in the zone of residence; 60% and 20% of subjects reported a very frequent transit of cars and lorries, respectively on the street of residence. High frequency of lorry traffic in the street of residence was associated with significantly increased risks for chronic cough or phlegm and sinusitis symptoms. These results, confirming previous findings (SIDRIA, 1994-95), show that children living near streets with intense traffic of heavy vehicles are at higher risk for adverse respiratory effects, especially for productive cough.

Adolescent↗

PubMedDate not supplied

[The proportion of respiratory disorders in childhood attributable to preventable and not preventable risk factors].

On the basis of the results of the SIDRIA-2 study, we estimated the population attributable risk (PAR%) of chronic respiratory disorders in childhood for the exposure to some preventable risk factors (passive smoking-ETS, molds/dampness on the walls of the bedroom, high traffic in the street of residence) and for not preventable risk factors such as parental history of respiratory disorders or allergies. About 27% of respiratory disorders could be attributed to this latter factor, while 15.5% and 18% (among children and adolescents respectively) are potentially avoidable if exposure to ETS, molds in the home and high traffic in the street of residence are avoided.

Adolescent↗

PubMedDate not supplied

[Access to health care for asthma in Italian children and adolescents].

Bronchial asthma represents the most frequent chronic illness in the paediatric age. Although a number of guidelines for the diagnosis, treatment and prevention of the disease exist, some studies have shown that their application on a large scale is still lacking, in this way leading to the inadequate treatment of symptoms and the frequent use of emergency visits and hospitalization. Within the scope of the SIDRIA-2 project, this article describes the main aspects of diagnosis, management and treatment of asthma in children (6/7 years old) and adolescents (13/14 years old). The information was obtained from the SIDRIA questionnaire completed by the parents. The analysis of data demonstrated some relevant differences between the actual management of asthma in the paediatric age in Italy and the suggestions available from the guidelines and the literature. Moreover, some choices in the management of asthma were associated to the socio-economic level of families of children and adolescents, such as a lower use of spirometry and a higher frequency of hospitalization in disadvantaged subjects.

Adolescent↗

PubMedDate not supplied

[Trends in the frequency of asthma and allergies].

The increase in the prevalence of asthma and allergies observed during the last decades has been largely investigated, but the reasons for such trend are still unclear. The distribution of factors traditionally considered responsible of the allergic disorders (such as pollen or moulds), do not explain the geographical differences observed internationally in the prevalence of asthma and allergies. The conduction of new studies aimed at monitoring the trend in asthma and allergies, and in the risk factors associated with these disorders, such as the SIDRIA study (Italian Studies on Respiratory Disorders in Children and the Environment), will shed new light on this phenomenon.

Adolescent↗