Biomedical subjects

Dirceu Solé

Publications and source records attributed to Dirceu Solé.

23 records · Page 2Linked to original sources

PubMedDate not supplied

[Prevalence of atopic eczema and associated symptoms in school children].

OBJECTIVE: To determine the prevalence of atopic dermatitis and associated symptoms in schoolchildren from the city of São Paulo in 1996 and 1999. METHODS: The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire was applied to the parents of 6 to 7-year-old children in 1996 and 1999 (3,005 in 1996 and 3,033 in 1999) and to 13 to 14-year-old adolescents (3,008 in 1996 and 3,487 in 1999). In the ISAAC, the option eczema ever indicates that a diagnosis of atopic eczema was made by a physician at least once in the subject's life. This was used to define "medical diagnosis" in the present study. The concomitant report of lesions in the last year in characteristic places constitutes the "combined criterion" for the diagnosis of atopic eczema and was also employed in the present study. Data were analyzed using the Epi-Info 6.0 software. RESULTS: In the 6 to 7-year-old group, there was a significant decrease in the number of "medical diagnoses" of atopic eczema in 1999 (11.4%) in comparison to 1996 (13.2%). The increase in the prevalence of "medical diagnoses" observed in 1999 among adolescents was not significant (14 vs. 15%). Considering the "combined criterion," there were no significant differences between 1996 and 1999 in either group (6.6% vs. 6.8% for 6 to 7 year-old children; 3.7% vs. 4.4% for adolescents). CONCLUSIONS: Despite the increase in the prevalence of atopic diseases worldwide, we documented a reduction in the prevalence of "medical diagnoses" of atopic eczema in 6 to 7-year-old children. Nevertheless, atopic eczema remains as a relevant disease in the pediatric population.

Adolescent↗

PubMedDate not supplied

[Sensitization to inhalant and food allergens in Brazilian atopic children by in vitro total and specific IgE assay. Allergy Project--PROAL].

OBJECTIVE: To determine the frequency of sensitization to inhalant and food allergens in children seen at Brazilian allergy services. PATIENTS AND METHODS: Total and specific IgE serum levels to inhalant and food allergens (RAST, UniCAP - Pharmacia) were measured in 457 children accompanied in pediatric allergy services and in 62 control children age matched. RAST equal or higher than class 1 was considered as positive (R+). RESULTS: Frequency of R+ was significantly higher among atopics (361/457, 79%) when compared to controls (16/62, 25.8%). There were no differences according to gender. The frequency of R+ to all allergens evaluated was higher among atopics when compared to controls. Significantly higher total IgE serum levels were observed among the atopics with R+ in comparison to those with R-. The frequency of R+ to main inhalant allergens were: D. pteronyssinus = 66.7% x 14.5% (p < 0.05), D. farinae = 64.5% x 17.8% (p < 0.05), B. tropicalis = 55.2% x 19.4% (p < 0.05), cockroach = 32.8% x 9.7% (p < 0.05), and cat = 12% x 8.1%. In relation to food allergens we observed: fish = 29.5% x 11.3% (p < 0.05), egg = 24.4% x 4.8% (p < 0.05), cow's milk = 23.1% x 3.2% (p < 0.05), wheat = 20% x 8.1% (p < 0.05), peanuts = 14% x 4.8% (p < 0.05), soy = 11.8% x 4.8% (p < 0.05), and corn = 10.6% x 4.8% (p < 0.05). With respect of age, food allergen sensitization predominates in young children whereas the inverse occurs with inhalant allergens. CONCLUSIONS: There was a predominant frequency of sensitization to inhalant allergens, mainly house dust mites in the evaluated patients. Food allergens were also responsible for a significant proportion of sensitization, mainly in infants.

Age Distribution↗

PubMedDate not supplied

[Allergic drug reactions].

OBJECTIVE: This review addresses the most recent published literature regarding drug allergy, in order to provide physicians with a background for a better understanding of this problem of great relevance for public health. SOURCES OF DATA: The sources of data for obtaining the original and review articles published in the last 10 years were MEDLINE, Pubmed and Lilacs. The articles chosen for this review relate drug allergy to immunological mechanisms, epidemiology, clinical and laboratory evaluation, skin lesions, clinical management, and re-exposure to the drug. SUMMARY OF THE FINDINGS: Allergic reactions represent one third of adverse drug reactions. They are considered rare but with high morbimortality. Gell and Coombs' definition has been useful for classifying some types of drug allergic reactions; however, some still remain without classification because of poor knowledge of the mechanisms involved. The existence of T cell subpopulations with diverse characteristics reveals the complexity of the subject and, at the same time, elucidates several questions raised about it. It was recently postulated a new concept of chemically inert drug presentation to T cells, restricted to the major histocompatibility complex, but in a non-covalent and labile way. In clinical practice, without adequate laboratory tests, it is difficult to correlate clinical symptoms and immunological mechanisms. In vitro and in vivo skin tests have been employed in cases of suspected drug allergy reaction. However, there are very few commercially available reagents. CONCLUSIONS: Drug allergy constitutes an important problem in adverse drug reactions because of its potential of morbidity and mortality. It is necessary to emphasize the relevance of pharmacovigilance during treatment of patients, as well as the identification of possible immunological mechanisms involved in the events, through laboratory tests and detailed history and clinical evaluation.

Drug Hypersensitivity↗

PubMedDate not supplied

[Adaptation and validation of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) in Brazilian asthmatic children and adolescents].

OBJECTIVES: To translate the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) into Portuguese and adapt it to the Brazilian context, for use in children and adolescents with asthma and to validate the adapted version of the questionnaire (PAQLQ-A). METHODS: Children and adolescents (7 to 17 years old) with asthma answered the PAQLQ-A on admission and were assessed using a clinical severity score. According to this score, patients were classified as mild (> or = 2) or moderate/severe (< 2). They were reassessed on at least two occasions at an interval of 2 to 4 weeks. Furthermore, patients in whom asthma was properly controlled were classified as stable, and those in whom it could not be controlled, as unstable. RESULTS: The reproducibility of the PAQLQ-A was evaluated in stable patients by comparing the mean domain scores: symptoms, emotions, activities, and the overall clinical severity score on two predefined occasions with an interval of 15 to 30 days in between. Responsiveness was evaluated among unstable patients. The mean domain scores and the overall score were different on both occasions, and so was the clinical severity score. The validity of the questionnaire was determined by the application of Cronbach's alpha reliability coefficient (alpha = 0.909). CONCLUSIONS: The translation of the PAQLQ into Portuguese did not modify the framework of the original questionnaire; the PAQLQ-A is easy to use, with easy reproducibility, constituting a valuable instrument for the evaluation of the quality of life in children and adolescents with asthma.

Adolescent↗

PubMedDate not supplied

[Prevalence and severity of asthma among adolescents and their relationship with the body mass index].

OBJECTIVE: To investigate the relationship between the increase of body mass index and the prevalence and severity of asthma in adolescents from Santa Maria, in southern Brazil, and surrounding regions. METHOD: A cross-sectional, observational, population-based study was carried out with 4,010 schoolchildren aged 13 and 14 years, without any gender restrictions, who answered the written questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) phase III. Body mass index was used (kg/m2) as recommended by the World Health Organization for the assessment of nutritional status: below the fifth percentile (underweight), at or above the fifth percentile and below the 85th percentile (normal weight), at or above the 85th percentile and below the 95th percentile (overweight), and at or above the 95th percentile (obesity). The relationship between body mass index and the prevalence and severity of asthma was analyzed using the chi-square test for trend (statistical significance: p < or = 0.05). RESULTS: There was a significant statistical association between the increase in body mass index and the prevalence of "wheezing ever" (p = 0.036), and "wheezing with exercise" (p = 0.008). When stratified by sex, there was a positive association just for "wheezing ever" (p = 0.028) for boys and "wheezing with exercise" (p = 0.03) for girls. CONCLUSION: The increase in body mass index was associated with the increase in the prevalence of wheezing ever, but not with the increase in the prevalence and severity of asthma among adolescents.

Adolescent↗