Evaluation of inflammatory and oxidative profile in patients with recurrent wheezing

Wheezing is a clinical expression of numerous respiratory-related conditions. Although asthma is the leading cause of wheezing during childhood. The present study aims to evaluate the inflammatory and oxidative profile of pediatric patients with recurrent wheezing. Seventy-eight volunteers were divided into three groups according to their age (≤ 36, 36 to 72 and ≥ 73 months). Blood was collected for hematological evaluation, serum detections of total immunoglobulin E (IgE), and C-reactive protein (PCRus). The oxidative profile was evaluated by total antioxidant capacity (FRAP), malondialdehyde (MDA) and carbonylated protein markers. There was no significant difference in the IgE and PCRus levels among the three groups evaluated. However, a significant positive correlation was observed for PCRus with total leukocyte and with neutrophils for the group of patients ≥ 73 months of age. The intermediate age group presented significantly reduced FRAP values in the serum, while significant values of oxidative damage markers were observed in the group of patients ≥ 73 months of age. When determining the correlation between inflammatory and oxidative markers, only the ≥ 73 months group showed significant. The group ≥ 73 months stands out with significant alterations of the oxidative stress markers and their correlations with the inflammatory profile

ANÁLISE DOS ATENDIMENTOS REALIZADOS PELO TELESSAÚDE-COVID EM UM MUNICÍPIO DE MINAS GERAIS

Objective: to analyze the sociodemographic and clinical profile of patients treated by the remote care service “Telessaúde-COVID” and the factors associated with positive results for COVID-19. Methods: an exploratory and analytical study, carried out based on the analysis of patient records treated by a remote care service called “Telessaúde-COVID”. Characteristics of the patients treated and variables related to the service's functioning were evaluated. Descriptive and inferential analysis was performed, using logistic regression. Results: 1,854 new patients were evaluated and an estimated 8,630 visits. There was a predominance of female patients (60.9%) and aged 20 to 59 years (75.9%). The most frequent signs and symptoms were: headache (41.8%), cough (33.3%) and runny nose (30.0%). Of the total number of patients, 66.4% were reported as suspected cases of COVID-19 and 14.5% had a positive result for COVID-19. The age of 60 years or more was more frequent among confirmed cases (26.6%). Most patients (80.4%) did not require face-to-face assistance. The positive results for COVID-19 were associated with the age of the patients (OR 1,020; I.C.95% 1,007-1,032); home contact with a positive/suspected case (OR 1,902; I.C95% 1,178 - 3,070); presence of nausea/vomiting (OR 2,403; I.C.95% 1,148 - 5,029) and changes in smell (OR 2,827; I.C.95% 1,294-6,176). Conclusion:  Telehealth-COVID was relevant in the management and notification of cases attended, avoiding the search for face-to-face consultations without clinical indication. Among the suspected cases, positivity for COVID-19 was associated with the elderly, history of home contact, gastrointestinal and olfactory symptoms.Objetivos: analisar o perfil sociodemográfico e clínico dos pacientes atendidos pelo serviço de atendimento remoto “Telessaúde-COVID” e os fatores associados aos resultados positivos para COVID-19. Métodos: estudo exploratório e analítico, realizado a partir da análise dos registros de pacientes atendidos por um serviço de atendimento remoto intitulado “Telessaúde-COVID”. Foram avaliadas características dos pacientes atendidos e variáveis relacionadas ao funcionamento do serviço. Realizou-se análise descritiva e inferencial, com utilização da regressão logística. Resultados: foram avaliados 1.854 novos pacientes e estimados 8.630 atendimentos. Houve predomínio de pacientes do sexo feminino (60,9%) e da faixa etária de 20 a 59 anos (75,9%).  Os sinais e sintomas mais frequentes foram: cefaleia (41,8%), tosse (33,3%) e coriza (30,0%). Do total de pacientes, 66,4% foram notificados como casos suspeitos de COVID-19 e 14,5% apresentaram resultado positivo para COVID-19. A idade igual ou superior a 60 anos foi mais frequente entre os casos confirmados (26,6%). A maioria dos pacientes (80,4%) não necessitou de atendimento presencial. Os resultados positivos para COVID-19 estiveram associados à idade dos pacientes (OR 1.020; I.C.95% 1.007-1.032); contato domiciliar com caso positivo ou suspeito (OR 1.902; I.C95% 1.178 – 3.070); presença de náuseas/vômitos (OR 2.403; I.C.95% 1.148 – 5.029) e alterações no olfato (OR 2.827; I.C.95% 1.294-6.176). Conclusões: o Telessaúde-COVID foi relevante na condução e notificação dos casos atendidos, evitando a procura por consultas presenciais sem indicação clínica. Dentre os casos suspeitos, a positividade para COVID-19 associou-se aos idosos, história de contato domiciliar, sintomas gastrointestinais e olfatórios

Vitamin D deficiency and its link to recurrent wheezing associated fators

Em estudos epidemiológicos a sibilância recorrente em pacientes pediátricos, tem sido considerado como sinônimo de asma. Representa um importante problema de saúde pública, por afetar a qualidade de vida desses indivíduos que frequentemente utilizam o sistema de saúde gerando um grande impacto econômico. O objetivo do presente estudo foi identificar fatores associados com sibilância recorrente, em pacientes atendidos em serviço de referência de pneumologia pediátrica no município de Viçosa. Realizou-se um estudo transversal com 124 crianças em seguimento no ambulatório de pneumologia pediátrica. Inicialmente utilizou-se um questionário semiestruturado, para detectar os fatores associados a sibilância recorrente e asma e posteriormente o nível de VitD sérica foi mensurado. O estudo foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos na Universidade Federal de Viçosa (1.713.903). A análise estatística foi realizada usando o pacote estatístico Stata 10 (Stata Corp, College Station, TX, USA). Da amostra estudada a maioria era do sexo masculino, não brancos com média de idade de 5 anos e 9 meses com desvio padrão de ± 4,6 anos. Cerca de 77,4 % das crianças frequentavam creche ou escola e 62,1% nasceram de parto cesáreo. Da amostra, 78,2% apresentaram renda mensal de até dois salários mínimos. Foi observado que 50,8 % da população estudada não realizou suplementação de VitD nos primeiros dois anos de vida. A prevalência de deficiência/insuficiência de VitD foi de 57,3% e após a regressão logística múltipla, as variáveis que permaneceram associadas à deficiência/insuficiência VitD foram: início da sibilância até o primeiro ano de vida (OR 2,54; IC 95% 1.12-5,76; p<0,025), antecedentes pessoais de dermatite atópica (OR 3,21; IC 95% 1.16-8,86; p<0,024), poluição ambiental (OR 1,72; IC 95% 1.14-2,59; p<0,009), suplementação da vitamina D nos primeiros dois anos de vida (OR 0,46; IC 95% 0,22-0.95; p<0,037). Vários trabalhos têm demonstrado uma elevada prevalência de deficiência/insuficiência de VitD e a sua importância, não só para saúde óssea, mas também para outras doenças imunomediadas. Observou-se no presente estudo, uma associação inversa entre os níveis deficiênte/insuficiêntes de VitD com a presença de sibilância no primeiro ano de vida, antecedentes pessoais de dermatite atópica e poluição ambiental em pacientes com sibilância recorrente e com asma.In epidemiological studies, recurrent s wheezing in pediatric patients has been considered as synonymous with asthma. It represents an important public health problem, since it affects the quality of life of those individuals who frequently use the health system, generating a great economic impact. The objective of the present study was to identify factors associated with recurrent wheezing in patients attended at a referral service of pediatric pneumology in the city of Viçosa. A cross-sectional study was carried out with 124 children in a pediatric outpatient clinic. Initially, there was applied a semi-structured questionnaire to detect the factors associated with recurrent wheezing and asthma, and later the serum VitD level was measured. The study was approved by the Research Ethics Committee with Human Beings at the Federal University of Viçosa (1,713,903). Statistical analysis was performed using the statistical package Stata 10 (Stata Corp, College Station, TX, USA). Of the sample studied, the majority were male, non-white with an average age of 5 years and 9 months, with some standard deviation of ± 4.6 years. About 77.4% of children attended daycare or school and 62.1% were born cesarean. Of the sample, 78.2% had a monthly income of up to two minimum wages. It was observed that 50.8% of the study population did not undergo VitD supplementation in the first two years of life. The prevalence of VitD deficiency/insufficiency was 57.3% and after multiple logistic regression, variables that remained associated with VitD deficiency/failure were: wheezing up to the first year of life (OR 2.54; (OR 3.21, 95% CI 1.16-8.86, p <0.024), environmental pollution (OR 1.72, 95% CI 1.14 to 5.8, p <0.025), personal history of atopic dermatitis (P <0.009), vitamin D supplementation in the first two years of life (OR 0.46, 95% CI 0.22-0.95, p <0.037). Several studies have demonstrated a high prevalence of VitD deficiency/ insufficiency and its importance, not only for bone health, but also for other immune-mediated diseases. In the present study, we observed an inverse association between the deficient/insufficient levels of VitD with the presence of wheezing in the first year of life, personal history of atopic dermatitis and environmental pollution in patients with recurrent wheezing and asthma

Prevalence of vitamin D deficiency and its relationship with factors associated with recurrent wheezing

ABSTRACT Objective: To determine the prevalence of vitamin D deficiency/insufficiency in children 0-18 years of age with recurrent wheezing and/or asthma residing in the microregion of Viçosa, Minas Gerais, Brazil, and treated at a referral center, and to determine its association with major risk factors for wheezing. Methods: A cross-sectional study was performed using a semi-structured questionnaire, which was administered by trained interviewers to the legal guardians of the study participants. Data were obtained regarding general characteristics of recurrent wheezing; general sociodemographic, environmental, and biologic factors; and atopy-related factors. The magnitude of the statistical association was assessed by calculating ORs and their corresponding 95% CIs by using multiple logistic regression. Results: We included 124 children in the study. The prevalence of vitamin D deficiency/insufficiency in the sample was 57.3%. Vitamin D deficiency/insufficiency was found to be associated with wheezing in the first year of life, personal history of atopic dermatitis, environmental pollution, and vitamin D supplementation until 2 years of age. Conclusions: The prevalence of vitamin D deficiency/insufficiency was high in our sample. Vitamin D concentrations were directly associated with vitamin D supplementation until 2 years of age and were inversely associated with wheezing events in the first year of life, personal history of atopic dermatitis, and environmental pollution