Association between desloratadine and prednisolone in the treatment of children with acute symptoms of allergic rhinitis: a double-blind, randomized and controlled clinical trial

Introduction: A combination of antihistamines and oral corticosteroids is often used to treat acute symptoms of allergic rhinitis. Objective: To evaluate safety and efficacy of desloratadine plus prednisolone in the treatment of acute symptoms of children (2-12 years) with allergic rhinitis, and to compare it to dexchlorpheniramine plus betamethasone. Methods: Children with moderate/severe persistent allergic rhinitis and symptomatic (nasal symptoms score [0-12] >= 6) were allocated in a double-blind, randomized fashion to receive dexchlorpheniramine plus betamethasone (n = 105; three daily doses) or desloratadine plus prednisolone (n = 105; single dose followed by two of placebo) for 7 days. At the beginning and end of the evaluation, the following were obtained: nasal symptoms score, extra nasal symptoms score, peak nasal inspiratory flow, blood biochemistry, and electrocardiogram. Ninety-six children of the dexchlorpheniramine plus betamethasone group and 98 of the desloratadine plus prednisolone group completed the protocol. Results: The two groups were similar regarding initial and final nasal symptoms scores, extra nasal symptoms scores and peak nasal inspiratory flow. A drop of 76.4% and 79.1% for nasal symptoms score, 86.0% and 79.2% for extra nasal symptoms score, as well as an increase of 25.2% and 24.3% for peak nasal inspiratory flow occurred for those treated with desloratadine plus prednisolone and dexchlorpheniramine plus betamethasone, respectively. There were no significant changes in blood chemistry. Sinus tachycardia was the most frequent electrocardiogram change, but with no clinical significance. Drowsiness was reported significantly more often among those of dexchlorpheniramine plus betamethasone group (17.14% x 8.57%, respectively). Conclusion: The desloratadine plus prednisolone combination was able to effectively control acute symptoms of rhinitis in children, improving symptoms and nasal function. Compared to the dexchlorpheniramine plus betamethasone combination, it showed similar clinical action, but with a lower incidence of adverse events and higher dosing convenience. (C) 2016 Published by Elsevier Editora Ltda. on behalf of Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial.Funding authority for Studies and Projects (FINEP) - Innovation and Research, BrazilEMS/AS - Sao Paulo, BrazilUniv Fed Sao Paulo Unifesp, EPM, Dept Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, EPM, Dept Ginecol, Sao Paulo, SP, BrazilFundacao Apoio Escola Paulista Med FAP, Sao Paulo, SP, BrazilUniv Santo Amaro Unisa, Clin Med, Sao Paulo, SP, BrazilHosp Nipo Brasileiro, Pediat, Sao Paulo, SP, BrazilUniv Estadual Campinas Unicamp, Campinas, SP, BrazilFundacao Getulio Vargas, Mkt, Rio De Janeiro, RJ, BrazilGrp NC Farma, Sao Paulo, SP, BrazilGrp NC Farma, Pesquisa Clin & Farmacovigilancia, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, EPM, Dept Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, EPM, Dept Ginecol, Sao Paulo, SP, BrazilFundacao Apoio Escola Paulista Med FAP, Sao Paulo, SP, BrazilEMS/AS - Sao Paulo, Brazil: 01.12.0094.00EMS/AS - Sao Paulo, Brazil: FINEP-1375/10Web of Scienc

Growth velocity and weight gain in prepubertal asthmatic children

Objective: To evaluate the stature growth rate (GR) and the weight gain of prepubertal asthmatic children. Method: A retrospective cohort study evaluating medical records of 85 children diagnosed with asthma, aged less than 9 years, of both sexes, with at least one year of follow-up in the allergy outpatient clinic. The data on the disease, weights and heights were collected through a standardized questionnaire on two occasions, with an interval of one year. The curves proposed by Tanner were applied for the analysis of the GR, and the Z-score of the GR (ZGR) was calculated. Results: Excess weight (risk for overweight, overweight and obesity) was observed in 31.8% (27/85) of the patients, but there was no association with the severity of asthma. Low GR (ZGR < -2) was found in 13.9% (11/79) of patients, most frequently among children with moderate/severe persistent asthma compared to persistent mild and intermittent forms (7/11 - 63.6% vs. 21/68 - 30.2%, respectively, p=0.047). Use of steroids (dose, type and time of use) was not associated with GR. Conclusion: GR was most affected in children with moderate/severe asthma.National Counsel of Technological and Scientific Development (CNPq)Univ Fed Sao Paulo Unifesp, Escola Paulista Med EPM, Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo, SP, BrazilUnifesp, EPM, Dept Pediat, Santo Andre, SP, BrazilFMABC, Dept Pediat, Santo Andre, SP, BrazilUniv Fed Sao Paulo, EPM, Dept Pediat, Rua Otonis 725, BR-04025002 Sao Paulo, SP, BrazilUniv Fed Sao Paulo Unifesp, Escola Paulista Med EPM, Pediat, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo, SP, BrazilUnifesp, EPM, Dept Pediat, Santo Andre, SP, BrazilUniv Fed Sao Paulo, EPM, Dept Pediat, Rua Otonis 725, BR-04025002 Sao Paulo, SP, BrazilWeb of Scienc

ERICA: prevalence of asthma in Brazilian adolescents

OBJECTIVE: To describe the prevalence of asthma and physician-diagnosed asthma in Brazilian adolescents. METHODS: Cross-sectional, national, school-based study with adolescents from 12 to 17 years old, participants in the Study of Cardiovascular Risks in Adolescents (ERICA). The study stratified the sample by region and grouped according to schools and classes with representativeness to the set of cities with more than 100,000 inhabitants of the Country, macro-regions, capitals, and Federal District. A questionnaire collected data through a self-filled in method. We calculated the prevalences and their confidence intervals of 95% (95% CI) according to sex, age group, type of school and skin color. RESULTS: Between 2013 and 2014, 74,589 adolescents were evaluated, 55.3% of the female sex. The total prevalence of active asthma was of 13.1% (95% CI 12.1-13.9), being higher in girls (14.8%; 95% CI 13.7-16.0) when compared to boys (11.2%; 95% CI 10.3-12.2) in all geographical strata examined. It was also higher between students of private schools (15.9%; 95% CI 14.2-17.7) when compared to public ones (12.4%; 95% CI 11.4-13.4). It was higher in the Southeast region (14.5%; 95% CI 12.9-16.1), and in the city of Sao Paulo (16.7%; 95% CI 14.7-18.7). The lowest prevalence was observed in North region (9.7%; 95% CI 9.7-10.5), and in Teresina (6.3%; 95% CI 4.9-7.7). The prevalence of physician-diagnosed asthma was of 8.7% (95% CI 8.2-9.1); higher in the North region (13.5%; 95% CI 12.7-14.2), and in Porto Alegre (19.8%; 95% CI 17.5-22.3). It was lower in the Midwest (6.9%; 95% CI 6.0-7.8), and in Cuiaba (4.8%; 95% CI 3.8-5.9). We found no significant difference in the expression of this rate between the sexes, as well as in other variables evaluated by the study. CONCLUSIONS: The prevalence of asthma in Brazilian adolescents is high. Rates of active asthma and physician-diagnosed asthma vary widely in different regions and capitals evaluated by the ERICA. These results may assist in the preparation of preventive programs and policies on health and a better understanding of the factors associated with asthma in this age group.Department of Science and Technology of the Science, Technology and Strategic Inputs Secretariat from the Brazilian Ministry of Health (Decit/SCTIE/MS)Health Sector Fund (CT-Saude) of the Ministry of Science, Technology and Innovation (MCTI)Research Incentive Fund of the Hospital de Clinicas de Porto AlegreUniv Estado Rio de Janeiro, Fac Ciencias Med, Dept Pediat, BR-20550011 Rio De Janeiro, RJ, BrazilUniv Fed Sergipe, Dept Med, Aracaju, SE, BrazilUniv Fed Sao Paulo, Dept Pediat, Disciplina Alergia Imunol Clin & Reumatol, Sao Paulo, SP, BrazilUniv Estado Rio de Janeiro, Fac Ciencias Med, Dept Med Interna, BR-20550011 Rio De Janeiro, RJ, BrazilUniv Estado Rio de Janeiro, Fac Ciencias Med, Programa Posgrad Ciencias Med, BR-20550011 Rio De Janeiro, RJ, BrazilUniv Estado Rio de Janeiro, Inst Nutr, Dept Nutr Aplicada, BR-20550011 Rio De Janeiro, RJ, BrazilFundacao Inst Brasileiro Geog & Estat, Escola Nacl Ciencias Estat, Rio De Janeiro, RJ, BrazilUniv Estado Rio de Janeiro, Fac Ciencias Med, Nucleo Estudos Saude Adolescente, BR-20550011 Rio De Janeiro, RJ, BrazilUniv Fed Sao Paulo, Dept Pediat, Disciplina Alergia Imunol Clin & Reumatol, Sao Paulo, SP, BrazilMCTI: FINEP - 01090421CNPq: 565037/2010-2Research Incentive Fund of the Hospital de Clinicas de Porto Alegre FIPE-HCPA: 405.009/2012-7Web of Scienc

Validation of the Modified Shuttle Test to Predict Peak Oxygen Uptake in Youth Asthma Patients Under Regular Treatment

Background: Oxygen uptake (VO2) evaluations by cardiopulmonary exercise test is expensive and time-consuming. Estimating VO2 based on a field test would be an alternative.Objective: To develop and validate an equation to predict VO2peak based on the modified shuttle test (MST).Methods: Cross sectional study, with 97 children and adolescents with asthma. Participants were divided in two groups: the equation group (EG), to construct the equation model of VO2peak, and the cross-validation group (VG). Each subject performed the MST twice using a portable gas analyzer. The peak VO2peak during MST was used in the equation model. The patients’ height, weight, gender, and distance walked (DW) during MST were tested as independent variables.Results: The final model [-0.457 + (gender × 0.139) + (weight × 0.025) + (DW × 0.002)] explained 87% of VO2peak variation. The VO2peak predicted was similar to VO2peak measured by gas analyzer (1.9 ± 0.5 L/min and 2.0 ± 0.5 L/min, respectively) (p = 0.67), and presented significant ICC 0.91 (IC95% 0.77 to 0.96); p &lt; 0.001. The Bland–Altman analysis showed low bias (-0.15 L/min) and limits of agreement (-0.65 to 0.35 L/min). There was no difference in DW between EG (760 ± 209 m) and VG (731 ± 180 m), p = 0.51.Conclusion: The developed equation adequately predicts VO2peak in pediatric patients with asthma