Jackeline Motta Franco

Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012)

OBJECTIVE To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13-14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3). METHODS The ISAAC-WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi-squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. RESULTS Considering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5%) and an increase in the frequency of severe asthma (4.5% vs. 4.7%) and physician-diagnosed asthma (14.3% vs. 17.6%). An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. CONCLUSIONS The prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

Socio-environmental conditions and geographical variability of asthma prevalence in Northeast Brazil

BACKGROUND This study aims to evaluate the association between environmental and socio-economic conditions with asthma prevalence in the eight ISAAC centres in North-East Brazil. METHODS Estimates on occurrence, severity and medical diagnoses of asthma in the previous 12 months were compared using environmental and socioeconomic indicators. Associations were assessed using simple linear regression and Pearson correlation coefficient. RESULTS There was no difference in asthma prevalence between centres. Active asthma prevalence increased with increasing water privation, and this would explain 62 % of the observed prevalence. Median temperature increase was inversely related to active asthma (r=0.81; p<0.05). There was a positive association between latitude and active asthma prevalence (r=0.82; p<0.005), a negative association between severe asthma and yearly medium temperature (r=-0.89; p<0.05), and a positive association with latitude (r=0.78; p<0.05). CONCLUSION Relation between the tropical weather and high prevalence of asthma was not confirmed. There were associations with water privation and latitude.

Primary Immunodeficiency May Be Misdiagnosed as Cow’s Milk Allergy: Seven Cases Referred to a Tertiary Pediatric Hospital

Introduction. The presence of eczema and gastrointestinal manifestations are often observed in cows milk allergy (CMA) and also in some primary immunodeficiency diseases (PID). Objective. To describe 7 patients referred to a tertiary allergy/immunology Center with a proposed diagnosis of CMA, who were ultimately diagnosed with PID. Methods. This was a retrospective study based on clinical and laboratory data from medical records. Results. Seven patients (6 males) aged between 3 mo and 6 y were referred to our clinic with a proposed diagnosis of CMA. They presented with eczema and/or gastrointestinal symptoms. Five were receiving replacement formula. All patients presented with other clinical features, including severe/recurrent infections unrelated to CMA, and two of them had a positive family history of PID. Laboratory tests showed immune system dysfunctions in all patients. Hyper-IgE and Wiskott-Aldrich syndromes, CD40L deficiency, severe combined immunodeficiency, X-linked agammaglobulinemia, transient hypogammaglobulinemia of infancy, and chronic granulomatous disease were diagnosed in these children. In conclusion, allergic diseases and immunodeficiency are a result of a different spectrum of abnormalities in the immune system and may be misdiagnosed. Educational programs on PID among clinical physicians and pediatricians can reduce the occurrence of this misdiagnosis.

Pulmonary function and symptoms in asthmatics adolescents

Background Asthma is a chronic inflammatory disease that may impose limitations to daily activities when not appropriately treated. It can be under-diagnosed in adolescents due to possible denial of symptoms in this age group or low perception of airflow obstruction. The aim of this study was to measure the degree of airway dysfunction in adolescents with asthma and determine the degree of disease control.

Increased sensitization to several allergens over a 12-year period in Brazilian children

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Sensibilização a aeroalérgenos em pacientes com suspeita de alergia respiratória atendidos na rede pública e privada no município de Aracaju

OBJETIVO: Identificar e comparar os padroes de sensibilizacao a alergenos inalantes entre pacientes com suspeita de alergias respiratorias atendidos em ambulatorios publicos e privados do municipio de Aracaju.METODOS: Foram analisados 1.514 resultados de testes cutâneos (TC) de punctura, realizados de abril de 2006 a setembro de 2009. Destes, 872 TC foram realizados em consultorio de setor privado, e 642 nos ambulatorios do setor publico. Os extratos alergenicos utilizados em TC foram: Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis, Periplaneta americana, Blattella germanica, penas, mistura de fungos e epitelios de cao e de gato. RESULTADOS: Asensibilizacao a pelo menos um alergeno foi de 55% (58,4% no setor privado vs 50,3% no setor publico; p