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Air quality and emergency pediatric care for symptoms of bronchial obstruction categorized by age bracket in Rio de Janeiro, Brazil

Moura,Marisa; Junger,Washington Leite; Mendonça,Gulnar Azevedo e Silva; Leon,Antonio Ponce de
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2009 EN
Relevância na Pesquisa
46.32%
The objective of this study was to estimate the association between levels of air pollutants and respiratory symptoms in children. An ecological time-series study was conducted between April 2002 and March 2003 with daily data on PM10, SO2, CO, NO2, and O3 and paediatric care in emergency rooms due to symptoms indicating bronchial obstruction. The potential confounding factors considered were: time trend, seasonality, meteorological variables, respiratory infections and the effects of weekends and holidays. A semi-parametric Poisson regression was used to model the time series. Splines (data smoothing functions), indicator variables and cubic polynomials were used to adjust the effects of the confounding variables. A 5% significance level was adopted for the study. A statistically significant increase of 6.7% in paediatric visits of children of less than 2 years of age was associated with PM10. A 3% positive association with O3 showed borderline significance (p < 0.06) in this age bracket. Our findings highlight the existence of an acknowledged public health problem in Rio de Janeiro, Brazil, and also emphasize the need to identify the principal sources of air pollutants.

Citric acid cough threshold and airway responsiveness in asthmatic patients and smokers with chronic airflow obstruction.

Auffarth, B; de Monchy, J G; van der Mark, T W; Postma, D S; Koëter, G H
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/1991 EN
Relevância na Pesquisa
36.53%
The relation between citric acid cough threshold and airway hyperresponsiveness was investigated in 11 non-smoking patients with allergic asthma (mean FEV1 94% predicted) and 25 non-atopic smokers with chronic airflow obstruction (mean FEV1 65% predicted). Cough threshold was determined on two occasions by administering doubling concentrations of citric acid. Seven of the 11 asthmatic subjects and 14 of 25 smokers with chronic airflow obstruction had a positive cough threshold on both test days. Cough threshold measurements were reproducible in both groups (standard deviation of duplicate measurements 1.2 doubling concentrations in asthma, 1.1 doubling concentrations in chronic airflow obstruction). Citric acid provocation did not cause bronchial obstruction in most patients, though four patients had a fall in FEV1 of more than 20% for a short time on one occasion only. No significant difference in cough threshold was found between the two patient groups despite differences in baseline FEV1 values. There was no significant correlation between cough threshold and the provocative concentration of histamine causing a 20% fall in FEV1 (PC20) histamine in either group. Thus sensory nerves can be activated with a tussive agent in patients with asthma and chronic airflow obstruction without causing bronchial smooth muscle contraction.

Lung mechanics in subjects showing increased residual volume without bronchial obstruction.

Vulterini, S; Bianco, M R; Pellicciotti, L; Sidoti, A M
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /06/1980 EN
Relevância na Pesquisa
46.32%
Fourteen subjects showing an increase of residual volume (RV) without any clinical or functional signs of bronchial obstruction were studied. Maximum expiratory flow volume (MEFV) curves were obtained with a pressure-corrected volume plethysmograph. Static pressure-volume curves were obtained by stepwise interruption of a slow expiration from total lung capacity (TLC) to RV. Static compliance was measured by the slope of pressure-volume curve between functional residual capacity (FRC) and FRC+20% of TLC. Maximum flow static recoil (MFSR) curves were constructed by plotting MEF obtained from MEFV curves against elastic pressure (Pst) obtained from pressure-volume curves at the same lung volumes. Most patients demonstrated a decrease of MEF 50% and 25% of VC. From the MFSR curves it was clear that this reduction was not the result of increased airways resistance, but rather of loss of elastic recoil. Most patients showed a significant decrease of Pst at different volumes and changes seem likely to be evidence of emphysema.

Expandable metal stents for non-malignant bronchial obstruction.

Fox, R. A.; De L Stanbridge, R.; Brown, J.; Riordan, J. F.; Rudd, R. M.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /09/1996 EN
Relevância na Pesquisa
46.32%
An expandable metal stent was inserted to relieve bronchial obstruction following lobectomy for localised squamous carcinoma which had not been relieved by bronchoplasty with a Goretex flap. This resulted in substantial improvement in lung function and exercise tolerance for nine months, following which severe inflammation around the stents required residual pneumonectomy.

Interior surface materials in the home and the development of bronchial obstruction in young children in Oslo, Norway.

Jaakkola, J J; Oie, L; Nafstad, P; Botten, G; Samuelsen, S O; Magnus, P
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/1999 EN
Relevância na Pesquisa
46.76%
OBJECTIVES: This study assessed the role of polyvinyl chloride (PVC) plastics and textile materials in the home in the development of bronchial obstruction during the first 2 years of life. METHODS: The study was a matched pair case-control study based on a cohort of 3754 newborns in Oslo in 1992 and 1993 who were followed up for 2 years. The case group consisted of 251 children with bronchial obstruction; the control group was matched one-to-one for date of birth. RESULTS: In conditional logistic regression analysis, the risk of bronchial obstruction was related to the presence of PVC flooring (adjusted odds ratio [OR] = 1.89; 95% confidence interval [CI] = 1.14, 3.14) and textile wall materials (adjusted OR = 1.58; 95% CI = 0.98, 2.54). The reference category was wood or parquet flooring and painted walls and ceiling. Further analysis revealed an exposure-response relationship between the assessed amount of PVC and other plasticizer-containing surface materials and the risk of bronchial obstruction. CONCLUSIONS: This study provides new evidence of the role of PVC and textile wall materials in the development of bronchial obstruction in young children.

Relation of the perception of airway obstruction to the severity of asthma

Bijl-Hofland, I; Cloosterman, S; Folgering, H; Akkermans, R; van Schayck, C P
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /01/1999 EN
Relevância na Pesquisa
36.8%
BACKGROUND—Patients with a poor perception of their symptoms of asthma seem to have an increased risk of an asthma attack. The influence of factors such as airway calibre, bronchial hyperresponsiveness, age and sex on the "perceptiveness" of a patient are poorly understood. It is of clinical importance to identify patients who are likely to have a poor perception of their symptoms. We have studied the perception of bronchoconstriction by asthmatic patients during a histamine provocation test and analysed the influence of bronchial obstruction, hyperresponsiveness, sex, and age. We were particularly interested to establish whether there was any difference in perception between subjects with a greater or lesser severity of asthma (expressed as bronchial obstruction, hyperresponsiveness).
METHODS—One hundred and thirty four patients with allergic asthma underwent a histamine provocation test. The FEV1 was measured after each inhalation of histamine. Subjects were asked to rate subjective quantification of the sensation of breathlessness on a visual analogue scale (VAS). The relationship between changes in VAS values and the reduction in FEV1 as a percentage of the baseline value was analysed by determining the linear regression slope (α) between the two parameters and indicates the perception of airway obstruction. Multiple regression analysis was performed to investigate the effect of baseline FEV1...

Successful use of high dose rate brachytherapy for non-malignant bronchial obstruction

Kramer, M; Katz, A; Yarmolovsky, A; Schifter, D; Fenig, E
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /05/2001 EN
Relevância na Pesquisa
46.56%
High dose rate (HDR) endobronchial brachytherapy is a palliative treatment for symptomatic airway obstruction by malignant tumours. We report a novel use of HDR brachytherapy for treating non-malignant bronchial obstruction. The patient had a metal stent placed in a reconstructed airway after a bronchial tear to ensure patency. Granulation tissue formation in and around the stent caused symptomatic occlusion of the airway, necessitating multiple laser applications. A single treatment of HDR brachytherapy (1000 cGy) was delivered following laser therapy. The patient remains well 15 months after treatment with no evidence of recurrent granulation tissue formation on bronchoscopy. HDR brachytherapy is an effective treatment for non-malignant airway obstruction.



Corticosteroids in primary tuberculosis with bronchial obstruction.

Toppet, M; Malfroot, A; Derde, M P; Toppet, V; Spehl, M; Dab, I
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1990 EN
Relevância na Pesquisa
46.32%
The usefulness of prednisolone in combination with the modern potent antituberculous drugs has been studied in 29 children with primary lung tuberculosis and hilar adenopathy causing bronchial obstruction. These children were divided at random in two groups of 15 and 14 patients. Both groups were treated similarly except that one group received prednisolone. Both groups were very similar before the onset of treatment for most variables. Tuberculous infection healed in both groups but the group on steroids improved earlier and had significantly fewer complications, both on radiography and bronchoscopy. Only two of the patients on steroids still had progressive lesions: a very young baby probably because he developed two severe viral infections consecutively, and another infant of 7 months whose treatment was unreliable, as the parents were not very compliant. Some patients initially not treated with prednisolone improved only after it was given. Prednisolone treatment is not recommended when the reliability of the treatment cannot be guaranteed, as the hazard of harm would exceed the expected benefit.

The promotion of patent airways and inhibition of antigen-induced bronchial obstruction by endogenous nitric oxide.

Persson, M. G.; Friberg, S. G.; Gustafsson, L. E.; Hedqvist, P.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /12/1995 EN
Relevância na Pesquisa
46.51%
1. The aim of the present study was to investigate the role of nitric oxide (NO), histamine and leukotrienes in bronchial obstruction. For this, guinea-pigs immunised against ovalbumin were studied under anaesthesia during challenge with antigen or agonists. 2. Challenge with nebulised antigen (0.1-1 mg) elicited dose-dependent increases in insufflation pressure which were abolished by combined administration of histamine and leukotriene antagonists. 3. Challenge with nebulised antigen (0.1-1 mg) also elicited dose-dependent increases in the concentration of endogenous nitric oxide in the exhaled air. After an initial peak, exhaled NO concentrations returned to pre-challenge levels. 4. The increase in insufflation pressure and in exhaled NO caused by ovalbumin challenge was inhibited by combined administration of histamine and leukotriene antagonists. 5. In non-immunised guinea-pigs, challenge of the airways with nebulised histamine (10-1000 nmol) or leukotriene C4 (LTC4, 30-300 pmol) elicited dose-dependent increases in insufflation pressure and in concentrations of endogenous NO in exhaled air. 6. The increase in exhaled NO correlated with the increase in insufflation pressure in response to ovalbumin, histamine and LTC4. An inhibitor of endogenous NO synthesis...

An unusual cause of bronchial obstruction

Liju, Ahmed; Sharma, Neel; Milburn, Heather
Fonte: Medknow Publications & Media Pvt Ltd Publicador: Medknow Publications & Media Pvt Ltd
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
46.51%
We present here a case of bronchial obstruction secondary to late paradoxical reactive enlargement and erosion by mediastinal lymph nodes into the left main bronchus in a 26-year-old woman with tuberculosis lymphadenitis. Bronchial obstruction due to paradoxical reactions, especially in the late phase of treatment, has not been described in adults before.

Bronchial obstruction by tumor embolus of contralateral lung during pneumonectomy: report of a case

Lee, Dong Kyu; Kim, Heezoo; Lim, Sang Ho; Choi, Young Ho; Kim, Hyun Koo
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em 19/02/2013 EN
Relevância na Pesquisa
46.61%
Bronchial obstruction due to a tumor embolus of the contralateral lung during pneumonectomy is an uncommon and fatal complication. According to previous cases, a bronchial balloon of double-lumen endotracheal tube (DLT) could prevent a dislodged tumor from traveling to the contralateral lung. We experienced a tumor embolism from the bronchus with cancer to the other bronchus despite applying DLT. A 59-year-old male with endobronchial lung cancer underwent a left pneumonectomy. One-lung ventilation was established by the right-sided DLT. After a left bronchial division, a sudden increase of peak airway pressure and reduction of the expired tidal volume to 50 ml was observed. Intraoperative fiberoptic bronchoscopy showed a near total obstruction of the right main bronchus due to tumor emboli. It was not possible to remove the tumor embolus through bronchoscopic suction and forceps. Therefore, we reopened the left bronchial stump and successfully extracted tumor embolus under bronchoscopic guidance.

An unusual bronchial obstruction in a fit young man

Freeman, Anna; Weeden, David; Wilkinson, Jane; Kurukulaaratchy, Ramesh J
Fonte: BMJ Publishing Group Publicador: BMJ Publishing Group
Tipo: Artigo de Revista Científica
Publicado em 09/01/2013 EN
Relevância na Pesquisa
46.32%
We describe the case of a previously well young man who presented acutely to hospital with a history of progressive chest symptoms and systemic upset. At admission, clinical evidence of left upper lobe collapse on respiratory examination and chest x-ray gave rise to significant clinical concern. Initial assessment by CT suggested a possible aspirated foreign body in the left upper lobe bronchus with distal left upper lobe collapse. Subsequent rigid bronchoscopy identified a solid abnormality totally occluding the left upper lobe bronchus, which did not appear to be a foreign body. The patient became progressively more unwell with clinical signs of chest sepsis and failed to settle with medical therapy. A decision was made to undertake a lobectomy to remove the collapsed lobe and obstructing endobronchial lesion. Histology confirmed that the cause of bronchial obstruction was a mesenchymoma (pulmonary hamartoma).

Balance Deficits are Correlated with Bronchial Obstruction Markers in Subjects with Asthma

Lopes, Agnaldo José; Pinto Almeida, Vívian; Silveira Menezes, Sara Lucia; Guimarães, Fernando Silva
Fonte: The Society of Physical Therapy Science Publicador: The Society of Physical Therapy Science
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.32%
[Purpose] Balance deficits are increasingly recognized in chronic obstructive pulmonary disease, but little is known regarding this issue in asthma. Our primary aim was to assess the correlation between postural balance and pulmonary function in adults with asthma. Secondarily, we aimed to correlate balance with functional capacity and body mass index in these subjects. [Methods] A cross-sectional study of 26 adults with asthma was performed in which they were subjected to stabilometry, pulmonary function testing, a 6-minute walking test, and nutritional assessment. [Results] We found significant correlations of forced expiratory volume at one second (ρ=−0.49) and total lung capacity (ρ=0.39) with mediolateral displacement with feet apart/eyes open. Significant correlations were observed between peak expiratory flow and a number of stabilometric parameters. There were several significant correlations between airway-specific conductance and the tasks performed on the force platform, especially one with the feet apart/eyes open. The Berg Balance Scale revealed significant correlations with mediolateral displacement, mediolateral range, and anteroposterior range for feet together/eyes closed (ρ=−0.49). There were no significant correlations between stabilometry...

Massive Cardiomegaly due to Dilated Cardiomyopathy Causing Bronchial Obstruction in an Infant

Lee, Ji Eun; Oh, Jin-Hee; Lee, Jae Young; Koh, Dae Kyun
Fonte: Korean Society of Echocardiography Publicador: Korean Society of Echocardiography
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.32%
Dilated cardiomyopathy (DCMP) remains a life threatening disease in young patients and is often difficult to differentiate from myocarditis. Early recognition and treatment of DCMP are crucial for good prognoses in this patient population. The clinical course of patients with DCMP that result in cardiogenic shock varies according to the etiology as well as patient age. The volumetric expansion of the enlarged heart can compress adjacent structures causing a number of related symptoms, especially in infants with soft cartilaginous bronchi. Therapeutic strategies for treating these issues vary according to the type of complication encountered. We report a case of severe DCMP with sudden onset of massive cardiomegaly with heart failure complicated by bronchial obstruction in an infant.

3D-modelling of transient left bronchial obstruction following bidirectional superior cavopulmonary shunt

Lone, Reyaz A; Chapron, Julien; Faris, Aslam; John, Jiju; Samaan, Sandra Abou; Bhat, Akhlaque Nabi
Fonte: Bloomsbury Qatar Foundation Journals Publicador: Bloomsbury Qatar Foundation Journals
Tipo: Artigo de Revista Científica
Publicado em 18/06/2014 EN
Relevância na Pesquisa
46.32%
Extrinsic compression of airways is one the most important causes of respiratory insufficiency in the perioperative period in children with congenital heart disease. This is especially true of pathologies that involve surgery of the aortic arch or conduit replacement of the right ventricular outflow tract. However bronchial obstruction is uncommon in the setting of bidirectional cavopulmonary shunt alone.

Functional variables associated with the clinical grade of dyspnoea in coal miners with pneumoconiosis and mild bronchial obstruction

Bauer, T; Schultze-Werningh..., G; Kollmeier, J; Weber, A; Eibel, R; Lemke, B; Schmidt, E
Fonte: BMJ Group Publicador: BMJ Group
Tipo: Artigo de Revista Científica
Publicado em /12/2001 EN
Relevância na Pesquisa
46.65%
OBJECTIVES—Dyspnoea is a common symptom in coal miners with pneumoconiosis. Among others, gas exchange disturbances due to airway obstruction or mismatch between ventilation and perfusion may be underlying mechanisms. The validation of dyspnoea by the degree of airway obstruction is controversial, because the extent of airway obstruction often does not correlate with the clinical grade of breathlessness.
METHODS—The association was investigated between breathlessness (self reported, on a six point scale) and indices of submaximal spiroergometry in 66 coal workers with radiographically confirmed pneumoconiosis (International Labour Organisation (ILO) grade of profusion ⩾1/0, mean (SD) age 64 (5.5) years, mean (SD) forced expired volume in 1 second (FEV1) 77.5 (22.9) % predicted).
RESULTS—The clinical degree of breathlessness was independently associated with minute ventilation/oxygen consumption (V̇E/V̇O2) ratio (β 0.423, 95% confidence interval (95% CI) 0.18 to 0.67, p=0.001) and smoking (β 0.318, 95% CI 0.21 to 1.79, p=0.014) in a multiple linear regression analysis. The V̇E/V̇O2 ratio (β 0.556, 95% CI 0.20 to 0.90, p=0.003) was also the best predictor of breathlessness when only coal miners with airway obstruction (FEV1 < 80% predicted) were analyzed.
CONCLUSION—The V̇E/V̇O2 ratio as a measurement of mismatch between ventilation and perfusion predicted the clinical grade of breathlessness better than measurements of bronchial obstruction at rest in coal workers with pneumoconiosis.


Keywords: coal workers' pneumoconiosis; bronchial obstruction; ventilation

Survey of construction workers repeatedly exposed to chlorine over a three to six month period in a pulpmill: II. Follow up of affected workers by questionnaire, spirometry, and assessment of bronchial responsiveness 18 to 24 months after exposure ended.

Bhérer, L; Cushman, R; Courteau, J P; Quévillon, M; Côté, G; Bourbeau, J; L'Archevêque, J; Cartier, A; Malo, J L
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /04/1994 EN
Relevância na Pesquisa
36.58%
OBJECTIVE--The aim was to determine the prevalence of persistent respiratory symptoms and bronchial hyper-responsiveness due to reactive airways dysfunction syndrome in a population of construction workers at moderate to high risk of developing the syndrome, at an interval of 18 to 24 months after multiple exposures to chlorine gas during renovations to a pulp and paper mill. DESIGN AND PARTICIPANTS--71 of 289 exposed workers (25%) were identified on the basis of an exposure and the onset of respiratory symptoms shortly after this event (moderate to high risk). A standardised respiratory questionnaire was first presented, followed by spirometry and a methacholine inhalation test on those whose questionnaire suggested the persistence of respiratory symptoms. RESULTS--64 of 71 (90%) subjects completed the respiratory questionnaire at the time of the follow up. The questionnaire suggested a persistence of respiratory symptoms in 58 of the 64 workers (91%). Of the 58 subjects, 51 underwent spirometry and assessment of bronchial responsiveness. All of them used bronchodilators as required (not regularly) and four required inhaled anti-inflammatory preparations. Sixteen had bronchial obstruction (forced expiratory volume in one second) (FEV1 < 80% predicted) and 29 showed significant bronchial hyper-responsiveness. CONCLUSION--Of the subjects (n = 71) who were at moderate to high risk of developing reactive airways dysfunction syndrome after being exposed to chlorine and were seen 18 to 24 months after exposure ended...

Testing bronchial hyper-responsiveness: provocation or peak expiratory flow variability?

den Otter, J J; Reijnen, G M; van den Bosch, W J; van Schayck, C P; Molema, J; van Weel, C
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/1997 EN
Relevância na Pesquisa
36.55%
BACKGROUND: Assessing bronchial hyper-responsiveness (BHR) is a main diagnostic criterion of asthma. Provocation testing is not readily available in general practice, but peak expiratory flow (PEF) is. Several guidelines promote the use of PEF variability as a diagnostic tool for BHR. This study tested the agreement between histamine challenge testing and PEF variability, and the consequences for diagnosing asthma. AIM: To investigate the possibility of assessing BHR by PEF variability, using a histamine provocation test as a reference. METHOD: Subjects with signs of symptoms indicating asthma (persistent or recurrent respiratory symptoms or signs of reversible bronchial obstruction) (n = 323) were studied. They had been identified in a population screening for asthma. A histamine provocation test and PEF variability were assessed over a three-week period. Asthma was defined as signs or symptoms together with a reversible airflow obstruction or BHR to the histamine challenge test. BHR was defined as a PC20 histamine of < or = 8 mg/ml or a PEF variability of > or = 15%. Overall correlation between PC20 and PEF variability was calculated using Spearman's rho. Furthermore, a decision tree was constructed to clarify the role of BHR in diagnosing asthma. RESULTS: Thirty-two patients had a reversibility in forced expiratory volume in 1 second (FEV1) of > or = 9% predicted...

Prevalência de obstrução numa população exposta ao fumo do tabaco – Projecto PNEUMOBIL; Prevalence of bronchial obstruction in a tobacco smoke exposed population – The PNEUMOBIL project

Ferreira, J.M.; Matos, Maria João; Rodrigues, Fátima; Belo, Aurora; Dias, Hermínia Brites; Cardoso, João; Simão, Paula; Moutinho dos Santos, J.; Almeida, João; Gouveia, António; Bárbara, Cristina
Fonte: Elsevier Publicador: Elsevier
Tipo: Artigo de Revista Científica
Publicado em /09/2009 POR
Relevância na Pesquisa
66.7%
A espirometria não atingiu ainda a divulgação que se justificaria em patologia respiratória, ou indivíduos que se encontram em risco relativamente a esta patologia, cujo diagnóstico é insuficiente, havendo um escasso conhecimento, e consequente controlo, dos custos atribuíveis a estas doenças, com destaque para a doença pulmonar obstrutiva crónica (DPOC). O PNEUMOBIL, iniciativa que visa esta divulgação entre fumadores e ex-fumadores, foi reactivado, após 10 anos de aplicação em Portugal, revelando agora, numa amostra de 5324 indivíduos, em que cerca de 50% ainda mantêm os hábitos tabágicos, sejam do sexo masculino ou feminino, que houve uma elevada prevalência de obstrução detectada por espirometria (30% e 25%, respectivamente) nas pessoas rastreadas perto de centros de saúde (grupo público) e em empresas (grupo privado). Este risco não se explica em regra por exposição ocupacional, nem se relaciona com a maioria dos sintomas respiratórios, muito frequentes nos rastreados. Apenas a dispneia (OR = 1,28; p = 0,02) e os episódios frequentes de expectoração (OR = 1,21; p = 0,008) ou de bronquite aguda (OR = 1,31; p = 0,05) revelam alguma relação com a obstrução. O reconhecimento prévio da DPOC é muito reduzi-do e a presença de obstrução não se correlaciona (p = 0...

Air quality and emergency pediatric care for symptoms of bronchial obstruction categorized by age bracket in Rio de Janeiro, Brazil

Moura,Marisa; Junger,Washington Leite; Mendonça,Gulnar Azevedo e Silva; Leon,Antonio Ponce de
Fonte: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Publicador: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2009 EN
Relevância na Pesquisa
46.32%
The objective of this study was to estimate the association between levels of air pollutants and respiratory symptoms in children. An ecological time-series study was conducted between April 2002 and March 2003 with daily data on PM10, SO2, CO, NO2, and O3 and paediatric care in emergency rooms due to symptoms indicating bronchial obstruction. The potential confounding factors considered were: time trend, seasonality, meteorological variables, respiratory infections and the effects of weekends and holidays. A semi-parametric Poisson regression was used to model the time series. Splines (data smoothing functions), indicator variables and cubic polynomials were used to adjust the effects of the confounding variables. A 5% significance level was adopted for the study. A statistically significant increase of 6.7% in paediatric visits of children of less than 2 years of age was associated with PM10. A 3% positive association with O3 showed borderline significance (p < 0.06) in this age bracket. Our findings highlight the existence of an acknowledged public health problem in Rio de Janeiro, Brazil, and also emphasize the need to identify the principal sources of air pollutants.