The aim of this case series report was to assess the bronchodilator response on forced expiratory flow at 25%–75% of the vital capacity of children and adolescents with asthma, sensitized and non-sensitized to house dust mites (HDM). A retrospective study was evaluated in the Hospital Municipal Jesus, Rio de Janeiro, Brazil, with 34 participants enrolled as asthma sensitized (n=26) and non-sensitized (n=8) to HDM. In spirometry tests had not obstructions in large airways. Only the FEF 25%-75% values were found reduced in relation to the reference ranges (62% vs. 38%, X2=1.39, P=0.2383) for HDM and non-HDM, respectively. The bronchodilator test with salbutamol was statistically significant in both groups (P<0.005). The measure of bronchodilator response from FEF 25%-75% values was important to evaluate the reversibility of the small airways in children and adolescents with asthma who were sensitized and non-sensitized to HDM.
The guidelines for asthma and spirometry do not mention the forced expiratory flow between 25% and 75% of forced vital capacity (FEF 25%-75%) in evaluation of airflow obstruction in asthma. The aim of this study was to assess the diagnostic performance of the FEF 25%-75% of children and adolescents with asthma sensitized to house dust mites (HDM). A retrospective case series was done in the Hospital Municipal Jesus, Rio de Janeiro, Brazil with 34 participants with asthma sensitized (n=26) and non-sensitized (n=8) to HDM. Standard reference value for FEF 25%-75% was considered abnormal if below at 65% of predicted. The percentages of 62% of sensitized participants and 38% of not sensitized to HDM had asthma with small airway obstruction by FEF 25-75% index and normal reference values for large airway flow in the spirometry report according to FEV 1/FVC ratio. The means of FEF 25%-75% for HDM and non-HDM were 44.27±9.96 vs. 56.62±13.56, respectively (t=1.86, P=0.0719). The results calculated were a positive predictive value of 80%, a sensitivity of 65%, and an accuracy of 62% amongst other significant parameters (P<0.05). We concluded that the FEF 25%-75% had a high diagnostic performance in children and adolescents with asthma sensitized to HDM.
Introduction: The GINA and the ATS do not mention that the forced expiratory flow between 25% and 75% of forced vital capacity (FEF 25%-75%) play importance in evaluation of airflow obstruction in asthma. Objectives: To investigate whether the evaluation of the FEF25%-75% in children and adolescents with asthma sensibilized to house dust mites (HDM) plays an important hole in airway obstruction from small airways. Methods. A retrospective study was done in Hospital Municipal Jesus (Rio de Janeiro, Brazil). Thirty-four children and adolescents with asthma were enrolled between January 2016 and December 2019. The FEIA (Immuno CAP®) was used to measure total and specific IgE antibodies to HDM. Standard reference value for small airways diseases with FEF 25%-75% was considered abnormal if below at 65% of predicted with FEV1/FVC ratio above or equal at 80%. Results. There was a significant difference between the mean ages of the sensitized (n=26; 9.8±2.53) and non-sensitized participants (n=8; 7.75±1.28) to HDM (P=0.0353). Male and female sexes were not significant in both groups (P=0.3698 and P=0.3298, respectively). If the FEF 25%-75% (L/s) was not valued in our study, 62% of sensitized participants (44.27±9.26) and 38% not sensitized (56.62±16.56) to HDM would be considered “according to normal reference values” (t=1.86; P=0.0719). Conclusions. The asthma in this study presented an obstructive respiratory disorder of small airways, regardless of a sensitization or a non-sensitization to HDM. The obstructive respiratory disorder of small airways was present, even with normal spirometry in the evaluation of large airways.
In total, 4,552 patients (female 57.9% and mean age 38.6AE14.6) with CU were included in this retrospective cohort study. K-medoid algorithm was used for clustering CU patients. Kaplan-Meier survival analysis with Cox regression were applied to identify predictors of CU remission.
Background The period of social isolation, due to the Covid-19 Pandemic, impacted the children's social and family life in different ways. The whole family's feelings and emotions are intertwined, and everyone is involved in a broad awareness. Children, having a more developed intuitive awareness, receive all this in the form of subliminal inputs. At the moment, there is a concern regarding behavioral disorders in children and the risk of medicalization. The systemic view of Homeopathy can contribute to understanding this context. Aims: To contextualize the pediatric emotional disorders resulting from Pandemic in Carillo Júnior's view of Classic Systemic Homeopathy and list possible homeopathic medicines. Methodology: Bibliographic survey about emotional disorders in children during the Pandemic period. A theoretical review of the concept of disease in the view of classic systemic homeopathy and selection of drugs based on the method of repertorization of signs and symptoms. Results and discussion: The classification of diseases based on the Carillo Jr Complex Systems Model is based on the concept of prevalence between intrinsic and extrinsic factors. Through this model, we can understand what is being received by children as subliminal "inputs" since they do not assess the irrational conscience. Individual resilience and vulnerability will determine how they respond. Emotional and behavior disorders: distraction, irritability, fear, agitation, anxiety, poor sleep, nightmares. Main suggested drugs: Belladona, Chamomilla, Aconitum nappelus, Argentum nitricum, Gelsemium, Tarentula hispanica, Stramonium, Ignatia amara, Aurum metalicum, Cypripedium, Coffea cruda. Conclusion: The imposed social isolation leads to an excess of external inputs on the pediatric population, and the difficulty in processing them can lead to the emergence of emotional disorders. Therefore, as a cognitive therapy that acts on the self-regulation of the organism, homeopathy is an excellent, beneficial, and assertive tool.
(23.1%), birch (17.9%), alder (14.5%), beech (12.7%), oak (11.0%) were common in group IV. Among mold allergen, sensitization rate to Alternaria (8.2%) was higher in group I than in the other groups (3.3%, 3.9%, 2.3%, respectively). CONCLUSIONS Although house dust mite is still the major allergen in child and adult with respiratory allergy, our study suggests various differences in the sensitization pattern to inhalant allergen according to age even in the same area. Further studies will be needed to explain these differences in sensitization pattern.
Background The Zika virus (ZIKV) is a flavivirus and the human disease caused by this virus has been described in the Americas in 2015. ZIKV has been identified as an etiological agent of acute exanthematous disease in Brazil. In the same year, an epidemic of microcephaly with images suggestive of congenital infection raised the suspicion of a relationship between these alterations and ZIKV infection. Epidemiological and histopathological studies point to a strong relationship between prenatal Zika virus infection and microcephaly. Newborns with microcephaly, may also present auditory and visual changes, seizures and severe neurodevelopmental impairment. In 2016, the World Health Organization (WHO) declared Zika virus (ZIKV) infection a public health emergency of international concern. Aims Clinical observation in the ambulatory school of ABRAH (Brazilian Association of Recycling and Homeopathy Assistance) of patients with encephalopathy of various origins, using the medicine Helleborus niger as equalizer of the NS (Nervous System), as described in the Complex Systems of Carillo, shows improvement in motor, cognitive and seizure disorders. Based on this observation, we propose to use this method in patients with ZIKV congenital infection. Methodology To evaluate 15 patients in follow-up at the AFR (Fluminense Rehabilitation Association), through homeopathic anamnesis, clinical, diathesic, biotypological and temperamental classification. The Gross Motor Function Classification System (GMFCS) will be used. All patients will receive Helleborus niger 6 Ch daily for 6 months. Results and discussion This study was forwarded to the research ethics committee and will begin in July 2019. Will be evaluated the use of Helleborus niger in patients with congenital infection by ZIKV, as equalizer of NS. The expected result is overall neurological improvement. Conclusion Helleborus niger, probably stimulating self-regulation through uninjured neurological pathways, will promote autopoiesis and construction of new programs of action, and will enable the improvement of patients with congenital ZIKV infection.
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