Fonte financiadora: Pharmacia do Brasil (doou kits para dosagens).Artigo submetido em 015.12.03, aceito em 03.03.04. AbstractObjective: To determine the frequency of sensitization to inhalant and food allergens in children seen at Brazilian allergy services.Patients and methods: Total and specific IgE serum levels to inhalant and food allergens (RAST, UniCAP ® Pharmacia) were measured in 457 children accompanied in pediatric allergy services and in 62 control children age matched. RAST equal or higher than class 1 was considered as positive (R+).Results: Frequency of R+ was significantly higher among atopics (361/457, 79%) when compared to controls (16/62, 25.8%). There were no differences according to gender. The frequency of R+ to all allergens evaluated were higher among atopics when compared to controls. Significantly higher total IgE serum levels were observed among the atopics with R+ in comparison to those with R-. The frequency of R+ to main inhalant allergens were: D. pteronyssinus = 66.7% x 14.5% (p < 0.05), D. farinae = 64.5% x 17.8% (p < 0.05), B. tropicalis = 55.2% x 19.4% (p < 0.05), cockroach = 32.8% x 9.7% (p < 0.05), and cat = 12% x 8.1%. In relation to food allergens we observed: fish = 29.5% x 11.3% (p < 0.05), egg = 24.4% x 4.8% (p < 0.05), cow s milk = 23.1% x 3.2% (p < 0.05), wheat = 20% x 8.1% (p < 0.05), peanuts = 14% x 4.8% (p < 0.05), soy = 11.8% x 4.8% (p < 0.05), and corn = 10.6% x 4.8% (p < 0.05). With respect of age, food allergen sensitization predominates in young children whereas the inverse occurs with inhalant allergens.Conclusions: There was a predominant frequency of sensitization to inhalant allergens, mainly house dust mites in the evaluated patients. Food allergens were also responsible for a significant proportion of sensitization, mainly in infants. ResumoObjetivo: Determinar a freqüência de sensibilização a alérgenos inalantes e alimentares em crianças atendidas em serviços brasileiros de alergia. Pacientes e métodos: IgE sérica total e específica (RAST) a alérgenos inalantes e alimentares (UniCAP ® Pharmacia) foram determinados em 457 crianças acompanhadas em serviços de alergia pediátrica e em um grupo de controles (n = 62). Resultados classe igual ou maior que 1 foram considerados positivos (R+).Resultados: A freqüência de R+ foi significantemente maior entre os atópicos (361/457, 79%) quando comparados aos controles (16/62, 25,8%). Não houve diferenças quanto ao sexo. A prevalência de R+ entre os atópicos foi significantemente maior para todos os alérgenos avaliados. Os níveis séricos de IgE total foram significantemente mais elevados entre os atópicos com R+ quando comparados aos com R-. Comparando-se atópicos e controles, a freqüência de R+ para os principais alérgenos inalantes foi como segue: D. pteronyssinus = 66,7 versus 14,5% (p < 0,05), D. farinae = 64,5 versus 17,8% (p < 0,05), B. tropicalis = 55,2 versus 19,4% (p < 0,05), barata = 32,8 versus 9,7% (p < 0,05) e gato = 12 versus 8,1%. Com os alimentos, observouse: peixe = 29,5 versus 11,3% (p < 0,05), ovo =...
There was a predominant frequency of sensitization to inhalant allergens, mainly house dust mites in the evaluated patients. Food allergens were also responsible for a significant proportion of sensitization, mainly in infants.
The technological and scientific evolution has imposed challenges on society and especially on medicine. Changes in the doctor-patient relationship and among healthcare professionals require new regulatory formats to such relationships. The current Brazilian Code of Medical Ethics adopts the principialist North American model as a universal ethical framework, based on autonomy that is out of step with the emerging bioethics in Latin America, whose theoretical assumptions on the plurality of moral subjects and multi-intertransdisciplinarity are oriented to public health and the defense of the most vulnerable. The text reflects on the historical aspects that organize professions and their codes, and on the reasons for the gap in the evolution of bioethics in Brazil and the revision of the code. Equally, the text considers the contemporary challenges to the medical authority, which imposes the extension of the ethical debate to draft more democratic formats of professional codes, considering the Universal Declaration on Bioethics and Human Rights as the structural axis. Keywords: Ethical theory. Codes of ethics. Ethics, medical. Bioethics. Resumo Código de Ética Médica brasileiro: limites deontológicos e bioéticosA evolução tecnocientífica tem imposto desafios à sociedade e, particularmente, à medicina. Mudanças sociais nas relações médico-paciente e entre profissionais da saúde demandam novas formas de regulação dessas relações. O atual Código de Ética Médica adota o modelo principialista norte-americano como referencial ético, universalista, baseado na autonomia, em descompasso com a emergente bioética latino-americana, que tem como pressupostos teóricos a pluralidade dos sujeitos morais e a prática multi, inter e transdisciplinar, orientada para saúde pública e coletiva e defesa dos mais vulnerados. O texto reflete sobre aspectos históricos conformadores das profissões e seus códigos e as razões do descompasso da evolução da bioética no Brasil e da revisão do Código de Ética Médica. Igualmente, reflete sobre os desafios contemporâneos para o poder médico, que impõem ampliação do debate ético para elaboração de formatos mais democráticos dos códigos profissionais, tendo como eixo estruturante a Declaração Universal sobre Bioética e Direitos Humanos. Palavras-chave: Teoria ética. Códigos de ética. Ética médica. Bioética. Resumen Código de Ética Médica brasileño: límites deontológicos y bioéticosLa evolución tecnológica y científica le ha impuesto retos a la sociedad y, en particular, a la medicina. Los cambios sociales en la relación médico-paciente y entre los profesionales de la salud requieren nuevos formatos regulatorios para estas relaciones. El actual Código de Ética Médica adopta el modelo norteamericano principialista como marco ético, universalista, basado en la autonomía, fuera de sintonía con la bioética latinoamericana emergente, que tiene como presupuestos teóricos la pluralidad de sujetos morales y las prácticas multi, inter y transdisciplinarias orientadas a la salud pública y colectiva, y a...
Resumo O objetivo deste estudo foi avaliar os atributos da APS desenvolvidos durante o estágio de internato em Saúde da Família do curso médico da Universidade Federal de Alagoas (Ufal
Objective: To determine the frequency of sensitization to inhalant and food allergens in children seen at Brazilian allergy services.Patients and methods: Total and specific IgE serum levels to inhalant and food allergens (RAST, UniCAP ® Pharmacia) were measured in 457 children accompanied in pediatric allergy services and in 62 control children age matched. RAST equal or higher than class 1 was considered as positive (R+).Results: Frequency of R+ was significantly higher among atopics (361/457, 79%) when compared to controls (16/62, 25.8%). There were no differences according to gender. The frequency of R+ to all allergens evaluated were higher among atopics when compared to controls. Significantly higher total IgE serum levels were observed among the atopics with R+ in comparison to those with R-. The frequency of R+ to main inhalant allergens were: D. pteronyssinus = 66.7% x 14.5% (p < 0.05), D. farinae = 64.5% x 17.8% (p < 0.05), B. tropicalis = 55.2% x 19.4% (p < 0.05), cockroach = 32.8% x 9.7% (p < 0.05), and cat = 12% x 8.1%. In relation to food allergens we observed: fish = 29.5% x 11.3% (p < 0.05), egg = 24.4% x 4.8% (p < 0.05), cow s milk = 23.1% x 3.2% (p < 0.05), wheat = 20% x 8.1% (p < 0.05), peanuts = 14% x 4.8% (p < 0.05), soy = 11.8% x 4.8% (p < 0.05), and corn = 10.6% x 4.8% (p < 0.05). With respect of age, food allergen sensitization predominates in young children whereas the inverse occurs with inhalant allergens.Conclusions: There was a predominant frequency of sensitization to inhalant allergens, mainly house dust mites in the evaluated patients. Food allergens were also responsible for a significant proportion of sensitization, mainly in infants.
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