Obesity has been pointed out as a risk factor for higher prevalence of asthma and asthma-related symptoms in adolescents. The objective was to evaluate the relationship between the prevalence of asthma and obesity in adolescents living in Santa Maria and surroundings (state of Rio Grande do Sul, southern Brazil), applying the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. A total of 4,010 of 6,123 schoolchildren, 13 to 14 years of age, enrolled in the ISAAC phase III protocol (asthma core questionnaire) and were nutritionally evaluated: height, weight, and triceps skinfold (TSF) measurements. Prevalence of asthma (wheeze in the last 12 months) and prevalence of severe asthma (two or more affirmative responses to: more than 4 acute attacks of asthma, speech disturbance, sleep disturbance, wheezing with exercise) were evaluated and compared according to their nutritional status: obese and non-obese. Obese adolescents were defined by body mass index (BMI, in kg/m(2)) > or =85th percentile and TSF > or =85th percentile. Obese and non-obese groups were compared for prevalence of asthma and asthma severity using the Chi-square test and odds ratio (OR) with 95% confidence interval. Analyzing all adolescents, we observed a significant positive relationship between the prevalence of obesity and affirmative responses to "wheeze ever" (OR = 1.28; 95% CI 1.08-1.52), "wheezing with exercise" (OR = 1.36; 95% CI 1.11-1.66), "asthma ever" (OR = 1.29; 95% CI 1.03-1.62), and severe asthma (OR = 1.55; 95% CI 1.12-2.14). Among the boys, there was a significant positive association between obesity and "wheeze ever" (OR = 1.49; 95% CI 1.13-1.86). In girls, there was a significant positive relationship with "asthma ever" (OR = 1.38; 95% CI 1.01-1.88) and "wheezing with exercise" (OR = 1.36; 95% CI 1.11-1.66). This cross-sectional study with adolescents living in the southern region of Brazil showed that there is a positive association between obesity and prevalence of asthma symptoms and asthma severity, a finding mainly confined to girls.

The prevalence of asthma related symptoms were higher among those adolescents living in the urban centers in comparison to the rural ones. These differences were significant for wheezy ever, wheezy in the last 12 months, asthma ever, and wheezy with exercise in Caruaru and for wheezy ever and asthma ever, in Santa Maria. Comparing urban areas, the prevalence of asthma related symptoms in Caruaru was higher than in Santa Maria, except for wheezy ever and wheezy with exercise. The opposite was observed comparing rural areas: the prevalence of asthma (except for nocturnal cough) was higher in Santa Maria despite lesser severity of symptoms in this city.

OBJECTIVE: To determine the clinical characteristics and the results of bronchoscopic treatment of children due to foreign body aspiration in a university hospital. METHOD: Time series of children who underwent bronchoscopies for foreign bodies aspirated into the airway between March 1993 and July 2002. Each patient was analyzed for age, sex, initial clinical diagnosis, nature and location of the foreign body, duration of symptoms between aspiration and bronchoscopy, radiological findings, results of bronchoscopic removal, complications of bronchoscopy and presence of foreign bodies in the airways. RESULTS: Thirty-four children, 20 (59%) boys, ages ranging from nine months to nine years (median = 23 months). In 32 (94%) children the foreign body was removed by rigid bronchoscope, and two resulted in thoracotomy. Foreign bodies were more frequent in children under three years of age (66%). A clinical history of foreign body inhalation was obtained in 27 (80%) cases. Most of the foreign bodies removed were organic (65%) and more frequently found in the right bronchial tree (59%). Foreign bodies were removed within 24 hours in 18 (53%) cases. The most frequent radiographic findings were: unilateral air trapping, atelectasis and radiopac foreign body. Major bronchoscopy complications occurred in seven children (22%), and there were no deaths. CONCLUSIONS: More attention is necessary to the respiratory symptoms of aspirations, mainly in boys at early ages, with clinical history and compatible radiological findings. Most foreign bodies removed were of organic nature. In this case series, therapeutic rigid bronchoscopy was effective with few complications

Objective: To investigate the relationship between the increase of body mass index and the prevalence and severity of asthma in adolescents from Santa Maria, in southern Brazil, and surrounding regions. Method:A cross-sectional, observational, population-based study was carried out with 4,010 schoolchildren aged 13 and 14 years, without any gender restrictions, who answered the written questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) phase III. Body mass index was used (kg/m²) as recommended by the World Health Organization for the assessment of nutritional status: below the fifth percentile (underweight), at or above the fifth percentile and below the 85th percentile (normal weight), at or above the 85th percentile and below the 95th percentile (overweight), and at or above the 95th percentile (obesity). The relationship between body mass index and the prevalence and severity of asthma was analyzed using the chi-square test for trend (statistical significance: p < 0.05).Results: There was a significant statistical association between the increase in body mass index and the prevalence of wheezing ever (p = 0.036), and wheezing with exercise (p = 0.008). When stratified by sex, there was a positive association just for wheezing ever (p = 0.028) for boys and wheezing with exercise (p = 0.03) for girls. Conclusion:The increase in body mass index was associated with the increase in the prevalence of wheezing ever, but not with the increase in the prevalence and gravity of asthma among adolescents. J Pediatr (Rio J)

The increase in body mass index was associated with the increase in the prevalence of wheezing ever, but not with the increase in the prevalence and severity of asthma among adolescents.

Introdução:A broncoconstrição temporária após o exercício físico tem elevada prevalência em crianças e adolescentes asmáticos.Objetivo: Determinar a freqüência e gravidade do broncoespasmo induzido pelo exercício em crianças e adolescentes, com diagnóstico clínico de asma leve, moderada e grave.Método: Foi realizado um estudo descritivo, tipo transversal, não controlado. A amostra constituiu-se de 40 indivíduos asmáticos, de ambos os sexos, com idade entre 7 e 18 anos, que não utilizavam regularmente medicação antiinflamatória. Foi realizado teste padronizado de provocação brônquica com exercício de corrida em esteira rolante. A espirometria foi padronizada em seis manobras expiratórias, realizadas antes e aos 1, 5, 10, 15, 20 e 30 minutos após o término do exercício, sendo escolhida a de maior valor. O volume expiratório forçado no primeiro segundo (VEF 1 ) foi utilizado para o diagnóstico e classificação da gravidade do broncoespasmo. Os pacientes asmáticos apresentavam condições clínicas e espirométricas adequadas para os testes (VEF 1 >70% do valor previsto). Foi utilizada como critério de positividade para o broncoespasmo induzido pelo exercício queda >10% em relação ao VEF 1 prévio ao exercício.Resultados: Vinte e seis (65%) pacientes desenvolveram broncoespasmo após o exercício. Dos pacientes com asma leve 44%, e dos com asma moderada e grave, 100% desenvolveram broncoespasmo. Houve associação significativa entre a freqüência do broncoespasmo induzido pelo exercício e a gravidade da asma (p< 0,05), e diferença significativa entre a sua gravidade (confirmada por uma queda no VEF 1 ) e a gravidade da asma (p < 0,05). Conclusão:A freqüência e gravidade do broncoespasmo induzido pelo exercício estiveram relacionadas com a gravidade clínica da asma.

INTRODUÇÃO: A asma é a doença crônica mais comum entre adolescentes. OBJETIVO: Determinar a prevalência de asma e sintomas relacionados utilizando o protocolo do International Study of Asthma and Allergies in Childhood (ISAAC) em adolescentes de Santa Maria (RS). MÉTODO: Estudo transversal, em que foram avaliados 3.066 escolares urbanos (13-14 anos) de Santa Maria (RS), selecionados por amostragem aleatória, conforme protocolo do ISAAC. Os dados foram coletados de março a junho de 2003 utilizando-se questionário padronizado do ISAAC. O questionário foi respondido pelos adolescentes em sala de aula, na presença dos pesquisadores. RESULTADOS: O número de questionários válidos devolvidos foi de 3.066 (95,5%). A prevalência dos sintomas de asma nos adolescentes foi: sibilos alguma vez na vida em 42,1% dos adolescentes; sibilos nos últimos doze meses em 16,7%; quatro crises ou mais de sibilos nos últimos doze meses em 1,9%; sono perturbado em uma ou mais noites por semana nos últimos doze meses em 3,8%; prejuízo na fala nos últimos doze meses em 3,8%; asma alguma vez na vida em 14,9%; sibilos após exercícios nos últimos doze meses em 19%; tosse seca à noite nos últimos doze meses em 32,4% deles. Houve valores significativamente superiores no sexo feminino. CONCLUSÃO: A prevalência dos sintomas relacionados à asma em adolescentes urbanos de Santa Maria mostrou-se elevada, predominando entre as meninas. Ficou entre a média internacional e foi inferior aos dados observados nas capitais brasileiras. Estes dados reforçam a necessidade de estudos regionais para o melhor entendimento da prevalência da asma no Brasil.

Objective: To investigate the relationship between the increase of body mass index and the prevalence and severity of asthma in adolescents from Santa Maria, in southern Brazil, and surrounding regions. Method:A cross-sectional, observational, population-based study was carried out with 4,010 schoolchildren aged 13 and 14 years, without any gender restrictions, who answered the written questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC) phase III. Body mass index was used (kg/m²) as recommended by the World Health Organization for the assessment of nutritional status: below the fifth percentile (underweight), at or above the fifth percentile and below the 85th percentile (normal weight), at or above the 85th percentile and below the 95th percentile (overweight), and at or above the 95th percentile (obesity). The relationship between body mass index and the prevalence and severity of asthma was analyzed using the chi-square test for trend (statistical significance: p < 0.05).Results: There was a significant statistical association between the increase in body mass index and the prevalence of wheezing ever (p = 0.036), and wheezing with exercise (p = 0.008). When stratified by sex, there was a positive association just for wheezing ever (p = 0.028) for boys and wheezing with exercise (p = 0.03) for girls. Conclusion:The increase in body mass index was associated with the increase in the prevalence of wheezing ever, but not with the increase in the prevalence and gravity of asthma among adolescents.J Pediatr (Rio J). 2005;81(4):305-9: Asthma, prevalence, adolescent, body mass index. ResumoObjetivo: Investigar a relação entre o aumento do índice de massa corporal e a prevalência e a gravidade da asma em escolares adolescentes residentes em Santa Maria e região (RS).Método: Estudo transversal de base populacional, do qual participaram 4.010 adolescentes (13 e 14 anos de idade), sem restrições de sexo, tendo preenchido de forma correta o questionário do International Study of Asthma and Allergies fase III (módulo asma). Utilizou-se o índice de massa corporal (kg/m²) com os seguintes percentis (Organização Mundial de Saúde) para definir o estado nutricional: abaixo do quinto (desnutrição), igual ou superior ao quinto e inferior ao 85º (normal), igual ou superior ao 85º e inferior ao 95º (sobrepeso), igual ou superior ao 95º (obesidade). Para verificar a associação entre índice de massa corporal e a prevalência e gravidade da asma, foi utilizado o teste do qui-quadrado para tendência linear, com nível de significância de 5%.Resultados: O aumento do índice de massa corporal mostrou associação positiva e significante com o da prevalência de sibilos alguma vez (p = 0,036) e a de sibilos após exercício (p = 0,008), independentemente do sexo. Quando estratificado por gênero, houve associação positiva apenas para sibilos alguma vez (p = 0,028) para meninos e sibilos após exercício (p = 0,03) para meninas.Conclusão: O aumento do índice de massa corporal associou-se com o aumento da pre...