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Revista Portuguesa de Pneumologia
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Revista Portuguesa de Pneumologia
Article . 1996
License: CC BY NC ND
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Papel da hipersensibilidade e da atopia no diagnóstico e na clínica da asma

Authors: João Almeida; Jorge Ferreira; Adriana Magalhães; Venceslau Hespanhol; J. Agostinho Marques; Rosa Santos; José Alves; +1 Authors

Papel da hipersensibilidade e da atopia no diagnóstico e na clínica da asma

Abstract

RESUMO: Numa amostra raodomizada da população geral de 815 indivíduos de ambos os sexos e com idades entre 20 e 44 anos, residentes nas freguesias de Bonfim e Paranhos, e em 180 indíviduos sintomáticos, definidos pela aplicação de um inquérito de rastreio aplicado a uma amostra maior (4 045), também aleatória e escolhida entre à mesma população, estudámos a hipersensibillidade brônquica à metacolina (Pd), a sensibilidade cutânea a 10 alergénios, os valores séricos de IgE total e de IgEs especfficas para 5 alergénios e as respostas a um inquérito de 71 questões. Concordaram em executar toda a sequência de exames excepto o doseamento de IgE 263 elementos. Em 227 daqueles doseou-se a IgE. Considerámos sintomáticos (Stm) OS indíviduos que responderam positivamente às questões nos 1, 1.1 e 1.2 (n=44) do inquérito e asmáticos (Amt) os que responderam positivamente às questões nos 13 e 13.1 e com coerência clínica às questões 13.2, 13.3 e 13.4 (n=40). Relativamente à asma, definimos 4 graus: 0- não Amt(n=223);1- Amt sem crises no último ano (n=12); 2- Amt com â¤3 crises no último ano(n=23) e 3- Amt com >3 crises no último ano(n=5). Definimos fumadores os indivíduos com carga tabágica >1 UMA (Unidade Maço Ano)(n=93) e ex-fumadores aqueles que com essa carga tabágica não fumavam há mais de 1 ano(n=30). Entre os respondentes que usaram medicação anti-asmática no último aoo, definimos 3 classes: 1- usaram β2 ou corticóides(n=20);2- β2 e corticóides(n=4) e 3-β2, corticóides e xantioa(n=5). Consideramos atópicos (Atp SC) se mostraram 1 prova positiva(n=72) ou (Atp IgE) se tinham uma das IgEsâ¥II (n=57). Definimos Pd+de acordo com os critérios clássicos(n=63). Obtivemos a percentagem de Stm, Atp SC, Atp IgE e Pd nos -t graus de Amt: 0- Stm 8,3, Atp SC 19,7, Atp IgE 17,4, Pd 17,5;1- Stm 2S, Atp SC S8,3, Atp IgE 50, Pd+50; 2- Stm 73,9, Atp SC 73,9, Atp IgE 64,9, Pd 60,9; 3- Stm 100, Atp SC 80, Atp IgE 100, Pd 80. Usámos o Chi 2 global, e, aplicado à tendência para avaliar a relação anterior, o 'p' foi<0,0000 para as 4 variáveis. Estudamos a sensibilidade(Ssb) e especificidade(Epc) de cada exame com o Teorema de Bayes. Obtivemos para a Ssb: Pd 38,1 %, Atp SC 70%, Atp IgE 63,2% e Stm 50% e para a Epc: Pd 92%, Atp SC 80,3%, Atp IgE 82,S% e Stm 97,3%. Usando regressão logística múltipla, procurámos os preditores mais importaotes de asma e hipersensibilidade, definindo para asma um modelo composto por Stm(p<0,000), Atp SC(p<0,000) e Pd(p<0,026) com Ssb 50% e Epc 97,7% e para a hipersensibilidade um modelo composto por Stm(p<0,004), Atp S­C(p<0,000) e DEM 2S/75(p<0,000) com Ssb 31,75% e Epc 94,5%.

Keywords

Pulmonary and Respiratory Medicine, Diseases of the respiratory system, RC705-779

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
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