Recurrent Wheezing in Infants: A Population-Based Study (original) (raw)
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Prevalence of recurrent wheezing in infants
Jornal de Pediatria, 2007
Objective: To identify the prevalence of recurrent wheezing in infants in the city of Curitiba, PR, Brazil. Methods: A cross-sectional study carried out by means of administering questionnaires to the parents of infants aged 12 to 15 months attending health centers for immunization during the period between August 2005 and December 2006. This is a standardized and validated instrument consisting of questions on demographic characteristics, wheezing, respiratory infections and risk factors. At the time of the study the City Health Department had 107 health centers, 35 of which were selected by lots and distributed homogeneously across the municipal territory. Results: A total of 1,364 infants (45.4%) had episodes of wheezing during their first 12 months of life, with onset at 5.5±3.1 months (mean ± standard deviation), and 678 (22.6%) had had three or more episodes. In 84.6% of the wheezing children treatment was with β 2-agonists, with inhaled corticosteroids in 18.5%, oral corticosteroids in 24.3% and leukotriene receptor antagonists were used with 5.4%. The wheezing children exhibited nocturnal symptoms, intense difficulty breathing and visits to emergency services in the proportions of 58.9, 46.2 and 57.6%, respectively; 12.7% were admitted to hospital for asthma and 10.9% had had a medical diagnosis of asthma. Nocturnal symptoms, visits to emergency, severity of symptoms, hospital admissions for asthma and medical diagnoses of asthma were all more common among those who had suffered three or more crises (p < 0.001). Conclusions: There is an elevated prevalence of wheezing among the infants of Curitiba, with early onset and elevated morbidity. It is possible that these infants represent a large contingent of asthmatics.
Journal of Chittagong Medical College Teachers' Association
Background: Wheeze in infants and toddlers are a common symptom and sign. Inhaled Corticosteroids are considered the most effective treatment available for long-term control of asthma or recurrent wheezing of children. The aim of the present study was to see the efficacy of very low dose inhaled Beclomethasone in reducing the misuse of antibiotics and hospital admission among the infants and toddlers with recurrent wheezing. Materials and methods: This was a prospective study done among 70 infants and toddlers of 4months to 3 years of age having a recurrent wheeze. Open -ended questionnaires were used. All patients were studied with Beclomethasone Dipropionate HFA inhaler 1puff (50 micrograms) twice daily and Salbutamol inhaler 1-2 puffs (Each puff contain 100 micrograms) 3 to 4 times daily when needed via small volume spacer with a mask. Sixty patients completed the study for total 3 months and were included in the analysis. Patients were followed up every 4 weeks interval and symp...
Children at the Risk of Recurrent Wheezing: A Matched Case-Control Study in a Tertiary Care Center
Cureus
Wheezing is a common symptom in early childhood. Recurrent wheezing is defined as more than three episodes of wheezing in the past year. Many studies have been conducted to delineate the risk factors for recurrent wheezing and to predict which of these children will progress to asthma. Most studies about risk factors and the clinicodemographic profile of children with recurrent wheeze have been carried out in developed nations. Data in developing countries may differ. This study was carried out to identify risk factors associated with recurrent wheezing in children in a tertiary care center. Materials and methods It was a retrospective, matched case-control study conducted over a period of two years (July 2019 to July 2021). Records of children aged one month to 12 years who came to pediatric OPD or were admitted to a pediatric ward with a history of recurrent wheezing were included in the study. Cases with uncontrolled recurrent wheezing diagnosed by examination with an unreliable history and those with a global developmental delay were excluded from the study. The study involved the hospital records of 60 children. Of these, 30 were recurrent wheezers, and 30 were non-wheezers (controls). Data were collected with detailed proformas from case histories and examination sheets. The proforma had several known and suspected risk factors associated with wheezes. Each risk factor was studied and compared with the control group. The risk factors included in this study were male gender, not exclusively breastfed, history of bottle feeding, exposure to vehicles; exposure to pollen; exposure to animals; using an agarbatti or dhoop, passive smoking, or playing with a soft toy. Data were entered in an Excel sheet, and appropriate statistical analyses were done. Results The male-to-female ratio was 2:1. Out of the number of cases, 73.33% were younger than six years; 56.66% of cases were not exclusively breastfed, and 43.33% were exclusively breastfed for six months; 20% of the cases were bottle-fed, and 40% of the controls were bottle-fed. The percentage of cases exposed to vehicle smoke was 26.66%, while 20% of cases had exposure to pollen and 16% of controls were exposed to pollen. 30% of cases were exposed to animals, and 23% of controls were exposed to animals. With regard to passive smoking, 16.66% of cases were exposed to passive smoking, and 20% of controls were not exposed to passive smoking. Out of the study group, 26.66% of the children played with soft toys. Of all these risk factors, a significant difference between cases and controls was found in only one factor: not being exclusively breastfed for six months. All other risk factors showed no significant difference between cases and controls. Conclusion The present study concluded that the significant risk factor that was associated with recurrent wheezing was "not exclusively breastfeeding." The other factors studied that were suspected to be associated with recurrent wheezing cannot be ruled out entirely due to the relatively small size of the sample and the need to be studied further in detail.
Persistent Wheeze in Infants: A Guide for General Pediatricians
Pediatric Annals, 2019
Infants with persistent wheeze is a common diagnostic challenge for the general pediatrician because of the broad differential diagnoses. The initial diagnostic approach should include a comprehensive history, physical examination, and chest radiography. Additional testing may be warranted. Involvement of a pediatric pulmonary subspecialist may also be indicated. [Pediatr Ann. 2019;48(3):e110-e114.]
54 Antibiotics but not Paracetamol Reduce the Risk for Recurrent Wheezing in Infants
World Allergy Organization Journal, 2012
Identified risk factors for the presence of wheezing in the last 12 months were: nasal symptoms accompanied with ocular symptoms (itching and tearing) in the last 12 months, OR 2.31 (95% CI, 2.01-2.66; P # 0.0001). Nasal symptoms (blocked nose, runny nose, and/or itching) in the last 12 months, OR 2.2 (95% CI, 1.66-2.92; P # 0.0001). Hay fever diagnosis by medical staff OR 2.02 (95% CI, 1.72-2.37; P # 0.0001). Atopic dermatitis symptoms (classic morphology and distribution) in the last 12 months,
Risk Factors for Recurrent Wheezing in Infants
Journal of Human Growth and Development, 2013
ResumoIntrodução: a sibilância é um dos sintomas respiratórios mais comuns na infância. Independentemente da causa, é motivo de procura por atendimento médico em serviços de urgência, sobretudo se há recorrência dos episódios. Muito frequente na infância, a sibilância de repetição tem seus primeiros episódios no primeiro ano de vida. Objetivo: verificar os fatores de risco para sibilância recorrente em lactentes no primeiro ano de vida. Método: pesquisa de campo do tipo exploratória, transversal com abordagem quantitativa, onde foi aplicado um questionário padronizado do Estudo Internacional de Sibilância em Lactentes, traduzido e validado no Brasil, constituído por questões objetivas. Foram questionadas 40 mães cadastradas em duas Unidades de Saúde da Família. Resultados: os fatores de risco encontrados: tabagismo durante a gestação, histórico familiar de asma, rinite e dermatite alérgica, presença de pelo menos um animal doméstico em domicílio na época do nascimento e idade do pri...
American Journal of Respiratory and Critical Care Medicine, 2016
Background: Infantile wheezing is a common problem, but there are no guidelines for the evaluation of infants with recurrent or persistent wheezing that is not relieved or prevented by standard therapies. Methods: An American Thoracic Society-sanctioned guideline development committee selected clinical questions related to uncertainties or controversies in the diagnostic evaluation of wheezing infants. Members of the committee conducted pragmatic evidence syntheses, which followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The evidence syntheses were used to inform the formulation and grading of recommendations. Results: The pragmatic evidence syntheses identified few studies that addressed the clinical questions. The studies that were identified constituted very low-quality evidence, consisting almost exclusively of case series with risk of selection bias, indirect patient populations,
Treatment of recurrent acute wheezing episodes in infancy with oral salbutamol and prednisolone
European Journal of Pediatrics, 1996
The aim of this study was to investigate the role of oral salbutamol and prednisolone in the treatment of acute episodes of wheezing in infants under 15 months of age. Sixty-two acute episodes of wheezing were studied in 59 babies (age range 3-14 months; mean 7 months), who had all suffered at least one previous wheezy episode. Patients were randomised to receive either salbutamol and prednisolone, salbutamol and placebo or double placebo. Parents were requested to keep a diary card record of twice daily scoring of their baby's symptoms over the next 14 days. A significantly greater number of treatment failures occurred in the placebo group compared to babies treated with oral salbutamol (relative risk 2.51; 95% confidence intervals for relative risk 1.09-5.79). There was no difference in the number of treatment failures between babies treated with a combination of salbutamol and placebo and those treated with salbutamol and prednisolone (relative risk 0.71; 95% confidence intervals for relative risk 0.18-2.80).