Objective: To determine the prevalence and severity of wheezing in infants, using the standardized protocol devised for the "Estudio Internacional de Sibilancias en Lactantes" (EISL, International Study of Wheezing in Infants), as well as to determine the relationship between such wheezing and physician-diagnosed asthma, in the first year of life. Methods: Between March of 2005 and August of 2006, the EISL questionnaire was administered to the parents or legal guardians of infants undergoing routine procedures or immunization at public primary health care clinics in the southern part of the city of São Paulo, Brazil. Results: Our sample comprised 1,014 infants (mean age = 5.0 ± 3.0 months), 467 (46.0%) of whom had at least one wheezing episode, 270 (26.6%) having three or more such episodes, in their first year of life. The use of inhaled β 2 agonists, inhaled corticosteroids, or antileukotrienes, as well as the occurrence of nocturnal symptoms, difficulty breathing, pneumonia, emergency room visits, and hospitalization due to severe wheezing, was significantly more common among those with recurrent wheezing (p < 0.05). Physician-diagnosed asthma was reported for 35 (7.5%) of the 467 wheezing infants and was found to be associated with the use of inhaled corticosteroids, difficulty breathing during the attacks, and six or more wheezing episodes in the first year of life. However, less than 40% of those infants were treated with inhaled corticosteroids or antileukotrienes. Conclusions: In this study, the prevalence of wheezing episodes among infants in their first year of life was high and had an early onset. The proportion of infants diagnosed with and treated for asthma was low.Keywords: Asthma/diagnosis; Asthma/epidemiology; Respiratory sounds. ResumoObjetivo: Avaliar a prevalência e a gravidade da sibilância, bem como sua relação com o diagnóstico médico de asma, em lactentes no primeiro ano de vida, utilizando o protocolo padronizado do "Estudio Internacional de Sibilancias en Lactantes" (EISL, Estudo Internacional de Sibilâncias em Lactentes). Métodos: Entre março de 2005 e agosto de 2006, os pais ou responsáveis de lactentes que procuraram unidades básicas de saúde na região centro-sul de São Paulo (SP) para procedimentos de rotina e imunização responderam ao questionário escrito do EISL. Resultados: A amostra foi constituída por 1.014 lactentes (média de idade = 5,0 ± 3,0 meses), 467 (46,0%) dos quais apresentaram sibilância no primeiro ano de vida, sendo que 270 (26,6%) tiveram três ou mais episódios. Entre esses últimos, o uso de β 2 -agonista inalatório, corticosteroide inalatório e antileucotrieno, assim como a presença de sintomas noturnos, dificuldade para respirar, pneumonia, idas ao pronto socorro e internação por sibilância grave, foram significantemente mais frequentes (p < 0,05). Os pais de 35 (7,5%) dos 467 lactentes relataram o diagnóstico médico de asma, o qual foi associado ao uso de corticosteroide inalatório, percepção de falta de ar durante as crises e seis ou mais episódios de s...

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IntroductionExercise‐induced bronchospasm (EIB) is common in young asthmatics and obesity is becoming an epidemic in this population. Both conditions can give rise to or worsen respiratory symptoms upon exercise and may interfere with recreational and sports activities.ObjectiveTo investigate the association between obesity and the risk and severity of EIB in asthmatic children and adolescents.MethodsThis study included data from asthmatic patients aged between 7 and 19 years undergoing treadmill running tests to evaluate EIB, defined as a reduction greater than or equal to 10% in forced expiratory volume in the first second (FEV1) compared to baseline. Eutrophic, obese, and overweight individuals were categorized according to body mass index z‐score (eutrophic, −0.5 < z ≤ 1; overweight, 1 < z < 2; and obese, z ≥ 2).ResultsOf the 156 individuals studied (42% female), 58% were eutrophic, 22% overweight, and 19% obese. Seventy‐three individuals (47%) presented with EIB, with higher risk among obese (OR, 2.86; 95% CI, 1.00‐8.14; P = .05). Asthma severity was another independent risk factor for EIB (OR, 2.95; 95% CI, 1.36‐6.42; P = .006). The number of patients in whom FEV1 returned to baseline values (difference less than 10% from baseline) at the 13th minute after challenge was lower in obese individuals compared to eutrophic and overweight ones (P = .04). Baseline FEV1, gender, or age were not found to be risk factors for EIB in any of the groups.ConclusionObese youngsters with asthma present a greater risk for EIB with slower recovery than their nonobese peers. Clinicians should be aware of this association, especially in those with more severe disease, for adequate recognition and treatment.

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