scholarly journals Lung function in obese children and adolescents without respiratory disease: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mariana Simões Ferreira ◽  
Fernando Augusto Lima Marson ◽  
Vaneza Lira Waldow Wolf ◽  
José Dirceu Ribeiro ◽  
Roberto Teixeira Mendes
Keyword(s):  
Systematic Review ◽  
Lung Function ◽  
Children And Adolescents ◽  
Controlled Trial ◽  
Healthy Children ◽  
Obese Children ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Obesity Control ◽  
Pulmonary Changes

Abstract Background Obesity in children and adolescents is associated with increased morbidity and mortality due to multisystemic impairment, including deleterious changes in lung function, which are poorly understood. Objectives To perform a systematic review to assess lung function in children and adolescents affected by obesity and to verify the presence of pulmonary changes due to obesity in individuals without previous or current respiratory diseases. Methods A systematic search was performed in the MEDLINE-PubMed (Medical Literature Analysis and Retrieval System Online), Embase (Excerpta Medica Database) and VHL (Virtual Health Library/Brazil) databases using the terms “Lung Function” and “Pediatric Obesity” and their corresponding synonyms in each database. A period of 10 years was considered, starting in February/2008. After the application of the filters, 33 articles were selected. Using the PICOS strategy, the following information was achieved: (Patient) children and adolescents; (Intervention/exposure) obesity; (Control) healthy children and adolescents; (Outcome) pulmonary function alterations; (Studies) randomized controlled trial, longitudinal studies (prospective and retrospective studies), cross-over studies and cross-sectional studies. Results Articles from 18 countries were included. Spirometry was the most widely used tool to assess lung function. There was high variability in lung function values, with a trend towards reduced lung function markers (FEV1/FVC, FRC, ERV and RV) in obese children and adolescents. Conclusion Lung function, measured by several tools, shows numerous markers with contradictory alterations. Differences concerning the reported results of lung function do not allow us to reach a consensus on lung function changes in children and adolescents with obesity, highlighting the need for more publications on this topic with a standardized methodology.

scholarly journals Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Saad Alhumaid ◽  
Abbas Al Mutair ◽  
Zainab Al Alawi ◽  
Ali A. Rabaan ◽  
Raghavendra Tirupathi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Case Series ◽  
Incidence Rates ◽  
Effect Sizes ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Pooled Prevalence ◽  
History Of

Abstract Background Currently there is no systematic review and meta-analysis of the global incidence rates of anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines in the general adult population. Objectives To estimate the incidence rates of anaphylactic and nonanaphylactic reactions after COVID-19 vaccines and describe the demographic and clinical characteristics, triggers, presenting signs and symptoms, treatment and clinical course of confirmed cases. Design A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] statement was followed. Methods Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, and Nature) were searched from 1 December 2020 to 31 May 2021 in the English language using the following keywords alone or in combination: anaphylaxis, non-anaphylaxis, anaphylactic reaction, nonanaphylactic reaction, anaphylactic/anaphylactoid shock, hypersensitivity, allergy reaction, allergic reaction, immunology reaction, immunologic reaction, angioedema, loss of consciousness, generalized erythema, urticaria, urticarial rash, cyanosis, grunting, stridor, tachypnoea, wheezing, tachycardia, abdominal pain, diarrhea, nausea, vomiting and tryptase. We included studies in adults of all ages in all healthcare settings. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. Results Of the 1,734 papers that were identified, 26 articles were included in the systematic review (8 case report, 5 cohort, 4 case series, 2 randomized controlled trial and 1 randomized cross-sectional studies) and 14 articles (1 cohort, 2 case series, 1 randomized controlled trial and 1 randomized cross-sectional studies) were included in meta-analysis. Studies involving 26,337,421 vaccine recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were analyzed. The overall pooled prevalence estimate of anaphylaxis to both vaccines was 5.0 (95% CI 2.9 to 7.2, I2 = 81%, p =  < 0.0001), while the overall pooled prevalence estimate of nonanaphylactic reactions to both vaccines was 53.9 (95% CI 0.0 to 116.1, I2 = 99%, p =  < 0.0001). Vaccination with Pfizer-BioNTech resulted in higher anaphylactic reactions compared to Moderna (8.0, 95% CI 0.0 to 11.3, I2 = 85% versus 2.8, 95% CI 0.0 to 5.7, I2 = 59%). However, lower incidence of nonanaphylactic reactions was associated with Pfizer-BioNTech compared to Moderna (43.9, 95% CI 0.0 to 131.9, I2 = 99% versus 63.8, 95% CI 0.0 to 151.8, I2 = 98%). The funnel plots for possible publication bias for the pooled effect sizes to determine the incidence of anaphylaxis and nonanaphylactic reactions associated with mRNA COVID-19 immunization based on mRNA vaccine type appeared asymmetrical on visual inspection, and Egger’s tests confirmed asymmetry by producing p values < 0.05. Across the included studies, the most commonly identified risk factors for anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines were female sex and personal history of atopy. The key triggers to anaphylactic and nonanaphylactic reactions identified in these studies included foods, medications, stinging insects or jellyfish, contrast media, cosmetics and detergents, household products, and latex. Previous history of anaphylaxis; and comorbidities such as asthma, allergic rhinitis, atopic and contact eczema/dermatitis and psoriasis and cholinergic urticaria were also found to be important. Conclusion The prevalence of COVID-19 mRNA vaccine-associated anaphylaxis is very low; and nonanaphylactic reactions occur at higher rate, however, cutaneous reactions are largely self-limited. Both anaphylactic and nonanaphylactic reactions should not discourage vaccination.

scholarly journals The Level of Physical Activity, Lung Function and Exercise Capacity of Children and Adolescents With Cystic Fibrosis Compared to Healthy Controls

2020 ◽  
Author(s):  
Marjane Cardoso ◽  
Caroline Jacoby Schmidt ◽  
Gabriela Motter ◽  
Gabrielle Costa Borba ◽  
Tatiana Helena Rech ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cystic Fibrosis ◽  
Lung Function ◽  
Children And Adolescents ◽  
Functional Capacity ◽  
Control Group ◽  
Healthy Children ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background : people with Cystic Fibrosis (CF) have progressive limitation to physical exercise and reduced daily living activities. Regular physical activity (PA) and exercise contribute to the quality of live of people with CF. The objective of this study was to evaluate level of PA , lung function and functional capacity in children and adolescents diagnosed with CF and compare them with those of healthy children and adolescents. Methodology: the study had a cross-sectional design with a control group. Patients with CF were followed at the Children’s Pneumology Outpatient Clinic, and were matched for age and sex with healthy controls from a local public school. The evaluations included daily step count, the shuttle walk test and spirometry. Results: 70 children and adolescents were evaluated, 35 diagnosed with CF and 35 healthy controls. The overall mean age was 11.6±2.9 years. There was no significant difference in level of PA between the patient and control groups. Gender analysis revealed no significant difference in level of PA between the groups or within the CF group. The CF group values were significantly lower than the control group for BMI (p=0.04), percentage of predicted FEV 1 and FEV 1 Z-score (p=0.02 and p=0.010). Conclusion: In this sample, children and adolescents with CF had the same level of PA as their healthy peers. Boys and girls with CF had similar level of PA when stratified by sex, as well as when compared to healthy peers of the same gender. Differences were observed between BMI, FEV 1 and some functional capacity test variables between the groups.

scholarly journals Current evidence does not support whole body vibration in clinical practice in children and adolescents with disabilities: a systematic review of randomized controlled trial

2019 ◽  
Vol 23 (3) ◽  
pp. 196-211 ◽  
Author(s):  
Hércules Ribeiro Leite ◽  
Ana Cristina Resende Camargos ◽  
Vanessa Amaral Mendonça ◽  
Ana Cristina Rodrigues Lacerda ◽  
Bruno Alvarenga Soares ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trial ◽  
Clinical Practice ◽  
Children And Adolescents ◽  
Controlled Trial ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Current Evidence ◽  
Body Vibration ◽  
Randomized Controlled

The Impact of Playing a Musical Instrument on Obstructive Sleep Apnea: A Systematic Review

2020 ◽  
Vol 129 (9) ◽  
pp. 924-929
Author(s):  
Jurjen C. de Jong ◽  
Andrew J. Maroda ◽  
Macario Camacho ◽  
Philip G. Chen
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Musical Instrument ◽  
Wind Instruments ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Obstructive Sleep ◽  
Cross Sectional Studies

Study Objectives: To conduct a systematic review of the medical literature evaluating the effects of playing a musical instrument on obstructive sleep apnea (OSA). Data Sources: Scopus, CINAHL, PubMed, and OVID. Review Methods: Searches were performed through October 22, 2019. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was followed. Results: After thorough investigation amidst specific exclusion criteria, four studies were included in the systematic review: one randomized controlled trial and three cross-sectional studies. Polysomnography was used to assess apnea-hypopnea index (AHI) related to obstructive sleep apnea (OSA) in the randomized controlled trial, while the Berlin questionnaire was used to assess high- and low risk OSA in the cross-sectional studies. Various instrument types were mentioned in these studies, largely focusing on wind instruments and subgroups within the wind instrument family. Conclusion: Current literature, although sparse, suggests that playing certain types of wind instruments are associated with either improving patients’ AHI or reducing the risk of developing OSA. Future studies with larger sample sizes utilizing validated diagnostic tools to measure the presence and severity of OSA are necessary to determine the true impact of such interventions. Although more research is needed, sustainable and minimally invasive interventions such as playing a specific type of musical instrument could serve as an accessible, inexpensive, and effective adjunctive treatment for OSA.

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