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9. Can environment or allergy explain international variation in prevalence of wheeze in childhood?

Author

Weinmayr, G., Jaensch, A., Ruelius, A. -K., Forastiere, F., Strachan, D. P., Weiland, S. K., Buchele, G., Dentler, C., Rzehak, P., Priftanji, A., Shkurti, A., Simenati, J., Grabocka, E., Shyti, K., Agolli, S., Gurakuqi, A., Stein, R. T., de Pereira, M. U., Jones, M. H., Pitrez, P. M., Cooper, P. J., Chico, M., Chen, Y. Z., Zhong, N. S., Lai, C. K. W., Wong, G. W. K., Riikjarv, M. -A., Annus, T., Annesi-Maesano, I., Gotua, M., Rukhadze, M., Abramidze, T., Kvachadze, I., Karsanidze, L., Kiladze, M., Dolidze, N., Leupold, W., Keil, U., von Mutius, E., Arthur, P., Addo-Yobo, E., Gratziou, C., Priftis, K., Papadopoulou, A., Katsardis, C., Tsanakas, J., Hatziagorou, E., Kirvassilis, F., Clausen, M., Shah, J. R., Mathur, R. S., Khubchandani, R. P., Mantri, S., Di Domenicantonio, R., De Sario, M., Sammarro, S., Pistelli, Riccardo, Serra, M. G., Corbo, Giuseppe Maria, Perucci, C. A., Svabe, V., Sebre, D., Casno, G., Novikova, I., Bagrade, L., Brunekreef, B., Schram, D., Doekes, G., Jansen-van Vliet, P. H. N., Janssen, N. A. H., Aarts, F. J. H., de Meer, G., Crane, J., Wickens, K., Barry, D., Nystad, W., Bolle, R., Lund, E., Batlles Garrido, J., Rubi Ruiz, T., Bonillo Perales, A., Gonzalez Jimenez, Y., Aguirre Rodriguez, J., Momblan deCabo, J., Losilla Maldonado, A., Daza Torres, M., Garcia-Marcos, L., Martinez Torres, A., Guillen Perez, J. J., Pinana Lopez, A., Castejon Robles, S., Garcia Hernandez, G., Martinez Gimeno, A., Moro Rodriguez, A. L., Luna Paredes, C., Gonzalez Gil, I., Morales Suarez-Varela, M. M., Llopis Gonzalez, A., Escribano Montaner, A., Tallon Guerola, M., Braback, L., Kjellman, M., Nilsson, L., Mai, X. -M., Sandin, A., Saraclar, Y., Kuyucu, S., Tuncer, A., Sackesen, C., Sumbuloglu, V., Geyik, P., Kocabas, C., Kaur, B., El-Sharif, N., Nemery, B., Barghuthy, F., Abu Huij, S., Qlebo, M., van Hage, M., Ait-Khaled, N., Anderson, H. R., Flohr, C., Williams, John Harford, Asher, I., Ellwood, P., Stewart, A., Mitchell, E., Pearce, N., Beasley, R., Bjorksten, B., Foliaki, S., Mallol, J., Montefort, S., Odhiambo, J., and Robertson, C.

Subjects
International variation, medicine.medical_specialty, Allergy, Epidemiology, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, Environment, 030204 cardiovascular system & hematology, Global Health, medicine.disease_cause, Atopy, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Wheeze, Hypersensitivity, Prevalence, Humans, Medicine, Environmental risk factors, 030212 general & internal medicine, Risk factor, Child, Asthma, business.industry, Public health, Aeroallergen, medicine.disease, medicine.symptom, business, Demography
Abstract

Asthma prevalence in children varies substantially around the world, but the contribution of known risk factors to this international variation is uncertain. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two studied 8-12 year old children in 30 centres worldwide with parent-completed symptom and risk factor questionnaires and aeroallergen skin prick testing. We used multilevel logistic regression modelling to investigate the effect of adjustment for individual and ecological risk factors on the between-centre variation in prevalence of recent wheeze. Adjustment for single individual-level risk factors changed the centre-level variation from a reduction of up to 8.4% (and 8.5% for atopy) to an increase of up to 6.8%. Modelling the 11 most influential environmental factors among all children simultaneously, the centre-level variation changed little overall (2.4% increase). Modelling only factors that decreased the variance, the 6 most influential factors (synthetic and feather quilt, mother's smoking, heating stoves, dampness and foam pillows) in combination resulted in a 21% reduction in variance. Ecological (centre-level) risk factors generally explained higher proportions of the variation than did individual risk factors. Single environmental factors and aeroallergen sensitisation measured at the individual (child) level did not explain much of the between-centre variation in wheeze prevalence.

Published
2018

17. Can environment or allergy explain international variation in prevalence of wheeze in childhood?

Author

Weinmayr G, Jaensch A, Ruelius A, Forastiere F, Strachan D, Weiland S, Buchele G, Dentler C, Rzehak P, Priftanji A, Shkurti A, Simenati J, Grabocka E, Shyti K, Agolli S, Gurakuqi A, Stein R, de Pereira M, Jones M, Pitrez P, Cooper P, Chico M, Chen Y, Zhong N, Lai C, Wong G, Riikjarv M, Annus T, Annesi-Maesano I, Gotua M, Rukhadze M, Abramidze T, Kvachadze I, Karsanidze L, Kiladze M, Dolidze N, Leupold W, Keil U, von Mutius E, Arthur P, Addo-Yobo E, Gratziou C, Priftis K, Papadopoulou A, Katsardis C, Tsanakas J, Hatziagorou E, Kirvassilis F, Clausen M, Shah J, Mathur R, Khubchandani R, Mantri S, Di Domenicantonio R, De Sario M, Sammarro S, Pistelli R, Serra M, Corbo G, Perucci C, Svabe V, Sebre D, Casno G, Novikova I, Bagrade L, Brunekreef B, Schram D, Doekes G, Jansen-van Vliet P, Janssen N, Aarts F, de Meer G, Crane J, Wickens K, Barry D, Nystad W, Bolle R, Lund E, Garrido J, Ruiz T, Perales A, Jimenez Y, Rodriguez J, de Cabo J, Maldonado A, Torres M, Garcia-Marcos L, Torres A, Perez J, Lopez A, Robles S, Hernandez G, Gimeno A, Rodriguez A, Paredes C, Gil I, Suarez-Varela M, Gonzalez A, Montaner A, Guerola M, Braback L, Kjellman M, Nilsson L, Mai X, Sandin A, Saraclar Y, Kuyucu S, Tuncer A, Sackesen C, Sumbuloglu V, Geyik P, Kocabas C, Kaur B, El-Sharif N, Nemery B, Barghuthy F, Abu Huij S, Qlebo M, van Hage M, Ait-Khaled N, Anderson H, Flohr C, Williams H, Asher I, Ellwood P, Stewart A, Mitchell E, Pearce N, Beasley R, Bjorksten B, Foliaki S, Mallol J, Montefort S, Odhiambo J, Robertson C, and ISAAC Phase Two Study Grp

Published
2019

21. Number of offspring and maternal allergy

Author

Forastiere, F., Sunyer, J., Farchi, S., Corbo, G., Pistelli, R., Baldacci, S., Simoni, M., Agabiti, N., Perucci, C. A., and Viegi, G.

Published
2005

23. Can environment or allergy explain international variation in prevalence of wheeze in childhood?

Author

Weinmayr, G., Jaensch, A., Ruelius, A. -K., Forastiere, F., Strachan, D. P., Weiland, S. K., Buchele, G., Dentler, C., Rzehak, P., Priftanji, A., Shkurti, A., Simenati, J., Grabocka, E., Shyti, K., Agolli, S., Gurakuqi, A., Stein, R. T., de Pereira, M. U., Jones, M. H., Pitrez, P. M., Cooper, P. J., Chico, M., Chen, Y. Z., Zhong, N. S., Lai, C. K. W., Wong, G. W. K., Riikjarv, M. -A., Annus, T., Annesi-Maesano, I., Gotua, M., Rukhadze, M., Abramidze, T., Kvachadze, I., Karsanidze, L., Kiladze, M., Dolidze, N., Leupold, W., Keil, U., von Mutius, E., Arthur, P., Addo-Yobo, E., Gratziou, C., Priftis, K., Papadopoulou, A., Katsardis, C., Tsanakas, J., Hatziagorou, E., Kirvassilis, F., Clausen, M., Shah, J. R., Mathur, R. S., Khubchandani, R. P., Mantri, S., Di Domenicantonio, R., De Sario, M., Sammarro, S., Pistelli, R., Serra, M. G., Corbo, G., Perucci, C. A., Svabe, V., Sebre, D., Casno, G., Novikova, I., Bagrade, L., Brunekreef, B., Schram, D., Doekes, G., Jansen-van Vliet, P. H. N., Janssen, N. A. H., Aarts, F. J. H., de Meer, G., Crane, J., Wickens, K., Barry, D., Nystad, W., Bolle, R., Lund, E., Batlles Garrido, J., Rubi Ruiz, T., Bonillo Perales, A., Gonzalez Jimenez, Y., Aguirre Rodriguez, J., Momblan deCabo, J., Losilla Maldonado, A., Daza Torres, M., Garcia-Marcos, L., Martinez Torres, A., Guillen Perez, J. J., Pinana Lopez, A., Castejon Robles, S., Garcia Hernandez, G., Martinez Gimeno, A., Moro Rodriguez, A. L., Luna Paredes, C., Gonzalez Gil, I., Morales Suarez-Varela, M. M., Llopis Gonzalez, A., Escribano Montaner, A., Tallon Guerola, M., Braback, L., Kjellman, M., Nilsson, L., Mai, X. -M., Sandin, A., Saraclar, Y., Kuyucu, S., Tuncer, A., Sackesen, C., Sumbuloglu, V., Geyik, P., Kocabas, C., Kaur, B., El-Sharif, N., Nemery, B., Barghuthy, F., Abu Huij, S., Qlebo, M., van Hage, M., Ait-Khaled, N., Anderson, H. R., Flohr, C., Williams, H., Asher, I., Ellwood, P., Stewart, A., Mitchell, E., Pearce, N., Beasley, R., Bjorksten, B., Foliaki, S., Mallol, J., Montefort, S., Odhiambo, J., Robertson, C., Pistelli R. (ORCID:0000-0003-3776-2482), Corbo G. (ORCID:0000-0002-8104-4659), Williams H., Weinmayr, G., Jaensch, A., Ruelius, A. -K., Forastiere, F., Strachan, D. P., Weiland, S. K., Buchele, G., Dentler, C., Rzehak, P., Priftanji, A., Shkurti, A., Simenati, J., Grabocka, E., Shyti, K., Agolli, S., Gurakuqi, A., Stein, R. T., de Pereira, M. U., Jones, M. H., Pitrez, P. M., Cooper, P. J., Chico, M., Chen, Y. Z., Zhong, N. S., Lai, C. K. W., Wong, G. W. K., Riikjarv, M. -A., Annus, T., Annesi-Maesano, I., Gotua, M., Rukhadze, M., Abramidze, T., Kvachadze, I., Karsanidze, L., Kiladze, M., Dolidze, N., Leupold, W., Keil, U., von Mutius, E., Arthur, P., Addo-Yobo, E., Gratziou, C., Priftis, K., Papadopoulou, A., Katsardis, C., Tsanakas, J., Hatziagorou, E., Kirvassilis, F., Clausen, M., Shah, J. R., Mathur, R. S., Khubchandani, R. P., Mantri, S., Di Domenicantonio, R., De Sario, M., Sammarro, S., Pistelli, R., Serra, M. G., Corbo, G., Perucci, C. A., Svabe, V., Sebre, D., Casno, G., Novikova, I., Bagrade, L., Brunekreef, B., Schram, D., Doekes, G., Jansen-van Vliet, P. H. N., Janssen, N. A. H., Aarts, F. J. H., de Meer, G., Crane, J., Wickens, K., Barry, D., Nystad, W., Bolle, R., Lund, E., Batlles Garrido, J., Rubi Ruiz, T., Bonillo Perales, A., Gonzalez Jimenez, Y., Aguirre Rodriguez, J., Momblan deCabo, J., Losilla Maldonado, A., Daza Torres, M., Garcia-Marcos, L., Martinez Torres, A., Guillen Perez, J. J., Pinana Lopez, A., Castejon Robles, S., Garcia Hernandez, G., Martinez Gimeno, A., Moro Rodriguez, A. L., Luna Paredes, C., Gonzalez Gil, I., Morales Suarez-Varela, M. M., Llopis Gonzalez, A., Escribano Montaner, A., Tallon Guerola, M., Braback, L., Kjellman, M., Nilsson, L., Mai, X. -M., Sandin, A., Saraclar, Y., Kuyucu, S., Tuncer, A., Sackesen, C., Sumbuloglu, V., Geyik, P., Kocabas, C., Kaur, B., El-Sharif, N., Nemery, B., Barghuthy, F., Abu Huij, S., Qlebo, M., van Hage, M., Ait-Khaled, N., Anderson, H. R., Flohr, C., Williams, H., Asher, I., Ellwood, P., Stewart, A., Mitchell, E., Pearce, N., Beasley, R., Bjorksten, B., Foliaki, S., Mallol, J., Montefort, S., Odhiambo, J., Robertson, C., Pistelli R. (ORCID:0000-0003-3776-2482), Corbo G. (ORCID:0000-0002-8104-4659), and Williams H.

Abstract

Asthma prevalence in children varies substantially around the world, but the contribution of known risk factors to this international variation is uncertain. The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Two studied 8–12 year old children in 30 centres worldwide with parent-completed symptom and risk factor questionnaires and aeroallergen skin prick testing. We used multilevel logistic regression modelling to investigate the effect of adjustment for individual and ecological risk factors on the between-centre variation in prevalence of recent wheeze. Adjustment for single individual-level risk factors changed the centre-level variation from a reduction of up to 8.4% (and 8.5% for atopy) to an increase of up to 6.8%. Modelling the 11 most influential environmental factors among all children simultaneously, the centre-level variation changed little overall (2.4% increase). Modelling only factors that decreased the variance, the 6 most influential factors (synthetic and feather quilt, mother’s smoking, heating stoves, dampness and foam pillows) in combination resulted in a 21% reduction in variance. Ecological (centre-level) risk factors generally explained higher proportions of the variation than did individual risk factors. Single environmental factors and aeroallergen sensitisation measured at the individual (child) level did not explain much of the between-centre variation in wheeze prevalence.

Published
2019

33. Sex differences in factors associated with heart failure and diastolic left ventricular dysfunction: a cross-sectional population-based study.

Author

Cesaroni, Giulia, Mureddu, Gian Francesco, Agabiti, Nera, Mayer, Flavia, Stafoggia, Massimo, Forastiere, Francesco, Latini, Roberto, Masson, Serge, Davoli, Marina, Boccanelli, Alessandro, on behalf of the PREDICTOR Study Group, Boccanelli, A., Cacciatore, G., Mureddu, G. F., Rizzello, V., Agabiti, N., Cesaroni, G., Forastiere, F., Perucci, C. A., and Davoli, M.

Subjects
CARDIOVASCULAR diseases risk factors, HEART failure risk factors, SEX differences in the heart, LIFESTYLES & health, DISEASE prevalence, ATRIAL fibrillation, DISEASES in older people, LEFT ventricular dysfunction
Abstract

Background: Although sex differences in cardiovascular diseases are recognised, including differences in incidence, clinical presentation, response to treatments, and outcomes, most of the practice guidelines are not sex-specific. Heart failure (HF) is a major public health challenge, with high health care expenditures, high prevalence, and poor clinical outcomes. The objective was to analyse the sex-specific association of socio-demographics, life-style factors and health characteristics with the prevalence of HF and diastolic left ventricular dysfunction (DLVD) in a cross-sectional population-based study.Methods: A random sample of 2001 65-84 year-olds underwent physical examination, laboratory measurements, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiography, and echocardiography. We selected the subjects with no missing values in covariates and echocardiographic parameters and performed a complete case analysis. Sex-specific multivariable logistic regression models were used to identify the factors associated with the prevalence of the diseases, multinomial logistic regression was used to investigate the factors associated to asymptomatic and symptomatic LVD, and spline curves to display the relationship between the conditions and both age and NT-proBNP.Results: In 857 men included, there were 66 cases of HF and 408 cases of DLVD (77% not reporting symptoms). In 819 women, there were 51 cases of HF and 382 of DLVD (79% not reporting symptoms). In men, the factors associated with prevalence of HF were age, ischemic heart disease (IHD), and suffering from three or more comorbid conditions. In women, the factors associated with HF were age, lifestyles (smoking and alcohol), BMI, hypertension, and atrial fibrillation. Age and diabetes were associated to asymptomatic DLVD in both genders. NT-proBNP levels were more strongly associated with HF in men than in women.Conclusions: There were sex differences in the factors associated with HF. The results suggest that prevention policies should consider the sex-specific impact on cardiac function of modifiable cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Published
2021
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39. Knowledge and health care resource allocation: CME/CPD course guidelines-based efficacy

Author

Braido, F., Comaschi, M., Valle, I., Delgado, L., Coccini, A., Guerreras, P., Stagi, E., Canonica, G. W., Arga, Study Group, Eaaci Cme, Committee, Angino, A., Baldacci, S., Borbotti, M., Cerrai, S., Di Pede, F., Maio, S., Mangione, M., Martini, F., Pala, P., Piegaia, B., Sarno, G., Silvi, P., Viegi, G., Dente, F., Bacci, E., Paggiaro, P., Bancalari, L., Foschino, M. P., Moscato, G., Pilucchi, A., Bresciani, M., Pierimarchi, P., Brunetto, B., Iacovacci, P., Pini, C., Tinghino, R., Forestiere, F., Perucci, C. A., Porta, D., Ancona, L., Protasi, S., Lazazzera, B., Ziroli, V., D Armini, E., Festa Campanile, S., Ferri, M., Lorusso, P., Pistelli, R., Salotti, R., Santagati, M., Casciari, C., Murgia, N., Spinozzi, F., Antonicelli, L., Braschi, M. C., Conti, V., Filippelli, A., Corbi, G. M., Giusy Russomanno, Baiardini, I., Balbi, F., Ferraioli, G., Bordo, A., Cerveri, I., Corsico, A., Grosso, A., Ansotegui, I. J., Gayraud, J., Nekam, K., Malling, H-J, Papadopolus, N., Popov, T., and Skevaki, C.

Subjects
Health Knowledge, Attitudes, Practice, diagnostic procedures, spirometry, continuing medical education, Pilot Projects, Guidelines, drugs, Education, General Practitioners, Medical, cost, Hypersensitivity, Humans, continuing professional development, Rhinitis, Practice, Asthma, hospitalization, medico-economic assessment, Health Knowledge, Continuing, Attitudes, Education, Medical, Continuing, Guideline Adherence
Abstract

Most health care systems consider continuing medical education a potential tool to improve quality of care and reduce disease management costs. Its efficacy in general practitioners needs to be further explored.This study assesses the effectiveness of a one-year continuing medical education/continuing professional development course for general practitioners, regarding the improvement in knowledge of ARIA and GINA guidelines and compliance with them in asthma management.Sixty general practitioners, covering 68,146 inhabitants, were randomly allocated to continuing medical education/continuing professional development (five residential events +four short distance-learning refresher courses over one year) or no training. Participants completed a questionnaire after each continuing medical education event; key questions were repeated at least twice. The Local Health Unit prescription database was used to verify prescription habits (diagnostic investigations and pharmacological therapy) and hospitalizations over one year before and after training.Fourteen general practitioners (46.7%) reached the cut-off of 50% attendance of the training courses. Knowledge improved significantly after training (p0.001, correct answers to key questions +13%). Training resulted in pharmaceutical cost containment (trained general practitioners +0.5% vs. controls +18.8%) and greater attention to diagnosis and monitoring (increase in spirometry +63.4%, p0.01).This study revealed an encouraging impact of educational events on improvement in general practitioner knowledge of guidelines and daily practice behavioral changes. Long-term studies of large populations are required to assess the effectiveness of education on the behavior of physicians in asthma management, and to establish the best format for educational events.

Published
2012

40. Effect of gas cooking on lung function in adolescents: modifying role of sex and immunoglobulin E

Author

Garbo, G M., Forastiere, F, Agabiti, N, Dell'Orco, V, Pistelli, R, Aebischer, M L., Valente, S, and Perucci, C A.

Subjects
Stoves, Gas -- Physiological aspects -- Usage, Teenagers -- Health aspects -- Usage -- Measurement -- Physiological aspects, Youth -- Health aspects -- Usage -- Measurement -- Physiological aspects, Pulmonary function tests -- Usage -- Health aspects -- Measurement -- Physiological aspects, Immunoglobulin E -- Measurement -- Usage -- Physiological aspects -- Health aspects, Health
Abstract

Abstract Background-A study was undertaken to investigate the effect of gas cooking on the lung function of adolescents while considering serum IgE level as a possible effect modifier. Method-The cross [...]

Published
2001

45. High Temperature and Hospitalizations for Cardiovascular and Respiratory Causes in 12 European Cities

Author

Michelozzi, P, Accetta, G, De Sario, M, D'Ippoliti, D, Marino, C, Baccini, M, Biggeri, A, Anderson, H, Katsouyanni, K, Ballester, F, Bisanti, L, Cadum, E, Forsberg, B, Forastiere, F, Goodman, P, Hojs, A, Kirchmayer, U, Medina, S, Paldy, A, Schindler, C, Sunyer, J, Perucci, C, and PHEWE Collaborative Grp

Subjects
Pulmonary and Respiratory Medicine, Adult, Male, Population ageing, Pediatrics, medicine.medical_specialty, Hot Temperature, Adolescent, Respiratory Tract Diseases, Critical Care and Intensive Care Medicine, heat, hospitalization, Young Adult, Patient Admission, Intensive care, Statistical significance, medicine, Humans, Poisson Distribution, Respiratory system, Young adult, Child, Aged, Aged, 80 and over, Air Pollutants, business.industry, Respiratory disease, Age Factors, Infant, Newborn, Urban Health, Infant, Middle Aged, medicine.disease, Confidence interval, Apparent temperature, Europe, Cerebrovascular Disorders, Cardiovascular Diseases, Child, Preschool, Female, Morbidity, business, Demography
Abstract

Rationale Episode analyses of heat waves have documented a comparatively higher impact on mortality than on morbidity (hospital admissions) in European cities. The evidence from daily time series studies is scarce and inconsistent. Objectives: To evaluate the impact of high environmental temperatures on hospital admissions during April to September in 12 European cities participating in the Assessment and Prevention of Acute Health Effects of Weather Conditions in Europe (PHEWE) project. Methods: For each city, time series analysis was used to model the relationship between maximum apparent temperature (lag 0-3 days) and daily hospital admissions for cardiovascular, cerebrovascular, and respiratory causes by age (all ages, 65-74 age group, and 75+ age group), and the city-specific estimates were pooled for two geographical groupings of cities. Measurements and Main Results: For respiratory admissions, there was a positive association that was heterogeneous between cities. For a 1 degrees C increase in maximum apparent temperature above a threshold, respiratory admissions increased by +4.5% (95% confidence interval, 1.9-7.3) and +3.1% (95% confidence interval, 0.8-5.5) in the 75+ age group in Mediterranean and North-Continental cities, respectively. In contrast, the association between temperature and cardiovascular and cerebrovascular admissions tended to be negative and did not reach statistical significance. Conclusions: High temperatures have a specific impact on respiratory admissions, particularly in the elderly population, but the underlying mechanisms are poorly understood. Why high temperature increases cardiovascular mortality but not cardiovascular admissions is also unclear. The impact of extreme heat events on respiratory admissions is expected to increase in European cities as a result of global warming and progressive population aging.

Published
2009

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