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  1. AU="Rizzo, José Angelo"
  2. AU="Hay, Jacqueline L"
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  1. Article ; Online: An expert review on breaking barriers in severe asthma in Brazil: Time to act.

    Pitrez, Paulo Márcio / Giavina-Bianchi, Pedro / Rizzo, José Ângelo / Souza-Machado, Adelmir / Garcia, Guilherme Freire / Pizzichini, Marcia Margaret Menezes

    Chronic respiratory disease

    2021  Volume 18, Page(s) 14799731211028259

    Abstract: Currently, Brazil lacks a national asthma management program and is burdened with nearly 200,000 hospitalizations due to the disease per year and approximately 5 deaths per day. The purpose of this article was to analyze the current issues surrounding ... ...

    Abstract Currently, Brazil lacks a national asthma management program and is burdened with nearly 200,000 hospitalizations due to the disease per year and approximately 5 deaths per day. The purpose of this article was to analyze the current issues surrounding severe asthma in Brazil, as the status of diagnosis and treatment is largely unknown, and to provide feasible recommendations to elicit imminent action. A panel of Brazilian medical experts in the field of severe asthma was provided with a series of relevant questions to address prior to a multi-day conference. Within this conference, each narrative was discussed and edited by the entire group. Through numerous rounds of discussion consensus was achieved. In order to overcome barriers to adequate asthma treatment, this panel recommends specific initiatives that can be implemented in the short-term to decrease the burden of severe asthma in Brazil. With increasing healthcare costs and limited resources globally, there is an opportunity to implement these recommendations in other countries in order to achieve adequate asthma care. Severe asthma is a heterogeneous and complex disease with various phenotypes that requires strict attention for diagnosis and management. Although this disease affects only a small proportion of the population with asthma, it poses a great burden to healthcare systems. Thus, barriers to diagnosis, treatment, and management should be overcome as quickly and efficiently as possible.
    MeSH term(s) Asthma/therapy ; Brazil ; Consensus ; Hospitalization ; Humans
    Language English
    Publishing date 2021-07-13
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2211488-9
    ISSN 1479-9731 ; 1479-9723
    ISSN (online) 1479-9731
    ISSN 1479-9723
    DOI 10.1177/14799731211028259
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Correction: Lung mechanics and respiratory morbidities in school-age children born moderate-to-late preterm.

    Dantas, Fabianne M N A / Magalhães, Paulo A F / Hora, Emilly C N / Andrade, Lívia B / Rizzo, José Ângelo / Peixoto, Décio M / Sarinho, Emanuel S C

    Pediatric research

    2021  Volume 91, Issue 5, Page(s) 1300

    Language English
    Publishing date 2021-06-15
    Publishing country United States
    Document type Published Erratum
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-021-01599-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Lung mechanics and respiratory morbidities in school-age children born moderate-to-late preterm.

    Dantas, Fabianne M N A / Magalhães, Paulo A F / Hora, Emilly C N / Andrade, Lívia B / Rizzo, José Ângelo / Peixoto, Décio M / Sarinho, Emanuel S C

    Pediatric research

    2021  Volume 91, Issue 5, Page(s) 1136–1140

    Abstract: Background: Late and moderate prematurity may have an impact on pulmonary function during childhood. The present study aimed to investigate lung mechanics in school-age children born moderate-to-late preterm (MLPT).: Methods: Children aged 5-10 years ...

    Abstract Background: Late and moderate prematurity may have an impact on pulmonary function during childhood. The present study aimed to investigate lung mechanics in school-age children born moderate-to-late preterm (MLPT).
    Methods: Children aged 5-10 years were enrolled in this case-control study. Lung function and bronchodilator response were assessed by impulse oscillometry (IOS) at two hospital-based specialized clinics. A structured questionnaire was employed to assess respiratory morbidities.
    Results: A total of 123 children was divided into two groups: case (MLPT) n = 52 and control (children born at term) n = 71. The results showed no difference between groups in mean baseline IOS variables: R5 0.80 ± 0.20 vs 0.82 ± 0.22 kPa/L/s, p = 0.594, R20 0.54 ± 0.13 vs 0.55 ± 0.13 kPa/L/s, p = 0.732, R5-R20 0.26 ± 0.12 vs 0.27 ± 0.15 kPa/L/s, p = 0.615, X5 -0.29 ± 0.01 vs -0.29 ± 0.1 kPa/L/s, p = 0.990, Fres 21.1 ± 3.3 vs 21.7 ± 3.1 L/s, p = 0.380, and AX 2.7 ± 3.36 vs 2.5 ± 1.31 kPa/L/s, p = 0.626. Bronchodilator response and the occurrence of respiratory morbidities after birth were also similar between groups.
    Conclusions: This study found lung mechanics parameters to be similar in school-age children born MLPT and those born at term, suggesting that pulmonary plasticity continues to occur in children up to school age.
    Impact: Late and moderate prematurity is associated with an increased risk of reduced pulmonary function during childhood. Follow-up reports in adolescents and adults born MLPT are scarce but have indicated pulmonary plasticity with normalization of airway function. Our results show that the lung function in school-age children born MLPT is similar to that of children born at term.
    MeSH term(s) Adolescent ; Adult ; Bronchodilator Agents ; Case-Control Studies ; Child ; Female ; Forced Expiratory Volume ; Humans ; Infant, Newborn ; Infant, Premature, Diseases ; Lung ; Morbidity ; Oscillometry/methods ; Spirometry
    Chemical Substances Bronchodilator Agents
    Language English
    Publishing date 2021-05-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 4411-8
    ISSN 1530-0447 ; 0031-3998
    ISSN (online) 1530-0447
    ISSN 0031-3998
    DOI 10.1038/s41390-021-01538-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Is there cardiac autonomic dysfunction in children and adolescents with exercise-induced bronchospasm?

    Chaves Quirino, Polyanna Guerra / Rizzo, José Ângelo / Hunter, Steve / de Albuquerque Rodrigues Filho, Edil / Sarinho, Emanuel / de Almeida Santos, Camila Matias / Medeiros, Decio / Costa, Emilia Chagas / Silva, Alexandre Sérgio / Farah, Breno Quintella / de Valois Correia Júnior, Marco Aurélio

    Expert review of respiratory medicine

    2023  Volume 17, Issue 9, Page(s) 823–831

    Abstract: Background: The pulmonary impairment in patients with bronchoconstriction induced by eucapnic voluntary hyperpnea(EVH) goes beyond the respiratory system, also impairing autonomic nervous modulation. This study aimed to evaluate the behavior of cardiac ... ...

    Abstract Background: The pulmonary impairment in patients with bronchoconstriction induced by eucapnic voluntary hyperpnea(EVH) goes beyond the respiratory system, also impairing autonomic nervous modulation. This study aimed to evaluate the behavior of cardiac autonomic modulation in young asthmatics with and without EIB after the EVH test.
    Research design and methods: A cross-sectional study design using 54 asthmatics(51.9% female), aged between 10 and 19 years, investigated with the EVH test. Forced expiratory volume in one second(FEV
    Results: Thirty(55.5%) asthmatics had EIB
    Conclusion: Young asthmatics with EIB
    MeSH term(s) Humans ; Female ; Adolescent ; Child ; Young Adult ; Adult ; Male ; Asthma, Exercise-Induced/diagnosis ; Cross-Sectional Studies ; Asthma ; Lung ; Bronchoconstriction/physiology ; Forced Expiratory Volume/physiology
    Language English
    Publishing date 2023-10-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2479146-5
    ISSN 1747-6356 ; 1747-6348
    ISSN (online) 1747-6356
    ISSN 1747-6348
    DOI 10.1080/17476348.2023.2265819
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Accuracy of peak nasal flow to determine nasal obstruction in patients with allergic rhinitis.

    de Oliveira, Gardênia Maria Martins / Correia Júnior, Marco Aurélio de Valois / Costa, Emilia Chagas / Lira, Georgia Véras de Araújo Gueiros / Rizzo, José Ângelo / Hunter, Steve / Gaua, Nádia / Sarinho, Emanuel Sávio Cavalcanti

    Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale

    2022  Volume 42, Issue 2, Page(s) 155–161

    Abstract: Objective: The aim of this study was to investigate the ability of Peak Nasal Inspiratory Flow (PNIF) and Peak Nasal Expiratory Flow (PNEF) measures to predict symptoms of nasal obstruction.: Methods: This is a cross-sectional study, carried out in ... ...

    Abstract Objective: The aim of this study was to investigate the ability of Peak Nasal Inspiratory Flow (PNIF) and Peak Nasal Expiratory Flow (PNEF) measures to predict symptoms of nasal obstruction.
    Methods: This is a cross-sectional study, carried out in 131 individuals (64 with symptomatic allergic rhinitis and 67 asymptomatic) aged between 16 and 50 years.
    Results: PNIF and PNEF were higher among non-rhinitis. In the curve analysis (receiver operating characteristic), a value of 115 was found for PNIF with a sensitivity of 98.4% and specificity of 87.5% (AUC = 0.99, p < 0.001) and 165 in PNEF with a sensitivity of 65.7% and specificity of 85.1% (AUC = 0.92, p < 0.001).
    Conclusions: PNIF and PNEF values were lower in patients with AR compared to asymptomatic cases. Our findings present reference values of PNIF and PNEF in the evaluation of nasal obstruction symptoms and reinforce the importance to complement more refined assessment of patients' symptoms. PNEF can be a valuable tool in screening patients and to complement PNIF measurement.
    MeSH term(s) Adolescent ; Adult ; Cross-Sectional Studies ; Data Collection ; Humans ; Middle Aged ; Nasal Obstruction/complications ; Nasal Obstruction/diagnosis ; Nose ; Rhinitis, Allergic/complications ; Young Adult
    Language English
    Publishing date 2022-05-24
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 604898-5
    ISSN 1827-675X ; 0392-100X
    ISSN (online) 1827-675X
    ISSN 0392-100X
    DOI 10.14639/0392-100X-N1617
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Can physical exercise assist in controlling and reducing the severity of exercise-induced bronchospasm in children and adolescents? A systematic review.

    Souza Silva, Bruno Rafael Vieira / da Silva, Gerlayne Alessandra Soares / de Albuquerque Rodrigues Filho, Edil / Peixoto, Décio Medeiros / de Almeida Santos, Camila Matias / Quirino, Polyanna Guerra Chaves / Rizzo, José Ângelo / de Valois Correia Junior, Marco Aurélio

    The clinical respiratory journal

    2022  

    Abstract: Objective: The aim of this study was to analyze whether physical exercise can contribute to improving the control and severity of exercise-induced bronchospasm (EIB) in children and adolescents.: Method: This is a systematic review that used PubMed/ ... ...

    Abstract Objective: The aim of this study was to analyze whether physical exercise can contribute to improving the control and severity of exercise-induced bronchospasm (EIB) in children and adolescents.
    Method: This is a systematic review that used PubMed/Medline and Scopus databases as a search source, and using descriptors indexed to DeCS/Mesh. The articles were analyzed in three stages in the selection process. Methodological quality was assessed using the TESTEX scale.
    Result and discussion: A total of 5867 articles were filtered in the initial search; however, only eight of these were included after the eligibility criteria. All presented improvements in cardiorespiratory fitness. Only two followed the international EIB diagnostic guidelines. Of these, only one described a reduction in FEV1 and considered that this improvement may influence the EIB response in children and adolescent athletes with a non-asthmatic sample.
    Conclusion: The studies analyzed in this review did not enable drawing a conclusion regarding the influence of physical exercise on EIB in asthmatics. The lack of clinical trials on EIB and physical exercise, as well as the difficulty in methodological standardization for EIB diagnosis evidence the lack of scientific knowledge in this area, serving as a stimulus for researchers to find more consolidated answers.
    Language English
    Publishing date 2022-12-04
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2442214-9
    ISSN 1752-699X ; 1752-6981
    ISSN (online) 1752-699X
    ISSN 1752-6981
    DOI 10.1111/crj.13559
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Ventilation Rates Achieved in Eucapnic Voluntary Hyperpnea Challenge and Exercise-Induced Bronchoconstriction Diagnosis in Young Patients with Asthma.

    Rizzo, José Ângelo / de Barros Albuquerque, Laienne Carla Barbosa / Medeiros, Décio / de Albuquerque, Claudio Gonsalves / de Albuquerque Rodrigues Filho, Edil / de Moura Santos, Marcos André / Hunter, Steve / Gaua, Nadia / de Correia Junior, Marco Aurélio Valois

    Lung

    2022  Volume 200, Issue 2, Page(s) 229–236

    Abstract: Purpose: Exercise-induced bronchoconstriction (EIB) affects approximately 50% of young asthma patients, impairing their participation in sports and physical activities. Eucapnic voluntary hyperpnea (EVH) is an approved surrogate challenge to exercise ... ...

    Abstract Purpose: Exercise-induced bronchoconstriction (EIB) affects approximately 50% of young asthma patients, impairing their participation in sports and physical activities. Eucapnic voluntary hyperpnea (EVH) is an approved surrogate challenge to exercise for objective EIB diagnosis, but the required minimum target hyperventilation rates remain unexplored in this population. This study aimed to evaluate the association between the achieved ventilation rates (VRs) during a challenge and EIB-compatible response (EIB-cr) in young asthma patients.
    Methods: This cross-sectional study included 72 asthma patients aged 10-20 years. Forced expiratory volume in the first second (FEV1) was measured before and 5, 15, and 30 min after the EVH. The target VR was set at 21 times the individual's baseline FEV1. A decrease of > 10% in FEV1 after the challenge was considered an EIB-cr. The challenge was repeated after 48-72 h in those without an EIB-cr.
    Results: Thirty-six individuals had an EIB-cr at initial evaluation. The median VRs achieved was not different between individuals with and without an EIB-cr (19.8 versus 17.9; p = 0.619). The proportion of individuals with an EIB-cr was nor different comparing those who achieved (12/25) or not (24/47) the calculated target VRs (p = 0.804). At the repeated EVH challenge an EIB-cr was observed in 14/36 individuals with a negative response in the first evaluation, with no differences in achieved VRs between the two tests (p = 0.463).
    Conclusion: Irrespective of the achieved VR, an EIB-compatible response after an EVH challenge must be considered relevant for clinical and therapeutic judgment and negative tests should be repeated.
    MeSH term(s) Asthma/diagnosis ; Asthma, Exercise-Induced/diagnosis ; Bronchoconstriction/physiology ; Cross-Sectional Studies ; Humans ; Hyperventilation/diagnosis
    Language English
    Publishing date 2022-02-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 6165-7
    ISSN 1432-1750 ; 0341-2040
    ISSN (online) 1432-1750
    ISSN 0341-2040
    DOI 10.1007/s00408-022-00519-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Comparison between impulse oscillometry parameters and spirometry for the diagnosis of exercise-induced bronchoconstriction in asthmatic children and adolescents.

    Correia Junior, Marco Aurélio de Valois / Filho, Edil de Albuquerque Rodrigues / Tenório, Ricardo César Espinhara / Albuquerque, Claudio Gonçalves de / Barbosa, Laienne Carla / Quirino, Polyanna Guerra Chaves / Sarinho, Emanuel / Medeiros, Décio / Rizzo, José Ângelo

    Pediatric pulmonology

    2022  Volume 57, Issue 10, Page(s) 2398–2404

    Abstract: Introduction: Impulse oscillometry (IOS) parameters are obtained more easily and effortlessly in comparison to forced expiratory volume in the first second (FEV1).: Objective: To compare IOS parameters to FEV1 in exercise-induced bronchoconstriction ( ...

    Abstract Introduction: Impulse oscillometry (IOS) parameters are obtained more easily and effortlessly in comparison to forced expiratory volume in the first second (FEV1).
    Objective: To compare IOS parameters to FEV1 in exercise-induced bronchoconstriction (EIB) diagnosis.
    Methods: Seventy-four (60.8% male; 39.2 female) young asthmatics aged between 7 and 17 years (mean 12.6 ± 2.8 years) were evaluated. EIB was defined as a reduction in FEV1 ≥ 10% compared with basal after standardized challenge by treadmill running (TR). IOS parameters and FEV1 were obtained at baseline and 5,15, and 30 min after TR. The area under the receiver operator characteristic curve (AUC) was calculated from the reduction in FEV1 ≥ 10% to evaluate the best psychometric characteristics of IOS parameters.
    Results: Twenty-four individuals (32.4%) were diagnosed with EIB. A moderate inverse correlation was found between the IOS and FEV1 variables immediately after the TR, with resistance at 5 Hz (R5Hz), resonant frequency (Fres), and reactance area (AX), (r = -0.64, r = -0.53 and r = -0.69, respectively, all with p < 0.05). An increase of 25 kPa/l/s in R5 Hz, of 19k Pa/l/s in AX and 21 Hz in Fres were found to best correlate with EIB diagnosis by FEV1 (sensitivity 67% and specificity 62%, sensitivity 84% and specificity 50%, and sensitivity 84% and specificity 60%, respectively).
    Conclusion: IOS parameters have a significant inverse correlation with FEV1. This study presents cut-off points for EIB diagnosis for R5Hz, AX, and Fres, however, the findings in IOS parameters should be used and interpreted carefully if the goal is to replace spirometry.
    MeSH term(s) Adolescent ; Asthma/diagnosis ; Bronchoconstriction ; Child ; Female ; Forced Expiratory Volume ; Humans ; Male ; Oscillometry ; Respiratory Function Tests ; Spirometry
    Language English
    Publishing date 2022-07-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26046
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Impulse oscillometry: pulmonary function assessment in preschool children.

    Medeiros, Décio / Castro, Pedro / Bianca, Ana Caroline Dela / Sarinho, Emanuel / Araújo, Jaqueline Figueirôa / Correia Junior, Marco / Rizzo, Jose Angelo

    Expert review of respiratory medicine

    2020  Volume 14, Issue 12, Page(s) 1261–1266

    Abstract: Objectives: In contrast to spirometry, which requires active participation of the individual and is challenging for the preschool age group, the impulse oscillometry system comprises a test that minimizes the degree of coordination required. The study ... ...

    Abstract Objectives: In contrast to spirometry, which requires active participation of the individual and is challenging for the preschool age group, the impulse oscillometry system comprises a test that minimizes the degree of coordination required. The study aimed to compare the results of Impulse Oscillometry System (IOS) in children with and without respiratory symptoms.
    Methods: A cross-sectional study was conducted in children aged between 3 and 6 years. A short version of the ATS-DLD-78-C questionnaire validated for Brazilian children was applied to identify two groups: children with and without respiratory symptoms. The IOS analysis was carried out measuring the following parameters in triplicate: resistance at 5 Hz (R5Hz) and 20 Hz (R20Hz), respiratory reactance at 5 Hz (X5Hz), and R5-R20Hz before and after bronchodilator application.
    Results: A total of 76 preschoolers were selected, 55 (72.4%) of whom had respiratory complaints. The coefficient of variability of R5Hz was ≤17% in 70/76 (92.1%) of the children. Resistances at R5Hz and R5-R20Hz in the children with respiratory complaints reached values higher than those of children without symptoms before bronchodilation.
    Conclusions: The results obtained for resistance using IOS in children with respiratory symptoms were higher in the pre-bronchodilator examination for R5Hz and R5-R20Hz compared to those of children without respiratory symptoms.
    Expert opinion: Prospective investigations suggest that irreversible changes in lung function begin in infancy, before reaching school age. Pulmonary function follow-up in children with recurrent wheezing or asthma is important for confirmation of diagnosis and evaluation of the disease severity. The Impulse Oscillometry System (IOS) can be useful in assessing children's pulmonary function since it requires minimal patient cooperation and can be successfully applied to preschool children being an alternative to individuals who have difficulty performing spirometry.
    MeSH term(s) Age Factors ; Asthma/diagnosis ; Asthma/pathology ; Brazil ; Bronchodilator Agents/therapeutic use ; Case-Control Studies ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Lung/physiopathology ; Male ; Monitoring, Physiologic/methods ; Oscillometry/methods ; Prospective Studies ; Respiratory Function Tests/methods ; Respiratory Tract Diseases/diagnosis ; Respiratory Tract Diseases/pathology ; Severity of Illness Index ; Spirometry
    Chemical Substances Bronchodilator Agents
    Language English
    Publishing date 2020-09-20
    Publishing country England
    Document type Evaluation Study ; Journal Article
    ZDB-ID 2479146-5
    ISSN 1747-6356 ; 1747-6348
    ISSN (online) 1747-6356
    ISSN 1747-6348
    DOI 10.1080/17476348.2020.1813573
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Reproducibility of eucapnic voluntary hyperpnoea for exercise-induced bronchoconstriction diagnosis in asthmatic children and adolescents.

    Rizzo, Jose Ângelo / Rodrigues Filho, Edil de Albuquerque / Gonçalves, Adriana Velozo / Albuquerque, Laienne Carla Barbosa De Barros / Albuquerque, Eduardo Martins de / Albuquerque, Cláudio Gonçalves de / Almeida, Anderson Henrique Souza de / Peixoto, Decio Medeiros / Correia Junior, Marco Aurelio de Valois

    Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology

    2021  Volume 32, Issue 8, Page(s) 1700–1708

    Abstract: Background: Respiratory symptoms after exercise are frequently reported by asthmatic patients, and exercise-induced bronchoconstriction (EIB) is a frequent cause, which requires objective testing for diagnosis. Eucapnic voluntary hyperpnea (EVH) is ... ...

    Abstract Background: Respiratory symptoms after exercise are frequently reported by asthmatic patients, and exercise-induced bronchoconstriction (EIB) is a frequent cause, which requires objective testing for diagnosis. Eucapnic voluntary hyperpnea (EVH) is recommended as a surrogate stimulus for this purpose. Its short-term reproducibility is not yet established in children and young adolescents with asthma.
    Objective: To evaluate the short-term test-retest agreement and reproducibility of FEV
    Methods: Asthmatic patients aged between 10 and 20 years underwent EVH for EIB diagnosis on two occasions 2-4 days apart at a specialized university clinic. FEV
    Results: A total of 26 of 62 recruited individuals tested positive for EIB on both visits (positive group) and 17 on one visit only (divergent group), while 19 tested negative on both visits (negative group). The overall agreement was 72.5% (95%CI 61.6%, 83.6%), and Cohen's kappa coefficient was 0.452. Low bias (0.87%) and high intra-class correlation coefficient (0.854, 95%CI 0.758,0.912; p < .001) for FEV
    Conclusions: More than one EVH test should be performed in children and young adolescents with asthma to exclude EIB and minimize misdiagnosis and mistreatment.
    MeSH term(s) Adolescent ; Adult ; Asthma/diagnosis ; Asthma, Exercise-Induced/diagnosis ; Bronchoconstriction ; Child ; Forced Expiratory Volume ; Humans ; Reproducibility of Results ; Young Adult
    Language English
    Publishing date 2021-08-09
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1057059-7
    ISSN 1399-3038 ; 0905-6157 ; 0906-5784
    ISSN (online) 1399-3038
    ISSN 0905-6157 ; 0906-5784
    DOI 10.1111/pai.13610
    Database MEDical Literature Analysis and Retrieval System OnLINE

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