Is selenium deficiency a risk factor for the development of asthma? ¿La deficiencia de selenio es un factor riesgo para el desarrollo del asma?

¿La deficiencia de selenio es un factor riesgo para el desarrollo del asma?

Arantxa Domínguez-Jiménez (1), José Luis Barranco Quintana (1), Mohamed Farouk Allama (1,2)

1. Área de Medicina Preventiva y Salud Pública. Facultad de Medicina, Universidad de Córdoba.
2. Department of Community, Environmental and Occupational Medicine. Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Medicina General y de Familia. 2018; 7(5): 202-207
Sociedad Española de Médicos Generales y de Familia

http://mgyf.org/la-deficiencia-de-selenio-es-un-factor-riesgo-para-el-desarrollo-del-asma/
http://dx.doi.org/10.24038/mgyf.2018.059

Objetivo. El objetivo de esta revisión sistemática es examinar la asociación entre los niveles de selenio (Se) y el riesgo de asma.
Material y métodos. Se realizó una búsqueda de estudios observacionales publicados hasta enero de 2016, en los que se investigó específicamente la asociación entre los niveles de Se y el riesgo de asma. Se extrajo o calculó el riesgo estimado (riesgo relativo u odds ratio), con su intervalo de confianza al 95 % (IC95 %), de los estudios encontrados, si era factible. Cuando la estimación de riesgo y su IC95 % no estaban disponibles en el artículo, calculamos valores no ajustados de los datos publicados en el artículo.
Resultados. Se localizaron 28 estudios; de ellos 6 estudios de casos y controles cumplieron con los criterios de inclusión. Los 6 estudios fueron publicados entre 1989 y 2012. Los resultados del metaanálisis no demostraron ninguna asociación positiva entre los niveles bajos de selenio y el riesgo de asma, y los IC95 % de 5 de los 6 estudios superaban la unidad. También se localizaron 10 estudios de casos y controles que midieron los niveles de Se en asmáticos y en controles sanos. De los 10 estudios, 5 demostraron niveles más bajos de Se en los asmáticos, con diferencias estadísticamente significativas.
Conclusiones. Nuestros resultados sugieren que el selenio sérico es menor en pacientes asmáticos que en no asmáticos. Son necesarios futuros estudios prospectivos que integren criterios homogéneos para investigar la asociación entre los niveles de selenio y el riesgo asma.

Palabras clave: Asma, Selenio, Metaanálisis, Revisión sistemática, Estudios observacionales.


Is selenium deficiency a risk factor for the development of asthma?

Objective. The objective of this systematic revision is to evaluate the association between plasma selenium (Se) levels and asthma risk.
Material and methods. Observational studies published before January 2016 that specifically investigated the association between plasma Se levels and asthma risk were reviewed. Odds ratios and 95% confidence intervals (95%CI) of these studies were extracted, when data were available. If odds ratio and its 95% CI were not published in the article, we calculated unadjusted parameters.
Results. From among the 28 localized studies, 6 case-controls studies met our inclusion criteria. The 6 studies were published between 1989 and 2012. The results of the meta-analysis did not show a positive association between low plasma Se levels and asthma risk, and 95%CI of 5 of the 6 studies overlapped unity. In addition, we localized 10 case-control studies that measured Se levels in asthmatics and controls. In 5 of them, differences in plasmatic Se levels of the asthmatic group were statistically significant.
Conclusions. Our results suggest an association between low plasmatic Se levels and asthma risk. Future prospective studies with similar homogenous criteria are required to investigate association between Se and asthma.

Keywords: Asthma, Selenium, Meta-analysis, Systematic review, Observational studies. 

Incidence Of Central Line-associated Bloodstream Infections In Intensive Care Units In A Private Hospital (Cairo, Egypt)

Incidence Of Central Line-associated Bloodstream Infections In Intensive Care Units In A Private Hospital (Cairo, Egypt)

Amira M. Malek, Hasnaa A. Abouseif, Khaled M. Abd Elaziz, Mohamed F. Allam* and Hoda I. Fahim

Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

The Open Public Health Journal, 2018, Volume 11, Page 562-571

DOI: 10.2174/1874944501811010562

Abstract:

Objective: The study aimed to measure the incidence, risk factors and most frequent causative organisms of central line-associated bloodstream infections (CLA-BSI) in the Medical/Coronary and Surgical Intensive Care Units (ICUs) at a private hospital.

Methods: This prospective study included 499 patients and was conducted between April 2014 and September 2014 in the Medical/Coronary ICU and Surgical ICU of a private hospital in Cairo, Egypt.

Results: Approximately 44% of all the patients admitted to the ICUs underwent Central Venous Catheter (CVC) insertion. The overall incidence density rate of CLA-BSI was 6 cases per 1000 central line-days. The central line utilization rate was 0.94 per 1000 patientdays. The mortality rate among cases with CLA-BSI was 16.8% (95% CI: 13.6% – 20.4%) during the study period. Risk factors for CLA-BSI were detected by univariate analysis and included associated co-morbidities such as heart failure, APACHE II scores of >15, an ICU stay of 5 days or more, duration of CVC placement, subclavian insertion of CVCs, and mechanical ventilation. Additionally, logistic regression analysis identified a long ICU stay of 5 days or more, mechanical ventilation and the presence of heart failure as the only significant predictors. Gram-negative bacteria, especially Enterobacter (36.8%: 95% CI: 16.3%– 61.6%), Pseudomonas aeruginosa (21.1%: 95% CI: 16.0% - 45.5%) were the predominant organisms detected in CLA-BSI cases.

Conclusion: CLA-BSI is an important cause of mortality in ICU patients. The infection rate is considerably higher than that in recent studies from developed counties, but it is still lower than the rates reported in comparable published studies in Egypt. Strict adherence to the standard infection prevention practices for critically ill patients is highly recommended.

Keywords: Adults, Central Line-Associated Blood Stream Infection, Cohort study, Intensive Care Unit, Incidence density rate, Risk factors.