array:23 [
  "pii" => "S1579212907600032"
  "issn" => "15792129"
  "doi" => "10.1016/S1579-2129(07)60003-2"
  "estado" => "S300"
  "fechaPublicacion" => "2006-12-01"
  "aid" => "60003"
  "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
  "copyrightAnyo" => "2006"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Arch Bronconeumol. 2006;42:621-6"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2570
    "formatos" => array:3 [
      "EPUB" => 79
      "HTML" => 1788
      "PDF" => 703
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1579212907600044"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(07)60004-4"
    "estado" => "S300"
    "fechaPublicacion" => "2006-12-01"
    "aid" => "60004"
    "copyright" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 2006;42:627-32"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2999
      "formatos" => array:3 [
        "EPUB" => 90
        "HTML" => 2126
        "PDF" => 783
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
      "titulo" => "Recording the Daily Physical Activity of COPD Patients With an Accelerometer&#58; An Analysis of Agreement and Repeatability"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "627"
          "paginaFinal" => "632"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Vanesa Lores, Francisco Garc&#237;a-R&#237;o, Blas Rojo, Sergio Alcolea, Olga Mediano"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Vanesa"
              "apellidos" => "Lores"
            ]
            1 => array:2 [
              "nombre" => "Francisco"
              "apellidos" => "Garc&#237;a-R&#237;o"
            ]
            2 => array:2 [
              "nombre" => "Blas"
              "apellidos" => "Rojo"
            ]
            3 => array:2 [
              "nombre" => "Sergio"
              "apellidos" => "Alcolea"
            ]
            4 => array:2 [
              "nombre" => "Olga"
              "apellidos" => "Mediano"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212907600044?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004200000012/v1_201305150234/S1579212907600044/v1_201305150234/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1579212907600020"
    "issn" => "15792129"
    "doi" => "10.1016/S1579-2129(07)60002-0"
    "estado" => "S300"
    "fechaPublicacion" => "2006-12-01"
    "aid" => "60002"
    "copyright" => "Sociedad Espa&#241;ola de Neumolog&#237;a y Cirug&#237;a Tor&#225;cica &#40;SEPAR&#41;"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Arch Bronconeumol. 2006;42:616-20"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2028
      "formatos" => array:3 [
        "EPUB" => 75
        "HTML" => 1376
        "PDF" => 577
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
      "titulo" => "Long-term Outcomes of Treatment With Bosentan in Pulmonary Hypertension"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "616"
          "paginaFinal" => "620"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Antonio Rom&#225;n, Pilar Gispert, V&#237;ctor Monforte, Carlos Bravo, Enric Domingo, Ferran Morell"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Antonio"
              "apellidos" => "Rom&#225;n"
            ]
            1 => array:2 [
              "nombre" => "Pilar"
              "apellidos" => "Gispert"
            ]
            2 => array:2 [
              "nombre" => "V&#237;ctor"
              "apellidos" => "Monforte"
            ]
            3 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Bravo"
            ]
            4 => array:2 [
              "nombre" => "Enric"
              "apellidos" => "Domingo"
            ]
            5 => array:2 [
              "nombre" => "Ferran"
              "apellidos" => "Morell"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212907600020?idApp=UINPBA00003Z"
    "url" => "/15792129/0000004200000012/v1_201305150234/S1579212907600020/v1_201305150234/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Articles</span>"
    "titulo" => "Associations Between Family History of Allergy&#44; Exposure to Tobacco Smoke&#44; Active Smoking&#44; Obesity&#44; and Asthma in Adolescents"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "621"
        "paginaFinal" => "626"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Francisco V&#225;zquez Nava, Aten&#243;genes H&#46; Sald&#237;var Gonz&#225;lez, Gerardo Mart&#237;nez Perales, Dolores Lin Ochoa, Mar&#237;a del Carmen Barrientos G&#243;mez, Eliza Mireya V&#225;zquez Rodr&#237;guez, Carlos Francisco V&#225;zquez Rodr&#237;guez, Francisco Javier Beltr&#225;n Guzm&#225;n"
        "autores" => array:8 [
          0 => array:4 [
            "nombre" => "Francisco"
            "apellidos" => "V&#225;zquez Nava"
            "email" => array:1 [
              0 => "fvazqueznava&#64;yahoo&#46;com&#46;mx"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Aten&#243;genes H&#46;"
            "apellidos" => "Sald&#237;var Gonz&#225;lez"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Gerardo Mart&#237;nez"
            "apellidos" => "Perales"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Dolores Lin"
            "apellidos" => "Ochoa"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Mar&#237;a"
            "apellidos" => "del Carmen Barrientos G&#243;mez"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Eliza Mireya V&#225;zquez"
            "apellidos" => "Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Carlos Francisco V&#225;zquez"
            "apellidos" => "Rodr&#237;guez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Francisco Javier Beltr&#225;n"
            "apellidos" => "Guzm&#225;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Departamento de Alergolog&#237;a e Inmunolog&#237;a&#44; Universidad Aut&#243;noma de Tamaulipas&#44; Tampico&#44; Tamaulipas&#44; Mexico"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Investigaci&#243;n en Epidemiolog&#237;a Cl&#237;nica&#44; Hospital General N&#250;mero 6&#44; Instituto Mexicano del Seguro Social&#44; Ciudad Madero&#44; Tamaulipas&#44; Mexico"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Investigaci&#243;n&#44; Facultad de Medicina de Tampico&#44; Universidad Aut&#243;noma de Tamaulipas&#44; Tampico&#44; Tamaulipas&#44; Mexico"
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "aff3"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "Correspondence&#58; Dr&#46; F&#46; V&#225;zquez Nava&#46; Matamoros&#44; 102&#46; Col&#46; Hip&#243;dromo&#46; 89560 Ciudad Madero&#46; Tamaulipas&#46; M&#233;xico"
          ]
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2006-01-08"
    "fechaAceptado" => "2006-05-23"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec154225"
          "palabras" => array:6 [
            0 => "Atopic hypersensitivity"
            1 => "familial"
            2 => "Tobacco use disorder"
            3 => "Obesity"
            4 => "Asthma"
            5 => "Adolescents"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras claves"
          "identificador" => "xpalclavsec154224"
          "palabras" => array:5 [
            0 => "Atopia familiar"
            1 => "Tabaquismo"
            2 => "Obesidad"
            3 => "Asma"
            4 => "Adolescentes"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The relationships between asthma in adolescents and various environmental and social exposures needs to be clarified&#46; The aim of this study was to determine the association between family history of allergy&#44; passive or active tobacco smoking&#44; obesity&#44; and asthma in adolescents&#46;</p> <span class="elsevierStyleSectionTitle">Subjects and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A population-based case-control study was carried out&#46; A random sample of 4003 students aged 13 to 18 years old was selected from secondary and preparatory schools in an urban area in northeastern Mexico&#46; Data was gathered in physical examinations and with a questionnaire administered by trained staff&#46; Two study groups were formed&#58; a group of 253 adolescents with asthma and a control group of students without asthma&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Variables associated with asthma were history of allergy &#40;odds ratio &#91;OR&#93;&#44; 1&#46;62&#59; 95&#37; confidence interval &#91;CI&#93;&#44; 1&#46;28-2&#46;06&#41;&#44; passive smoking &#40;OR&#44; 1&#46;53&#59; 95&#37; CI&#44; 1&#46;18-1&#46;99&#41;&#44; and obesity &#40;OR&#44; 1&#46;96&#59; 95&#37; CI&#44; 145-2&#46;65&#41;&#46; Female gender and active smoking were unrelated to asthma&#46; The percentage of obese adolescents was higher in the group of asthmatics &#40;18&#46;2&#37;&#41; than in the control group &#40;12&#46;8&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Family history of allergy&#44; passive tobacco smoking&#44; and obesity seem to be the main risk factors for the development of asthma in adolescents&#46; The relationship of active smoking and asthma requires further study&#46;</p>"
      ]
      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Es necesario aclarar la relaci&#243;n entre varias exposiciones ambientales y sociales y el asma en la poblaci&#243;n adolescente&#46; El objetivo de este estudio ha sido determinar la asociaci&#243;n entre la atopia familiar&#44; la inhalaci&#243;n pasiva o acti-va de humo de tabaco&#44; la obesidad y el asma en adolescentes&#46;</p> <span class="elsevierStyleSectionTitle">Sujetos y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio de casos y controles basado en un estudio de poblaci&#243;n&#46; Se encuest&#243; a 4&#46;003 estudiantes de 13 a 18 a&#241;os de edad&#44; seleccionados ale-atoriamente&#44; que acud&#237;an a escuelas de secundaria y prepa-ratoria de un &#225;rea urbana del nordeste de M&#233;xico&#46; La informaci&#243;n sobre las variables estudiadas se recab&#243; a trav&#233;s de la exploraci&#243;n f&#237;sica y de la aplicaci&#243;n de un cuestionario por parte de personal capacitado&#46; Se formaron 2 grupos de estudio&#58; uno compuesto por 253 adolescentes con asma&#44; y un grupo control formado por estudiantes sin asma&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">De los resultados se desprende que la atopia familiar &#40;odds ratio &#91;OR&#93; &#61; 1&#44;62&#59; intervalo de confianza &#91;IC&#93; del 95&#37;&#44; 1&#44;28-2&#44;06&#41;&#44; la exposici&#243;n involuntaria al humo de tabaco &#40;OR &#61; 1&#44;53&#59; IC del 95&#37;&#44; 1&#44;18-1&#44;99&#41; y la obesidad &#40;OR &#61; 1&#44;96&#59; IC del 95&#37;&#44; 1&#44;45-2&#44;65&#41; se encuentran asociadas con el asma en adolescentes&#46; El sexo femenino y el tabaquismo activo no se relacionan con dicha enfermedad&#46; El porcentaje de obesos fue mayor en el grupo de adolescentes con asma &#40;18&#44;2&#37;&#41; que en el grupo control &#40;12&#44;8&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La atopia familiar&#44; la inhalaci&#243;n involuntaria de humo de tabaco y la obesidad parecen ser los facto-res de riesgo m&#225;s importantes para el desarrollo de asma en adolescentes&#46; La relaci&#243;n entre tabaquismo activo y asma requiere una mejor evaluaci&#243;n&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of asthma and other allergic diseases in an adolescent population&#58; association with gender and race"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "JK Fagan"
                            1 => "PA Scheff"
                            2 => "D Hryhorezuk"
                            3 => "V Ramakrishnan"
                            4 => "M Ross"
                            5 => "V Persky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1081-1206(10)62688-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol"
                        "fecha" => "2001"
                        "volumen" => "86"
                        "paginaInicial" => "177"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11258687"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Variaciones geogr&#225;ficas en la prevalencia de s&#237;ntomas de asma en los ni&#241;os y adolescentes espa&#241;oles&#46; International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41; fase III Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I Carvajal-Ure&#241;a"
                            1 => "L Garc&#237;a-Marcos"
                            2 => "R Busquets-Monge"
                            3 => "MM Su&#225;rez-Varela"
                            4 => "NA de Garc&#237;a"
                            5 => "J Batll&#233;s-Garrido"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "659"
                        "paginaFinal" => "666"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16373042"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early life risk factors for adult asthma&#58; a birth cohort study of subjects at risk"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "HL Rhodes"
                            1 => "R Sporik"
                            2 => "P Thomas"
                            3 => "ST Holgate"
                            4 => "JJ Cogswell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1067/mai.2001.119151"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2001"
                        "volumen" => "108"
                        "paginaInicial" => "720"
                        "paginaFinal" => "725"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11692095"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased prevalence of asthma and allied diseases among active adolescent tobacco smokers after controlling for passive smoking exposure&#46; A cause for concern&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I Annesi-Maesano"
                            1 => "MP Oryszczyn"
                            2 => "C Raherison"
                            3 => "C Kopferschmitt"
                            4 => "G Pauli"
                            5 => "A Taytard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2222.2004.02002.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Allergy"
                        "fecha" => "2004"
                        "volumen" => "34"
                        "paginaInicial" => "1017"
                        "paginaFinal" => "1023"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15248844"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The incidence of asthma in young adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "SF Thomsen"
                            1 => "CS Ulrik"
                            2 => "KO Kyvik"
                            3 => "K Larsen"
                            4 => "LR Skadhauge"
                            5 => "I Steffensen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.127.6.1928"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2005"
                        "volumen" => "127"
                        "paginaInicial" => "1928"
                        "paginaFinal" => "1934"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15947304"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and prevention of allergic disease in childhood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "BB Bj&#246;rkst&#233;n"
                            1 => "N-IM Kjellman"
                            2 => "RS Zeiger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Middleton&#39;s allergy principles and practice"
                        "paginaInicial" => "816"
                        "paginaFinal" => "837"
                        "edicion" => "5th ed&#46;"
                        "serieFecha" => "1998"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A longitudinal&#44; population-based&#44; cohort study of childhood asthma followed to adulthood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "MR Sears"
                            1 => "JM Greene"
                            2 => "AR Willan"
                            3 => "EM Wiecek"
                            4 => "DR Taylor"
                            5 => "EM Flannery"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa022363"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2003"
                        "volumen" => "349"
                        "paginaInicial" => "1414"
                        "paginaFinal" => "1422"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14534334"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Are asthma and allergies in children and adolescents increasing&#63; Results from ISAAC phase 111 surveys in M&#252;nster&#44; Germany"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "W Maziak"
                            1 => "T Behrens"
                            2 => "TM Brasky"
                            3 => "H Duhme"
                            4 => "P Rzehak"
                            5 => "SK Weiland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2003"
                        "volumen" => "58"
                        "paginaInicial" => "572"
                        "paginaFinal" => "579"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12823113"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Are environmental controls effective for house-dust-mite allergies&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A Valero"
                            1 => "C Serrano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2004"
                        "volumen" => "40"
                        "paginaInicial" => "389"
                        "paginaFinal" => "391"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15458613"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pulmonary effects of smoking"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "DR Patel"
                            1 => "DN Homnick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Adolesc Med"
                        "fecha" => "2000"
                        "volumen" => "11"
                        "paginaInicial" => "567"
                        "paginaFinal" => "576"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11060554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The environmental predictors of allergic disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E von Mutius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2000"
                        "volumen" => "105"
                        "paginaInicial" => "9"
                        "paginaFinal" => "19"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10629447"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asma y humo de tabaco"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "PJ Romero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Bronconeumol"
                        "fecha" => "2004"
                        "volumen" => "40"
                        "paginaInicial" => "414"
                        "paginaFinal" => "418"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15458618"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for smoking among adolescents with asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "SM Zbikowski"
                            1 => "RC Klesges"
                            2 => "LA Robinson"
                            3 => "CM Alfano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Adolesc Health"
                        "fecha" => "2002"
                        "volumen" => "30"
                        "paginaInicial" => "279"
                        "paginaFinal" => "287"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11927240"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking habits in adolescents with mild to moderate asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E Zimlichman"
                            1 => "D Mandel"
                            2 => "FB Mimouni"
                            3 => "T Shochat"
                            4 => "I Grotto"
                            5 => "Y Kreiss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/ppul.20080"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Pulmonol"
                        "fecha" => "2004"
                        "volumen" => "38"
                        "paginaInicial" => "193"
                        "paginaFinal" => "197"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15274096"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Smoking patterns among adolescents with asthma attending upper secondary schools&#58; a community-based study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "PD Hansen"
                            1 => "L Keiding"
                            2 => "M Madsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2003"
                        "volumen" => "111"
                        "paginaInicial" => "562"
                        "paginaFinal" => "568"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Increased effects of smoking and obesity on asthma among female Canadians&#58; the National Population Health Survey&#44; 1994-1995"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y Chen"
                            1 => "R Dales"
                            2 => "D Krewski"
                            3 => "K Breithaupt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Epidemiol"
                        "fecha" => "1999"
                        "volumen" => "150"
                        "paginaInicial" => "255"
                        "paginaFinal" => "262"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10430229"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of asthma in Swedish teenagers&#58; relation to sex and smoking habits"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L Larsson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "1995"
                        "volumen" => "50"
                        "paginaInicial" => "260"
                        "paginaFinal" => "264"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7660339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The epidemic of obesity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C Stein"
                            1 => "GA Colditz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1210/jc.2004-0288"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Endocrinol Metab"
                        "fecha" => "2004"
                        "volumen" => "89"
                        "paginaInicial" => "2522"
                        "paginaFinal" => "2525"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15181019"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and trends in overweight among US children and adolescents&#44; 1999-2000"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "CL Ogden"
                            1 => "KM Flegal"
                            2 => "MD Carroll"
                            3 => "CL Johnson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2002"
                        "volumen" => "288"
                        "paginaInicial" => "1728"
                        "paginaFinal" => "1732"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12365956"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Overweight in children and adolescents&#46; Pathophysiology&#44; consequences&#44; prevention&#44; and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "SR Daniels"
                            1 => "DK Arnett"
                            2 => "RH Eckel"
                            3 => "SS Gidding"
                            4 => "LL Hayman"
                            5 => "S Kumanyika"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.0000161369.71722.10"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2005"
                        "volumen" => "111"
                        "paginaInicial" => "1999"
                        "paginaFinal" => "2012"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15837955"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is there a causal relation between obesity and asthma&#63; Evidence from Chile"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P Bustos"
                            1 => "H Amigo"
                            2 => "M Oyarz&#250;n"
                            3 => "RJ Rona"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Obes"
                        "fecha" => "2005"
                        "volumen" => "29"
                        "paginaInicial" => "804"
                        "paginaFinal" => "809"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Weight history from birth through childhood and youth in relation to adult lung function&#44; in Danish juvenile obese and non-obese men"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J Bua"
                            1 => "E Prescott"
                            2 => "L Schack-Nielsen"
                            3 => "L Petersen"
                            4 => "NS Godtfredsen"
                            5 => "TIA Sorensen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Obes"
                        "fecha" => "2005"
                        "volumen" => "29"
                        "paginaInicial" => "1055"
                        "paginaFinal" => "1062"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complex interactions in complex traits&#58; obesity and asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "KG Tantisira"
                            1 => "ST Weiss"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2001"
                        "volumen" => "56"
                        "numero" => "Suppl 11"
                        "paginaInicial" => "62"
                        "paginaFinal" => "74"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11120907"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesity and the risk of newly diagnosed asthma in school-age children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "FD Gilliland"
                            1 => "K Berhane"
                            2 => "T Islam"
                            3 => "R McConnell"
                            4 => "WJ Gauderman"
                            5 => "S Gilliland"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Epidemiol"
                        "fecha" => "2003"
                        "volumen" => "158"
                        "paginaInicial" => "406"
                        "paginaFinal" => "415"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12936895"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relation of bronchial responsiveness to body mass in the ECRHS"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S Chinn"
                            1 => "D Jarvis"
                            2 => "P Burney"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2002"
                        "volumen" => "57"
                        "paginaInicial" => "1028"
                        "paginaFinal" => "1033"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12454296"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "LM Schachter"
                            1 => "CM Salome"
                            2 => "JK Peat"
                            3 => "AJ Woolcock"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2001"
                        "volumen" => "56"
                        "paginaInicial" => "4"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11120896"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obesity is a risk factor for dyspnea but not for airflow obstruction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "DD Sin"
                            1 => "RL Jones"
                            2 => "P Man"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Intern Med"
                        "fecha" => "2002"
                        "volumen" => "162"
                        "paginaInicial" => "1477"
                        "paginaFinal" => "1481"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12090884"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of obesity on asthma among adult Indian women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V Mishra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Obes"
                        "fecha" => "2004"
                        "volumen" => "28"
                        "paginaInicial" => "1048"
                        "paginaFinal" => "1058"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Association of body mass with pulmonary function in the childhood asthma management program"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "KG Tantisira"
                            1 => "AA Litonjua"
                            2 => "ST Weiss"
                            3 => "AL Fuhlbrigge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2003"
                        "volumen" => "58"
                        "paginaInicial" => "1036"
                        "paginaFinal" => "1041"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14645968"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between asthma and obesity in urban minority children and adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J Gennuso"
                            1 => "L Epstein"
                            2 => "RA Paluch"
                            3 => "F Cerny"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Pediatr Adolesc Med"
                        "fecha" => "1998"
                        "volumen" => "152"
                        "paginaInicial" => "1197"
                        "paginaFinal" => "1200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9856429"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000004200000012/v1_201305150234/S1579212907600032/v1_201305150234/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004200000012/v1_201305150234/S1579212907600032/v1_201305150234/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212907600032?idApp=UINPBA00003Z"
]
Share
Journal Information
Vol. 42. Issue 12.
Pages 621-626 (December 2006)
Share
Share
Download PDF
More article options
Vol. 42. Issue 12.
Pages 621-626 (December 2006)
Original Articles
Full text access
Associations Between Family History of Allergy, Exposure to Tobacco Smoke, Active Smoking, Obesity, and Asthma in Adolescents
Visits
4666
Francisco Vázquez Navaa,b,
Corresponding author
fvazqueznava@yahoo.com.mx

Correspondence: Dr. F. Vázquez Nava. Matamoros, 102. Col. Hipódromo. 89560 Ciudad Madero. Tamaulipas. México
, Atenógenes H. Saldívar Gonzálezb,c, Gerardo Martínez Peralesb,c, Dolores Lin Ochoab,c, María del Carmen Barrientos Gómezb,c, Eliza Mireya Vázquez Rodríguezc, Carlos Francisco Vázquez Rodríguezc, Francisco Javier Beltrán Guzmánc
a Departamento de Alergología e Inmunología, Universidad Autónoma de Tamaulipas, Tampico, Tamaulipas, Mexico
b Unidad de Investigación en Epidemiología Clínica, Hospital General Número 6, Instituto Mexicano del Seguro Social, Ciudad Madero, Tamaulipas, Mexico
c Departamento de Investigación, Facultad de Medicina de Tampico, Universidad Autónoma de Tamaulipas, Tampico, Tamaulipas, Mexico
This item has received
Article information
Objective

The relationships between asthma in adolescents and various environmental and social exposures needs to be clarified. The aim of this study was to determine the association between family history of allergy, passive or active tobacco smoking, obesity, and asthma in adolescents.

Subjects and methods

A population-based case-control study was carried out. A random sample of 4003 students aged 13 to 18 years old was selected from secondary and preparatory schools in an urban area in northeastern Mexico. Data was gathered in physical examinations and with a questionnaire administered by trained staff. Two study groups were formed: a group of 253 adolescents with asthma and a control group of students without asthma.

Results

Variables associated with asthma were history of allergy (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.28-2.06), passive smoking (OR, 1.53; 95% CI, 1.18-1.99), and obesity (OR, 1.96; 95% CI, 145-2.65). Female gender and active smoking were unrelated to asthma. The percentage of obese adolescents was higher in the group of asthmatics (18.2%) than in the control group (12.8%).

Conclusions

Family history of allergy, passive tobacco smoking, and obesity seem to be the main risk factors for the development of asthma in adolescents. The relationship of active smoking and asthma requires further study.

Key words:
Atopic hypersensitivity
familial
Tobacco use disorder
Obesity
Asthma
Adolescents
Objetivo

Es necesario aclarar la relación entre varias exposiciones ambientales y sociales y el asma en la población adolescente. El objetivo de este estudio ha sido determinar la asociación entre la atopia familiar, la inhalación pasiva o acti-va de humo de tabaco, la obesidad y el asma en adolescentes.

Sujetos y métodos

Se ha realizado un estudio de casos y controles basado en un estudio de población. Se encuestó a 4.003 estudiantes de 13 a 18 años de edad, seleccionados ale-atoriamente, que acudían a escuelas de secundaria y prepa-ratoria de un área urbana del nordeste de México. La información sobre las variables estudiadas se recabó a través de la exploración física y de la aplicación de un cuestionario por parte de personal capacitado. Se formaron 2 grupos de estudio: uno compuesto por 253 adolescentes con asma, y un grupo control formado por estudiantes sin asma.

Resultados

De los resultados se desprende que la atopia familiar (odds ratio [OR] = 1,62; intervalo de confianza [IC] del 95%, 1,28-2,06), la exposición involuntaria al humo de tabaco (OR = 1,53; IC del 95%, 1,18-1,99) y la obesidad (OR = 1,96; IC del 95%, 1,45-2,65) se encuentran asociadas con el asma en adolescentes. El sexo femenino y el tabaquismo activo no se relacionan con dicha enfermedad. El porcentaje de obesos fue mayor en el grupo de adolescentes con asma (18,2%) que en el grupo control (12,8%).

Conclusiones

La atopia familiar, la inhalación involuntaria de humo de tabaco y la obesidad parecen ser los facto-res de riesgo más importantes para el desarrollo de asma en adolescentes. La relación entre tabaquismo activo y asma requiere una mejor evaluación.

Palabras claves:
Atopia familiar
Tabaquismo
Obesidad
Asma
Adolescentes
Full text is only aviable in PDF
REFERENCES
[1]
JK Fagan, PA Scheff, D Hryhorezuk, V Ramakrishnan, M Ross, V Persky.
Prevalence of asthma and other allergic diseases in an adolescent population: association with gender and race.
Ann Allergy Asthma Immunol, 86 (2001), pp. 177-184
[2]
I Carvajal-Ureña, L García-Marcos, R Busquets-Monge, MM Suárez-Varela, NA de García, J Batllés-Garrido, et al.
Variaciones geográficas en la prevalencia de síntomas de asma en los niños y adolescentes españoles. International Study of Asthma and Allergies in Childhood (ISAAC) fase III España.
Arch Bronconeumol, 41 (2005), pp. 659-666
[3]
HL Rhodes, R Sporik, P Thomas, ST Holgate, JJ Cogswell.
Early life risk factors for adult asthma: a birth cohort study of subjects at risk.
J Allergy Clin Immunol, 108 (2001), pp. 720-725
[4]
I Annesi-Maesano, MP Oryszczyn, C Raherison, C Kopferschmitt, G Pauli, A Taytard, et al.
Increased prevalence of asthma and allied diseases among active adolescent tobacco smokers after controlling for passive smoking exposure. A cause for concern?.
Clin Exp Allergy, 34 (2004), pp. 1017-1023
[5]
SF Thomsen, CS Ulrik, KO Kyvik, K Larsen, LR Skadhauge, I Steffensen, et al.
The incidence of asthma in young adults.
Chest, 127 (2005), pp. 1928-1934
[6]
BB Björkstén, N-IM Kjellman, RS Zeiger.
Development and prevention of allergic disease in childhood.
Middleton's allergy principles and practice, 5th ed., pp. 816-837
[7]
MR Sears, JM Greene, AR Willan, EM Wiecek, DR Taylor, EM Flannery.
A longitudinal, population-based, cohort study of childhood asthma followed to adulthood.
N Engl J Med, 349 (2003), pp. 1414-1422
[8]
W Maziak, T Behrens, TM Brasky, H Duhme, P Rzehak, SK Weiland.
Are asthma and allergies in children and adolescents increasing? Results from ISAAC phase 111 surveys in Münster, Germany.
Allergy, 58 (2003), pp. 572-579
[9]
A Valero, C Serrano.
Are environmental controls effective for house-dust-mite allergies?.
Arch Bronconeumol, 40 (2004), pp. 389-391
[10]
DR Patel, DN Homnick.
Pulmonary effects of smoking.
Adolesc Med, 11 (2000), pp. 567-576
[11]
E von Mutius.
The environmental predictors of allergic disease.
J Allergy Clin Immunol, 105 (2000), pp. 9-19
[12]
PJ Romero.
Asma y humo de tabaco.
Arch Bronconeumol, 40 (2004), pp. 414-418
[13]
SM Zbikowski, RC Klesges, LA Robinson, CM Alfano.
Risk factors for smoking among adolescents with asthma.
J Adolesc Health, 30 (2002), pp. 279-287
[14]
E Zimlichman, D Mandel, FB Mimouni, T Shochat, I Grotto, Y Kreiss.
Smoking habits in adolescents with mild to moderate asthma.
Pediatr Pulmonol, 38 (2004), pp. 193-197
[15]
PD Hansen, L Keiding, M Madsen.
Smoking patterns among adolescents with asthma attending upper secondary schools: a community-based study.
Pediatrics, 111 (2003), pp. 562-568
[16]
Y Chen, R Dales, D Krewski, K Breithaupt.
Increased effects of smoking and obesity on asthma among female Canadians: the National Population Health Survey, 1994-1995.
Am J Epidemiol, 150 (1999), pp. 255-262
[17]
L Larsson.
Incidence of asthma in Swedish teenagers: relation to sex and smoking habits.
Thorax, 50 (1995), pp. 260-264
[18]
C Stein, GA Colditz.
The epidemic of obesity.
J Clin Endocrinol Metab, 89 (2004), pp. 2522-2525
[19]
CL Ogden, KM Flegal, MD Carroll, CL Johnson.
Prevalence and trends in overweight among US children and adolescents, 1999-2000.
JAMA, 288 (2002), pp. 1728-1732
[20]
SR Daniels, DK Arnett, RH Eckel, SS Gidding, LL Hayman, S Kumanyika, et al.
Overweight in children and adolescents. Pathophysiology, consequences, prevention, and treatment.
Circulation, 111 (2005), pp. 1999-2012
[21]
P Bustos, H Amigo, M Oyarzún, RJ Rona.
Is there a causal relation between obesity and asthma? Evidence from Chile.
Int J Obes, 29 (2005), pp. 804-809
[22]
J Bua, E Prescott, L Schack-Nielsen, L Petersen, NS Godtfredsen, TIA Sorensen, et al.
Weight history from birth through childhood and youth in relation to adult lung function, in Danish juvenile obese and non-obese men.
Int J Obes, 29 (2005), pp. 1055-1062
[23]
KG Tantisira, ST Weiss.
Complex interactions in complex traits: obesity and asthma.
Thorax, 56 (2001), pp. 62-74
[24]
FD Gilliland, K Berhane, T Islam, R McConnell, WJ Gauderman, S Gilliland, et al.
Obesity and the risk of newly diagnosed asthma in school-age children.
Am J Epidemiol, 158 (2003), pp. 406-415
[25]
S Chinn, D Jarvis, P Burney.
Relation of bronchial responsiveness to body mass in the ECRHS.
Thorax, 57 (2002), pp. 1028-1033
[26]
LM Schachter, CM Salome, JK Peat, AJ Woolcock.
Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness.
Thorax, 56 (2001), pp. 4-8
[27]
DD Sin, RL Jones, P Man.
Obesity is a risk factor for dyspnea but not for airflow obstruction.
Arch Intern Med, 162 (2002), pp. 1477-1481
[28]
V Mishra.
Effect of obesity on asthma among adult Indian women.
Int J Obes, 28 (2004), pp. 1048-1058
[29]
KG Tantisira, AA Litonjua, ST Weiss, AL Fuhlbrigge.
Association of body mass with pulmonary function in the childhood asthma management program.
Thorax, 58 (2003), pp. 1036-1041
[30]
J Gennuso, L Epstein, RA Paluch, F Cerny.
The relationship between asthma and obesity in urban minority children and adolescents.
Arch Pediatr Adolesc Med, 152 (1998), pp. 1197-1200
Copyright © 2006. Sociedad Española de Neumología y Cirugía Torácica (SEPAR)
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?