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nas regi&#245;es de clima seco&#44; agentes diferentes dos &#225;caros podem ser os respons&#225;veis por desencadear asma&#44; dentre eles outros aeroal&#233;rgenos&#44; como p&#243;lens&#44; polui&#231;&#227;o do ar&#44; pequenas part&#237;culas presentes nos solos&#44; epit&#233;lios de animais&#44; al&#233;m do uso de umidificadores nas resid&#234;ncias&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">4&#44;8&#44;9</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">No Brasil ainda s&#227;o escassas as pesquisas sobre a asma e fatores de risco nas diferentes regi&#245;es do pa&#237;s&#44; especialmente no que se refere aos v&#225;rios ecossistemas&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2&#44;11</span></a> Esse fato dificulta o planejamento e a execu&#231;&#227;o de pol&#237;ticas p&#250;blicas que visam &#224; sua preven&#231;&#227;o&#44; pois os estudos existentes foram feitos em grande parte em cidades maiores&#44; principalmente nas capitais&#44; cuja maioria se encontra no litoral ou em regi&#245;es subtropicais nos estados da regi&#227;o Sul&#47;Sudeste&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2&#44;11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Assim&#44; o objetivo deste estudo foi avaliar a preval&#234;ncia&#44; a gravidade e os fatores associados &#224; asma em adolescentes de 13 e 14 anos em regi&#227;o de baixa umidade&#44; com clima quente e seco&#46; A pesquisa foi feita numa cidade com um clima classificado como&#160;semi&#225;rido caracterizado pela escassez e irregularidade de chuvas e altas temperaturas&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Trata&#8208;se de um estudo transversal de base populacional feito em estudantes de 13 e 14 anos matriculados na rede p&#250;blica estadual de ensino em 2014 em Petrolina &#40;Pernambuco&#41;&#44; no Nordeste brasileiro&#44; que conta com 294 mil habitantes<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> e ocupa uma &#225;rea correspondente a 4&#46;561&#44;872 Km<span class="elsevierStyleSup">2</span>&#46; Este estudo foi aprovado pelo comit&#234; de &#233;tica em pesquisa com seres humanos da Universidade de Pernambuco &#40;protocolo&#58; 459&#46;304&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Os dados foram obtidos por meio de question&#225;rios aplicados nas escolas com registro das informa&#231;&#245;es em formul&#225;rios compostos por perguntas pr&#233;&#8208;codificadas&#44; com quesitos sobre idade&#44; sexo&#44; doen&#231;as al&#233;rgicas&#44; n&#237;vel de atividade f&#237;sica &#40;NAF&#41;&#44; escolaridade da m&#227;e&#44; renda familiar&#44; presen&#231;a de fumante em casa e antecedentes de asma nos genitores&#46; Os question&#225;rios preenchidos pelos adolescentes eram revisados ao fim do dia para identifica&#231;&#227;o e corre&#231;&#227;o oportuna de erros de preenchimento&#44; checaram&#8208;se&#44; mediante novas visitas&#44; as informa&#231;&#245;es incompletas&#44; duvidosas ou inconsistentes&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para avalia&#231;&#227;o das doen&#231;as al&#233;rgicas foi usado o question&#225;rio Isaac traduzido e validado para o Brasil&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> Esse question&#225;rio apresenta tr&#234;s m&#243;dulos &#40;asma&#44; rinite e eczema&#41; com at&#233; oito quest&#245;es cada&#44; autoaplic&#225;vel e de f&#225;cil entendimento&#46; Foi considerado para classifica&#231;&#227;o de preval&#234;ncia de asma ou asma em atividade quem respondesse &#8220;sim&#8221; &#224; pergunta &#8220;Nos &#250;ltimos 12 meses&#44; voc&#234; teve sibilos &#40;chiado no peito&#41;&#63;&#8221;&#44; para diagn&#243;stico de asma quem respondesse &#8220;sim&#8221; &#224; pergunta &#8220;Alguma vez na vida voc&#234; teve asma&#63;&#8221; e para o diagn&#243;stico de asma grave&#44; aqueles adolescentes classificados como tendo asma em atividade que relataram chiado no peito t&#227;o forte a ponto de afetar a fala&#46; Esse question&#225;rio n&#227;o cont&#233;m perguntas relativas ao consumo de medicamentos&#46; Foi considerado como tendo rinite e dermatite at&#243;pica quem respondesse &#8220;sim&#8221; &#224;s seguintes perguntas respectivamente &#8220;Nos &#250;ltimos 12 meses&#44; voc&#234; teve algum problema com espirros&#44; coriza &#40;corrimento nasal&#41; ou obstru&#231;&#227;o nasal&#44; quando n&#227;o estava gripado ou com resfriado&#63;&#8221; e &#8220;Nos &#250;ltimos 12 meses&#44; voc&#234; teve manchas na pele &#40;eczema&#41;&#63;&#8221;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Para avaliar a repercuss&#227;o da asma nas atividades di&#225;rias dos adolescentes foram avaliados o absente&#237;smo e o rendimento escolar geral e a atividade nas aulas de educa&#231;&#227;o f&#237;sica&#46; O absente&#237;smo escolar foi avaliado observando o n&#250;mero total de faltas escolares em cada disciplina por meio da frequ&#234;ncia escolar referente ao ano anterior &#224; pesquisa&#46; O desempenho escolar foi avaliado por meio das m&#233;dias das notas obtidas durante o ano anterior &#224; pesquisa nas disciplinas obrigat&#243;rias &#40;matem&#225;tica&#44; portugu&#234;s&#44; ci&#234;ncias&#44; ci&#234;ncias sociais e educa&#231;&#227;o art&#237;stica&#41; comuns a todas as escolas&#46; O grau de instru&#231;&#227;o da m&#227;e foi caracterizado em 0 a 9 anos de estudo&#44; 10 a 13 anos de estudo e maior do que 14 anos de estudo e a renda familiar em at&#233; dois sal&#225;rios e maior do que dois sal&#225;rios m&#237;nimos&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">O n&#237;vel de atividade f&#237;sica foi avaliado por meio do question&#225;rio internacional de atividade f&#237;sica &#40;IPAQ&#44; vers&#227;o curta&#41; validado para o Brasil&#44;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> que classifica o indiv&#237;duo em muito ativo&#44; ativo&#44; irregularmente ativo ou sedent&#225;rio&#44; conforme frequ&#234;ncia&#44; dura&#231;&#227;o e intensidade das atividades f&#237;sicas semanais&#46; Foram considerados ativos os indiv&#237;duos que atingiram os seguintes crit&#233;rios&#58; a&#41; atividade f&#237;sica vigorosa com frequ&#234;ncia igual ou superior a tr&#234;s dias&#47;semana com dura&#231;&#227;o igual ou maior do que 20 minutos&#47;sess&#227;o&#59; b&#41; atividade f&#237;sica moderada ou caminhada com frequ&#234;ncia igual ou superior a cinco dias&#47;semana e dura&#231;&#227;o igual ou maior do que 30 minutos&#47;sess&#227;o&#59; c&#41; qualquer atividade f&#237;sica cuja frequ&#234;ncia somada fosse igual ou superior a cinco dias&#47;semana e com dura&#231;&#227;o igual ou maior do que 150 minutos&#47;semana&#46; Os sujeitos que n&#227;o alcan&#231;aram os crit&#233;rios supracitados foram classificados como inativos&#46; Os question&#225;rios escritos foram distribu&#237;dos nas salas de aula e preenchidos pelos pr&#243;prios adolescentes com supervis&#227;o dos pesquisadores previamente treinados&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Tamanho da amostra e an&#225;lise estat&#237;stica</span><p id="par0050" class="elsevierStylePara elsevierViewall">Para quantifica&#231;&#227;o do tamanho da amostra no programa WinPepi &#40;PEPI&#8208;for&#8208;Windows&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> foram usados os seguintes crit&#233;rios&#58; popula&#231;&#227;o estimada em 31&#46;555 alunos&#59; intervalo de confian&#231;a de 95&#37;&#59; erro amostral de cinco pontos percentuais&#59; preval&#234;ncia estimada em 50&#37; por se tratar de mais de duas vari&#225;veis de interesse&#59; e efeito de delineamento amostral estabelecido em tr&#234;s vezes o tamanho m&#237;nimo da amostra&#59; e perda amostral de 20&#37;&#46; Totalizou&#44; portanto&#44; uma amostra m&#237;nima de 1&#46;425 alunos&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">O procedimento de sele&#231;&#227;o da amostra obedeceu a uma sequ&#234;ncia de etapas na tentativa de se obter uma amostragem representativa de escolares da rede estadual de ensino quanto &#224; distribui&#231;&#227;o conforme o porte de escolas&#46; Com o objetivo de auxiliar o planejamento amostral&#44; as escolas foram organizadas em tr&#234;s categorias&#58; pequeno porte &#40;at&#233; 200 alunos&#41;&#44; m&#233;dio porte &#40;201 a 499 alunos&#41; e grande porte &#40;superior a 500 alunos&#41; e foi aplicado crit&#233;rio de estratifica&#231;&#227;o considerando a proporcionalidade por porte&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Ap&#243;s todas as etapas&#44; chegou&#8208;se ao n&#250;mero total de 18 escolas e 57 turmas&#44; o que representa 42&#37; das escolas estaduais de Petrolina&#46; Considerando um n&#250;mero m&#237;nimo de 25 alunos por turma&#44; esperava&#8208;se avaliar 1&#46;425 alunos&#46; Como algumas turmas tinham mais do que 25 alunos por turma&#44; 1&#46;591 estudantes foram avaliados&#46; As escolas foram escolhidas por sorteio ap&#243;s a randomiza&#231;&#227;o feita no programa WinPepi&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Os dados foram processados e analisados com os programas <span class="elsevierStyleItalic">Statistical Package for the Social Sciences</span> &#40;SPSS&#41;&#44; vers&#227;o 20&#46;0 e o Stata 7&#46;0 &#40;StataCorp&#46; 2015&#46;&#160;<span class="elsevierStyleItalic">Stata Statistical Software&#58; release 7</span>&#46; College Station&#44; EUA&#41;&#46; Inicialmente os dados foram inseridos no pacote estat&#237;stico SPPS por meio de digita&#231;&#227;o dupla e comparadas poss&#237;veis inconsist&#234;ncias&#46; Para testar a suposi&#231;&#227;o de normalidade dos dados foi aplicado o teste de Kolmogorov&#8208;Smirnov&#46; A compara&#231;&#227;o entre as medianas foi feita com o teste de Mann&#8208;Whitney para vari&#225;veis n&#227;o param&#233;tricas&#46; Para avaliar as diferen&#231;as entre as propor&#231;&#245;es de asma e os fatores associados foram usados os testes qui&#8208;quadrado e qui&#8208;quadrado com corre&#231;&#227;o de Yates&#44; quando apropriados&#46; Todas as conclus&#245;es foram tomadas no n&#237;vel de signific&#226;ncia de 5&#37;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">As raz&#245;es de preval&#234;ncia &#40;RP&#41; para asma foram calculadas para cada vari&#225;vel de exposi&#231;&#227;o por regress&#227;o de Poisson&#46; As vari&#225;veis com valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;20 nas an&#225;lises bivariadas foram selecionadas para compor o modelo de regress&#227;o multivariado&#44; com a finalidade de avaliar o impacto das vari&#225;veis explanat&#243;rias&#46; Os resultados foram expressos por raz&#245;es de preval&#234;ncias &#40;RP&#41; ajustadas com respectivos intervalos de 95&#37; de confian&#231;a &#40;IC95&#37;&#41; e foram considerados estatisticamente significantes valores p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">Participaram da pesquisa 1&#46;591 adolescentes de 13 e 14 anos&#44; 791 &#40;49&#44;7&#37;&#41; do sexo masculino e 800 &#40;50&#44;3&#37;&#41; do feminino&#44; 67&#44;2&#37; das fam&#237;lias ganhavam at&#233; dois sal&#225;rios m&#237;nimos e apenas 17&#44;8&#37; das m&#227;es tinham n&#237;vel superior&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A distribui&#231;&#227;o dos adolescentes por sexo e fatores relacionados &#224;s doen&#231;as al&#233;rgicas demonstra que as preval&#234;ncias para asma em atividade&#44; asma grave e diagn&#243;stico m&#233;dico de asma foram de 14&#37;&#44; 10&#44;4&#37; e 17&#44;8&#37;&#44; respectivamente&#44; e verifica&#8208;se que as adolescentes apresentaram maior preval&#234;ncia de asma&#44; rinite al&#233;rgica e dermatite &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">A an&#225;lise bivariada entre a preval&#234;ncia de asma em atividade e os poss&#237;veis fatores intervenientes &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41; demonstraram a import&#226;ncia da associa&#231;&#227;o com a rinite al&#233;rgica e com a dermatite at&#243;pica bem como com a hist&#243;ria de antecedentes de asma nos genitores &#40;28&#44;2&#37; <span class="elsevierStyleItalic">vs</span>&#46; 10&#44;4&#37;&#44; 35&#44;8&#37; <span class="elsevierStyleItalic">vs</span>&#46; 12&#44;4&#37; e 27&#44;3&#37; <span class="elsevierStyleItalic">vs</span>&#46; 8&#44;3&#37;&#44; respectivamente&#44; todos com p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Os adolescentes com asma se abstiveram mais nas aulas&#44; inclusive nas aulas de educa&#231;&#227;o f&#237;sica&#44; do que os seus pares n&#227;o asm&#225;ticos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Contudo&#44; n&#227;o foi detectado menor rendimento escolar desses estudantes com asma &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Na an&#225;lise de regress&#227;o de Poisson&#44; que incluiu o sexo feminino e o menor n&#237;vel de atividade f&#237;sica&#44; verificou&#8208;se que apenas mantiveram&#8208;se no modelo final as vari&#225;veis de rinite al&#233;rgica e dermatite at&#243;pica&#44; bem como antecedentes de asma nos genitores &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discuss&#227;o</span><p id="par0100" class="elsevierStylePara elsevierViewall">As preval&#234;ncias de asma&#44; asma grave e diagn&#243;stico m&#233;dico de asma neste estudo feito no semi&#225;rido brasileiro foram de 14&#37;&#44; 10&#44;4&#37; e 17&#44;8&#37;&#44; respectivamente&#46; Os fatores associados &#224; asma foram a rinite al&#233;rgica e a dermatite at&#243;pica&#44; bem como antecedentes de asma nos genitores&#46; Al&#233;m disso&#44; os adolescentes asm&#225;ticos faltaram mais &#224;s aulas do que seus pares&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">As diferen&#231;as clim&#225;ticas podem ter influ&#234;ncia significativa na preval&#234;ncia da asma&#44; o que &#233; indicado pela verifica&#231;&#227;o de maiores preval&#234;ncias em regi&#245;es com umidade relativa do ar e &#237;ndices pluviom&#233;tricos mais elevados e menores em regi&#245;es de climas quentes e secos&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2&#8211;6</span></a> Na compara&#231;&#227;o dos nossos achados com os de estudos feitos em outras localidades brasileiras<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2&#44;11</span></a> verificamos uma menor preval&#234;ncia de asma&#44; possivelmente relacionada com as caracter&#237;sticas clim&#225;ticas espec&#237;ficas da regi&#227;o estudada&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2&#8211;6</span></a> O clima seco dificulta a sobreviv&#234;ncia dos &#225;caros&#44; principais al&#233;rgenos intradomiciliares&#44; que necessitam de hidrata&#231;&#227;o obtida da umidade do ar para sobreviver e ambientes com umidade relativa abaixo de 55&#37; lhes s&#227;o letais&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">6&#44;9</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">No entanto&#44; assim como neste estudo&#44; a asma ainda assim &#233; detectada nessas regi&#245;es e provavelmente uma das poss&#237;veis hip&#243;teses explicativas &#233; a presen&#231;a de outros aeroal&#233;rgenos&#44; como os p&#243;lens e esporos das plantas&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> ou ainda o contato com epit&#233;lios de animais&#44; al&#233;m da suspens&#227;o de subst&#226;ncias encontradas nos solos&#44; que&#44; quando transformadas em part&#237;culas menores&#44; podem ser transportados pelos ventos por longas dist&#226;ncias&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> Existem relatos de sensibiliza&#231;&#227;o al&#233;rgica em &#225;reas pr&#243;ximas de planta&#231;&#245;es de pistache no deserto do Ir&#227;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a> e esp&#233;cies de fungos foram descritas como o agente com maior associa&#231;&#227;o com a asma em climas semi&#225;ridos no deserto&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#8211;17</span></a> As doen&#231;as respirat&#243;rias al&#233;rgicas causadas por plantas podem tamb&#233;m existir de forma ainda n&#227;o identificada nessa &#225;rea do Nordeste brasileiro&#44; pois uma das caracter&#237;sticas da regi&#227;o de nossa pesquisa &#233; a fruticultura irrigada com grandes campos de planta&#231;&#245;es&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Outro fato interessante &#233; que&#44; apesar de a asma ser menos prevalente nessa localidade&#44; os adolescentes asm&#225;ticos relataram maior gravidade da doen&#231;a&#44; o que parece interferir diretamente na vida desses indiv&#237;duos&#46; Rabe et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a> descrevem um efeito negativo da asma com consider&#225;vel perda de dias de trabalho e de escola nos casos mais graves&#44; al&#233;m de o atual controle em todo o mundo estar muito aqu&#233;m dos objetivos fixados nas orienta&#231;&#245;es das diretrizes internacionais&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> De fato&#44; o maior absente&#237;smo escolar encontrado em nossa pesquisa &#40;33 <span class="elsevierStyleItalic">vs&#46;</span> 22 aulas&#47;ano&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41; parece ter rela&#231;&#227;o com a maior gravidade da asma&#44; uma vez que a maioria &#40;74&#37;&#41; dos adolescentes com asma em atividade relatou sintomas compat&#237;veis com asma grave&#46;<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">8&#44;18&#44;19</span></a> Esse fato indica uma poss&#237;vel falta de reconhecimento e de controle da doen&#231;a e&#44; al&#233;m disso&#44; &#233; poss&#237;vel que no clima quente e seco os pacientes apresentem um fen&#243;tipo mais grave da afec&#231;&#227;o&#46; Modelos com desencadeamento de asma ap&#243;s exerc&#237;cio com os pacientes que respiram ar seco sugerem que broncoespasmo pode ser mais grave nessas condi&#231;&#245;es&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Mesmo que apresente preval&#234;ncia de asma inferior &#224; m&#233;dia brasileira &#40;14&#37; <span class="elsevierStyleItalic">vs&#46;</span> 19&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> a asma nessa localidade parece ter uma apresenta&#231;&#227;o mais grave &#40;10&#44;4&#37;&#41; quando comparada com a do restante do Brasil &#40;4&#44;7&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> e do mundo &#40;6&#44;9&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> Estudos feitos em regi&#245;es des&#233;rticas da Ar&#225;bia Saudita<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;23</span></a> evidenciaram um maior n&#250;mero de visitas &#224;s emerg&#234;ncias nos indiv&#237;duos com asma quando comparados com indiv&#237;duos habitantes de cidades da Europa &#40;62&#37; <span class="elsevierStyleItalic">vs&#46;</span> 24&#37;&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a> o que indica uma associa&#231;&#227;o com uma maior gravidade da doen&#231;a nessas &#225;reas&#44; o que pode estar relacionado com a disponibilidade de atendimento&#44; mas tamb&#233;m com as caracter&#237;sticas clim&#225;ticas da regi&#227;o&#46; Dados do Departamento de Inform&#225;tica do Sistema &#218;nico de Sa&#250;de &#40;Datasus&#41; demonstram que o n&#250;mero de interna&#231;&#245;es por asma no per&#237;odo de sete anos em Petrolina &#233; maior do que em munic&#237;pios do litoral e do agreste de Pernambuco e com tamanho populacional semelhante&#46; A taxa de internamento padronizada por 100&#46;000 habitantes foi de 509&#44;4 em Petrolina &#40;semi&#225;rido&#41;&#44; 259&#44;58 em Caruaru &#40;agreste&#41; e 180&#44;53 em Paulista &#40;litoral&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> Esse &#233; um preocupante cen&#225;rio de asma nessa regi&#227;o que parece ser efetivamente mais grave e predominantemente al&#233;rgica&#44; pois vem fortemente associada a outras caracter&#237;sticas de atopia&#44; como a rinite al&#233;rgica e a dermatite at&#243;pica&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Neste estudo&#44; ap&#243;s ajuste das vari&#225;veis&#44; a associa&#231;&#227;o de asma com a rinite al&#233;rgica &#40;raz&#227;o de preval&#234;ncia<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;96&#41; foi inferior &#224; encontrada em outros estudos brasileiros &#40;valores descritos entre 2&#44;19 e 4&#44;36&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">25</span></a> Mesmo assim&#44; junto com a dermatite at&#243;pica&#44; foi um importante fator para o diagn&#243;stico de asma na popula&#231;&#227;o estudada&#46; Esses achados sugerem que mesmo em clima seco e quente a atopia parece ser um fator presente e preponderante&#46; Um fato adicional al&#233;m dessa associa&#231;&#227;o com outras doen&#231;as al&#233;rgicas &#233; o relato de asma nos genitores como fator consistente associado com a preval&#234;ncia de asma e que contribuiu com raz&#227;o de preval&#234;ncia de 2&#44;65&#46; Isso pode sugerir a necessidade de alertar aos adultos asm&#225;ticos para identificar sinais dessa enfermidade nos filhos e contribuir com a equipe de sa&#250;de de forma precoce no cuidado apropriado&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">19&#44;20&#44;26</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">&#201; importante considerar algumas limita&#231;&#245;es deste estudo&#46; O uso de question&#225;rios pode trazer alguns vieses de recorda&#231;&#227;o e&#47;ou interpreta&#231;&#227;o e a lacuna temporal existente entre as pesquisas multic&#234;ntricas do Isaac no Brasil&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27&#44;28</span></a> Trabalhos feitos h&#225; quase dez anos no mesmo estado&#44; com metodologia an&#225;loga&#44; mas em locais com caracter&#237;sticas clim&#225;ticas bem distintas&#44; observaram diferen&#231;as na preval&#234;ncia entre a regi&#227;o mais &#250;mida do litoral &#40;19&#44;1&#37;&#41;&#44; intermedi&#225;ria do agreste &#40;17&#44;9&#37;&#41; e a atual observa&#231;&#227;o&#44; feita no semi&#225;rido &#40;14&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> Al&#233;m disso&#44; vari&#225;veis n&#227;o inclu&#237;das na pesquisa&#44; como h&#225;bitos alimentares&#44; sensibiliza&#231;&#227;o at&#243;pica e fatores psicol&#243;gicos&#44; podem influenciar a ocorr&#234;ncia de asma&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">26&#44;29&#44;30</span></a> O fato de o question&#225;rio Isaac n&#227;o conter perguntas sobre o tratamento n&#227;o nos permite fazer infer&#234;ncias a respeito de uma poss&#237;vel associa&#231;&#227;o entre a preval&#234;ncia de asma ou mesmo de asma grave observada e o uso de medicamentos&#44; que&#44; mesmo prescritos&#44; n&#227;o significam objetivamente o seu uso&#46; Contudo&#44; os resultados aqui descritos podem ajudar na compreens&#227;o da preval&#234;ncia da asma e sua gravidade nos climas quentes e secos&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; em Petrolina&#44; na regi&#227;o semi&#225;rida do Nordeste brasileiro&#44; a preval&#234;ncia de asma foi inferior &#224;quelas relatadas em outras cidades brasileiras em estudos que empregaram metodologia an&#225;loga&#44; por&#233;m chamou a aten&#231;&#227;o a alta propor&#231;&#227;o de relatos de sintomas de maior gravidade da doen&#231;a&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2&#44;27&#44;28</span></a> Pelas respostas ao question&#225;rio do Isaac podemos inferir que a asma&#44; pelo menos por parte dos m&#233;dicos&#44; n&#227;o &#233; negligenciada&#44; uma vez que a frequ&#234;ncia de diagn&#243;stico m&#233;dico de asma &#233; superior &#40;17&#44;9&#37;&#41; &#224; de sibil&#226;ncia no &#250;ltimo ano &#40;14&#37;&#41;&#46; Entretanto&#44; isso n&#227;o &#233; garantia de que os pacientes venham sendo tratados de modo apropriado&#46; A baixa umidade do ar e a falta de controle cl&#237;nico s&#227;o poss&#237;veis explica&#231;&#245;es para esse achado&#46; Esses dados devem servir para orientar as pol&#237;ticas de sa&#250;de em condi&#231;&#245;es semelhantes e estudos posteriores dever&#227;o ser feitos para avaliar se a melhoria da assist&#234;ncia m&#233;dica ser&#225; capaz de reduzir o n&#250;mero de internamentos e visitas &#224;s emerg&#234;ncias por asma que foi encontrado&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflitos de interesse</span><p id="par0140" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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    "fechaRecibido" => "2015-12-11"
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            0 => "Asthma"
            1 => "Risk factors"
            2 => "Allergic rhinitis"
            3 => "Adolescent"
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            0 => "Asma"
            1 => "Fatores de risco"
            2 => "Rinite al&#233;rgica"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To estimate asthma prevalence&#44; severity&#44; and associated factors in adolescents who live in a low relative humidity environment&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In this cross&#8208;sectional study&#44; adolescents aged 13&#8211;14 years from the city of Petrolina located in the Brazilian semiarid region answered the International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41; questionnaire&#46; The possible explanatory variables of the study were gender&#44; family income&#44; mother&#39;s education&#44; smokers in the household&#44; parental history of asthma&#44; personal history of allergic rhinitis or atopic dermatitis&#44; and physical activity level&#46; Poisson regression analysis was used to assess the association between asthma and the explanatory variables&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 1591 adolescents participated in the study&#44; of whom 49&#46;7&#37; were male&#46; The prevalence of active asthma&#44; severe asthma&#44; and physician&#8208;diagnosed asthma were 14&#46;0&#37;&#44; 10&#46;4&#37;&#44; and 17&#46;8&#37;&#44; respectively&#46; Adolescents with asthma missed more school days than their peers &#40;33 vs&#46; 22 days&#47;year&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41;&#46; Associated factors that remained significant after adjustment were history of asthma in parents &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;65&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and personal diagnosis of allergic rhinitis &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;96&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and&#47;or atopic dermatitis &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;18&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Asthma prevalence in this low&#8208;humidity environment was lower&#44; but more severe than those reported in other Brazilian cities&#46; The dry climate might hamper disease control and this may have contributed to the higher school absenteeism observed&#46; The association of asthma with allergic rhinitis and atopic dermatitis as well as a history of asthma in parents suggests that atopy is an important risk factor for asthma in this population&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Estimar a preval&#234;ncia&#44; a gravidade e os fatores associados &#224; asma em adolescentes que vivem em uma regi&#227;o de baixa umidade relativa do ar&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal em adolescentes de 13 e 14 anos do semi&#225;rido brasileiro&#46; Os participantes responderam ao question&#225;rio <span class="elsevierStyleItalic">International Study of Asthma and Allergies in Childhood</span> &#40;Isaac&#41;&#46; As vari&#225;veis explanat&#243;rias do estudo foram sexo&#44; renda familiar&#44; escolaridade da m&#227;e&#44; fumante na resid&#234;ncia&#44; antecedente de asma nos genitores&#44; antecedentes de rinite al&#233;rgica&#44; dermatite at&#243;pica e n&#237;vel de atividade f&#237;sica&#46; A an&#225;lise de regress&#227;o de Poisson foi usada para avaliar a associa&#231;&#227;o entre a asma e as vari&#225;veis explanat&#243;rias&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Participaram da pesquisa 1&#46;591 adolescentes&#44; 49&#44;7&#37; do sexo masculino&#46; As preval&#234;ncias para asma em atividade&#44; asma grave e diagn&#243;stico m&#233;dico de asma foram de 14&#37;&#44; 10&#44;4&#37; e 17&#44;8&#37;&#44; respectivamente&#46; Adolescentes asm&#225;ticos faltaram mais &#224;s aulas do que seus pares &#40;33 <span class="elsevierStyleItalic">vs</span>&#46; 22 aulas&#47;ano&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41;&#46; Fatores associados que permaneceram significantes ap&#243;s ajuste foram antecedentes de asma nos genitores &#40;RP<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;65&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; rinite al&#233;rgica &#40;RP<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;96&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e&#47;ou dermatite at&#243;pica &#40;RP<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;18&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#227;o</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Neste ambiente de baixa umidade foram observadas menor preval&#234;ncia&#44; mas maior gravidade da asma do que aquelas relatadas em outras cidades brasileiras&#46; O clima seco talvez possa dificultar o controle da doen&#231;a e isso pode ter contribu&#237;do para o maior absente&#237;smo escolar nos doentes&#46; A associa&#231;&#227;o entre rinite al&#233;rgica&#44; dermatite at&#243;pica e antecedentes de asma nos genitores sugere que a atopia &#233; importante fator de risco para a asma nesta popula&#231;&#227;o&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Como citar este artigo&#58; Correia Junior MA&#44; Sarinho ES&#44; Rizzo JA&#44; Sarinho SW&#46; Lower prevalence and greater severity of asthma in hot and dry climate&#46; J Pediatr &#40;Rio J&#41;&#46; 2017&#59;93&#58;148&#8211;55&#46;</p>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;8&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">99 &#40;6&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60; 0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dificuldade de falar nos &#250;ltimos 12 meses</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63 &#40;8&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">102 &#40;12&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">165 &#40;10&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#44;002</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Chiado no peito ap&#243;s exerc&#237;cio f&#237;sico</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">123 &#40;15&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">157 &#40;19&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">280 &#40;17&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;539&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Tosse a noite nos &#250;ltimos 12 meses</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;4&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;4&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67 &#40;4&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;863&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Alguma vez na vida teve asma</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">120 &#40;15&#44;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">164 &#40;20&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">284 &#40;17&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#44;006</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Antecedente de asma nos genitores</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">163 &#40;20&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">264 &#40;33&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">427 &#40;26&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60; 0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Rinite al&#233;rgica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">108 &#40;13&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">208 &#40;26&#44;0&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">316 &#40;19&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60; 0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Dermatite at&#243;pica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;3&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">78 &#40;9&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">106 &#40;6&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60; 0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">N&#237;vel de atividade f&#237;sica</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inativo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">315 &#40;40&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">369 &#40;46&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">684 &#40;43&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#44;021</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black"></th><th class="td" title="table-head  " colspan="4" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Preval&#234;ncia de asma question&#225;rio Isaac</th></tr><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#91;IC&#44; 95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p valor<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Sexo</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">08&#44;7&#8208;13&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60; 0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Feminino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">137&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#44;4&#8208;19&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Renda familiar</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>At&#233; dois sal&#225;rios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">147&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;8&#8208;15&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;388&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mais de dois sal&#225;rios&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;9&#8208;19&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Escolaridade da m&#227;e</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>0&#8208;9 anos de estudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;6&#8208;18&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;726&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>10&#8208;13 anos de estudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">09&#44;8&#8208;15&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#62; 14 anos de estudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#44;7&#8208;19&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Tem fumante em casa</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">194&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;2&#8208;15&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;454&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">08&#44;0&#8208;30&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Antecedente asma nos genitores</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">07&#44;5&#8208;10&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60; 0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#44;2&#8208;31&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Rinite al&#233;rgica</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">08&#44;7&#8208;12&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60; 0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23&#44;7&#8208;33&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Dermatite at&#243;pica</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">184&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;7&#8208;13&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">&#60; 0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">27&#44;4&#8208;45&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">N&#237;vel de atividade f&#237;sica</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ativo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">133&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">12&#44;8&#8208;17&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inativo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">09&#44;8&#8208;14&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0010"
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              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Teste qui&#8208;quadrado&#46;</p>"
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          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Preval&#234;ncia de asma nos adolescentes segundo sexo&#44; renda familiar&#44; escolaridade da m&#227;e&#44; fumo&#44; antecedente de asma&#44; rinite al&#233;rgica&#44; dermatite at&#243;pica e n&#237;vel de atividade f&#237;sica &#40;n&#250;mero total de adolescentes investigados&#58; 1&#46;591&#41;</p>"
        ]
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          "leyenda" => "<p id="spar3060" class="elsevierStyleSimplePara elsevierViewall">Os valores em negrito indicam diferen&#231;a estat&#237;stica&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mediana&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14&#8208;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#44;030</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sem asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11&#8208;42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Absente&#237;smo ed&#46; f&#237;sica</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">00&#8208;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top"><span class="elsevierStyleBold">0&#44;036</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sem asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">00&#8208;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Rendimento escolar</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;42&#8208;7&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;198&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sem asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;68&#8208;7&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Rendimento ed&#46; f&#237;sica</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;68&#8208;8&#44;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;342&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6&#44;62&#8208;8&#44;60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Absente&#237;smo geral&#44; absente&#237;smo em educa&#231;&#227;o f&#237;sica&#44; rendimento escolar geral e rendimento em educa&#231;&#227;o f&#237;sica nos estudantes</p>"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">IC&#44; intervalo de confian&#231;a&#59; RP&#44; raz&#227;o de preval&#234;ncia&#46; Os valores em negrito indicam diferen&#231;a estat&#237;stica&#46;</p>"
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Feminino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;22&#8208;2&#44;09&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;80&#8208;1&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;603&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Antecedente nos genitores</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Regress&#227;o de Poisson para preval&#234;ncia de asma segundo sexo&#44; antecedente de asma nos genitores&#44; rinite al&#233;rgica&#44; dermatite at&#243;pica e n&#237;vel de atividade f&#237;sica</p>"
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      "titulo" => "Refer&#234;ncias"
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        0 => array:2 [
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            0 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                        0 => array:3 [
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                          "etal" => false
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                            0 => "D&#46; Sol&#233;"
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                            2 => "I&#46;C&#46; Camelo-Nunes"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                    0 => array:2 [
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                            0 => "S&#46; Farajzadeh"
                            1 => "I&#46; Esfandiarpour"
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                          "etal" => true
                          "autores" => array:6 [
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                            0 => "J&#46; Portnoy"
                            1 => "J&#46;D&#46; Miller"
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                    0 => array:2 [
                      "titulo" => "Prevalence of asthma and associated factors in adolescents living in Belem &#40;Amazon region&#41;&#44; Para&#44; Brazil"
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                          "etal" => false
                          "autores" => array:2 [
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                      "Revista" => array:5 [
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                0 => array:2 [
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                      "titulo" => "Meteorological conditions&#44; climate change&#44; new emerging factors&#44; and asthma and related allergic disorders&#46; A statement of the World Allergy Organization"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; D&#8217;Amato"
                            1 => "S&#46;T&#46; Holgate"
                            2 => "R&#46; Pawankar"
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                          "etal" => false
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                            0 => "L&#46;G&#46; Arlian"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                            0 => "A&#46;K&#46; Andiappan"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                          "etal" => true
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                            0 => "C&#46;K&#46; Lai"
                            1 => "R&#46; Beasley"
                            2 => "J&#46; Crane"
                            3 => "S&#46; Foliaki"
                            4 => "J&#46; Shah"
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                      "doi" => "10.1136/thx.2008.106609"
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