array:23 [
  "pii" => "S1695403307703247"
  "issn" => "16954033"
  "doi" => "10.1157/13098933"
  "estado" => "S300"
  "fechaPublicacion" => "2007-02-01"
  "aid" => "70324"
  "copyright" => "Asociación Española de Pediatría"
  "copyrightAnyo" => "2007"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "An Pediatr (Barc). 2007;66:154-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 4973
    "formatos" => array:3 [
      "EPUB" => 74
      "HTML" => 4326
      "PDF" => 573
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1695403307703259"
    "issn" => "16954033"
    "doi" => "10.1016/S1695-4033(07)70325-9"
    "estado" => "S300"
    "fechaPublicacion" => "2007-02-01"
    "aid" => "70325"
    "copyright" => "Asociación Española de Pediatría"
    "documento" => "simple-article"
    "crossmark" => 0
    "subdocumento" => "err"
    "cita" => "An Pediatr (Barc). 2007;66:153"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 910
      "formatos" => array:3 [
        "EPUB" => 82
        "HTML" => 542
        "PDF" => 286
      ]
    ]
    "es" => array:6 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Fe de errores</span>"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "153"
        ]
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403307703259?idApp=UINPBA00005H"
    "url" => "/16954033/0000006600000002/v2_201308271339/S1695403307703259/v2_201308271339/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1695403307703235"
    "issn" => "16954033"
    "doi" => "10.1157/13098932"
    "estado" => "S300"
    "fechaPublicacion" => "2007-02-01"
    "aid" => "70323"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2007;66:146-53"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 4801
      "formatos" => array:3 [
        "EPUB" => 86
        "HTML" => 4109
        "PDF" => 606
      ]
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Originales</span>"
      "titulo" => "Prevalencia de s&#237;ntomas de asma y rinitis en la poblaci&#243;n de A Coru&#241;a"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "146"
          "paginaFinal" => "153"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Prevalence of asthma and rhinitis symptoms in a Coru&#241;a &#40;Spain&#41;"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; L&#243;pez-Silvarrey Varela, F&#46;J&#46; Gonz&#225;lez Barcala, J&#46;J&#46; Paz Esquete, T&#46;R&#46; P&#233;rez Castro, L&#46; Vald&#233;s Cuadrado, A&#46; Castro Iglesias"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "L&#243;pez-Silvarrey Varela"
            ]
            1 => array:2 [
              "nombre" => "F&#46;J&#46;"
              "apellidos" => "Gonz&#225;lez Barcala"
            ]
            2 => array:2 [
              "nombre" => "J&#46;J&#46;"
              "apellidos" => "Paz Esquete"
            ]
            3 => array:2 [
              "nombre" => "T&#46;R&#46;"
              "apellidos" => "P&#233;rez Castro"
            ]
            4 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Vald&#233;s Cuadrado"
            ]
            5 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Castro Iglesias"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403307703235?idApp=UINPBA00005H"
    "url" => "/16954033/0000006600000002/v2_201308271339/S1695403307703235/v2_201308271339/es/main.assets"
  ]
  "es" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Originales</span>"
    "titulo" => "Incidencia de rinitis al&#233;rgica en escolares entre 1994 y 2002 en Castell&#243;n seg&#250;n el estudio ISAAC"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "154"
        "paginaFinal" => "158"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "E&#46; Tornador-Gaya, R&#46; Tosca-Segura, A&#46; Arnedo-Pena, J&#46; Puig-Barber&#225;, J&#46;B&#46; Bellido-Blasco, M&#46;&#170;R&#46; Pac-Sa, A&#46; Artero-Civera, J&#46;B&#46; Campos-Crua&#241;es, L&#46; Museros-Recatala"
        "autores" => array:9 [
          0 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Tornador-Gaya"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "R&#46;"
            "apellidos" => "Tosca-Segura"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff1"
              ]
            ]
          ]
          2 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Arnedo-Pena"
            "email" => array:1 [
              0 => "arnedo&#95;alb&#64;gva&#46;es"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor1"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Puig-Barber&#225;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff3"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "J&#46;B&#46;"
            "apellidos" => "Bellido-Blasco"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "M&#46;&#170;R&#46;"
            "apellidos" => "Pac-Sa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff4"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Artero-Civera"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff5"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "J&#46;B&#46;"
            "apellidos" => "Campos-Crua&#241;es"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff6"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Museros-Recatala"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff2"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:6 [
          0 => array:3 [
            "entidad" => "Servicio de Pediatr&#237;a&#46; Hospital General&#46; Castell&#243;n"
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "aff1"
          ]
          1 => array:3 [
            "entidad" => "Secci&#243;n de Epidemiolog&#237;a&#46; Centro Salud P&#250;blica&#46; Castell&#243;n"
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "aff2"
          ]
          2 => array:3 [
            "entidad" => "Unidad de Programas&#46; Centro Salud P&#250;blica&#46; Castell&#243;n"
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "aff3"
          ]
          3 => array:3 [
            "entidad" => "Secci&#243;n de Ordenaci&#243;n Sanitaria&#46; Direcci&#243;n Territorial de Sanidad&#46; Castell&#243;n"
            "etiqueta" => "<span class="elsevierStyleSup">d</span>"
            "identificador" => "aff4"
          ]
          4 => array:3 [
            "entidad" => "Centro de Salud&#46; Burriana"
            "etiqueta" => "<span class="elsevierStyleSup">e</span>"
            "identificador" => "aff5"
          ]
          5 => array:3 [
            "entidad" => "SAMU de L&#8217;Alcora&#46; Conselleria de Sanitat&#46; Castell&#243;n&#46; Espa&#241;a"
            "etiqueta" => "<span class="elsevierStyleSup">f</span>"
            "identificador" => "aff6"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia&#58; Dr&#46; A&#46; Arnedo-Pena&#46; Secci&#243;n de Epidemiolog&#237;a&#46; Centro Salud P&#250;blica&#46; L&#8217;Olivera&#44; 5&#44; 2-C&#46; 12005 Castell&#243;n&#46; Espa&#241;a&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Incidence of allergic rhinitis in a cohort of schoolchildren between 1994 and 2002 in Castell&#243;n &#40;Spain&#41;&#44; following the isaac study"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2006-07-31"
    "fechaAceptado" => "2006-10-31"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec246180"
          "palabras" => array:3 [
            0 => "Rinitis al&#233;rgica"
            1 => "Incidencia"
            2 => "Adolescentes"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec246179"
          "palabras" => array:3 [
            0 => "Allergic rhinitis"
            1 => "Incidence"
            2 => "Adolescents"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Estimar la incidencia de rinitis al&#233;rgica en poblaci&#243;n escolar de Castell&#243;n al comparar las fases I y III del International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41;&#44; efectuadas en 1994 y 2002&#44; respectivamente&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Se estudi&#243; una cohorte de 3&#46;607 escolares que participaron en la fase I &#40;grupo de 6 y 7 a&#241;os&#41;&#46; De ellos&#44; 8 a&#241;os m&#225;s tarde&#44; participaron en la fase III 1&#46;805 &#40;grupo de 14 y 15 a&#241;os&#41;&#44; con 1&#46;627 escolares sin rinitis al&#233;rgica en la fase I&#46; Se estim&#243; la incidencia acumulada de rinitis al&#233;rgica&#46; Se utilizaron dos definiciones como caso nuevo de rinitis al&#233;rgica&#44; la primera por diagn&#243;stico o tratamiento m&#233;dico de la rinitis al&#233;rgica y la segunda incluyendo&#44; adem&#225;s&#44; s&#237;ntomas en los &#250;ltimos 12 meses&#46; Se calcul&#243; el riesgo relativo mediante modelos de regresi&#243;n de Poisson&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La participaci&#243;n alcanz&#243; el 50 &#37; y se detectaron 151 casos nuevos de rinitis al&#233;rgica seg&#250;n la primera definici&#243;n &#40;incidencia acumulada 9&#44;3 y 1&#44;2 &#37; anual&#41;&#44; y 339 casos nuevos con la segunda definici&#243;n &#40;incidencia acumulada 20&#44;8 y 2&#44;6 &#37; anual&#41;&#46; No se observaron diferencias por sexo para la primera definici&#243;n &#40;riesgo relativo RR&#93;&#58; 1&#44;00&#59; intervalo de confianza del 95 &#37; &#91;IC 95&#37;&#93;&#58; 0&#44;73-1&#44;38&#41;&#44; pero con la segunda definici&#243;n las mujeres tuvieron mayor incidencia &#40;RR&#58; 1&#44;46&#59; IC 95 &#37;&#58; 1&#44;18-1&#44;82&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La incidencia acumulada de rinitis al&#233;rgica seg&#250;n la primera definici&#243;n fue comparable a las estimadas en estudios de cohorte de poblaciones adolescentes&#46;</p>"
      ]
      "en" => array:1 [
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To estimate the incidence of allergic rhinitis in schoolchildren in Castell&#243;n by comparing phases I and III of the International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41;&#44; carried out in 1994 and 2002&#44; respectively&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A cohort study was performed with 3607 schoolchildren aged 6-7 years old who participated in phase I of the ISAAC study&#46; Of these&#44; 1805 participated in phase III &#40;8 years later&#41; at the age of 14-15 years&#44; with 1627 schoolchildren without allergic rhinitis in phase I&#46; The cumulative incidence of allergic rhinitis was estimated&#46; Two definitions of new cases of allergic rhinitis were used&#58; the first was based on medical diagnosis or treatment of the disease&#44; and the second also included symptoms of allergic rhinitis in the previous 12 months&#46; Relative risks were calculated using Poisson regression&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Participation was 50&#46;0&#37;&#44; and 151 new cases of allergic rhinitis according to the first definition &#40;cumulative incidence of 9&#46;3&#37; and 1&#46;2&#37; per year&#41; and 339 new cases according to the second definition &#40;cumulative incidence of 20&#46;8 &#37; and 2&#46;6&#37; per year&#41; were found&#46; No differences in incidence by gender were observed with the first definition &#40;RR &#61; 1&#46;00 95 &#37; CI 0&#46;73-1&#46;38&#41; but with the second definition&#44; the incidence was greater in girls &#40;RR &#61; 1&#46;46 95&#37; CI 1&#46;18-1&#46;82&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The cumulative incidence of allergic rhinitis according to the first definition was in the range of incidence from cohort studies of adolescents&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:30 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of environmental factors on the development of allergic disorders in infancy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;H&#46; Arshad"
                            1 => "D&#46;W&#46; Hide"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol&#46;"
                        "fecha" => "1992"
                        "volumen" => "90"
                        "paginaInicial" => "235"
                        "paginaFinal" => "241"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1500628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Allergic rhinoconjunctivitis&#58; Epidemiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46; Phipatanakul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.iac.2005.03.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Immunol Allergy Clin North Am&#46;"
                        "fecha" => "2005"
                        "volumen" => "25"
                        "paginaInicial" => "263"
                        "paginaFinal" => "280"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15878455"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalencia de rinitis al&#233;rgica y eczema at&#243;pico en poblaci&#243;n escolar de Castell&#243; Tesis doctoral"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Arnedo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1999"
                        "editorial" => "Universidad P&#250;blica de Navarra"
                        "editorialLocalizacion" => "Pamplona"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The International Study of Asthma and Allergy in Childhood&#58; Rational and methods"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;I&#46; Asher"
                            1 => "H&#46;R&#46; Anderson"
                            2 => "R&#46; Beasley"
                            3 => "J&#46; Crane"
                            4 => "F&#46; Mart&#237;nez"
                            5 => "E&#46;A&#46; Mitchell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Resp J&#46;"
                        "fecha" => "1995"
                        "volumen" => "8"
                        "paginaInicial" => "483"
                        "paginaFinal" => "491"
                        "itemHostRev" => array:3 [
                          "pii" => "S0002937803009487"
                          "estado" => "S300"
                          "issn" => "00029378"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Objetivos y m&#233;todos del estudio ISAAC &#40;International Study of Asthma and Allergy in Childhood&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Grupo ISAAC Espa&#241;ol"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Anales Sis San Navarra"
                        "fecha" => "1997"
                        "volumen" => "20"
                        "paginaInicial" => "57"
                        "paginaFinal" => "66"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalencia de s&#237;ntomas sugestivos de rinitis al&#233;rgica y dermatitis at&#243;pica en adolescentes&#58; estudio ISAAC Espa&#241;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "Grupo ISAAC Espa&#241;ol"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Esp Pediatr&#46;"
                        "fecha" => "1999"
                        "volumen" => "51"
                        "paginaInicial" => "369"
                        "paginaFinal" => "376"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10690229"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evoluci&#243;n temporal de la prevalencia de s&#237;ntomas de rinitis al&#233;rgica en escolares de 13-14 a&#241;os de 8 &#225;reas espa&#241;olas entre 1993-1994 y 2001-2002 seg&#250;n el Estudio Internacional sobre Asma y Alergias en la Infancia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Arnedo-Pena"
                            1 => "L&#46; Garc&#237;a-Marcos"
                            2 => "A&#46; Blanco-Quir&#243;s"
                            3 => "A&#46; Mart&#237;nez"
                            4 => "I&#46; Aguinaga"
                            5 => "C&#46; Gonz&#225;lez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Barc&#41;"
                        "fecha" => "2004"
                        "volumen" => "123"
                        "paginaInicial" => "490"
                        "paginaFinal" => "495"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stata statistical software&#58; release 6&#46;0&#46; College Station&#44; Texas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "StataCorp&#46;"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "1999"
                        "editorial" => "Stata Corporation"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tendencia temporal y variaciones geogr&#225;ficas de la prevalencia de s&#237;ntomas de rinitis al&#233;rgica en escolares de 6-7 a&#241;os de ocho &#225;reas espa&#241;olas&#44; seg&#250;n el ISAAC"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Arnedo-Pena"
                            1 => "L&#46; Garc&#237;a-Marcos"
                            2 => "G&#46; Garc&#237;a-Hern&#225;ndez"
                            3 => "I&#46; Aguinaga"
                            4 => "C&#46; Gonz&#225;lez"
                            5 => "M&#46; Morales"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2005"
                        "volumen" => "62"
                        "paginaInicial" => "229"
                        "paginaFinal" => "236"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breast feeding and allergic diseases in infants-a prospective birth cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46; Kull"
                            1 => "M&#46; Wickman"
                            2 => "G&#46; Lilja"
                            3 => "S&#46;L&#46; Nordvall"
                            4 => "G&#46; Pershagen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "2002"
                        "volumen" => "87"
                        "paginaInicial" => "478"
                        "paginaFinal" => "481"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12456543"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Siblings&#44; multiple births&#44; and the incidence of allergic disease&#58; A birth cohort study using the West Midlands general practice research database"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; McKeever"
                            1 => "S&#46; Lewis"
                            2 => "C&#46; Smith"
                            3 => "J&#46; Collins"
                            4 => "H&#46; Heatlie"
                            5 => "M&#46; Frischer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2001"
                        "volumen" => "56"
                        "paginaInicial" => "758"
                        "paginaFinal" => "762"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11562513"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence and risk factors for atopy in early childhood&#58; A whole population birth cohort study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46; Tarig"
                            1 => "S&#46;M&#46; Matthews"
                            2 => "E&#46;A&#46; Akim"
                            3 => "M&#46; Stevens"
                            4 => "S&#46;H&#46; Arshad"
                            5 => "D&#46;H&#46; Hice"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0091-6749(98)70164-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol&#46;"
                        "fecha" => "1998"
                        "volumen" => "101"
                        "paginaInicial" => "587"
                        "paginaFinal" => "593"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9600493"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Low socioeconomic status as a risk factor for asthma&#44; rhinitis and sensitization at 4 years in a birth cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Almqvist"
                            1 => "G&#46; Pershagen"
                            2 => "M&#46; Wickman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2222.2005.02243.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Allergy"
                        "fecha" => "2005"
                        "volumen" => "35"
                        "paginaInicial" => "612"
                        "paginaFinal" => "618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15898983"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of physician-diagnosed allergic rhinitis in childhood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Wright"
                            1 => "C&#46; Holberg"
                            2 => "F&#46; Mart&#237;nez"
                            3 => "M&#46; Halonen"
                            4 => "W&#46; Morgan"
                            5 => "L&#46;M&#46; Taussing"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1994"
                        "volumen" => "94"
                        "paginaInicial" => "895"
                        "paginaFinal" => "901"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7971008"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development of seasonal allergic rhinitis during the first 7 years of life"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46; Kulig"
                            1 => "U&#46; Klettke"
                            2 => "V&#46; Wahn"
                            3 => "J&#46; Forster"
                            4 => "C&#46;P&#46; Bauer"
                            5 => "U&#46; Wahn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol&#46;"
                        "fecha" => "2000"
                        "volumen" => "106"
                        "paginaInicial" => "832"
                        "paginaFinal" => "839"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11080703"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early respiratory infections&#44; asthma&#44; and allergy&#58; 10-year follow-up of the Oslo Birth Cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Nafstad"
                            1 => "B&#46; Brunekreef"
                            2 => "A&#46; Skrondal"
                            3 => "W&#46; Nystad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "2005"
                        "volumen" => "116"
                        "paginaInicial" => "255"
                        "paginaFinal" => "262"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atopy in childhood I Gender and allergen related risked for development of hay fever and asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Sears"
                            1 => "B&#46; Burrows"
                            2 => "E&#46;M&#46; Flannery"
                            3 => "G&#46;P&#46; Herbison"
                            4 => "M&#46;D&#46; Holdaways"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Allergy"
                        "fecha" => "1993"
                        "volumen" => "23"
                        "paginaInicial" => "941"
                        "paginaFinal" => "948"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10779282"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Investigation into increase in hay fever and eczema at the age 16 observed between the 1958 and 1970 British birth cohort"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46;K&#46; Butland"
                            1 => "D&#46;P&#46; Strachan"
                            2 => "S&#46; Lewis"
                            3 => "J&#46; Bynner"
                            4 => "N&#46; Butler"
                            5 => "J&#46; Britton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1997"
                        "volumen" => "315"
                        "paginaInicial" => "717"
                        "paginaFinal" => "721"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9314757"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and incidence of asthma and rhinoconjunctivitis in Swedish teenagers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46; Norrman"
                            1 => "L&#46; Nystr&#246;m"
                            2 => "E&#46; J&#246;nsson"
                            3 => "N&#46; Stjernberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "1998"
                        "volumen" => "53"
                        "paginaInicial" => "28"
                        "paginaFinal" => "35"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10096804"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence and prevalence of asthma and allergic rhinitis&#58; A cohort study of Finish adolescents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;M&#46; Huurre"
                            1 => "H&#46;M&#46; Aro"
                            2 => "J&#46;J&#46; Jaakkola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Asthma"
                        "fecha" => "2004"
                        "volumen" => "41"
                        "paginaInicial" => "311"
                        "paginaFinal" => "317"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15260464"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term risk factors for developing asthma and allergic rhinitis&#58; A 23-year followup study of college students"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;J&#46; Settipane"
                            1 => "G&#46;W&#46; Hagy"
                            2 => "G&#46;A&#46; Settipane"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy Proc&#46;"
                        "fecha" => "1994"
                        "volumen" => "15"
                        "paginaInicial" => "21"
                        "paginaFinal" => "25"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8005452"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children&#58; The International Study of Asthma and Allergy in Childhood&#58; Rational and methods"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;P&#46; Strachan"
                            1 => "B&#46; Sibbald"
                            2 => "S&#46;K&#46; Weiland"
                            3 => "N&#46; A&#239;t-Khaled"
                            4 => "G&#46; Anabwani"
                            5 => "H&#46;R&#46; Anderson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Allergy Immunol&#46;"
                        "fecha" => "1997"
                        "volumen" => "8"
                        "paginaInicial" => "161"
                        "paginaFinal" => "176"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9553981"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of allergic rhinitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46; Sibbald"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Epidemiology of clinical allergy"
                        "paginaInicial" => "61"
                        "paginaFinal" => "79"
                        "serieFecha" => "1993"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and rate of diagnosis of allergic rhinitis in Europe"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46; Bauchau"
                            1 => "S&#46;R&#46; Durham"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.04.00013904"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J&#46;"
                        "fecha" => "2004"
                        "volumen" => "24"
                        "paginaInicial" => "758"
                        "paginaFinal" => "764"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15516669"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "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 I and phase III surveys in Munster&#44; Germany"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "W&#46; Maziak"
                            1 => "T&#46; Behrens"
                            2 => "T&#46;M&#46; Brasky"
                            3 => "H&#46; Duhme"
                            4 => "P&#46; Rzehak"
                            5 => "S&#46;K&#46; 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"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "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 => "J&#46;K&#46; Fagan"
                            1 => "P&#46;A&#46; Scheff"
                            2 => "D&#46; Hryhorczuk"
                            3 => "V&#46; Ramakrishnan"
                            4 => "M&#46; Ross"
                            5 => "V&#46; Persky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1081-1206(10)62688-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol&#46;"
                        "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"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gender differences in respiratory&#44; nasal&#44; and skin symptoms&#58; 6-7 versus 13-14 year-old children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;H&#46; Wieringa"
                            1 => "J&#46;J&#46; Weyler"
                            2 => "H&#46;P&#46; Van Bever"
                            3 => "V&#46;J&#46; Nelen"
                            4 => "P&#46;A&#46; Vermeire"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Acta Pediatr&#46;"
                        "fecha" => "1999"
                        "volumen" => "80"
                        "paginaInicial" => "147"
                        "paginaFinal" => "149"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diffences in nasal irritant sensitivity by age&#44; gender&#44; allergic rhinitis status"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Shusterman"
                            1 => "M&#46;A&#46; Murphy"
                            2 => "J&#46; Balmes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00420-003-0459-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Arch Occup Environ Health"
                        "fecha" => "2003"
                        "volumen" => "76"
                        "paginaInicial" => "577"
                        "paginaFinal" => "583"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12920525"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Therapeutic implications of sex differences in asthma and atopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Osman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dis Child"
                        "fecha" => "2003"
                        "volumen" => "88"
                        "paginaInicial" => "587"
                        "paginaFinal" => "590"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12818904"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asthma and atopy&#58; Endocrine or metabolic conditions&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Forbes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2005.047050"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2005"
                        "volumen" => "60"
                        "paginaInicial" => "793"
                        "paginaFinal" => "944"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16192360"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/16954033/0000006600000002/v2_201308271339/S1695403307703247/v2_201308271339/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "14282"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/16954033/0000006600000002/v2_201308271339/S1695403307703247/v2_201308271339/es/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403307703247?idApp=UINPBA00005H"
]
Share
Journal Information
Vol. 66. Issue 2.
Pages 154-158 (1 February 2007)
Share
Share
Download PDF
More article options
Vol. 66. Issue 2.
Pages 154-158 (1 February 2007)
Originales
Full text access
Incidencia de rinitis alérgica en escolares entre 1994 y 2002 en Castellón según el estudio ISAAC
Incidence of allergic rhinitis in a cohort of schoolchildren between 1994 and 2002 in Castellón (Spain), following the isaac study
Visits
8709
E. Tornador-Gayaa, R. Tosca-Seguraa, A. Arnedo-Penab,
Corresponding author
arnedo_alb@gva.es

Correspondencia: Dr. A. Arnedo-Pena. Sección de Epidemiología. Centro Salud Pública. L’Olivera, 5, 2-C. 12005 Castellón. España.
, J. Puig-Barberác, J.B. Bellido-Blascob, M.ªR. Pac-Sad, A. Artero-Civerae, J.B. Campos-Cruañesf, L. Museros-Recatalab
a Servicio de Pediatría. Hospital General. Castellón
b Sección de Epidemiología. Centro Salud Pública. Castellón
c Unidad de Programas. Centro Salud Pública. Castellón
d Sección de Ordenación Sanitaria. Dirección Territorial de Sanidad. Castellón
e Centro de Salud. Burriana
f SAMU de L’Alcora. Conselleria de Sanitat. Castellón. España
This item has received
Article information
Objetivo

Estimar la incidencia de rinitis alérgica en población escolar de Castellón al comparar las fases I y III del International Study of Asthma and Allergies in Childhood (ISAAC), efectuadas en 1994 y 2002, respectivamente.

Material y métodos

Se estudió una cohorte de 3.607 escolares que participaron en la fase I (grupo de 6 y 7 años). De ellos, 8 años más tarde, participaron en la fase III 1.805 (grupo de 14 y 15 años), con 1.627 escolares sin rinitis alérgica en la fase I. Se estimó la incidencia acumulada de rinitis alérgica. Se utilizaron dos definiciones como caso nuevo de rinitis alérgica, la primera por diagnóstico o tratamiento médico de la rinitis alérgica y la segunda incluyendo, además, síntomas en los últimos 12 meses. Se calculó el riesgo relativo mediante modelos de regresión de Poisson.

Resultados

La participación alcanzó el 50 % y se detectaron 151 casos nuevos de rinitis alérgica según la primera definición (incidencia acumulada 9,3 y 1,2 % anual), y 339 casos nuevos con la segunda definición (incidencia acumulada 20,8 y 2,6 % anual). No se observaron diferencias por sexo para la primera definición (riesgo relativo RR]: 1,00; intervalo de confianza del 95 % [IC 95%]: 0,73-1,38), pero con la segunda definición las mujeres tuvieron mayor incidencia (RR: 1,46; IC 95 %: 1,18-1,82).

Conclusiones

La incidencia acumulada de rinitis alérgica según la primera definición fue comparable a las estimadas en estudios de cohorte de poblaciones adolescentes.

Palabras clave:
Rinitis alérgica
Incidencia
Adolescentes
Objective

To estimate the incidence of allergic rhinitis in schoolchildren in Castellón by comparing phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC), carried out in 1994 and 2002, respectively.

Material and methods

A cohort study was performed with 3607 schoolchildren aged 6-7 years old who participated in phase I of the ISAAC study. Of these, 1805 participated in phase III (8 years later) at the age of 14-15 years, with 1627 schoolchildren without allergic rhinitis in phase I. The cumulative incidence of allergic rhinitis was estimated. Two definitions of new cases of allergic rhinitis were used: the first was based on medical diagnosis or treatment of the disease, and the second also included symptoms of allergic rhinitis in the previous 12 months. Relative risks were calculated using Poisson regression.

Results

Participation was 50.0%, and 151 new cases of allergic rhinitis according to the first definition (cumulative incidence of 9.3% and 1.2% per year) and 339 new cases according to the second definition (cumulative incidence of 20.8 % and 2.6% per year) were found. No differences in incidence by gender were observed with the first definition (RR = 1.00 95 % CI 0.73-1.38) but with the second definition, the incidence was greater in girls (RR = 1.46 95% CI 1.18-1.82).

Conclusions

The cumulative incidence of allergic rhinitis according to the first definition was in the range of incidence from cohort studies of adolescents.

Key words:
Allergic rhinitis
Incidence
Adolescents
Full text is only aviable in PDF
Bibliografía
[1.]
S.H. Arshad, D.W. Hide.
Effect of environmental factors on the development of allergic disorders in infancy.
J Allergy Clin Immunol., 90 (1992), pp. 235-241
[2.]
W. Phipatanakul.
Allergic rhinoconjunctivitis: Epidemiology.
Immunol Allergy Clin North Am., 25 (2005), pp. 263-280
[3.]
A. Arnedo.
Prevalencia de rinitis alérgica y eczema atópico en población escolar de Castelló Tesis doctoral.
Universidad Pública de Navarra, (1999),
[4.]
M.I. Asher, H.R. Anderson, R. Beasley, J. Crane, F. Martínez, E.A. Mitchell, et al.
The International Study of Asthma and Allergy in Childhood: Rational and methods.
Eur Resp J., 8 (1995), pp. 483-491
[5.]
Grupo ISAAC Español.
Objetivos y métodos del estudio ISAAC (International Study of Asthma and Allergy in Childhood).
Anales Sis San Navarra, 20 (1997), pp. 57-66
[6.]
Grupo ISAAC Español.
Prevalencia de síntomas sugestivos de rinitis alérgica y dermatitis atópica en adolescentes: estudio ISAAC España.
An Esp Pediatr., 51 (1999), pp. 369-376
[7.]
A. Arnedo-Pena, L. García-Marcos, A. Blanco-Quirós, A. Martínez, I. Aguinaga, C. González, et al.
Evolución temporal de la prevalencia de síntomas de rinitis alérgica en escolares de 13-14 años de 8 áreas españolas entre 1993-1994 y 2001-2002 según el Estudio Internacional sobre Asma y Alergias en la Infancia.
Med Clin (Barc), 123 (2004), pp. 490-495
[8.]
StataCorp..
Stata statistical software: release 6.0. College Station, Texas.
Stata Corporation, (1999),
[9.]
A. Arnedo-Pena, L. García-Marcos, G. García-Hernández, I. Aguinaga, C. González, M. Morales, et al.
Tendencia temporal y variaciones geográficas de la prevalencia de síntomas de rinitis alérgica en escolares de 6-7 años de ocho áreas españolas, según el ISAAC.
An Pediatr (Barc), 62 (2005), pp. 229-236
[10.]
I. Kull, M. Wickman, G. Lilja, S.L. Nordvall, G. Pershagen.
Breast feeding and allergic diseases in infants-a prospective birth cohort study.
Arch Dis Child, 87 (2002), pp. 478-481
[11.]
T. McKeever, S. Lewis, C. Smith, J. Collins, H. Heatlie, M. Frischer, et al.
Siblings, multiple births, and the incidence of allergic disease: A birth cohort study using the West Midlands general practice research database.
Thorax, 56 (2001), pp. 758-762
[12.]
S. Tarig, S.M. Matthews, E.A. Akim, M. Stevens, S.H. Arshad, D.H. Hice.
The prevalence and risk factors for atopy in early childhood: A whole population birth cohort study.
J Allergy Clin Immunol., 101 (1998), pp. 587-593
[13.]
C. Almqvist, G. Pershagen, M. Wickman.
Low socioeconomic status as a risk factor for asthma, rhinitis and sensitization at 4 years in a birth cohort.
Clin Exp Allergy, 35 (2005), pp. 612-618
[14.]
A. Wright, C. Holberg, F. Martínez, M. Halonen, W. Morgan, L.M. Taussing.
Epidemiology of physician-diagnosed allergic rhinitis in childhood.
Pediatrics, 94 (1994), pp. 895-901
[15.]
M. Kulig, U. Klettke, V. Wahn, J. Forster, C.P. Bauer, U. Wahn.
Development of seasonal allergic rhinitis during the first 7 years of life.
J Allergy Clin Immunol., 106 (2000), pp. 832-839
[16.]
P. Nafstad, B. Brunekreef, A. Skrondal, W. Nystad.
Early respiratory infections, asthma, and allergy: 10-year follow-up of the Oslo Birth Cohort.
Pediatrics, 116 (2005), pp. 255-262
[17.]
M. Sears, B. Burrows, E.M. Flannery, G.P. Herbison, M.D. Holdaways.
Atopy in childhood I Gender and allergen related risked for development of hay fever and asthma.
Clin Exp Allergy, 23 (1993), pp. 941-948
[18.]
B.K. Butland, D.P. Strachan, S. Lewis, J. Bynner, N. Butler, J. Britton.
Investigation into increase in hay fever and eczema at the age 16 observed between the 1958 and 1970 British birth cohort.
BMJ, 315 (1997), pp. 717-721
[19.]
E. Norrman, L. Nyström, E. Jönsson, N. Stjernberg.
Prevalence and incidence of asthma and rhinoconjunctivitis in Swedish teenagers.
Allergy, 53 (1998), pp. 28-35
[20.]
T.M. Huurre, H.M. Aro, J.J. Jaakkola.
Incidence and prevalence of asthma and allergic rhinitis: A cohort study of Finish adolescents.
J Asthma, 41 (2004), pp. 311-317
[21.]
R.J. Settipane, G.W. Hagy, G.A. Settipane.
Long-term risk factors for developing asthma and allergic rhinitis: A 23-year followup study of college students.
Allergy Proc., 15 (1994), pp. 21-25
[22.]
D.P. Strachan, B. Sibbald, S.K. Weiland, N. Aït-Khaled, G. Anabwani, H.R. Anderson, et al.
Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: The International Study of Asthma and Allergy in Childhood: Rational and methods.
Pediatr Allergy Immunol., 8 (1997), pp. 161-176
[23.]
B. Sibbald.
Epidemiology of allergic rhinitis.
Epidemiology of clinical allergy, pp. 61-79
[24.]
V. Bauchau, S.R. Durham.
Prevalence and rate of diagnosis of allergic rhinitis in Europe.
Eur Respir J., 24 (2004), pp. 758-764
[25.]
W. Maziak, T. Behrens, T.M. Brasky, H. Duhme, P. Rzehak, S.K. Weiland, et al.
Are asthma and allergies in children and adolescents increasing? Results from ISAAC phase I and phase III surveys in Munster, Germany.
Allergy, 58 (2003), pp. 572-579
[26.]
J.K. Fagan, P.A. Scheff, D. Hryhorczuk, 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
[27.]
M.H. Wieringa, J.J. Weyler, H.P. Van Bever, V.J. Nelen, P.A. Vermeire.
Gender differences in respiratory, nasal, and skin symptoms: 6-7 versus 13-14 year-old children.
Acta Pediatr., 80 (1999), pp. 147-149
[28.]
D. Shusterman, M.A. Murphy, J. Balmes.
Diffences in nasal irritant sensitivity by age, gender, allergic rhinitis status.
Int Arch Occup Environ Health, 76 (2003), pp. 577-583
[29.]
M. Osman.
Therapeutic implications of sex differences in asthma and atopy.
Arch Dis Child, 88 (2003), pp. 587-590
[30.]
L. Forbes.
Asthma and atopy: Endocrine or metabolic conditions?.
Thorax, 60 (2005), pp. 793-944
Copyright © 2007. Asociación Española de Pediatría
Download PDF
Idiomas
Anales de Pediatría (English Edition)
Article options
Tools