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ISAAC&#41; foi pioneiro na utiliza&#231;&#227;o de question&#225;rios padronizados com o objectivo de obter um mapa mundial das alergias na inf&#226;ncia<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23&#44;36</span></a>&#46; Portugal aderiu ao ISAAC em 1993&#44; com cinco &#225;reas de estudo &#40;Lisboa&#44; Porto&#44; Coimbra&#44; Portim&#227;o e Funchal&#41;&#44; tendo sido inquiridas crian&#231;as dos 13 aos 14 anos de idade&#46; Em tr&#234;s destes centros &#40;Lisboa&#44; Portim&#227;o e Funchal&#41;&#44; foram tamb&#233;m integradas no estudo crian&#231;as dos 6 aos 7 anos<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">37&#44;38</span></a>&#46; Al&#233;m da evolu&#231;&#227;o tendencial da preval&#234;ncia da asma infantil e sintomas relacionados&#44; o programa ISAAC tem salientado a necessidade de novos estudos para explicar as diferen&#231;as observadas e melhor compreender os mecanismos causais&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Com o objectivo de determinar a preval&#234;ncia e os factores de risco da asma e sintomas al&#233;rgicos em crian&#231;as que frequentam os estabelecimentos do ensino b&#225;sico de Lisboa e de comparar os resultados com os obtidos em estudos anteriores&#44; foi aplicado o question&#225;rio padronizado ISAAC a uma amostra populacional escolar&#46; A investiga&#231;&#227;o sobre os potenciais factores de risco da asma e doen&#231;as al&#233;rgicas contribui para um melhor entendimento sobre as diferen&#231;as geogr&#225;ficas na preval&#234;ncia e serve de suporte &#224; adop&#231;&#227;o de estrat&#233;gias de preven&#231;&#227;o&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material e M&#233;todos</span><p id="par0015" class="elsevierStylePara elsevierViewall">As crian&#231;as a frequentar as escolas do ensino b&#225;sico foram seleccionadas como popula&#231;&#227;o-alvo&#46; Vinte e duas escolas com uma ampla distribui&#231;&#227;o geogr&#225;fica&#44; representativas da &#225;rea urbana de Lisboa foram convidadas a participar neste estudo<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a>&#46; Catorze escolas aceitaram participar&#46; Ap&#243;s obter as autoriza&#231;&#245;es das coordena&#231;&#245;es das escolas&#44; duas salas de aula de cada escola foram seleccionadas para um programa de monitoriza&#231;&#227;o da qualidade do ar interior<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">40&#44;41</span></a>&#46; Um question&#225;rio&#44; acompanhado de uma carta explicativa&#44; foi distribu&#237;do a 900 alunos em todas as salas seleccionadas&#46; O question&#225;rio usado neste estudo &#233; a vers&#227;o portuguesa do programa ISAAC e teve de ser preenchido pelos pais dos alunos&#46; O question&#225;rio foi adaptado para facilitar o preenchimento por parte dos encarregados de educa&#231;&#227;o&#44; retirando-se algumas quest&#245;es sobre consumo de medicamentos&#44; que n&#227;o eram objectivo do presente estudo&#46; O inqu&#233;rito foi realizado entre Outubro e Dezembro de 2008 a crian&#231;as entre os 5 e os 12 anos de idade&#46; Um total de 342 question&#225;rios foi devolvido&#46; O question&#225;rio inclu&#237;a quest&#245;es sobre frequ&#234;ncia de sintomas respirat&#243;rios e al&#233;rgicos na inf&#226;ncia&#44; actividades f&#237;sicas&#44; caracter&#237;sticas s&#243;cio-demogr&#225;ficas&#44; condi&#231;&#245;es residenciais&#44; e outras poss&#237;veis fontes de polui&#231;&#227;o do ar interior &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Tabela 1</a>&#41;&#46; Entre os factores relacionados com o estilo de vida&#44; foi dedicada especial aten&#231;&#227;o &#224; exposi&#231;&#227;o das crian&#231;as ao fumo do tabaco&#44; modo de alimenta&#231;&#227;o nos primeiros meses de vida &#40;amamenta&#231;&#227;o ou leite comercial&#41; e tipo de dieta actual&#46; As respostas foram transferidas para o computador&#44; codificadas e confirmadas por duas pessoas distintas&#46; Modelos de regress&#227;o log&#237;stica foram utilizados&#46; Para avaliar poss&#237;veis associa&#231;&#245;es entre factores de risco e asma e sintomas al&#233;rgicos foram utilizados modelos de regress&#227;o log&#237;stica&#44; tendo sido estimados riscos relativos atrav&#233;s de <span class="elsevierStyleItalic">odds ratios</span> &#40;OR&#41; e 95&#37; do intervalo de confian&#231;a &#40;CI&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0020" class="elsevierStylePara elsevierViewall">A popula&#231;&#227;o amostrada abrangeu 342 estudantes entre os 5 e 12 anos&#44; embora 92&#37; do total estivesse inclu&#237;do na faixa et&#225;ria dos 6-8 anos&#46; Dado n&#227;o se terem observado diferen&#231;as dim&#243;rficas no que toca &#224;s frequ&#234;ncias de alergias&#44; nenhuma divis&#227;o por sexo foi aplicada em an&#225;lises posteriores&#46; A percentagem de crian&#231;as com sibil&#226;ncia foi de 43&#44;3&#37;&#46; A preval&#234;ncia de asma foi de 5&#44;6&#37;&#46; Os sintomas de rinite al&#233;rgica foram relatados para 42&#44;9&#37; das crian&#231;as&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Cerca de 9&#44;5&#37; das crian&#231;as inquiridas nasceram no estrangeiro&#46; A propor&#231;&#227;o de pais que declararam ter educa&#231;&#227;o b&#225;sica&#44; ensino secund&#225;rio e ensino superior &#233; de cerca de 20&#44; 56 e 20&#37;&#44; respectivamente&#46; As caracter&#237;sticas das resid&#234;ncias dos inquiridos foram avaliadas &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Tabela 2</a>&#41;&#58; cerca de 33&#37; das fam&#237;lias vivem em ruas com tr&#226;nsito de ve&#237;culos pesados&#59; 23&#37; secam roupas no interior da habita&#231;&#227;o e apenas 3&#37; dos quartos das crian&#231;as possuem alcatifa no ch&#227;o&#46; Aproximadamente 84&#37; dos entrevistados afirmaram utilizar g&#225;s para cozinhar&#46; Quase 23&#37; das fam&#237;lias possuem um animal de estima&#231;&#227;o em casa&#44; enquanto 62&#37; informaram ter peluches no quarto dos &#40;as&#41; filhos &#40;as&#41;&#46; A presen&#231;a de mofos ou infiltra&#231;&#245;es nas constru&#231;&#245;es foi relatada para 19&#37; das resid&#234;ncias&#44; enquanto 23&#37; das crian&#231;as foram expostas a fumo de tabaco durante o primeiro ano de vida&#46; Mais da metade das crian&#231;as participantes vive com um ou mais fumadores&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Os resultados da an&#225;lise de regress&#227;o log&#237;stica revelaram que as perguntas &#171;&#160;Quantos ataques de pieira o&#40;a&#41; seu&#40;sua&#41; filho&#40;a&#41; teve durante o ano passado&#63;&#160;&#187; e &#171;&#160;O&#40;a&#41; seu&#40;sua&#41; filho&#40;a&#41; teve tosse seca &#224; noite&#44; n&#227;o associada a constipa&#231;&#227;o comum ou gripe nos &#250;ltimos 12 meses&#63;&#160;&#187; s&#227;o estatisticamente significativas na previs&#227;o da asma&#46; Quanto &#224; primeira quest&#227;o&#44; a estimativa de probabilidade de ocorr&#234;ncia de asma na inf&#226;ncia &#233; 10 vezes superior para a categoria de resposta &#171;&#160;1 a 3&#160;&#187; &#40;um a tr&#234;s ataques de pieira no ano passado&#41; do que para aqueles que responderam &#171;&#160;nenhum&#160;&#187; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44;07&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;98&#44; 33&#44;96&#41;&#46; As crian&#231;as inclu&#237;das na categoria &#171;&#160;4 a 12&#160;&#187; t&#234;m aproximadamente 20 vezes mais probabilidade de desenvolver a doen&#231;a em compara&#231;&#227;o com as da categoria de resposta &#171;&#160;nenhuma&#160;&#187; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#44;88&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;22&#44; 93&#44;54&#41;&#46; A ocorr&#234;ncia de tosse seca &#224; noite aumenta em quase seis vezes a probabilidade de manifesta&#231;&#227;o da asma &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#44;77&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;20&#44; 27&#44;70&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para a vari&#225;vel representada pela pergunta &#171;&#160;Durante os &#250;ltimos 12 meses&#44; os problemas de pieira t&#234;m afectado as actividades di&#225;rias do&#40;a&#41; seu &#40;sua&#41; filho&#40;a&#41;&#63;&#160;&#187;&#44; o <span class="elsevierStyleItalic">odds ratio</span> entre a categoria &#171;&#160;n&#227;o afectam as actividades di&#225;rias&#160;&#187; e a categoria &#171;&#160;afectou um pouco as actividades di&#225;rias&#160;&#187; &#233; 2&#44;55 &#40;IC<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;28&#44; 5&#44;08&#41;&#46; Isto significa que a estimativa pontual da probabilidade de ocorr&#234;ncia de pieira &#233; 2&#44;55 maior para os que responderam &#171;&#160;n&#227;o afectou as actividades di&#225;rias&#160;&#187; do que para aqueles que responderam &#171;&#160;afectou um pouco as actividades di&#225;rias&#160;&#187;&#46; O <span class="elsevierStyleItalic">odds ratio</span> entre as categorias &#171;&#160;n&#227;o afectou as actividades di&#225;rias&#160;&#187; e &#171;&#160;afectou moderadamente as actividades di&#225;rias&#160;&#187; &#233; de aproximadamente 27 &#40;CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44;17&#44; 126&#44;36&#41;&#46; A estimativa pontual da probabilidade de ocorr&#234;ncia de pieira &#233; 13 vezes superior para as respostas positivas para &#171;&#160;J&#225; alguma vez o&#40;a&#41; seu &#40;sua&#41; filho&#40;a&#41; teve febre dos fenos&#63;&#160;&#187; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#44;02&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;52&#44; 109&#44;5&#41;&#46; As crian&#231;as que tiveram um animal de estima&#231;&#227;o em casa nos &#250;ltimos 12 meses parecem ter um maior risco de apresentar pieira &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;66&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;27&#44; 10&#44;57&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">A ocorr&#234;ncia de tosse seca &#224; noite&#44; n&#227;o associada com constipa&#231;&#227;o comum nos &#250;ltimos 12 meses&#44; tamb&#233;m foi associada positivamente com sintomas de rinite al&#233;rgica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;77&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;19&#44; 6&#44;44&#41;&#46; A estimativa pontual da probabilidade de ocorr&#234;ncia de rinite al&#233;rgica &#233; de cerca de 145 vezes mais elevada em crian&#231;as com crise de espirros&#44; corrimento ou congest&#227;o nasal&#44; n&#227;o associados a constipa&#231;&#245;es comuns&#44; comparativamente com aquelas sem estes sintomas &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>145&#44;47&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>53&#44;53&#44; 395&#44;28&#41;&#46; Entre as vari&#225;veis relacionadas com os h&#225;bitos alimentares&#44; a &#250;nica rela&#231;&#227;o estatisticamente significante foi encontrada para o consumo de ovos&#46; As crian&#231;as que ingerem frequentemente este alimento t&#234;m um risco 90&#37; maior de desenvolver rinite al&#233;rgica em rela&#231;&#227;o &#224;quelas que n&#227;o consomem &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#59; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#44; 0&#44;54&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discuss&#227;o</span><p id="par0045" class="elsevierStylePara elsevierViewall">A propor&#231;&#227;o entre as preval&#234;ncias de asma em crian&#231;as dos g&#233;neros masculino e feminino tem estreitado consideravelmente ao longo dos &#250;ltimos 35 anos&#44; quase desaparecendo a predomin&#226;ncia masculina anterior<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#46; Em compara&#231;&#227;o com estudos anteriores realizados em Portugal&#44; as crian&#231;as que vivem em Lisboa mostram uma redu&#231;&#227;o na preval&#234;ncia da asma &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46; Esta redu&#231;&#227;o pode ser explicada pela exist&#234;ncia de novos m&#233;todos para diagnosticar e controlar a doen&#231;a&#44; pela aposta na educa&#231;&#227;o do doente asm&#225;tico e das suas fam&#237;lias tendo em vista alcan&#231;ar o sucesso terap&#234;utico e pela melhoria do autocontrolo dos doentes asm&#225;ticos&#44; atrav&#233;s do uso de corticoster&#243;ides inalados e broncodilatadores&#46; Estes resultados s&#227;o sustentados por outros estudos que utilizaram o question&#225;rio do programa ISAAC<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#46; Segundo este programa&#44; as maiores taxas de preval&#234;ncia de asma localizam-se na Austr&#225;lia e Nova Zel&#226;ndia &#40;29&#44;7&#37;&#41;&#44; seguidas da Am&#233;rica do Norte &#40;24&#44;4&#37;&#41; e Am&#233;rica Latina &#40;17&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; Em contraste com o presente estudo&#44; noutras regi&#245;es tem sido observada uma tend&#234;ncia de aumento da asma&#58; Taiwan<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a>&#44; Reino Unido<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&#44; Hong Kong<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#44; Estados Unidos<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a>&#44; Austr&#225;lia<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a>&#44; Brasil<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a>&#44; &#193;ustria<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">45</span></a>&#44; e Espanha<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a>&#46; Contudo&#44; em investiga&#231;&#245;es recentes t&#234;m sido encontrados sinais indicativos de uma interrup&#231;&#227;o na tend&#234;ncia de aumento da asma<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;26&#44;47&#8211;50</span></a>&#46; Segundo Bazzazi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#44; as disparidades de valores registados para a preval&#234;ncia da asma e outras alergias revelam tratar-se de uma quest&#227;o irresoluta&#46; Duas teorias antag&#243;nicas&#44; mas que se interpenetram&#44; t&#234;m relacionado as altera&#231;&#245;es dos factores ambientais com a tend&#234;ncia evolutiva da asma e da epidemiologia das alergias&#46; A mais antiga teoria&#44; a &#171;&#160;hip&#243;tese da higiene&#160;&#187;&#44; clama que as modifica&#231;&#245;es no ambiente infeccioso e no padr&#227;o de exposi&#231;&#227;o microbiana das crian&#231;as&#44; associados &#224; ocidentaliza&#231;&#227;o s&#227;o factores que contribuem para o aumento da gravidade e preval&#234;ncia das doen&#231;as at&#243;picas&#46; Segundo esta teoria&#44; as exposi&#231;&#245;es ambientais que promovem uma supress&#227;o generalizada de citocinas Th2 e desencadeiam fortes respostas de Th1 t&#234;m-se tornado progressivamente menos comuns<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">51</span></a>&#46; A teoria mais recente&#44; a &#171;&#160;hip&#243;tese da imunotoler&#226;ncia&#160;&#187;&#44; afirma que a exposi&#231;&#227;o precoce aos alerg&#233;nios reduz o risco por potenciar a capacidade de regula&#231;&#227;o do sistema imunit&#225;rio<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">52</span></a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">No presente estudo&#44; as crian&#231;as com crises de espirros&#44; corrimento ou congest&#227;o nasal&#44; n&#227;o associados com constipa&#231;&#227;o comum ou gripe&#44; representaram 43&#44;0&#37; do total&#46; A preval&#234;ncia de rinite nesta faixa et&#225;ria foi estimada em 39&#44;5&#37;&#46; A preval&#234;ncia desta doen&#231;a al&#233;rgica em Lisboa &#233; maior do que a m&#233;dia nacional&#46; Uma vez que Portugal &#233; um pa&#237;s com diversas &#225;reas geogr&#225;ficas&#44; as diverg&#234;ncias registadas entre cidades pode ser explicada pelas v&#225;rias tipologias clim&#225;ticas&#44; os n&#237;veis de polui&#231;&#227;o do ar e os diversos n&#237;veis de contacto com alerg&#233;nios&#46; Lee et al&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a> observaram um aumento na preval&#234;ncia de rinite al&#233;rgica em crian&#231;as de Hong Kong entre 1995 e 2001&#46; A mesma tend&#234;ncia de crescimento tem sido observada em adolescentes israelitas<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#46; No Brasil&#44; a preval&#234;ncia da rinite em crian&#231;as do ensino b&#225;sico e em adolescentes enquadra-se em gamas de valores muito abrangentes&#58; 1&#44;5-41&#44;8&#37; e 3&#44;2-66&#44;6&#37;&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">53</span></a>&#46; Em It&#225;lia&#44; a preval&#234;ncia da rinite aumentou de 13&#44;8 para 18&#44;9&#37; e de 31&#44;6 para 35&#44;1&#37; entre crian&#231;as &#40;6 a 7 anos de idade&#41; e adolescentes &#40;13 a 14 anos de idade&#41;&#44; respectivamente&#44; entre 1994 e 2002<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A propor&#231;&#227;o de crian&#231;as com sintomas respirat&#243;rios que experimentaram um ataque de pieira teve um aumento significativo entre 1993&#47;94 e 2008 &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Tabela 3</a>&#41;&#46; Contudo&#44; a preval&#234;ncia de pieira nos &#250;ltimos 12 meses foi de apenas 15&#37;&#46; A preval&#234;ncia da pieira estimada a partir de estudos em 155 centros mundialmente distribu&#237;dos oscilou de 2&#44;1 a 32&#44;2&#37;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#46; Na Austr&#225;lia&#44; entre 1993 e 2002&#44; foi observada uma diminui&#231;&#227;o de 26&#37; na preval&#234;ncia da pieira na popula&#231;&#227;o infantil nos &#250;ltimos 12 meses<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">54</span></a>&#46; Em Espanha&#44; a preval&#234;ncia da pieira em crian&#231;as entre os 13 e 14 anos de idade n&#227;o sofreu altera&#231;&#245;es entre 1994-1995 e 2002-2003<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a>&#46; Na B&#233;lgica&#44; n&#227;o foi observada uma varia&#231;&#227;o clara na preval&#234;ncia de asma&#44; mas registou-se um decr&#233;scimo do n&#250;mero de casos de pieira de 1996 para 2002<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46; V&#225;rios outros estudos na Gr&#227;-Bretanha&#44; Alemanha&#44; It&#225;lia e Dinamarca conduzidos na &#250;ltima d&#233;cada relataram um aumento na preval&#234;ncia da asma e pieira nos &#250;ltimos 12 meses<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;19&#44;55&#44;56</span></a>&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">O consumo frequente de ovos foi tamb&#233;m associado com um aumento do risco dos sintomas respirat&#243;rios entre as crian&#231;as das escolas de Taipei<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">57</span></a>&#46; As reac&#231;&#245;es al&#233;rgicas aos alimentos podem ser ou n&#227;o mediadas pela imunoglobulina E &#40;IgE&#41;&#46; Indiv&#237;duos predispostos hereditariamente para a sintomatologia at&#243;pica produzem anticorpos IgE contra certas prote&#237;nas alerg&#233;nias&#46; Estes anticorpos ligam-se aos mast&#243;citos e aos bas&#243;filos que circulam na corrente sangu&#237;nea&#46; Quando a prote&#237;na do alimento &#233; ingerida&#44; a IgE reconhece-a na superf&#237;cie destas c&#233;lulas&#44; s&#227;o libertados mediadores &#40;histamina&#41; e os sintomas al&#233;rgicos aparecem&#46; Al&#233;m da pele e do tracto-grastrointestinal&#44; os sintomas das reac&#231;&#245;es mediadas pela IgE envolvem geralmente o sistema respirat&#243;rio<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">58</span></a>&#46; Os ovos est&#227;o entre os alimentos que mais provocam estas reac&#231;&#245;es al&#233;rgicas nas crian&#231;as&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Neste estudo&#44; nenhuma associa&#231;&#227;o com quaisquer outros factores alimentares foi encontrada&#46; N&#227;o foi observado um efeito protector da amamenta&#231;&#227;o contra a alergia respirat&#243;ria nas crian&#231;as&#46; Al&#233;m dos animais de estima&#231;&#227;o&#44; nenhum outro factor relacionado com as condi&#231;&#245;es dom&#233;sticas foi significativamente relacionado com poss&#237;veis sintomas respirat&#243;rios&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Este estudo apresenta algumas limita&#231;&#245;es&#44; nomeadamente os vi&#233;ses de preval&#234;ncia&#47;incid&#234;ncia associados aos estudos tranversais e a n&#227;o realiza&#231;&#227;o de exames complementares de diagn&#243;stico&#46; No entanto&#44; a maioria das estimativas de preval&#234;ncia de asma&#44; pieira e rinite t&#234;m sido baseadas em dados de inqu&#233;ritos sobre sintomatologias ou em diagn&#243;stico m&#233;dico anterior&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="par0075" class="elsevierStylePara elsevierViewall">Ao contr&#225;rio da asma&#44; foi observado um aumento significativo da preval&#234;ncia da rinite e da pieira entre as crian&#231;as a frequentar o ensino b&#225;sico em Lisboa&#46; As diferen&#231;as nas taxas de preval&#234;ncia obtidas em v&#225;rios estudos podem indicar n&#227;o s&#243; exposi&#231;&#227;o a distintos factores de risco&#44; como tamb&#233;m variabilidade racial&#44; ambiental e das condi&#231;&#245;es socioecon&#243;micas&#44; crit&#233;rios de diagn&#243;stico heterog&#233;neos&#44; ou um aumento real da taxa de preval&#234;ncia de doen&#231;as al&#233;rgicas&#46; Neste estudo&#44; os ataques de pieira foram estatisticamente associados com a asma&#46; A febre dos fenos foi identificada como um factor de risco para a manifesta&#231;&#227;o de sintomas de pieira&#46; As crian&#231;as com tosse seca &#224; noite devem ser avaliadas quanto a sintomas de rinite e asma&#46; Deve ser utilizada uma estrat&#233;gia combinada para tratar as doen&#231;as das vias a&#233;reas superiores e inferiores de forma segura e eficaz&#46; A presen&#231;a de animais de estima&#231;&#227;o em casa foi identificada como factor de risco para a rinite&#44; enquanto factores como a exposi&#231;&#227;o ao fumo do tabaco&#44; mofo&#44; peluches&#44; alimenta&#231;&#227;o &#40;com excep&#231;&#227;o do consumo de ovos&#41;&#44; amamenta&#231;&#227;o ou outros n&#227;o representaram risco para o desencadeamento dos problemas respirat&#243;rios&#46; Os resultados obtidos suportam a observa&#231;&#227;o de que altera&#231;&#245;es profundas na din&#226;mica da epidemiologia da asma e das doen&#231;as al&#233;rgicas est&#227;o a ocorrer a n&#237;vel global&#44; exigindo uma ampla e cont&#237;nua vigil&#226;ncia&#46; S&#227;o necess&#225;rios estudos adicionais quer para identificar os factores de risco e de protec&#231;&#227;o&#44; quer para examinar a tend&#234;ncia evolutiva da preval&#234;ncia da asma e doen&#231;as al&#233;rgicas em Portugal&#46; As investiga&#231;&#245;es sobre os factores de risco que potenciam a asma e as alergias respirat&#243;rias permitem melhorar o entendimento das diferen&#231;as geogr&#225;ficas e apoiar decis&#245;es sobre estrat&#233;gias de preven&#231;&#227;o&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflito de interesse</span><p id="par0080" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflito de interesse&#46;</p></span></span>"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2010-05-19"
    "fechaAceptado" => "2010-08-02"
    "PalabrasClave" => array:2 [
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec565840"
          "palabras" => array:5 [
            0 => "Asma"
            1 => "Rinite"
            2 => "Pieira"
            3 => "Inqu&#233;ritos"
            4 => "Crian&#231;as"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec565841"
          "palabras" => array:5 [
            0 => "Asthma"
            1 => "Rhinitis"
            2 => "Wheeze"
            3 => "Questionnaire"
            4 => "Children"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Com o objectivo de identificar h&#225;bitos alimentares e caracter&#237;sticas habitacionais como factores de risco para a preval&#234;ncia de problemas respirat&#243;rios na popula&#231;&#227;o escolar do 1&#46;&#176; ciclo da cidade de Lisboa foi realizado um estudo transversal&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Material e M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">De Outubro a Dezembro de 2008&#44; os pais de 900 alunos das escolas do 1&#46;&#176; ciclo de Lisboa foram convidados a responder a um question&#225;rio similar ao do Programa Internacional de Estudo de Asma e Alergias na Inf&#226;ncia &#40;<span class="elsevierStyleItalic">International Study of Asthma and Allergies in Childhood Program &#8211; ISAAC</span>&#41;&#46; A taxa de resposta foi de 40&#37;&#46; Aos resultados foi aplicada an&#225;lise de regress&#227;o log&#237;stica&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A preval&#234;ncia de asma&#44; rinite al&#233;rgica e sibil&#226;ncia foi de 5&#44;6&#44; 43&#44;0 e 43&#44;3&#37;&#44; respectivamente&#46; Os factores de risco independentemente associados &#224; asma foram a sibil&#226;ncia e a tosse seca &#224; noite&#44; n&#227;o relacionadas com sintomas de constipa&#231;&#227;o comum nos &#250;ltimos 12 meses&#46; As crises de pieira foram consideradas suscept&#237;veis de afectar as actividades di&#225;rias das crian&#231;as&#46; Os factores de risco para sibil&#226;ncia foram a febre dos fenos e a presen&#231;a de um animal de estima&#231;&#227;o em casa&#46; A tosse durante a noite foi identificada como um factor de risco para a rinite&#46; O consumo frequente de ovo foi tamb&#233;m associado a um maior risco de manifestar rinite&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ao contr&#225;rio da asma&#44; a preval&#234;ncia de rinite al&#233;rgica e sibil&#226;ncia aumentou em compara&#231;&#227;o com estudos anteriores ISAAC&#46; Os ataques de pieira foram associados com os epis&#243;dios asm&#225;ticos&#44; e a febre dos fenos foi identificada como um factor de risco para a pieira&#46; Ter animais de estima&#231;&#227;o em casa foi apontado como um factor de risco para a rinite&#44; enquanto a exposi&#231;&#227;o ao fumo&#44; mofo&#44; artigos de peluche&#44; alimenta&#231;&#227;o &#40;excepto o consumo de ovos&#41;&#44; amamenta&#231;&#227;o ou outros par&#226;metros n&#227;o representaram um factor de risco para a doen&#231;a&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span><span class="elsevierStyleSectionTitle">Aims</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional study was carried out with the objective of identifying nutrition habits and housing conditions as risk factors for respiratory problems in schoolchildren in Lisbon&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Material and Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Between October and December 2008&#44; parents of 900 students of the basic schools of Lisbon were invited to answer a questionnaire of the International Study of Asthma and Allergies in Childhood Program &#40;ISAAC&#41;&#46; The response rate was 40&#37;&#46; Logistic regression was used in the analysis of results&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The prevalence of asthma&#44; allergic rhinitis and wheeze was 5&#46;6&#37;&#44; 43&#46;0&#37; and 43&#46;3&#37;&#44; respectively&#46; Risk factors independently associated with asthma were wheezing attacks&#44; and dry cough at night not related to common cold in the last 12 months&#46; Wheezing crises were found to affect children daily activities&#46; Risk factors for wheeze were hay fever and the presence of a pet at home&#46; A risk factor for rhinitis was cough at night&#46; The frequent consumption of egg was also associated with increased risk of rhinitis&#46;</p></span> <span><span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Contrarily to asthma&#44; the prevalence of allergic rhinitis and wheeze increased in comparison with previous ISAAC studies&#46; Wheezing attacks were associated with asthma and hay fever was identified as a risk factor of manifesting wheezing symptoms&#46; Having pets at home was pointed out as a significant risk factor for rhinitis&#44; but not smoking exposure&#44; mould&#44; plush toys&#44; diet &#40;except egg consumption&#41;&#44; breastfeeding or other conditions&#46;</p></span>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Pieira&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">O seu filho&#40;a&#41; j&#225; alguma vez teve pieira ou assobios &#40;silvos&#41; no peito&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><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">O seu filho teve pieira ou assobios &#40;silvos&#41; nos &#250;ltimos 12 meses&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><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">Quantos ataques de pieira teve o seu filho nos &#250;ltimos 12 meses&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><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">Nos &#250;ltimos 12 meses&#44; quantas vezes&#44; em m&#233;dia&#44; o seu filho acordou devido &#224; pieira&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><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">Nos &#250;ltimos 12 meses&#44; alguma vez sentiu pieira no peito do seu filho durante ou depois de fazer exerc&#237;cio&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">O seu filho&#40;a&#41; tem asma&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Tosse seca nocturna&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Nos &#250;ltimos 12 meses&#44; o seu filho teve tosse seca &#224; noite al&#233;m da tosse associada &#224; constipa&#231;&#227;o ou infec&#231;&#227;o respirat&#243;ria&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Rinite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Alguma vez o seu filho teve crises de espirros&#44; corrimento nasal&#44; ou nariz entupido sem estar constipado ou com gripe&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><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">Nos &#250;ltimos 12 meses&#44; o seu filho teve crises de espirros&#44; corrimento nasal&#44; ou nariz entupido sem estar constipado ou com gripe&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><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">Nos &#250;ltimos 12 meses&#44; este problema no nariz afectou as actividades di&#225;rias do seu filho&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Febre dos fenos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">J&#225; alguma vez o seu filho teve febre dos fenos&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">H&#225;bitos alimentares&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Quais s&#227;o os h&#225;bitos alimentares no que se refere ao consumo de carne&#44; peixe&#44; fruta&#44; vegetais&#44; cereais&#44; massas&#44; p&#227;es&#44; arroz&#44; manteiga&#44; margarina&#44; frutos secos&#44; batatas&#44; leite&#44; ovos e &#171;&#160;fast-food&#160;&#187; nos &#250;ltimos 12 meses&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Amamenta&#231;&#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">O seu filho&#40;a&#41; foi amamentado&#40;a&#41;&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Desporto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Seu filho pratica algum desporto frequentemente&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><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">Quantas vezes por semana o&#40;a&#41; seu&#40;sua&#41; filho&#40;a&#41; tem uma actividade f&#237;sica vigorosa que o&#40;a&#41; leva a ficar ofegante&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Caracter&#237;sticas residenciais e h&#225;bitos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Combust&#237;vel utilizado para cozinhar&#59; secagem de roupas no interior das habita&#231;&#245;es&#59; utiliza&#231;&#227;o de carv&#227;o para aquecimento ou cozinhar&#59; intensidade de passagem de ve&#237;culos pesados na rua da resid&#234;ncia&#59; utiliza&#231;&#227;o de sistemas de aquecimento&#59; sinais de bolores&#44; humidades ou rachaduras com infiltra&#231;&#245;es no interior da constru&#231;&#227;o&#59; contacto com animais de estima&#231;&#227;o ou animais de quinta&#59; presen&#231;a de peluches no quarto do&#40;a&#41; filho&#40;a&#41;&#59; tipo de pavimento e acabamento nas paredes &#40;pintura&#44; papel de parede&#44; corti&#231;a&#44; etc&#41; no quarto do&#40;a&#41; filho&#40;a&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">H&#225;bitos tab&#225;gicos dos pais ou respons&#225;veis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fumadores em contacto regular com a crian&#231;a &#40;por exemplo&#44; m&#227;e&#44; av&#243;s ou amas&#41;&#59; n&#250;mero de cigarros utilizados por fumadores diariamente na habita&#231;&#227;o da crian&#231;a&#59; pai ou m&#227;e ou respons&#225;vel fumava durante o primeiro ano de vida da crian&#231;a&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab885005.png"
              ]
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          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Quest&#245;es presentes no question&#225;rio ISAAC utilizado neste estudo&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <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  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas das resid&#234;ncias&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">Defini&#231;&#227;o&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></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " rowspan="4" align="left" valign="top">Combust&#237;vel utilizado em casa para cozinhar</td><td class="td" title="table-entry  " align="left" valign="top">Combust&#237;vel utilizado&#58;&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- electricidade&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- g&#225;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">83&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- outro&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;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Secagem de roupa no interior da casa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Uso de estendais no interior da resid&#234;ncias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Uso de carv&#227;o no interior da habita&#231;&#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">Uso de carv&#227;o para cozinhar ou como combust&#237;vel de aquecimento&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;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">Fontes de polui&#231;&#227;o pr&#243;ximas da habita&#231;&#227;o</td><td class="td" title="table-entry  " align="left" valign="top">Tr&#226;nsito de ve&#237;culos pesados na rua&#58;&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- o dia inteiro&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;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- frequentemente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- raramente&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">47&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- nunca&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;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">Uso de aquecimento dom&#233;stico</td><td class="td" title="table-entry  " align="left" valign="top">Uso de qualquer um dos aquecimentos abaixo&#58;&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- el&#233;ctrico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- g&#225;s&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;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- madeira&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;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- outro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Mofo nos &#250;ltimos 12 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Sinais de rachaduras&#44; infiltra&#231;&#227;o&#44; crescimentos de mofo na constru&#231;&#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">19&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="6" align="left" valign="top">Animais de estima&#231;&#227;o</td><td class="td" title="table-entry  " align="left" valign="top">Refere-se ao contacto com c&#227;es&#44; gatos ou outros animais de quinta&#58;&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- gatos nos &#250;ltimos 12 meses&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;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- gatos no primeiro ano de vida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- c&#227;es nos &#250;ltimos 12 meses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- c&#227;es no primeiro ano de vida&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;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- contacto no primeiro ano de vida com animais de quinta&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;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Peluches&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Presen&#231;a de peluches no quarto da crian&#231;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="5" align="left" valign="top">Pavimento do quarto</td><td class="td" title="table-entry  " align="left" valign="top">Tipos de pavimentos&#58;&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- alcatifa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- madeira&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">70&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- tijoleira&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- outro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Paredes do quarto</td><td class="td" title="table-entry  " align="left" valign="top">Tipos de acabamento do quarto&#58;&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- pintura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">95&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- papel de parede&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;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Exposi&#231;&#227;o ao fumo de tabaco no primeiro ano de vida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Fumadores regulares em contacto com a crian&#231;a no primeiro ano de vida &#40;m&#227;e&#44; pai&#44; ama&#44; etc&#46;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="6" align="left" valign="top">Fumadores actuais na resid&#234;ncia</td><td class="td" title="table-entry  " align="left" valign="top">N&#250;mero de cigarro fumados diariamente na resid&#234;ncia da crian&#231;a&#58;&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- nenhum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- um&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;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- dois&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></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- tr&#234;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- quatro ou mais&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " rowspan="3" align="left" valign="top">Pais ou respons&#225;veis fumadores</td><td class="td" title="table-entry  " align="left" valign="top">Pai ou m&#227;e fumador que resida com a crian&#231;a&#58;&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  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- m&#227;e&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>- pai&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas das resid&#234;ncias e do ambiente aos quais as crian&#231;as est&#227;o expostas&#46;</p>"
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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  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&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">Asma&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">Rinite al&#233;rgica&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">Pieira&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">Refer&#234;ncia&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  " align="left" valign="top"><span class="elsevierStyleItalic">Pa&#237;ses europeus</span>&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><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" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lisboa&#44; Portugal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#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">43&#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">43&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Este estudo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Porto&#44; Portugal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#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">12&#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">18&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Falc&#227;o et al&#46; &#40;2008&#41;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">59</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Lisboa&#44; Portugal&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;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#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">26&#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">Khan et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Portugal 2002&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;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;1&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;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pl&#225;cido &#40;2004&#41;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#44; Pinto et al&#46; &#40;2006&#41;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Portugal 1993&#47;94&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;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#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">27&#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">Trindade &#40;1999&#41;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Aberdeen&#44; Esc&#243;cia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#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><td class="td" title="table-entry  " align="char" valign="top">28&#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">Devenny et al&#46; &#40;2004&#41;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sanliurfa&#44; Turquia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#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">2&#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><td class="td" title="table-entry  " align="left" valign="top">Zeyrek et al&#46; &#40;2006&#41;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">60</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>It&#225;lia&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;1&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;3&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;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Galassi et al&#46; &#40;2006&#41;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&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  " align="left" valign="top"><span class="elsevierStyleItalic">Outros pa&#237;ses</span>&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><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" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gorgan&#44; Ir&#227;&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;0&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;3&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;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Bazzazi et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ciudad Ju&#225;rez&#44; M&#233;xico&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;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#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">20&#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">Barraza-Villarreal et al&#46; &#40;2001&#41;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Israel&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="char" valign="top">10&#44;5&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">Romano-Zelekha et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ilhas Can&#225;rias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#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">S&#225;nchez-Lerma et al&#46; &#40;2009&#41;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Paquist&#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">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">28&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#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">Hasnain et al&#46; &#40;2009&#41;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Oman&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#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">10&#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><td class="td" title="table-entry  " align="left" valign="top">Al-Riyami et al&#46; &#40;2003&#41;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">61</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#205;ndia&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;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20-30&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">Singh et al&#46; &#40;2004&#41;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">62</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ar&#225;bia Saudita&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#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">25&#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><td class="td" title="table-entry  " align="left" valign="top">Al Frayh et al&#46; &#40;2001&#41;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">63</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Austr&#225;lia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">46&#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><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">Wilson et al&#46; &#40;2006&#41;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hong Kong&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#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">52&#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">20&#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">Leung et al&#46; &#40;1997&#41;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tibete&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#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">1&#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">Droma et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">64</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>L&#237;bano&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#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><td class="td" title="table-entry  " align="left" valign="top">Waked and Salameh &#40;2009&#41;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Taiwan&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;4&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><td class="td" title="table-entry  " align="left" valign="top">Lee et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tonga&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="char" valign="top">16&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26&#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">Foliaki et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">65</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Polin&#233;sia Francesa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#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">12&#44;3&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;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Foliaki et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">65</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Kuwait&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="char" valign="top">41&#44;4&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;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Owayed et al&#46; &#40;2007&#41;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Brasil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;5-31&#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">19&#44;3-35&#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><td class="td" title="table-entry  " align="left" valign="top">Sol&#233; et al&#46; &#40;2006&#41;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">53</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Preval&#234;ncia das doen&#231;as al&#233;rgicas em v&#225;rias regi&#245;es &#40;valores em percentagem&#41;&#46;</p>"
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                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Port de Clin Geral"
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              "etiqueta" => "7"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The genetics of asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Sandford"
                            1 => "T&#46; Weir"
                            2 => "P&#46; Par&#233;"
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                      ]
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                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.153.6.8665031"
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                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1996"
                        "volumen" => "153"
                        "paginaInicial" => "1749"
                        "paginaFinal" => "1765"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8665031"
                            "web" => "Medline"
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                ]
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              "identificador" => "bib0040"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of genetic factors in occupational asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;E&#46; Mapp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Resp J"
                        "fecha" => "2003"
                        "volumen" => "22"
                        "paginaInicial" => "173"
                        "paginaFinal" => "178"
                      ]
                    ]
                  ]
                ]
              ]
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            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genetics of allergic disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;W&#46; Steinke"
                            1 => "S&#46;S&#46; Rich"
                            2 => "L&#46; Boris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2008"
                        "volumen" => "121"
                        "paginaInicial" => "384"
                        "paginaFinal" => "387"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors in early childhood for the development of atopic diseases"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46; Bjorksten"
                          ]
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2004"
                        "volumen" => "49"
                        "paginaInicial" => "400"
                        "paginaFinal" => "407"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8074261"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            10 => array:3 [
              "identificador" => "bib0055"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of housing characteristics and home environmental factors on respiratory symptoms of 10&#44;784 elementary school children from Northeast China"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;H&#46; Dong"
                            1 => "Y&#46;N&#46; Ma"
                            2 => "H&#46;L&#46; Ding"
                            3 => "J&#46; Jin"
                            4 => "Y&#46; Cao"
                            5 => "Y&#46;D&#46; Zhao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000121370"
                      "Revista" => array:6 [
                        "tituloSerie" => "Respiration"
                        "fecha" => "2008"
                        "volumen" => "76"
                        "paginaInicial" => "82"
                        "paginaFinal" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18337632"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory symptoms in relation to residential coal burning and environmental tobacco smoke among early adolescents in Wuhan&#44; China&#58; a cross-sectional study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;M&#46; Salo"
                            1 => "J&#46; Xia"
                            2 => "C&#46;A&#46; Johnson"
                            3 => "Y&#46; Li"
                            4 => "G&#46;E&#46; Kissling"
                            5 => "E&#46;L&#46; Avol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1476-069X-3-14"
                      "Revista" => array:6 [
                        "tituloSerie" => "Environ Health"
                        "fecha" => "2004"
                        "volumen" => "3"
                        "paginaInicial" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15585063"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S001650850701640X"
                          "estado" => "S300"
                          "issn" => "00165085"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Snoring in primary school children and domestic environment&#58; A Perth school based study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Zhang"
                            1 => "J&#46; Spickett"
                            2 => "K&#46; Rumchev"
                            3 => "A&#46;H&#46; Lee"
                            4 => "S&#46; Stick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1465-9921-5-19"
                      "Revista" => array:5 [
                        "tituloSerie" => "Respir Res"
                        "fecha" => "2004"
                        "volumen" => "5"
                        "paginaInicial" => "19"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15527500"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diet and asthma&#58; looking back&#44; moving forward"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;H&#46; Kim"
                            1 => "P&#46;H&#46; Ellwood"
                            2 => "M&#46;I&#46; Asher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1465-9921-10-49"
                      "Revista" => array:5 [
                        "tituloSerie" => "Respir Res"
                        "fecha" => "2009"
                        "volumen" => "10"
                        "paginaInicial" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19519921"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and correlates of allergic diseases among children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Pawlinska-Chmara"
                            1 => "I&#46; Wronka"
                            2 => "M&#46; Muc"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Physiol Pharmacol"
                        "fecha" => "2008"
                        "volumen" => "59"
                        "paginaInicial" => "549"
                        "paginaFinal" => "556"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19218680"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Changes in respiratory and allergic symptoms in schoolchildren from 1996 to 2002&#44; results from the ISAAC surveys in Antwerp &#40;Belgium&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Vellinga"
                            1 => "J&#46;H&#46; Droste"
                            2 => "P&#46;A&#46; Vermeire"
                            3 => "K&#46; Desager"
                            4 => "W&#46;A&#46; De Backer"
                            5 => "V&#46;J&#46; Nelen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1179/acb.2005.038"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Clin Belg"
                        "fecha" => "2005"
                        "volumen" => "60"
                        "paginaInicial" => "219"
                        "paginaFinal" => "225"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16398318"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of asthma and allergic disorders among school children in Gorgan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Bazzazi"
                            1 => "M&#46; Gharagozlou"
                            2 => "M&#46; Kassaiee"
                            3 => "A&#46; Parsikia"
                            4 => "H&#46; Zahmatkesh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Res Med Sci"
                        "fecha" => "2007"
                        "volumen" => "12"
                        "paginaInicial" => "28"
                        "paginaFinal" => "33"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalencia de asma y otras enfermedades al&#233;rgicas en ni&#241;os escolares de Ciudad Ju&#225;rez&#44; Chihuahua"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;L&#46;E&#46; Barraza-Villarreal"
                            1 => "L&#46;H&#46; San&#237;n-Aguirre"
                            2 => "M&#46;M&#46; T&#233;llez-Rojo"
                            3 => "M&#46; Lacasa&#241;a-Navarro"
                            4 => "I&#46;M&#46;P&#46;H&#46; Romieu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Salud Publica Mexico"
                        "fecha" => "2001"
                        "volumen" => "43"
                        "paginaInicial" => "433"
                        "paginaFinal" => "443"
                        "itemHostRev" => array:3 [
                          "pii" => "S0168827811000328"
                          "estado" => "S300"
                          "issn" => "01688278"
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                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory symptoms and atopy in children in Aberdeen&#58; questionnaire studies of a defined school population repeated over 35<span class="elsevierStyleHsp" style=""></span>years"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Devenny"
                            1 => "H&#46; Wassall"
                            2 => "T&#46; Ninan"
                            3 => "M&#46; Omran"
                            4 => "S&#46;D&#46; Khan"
                            5 => "G&#46; Russel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Br Med J"
                        "fecha" => "2004"
                        "volumen" => "329"
                        "paginaInicial" => "489"
                        "paginaFinal" => "490"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in prevalence of asthma&#44; allergic rhinitis and atopic dermatitis in 5-7-year old Swiss children from 1992 to 2001"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Grize"
                            1 => "M&#46; Gassner"
                            2 => "B&#46; W&#252;thrich"
                            3 => "B&#46; Bringolf-Isler"
                            4 => "K&#46; Takken-Sahli"
                            5 => "F&#46;H&#46; Sennhauser"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1398-9995.2006.01030.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2006"
                        "volumen" => "61"
                        "paginaInicial" => "556"
                        "paginaFinal" => "562"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16629784"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
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            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Prevalence of asthma and allergic rhinitis among school children of Karachi&#44; Pakistan&#44; 2007"
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                          "etal" => false
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                            2 => "A&#46; Saleem"
                            3 => "M&#46;A&#46; Waqar"
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                        ]
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/02770900802513023"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Asthma"
                        "fecha" => "2009"
                        "volumen" => "46"
                        "paginaInicial" => "86"
                        "paginaFinal" => "90"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19191144"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
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              "identificador" => "bib0110"
              "etiqueta" => "22"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Worldwide variation in prevalence of symptoms of asthma&#44; allergic rhinoconjunctivitis&#44; and atopic eczema&#58; ISAAC"
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                        0 => array:2 [
                          "colaboracion" => "International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41;&#46;Steering Committee"
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Lancet"
                        "fecha" => "1998"
                        "volumen" => "351"
                        "paginaInicial" => "1225"
                        "paginaFinal" => "1232"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9643741"
                            "web" => "Medline"
                          ]
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                    ]
                  ]
                ]
              ]
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            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Worldwide variations in the prevalence of asthma symptoms&#58; the International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41;"
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                        0 => array:2 [
                          "colaboracion" => "International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41; Steering Committee"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Resp J"
                        "fecha" => "1998"
                        "volumen" => "12"
                        "paginaInicial" => "315"
                        "paginaFinal" => "335"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of asthma and allergy in Hong Kong schoolchildren&#58; an ISAAC study"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Leung"
                            1 => "G&#46; Wong"
                            2 => "J&#46; Lau"
                            3 => "A&#46; Ho"
                            4 => "J&#46;K&#46;W&#46; Chan"
                            5 => "D&#46; Choy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur Resp J"
                        "fecha" => "1997"
                        "volumen" => "10"
                        "paginaInicial" => "354"
                        "paginaFinal" => "360"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Changing prevalence of asthma and allergic diseases among Kuwaiti children"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Owayed"
                            1 => "N&#46; Behbehani"
                            2 => "J&#46; Al-Momen"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000129607"
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                        "tituloSerie" => "Med Princ Pract"
                        "fecha" => "2008"
                        "volumen" => "17"
                        "paginaInicial" => "284"
                        "paginaFinal" => "289"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18523395"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in the prevalence of asthma symptoms and allergic diseases in Israeli adolescents&#58; results from a national survey 2003 and comparison with 1997"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
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                            1 => "Y&#46; Graif"
                            2 => "B&#46;Z&#46; Garty"
                            3 => "I&#46; Livne"
                            4 => "M&#46;S&#46; Green"
                            5 => "T&#46; Shohat"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/02770900701363983"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Asthma"
                        "fecha" => "2007"
                        "volumen" => "44"
                        "paginaInicial" => "365"
                        "paginaFinal" => "369"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17613631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High prevalence of asthma and allergic diseases in children aged 6 and 7<span class="elsevierStyleHsp" style=""></span>years from the Canary Islands&#58; The international study of asthma and allergies in childhood"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; S&#225;nchez-Lerma"
                            1 => "F&#46;J&#46; Morales-Chirivella"
                            2 => "I&#46; Pe&#241;uelas"
                            3 => "C&#46;B&#46; Guerra"
                            4 => "F&#46;M&#46; Lugo"
                            5 => "I&#46; Aguinaga-Ontoso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Invest Allerg Clin"
                        "fecha" => "2009"
                        "volumen" => "19"
                        "paginaInicial" => "383"
                        "paginaFinal" => "390"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diet and asthma &#8211; Can you change what you or your children are by changing what you eat&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Vries"
                            1 => "S&#46;E&#46;M&#46; Howie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Pharmacol Therapeut"
                        "fecha" => "2009"
                        "paginaInicial" => "78"
                        "paginaFinal" => "82"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Risk factors for asthma and allergic diseases in school children across Lebanon"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46; Waked"
                            1 => "P&#46; Salameh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Asthma Allergy"
                        "fecha" => "2009"
                        "volumen" => "2"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21437138"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in asthma prevalence and population changes in South Australia&#44; 1990-2003"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;H&#46; Wilson"
                            1 => "R&#46;J&#46; Adams"
                            2 => "G&#46; Tucker"
                            3 => "S&#46; Appleton"
                            4 => "A&#46;W&#46; Taylor"
                            5 => "R&#46;E&#46; Ruffin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Med J Australia"
                        "fecha" => "2006"
                        "volumen" => "184"
                        "paginaInicial" => "226"
                        "paginaFinal" => "229"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16515433"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0016508511009383"
                          "estado" => "S300"
                          "issn" => "00165085"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of the Spanish version of the Phase III ISAAC questionnaire on asthma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;M&#46; Fern&#225;ndez"
                            1 => "M&#46; Fern&#225;ndez-Ben&#237;tez"
                            2 => "M&#46;P&#46; Miranda"
                            3 => "F&#46;G&#46; Grima"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Invest Allergol Clin Immunol"
                        "fecha" => "2005"
                        "volumen" => "15"
                        "paginaInicial" => "201"
                        "paginaFinal" => "210"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The validity of the ISAAC written questionnaire and the ISAAC video questionnaire &#40;AVQ 3&#46;0&#41; for predicting asthma associated with bronchial hyperreactivity in a Group of 13-14 year old Korean schoolchildren"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;J&#46; Hong"
                            1 => "S&#46;W&#46; Kim"
                            2 => "J&#46;W&#46; Oh"
                            3 => "Y&#46;H&#46; Rah"
                            4 => "Y&#46;M&#46; Ahn"
                            5 => "K&#46;E&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3346/jkms.2003.18.1.48"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Korean Med Sci"
                        "fecha" => "2003"
                        "volumen" => "18"
                        "paginaInicial" => "48"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12589086"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Determining the score and cut-off point that would identify asthmatic adults in epidemiological studies using the asthma module of the International Study of Asthma and Allergies in Childhood questionnaire"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;F&#46; Ma&#231;&#227;ira"
                            1 => "E&#46; Algranti"
                            2 => "R&#46; Stelmach"
                            3 => "M&#46; Ribeiro"
                            4 => "M&#46;P&#46;T&#46; Nunes"
                            5 => "E&#46;M&#46;C&#46; Mendon&#231;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bras Pneumol"
                        "fecha" => "2005"
                        "volumen" => "31"
                        "paginaInicial" => "477"
                        "paginaFinal" => "485"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development and validation of school-based asthma and allergy screening questionnaires in a 4-city study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Redline"
                            1 => "R&#46;S&#46; Gruchalla"
                            2 => "R&#46;L&#46; Wolf"
                            3 => "B&#46;P&#46; Yawn"
                            4 => "L&#46; Cartar"
                            5 => "V&#46; Gan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1081-1206(10)61445-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol"
                        "fecha" => "2004"
                        "volumen" => "93"
                        "paginaInicial" => "36"
                        "paginaFinal" => "48"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15281470"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The quality of data obtained from self-completed questionnaires in a survey of high school students"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;C&#46; Richardson"
                            1 => "K&#46; Politikou"
                            2 => "M&#46; Terzidou"
                            3 => "Z&#46; Maka"
                            4 => "A&#46; Kokkevi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Qual Quant"
                        "fecha" => "2006"
                        "volumen" => "40"
                        "paginaInicial" => "121"
                        "paginaFinal" => "127"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "International study of asthma and allergies in childhood &#40;ISAAC&#41;&#58; rationale and methods"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;I&#46; Asher"
                            1 => "U&#46; Keil"
                            2 => "H&#46;R&#46; Anderson"
                            3 => "R&#46; Beasley"
                            4 => "J&#46; Crane"
                            5 => "F&#46; Martinez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "1995"
                        "volumen" => "8"
                        "paginaInicial" => "483"
                        "paginaFinal" => "491"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7789502"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of asthma and allergic diseases in Portuguese speaking regions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;J&#46; Pinto"
                            1 => "A&#46; Gaspar"
                            2 => "M&#46;M&#46; Morais- Almeida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Fr Allergol Immunol Clin"
                        "fecha" => "2006"
                        "volumen" => "46"
                        "paginaInicial" => "305"
                        "paginaFinal" => "308"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Allergic diseases and pediatric allergology in Portugal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;C&#46; Trindade"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatric Pulmonology"
                        "fecha" => "1999"
                        "volumen" => "S18"
                        "paginaInicial" => "150"
                        "paginaFinal" => "153"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Khan&#44; IR&#44; Freitas&#44; MC&#44; Dion&#237;sio&#44; I&#44; Pacheco&#44; MG&#46; Indoor habits of children aged 5 to 10<span class="elsevierStyleHsp" style=""></span>years learning at the public basic schools of Lisbon-city&#44; Portugal&#46; Proceedings of Clima 2007 WellBeing Indoors 2007&#59; Helsinki&#44; Finland&#46;"
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Pegas PN&#44; Alves CA&#44; Evtyugina MG&#44; Nunes T&#44; Cerqueira M&#44; Franchi M&#44; et al&#46; Indoor air quality in elementary schools of Lisbon in spring&#46; Paper presented at&#58; SEGH 2010 International Conference and Workshops on Environmental Quality and Human Health Galway&#44; 2010&#59; Ireland&#46;"
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Outdoor&#47;Indoor air quality in primary schools in Lisbon&#58; A preliminary study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;N&#46; Pegas"
                            1 => "M&#46;G&#46; Evtyugina"
                            2 => "C&#46;A&#46; Alves"
                            3 => "T&#46; Nunes"
                            4 => "M&#46; Cerqueira"
                            5 => "M&#46; Franchi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Quim Nova"
                        "fecha" => "2010"
                        "volumen" => "33"
                        "paginaInicial" => "1145"
                        "paginaFinal" => "1149"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Time trend of asthma prevalence among school children in Taiwan&#58; ISAAC phase I and III surveys"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46;L&#46; Lee"
                            1 => "B&#46;F&#46; Hwang"
                            2 => "Y&#46;C&#46; Lin"
                            3 => "Y&#46;L&#46; Guo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatr Allergy Immu"
                        "fecha" => "2007"
                        "volumen" => "18"
                        "paginaInicial" => "188"
                        "paginaFinal" => "195"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The environment and asthma in US inner cities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;A&#46; Eggleston"
                          ]
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "110.1378/chest.07-1906"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2007"
                        "volumen" => "132"
                        "paginaInicial" => "782S"
                        "paginaFinal" => "788S"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17998342"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asthma and atopy prevalence in a group of students from Porto Alegre&#44; Rio Grande do Sul"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;W&#46; Fiore"
                            1 => "A&#46;B&#46; Comparsi"
                            2 => "C&#46;L&#46; Reck"
                            3 => "J&#46;K&#46; Oliveira"
                            4 => "K&#46;B&#46; Pampanelli"
                            5 => "C&#46;C&#46; Fritscher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pneumologia"
                        "fecha" => "2001"
                        "volumen" => "27"
                        "paginaInicial" => "237"
                        "paginaFinal" => "242"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Time trends of the prevalence of asthma and allergic disease in Austrian children"
                      "autores" => array:1 [
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;S&#46; Schernhammer"
                            1 => "C&#46; Vutuc"
                            2 => "T&#46; Waldh&#246;r"
                            3 => "G&#46; Haidinger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Pediatr Allergy Immu"
                        "fecha" => "2008"
                        "volumen" => "19"
                        "paginaInicial" => "125"
                        "paginaFinal" => "131"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0230"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stabilization of asthma prevalence among adolescents and increase among schoolchildren &#40;ISAAC phases I and III&#41; in Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Garc&#237;a-Marcos"
                            1 => "A&#46;B&#46; Quir&#243;s"
                            2 => "G&#46;G&#46; Hern&#225;ndez"
                            3 => "F&#46; Guill&#233;n-Grima"
                            4 => "C&#46;G&#46; D&#237;az"
                            5 => "I&#46;C&#46; Ure&#241;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1398-9995.2004.00562.x"
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                        "tituloSerie" => "Allergy"
                        "fecha" => "2004"
                        "volumen" => "59"
                        "paginaInicial" => "1301"
                        "paginaFinal" => "1307"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15507099"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0235"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Declining incidence of episodes of asthma&#58; a study of trends in new episodes presenting to general practitioners in the period 1989-98"
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                          "etal" => false
                          "autores" => array:4 [
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                            1 => "R&#46; Sunderland"
                            2 => "K&#46;W&#46; Cross"
                            3 => "A&#46;M&#46; Ross"
                          ]
                        ]
                      ]
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                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2000"
                        "volumen" => "55"
                        "paginaInicial" => "657"
                        "paginaFinal" => "661"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10899241"
                            "web" => "Medline"
                          ]
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                ]
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              "etiqueta" => "48"
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                0 => array:2 [
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                      "titulo" => "Is the increase in childhood asthma coming to an end&#63; Findings from three surveys in Rome&#44; Italy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Ronchetti"
                            1 => "M&#46; Villa"
                            2 => "M&#46; Barreto"
                            3 => "R&#46; Rota"
                            4 => "J&#46; Pagani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2001"
                        "volumen" => "17"
                        "paginaInicial" => "881"
                        "paginaFinal" => "886"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11488320"
                            "web" => "Medline"
                          ]
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                        "itemHostRev" => array:3 [
                          "pii" => "S0016508507000078"
                          "estado" => "S300"
                          "issn" => "00165085"
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                  ]
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              "identificador" => "bib0245"
              "etiqueta" => "49"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of asthma and allergy in schoolchildren in Belmont&#44; Australia&#58; three cross sectional surveys over 20<span class="elsevierStyleHsp" style=""></span>years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46;G&#46; Toelle"
                            1 => "K&#46; Ng"
                            2 => "E&#46; Belousova"
                            3 => "C&#46;M&#46; Salome"
                            4 => "J&#46;K&#46; Peat"
                            5 => "G&#46;B&#46; Marks"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.328.7436.386"
                      "Revista" => array:6 [
                        "tituloSerie" => "Brit Med J"
                        "fecha" => "2004"
                        "volumen" => "328"
                        "paginaInicial" => "386"
                        "paginaFinal" => "387"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14962876"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0250"
              "etiqueta" => "50"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "No increase in the prevalence of asthma&#44; allergies&#44; and atopic sensitization among children in Germany&#58; 1992-2001"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46;K&#46; Zollner"
                            1 => "S&#46;K&#46; Weiland"
                            2 => "I&#46; Piechotowski"
                            3 => "T&#46; Gabria"
                            4 => "E&#46; Von Mutius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2004.029561"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2005"
                        "volumen" => "60"
                        "paginaInicial" => "545"
                        "paginaFinal" => "548"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15994260"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "51"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hay fever&#44; hygiene&#44; and household size"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Strachan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Brit Med J"
                        "fecha" => "1989"
                        "volumen" => "299"
                        "paginaInicial" => "1259"
                        "paginaFinal" => "1260"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2513902"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "52"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sensitisation&#44; asthma&#44; and a modified Th2 response in children exposed to cat allergen&#58; a population-based cross-sectional study"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "T&#46; Platts-Mills"
                            1 => "J&#46; Vaughan"
                            2 => "S&#46; Squillace"
                            3 => "J&#46; Woodfolk"
                            4 => "R&#46; Sporik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(00)04168-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2001"
                        "volumen" => "357"
                        "paginaInicial" => "752"
                        "paginaFinal" => "756"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11253969"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0265"
              "etiqueta" => "53"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of symptoms of asthma&#44; rhinitis&#44; and atopic eczema among Brazilian children and adolescents identified by the International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41; - Phase 3"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ISAAC &#8211; Brasilian group"
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Sol&#233;"
                            1 => "G&#46;F&#46; Wandalsen"
                            2 => "I&#46;C&#46; Camelo-Nunes"
                            3 => "C&#46;K&#46; Naspitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "2006"
                        "volumen" => "82"
                        "paginaInicial" => "341"
                        "paginaFinal" => "346"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "54"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Asthma prevalence in Melbourne schoolchildren&#58; have we reached the peak&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;F&#46; Robertson"
                            1 => "M&#46;F&#46; Roberts"
                            2 => "J&#46;H&#46; Kappers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med J Australia"
                        "fecha" => "2004"
                        "volumen" => "180"
                        "paginaInicial" => "273"
                        "paginaFinal" => "276"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15012564"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "55"
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                0 => array:2 [
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                    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" => false
                          "autores" => array:5 [
                            0 => "W&#46; Maziak"
                            1 => "T&#46; Behrens"
                            2 => "T&#46; Brasky"
                            3 => "H&#46; Duhme"
                            4 => "P&#46; Rzehak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "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"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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            55 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "56"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Change in prevalence of asthma in Danish children and adolscents"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46;F&#46; Thomsen"
                            1 => "C&#46;S&#46; Ulrik"
                            2 => "K&#46; Larsen"
                            3 => "V&#46; Backer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1081-1206(10)61757-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Allergy Asthma Immunol"
                        "fecha" => "2004"
                        "volumen" => "92"
                        "paginaInicial" => "506"
                        "paginaFinal" => "511"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15191018"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "57"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The association of diet with respiratory symptoms and asthma in schoolchildren in Taipei&#44; Taiwan"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;J&#46; Tsai"
                            1 => "A&#46;C&#46; Tsai"
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/02770900701539509"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Asthma"
                        "fecha" => "2007"
                        "volumen" => "44"
                        "paginaInicial" => "599"
                        "paginaFinal" => "603"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17943568"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "58"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Manifestations of food allergy&#58; evaluation and management"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;H&#46; Sicherer"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Fam Physician"
                        "fecha" => "1999"
                        "volumen" => "59"
                        "paginaInicial" => "415"
                        "paginaFinal" => "424"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9930132"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
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                0 => array:2 [
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                      "titulo" => "Prevalence of asthma and rhinits in 13 year old adolescents in Porto&#44; Portugal"
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                          "etal" => false
                          "autores" => array:4 [
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                            1 => "E&#46; Ramos"
                            2 => "A&#46; Marques"
                            3 => "H&#46; Barros"
                          ]
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                      ]
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Port Pneumol"
                        "fecha" => "2008"
                        "volumen" => "XIV"
                        "paginaInicial" => "747"
                        "paginaFinal" => "768"
                      ]
                    ]
                  ]
                ]
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              "identificador" => "bib0300"
              "etiqueta" => "60"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Prevalence of asthma and allergic diseases in Sanliurfa&#44; Turkey&#44; and the relation to environmental and socioeconomic factors&#58; Is the hygiene hypothesis enough&#63;"
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                          "etal" => false
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                            2 => "E&#46; Sevinc"
                            3 => "E&#46; Demir"
                          ]
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                      "Revista" => array:5 [
                        "tituloSerie" => "J Invest Allergol Clin Immunol"
                        "fecha" => "2006"
                        "volumen" => "16"
                        "paginaInicial" => "290"
                        "paginaFinal" => "295"
                      ]
                    ]
                  ]
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              "identificador" => "bib0305"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A relatively high prevalence and severity of asthma&#44; allergic rhinitis and atopic eczema in schoolchildren in the Sultanate of Oman"
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                          "etal" => false
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                            3 => "L&#46;G&#46; Jasim"
                            4 => "A&#46;J&#46; Mohammed"
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                        "paginaInicial" => "69"
                        "paginaFinal" => "76"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12856745"
                            "web" => "Medline"
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              "identificador" => "bib0310"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Evaluation of quality of life in Indian children with bronchial asthma using a disease-specific and locally appropriate questionnaire"
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                            4 => "L&#46; Kumar"
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                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Paediatr"
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                        "paginaInicial" => "554"
                        "paginaFinal" => "555"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15188987"
                            "web" => "Medline"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Increased prevalence of asthma in Saudi Arabia"
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                            3 => "S&#46;M&#46; Hasnain"
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                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Allerg Asthma Im"
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                        "volumen" => "86"
                        "paginaInicial" => "292"
                        "paginaFinal" => "296"
                      ]
                    ]
                  ]
                ]
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              "identificador" => "bib0320"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Prevalence and severity of asthma and allergies in schoolchildren in Lhasa&#44; Tibet"
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                            2 => "Y&#46; Yangzom"
                            3 => "M&#46; Shan"
                            4 => "L&#46; Pingzo"
                            5 => "P&#46; Song"
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                        ]
                      ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2222.2007.02781.x"
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                        "tituloSerie" => "Clin Exp Allergy"
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                        "paginaInicial" => "1326"
                        "paginaFinal" => "1333"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17845413"
                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Prevalence of symptoms of childhood asthma&#44; allergic rhinoconjunctivitis and eczema in the Pacific&#58; The International Study of Asthma and Allergies in Childhood &#40;ISAAC&#41;"
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                            4 => "M&#46; Magatongia"
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                        "tituloSerie" => "Allergy"
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                        "paginaFinal" => "264"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17298342"
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        "texto" => "<p id="par0085" class="elsevierStylePara elsevierViewall">Este estudo foi realizado no &#226;mbito do projecto &#171;&#160;Impacto do ambiente interior na sa&#250;de humana&#160;&#187; &#40;PTDC&#47;SAU-ESA&#47;65597&#47;2006&#41;&#46; Priscilla Pegas agradece &#224; Funda&#231;&#227;o para a Ci&#234;ncia e a Tecnologia &#8211;FCT&#8211; pela bolsa de doutoramento &#40;SFRH&#47;BD&#47;45233&#47;2008&#41;&#46; Os autores tamb&#233;m s&#227;o gratos a todos os alunos e encarregados de educa&#231;&#227;o pela participa&#231;&#227;o&#44; e aos professores e coordenadores pela colabora&#231;&#227;o&#46;</p>"
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