• 文章类型: Journal Article
    鉴于过敏性疾病的发生率持续上升,膳食模式的改变被认为是导致这些疾病出现和进展的一个可能因素.目前,人们非常关注利用具有抗过敏特性的天然化合物的饮食疗法的开发。膳食多酚和植物代谢物由于其有据可查的抗炎作用而得到了深入研究,抗氧化剂,和免疫调节特征,使它们成为最突出的天然生物活性化学物质之一。这项研究旨在讨论这些分子可能发挥抗过敏作用的深入机制,即通过它们减少蛋白质过敏性的能力,调节免疫反应,并改变肠道微生物群的组成。然而,需要进一步调查才能充分了解这些影响。本文研究了来自实验和临床研究的现有证据,这些证据支持以下观点:不同的多酚,比如儿茶素,白藜芦醇,姜黄素,槲皮素,和其他人,可以减少过敏性炎症,缓解食物过敏的症状,哮喘,特应性皮炎,和过敏性鼻炎,并防止过敏性免疫反应的进展。总之,膳食多酚和植物代谢物具有显著的抗过敏特性,可用于开发针对过敏性疾病的预防和治疗策略。本文还讨论了多酚研究和广泛使用的制约因素,以及未来研究的潜在途径。
    Given the ongoing rise in the occurrence of allergic disorders, alterations in dietary patterns have been proposed as a possible factor contributing to the emergence and progression of these conditions. Currently, there is a significant focus on the development of dietary therapies that utilize natural compounds possessing anti-allergy properties. Dietary polyphenols and plant metabolites have been intensively researched due to their well-documented anti-inflammatory, antioxidant, and immunomodulatory characteristics, making them one of the most prominent natural bioactive chemicals. This study seeks to discuss the in-depth mechanisms by which these molecules may exert anti-allergic effects, namely through their capacity to diminish the allergenicity of proteins, modulate immune responses, and modify the composition of the gut microbiota. However, further investigation is required to fully understand these effects. This paper examines the existing evidence from experimental and clinical studies that supports the idea that different polyphenols, such as catechins, resveratrol, curcumin, quercetin, and others, can reduce allergic inflammation, relieve symptoms of food allergy, asthma, atopic dermatitis, and allergic rhinitis, and prevent the progression of the allergic immune response. In summary, dietary polyphenols and plant metabolites possess significant anti-allergic properties and can be utilized for developing both preventative and therapeutic strategies for targeting allergic conditions. The paper also discusses the constraints in investigating and broad usage of polyphenols, as well as potential avenues for future research.
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  • 文章类型: Journal Article
    近年来,智能手机和其他无线技术在医疗保健中的使用发展迅速。然而,在某些情况下,尤其是儿科医疗问题,移动医疗技术获取信息的可靠性仍然存在争议。本文的主要目的是评估智能手机应用程序在儿科医疗条件的检测和诊断中的相关性,其中已经开发了最多的应用程序。这是为诊断急性中耳炎而开发的智能手机应用程序的情况,渗出性中耳炎,听力障碍,肥胖,弱视,和视力筛查。在某些情况下,这些应用程序提供的信息显着提高了医生的诊断能力。然而,区分有效的应用程序和可能导致错误的应用程序可能非常困难。这凸显了在日常临床实践中包括基于智能手机的人工智能之前仔细选择应用程序的重要性。
    In recent years, the use of smartphones and other wireless technology in medical care has developed rapidly. However, in some cases, especially for pediatric medical problems, the reliability of information accessed by mobile health technology remains debatable. The main aim of this paper is to evaluate the relevance of smartphone applications in the detection and diagnosis of pediatric medical conditions for which the greatest number of applications have been developed. This is the case of smartphone applications developed for the diagnosis of acute otitis media, otitis media with effusion, hearing impairment, obesity, amblyopia, and vision screening. In some cases, the information given by these applications has significantly improved the diagnostic ability of physicians. However, distinguishing between applications that can be effective and those that may lead to mistakes can be very difficult. This highlights the importance of a careful application selection before including smartphone-based artificial intelligence in everyday clinical practice.
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  • 文章类型: Journal Article
    鉴于听力损失(HL)的个性化管理和治疗的关键作用,早期进行病因调查,和遗传分析显着有助于确定大多数综合征和非综合征HL病例。知道数百个与HL的综合征关联,关于由于连续基因的微缺失或微重复而导致的基因组疾病中HL的全面数据很少。结合对新患者的描述,该患者具有新的3.7Mb的Xq21关键基因座缺失,我们建议对Xq21缺失综合征患者及其家庭成员的临床发现进行未报道的文献综述.最后,我们提出了连续基因综合征中HL的全面综述,以确认细胞基因组微阵列分析在研究无法解释的HL病因中的作用。
    Given the crucial role of the personalized management and treatment of hearing loss (HL), etiological investigations are performed early on, and genetic analysis significantly contributes to the determination of most syndromic and nonsyndromic HL cases. Knowing hundreds of syndromic associations with HL, little comprehensive data about HL in genomic disorders due to microdeletion or microduplications of contiguous genes is available. Together with the description of a new patient with a novel 3.7 Mb deletion of the Xq21 critical locus, we propose an unreported literature review about clinical findings in patients and their family members with Xq21 deletion syndrome. We finally propose a comprehensive review of HL in contiguous gene syndromes in order to confirm the role of cytogenomic microarray analysis to investigate the etiology of unexplained HL.
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  • 文章类型: Journal Article
    听觉损伤是一个普遍的全球性问题,对个人的日常功能和人际交往产生重大影响。人工耳蜗(CI)已成为严重至严重听力损失的尖端解决方案,用电信号直接刺激听觉神经。CI程序的成功取决于精确的术前计划和术后评估,突出了先进的三维(3D)内耳重建软件的意义。准确的术前成像对于识别解剖标志和评估耳蜗畸形至关重要。像3D切片器这样的工具,Amira和OTOPLAN提供了耳蜗解剖的详细描述,帮助外科医生模拟植入场景和完善手术方法。术后扫描在检测并发症和确保CI寿命方面起着至关重要的作用。尽管技术进步,标准化和优化等挑战依然存在。本文综述了3D内耳重建软件在患者选择中的作用,手术计划,和术后评估,跟踪其演变,强调图像分割和虚拟仿真等特征。它解决了软件限制并提出了解决方案,倡导将其融入临床实践。最终,这篇综述强调了3D内耳重建软件对人工耳蜗植入的影响,将创新与精准医学联系起来。
    Auditory impairment stands as a pervasive global issue, exerting significant effects on individuals\' daily functioning and interpersonal engagements. Cochlear implants (CIs) have risen as a cutting-edge solution for severe to profound hearing loss, directly stimulating the auditory nerve with electrical signals. The success of CI procedures hinges on precise pre-operative planning and post-operative evaluation, highlighting the significance of advanced three-dimensional (3D) inner ear reconstruction software. Accurate pre-operative imaging is vital for identifying anatomical landmarks and assessing cochlear deformities. Tools like 3D Slicer, Amira and OTOPLAN provide detailed depictions of cochlear anatomy, aiding surgeons in simulating implantation scenarios and refining surgical approaches. Post-operative scans play a crucial role in detecting complications and ensuring CI longevity. Despite technological advancements, challenges such as standardization and optimization persist. This review explores the role of 3D inner ear reconstruction software in patient selection, surgical planning, and post-operative assessment, tracing its evolution and emphasizing features like image segmentation and virtual simulation. It addresses software limitations and proposes solutions, advocating for their integration into clinical practice. Ultimately, this review underscores the impact of 3D inner ear reconstruction software on cochlear implantation, connecting innovation with precision medicine.
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  • 文章类型: Journal Article
    背景:听力障碍是我们老龄化社会中不断增加的负担。听力损失与认知表现降低以及平衡和步态下降有关。因此,听力受损也影响双任务(DT)。这篇综述的目的是总结在保持平衡或行走过程中听力受损的老年人DT表现下降的证据。
    方法:根据PRISMA指南使用MEDLINE进行系统的文献研究,APA心理信息,和WebofScience。纳入标准是:独立生活的老年人≥60岁,有听力障碍,使用DT范例测试平衡或行走条件下听力受损的老年人。
    结果:在数据库中发现了N=57项研究。纳入了8项研究(N=456名参与者(58%为女性),包括n=200名具有不同程度听力损失的老年听力受损者)。大多数纳入的研究都将听力障碍的纳入标准定为轻度听力损失的阈值,纯音平均(0.5-4kHz)≥25和<40dB。其中三项研究集中在DT平衡性能上,五项使用DT步行来比较有无听力损失的参与者。对于DT平衡和步态性能,与健康老年人相比,听力受损组的下降幅度更高.绩效下降伴随着平衡绩效补偿策略的减少。
    结论:与没有听力障碍的参与者相比,有听力障碍的参与者的DT性能下降更明显。这意味着听力受损的老年人可能需要特定的干预措施来减少认知运动干扰(CMI),以在需要同时管理认知和运动任务的日常情况下保持平衡控制或行走稳定性。然而,考虑到所有结果,需要进一步研究该目标群体的CMI的潜在机制。
    背景:此评论已在Prospero注册,ID为CRD42022340232。
    BACKGROUND: Hearing impairments are a rising burden in our aging society. Hearing loss is associated with reduced cognitive performance as well as decrements in balance and gait. Therefore, impaired hearing affects also dual tasking (DT). The aim of this review is to summarize the evidence for DT performance decrements of older adults with hearing impairments during maintaining balance or walking.
    METHODS: The systematic literature research according to PRISMA guidelines was conducted using MEDLINE, APA Psych-Info, and Web of Science. Inclusion criteria were: Independent living older people ≥ 60 years with hearing impairments, use of a DT paradigm to test hearing impaired older adults within a balance or walking condition.
    RESULTS: N = 57 studies were found within the databases. Eight studies were included (N = 456 participants (58% women), including n = 200 older hearing-impaired persons with different levels of hearing loss). Most of the included studies oriented their inclusion criteria for hearing-impairments at thresholds for mild hearing loss with Pure Tone Average (0.5-4 kHz) ≥ 25 and < 40 dB. Three of the studies focused on DT balance performance and five used DT walking comparing participants with and without hearing loss. For DT balance and gait performance, higher decrements for the hearing-impaired group were observed compared to healthy older adults. Performance decrements were accompanied by reduced compensatory strategies in balance performance.
    CONCLUSIONS: More pronounced decrements in DT performance were observed for participants with hearing impairments compared to those without. This implies that hearing-impaired older adults might need specific interventions to reduce the cognitive-motor interference (CMI) to maintain balance control or walking stability in daily situations that require managing of cognitive and motor tasks simultaneously. However, taking all results into account the underlying mechanisms of CMI for this target group needs to be further examined.
    BACKGROUND: This review was registered at Prospero with the ID CRD42022340232.
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  • 文章类型: Journal Article
    目的:为了在内窥镜鼻窦手术(ESS)后的长期(>5年)结果中提供当前的证据,重点是患者报告的结局指标(PROM)和其他鼻窦结局,同时评估ESS在CRSwNP治疗中的作用,并确定影响ESS结果的结果,并为未来的研究确定建议。
    结果:CRSwNP中ESS的长期结果可以在PROM和其他客观测量中进行分支。尽管报告结果的异质性使得难以进行比较和荟萃分析,ESS改进了PROM,包括症状,QOL和嗅觉。目标成果,如NPS,LMS,手术类型,或复发和翻修手术在长期结果中没有明确的作用。聚集患者提示哮喘,N-ERD,过敏,嗜酸性粒细胞计数和IL-5可能在预测复发和严重疾病中发挥作用。用ESS治疗的CRSwNP的长期研究很少。非常需要使结果报告标准化。使用SNOT-22,NPS,经过验证的气味测试,以统一的系统方式定义疾病复发和控制标准以及ESS扩展可以更好地比较生物制剂新时代的治疗方法.
    OBJECTIVE: To present current evidence in long-term (> 5 years) results after endoscopic sinus surgery (ESS) focusing on Patients Reported Outcome Measures (PROMs) and other sinonasal outcomes while assessing the role of ESS in the treatment of CRSwNP, and identifying outcomes which affect the results of ESS and defining recommendations for future studies.
    RESULTS: Long-term results of ESS in CRSwNP can be branched in PROMs and other objective measurements. Despite the heterogeneity of reported outcomes make it difficult to perform comparisons and meta-analysis, ESS improves PROMs, including symptoms, QOL and olfaction. Objectives outcomes such as NPS, LMS, type of surgery, or recurrence and revision surgery don\'t have a clear role in long-term results. Clustering patients suggest asthma, N-ERD, allergy, eosinophil count and IL-5 could have a role in predicting recurrence and severe disease. Long-term studies of CRSwNP treated with ESS are scarce. There is a significant need to standardize the report of results. The use of tools as SNOT-22, NPS, validated smell tests, defined criteria for disease recurrence and control and ESS extension in a unified systematic way could allow better comparisons between treatments in the new era of biologics.
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  • 文章类型: Journal Article
    目的:评价鼓室内庆大霉素联合糖皮质激素治疗梅尼埃病(MD)的疗效及治疗后疗效。方法:基于PubMed和Embase数据库,使用鼓室注射4种药物(庆大霉素,甲基强的松龙,地塞米松,和安慰剂)从1995年至2023年10月进行了MD治疗,并根据纳入和排除标准筛选了文献,并使用Stata17对数据进行荟萃分析。结果:共选取13项研究,涉及559名参与者,随访时间3~28个月。Meta分析显示庆大霉素和地塞米松的纯音平均值差异无统计学意义[标准化平均差(SMD)=0.09,95%置信区间(CI)(-0.42,0.24),P<0.05]。与安慰剂相比,鼓室注射庆大霉素[风险比(RR)=1.18,95%CI(0.43,1.93)],甲基强的松龙[RR=0.88,95%CI(0.07,1.70)],和地塞米松[RR=0.70,95%CI(-0.01,1.41)]均显示出治疗眩晕的更好疗效。对于耳鸣的治疗,SUCRA排名结果表明,地塞米松是最有效的,其次是甲基强的松龙和庆大霉素。结论:药物干预治疗MD比安慰剂更有效。尽管庆大霉素治疗在治疗眩晕方面显示出显着效果,在控制听力损失和眩晕症状方面,皮质类固醇联合治疗明显优于庆大霉素。
    Objective: Evaluation of the effectiveness and posttreatment effects of intratympanic gentamicin and corticosteroids in treating patients with Ménière\'s disease (MD). Methods: Based on PubMed and Embase databases, randomized controlled trials using intratympanic injections of 4 drugs (gentamicin, methylprednisolone, dexamethasone, and placebo) for the treatment of MD were searched from 1995 to October 2023, and the literature was screened according to inclusion and exclusion criteria, and data were netted for meta-analysis using Stata 17. Results: A total of 13 studies were selected, involving 559 participants, with follow-up time ranging from 3 to 28 months. Meta-analysis showed that there was no statistically significant difference in pure-tone average between gentamicin and dexamethasone [standardized mean difference (SMD) = 0.09, 95% confidence interval (CI) (-0.42, 0.24), P < .05]. Compared to placebo, intratympanic injection of gentamicin [risk ratio (RR) = 1.18, 95% CI (0.43, 1.93)], methylprednisolone [RR = 0.88, 95% CI (0.07, 1.70)], and dexamethasone [RR = 0.70, 95% CI (-0.01, 1.41)] all showed better efficacy in treating vertigo. For the treatment of tinnitus, the SUCRA ranking results showed that dexamethasone was the most effective, followed by methylprednisolone and gentamicin. Conclusion: Pharmacological intervention is more effective than placebo in treating MD. Although gentamicin treatment shows significant effects in treating vertigo, corticosteroid combination therapy is markedly superior to gentamicin in controlling hearing loss and vertigo symptoms.
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  • 文章类型: Journal Article
    背景:怀孕期间突然的感音神经性听力损失(SSNHL)是一种罕见的疾病,尚未进行大量研究。该研究旨在对风险因素进行系统评价和荟萃分析,并发症,和孕妇SSNHL的治疗方式。
    方法:PubMed,WebofScience,Scopus,ProQuest,和谷歌学者被用于文献检索。使用Cochrane技术评估偏倚风险用于文章质量评估,使用RevMan5.4进行荟萃分析。使用标准平均差(SMD)和比值比,置信区间为95%(95%CI)。异质性和发表偏倚使用I平方(I2)检验统计量和Egger检验进行评估,分别。
    结论:七项主要研究采用前瞻性和回顾性研究设计。荟萃分析显示,与对照组相比,实验组中SSNHL的风险变量较少(SMD=-0.45至3.24,95%CI=-3.063至2.16-2.85),这表明分析显示出微不足道的差异。然而,接受治疗的患者表现出听力改善,表明有意义的分析(SMD=-0.671.20,95%CI=-1.2713.51至-0.066.88)。此外,治疗后,观察到两组SMD(SMD=-0.7415.18,95%CI=-1.2423.85至-0.256.40)之间的实质性差异,有利于实验组患者,基于四项纳入研究的分析结果。然而,I2值为0%,表明异质性较低。
    结论:妊娠期间的SSNHL是一种非常罕见的疾病,原因不明。然而,荷尔蒙波动,特别是怀孕期间雌激素和孕激素水平升高,经常被认为是SSNHL的潜在触发因素。
    BACKGROUND: Sudden sensorineural hearing loss (SSNHL) during pregnancy is a rare condition and has not been much studied. The study aimed to perform a systematic review and meta-analysis of the risk factors, complications, and treatment modalities for SSNHL in pregnant women.
    METHODS: PubMed, Web of Science, Scopus, ProQuest, and Google Scholar were used for the literature search. The Cochrane technique for assessing risk of bias was used for the article quality appraisal, and RevMan 5.4 was used for conducting the meta-analysis. Standard mean difference (SMD) and odds ratios with a 95% confidence interval (95% CI) were utilized. Heterogeneity and publication bias were assessed using the I-square (I2) test statistic and the Egger\'s test, respectively.
    CONCLUSIONS: The seven primary studies employed prospective and retrospective study designs. The meta-analysis showed that there were fewer risk variables for SSNHL in the experimental group compared with those in the control group (SMD = -0.45 to 3.24, 95% CI = -3.063.63 to 2.16-2.85), indicating that the analysis revealed an insignificant difference. However, the treated patients presented hearing improvement, suggesting a significant analysis (SMD = -0.6710.20, 95% CI = -1.2713.51 to -0.066.88). Furthermore, after therapy, substantial differences were observed in SMD between the two groups (SMD = -0.7415.18, 95% CI = -1.2423.85 to -0.256.40) in favor of the experimental group patients, based on the analysis results of four included studies. However, the I2-value of 0% showed that the heterogeneity was low.
    CONCLUSIONS: SSNHL during pregnancy is a notably rare condition with an unknown cause. However, hormonal fluctuations, particularly increased levels of estrogen and progesterone during pregnancy, have been frequently implicated as potential triggers for SSNHL.
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  • 文章类型: Journal Article
    目的:过度的噪音是令人不快的,会引起一些生理和心理影响。噪声污染是对人类的潜在威胁,特别是那些连续长时间暴露在一天中多年的人。这篇综述旨在研究与长期暴露于噪声污染相关的各种听觉和非听觉结果。
    方法:本综述利用相关关键词的组合来搜索电子数据库。在根据所应用的标题选择标准进行筛选后,abstract,和全文,最终选择了44篇文章进行批判性审查。
    结果:我们确定并分析了与噪声引起的听力损失有关的研究结果,耳鸣,和睡眠障碍以及烦恼等非听觉问题,认知障碍,和与心血管疾病相关的精神压力。此外,对现有研究进行了比较和整理,以强调噪声污染作为一种独特的环境问题的独特挑战和意义,并探索其研究和预防方面的持续努力,包括噪声引起的听力损失的早期检测和潜在逆转。
    结论:噪声污染的基本健康后果强调了需要进行广泛的研究,包括新兴的噪声源和技术,以建立专门的健康管理系统,以解决与噪声相关的健康问题并降低人群中的噪声暴露风险。最后,有必要进行进一步的研究,以确保改善噪声暴露和相关健康结果的测量,尤其是在职业噪声的背景下。
    OBJECTIVE: Excessive noise is unpleasant and induces several physiological and psychological effects. Noise pollution is a potential threat to humans, particularly those continuously exposed for extended periods throughout the day over many years. This review aims to examine the various auditory and non-auditory outcomes associated with prolonged exposure to noise pollution.
    METHODS: The review utilized a combination of relevant keywords to search the electronic databases. After screening based on the applied selection criteria for title, abstract, and full text, 44 articles were finally selected for critical review.
    RESULTS: We identified and analyzed research findings related to noise-induced hearing loss, tinnitus, and sleep disturbances along with non-auditory issues such as annoyance, cognitive impairments, and mental stress associated with cardiovascular disorders. Furthermore, the existing studies were compared and collated to highlight the unique challenges and significance of noise pollution as a distinctive environmental concern and to explore the ongoing efforts in its research and prevention, including the early detection and potential reversal of noise-induced hearing loss.
    CONCLUSIONS: The fundamental health consequences of noise pollution underscore the need for extensive research encompassing emerging noise sources and technologies to establish a health management system tailored to address noise-related health concerns and reduce noise exposure risk among populations. Finally, further research is warranted to ensure improved measurement of noise exposure and related health outcomes, especially in the context of occupational noise.
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  • 文章类型: Journal Article
    背景:过敏性疾病由于其在全球范围内的患病率不断增加,因此仍然受到关注。内在和环境危险因素与变应性疾病的发病机理有关。在可能的风险因素中,迁移与过敏性疾病的表现有关。我们旨在巩固现有证据,回顾环境因素与过敏性疾病之间关系的假设,为今后的工作提供方向。
    方法:本系统评价和荟萃分析符合系统评价和荟萃分析(PRISMA)指南的首选报告项目。2023年9月搜索了WebofScience数据库,以检索调查过敏性鼻炎(AR)之间关系的出版物,特应性皮炎(AD),或哮喘和以下因素:(I)移民身份(即,移民vs.本地人)或(ii)移民移民以来的持续时间。使用JBI关键评估工具评估偏倚风险。还总结了纳入研究的细节和发现,并在适当的情况下进行了荟萃分析。
    结果:综述了50项研究,估计有3,755,248人。文章调查了哮喘(n=46),AR(n=16),和AD(n=14)。还研究了各种与迁移相关的因素:个体跨区域的运动(n=40),移民后的持续时间(n=12),移民年龄(n=9),和文化适应(n=2)。迁移状态与AD无显著相关(合并比值比[pOR]=0.68,95%置信区间(CI)=0.31,1.49)。尽管移民的AR患病率低于本地人(pOR=0.58,95%CI=0.45,0.74),在目的地国家居住至少10年的移民患AR的风险高于居住时间少于10年的移民(pOR=8.36,95%CI=4.15,16.81)。移民也与哮喘风险降低相关(pOR=0.56,95%CI=0.44,0.72)。在移民中,在东道国居住至少10年与哮喘表现增加相关(pOR=1.85,95%CI=1.25,2.73).与5岁以上移民的移民相比,5岁及以下移民的移民患哮喘的可能性没有显着提高(pOR=1.01,95%CI=0.68,1.50)。
    结论:本综述受到纳入研究的主要横断面性质的限制。过敏性疾病的客观诊断,例如使用支气管扩张剂可逆性测试的肺活量测定哮喘而不是问卷回答,可以增加结果的可靠性。此外,移民群体大多是非特异性的,他们的原籍国几乎没有区别。总的来说,迁移似乎是过敏性疾病的保护因素,但是随着时间的推移,保护逐渐消退,移民群体中过敏性疾病的患病率接近宿主人群。
    BACKGROUND: Allergic diseases remain of concern due to their increasing prevalence worldwide. Intrinsic and environmental risk factors have been implicated in the pathogenesis of allergic disease. Among the possible risk factors, migration has been associated with the manifestation of allergic diseases. We aimed to consolidate the existing evidence, review the hypotheses for the relationship between environmental factors and allergic disease, and provide a direction for future work.
    METHODS: This systematic review and meta-analysis complied with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Web of Science database was searched in September 2023 to retrieve publications investigating the relationship between allergic rhinitis (AR), atopic dermatitis (AD), or asthma and the following factors: (i) migrant status (i.e., migrants vs. natives) or (ii) duration since migration among migrants. Risk of bias was assessed using the JBI critical appraisal tool. Details and findings from the included studies were also summarized and meta-analyses were conducted where appropriate.
    RESULTS: Fifty studies encompassing an estimated 3,755,248 individuals were reviewed. Articles investigated asthma (n = 46), AR (n = 16), and AD (n = 14). A variety of migration-related factors were also studied: movement of individuals across regions (n = 40), duration since immigration (n = 12), age at immigration (n = 9), and acculturation (n = 2). Migration status was not significantly associated with AD (pooled odds ratio [pOR] = 0.68, 95% confidence interval (CI) = 0.31, 1.49). Although AR prevalence was lower among immigrants than natives (pOR = 0.58, 95% CI = 0.45, 0.74), immigrants who had resided at least 10 years in the destination country had a higher risk of AR than immigrants with a duration of residence of less than 10 years (pOR = 8.36, 95% CI = 4.15, 16.81). Being an immigrant was also associated with a decreased risk of asthma (pOR = 0.56, 95% CI = 0.44, 0.72). Among immigrants, residing in the host country for at least 10 years was associated with increased asthma manifestation (pOR = 1.85, 95% CI = 1.25, 2.73). Immigrants who migrated aged 5 and below did not exhibit a significantly higher likelihood of asthma than migrants who immigrated older than 5 years (pOR = 1.01, 95% CI = 0.68, 1.50).
    CONCLUSIONS: This review was limited by the primarily cross-sectional nature of the included studies. Objective diagnoses of allergic disease, such as using the spirometry of bronchodilator reversibility test for asthma rather than questionnaire responses, could add to the reliability of the outcomes. Furthermore, immigrant groups were mostly nonspecific, with little distinction between their country of origin. Overall, migration appears to be a protective factor for allergic diseases, but the protection subsides over time and the prevalence of allergic diseases among the immigrant group approaches that of the host population.
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