[Cost of childhood asthma in Spain: a cost evaluation model based on the prevalence]. / Coste del asma en pediatría en España: un modelo de evaluación de costes basado en la prevalencia.

INTRODUCTION: Asthma is the most common chronic disease in childhood, reduces the quality of life of children and their families, and produces high social and health care costs. In Spain, the cost of managing paediatric asthma is unknown. OBJECTIVE: To estimate the cost of managing paediatric asthma in Spain and to examine its variability depending on asthma severity. PATIENTS AND METHODS: The cost of asthma in children under 16 years in 2008 was estimated by building a costs assessment model including the factors that influence the cost of asthma in children: prevalence, distribution of disease severity, age, frequency of resources use depending on severity, and the cost of each resource. A sensitivity analysis was conducted to evaluate the underlying uncertainty depending on the variability of the estimators of resource use, the unit cost of each resource, and the prevalence. RESULTS: According to the model, the total cost of paediatric asthma in Spain is around 532 million euros, with a range of 392 to 693 million euros. Direct costs (health care costs) represent 60% of the total costs, and indirect costs (carer time), 40%. The mean annual cost per child with asthma is 1,149 euros, ranging from 403 euros for the mildest category of the disease to 5,380 euros for the most severe. CONCLUSIONS: The cost of paediatric asthma in Spain is very high and depends on disease severity. Although the most important costs are for the health care system, indirect costs are not negligible.

Clinical correlates and determinants of airway inflammation in pediatric asthma.

BACKGROUND: Airway inflammation is a key component in the pathophysiology of asthma. However, neither its role in the clinical features of asthma nor the factors affecting the degree of inflammation have been fully defined. METHODS: We determined the fractional exhaled nitric oxide concentration (FE(NO)) using a portable device (NIOX-MINO, Aerocrine, Solna, Sweden) in a consecutive sample of 149 asthmatic children aged 6 to 14 years. In order to establish an association with FE(NO), we analyzed symptoms, spirometric parameters before and after a bronchodilator test, and the impact of asthma on quality of life during the previous 4 weeks. We also investigated how clinical variables that regulate inflammation affected FE(NO). RESULTS: In patients not treated with inhaled corticosteroids (ICs), FE(NO) was higher when specific symptoms (wheeze and cough) had been present during the previous 4 weeks; however, we were unable to establish a relationship with symptom frequency, bronchodilator use, asthma crises, hospital admissions, limitation of daily activities, or spirometry results. In patients treated with ICs, FE(NO) was not related to the clinical expression of asthma, except for a reduced ratio of forced expiratory volume in 1 second to forced vital capacity, both before and after bronchodilation. The main determinant of FE level in untreated patients was sensitization to house dust mite. In patients treated with ICs, FE(NO) was only associated with adherence to therapy. CONCLUSION: Airway inflammation, as determined by FE(NO), is only weakly associated with the clinical expression of asthma and spirometry results. Adherence to treatment is the main determinant of the degree of inflammation in patients taking ICs.

Perfil de sensibilización alérgica en niños de 0 a 5 años con sibilancias o dermatitis atópica / Allergic sensitization profile in 0–5 year old children with wheezing and/or atopic dermatitis

Antecedentes Aunque las enfermedades alérgicas son frecuentes en la infancia, pocos estudios han caracterizado el perfil de sensibilización inmunoglobulina (Ig) E en niños pequeños con síntomas de posible origen alérgico. Objetivo Establecer la prevalencia y el tipo de sensibilización alérgica, y los factores demográficos y ambientales relacionados con ambas características, en niños de 0 a 5 años de edad con sibilancias o dermatitis atópica. Población y métodos Estudio transversal colaborativo en el que participaron 20 centros de atención primaria de diversas áreas geográficas de España. En conjunto, 468 niños con sibilancias o dermatitis atópica realizaron una evaluación alergológica que incluyó la determinación en sangre de anticuerpos IgE específicos frente a neumoalérgenos y trofoalérgenos prevalentes. Resultados Se detectó sensibilización alérgica en el 32,4% de los niños con sibilancias (intervalo de confianza [IC] del 95%: 26,3–38,6%), el 54,8% de los niños con dermatitis atópica (IC del 95%: 42,1–67,6%) y el 39,2% de los que tuvieron ambos procesos (IC del 95%: 32,0–46,4%). El riesgo de sensibilización se vio influido por el sexo (odds ratio ajustado [ORA] masculino versus femenino: 1,91; IC del 95%: 1,24–2,95), la edad (ORA 3–5 versus 0–2 años: 1,96; IC del 95%: 1,27–3,0), el tipo de lactancia (ORA materna versus artificial: 0,51; IC del 95%: 0,31–0,84) y el área geoclimática (ORA continental versus atlántica: 2,26; IC del 95%: 1,30–3,93). Con respecto al área atlántica, la sensibilización en el área continental fue menor a ácaros (ORA: 0,16; IC del 95%: 0,07–0,36) y mayor a gramíneas (ORA: 4,65; IC del 95%: 1,99–10,86), leche de vaca (ORA: 5,17; IC del 95%: 1,71–15,62) y huevo (ORA: 5,26; IC del 95%: 2,04–13,62), mientras que en el área mediterránea fue menor a ácaros (ORA: 0,29; IC del 95%: 0,13–0,64) y mayor a leche de vaca (ORA: 3,81; IC del 95%: 1,20–12,14) y huevo (ORA: 5,24; IC del 95%: 1,94–14,20). Conclusiones Una proporción relevante de los niños pequeños asistidos en atención primaria por sibilancias o dermatitis atópica presentan sensibilización alérgica. En España parecen existir variaciones según el área geoclimática en la prevalencia de sensibilización a inhalantes y alimentos en lactantes y niños preescolares con síntomas de posible origen alérgico (AU)

Background Although allergic diseases are frequent in childhood, few studies have characterised the IgE sensitization profile among young children with allergic-like symptoms. Objective To determine the prevalence and the type of allergic sensitization, as well as the demographic and environmental factors related to both characteristics, among 0–5 year old children presenting with wheezing and/or atopic dermatitis. Methods Collaborative cross-over study developed in the paediatric setting of 20 Spanish Primary Health Care Centres. An allergology evaluation including blood determination of specific IgE antibodies to common inhalant and food allergens was performed on 468 children who presented with wheezing and/or atopic dermatitis. Results Allergic sensitization was detected in 32.4% of the children with wheezing (95% confidence interval, 95%CI, 26.3–38.6%), in 54.8% of the children who had atopic dermatitis (95%CI, 42.1–67.6%) and in 39.2% of the children with both processes (95%CI, 32.0–46.4%). The risk of allergic sensitization was sex related (male versus female adjusted odds ratio, ORA, 1.91, 95%CI, 1.24–2.95), and also related to the age (3–5 versus 0–2 year old ORA 1.96, 95%CI, 1.27–3.0), type of early feeding (maternal milk versus infant formula ORA 0.51, 95%CI, 0.31–0.84) and geoclimatic area (ORA Continental versus Atlantic 2.26, 95%CI, 1.30–3.93). Compared to the Atlantic area, the Continental area the sensitization was lower to mites (ORA 0.16, 95%CI, 0.07–0.36) and higher to grass (ORA 4.65, 95%CI 1.99–10.86), cow milk (ORA 5.17, 95%CI, 1.71–15.62) and egg (ORA 5.26, 95%CI, 2.04–13.62), whereas in the Mediterranean area the sensitization was lower to mites (ORA 0.29, 95%CI, 0.13–0.64) and higher to cow milk (ORA 3.81, 95%CI, 1.20–12.14) and egg (ORA 5.24, 95%CI, 1.94–14.20). Conclusion A significant proportion of small children treated at the paediatric primary health care centres due to wheezing and/or atopic dermatitis had allergic sensitization. There appears to be a geoclimatic variation in the prevalence of sensitization to inhalant and food allergens among young children with allergic like symptoms who live in Spain (AU)

[Allergic sensitization profile in 0-5 year old children with wheezing and/or atopic dermatitis]. / Perfil de sensibilización alérgica en niños de 0 a 5 años con sibilancias o dermatitis atópica.

BACKGROUND: Although allergic diseases are frequent in childhood, few studies have characterised the IgE sensitization profile among young children with allergic-like symptoms. OBJECTIVE: To determine the prevalence and the type of allergic sensitization, as well as the demographic and environmental factors related to both characteristics, among 0-5 year old children presenting with wheezing and/or atopic dermatitis. METHODS: Collaborative cross-over study developed in the paediatric setting of 20 Spanish Primary Health Care Centres. An allergology evaluation including blood determination of specific IgE antibodies to common inhalant and food allergens was performed on 468 children who presented with wheezing and/or atopic dermatitis. RESULTS: Allergic sensitization was detected in 32.4% of the children with wheezing (95% confidence interval, 95%CI, 26.3-38.6%), in 54.8% of the children who had atopic dermatitis (95%CI, 42.1-67.6%) and in 39.2% of the children with both processes (95%CI, 32.0-46.4%). The risk of allergic sensitization was sex related (male versus female adjusted odds ratio, OR(A), 1.91, 95%CI, 1.24-2.95), and also related to the age (3-5 versus 0-2 year old OR(A) 1.96, 95%CI, 1.27-3.0), type of early feeding (maternal milk versus infant formula OR(A) 0.51, 95%CI, 0.31-0.84) and geoclimatic area (OR(A) Continental versus Atlantic 2.26, 95%CI, 1.30-3.93). Compared to the Atlantic area, the Continental area the sensitization was lower to mites (OR(A) 0.16, 95%CI, 0.07-0.36) and higher to grass (OR(A) 4.65, 95%CI 1.99-10.86), cow milk (OR(A) 5.17, 95%CI, 1.71-15.62) and egg (OR(A) 5.26, 95%CI, 2.04-13.62), whereas in the Mediterranean area the sensitization was lower to mites (OR(A) 0.29, 95%CI, 0.13-0.64) and higher to cow milk (OR(A) 3.81, 95%CI, 1.20-12.14) and egg (OR(A) 5.24, 95%CI, 1.94-14.20). CONCLUSION: A significant proportion of small children treated at the paediatric primary health care centres due to wheezing and/or atopic dermatitis had allergic sensitization. There appears to be a geoclimatic variation in the prevalence of sensitization to inhalant and food allergens among young children with allergic like symptoms who live in Spain.

Factibilidad de la medición en atención primaria de la fracción exhalada de óxido nítrico en niños con asma. Estudio CANON / Feasibility of FeNO measurement in asthmatic children in the primary care setting. CANON Study

Objetivo: Evaluar la factibilidad de la medición de la fracción exhalada de óxido nítrico (FeNO) en niños con asma, mediante la utilización de un dispositivo portátil, en el contexto de la atención primaria de salud. Métodos: Estudio multicéntrico, transversal, de visita única, en 7 centros de salud de España. Cada centro incluyó, de forma consecutiva, a niños de 6 a 14 años con diagnóstico médico de asma. Cada niño debía realizar 2 maniobras válidas de la FeNO utilizando el medidor portátil NIOX MINO(R) (Aerocrine AB, Solna, Suecia). El análisis de factibilidad incluyó: a) porcentaje de niños capaces de realizar la maniobra; b) determinación del número de pruebas necesarias hasta obtener un resultado válido; c) tiempo empleado entre el inicio de la primera maniobra y la obtención del resultado, y d) opinión del técnico sobre la facilidad de la enseñanza de la maniobra y valoración de la dificultad para su realización. Resultados: Se invitó a participar a 151 niños, de los cuales 149 (98,7%) fueron capaces de hacer la maniobra de la FeNO. El 55% de los niños tenía experiencia previa en el uso del dispositivo. Para el conjunto de los niños, la mediana de intentos necesarios hasta una medición válida fue de 2 (amplitud intercuartílica [IQR]: 1 a 3) y la mediana de tiempo empleado fue de 4min (IQR: 3 a 5). El personal sanitario a cargo de la prueba consideró el procedimiento (enseñanza y maniobra) fácil o muy fácil para el 87,8% (enseñanza) y para el 86,5% (maniobra) de los niños. Comparativamente, los niños con experiencia previa realizaron la prueba en menos intentos y menos tiempo, y la enseñanza y la ejecución les resultaron significativamente más fáciles que a los niños sin experiencia. Conclusiones: La medición de la FeNO con el medidor NIOX MINO(R), en el contexto de la atención primaria, es técnicamente factible y aceptable para los niños y el personal sanitario. La experiencia previa ejerce un papel de aprendizaje positivo y proporciona resultados válidos en menor tiempo y con menor número de intentos (AU)

Aim: Asses the feasibility of exhaled nitric oxide (FeNO) measurement in asthmatic children using a hand-held device in the primary care setting. Methods: Multicentre study performed in the paediatric clinics in seven Spanish primary health care centres. Each centre consecutively included 6–14 year-old children with doctor-diagnosed asthma. Children were asked to obtain two valid measurements of FeNO with the hand-held device NIOX MINO(R) (Aerocrine AB, Solna, Sweden). Feasibility analysis included: (a) percentage of children able to perform the manoeuvre, (b) time required to obtain a successful determination, (c) number of attempts needed, and (d) acceptability of the technical procedure by clinical personnel involved in their guidance. Results: The Study enrolled 151 children. A total of 149 (98.7%) were able to perform the FeNO manoeuvre. The majority (55%) of children had previous experience of using the hand-held device. The Overall median (and Interquartile Range, IQR) of attempts needed to reach a first valid measurement was 2 (1–3) and median (IQR) of time taken was 4min (3–5). Nurses considered the overall procedure was very easy or easy in 87.8% (teaching) and 86.5% (performing) of children. Children with previous experience performed the manoeuvre in less attempts, less time and more easily than children without experience. Conclusions: Measurement of FeNO using NIOX MINO(R) device is technically feasible and acceptable for children and staff in the clinical context of asthma management in primary health care. Previous experience had a positive, learning effect, in teaching and performing the FeNO manoeuvre (AU)

[Feasibility of FeNO measurement in asthmatic children in the primary care setting. CANON Study]. / Factibilidad de la medición en atención primaria de la fracción exhalada de óxido nítrico en niños con asma. Estudio CANON.

AIM: Asses the feasibility of exhaled nitric oxide (FeNO) measurement in asthmatic children using a hand-held device in the primary care setting. METHODS: Multicentre study performed in the paediatric clinics in seven Spanish primary health care centres. Each centre consecutively included 6-14 year-old children with doctor-diagnosed asthma. Children were asked to obtain two valid measurements of FeNO with the hand-held device NIOX MINO (Aerocrine AB, Solna, Sweden). Feasibility analysis included: (a) percentage of children able to perform the manoeuvre, (b) time required to obtain a successful determination, (c) number of attempts needed, and (d) acceptability of the technical procedure by clinical personnel involved in their guidance. RESULTS: The Study enrolled 151 children. A total of 149 (98.7%) were able to perform the FeNO manoeuvre. The majority (55%) of children had previous experience of using the hand-held device. The Overall median (and Interquartile Range, IQR) of attempts needed to reach a first valid measurement was 2 (1-3) and median (IQR) of time taken was 4 min (3-5). Nurses considered the overall procedure was very easy or easy in 87.8% (teaching) and 86.5% (performing) of children. Children with previous experience performed the manoeuvre in less attempts, less time and more easily than children without experience. CONCLUSIONS: Measurement of FeNO using NIOX MINO device is technically feasible and acceptable for children and staff in the clinical context of asthma management in primary health care. Previous experience had a positive, learning effect, in teaching and performing the FeNO manoeuvre.

De las facultades de Medicina a la residencia de Pediatría, pasando por el examen de médico interno residente: ¿algo debe cambiar? Resultados de una encuesta en residentes de Pediatría de cuarto año / From medical school to paediatric residency, stopping of at the MIR exam: Something must change? A survey of fourth year pediatric residents

Introducción: El sistema educativo español de Medicina ha contribuido de forma importante al desarrollo del Sistema Nacional de Salud, pero continúa siendo necesario un proceso integral de evaluación. Objetivo: Valorar diversos aspectos de la formación médica pregraduada y posgraduada (médico interno residente [MIR]) de los residentes españoles en Pediatría. Material y métodos: Encuesta anónima con respuestas codificadas dirigida a 61 residentes de Pediatría de cuarto año. Resultados: Dos tercios de los residentes consideran que el programa curricular de Medicina debe cambiar, y proponen menos educación teórica. Similar proporción de residentes consideran que el examen MIR debe introducir cuestiones sobre capacidades y sobre aptitudes, además de las exclusivas preguntas actuales sobre conocimientos. El tutor MIR se considera una figura importante para el 90% de los residentes de Pediatría, pero en su valoración, se suspende al 35% de los tutores. Los conceptos relacionados con la Medicina basada en la evidencia (MBE) se están introduciendo en la formación médica de pregrado (un 48% de los residentes considera haber recibido una correcta preparación) y en la de posgrado (69%), pero aún se detectan áreas en las que cabe mejorar la formación, como en la búsqueda de información bibliográfica y en la lectura crítica de documentos. Conclusiones: La calidad de la educación médica (pregrado y posgrado) muestra varios aspectos que deben cambiar, principalmente en relación con 2 paradigmas actuales: el Espacio Europeo de Educación Superior y la MBE (AU)

Introduction: The Spanish medical education system has made a great contribution to the development of the National Health Service, but a need for an overall assessment process still remains. Aim: Evaluate several issues of under- and postgraduate (MIR) medical education of Spanish residents in Paediatrics. Method: An anonymous questionnaire with coded answers administered to 61 paediatric residents in the fourth year of specialty. Results: Two thirds of residents think that the Medicine curriculum must change, with less theoretical education. Similarly a proportion of residents believes that the MIR Exam should introduce items on skills and abilities in addition to the current items. Resident tutors are considered positively in 90% of cases, but 35% of them failed in their assessment. Concepts related to evidence-based medicine are being introduced into undergraduate medical education (48% of answers) and postgraduate (69%), but we still found several areas for improvement: bibliographic information searching and critical appraisal of scientific documents. Conclusions: The quality of medical education (undergraduate and postgraduate) shows several issues that must change, mainly related to two current paradigms: the European Higher Education Area (EEHA) and Evidence-Based Medicine (EBM) (AU)

[From medical school to paediatric residency, stopping of at the MIR exam: something must change? A survey of fourth year pediatric residents]. / De las facultades de Medicina a la residencia de Pediatría, pasando por el examen de médico interno residente: ¿algo debe cambiar? Resultados de una encuesta en residentes de Pediatría de cuarto año.

INTRODUCTION: The Spanish medical education system has made a great contribution to the development of the National Health Service, but a need for an overall assessment process still remains. AIM: Evaluate several issues of under- and postgraduate (MIR) medical education of Spanish residents in Paediatrics. METHOD: An anonymous questionnaire with coded answers administered to 61 paediatric residents in the fourth year of specialty. RESULTS: Two thirds of residents think that the Medicine curriculum must change, with less theoretical education. Similarly a proportion of residents believes that the MIR Exam should introduce items on skills and abilities in addition to the current items. Resident tutors are considered positively in 90% of cases, but 35% of them failed in their assessment. Concepts related to evidence-based medicine are being introduced into undergraduate medical education (48% of answers) and postgraduate (69%), but we still found several areas for improvement: bibliographic information searching and critical appraisal of scientific documents. CONCLUSIONS: The quality of medical education (undergraduate and postgraduate) shows several issues that must change, mainly related to two current paradigms: the European Higher Education Area (EEHA) and Evidence-Based Medicine (EBM).

Group education on asthma for children and caregivers: a randomized, controlled trial addressing effects on morbidity and quality of life.

OBJECTIVE: To establish the efficacy in terms of morbidity and quality of life of a group education program on asthma aimed at children and caregivers. METHODS: An open, randomized, controlled trial was undertaken in 13 primary health care centers in Spain, Cuba, and Uruguay and involved 245 children with active asthma aged 9 to 13 years and their caregivers. The intervention consisted of 3 educational sessions lasting 45 to 60 minutes each and was performed with 3 intervention groups: children alone, caregivers alone, and both children and caregivers. The outcome measures were difference between intervention and control groups in the rate of asthma attacks and hospital admission, as well as the quality of life of children and caregivers in the 6 months following the intervention. RESULTS: The rate of asthma attacks per patient-year decreased when the intervention was given only to children (mean difference, -1.61; 95% confidence interval [CI], -2.87 to -0.34) or to both children and caregivers (-1.60; 95% CI, -2.88 to -0.31). Hospital admissions per patient-year decreased in the intervention groups children alone (-0.28; 95% CI, -0.51 to -0.05) and both children and caregivers (-0.25; 95% CI, -0.49 to -0.02). Education provided to caregivers alone was not associated with any changes in morbidity. No differences were observed in terms of quality of life between controls and any of the intervention groups. CONCLUSIONS: Group education on asthma reduces morbidity but does not improve quality of life. The benefits are apparent when education is aimed at children but no additional benefit is obtained if the intervention is also aimed at their caregivers. Finally, group education for adult caregivers alone is not effective.

Taller de diagnóstico de la alergia / Workshop on allergy diagnosis

La elevada y creciente prevalencia de las enfermedades alérgicas en los niños y adolescentes origina un gran número de consultas entre los pediatras de Atención Primaria. El objetivo principal de este taller es revisar los métodos diagnósticos de la alergia mediada por IgE, su utilidad e indicaciones. Para ello se resolverán distintos casos representativos de los escenarios clínicos que, con frecuencia, tiene que resolver el pediatra (AU)

Allergic conditions have a high and growing prevalence in children and adolescents, witch produce a great number of consultations among Primary Care paediatricians. The main objective of this workshop is to review the diagnostic procedures of IgE mediated allergy, their usefulness and indications. We will solve several different situations representative of the clinical background that often has to solve the paediatrician (AU)

Réplica / No disponible

No disponible

Asma: protocolos, guías y consensos ¿con cuál quedarse? / Asthma: protocols, guidelines and consensus statements. Which sould be kept?

No disponible

Internet y asma: los 10 recursos clave para estar al día / No disponible

El asma es una enfermedad que despierta notable interés en Internet, contándose por miles los sitios dedicados a la misma en la red. El presente trabajo realiza un repaso a los diez recursos más interesantes, tres en español, cuatro en inglés y otros tres bilingües; en los que los profesionales sanitarios pueden obtener la información más fiable

Asthma is a disease with a remarkable presence in the Internet, counting thousands of web sites devoted to it. This paper reviews the ten more interesting resources, three in Spanish, four in English and three in both languages. In these web sites health care providers find out the most reliable information

[Interactions using the Internet among parents and pediatric societies in Spain and the Latin American Pediatric Association]. / Interacción con los padres a través de internet de las sociedades pediátricas españolas y las integradas en la ALAPE.

BACKGROUND: The Internet has revolutionized access to biomedical information among health professionals and the general public. There is demand for pediatric societies to develop quality contents directed at both pediatricians and parents. OBJECTIVE: To evaluate interaction through the Internet among parents and the pediatric societies in Spain and member organizations of the Latin American Pediatric Association. MATERIAL AND METHODS: All the official Spanish pediatric societies (n = 45) and the national organizations belonging to the Latin American Pediatric Association (25) were examined. Societies with their own websites (26 in Spain and 13 in Latin America) were identified. For each website, the following data were collected: size, access to contents, adherence to an ethical code, terms of use, division of contents for pediatricians and those for parents, and means of contact for parents. RESULTS: All the websites provided free access to biomedical information. Only 35 % of websites from Spain and 15.4 % of those from the Latin American Pediatric Association subscribed to an ethical code while 54 % and 84.6 % respectively had no terms of use section. Overall, 46 % had a specific area for parents. The most common means of contact between parents and websites was through electronic mail and 5 % of the sites explicitly accepted online consultations. Only six out of 39 websites fulfilled all the criteria evaluated. CONCLUSIONS: The presence of pediatric societies on the Internet is acceptable, without noteworthy differences between Spanish organizations and member organizations of the Latin American Pediatric Association. In general, interaction with parents is of poor quality.

Interacción con los padres a través de internet de las sociedades pediátricas españolas y las integradas en la ALAPE / Interactions using the internet among parents and pediatric societies in Spain and the latin american pediatric association

Antecedentes. Internet ha supuesto una revolución en la accesibilidad a la información biomédica, tanto para los profesionales como para el público general. Las sociedades pediátricas están llamadas a generar contenidos de calidad, dirigidos a pediatras y padres. Objetivo. Evaluar la interacción con los padres a través de internet de las sociedades pediátricas españolas y de las integrantes de la Asociación Latinoamericana de Pediatría (ALAPE).Material y métodos. Se evaluaron las 45 sociedades pediátricas españolas oficiales y las 25 organizaciones nacionales de la ALAPE. Se identificaron aquellas con web propia (26 y 13 respectivamente) y en cada una se evaluó: tamaño, acceso a sus contenidos, adhesión a algún código ético, presencia de advertencias de uso, división de contenidos según visitantes y formas de contacto con los padres. Resultados. Todas las webs ofrecían información biomédica de libre acceso. El 35 por ciento de las españolas y 15,4 por ciento de la ALAPE suscribían algún código ético. El 54 y el 84,6 por ciento no mostraban advertencias de uso de la información. En conjunto, el 46 por ciento tenían área específica para padres. La forma más común de contacto con los padres fue el correo electrónico y el 5 por ciento aceptaban de forma explícita consultas virtuales. Sólo 6 webs cumplían con todos los criterios valorados. Conclusiones. La presencia en internet de las sociedades pediátricas es aceptable, sin diferencias reseñables entre las miembro de la AEP y de la ALAPE. En términos generales el tratamiento que se da a la interacción con los padres es de baja calidad (AU)

La investigación pediátrica en Atención Primaria / Pediatric research in Primary Health Care

No disponible

Perfil de sensibilización a neumoalergenos en niños con asma y rinoconjuntivitis en una zona de salud de Asturias / Profile of sensitization to pneumoallergens in children with asthma and rhinoconjunctivitis in a health care area of Asturias

Objetivos: Describir el perfil de sensibilización a neumoalergenos en niños con asma y/o rinoconjuntivitis alérgica. Material y métodos: Estudio de prevalencia de base poblacional. Se incluyeron todos los niños de 4 a 13 con algún registro en su historia clínica en los últimos cuatro años de una Zona de Salud de Asturias. Para cada niño se investigó: presencia de diagnóstico de asma, de rinoconjuntivitis alérgica, tipo de estudio alérgico realizado y resultado del mismo. Punto de corte: 1 de enero del 2003.Resultados: La población de estudio fue de 452 niños (53 por ciento varones). El 19,02 por ciento presentaban asma alérgica y/o rinoconjuntivitis. Dos de cada tres eran varones. El 17,69 por ciento cumplió criterios de asma (un 11,28 por ciento alérgica y un 5,3 por ciento no alérgica). El 15,48 por ciento tenía rinoconjuntivitis. De entre los alérgicos el 40,7 por ciento presentaban asma y rinoconjuntivitis, el 40,7 por ciento sólo rinoconjuntivitis y el 18,6 por ciento sólo asma. El alergeno más prevalente fue el ácaro (88,7 por ciento), seguido de gramíneas (50 por ciento), perro (16,25 por ciento), Alternaria (12,5 por ciento), gato (10 por ciento) y cucarachas (10 por ciento). Los niños con rinoconjuntivitis (sola o asociada a asma) tenían más sensibilización a gramíneas y más polisensibilizaciones que los que sólo tenían asma. La sensibilización a ácaros fue alta ya desde los 4 años de vida y la de gramíneas ascendente desde los 5-6 años. Conclusiones: 1) La mayor parte de los niños con asma alérgica presentan a la vez rinoconjuntivitis. 2) Dos de cada tres alérgicos son varones. 3) El ácaro es el alergeno más prevalente en todos los grupos de edad. 4) Las gramíneas siguen un patrón ascendente según la edad (AU)