Validity of parent-reported height and weight for defining obesity among asthmatic and nonasthmatic schoolchildren.

BACKGROUND: The relationship between parent-reported and measured height and weight is not well established in schoolchildren. This relationship has never been studied in asthmatic children. The objective of this study is to test the validity of the parent-reported weight and height for defining obesity by BMI and to know whether the perception of this height and weight changes when the child suffers from asthma. METHODS: All classes of children of the target ages of 6-8 years (n = 1,672, participation rate 70.2%) of all schools in four municipalities of Murcia (Spain) were included. Parents were asked about their children's weight and height using a questionnaire which included the International Study of Asthma and Allergies in Childhood (ISAAC) core questions on asthma. Parents were not aware that their children were going to be weighed and measured within 1 week's time. Measurements were performed using a rigid stadiometer to the nearest 0.1 cm and a scale to the nearest 0.1 kg. RESULTS: The bias (reported minus real) was, respectively, for nonasthmatics and asthmatics: weight +0.42 kg (95% CI +0.24; +0.59 kg) versus +0.97 kg (+0.50; +1.44 kg), height +2.37 cm (+2.06; +2.68 cm) versus +2.87 cm (+1.87; +3.87 cm); BMI -0.39 kg/m(2) (-0.52; -0.23 kg/m(2)) versus -0.23 kg/m(2) (-0.58; +0.13 kg/m(2)). Diagnostic accuracy of obesity calculated from reported measurements was, respectively, for nonasthmatics and asthmatics: sensitivity 78.0 versus 77.8%, specificity 96.2 versus 94.5%, positive predictive value 77.2 versus 73.7% and negative predictive value 96.4 versus 91.7%. CONCLUSIONS: Reported weights and heights had large biases, comparable between parents of both asthmatic and those of nonasthmatic children. However, this information could be reasonably valid for classifying children as obese or nonobese in large epidemiological studies.

Electroanalytical determination of cadmium and lead in deciduous teeth after microwave oven digestion.

A method using differential pulse anodic stripping voltammetry after microwave oven digestion was developed for the simultaneous determination of Cd(II) and Pb(II) in the deciduous teeth of children. Each tooth was weighed; deposited in a 120 mL capped Teflon vessel with 5 mL 65% nitric acid, Suprapur analytical grade; and digested in a 2-step microwave oven for 15 min. The detection limits for Cd(II) and Pb(II) in the final solution were 0.078 and 0.323 microg/L, and the quantitation limits 0.394 and 1.613 microg/L, respectively, with a linearity range of 2 microg/L for Cd(II) and 23.3 microg/L for Pb(II). The sensitivity was 2.51 nA/microg-L and 1.37 nA/microg-L, for Cd(II) and Pb(II). The main advantages of this technique are a complete and satisfactory dissolution of the tooth material with the proposed microwave oven digestion procedure, without sample pretreatments, such as drying, ashing, or powdering. The voltammetric procedure proved to be well designed because of significant goodness of fit to a linear model, and the accuracy of the method was established as compared with standard reference material. The methodology has enabled us to study Cd(II) and Pb(II) in 371 deciduous teeth from school children in Cartagena, Spain.

[Peak inspiratory flow using 2 different inhalers and a new portable device]. / Pico de flujo inspiratorio de dos inhaladores diferentes con un nuevo aparato portátil.

BACKGROUND: Inhaled medication through dry powder inhalers is widely used in children, but pediatric studies focussing on the ages at which these devices can be used are sparse. OBJECTIVE: To establish the difference in peak inspiratory flow (PIF) through Accuhaler and Turbuhaler in healthy children using a new device, In-check, and to determine the differences between the two different models of this device. METHODS: PIF was measured in 64 healthy male children (mean age 11.2 years, range 8.8-14.7) by means of In-check and In-check Dial using Accuhaler and Turbuhaler resistances. The best attempt of three was chosen. Height,weight, and forced expiratory volume in 1 second were also measured. RESULTS: Significant differences in PIF were found between the two inhalers: PIF In-check Accuhaler-PIF In-check Turbuhaler (134.4 +/- 15.5 L/min vs 99.9 6 +/- 11.1 L/min; p<0,000) and PIF In-check Dial Accuhaler-PIF In-check Dial Turbuhaler (109.6+/-10.5 L/min vs 86.8+/-8.9 L/min; p<0.000). The best correlation obtained among the different In-check measurements was between In-check Ac-cuhaler and In-check Turbuhaler (r=0.88; p<0.001), and the worst was between In-check Dial Accuhaler and In-check Turbuhaler (r =0.71; p<0.001). CONCLUSIONS: PIF through Accuhaler is significantly higher than that through Turbuhaler, although in both cases PIF was sufficient to provide adequate distribution of the inhaled medication in children aged 9-14 years. Consequently, in children younger than 9 years old, and especially during an asthma attack, In-check should be tried in order to discover whether the child is capable of using Turbuhaler correctly.

Pico de flujo inspiratorio de dos inhaladores diferentes con un nuevo aparato portátil / Peak inspiratory flow in healthy children aged 9-14years through two inhalers, using two different models of a new portable apparatusbackground

Antecedentes: La medicación inhalada a través de dispositivos de polvo seco se utiliza cada vez más en niños, pero hay pocos estudios pediátricos que determinen a qué edades es posible su uso. Objetivos: Establecer la diferencia en el pico de flujo inspiratorio (PIF) a través de Accuhaler y Turbuhaler en niños normales por medio del dispositivo In-check y determinar las diferencias entre dos modelos distintos de este aparato. Métodos: A 64 varones normales (media, 11,2 años; límites, 8,8-14,7), se les midió el pico de flujo inspiratorio (PIF) con In-check e In-check Dial utilizando las resistencias de Accuhaler y Turbuhaler . Se eligió la mejor maniobra de entre tres. Además se midió peso, talla y volumen espiratorio máximo al primer segundo (FEV1 ). Resultados: Existieron diferencias significativas cuando se compararon los PIF a través de ambos inhaladores: PIF In-check Accuhaler- PIF In-check Turbuhaler (134,4 +/- 15,5 frente a 99,9 6 11,1 l/min; p ,0,000) y PIF In-check Dial Accuhaler-PIF In-check Dial Turbuhaler (109,6 6 10,5 l frente a 86,8 6 8,9 l/min; p ,0,000). La mejor correlación conseguida entre las distintas mediciones del In-check lo fue entre In-check Accuhaler e In-check Turbuhaler (r 5 0,88; p ,0,001), y la peor lo fue entre In-check Dial Accuhaler e In-check Turbuhaler (r 5 0,71; p ,0,001). Conclusiones: El PIF a través de Accuhaler es significativamente mayor que a través de Turbuhaler , aunque en ambos casos suficiente para una buena distribución de la medicación inhalada en niños de 9 a 14 años. Por consiguiente, por debajo de esta edad, y en especial durante una crisis asmática, puede ser adecuado practicar una prueba con In-check para determinar si un niño concreto es capaz de utilizar Turbuhaler (AU)

[The EMECAM project: the Spanish Multicenter Study on the Relationship between Air Pollution and Mortality. The background, participants, objectives and methodology]. / El proyecto EMECAM: Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica y la Mortalidad. Antecedentes, participantes, objetivos y métodología.

In recent years, a growing number of studies suggests that increases in air pollution levels may have short-term impact on human health, even at pollution levels similar to or lower than those which have been considered to be safe to date. The different methodological approaches and the varying analysis techniques employed have made it difficult to make a direct comparison among all of the findings, preventing any clear conclusions from being drawn. This has led to multicenter projects such as the APHEA (Short-Term Impact of Air Pollution on Health. A European Approach) within a European Scope. The EMECAM Project falls within the context of the aforesaid multicenter studies and has a wide-ranging projection nationwide within Spain. Fourteen (14) cities throughout Spain were included in this Project (Barcelona, Metropolitan Area of Bilbao, Cartagena, Castellón, Gijón, Huelva, Madrid, Pamplona, Seville, Oviedo, Valencia, Vigo, Vitoria and Saragossa) representing different sociodemographic, climate and environmental situations, adding up to a total of nearly nine million inhabitants. The objective of the EMECAM project is that to asses the short-term impact of air pollution throughout all of the participating cities on the mortality for all causes, on the population and on individuals over age 70, for respiratory and cardiovascular design causes. For this purpose, with an ecological, the time series data analyzed taking the daily deaths, pollutants, temperature data and other factors taken from records kept by public institutions. The period of time throughout which this study was conducted, although not exactly the same for all of the cities involved, runs in all cases from 1990 to 1996. The degree of relationship measured by means of an autoregressive Poisson regression. In the future, the results of each city will be combined by means of a meta-analysis.

[The short-term results of air pollution on mortality: the results of the EMECAM project in Cartagena, 1992-96. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica y la Mortalidad]. / Efectos a corto plazo de la contaminación atmosférica sobre la mortalidad: resultados del proyecto EMECAM en Cartagena, 1992-96.

BACKGROUND: The problems of air pollution became noticeable in Cartagena in the seventies, high SO2 and particle levels having been reached from time to time. Our aim is to assess, using the EMECAM methodology, the acute impact of SO2 and particle air pollution on the daily death rate of the city of Cartagena in the 1992-1996 period. METHODS: A daily listing is provided of the total number of non-accidental deaths within the population as a whole and for those over age 70, the cardiovascular and the respiratory deaths due to dioxide and particle air pollution for the 1992-1996 period using autoregressive Poisson models which control seasonality, weather, time of year, flu, special events, and time lags. RESULTS: In the period under study, there has been a drop in the SO2 air pollution as compared to previous years, which was not as marked for the particles. The analyses reveal significant relationships in the total non-accidental deaths in those over age 69, with the average particle count and those particles with cardiovascular deaths for the months of May to October. In the six-month period of the year, when the weather is cold, we found a positive statistically significant relationship to exist in the maximum daily hourly value of the particles and the deaths due to cardiocirculatory and respiratory diseases. However, there is no consistency in the between on assessing the reliability of the models.

[The EMECAM project: a discussion of the results in the participating cities. Estudio Multicéntrico Español sobre la Relación entre la Contaminación Atmosférica y la Mortalidad]. / El proyecto EMECAM: discusión de los resultados en las ciudades participantes.

This article draws a comparison and provides a discussion of the findings resulting from the local analyses of the 14 cities participating in the EMECAM Project. An analysis is made of the time series related to mortality, pollutants (particles in suspension, SO2, NO2, O3 and CO), temperature and other factors taken from records of public institutions. By using Poisson autoregressive regression, an estimate has been made of the short-term relationship between the number of deaths and the air pollution indicators in each one of the following cities: Barcelona, metropolitan area of Bilbao, Cartagena, Castellón, Gijón, Huelva, Madrid, Pamplona, Seville, Oviedo, Valencia, Vigo, Vitoria and Saragossa. The findings reveal the air pollution figures in our country to be similar to those of other European cities. The levels of the different pollutants point toward road traffic as being the main source of most of this pollution. A relationship has been found between the mortality and different pollutants in most cities, although the results are not homogeneous among the cities and show variability in the different causes under study. In some cities, especially in those having smaller populations, there have been no findings providing any evidence of a relationship, or the findings themselves are not highly consistent. The meta-analysis will provide estimates for all of the cities as a whole and will allow the possibility of making a more clear-cut assessment of the time lag impact of air pollution on the mortality. Worthy of special mention is the participation in this project of public health officers as actively involved researchers.

[Mortality rates in childhood and their causes in Spain. 1991]. / Tasas de mortalidad en la infancia y sus causas en España. 1991.

OBJECTIVE: The purpose of this study is to present the different pediatric mortality rates in Spain during 1991 and to describe the groups of mortality causes for the different ages in relationship to these rates. PATIENTS AND METHODS: We have used data from the National Institute of Statistics for the year studied. These data were summarized, grouped and simplified. In order to clarify them, causes of death have been expressed in percentage. RESULTS: The different mortality rates were: Infant mortality 7.19; neonatal mortality 4.57; early neonatal mortality rate 3.32; late neonatal mortality rate 1.25; postneonatal mortality 2.62; perinatal mortality 7.24; preschool mortality 1.75; mortality within the age group 5-9 years 1.26. For infantile, neonatal, early neonatal, late neonatal and postneonatal mortality the biggest percentage was due to causes depending upon congenital malformations and perinatal diseases. For preschool and school mortality accidents and tumors were the most frequent causes of death, although causes related to congenital anomalies were also responsible for a large percentage of deaths. CONCLUSIONS: Pediatric mortality rates in our country are more than acceptable and their causes are similar to those of other civilized countries.

[Unusual attendance at Hospital Emergency Services for asthma and chronic obstructive pulmonary disease and SO2 air pollution in Cartagena (Spain)]. / Afluencia inusual por asma y enfermedad pulmonar obstructiva crónica en urgencias hospitalarias y contaminación por SO2 en Cartagena.

BACKGROUND: The objective of this investigation is to determine the influence of air pollution (SO2 and particulate matter) on the existence of days of unusual attendance at emergency services for asthma and chronic obstructive pulmonary lung disease (COPD). A registry of attendances for these diseases and the daily mean concentrations of SO2 and particles were used (1989-1991). RESULTS: Unusual attendance days are establish by the fortnightly movable mean of the period that has that day as central one, under the hypothesis of a Poisson distribution with equal mean as the calculated one. In the logistic regression model, Odds Ratio (OR) between an excess of attendance of cases for asthma and SO2 levels greater than 80.60 m/m3 was 3.6 (CI95%: 1.1-11.7). For COPD, SO levels ten days before were introduced, and OR for SO2 levels more than 56.5m/m was 4.7 (CI95%: 1.5-15.1). CONCLUSIONS: High SO2 levels are related with the appearances of days with an excessive use of emergencies for Asma and EPOC.

[Air pollution and respiratory disease in children. Experience in Cartagena]. / Polución atmosférica y enfermedad respiratoria en niños. Experiencia de Cartagena.

Studies on air pollution (SO2) and their influence on respiratory diseases in children conducted in Cartagena are reviewed and compared with those from other spanish cities. In Cartagena we find a weak relation between SO2 levels and number of children admitted to hospital for asthma attack. Indoor pollution is stressed, specially smoking of mother.

[Childhood scabies: a different entity]. / Sarna infantil: una entidad diferente.

Epidemiological, clinical, diagnostic and therapeutic aspects that make scabies a clinical entity with a special personality in the pediatric field, are reviewed. On the epidemiological aspects, a special mention of its unsuspected frequency in this age is made. Scabies is an endemic disease in our country among the more deprived people. On the clinical aspects, the great importance of clinical history and distribution of skin lesions for the early diagnosis is pointed out. Some "alert pointers" are described for this early diagnosis. On the therapeutic field, the importance of the primary care prevention is discussed, and the drug approach for its relieve is commented.