ABSTRACT
Objetivos: Describir las opiniones y expectativas de los padres relacionadas con la disposición a consultar por infecciones respiratorias agudas de lactantes y pre-escolares. Métodos: Estudio transversal con muestra oportunista de padres de niños menores de cinco años. Se diseñó un cuestionario que exploraba las opiniones acerca de la frecuencia, sintomatología, gravedad y tratamiento de las infecciones respiratorias agudas, así como las expectativas respecto a la atención médica por esas enfermedades, y la disposición de los padres a consultar con el médico en distintas situaciones. Se realizó un análisis multivariante exploratorio para identificar las variables más relacionadas con la disposición a consultar. Resultados: Se recogieron 317 encuestas. El 54,6% de los niños del estudio eran varones, la edad mediana (amplitud intercuartil) era de 2,0 (0,6-3,3 años) y un 5,7% había estado alguna vez hospitalizado por enfermedades respiratorias. El modelo multivariante encontró siete variables asociadas a la disposición a consultar, agrupables en tres dominios: 1) percepción de vulnerabilidad del niño (menor edad y antecedentes de hospitalización); 2) percepción de una amenaza (creencia en la gravedad de las infecciones respiratorias y expectativa de que el médico le indique si es grave); y 3) percepción de eficacia del tratamiento farmacológico (creer en la eficacia de medicinas para tos y mocos, creer en la eficacia de antibióticos, y esperar una prescripción en la consulta). Conclusiones: La disposición a consultar por las infecciones respiratorias agudas de lactantes y pre-escolares se asocia a un conjunto definido de opiniones y expectativas de los padres
Aim: Describe the parents' beliefs and expectations related to the willingness to consult for acute respiratory infections in infants and preschool children. Methods: Cross-sectional study of an opportunistic sample of parents of children of less than five years. A questionnaire was designed to explore beliefs about frequency, symptoms, severity and treatment of acute respiratory infections, expectations on health care from doctors, and willingness to consult in certain circumstances. In an exploratory multivariate analysis, the main variables related to willingness to consult were identified. Results:. There were 317 questionnaires collected; 54.6 percent of children were male, their median age (interquartile range) was 2.0 years (0.6-3.3 years), and 5.7% had been hospitalized because respiratory diseases. The multivariate model found seven variables related to the willingness to consult, that could be clustered in three domains: 1) perception of vulnerability in children (lower age and previous hospitalization); 2) perception of threat (beliefs about severity of respiratory diseases and expectations that the doctor says whether the disease is severe); and 3) perception of efficacy of drugs (beliefs about efficacy of symptomatic drugs and of antibiotics, and expectations of being prescribed a drug). Conclusions:. The willingness to consult for acute respiratory infections in infants and preschool children is related to a definite set parents' beliefs and expectations
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Respiratory Tract Infections/epidemiology , Patient Medication Knowledge/statistics & numerical data , Professional-Family Relations , Health Knowledge, Attitudes, Practice , Parents , Motivation , Referral and Consultation/statistics & numerical dataABSTRACT
The prevalence of obesity in children has increased in developed countries in the last decades. It is associated with alterations in glucose metabolism that may be present in childhood. To assess the frequency of glucose metabolism alterations and insulin resistance and their possible determinants in a sample of obese children from Valladolid (Spain), we retrospectively studied 100 obese children and adolescents (11.59 ± 2.73 years). Anthropometric measures, biochemical parameters, and oral glucose tolerance test (OGTT) were performed. Insulin resistance was evaluated with fasting insulin, HOMA index, and insulin values in OGTT. Impaired glucose tolerance was found in 15% of the sample, and was the most frequent of glucose metabolism alterations. Impaired fasting glucose was found in 2%. No case of type 2 diabetes was found. Acanthosis nigricans was present in 22%, with predominance in females, but not all presented insulin resistance. The prevalence of insulin resistance was 29% when HOMA index was used, and 50% when the insulin response in OGTT was used. Not all patients with impaired glucose tolerance had a pathological HOMA index, and not all with pathological HOMA index presented insulin resistance when insulin values in OGTT were used. Higher 2-h post-OGTT insulin levels were found in children with impaired glucose tolerance. It is paramount to identify young people with glucose regulation alterations for early, intensive intervention to prevent or at least postpone the onset of type 2 diabetes. OGTT is a screening tool necessary to fulfill this objective.
Subject(s)
Glucose Intolerance/epidemiology , Glucose Intolerance/metabolism , Insulin Resistance , Obesity/complications , Acanthosis Nigricans/complications , Adolescent , Body Mass Index , Child , Child, Preschool , Female , Glucose Intolerance/complications , Glucose Intolerance/ethnology , Glucose Tolerance Test , Hospitals, University , Humans , Insulin/blood , Male , Prevalence , Retrospective Studies , Sex Factors , Spain/epidemiologyABSTRACT
Giardia lamblia es uno de los parásitos intestinales patógenos más frecuente, causante de enfermedad tanto autóctona como importada. Aunque la infección es asintomática en la mayoría de los casos, puede cursar con patología digestiva diversa. Los derivados nitroimidazólicos, en especial el metronidazol, continúan siendo el tratamiento de elección. El aumento en el número de resistencias ha hecho necesario la introducción de nuevas pautas terapéuticas. Se presenta un caso de giardiasis resistente a metronidazol, que respondió a tratamiento con quinacrina
Giardia Lamblia is one of the most frequent intestinal pathogen parasite, responsible for autochthonous as well as imported illness. Although the infection is asymptomatic in the majority of the cases, it can be revealed by several digestive conditions. Nitroimidazole derivatives, especially Metronidazole, keep on being the treatment of choice. The increase in the number of resistances has made necessary the introduction of new therapeutical patterns. A case of giardiasis resistant to metronidazole which responded to a quinacrine treatment is presented
