[Exercise-induced asthma as perceived by pediatric patients and their parents]. / Asma inducida por ejercicio: Diferencias en la percepciónde síntomas entre pacientes pediátricos y sus padres.

BACKGROUND: Exercise is a frequent trigger of symptoms in asthmatic children and it worsens their quality of life. AIM: To compare the perception about exercise among asthmatic pediatric patients and their parents. MATERIAL AND METHODS: Asthmatic patients with symptoms related to exercise, were tested with an exercise challenge test following the Tal protocol. Before testing, a questionnaire about symptoms triggered by exercise was answered by children and their parents. The data was analyzed with a Kappa correlation test. RESULTS: Seventy five patients, aged 6 to 15 years, were studied. Forty one percent exercised less than one hour per week. Although 64% reported to experience respiratory difficulty and 80% cough during exertion, 87% were willing to perform more exercise. Forty percent of all patients had a positive challenge test for exercise-induced asthma. Correlation between patient's and parent's answers about the effect of physical activity exercise was low, with a kappa of 0.53. There was no correlation between exercise test and the answers to the questionnaire. CONCLUSIONS: Children with asthma frequently have exercise-associated symptoms and parental perception about this problem is very low.

[Congenital hepatic fibrosis. Report of five cases]. / Fibrosis hepática congénita: un espectro clínico variable. Casos clínicos.

BACKGROUND: Congenital hepatic fibrosis (CHF) is an autosomic dominant disease that has been associated with polycystic kidney disease. AIM: To describe the medical management of 5 children with CHF and to evaluate the presence and extension of the associated renal disease. PATIENTS AND METHODS: Retrospective review of the medical charts of 5 children with CHF, aged 2 to 14 years. RESULTS: Three children presented autosomic recessive polycystic kidney disease, which was diagnosed before the appearance of liver disease manifestations. They presented a more severe liver damage, with a more aggressive clinical course requiring use of transjugular intrahepatic porto-systemic shunts (TIPS) or surgical porto-systemic shunts to control portal hypertension. The other two children, in whom the diagnosed was based on asymptomatic hepatomegaly, had normal renal function and structure with a more benign clinical course. CONCLUSIONS: The diagnosis of CHF should be suspected not only in children with polycystic kidney disease but in those children with persistent, hard consistency, left lobe predominance hepatomegaly.