[Conocimiento de las madres de niños menores de 5 años sobre la vacunación en la Unidad de Medicina Familiar 1, Orizaba, Veracruz].

Objective: Determine the level of knowledge and acceptance that mothers of children under 5 years of age have about vaccination. Methods: Statistical analysis was performed using the GraphPad Prism statistical program. Absolute frequencies and percentages were estimated for the qual- itative variables, and measures of central tendency and dispersion for numerical variables. The level of knowledge and acceptance of vaccination was associated with the variables using Pearson's Chi-square. Results: The level of knowledge that prevailed was high (70.3%) and was associated with age (p=0.00), education (p=0.00) and occupation (p=0.03). The most frequent occupation was housewife (47.1%), the most frequent schooling was professional education (3.5%), the majority were married women (60.2%) and Catholics (81.2%). Conclusions: The null hypothesis of our study is confirmed, obtaining that 70.3% of the population has high knowledge about vaccination in children under 5 years of age, it was also found that this knowledge is associated with age, schooling and occupation of the mothers participating in this study.

Objetivo: Determinar el nivel de conocimiento y aceptación que tienen las madres de niños menores de 5 años sobre la vacunación. Métodos: Se realizo el análisis estadístico en el programa estadístico GraphPad Prism. Se estimaron frecuencias absolutas y porcentajes para las variables cualitativas, y medidas de tendencia central y dispersión para variables numéricas. Se asocio el nivel de conocimiento y aceptación sobre la vacunación con las variables mediante de Chi cuadrada de Pearson. Resultados: El nivel de conocimiento que predomino fue alto (70.3%) y se encontró asociado a la edad (p=0.00), escolaridad (p=0.00) y ocupación (p=0.03). La ocupación más frecuente fue ama de casa (47.1%), la escolaridad con mayor frecuencia fue educación profesional (3.5%), la mayoría fueron mujeres casadas (60.2%) y católicas (81.2%). Conclusiones: Se confirma la hipótesis nula de nuestro estudio obteniendo que el 70.3% de la población tiene un conocimiento alto acerca de la vacunación en niños menores de 5 años, además se encontró que este conocimiento se encuentra asociado a la edad, escolaridad y ocupación de las madres participantes en este estudio.

[Drug allergy: Fundamental aspects in diagnosis and treatment.] / Alergia a medicamentos: aspectos fundamentales en el diagnóstico y tratamiento. Reporte de grupo del Colegio Mexicano de Inmunología Clínica y Alergia.

BACKGROUND: Any substance used as a treatment for any disease can produce harmful or unpleasant events called adverse drug reactions (ADRs). They are due to inherent biological effects of the drug and are caused by immunological and non-immunological mechanisms. OBJECTIVES: To describe the immunological mechanisms of hypersensitivity reactions (HSR) to drugs, their epidemiology, risk factors, classification, clinical manifestations, diagnosis, treatment, and prognosis. METHODS: A review of the most current literature in English and Spanish was carried out, in the main databases, related to the HSR of various drug groups. RESULTS: This study describes the terms used to define ADRs and HSRs, their classification and clinical manifestations, current diagnostic tools, treatment algorithms and prognosis of the most frequently used medications and with the highest prevalence of reported adverse events. CONCLUSION: ADRs are a challenging entity, with a complex pathophysiology that has not been fully understood. Its approach requires a careful consideration since not all drugs have validated tests for their diagnosis nor a specific treatment. When indicating the use of any drug, the severity of the disease, the availability of other treatments and the potential risks of developing future adverse events should always be taken into consideration.

ANTECEDENTES: Cualquier sustancia prescrita en el tratamiento de algún padecimiento es capaz de producir eventos dañinos o desagradables, y se denominan reacciones adversas a medicamentos. Estas reacciones se originan por mecanismos inmunológicos y no inmunológicos. OBJECTIVOS: Describir los mecanismos inmunológicos de las reacciones de hipersensibilidad a medicamentos, epidemiologia, factores de riesgo, clasificación, manifestaciones clínicas, diagnóstico, tratamiento y pronóstico. MÉTODOS: Se revisó la bibliografía actualizada, en inglés y español, asociada con reacciones de hipersensibilidad a medicamentos en las principales bases de datos. RESULTADOS: Se describen los términos para definir las reacciones adversas y de hipersensibilidad a medicamentos, su clasificación y manifestaciones clínicas, métodos diagnósticos actuales y en estudio, algoritmos de tratamiento y pronóstico de los medicamentos más frecuentemente prescritos y con mayor prevalencia de eventos adversos reportados. CONCLUSIÓN: Las reacciones adversas a medicamentos representan un reto, con una fisiopatología compleja y no del todo comprendida. Su abordaje requiere un enfoque cuidadoso, porque no todos los fármacos cuentan con pruebas validadas para establecer el diagnóstico y tratamiento específico. Antes de indicar cualquier medicamento debe considerarse la gravedad de la enfermedad, disponibilidad de otros tratamientos y riesgos potenciales de sufrir eventos adversos.

[Prevalence of allergic rhinitis and associated factors in Mexican students. A multicenter study]. / Prevalencia de rinitis alérgica y factores asociados en estudiantes mexicanos. Un estudio multicéntrico.

OBJECTIVE: To determine the prevalence of allergic rhinitis and its associated factors in students from several Mexican states. METHODS: A cross-sectional study was conducted in order to identify the factors that are associated with the prevalence of allergic rhinitis. The "Allergic Rhinitis Diagnostic Questionnaire for Epidemiological Studies" was used, together with another questionnaire, to identify risk factors in allergic rhinitis. RESULTS: 11381 students of 12-24 years of age were included; the prevalence of allergic rhinitis was of 18 % (CI 95 % = 11.4-24.6), with predominance in females (60%). The factors associated with allergic rhinitis were: heredity, (OR = 2-4, p < 0.0001), respiratory infections, (OR = 2-4.6, p < 0.0001); areas with humidity at home (OR= 1.5 - 1.9, p < 0.0001), and being female (OR = 1.7 - 2.4, p < 0.002). The use of tobacco, the educational level and vehicular traffic, as well as carpeting and the use of scented disinfectants, showed no association. CONCLUSIONS: The factors associated with allergic rhinitis in students were; heredity, respiratory infections, humidity in house walls, and being female.

Objetivo: Determinar la prevalencia de rinitis alérgica y sus factores asociados en estudiantes de varios estados de la República Mexicana. Métodos: Se realizó un estudio transversal para identificar los factores asociados con la prevalencia de rinitis alérgica. Se utilizó el Cuestionario Diagnóstico de Rinitis Alérgica para Estudios Epidemiológicos y un cuestionario para identificar los factores de riesgo en rinitis alérgica. Resultados: Se incluyeron 11381 estudiantes de 12 a 24 años; la prevalencia de rinitis alérgica fue 18 % (IC 95 % = 11.4-24.6), con un predominio del sexo femenino (60 %). Los factores asociados con rinitis alérgica fueron herencia (RM = 2-4, p < 0.0001), infecciones respiratorias (RM = 2-4.6, p < 0.0001), zonas de humedad en casa (RM = 1.5-1.9, p < 0.0001), ser mujer (RM = 1.7-2.4, p < 0.002). El tabaquismo, el nivel educativo, el tráfico vehicular, la alfombra y el uso de desinfectantes aromatizados no mostraron asociación. Conclusiones: Los factores asociados con rinitis alérgica en estudiantes fueron la herencia, las infecciones respiratorias, la humedad en paredes de la casa y el sexo femenino.

[Assessment of knowledge in the use of metered dose inhalers in parents of asthmatic school children]. / Evaluación del conocimiento del uso de inhaladores de dosis medida en padres de asmáticos escolares.

BACKGROUND: The use of metered dose inhaler (MDI) is key in the treatment of asthma; its effectiveness is related to proper technique. OBJECTIVE: The purpose of this study is to evaluate the use of the technique of metered dose inhalers for the parents or guardians of school children with asthma. METHODS: In this cross-sectional study, we used a sample of 221 individual caregivers (parent or guardian) of asthmatic children from 5 to 12 years old, who use MDI. We designed a validated questionnaire consisting of 27 items which addressed the handling of inhaler technique. Descriptive statistics was used. RESULTS: Caregivers were rated as "good technique" in 41 fathers (18.6%), 77 mothers (34.8%) and 9 tutors (4.1%), and with a "regular technique" 32 fathers (14.5%), 48 mothers (21.2%) and 14 guardians (6.3%). Asthmatic children aged 9 were rated as with "good technique" in 24 (10.9%). According to gender, we found a "good technique" in 80 boys (36.2%) and 47 girls (21.3%) and with a "regular technique" in 59 boys (26.7%) and 35 girls (15.8%), P 0.0973, RP 0.9. We found with a "regular technique" mainly those asthmatic children diagnosed at ages between 1 to 3 years. CONCLUSIONS: Most of the participants had a good technical qualification; however major mistakes were made at key points in the performance of it.

[Internalization disorders in children with asthma]. / Trastornos de internalización en menores de edad asmáticos.

BACKGROUND: The presence of asthma may increase the risk for internalizing disorders such as major depression and anxiety. OBJECTIVE: To determine if the diagnosis of asthma in children is associated with other internalizing disorders such as panic disorder, social phobia, separation anxiety, and total anxiety. METHODS: In this analytical, descriptive and comparative cross sectional study, 144 asthmatic and 144 nonasthmatic patients, with ages between 8 and 17 years, were included. We used the GINA asthma diagnostic criteria. We applied the Hospital Anxiety and Depression Scale for diagnosis of internalizing disorders. RESULTS: Asthmatic children had a significant association with panic disorder P 0.001, RP 2.7; with social phobia P 0.026, RP 2.5; with separation anxiety P 0.002, RP 3.3; and with total anxiety P 0.017, RP 2.3. Nonasthmatic children did not have these associations. Asthma severity was intermittent in 36 cases (12.5%), mild persistent in 86 (29.9%) cases, and moderate persistent in 22 (7.6%) cases. We observed no statistically significant relationship between the severity of asthma and the diagnosis of an internalization disorder. CONCLUSIONS: We observed a meaningful association between asthma and internalizing disorders such as panic disorder, social phobia, separation anxiety and total anxiety in children.