Do Teachers Confirm Parent's Ratings of ADHD DSM-IV Criteria? A Study of a Mexican Population.

BACKGROUND AND OBJECTIVE: Collecting information from different raters is important for diagnosing ADHD, but several factors can lead to gathering discrepant information. Our aim was to determine the agreement between parent and teacher's when rating the list of ADHD symptoms (criterion A, DSM-IV) in a sample of Mexican school-age children. We explored whether inter-rater agreement varied by children's age and sex, and each symptom of inattention, hyperactivity, and impulsivity. METHODS: A total of 789 children (335 girls) from six elementary school grades grouped as G1 [grades 1-2], G2 [grades 3-4], and G3 [grades 5-6]) were rated by their parents and teachers. We identified inter-rater reliability by using Cohen's kappa coefficient by school level, sex, and ADHD symptoms. We explored the presence of symptoms considering parents' and teachers' ratings, individually and collapsed, using the AND/OR rules. RESULTS: Low inter-rater agreement was observed. Moderate levels were observed in G1, but not in G2 or G3. Both groups of informants reported that more boys than girls met these criteria, but agreement by sex was still low, as were the results of the analyses by individual symptoms. Among the children that met the ADHD criteria, an inattention symptom was the one most frequently reported by both raters, whereas among non-ADHD children, a hyperactive symptom was the one most often reported. DISCUSSION: The exclusive use of questionnaires fails to provide convergent information between raters. We highlight the importance of conducting comprehensive clinical histories when diagnosing ADHD in order to explore what these discrepancies show about the relationship symptoms/context.

Colonización por hongos ambientales en el paciente alérgico respiratorio no controlado / Colonization by environmental fungi in the uncontrolled respiratory allergic patient

Introducción: La presencia de hongos en las vías respiratorias puede provocar en personas susceptibles diversas manifestaciones alérgicas. Objetivo: Determinar si las especies fúngicas aisladas de la mucosa nasal de pacientes alérgicos respiratorios pueden ser definidas como alergenos sensibilizantes a través de las pruebas cutáneas. Métodos: Estudio observacional, prospectivo y de corte transversal, donde el universo estuvo constituido por todos los pacientes con diagnóstico de alergia respiratoria o inicio de asma bronquial variable descompensada, mayores de 2 años y menores de19,que se asistieron en las consultas de alergia en La Habana, desde enero 2016 a enero 2017. La muestra obtenida fue de 80 pacientes alérgicos respiratorios. Resultados: Del total de pacientes con clínica de asma, rinitis o ambas, se obtuvieron pruebas cutáneas por el test de Prick positivas a hongos en 52 de ellos (65 por ciento) con una polisensibilización en 24 para 46,1 por ciento. La reactividad cruzada de mayor relevancia se produjo con los alérgenos de Aspergillus, Penicillium y Alternaria. El cultivo resultó positivo en 54 muestras nasales (67 por ciento). El género de hongos predominante en los pacientes alérgicos fue el Aspergillus en 70,3 por ciento y dentro de este el Aspergillus fumigatus en 52,6 por ciento. Conclusiones: El estudio de la micobiota nasal es una prueba que debe interpretarse junto con las pruebas cutáneas para el diagnóstico de enfermedades alérgicas por hongos ambientales y tener en cuenta su importancia para el control epidemiológico en la exposición a hongos(AU)

Introduction: The presence of fungi in the respiratory tract can cause different allergic manifestations in sensitive persons. Objective: To determine if fungi species isolated from the nasal mucosa of respiratory allergic patients can be defined as allergen-sensitive by means of skin tests. Methods: Observational, prospective and cross-sectional study, where the overall sample consisted of all patients with a diagnosis of respiratory allergy or onset of decompensated variable bronchial asthma, over 2 years old and under 19 years old who attended to Allergy consultations in Havana, from January 2016 to January 2017. The sample obtained was 80 respiratory allergic patients. Results: Of the total number of patients with symptoms of clinical asthma, rhinitis or both, Prick´s skin tests were obtained by fungal positive test in 52 of them (65 percent) with a polysensitization in 24 (46.1 percent). The most relevant cross reactivity occurred with the allergens of Aspergillus, Penicillium and Alternaria. The culture was positive in 54 nasal samples (67 percent). The predominant fungal genus in allergic patients was Aspergillus in 70.3 percent and within this Aspergillus fumigatus in 52.6 percent. Conclusions: The study of nasal mycobiota is a test that should be interpreted together with skin tests for the diagnosis of allergic diseases due to environmental fungi and it must be taken into account its importance for epidemiological control in fungal exposure(AU)

Características del trastorno por déficit de atención e hiperactividad en escolares mexicanos de acuerdo con la percepción de los padres / Attention deficit-hyperactivity disorder traits among Mexican school-age children according to parents perception

El trastorno por déficit de atención e hiperactividad (TDAH) es uno de los trastornos del neurodesarrollo que más se detectan en la infancia. El objetivo del presente estudio fue estimar la prevalencia del TDAH en una muestra de niños mexicanos de edad escolar. Se estudiaron 6639 alumnosde escuelas públicas de Guadalajara, Jalisco, México, a los que se les levantó una encuesta con el informe de los padres en un cuestionario diseñado bajo los criterios que el DSM-IV considera para el diagnóstico de TDAH. Se re cuperaron y analizaron 4399 cuestionarios. De acuerdo con el informe de los padres, el 8.9% de los niños tienen un perfil de conductas compatibles con los criterios del DSM-IV para el diagnóstico de TDAH. La proporción masculino: femenino fue de 2:1. La distribución por subtipos fue: 147 escolares con tipo combinado, 132 inatento y 114 del tipo hiperactivo-impulsivo. La prevalencia fue mayor del primero al tercer grado que del cuarto al sexto. La prevalencia de TDAH calculada se encuentra dentro del rango informado en otros países. Los estudios realizados en grandes muestras son útiles para diseñar estrategias de intervención acordes a la población en cuestión.

Attention deficit with hyperactivity disorder (ADHD) is one of the most frequent neuro developmental disorders identified in children. The aim of this study was to estimate the prevalence of ADHD behaviour in a sample of Mexican school-aged children. Data were obtained from 6639 pupils enrolled in public elementary schools in Guadalajara, Jalisco, Mexico. Prevalence was based on parental reports collected using the full DSM-IV criteria. A total of 4399 questionnaires were received and analysed. According to the parents, 8.9% of the children met the DSM-IV ADHD criteria. The male: female ratio was 2:1. Distribution by subtypes was as follows: 147 children with combined type, 132 inattentive children, and 114 with the hyperactive-impulsive type. Prevalence was higher from first grade to third grade than it was from fourth to sixth grade. The calculated ADHD prevalence is consistent with the range reported by other countries. Studies conducted with large samples are useful in the design of intervention strategies in accordance with the target population.

Atencion primaria odontologica en el subsector de obras sociales

Realiza analisis de situacion de la atencion odontologica enfocando al niño, la embarazada y el adulto y propone la estrategia de atencion primaria en reemplazo de las practicas reparativas. Presenta nomenclador de prestaciones odontologicas con valores a febrero 1989