Validation of a Spanish version of the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire in children living in a high-altitude city.

OBJECTIVES: We aimed to validate a Spanish version of the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (SRBD-PSQ) in children living in a high-altitude Colombian city. METHODS: In a prospective cohort validation study, patients aged between 2 and 17 years who attended the Ear, Nose, and Throat pediatric department of our institution for symptoms related to sleep-related breathing disorders had a baseline visit at enrollment, a second visit the day scheduled for the surgical intervention, and a follow-up visit at least 3 months after the surgical intervention. In these three visits, we gathered the necessary data for assessing the criterion validity, construct validity, test-retest reliability, internal consistency, and sensitivity to change of the Spanish version of the SRBD-PSQ. RESULTS: In total, 121 patients were included in the analyses. The exploratory factor analysis (generalized least squares method, varimax rotation) yielded a four-factor structure, explaining 65.93% of the cumulative variance. The intraclass correlation coefficient (ICC) of the measurements was 0.887 (95% CI: 0.809-0.934), and the Lin concordance correlation coefficient was 0.882 (95% CI, 0.821-0.943). SRBD-PSQ scores at baseline were significantly higher than those obtained after adenotonsillectomy surgery (median [IQR] 11.0 [9.0- 14.0] vs. 4.00 [1.50-7.0]; p < 0.0001). Cronbach's α was 0.7055 for the questionnaire as a whole. CONCLUSIONS: The Spanish version of the SRBD-PSQ has acceptable construct validity, excellent test-retest reliability and sensitivity to change, and adequate internal consistency-reliability when used in pediatric patients living at high altitude with symptoms related to sleep-related breathing disorders.

Validación del cuestionario pediátrico de sueño en la población colombiana / Validation of the pediatric sleep questionnaire in colombian population

Introducción: El síndrome de apnea e hipopnea obstructiva del sueño es una patología frecuente en la población pediátrica que genera un alto impacto en la calidad de vida tanto de los pacientes como de sus familias. Objetivo: Realizar la validación del Cuestionario Pediátrico de Sueño a la población pediátrica colombiana a grandes alturas y determinar si existe asociación entre los hallazgos en el cuestionario y los hallazgos polisomnográficos. Diseño: Observacional analítico prospectivo. Materiales y métodos: Este estudio fue realizado a 2,600 metros sobre el nivel del mar. Se incluyeron 121 pacientes entre 2 y 18 años, candidatos a adeno/amigdalectomía a los que se les aplicó el cuestionario pediátrico de sueño, y fue sometido a un proceso de validación específico para la población colombiana. Resultados: No se obtuvo una correlación de los resultados del cuestionario con los resultados de severidad de la enfermedad en el polisomnograma. Discusión: El cuestionario pediátrico de sueño (PSQ) fue sometido a un proceso de validación específico para la población colombiana a grandes alturas. Sin embargo, dado que los ítems A24, A25, B7, B9, y B22 se determinaron como redundantes, se podría proponer una escala condensada específica para la población colombiana, omitiendo estas preguntas. Conclusiones: El cuestionario pediátrico de sueño (PSQ) fue validado satisfactoriamente a la población colombiana habitante de grandes alturas. Sin embargo, se propone una modificación, eliminando las preguntas A24, A25, B7, B9, y B22, logrando un cuestionario más corto y simplificado, sin tener efectos sobre la validez del mismo.

Introduction: The obstructive sleep apnea and hypopnea syndrome is a frequent pathology in the pediatric population that generates a high impact on the quality of both patients and their families. Objective: To validate the Pediatric Sleep Questionnaire to the Colombian pediatric population. Design: Prospective analytical observational. Methods: This study was conducted at 2,600 meters above sea level. We included 121 patients between 2 and 18 years old, who were candidates for adeno/tonsillectomy to whom the Pediatric Sleep Questionnaire was applied; this questionnaire was underwent to a specific validation process for the Colombian population. Results: The results of the questionnaire was not correlated with disease severity determined by polysomnogram. Discussion: The pediatric sleep questionnaire (PSQ) was underwent to a specific validation process for the Colombian population at high altitudes. However, due to that articles A24, A25, B7, B9 and B22 were determined as redundant, a specific escalation could be proposed for the Colombian population, omitting these questions. Conclusions: The pediatric sleep questionnaire (PSQ) was validated satisfactorily in the Colombian population living at high altitudes. However, a modification is proposed, eliminating the questions A24, A25, B7, B9 and B22, obtaining a shorter and simplified questionnaire, without having effects on the duration of the same.

Dysphagia caused by spindle cell lipoma of hypopharynx: presentation of clinical case and literature review.

Spindle cell lipoma of the hypopharynx is an extremely rare entity. Here, we present the first case of this lesion originated in the cricopharyngeal region, with symptoms of chronic progressive dysphagia, which can be confused with other pathologies; endoscopic and magnetic resonance imaging (MRI) evaluation are the methods of choice for its diagnostic approach. The best therapeutic approach is endoscopic resection with rapid recovery and few complications. Long-term followup is recommended, either endoscopic or imaging, given that it can be confused with an undiagnosed liposarcoma; additionally, its long-term behavior is unknown.

Enfoque y tratamiento actual de laparotiditis recurrente: revisión sistemática de la literatura / The current approach to recurring parotitis and its treatment: a systematic review of the literature

Objetivos: realizar una revisión de la literatura actual en cuanto a etiología, enfoque médico,diagnóstico y tratamiento de la parotiditis recurrente. Metodología: búsqueda en Pubmed desde 2000 hasta enero 2010, con revisión de artículos relevantes por su casuística, opciones terapéuticas o diagnósticas innovadoras y diseño metodológico adecuado. Resultados: se hallaron 69 artículos, de los cuales se seleccionaron 35. Se aclaran mecanismos etiopatogénicos de la enfermedad como inflamación, infección, deshidratacióny eventos que promueven la recurrencia. El diagnóstico de la enfermedad se basa en la recurrencia del cuadro. Se describe el diagnóstico diferencial y priorización en los paraclínicos de apoyo. Las imágenes recomendadas son en primer lugar la ecografía de alta resolución, seguida de la siolografía, que provee diagnóstico y según algunos autores tratamiento. Las últimas tendencias involucran la sialografía por RMN y por TAC. El tratamiento de la etapa aguda continúa siendo el uso de antibióticos contra gram positivos, antiinflamatorios esteroideos y no esteroideos, hidratación y alimentos con capacidad sialogoga. Para el manejo de las recurrencias se plantea manejo conservador discutiendo el uso de antibióticos, sialografía, y diversas estrategias de ablación no quirúrgica y la sialo endoscopia. El tratamiento quirúrgico queda reservado para casos de alta recurrencia, planteándosela parotidectomía y la denervación parasimpática mediante neuronectomía del nervio de Jacobson. Conclusiones: la parotiditis recurrente presenta nuevas estrategias diagnósticas y terapéuticas, que deben ser seguidas para construir en poco tiempo un manejo ideal de esta patología. Palabras clave: parotiditis crónica, parotiditis recurrente, diagnóstico, tratamiento.

Objectives: To conduct a review of the current literature as far as the etiology, medical approach, diagnoses and treatment for the recurrent parotitis is concerned. Methodology: a search in Pubmed from 2000 to 2009 was performed. All articles that were relevant due to the causes, therapeutic or innovative diagnose options and the appropriate methodologicaldesign, were revised. Results: 69 articles were found, 33 of which were selected. Some etiopathogenic mechanisms of the disease such as inflammation, infection, dehydration and those events promoting recurrence wereclarified. Diagnosing the disease is done based on the recurrence rate of the chart. The differential diagnose as well as the prioritization are described in the supporting paraclinical procedures. Therecommended images are a high resolution ultrasound scan, followed by a sialography, which diagnosesand treats according to some authors. The latest trends involve a sialography by RMN and TAC. The treatment continues to be using antibiotics against great positive, non- steroidal and steroidal anti inflammatory drugs, hydration and foods that have great sialogogue ability during the acute phase. In order to handle recurrences a conservative management is suggested by discussing using antibiotics,a sialography, as well as several other non- surgical ablations and the endoscopic sialography. Surgical treatment is then reserved for those cases that have a great recurrence rate. A parotidectomy surgery as well as the parasympathetic denervation by means of the neuronectomy of the Jacobsonnerve has been suggested treatments.Conclusions: recurrent parotitis has exhibited new diagnosing and therapeutic strategies that need tobe followed in order to construct, in a short period of time, an ideal management for this pathology.