[Allergic sensitization profile in 0-5 year old children with wheezing and/or atopic dermatitis]. / Perfil de sensibilización alérgica en niños de 0 a 5 años con sibilancias o dermatitis atópica.

BACKGROUND: Although allergic diseases are frequent in childhood, few studies have characterised the IgE sensitization profile among young children with allergic-like symptoms. OBJECTIVE: To determine the prevalence and the type of allergic sensitization, as well as the demographic and environmental factors related to both characteristics, among 0-5 year old children presenting with wheezing and/or atopic dermatitis. METHODS: Collaborative cross-over study developed in the paediatric setting of 20 Spanish Primary Health Care Centres. An allergology evaluation including blood determination of specific IgE antibodies to common inhalant and food allergens was performed on 468 children who presented with wheezing and/or atopic dermatitis. RESULTS: Allergic sensitization was detected in 32.4% of the children with wheezing (95% confidence interval, 95%CI, 26.3-38.6%), in 54.8% of the children who had atopic dermatitis (95%CI, 42.1-67.6%) and in 39.2% of the children with both processes (95%CI, 32.0-46.4%). The risk of allergic sensitization was sex related (male versus female adjusted odds ratio, OR(A), 1.91, 95%CI, 1.24-2.95), and also related to the age (3-5 versus 0-2 year old OR(A) 1.96, 95%CI, 1.27-3.0), type of early feeding (maternal milk versus infant formula OR(A) 0.51, 95%CI, 0.31-0.84) and geoclimatic area (OR(A) Continental versus Atlantic 2.26, 95%CI, 1.30-3.93). Compared to the Atlantic area, the Continental area the sensitization was lower to mites (OR(A) 0.16, 95%CI, 0.07-0.36) and higher to grass (OR(A) 4.65, 95%CI 1.99-10.86), cow milk (OR(A) 5.17, 95%CI, 1.71-15.62) and egg (OR(A) 5.26, 95%CI, 2.04-13.62), whereas in the Mediterranean area the sensitization was lower to mites (OR(A) 0.29, 95%CI, 0.13-0.64) and higher to cow milk (OR(A) 3.81, 95%CI, 1.20-12.14) and egg (OR(A) 5.24, 95%CI, 1.94-14.20). CONCLUSION: A significant proportion of small children treated at the paediatric primary health care centres due to wheezing and/or atopic dermatitis had allergic sensitization. There appears to be a geoclimatic variation in the prevalence of sensitization to inhalant and food allergens among young children with allergic like symptoms who live in Spain.

[The evolution of the prevalence of breast feeding in the Manlleu Basic Health Area (1988-1991)]. / Evolución de la prevalencia de la lactancia materna en el ABS Manlleu (1988-1991).

OBJECTIVE: To discover the prevalence of maternal lactation in the Manlleu Health Area and the variations in latency since the area was set up to the present day. DESIGN: Crossover study, based on the record-sheet of the health controls in the clinical notes, of maternal lactation for those recently-born babies monitored in the area between January 1988 and December 1991 (n = 686). SITE. The geographical boundaries of Manlleu Basic Health area (Barcelona). MAIN MEASUREMENTS AND RESULTS: The prevalence of maternal lactation progressively increased from the base of 1988 (lineal tendency chi 2 = 34.3 p < 0.0001). The number of mothers beginning maternal lactation went up from 62% in 1988 to 72% in 1991. Right from the first month duration also increased, but the differences were especially marked between the second and the fifth months (p < 0.05). The average time of lactation also increased, from 92 days in 1988 to over 114 days in 1991 (p = 0.02). CONCLUSIONS: Prevalence and duration of maternal lactation has improved substantially since the setting-up of the Basic Health Area. This improvement could be attributed to the publicity material that we made available at general health check-ups during the first 6 months.

[Relation of birth weight and gestational age in a population of newborn infants at the Valle de Hebron Maternity Hospital]. / Relación entre el peso de nacimiento y la edad de gestación en una población de recién nacidos del Hospital Maternal "Valle de Hebrón".

Birth weight and gestational age data from 5,418 infants born in the Maternal Hospital "Valle de Hebrón" during 1984, were retrospectively reviewed. 295 infants (5.4%) were excluded for different reasons. Tabulated data of the 5,123 remaining cases were used to design a representative chart of this population of infants. Simultaneous inclusion in the chart of +/- 2 SD curves and 10th and 90th percentile curves, allows us to establish an easy distinction between the low birthweight infants with moderate intrauterine growth retardation and those with a severe delay. This distinction may be clinically important. Data collecting methods for designing intrauterine growth charts are also discussed.

Perfil de sensibilización alérgica en niños de 0 a 5 años con sibilancias o dermatitis atópica / Allergic sensitization profile in 0–5 year old children with wheezing and/or atopic dermatitis

Antecedentes Aunque las enfermedades alérgicas son frecuentes en la infancia, pocos estudios han caracterizado el perfil de sensibilización inmunoglobulina (Ig) E en niños pequeños con síntomas de posible origen alérgico. Objetivo Establecer la prevalencia y el tipo de sensibilización alérgica, y los factores demográficos y ambientales relacionados con ambas características, en niños de 0 a 5 años de edad con sibilancias o dermatitis atópica. Población y métodos Estudio transversal colaborativo en el que participaron 20 centros de atención primaria de diversas áreas geográficas de España. En conjunto, 468 niños con sibilancias o dermatitis atópica realizaron una evaluación alergológica que incluyó la determinación en sangre de anticuerpos IgE específicos frente a neumoalérgenos y trofoalérgenos prevalentes. Resultados Se detectó sensibilización alérgica en el 32,4% de los niños con sibilancias (intervalo de confianza [IC] del 95%: 26,3–38,6%), el 54,8% de los niños con dermatitis atópica (IC del 95%: 42,1–67,6%) y el 39,2% de los que tuvieron ambos procesos (IC del 95%: 32,0–46,4%). El riesgo de sensibilización se vio influido por el sexo (odds ratio ajustado [ORA] masculino versus femenino: 1,91; IC del 95%: 1,24–2,95), la edad (ORA 3–5 versus 0–2 años: 1,96; IC del 95%: 1,27–3,0), el tipo de lactancia (ORA materna versus artificial: 0,51; IC del 95%: 0,31–0,84) y el área geoclimática (ORA continental versus atlántica: 2,26; IC del 95%: 1,30–3,93). Con respecto al área atlántica, la sensibilización en el área continental fue menor a ácaros (ORA: 0,16; IC del 95%: 0,07–0,36) y mayor a gramíneas (ORA: 4,65; IC del 95%: 1,99–10,86), leche de vaca (ORA: 5,17; IC del 95%: 1,71–15,62) y huevo (ORA: 5,26; IC del 95%: 2,04–13,62), mientras que en el área mediterránea fue menor a ácaros (ORA: 0,29; IC del 95%: 0,13–0,64) y mayor a leche de vaca (ORA: 3,81; IC del 95%: 1,20–12,14) y huevo (ORA: 5,24; IC del 95%: 1,94–14,20). Conclusiones Una proporción relevante de los niños pequeños asistidos en atención primaria por sibilancias o dermatitis atópica presentan sensibilización alérgica. En España parecen existir variaciones según el área geoclimática en la prevalencia de sensibilización a inhalantes y alimentos en lactantes y niños preescolares con síntomas de posible origen alérgico (AU)

Background Although allergic diseases are frequent in childhood, few studies have characterised the IgE sensitization profile among young children with allergic-like symptoms. Objective To determine the prevalence and the type of allergic sensitization, as well as the demographic and environmental factors related to both characteristics, among 0–5 year old children presenting with wheezing and/or atopic dermatitis. Methods Collaborative cross-over study developed in the paediatric setting of 20 Spanish Primary Health Care Centres. An allergology evaluation including blood determination of specific IgE antibodies to common inhalant and food allergens was performed on 468 children who presented with wheezing and/or atopic dermatitis. Results Allergic sensitization was detected in 32.4% of the children with wheezing (95% confidence interval, 95%CI, 26.3–38.6%), in 54.8% of the children who had atopic dermatitis (95%CI, 42.1–67.6%) and in 39.2% of the children with both processes (95%CI, 32.0–46.4%). The risk of allergic sensitization was sex related (male versus female adjusted odds ratio, ORA, 1.91, 95%CI, 1.24–2.95), and also related to the age (3–5 versus 0–2 year old ORA 1.96, 95%CI, 1.27–3.0), type of early feeding (maternal milk versus infant formula ORA 0.51, 95%CI, 0.31–0.84) and geoclimatic area (ORA Continental versus Atlantic 2.26, 95%CI, 1.30–3.93). Compared to the Atlantic area, the Continental area the sensitization was lower to mites (ORA 0.16, 95%CI, 0.07–0.36) and higher to grass (ORA 4.65, 95%CI 1.99–10.86), cow milk (ORA 5.17, 95%CI, 1.71–15.62) and egg (ORA 5.26, 95%CI, 2.04–13.62), whereas in the Mediterranean area the sensitization was lower to mites (ORA 0.29, 95%CI, 0.13–0.64) and higher to cow milk (ORA 3.81, 95%CI, 1.20–12.14) and egg (ORA 5.24, 95%CI, 1.94–14.20). Conclusion A significant proportion of small children treated at the paediatric primary health care centres due to wheezing and/or atopic dermatitis had allergic sensitization. There appears to be a geoclimatic variation in the prevalence of sensitization to inhalant and food allergens among young children with allergic like symptoms who live in Spain (AU)