Indicators for childhood asthma in Spain, using the Rand method.

OBJECTIVE: To develop quality indicators to measure asthma care in primary health care. METHOD: A modified RAND was used, which included the systematic review of the literature in Embase, Cochrane and Pubmed Quality Agencies and Database. The work group identified the indicators, translated them into Spanish and resolved any duplicates. Each indicator is composed of several dimensions (access to care, clinical effectiveness, patient-centred quality and patient safety). A multidisciplinary panel of 98 professionals from all over Spain were invited to score each indicator using a Likert scale. After calculating the average and median of each indicator, this information was sent to those who responded (n=38) for a second round and further scoring. The agreement percentage for the group was obtained for each indicator. RESULTS: Of the 105 asthma indicators reviewed, we selected 46 that were presented to the panel of experts. In both Delphi phases, 37.1% of the members of the initial panel of experts responded. Of these, 26 were primary care paediatricians, six were pulmonologists, three were nurses, two were pharmacists and one was an allergist. For 32 indicators, agreement exceeded 70% and seven of those scored highest for the various care aspects for asthmatic children. CONCLUSION: Quality indicators are presented for the follow-up of asthma and their implementation in primary care, which have undergone a strict selection and agreement process by a multidisciplinary work group.

[Bilateral tubo-ovarian abscess caused by Enterobius vermicularis. Presentation of a case]. / Absceso tubo-ovárico bilateral debido a granulomas por Enterobius vermicularis. Presentación de un caso.

We present the case of a 33-year-old patient who had undergone hysterectomy due to an in situ carcinoma of the uterine cervix; exploratory laparotomy was carried out for a suspected abscessed pelvic tumor. It was confirmed that the two Fallopian tubes and ovaries were abscessed and exeresis was carried out. The anatomicopathological study of these showed granulomas containing gravid female specimens of the Enterobius vermicularis species.