Spirometry and respiratory oscillometry: Feasibility and concordance in schoolchildren with asthma.

OBJECTIVE: The purpose of this study was to describe the feasibility of respiratory oscillometry (RO) in schoolchildren with asthma, and the concordance of its results with those of spirometry, to determine its clinical usefulness. METHODS: RO and spirometry were performed in 154 children (6 to 14-year-old) with asthma, following strict quality criteria for the tests. Their feasibility (probability of valid test, time of execution, number of maneuvers needed to achieve a valid test, and perceived difficulty) was compared. The factors that influence feasibility were analyzed with multivariate methods. FEV1, FEV1/FVC, FVC and FEF25-75 for spirometry, and R5, AX and R5-19 for RO, were converted into z-scores and their concordance was investigated through intraclass correlation coefficients (ICC) and kappa indices for normal/abnormal values. RESULTS: There were no differences in the probability of obtaining a valid RO or spirometry (83.1% vs. 81.8%, p = 0.868). RO required a lower number of maneuvers [mean (SD) 4.2 (1.8) versus 6.0 (1.6), p < 0.001] and less execution time [5.1 (2.7) versus 7.6 (2.4) minutes, p < 0.001], and patients considered it less difficult. Age increased the probability of obtaining valid RO and spirometry. The concordance of results between RO and spirometry was low, and only between zFEV1 and zAX could it be considered moderate (ICC = 0.412, kappa = 0.427). CONCLUSION: RO and spirometry are feasible in children with asthma. RO has some practical advantages, but the concordance of its results with spirometry is low.

Sensibilidad del test de diagnóstico rápido SARS-CoV-2 Panbio en Atención Primaria / Sensitivity of the Panbio COVID-19 rapid antigen detection test in primary care

Introducción y objetivos: los pediatras de Atención Primaria necesitamos técnicas de diagnóstico rápido (TDR) fiables para prevenir la propagación de la enfermedad COVID-19 mediante un cribado temprano y eficaz a la espera de una vacuna. El objetivo de este trabajo fue evaluar como novedad en Atención Primaria, tanto en adultos como niños, sintomáticos y contactos asintomáticos, la sensibilidad (S) de los test de antígeno SARS-CoV-2 Panbio del laboratorio Abbott respecto a la reacción en cadena de la polimerasa (PCR).Pacientes y métodos: se incluyeron 591 pacientes (222 menores de 14 años) (249 sintomáticos y 342 contactos). Se calculó la sensibilidad (S) y la especificidad (E) junto con sus intervalos de confianza (IC) del 95%. La independencia de los dos resultados ha sido analizada mediante el test de McNemar.Resultados: la S del test en adultos fue del 81% (IC 95%: 66,16-96,34) y en niños del 80% (IC 95%: 34,94-100) dentro de los 5 primeros días. En contactos se evaluó la S en los cinco primeros días, en adultos (68%; IC 95%: 51,13-86,37), del 5.º al 9.º día (85%) y en niños (66%; IC 95%: 30,31-100). El tipo de contacto más frecuente fue domiciliario en un 52% de los casos. La E fue 100% en todos los casos.Conclusiones: el test rápido de antígeno SARS-CoV-2 Panbio puede ser útil para diagnóstico de adultos y niños los primeros cinco días de inicio de síntomas, así como entre el 5.º y 9.º día tras el contacto con positivo COVID-19 confirmado, pendiente de interpretar en futuros estudios. (AU)

Introduction and objectives: primary care paediatricians need reliable rapid diagnostic techniques (RDTs) to prevent the spread of coronavirus disease 19 (COVID-19) through early and effective screening while awaiting a vaccine. The objective of this study was to evaluate the sensitivity (Sen) of the Abbott laboratory SARS-CoV-2 Panbio antigen test, newly introduced in primary care, in both adults and children (symptomatic and asymptomatic contacts) in comparison to the polymerase chain reaction (PCR) test.Sample and methods: the study included 591 patients (222 aged less than 14 years) from 7 primary care centres; of who 249 were symptomatic and 342 asymptomatic contacts. We calculated the Sen and specificity (Spe) with their 95% confidence intervals (CIs). We assessed the independence of the two results with the McNemar test.Results: the Sen of the test within 5 days from onset was 81% in adults (95% CI, 66.16-96.34) and 80% in children (95% CI: 34.94-100). In contacts, we assessed the Sen within 5 days, in adults (68%; 95% CI: 51.13- 86.37), in 5 to 9 days (85%) and in children (66%; 95% CI: 30.31-100). The most frequent source of exposure were household contacts (52% of the cases). The Spe was 100% in every case.Conclusions: the Panbio SARS-CoV-2 rapid antigen test can be useful for diagnosis in adults and children within 5 days of onset, and from days 5 to 9 in contacts of confirmed COVID 19 cases. Further studies are required for adequate interpretation of the latter result. (AU)

Impacto de una intervención educativa sobre asma en los profesores de Educación Infantil y Primaria de una zona básica de salud / Impact of an educational intervention about asthma on early childhood and primary education teachers in one health district

INTRODUCCIÓN: un adecuado conocimiento sobre asma por los profesores de los centros educativos es necesario para un correcto control de la enfermedad. OBJETIVO: determinar el impacto de una intervención educativa en el nivel de conocimientos sobre el asma y su manejo en profesores de Educación Infantil y Primaria. MATERIAL Y MÉTODOS: estudio cuasiexperimental, tipo antes y después, de una intervención educativa (IE) sobre asma en profesores de centros escolares de una zona básica de salud de Valladolid. Se realizó un cuestionario previo a la intervención educativa, inmediatamente después y a los seis meses. RESULTADOS: participaron 100 docentes (69,93%) de cinco colegios. Edad media 44,2 ± 8 años (rango: 28-59). Mujeres: 82%. El nivel de conocimientos sobre asma es bajo. Identifica los principales síntomas del asma el 65% de los participantes y los desencadenantes de una crisis el 59%. No sabe si los niños con asma pueden hacer deporte de competición el 30%. Cree que una crisis no puede ser evitada durante el ejercicio el 26%. Considera el tratamiento inhalado el más eficaz el 79% y los antibióticos parte del tratamiento el 7%. Cree que el salbutamol daña el corazón el 5%. Después de la intervención educativa observamos un incremento significativo en los conocimientos sobre asma (p <0,001) y se mantiene a los seis meses. CONCLUSIONES: una intervención educativa dirigida a los profesores aumenta significativamente el nivel de conocimientos sobre el asma. Este incremento se mantiene durante al menos seis meses. Son necesarias actividades educativas y medidas organizativas sobre asma en la escuela

INTRODUCTION: an appropriate knowledge about asthma by teachers in schools is essential for its control. OBJECTIVE: to determine the impact of an educational intervention on the knowledge of teachers about asthma and its management in the primary schools located in one health district. PATIENTS AND METHODS: quasi-experimental pre-post intervention study assessing an educational intervention aimed at improving the knowledge on asthma of teachers. A questionnaire was administered before, immediately after and 6 months after the educational intervention. RESULTS: 100 teachers (69.93%) employed in 5 schools participated in the study. The mean age was 44.2 ± 8 years (range, 28-59 years), 82% were women. We found a low level of asthma knowledge in the teaching staff. Many participants could identify the main symptoms of asthma (65%) and the main triggers (59%). Thirty percent did not know whether these students could participate in competitive sports, and 26% believed it was not possible to prevent exercise-induced asthma attacks. Seventy-nine percent knew that inhaled therapy was the best approach. Seven percent stated that antibiotics are a component of asthma treatment. Five percent believed salbutamol could damage the heart. After the educational intervention, we noticed a significant increase on asthma knowledge (p <0.001). The level of knowledge was maintained 6 months after the intervention. CONCLUSIONS: educational interventions aimed at teachers significantly increase the level of asthma knowledge. This improvement is maintained for at least 6 months. Educational activities and organizational measures on asthma are necessary in the school setting