Quality of life in caregivers of children with asthma: Validity and reliability of the IFABI-R questionnaire.

BACKGROUND: Parents'/caregivers' quality of life is an important aspect to consider when handling paediatric asthma, but there is a paucity of valid and reliable instruments to measure it. The Family Impact of Childhood Bronchial Asthma (IFABI-R) is a recently developed questionnaire to facilitate the assessment of asthma-related parents'/caregivers' quality of life. This study researches the psychometric properties of IFABI-R. METHODS: Parents/main caregivers of 462 children between 4 and 14 years of age with active asthma were included in the sample. IFABI-R was administered on two different occasions and a number of other variables related to the parents'/caregivers' quality of life were measured: child's asthma control, family functioning, and parents'/caregivers' perception of asthma symptoms in the child. IFABI-R evaluative and discriminative properties were analysed, and the minimal important change in the IFABI-R score was identified. RESULTS: IFABI-R showed high internal consistency (Cronbach's alpha=0.941), cross-sectional construct validity (correlation with the degree of child's asthma control, family functioning and parent/caregiver perception of the child's asthma symptoms), longitudinal construct validity (correlation of changes in the IFABI-R with changes in asthma control and changes in the perception of symptoms), sensitivity to change and test-retest reliability. An absolute change of 0.3 units in IFABI-R related to a minimal significant change in the parents'/caregivers' quality of life. CONCLUSIONS: IFABI-R is a reliable and valid instrument to study the quality of life of parents/caregivers of children with asthma.

Taller de diagnóstico de la alergia / Workshop on allergy diagnosis

La elevada y creciente prevalencia de las enfermedades alérgicas en los niños y adolescentes origina un gran número de consultas entre los pediatras de Atención Primaria. El objetivo principal de este taller es revisar los métodos diagnósticos de la alergia mediada por IgE, su utilidad e indicaciones. Para ello se resolverán distintos casos representativos de los escenarios clínicos que, con frecuencia, tiene que resolver el pediatra (AU)

Allergic conditions have a high and growing prevalence in children and adolescents, witch produce a great number of consultations among Primary Care paediatricians. The main objective of this workshop is to review the diagnostic procedures of IgE mediated allergy, their usefulness and indications. We will solve several different situations representative of the clinical background that often has to solve the paediatrician (AU)

[Prognosis in recurrent peripheral idiopathic facial paralysis in childhood]. / Pronóstico de la parálisis facial periférica idiopática y recidivante en la infancia.

Fifty-nine cases of idiopathic peripheral facial palsy were diagnosed in our unit during the period from January 1, 1984 to December 31, 1989. During follow-up examinations we observed a relapse in eleven cases, corresponding to 18.6% of the patients. Nine patients suffered a relapse once, one case twice and another case four times. The children that presented more than one recurrence have later shown functional sequelae, both clinical and neurophysiological. We conclude that in our series of patients relapse of facial palsy is a factor that worsens the prognosis for recovery. Furthermore, the existence of facial palsy in the family history leads to a greater risk of a recurrence.

[The P-10 as a tool in the evaluation of the use of a pediatric hospital emergency service by the primary care network]. / El P-10 como instrumento para la evaluación del uso de un servicio hospitalario de urgencias pediátricas por parte de la red de asistencia primaria.

With the aim of determining if the Primary Care network adequately uses our centre's Emergency service, the 390 P-10s received during May and June 1990 were examined. The presence of clinical judgement, the percentage of admissions, the place of origin of the P-10, the relationship of the issuing centre to our Health Area, the diagnosis made in the Emergency Centre and the patient's destination were all analysed. 42.3% came from rural areas. Clinical judgement was exercised in 56.13%. The P-10s from urban areas showed that clinical judgement had been exercised in 63.6% of cases, as against only 49.7% in the rural areas and 43.2% in the special emergency service. 13.2% were admitted. 41.7% of the referral forms did not come from our health area. The results led us to conclude that there is an insufficient use of the P-10 in our field, as the majority of these patients could have been taken on by the Primary Care network.

[Beckwith-Wiedemann syndrome: study of eleven cases]. / Síndrome de Beckwith-Wiedemann: estudio de once casos.

In this paper we report a review of the omphalic pathology that was admitted to our hospital from january 1973 through december 1990. Eleven cases of Beckwith-Wiedemann Syndrome were diagnosed during this period of time. Our eleven cases comply with at least three of the four major criteria (omphalocele, macroglossia, gigantism and neonatal hypoglycemia) and several of the minor criteria. The interest of this paper is based on the rareness of this syndrome and its association in two of our cases with Cacchi-Ricci Syndrome. Moreover, one of these cases later presented with a Wilms' tumor. Finally, we emphasize the importance of an early diagnosis of this syndrome in order to avoid the metabolic disturbances (hypoglycemia), to establish prompt treatment of the serious anomalies (omphalocele) and to control and follow these patients since they have increased risk to develop neoplastic disease.

[Type 4 echovirus meningitis in childhood. Epidemiologic and clinical aspects apropos of an epidemiologic outbreak]. / Meningitis por echovirus tipo 4 en la infancia. Aspectos epidemiológicos y clínicos a propósito de un brote epidémico.

In the first half of 1988 we observed 13 cases of lymphocytic meningitis from which echovirus type 4 was isolated in the CSF. We found a higher infection rate in the 6-9 years old group (54%) and in the masculine sex (69%). Almost all of the cases occurred during the springtime. The clinical and CSF characteristics of this epidemic do not differ much from those that have appeared in the literature. Throughout 1988, in our hospital, 46 cases of lymphocytic meningitis took place and in 20 of them an etiologic diagnosis was done. We think that the introduction of enterovirus cultures can help to know the etiology of many of these cases of meningitis since this virus is responsible for a great part of them.

[Lymphoblastic non-Hodgkin's lymphoma: estimation of the survival of patients with the disseminated form of the disease (stages III and IV) treated by the LSA2-L2 protocol]. / Linfoma no Hodgkin de tipo linfoblástico: evaluación de la supervivencia en pacientes con enfermedad diseminada (estadío III y IV) tratados con el protocolo LSA2-L2.

We analyze the survival rate in 17 pediatric patients (twelve males and five females) that were diagnoses of non-Hodgkin's lymphoblastic lymphoma (cases with Burkitt's lymphoma were excluded) during the period from 1982 to 1990. All of them were treated using the LSA2-L2 therapeutic protocol. The follow-up period ranged from 14 to 99 months (follow-up median 43 months). Staging of our newly diagnosed patients, we found 9 patients in stage III and 8 in stage IV disease. Survival was analyzed by the Kaplan-Meier method. The overall survival rate of our patients is 69.5% and the disease free survival is 62.6%. The disease free survival for separated stages is 66.5% for stage III and 58.3% for stage IV. We compare our results with other casuisties published in literature.

[Accidents in childhood: apropos of 14,301 cases treated in the course of one year]. / Accidentes en la infancia: a propósito de los 14.301 casos atendidos durante 1 año.

The present study aims: to revise all the cases of paediatric accidents attended at a Emergency Service of a tertiary Hospital; to analyze the epidemiological variables; and to try to draw conclusions in view of prevention. In order to achieve that, the 14.301 accidents attended during 1989 have been collected. The relation between little boys and little girls is 58.2:41.8. The average age is 7.12 years, though the mode has been 2 years. A larger number of accidents occur during non holiday. 44.3% of cases are attended between 18 and 23 hours. 89% of the accidents are, first of all, traumatisms and/or wounds; secondly, those which are produced by strange bodies (4.4%). In 51.9% of cases no complementary trial was carried out. Only 2.9% of cases were admitted to hospital, whereas 104% requires observation, and the rest returns home. The variables in the admitted patients are also analyzed, and a brief exposition of results for each of the 6 diagnostic groups is made.