Cross-sectional study about impact of parental smoking on rhinitis symptoms in children.

OBJECTIVE: Assess the prevalence of rhinitis and exposure to environmental tobacco smoke (ETS) of children in our community and its relationship with symptoms of rhinitis METHODS (DESIGN, SETTING, PARTICIPANTS, MAIN OUTCOME MEASURES): Cross-sectional study using questionnaire on rhinitis of the International Study of Asthma and Allergies in Childhood, in children (6-7 years) and adolescents (13-14 years). Categories: "rhinitis ever", "recent rhinitis", "recent rhinoconjunctivitis", "severe rhinoconjunctivitis". Parental smoking: (i) neither parent smokes; (ii) only the mother smokes; (iii) only the father smokes; and (iv) both parents smoke. Odds ratio of the prevalence of symptoms of rhinitis according to ETS exposure was calculated using logistic regression. RESULTS: 10 690 children and 10 730 adolescents. The prevalence of "rhinitis ever" in children: 29.4%, "recent rhinitis" 24%, "recent rhinoconjunctivitis" 11.5% and "severe rhinoconjunctivitis" 0.1%. In adolescents: 46.2%, 34.5%, 16.2% and 0.2%, respectively. Environmental tobacco smoke exposure in the home occurred in 51% of cases. Parental smoking was associated with a higher prevalence of forms of rhinitis in adolescents when only the mother was a smoker. In children when both parents were smokers. CONCLUSION: Rhinitis is highly prevalent in our community. Environmental tobacco smoke exposure is still very common. The relationship between ETS and rhinitis symptoms in children of this community is not as robust as that found for asthma.

[Use of sugars and sweeteners in children's diets. Recommendations of the Nutrition Committee of the Spanish Paediatric Association]. / Uso de azúcares y edulcorantes en la alimentación del niño. Recomendaciones del Comité de Nutrición de la Asociación Española de Pediatría.

The term «sweetener¼ refers to a food additive that imparts a sweet flavour and usually provides no or very low energy. It is used to sweeten foods, medicines and food supplements with no nutritional purposes. For years, no-calorie sweeteners have been used as substitutes for all or part of the sugar content in foods and beverages. In recent decades its consumption has risen to prevent tooth decay, or as an aid in weight control, obesity and diabetes and, in general, to achieve an optimal energy balance. However, consumption of sugary or sweetened food and soft drinks is high, making this situation of special interest in calorie intake and in the poor behavioural pattern of eating habits in children. In addition, questions remain among consumers about the risks to health associated with their use, whether they are artificial or natural. The «artificial sweeteners¼ are the group of greatest interest in research in order to demonstrate their safety and to provide firm data on their possible therapeutic effects. The aim of the present document is to increase information for paediatricians on the characteristics of different sweeteners, and to advise on the choice of sweeteners, based on their properties.

Obesity and asthma: An association modified by age

Background: Some studies indicate some causal relationship between obesity and asthma, while others show inconsistent results. Our objective was to evaluate the prevalence of asthma according to obesity in children. Methods: A cross-sectional study, following the ISAAC study methodology, was conducted on two randomly selected groups consisting of 6---7 year-old children (n = 7485) and 13-14 year-old adolescents (n = 8496).The asthma symptoms and potential risk factors were determined from the questionnaire. Overweight and obesity were defined based on the body mass index. Multiple logistic regression was used to obtain adjusted prevalence odds ratios (OR) and 95%confidence intervals. Results: Obesity was associated with an increase in wheezing ever (OR: 1.35) and exercise induced asthma (OR: 1.62) in the 6-7 year-old group. No significant relationship was observed in the adolescent population. Conclusion: Obesity was associated with a higher prevalence of asthma in young children, but not in adolescents (AU)

Truck traffic related air pollution associated with asthma symptoms in young boys: a cross-sectional study.

OBJECTIVES: The aim of this study was to evaluate the influence of intensity of truck traffic on asthma symptomatology, and its relationship with age and gender. STUDY DESIGN: A cross-sectional study was conducted on children and adolescents from Galicia (North-West Spain). METHODS: Following the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC): children from schools randomly selected, answered a self-administered questionnaire included questions on asthma symptoms and some risk factors. The association between self-reported truck traffic on the street of residence and symptoms of asthma were investigated by logistic regression adjusted for body mass index, maternal education and parental smoking. RESULTS: Almost 40% of children in Galicia are exposed to the frequent and constant passing of heavy goods vehicles. The odds of 6-7 year-old boys having severe or exercise induced asthma is tripled when they live in streets with the constant passing of heavy goods vehicles, compared with those living in streets where these vehicles never pass. In adolescents and 6-7 year-old girls, no relationship was observed between truck traffic and asthma symptoms. CONCLUSIONS: The results of this study appear to support a distinct effect of truck traffic on asthma symptoms depending on the age and sex of the exposed population, being more harmful for young males.

Obesity and asthma: an association modified by age.

BACKGROUND: Some studies indicate some causal relationship between obesity and asthma, while others show inconsistent results. Our objective was to evaluate the prevalence of asthma according to obesity in children. METHODS: A cross-sectional study, following the ISAAC study methodology, was conducted on two randomly selected groups consisting of 6-7 year-old children (n=7485) and 13-14 year-old adolescents (n=8496). The asthma symptoms and potential risk factors were determined from the questionnaire. Overweight and obesity were defined based on the body mass index. Multiple logistic regression was used to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals. RESULTS: Obesity was associated with an increase in wheezing ever (OR: 1.35) and exercise-induced asthma (OR: 1.62) in the 6-7 year-old group. No significant relationship was observed in the adolescent population. CONCLUSION: Obesity was associated with a higher prevalence of asthma in young children, but not in adolescents.

Mediterranean diet and asthma in Spanish schoolchildren.

There is still debate on the effect of dietetic factors on the prevalence or severity of asthma, as well as the interaction with other factors. We have analysed the prevalence and severity of asthma according to adherence to the Mediterranean diet (MD), its association with obesity and family life style. We performed a cross-sectional study on 14,700 children and adolescents in six health areas in our region. We used the International Study of Asthma and Allergies in Childhood questionnaire to collect asthma symptoms, dietary habits, anthropometric parameters, parental smoking habits and maternal education level. The diet pattern was analysed using a Mediterranean Diet Score. In the logistic regression we analysed the influence of adhering to the MD on the prevalence and severity of asthma, adjusted for the other parameters included. Greater adherence to the MD is associated with a higher risk of severe asthma (odds ratios = 2.26, 95% CI: 1.21-4.22) in girls of 6-7 yr. There was no significant relationship for the other asthma categories in the population studied. The results of our study do not support a protective effect of the MD on the prevalence or severity of asthma.

Incontinencia y trastornos miccionales: ¿qué podemos hacer? / No disponible

Las alteraciones relativas a la micción son un motivo de consulta cada vez más frecuenteen pediatría. Pueden referirse tanto a problemas del patrón miccional diurno como a incontinencia.Las infecciones urinarias de repetición también pueden ser una expresión de estos trastornos.Pueden deberse a la presencia de anomalías orgánicas, como la obstrucción anatómicadel tracto urinario inferior o la vejiga neurógena. Pero son más frecuentes las causas funcionales,que clásicamente se han agrupado bajo el término micción disfuncional y que en la actualidadse denominan trastornos de la función del tracto urinario inferior. Su repercusión clínica varíadesde los cambios en el patrón miccional o la incontinencia leve hasta trastornos más gravesque llevan a la alteración irreversible de la función vesical. El diagnóstico descansa fundamentalmenteen una buena historia clínica y en la exploración física junto con el llamado diariomiccional. Las exploraciones complementarias (incluido el examen urodinámico) han de valorarseindividualmente.Una comprensión adecuada del funcionamiento normal y anormal de la vejiga permite unabordaje satisfactorio del problema desde la Pediatría de Atención Primaria. Hay que dar la mayorimportancia al primer nivel de tratamiento: hábitos dietéticos sanos, tratamiento del estreñimiento,higiene correcta y patrón miccional regular. Cuando la evaluación inicial identificaun problema orgánico, o cuando el tratamiento inicial fracasa, es necesario derivar al nivel hospitalario(AU)

Alterations on urination are a common reason for more and more frequent consultation inPediatrics. They can refer so much to problems of daytime voiding pattern as to incontinence.Recurrent urinary tract infections can also be an expression of these disorders. They can be dueto the presence of organic anomalies such as the anatomical obstruction of the lower urinarytract or the neurogenic bladder. But there are more common the functional causes, which traditionally have been grouped under the term dysfunctional voiding and at present they are nameddisorders of the lower urinary tract function. Its clinical impact varies from changes in thepattern of voiding or slight incontinence, to more severe disorders that lead to irreversible alterationof bladder function. The diagnosis rests fundamentally on a good clinical history andphysical examination along with the so-called voiding diary. The complementary explorations(including urodynamic evaluation) should be assessed individually.A suitable understanding of normal and abnormal functioning of the bladder allows a satisfactoryapproach to the problem in the paediatric primary care. We must give great importanceto the first level of treatment: healthy diet, treatment of constipation, proper hygiene andregular voiding pattern. When the initial evaluation identifies an organic problem, or when initialtreatment fails, we must refer the hospital level(AU)

Vacuna conjugada neumocócica heptavalente: ¿luces y sombras? / No disponible

La vacuna antineumocócica conjugada heptavalente ha demostrado una alta eficacia, no solo al reducir la frecuencia de enfermedad neumocócica invasiva en niños, sino también en la disminución de resistencias a los antibióticos y de la colonización nasofaríngea, lo que repercute en grupos de más edad. La publicación de trabajos que muestran un aumento de los aislamientos de serotipos no vacunales, principalmente el 19A, aunque con un impacto sobre la enfermedad aún poco importante, arroja sombras en el mencionado panorama de éxito vacunal. Proponemos una revisión de la bibliografía reciente con el objetivo de ofrecer una visión actual tanto de la vacuna, como de las posibles controversias (AU)

The heptavalent pneumococcal conjugate vaccine has proved a high efficacy, not only to reduce the incidence of invasive pneumococcal disease in children, but also in the decrease of resistance to antibiotics and nasopharyngeal colonization, which affects older age groups. The publication of papers that show an increase of isolates of non-vaccine serotypes, mainly 19A, but with an impact on the disease still unimportant, casts shadows in the above picture of success vaccine. We propose a review of recent literature with the aim of providing an overview of both the current vaccine, as well as the potential disputes (AU)

Atención urgente de una población pediátrica rural en un punto de atención continuada / Urgent care of a rural paediatric population at a continuous care point

No disponible