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1.
Allergol. immunopatol ; 47(2): 107-121, mar.-abr. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-180798

RESUMO

Background and aim: The definition and diagnosis of asthma are the subject of controversy that is particularly intense in the case of individuals in the first years of life, due to reasons such as the difficulty of performing objective pulmonary function tests or the high frequency with which the symptoms subside in the course of childhood. Since there is no consensus regarding the diagnosis of asthma in preschool children, a systematic review has been carried out. Materials and methods: A systematic search was made of the clinical guidelines published in the last 10 years and containing information referred to the concept or diagnosis of asthma in childhood - including the first years of life (infants and preschool children). A series of key questions were established, and each selected guide was analyzed in search of answers to those questions. The review protocol was registered in the international prospective register of systematic reviews (PROSPERO), with registration number CRD42017074872. Results: Twenty-one clinical guidelines were selected: 10 general guides (children and adults), eight pediatric guides and three guides focusing on preschool children. The immense majority accepted that asthma can be diagnosed from the first years of life, without requiring pulmonary function tests or other complementary techniques. The response to treatment and the exclusion of other alternative diagnoses are key elements for establishing the diagnosis. Only one of the guides denied the possibility of diagnosing asthma in preschool children. Conclusions: There is generalized although not unanimous agreement that asthma can be diagnosed in preschool children


No disponible


Assuntos
Humanos , Lactente , Pré-Escolar , Antiasmáticos/uso terapêutico , Asma/diagnóstico , Asma/tratamento farmacológico , Testes de Função Respiratória
2.
Artigo em Inglês | MEDLINE | ID: mdl-30193886

RESUMO

BACKGROUND AND AIM: The definition and diagnosis of asthma are the subject of controversy that is particularly intense in the case of individuals in the first years of life, due to reasons such as the difficulty of performing objective pulmonary function tests or the high frequency with which the symptoms subside in the course of childhood. Since there is no consensus regarding the diagnosis of asthma in preschool children, a systematic review has been carried out. MATERIALS AND METHODS: A systematic search was made of the clinical guidelines published in the last 10 years and containing information referred to the concept or diagnosis of asthma in childhood - including the first years of life (infants and preschool children). A series of key questions were established, and each selected guide was analyzed in search of answers to those questions. The review protocol was registered in the international prospective register of systematic reviews (PROSPERO), with registration number CRD42017074872. RESULTS: Twenty-one clinical guidelines were selected: 10 general guides (children and adults), eight pediatric guides and three guides focusing on preschool children. The immense majority accepted that asthma can be diagnosed from the first years of life, without requiring pulmonary function tests or other complementary techniques. The response to treatment and the exclusion of other alternative diagnoses are key elements for establishing the diagnosis. Only one of the guides denied the possibility of diagnosing asthma in preschool children. CONCLUSIONS: There is generalized although not unanimous agreement that asthma can be diagnosed in preschool children.

3.
Allergol. immunopatol ; 46(4): 361-369, jul.-ago. 2018. tab, mapas
Artigo em Inglês | IBECS | ID: ibc-177867

RESUMO

Background: Describe the assistance provided to asthmatic patients by Primary Care Paediatricians (PCP) in Spain and the material and human resources available for diagnosis and follow-up. Methods: A cross-sectional descriptive study using an on-line survey, sent to PCP regarding the availability of diagnostic resources, carrying out programmed and educational activities, collaboration of nursing staff and their relationship with existing institutional plans to care for children with asthma. A latent class model (LCM) was used to describe the differences among paediatricians based on the variables studied. Results: Of the 708 answers, 675 were considered valid; 76% of the paediatricians had a spirometer, 75% specific IgE, 17% prick-test, 95% had placebo inhalers and 97% inhalation chambers. 57% performed programmed activities with their patients, while 56% shared their care of asthmatic patients with their nursing staff, but only 25% of the nurses were involved in the follow-up and 12% in education. LCM identified four patterns. The two groups with greater access to diagnostic resources counted on institutional plans/guidelines. However, the only variable differentiating the groups with more programmed and educational activities was the participation of nurses. Conclusions: The availability of asthma plans/guidelines and resources for diagnosis and follow-up is not sufficient to improve important aspects of primary care for children with asthma. Organisational changes are necessary to include programmed asthma-related visits and paediatric teams with greater involvement of the nurses when caring for these patients


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Asma/diagnóstico , Asma/enfermagem , Enfermagem de Atenção Primária/estatística & dados numéricos , Atenção Primária à Saúde , Estudos Transversais , Pediatria/organização & administração , Inquéritos e Questionários , Espanha
4.
Allergol Immunopathol (Madr) ; 46(4): 361-369, 2018 Jul - Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29739688

RESUMO

BACKGROUND: Describe the assistance provided to asthmatic patients by Primary Care Paediatricians (PCP) in Spain and the material and human resources available for diagnosis and follow-up. METHODS: A cross-sectional descriptive study using an on-line survey, sent to PCP regarding the availability of diagnostic resources, carrying out programmed and educational activities, collaboration of nursing staff and their relationship with existing institutional plans to care for children with asthma. A latent class model (LCM) was used to describe the differences among paediatricians based on the variables studied. RESULTS: Of the 708 answers, 675 were considered valid; 76% of the paediatricians had a spirometer, 75% specific IgE, 17% prick-test, 95% had placebo inhalers and 97% inhalation chambers. 57% performed programmed activities with their patients, while 56% shared their care of asthmatic patients with their nursing staff, but only 25% of the nurses were involved in the follow-up and 12% in education. LCM identified four patterns. The two groups with greater access to diagnostic resources counted on institutional plans/guidelines. However, the only variable differentiating the groups with more programmed and educational activities was the participation of nurses. CONCLUSIONS: The availability of asthma plans/guidelines and resources for diagnosis and follow-up is not sufficient to improve important aspects of primary care for children with asthma. Organisational changes are necessary to include programmed asthma-related visits and paediatric teams with greater involvement of the nurses when caring for these patients.


Assuntos
Asma/diagnóstico , Asma/enfermagem , Enfermagem de Atenção Primária/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pediatria/organização & administração , Espanha , Inquéritos e Questionários
5.
Allergol. immunopatol ; 45(4): 375-386, jul.-ago. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-165098

RESUMO

Objective: Assess whether the Asthma, Sport and Health (ASAH) programme taught by teachers improves asthmatics’ quality of life, asthma knowledge, and reduces school absenteeism. Design: Randomised cluster trial parallel group. Participants: 2293 students (203 asthmatic) in the Intervention School group (IS) and 2214 in the Comparison School (CS) (224 asthmatic) belonging to primary school. Intervention: Implementation of the educational programme ‘Asthma, Sport and Health’ at grade schools, taught by physical education teachers. Main outcome: Quality of life according to the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Secondary outcomes: Asthma knowledge, asthma control, school absenteeism. Results: After implementing the programme in the IS group, global quality of life improved significantly (p < 0.001) as did their domains, symptoms (p < 0.001), emotional function (p < 0.001) and activity limitations ( p < 0.01), while in the CS group improvement was seen in global life quality (p < 0.01) without any significant changes in the domains for emotional function and activity limitations. Asthma knowledge only increased in IS, among asthmatic students from 16.51 (CI 95% 16.04-16.98) to 18.16 (CI 95% 17.69-18.62) (p < 0.001) and students without asthma from 15.49 (CI95% 15.36-15.63) to 17.50 (CI95% 17.36–17.64) (p < 0.001). The multiple regression analysis showed that quality of life and its domains depend on asthma knowledge and above all, having well-controlled asthma. We found no decrease in school absenteeism. Conclusions: The ASAH programme improved certain quality of life aspects regarding asthma (emotional function and limitation of activities) and asthma knowledge, but it failed to reduce school absenteeism NCT01607749 (AU)


No disponible


Assuntos
Humanos , Educação em Saúde/métodos , Asma , Promoção da Saúde/métodos , Docentes , Serviços de Saúde Escolar , Educação Física e Treinamento/organização & administração , Amostragem por Conglomerados , Qualidade de Vida , Avaliação de Eficácia-Efetividade de Intervenções , Conhecimentos, Atitudes e Prática em Saúde
7.
Allergol Immunopathol (Madr) ; 45(4): 375-386, 2017 Jul - Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28318759

RESUMO

OBJECTIVE: Assess whether the Asthma, Sport and Health (ASAH) programme taught by teachers improves asthmatics' quality of life, asthma knowledge, and reduces school absenteeism. DESIGN: Randomised cluster trial parallel group. PARTICIPANTS: 2293 students (203 asthmatic) in the Intervention School group (IS) and 2214 in the Comparison School (CS) (224 asthmatic) belonging to primary school. INTERVENTION: Implementation of the educational programme "Asthma, Sport and Health" at grade schools, taught by physical education teachers. MAIN OUTCOME: Quality of life according to the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). SECONDARY OUTCOMES: Asthma knowledge, asthma control, school absenteeism. RESULTS: After implementing the programme in the IS group, global quality of life improved significantly (p<0.001) as did their domains, symptoms (p<0.001), emotional function (p<0.001) and activity limitations (p<0.01), while in the CS group improvement was seen in global life quality (p<0.01) without any significant changes in the domains for emotional function and activity limitations. Asthma knowledge only increased in IS, among asthmatic students from 16.51 (CI 95% 16.04-16.98) to 18.16 (CI 95% 17.69-18.62) (p<0.001) and students without asthma from 15.49 (CI95% 15.36-15.63) to 17.50 (CI95% 17.36-17.64) (p<0.001). The multiple regression analysis showed that quality of life and its domains depend on asthma knowledge and above all, having well-controlled asthma. We found no decrease in school absenteeism. CONCLUSIONS: The ASAH programme improved certain quality of life aspects regarding asthma (emotional function and limitation of activities) and asthma knowledge, but it failed to reduce school absenteeism NCT01607749.


Assuntos
Asma/epidemiologia , Educação em Saúde , Professores Escolares , Absenteísmo , Criança , Emoções , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Educação Física e Treinamento , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Instituições Acadêmicas , Espanha/epidemiologia
8.
Allergol. immunopatol ; 44(2): 131-137, mar.-abr. 2016. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-150660

RESUMO

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 (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Cuidadores/psicologia , Qualidade de Vida , Asma/diagnóstico , Asma/prevenção & controle , Monitoramento Epidemiológico/tendências , Impactos na Saúde , Saúde da Família , Psicometria , Espanha/epidemiologia
9.
Allergol Immunopathol (Madr) ; 44(2): 131-7, 2016 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26242567

RESUMO

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.


Assuntos
Asma/epidemiologia , Cuidadores/estatística & dados numéricos , Qualidade de Vida , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Psicometria/métodos , Reprodutibilidade dos Testes , Espanha/epidemiologia , Inquéritos e Questionários/normas
12.
Allergol. immunopatol ; 43(2): 147-156, mar.-abr. 2015. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-134680

RESUMO

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 (AU)


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Asma/diagnóstico , Asma/metabolismo , Nebulizadores e Vaporizadores/classificação , Assistência ao Paciente/métodos , Educação de Pacientes como Assunto/métodos , Clínicas de Dor/organização & administração , Asma/enfermagem , Asma/prevenção & controle , Nebulizadores e Vaporizadores/provisão & distribução , Assistência ao Paciente/normas , Educação de Pacientes como Assunto , Clínicas de Dor
13.
Allergol Immunopathol (Madr) ; 43(2): 147-56, 2015 Mar-Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24731769

RESUMO

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.


Assuntos
Asma/epidemiologia , Indicadores de Qualidade em Assistência à Saúde , Asma/diagnóstico , Asma/tratamento farmacológico , Criança , Consenso , Técnica Delfos , Prova Pericial , Acesso aos Serviços de Saúde , Humanos , Comunicação Interdisciplinar , Segurança do Paciente , Assistência Centrada no Paciente , Atenção Primária à Saúde/métodos , Espanha , Resultado do Tratamento
15.
An. pediatr. (2003, Ed. impr.) ; 79(3): 188-188[e1-e5], sept. 2013.
Artigo em Espanhol | IBECS | ID: ibc-116573

RESUMO

La prevalencia del asma ha aumentado en las últimas décadas, especialmente en los países desarrollados, por motivos no bien esclarecidos. En los últimos años se ha observado una asociación entre el uso de paracetamol en distintas etapas de la vida, incluyendo la gestación y la infancia, y la prevalencia de asma. El carácter observacional de los estudios publicados no permite establecer una relación causal. Sería necesario realizar ensayos clínicos para comprobar la naturaleza de la asociación, que podría deberse a la presencia de diversos factores de confusión. Las sociedades pediátricas españolas firmantes de este artículo consideran que los datos disponibles hasta la fecha no son suficientes para desaconsejar el uso de paracetamol durante la gestación ni en niños asmáticos o con riesgo de asma (AU)


Asthma prevalence has increased over the last few decades, especially in developed countries, and possibly due to different reasons. An association between paracetamol use or exposure at different periods of life, including gestation and childhood, and asthma prevalence has been observed in the last few years. Causality can not be established from observational reports, due to the arguable presence of many confounding factors and biases. Randomised trials are needed to elucidate the nature of this association. The Spanish Paediatric societies subscribing to this paper consider that current evidence is insufficient to discourage the use of paracetamol during gestation or in children with or at risk of asthma (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Acetaminofen/efeitos adversos , Asma/induzido quimicamente , Fatores de Risco , Exposição Materna
16.
An Pediatr (Barc) ; 79(3): 188.e1-5, 2013 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-23462095

RESUMO

Asthma prevalence has increased over the last few decades, especially in developed countries, and possibly due to different reasons. An association between paracetamol use or exposure at different periods of life, including gestation and childhood, and asthma prevalence has been observed in the last few years. Causality can not be established from observational reports, due to the arguable presence of many confounding factors and biases. Randomised trials are needed to elucidate the nature of this association. The Spanish Paediatric societies subscribing to this paper consider that current evidence is insufficient to discourage the use of paracetamol during gestation or in children with or at risk of asthma.


Assuntos
Acetaminofen/efeitos adversos , Analgésicos não Entorpecentes/efeitos adversos , Antipiréticos/efeitos adversos , Asma/induzido quimicamente , Asma/prevenção & controle , Acetaminofen/uso terapêutico , Analgésicos não Entorpecentes/uso terapêutico , Antipiréticos/uso terapêutico , Criança , Humanos
17.
An. pediatr. (2003, Ed. impr.) ; 77(4): 226-235, oct. 2012. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-102699

RESUMO

Introducción: Los conocimientos y las actitudes hacia el asma pueden condicionar la integración de adolescentes con asma en la escuela, así como a afectar su calidad de vida. Nuestro objetivo fue conocer el estado de los conocimientos y las actitudes sobre asma en centros de enseñanza secundaria y su relación con la calidad de vida de estudiantes con asma, como primer paso a una intervención educativa. Material y método: Estudio descriptivo y transversal en estudiantes de 13 y 14 años de edad y su profesorado en 26 institutos de Sevilla y provincia. Se han utilizado como herramientas de estudio el cuestionario de conocimientos NAKQ, el de actitudes de Gibson frente al asma y el Paediatric Asthma Quality of Life Questionnaire. Para valorar la normalidad de variables se usó el test de Kolmogorov-Smirnov y como tests no paramétricos la U de Mann-Whitney y W de Wilcoxon. Para la asociación entre variables, usamos coeficientes de regresión y la rho de Spearman. Resultados: Se han estudiado a 3.827 estudiantes (279 con asma) y 548 profesores. Todos tenían bajos conocimientos sobre asma. La calidad de vida en asma estaba leve a moderadamente afectada, más baja en mujeres 5,38±1,08 (IC del 95%, 5,20-5,55) que en varones 5,77±1,18) (IC del 95%, 5,56-5,97), p=0,0000. No encontramos relación entre conocimientos, actitudes y calidad de vida en el asma. Conclusiones: Se constata un bajo nivel de conocimientos sobre el asma en el alumnado y el profesorado. Los asmáticos presentan una afectación de la calidad de vida relacionada con el asma, de grado leve a moderado, que es peor en las chicas. Los conocimientos no tienen relación con las actitudes frente al asma en todos los grupos ni con la calidad de vida de los asmáticos(AU)


Introduction: Knowledge and attitudes toward asthma can condition the integration of adolescents with asthma in school and affect their quality of life. Our objective was to determine the state of knowledge, attitudes on asthma in secondary schools, and its relationship to quality of life of pupils with asthma, as an early step to an educational intervention. Methods: Descriptive and cross-sectional study of pupils aged 13 and 14 years old and their teachers in 26 schools of Seville and province. We used, as study tools, the Newcastle Asthma Knowledge Questionnaire, the Gibson attitudes towards asthma, and the Paediatric Asthma Quality of Life Questionnaire. To assess the normality of variables, the Kolmogorov-Smirnov test was used, and for non-parametric variables the U Mann-Whitney and W Wilcoxon tests were used. For the association between variables, we use the regression coefficients and rho Spearman. Results: We studied 3827 pupils (279 with asthma) and 548 teachers. All had little knowledge about asthma. The quality of life in asthma was mild to moderately affected, and lower in girls, 5.38±1.08 (95% CI=5.20 to 5.55) than in boys 5.77 (± 1.18) (95% CI=5.56 to 5.97), P=.0000. We found no relationship between knowledge, attitudes and quality of life in asthma. Conclusions: We found a low level of knowledge about asthma in pupils and teacher. Asthma sufferers have a mild to moderate asthma quality of life, which is worse for girls. Knowledge has no relationship with attitudes to asthma in all groups, or with the quality of life of asthma sufferers(AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Asma/epidemiologia , Educação em Saúde/organização & administração , Conhecimentos, Atitudes e Prática em Saúde , Qualidade de Vida , Serviços de Saúde Escolar
18.
Pediatr. aten. prim ; 14(54): 139-143, abr.-jun. 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-102458

RESUMO

La mononucleosis infecciosa es una enfermedad frecuente en la edad pediátrica, cuya máxima incidencia se encuentra en la primera infancia y en la adolescencia o inicio de la edad adulta. El edema palpebral bilateral puede ser un hallazgo clínico sutil en el curso de dicha entidad, y aunque no forma parte de los síntomas característicos, puede estar presente al inicio del cuadro hasta en un tercio de los pacientes. Presentamos cuatro casos clínicos, en los cuales el edema palpebral bilateral es el síntoma guía que orienta el diagnóstico, reflexionando así sobre la necesidad de incluir la mononucleosis infecciosa dentro del diagnóstico diferencial planteado frente al edema palpebral (AU)


Infectious mononucleosis is a common disease in children, whose incidence is highest in early childhood and adolescence or early adulthood. Bilateral eyelid edema may be a subtle clinical finding in the course of that entity, and although not part of the characteristic symptoms may be present at the onset of up to one third of patients. We present four cases in which bilateral eyelid edema is a symptom guide for the diagnosis, thus reflecting the need to include infectious mononucleosis in the differential diagnosis raised against the palpebral edema (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Mononucleose Infecciosa/complicações , Mononucleose Infecciosa/diagnóstico , Edema/complicações , Edema/diagnóstico , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Amoxicilina/uso terapêutico , Citomegalovirus/isolamento & purificação , Mononucleose Infecciosa/fisiopatologia , Diagnóstico Diferencial , Febre/complicações , Esplenomegalia/complicações , Cefaleia/complicações
19.
An Pediatr (Barc) ; 77(4): 226-35, 2012 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-22465286

RESUMO

INTRODUCTION: Knowledge and attitudes toward asthma can condition the integration of adolescents with asthma in school and affect their quality of life. Our objective was to determine the state of knowledge, attitudes on asthma in secondary schools, and its relationship to quality of life of pupils with asthma, as an early step to an educational intervention. METHODS: Descriptive and cross-sectional study of pupils aged 13 and 14 years old and their teachers in 26 schools of Seville and province. We used, as study tools, the Newcastle Asthma Knowledge Questionnaire, the Gibson attitudes towards asthma, and the Paediatric Asthma Quality of Life Questionnaire. To assess the normality of variables, the Kolmogorov-Smirnov test was used, and for non-parametric variables the U Mann-Whitney and W Wilcoxon tests were used. For the association between variables, we use the regression coefficients and rho Spearman. RESULTS: We studied 3827 pupils (279 with asthma) and 548 teachers. All had little knowledge about asthma. The quality of life in asthma was mild to moderately affected, and lower in girls, 5.38±1.08 (95% CI=5.20 to 5.55) than in boys 5.77 (± 1.18) (95% CI=5.56 to 5.97), P=.0000. We found no relationship between knowledge, attitudes and quality of life in asthma. CONCLUSIONS: We found a low level of knowledge about asthma in pupils and teacher. Asthma sufferers have a mild to moderate asthma quality of life, which is worse for girls. Knowledge has no relationship with attitudes to asthma in all groups, or with the quality of life of asthma sufferers.


Assuntos
Asma/psicologia , Docentes , Conhecimentos, Atitudes e Prática em Saúde , Qualidade de Vida , Estudantes/psicologia , Adolescente , Asma/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , População Rural , Instituições Acadêmicas , Fatores Sexuais , Espanha/epidemiologia , Estatísticas não Paramétricas , Inquéritos e Questionários , População Urbana
20.
An Pediatr (Barc) ; 70(3): 209-17, 2009 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-19409237

RESUMO

INTRODUCTION: The Newcastle Asthma Knowledge Questionnaire for parents of children with asthma (NAKQ) has proven to be a valid instrument for asthma knowledge assessment of patients and their parents. The widespread use of the SRS-22 in non-English-speaking countries requires its transcultural adaptation. Our objective was to obtain a version of the NAKQ questionnaire adapted to Spanish and to analyze its validity and reliability. MATERIAL AND METHODS: The Spanish version was obtained by using the forward/back-translation method with expert, bilingual translators. The questionnaire was administered to 157 parents with high knowledge (n = 78) and low knowledge (n = 79) of asthma. The differences in the number of answers between both groups were analyzed with the chi(2) test. Internal consistency was determined with Cronbach's alpha coefficient and test-retest reliability with the tau-b of Kendall correlation coefficient, and kappa statistics. RESULTS: At the end of the process, 23 of the 31 items were classified as of total equivalence and eight ase of moderate equivalence. The mean score of parents high knowledge was 23 +/- 2.94 and the mean score of parents low knowledge was 16.84 +/- 2.56. The difference between the two groups was statistically significant (p < 0.001). The overall Cronbach's alpha coefficient of the questionnaire was 0.72, the Kendall's tau-b 0,8573 was significant (p = 0.01) and the kappa index showed good or very good consistency in more than half of the items. CONCLUSIONS: The Spanish version of the NAKQ has proven to be acceptable and culturally equivalent to the original version and it has a good degree of consistency, validity and reliability.


Assuntos
Asma , Características Culturais , Pais , Inquéritos e Questionários , Adulto , Feminino , Humanos , Linguagem , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
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