Risk factors for wheezing in primary health care settings in the tropics.

BACKGROUND: The International Study of Wheezing in Infants (EISL) is a cross-sectional, population-based study, based on ISAAC (http://www.isaac.auckland.ac.nz). It uses a validated questionnaire on early wheezing and risk/protective factors. OBJECTIVE: To apply the EISL questionnaire regarding wheezing events in 0- to 12-month-old infants with or without atopic background searching for risk factors in the tropics. METHODS: The population was toddlers coming in for a checkup or 12-months' vaccination in primary health care clinics of a tropical city. Apart from child factors (eg, daycare attendance), we evaluated home factors (eg, air conditioning, bathroom, carpet, >6 persons, pollution) and mothers' factors (eg, education level, employment, cellphone). Data analysis was descriptive and case-control, with as cases atopic (AW) or non-atopic (NAW) wheezing children vs healthy controls. Wheezing-associated factors were evaluated using multivariate analysis, adjusted for the relation of AW/NAW with factors that were significant in prior univariate analysis. RESULTS: The study included 999 toddlers. Any wheeze: 31.3%, recurrent wheeze (≥3 episodes): 12.1%. Major risk factors for AW (OR; 95%CI) included smoking (11.39; 2.36-54.99), common cold before 3 months of life (3.72; 2.59-5.36), mold (3.48; 2.28-5.30), kitchen indoors (2.40; 1.27-4.54), and pets (1.69; 1.09-2.62); breastfeeding was almost protective. For NAW, common cold and pets were risk factors, but cesarean section (0.44; 0.23-0.82), more than 1 sibling (0.33; 0.18-0.61), and breastfeeding for longer than 3 months (0.50; 0.28-0.91) were protective. CONCLUSION: Wheezing is a health care burden. We found potential new risk factors for AW, some possibly unique for tropical climates. We suggest testing several hypotheses: could early AW be reduced in the tropics by attacking mold growth? Enhancing cooking place ventilation? Keeping pets outside? Or by postponing daycare attendance until after 4 months of age and avoiding (passive) smoking during pregnancy?

El doctor Eduardo Liceaga, pediatra.

Aun cuando se han escrito diversos trabajos acerca de la vida y obra del doctor Eduardo Liceaga, muy poco se menciona acerca de su actividad en el campo de la atención a la salud infantil. Al inicio de su actividad profesional, el doctor Liceaga mostró una inclinación por la atención de los niños enfermos. Preferentemente por los aspectos quirúrgicos, así lo señalan sus primeros trabajos, aunque después también se preocupó por otros temas relacionados con la infancia y, finalmente, por los asuntos sanitarios. El doctor Liceaga fue el médico responsable de la primera sala de niños enfermos que hubo en México en el Hospital de San Andrés, el primer director del Hospital de Infancia, autor de varias publicaciones sobre problemas pediátricos, introductor de la vacuna contra la rabia en México y creador del Hospital General.Although much has been written about Dr. Eduardo Liceaga's life and works, very little is mentioned about his activities in the field of children's healthcare. At the beginning of his professional activities Dr. Liceaga showed an inclination for the care of sick children. His preference for surgical matters is shown by his early works, although later he also took an interest in other childhood-related issues, and ultimately, in healthcare policies. Dr. Liceaga was the physician responsible for the first ward for sick children in Mexico at Hospital de San Andrés, first director of the Hospital de Infancia, and author of several publications on pediatric problems; he introduced the rabies vaccine in Mexico and was the founder of the Hospital General de México.

El Dr. Manuel Justo Domínguez Quintanar, fundador de la puericultura racional y la pediatría técnica en México.

This paper presents some biographical notes, both personal and professional, for Dr. Manuel Justo Dominguez Quintanar; a native of Queretaro, who over 80 years lived firsthand the historical stages in which Mexico turned into an independent country: from the First Federal Republic to the Porfiriato. He had an active participation in them all; either as a doctor, a teacher, administrator or politician. He was renowned for his charity work, especially in the Foundling House (The Cradle), which made him years later, to be considered as the founder of rational childcare and the creator of technical pediatrics in Mexico.

Regional variation in asthma symptom prevalence in Latin American children.

OBJECTIVES: This study investigates the distribution pattern of asthma symptom prevalence in Latin American children aged 13-14 years. METHODS: A randomized, cross-sectional and multicentric study on the prevalence and severity of asthma symptoms (lifetime asthma, current wheezing, and frequent sleep disturbance by wheezing) was conducted in 165,917 schoolchildren from 56 centers in 17 Latin American countries, as part of the International Study of Asthma and Allergies in Childhood (ISAAC), Phase Three. RESULTS: The prevalence of lifetime asthma prevalence ranged from 1.2% to 33.1%, whereas current wheezing went from 3.9% to 30.8% and frequent sleep disturbance from 0.6% to 6.1%. An important proportion of centers (55%) reported a prevalence of asthma symptoms over 15%. There was no significant correlation between asthma symptom prevalence and latitude, altitude, or tropical setting. At country level, the prevalence of asthma was not associated with gross national income (GNI), proportion of population under the poverty line, or ancestry. CONCLUSIONS: This study suggests that ecological interactions, probably typical for each locality, may be the main determinants for the large variability of asthma prevalence in Latin America. The high prevalence of asthma symptoms found in children living in areas with low socioeconomic development would challenge the protective role against asthma of factors related to low hygiene and poverty; contrarily, in this region they would act as risk factors.

First surgical care of Mexican children in the nineteenth century.

Here, two papers are presented, which constitute the first reports of surgical procedures in Mexican children performed at the 19th century. The two publications refer to surgical operations for the extraction of bladder stones. At that time, there was no anesthesia, so part of the description alludes to the suffering of the patients and the operative difficulties. The first case, is referred to as a lithotomy in a 17-year-old girl, performed by surgeon José Victoriano Guerrero in Guadalajara in 1822. The publication is not an academic report, but a pamphlet written as a gift to Emperor Augustin I to celebrate his ascension to the throne. The second work, is a lateral lithotomy in a 5-year-old boy, published by Dr. Luis Jecker in the first issue of the Periódico de la Academia de Medicina de Mégico in 1836.

Se presentan dos trabajos que constituyen los primeros informes de procedimientos quirúrgicos en niños mexicanos en el siglo XIX. Las dos publicaciones se refieren a operaciones para la extracción de cálculos vesicales. En ese tiempo no existía anestesia, por lo que parte de la descripción incluye el sufrimiento de los pacientes y las dificultades operatorias. El primer caso está referido como una litotomía en una joven de 17 años, operada por el cirujano José Victoriano Guerrero en Guadalajara en 1822. La publicación no constituye un informe académico, sino un folleto escrito como un obsequio para el emperador Agustín I para celebrar su ascensión al trono. El segundo trabajo es una talla lateral en un niño de 5 años edad, publicado por el doctor Luis Jecker en el primer número del Periódico de la Academia de Medicina de Mégico en 1836.

The foundation of the Hospital Infantil de México, today Hospital Infantil de México Federico Gómez.

In the early years of the 20th century, no hospital in Mexico held the capacity to address the health problems of Mexican children, making it necessary to build a modern institution to take care of these issues. This situation mobilized a group of doctors led by Dr. Federico Gómez Santos to seek the acknowledgement of the President, Abelardo L. Rodríguez, of the urgent need of a children's hospital. Later, the President approved the project for its construction in 1933. After 10 years of struggle in the political, social and economic fields, and with the support of presidents Lázaro Cárdenas and Manuel Ávila Camacho, the Hospital Infantil de México was inaugurated on April 30th, 1943. Today, 75 years after its creation, the hospital has withstood the test of time maintaining intact its principles of assistance, teaching and research, and emerging as the cradle of Mexican and Latin American pediatrics.

En los primeros años del siglo XX, no existía en México un hospital que tuviera la capacidad de atender los problemas de salud de la niñez mexicana, lo que hacía necesaria la construcción de una institución moderna para atenderlos. En 1933, esta situación llevó a un grupo de médicos, encabezados por el Dr. Federico Gómez Santos, a solicitar y conseguir que el presidente de la República, Abelardo L. Rodríguez, reconociera la imperiosa necesidad de contar con un hospital de niños y aprobara el proyecto para su construcción. Luego de diez años de lucha en el campo político, social y económico, y con el apoyo de los presidentes Lázaro Cárdenas y Manuel Ávila Camacho, el 30 de abril de 1943 se inauguró el Hospital Infantil de México. Hoy, después de 75 años de su creación, el hospital ha resistido la prueba del tiempo y mantiene incólume sus principios de asistencia, enseñanza e investigación, emergiendo como la cuna de la pediatría mexicana y latinoamericana.

Firsts surgical care of Mexican children in the nineteenth century. / Primicias de la atención quirúrgica de los niños mexicanos en el siglo XIX

Here, two papers are presented, which constitute the first reports of surgical procedures in Mexican children performed at the 19th century. The two publications refer to surgical operations for the extraction of bladder stones. At that time, there was no anesthesia, so part of the description alludes to the suffering of the patients and the operative difficulties. The first case, is referred to as a lithotomy in a 17-year-old girl, performed by surgeon José Victoriano Guerrero in Guadalajara in 1822. The publication is not an academic report, but a pamphlet written as a gift to Emperor Augustin I to celebrate his ascension to the throne. The second work, is a lateral lithotomy in a 5-year-old boy, published by Dr. Luis Jecker in the first issue of the Periódico de la Academia de Medicina de Mégico in 1836.

Se presentan dos trabajos que constituyen los primeros informes de procedimientos quirúrgicos en niños mexicanos en el siglo XIX. Las dos publicaciones se refieren a operaciones para la extracción de cálculos vesicales. En ese tiempo no existía anestesia, por lo que parte de la descripción incluye el sufrimiento de los pacientes y las dificultades operatorias. El primer caso está referido como una litotomía en una joven de 17 años, operada por el cirujano José Victoriano Guerrero en Guadalajara en 1822. La publicación no constituye un informe académico, sino un folleto escrito como un obsequio para el emperador Agustín I para celebrar su ascensión al trono. El segundo trabajo es una talla lateral en un niño de 5 años edad, publicado por el doctor Luis Jecker en el primer número del Periódico de la Academia de Medicina de Mégico en 1836.

The International Study of Wheezing in Infants: questionnaire validation.

BACKGROUND: There are no internationally validated questionnaires to investigate the prevalence of infant wheezing. This study was undertaken to validate a questionnaire for the International Study on the Prevalence of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). MATERIAL AND METHODS: Construct and criterion validity were tested for the question 'Has your baby had wheezing or whistling in the chest during his/her first 12 months of life?'. Construct validity (i.e. the ability of parents and doctors to refer to the same symptoms with the same words) was tested in a sample of 50 wheezing and 50 non-wheezy infants 12-15 months of age in each of 10 centres from 6 different Spanish- or Portuguese-speaking countries. Criterion validity (i.e. the ability of parents to correctly detect the symptom in the general population) was evaluated in 2 samples (Santiago, Chile and Cartagena, Spain) of 50 wheezing and 50 non-wheezing infants (according to parents) of the same age, randomly selected from the general population, who were later blindly diagnosed by a paediatric pulmonologist. RESULTS: Construct validity was very high (kappa test: 0.98-1) in all centres. According to Youden's index, criterion validity was good both in Cartagena (75.5%) and in Santiago (67.0%). Adding questions about asthma medication did not improve diagnosis accuracy. CONCLUSIONS: The EISL questionnaire significantly distinguished wheezy infants from healthy ones. This questionnaire has a strong validity and can be employed in large international multicentre studies on wheezing during infancy.

[Origins of institutional Pediatrics: Maternity and Childhood Hospital of Mexico City in the nineteenth century]. / Orígenes de la pediatría institucional: el Hospital de Maternidad e Infancia de la Ciudad de México en el siglo XIX.

In June of 1866, the empress Carlota founded the Maternity House in the Department of Secret Births at the Hospice of the Poor. Upon the reinstatement of a republican government, Dr. Ramon Pacheco was appointed director of the Maternity House. Shortly after, in February of 1868, Dr. Luis Fernandez Gallardo established a pavilion for sick children in the Hospital of San Andres. After realizing this pavilion didn't have the adequate conditions to operate properly, and in the need of a children's hospital in Mexico City, Dr. Pacheco merged both institutions in April 2, 1869 -with the help of Ms. Luciana Arrazola- and founded the Maternity and Childhood Hospital, the first institution for the care of ill children in the independent Mexico. Ever since it was founded, Dr. Eduardo Liceaga was in charge of the children's health. Later, with the help of the presidents Juarez, Lerdo de Tejada and Díaz, he was able to consolidate the hospital in academic and health services aspects. This noble institution closed its doors on February 5, 1905, upon its incorporation to the General Hospital of Mexico, after 36 years of working for the welfare of Mexican children.

La fundación del Hospital Infantil de México, ahora Hospital Infantil de México Federico Gómez / The foundation of the Hospital Infantil de México, today Hospital Infantil de México Federico Gómez

Resumen En los primeros años del siglo XX, no existía en México un hospital que tuviera la capacidad de atender los problemas de salud de la niñez mexicana, lo que hacía necesaria la construcción de una institución moderna para atenderlos. En 1933, esta situación llevó a un grupo de médicos, encabezados por el Dr. Federico Gómez Santos, a solicitar y conseguir que el presidente de la República, Abelardo L. Rodríguez, reconociera la imperiosa necesidad de contar con un hospital de niños y aprobara el proyecto para su construcción. Luego de diez años de lucha en el campo político, social y económico, y con el apoyo de los presidentes Lázaro Cárdenas y Manuel Ávila Camacho, el 30 de abril de 1943 se inauguró el Hospital Infantil de México. Hoy, después de 75 años de su creación, el hospital ha resistido la prueba del tiempo y mantiene incólume sus principios de asistencia, enseñanza e investigación, emergiendo como la cuna de la pediatría mexicana y latinoamericana.

Abstract In the early years of the 20th century, no hospital in Mexico held the capacity to address the health problems of Mexican children, making it necessary to build a modern institution to take care of these issues. This situation mobilized a group of doctors led by Dr. Federico Gómez Santos to seek the acknowledgement of the President, Abelardo L. Rodríguez, of the urgent need of a children's hospital. Later, the President approved the project for its construction in 1933. After 10 years of struggle in the political, social and economic fields, and with the support of presidents Lázaro Cárdenas and Manuel Ávila Camacho, the Hospital Infantil de México was inaugurated on April 30th, 1943. Today, 75 years after its creation, the hospital has withstood the test of time maintaining intact its principles of assistance, teaching and research, and emerging as the cradle of Mexican and Latin American pediatrics.

Orígenes de la pediatría institucional: el Hospital de Maternidad e Infancia de la Ciudad de México en el siglo XIX / Origins of institutional Pediatrics: Maternity and Childhood Hospital of Mexico City in the nineteenth century

Resumen: En junio de 1866, la emperatriz Carlota fundó la Casa de Maternidad en el Departamento de Partos Ocultos del Hospicio de Pobres. Con el restablecimiento de la república, se nombró al Dr. Ramón Pacheco director de la Casa de Maternidad. Poco después, en febrero de 1868, el Dr. Luis Fernández Gallardo estableció una sala de niños enfermos en el Hospital de San Andrés. Considerando que esta sala no reunía las condiciones necesarias, y ante la necesidad de un hospital infantil en la Ciudad de México, el Dr. Pacheco -con el apoyo de la Sra. Luciana Arrazola-, fusionó ambas instituciones el 2 de abril de 1869, fundando el Hospital de Maternidad e Infancia, la primera institución de México independiente para la atención de los problemas de salud infantiles. Desde su creación, el Dr. Eduardo Liceaga estuvo a cargo de la atención de los niños; con el respaldo de los presidentes Juárez, Lerdo de Tejada y Díaz, logró la consolidación del hospital en los aspectos asistenciales y docentes. Esta noble institución cerró sus puertas el 5 de febrero de 1905, al ser incorporada al Hospital General de México, después de 36 años de trabajo en favor de los de los niños mexicanos.

Abstract: In June of 1866, the empress Carlota founded the Maternity House in the Department of Secret Births at the Hospice of the Poor. Upon the reinstatement of a republican government, Dr. Ramon Pacheco was appointed director of the Maternity House. Shortly after, in February of 1868, Dr. Luis Fernandez Gallardo established a pavilion for sick children in the Hospital of San Andres. After realizing this pavilion didn't have the adequate conditions to operate properly, and in the need of a children's hospital in Mexico City, Dr. Pacheco merged both institutions in April 2, 1869 -with the help of Ms. Luciana Arrazola- and founded the Maternity and Childhood Hospital, the first institution for the care of ill children in the independent Mexico. Ever since it was founded, Dr. Eduardo Liceaga was in charge of the children's health. Later, with the help of the presidents Juarez, Lerdo de Tejada and Díaz, he was able to consolidate the hospital in academic and health services aspects. This noble institution closed its doors on February 5, 1905, upon its incorporation to the General Hospital of Mexico, after 36 years of working for the welfare of Mexican children.

[Acute asthma prevalence in children and teenagers from Merida, Yucatan, Mexico]. / Prevalencia de asma aguda en niños y adolescentes de Mérida, Yucatán, México.

OBJECTIVE: To quantify the number of asthma attacks treated in the emergency room of a public hospital and to study seasonal fluctuations. MATERIAL AND METHODS: A retrospective survey was conducted in the pediatrician emergency room of General Hospital Agustin O'Horan in Merida, Yucatan, Mexico during one year (January 1 to December 31st, 2005). A total of 7,674 emergency room consultations were registered during a period of one year. All patients were younger than 14 years old. RESULTS: Among the conditions treated, acute asthma (10.3%) was the third most common diagnosis. There were 622 children with asthma, 376 boys (60%). Most of the asthma consultations (22.6%) involved children of 1 year old of age. The consultation for asthma attacks increased in December (18.4%), October (14.1%) and September (12.2%). A significative association was found between the monthly number of emergency room visits due to acute asthma and upper respiratory infections (r = 0.9059, p = < 0.001, I.C. 99%). CONCLUSION: The acute asthma is one of the most frequent emergency consult causes in children and there was a positive association between acute asthma and upper respiratory infections.

Asthma prevalence in children living in north Mexico City and a comparison with other Latin American cities and world regions.

Reports of previous studies done without following the international guidelines in different cities of Mexico showed a decrease in asthma prevalence. The aim of this study was to determine the prevalence and severity of asthma symptoms in children and teenagers living in north Mexico City and compare them with those of other Latin American cities and world regions. The cross-sectional survey followed the protocol of the International Study of Asthma and Allergies in Childhood IIIb phase survey. The study population included children 6-7 years old and teenagers 13-14 years old from randomly selected primary and secondary schools. There were 1629 boys and 1582 girls in the group of 6- to 7-year-old children and 2039 boys and 1860 girls in the 13- to 14-year-old group. "Wheezing or whistling in the chest at any time in the past" was present in 19.2% (95% confidence interval [CI], 17.9, 20.6) of the children and in 17.0% (95% CI, 15.8, 18.1) of the teenagers; "wheezing or whistling in the chest in the last 12 months" was reported in 6.8% (95% CI, 5.9, 7.6) of the children and 9.9% (95% CI, 9.0, 10.8) of the teenagers; "asthma ever" was claimed in 4.5% (95% CI, 3.8, 5.2) of the children and 8.0% (95% CI, 7.1, 8.8) of the teenagers. These prevalences were low compared with other ISAAC Latin American surveys and intermediate in comparison with worldwide regional prevalences reported by ISAAC surveys. The prevalence of asthma is low in Mexico City in comparison with other surveyed locations, but the number of patients with asthma makes it an important issue for Mexican public health programs.

Identification of asthma risk factors in Mexico City in an International Study of Asthma and Allergy in Childhood survey.

The International Study of Asthma and Allergy in Childhood (ISAAC) has assessed the prevalence of asthma, as well as the factors related to the disease in different countries. The aim of this study was to identify asthma risks factors in Mexico City. Data were obtained from questionnaires of children participating in a phase 3b ISAAC survey. Two thousand ninety-eight boys and 2008 girls were recruited in the 6- to 7-year-old group and 3243 boy and 3333 girls were recruited in the 13- to 14-year-old group. Logistic regression was used to determine the asthma risks factors. In the logistic regression for cumulative and current asthma prevalence, the variables allergic rhinitis and atopic dermatitis were the most important risk factors with the highest odds ratios (OR > 1.5; p < 0.05). The use of antibiotics and paracetamol in the first 12 months of life were related to cumulative asthma in both genders in the 6- to 7-year-old group. Contact of pregnant mother with farm animals was positively related with cumulative asthma in boys in the 6- to 7-year-old group. The main factors associated with the cumulative and current prevalence of asthma in both age groups were atopic dermatitis and allergic rhinitis. Future interventions for the prevention and early diagnosis and treatment could be focused in the natural history of the atopic march.

[Prevalence of positive skin tests to indoor allergens in preschooler children with respiratory allergy in Merida, Yucatan, Mexico]. / Prevalencia de pruebas cutáneas positivas a alergenos intradomiciliarios en preescolares con alergia respiratoria de Mérida, Yucatán, México.

BACKGROUND: Infantile asthma and rhinitis are commonly thought to be caused by indoor allergens but preschooler children are not commonly skin tested. OBJECTIVE: To know the frequency of skin test reactivity to indoor allergens in allergic preschooler children. MATERIAL AND METHODS: We evaluated 176 children (103 females/73 males) between 2 and 5 years old with respiratory allergy. All of the children tested had at least one positive skin test (house dust mite, cockroach, dog, feathers, and cat). RESULTS: Seventy seven children had allergic rhinitis (44%), 68 had asthma and rhinitis (39%), and 31 had only asthma (18%). One hundred thirty two (75%) of the children were skin test positive to house dust mite, 91 (52%) to cockroach, 31 (18%) to dog, 25 (14%) to feathers, and 24 (14%) to cat. Furthermore, the frequency of sensitization to house dust mite has an increase associated with the age of the patients with a significant difference at 5 years old (odds ratio=11.63, I.C. 95%=3.83-37.10; p <0.001). CONCLUSIONS: The most frequent indoor allergen was house dust mite, with a trend directly proportional to age of the patients.

Obesity risk factors in the ISAAC (International Study of Asthma and Allergies in Childhood) in Mexico City.

BACKGROUND: The International Study of Asthma and Allergies in Childhood (ISAAC) has promoted surveys in asthma and allergic diseases using standardized methodologies including validated questionnaires. Many items in the questionnaires have also been implied in the overweight and obesity etiology. OBJECTIVE: To describe the factors associated with obesity in subjects of 6-7 years and 13-14 years in the ISAAC survey in Mexico City. MATERIAL AND METHODS: Data were obtained from questionnaires of children participating in a phase 3b ISAAC survey. Logistic regression was used to determine the obesity risks factors. RESULTS: The factors related to obesity were weekly consumption of meat (+, positive relationship), vegetables, pasta, rice (+) and quartiles of birth weight (+) in boys of 6-7 years. Having suffered eczema at any time, weekly consumption of fruit, pasta, butter, nuts, potato (+), fast food (+), daily TV viewing (+) in girls of 6-7years. Having suffered eczema at any time, weekly consumption of pasta (+), butter, potato, weekly physical exercise in boys of 13-14 years; weekly consumption of pasta, margarine, milk, fast food (+), currently smoking in girls of 13-14 years. CONCLUSIONS: There were not common factor patterns for the different groups, birth weight, fast food, TV viewing and lack of exercise have been previously related to pediatric obesity. Asthma was not associated with a higher risk of obesity but medical history of eczema was associated with lower risk of obesity in the 6-7 years girls, and 13-14 years boys. The present study provides the bases for future epidemiological studies and gives some clues on possible public health actions.

[Increase in frequency of asthma in school children from Villahermosa, Tabasca, Mexico]. / Incremento de la frecuencia de asma en niños escolares de Villahermosa, Tabasco, México.

BACKGROUND: There is evidence that the worldwide prevalence of asthma is increasing, particularly in children. OBJECTIVE: To compare the cumulative prevalence of medical diagnosis of asthma among Mexican schoolchildren in two surveys 12 years apart. MATERIAL AND METHODS: The study populations of the two comparable cross sectional surveys comprise six to twelve years old public and private schoolchildren in Villahermosa, Tabasco, Mexico. Sample sizes in 1986 and 1998 were 6,465 and 6,073 children and response rates were 72 and 85%, respectively. The sampling frame and sampling method were identical in both surveys. The prevalence of medical diagnosis was expressed by sex and age comparing 1986 to 1998. An analysis of contingency tables was used to asses the differences in the prevalence rates. RESULTS: Cumulative prevalence of medical diagnosis of asthma in 1986 and 1998 were 8.74 and 12.63%, respectively, 45% of increase. We found a significant increase in lifetime of asthma (p = 0.001). The observed increases were independent of sex and age. CONCLUSION: As it has come to pass all over, our results support a significant increase in the cumulative prevalence in the last 12 years among schoolchildren in Villahemosa, Tabasco, Mexico.

[Peak expiratory flow in 6-12 year-old children from Merida, Yucatan, Mexico]. / Flujo espiratorio máximo en niños de 6 a 12 años de edad de la ciudad de Mérida, Yucatán, México.

BACKGROUND: Assessment of pulmonary function may be done by several procedures, such as spirometric and flow metric ones. OBJECTIVE: To obtain a peak expiratory flow rate (PEFR) percentilar curve in healthy schoolchildren of both sexes of Merida, Yucatan, Mexico. MATERIAL AND METHODS: We carried out a transversal and observational study in schoolchildren between 6 and 12 years old of both sexes. They were evaluated by a demographic questionnaire that included age, weight, height and health status, and then the PEFR was assessed using a mini-Wright Peak Flow Meter recording the highest of the three numbers achieved. RESULTS: We included 621 healthy schoolchildren between 6 and 12 years old of both sexes, 321 girls and 300 boys, of two schools that were selected by random sampling. The media age was 9 +/- 2 years old, height 128 +/- 10 cm, weight 30.34 +/- 9.75 kg, corporal surface 1.049 +/- 0.22 m2, and PEFR 293.72 +/- 66 L/min. When we compared the PEFR with age, height and weight, we saw that height was a more reliable predictor than age or weight, since higher values of R were obtained. There was not a significant difference of PEFR between boys and girls. CONCLUSIONS: Our results show that the pulmonary function values increase proportionally to height, which showed the higher correlation to FEM.

Prevalencia de asma en niños escolares de Mérida, Yucatán / Asthma prevalence in scholchildren in Merida, Yucatan

De febrero a junio de 1994 se realizó en la ciudad de Mérida, Yucatán, México, una encuesta para determinar la prevalencia de asma y la frecuencia de antecedentes familiares del padecimiento en niños de edad escolar. Se estudió una muestra aleatoria de 505 niños de 6 a 12 años de edad, de ambos sexos, alumnos de las escuelas de educación primaria del área urbana de Mérida. Se administró una encuesta al padre o a la madre del niño. Se preguntó si el niño había padecido repetidas veces respiración ruidosa con dificultad respiratoria y silbidos, si había padecido bronquitis, bronquitis asmatiforme o asma, y si la madre, el padre o alguno de los hermanos había padecido asma. En total se encontraron 61 niños asmáticos (prevalencia acumulada, 12 por ciento), en los cuales los antecedentes maternos o paternos de asma fueron más frecuentes (25 y 18 por ciento, respectivamente) que ne los demás niños (10 y 6 por ciento, respectivamente), siendo la diferencia estadísticamente significativa (P<0,002) en ambos casos). Los resultados muestran la alta prevalencia de asma en Mérida y sugieren la participación de la herencia en el desarrollo de la enfermedad

A survey was conducted in Merida, Yucatan, between February and June 1994 in order to determine the prevalence of asthma and the frequency of a family history of the disease in school-age children. A random sample was taken of 505 children of both sexes between the ages of 6 and 12 who were enrolled in elementary schools in the urban area of Merida. Every child's father or mother was surveyed and asked if the child had had recurrent episodes of loud, difficult breathing with wheezing chest sounds, if he or she had had bronchitis, asthmatiform bronchitis, or asthma, and if the mother, father, or any of the siblings had ever suffered from asthma. A total of 61 children with asthma (cumulative prevalence, 12%) was found. Among these children a history of maternal or paternal asthma was more frequent (25 and 18%, respectively) than in other children (10 and 6%, respectively), the difference being statistically significant (P < 0,002) in both cases. Results show the high prevalence of asthma in Merida and suggest that heredity plays a role in the development of the disease.