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Allergic diseases cause great impact on the health related quality of life in children and adolescents, resulting in increased school absenteeism and deficiencies in school performance. Although the bibliographic framework on allergic diseases is wide, in our country, there are no guidelines for proper management of the allergic child at school. It is necessary to establish guidelines for coordinated action among the educational community, the families, the pediatrician, the health team and governmental and non-governmental authorities. This position paper aims to provide information about the impact of allergic diseases on school activities, establish standards of competence of the various stakeholders at school and consider the legal framework for the intervention of the school staff about the child with allergies at school.

Primary immunodeficiencies (PID) are low-prevalence diseases. There are warning signs that may raise clinical suspicion. The objectives of this study were to describe the clinical characteristics and warning signs of patients with PID and to compare the clinical differences between selective immunoglobulin A (IgA) deficiency and other PIDs. Eighty-nine patients were studied; their median age at the time of diagnosis was 6 years old (4.08-11.67). Fifty-three (59.5%) patients were male. Fifty-four (60.7%) patients had selective IgA deficiency, and 35 (39.3%) had other PIDs. The main clinical manifestations were rhinopharyngitis in 65 (73.03%) patients and atopy in 39 (43.82%). Twenty- four (26.97%) patients showed warning signs, and none had selective IgA deficiency. Patients with other PIDs had a higher incidence of lower respiratory tract infection, sepsis, skin infections, mucocutaneous candidiasis, dental alterations, cardiovascular malformations, angioedema, hospitalizations and death. Ten (28.57%) patients received intravenous gammaglobulin, 15 (42.85%) antibiotic prophylaxis, and 2 (2.24%) antifungal prophylaxis.

In 1998, the Sociedad Argentina de Pediatría issued the recommendation of the treatment of anaphylactic shock. While this recommendation suggested the use of subcutaneous epinephrine, currently the intramuscular via is considered the most appropriate one. Pharmacological aspects determine this preference. For outpatient treatment, the correct use of autoinjectors can control anaphylaxis quickly and effectively. The use of other medications in the proposed 1998 recommendation remains unchanged.

Introduction: Over the last years, the use of accelerometers has become relevant to quantify physical activity among youth. Methods used with accelerometers might modify the results and the possibility to compare different papers. These devices have been proved to be effective and valid quantifying long periods of physical activity compared to other methods., Objective: To show methodological criteria regarding physical activity assessed by accelerometry with schoolars., Methodology: It was conducted a review of the literature related to accelerometers and scholar-aged subjects at PubMed from January 2002 to August 2013, selecting 133 papers., Results: As far as it is shown, it appears to be some tendencies related to the choice of attachment of the device, wearing time and a shorter epoch-length; however, it has been found a wide variability regarding the model of accelerometer and cutoff points used., Discussion and Conclusions: The different criterion used makes it difficult to compare methodological aspects among studies in spite of some papers carried out similar methods., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Purpose: To determine the association of the ACTN3 R577X polymorphism with leg-muscle explosive power in Spanish (white) elite basketball players and controls., Participants: 100 (60 men) elite basketball players (cases) and 283 nonathletic controls., Methods: The authors assessed power performance by means of the vertical-squat and countermovement-jump tests., Results: Genotype distributions did not differ between groups (cases: 37.0% [RR], 42.0% [RX], and 21.0% [XX]; controls: 31.8% [RR], 49.8% [RX], and 18.4% [XX]; P = .353). The authors did not observe any effect of the ACTN3 R577X polymorphism on study phenotypes in either group, including when they performed the analyses separately in men and women. They found no association between the ACTN3 R577X polymorphism and the likelihood of being an elite basketball player using the dominant or the recessive model, and the results remained unaltered when the analyses were adjusted for sex, weight, height, and age or when performed for men and women separately., Conclusions: Although the ACTN3 R577X is associated with explosive muscle performance and this phenotype is important in the sport of basketball (ie, during jumps), the authors found no association with leg explosive power in elite basket players or with the status of being this type of athlete.

The link between upper and lower airways has been observed in the past, but only carefully investigated during the last years. Allergic rhinitis and asthma are often comorbid conditions. Its relationship is supported by epidemiological, anatomical and physiological, immunopathological, clinical and therapeutic studies, mostly related to allergic rhinitis. Rhinitis and asthma occur together at rates that greatly exceed what would be expected from the baseline prevalence of each disorder alone. Many researchers have considered rhinitis as a risk factor for developing asthma. Also, the severity of rhinitis has been directly correlated with the severity of asthma although less evidence supporting the reverse impact. Different clinical and experimental observations suggested the hypothesis of the unity of upper and lower respiratory tract. Evidence suggests that rhinitis and asthma are different facets of a broader systemic inflammatory process involving upper and lower airways. Treatment of rhinitis simultaneously produces a favorable effect on symptoms of asthma and concurrent improvement in lung function and bronchial hyperresponsiveness. In this article, we review the most relevant epidemiological, genetic and clinical evidence linking rhinitis and asthma, the possible mechanisms of the nose-lung interaction and the rational basis of a set treatment that support the hypothesis of "one airway, one disease "considering aspects not yet clarified on the subject.

Introduction: There is epidemiological, functional and pathologic evidence that relates upper and lower airways, clinically known as a single respiratory tract. Patients with allergic rhinitis without asthma may present subclinical abnormal spirometry parameters., Objectives: To describe the results of the flow-volume curve in a group of patients with allergic rhinitis without asthma and analyze the possible associations between anthropometric, clinical and biochemical outcome measures with abnormal spirometry results., Population and Methods: Observational, descriptive study including children and adolescents aged 6 to 18 years old with symptoms of allergic rhinitis without asthma. Age, gender, body mass index and duration of rhinitis were determined as per the subject's medical record. Allergen skin tests, flow-volume curve spirometry, determination of eosinophil count in blood and in nasal secretions, and total serum IgE were performed., Results: A total of 84 patients were studied; 21 (25%; 95% CI: 15.1-34.8) presented at least one altered spirometry outcome measure. The FEV1/FVC ratio was the most affected outcome measure (10/84; 12%; 95% CI: 4.3-19.4). The multiple logistic regression analysis determined that spirometry alterations were associated with the number of blood eosinophils (OR: 1.00229; 95% CI: 1.00022-1.00436; p= 0.03) and the body mass index (OR: 1.31282; 95% CI: 1.08611-1.58685; p= 0.0049)., Conclusions: Our results showed spirometry alterations in a considerable percentage of children and adolescents with allergic rhinitis without asthma. The blood eosinophil count and the body mass index could be associated with a sub-clinical alteration of pulmonary function.

Chronic cough is a symptom of various respiratory and non-respiratory conditions with negative impact on quality of life of children and their families. The pediatricians should focus their efforts in search for etiological diagnosis. A careful medical history and physical examination are the mainstays of diagnosis and guidance to further studies that may contribute to detection of final causes. The etiological identification of chronic cough must be followed by specific treatment. The symptomatic approach with antitussives and mucolytic drugs is exceptionally necessary and should be considered for some situations of nonspecific cough without any specific disease association.

Background: Patients who receive allergen immunotherapy (IT) have a potential risk of systemic reactions, however such reactions are rare when IT administered properly. The frequency of systemic reactions (SR) due to conventional IT is less than 1%., Objective: To determine the frequency of secondary SR to allergen IT, and to identify the possible factors involved in developing them., Methods: A retrospective descriptive study that included 2.319 patients who received 14.600 allergen immunotherapy injections during the period from May 1, 2001 to April 30, 2002., Results: Twelve patients had a SR (age 7 - 40 years), all of which occurred within the first 30 minutes after the IT. These were more frequent during the dose - increase phase (58%). The frequency of (RS) in relation to the number of injections was 1:1216, and regarding to the number of patients, 1:193. The clinical manifestations included bronchospasm 83%, urticaria 67%, gastrointestinal symptoms and hypotension 8.3%. The 58% had anaphylaxis and pulmonary or dermatological symptoms only in 33% and 8.3% respectively. The possible factors involved in the onset of SR were: sensitivity identified by large skin reactions in skin test (PC) 83%, uncontrolled asthma 50%, application of allergens IT during high pollination season 42%, inadequate immunotherapy scheme monitoring 17%., Conclusions: The frequency of SR in this group of patients was low as that reported in other publications.