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Background: Social and family factors may influence the probability of achieving asthma control in children. Parents' quality of life has been insufficiently explored as a predictive factor linked to the probability of achieving disease control in asthmatic children., Objective: Determine whether the parents' quality of life predicts medium-term asthma control in children., Methods: Longitudinal study of children between 4 and 14 years of age, with active asthma. The parents' quality of life was evaluated using the specific IFABI-R instrument, in which scores were higher for poorer quality of life. Its association with asthma control measures in the child 16 weeks later was analyzed using multivariate methods, adjusting the effect for disease, child and family factors., Results: The data from 452 children were analyzed (median age 9.6 years, 63.3% males). The parents' quality of life was predictive for asthma control; each point increase on the initial IFABI-R score was associated with an adjusted odds ratio (95% confidence interval) of 0.56 (0.37-0.86) for good control of asthma on the second visit, 2.58 (1.62-4.12) for asthma exacerbation, 2.12 (1.33-3.38) for an unscheduled visit to the doctor, and 2.46 (1.18-5.13) for going to the emergency room. The highest quartile for the IFABI-R score had a sensitivity of 34.5% and a specificity of 82.2% to predict poorly controlled asthma., Conclusions: Parents' poorer quality of life is related to poor, medium-term asthma control in children. Assessing the parents' quality of life could aid disease management decisions. Pediatr Pulmonol. 2016;51:670-677. © 2015 Wiley Periodicals, Inc., (© 2015 Wiley Periodicals, Inc.)

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., (Copyright © 2015 SEICAP. Published by Elsevier Espana. All rights reserved.)

Objective: Describe the association between parents' quality of life and the two components of asthma control in children: impairment and risk., Methods: Cross-sectional study with children between 4 and 14 years of age with active asthma recruited at primary care centers in Spain. Asthma control was assessed according to the Third National Asthma Expert Panel Report, classifying "impairment" in three levels (well-controlled asthma, partially controlled, and poorly controlled), and "risk" as high or low. The parents' quality of life was evaluated using the specific Family Impact of Childhood Bronchial Asthma Questionnaire instrument (IFABI-R). The association between asthma control and the parents' quality of life was analyzed using multivariate regression models adjusted for other social and family variables., Results: Data from 408 children were analyzed. The parents' quality of life was affected in the partially controlled asthma group when compared with well-controlled asthma, as showed by an increase in IFABI-R scores in all dimensions: functional 17.2% (p < 0.001), emotional 10.4% (p = 0.021), and socio-occupational 6.8% (p = 0.056). The differences were higher in poorly controlled asthma compared with well-controlled asthma: functional 24.3% (p = 0.001), emotional 18.9% (p = 0.008), and socio-occupational 11.5% (p = 0.036). The "risk" component was independently associated with the parents' quality of life. Of all the elements used to assess the control, the only one independently associated with the parents' quality of life was recurrent asthma crisis., Conclusions: In asthma control, both "impairment" and "risk" in children are gradually associated with the parents' quality of life. The global assessment of the control surpasses the importance of each individual element used in this assessment.

Objectives: To study the frequency, characteristics, and complications of non-therapeutic male circumcision on immigrant children from Africa in Spain., Methods: This descriptive study focused on primary care consultations conducted at 21 Aragon health centres during 2010 and 2011. The data were gathered through interviewer-administered questionnaires to the parents of African children. Sociodemographic variables were studied, along with others related to the practice of circumcision., Results: 283 questionnaires were obtained. 98.93 % of the children had undergone or were planning to undergo circumcision. 68.2 % were circumcised. Circumcisions were most frequently performed during a vacation to the country of origin (67.04 %), especially so for the Maghreb population. The remaining circumcisions had been performed in Spain. Half of the circumcisions practiced in Spain were performed at home, and 84 % of these were performed on Gambian children., Conclusions: The current study demonstrates that, in Aragon, Spain, almost all immigrant children from Africa have been or will be circumcised and that a considerable proportion has been circumcised at home by unqualified individuals. Gambians are particularly at risk of performing unsafe circumcision.

Background and Objective: To determine the characteristics influencing pneumococcal serotype colonization in healthy pre-school aged children, the distribution of serotypes and their antimicrobial susceptibility, after the introduction of pneumococcal 7-valent conjugate vaccine (VNC-7 v). SUJETOS AND METHODS: Nasopharyngeal samples were collected from children under 6 years of age attending well-child examinations in the province of Zaragoza (Spain). Logistic regression was used to study different variables related to the status of the carriers., Results: Of the 371 children studied 30.7% were found to be carriers. With a vaccine coverage rate of 66%, factors related with presence of pneumococcal carriage were found to be the number of siblings (OR 1.44; CI 95% 1.05-1.97 for each sibling), attending a school or child day care centre (OR 3.99; CI 95% 2.00-7.96) and suffering from a minor upper respiratory tract infection (URTI) (OR 1.72; CI 95% 1.02-2.90). Only 8.7% corresponded to VNC-7 v serotypes. The most common non VNC-7 v serotypes isolated were 19A, 6A, 15B, 11, and 15A. Significantly greater resistance was detected among VNC-7 v serotypes., Conclusion: Children in the setting of this study carried pneumococci more commonly when they have siblings, attend school or day care, or suffer from minor URTI. In the VNC-7 v vaccine era, VNC-7 v serotypes have become rare occurrences (8.7%) and emerging serotypes present better susceptibility to antibiotics., (Copyright © 2010 Elsevier España, S.L. All rights reserved.)

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.

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.

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.

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.

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.

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.