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Atopic eczema (AE) is a chronic skin disease. Recent reports indicate that the worldwide prevalence of AE is increasing and that various environmental factors are implicated in its aetiology. Climatic conditions have been related with AE prevalence, and Spain has varying climatic conditions. The aim of this study is to document the possible climatic influence on the prevalence of AE in schoolchildren aged 6-7 years in three different climatic regions in Spain. We conducted a cross-sectional population-based survey of 28,394 schoolchildren aged 6-7 years from 10 Spanish centres in three different climatic regions. The mean participation rate was 76.5%. AE prevalence was assessed using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the Spanish Academy of Dermatology criteria used in Spain to diagnose AE. The data, including annual temperature, precipitation, relative humidity and the annual number of sunny hours per climatic region, were obtained from the Spanish National Institute of Meteorology. Different AE prevalences were found in all three climatic regions studied: Atlantic, 32.9; Mediterranean 28.3; and Continental 31.2 per 100 children studied (p < 0.005). AE was positively associated with precipitation and humidity, and was negatively associated with temperature and the number of sunny hours. The results show that AE is significantly dependent on meteorological conditions.

Objectives: To describe the prevalence of atopic eczema (AE) and to find the characteristics of the diet of children with AE., Design: Descriptive, transversal study., Setting: Primary schools., Main Measurements: The study used the standardized and validated questionnaire of the ISAAC phase III study, which finds the prevalence of AE in children and enables inter-centre comparison to be conducted. A questionnaire about food consumption was included. The prevalence ratio (PR) of AE and food consumption (95% confidence intervals) was calculated., Results: A total of 28 448 children aged 6-7 were included in the study. The prevalence of clinically diagnosed AE was 15.35% in boys and 15.24% in girls. The foods most often consumed were: dairy and cereals, followed by rice, pasta, and eggs. The least consumed were: butter, margarine, and fast food. The PR for children who consumed pasta was (PR=1.35), seafood (PR=1.28), cereals (PR=1.26), eggs (PR=1.13), and meat (PR=1.09)., Conclusions: The prevalence of AE in Spain was 15.3%, and was associated with food consumption. The consumption of dairy products, cereals, and olive oil was appropriate. The intake of fruit, vegetables, seafood, and legumes was below the recommended amounts. Future studies on the question are needed.

Background: Obesity and overweight have been described as factors associated with asthma. Our aim was to evaluate the role obesity plays on asthma in children. SCOPE AND SUBJECTs: A study carried out on children and teenagers between 8 and 15 years of age, chosen for a cluster-type random sampling from children who studied in 80 schools, which represents 30% of the schools in the city of Valencia., Material and Methods: The analysed data was organized into two groups, obese (from the Body Mass Index (Kg/m2)), showing children with a percentile over 85% of the measuring reference for the Spanish population) and non obese, when they did not fulfil this condition. The prevalence of the different parameters studied was calculated by an Interval of Confidence of 95%. The risk was calculated (Relative Risk) from those symptoms compatible with asthma among obese children compared to non obese children., Results: No significant relative risk (RR) was seen for obesity with regards to asthma in those percentiles of obesity over 85. Otherwise, an increase in the relative risk (RR) regarding the severity of asthma was seen in relation to obesity, mainly in the 85th percentile (RR = 1.51 of suffering between 4-12 wheezing attacks and RR = 1.86 of suffering more than 12 attacks in obese children as opposed to non obese children)., Conclusions: In this study, we did not identify a higher risk of asthma among obese children than among non obese children, although we did find there was a higher risk of severity of asthmatic symptoms. As far as the severity of the asthma is concerned, we saw a higher risk of wheezing and whistling attacks among obese children with the 85th and the 95th percentiles according to the Body Mass Index.

Background: Atopic dermatitis is favored by exogenous factors, such as air pollution interacting with a genetic predisposition., Objective: The aim of the present study was to evaluate the influence of sex and air pollution in the city of Cartagena on the prevalence of atopic dermatitis., Design and Methods: We performed a cross-sectional study using the ISAAC questionnaire in schoolchildren aged 13 and 14 years old from Cartagena (Murcia). The influence of sex and the schools' location in two distinct areas (polluted and unpolluted) on the prevalence of atopic dermatitis and its severity (described as being awakened by nocturnal itching) was analyzed., Results: The prevalence of atopic eczema was 6.3 %. Atopic eczema was severe in 19 % of the cases. Risk factors for atopic eczema were female sex (OR 2.19 95 % CI: 1.59-3. 02) and attending school in a polluted area (OR: 1.83, 95 % CI 1.01-1.87) but these factors were not associated with greater severity., Conclusions: Air pollution is associated with a higher prevalence of atopic eczema and there is a trend that this eczema is more severe. The condition was more prevalent among girls.

Background: Atopic dermatitis is closely related to other atopic diseases, especially asthma and allergic rhinitis. Although there is a certain agreement that suffering from atopic eczema predisposes to asthma and allergic rhinitis, the risk of developing these diseases should be quantified in populations following a standardized method, which is the objective of this study., Method: Using the questionnaire from the International Study of Asthma and Allergy in Childhood (ISAAC), we performed a cross-sectional study of all schoolchildren aged 13 and 14 years old in the city of Cartagena (Murcia, Spain). The relationship between atopic dermatitis and its severity with asthma, allergic asthma, and allergic rhinitis was analyzed., Results: Quantification of risk showed that schoolchildren with atopic eczema had a 3-fold risk of allergic rhinitis (OR: 3.33; 95 % CI: 2.45-4.54), a 4-fold risk of asthma (OR: 3.85; 95 % CI: 2.74-5.42) and a 5-fold risk of allergic asthma (OR: 4.91; 95 % CI: 3.17-7.59) compared with schoolchildren without atopic eczema. The severity of eczema was also directly related to that of asthma and rhinitis.

Background: The ISAAC phase I results have supplied valuable information on the prevalence of asthma and allergy in childhood throughout the world., Objectives: To describe the implementation and participation rate of normal children in each test performed in phase II of the ISAAC in the four Spanish cities participating the study, and to establish the influence of type of school and geographical situation (in a polluted or unpolluted area) in Cartagena., Methods: The ISAAC phase II included a questionnaire on symptoms, risk factors and treatment, skin examination, skin-prick test, bronchial challenge test, total and specific IgE measurement, as well as mite and bacterial endotoxin determination in house dust. The questionnaire was distributed with a letter requesting authorization from the parents in primary schools (fourth and fifth grades) in sufficient number to achieve approximately 1,000 skin prick-test authorizations in each city., Results: The participation rate for the questionnaire, skin examination, skin-prick test, blood extraction, bronchial challenge test, and dust collection was, respectively, for each city: Cartagena: 58.9, 49.2, 43.2, 33.1, 39.9 and 29.8 %; Almería: 42.5, 40.6, 39.1, 39.1 and 37.6 %; Valencia: 43.7, 30.4, 23.5, 21.5, 20.1 and 17.1 %; Madrid: 53.2, 40.8, 38.6, 27.6, 30.6 and 21.1 %. In Cartagena, participation was significantly higher in private schools receiving a state subsidy and in those in unpolluted areas., Conclusions: The participation rate was highly variable and lower than that among the European centres that have already completed the study. The rate was significantly influenced by geographical area and type of school.

There is enough evidence of an epidemiological, etiological and physiopathological link between chronic rhinitis (usually allergic) and asthma, and also between chronic sinusitis (generally bacterial) and this disease. Allergic inflammation of nasal mucosa could favor the development of chronic sinusitis. Indeed, some authors believe that the term "rhinosinusitis" should be used as nasal and sinus mucosa are one and the same thing. Some studies have demonstrated that treatment of chronic rhinitis or chronic sinusitis produces a benefit in the evolution of asthma when both diseases co-occur in the same patient, which suggests a therapeutic link. However, there is insufficient evidence that adenoidectomy and/or tonsillectomy worsen the evolution of asthma. When managing the asthmatic child, physicians should not forget to pay attention to the upper respiratory tract, evaluating and treating diseases in this area if necessary, as such therapeutic measures will also benefit asthma control.

Background: Inhaled medication through dry powder inhalers is widely used in children, but pediatric studies focussing on the ages at which these devices can be used are sparse., Objective: To establish the difference in peak inspiratory flow (PIF) through Accuhaler and Turbuhaler in healthy children using a new device, In-check, and to determine the differences between the two different models of this device., Methods: PIF was measured in 64 healthy male children (mean age 11.2 years, range 8.8-14.7) by means of In-check and In-check Dial using Accuhaler and Turbuhaler resistances. The best attempt of three was chosen. Height,weight, and forced expiratory volume in 1 second were also measured., Results: Significant differences in PIF were found between the two inhalers: PIF In-check Accuhaler-PIF In-check Turbuhaler (134.4 +/- 15.5 L/min vs 99.9 6 +/- 11.1 L/min; p<0,000) and PIF In-check Dial Accuhaler-PIF In-check Dial Turbuhaler (109.6+/-10.5 L/min vs 86.8+/-8.9 L/min; p<0.000). The best correlation obtained among the different In-check measurements was between In-check Ac-cuhaler and In-check Turbuhaler (r=0.88; p<0.001), and the worst was between In-check Dial Accuhaler and In-check Turbuhaler (r =0.71; p<0.001)., Conclusions: PIF through Accuhaler is significantly higher than that through Turbuhaler, although in both cases PIF was sufficient to provide adequate distribution of the inhaled medication in children aged 9-14 years. Consequently, in children younger than 9 years old, and especially during an asthma attack, In-check should be tried in order to discover whether the child is capable of using Turbuhaler correctly.

Background: The problems of air pollution became noticeable in Cartagena in the seventies, high SO2 and particle levels having been reached from time to time. Our aim is to assess, using the EMECAM methodology, the acute impact of SO2 and particle air pollution on the daily death rate of the city of Cartagena in the 1992-1996 period., Methods: A daily listing is provided of the total number of non-accidental deaths within the population as a whole and for those over age 70, the cardiovascular and the respiratory deaths due to dioxide and particle air pollution for the 1992-1996 period using autoregressive Poisson models which control seasonality, weather, time of year, flu, special events, and time lags., Results: In the period under study, there has been a drop in the SO2 air pollution as compared to previous years, which was not as marked for the particles. The analyses reveal significant relationships in the total non-accidental deaths in those over age 69, with the average particle count and those particles with cardiovascular deaths for the months of May to October. In the six-month period of the year, when the weather is cold, we found a positive statistically significant relationship to exist in the maximum daily hourly value of the particles and the deaths due to cardiocirculatory and respiratory diseases. However, there is no consistency in the between on assessing the reliability of the models.

Background: The objective of this investigation is to determine the influence of air pollution (SO2 and particulate matter) on the existence of days of unusual attendance at emergency services for asthma and chronic obstructive pulmonary lung disease (COPD). A registry of attendances for these diseases and the daily mean concentrations of SO2 and particles were used (1989-1991)., Results: Unusual attendance days are establish by the fortnightly movable mean of the period that has that day as central one, under the hypothesis of a Poisson distribution with equal mean as the calculated one. In the logistic regression model, Odds Ratio (OR) between an excess of attendance of cases for asthma and SO2 levels greater than 80.60 m/m3 was 3.6 (CI95%: 1.1-11.7). For COPD, SO levels ten days before were introduced, and OR for SO2 levels more than 56.5m/m was 4.7 (CI95%: 1.5-15.1)., Conclusions: High SO2 levels are related with the appearances of days with an excessive use of emergencies for Asma and EPOC.

Epidemiological, clinical, diagnostic and therapeutic aspects that make scabies a clinical entity with a special personality in the pediatric field, are reviewed. On the epidemiological aspects, a special mention of its unsuspected frequency in this age is made. Scabies is an endemic disease in our country among the more deprived people. On the clinical aspects, the great importance of clinical history and distribution of skin lesions for the early diagnosis is pointed out. Some "alert pointers" are described for this early diagnosis. On the therapeutic field, the importance of the primary care prevention is discussed, and the drug approach for its relieve is commented.