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Background: Eczema (atopic dermatitis) is a major global public health issue with high prevalence and morbidity. Our goal was to evaluate eczema prevalence over time, using standardized methodology. Methods: The Global Asthma Network (GAN) Phase I study is an international collaborative study arising from the International Study of Asthma and Allergies in Children (ISAAC). Using surveys, we assessed eczema prevalence, severity, and lifetime prevalence, in global centres participating in GAN Phase I (2015–2020) and one/ both of ISAAC Phase I (1993–1995) and Phase III (2001–2003). We fitted linear mixed models to estimate 10‐yearly prevalence trends, by age group, income, and region. Results: We analysed GAN Phase I data from 27 centres in 14 countries involving 74,361 adolescents aged 13–14 and 47,907 children aged 6–7 (response rate 90%, 79%). A median of 6% of children and adolescents had symptoms of current eczema, with 1.1% and 0.6% in adolescents and children, respectively, reporting symptoms of severe eczema. Over 27 years, after adjusting for world region and income, we estimated small overall 10‐year increases in current eczema prevalence (adolescents: 0.98%, 95% CI 0.04%–1.92%; children: 1.21%, 95% CI 0.18%–2.24%), and severe eczema (adolescents: 0.26%, 95% CI 0.06%–0.46%; children: 0.23%, 95% CI 0.02%–0.45%) with larger increases in lifetime prevalence (adolescents: 2.71%, 95% CI 1.10%–4.32%; children: 3.91%, 95% CI 2.07%–5.75%). There was substantial heterogeneity in 10‐year change between centres (standard deviations 2.40%, 0.58%, and 3.04%), and strong evidence that some of this heterogeneity was explained by region and income level, with increases in some outcomes in high‐income children and middle‐income adolescents. Conclusions: There is substantial variation in changes in eczema prevalence over time by income and region. Understanding reasons for increases in some regions and decreases in others will help inform prevention strategies.

Asthma; Comorbidities; Risk factors Asma; Comorbilitats; Factors de risc Asma; Comorbilidades; Factores de riesgo Asthma and rhinitis often co-exist in the same patient. Although some authors observed a higher prevalence and/or greater severity of asthma in patients with rhinitis, this view is not homogeneous and the debate continues. The aim of our study is to describe the prevalence of rhinitis in children and adolescents and to analyse their relationship with the prevalence of asthma. A multicentre study was conducted using the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC). The target population of the study was all those school children aged 6–7 and 13–14 years from 6 of the main health catchment areas of Galicia (1.9 million inhabitants). The schools required were randomly selected, and all children in the targeted age ranges were included. Multiple logistic regression was used to obtain adjusted prevalence odds ratios (OR) between asthma symptoms of the schoolchildren and rhinitis prevalence. The results were adjusted for parental smoking habits, maternal education level, cat and dog exposure, and obesity. A total of 21,420 valid questionnaires were finally obtained. Rhinitis was associated with a significant increase in the prevalence of asthma in both age groups. The highest OR were 11.375 for exercise induced asthma (EIA) for children with recent rhinoconjunctivitis and 9.807 for children with recent rhinitis in 6–7 years old group. The prevalence OR’s are higher in EIA and severe asthmatics. Rhinitis in children and adolescents is associated with a higher prevalence and severity of asthma. This work was funded by the Maria Jose Jove Foundation.

The temporal evolution of the prevalence of asthma described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 is unknown, or if the geographical or age differences are maintained in Spain.To describe the prevalence of asthma symptoms in different Spanish geographic areas and compare it with that of those centers that participated in the ISAAC.Cross-sectional study of asthma prevalence, carried out in 2016-2019 with 19,943 adolescents aged 13-14 years and 17,215 schoolchildren aged 6-7 years from 6 Spanish geographical areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona and Salamanca). Asthma symptoms were collected using a written questionnaire and video questionnaire according to the Global Asthma Network (GAN) protocol.The prevalence of recent wheezing (last 12 months) was 15.3% at 13-14 years and 10.4% at 6-7 years, with variations in adolescents, from 19% in Bilbao to 10.2% in Cartagena; and in schoolchildren, from 11.7% in Cartagena to 7% in Pamplona. These prevalences were higher than those of the ISAAC (10.6% in adolescents and 9.9% in schoolchildren). 21.3% of adolescents and 12.4% of schoolchildren reported asthma at some time.There is a high prevalence of asthmatic symptoms with an increase in adolescents and a stabilization in Spanish schoolchildren with respect to the ISAAC. Geographic variations in asthma prevalence are not so clearly appreciated, but areas with high prevalences maintain high numbers.

La Universidad Camilo José Cela, en su conjunto, y particularmente desde la Catedra Ólimpica Marqués de Samaranch, en consonancia con el espíritu olímpico, se caracteriza por una alta sensibilidad con el desarrollo del individuo a través del deporte, para promover la salud individual y social. Creemos que este libro puede ayudar, tanto a pacientes como a profesionales, a visualizar la enfermedad, desempolvar y refrescar conocimientos, y promover la investigación, en esta patología. Catedra Ólimpica Marqués de Samaranch

Background\ud Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.\ud Methods\ud This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Childhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.\ud Findings\ud Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.\ud Interpretation\ud Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.\ud Funding\ud International Union Against Tuberculosis and Lung Disease, Boehringer Ingelheim New Zealand, AstraZeneca Educational Grant, National Institute for Health Research, UK Medical Research Council, European Research Council, and Instituto de Salud Carlos III.

SummaryObjective To analyze the knowledge of asthma and its management in Spanish school teachers using the Newcastle Asthma Questionnaire (NAKQ). Design Descriptive, observational prevalence study, using a self-report questionnaire on knowledge about childhood asthma and its management by teachers in pre-school, primary, and secondary schools in nine Spanish cities. Age, sex, academic training, teaching experience, courses in which they taught, and personal and family history of asthma, were collected from each teacher. For knowledge determination, the validated Spanish version of the NAKQ was used. Results A total of 208 centers participated, including 7,494 teachers. The questionnaire was completed by 4,679 teachers (62.4%). The mean score of correct responses was 16.0 ± 4.8 points out of 31 (median = 17, range: 0–30). Only 6.8% of teachers were capable of pointing out the three main symptoms of the disease; 1.5% knew the triggering factors of an asthma attack; 8.6% knew two medicines useful during an asthma attack; 32.7% knew that inhaled medications had less side effects than pills, and only 3.8% knew of ways to prevent asthma attacks during exercise. In the multivariate analysis, variables significantly associated with a higher questionnaire score were a “lower age” (Beta coefficient = −0.09), “male gender” (Beta = 0.77), “being asthmatic” (Beta = 2.10), or “having close relatives with asthma” (Beta = 1.36) and “teaching in a private school” (Beta = 0.66) or in “compulsory secondary education” (Beta = 0.59). Conclusions Teachers have a low level of knowledge about asthma, with an important limitation in some aspects of the disease. They should be trained to recognize the main symptoms of the disease, on how to act in the event of symptoms, and the early identification of situations in which the pupils require health care assistance. Pediatr Pulmonol. 2016;51:678–687. © 2015 Wiley Periodicals, Inc.

La Cátedra Olímpica de la Universidad Camilo José Cela y Sanitas Hospitales han abordado el tema de Corazón y Deporte en esta segunda entrega de la trilogía sobre Deporte y Salud. Como en la primera edición, que versaba sobre Mujer y Deporte, ambas instituciones han sumado el conocimiento de sus expertos para desgranar los aspectos clave de la salud del corazón y de la práctica deportiva, de cara a que cualquier persona pueda practicar deporte de un modo cardio-protegido, padezca o no alguna condición cardiaca. La práctica deportiva con moderación mejora nuestro estado de salud y añade beneficios a nuestros sistemas inmunológico, musculoesquelético y, naturalmente, al cardiovascular. Así, el deporte ayuda a prevenir situaciones clínicas indeseadas y nos mantiene libres de enfermedad más tiempo. Es notorio que la práctica deportiva, tanto deportiva como recreacional, se ha incrementado significativamente en los últimos 30 años. Pero al elevar la intensidad con la que practicamos deporte también añadimos cierta carga de riesgo que es preciso conocer para prevenir. En el ámbito de la salud de nuestro corazón, los reconocimientos médicos deportivos son el mejor instrumento de prevención. De acuerdo con los datos de la Sociedad Española de Cardiología, más del 90% de las muertes súbitas sucedidas durante la práctica deportiva están relacionadas con un problema cardiaco, que podría haber sido diagnosticado en muchos casos durante un reconocimiento médico deportivo. En el arco de edades por debajo de los 35 años, la mayoría de los problemas cardiacos se deben a alteraciones congénitas. Si examinamos a personas mayores de 35 años, las causas más frecuentes son enfermedades coronarias desconocidas o no bien valoradas en función del deporte que el paciente deseaba practicar. La Asociación Americana del Deporte recomienda a todas las personas mayores de 35 años someterse a una prueba de esfuerzo al año para monitorizar su salud. De este modo conocerían mejor los límites de su esfuerzo y podrían planificar su actividad para prevenir más eficientemente posibles situaciones clínicas indeseadas. Además, estamos convencidos de que esta obra tiene un alto valor como material de consulta y referencia para ayudar, a todos los profesionales de la salud y de la actividad física, en su labor de asesoramiento y recomendación del deporte a personas de distintas edades y condiciones de salud. Por tanto también pretende ser un libro formativo para los deportistas que estén interesados en su salud cardiovascular. La Cátedra Olímpica de la Universidad Camilo José Cela y Sanitas Hospitales

En la actualidad hay consenso suficiente para considerar el asma como un sindrome mas que como una enfermedad especifica, ya que incluye diversos fenotipos que comparten manifestaciones clinicas similares pero de etiologias probablemente diferentes1. El caracter cronico de este sindrome indica que no tiene curacion, por lo que el objetivo del tratamiento se cine a alcanzar un adecuado control de los sintomas, mantener una actividad fisica y una funcion pulmonar normales, asi como prevenir las reagudizaciones. Gracias a la existencia de medicamentos muy eficaces, administrados solos o en combinacion, asi como pautas de administracion bastante claras, una amplia mayoria de los pacientes asmaticos consiguen un adecuado control de los sintomas2. Sin embargo, diferentes estudios coinciden en que una parte importante de los asmaticos no alcanzan ese grado de control deseable3,4. De ahi que en los ultimos anos se insista en la necesidad de una mayor dedicacion por parte de los sanitarios hacia los aspectos educativos que, como en toda enfermedad cronica, requiere el asma. Para implementar cualquier programa o intervencion educativa, como paso previo, es necesaria una alianza o asociacion entre los profesionales sanitarios y los pacientes y

The association between early exposure to paracetamol or to antibiotics and eczema is conflicting. This study aims to know whether the early exposure to those drugs is associated with eczema at school age, and whether the strength of the association is modified by the presence of asthma or rhinoconjunctivitis. Children aged 6-7 (n = 13908) from the International Study of Asthma and Allergies in Childhood in Spain provided data about current asthma, rhinoconjunctivitis and eczema. Parent-reported information was also obtained on paracetamol and antibiotic consumption during the first year of life. Logistic regression analysis with eczema as outcome and including exposure to paracetamol or to antibiotics, together with possible confounders, was carried out in the whole sample of children and in five different strata: no respiratory symptom and any respiratory symptom further subdivided into: asthma with rhinoconjunctivitis, asthma without rhinoconjunctivitis and rhinoconjunctivitis without asthma. In the whole sample, exposure to paracetamol was associated with eczema (aOR 1.56 [1.36-1.80]) as was antibiotic consumption (aOR 1.66 [1.43-1.92]). These associations did not substantially change after additionally adjusting for the other drug. A similar pattern was found among children without respiratory symptoms. In children with symptoms, adjusting for the other drug modified the association with paracetamol (aOR from 1.32 [1.03-1.71] to 1.09 [0.83-1.43]) but did not change that with antibiotics (aOR from 1.80 [1.38-2.35] to 1.81 [1.37-2.39]). Early exposure to paracetamol or to antibiotics is associated with an increased prevalence of eczema at school age. Asthma and/or rhinoconjunctivitis substantially modifies this association.

The objective of this study was to estimate the relationship between the prevalence of asthma in schoolchildren aged 6-7 years and 13-14 years and the mean annual sunny hours (MASH) in Spain, and to explore predictive models for asthma prevalence. The prevalence of asthma was obtained from the International Study of Asthma and Allergies (ISAAC) Phase III 2002-2003, and climate and socio-economic variables from official sources. Nine centres were studied and a further four centres, two of which are in ISAAC, to test the predictive models. Logistic regression was used to estimate adjusted prevalence rates of asthma for each centre, and multiple regression models to study the effects of MASH and other meteorological and socio-economic variables. The adjusted prevalence rate of asthma decreased 0.6% [95% confidence interval (CI) 0.4-0.8%] for the 6-7 years group and 1.1% (95% CI 0.8-1.3%) for the 13-14 years group with an increase in the MASH of 100 h. Relative humidity was negatively associated with asthma in the older age group, and gross province product per capita (GPP) was positively associated with asthma in the younger age group. The predictive models, which included MASH, gender, relative humidity, and GPP, anticipated prevalence rates of asthma without significant differences between the levels observed and those expected in 9 of the 11 measurements carried out. The results indicate that sunny hours have a protective effect on the prevalence of asthma in schoolchildren.

Objective The objective of the study was to analyze the relationship between air pollutants and the prevalence of recent symptoms of asthma, allergic rhinitis, and atopic eczema in schoolchildren aged between 6 and 7 years. Patients and Methods The prevalence of recent (previous 12 months) symptoms of allergic diseases was obtained by means of the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC), Spain, with the participation of 7 centers (Asturias, Barcelona, Bilbao, Cartagena, La Coruna, Madrid, and Valencia) and 20 455 schoolchildren aged between 6 and 7 years, from 2002 to 2003. The pollutant detection systems of the aforementioned centers provided the mean annual concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and total suspended particulate matter. Results The annual average concentration of SO2 showed a significant association with a higher prevalence of recent severe asthma (adjusted odds ratio [aOR] between level-1 and level-3 pollution, 1.32; 95% confidence interval [CI], 1.01–1.73), rhinitis (aOR, 1.56; 95% CI, 1.39–1.75), and rhinoconjunctivitis (aOR, 1.70; 95% CI, 1.45–2.00). The annual average concentration of CO was associated with a higher prevalence of rhinitis (aOR, 1.65; 95% CI, 1.34-2.04), rhinoconjunctivitis (aOR, 1.76; 95% CI, 1.31–2.37), and eczema (aOR, 1.55; 95% CI, 1.17–2.04). The annual average concentration for NO2 and total suspended particulate matter showed inverse associations with the prevalence of nocturnal dry cough. Conclusions Findings suggest that air pollutants such as SO2 and CO increase the risk of recent symptoms of asthma and allergic rhinitis in schoolchildren aged between 6 and 7 years in Spain.

Summary Background The association between asthma and obesity in children, and the effect modification of allergy on this association have not been fully established. Aims The objective of the study was to know the effect modification of the severity of asthma and of the coexistence of rhinoconjunctivitis (RC) in the relationship between obesity and asthma. Methods A cross-sectional study of 17145 schoolchildren 6‐7 years old from eight Spanish cities who had completed information on height and weight of the ISAAC phase III questionnaire, which also included questions about asthma and RC symptoms and on various risk factors. Body mass index (BMI) was used to define obesity according to international standards. Two different logistic regressions, using current occasional asthma (COA) and current severe asthma (CSA) as dependent variables, were made stratifying for gender and for the coexistence of RC and controlling for age, older and younger siblings, exercise, mother’s education, truck traffic, cat/dog during the first year of life and smoking father or mother. Results Obesity was a risk factor of CSA without RC, both for boys (1.92, CI 95% 1.13‐3.25) and for girls (2.99, CI 95%1.68‐5.32). Every BMI unit increment increased by 6.7% the risk of CSA without RC in boys and by 12.4% in girls. Obesity was not a risk factor for CSA with RC. The association between COA and obesity was weaker and the coexistence of RC did not modify it greatly. Conclusions Obese schoolchildren are more at risk of suffering from non-allergic asthma than the non-obese subjects.

Background: Although several studies have investigated the influence of diet on asthma in schoolchildren, none of them has evaluated how obesity can modify this effect. A study was undertaken to evaluate the association of various foods and a Mediterranean diet with the prevalence of asthma and rhinoconjunctivitis, adjusting for obesity and exercise. Methods: A cross-sectional study was performed in 20 106 schoolchildren aged 6–7 years from eight Spanish cities. Using the ISAAC phase III questionnaire, parents reported chest and nose symptoms, food intake, weight, height and other factors, including exercise. A Mediterranean diet score was developed. A distinction was made between current occasional asthma (COA) and current severe asthma (CSA). Results: Independent of the amount of exercise, each Mediterranean score unit had a small but protective effect on CSA in girls (adjusted OR 0.90, 95% CI 0.82 to 0.98). Exercise was a protective factor for COA and rhinoconjunctivitis in girls and boys (the more exercise, the more protection). Obesity was a risk factor for CSA in girls (adjusted OR 2.35, 95% CI 1.51 to 3.64). Individually, a more frequent intake (1–2 times/week and ⩾3 times/week vs never/occasionally) of seafood (adjusted ORs 0.63 (95% CI 0.44 to 0.91) and 0.53 (95% CI 0.35 to 0.80)) and cereals (adjusted OR 0.56 (95% CI 0.30 to 1.02) and 0.39 (95% CI 0.23 to 0.68)) were protective factors for CSA, while fast food was a risk factor (adjusted ORs 1.64 (95% CI 1.28 to 2.10) and 2.26 (95% CI 1.09 to 4.68)). Seafood (adjusted ORs 0.74 (95% CI 0.60 to 0.92) and 0.67 (95% CI 0.53 to 0.85)) and fruit (adjusted ORs 0.76 (95% CI 0.60 to 0.97) and 0.71 (95% CI 0.57 to 0.88)) were protective factors for rhinoconjunctivitis. Conclusions: A Mediterranean diet has a potentially protective effect in girls aged 6–7 years with CSA. Obesity is a risk factor for this type of asthma only in girls.

Ponencia presentada en el IV Congreso de la Sociedad de Pediatría de Galicia, Verín, 2004 [Resumen] Introducción. El asma y la rinitis son dos enfermedades con elevada prevalencia en la infancia, con tendencia a incrementarse en los últimos años. En ambas es frecuente el infradiagnóstico. Objetivo. Verificar la prevalencia de síntomas de asma y rinitis en la población infantil. Material y métodos. Hemos realizado, mediante cuestionario escrito, un estudio transversal siguiendo la metodología del International Study of Asthma and Allergies in Childhood (ISAAC), de prevalencia de sintomatología de asma y rinitis en el área de A Coruña. Resultados. Han sido incluidos 3.017 niños y niñas de 6 y 7 años (tasa de respuesta del 73,9%), y 2.981 de 13 y 14 años (tasa de respuesta del 93,6%). Refirieron haber presentado sibilancias alguna vez el 25,3% de los niños y niñas de 13 y 14 años y el 37,2% de los de 6 y 7 años. Han presentado asma en alguna ocasión el 18,5% de los adolescentes y el 13,7 % del grupo de menor edad. La prevalencia de rinitis alguna vez fue del 30,4% a los 6 y 7 años y del 47,3% a los 13 y 14 años. La mayor prevalencia de rinitis se produjo en el otoño. Conclusiones. El asma y la rinitis son especialmente frecuentes en nuestra población, superior a la observada en la mayoría de poblaciones españolas estudiadas. [Abstract] Introduction. The prevalence of asthma and rhinitis is high in childhood and has been increasing in the last few years. In both diseases underdiagnosis is frequent. Objective. To asses the prevalence of asthma and rhinitis symptoms in childhood. Material and methods. We performed a cross-sectional study using a written questionnaire, following the methodology of the International Study of Asthma and Allergies in Childhood (ISAAC), on the prevalence of symptoms of asthma and rhinitis in La Coruña. Results. A total of 3017 boys and girls aged 6-7 years old (response rate 73.9 %) and 2981 boys and girls aged 13-14 years old (response rate 93.6 %) were included. The prevalence of “wheezing at some time” was 25.3% in adolescents aged 13-14 years old and was 37.2 % in children aged 6-7 years. The prevalence of “asthma at some time” was 18.5% in adolescents and 13.7% in children. The prevalence of “rhinitis at some time” was 30.4% in the group aged 6-7 years and 47.3% in the group of adolescents. The prevalence of rhinitis was highest in autumn. Conclusions. The prevalence of asthma and rhinitis is high in our population and is higher than that observed in most Spanish populations studied.

To analyze the knowledge of asthma and its management in Spanish school teachers using the Newcastle Asthma Questionnaire (NAKQ).Descriptive, observational prevalence study, using a self-report questionnaire on knowledge about childhood asthma and its management by teachers in pre-school, primary, and secondary schools in nine Spanish cities. Age, sex, academic training, teaching experience, courses in which they taught, and personal and family history of asthma, were collected from each teacher. For knowledge determination, the validated Spanish version of the NAKQ was used.A total of 208 centers participated, including 7,494 teachers. The questionnaire was completed by 4,679 teachers (62.4%). The mean score of correct responses was 16.0 ± 4.8 points out of 31 (median = 17, range: 0-30). Only 6.8% of teachers were capable of pointing out the three main symptoms of the disease; 1.5% knew the triggering factors of an asthma attack; 8.6% knew two medicines useful during an asthma attack; 32.7% knew that inhaled medications had less side effects than pills, and only 3.8% knew of ways to prevent asthma attacks during exercise. In the multivariate analysis, variables significantly associated with a higher questionnaire score were a "lower age" (Beta coefficient = -0.09), "male gender" (Beta = 0.77), "being asthmatic" (Beta = 2.10), or "having close relatives with asthma" (Beta = 1.36) and "teaching in a private school" (Beta = 0.66) or in "compulsory secondary education" (Beta = 0.59).Teachers have a low level of knowledge about asthma, with an important limitation in some aspects of the disease. They should be trained to recognize the main symptoms of the disease, on how to act in the event of symptoms, and the early identification of situations in which the pupils require health care assistance. Pediatr Pulmonol. 2016;51:678-687. © 2015 Wiley Periodicals, Inc.

Fundamento y objetivo Estimar la evolucion temporal de la prevalencia de sintomas de rinitis alergica y sus variaciones geograficas. Pacientes y metodo Durante 2001-2002 se efectuo la tercera fase del estudio ISAAC, cuyos resultados se compararon con los de la primera fase (1993-1994). Este estudio transversal incluyo a 30.046 escolares de 13-14 anos en 9 centros (Asturias, Barcelona, Bilbao, Cartagena, Castellon, Madrid, Pamplona, Valencia y Valladolid). Se empleo un cuestionario sobre sintomas de rinitis cumplimentado por los escolares en colegios e institutos con una participacion entre el 100 y el 75,8%. Se emplearon modelos de regresion de Poisson para estudiar la evolucion. Resultados Se aprecio una evolucion dispar de la prevalencia de sintomas de rinitis alergicas con disminucion en Barcelona y Bilbao, estabilizacion en Cartagena, Pamplona y Valencia, e incremento en Castellon, Madrid y Valladolid, aunque el aumento de la alergia nasal fue general. Ajustando por sexo, centro y cambio estacional, las prevalencias de rinoconjuntivitis en los ultimos 12 meses (razon de prevalencia = 1,13; intervalo de confianza del 95%, 1,07-1,19) y de alergia nasal alguna vez (razon de prevalencia = 1,22; intervalo de confianza del 95%, 1,15-1,30) crecieron. La prevalencia de sintomas de rinitis alguna vez descendio y la de rinitis en los ultimos 12 meses no experimento variacion. Las prevalencias de rinoconjuntivitis y alergia nasal variaron por centros, correspondiendo a Madrid, Asturias, Cartagena y Bilbao las mas elevadas. En conjunto, los datos indican una situacion intermedia al comparar con otros paises segun el metodo ISAAC. Conclusiones Se han identificado dos patrones en la evolucion de los sintomas de rinitis alergica y el estudio de factores de riesgo en el ambito local seria de importancia para su prevencion.

[Resumen] Objetivos. Determinar la prevalencia y variaciones geográficas de síntomas relacionados con asma en niños y adolescentes gallegos. Población y métodos. Estudio transversal según la metodología ISAAC (Internacional Study of Asthma and Allergies in Childhood) mediante cuestionario escrito distribuido en el medio escolar. Se incluyeron 10.371 niños de 6-7 años y 10.372 adolescentes de 13-14 años de todas las Áreas Sanitarias de Galicia. Se analizaron las variaciones geográficas mediante un modelo de regresión logística. Resultados. Las sibilancias en los últimos 12 meses oscilaron en los pequeños, del 11,4 (Santiago) al 15,7% (Vigo) y en los adolescentes del 8,8 (Ourense) al 18,8% (Vigo). Según el género se observó una mayor frecuencia en varones de 6-7 años (p < 0,001) y con tendencia a la significación estadística en las chicas de 13-14 años (p = 0,08). El riesgo (Odds ratio [OR]) de sibilancias en los últimos 12 meses, en el área de mayor prevalencia con respecto a la de menor, fue 1,45 (intervalo de confianza [IC] del 95%: 1,12-1,88) en niños y 2,39 (IC 95%: 1,82-3,13) en adolescentes. La prevalencia de asma estimada para Galicia fue de 13,6% en niños y 12,2% en adolescentes. Conclusiones. La prevalencia de sibilancias en los últimos 12 meses en las diferentes áreas gallegas es sensiblemente superior al resto de ciudades españolas participantes en el ISAAC en los pequeños, siendo muy similar en los adolescentes, salvo en Vigo donde es sensiblemente superior. Encontramos un patrón geográfico muy definido en los adolescentes, siendo mayores las prevalencias en la costa que en el interior. [Abstract] Objectives. To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. Population and methods. A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. Results. In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P < .001), and near to be statistically significant in 13-14 year-old females (P = .08). The risk (odds ratio [OR]) of wheezing in the last 12 months in the area with highest prevalence in comparison with the area of lowest prevalence was 1.45 (95% Confidence Interval [CI], 1.12-1.88) for children and 2.39 (95% CI, 1.82-3.13) for adolescents. The estimated prevalence of asthma in the Autonomous Community of Galicia was 13.6% in younger children and 12.2% in adolescents. Conclusions. The prevalence of wheezing in the last 12 months in the different areas of Galicia is considerably higher than the rest of Spanish ISAAC cities in the 6-7 years group and very similar in the 13-14 years group, except in Vigo where it is considerably higher. We found a clearly defined geographic pattern in the adolescent group, with higher prevalences in coastal areas than in the interior.

Objectives: To determine the prevalence and geographic variations of the symptoms associated with asthma in Galician children and adolescents. Population and methods: A cross-sectional epidemiological study following ISAAC (International Study of Asthma and Allergies in Childhood) methodology, and using a written questionnaire distributed in schools. The study sample included 10,371 6-7 year-old children and 10,372 13-14 year-old adolescents, all of them from Galician Health Areas. A logistic regression model was used to analyse geographic variations. Results: In the 6-7 year-old group, wheezing in the last 12 months varied from 11.4% (Santiago) to 15.7% (Vigo) and in the adolescents varied from 8.8% (Ourense) to 18.8% (Vigo). The distribution by gender showed a predominant significance in 6-7 year-old males (P

Atopic Eczema (AE) is a chronic inflammatory skin disease that affects children and adults, and alters quality of life with a high morbidity rate and severe economic burden. The objective of the present work was to analyse specific atmospheric pollutants (O3, NO, PM10 and SO2) affecting the prevalence of diagnosed AE and its symptoms among 6-7-year-old schoolchildren. The participants included 21311 schoolchildren aged 6-7 years from 8 Spanish regions, whose parents completed the ISAAC Phase III questionnaire to ascertain AE diagnosis and symptoms. The mean levels (µg/m3) of O3, NO, PM10 (particles 10 micrometers or less in diameter) and SO2 were determined in each geographical area participating in this study. According to these mean levels, three levels of exposure to each pollutant were considered: level 1 (percentiles 0-25); level 2 (percentiles 26-74); level 3 (percentiles 75-100). Exposure to O3 was associated with increased prevalence of rashes (exposure level 2, Odds Ratio (OR): 1.22, 95% Confidence Interval (95%CI): 1.02-1.45; level 3 OR: 1.33, 95%CI:1.10-1.61) and diagnosed AE (level 2, OR: 1.27, 95%CI: 1.17-1.39; level 3 OR: 1.27, 95%CI:1.15-1.41). An association was found between the level of NO and a drop in the prevalence of diagnosed AE (exposure level 2, OR: 0.88, 95%CI: 0.81-0.95; level 3 OR: 0.85, 95%CI:0.74-0.97). There was also an association between the highest exposure level to PM10 and a reduced prevalence of rashes (level 3 OR: 0.42, 95%CI: 0.22-0.81) and diagnosed AE (level 3OR: 0.53, 95%CI: 0.38-0.75). Future studies into exposure to O3 and its relationship with allergic diseases may be conducted in order to prevent this association.

a b s t r a c t Objective: To evaluate the reliability and validity of the Spanish version of the Newcastle Asthma Knowl- edge Questionnaire (NAKQ) for determining asthma knowledge in teachers. Methods: Design and sample: A cross-sectional observational study in educational centers of A Coru ˜ na providing preschool, primary school and/or compulsory secondary education. Centers were selected by random sampling, stratified by ownership and educational level (24 centers, 864 teachers). A total of 537 (62.1%) teachers responded (precision, ±4%, confidence, 95%). Measurements: Age, sex, academic training, teaching experience, personal/family history of asthma, NAKQ. Analysis: Evaluation of internal consistency (Cronbach's alpha). Concurrent validity was determined by comparing scores of asthmatic teachers or with asthmatic relatives with teachers with no contact with asthma. Test-retest reliability was evaluated in 2 randomly selected centers by the kappa index, Bland-Altman method and intraclass correlation coefficient. Results: Mean score on the NAKQ was 15.7 ± 5.3 (median 17), correctly answering 50.6% of items. Cronbach's alpha coefficient was 0.824 (95% CI: 0.802-0.845). NAKQ score was higher in asthmatic teachers or with close asthmatic relatives (17.7 ± 3.3) than in teachers with distant asthmatic relatives (16.1 ± 5.4) and teachers without close contact with asthma (15.1 ± 5.6; P