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 (ĸ 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.
This study suggests that FENO values higher than 27ppb are likely to be abnormal and would reflect airway inflammation in children as those in the present study.
Once-daily generic ciclesonide (80 μg or 160 μg), for 12 weeks, is effective to improve airway inflammation and asthma control in atopic children with persistent asthma.
La sulfadiacina es una sulfamida utilizada actualmente en el tratamiento de la toxoplasmosis cerebral en pacientes con SIDA. Presenta escasa solubilidad en medio ácido y en éstos enfermos pueden concurrir otras situaciones predisponentes para su precipitación en el sistema urinario. Presentamos el caso de una paciente con toxoplasmosis cerebral en tratamiento con sulfadiacina y pirimetamida, que presenta daño tubular renal por precipitación de cristales de sulfadiacina. Describimos las características farmacocinéticas que influirán en la eliminación renal del asulfadiacina, y los factores de riesgo, el tratamiento y las medidas profilácticas disponibles para evitar dicha toxicidad. CASO APORTADO Paciente mujer de 38 años de edad con antecedentes personales de hábito tabáquico (40 cigarrillos/día), esplenectomizada tras traumatismo hace 21 años, ex-adicta a drogas por vía parenteral desde hace 3 años, y en tratamiento actual con metadona. Diagnosticada de [0212-7199 (2007) 24: 5; pp 235-238] ANALES DE MEDICINA INTERNA
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