Introduction: Spirometry is a widely used pulmonary function test that requires several steps to be performed. In Thailand, there is only limited amount of data on the success rate and associated factors in children. Objective: To determine the success rate and factors affecting spirometry performance. Method: This cross-sectional study involved participants aged 5–18 years who underwent spirometry testing at the Naresuan University Hospital between 1 January 2015 and 31 December 2020. The subjects were divided into success and failure groups using the American Thoracic Society and European Respiratory Society 2005 criteria for acceptability and repeatability. The data collected include general characteristics, spirometry techniques and processes to determine the success rate and its associated factors. Results: A total of 132 subjects underwent spirometry testing, with a success rate of 71.2%. The success group’s mean age, weight and height were significantly greater than the failure group. The most unsuccessful spirometry step in the failure group was a prolonged exhalation. Between the two groups, there was a statistically significant difference in the plateau phase of the volume time curve (85.1% vs. 55.3%, P < 0.001). Conclusion: Children’s age, weight and height are all considered predictor variables of success. The most frequently step failure in spirometry tests is prolonged exhalation phase. However, the plateau on volume time curves is a critical component of success. To achieve optimal success, encourage children to blow vigorously as long as they can be stable throughout the prolonged exhalation phase and assess their ability to follow instructions.
Allergic disorders and headache are both common in pediatric populations. Chronic allergic disorders may affect sleep leading to chronic daily headaches. Poor controlled allergies may cause neurogenic inflammation that may be a predisposing factor to migraine headaches. We hypothesized that a higher prevalence of headaches may be found in children with allergy compared with those without allergy. Patients with either multiple allergic disorders or with poorly controlled allergic symptoms may be associated with headaches, especially migraine headaches. This study aimed to examine (1) the prevalence of headache in allergic children and (2) the association between allergic diseases and headache. Patients with allergic diseases and nonallergic children as control were recruited in the pediatric outpatient clinic of Naresuan University Hospital between January 2017 and January 2018. A neurological examination was performed by a pediatric neurologist. The questionnaire consisted of the pediatric headache symptom checklist and the items for evaluation of allergy control status. The diagnosis and classification of headache were based on the International Classification of Headache Disorders-3 criteria. The results were analyzed using the Student's t-test, chi-squared tests, odds ratios, and 95% confidence interval. One hundred fifty-five subjects were enrolled in our study, of which 85 subjects (54.8%) were diagnosed with allergic diseases. The allergic group had a significantly higher prevalence of headache than the control group (37 [43.5%] vs. 19 [27.1%], p = 0.035). The allergic group also had a significantly higher prevalence of migraine and probable migraine headache than the control group (23 [27.06%] vs. 7 [10%], p = 0.007). The prevalence of headache did not increase in subjects who had more than one allergic disease. There was no association between the control of allergy and headache. The present study showed that allergic diseases were associated with increased prevalence of headache and migraine in children. However, the control of allergic symptoms and the number of allergic diseases were not associated with headache. The physicians should be aware of headache in allergic patients and give appropriate treatment. Further study would be to identify specific biomarkers for the development of better treatment in these comorbid diseases.
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