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Introduction: Studies on the prevalence of asthma and allergies often lack representation of the pediatric population, and their impact has not been examined using children without these diseases as a reference group. This study aimed to determine the prevalence of asthma and allergies in children under 14 years old in Spain and their impact on health-related quality of life, activities, healthcare utilization, and environmental and household exposure risk factors., Methods: Data came from a Spanish population-based representative survey of children aged <14 years (N=6297). A sample of controls (1:4) from the same survey was matched using propensity score matching. Logistic regression models and population-attributable fractions were calculated to determine the impact of asthma and allergy., Results: The population prevalence of asthma was 5.7% (95% CI: 5.0%, 6.4%), and of allergy was 11.4% (95% CI: 10.5%, 12.4. In children with lower percentiles of health-related quality of life (≤20th), 32.3% (95% CI, 13.6%, 47.0%) was attributed to asthma and 27.7% (95% CI: 13.0%, 40.0%) to allergy. Forty-four percent of restrictions in usual activity were attributed to asthma (OR: 2.0, p-value: <0.001), and 47.9% to allergy (OR: 2.1, p-value: <0.001). 62.3% of all hospital admissions were attributed to asthma (OR: 2.8, p-value: <0.001), and 36.8% (OR: 2.5, p-value: <0.001) of all specialist consults to allergy., Conclusions: The high prevalence of atopic disease and its impact on daily life and healthcare utilization call for an integrated healthcare system focused on children and caregivers' needs with continuity of care across education and healthcare settings., (Copyright © 2023 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art., Background: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence., Method: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation., Results: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention., Conclusions: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and remains a major problem in pediatric pulmonology units. The decision of discharging from the Neonatal Unit should be based on a thorough assessment of the condition of the patient and compliance with certain requirements, including respiratory and nutritional stability, and caregiver education on disease management. For proper control of the disease, a schedule of visits and complementary tests should be established prior to discharge, and guidelines for prevention of exacerbations and appropriate treatment should be applied. In this paper, the Working Group in Perinatal Respiratory Diseases of the Spanish Society of Pediatric Pulmonology proposes a protocol to serve as a reference for the follow up of patients with BPD among different centers and health care settings. Key factors to consider when planning discharge from the Neonatal Unit and during follow up are reviewed. Recommendations on treatment and prevention of complications are then discussed. The final section of this guide aims to provide a specific schedule for follow-up and diagnostic interventions to be performed in patients with BPD., (Copyright © 2015 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Background: The incidence of obesity and its most feared comorbidity, diabetes mellitus type 2, is increasing and there would not seem to be any medical treatment to help control these pandemics. However, there is a bariatric surgery technique, the Roux-en-Y Gastric Bypass (RYGB), which is safe and not only helps control excess weight, but produces encouraging results in the control and remission of diabetes., Methods: We present 15 selected patients with a BMI between 30 and 35 kg/mt² and diabetes type 2 who underwent a laparoscopic RYGB with of one-year follow-up., Results: A total of 14 women and one man were operated with the following average values: age: 37 years, weight: 88.3 kg, BMI: 32.8 kg/mt², blood glucose: 120 ± 38.8 mg%, HbA1c: 7.6 ± 0.73. Forty percent (40%) suffered from high blood pressure and 33.3% were dyslipidemic. Average surgical time was 75 minutes, hospital length of stay was two days, and there was a low rate of complications and no mortality. Diabetes remission was achieved in 93% of cases with significant drops in blood glucose and HbA1c (p ≤ 0.05 and p ≤ 0.001 respectively), dyslipidemia was 100% controlled and hypertension was 83.3% controlled., Conclusions: RYGB in selected patients with obesity type 1 and diabetes mellitus type 2 is a safe and effective technique for metabolic control and obesity control.

Objective: Analysing barriers to and opportunities for user involvement as perceived by the social actors involved in implementing Colombian policy regarding social participation in health., Methods: An exploratory qualitative study was carried out in the Colombian towns of Tuluá and Palmira between 2000 and 2001. There were 10 focus groups having 260 users and leaders. Semi-structured individual interviews were given to health personnel (36) and policy-makers (3). Narrative content, mixed categories and data segmentation by informants and topics were then analysed., Results: Users and leaders considered their own lack of knowledge, apathy and fear of revenge as barriers for participation. However, there were institutional factors such as lack of institutional transparency, limited receptiveness and responsiveness regarding participation. These opinions were shared by policy-makers. Most health personnel identified users' knowledge and attitudes as barriers for participation; few mentioned any institutional barriers such as the behaviour of personnel, institutional opacity and the lack of resources for fostering work in the community. Opportunities for participation were described in terms of suitable and possible scenarios. Users perceived their great ability to achieve change through their direct participation appeared to them as presenting an important opportunity., Conclusions: Users' and leaders' perceptions of the current barriers and opportunities seemed to show that they are critical of their own reality and constitute important potential actors for becoming key interlocutors with institutions and the state. A similar attitude would be necessary on the part of institutional actors to build a real and permanent participatory culture.

Objective: To investigate the influence of social support and adverse life events on depression symptoms, before and after therapy (15-30 days) and during follow-up (4 months) of a psycho-educational intervention for depression., Material and Methods: The study population consisted of 254 women with depression symptoms selected among those seeking treatment for their symptoms in three community mental health centers and in one Ministry of Health center, all of them in Mexico City, between January 1998 and December 2000. The intervention has been proved effective previously in reducing depression symptoms. Symptoms were assessed using Radloff's CES-D scale, while specifically designed scales were used for events and social support. Hierarchical regression analyses were carried out to test various models., Results: Model I: effect of variables: life events, social support, and socio-demographic variables (age, education level, income, and work status) on CES-D pre-treatment. The model was significant (p<0.000) and the first two variables and age were included in the model. Model 2: effect of the same predictive variables on CES-D post-treatment. The model was significant (p<0.001) and included social support and life events. Model 3: effect of the same variables on CES-D during follow-up. The model was significant (p<0.000) and included life events and educational achievement. Model 4: effect of social support and life events during follow-up on CES-D during follow-up. The model was also significant (p<0.000) and both variables were included in the model. Additional analyses for models 2 and 3 adding CES-D pre-treatment as a predictor showed that only the latter was significant., Conclusions: Life events and social support are associated with initial depression symptoms and also predict the reduction of symptoms following the psycho-educational intervention. This may be due to the high correlation of life events and social support with CES-D pre-treatment. Life events and social support following the intervention also have an effect on CES-D in this same stage. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Cat-scratch disease is caused by a Gram-negative bacillus known as Bartonella henselae. This disease is usually benign and causes regional adenitis that does not require treatment. However, some patients develop more serious atypical forms of the disease including prolonged systemic illness with hepatic and splenic abscesses.A 14-year-old girl was admitted to hospital with a 12-day history of persistent high fever and abdominal pain. Ultrasonography and computerized tomography of the abdomen revealed splenic abscesses. These findings, together with an antecedent of cat exposure, led to the suspicion of cat-scratch disease, which was confirmed by serology. The girl was treated with intramuscular ceftriaxone and clinical evolution was favorable. Splenic cat-scratch disease is infrequent. Cat-scratch disease sometimes presents as fever of unknown origin and consequently this disease should be considered in the differential diagnosis of prolonged fever. Although evolution is usually favorable, antibiotic therapy is recommended in systemic manifestations of cat-scratch disease.

Objective: To describe the seasonal allergy distribution and its relation with grass pollen in environment., Design: Ecological and descriptive study. SITE. Primary care centre in townshipe Coslada (Madrid). PATIENTS OR OTHER PARTICIPANT: People who are attended because of seasonal allergy from 20th April to 14th June in 1990 and 1991, of the total people covered by a primary care team., Main Measurements and Results: No differences were found in relation to sex. 5-19 age group cumulated 66.1 and 61.2% of the episodes in 1990 and 1991 respectively. 36.2 and 31% (1990-1991) described respiratory difficulties and 21.5 and 18.8% respiratory wheezings. 82.7 and 88.4% of patients asserted that the symptoms repeated annually. Patients who related known allergy, 91.8 and 98.3% attributed their problems to grass pollen. Correlations of r = 0.5207 (p < 0.001) in 1990 and r = 0.4978 (p < 0.01) in 1991 between grass pollen the day before and the notification date were found., Conclusions: We found the highest care assistance in the infant-juvenile age group, the same as an important number of cases with asthmatic symptomatology. We seen a moderate relationship between the episodes notification date and grass pollen in the environment.