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Biomedical subjects

G García Hernández

Publications and source records attributed to G García Hernández.

12 recordsLinked to original sources

BCG immunization at birth and atopic diseases in a homogeneous population of Spanish schoolchildren.

BACKGROUND: The role of immunization with bacillus Calmette-Guérin (BCG) in the prevalence of asthma, hay fever and atopic dermatitis is not definitely established and seems to be influenced by ethnic background. The aim of this study was to analyze the relationship between this immunization and the prevalence of those diseases in a homogeneous population of Spanish schoolchildren. METHODS: The International Study of Asthma and Allergies in Childhood (ISAAC) core and environmental questionnaires were used in four different centers of the Spanish North Atlantic coast. Bilbao, San Sebastián and Asturias have a universal BCG immunization policy during the first days of life, whereas La Coruña discontinued this practice in 1989. Except for this center, immunization coverage was above 90%. A random sample of schools of Asturias or all schools in the city district (rest of centers) with children 6 and 7 years old was surveyed. RESULTS: The participation rate was above 70%. After excluding those children born outside Spain, the numbers were 6,762 immunized and 2,828 nonimmunized. After adjusting for gender, age, smoking habits of the father and mother, truck traffic near the household, older and younger siblings and having a cat or a dog during the first year of the child's life, the adjusted ORs of the BCG-immunized children suffering from asthma, hay fever and atopic dermatitis were respectively 0.87 (95% CI 0.76-1.00), 0.87 (0.75-1.01) and 0.89 (0.76-1.05). CONCLUSIONS: BCG immunization offers a weak but significant protection against asthma and hay fever in Spanish schoolchildren.

Age Factors↗

[Time trends and geographical variations in the prevalence of symptoms of allergic rhinitis in 6-7-year-old children from eight areas of Spain according to the ISAAC].

BACKGROUND: Phase III of the International Study of Asthma and other Allergies in Childhood (ISAAC) was carried out in schoolchildren aged 6-7 years from eight areas of Spain to estimate time trends and geographic variations in the prevalence of symptoms of allergic rhinitis (AR). MATERIAL AND METHOD: A standard and validated questionnaire was used following ISAAC methodology and was completed by the schoolchildren's parents. The prevalence of symptoms of AR in Phase I (1993-1994) and Phase III (2001-2002) was compared. Eight centers participated: Asturias, Barcelona, Bilbao, Cartagena, Castellón, Madrid, Pamplona and Valencia. Poisson regression was used in the analysis. RESULTS: A total of 25,113 schoolchildren were studied with a median participation of 81.7 %. In all centers, AR symptoms tended to increase, with a prevalence ratio of rhinoconjunctivitis in the previous year of 1.61 (95 % confidence interval: 1.48-1.76) when both phases, adjusted by gender, center, and seasonal variation, were compared. The prevalence of AR symptoms was higher in boys than in girls. Wide variations in the prevalence of AR were observed across centers with a higher prevalence in Asturias, Madrid, Cartagena and Bilbao. Lower prevalences were reported in Barcelona, Castellón and Pamplona. CONCLUSIONS: There seems to have been a general increase in AR symptoms. Substantial variations between centers suggested that there may be local differences in risk factors. Intense research will be required for satisfactory preventive actions.

Child↗

Stabilization of asthma prevalence among adolescents and increase among schoolchildren (ISAAC phases I and III) in Spain.

BACKGROUND: Most studies show a steep increase in asthma prevalence in the last decades, although few studies had applied the same methodology. Recent reports point out the possibility that the epidemic has come to an end. We have studied the prevalence of asthma in a very large sample of children, repeating the study eight years apart. METHODS: Repeated cross-sectional studies using the International Study of Asthma and Allergies in Childhood (ISAAC) protocol in a sample of Spanish schoolchildren 6-7 (parent-reported) and 13-14 (self-reported) years old in 1994-95 (phase I) and 2002-2003 (phase III). The number of participants was 42 417 in phase I and 42 813 in phase III. The participation rate was over 87% (13-14 years) and 70% (6-7 years). RESULTS: The prevalence of wheezing in the previous year in children aged 13-14 years was 9.0 and 9.3% for boys and 9.6 and 9.2% for girls for phases I and III, respectively. Children 6-7 years of age showed a substantial increase in wheezing in the previous year (7.0 and 10.7% for boys and 5.3 and 8.2% for girls). Other symptoms and severity indexes followed the same patterns. CONCLUSIONS: In the last 8 years, the prevalence of asthma has not changed in 13-14-year-old Spanish children but has increased substantially in 6-7-year olds.

Adolescent↗

[International Study of Asthma and Allergies in Childhood (ISAAC) Phase II: Methodology and results of the participation rate in Spain].

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.

Asthma↗

[Treatment of congenital tracheal stenosis using a slide tracheoplasty].

Congenital tracheal stenosis (CTS) is a rare malformation that usually require corrective surgery. Resection and tracheal anastomosis is the treatment of choice when the stenosis is short. However, such an approach is not usually viable when the CTS is long, given that anastomotic pressure would be too great. New surgical techniques have allowed this serious airway malformation to be corrected satisfactorily. We report the case of a three-year-old boy with a long CTS (51% of the length of the trachea) treated with a new reconstructive technique called slide tracheoplasty. Outcome was excellent.

Child, Preschool↗

[Eosinophil cationic protein in the asthmatic infant: correlation with the clinic and pulmonary function].

PATIENTS AND METHODS: Serum eosinophil cationic protein (ECP) was measured in 99 chronic asthmatic patients (51 males and 48 females) with a mean age of 10.59 years and correlated with the number of eosinophils, lung function, symptoms in the last 6 months and clinical scoring (that reflecting the clinical situation during the last 15 days). RESULTS: Serum ECP showed a significant correlation with the total number of eosinophils (p < 0.001, R = 0.44), clinical scoring (p < 0.05, R = 0.26), number of inhaled beta 2-agonist doses needed in the last 15 days (p < 0.05, R = 0.26), forced expiratory volume during 1 second (FEV1; p < 0.01, R = -0.27), forced vital capacity (FVC; p < 0.05, R = -0.23), maximal mid-expiratory flow (FEF25-27; p < 0.001, R = -0.37). However, there was no significant correlation between the total number of eosinophils and the clinical situation of the children or the FEV1, but we found a significant correlation with the FEF25-27. Patients with ECP < 20 had better results on lung function tests than patients with ECP > 20 (FEV1: 108.89 +/- 17.7 vs 100.5 +/- 22 (p < 0.05), FEF25-27: 93.81 +/- 24.4 vs 75.21 +/- 24.5 (p < 0.001). CONCLUSIONS: The findings of this study suggest that the ECP level is a good marker of the situation of asthma in childhood. The levels of ECP will probably be able to help us to evaluate the degree of bronchial inflammation that neither the clinical state nor the lung function define completely.

Asthma↗

[Secretory IgA and infantile respiratory pathology].

Secretory component of IgA is the major class of immunoglobulin in secretions and mucous membranes. Many causes have been involved in etiopathogenesis of respiratory tract disease in children, one of them the possible deficit of secretory component of IgA. Authors have studied 191 children with respiratory tract disease secondary to infections and/or allergy and a control group of 35 healthy children. In all of them the secretory IgA non stimulated sputum was measured. In the group with respiratory disease serum IgA, IgG, IgM and IgE were also measured. Levels of secretory IgA were greater in group with respiratory disease than in control; also serum level of IgA was above normal for their ages. Level of secretory IgA was greater in children with "wheezing respiratory disease". These findings do not agree with theory of existence of an IgA secretory deficit as a cause or respiratory tract disease in children.

Adolescent↗

[Extrarespiratory manifestations of Mycoplasma pneumoniae infection].

Three patients with Mycoplasma pneumoniae infection, documented by CF antibody titers greater than 128, developed severe extrapulmonary manifestations. Two of them had a Stevens-Johnson syndrome seven and two days after the beginning of respiratory symptoms and the third a demyelinating polyradicyloneuropathy three weeks later. One of the patients with Stevens-Johnson syndrome and serious respiratory involvement also had hemolytic anemia associated with a cold agglutinins titer of 128. Authors determined lymphocytes subpopulations in one of the cases of Stevens-Johnson syndrome and in the patient with polyradiculoneuropathy. In both of them they found a reduced number of T-helper lymphocytes, and in the patient with Guillain-Barré syndrome an increase in suppressor T cells was also demonstrated.

Adolescent↗