ABSTRACT
Conclusiones de los autores del estudio: el uso selectivo del electrocardiograma (ECG) en los exámenes previos a la participación de atletas jóvenes proporciona una alta tasa de detección de cardiopatías. Se debe demostrar que la implantación del ECG como cribado tiene una mayor eficiencia para la prevención de la muerte súbita que su uso selectivo, antes de valorar su implantación generalizada. Comentario de los revisores: las deficiencias metodológicas de este estudio hacen que sus resultados no condicionen ningún cambio en las actuales directrices respecto a los exámenes preparticipación de atletas jóvenes. Las directrices europeas y españolas en estos momentos aconsejan el uso de ECG como cribado en las evaluaciones preparticipación (AU)
Athors´ conclusions: due to the methodological shortcomings of this study, the results dont make any change to current guidelines regarding preparticipation athletic evaluations among youths. Current European and Spanish guidelines advise using ECG screening in preparticipation athletic evaluations. Reviewers´ commentary: selective ECG use for preparticipation athletic evaluations has a high rate of identification of cardiac disease. Adoption of a mass ECG screening program would need to prove to be more efficient at identifying diseases associated with sudden cardiac death than a selective approach (AU)
Subject(s)
Humans , Male , Female , Child , Sudden Infant Death/epidemiology , Sudden Infant Death/prevention & control , Death, Sudden/epidemiology , Death, Sudden/prevention & control , Evidence-Based Medicine/instrumentation , Evidence-Based Medicine/methods , Evidence-Based Practice/methods , Mass Screening/methods , Electrocardiography/instrumentation , Electrocardiography/methods , Sports/physiology , Retrospective StudiesABSTRACT
Se realiza una revisión de la bibliografía obtenida, tras una búsqueda sistemática en lasprincipales bases de datos, para responder a algunas preguntas clínicas relacionadas con eltrastorno por déficit de atención con/sin hiperactividad (TDAH), la escuela y los trastornos deaprendizaje: ¿los niños con TDAH tienen problemas de aprendizaje, emocionales o sociales?,¿cuáles son y quién los detecta?, ¿los tratamientos en el ámbito escolar tienen algún papelpara mejorar su resolución?, ¿qué nivel de evidencia tienen las respuestas que se proponen?Se concluye que existen problemas de aprendizaje, de conducta y emocionales que semanifiestan especialmente en el ecosistema escolar alterando la calidad de vida del niño y quese deben abordar de un modo comprehensivo, mediante programas de intervención multimodal.Se presenta además un glosario de términos, conocidos en el ambiente escolar, quepueden resultar confusos para el pediatra de Atención Primaria y un ejemplo de trabajo decolaboración entre la escuela y el centro de salud de una comunidad rural madrileña
This work presents the results of a systematic search in the most important bibliographicdatabases in order to answer some clinical questions related to attention-deficit/hyperactivitydisorder (ADHD), school and learning impairment: do children with ADHD havelearning, emotional or social impairments?, which are these impairments and who detectsthem?, do treatments at school have any role at improving the outcome?, what level of evidencehave the proposed answers?The results indicate that there is ample evidence that children identified as havingADHD have significant impairments in psychosocial and academic functioning, learning disorders,emotional problems and psychosocial problems, that can impact on childs functioning. They can be accurately detected by the teacher at school. The underlying principle ofsuccessful management includes multiple treatment modalities to address the multidimensionalnature of the disorder. A glossary of terms of the school environment is included. PrimaryCare paediatricians can be unfamiliar with these terms. We also describe a project asan example of cooperation among schools and a health centre in a population located inthe surroundings of Madrid
Subject(s)
Male , Female , Child , Humans , Learning Disabilities/etiology , Underachievement , Attention Deficit Disorder with Hyperactivity/complications , School Health Services , Behavior Therapy/methods , Early Intervention, EducationalABSTRACT
BACKGROUND: In spring of 1998, an acute gastroenteritis outbreak, which mainly affected preschool children, took place in Guadarrama (Community of Madrid, Spain). METHODS: A descriptive and analytical (cases and controls) study of the outbreak was done. Stool samples of the cases were taken to microbiological investigation. The tap water getting system of the municipality was inspected and samples were collected to microbiological analysis. RESULTS: Twenty one children from 0 to 5 years-old had liquid diarrhea which lasted more than five days. A significant statistical association was found within tap water consumption and gastroenteritis [OR = 5.73 (1.18-43.30); p < 0.05]. It did not have association with other variables investigated. Cryptosporidium parvum (Cp) oocysts were detected in stool samples of eight cases. Deficiencies were observed in the tap water getting and treatment system of the municipality but no oocysts were found in the analysis of the water. CONCLUSIONS: The results of the epidemiological investigation support that the source of the gastroenteritis outbreak was tap water, likely contaminated with Cp. While this parasite was not detected in the analysis of the water, it is explainable for the difficulties which this technique involves. In our review similar descriptions of outbreaks have not been found in Spain, but it seems that this reports are not infrequent in neighbour countries. Therefore, Cp should be borne in mind in diagnostic and management of these situations.
