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04 October 2010

Are pre-teen babysitters able to deal with emergencies?

Nearly all (98 percent) of 11- to 13-year-old babysitters know who to contact in the event of an intruder or if a child is sick or injured (96 percent) or poisoned (85 percent), according to research presented Sunday, Oct. 3, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in San Francisco. However, 40 percent of younger babysitters reported that they had left children unattended while babysitting, and 20 percent opened the door to strangers.
In the study, "Babysitter Safety Training: Are Children Aged 11-13 Years Prepared to Deal with Emergencies While Caring for Younger Children?" researchers surveyed 727 pre-teens who have cared for a younger infant or child as a babysitter.
Fifty-one percent of the children interviewed had taken a first-aid training class; 47 percent, a class in cardio-pulmonary resuscitation, and 19 percent, the American Red Cross Safe Sitter or other babysitter class. Ninety-two percent of pre-teen babysitters were familiar with the location of first aid supplies and 64 percent with the location of a fire extinguisher. Ten percent of pre-teen babysitters have had a personal experience with an emergency requiring 911 activation: 10 respondents called 911 after a child sustained injuries from a significant fall, eight because of a house fire, six because a child had profuse bleeding from a laceration, and six for a significant head trauma.
The study provided a snapshot of pre-teen babysitter strengths and weaknesses, said lead study author Nicole M. Hackman, MD, FAAP, of Penn State Hershey Children's Hospital. "By identifying the unsafe behaviors, we have the opportunity to design specific educational programs to prepare pre-teen babysitters to safely respond to common emergency situations."

**Published by American Academy of Pediatrics

Are pre-teen babysitters able to deal with emergencies?

Nearly all (98 percent) of 11- to 13-year-old babysitters know who to contact in the event of an intruder or if a child is sick or injured (96 percent) or poisoned (85 percent), according to research presented Sunday, Oct. 3, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in San Francisco. However, 40 percent of younger babysitters reported that they had left children unattended while babysitting, and 20 percent opened the door to strangers.
In the study, "Babysitter Safety Training: Are Children Aged 11-13 Years Prepared to Deal with Emergencies While Caring for Younger Children?" researchers surveyed 727 pre-teens who have cared for a younger infant or child as a babysitter.
Fifty-one percent of the children interviewed had taken a first-aid training class; 47 percent, a class in cardio-pulmonary resuscitation, and 19 percent, the American Red Cross Safe Sitter or other babysitter class. Ninety-two percent of pre-teen babysitters were familiar with the location of first aid supplies and 64 percent with the location of a fire extinguisher. Ten percent of pre-teen babysitters have had a personal experience with an emergency requiring 911 activation: 10 respondents called 911 after a child sustained injuries from a significant fall, eight because of a house fire, six because a child had profuse bleeding from a laceration, and six for a significant head trauma.
The study provided a snapshot of pre-teen babysitter strengths and weaknesses, said lead study author Nicole M. Hackman, MD, FAAP, of Penn State Hershey Children's Hospital. "By identifying the unsafe behaviors, we have the opportunity to design specific educational programs to prepare pre-teen babysitters to safely respond to common emergency situations."

**Published by American Academy of Pediatrics

Are pre-teen babysitters able to deal with emergencies?

Nearly all (98 percent) of 11- to 13-year-old babysitters know who to contact in the event of an intruder or if a child is sick or injured (96 percent) or poisoned (85 percent), according to research presented Sunday, Oct. 3, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in San Francisco. However, 40 percent of younger babysitters reported that they had left children unattended while babysitting, and 20 percent opened the door to strangers.
In the study, "Babysitter Safety Training: Are Children Aged 11-13 Years Prepared to Deal with Emergencies While Caring for Younger Children?" researchers surveyed 727 pre-teens who have cared for a younger infant or child as a babysitter.
Fifty-one percent of the children interviewed had taken a first-aid training class; 47 percent, a class in cardio-pulmonary resuscitation, and 19 percent, the American Red Cross Safe Sitter or other babysitter class. Ninety-two percent of pre-teen babysitters were familiar with the location of first aid supplies and 64 percent with the location of a fire extinguisher. Ten percent of pre-teen babysitters have had a personal experience with an emergency requiring 911 activation: 10 respondents called 911 after a child sustained injuries from a significant fall, eight because of a house fire, six because a child had profuse bleeding from a laceration, and six for a significant head trauma.
The study provided a snapshot of pre-teen babysitter strengths and weaknesses, said lead study author Nicole M. Hackman, MD, FAAP, of Penn State Hershey Children's Hospital. "By identifying the unsafe behaviors, we have the opportunity to design specific educational programs to prepare pre-teen babysitters to safely respond to common emergency situations."

**Published by American Academy of Pediatrics

Unemployment linked with child maltreatment

The stresses of poverty have long been associated with child abuse and neglect. In a study presented Sunday, Oct. 3, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in San Francisco, researchers directly linked an increased unemployment rate to child maltreatment one year later.
Researchers reviewed state-level unemployment statistics from the Bureau of Labor Statistics, and compared them with child maltreatment data from the National Child Abuse and Neglect Data System (NCANDS), during the years 1990 to 2008. Each 1 percent increase in unemployment was associated with at least a 0.50 per 1,000 increase in confirmed child maltreatment reports one year later. In addition, higher levels of unemployment appeared to raise the likelihood of child maltreatment, as it was not only the lagged change in unemployment, but also the previous year's unemployment level that influenced the number of child abuse cases.
According to the study, a prolonged rise in unemployment rates is not only detrimental to the economic health of the country but also to the physical and mental health of children. Maltreated children suffer the immediate physical consequences of abuse, including physical injury and even death, and are also at increased risk of physical and mental health effects, often lasting for decades.
Unemployment in the U.S. has risen from 4.5 percent in 2007 to a current level of 9.5 percent.
"When times are bad, children suffer," said study author Robert Sege, MD, PhD, FAAP, professor of pediatrics, Boston University School of Medicine, and director, Division of Ambulatory Pediatrics, Boston Medical Center. "These results suggest that programs to strengthen families and prevent maltreatment should be expanded during economic downturns."

1 in 8 parents forgoes pediatrician-recommended care

One in eight parents reported that his or her child had not received pediatrician-recommended care – medication, laboratory testing and/or appointments with specialists – during the previous 12 months due to concerns over cost and payment, according to a study, presented Sunday, Oct. 3, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in San Francisco.
For the study, "Parents Perspectives on their Children's Health Insurance: The Plight of the Underinsured," 1,978 southwest Ohio parents were queried regarding the impact of their children's health insurance on their ability to follow pediatric recommendations, as well as on their child's health. Children were considered "underinsured" if their parents had not been able to follow at least one recommendation from a pediatrician during the previous 12 months due to insufficient insurance coverage.
Forty-two percent of parents with underinsured children agreed with the statement their "child's health had suffered because of not being able to afford the cost of the needed care," compared to less than 2 percent of parents who were not underinsured
The study also found that private insurance is a risk factor for underinsurance. After controlling, for annual family income and health status, children with private insurance were about twice as likely as children with public insurance to be underinsured. In addition, children with poorer health or from poorer families (those with household incomes between $15,000 and $34,999) were at greater risk for underinsurance than children who were healthier or from wealthier families (household earning more than $75,000 annually).
"These results serve to highlight a major public health problem pediatricians have observed for years," said John M. Pascoe, MD, MPH, FAAP. The investigators believe that the explanation for the high level of child underinsurance among lower income families whose children do not qualify for public insurance is the high deductibles and co-pays imposed by their private insurance companies. Many parents believe their children's health has suffered as a direct result of their inability to afford recommended care for their underinsured children."

**Published in "Eurekalert.org"

El tiempo de espera en la consulta es un buen momento para que “Pensemos en la salud”

En el último número de la revista médico divulgativa “Pensemos en la salud”, editada por la Fundación Doctor Pascual, se ofrece información de salud especialmente pensada para hacerla llegar a los pacientes en esos minutos previos a ser atendidos en la consulta.
Se habla, por ejemplo, de las miopatías, y se explica cómo los ,músculos son muy sensibles al efecto tóxico de diversas sustancias de tipo industrial, vegetal o animal. Se recuerda a los pacientes que en la asistencia clínica suelen aparecer procesos de difícil diagnóstico, lo que explica la necesidad de preguntar en muchas ocasiones al paciente, por los hábitos alimenticos que haya podido seguir o por algún tipo de alimento que haya podido ingerir y que pudiera ser la causa de la dolencia.
En esta misma línea, se dan consejos sobre el anisakis, un gusano parásito del pescado que podemos ingerir sobre todo si la compra se ha hecho en sitios dudosos o de muy bajo precio. Para extremar las medidas de prevención se recomienda no comer pescado crudo o poco hecho, y si se congela, hacerlo a -20ºC por lo menos durante tres días y quitándole todas las vísceras.
En pleno inicio del curso escolar, se recuerdan los consejos impartidos recientemente en la sede de la Organización Médica Colegial (OMC) sobre la prevención de dolores de espalda en los niños. Se hace un llamamiento para que el peso que soporten los mismos no supere el 10% del peso corporal y se dan consejos como dejar el material en las taquillas del colegio, utilizar mochilas con ruedas, y trasladar a diario sólo el material escolar que se vaya a utilizar en ese día a fin de reducir la carga en todo lo posible.
“Pensemos en la salud” ofrece igualmente informaciones u consejos sobre las más diversas cuestiones relacionadas con la salud, como la diverticulosis, sinusitis, menopausia y terapia hormonal, calzado deportivo, etc.

**Publicado en "Médicos y pacientes"

En España hay 3.000 afectados por enfermedades liposomales


Este fin de semana se ha celebrado en Marbella el “VI Congreso sobre enfermedades de Mucopolisacaridosis y Síndromes Relacionados”, punto de encuentro que ha congregado a destacados especialistas internacionales y nacionales para presentar las últimas investigaciones en los tratamientos de estas patologías lisosomales que afectan a más de 3.000 españoles.
El neuropediatra Eduardo López Laso, del Hospital Universitario Reina Sofía de Córdoba, ha explicado a las familias que las enfermedades lisosomales son muchas y muy complejas en su diagnóstico y pueden afectar en su globalidad a unas 3.000 personas españolas, de las cuales más de la mitad están diagnosticadas y el resto pueden ser portadoras.
Por su parte la Doctora Pilar Giraldo, Jefa de Sección de Hematología del Hospital Miguel Servet, ha resaltado la complejidad que entraña el diagnóstico de algunas enfermedades lisosomales como, por ejemplo, en la enfermedad de Fabry. “En el caso concreto de esta patología los clínicos la denominamos enfermedad impostora porque simula sus síntomas simulan otras muchas patologías. El diagnóstico en los varones es más sencillo puesto que basta con hacerles un análisis de sangre, mientras que con las mujeres es necesario hacer pruebas de ADN y existen más de 465 mutaciones genéticas. Las féminas afectadas por la enfermedad de Fabry, suelen estar diagnosticadas de fibromialgia, lupus o artritis reumatoide”.
También se ha referido la Dra. Giraldo a lo costoso que resulta comprobar la efectividad de la medicación en la enfermedad de Fabry, puesto que es necesario hacer múltiples pruebas de monitorización para evaluar el estado del corazón con un doppler tisular Immage (DTI) o pruebas para analizar el estado del riñón u otro tipo de pruebas neurológicas para verificar los accidentes cerebrovasculares. En su opinión, estos exámenes clínicos resultan muy complejos y caros, y, además precisan un equipo médico multidisciplinar que no todos los hospitales pueden ofrecer.
Por su parte, el Dr. José Luis López Ayala, anestesista del Hospital Fundación Jiménez Díaz de Madrid, ha explicado que las anestesias y procedimientos quirúrgicos en los niños afectados por mucopolisacaridosis son muy delicadas por las diferencias anatómicas específicas que presentan la vía respiratoria de estos pacientes pediátricos “Actualmente algunos anestesistas estamos muy especializados en este tipo de procedimientos quirúrgicos que entrañan una mayor dificultad. Las familias necesitan y quieren tener toda la información en estos procesos”.
También ha participado en este encuentro el Dr. Bryan Winchester, experto de la Unidad de Endocrinología, Bioquímica y Metabolismo del Instituto de Salud Infantil del Hospital Great Ormond Street Hospital, de Londres, quién se ha referido a que las novedades terapéuticas en este campo serán tratamientos mixtos de base enzimática combinados con terapia celular donde se están produciendo los grandes avances científicos.


-Las enfermedades liposomales, grandes desconocidas
La Federación MPS España reúne a los afectados por enfermedades lisosomales de almacenaje lisosomal causadas por una anormalidad genética. Carecen de la capacidad de producir una enzima que degrada los mucopolisacáridos a moléculas más simples. La falta de estas enzimas en el organismo provoca que los mucopolisacáridos se acumulen en las células de todos los órganos, especialmente en el cerebro, originando multitud de anomalías físicas. Los síntomas más característicos de estas patologías son la hiperactividad, los desórdenes del sueño, la pérdida del habla, deformaciones físicas y en algunos casos, el retraso mental y, en los casos más graves, hasta demencia.
Todas estas enfermedades tienen origen genético. La mayoría afectan a la población pediátrica y tienen un efecto devastador tanto para los mismos afectados como para el entorno familiar y social. En muchas ocasiones los pequeños afectados nacen completamente asintomáticos. Con los años, estos niños afectados desarrollarán poco a poco todos los síntomas al acumularse las enzimas que provocan estos cuadros clínicos.
Existe todavía un importante desconocimiento biomédico y epidemiológico de estas enfermedades. A esto se suma la falta de expertos y de centros de referencia en nuestro país y la demora en la obtención de diagnóstico genético, bioquímico y clínico, y la falta de tratamientos satisfactorios. “En nuestro país ni siquiera esta reconocida la especialidad de genética y algunas de estas enfermedades no tienen ningún tratamientos como ocurre en el caso de la enfermedad de SanFilippo”, explica Jordi Cruz, Presidente de la Federación MPS España y padre de una niña que sufre esta enfermedad.
No hay que olvidar que en España, hay 3 millones de afectados por enfermedades raras y en el conjunto europeo esta cifra alcanza los 30 millones de pacientes.


**En la foto Cruz Martínez con su hijo Miguel, afectado porMucopolisacaridosis. Ambos son miembros de la Federación Española MPS

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