Síndrome de muerte súbita del lactante: ¿siguen las familias las recomendaciones? / Sudden infant death syndrome: Do the parents follow the recommendations?

INTRODUCCIÓN: La postura en decúbito prono al dormir es el principal factor de riesgo modificable conocido para el síndrome de muerte súbita del lactante (SMSL). Existen otras recomendaciones respecto al SMSL con menor impacto. El objetivo de este estudio es conocer la prevalencia del decúbito prono durante el sueño así como de otros factores de riesgo asociados a SMSL en una muestra de lactantes españoles. MATERIAL Y MÉTODOS: Estudio transversal realizado en 640 familias con niños de 0 meses a 11 meses. Además de la postura, se analizó la adherencia a otras cuatro recomendaciones respecto al SMSL: lugar donde duerme el lactante, lactancia materna, succión no nutritiva y tabaquismo materno. RESULTADOS: El 41,3% de los menores de 6 meses y el 59,7% de los lactantes de 6 a 11 meses dormían en una postura no recomendada. Solo el 6,4% de las familias seguían las cinco recomendaciones analizadas. DISCUSIÓN: Existe una elevada prevalencia de factores de riesgo modificables de SMSL en la población estudiada. Parece necesario reimpulsar la educación personalizada y otras campañas de concienciación y prevención del SMSL

INTRODUCTION: Prone sleeping position is the main known modifiable risk factor for sudden infant death syndrome (SIDS). There are other SIDS recommendations although with less impact. The objective of this study is to describe the prevalence of prone position during sleep as well as other risk factors associated with SIDS in a sample of Spanish babies and infants. METHODS: Cross-sectional study carried out on 640 families with children from 0 months to 11 months. In addition to the sleep position, the adherence to four other recommendations regarding SIDS was analysed: place where infant sleeps, breastfeeding, use of non-nutritive suction, and maternal smoking. RESULTS: A total of 41.3% of infants under 6 months and 59.7% of infants aged 6 to 11 months slept in a non-recommended position. Only 6.4% of families analysed followed all five recommendations. DISCUSSION: There is a high prevalence of modifiable risk factors for SIDS among the studied population. Personalized education should be promoted, along with other campaigns to raise awareness and prevent SIDS

[Sudden infant death syndrome: Do the parents follow the recommendations?] / Síndrome de muerte súbita del lactante: ¿siguen las familias las recomendaciones?

INTRODUCTION: Prone sleeping position is the main known modifiable risk factor for sudden infant death syndrome (SIDS). There are other SIDS recommendations although with less impact. The objective of this study is to describe the prevalence of prone position during sleep as well as other risk factors associated with SIDS in a sample of Spanish babies and infants. METHODS: Cross-sectional study carried out on 640 families with children from 0 months to 11 months. In addition to the sleep position, the adherence to four other recommendations regarding SIDS was analysed: place where infant sleeps, breastfeeding, use of non-nutritive suction, and maternal smoking. RESULTS: A total of 41.3% of infants under 6 months and 59.7% of infants aged 6 to 11 months slept in a non-recommended position. Only 6.4% of families analysed followed all five recommendations. DISCUSSION: There is a high prevalence of modifiable risk factors for SIDS among the studied population. Personalized education should be promoted, along with other campaigns to raise awareness and prevent SIDS.

[Prevalence of smoke-free homes and passive exposure to tobacco in pediatric population (children from 3 to 36 months)]. / Prevalencia de hogares libres de humo y exposición pasiva al tabaco en población pediátrica (niños de 3 a 36 meses).

OBJECTIVE: Pediatric population is the most vulnerable to secondhand smoke (SHS), exposure being households the main source of exposure in children. The objective of this study is to describe smoke-free households and the prevalence of SHS in the pediatric population (from 3 to 36 months) in Spain. METHODS: Cross-sectional study with 1,368 parents, mothers or guardians with children from 3 to 36 months carried out in Spain from March to November of 2017 through an online questionnaire as part of the EPISON study. Information was collected on the voluntary adoption of tobacco use regulations at home and SHS exposure at home and other environments. We calculated prevalences and Odds Ratio adjusted (ORa) for sex, age, level of education, and smoking status. RESULTS: 87.6% of respondents claimed to have a smoke-free home. 12.4% of respondents had partial regulation or did not have regulation at home, increasing up to 26.0% when the parent was a smoker or to 21.8% when the parent had primary or lower education. 5.4% of parents reported SHS exposure in their children at their homes, rising to 14.5% when it occurs in other environments, increasing with statistically significant differences between smoking parents and parents with lower educational level. CONCLUSIONS: The smoke-free homes are the majority; but SHS exposure to tobacco at home persists in children under 3 years of age, especially in families with a lower educational level. Therefore, awareness-raising campaigns on the effects of passive exposure on minors among families with.

OBJETIVO: La población pediátrica es la más vulnerable a la exposición pasiva al humo ambiental del tabaco (HAT), siendo los hogares la fuente principal de exposición en niños. El objetivo de este estudio fue describir los hogares libres de humo y la prevalencia de exposición pasiva al HAT en la población pediátrica (de 3 a 36 meses) en España. METODOS: Estudio transversal con 1.368 padres, madres o tutores con hijos de 3 a 36 meses realizado en España de marzo a noviembre de 2017 mediante cuestionario online como parte del estudio EPISON. Se recogió información sobre la adopción voluntaria de normas de consumo de tabaco en el hogar y exposición al HAT en casa y otros ambientes. Se calcularon las prevalencias y las Odds Ratio ajustadas (ORa) por sexo, edad, nivel educativo y consumo de tabaco. RESULTADOS: El 87,6% de los encuestados afirmó tener un hogar libre de humo. El 12,4% de los encuestados tenían regulación parcial o no tenían ninguna regulación en el hogar, incrementándose hasta el 26% cuando el progenitor era fumador o al 21,8% cuando tenía estudios primarios o inferiores. El 5,4% de los padres refirió exposición pasiva al tabaco en niños en sus hogares, elevándose hasta el 14,5% cuando la exposición se produjo en otros ambientes, incrementándose de forma estadísticamente significativa la diferencia entre los padres fumadores y con menor nivel educativo. CONCLUSIONES: Los hogares libres de humo son mayoritarios, pero persiste la exposición pasiva al tabaco en el hogar con niños menores de 3 años, especialmente en familias con menor nivel educativo. Por ello, se deberían incentivar campañas de sensibilización sobre los efectos de la exposición pasiva en menores, especialmente en familias con menos recursos.

Prevalencia de hogares libres de humo y exposición pasiva al tabaco en población pediátrica (niños de 3 a 36 meses) / Prevalence of smoke-free homes and passive exposure to tobacco in pediatric population (children from 3 to 36 months)

OBJETIVO: La población pediátrica es la más vulnerable a la exposición pasiva al humo ambiental del tabaco (HAT), siendo los hogares la fuente principal de exposición en niños. El objetivo de este estudio fue describir los hogares libres de humo y la prevalencia de exposición pasiva al HAT en la población pediátrica (de 3 a 36 meses) en España. MÉTODOS: Estudio transversal con 1.368 padres, madres o tutores con hijos de 3 a 36 meses realizado en España de marzo a noviembre de 2017 mediante cuestionario online como parte del estudio EPISON. Se recogió información sobre la adopción voluntaria de normas de consumo de tabaco en el hogar y exposición al HAT en casa y otros ambientes. Se calcularon las prevalencias y las Odds Ratio ajustadas (ORa) por sexo, edad, nivel educativo y consumo de tabaco. RESULTADOS: El 87,6% de los encuestados afirmó tener un hogar libre de humo. El 12,4% de los encuestados tenían regulación parcial o no tenían ninguna regulación en el hogar, incrementándose hasta el 26% cuando el progenitor era fumador o al 21,8% cuando tenía estudios primarios o inferiores. El 5,4% de los padres refirió exposición pasiva al tabaco en niños en sus hogares, elevándose hasta el 14,5% cuando la exposición se produjo en otros ambientes, incrementándose de forma estadísticamente significativa la diferencia entre los padres fumadores y con menor nivel educativo. CONCLUSIONES: Los hogares libres de humo son mayoritarios, pero persiste la exposición pasiva al tabaco en el hogar con niños menores de 3 años, especialmente en familias con menor nivel educativo. Por ello, se deberían incentivar campañas de sensibilización sobre los efectos de la exposición pasiva en menores, especialmente en familias con menos recursos

OBJECTIVE: Pediatric population is the most vulnerable to secondhand smoke (SHS), exposure being households the main source of exposure in children. The objective of this study is to describe smoke-free households and the prevalence of SHS in the pediatric population (from 3 to 36 months) in Spain. METHODS: Cross-sectional study with 1,368 parents, mothers or guardians with children from 3 to 36 months carried out in Spain from March to November of 2017 through an online questionnaire as part of the EPISON study. Information was collected on the voluntary adoption of tobacco use regulations at home and SHS exposure at home and other environments. We calculated prevalences and Odds Ratio adjusted (ORa) for sex, age, level of education, and smoking status. RESULTS: 87.6% of respondents claimed to have a smoke-free home. 12.4% of respondents had partial regulation or did not have regulation at home, increasing up to 26.0% when the parent was a smoker or to 21.8% when the parent had primary or lower education. 5.4% of parents reported SHS exposure in their children at their homes, rising to 14.5% when it occurs in other environments, increasing with statistically significant differences between smoking parents and parents with lower educational level. CONCLUSIONS: The smoke-free homes are the majority; but SHS exposure to tobacco at home persists in children under 3 years of age, especially in families with a lower educational level. Therefore, awareness-raising campaigns on the effects of passive exposure on minors among families with

Knowledge and attitudes toward thirdhand smoke among parents with children under 3 years in Spain.

INTRODUCTION: The knowledge and beliefs about what is thirdhand smoke (THS) are limited. Our objective is to characterize the knowledge and beliefs about THS in parents of children under 3 years old in Spain. METHODS: A cross-sectional study (n = 1406 parents) was conducted online in 2017. We collected information about the knowledge of THS given later, written information with the definition of THS, and asking about beliefs of the effects of THS on children's health. RESULTS: A total of 27% of the respondents had heard about THS. We only found significant differences among smoking status, being the smokers who declare higher knowledge about THS. A total of 86% of the respondents believed that THS is harmful to their children with statistically significant differences according to educational level, higher among parents with a university degree (ORa = 2.6), and according to the previous knowledge on THS (ORa = 2.1). CONCLUSIONS: This is the first study in Europe to describe the knowledge and belief of THS. Around 3 out of 10 parents have heard about THS and more than 8 out of 10 parents believed that THS is harmful to their children. Currently, they were not aware of THS but after providing brief information about it, most of them agreed that THS exposure is harmful to their children.

Los programas de prevención de la enfermedad invasiva perinatal por estreptococo del grupo B son eficaces para disminuir la mortalidad neonatal precoz, pero no modifican la mortalidad en edades posteriores / No disponible

No disponible

El suero salino hipertónico nebulizado puede disminuir la duración del ingreso hospitalario en lactantes con bronquiolitis aguda / No disponible

No disponible

[Usefulness of Cochrane Collaboration for pediatric cardiology]. / Utilidad de la Colaboración Cochrane en la cardiología pediátrica.

The Cochrane Collaboration provides growing and readily accessible resources to help ensure that medical decision-making is based on detailed, methodical, and up-to-date reviews of the best available evidence. We analyzed systematic reviews in the field of pediatric cardiology published by the Cochrane Collaboration's 50 Collaborative Review Groups. We found a total of 20 systematic reviews: 13 published by the Cochrane Neonatal Group, 6 by the Cochrane Heart Group, and 1 by the Cochrane Peripheral Vascular Disease Group. Systematic reviews in pediatric cardiology appear infrequently. They only concern evidence-based decision-making in the therapeutic management of patent ductus arteriosus and arterial hypotension in preterm infants, and in the management of children with Kawasaki disease. The quality of the clinical trials contained in the systematic reviews of acute rheumatic fever or obesity in children is limited. Consequently, the reviewers' conclusions provide an inadequate basis for inferring probable effects in clinical practice. In pediatric cardiology, many therapies continue to be used without supportive evidence. We found no systematic reviews of important cardiologic topics in childhood such as heart failure, shock, hypertension, congenital cardiopathy, and arrhythmia. Clinical practice guidelines complement systematic reviews, which can recommend only strategies that are supported by strong evidence or suggest further research when scientific evidence is inadequate.

Utilidad de la Colaboración Cochrane en la cardiología pediátrica / Usefulness of Cochrane Collaboration for pediatric cardiology

La Colaboración Cochrane (CC) es una fuente de información importante y fácilmente accesible para que la atención sanitaria se fundamente en revisiones exhaustivas, críticas y actualizadas de las mejores pruebas científicas disponibles. Analizamos las revisiones sistemáticas (RS) relacionadas con la cardiología pediátrica publicadas en los 50 Grupos Colaboradores de Revisión de la CC. Detectamos 20 RS, publicadas en Cochrane Neonatal Group (13 RS), Cochrane Heart Group (6 RS) y Cochrane Peripheral Vascular Disease Group (1 RS). Las RS sobre cardiología pediátrica son infrecuentes y sólo permiten realizar una toma de decisiones basadas en pruebas en el tratamiento del conducto arterioso persistente e hipotensión arterial del prematuro, y en el tratamiento de la enfermedad de Kawasaki. Se constata una limitada calidad en los ensayos clínicos de las RS relacionadas con la fiebre reumática y la obesidad infantil, por lo que las conclusiones de los revisores son insuficientes para inferir probables efectos en la práctica clínica. Muchas intervenciones en cardiología pediátrica permanecen sin un adecuado soporte de evidencias, y no encontramos RS relacionadas con importantes temas cardiológicos en la infancia: insuficiencia cardíaca, shock, hipertensión, cardiopatías congénitas, arritmias, etc. Las guías de práctica clínica son una herramienta complementaria a las RS, que recomiendan sólo estrategias que están apoyadas por pruebas científicas fuertes y recomiendan realizar futuros estudios cuando la evidencia científica es inadecuada (AU)

The Cochrane Collaboration provides growing and readily accessible resources to help ensure that medical decision-making is based on detailed, methodical, and up-to-date reviews of the best available evidence. We analyzed systematic reviews in the field of pediatric cardiology published by the Cochrane Collaboration's 50 Collaborative Review Groups. We found a total of 20 systematic reviews: 13 published by the Cochrane Neonatal Group, 6 by the Cochrane Heart Group, and 1 by the Cochrane Peripheral Vascular Disease Group. Systematic reviews in pediatric cardiology appear infrequently. They only concern evidence-based decision-making in the therapeutic management of patent ductus arteriosus and arterial hypotension in preterm infants, and in the management of children with Kawasaki disease. The quality of the clinical trials contained in the systematic reviews of acute rheumatic fever or obesity in children is limited. Consequently, the reviewers' conclusions provide an inadequate basis for inferring probable effects in clinical practice. In pediatric cardiology, many therapies continue to be used without supportive evidence. We found no systematic reviews of important cardiologic topics in childhood such as heart failure, shock, hypertension, congenital cardiopathy, and arrhythmia. Clinical practice guidelines complement systematic reviews, which can recommend only strategies that are supported by strong evidence or suggest further research when scientific evidence is inadequate (AU)