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    ABSTRACT: Child maltreatment remains a major public-health and social-welfare problem in high-income countries. Every year, about 4-16% of children are physically abused and one in ten is neglected or psychologically abused. During childhood, between 5% and 10% of girls and up to 5% of boys are exposed to penetrative sexual abuse, and up to three times this number are exposed to any type of sexual abuse. However, official rates for substantiated child maltreatment indicate less than a tenth of this burden. Exposure to multiple types and repeated episodes of maltreatment is associated with increased risks of severe maltreatment and psychological consequences. Child maltreatment substantially contributes to child mortality and morbidity and has longlasting effects on mental health, drug and alcohol misuse (especially in girls), risky sexual behaviour, obesity, and criminal behaviour, which persist into adulthood. Neglect is at least as damaging as physical or sexual abuse in the long term but has received the least scientific and public attention. The high burden and serious and long-term consequences of child maltreatment warrant increased investment in preventive and therapeutic strategies from early childhood.
    The Lancet 01/2009; 373(9657):68-81. DOI:10.1016/S0140-6736(08)61706-7 · 45.22 Impact Factor
  • Pediatrics 05/1973; 51:Suppl 4:773-6. · 5.30 Impact Factor
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    ABSTRACT: RESUMEN Antecedentes. La pediatría mexicana requiere una modificación sustancial en su enfoque y ejercicio para el siglo XXI. Con base al cambio de la pirámide poblacional, así como a la variación de los padecimientos en los niños y adolescentes. Actualmente destacan las enfermedades crónico-degenerativas, el cáncer, los accidentes y la violencia a estas edades. Objetivo. Como ejemplos básicos del maltrato infantil se presentan y analizan el maltrato físico, el síndrome del niño sacudido y el abuso sexual, variantes más frecuentes y graves del maltrato infantil. Resultados. Se hace una descripción básica de estos subtipos para que los médicos y otros profesionales que interactúan con niños y adolescentes puedan sospechar, diagnosticar y atender integralmente a las víctimas de este flagelo médico-social-legal de la humanidad. Se insiste en la necesidad de una intervención interdisciplinaria e interinstitucional en cada una de las formas descritas. Palabras clave. Pediatría mexicana, maltrato infantil y juvenil, maltrato físico, niño sacudido, abuso sexual. ABSTRACT Background. Mexican pediatrics requires substantial modifications in its approach and its exercise for the XXI century, based on the chan-ges in the population pyramid and the variability of children and adolescent diseases. Currently chronic-degenerative diseases, cancer, accidents and child abuse are the leading problems in these ages. Objective. The most frequent examples of child abuse are presented and analyzed such as physical battering, shaking baby syndrome and sexual abuse. Results. A basic description of these subtypes of child abuse is done in order to inform physicians and other professionals that interact with children and adolescents when to suspect, to diagnose and to manage the victims of this social, medical and legal problem of humanity. It is mandatory to have a multidisciplinary and interinstitutional intervention in each one of the child abuse subtypes described.
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