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\pard\li466\ri0\sl-573\slmult0 \fs50\cf0\f0\charscalex100 {Evidencias en Pediatra
}\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li466\ri0\sl-333\slmult0 \fs28\cf0\f0\charscalex100 {Artculo V
alorado Crticamente}\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\r
i0\sl-533\slmult0 \fs28\cf0\f0\charscalex100\b {Los adolescentes que fueron prem
aturos con hemorragia intraventricular}\b0 \par\pard\li466\ri0\sl-346\slmult0 \f
s28\cf0\f0\charscalex100\b {tienen ms alteraciones cognitivas}\b0 \par\pard\li466
\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pa
rd\li466\ri0\sl-400\slmult0 \fs22\cf0\f0\charscalex100 {M Paz Gonzlez Rodrguez. CS
Barrio del Pilar. rea 5. Madrid (Espaa).}\par\pard\li466\ri0\sl-266\slmult0 \fs22\
cf0\f0\charscalex100 {Correo electrnico: paz.gonzalez@ctv.es}\par\pard\li466\ri0\

sl-266\slmult0 \fs22\cf0\f0\charscalex100 {Vctor De la Rosa Morales, Policlnica de


Especialidades Medicas, Tlaxcala (Mxico).}\par\pard\li466\ri0\sl-266\slmult0 \fs
22\cf0\f0\charscalex100 {Correo electrnico: vdlarosa@prodigy.net.mx}\par\pard\li4
66\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\
pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\
cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-240\slmult
0 \fs20\cf0\f0\charscalex100 {Trminos clave en ingls: adolescence; adolescent; inf
ant premature; cognition disorders; cerebral hemorrhage}\par\pard\li466\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-440\slmult0 \fs20\cf0\f0\charscalex10
0 {Trminos clave en espaol: adolescencia; adolescente; prematuro; trastornos cogni
tivos; hemorragia cerebral}\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard
\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\
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s18\cf0\par\pard\li466\ri0\sl-360\slmult0 \fs16\cf0\f0\charscalex100 {Fecha de r
ecepcin: 11 de noviembre de 2008}\par\pard\li466\ri0\sl-186\slmult0 \fs16\cf0\f0\
charscalex100 {Fecha de aceptacin: 17 de noviembre de 2008}\par\pard\li466\ri0\sl
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6\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {Fecha de publicacin: 1 de diciem
bre de 2008}\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-2
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0 {Evid Pediatr. 2008; 4: 84
doi: vol4/2008_numero_4/2008_vol4_numer
o4.18.htm}\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213
\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-293\slmult0 \fs20\cf0\f
0\charscalex100 {Cmo citar este artculo}\par\pard\li466\ri0\sl-293\slmult0 \fs18\c
f0\f0\charscalex100 {Gonzlez Rodriguez MP, De la Rosa Morales V. Los adolescentes
que fueron prematuros con hemorragia intraventricular tienen}\par\pard\li466\ri
0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {ms alteraciones cognitivas. Evid Ped
iatr. 2008; 4: 84}\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri
0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\
li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\p
ar\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs
18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-240\slm
ult0 \fs20\cf0\f0\charscalex100 {Para recibir Evidencias en Pediatra en su correo
electrnico debe darse de alta en nuestro boletn por medio del}\par\pard\li466\ri0
\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {ETOC en http://www.aepap.org/EvidPed
iatr/etoc.htm}\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl
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ard\li466\ri0\sl-213\slmult0 \fs16\cf0\f0\charscalex100 {Este artculo est disponib
le en:http://www.aepap.org/EvidPediatr/numeros/vol4/2008_numero_4/2008_vol4_nume
ro4.18.htm }\par\pard\li466\ri0\sl-186\slmult0 \fs14\cf0\f0\charscalex100 {EVIDE
NCIAS EN PEDIATRIA es la revista oficial del Grupo de Pediatra Basada en la Evide
ncia de la Asociacin Espaola de Pediatra de Atencin}\par\pard\li466\ri0\sl-200\slmul
t0 \fs16\cf0\f0\charscalex100 {Primaria. 2005-08. Todos los derechos reservados.
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66\ri0\sl-200\slmult0 \fs16\cf0\f0\charscalex100 {Evid Pediatr. 2008; 4: 84}\par
\column\pard\li0\ri0\sl-200\slmult0 \fs16\cf0\f0\charscalex100 { http://www.aepa
p.org/EvidPediatr/numeros/vol4/2008_numero_4/pdf/2008_vol4_numero4.18.pdf}\par\p
ard\li5400\ri0\sl-386\slmult0 \fs22\cf0\f0\charscalex100 {PRONSTICO}\par\pard\sec
t\sectd\sbknone\pgwsxn11893\pghsxn16826\marglsxn666\margrsxn133\pard\li466\ri0\s
l-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-373\slmult0 \fs24\cf0\f0\charscale
x100\b {Los adolescentes que fueron prematuros con hemorragia intraventricular t
ienen ms alte-}\b0 \par\pard\li466\ri0\sl-293\slmult0 \fs24\cf0\f0\charscalex100\
b {raciones cognitivas}\b0 \par\pard\li466\ri0\sl-320\slmult0 \fs20\cf0\f0\chars
calex100 {M Paz Gonzlez Rodrguez. CS Barrio del Pilar. rea 5. Madrid (Espaa). Correo
electrnico: paz.gonzalez@ctv.es}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\c
harscalex100 {Vctor De la Rosa Morales, Policlnica de Especialidades Medicas, Tlax
cala (Mxico).}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {Corr
eo electrnico: vdlarosa@prodigy.net.mx}\par\pard\li466\ri0\sl-293\slmult0 \fs20\c
f0\f0\charscalex100\b {Referencia bibliogrfica: }\b0 { }\fs18\cf0\f0\charscalex10
0 {Narberhaus A, Segarra-Castel s MD, Pueyo-Benito R, Botet-Mussons F, Junqu C. D
isfunciones}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {cogni
tivas a largo plazo en sujetos prematuros con hemorragia intraventricular. Rev N
eurol. 2008; 47: 57-60.}\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li
466\ri0\sl-346\slmult0 \fs18\cf0\f0\charscalex100\b {RESUMEN}\b0 \par\pard\li466
\ri0\sl-346\slmult0 \fs18\cf0\f0\charscalex100\b {Conclusiones de los autores de
l estudio:}\b0 \fs18\cf0\f0\charscalex100 { los adolescentes con antecedentes de
prematuridad con hemorragia}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\cha
rscalex100 {intraventricular (HIV) neonatal presentan disfunciones en el rendimi
ento cognitivo, que podran explicar los problemas}\par\pard\li466\ri0\sl-240\slmu
lt0 \fs20\cf0\f0\charscalex100 {de rendimiento acadmico frecuentemente descritos

en esta poblacin.}\par\pard\li466\ri0\sl-346\slmult0 \fs16\cf0\f0\charscalex100\b


{Comentario de los revisores:}\b0 \fs18\cf0\f0\charscalex100 { los adolescentes
que fueron prematuros tienen dificultades de aprendizaje y de conducta}\par\par
d\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {en comparacin con los que
no lo fueron. La presencia de hemorragia intraventricular en el periodo perinata
l se ha}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {asociado
con peor rendimiento escolar, aunque los resultados de este estudio no permiten
afirmar esto. Para conocer}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\chars
calex100 {qu factores se asocian con el pronstico durante la infancia y adolescenc
ia son necesarios estudios prospectivos de}\par\pard\li466\ri0\sl-240\slmult0 \f
s20\cf0\f0\charscalex100 {seguimiento desde el nacimiento.}\par\pard\li466\ri0\s
l-360\slmult0 \fs20\cf0\f0\charscalex100\b {Palabras clave:}\b0 \fs20\cf0\f0\cha
rscalex100 { adolescencia; adolescente; prematuro; trastornos cognitivos; hemorr
agia cerebral}\par\pard\li466\ri0\sl-346\slmult0 \fs18\cf0\f0\charscalex100\b {A
BSTRACT}\b0 \par\pard\li466\ri0\sl-360\slmult0 \fs18\cf0\f0\charscalex100\b {Aut
hors conclusions:}\b0 \fs18\cf0\f0\charscalex100 { the present study suggests tha
t long-term difficulties are evident for general cognitive}\par\pard\li466\ri0\s
l-240\slmult0 \fs18\cf0\f0\charscalex100 {performance as well as for specific co
gnitive abilities in preterm subjects with intraventricular hemorrhage in the}\p
ar\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {newborn period. The
se data could explain the academic problems shown by these individuals.}\par\par
d\li466\ri0\sl-346\slmult0 \fs18\cf0\f0\charscalex100\b {Reviewers commentary:}\b
0 \fs18\cf0\f0\charscalex100 { adolescents who were preterm have learning and be
havior difficulties. The presence of}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf
0\f0\charscalex100 {intraventricular hemorrhage in the perinatal period has been
associated with poor educational performance, although}\par\pard\li466\ri0\sl-2
40\slmult0 \fs18\cf0\f0\charscalex100 {the results of this study do not allow to
confirm this aspect. To find out what factors are associated with the prognosis
}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {in childhood and
adolescence prospective follow-up studies from birth should be conducted.}\par\
pard\li466\ri0\sl-360\slmult0 \fs20\cf0\f0\charscalex100\b {Keywords:}\b0 \fs20\
cf0\f0\charscalex100 { adolescence; adolescent; infant premature; cognition dis
orders; cerebral hemorrhage}\par\pard\sect\sectd\sbknone\pgwsxn11893\pghsxn16826
\marglsxn666\margrsxn133\cols2\colno1\colw5480\colsr-0\colno2\colw5613\pard\li46
6\ri0\sl-480\slmult0 \fs22\cf0\f0\charscalex100\b {Resumen estructurado:}\b0 \pa
r\pard\li466\ri0\sl-306\slmult0 \fs20\cf0\f0\charscalex100\b {Objetivo:}\b0 \fs2
0\cf0\f0\charscalex100 { explorar el rendimiento cognitivo de}\par\pard\li4
66\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {adolescentes que nacieron p
rematuros (RNPT ),}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex10
0 {con hemorragia intraventricular (HIV) en el perodo}\par\pard\li466\ri0\s
l-240\slmult0 \fs20\cf0\f0\charscalex100 {neonatal.}\par\pard\li466\ri0\sl-293\s
lmult0 \fs20\cf0\f0\charscalex100\b {Diseo:}\b0 \fs20\cf0\f0\charscalex100 { estu
dio transversal comparativo.}\par\pard\li466\ri0\sl-293\slmult0 \fs20\cf0\f0\cha
rscalex100\b {Emplazamiento:}\b0 \fs20\cf0\f0\charscalex100 { dos hospitales de
Barcelona, Espaa.}\par\pard\li466\ri0\sl-293\slmult0 \fs18\cf0\f0\charscalex100\b
{Poblacin de estudio:}\b0 \fs18\cf0\f0\charscalex100 { muestra de 16 sujetos, 3
mujeres}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {y 13 homb
res con edades entre los 11 y 18 aos con}\par\pard\li466\ri0\sl-240\slmult0 \fs20
\cf0\f0\charscalex100 {antecedente de prematuridad (edad gestacional}\par\pa
rd\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {<33 semanas) y con H
IV en el perodo neonatal. Se}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0
\charscalex100 {compararon con 30 sujetos, 13 mujeres y 17 hombres,}\par\pard\li
466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {con edad gestacional > 37 sem
anas sin antecedentes}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex
100 {perinatales.}\par\pard\li466\ri0\sl-306\slmult0 \fs20\cf0\f0\charscalex100\
b {Evaluacin del factor de riesgo:}\b0 \fs20\cf0\f0\charscalex100 { se evalu el co
ciente}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {de inteli
gencia (CI), el aprendizaje, la memoria, las}\par\pard\li466\ri0\sl-240\sl
mult0 \fs20\cf0\f0\charscalex100 {habilidades visuoespaciales y visuoconstructiv
as, y las}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {funcion

es frontales.}\par\pard\li466\ri0\sl-293\slmult0 \fs18\cf0\f0\charscalex100\b {M
edicin del resultado:}\b0 \fs18\cf0\f0\charscalex100 { el CI se evalu mediante la}
\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {escala de intelig
encia de Wechsler. El aprendizaje verbal,}\par\pard\li466\ri0\sl-240\slmult0 \fs
20\cf0\f0\charscalex100 {la memoria verbal y la memoria de reconocimiento
}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {mediante el te
st de aprendizaje auditivo-verbal de}\par\pard\li466\ri0\sl-240\slmult0 \fs1
8\cf0\f0\charscalex100 {Rey; la memoria visual a travs de la tarea de recuerdo}\p
ar\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {del test de la figu
ra compleja, y la memoria de la vida}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf
0\f0\charscalex100 {cotidiana mediante el test conductual de Rivermead. Las}\par
\column\pard\li0\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li0\ri0\sl-253\slmult0 \f
s20\cf0\f0\charscalex100 {habilidades visuoespaciales y visuoconstructivas con l
a}\par\pard\li0\ri0\sl-253\slmult0 \fs20\cf0\f0\charscalex100 {tarea de copia de
l test de la figura compleja de Rey. Para}\par\pard\li0\ri0\sl-240\slmult0 \fs20
\cf0\f0\charscalex100 {las funciones frontales, atencin y velocidad motora se}\pa
r\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {utiliz la parte A del T
rail Making Test. La memoria de}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\ch
arscalex100 {trabajo y la velocidad de procesamiento visuomotor se}\par\pard\li0
\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {midieron con los subtest de las
escalas de inteligencia}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex
100 {de Wechsler.}\par\pard\li0\ri0\sl-293\slmult0 \fs18\cf0\f0\charscalex100\b
{Resultados principales:}\b0 \fs18\cf0\f0\charscalex100 { los RNPT con HIV compa
rados con}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {el grupo
control, tuvieron puntuaciones significativamente}\par\pard\li0\ri0\sl-240\slmul
t0 \fs20\cf0\f0\charscalex100 {menores en el CI total y manipulativo, aprendizaj
e verbal,}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {memoria v
erbal, memoria de reconocimiento, memoria}\par\pard\li0\ri0\sl-240\slmult0 \fs20
\cf0\f0\charscalex100 {de la vida cotidiana, habilidades visuoespaciales y
}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {visuoconstructivas
y fluidez verbal semntica. Los}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f
0\charscalex100 {sujetos con HIV grados III-IV rendan significativamente}\par\par
d\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {peor en aprendizaje verbal
(p = 0,03), memoria de la}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscal
ex100 {vida cotidiana (p = 0,05) y habilidades visuoespaciales}\par\pard\li0\ri0
\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {y visuoconstructivas (p = 0,02) resp
ecto a los sujetos}\par\pard\li0\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {
con HIV grados I-II. Al comparar el grupo con HIV con un}\par\pard\li0\ri0\sl-24
0\slmult0 \fs20\cf0\f0\charscalex100 {grupo de prematuros sin HIV (5 mujeres y 1
1 hombres),}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {en el g
rupo con HIV el rendimiento fue ms bajo para el CI}\par\pard\li0\ri0\sl-240\slmul
t0 \fs20\cf0\f0\charscalex100 {total (p = 0,008), aprendizaje verbal (p=0,009) y
memoria}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {verbal (p
= 0,003).}\par\pard\li0\ri0\sl-293\slmult0 \fs20\cf0\f0\charscalex100\b {Conclus
in}\b0 \fs20\cf0\f0\charscalex100 {: los adolescentes con antecedentes de}\p
ar\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {prematuridad con HIV
neonatal presentan disfunciones}\par\pard\li0\ri0\sl-240\slmult0 \fs20\cf0\f0\ch
arscalex100 {en el rendimiento cognitivo, que podran explicar los}\par\pard\li0\r
i0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {problemas de rendimiento acadmico f
recuentemente}\par\pard\li453\ri0\sl-346\slmult0 \fs12\cf0\f0\charscalex100 {
Pgina 2 de 3}\par\pard\li453\ri0\sl-200\slmult0 \fs16\cf0\f0\charsca
lex100 {
(Nmero de pgina de este artculo, no vlido para citacin)}\par\pard\sect\
sectd\sbknone\pgwsxn11893\pghsxn16826\marglsxn666\margrsxn133\pard\sect\sectd\sb
kpage\pgwsxn11893\pghsxn16826\marglsxn666\margrsxn133\margtsxn426\margbsxn173\co
ls2\colno1\colw3453\colsr-0\colno2\colw7640\pard\li453\ri0\sl-200\slmult0 \fs16\
cf0\f0\charscalex100 {Evid Pediatr. 2008; 4: 84}\par\pard\li466\ri0\sl-213\slmul
t0 \fs18\cf0\par\pard\li466\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-2
13\slmult0 \fs18\cf0\par\pard\li466\ri0\sl-346\slmult0 \fs20\cf0\f0\charscalex10
0 {descritos en esta poblacin.}\par\pard\li466\ri0\sl-360\slmult0 \fs20\cf0\f0\ch

arscalex100\b {Conflicto de intereses:}\b0 \fs20\cf0\f0\charscalex100 { no const


a.}\par\column\pard\li0\ri0\sl-200\slmult0 \fs16\cf0\f0\charscalex100 { http://w
ww.aepap.org/EvidPediatr/numeros/vol4/2008_numero_4/pdf/2008_vol4_numero4.18.pdf
}\par\pard\li2026\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2026\ri0\sl-213\slmult
0 \fs18\cf0\par\pard\li2026\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li2026\ri0\sl346\slmult0 \fs20\cf0\f0\charscalex100 {influyen en el desarrollo.}\par\pard\sec
t\sectd\sbknone\pgwsxn11893\pghsxn16826\marglsxn666\margrsxn133\cols2\colno1\col
w5480\colsr-0\colno2\colw5613\pard\li466\ri0\sl-360\slmult0 \fs20\cf0\f0\charsca
lex100\b {Fuente de financiacin:}\b0 \fs20\cf0\f0\charscalex100 { estudio subvenc
ionado por el}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {Min
isterio de Educacin y Ciencia (Ref.: SAF 2005-07340)}\par\pard\li466\ri0\sl-240\s
lmult0 \fs18\cf0\f0\charscalex100 {y por el Departamento de Educacin y Universida
des de}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {la General
itat de Catalunya y el Fondo Social Europeo.}\par\pard\li466\ri0\sl-213\slmult0
\fs18\cf0\par\pard\li466\ri0\sl-400\slmult0 \fs22\cf0\f0\charscalex100\b {Coment
ario crtico:}\b0 \par\pard\li466\ri0\sl-320\slmult0 \fs20\cf0\f0\charscalex100\b
{Justificacin:}\b0 \fs20\cf0\f0\charscalex100 { la prematuridad se asocia con les
iones}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {orgnicas y
funcionales que se manifiestan durante}\par\pard\li466\ri0\sl-240\slmult0 \
fs20\cf0\f0\charscalex100 {la infancia como dificultades del aprendizaje,
peor}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {rendimiento
social, problemas emocionales y de}\par\pard\li466\ri0\sl-240\slmult0 \fs20
\cf0\f0\charscalex100 {integracin social}\fs12\cf0\f0\charscalex100 {1}\fs20\cf0
\f0\charscalex100 {. Con el aumento de edad de los}\par\pard\li466\ri0\sl
-240\slmult0 \fs18\cf0\f0\charscalex100 {RNPT se han comenzado a estudiar la
morbilidad en}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {la
adolescencia y vida adulta, encontrando problemas}\par\pard\li466\ri0\sl-240\sl
mult0 \fs20\cf0\f0\charscalex100 {de aprendizaje, problemas de conducta y
deficits de}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {crec
imiento}\fs10\cf0\f0\charscalex100 {2}\fs18\cf0\f0\charscalex100 {. Dentro de lo
s factores que empeoran el}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\chars
calex100 {pronstico posterior se encuentra la HIV sobre todo los}\par\pard\li466\
ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {grados mas graves}\fs12\cf0\f0\ch
arscalex100 {3}\fs20\cf0\f0\charscalex100 {.}\par\pard\li466\ri0\sl-306\slmult0
\fs18\cf0\f0\charscalex100\b {Validez o rigor cientfico:}\b0 \fs18\cf0\f0\charsca
lex100 { la seleccin de los casos se}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0
\f0\charscalex100 {realiz por exclusin resultando un grupo pequeo sin}\par\pard\li4
66\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {que se conozca la poblacin tota
l de RNPT con HIV. No}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex
100 {figuran otros datos asociados a la prematuridad que}\par\pard\li466\
ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {hubiesen podido influir en el des
arrollo cognitivo. La}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex
100 {comparacin con un grupo de prematuros sin HIV de}\par\pard\li466\ri0\sl-240\
slmult0 \fs20\cf0\f0\charscalex100 {los que no se aporta ninguna informacin no pe
rmite}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {extraer con
clusiones vlidas en cuanto a las diferencias}\par\pard\li466\ri0\sl-253\slmult0
\fs20\cf0\f0\charscalex100 {encontradas.}\par\pard\li466\ri0\sl-320\slmult0 \fs2
0\cf0\f0\charscalex100\b {Inters o pertinencia clnica:}\b0 \fs20\cf0\f0\charscalex
100 { aunque se ha descrito un}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\c
harscalex100 {aumento de las dificultades escolares en los adolescentes}\par\par
d\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {que adems de RNPT tuvi
eron HIV}\fs12\cf0\f0\charscalex100 {4}\fs20\cf0\f0\charscalex100 {, existen
otros}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {muchos fac
tores asociados al peor pronstico como}\par\pard\li466\ri0\sl-240\slmult0 \f
s18\cf0\f0\charscalex100 {son la ventilacin mecnica prolongada, infecciones,}
\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {peso al nacimient
o, anomalas en la ecografa cerebral,}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\
f0\charscalex100 {nivel educacional y socioeconmico, sin que se haya}\par\pard\li
466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {descrito que un factor de for
ma aislada tenga mayor}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscale

x100 {responsabilidad. Por otro lado en estudios prospectivos}\par\pard\li466\ri


0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {se ha encontrado que hasta un
30% de RNPT con}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex10
0 {ECO normal pueden tener alteraciones como parlisis}\par\pard\li466\ri0\sl-240\
slmult0 \fs20\cf0\f0\charscalex100 {cerebral y un CI bajo}\fs12\cf0\f0\charscale
x100 {5}\fs20\cf0\f0\charscalex100 {. Con los resultados de este estudio}\par\pa
rd\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {no se puede concluir que
las dificultades cognitivas del}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0
\charscalex100 {grupo descrito tengan su origen en la HIV en el periodo}\par\par
d\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {perinatal, pudiendo estar
relacionadas con otros aspectos}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0
\charscalex100 {relacionados con la prematuridad.}\par\pard\li466\ri0\sl-293\slm
ult0 \fs20\cf0\f0\charscalex100\b {Aplicabilidad en la prctica clnica:}\b0 \fs
20\cf0\f0\charscalex100 { los nios y}\par\pard\li466\ri0\sl-240\slmult0 \fs20\
cf0\f0\charscalex100 {adolescentes que han sido prematuros tienen mas}\par
\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {dificultades cognitiv
as y del aprendizaje que los que no}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0
\f0\charscalex100 {lo fueron, sin que la presencia de HIV de forma aislada en}\p
ar\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {el periodo neonatal
pueda predecir la evolucin posterior.}\par\pard\li466\ri0\sl-240\slmult0 \fs20\c
f0\f0\charscalex100 {El desarrollo de cuidados centrados en el desarrollo de}\pa
r\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {las unidades neonata
les}\fs10\cf0\f0\charscalex100 {6}\fs18\cf0\f0\charscalex100 {, la atencin y segu
imiento de}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {los R
NPT durante la infancia y adolescencia, pueden}\par\pard\li466\ri0\sl-240\
slmult0 \fs18\cf0\f0\charscalex100 {contribuir a mejorar el pronstico de estos nio
s. Para}\par\pard\li466\ri0\sl-240\slmult0 \fs18\cf0\f0\charscalex100 {poder det
erminar qu factores influyen en el desarrollo}\par\pard\li466\ri0\sl-240\slmult0
\fs20\cf0\f0\charscalex100 {posterior, son necesarios estudios prospectivos
que}\par\pard\li466\ri0\sl-240\slmult0 \fs20\cf0\f0\charscalex100 {analicen qu
factores durante el periodo perinatal}\par\column\pard\li0\ri0\sl-306\slmul
t0 \fs20\cf0\f0\charscalex100\b {Bibliografa:}\b0 \par\pard\li0\ri0\sl-266\slmult
0 \fs18\cf0\f0\charscalex100 {1.- Allen MC. Neurodevelopment outcomes of preterm
infants.}\par\pard\li0\ri0\sl-226\slmult0 \fs18\cf0\f0\charscalex100 {Curr Opin
Neurol. 2008; 21:123-8.}\par\pard\li0\ri0\sl-266\slmult0 \fs16\cf0\f0\charscale
x100 {2.- Saigal S, Pinel i J, Hoult L, Kim MM; Boyle M. Psychopathology}\par\pa
rd\li0\ri0\sl-213\slmult0 \fs18\cf0\f0\charscalex100 {and social competencies of
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arscalex100 {low birth weight. Pediatrics. 2003;111:969-75.}\par\pard\li0\ri0\sl
-280\slmult0 \fs18\cf0\f0\charscalex100 {3.- Ancel PY, Livinec F, Larroque B, Ma
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ex100 {V et al. Cerebral palsy among very preterm children in relation}\par\pard
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charscalex100 {EPIPAGE cohort study. Pediatrics. 2006; 117: 828-35.}\par\pard\li
0\ri0\sl-280\slmult0 \fs18\cf0\f0\charscalex100 {4.- Van de Bor M, Den Oude
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mong extremely low birth weight infants with a normal head}\par\pard\li0\ri0\sl226\slmult0 \fs18\cf0\f0\charscalex100 {ultrasound: prevalence and antecedents.
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00 {673-80.}\par\pard\li0\ri0\sl-280\slmult0 \fs18\cf0\f0\charscalex100 {6.-Palls
Alonso CR, Arriaga Redondo M. Nuevos aspectos en}\par\pard\li0\ri0\sl-213\slmul
t0 \fs18\cf0\f0\charscalex100 {torno a la prematuridad. Evid Pediatr. 2008;4:26.

}\par\pard\sect\sectd\sbknone\pgwsxn11893\pghsxn16826\marglsxn666\margrsxn133\pa
rd\li4893\ri0\sl-213\slmult0 \fs18\cf0\par\pard\li4893\ri0\sl-226\slmult0 \fs12\
cf0\f0\charscalex100 {
Pgina 3 de 3
}\par\pard\li4893\ri0\sl-186\slmult0 \fs16\cf0\f0\charscalex100 {
(Nmero de pgina de este artculo, no vlido para citacin)}\par}