array:22 [
  "pii" => "S2341287916000260"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2016.01.002"
  "estado" => "S300"
  "fechaPublicacion" => "2016-04-01"
  "aid" => "2046"
  "copyright" => "Asociación Española de Pediatría"
  "copyrightAnyo" => "2015"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "An Pediatr (Barc). 2016;84:187-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1518
    "formatos" => array:3 [
      "EPUB" => 117
      "HTML" => 914
      "PDF" => 487
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S234128791600017X"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2015.06.017"
    "estado" => "S300"
    "fechaPublicacion" => "2016-04-01"
    "aid" => "1899"
    "copyright" => "Asociación Española de Pediatría"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr (Barc). 2016;84:189-94"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1699
      "formatos" => array:3 [
        "EPUB" => 110
        "HTML" => 1188
        "PDF" => 401
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Families of the economic crisis in paediatric primary care clinics&#58; Descriptive observational study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "189"
          "paginaFinal" => "194"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Las familias de la crisis en las consultas pedi&#225;tricas de Atenci&#243;n Primaria&#58; estudio descriptivo observacional"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46; Mart&#237;n Mart&#237;n, M&#46; S&#225;nchez Bayle, C&#46; Gancedo Garc&#237;a, M&#46;C&#46; Teruel de Francisco, A&#46; Coullaut L&#243;pez"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Mart&#237;n Mart&#237;n"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "S&#225;nchez Bayle"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Gancedo Garc&#237;a"
            ]
            3 => array:2 [
              "nombre" => "M&#46;C&#46;"
              "apellidos" => "Teruel de Francisco"
            ]
            4 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Coullaut L&#243;pez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403315002404"
        "doi" => "10.1016/j.anpedi.2015.06.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315002404?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791600017X?idApp=UINPBA00005H"
    "url" => "/23412879/0000008400000004/v1_201603300938/S234128791600017X/v1_201603300938/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Cardiovascular screening prior to sport practice in children and adolescents"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "187"
        "paginaFinal" => "188"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "D&#46; Crespo Marcos, F&#46;J&#46; P&#233;rez-Lescure Picarzo, A&#46; Boraita P&#233;rez"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "D&#46;"
            "apellidos" => "Crespo Marcos"
            "email" => array:1 [
              0 => "davidkrespo&#64;yahoo&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "F&#46;J&#46;"
            "apellidos" => "P&#233;rez-Lescure Picarzo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Boraita P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Cardiolog&#237;a Pedi&#225;trica&#44; &#193;rea de Pediatr&#237;a y Neonatolog&#237;a&#44; Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#44; Alcorc&#243;n&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Cardiolog&#237;a&#44; Centro de Medicina del Deporte&#44; Departamento de Deporte y Salud&#44; Agencia Espa&#241;ola de Protecci&#243;n de la Salud en el Deporte&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "La evaluaci&#243;n cardiovascular predeportiva en ni&#241;os y adolescentes"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cardiovascular events related to sport practice are fortunately rare in the paediatric age group&#46; An incidence of sport-related sudden death of 1 per 43&#44;000&#8211;100&#44;000 individuals aged less than 35 years has been described&#44; the great majority &#40;75&#8211;98&#37;&#41; due to cardiovascular causes&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1&#44;2</span></a> In addition&#44; the prevalence of cardiovascular disorders predisposing young athletes to sudden cardiac death episodes is estimated to be around 0&#46;3&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> Contrary to the widespread belief that these events are related to high-level competitive sport&#44; Marijon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> found in a prospective study carried out in France in the period 2005&#8211;2010 that over 90&#37; occurred during recreational sport practice&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is difficult to analyse the epidemiology of this devastating health problem&#44; as there are wide variations in the published incidence&#44; the data collection methods and the reported causes of sudden cardiac death in athletes at both competitive and recreational level&#46; Indeed&#44; there is no universally accepted definition of sports-related sudden cardiac death&#44; though it is generally considered to be that which occurs during physical exercise or in the hour following its cessation&#46; For this reason&#44; the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation has produced a document<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> containing proposals for establishing a uniform register at international level&#44; which will enable us to ascertain the true magnitude of the issue before us&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There is a general consensus that screening prior to sport practice&#44; making it possible to detect potentially lethal cardiovascular diseases&#44; is justified and may be beneficial&#44; but there are wide divergences in protocols and legal provisions&#46; In many European countries screening is limited to elite athletes&#44; and there are currently only 2 countries worldwide&#44; Italy and Israel&#44; in which screening&#44; including an electrocardiogram &#40;ECG&#41;&#44; is systematically performed for sport practice at all levels&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In Italy a decree has existed since 1982 making it obligatory for such examinations to be performed by doctors with specific training&#46; In the rest of the world learned societies recommend that this should be done&#44; but without legislative backing&#46; In Spain&#44; Organic Act 3&#47;2013 on the protection of athletes&#8217; health and the fight against doping in sports activity came into force in June 2013&#46; Here is an extract from Section 46 of this Act &#40;&#8220;On medical examinations&#8221;&#41;&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0025" class="elsevierStylePara elsevierViewall">The Spanish Agency for Health Protection in Sport shall progressively determine the obligation to carry out medical examinations before the corresponding federation licence is issued in those sports in which this is considered necessary in order to provide better prevention of risks to the health of their practitioners&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0030" class="elsevierStylePara elsevierViewall">The purpose of carrying out these medical examinations is to protect the health of athletes with respect to the sports activity&#46; In designing the examinations and applying them to each sports discipline the following shall be taken into account&#58; &#91;&#8230;d&#41; The specific needs of women and men&#44; of minors and of disabled persons&#8230;&#93;&#46;</p></li></ul></p><p id="par0035" class="elsevierStylePara elsevierViewall">This Act will regulate medical examinations prior to sport practice for affiliated members of federations&#44; but it will not affect sport practised outside this context by a large number of children and adolescents at local&#44; municipal or school level&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The main argument is over the need to perform an ECG systematically in these evaluations&#46; In the great majority of European countries it is recommended as a matter of routine&#44; while in the United States it is not advised&#46; The American Heart Association &#40;AHA&#41; and the American College of Cardiology &#40;ACC&#41; reaffirmed their position on this issue in 2015&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> maintaining that performing an ECG is not indicated as they do not consider that there is sufficient evidence to demonstrate its benefit&#46; A recent meta-analysis carried out by Harmon et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> whose aim was to analyse the various pre-participation cardiovascular screening strategies&#44; concluded that ECG is the most effective strategy&#44; being five times more sensitive than medical history and ten times more sensitive than physical examination&#44; with a false positive rate of 6&#37;&#44; lower than that of medical history &#40;8&#37;&#41; and physical examination &#40;10&#37;&#41;&#46; Another area of divergence concerns who should perform these examinations&#46; In the United States non-medical and even non-healthcare staff are allowed to carry them out&#44; whereas in Europe it is advocated that medical staff with specific training in this area should be responsible&#46; Super-specialisation is becoming so important that the European Cardiology Society has developed a 12-month training programme<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> in Sports Cardiology&#44; available to those specialising in Cardiology and Sports Medicine&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">There are numerous guidelines for pre-participation cardiovascular evaluation designed primarily for adults and focusing in many cases on high-level competitive athletes&#59; few of them&#44; however&#44; refer to children and adolescents practising physical activity at any level of competition&#46; For this reason the Sociedad Espa&#241;ola de Cardiolog&#237;a Pedi&#225;trica y Cardiopat&#237;as Cong&#233;nitas &#40;SECPCC&#58; Spanish Paediatric Cardiology and Congenital Heart Disease Society&#41; and the Consejo Superior de Deportes &#40;CSD&#58; Higher Sports Council&#41; have produced the <span class="elsevierStyleItalic">Clinical Guidelines for Cardiovascular Evaluation Prior to Sport Practice in Paediatrics</span>&#44; published in February 2015 with the endorsement of the following learned societies&#58; Sociedad Espa&#241;ola de Cardiolog&#237;a &#40;SEC&#58; Spanish Cardiology Society&#41;&#44; Fundaci&#243;n Espa&#241;ola del Coraz&#243;n &#40;FEC&#58; Spanish Heart Foundation&#41;&#44; Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a &#40;AEP&#58; Spanish Association of Paediatrics&#41;&#44; Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a de Atenci&#243;n Primaria &#40;AEPap&#58; Spanish Association of Primary Care Paediatrics&#41;&#44; Sociedad Espa&#241;ola de Pediatr&#237;a Extrahospitalaria y Atenci&#243;n Primaria &#40;SEPEAP&#58; Spanish Association of Ambulatory Paediatrics and Primary Care&#41;&#44; Sociedad Espa&#241;ola de Medicina de Familia y Comunitaria &#40;semFYC&#58; Spanish Society of Family and Community Medicine&#41;&#44; Sociedad Espa&#241;ola de M&#233;dicos de Atenci&#243;n Primaria &#40;SEMERGEN&#58; Spanish Society of Primary Care Physicians&#41;&#44; Sociedad Espa&#241;ola de M&#233;dicos Generales y de Familia &#40;SEMG&#58; Spanish Society of General and Family Practitioners&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The main purpose of these guidelines&#44; which include medical history&#44; physical examination and ECG&#44; is to serve as a tool for protecting the health of young athletes through early detection of cardiovascular disease that could put the lives of children practising sport at risk&#46; It is freely available online at the websites of the SECPCC &#40;<a id="intr0010" class="elsevierStyleInterRef" href="http://ow.ly/JhbH9">http&#58;&#47;&#47;ow&#46;ly&#47;JhbH9</a>&#41; and of the Ministry of Education&#44; Culture and Sport &#40;<a id="intr0015" class="elsevierStyleInterRef" href="https://sede.educacion.gob.es/publiventa/detalle.action?cod=20251">https&#58;&#47;&#47;sede&#46;educacion&#46;gob&#46;es&#47;publiventa&#47;detalle&#46;action&#63;cod&#61;20251</a>&#41;&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Crespo Marcos D&#44; P&#233;rez-Lescure Picarzo FJ&#44; Boraita P&#233;rez A&#46; La evaluaci&#243;n cardiovascular predeportiva en ni&#241;os y adolescentes&#46; An Pediatr &#40;Barc&#41;&#46; 2016&#59;84&#58;187&#8211;188&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sports-related sudden death in the general population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Marijon"
                            1 => "M&#46; Tafflet"
                            2 => "D&#46;S&#46; Celermajer"
                            3 => "F&#46; Dumas"
                            4 => "M&#46;C&#46; Perier"
                            5 => "H&#46; Mustafic"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.110.008979"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2011"
                        "volumen" => "124"
                        "paginaInicial" => "672"
                        "paginaFinal" => "681"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21788587"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of sudden cardiac death in national collegiate athletic association athletes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;G&#46; Harmon"
                            1 => "I&#46;M&#46; Asif"
                            2 => "D&#46; Klossner"
                            3 => "J&#46;A&#46; Drezner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.110.004622"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2011"
                        "volumen" => "123"
                        "paginaInicial" => "1594"
                        "paginaFinal" => "1600"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21464047"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effectiveness of screening history&#44; physical exam&#44; and ECG to detect potentially lethal cardiac disorders in athletes&#58; a systematic review&#47;meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;G&#46; Harmon"
                            1 => "M&#46; Zigman"
                            2 => "J&#46;A&#46; Drezner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jelectrocard.2015.02.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Electrocardiol"
                        "fecha" => "2015"
                        "volumen" => "48"
                        "paginaInicial" => "329"
                        "paginaFinal" => "338"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25701104"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden cardiac arrest in sports &#8211; need for uniform registration&#58; a position paper from the sport cardiology section of the European association for cardiovascular prevention and rehabilitation"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Sport Cardiology Section of the EACPR of the ESC"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;E&#46; Solberg"
                            1 => "M&#46; Borjesson"
                            2 => "S&#46; Sharma"
                            3 => "M&#46; Papadakis"
                            4 => "M&#46; Wilhelm"
                            5 => "J&#46;A&#46; Drezner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Eur J Prev Cardiol"
                        "fecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities&#58; task force 2&#58; preparticipation screening for cardiovascular disease in competitive athletes&#58; a scientific statement from the American heart association and American college of cardiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46;J&#46; Maron"
                            1 => "B&#46;D&#46; Levine"
                            2 => "R&#46;L&#46; Washington"
                            3 => "A&#46;L&#46; Baggish"
                            4 => "R&#46;J&#46; Kovacs"
                            5 => "M&#46;S&#46; Maron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2015.09.034"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2015"
                        "volumen" => "66"
                        "paginaInicial" => "2356"
                        "paginaFinal" => "2361"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26542659"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Position paper&#58; proposal for a core curriculum for a European Sports Cardiology qualification"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Heidbuchel"
                            1 => "M&#46; Papadakis"
                            2 => "N&#46; Panhuyzen-Goedkoop"
                            3 => "F&#46; Carr&#233;"
                            4 => "D&#46; Dugmore"
                            5 => "K&#46;P&#46; Mellwig"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/2047487312446673"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Prev Cardiol"
                        "fecha" => "2013"
                        "volumen" => "20"
                        "paginaInicial" => "889"
                        "paginaFinal" => "903"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22582328"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008400000004/v1_201603300938/S2341287916000260/v1_201603300938/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "25501"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008400000004/v1_201603300938/S2341287916000260/v1_201603300938/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916000260?idApp=UINPBA00005H"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Editorial
Cardiovascular screening prior to sport practice in children and adolescents
La evaluación cardiovascular predeportiva en niños y adolescentes
D. Crespo Marcosa,
Corresponding author
davidkrespo@yahoo.com

Corresponding author.
, F.J. Pérez-Lescure Picarzoa, A. Boraita Pérezb
a Cardiología Pediátrica, Área de Pediatría y Neonatología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
b Servicio de Cardiología, Centro de Medicina del Deporte, Departamento de Deporte y Salud, Agencia Española de Protección de la Salud en el Deporte, Madrid, Spain
Read
4583
Times
was read the article
2183
Total PDF
2400
Total HTML
Share statistics
 array:22 [
  "pii" => "S2341287916000260"
  "issn" => "23412879"
  "doi" => "10.1016/j.anpede.2016.01.002"
  "estado" => "S300"
  "fechaPublicacion" => "2016-04-01"
  "aid" => "2046"
  "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
  "copyrightAnyo" => "2015"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:187-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1518
    "formatos" => array:3 [
      "EPUB" => 117
      "HTML" => 914
      "PDF" => 487
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S234128791600017X"
    "issn" => "23412879"
    "doi" => "10.1016/j.anpede.2015.06.017"
    "estado" => "S300"
    "fechaPublicacion" => "2016-04-01"
    "aid" => "1899"
    "copyright" => "Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "An Pediatr &#40;Barc&#41;. 2016;84:189-94"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1699
      "formatos" => array:3 [
        "EPUB" => 110
        "HTML" => 1188
        "PDF" => 401
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Families of the economic crisis in paediatric primary care clinics&#58; Descriptive observational study"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "189"
          "paginaFinal" => "194"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Las familias de la crisis en las consultas pedi&#225;tricas de Atenci&#243;n Primaria&#58; estudio descriptivo observacional"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46; Mart&#237;n Mart&#237;n, M&#46; S&#225;nchez Bayle, C&#46; Gancedo Garc&#237;a, M&#46;C&#46; Teruel de Francisco, A&#46; Coullaut L&#243;pez"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Mart&#237;n Mart&#237;n"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "S&#225;nchez Bayle"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Gancedo Garc&#237;a"
            ]
            3 => array:2 [
              "nombre" => "M&#46;C&#46;"
              "apellidos" => "Teruel de Francisco"
            ]
            4 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Coullaut L&#243;pez"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1695403315002404"
        "doi" => "10.1016/j.anpedi.2015.06.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403315002404?idApp=UINPBA00005H"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234128791600017X?idApp=UINPBA00005H"
    "url" => "/23412879/0000008400000004/v1_201603300938/S234128791600017X/v1_201603300938/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
    "titulo" => "Cardiovascular screening prior to sport practice in children and adolescents"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "187"
        "paginaFinal" => "188"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "D&#46; Crespo Marcos, F&#46;J&#46; P&#233;rez-Lescure Picarzo, A&#46; Boraita P&#233;rez"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "D&#46;"
            "apellidos" => "Crespo Marcos"
            "email" => array:1 [
              0 => "davidkrespo&#64;yahoo&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "F&#46;J&#46;"
            "apellidos" => "P&#233;rez-Lescure Picarzo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Boraita P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Cardiolog&#237;a Pedi&#225;trica&#44; &#193;rea de Pediatr&#237;a y Neonatolog&#237;a&#44; Hospital Universitario Fundaci&#243;n Alcorc&#243;n&#44; Alcorc&#243;n&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Cardiolog&#237;a&#44; Centro de Medicina del Deporte&#44; Departamento de Deporte y Salud&#44; Agencia Espa&#241;ola de Protecci&#243;n de la Salud en el Deporte&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "La evaluaci&#243;n cardiovascular predeportiva en ni&#241;os y adolescentes"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cardiovascular events related to sport practice are fortunately rare in the paediatric age group&#46; An incidence of sport-related sudden death of 1 per 43&#44;000&#8211;100&#44;000 individuals aged less than 35 years has been described&#44; the great majority &#40;75&#8211;98&#37;&#41; due to cardiovascular causes&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1&#44;2</span></a> In addition&#44; the prevalence of cardiovascular disorders predisposing young athletes to sudden cardiac death episodes is estimated to be around 0&#46;3&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> Contrary to the widespread belief that these events are related to high-level competitive sport&#44; Marijon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> found in a prospective study carried out in France in the period 2005&#8211;2010 that over 90&#37; occurred during recreational sport practice&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is difficult to analyse the epidemiology of this devastating health problem&#44; as there are wide variations in the published incidence&#44; the data collection methods and the reported causes of sudden cardiac death in athletes at both competitive and recreational level&#46; Indeed&#44; there is no universally accepted definition of sports-related sudden cardiac death&#44; though it is generally considered to be that which occurs during physical exercise or in the hour following its cessation&#46; For this reason&#44; the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation has produced a document<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> containing proposals for establishing a uniform register at international level&#44; which will enable us to ascertain the true magnitude of the issue before us&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There is a general consensus that screening prior to sport practice&#44; making it possible to detect potentially lethal cardiovascular diseases&#44; is justified and may be beneficial&#44; but there are wide divergences in protocols and legal provisions&#46; In many European countries screening is limited to elite athletes&#44; and there are currently only 2 countries worldwide&#44; Italy and Israel&#44; in which screening&#44; including an electrocardiogram &#40;ECG&#41;&#44; is systematically performed for sport practice at all levels&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In Italy a decree has existed since 1982 making it obligatory for such examinations to be performed by doctors with specific training&#46; In the rest of the world learned societies recommend that this should be done&#44; but without legislative backing&#46; In Spain&#44; Organic Act 3&#47;2013 on the protection of athletes&#8217; health and the fight against doping in sports activity came into force in June 2013&#46; Here is an extract from Section 46 of this Act &#40;&#8220;On medical examinations&#8221;&#41;&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0025" class="elsevierStylePara elsevierViewall">The Spanish Agency for Health Protection in Sport shall progressively determine the obligation to carry out medical examinations before the corresponding federation licence is issued in those sports in which this is considered necessary in order to provide better prevention of risks to the health of their practitioners&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0030" class="elsevierStylePara elsevierViewall">The purpose of carrying out these medical examinations is to protect the health of athletes with respect to the sports activity&#46; In designing the examinations and applying them to each sports discipline the following shall be taken into account&#58; &#91;&#8230;d&#41; The specific needs of women and men&#44; of minors and of disabled persons&#8230;&#93;&#46;</p></li></ul></p><p id="par0035" class="elsevierStylePara elsevierViewall">This Act will regulate medical examinations prior to sport practice for affiliated members of federations&#44; but it will not affect sport practised outside this context by a large number of children and adolescents at local&#44; municipal or school level&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The main argument is over the need to perform an ECG systematically in these evaluations&#46; In the great majority of European countries it is recommended as a matter of routine&#44; while in the United States it is not advised&#46; The American Heart Association &#40;AHA&#41; and the American College of Cardiology &#40;ACC&#41; reaffirmed their position on this issue in 2015&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> maintaining that performing an ECG is not indicated as they do not consider that there is sufficient evidence to demonstrate its benefit&#46; A recent meta-analysis carried out by Harmon et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> whose aim was to analyse the various pre-participation cardiovascular screening strategies&#44; concluded that ECG is the most effective strategy&#44; being five times more sensitive than medical history and ten times more sensitive than physical examination&#44; with a false positive rate of 6&#37;&#44; lower than that of medical history &#40;8&#37;&#41; and physical examination &#40;10&#37;&#41;&#46; Another area of divergence concerns who should perform these examinations&#46; In the United States non-medical and even non-healthcare staff are allowed to carry them out&#44; whereas in Europe it is advocated that medical staff with specific training in this area should be responsible&#46; Super-specialisation is becoming so important that the European Cardiology Society has developed a 12-month training programme<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> in Sports Cardiology&#44; available to those specialising in Cardiology and Sports Medicine&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">There are numerous guidelines for pre-participation cardiovascular evaluation designed primarily for adults and focusing in many cases on high-level competitive athletes&#59; few of them&#44; however&#44; refer to children and adolescents practising physical activity at any level of competition&#46; For this reason the Sociedad Espa&#241;ola de Cardiolog&#237;a Pedi&#225;trica y Cardiopat&#237;as Cong&#233;nitas &#40;SECPCC&#58; Spanish Paediatric Cardiology and Congenital Heart Disease Society&#41; and the Consejo Superior de Deportes &#40;CSD&#58; Higher Sports Council&#41; have produced the <span class="elsevierStyleItalic">Clinical Guidelines for Cardiovascular Evaluation Prior to Sport Practice in Paediatrics</span>&#44; published in February 2015 with the endorsement of the following learned societies&#58; Sociedad Espa&#241;ola de Cardiolog&#237;a &#40;SEC&#58; Spanish Cardiology Society&#41;&#44; Fundaci&#243;n Espa&#241;ola del Coraz&#243;n &#40;FEC&#58; Spanish Heart Foundation&#41;&#44; Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a &#40;AEP&#58; Spanish Association of Paediatrics&#41;&#44; Asociaci&#243;n Espa&#241;ola de Pediatr&#237;a de Atenci&#243;n Primaria &#40;AEPap&#58; Spanish Association of Primary Care Paediatrics&#41;&#44; Sociedad Espa&#241;ola de Pediatr&#237;a Extrahospitalaria y Atenci&#243;n Primaria &#40;SEPEAP&#58; Spanish Association of Ambulatory Paediatrics and Primary Care&#41;&#44; Sociedad Espa&#241;ola de Medicina de Familia y Comunitaria &#40;semFYC&#58; Spanish Society of Family and Community Medicine&#41;&#44; Sociedad Espa&#241;ola de M&#233;dicos de Atenci&#243;n Primaria &#40;SEMERGEN&#58; Spanish Society of Primary Care Physicians&#41;&#44; Sociedad Espa&#241;ola de M&#233;dicos Generales y de Familia &#40;SEMG&#58; Spanish Society of General and Family Practitioners&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The main purpose of these guidelines&#44; which include medical history&#44; physical examination and ECG&#44; is to serve as a tool for protecting the health of young athletes through early detection of cardiovascular disease that could put the lives of children practising sport at risk&#46; It is freely available online at the websites of the SECPCC &#40;<a id="intr0010" class="elsevierStyleInterRef" href="http://ow.ly/JhbH9">http&#58;&#47;&#47;ow&#46;ly&#47;JhbH9</a>&#41; and of the Ministry of Education&#44; Culture and Sport &#40;<a id="intr0015" class="elsevierStyleInterRef" href="https://sede.educacion.gob.es/publiventa/detalle.action?cod=20251">https&#58;&#47;&#47;sede&#46;educacion&#46;gob&#46;es&#47;publiventa&#47;detalle&#46;action&#63;cod&#61;20251</a>&#41;&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Crespo Marcos D&#44; P&#233;rez-Lescure Picarzo FJ&#44; Boraita P&#233;rez A&#46; La evaluaci&#243;n cardiovascular predeportiva en ni&#241;os y adolescentes&#46; An Pediatr &#40;Barc&#41;&#46; 2016&#59;84&#58;187&#8211;188&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sports-related sudden death in the general population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Marijon"
                            1 => "M&#46; Tafflet"
                            2 => "D&#46;S&#46; Celermajer"
                            3 => "F&#46; Dumas"
                            4 => "M&#46;C&#46; Perier"
                            5 => "H&#46; Mustafic"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.110.008979"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2011"
                        "volumen" => "124"
                        "paginaInicial" => "672"
                        "paginaFinal" => "681"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21788587"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence of sudden cardiac death in national collegiate athletic association athletes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;G&#46; Harmon"
                            1 => "I&#46;M&#46; Asif"
                            2 => "D&#46; Klossner"
                            3 => "J&#46;A&#46; Drezner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.110.004622"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2011"
                        "volumen" => "123"
                        "paginaInicial" => "1594"
                        "paginaFinal" => "1600"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21464047"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effectiveness of screening history&#44; physical exam&#44; and ECG to detect potentially lethal cardiac disorders in athletes&#58; a systematic review&#47;meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;G&#46; Harmon"
                            1 => "M&#46; Zigman"
                            2 => "J&#46;A&#46; Drezner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jelectrocard.2015.02.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Electrocardiol"
                        "fecha" => "2015"
                        "volumen" => "48"
                        "paginaInicial" => "329"
                        "paginaFinal" => "338"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25701104"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden cardiac arrest in sports &#8211; need for uniform registration&#58; a position paper from the sport cardiology section of the European association for cardiovascular prevention and rehabilitation"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Sport Cardiology Section of the EACPR of the ESC"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;E&#46; Solberg"
                            1 => "M&#46; Borjesson"
                            2 => "S&#46; Sharma"
                            3 => "M&#46; Papadakis"
                            4 => "M&#46; Wilhelm"
                            5 => "J&#46;A&#46; Drezner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [
                        "tituloSerie" => "Eur J Prev Cardiol"
                        "fecha" => "2015"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities&#58; task force 2&#58; preparticipation screening for cardiovascular disease in competitive athletes&#58; a scientific statement from the American heart association and American college of cardiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "B&#46;J&#46; Maron"
                            1 => "B&#46;D&#46; Levine"
                            2 => "R&#46;L&#46; Washington"
                            3 => "A&#46;L&#46; Baggish"
                            4 => "R&#46;J&#46; Kovacs"
                            5 => "M&#46;S&#46; Maron"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2015.09.034"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2015"
                        "volumen" => "66"
                        "paginaInicial" => "2356"
                        "paginaFinal" => "2361"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26542659"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Position paper&#58; proposal for a core curriculum for a European Sports Cardiology qualification"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Heidbuchel"
                            1 => "M&#46; Papadakis"
                            2 => "N&#46; Panhuyzen-Goedkoop"
                            3 => "F&#46; Carr&#233;"
                            4 => "D&#46; Dugmore"
                            5 => "K&#46;P&#46; Mellwig"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/2047487312446673"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Prev Cardiol"
                        "fecha" => "2013"
                        "volumen" => "20"
                        "paginaInicial" => "889"
                        "paginaFinal" => "903"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22582328"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/23412879/0000008400000004/v1_201603300938/S2341287916000260/v1_201603300938/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "25501"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Editorial"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008400000004/v1_201603300938/S2341287916000260/v1_201603300938/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916000260?idApp=UINPBA00005H"
]
Article information
ISSN: 23412879
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 6 11 17
2024 October 40 54 94
2024 September 37 33 70
2024 August 61 51 112
2024 July 31 30 61
2024 June 28 27 55
2024 May 35 35 70
2024 April 33 31 64
2024 March 24 23 47
2024 February 25 25 50
2024 January 24 25 49
2023 December 9 16 25
2023 November 26 21 47
2023 October 23 30 53
2023 September 19 20 39
2023 August 27 13 40
2023 July 29 30 59
2023 June 22 27 49
2023 May 24 21 45
2023 April 24 17 41
2023 March 32 25 57
2023 February 17 15 32
2023 January 21 24 45
2022 December 32 32 64
2022 November 55 40 95
2022 October 31 39 70
2022 September 21 37 58
2022 August 25 41 66
2022 July 25 36 61
2022 June 24 34 58
2022 May 30 25 55
2022 April 28 38 66
2022 March 35 42 77
2022 February 24 32 56
2022 January 50 30 80
2021 December 23 35 58
2021 November 34 50 84
2021 October 37 65 102
2021 September 16 36 52
2021 August 14 49 63
2021 July 19 48 67
2021 June 17 49 66
2021 May 14 32 46
2021 April 53 79 132
2021 March 33 24 57
2021 February 15 14 29
2021 January 20 20 40
2020 December 21 21 42
2020 November 13 13 26
2020 October 16 18 34
2020 September 16 17 33
2020 August 12 14 26
2020 July 11 14 25
2020 June 17 13 30
2020 May 24 15 39
2020 April 20 15 35
2020 March 31 16 47
2020 February 31 15 46
2020 January 11 11 22
2019 December 25 17 42
2019 November 28 13 41
2019 October 16 13 29
2019 September 18 18 36
2019 August 24 18 42
2019 July 19 30 49
2019 June 22 35 57
2019 May 17 15 32
2019 April 48 21 69
2019 March 18 25 43
2019 February 33 22 55
2019 January 17 15 32
2018 December 30 30 60
2018 November 56 32 88
2018 October 66 22 88
2018 September 26 8 34
2018 August 1 0 1
2018 June 4 0 4
2018 May 10 0 10
2018 April 34 0 34
2018 March 18 0 18
2018 February 10 0 10
2018 January 7 0 7
2017 December 17 0 17
2017 November 6 0 6
2017 October 15 0 15
2017 September 9 0 9
2017 August 14 0 14
2017 July 12 0 12
2017 June 19 12 31
2017 May 30 22 52
2017 April 26 23 49
2017 March 11 11 22
2017 February 12 8 20
2017 January 5 8 13
2016 December 24 17 41
2016 November 30 14 44
2016 October 21 8 29
2016 September 30 2 32
2016 August 31 2 33
2016 July 23 9 32
2016 April 3 0 3
Show all

Follow this link to access the full text of the article

Idiomas
Anales de Pediatría (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?