[
    {
        "page": 1,
        "title": "Malos tratos y abandono en la infancia (Capitulo 16)",
        "body": "<p>\n\n\n<meta http-equiv=\"Content-Type\" content=\"text\/html; charset=utf-8\" \/>\n<meta name=\"ProgId\" content=\"Word.DocumentW\" \/>\n<meta name=\"Generator\" content=\"Microsoft Word 15\" \/>\n<meta name=\"Originator\" content=\"Microsoft Word 15\" \/>\n<link rel=\"File-List\n\" href=\"file:\/\/\/C:\/Users\/Georgi\/AppData\/Local\/Temp\/msohtmlclip1\/01\/clip_filelist.xml\" \/>\n<link rel=\"Edit-Time-Data\n\" href=\"file:\/\/\/C:\/Users\/Georgi\/AppData\/Local\/Temp\/msohtmlclip1\/01\/clip_editdata.mso\" \/>\n\n<style>\nv\\:* {behavior:url(#default#VML);}\no\\:* {behavior:url(#default#VML);}\nw\\:* {behavior:url(#default#VML);}\n.shape {behavior:url(#default#VML);}\n<\/style>\n<xml>\n \n  \n \n<\/xml>\n<link rel=\"themeData\n\" href=\"file:\/\/\/C:\/Users\/Georgi\/AppData\/Local\/Temp\/msohtmlclip1\/01\/clip_themedata.thmx\" \/>\n<link rel=\"colorSchemeMapping\n\" href=\"file:\/\/\/C:\/Users\/Georgi\/AppData\/Local\/Temp\/msohtmlclip1\/01\/clip_colorschememapping.xml\" \/>\n<xml>\n \n  \n  \n   \n   \n   \n   \n   \n   \n   \n   \n   \n  \n  \n   \n   \n   \n   \n   \n   \n   \n   \n   \n   \n   \n  \n<\/xml><xml>\n \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n \n<\/xml>\n<style>\n\n<\/style>\n\n<style>\n \/* Style Definitions *\/\n table.MsoNormalTable\n\t{mso-style-name:\"Tabla normal\";\n\tmso-tstyle-rowband-size:0;\n\tmso-tstyle-colband-size:0;\n\tmso-style-noshow:yes;\n\tmso-style-priority:99;\n\tmso-style-parent:\"\";\n\tmso-padding-alt:0cm 5.4pt 0cm 5.4pt;\n\tmso-para-margin-top:0cm;\n\tmso-para-margin-right:0cm;\n\tmso-para-margin-bottom:8.0pt;\n\tmso-para-margin-left:0cm;\n\tline-height:107%;\n\tmso-pagination:widow-orphan;\n\tfont-size:11.0pt;\n\tfont-family:\"Calibri\",sans-serif;\n\tmso-ascii-font-family:Calibri;\n\tmso-ascii-theme-font:minor-latin;\n\tmso-hansi-font-family:Calibri;\n\tmso-hansi-theme-font:minor-latin;\n\tmso-bidi-font-family:\"Times New Roman\";\n\tmso-bidi-theme-font:minor-bidi;\n\tmso-font-kerning:1.0pt;\n\tmso-ligatures:standardcontextual;\n\tmso-fareast-language:EN-US;}\n<\/style>\n\n\n\n\n\n\n\n\n\n<meta http-equiv=\"Content-Type\" content=\"text\/html; charset=utf-8\" \/>\n<meta name=\"ProgId\" content=\"Word.DocumentW\" \/>\n<meta name=\"Generator\" content=\"Microsoft Word 15\" \/>\n<meta name=\"Originator\" content=\"Microsoft Word 15\" \/>\n<link rel=\"File-List\n\" href=\"file:\/\/\/C:\/Users\/Georgi\/AppData\/Local\/Temp\/msohtmlclip1\/01\/clip_filelist.xml\" \/>\n<link rel=\"Edit-Time-Data\n\" href=\"file:\/\/\/C:\/Users\/Georgi\/AppData\/Local\/Temp\/msohtmlclip1\/01\/clip_editdata.mso\" \/>\n\n<style>\nv\\:* {behavior:url(#default#VML);}\no\\:* {behavior:url(#default#VML);}\nw\\:* {behavior:url(#default#VML);}\n.shape {behavior:url(#default#VML);}\n<\/style>\n<xml>\n \n  \n \n<\/xml>\n<link rel=\"themeData\n\" href=\"file:\/\/\/C:\/Users\/Georgi\/AppData\/Local\/Temp\/msohtmlclip1\/01\/clip_themedata.thmx\" \/>\n<link rel=\"colorSchemeMapping\n\" href=\"file:\/\/\/C:\/Users\/Georgi\/AppData\/Local\/Temp\/msohtmlclip1\/01\/clip_colorschememapping.xml\" \/>\n<xml>\n \n  \n  \n   \n   \n   \n   \n   \n   \n   \n   \n   \n  \n  \n   \n   \n   \n   \n   \n   \n   \n   \n   \n   \n   \n  \n<\/xml><xml>\n \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n  \n \n<\/xml>\n<style>\n\n<\/style>\n\n<style>\n \/* Style Definitions *\/\n table.MsoNormalTable\n\t{mso-style-name:\"Tabla normal\";\n\tmso-tstyle-rowband-size:0;\n\tmso-tstyle-colband-size:0;\n\tmso-style-noshow:yes;\n\tmso-style-priority:99;\n\tmso-style-parent:\"\";\n\tmso-padding-alt:0cm 5.4pt 0cm 5.4pt;\n\tmso-para-margin-top:0cm;\n\tmso-para-margin-right:0cm;\n\tmso-para-margin-bottom:8.0pt;\n\tmso-para-margin-left:0cm;\n\tline-height:107%;\n\tmso-pagination:widow-orphan;\n\tfont-size:11.0pt;\n\tfont-family:\"Calibri\",sans-serif;\n\tmso-ascii-font-family:Calibri;\n\tmso-ascii-theme-font:minor-latin;\n\tmso-hansi-font-family:Calibri;\n\tmso-hansi-theme-font:minor-latin;\n\tmso-bidi-font-family:\"Times New Roman\";\n\tmso-bidi-theme-font:minor-bidi;\n\tmso-font-kerning:1.0pt;\n\tmso-ligatures:standardcontextual;\n\tmso-fareast-language:EN-US;}\n<\/style>\n\n\n\n\n\n\n<\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Definiciones<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Maltrato<\/span><\/b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">: actos de comisi\u00f3n (golpes, quemaduras,\n     abuso sexual, maltrato emocional).<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Abandono<\/span><\/b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">: actos de omisi\u00f3n (falta de\n     alimentaci\u00f3n, atenci\u00f3n m\u00e9dica, educaci\u00f3n, supervisi\u00f3n).<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Definici\u00f3n legal (EE. UU.): <i>acto u omisi\u00f3n de un cuidador que\n     provoque muerte, da\u00f1o f\u00edsico o emocional grave, abuso o explotaci\u00f3n\n     sexual, o riesgo de da\u00f1o<\/i>.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Maltrato f\u00edsico<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">:\n     golpes, zarandeos, mordeduras, quemaduras. El castigo corporal tiende a\n     prohibirse; lesiones m\u00e1s all\u00e1 de eritema transitorio constituyen maltrato.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Abuso sexual<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">:\n     implicaci\u00f3n de menores en actividades sexuales sin capacidad de\n     consentimiento; incluye tocamientos, penetraci\u00f3n, exposici\u00f3n a\n     pornograf\u00eda.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Maltrato psicol\u00f3gico<\/span><\/b><span style=\"font-size:12.0pt;\n     font-family:&quot;Times New Roman&quot;,serif\">:\n     humillaci\u00f3n, amenazas, intimidaci\u00f3n; efectos: depresi\u00f3n, ansiedad, baja\n     autoestima.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Abandono m\u00e9dico<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">:\n     omisi\u00f3n de cuidados sanitarios necesarios, generando da\u00f1o real o\n     potencial.<\/span><\/li><\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Incidencia\ny Prevalencia<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Mundial (OMS\/UNICEF)<\/span><\/b><span style=\"font-size:12.0pt;\n     font-family:&quot;Times New Roman&quot;,serif\">:<\/span><\/li>\n <ul type=\"circlec\">\n  <li style=\"line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">18% ni\u00f1as y 8% ni\u00f1os sufrieron abuso sexual.<\/span><\/li>\n  <li style=\"line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">23% maltrato f\u00edsico.<\/span><\/li>\n  <li style=\"line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">En varias regiones, 30% de ni\u00f1os fueron golpeados o atados por\n      cuidadores.<\/span><\/li>\n <\/ul>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">EE. UU. (2015)<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">:<\/span><\/li>\n <ul type=\"circlec\">\n  <li style=\"line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">4 millones de denuncias a Servicios de Protecci\u00f3n al Menor (SPM).<\/span><\/li>\n  <li style=\"line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Casos corroborados: 683.000 (9,2\/1000).<\/span><\/li>\n  <li style=\"line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">78% abandono, 17% maltrato f\u00edsico, 8% abuso sexual, 6% psicol\u00f3gico. Personal<\/span>&nbsp;m\u00e9dico realiz\u00f3 9% de denuncias.<\/li><\/ul><\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Etiolog\u00eda<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Multifactorial<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">, con\n     interacci\u00f3n de factores:<\/span><\/li>\n <ul type=\"circlec\">\n  <li style=\"line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Individuales<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n      &quot;Times New Roman&quot;,serif\">:\n      discapacidad del ni\u00f1o, depresi\u00f3n, consumo de drogas de padres.<\/span><\/li>\n  <li style=\"line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Familiares<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n      &quot;Times New Roman&quot;,serif\">:\n      violencia dom\u00e9stica, disfunci\u00f3n.<\/span><\/li>\n  <li style=\"line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Comunitarios<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n      &quot;Times New Roman&quot;,serif\">:\n      vecindarios inseguros, falta de recursos.<\/span><\/li>\n  <li style=\"line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Sociales<\/span><\/b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">: pobreza, marginalidad.<\/span><\/li>\n <\/ul>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Factores protectores<\/span><\/b><span style=\"font-size:12.0pt;\n     font-family:&quot;Times New Roman&quot;,serif\">:\n     v\u00ednculos familiares, apoyos sociales, figuras cuidadoras estables.<\/span><\/li><\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Manifestaciones\nCl\u00ednicas<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:13.5pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Maltrato\nf\u00edsico<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Hematomas<\/span><\/b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">: en lactantes no deambuladores, zonas\n     acolchadas (nalgas, mejillas, orejas, genitales), patrones de objetos, en\n     diferentes fases evolutivas.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Mordeduras<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">:\n     patr\u00f3n de arcos opuestos; distinguir entre humano, animal, adulto\/ni\u00f1o.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Quemaduras<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">: por\n     inmersi\u00f3n (patr\u00f3n en guante o calcet\u00edn), objetos calientes (cigarrillos,\n     planchas, radiadores).<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Fracturas<\/span><\/b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">: alta especificidad: metafisarias\n     cl\u00e1sicas, costales posteriores, esc\u00e1pula, estern\u00f3n, ap\u00f3fisis espinosas.\n     Moderada especificidad: m\u00faltiples, en fases evolutivas distintas.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Traumatismo craneal por maltrato (TCM)<\/span><\/b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">:<\/span><\/li>\n <ul type=\"circlec\">\n  <li style=\"line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Hematomas subdurales, hemorragias retinianas m\u00faltiples y extensas,\n      lesiones axonales difusas.<\/span><\/li>\n  <li style=\"line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">S\u00edntomas: v\u00f3mitos, letargo, convulsiones, coma.<\/span><\/li>\n <\/ul>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Traumatismo abdominal<\/span><\/b><span style=\"font-size:12.0pt;\n     font-family:&quot;Times New Roman&quot;,serif\">:\n     lesiones de h\u00edgado, bazo, intestino o vasos; puede manifestarse como\n     abdomen agudo o shock.<\/span><\/li>\n<\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:13.5pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Abandono<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Manifestaciones: retraso del crecimiento, malnutrici\u00f3n, obesidad no\n     tratada, infecciones recurrentes, falta de controles m\u00e9dicos\/dentales,\n     accidentes por supervisi\u00f3n deficiente, fracaso escolar.<\/span><\/li><\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Diagn\u00f3stico<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Anamnesis y exploraci\u00f3n exhaustiva<\/span><\/b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">, entrevistas separadas a padres e hijos.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Documentaci\u00f3n precisa: citas literales, fotograf\u00edas, croquis.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Evaluaci\u00f3n diferencial: discrasias sangu\u00edneas, osteog\u00e9nesis\n     imperfecta, imp\u00e9tigo, hemangiomas, pr\u00e1cticas culturales (ventosas, cao\n     gio).<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Estudio radiol\u00f3gico completo<\/span><\/b><span style=\"font-size:12.0pt;\n     font-family:&quot;Times New Roman&quot;,serif\"> en\n     &lt;2 a\u00f1os con sospecha: proyecciones m\u00faltiples de cr\u00e1neo, columna, t\u00f3rax,\n     pelvis, huesos largos, manos y pies.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Seguimiento con radiograf\u00edas a 2 semanas.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">TC\/RM en sospecha de TCM; TC\/eco abdominal si hay sospecha de\n     trauma oculto.<\/span><\/li><\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Manejo<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><span style=\"font-weight: bold;\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Atenci\u00f3n inmediata a problemas m\u00e9dicos<\/span><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">.<\/span><\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Garantizar la seguridad del ni\u00f1o<\/span><\/b><span style=\"font-size:\n     12.0pt;font-family:&quot;Times New Roman&quot;,serif\">, en\n     coordinaci\u00f3n con SPM.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Comunicaci\u00f3n con padres: clara, emp\u00e1tica, sin culpabilizaci\u00f3n.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Denuncia obligatoria ante sospecha razonable de maltrato.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Hospitalizaci\u00f3n en casos graves o cuando el entorno es inseguro.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Intervenciones menos intrusivas en casos leves (ej.: error en\n     mezcla de f\u00f3rmula).<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Enfoque multidisciplinario: m\u00e9dicos, trabajadores sociales,\n     psic\u00f3logos, educadores.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Plan terap\u00e9utico con objetivos claros, medibles y revisiones\n     peri\u00f3dicas.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Fortalecer factores protectores familiares y comunitarios.<\/span><\/li><\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Consecuencias<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">A corto plazo<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">:\n     TEPT, ansiedad, depresi\u00f3n, problemas conductuales, bajo rendimiento\n     escolar.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">A largo plazo<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\">:\n     tabaquismo, alcohol, drogas, suicidio, enfermedades cr\u00f3nicas\n     (cardiopat\u00edas, artritis), transmisi\u00f3n intergeneracional del maltrato.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Cambios neurobiol\u00f3gicos en cerebro en desarrollo contribuyen a\n     secuelas.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><b><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Resiliencia<\/span><\/b><span style=\"font-size:12.0pt;font-family:\n     &quot;Times New Roman&quot;,serif\"> posible\n     si existen factores protectores y se realizan intervenciones tempranas.<\/span><\/li><\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<div align=\"center\" style=\"text-align:center;\nline-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">\n\n<\/span><\/div>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Prevenci\u00f3n<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Educaci\u00f3n a padres sobre salud, disciplina positiva y riesgos del\n     zarandeo.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Cribado en atenci\u00f3n primaria de factores de riesgo psicosocial\n     (depresi\u00f3n, violencia de pareja, consumo de sustancias).<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Programas preventivos como <b>SEEK (Safe Environment for Every Kid)<\/b>\n     en pediatr\u00eda primaria.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Promoci\u00f3n de pol\u00edticas p\u00fablicas que reduzcan pobreza y fortalezcan\n     apoyos familiares.<\/span><\/li>\n<\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Apoyo<\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Pediatras como defensores del ni\u00f1o: abordar factores de riesgo,\n     mejorar funcionamiento familiar, coordinar con recursos comunitarios y\n     legales.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Mantener seguimiento y acompa\u00f1amiento tras denuncia.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Participaci\u00f3n activa en pol\u00edticas y programas de protecci\u00f3n\n     infantil.<\/span><\/li><\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p style=\"\nline-height:normal\"><b><span style=\"font-size:18.0pt;\nfont-family:&quot;Times New Roman&quot;,serif\">Abuso\nSexual <\/span><\/b><\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<ul type=\"discd\">\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Prevalencia en EE. UU.: 18% mujeres y 7% hombres sufrieron abuso en\n     la infancia.<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Definici\u00f3n: conducta sexual dirigida a un ni\u00f1o, deseada o no, con o\n     sin contacto f\u00edsico (incluye exposici\u00f3n a pornograf\u00eda).<\/span><\/li>\n <li style=\"\n     line-height:normal\"><span style=\"font-size:12.0pt;font-family:&quot;Times New Roman&quot;,serif\">Rol del pediatra: identificaci\u00f3n, denuncia a SPM, cribado de ETS,\n     apoyo psicol\u00f3gico, prevenci\u00f3n.<\/span><\/li>\n<\/ul>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<p class=\"MsoNormalM\">&nbsp;<\/p>\r\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\r\n<br \/>",
        "footer": "P\u00e1gina 1"
    }
]