Sono sempre perplessa quando sento altre mamme far effettuare esami del sangue di routine ai loro bimbi solo perché “una volta all’anno è giusto controllarsi”. Credo che spesso si viva in maniera troppo “medicalizzata” e io talvolta “sgrido” anche qualche mio paziente avanti con gli anni dicendo loro che “vivono da malati per morire da sani”. Ma tornando ai nostri bimbi in Pediatria è corretto eseguire accertamenti (del sangue, strumentali o visite specialistiche) solo quando esiste un sospetto diagnostico. Altrimenti bastano le normali visite del Pediatra che rappresentano lo strumento più completo e prezioso attraverso cui la salute del bambino viene garantita e controllata.
Diverso è il discorso degli screening, cioè dei controlli di massa sulla popolazione sana (per esempio l’ecografia per la displasia dell’anca, il test di Goutrie alla nascita o i controlli oculistici e audiometrici) indispensabili per la prevenzione di patologie comuni con un basso rapporto costo-beneficio.
Il discorso cambia parlando di adolescenti e teenager. Sebbene le linee guida dell’American Medical Association e dell’American Academy of Pediatrics raccomandino un controllo all’anno nella fascia di età tra gli 11 e i 21 anni, meno del 2% dei ragazzi americani segue queste indicazione. Ciò è messo in luce da uno studio pubblicato sulla rivista Annals of Family Medicine.
E in genere anche i ragazzi italiani vanno poco dal medico perché pensano di non averne bisogno. Il numero delle visite e la frequenza dei controlli tende ad aumentare a partire dai 20-30 anni, ma non in ugual misura tra maschi e femmine. Di solito i controlli, almeno all’inizio, sono più frequenti nelle ragazze per problematiche spesso ginecologiche (per esempio l’arrivo della prima mestruazione e la vaccinazione contro il papilloma virus).
L’adolescenza è un’età impegnativa sia dal punto di vista dei cambiamenti fisici sia da quello psicologico. È importante che il medico instauri un rapporto con il giovane e getti le basi per affrontare anche tematiche delicate come contraccezione e malattie sessualmente trasmesse. Particolarmente importante in questi casi la collaborazione dei genitori che andrebbero sollecitati ad allontanarsi discretamente per non imbarazzare il figlio durante il colloquio con il medico.
That takes us up to the next level. Great potgnis.
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