Recommendations for the use of microarrays in prenatal diagnosis. / Recomendaciones para el uso de microarrays en el diagnóstico prenatal.

Microarray technology, recently implemented in international prenatal diagnosis systems, has become one of the main techniques in this field in terms of detection rate and objectivity of the results. This guideline attempts to provide background information on this technology, including technical and diagnostic aspects to be considered. Specifically, this guideline defines: the different prenatal sample types to be used, as well as their characteristics (chorionic villi samples, amniotic fluid, fetal cord blood or miscarriage tissue material); variant reporting policies (including variants of uncertain significance) to be considered in informed consents and prenatal microarray reports; microarray limitations inherent to the technique and which must be taken into account when recommending microarray testing for diagnosis; a detailed clinical algorithm recommending the use of microarray testing and its introduction into routine clinical practice within the context of other genetic tests, including pregnancies in families with a genetic history or specific syndrome suspicion, first trimester increased nuchal translucency or second trimester heart malformation and ultrasound findings not related to a known or specific syndrome. This guideline has been coordinated by the Spanish Association for Prenatal Diagnosis (AEDP, «Asociación Española de Diagnóstico Prenatal¼), the Spanish Human Genetics Association (AEGH, «Asociación Española de Genética Humana¼) and the Spanish Society of Clinical Genetics and Dysmorphology (SEGCyD, «Sociedad Española de Genética Clínica y Dismorfología¼).

[Clinical and managerial autonomy. Perception of the coordinators of the health centers in Mallorca, Spain]. / Autonomía clínica y de gestión. Percepción de los coordinadores de los centros de salud de Mallorca.

BACKGROUND: The self-management has been linked with increased efficiency and job satisfaction. Before any changes aimed at a more autonomous management is important to know the position of professionals and managers. objective: To assess the importance attached by the coordinators of the health centers (HC) to the clinical and managerial autonomy, knowing their decision making capacity and their expectations about the feasibility of implementing a project of self-management. DESIGN: cross-sectional study, application questionnaire. LOCATION: Primary Care, 2009. PARTICIPANTS: All the coordinators of the HC of Mallorca (N = 47). INTERVENTIONS AND MEASUREMENTS: 27 questions that explore the coordinator's opinion about the importance of the components of the self-management, its ability to present intervention, the propensity / aversion to risk, leadership, and the feasibility of a self-management. RESULTS: response rate: 42/47 (89,4%). 42 (100%) attaches the highest importance to the management of human resources, 41 (97,6%) to demand management and 40 (95,2%) to the management of waiting lists. 15 (35,7%) would take a financial risk, 14 (33,3%) were considered trained and 18 (42,9%) were willing to lead a process of self-management. 14 (33,3%) thought that the professionals in your team would not be interested in a process of self-management and 29 (69%) believed that others could develop HC of Mallorca. CONCLUSIONS: The respondents were coordinators have a limited ability to decide on the components of the self-management, being risk averse and make a little leadership ability and willingness to self-management projects.

Cólera en pediatría: Reporte preliminar / Cholera in pediatrics: Preliminary report

Durante el mes de febrero hubieron 843 casos de EDA en pediatría, de los cuales se cultivaron 272 pacientes(32 por ciento). De ellos, serecuperó V. cholerae 01 en 137 pacientes (50.4 por ciento). Se utilizaron estos grupos con el objeto de comparar características de la diarrea por V. cholerae. En los pacientes con V. cholerae la edad promedio fue significativamente mayor, 67.5m vs 43.5 (p<0.0001). Se recuperó mas frecuentemente en escolares (p<0.0001) y los mayores de 2 a. tuvieron 3.6 veces más probabilidad de enfermarse(2.07