Prevalence of Trypanosoma cruzi infection in pregnant Latin American women and congenital transmission rate in a non-endemic area: the experience of the Valencian Health Programme (Spain).

This study describes the results of the health programme implemented in the Valencian Community (Spain) to achieve an early diagnosis of Chagas disease in pregnant Latin American women and their newborns. During 2009 and 2010, 1975 women living in the health districts of three university hospitals were enrolled via midwives or at the time of delivery. Diagnosis of disease was performed using two serological tests with different antigens. Congenital infection was diagnosed by parasitological, molecular or serological methods from blood samples obtained at birth or in subsequent controls. The overall seroprevalence of Chagas infection in pregnant women from 16 different endemic countries was 11·4%. Infection was higher in those from countries in the Gran Chaco Region (Bolivia, 34·1%; Paraguay, 7·4%; Argentina, 5·3%). Eight newborn infants from Bolivian mothers had congenital Chagas which represents a vertical transmission rate of 3·7%. In conclusion, this work supports the benefits of offering an early diagnosis to pregnant women and newborns during routine prenatal healthcare.

[Tracheostomy as a solution for subcutaneous emphysema and pneumomediastinum with severe respiratory failure]. / Traqueostomía como solución de enfisema subcutáneo y neumomediastino con compromiso respiratorio grave.

Subcutaneous emphysema and pneumomediastinum have many causes. Generally they course without severe pathophysiological complications and severe respiratory complications are rare. However, cases with progressive dyspnea should be treated with tracheostomy or superficial incisions. A case is reported of a patient who underwent hip surgery under general anesthesia with tracheal intubation and later presented progressive dyspnea with subcutaneous emphysema and neuromediastinum. Tracheostomy yielded satisfactory results.