An unusual umbilical venous connection to a left posterior intercostal vein.

A foetal echocardiogram, in a 27-week foetus referred for cardiomegaly, demonstrated dextrocardia, absence of the ductus venosus, and an unrestricted unusual umbilical venous drainage to a left posterior intercostal vein, which continued to left hemiazygos vein and drained into the coronary sinus. Progressive cardiomegaly led to early delivery. To the best of our knowledge, no case with similar umbilical venous drainage has been previously reported.

Blood concentrations of p,p'-DDE and PCBs in harriers breeding in Spain and Kazakhstan.

Organochlorine compounds (OC) are of interest in current biomonitoring studies because of their well-known persistence, accumulation capacity and the adverse effects they caused in the past. P,p'-DDE has been shown to cause severe reproductive failures and population declines in birds of prey. However, there are knowledge gaps regarding OC exposure for some species (e.g. harriers), the historical record and the broader picture. The main goal was to evaluate exposure to p,p'-DDE and PCBs in two raptor species: Montagu's and pallid harriers (Circus pygargus and Circus macrourus), and to investigate if birds from different breeding areas and wintering grounds differ in pollutant levels. For this purpose, we collected blood of adult and nestling Montagu's and pallid harriers breeding in the natural steppes of Kazakhstan, and adult and nestling Montagu's harriers breeding in agricultural and natural habitats of Spain, in 2007-2008. We determined the blood concentrations of p,p'-DDE and PCBs. Adult harriers generally showed higher concentrations of p,p'-DDE and PCBs than nestlings, probably because they had more time for a progressive accumulation of these compounds due to a higher intake than excretion rate. The p,p'-DDE concentrations in adults were equivalent in all the studied areas. The ratio p,p'-DDE/PCB 153 was higher in adults than in nestlings, suggesting that a portion of the p,p'-DDE in adult harriers may have come from p,p'-DDT applied in the past in the wintering areas. Overall, the concentrations of p,p'-DDE and ∑PCBs reported were generally low and below any demonstrated threshold of harm.

La pulsioximetría como herramienta para la tamización de cardiopatías congénitas críticas. Una revisión narrativa / Pulse oximetry as a screening tool for critical congenital heart diseases. A narrative review

Resumen Objetivo: Revisar el concepto de cardiopatía congénita crítica, describir el proceso de consolidación de la pulsioximetría como herramienta para su tamización y llamar la atención sobre la necesidad de implementarla en países de bajos ingresos como Colombia. Métodos: Se hizo una búsqueda en las bases de datos PubMed-MEDLINE y Scholar Google, usando los términos MeSH: "CongenitalAbnormalities", "HeartDefects, Congenital" "Oximetry" y "Neonatal Screening", cruzando el término "HeartDefects, Congenital" con los demás, por medio del operador booleano AND. Se incluyeron publicaciones desde 1992 y no se excluyeron artículos por metodología o idioma. Resultados: El 25% de los casos de recién nacidos vivos con cardiopatía congénita son críticos y la pulsioximetría es una alternativa efectiva para su reconocimiento temprano. Se hizo una revisión sobre el tema, mencionando los estudios con los mayores tamaños de muestra que han permitido la consolidación de la pulsioximetría como herramienta para tamización de cardiopatías congénitas críticas, describiendo el abordaje estadounidense al respecto y llamando la atención sobre la necesidad de implementar dicha tamización en Colombia. Conclusiones: Existe evidencia para la introducción de la pulsioximetría como prueba de tamización para defectos cardiacos congénitos críticos. En Colombia no se han presentado iniciativas oficiales para generalizar la práctica.

Abstract Objective: This article sets out to review the concept of critical congenital heart diseases, as well as to describe the consolidation process with pulse oximetry as a tool for their screening, and to call attention to the need to implement this in low income countries like Colombia. Methods: A search was made in the PubMed-MEDLINE and Google Scholar databases using the MeSH terms: "Congenital Abnormalities", "Heart Defects, Congenital'" "Oximetry" and "Neonatal Screening", crossing the term "Heart Defects, Congenital" with the rest, by means of the Boolean operator AND. Publications since 1992 were included and article were not excluded due to methodology or language. Results: Around one-quarter (25%) of live newborns with a congenital heart disease are critical, and pulse oximetry is an effective alternative for its early recognition. A review was carried out on the subject, mentioning studies with large sample sizes that have allowed the consolidation of pulse oximetry as screening tool for critical congenital heart diseases. The approach used in the USA in this respect is described, as well as calling attention to the need to implement this screening method in Colombia. Conclusions: There is evidence for the introduction of pulse oximetry as a screening test for critical congenital heart disease defects. No official initiatives have been presented in Colombia to generalise the practice.

Conocimiento y aplicación del tamizaje neonatal de cardiopatías congénitas críticas mediante el uso de oximetría de pulso / Knowledge and implementation of the neonatal screening for critical congenital heart diseases with a pulse oximetry

Resumen Objetivo: Evaluar el conocimiento y la aplicación de la prueba de tamizaje neonatal de las cardiopatías congénitas críticas mediante el uso de la oximetría de pulso entre diferentes médicos en el área pediátrica. Métodos: Estudio descriptivo y analítico, mediante encuesta sobre: el conocimiento, la capacitación y la aplicación de la prueba de tamizaje, en los médicos que atienden a recién nacidos en Cali, Colombia. Se establecieron asociaciones entre: la formación profesional, la capacitación y el conocimiento de la prueba. Se realizaron pruebas no paramétricas validando el error alfa < 5%. Resultados: 100 encuestados: 21 médicos generales o familiares, 50 pediatras, 21 residentes y 8 neonatólogos. 62% conocían la prueba de tamizaje, 19% afirmaron recibir capacitación, 24% la realizaban a todos los neonatos previo egreso siendo significativamente mayor en el grupo de pediatras. 25% conocían todas las respuestas correctas de la prueba y solo hay diferencias significativas entre los residentes de pediatría y los otros profesionales. Conclusiones: Existe un conocimiento general sobre la necesidad de realizar la detección precoz de las cardiopatías congénitas críticas en los recién nacidos por parte de los médicos, aunque no hay una adecuada capacitación sobre los aspectos fisiopatológicos que se pueden evaluar con la toma de la pulsioximetría de pulsos en las primeras 24 horas de vida.

Abstract Objective: To assess knowledge and implementation of the neonatal screening for critical congenital heart diseases by means of a pulse oximetry between several physicians in the pediatric ward. Methods: Descriptive and analytical study with a survey about knowledge, capability and implementation of screening test carried out by physicians assisting newborns in Cali, Colombia. Associations between professional training, capability and knowledge of the test were established. Nonparametric tests were conducted validating alpha error <5%. Results: 100 survey respondents: 21 general or family practitioners, 50 pediatricians, 21 residents and 8 neonatologists. 62% knew the screening test, 19% had received training, 24% conducted it on all newborns prior to admission, the pediatrician group being significantly higher. 25% know all correct answers for the test and significant differences can only be found between the pediatric residents and other physicians. Conclusions: General knowledge of the need to carry out early detection of critical congenital heart diseases exists amongst physicians, though there is no proper training about pathophysiological aspects that can be assessed with a pulse oximetry during the first 24 hours of life.