Arsenic levels in immigrant children from countries at risk of consuming arsenic polluted water compared to children from Barcelona.

Arsenic is a highly toxic element that pollutes groundwater, being a major environmental problem worldwide, especially in the Bengal Basin. About 40% of patients in our outpatient clinics come from those countries, and there is no published data about their arsenic exposure. This study compares arsenic exposure between immigrant and native children. A total of 114 children (57 natives, 57 immigrants), aged 2 months to 16 years, were recruited and sociodemographic and environmental exposure data were recorded. Total arsenic in urine, hair, and nails and arsenic-speciated compounds in urine were determined. We did not find significant differences in total and inorganic arsenic levels in urine and hair, but in organic arsenic monomethylarsenic acid (MMA) and dimethylarsinous acid (DMA) in urine and in total arsenic in nails. However, these values were not in the toxic range. There were significant differences between longer than 5 years exposure and less than 5 years exposure (consumption of water from tube wells), with respect to inorganic and organic MMA arsenic in urine and total arsenic in nails. There was partial correlation between the duration of exposure and inorganic arsenic levels in urine. Immigrant children have higher arsenic levels than native children, but they are not toxic. At present, there is no need for specific arsenic screening or follow-up in immigrant children recently arrived in Spain from exposure high-risk countries.

Patología ocular en adopción internacional: importancia de la región de origen / Eye disease in international adoption: Importance of the region of origin

INTRODUCCIÓN: Los ninos adoptados tienen una mayor prevalencia de patología oftalmológica. El objetivo es estudiar la patología oftalmológica en niños españoles procedentes de adopción internacional, valorando la influencia de la región geográfica de origen y del periodo institucional preadoptivo. MATERIAL Y MÉTODOS: Se realizó un estudio prospectivo en 232 niñnos. Se establecieron 4 grupos según la región geográfica de origen: grupo 1: Europa del Este (n = 95); grupo 2: Asia (n = 95); grupo 3: América Central y Sudamérica (n = 26), y grupo 4: África (n = 16). Se realizó un estudio oftalmológico completo. RESULTADOS: El 57,8% (134) de los niños presentaron patología oftalmológica. La prevalencia de ametropía se correlacionó significativamente con la región geográfica de origen, siendo estadísticamente superior en el grupo 3 (65,4%) con respecto a la del resto de grupos. El estrabismo y la hipoplasia del nervio óptico fueron más prevalentes en el grupo 1 (el 15,8 y el 3,2%, respectivamente). El periodo institucional preadoptivo fue significativamente mayor en los niños de los grupos 1 y 3 (24,5 y 27,7 meses, respectivamente). CONCLUSIONES: Los niños procedentes de adopción internacional de América Central y Sudamérica son el grupo con mayor prevalencia de ametropía. A pesar de no existir diferencias estadísticamente significativas, los ninos procedentes de Europa del Este presentaron una mayor tendencia a presentar estrabismo e hipoplasia de nervio óptico. Los padres adoptivos, pediatras y oftalmólogos deben conocer la elevada prevalencia de problemas oftalmológicos y velar por un diagnóstico precoz y un tratamiento adecuado

INTRODUCTION: To describe the ophthalmological conditions seen in children adopted internationally by Spanish families, and to assess the influence of the world region of origin and the preadoption period of institutional care on these conditions. MATERIAL AND METHODS: A descriptive, observational, cross-sectional study was conducted on 232 children divided into 4 groups according to world region of origin: Group 1, eastern Europe (n = 95); Group 2, Asia (n = 95); Group 3, Central and South America (n = 26); and Group 4, Africa (n = 16). A complete ophthalmological study was carried out and the groups were compared for the prevalence of ophthalmological conditions. RESULTS: Among the total, 57.8% (134) of children presented ophthalmological abnormalities. The prevalence of ametropia was strongly correlated with the world region of origin, and was significantly higher in Group 3 (65.4%) compared to the remaining groups. Strabismus and optic nerve hypoplasia (15.8% and 3.2%, respectively) were more prevalent in Group 1. The preadoption institutional care period was longer in children in Groups 1 and 3 (24.5 and 27.7 months, respectively). CONCLUSIONS: Children adopted from Central and South America had the highest prevalence of ametropia. Adopted children from eastern Europe showed a weak tendency to present strabismus and optic nerve hypoplasia. Adoptive parents, pediatricians and ophthalmologists should be aware of the high prevalence of ophthalmologic conditions in internationally adopted children and provide the means for a prompt diagnosis and appropriate treatment

[Eye disease in international adoption: Importance of the region of origin]. / Patología ocular en adopción internacional: importancia de la región de origen.

INTRODUCTION: To describe the ophthalmological conditions seen in children adopted internationally by Spanish families, and to assess the influence of the world region of origin and the preadoption period of institutional care on these conditions. MATERIAL AND METHODS: A descriptive, observational, cross-sectional study was conducted on 232 children divided into 4 groups according to world region of origin: Group 1, eastern Europe (n=95); Group 2, Asia (n=95); Group 3, Central and South America (n=26); and Group 4, Africa (n=16). A complete ophthalmological study was carried out and the groups were compared for the prevalence of ophthalmological conditions. RESULTS: Among the total, 57.8% (134) of children presented ophthalmological abnormalities. The prevalence of ametropia was strongly correlated with the world region of origin, and was significantly higher in Group 3 (65.4%) compared to the remaining groups. Strabismus and optic nerve hypoplasia (15.8% and 3.2%, respectively) were more prevalent in Group 1. The preadoption institutional care period was longer in children in Groups 1 and 3 (24.5 and 27.7 months, respectively). CONCLUSIONS: Children adopted from Central and South America had the highest prevalence of ametropia. Adopted children from eastern Europe showed a weak tendency to present strabismus and optic nerve hypoplasia. Adoptive parents, pediatricians and ophthalmologists should be aware of the high prevalence of ophthalmologic conditions in internationally adopted children and provide the means for a prompt diagnosis and appropriate treatment.

[False low oximetry reading caused by patent blue vital dye during breast surgery]. / Falsa desaturación provocada por colorante durante la cirugía de mama.

Patent blue vital (patent blue V; Laboratoire Guerbet, France) is used to identify the sentinel node during surgery for invasive breast cancer. Detecting the sentinel node that first drains the primary tumor reduces the need for total breast and wide axillary node removal, with the problems that such radical surgery involves. Like other dyes, patent blue V can interfere with accurate pulse oximeter reading, leading to underestimation of real values. We report the case of a 31-year-old woman who underwent lumpectomy and removal of the sentinel node. After intradermal injection of patent blue V dye into the left breast (100 mg administered because the sentinel node was difficult to locate) a drop in peripheral oxyhemoglobin saturation from 99% to 93% was detected by the pulse oximeter. When arterial blood gas analysis showed normal values and other causes were ruled out, the diagnosis was false low oximetry reading due to patent blue V dye.

Falsa desaturación provocada por colorante durante la cirugía de mama / False low oximetry reading caused by patent blue vital dye during breast surgery

El Azul Patente V (APV) o Patent Blue Vital (BPV) (Laboratoire Guerbet, Francia) es un colorante utilizado intraoperatoriamente para identificar el ganglio centinela en el carcinoma invasivo de mama. Este es el primer ganglio que drena del tumor primario, por lo que su detección disminuye la necesidad de extirpación total de la mama junto con el vaciamiento ganglionar y los problemas que de ello se derivan. Al igual que otros colorantes, el APV puede interferir en la correcta lectura del pulsioxímetro, infravalorando los valores reales. Exponemos el caso de una mujer de 31 años sometida a tumorectomía y vaciamiento del ganglio centinela. Tras inyección intradérmica de APV (100 mg, administrados debido a la dificultad para localizar el ganglio centinela) en la mama izquierda se detectó un descenso en la saturación periférica de la hemoglobina (SpO2 ) pasando de 99% a 93%. Tras la determinación de gasometrías arte-riales que resultaron ser normales y descartándose otras patologías se realizó el diagnóstico diferencial

Patent blue vital (patent blue V; Laboratoire Guerbet, France) is used to identify the sentinel node during surgery for invasive breast cancer. Detecting the sentinel node that first drains the primary tumor reduces the need for total breast and wide axillary node removal, with the problems that such radical surgery involves. Like other dyes, patent blue V can interfere with accurate pulse oximeter reading, leading to underestimation of real values. We report the case of a 31-year-old woman who underwent lumpectomy and removal of the sentinel node. After intradermal injection of patent blue V dye into the left breast (100 mg administered because the sentinel node was difficult to locate) a drop in peripheral oxyhemoglobin saturation from 99% to 93% was detect-ed by the pulse oximeter. When arterial blood gas analysis showed normal values and other causes were ruled out, the diagnosis was false low oximetry reading due to patent blue V dye