Debut pediátrico de fascitis necrotizante / Necrotizing fasciitis pediatric debut

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Síndrome hemofagocítico por Leishmania en paciente con síndrome poliglandular / Hemofagoctic sindrome by Leishmania in patient with poliglandular sindrome

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Assessment of a change of protocol of prenatal screening by inclusion of non-invasive prenatal diagnosis.

Objectives: Non-invasive prenatal screening (NIPS) is a test for the detection of major fetal chromosomal abnormalities in maternal blood during pregnancy. The purpose of this study was to assess the performance of NIPS implemented within the framework of the Screening Program for Congenital Abnormalities of the Andalusian Health System. Methods: A retrospective observational study was undertaken to determine the number of NIPS tests performed since its introduction. The number of invasive diagnostic tests done after the implementation of NIPS in the patients included in the program between March 2016 and August 2017 was also quantified. Results: A total of 6,258 combined first- and second trimester screening tests were performed, covering 95% of the population. In total, 250 subjects were identified as high risk, of whom 200 underwent NIPS after loss to follow-up. NIPS showed a sensitivity of 100% (95% CI: 76.84-100%) and a specificity of 99.46% (95% CI: 97.04-99.99%). Conclusions: This test has proven to have a very high sensitivity and specificity. The results obtained demonstrate that the incorporation of NIPS in clinical practice minimizes the rate of miscarriages and reduces the frequency of invasive procedures by 70%.

Elevación persistente de troponina en un paciente sin evidencia de cardiopatía isquémica / Persistent increase in troponin levels in a patient without evidence of ischaemic heart disease

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