Survey about the current use of fetal MRI in Spain.

In June 2019 in Seville, at the first course in fetal MRI, endorsed by the Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Pediatric Radiology (SERPE), the Spanish fetal MRI group was founded. To establish this group, a questionnaire was designed for radiologists dedicated to prenatal imaging in Spain and disseminated to the SERAM's members. The questions were related to the type of hospital, to MRI studies (magnetic field, gestational age, use of sedation, number of studies per year, proportion of fetal neuroimaging studies), and to teaching and research about fetal MRI. A total of 41 responses were received from radiologists in 25 provinces (88% working in public hospitals). Very few radiologists in Spain perform prenatal ultrasonography (7%) or prenatal CT. MRI is done in the second trimester (34%) or in the third trimester (44%). In 95% of centers, fetal brain MRI studies predominate. In 41% of the centers, studies can be done on 3 T MRI scanners. Maternal sedation is used in 17% of centers. The number of fetal MRI studies per year varies widely, being much higher in Barcelona and Madrid than in the rest of Spain.

Encuesta sobre la situación actual de la resonancia magnética fetal en España / Survey about the current use of fetal MRI in Spain

En junio de 2019 se organizó en Sevilla el primer curso de resonancia magnética (RM) fetal, con el aval de las sociedades españolas de Radiología Médica (SERAM) y Radiología Pediátrica (SERPE), y se fundó el grupo español de RM fetal. Para establecer este grupo, se diseñó un cuestionario para radiólogos que se dediquen a la imagen prenatal en España que anunció la Sociedad Española de Radiología a sus socios. Las preguntas estaban relacionadas con el tipo de hospital, con los estudios de RM (campo magnético, edad gestacional, uso de sedación, número de estudios por año, proporción de estudios de neuroimagen fetal) y con la docencia e investigación de la RM fetal. Recogimos 41 respuestas de 25 provincias (88% hospitales públicos). Muy pocos radiólogos realizan ecografía (7%) o tomografía computarizada prenatal en España. La RM se realiza en el segundo trimestre (34%) o tercer trimestre (44%). En el 95% de los centros predominan los estudios del cerebro fetal. El 41% de los centros tienen la posibilidad de realizar sus estudios en RM 3 Tesla. La sedación materna se usa en el 17% de los centros. El número de estudios de RM fetal por año es muy variable, siendo mucho mayor en Barcelona y Madrid que en el resto de España.(AU)

In June 2019 in Seville, at the first course in fetal MRI, endorsed by the Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Pediatric Radiology (SERPE), the Spanish fetal MRI group was founded. To establish this group, a questionnaire was designed for radiologists dedicated to prenatal imaging in Spain and disseminated to the SERAM's members. The questions were related to the type of hospital, to MRI studies (magnetic field, gestational age, use of sedation, number of studies per year, proportion of fetal neuroimaging studies), and to teaching and research about fetal MRI. A total of 41 responses were received from radiologists in 25 provinces (88% working in public hospitals). Very few radiologists in Spain perform prenatal ultrasonography (7%) or prenatal CT. MRI is done in the second trimester (34%) or in the third trimester (44%). In 95% of centers, fetal brain MRI studies predominate. In 41% of the centers, studies can be done on 3 T MRI scanners. Maternal sedation is used in 17% of centers. The number of fetal MRI studies per year varies widely, being much higher in Barcelona and Madrid than in the rest of Spain.(AU)

Survey about the current use of fetal MRI in Spain. / Encuesta sobre la situación actual de la resonancia magnética fetal en España.

In June 2019 in Seville, at the first course in fetal MRI, endorsed by the Spanish Society of Medical Radiology (SERAM) and the Spanish Society of Pediatric Radiology (SERPE), the Spanish fetal MRI group was founded. To establish this group, a questionnaire was designed for radiologists dedicated to prenatal imaging in Spain and disseminated to the SERAM's members. The questions were related to the type of hospital, to MRI studies (magnetic field, gestational age, use of sedation, number of studies per year, proportion of fetal neuroimaging studies), and to teaching and research about fetal MRI. A total of 41 responses were received from radiologists in 25 provinces (88% working in public hospitals). Very few radiologists in Spain perform prenatal ultrasonography (7%) or prenatal CT. MRI is done in the second trimester (34%) or in the third trimester (44%). In 95% of centers, fetal brain MRI studies predominate. In 41% of the centers, studies can be done on 3 T MRI scanners. Maternal sedation is used in 17% of centers. The number of fetal MRI studies per year varies widely, being much higher in Barcelona and Madrid than in the rest of Spain.

Corrección intrauterina de mielomeningocele: experiencia del programa de medicina y terapia fetal del Hospital Universitario Virgen del Rocío / Intrauterine myelomeningocele repair: Experience of the fetal medicine and therapy program of the Virgen de Rocío University Hospital

La forma más frecuente de espina bífida es el mielomeningocele, para el que no existe un tratamiento postnatal óptimo. Además del trastorno motor o sensitivo dependiente del nivel de la lesión, los niños suelen tener asociada la malformación de Arnold Chiari ii. El mielomeningocele presenta una alta mortalidad y puede acompañarse, hasta en el 80-90%, de hidrocefalia que es responsable de la gran afectación neurocognitiva, precisando de derivación para su supervivencia. La reparación intrauterina de malformaciones fetales mediante acceso abierto a través de histerotomía se ha convertido en una opción terapéutica gracias a la mejora de las técnicas quirúrgicas y anestésicas, y de la correspondiente instrumentación, que han convertido este tipo de intervenciones en una práctica relativamente frecuente. El tratamiento anestésico debe orientarse tanto a la madre como al feto, siendo importante mantener controlados los factores hemodinámicos que regulan el flujo placentario, la dinámica uterina, las pérdidas sanguíneas y el bienestar fetal. Dentro de nuestro Programa de Medicina y Terapia Fetal se han realizado 21 procedimientos de cirugía fetal abierta, 17 procedimientos EXIT y 4 procedimientos para la corrección intrauterina de mielomeningocele fetal. Describimos nuestra experiencia en la corrección intrauterina de mielomeningocele fetal mediante cirugía fetal abierta (AU)

The most frequent form of spina bifida is myelomeningocele. There is no optimal postnatal treatment for this defect. In addition to the motor or sensory deficits, which depend on the location of the lesion, the defect is usually associated with Chiari ii malformation in affected children. Myelomeningocele has high mortality and, in up to 80% to 90% of patients, can be accompanied by hydrocephalus, which causes severe neurocognitive impairment and requires the patient to be shunted for survival. Intrauterine repair of fetal malformations employing open access through hysterotomy has become a therapeutic option due to improved anesthetic and surgical techniques and instrumentation, which have allowed this type of intervention to become relatively frequent. Anesthetic treatment should focus on both the mother and fetus and the hemodynamic factors regulating placental flow, uterine dynamics, blood loss and fetal well-being must remain well-controlled. Within our Program for Fetal Medicine and Therapy, 21 open fetal interventions have been performed: 17 EXIT procedures and 4 procedures for the intrauterine correction of fetal myelomeningocele. We describe our experience of the intrauterine repair of fetal myelomeningocele through open fetal surgery (AU)

[Intrauterine myelomeningocele repair: experience of the fetal medicine and therapy program of the Virgen de Rocío University Hospital]. / Corrección intrauterina de mielomeningocele: experiencia del programa de medicina y terapia fetal del Hospital Universitario Virgen del Rocío.

The most frequent form of spina bifida is myelomeningocele. There is no optimal postnatal treatment for this defect. In addition to the motor or sensory deficits, which depend on the location of the lesion, the defect is usually associated with Chiari ii malformation in affected children. Myelomeningocele has high mortality and, in up to 80% to 90% of patients, can be accompanied by hydrocephalus, which causes severe neurocognitive impairment and requires the patient to be shunted for survival. Intrauterine repair of fetal malformations employing open access through hysterotomy has become a therapeutic option due to improved anesthetic and surgical techniques and instrumentation, which have allowed this type of intervention to become relatively frequent. Anesthetic treatment should focus on both the mother and fetus and the hemodynamic factors regulating placental flow, uterine dynamics, blood loss and fetal well-being must remain well-controlled. Within our Program for Fetal Medicine and Therapy, 21 open fetal interventions have been performed: 17 EXIT procedures and 4 procedures for the intrauterine correction of fetal myelomeningocele. We describe our experience of the intrauterine repair of fetal myelomeningocele through open fetal surgery.

Food habits and nutritional status of elderly people living in a Spanish Mditerranean city / Hábitos alimentarios y estado nutricional de ancianos que viven en una ciudad española del Mediterráneo

Aims: The aim of this study was to assess the food habits and nutritional status of free-living, non-institutionalised, elderly people of Torrevieja, a Spanish city located in the Mediterranean coast. Methods: Anthropometric and dietary survey (two 24 hour recalls) were assessed in 200 (83 men and 117 women) free-living elderly people (average age 72.3 ± 6.6 years). Results: Just married women accomplished the recommended energy intake. The contribution of macronutrients to the total energy intake was different from the Recommended Intake for the elderly, since it was too derived from proteins, fats, SFA and sugars, but in only small amounts was derived from complex carbohydrates. High percentages of elderly persons showed inadequate intake of calcium, zinc, magnesium, potassium, copper, iodine, folic acid, vitamin A, vitamin D, vitamin E, and riboflavin. Men showed lower micronutrient intake than women. Conclusions: An increase in dietary complex carbohydrate, and a decrease in protein and fats, especially SFA, is recommended. It would be desirable to increase the consumption of fruits, vegetables, whole cereals, fish and skimmed dairy products (AU)

Objetivo: El objetivo de este estudio fue valorar los hábitos alimentarios y el estado nutricional de un grupo de ancianos de Torrevieja que viven de forma no institucionalizada. Métodos: Las medidas antropométricas y el análisis de la dieta (2 cuestionarios de recuerdo de 24 horas) se utilizaron en 200 personas (83 hombres y 117 mujeres) ancianos que viven independientes (media de edad 72,3 ± 6,6 años). Resultados: Las mujeres casadas cumplían con las recomendaciones diarias de ingesta de energía. La contribución de los macronutrientes a la ingesta energética total fue diferente de las ingestas recomendadas a los ancianos, debido al exceso de ingesta de proteínas, grasas, AGS, y azúcares simples, sin embargo solo una pequeña cantidad derivaba de carbohidratos complejos. Un alto porcentaje de ancianos mostraron ingesta inadecuada de calcio, zinc, magnesio, potasio, cobre, iodo, ácido fólico, vitamina A, vitamina D, vitamina E y riboflavina. Los hombres mostraron menor ingesta de micronutrientes que las mujeres. Conclusión: Un incremento de carbohidratos complejos y una disminución en la ingesta de proteínas y grasas, sobretodo saturadas es lo que se recomienda. Sería interesante incrementar el consumo de vegetales, frutas, cereales integrales, pescado y productos lácteos desnatados. Además de suplementar la dieta, especialmente con calcio, vitamina E y ocasionalmente vitamina D, podría ser útil para mejorar el estado de salud y el estado nutricional de los ancianos que viven en Torrevieja(AU)

[Pathogenesis of severe vision deficiency in school-age children in Hungary]. / Az iskoláskorú súlyos látási fogyatékos gyermekek kóreredete Magyarországon.

A population-based aetiological study was carried out on 6 to 14 year-old severely visually handicapped children in Hungary. Of the 547 recorded cases 491 (90%) were included in the analysis. Eleven aetiological groups were separated: isolated cataracts (16.7%), congenital abnormalities of the eye (15.1%), high myopia +/- retinal detachment and other cases (13.4%), retinopathia praematurorum (11.0%), choroidoretinal degenerations (10.0%), syndromes (9.6%), nystagmus and/or hypermetropia (9.0%), isolated and complicated optic atrophy (6.7%), postnatal causes (4.9%), retinoblastoma (1.8%), praenatal causes (1.8%). A significantly higher rate of previous induced abortions was found in the group of retinopathia praematurorum. Perinatal damage syndrome and Mendelian monogenic defects are the two most common aetiological categories in the origin of severe visual handicaps in Hungary.

[Congenital monomorph adenoma of the parotid gland (author's transl)]. / Adenoma monomorfo congénito de parótida.

Congenital monomorph tubular adenoma is a very infrequent tumor. Usually diagnosis is an operative finding. Together with its' infrequency, rapid rate of growth, differential diagnosis with other vascular tumors, specially cystic lymphangioma, and its surgical excision avoiding lesion of the facial nerve, account for this publication.