Mortality in neonates with giant omphalocele subjected to a surgical technique in Barranquilla, Colombia from 1994 to 2019.

No studies of the efficacy and safety of surgical techniques for the primary closure of giant omphalocele have been performed in Colombia. To determine the mortality rate and factors associated with mortality in neonates with giant omphalocele subjected to the surgical technique of early closure with a surgical silo described by Abello in Barranquilla, Colombia from 1994 to 2019. Retrospective cohort study of 30 neonates diagnosed with giant omphalocele and subjected to early closure of the defect. Medical history data were collected, information bias was controlled for, and descriptive statistical analysis was performed using Fisher's exact test and the Mann-Whitney U test in SPSS 25.0. Of the patients in the cohort, 36.7% presented technique-related complications, 56.7% developed sepsis, 23.3% had low birth weight, 26.7% were preterm births, 43.3% had other malformations, 26.7% had congenital heart defects, and 13.3% presented pulmonary hypertension. The mean hospital stay was 26 days. The mortality rate was 16.7%; it was significantly higher among patients with other malformations, congenital heart defects, pentalogy of Cantrell and pulmonary hypertension. The Abello technique for the treatment of giant omphalocele showed a high neonatal survival rate and a low rate of procedure-related complications. The main factors associated with the death of neonatal patients were the presence of other malformations, congenital heart defect, pentalogy of Cantrell and pulmonary hypertension.

Metered-dose inhalers versus nebulization for the delivery of albuterol for acute exacerbations of wheezing or asthma in children: A systematic review with meta-analysis.

OBJECTIVES: The benefits of metered-dose inhalers with a spacer (MDI+S) have increasingly been recognized as an alternative method of albuterol administration for treating pediatric asthma exacerbations. The aim of this systematic review was to compare the response to albuterol delivered through nebulization (NEB) with albuterol delivered through MDI+S in pediatric patients with asthma exacerbations. METHODS: We conducted an electronic search in MEDLINE/PubMed, EMBASE, Ovid, and ClinicalTrials. To be included in the review, a study had to a randomized clinical trial comparing albuterol delivered via NEB versus MDI+S; and had to report the rate of hospital admission (primary outcome), or any of the following secondary outcomes: oxygen arterial saturation, heart rate (HR), respiratory rate (RR), the pulmonary index score (PIS), adverse effects, and need for additional treatment. RESULTS: Fifteen studies (n = 2057) met inclusion criteria. No significant differences were found between the two albuterol delivery methods in terms of hospital admission (relative risk, 0.89; 95% confidence interval [CI], 0.55-1.46; I2 = 32%; p = .65). There was a significant reduction in the PIS score (mean difference [MD], -0.63; 95% CI, -0.91 to -0.35; I2 = 0%; p < .00001), and a significantly smaller increase in HR (better; MD -6.47; 95% CI, -11.69 to -1.25; I2 = 0%; p = .02) when albuterol was delivered through MDI+S than when it was delivered through NEB. CONCLUSIONS: This review, an update of a previously-published meta-analysis, showed a significant reduction in the PIS and a significantly smaller increase in HR when albuterol was delivered through MDI+S than when it was delivered through NEB.

Abordaje de un grupo familiar con Displasia Ectodérmica Hipohidrotica a partir de Salud Familiar / Approaching a family with hypohidrotic ectodermic dysplasia from the view of the Family Health

La salud del grupo familiar está sujeta a una complejidad de condiciones socioeconómicas, culturales, ambientales, biológicas, genéticas, psicológicas y relacionales, que configuran los factores condicionantes de la salud. Por lo anterior, la Salud Familiar incide de manera importante en la dinámica poblacional, en el desencadenamiento de la enfermedad, en el cumplimiento de funciones claves en el desarrollo biopsicosocial del ser humano y en las decisiones acerca de la utilización de los servicios de salud. En las familias con enfermedades de origen genético, sus miembros desarrollan temores a morir a una determinada edad. El caso objeto de estudio se presentó en un centro de salud de la ciudad de Barranquilla (Colombia) con una escolar que llegó a control de Crecimiento y Desarrollo, quien fue asignada a un estudiante para su seguimiento. Luego de una evaluación médica multidisciplinaria, fue diagnosticada Displasia Ectodérmica Hipohidrotica.

The Health of a family group is subjected to complex socio-economic, cultural, environmental, biological, genetic, psychological and relational factors, that shape health conditions, as it affects population dynamics in the onset of the disease, in fulfilling key roles in the biopsychosocial development of human beings and in decisions about the use of health services. In families with genetic diseases, their members develop fears to die at a certain age. The situation to be presented has occurred in a health center in the city of Barranquilla (Colombia), a schoolgirl who has arrived in the facilities for monitoring of growth and development is assigned to a student for follow up. She is diagnosed with Hipohidrotic Ectodermal Dysplasia.