CHAOS: síndrome de obstrucción congénita de las vías aéreas superiores / CHAOS: congenital high airway obstruction syndrome

Resumen El síndrome de obstrucción congénita de vías áreas superiores (CHAOS) es una condición que se caracteriza por la existencia de una obstrucción en las vías áreas altas en el feto, la cual puede ser parcial o completa. Comúnmente es una situación incompatible con la vida, por lo que su diagnóstico prenatal es importante considerando el pronóstico y los diferentes manejos prenatales y posnatales que existen. Presentamos un caso de CHAOS diagnosticado en la semana 21, con una breve revisión de la literatura sobre su diagnóstico, pronóstico y alternativas terapéuticas.

Abstract Congenital high airway obstruction syndrome (CHAOS) is a condition characterized by the existence of an obstruction of the fetal upper airways, which may be partial or complete. It is commonly incompatible with life, so its prenatal diagnosis is important due to the prognosis and the recently described pre and postnatal management options. We present a case of CHAOS in a pregnancy of 21 weeks with a brief review of the current literature about its diagnosis, prognosis and therapeutic alternatives.

Evaluation of the fate of carcasses and dummies deployed in the nearshore and offshore waters of the northern Gulf of Mexico.

In response to the Deepwater Horizon oil spill, federal and state agencies conducted field studies to develop inputs for a shoreline deposition model used to estimate nearshore avian mortality resulting from the spill. A 2011 carcass drift study was designed to generate data on the likelihood that birds that died on the water would deposit along the northern Gulf of Mexico coast (rather than becoming lost at sea). In the case of the Deepwater Horizon oil spill, carcass losses at sea accounted for a significant portion of nearshore avian mortality. We evaluate the data collected during the Deepwater Horizon carcass drift study and compare the results obtained from the use of avian carcasses versus dummy carcasses (dummies) and the differences between those deployed nearshore versus further offshore. We conclude that, although the use of dummies provided valuable confirmation on the drift patterns of dead birds, dummies drifted greater distances, for longer periods of time, and were more likely to be observed beached compared to avian carcasses, with 64.6% of dummies beaching compared to 17.2% of carcasses. In response to future spills, researchers should account for these potential biases when incorporating dummy drift data into estimates of avian carcass loss. Further, none of the avian carcasses and dummies released more than 40 km from the shoreline made it to shore. In the northern Gulf of Mexico, carcasses that die on the waters farther offshore are unlikely to make it to shore to be captured in a deposition model; therefore, it may be appropriate to utilize a separate methodology to estimate offshore mortality. The applicability of these results to other spill events should be evaluated in the context of the specific spill characteristics.