Necesidades y objetivos de los pediatras del País Vasco/Euskadi (España) / Needs and objectives of the paediatricians in the Basque Country

Objetivos: conocer la situación laboral, la carga de trabajo y las propuestas de mejora para los pediatras de la Comunidad Autónoma del País Vasco/Euskadi. Material y métodos: encuesta enviada por correo electrónico a todos los pediatras de Atención Primaria (PAP) del País Vasco/Euskadi (N=255). La encuesta contenía preguntas sobre el perfil socioprofesional y las expectativas de futuro. Resultados: han respondido a la encuesta 192 pediatras, el 75% de los encuestados. El 68% son mujeres; el 70%, mayores de 45 años, y un 30%, mayores de 55 años. El 20% tiene menos de 800 tarjetas individuales sanitarias (TIS), y el 25%, más de 1000. La mayoría (55%) tiene que compartir personal de Enfermería con otro pediatra. El 30% se siente quemado y, a pesar de ello, el 70% no cambiaría su puesto de trabajo de PAP. Hay una demanda de formación continuada y de menor burocratización de las consultas. Conclusiones: feminización del colectivo de PAP. El número de TIS excede el pactado con el Servicio de Salud Osakidetza (800 TIS/pediatra). El apoyo de Enfermería es insuficiente. La edad es elevada y los problemas detectados se acrecentarán en los próximos años. Hay un elevado porcentaje de pediatras quemados. La Administración debería facilitar la formación continuada de los profesionales(AU)

Objectives: to assess the social and working conditions and the needs of primary care paediatricians in the Autonomous Community of the Basque Country. Material and methods: a survey was carried out to the primary care paediatricians in February 2010. The questionnaire was sent to 255 paediatricians. It included questions about their social and working profile and future expectations. Results: the total number of answers was 192 (75%). There was a majority of women (68%) and aged more of 45 years (70%). The number of patients assigned to each paediatrician is more than 1000 (25%) and only 20% have less than 800 patients. Most paediatricians (55%) must share the nurse with another paediatrician. Thirty percent of paediatricians suffer burnout but 70% would not change his work in Primary Care. There is a great demand of continuous training and less bureaucratization. Conclusions: feminization is growing in Paediatric Primary Care. The number of patients assigned to each paediatrician is higher than agreed (800 patients) with the Sanitary Administration. The help of nursery is insufficient. The age of paediatricians is high and the detected problems will grow on in the next years. There is a high percentage of burnout paediatricians. The Sanitary Administration should provide continuous training for the paediatricians who work in Primary Care(AU)

[Left coronary artery-right ventricle fistula secondary to heart surgery. Non-invasive diagnosis with Doppler-color bidimensional echocardiography]. / Fístula de arteria coronaria izquierda-ventrículo derecho secundaria a intervención quirúrgica cardíaca. Diagnóstico no invasivo con ecocardiografía bidimensional-Doppler color.

A case of 20 year-old man with a left coronary artery fistula to right ventricle secondary to open heart surgery is reported; he was asymptomatic and a continuous precordial murmur was found on physical examination. Two dimensional echocardiography-Doppler color flow imaging visualized a dilated left coronary artery with flow into the right ventricle. The discovery was confirmed by coronary angiography. We conclude that two dimensional echocardiography Doppler color flow imaging may be a method included in evaluation of pediatric patients with coronary artery fistula suspicion.

[Aneurysm of the atrial septum associated with interatrial communication: a study of 12 cases by 2-dimensional color echocardiography]. / Aneurisma del septo auricular asociado a comunicación interauricular. Estudio de 12 casos con ecocardiografía bidimensional-color.

Between 1983-1991 we have studied 5,221 two-dimensional echocardiography in patients suffering cardiopathies. Twelve (0.22%) had an aneurysm of the atrial septum associated with atrial septal defect. Eight patients had other cardiac anomalies. The criteria used to diagnosis the aneurysm were: 1) The atrial septum central part protrudes in the atrium. 2) 6 mm aneurysm base. 3) Minimum distance from the base to the protrusion top 6 mm. The aneurysm was located in the oval fossa in 6 patients (50%) and in the other 6 patients the aneurysm was situated in the ostium secundum. The aneurysm base measured 7.79 +/- 1 mm and the left or right septum displacement was of 7.37 +/- 1.82 mm. The left displacement was observed in 10 patients (83.3%) and the right in 2 patients (16.6%). The spontaneous closure of atrial septal defect by the aneurysm was showed in 2 (16.6%) patients and in one (8%) was necessary the surgical closure. The other 9 patients: five rested along the follow-up without any change and other 4 patients died because of cardiac malformation. To conclude the atrial septal aneurysm associated with atrial septal defect in an unusual cardiopathy. Two dimensional echocardiography and Doppler color was diagnostic in all infants.

[Aortic atresia with situs inversus]. / Atresia aórtica con situs inversus.

We report a case of mitro-aortic atresia with situs inversus. The patient was studied with two-dimensional echocardiography and the diagnosis was confirmed in the necropsy. Our newborn infant is the second case reported with this abnormality and the first in our country.