Prevalence of congenital malformations at birth in chilean maternity hospitals

Los objetivos de este trabajo son dar a conocer el estado actual de la prevalencia al nacimiento de las malformaciones congénitas más relevantes en los hospitales chilenos participantes en el ECLAMC en el período 2001-2010 y comparar las tasas de prevalencia al nacimiento con las de períodos anteriores ya publicados:1982-1988, 1989-1994,1995-1999

Identification of risk factors for congenital malformations

El objetivo de este estudio es identificar factores de riesgo de malformaciones congénitas (MFC) y comparar el riesgo de ocurrencia de MFC según gravedad, dados estos factores

Vigilancia epidemiológica del síndrome de Down en Chile, 1972 a 2005

International audienceRoutledge, 2014, 422

Restricción del crecimiento intrauterino como factor de riesgo para malformaciones congénitas

Indexación: ScieloAntecedentes: La restricción del crecimiento intrauterino (RCIU) se estima que está presente en el 5% de los nacimientos y es la manifestación de procesos aberrantes que impiden el desarrollo normal del feto. Objetivos: Estimar la frecuencia de esta patología en la maternidad del Hospital Clínico de la Universidad de Chile. Obtener la tasa prevalencia al nacimiento de malformaciones congénitas (MFC) y comparar la frecuencia en recién nacidos pequeños (PEG) con los adecuados (AEG) y grandes (GEG) para la edad gestacional. Método: Se estudian todos los nacimientos, vivos y mortinatos, ocurridos entre enero de 1997 a diciembre de 2008, contenidos en la base de datos del ECLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas) desde 1969 a la fecha. Se excluyen los recién nacidos con malformaciones como hidrocefalia, anencefalia e hidrops, que por sus características dificultan la posibilidad de clasificación en PEG, AEG o GEG. Resultados: 10,1% de los nacimientos del período eran PEG. Entre los nacidos vivos 10% fueron PEG, mientras que 33,5% de los mortinatos eran PEG (p<0,05). Eran malformados el 12,9% de los PEG, 8,5% de los AEG y 9,3% de los GEG (p<0,05). La tasa global de malformaciones fue de 9,5%; en NV el 9,4% y en mortinatos el 33%. Conclusión: El RCIU es un factor que aumenta el riesgo de mortalidad fetal tardía y de presentar malformaciones congénitas.Background: Fetal growth restriction (FGR) is the result of anomalies that prevent the normal development of the fetus, it is present in about the 5% of births. Objectives: To estímate the frequency of FGR in the Clini-cal Hospital of the University of Chile. To estímate the congenital malformation prevalence rate at birth and compare it among small (SGE), adequate (AGE) and large (LGE) newborns according their gestational age. Methods: All live births and stillbirths included in the ECLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas) registered from January 1997 and December 2008 were considered. Newborns with congenital malformations that modified per se the size of the child, like hydrocephaly anencephaly and hydrops were excluded. Results: 10.1% of newborns were SGE. Among live births 10% were SGE instead of the 33.5% found in stillbirths (p<0.05). Congenital malformation rate at birth was 12.9% in SGE, 8.5% in AGE and 9.3% in LGE newborns (p<0.05). The global congenital malformation prevalence rate at birth was 9.5%; 9.4% in live newborns and 33% in stillbirth. Conclusión: The FGR increase the risk of late fetal mortality and congenital anomalies.http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-75262009000600008&nrm=is

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Prevención primaria de los defectos congénitos

Chile has experienced advances in the primary prevention of congenital defects. This article review separately the pre-conception and pre-natal prevention. The first avoids the production of a defective embryo and the latter avoids the effects of external agents, such as environmental teratogens, over a normaly conceived embryo. The preventive measures include education about the use of medications, lifestyles, alcohol and drug use and prenatal control of pregnant women. Special mention deserves nation wide programs held by the ministry of Health such as mandatory rubella vaccination, flour folic acid fortification and metabolic screening of phenylketonuria and congenital hypothyroidism. The role of the main chemical, physical and infectious teratogens is reviewed. A Decalogue of recommendations for primary prevention, elaborated by the Latin American Collaborative Study for Congenital Defects, is included (Rev Méd Chile 2004; 132: 501-8