Neonatal Screening for Congenital Hypothyroidism in Nicaragua: Audit of a Cord-blood Thyrotropin-based Program (2005-2015)

J. Inborn Errors Metab. Screen.
Vol. 7, Porto Alegre 2019. Epub Aug 29, 2019
Aura Fúnez, María Eugenia Lara, Ana Cecilia Chévez, Efrén Alí Castellón, Salvador Perán, María Josefa Toro, Eladio Montoya, José Carlos Moreno.

Abstract The aim of this study is to evaluate the Nicaraguan screening program for congenital hypothyroidism in terms of coverage and effectiveness of detection and confirmation of cases with the condition throughout a decade. Thyrotropin was quantified in cord-blood samples by a validated ELISA and a cut-off of 20 mU/l was applied. Coverage, positive predictive value, recall rate and prevalence were retrospectively analysed. Babies with positive screening results were contacted for confirmation by means of determination of thyrotropin and thyroid profile in serum samples. 272,338 babies were screened during the period 2005-2015. The mean coverage reached by the program in the participating departments was 71%, with a positive predictive value of 83% and a recall rate of 0.055%. Eighty cases of congenital hypothyroidism were identified, representing an incidence of 1 in 3229 live births, most of them (81%) being severe. The performance of the Nicaraguan screening program is comparable to those in Latin America also using cord-blood samples. The incidence of congenital hypothyroidism is within the low range of other countries worldwide. Strategies are needed to expand the program to the whole country, improve recall rates and achieve earlier treatment of babies, with the condition. 

Keywords Congenital hypothyroidism, newborn, screening, cord-blood, TSH, Nicaragua. 

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http://www.scielo.br/pdf/jiems/v7/2326-4594-jiems-7-e20190003.pdf

NUEVA JUNTA DIRECTIVA SONIPED - PERÍODO 2019-2021

Dra. Lissette Castillo Úbeda, Presidenta

Dra. María Isabel Barrantes, Vice-Presidenta

Dra. Maribel Palacios Sequeira, Secretaria

Dra. Guiselle Urbina Palacios, Tesorera

Dra. Mabel Sandoval Díaz, I Vocal

Dra. Marisol Espinoza Hernández, II Vocal

Dra. María Alejandra Montealegre, III Vocal

Consenso sobre el traslado de niños críticamente enfermos 
(Consensus on transport of critically ill children)

Comité Nacional de Emergencias y Cuidados Críticos 
Arch Argent Pediatr 2019;117 Supl 1:S1-S23 / S1

RESUMEN 
El mayor desarrollo y la creación de nuevas unidades de terapia intensiva pediátrica en los últimos años obligan a revisar la estructuración adecuada de los cuidados correspondientes entre la reanimación inicial del paciente grave y la atención por especialistas en ámbitos de alta complejidad. El proceso de transporte debe ofrecer al paciente grave un estándar de cuidado similar al que se le ofrece en dicha Unidad. Este se logra con un equipo entrenado en el transporte pediátrico y con capacidad de proveer cuidados críticos. La decisión de transportar a un paciente dentro del mismo hospital o a otra institución se basa en la evaluación de los potenciales beneficios sopesados contra potenciales riesgos, ya que existe un incremento de la morbilidad y la mortalidad durante el transporte. Las recomendaciones que se presentan en este documento tienen el objetivo de intentar mejorar el traslado de pacientes críticos en nuestro país. Palabras clave: transportes, pediatría, cuidados críticos, transferencia de pacientes. 

ABSTRACT 
The greater development and creation of new Pediatric Intensive Care Units in recent years requires us to review the appropriate structure of the corresponding care between the initial resuscitation of the critical pediatric patient and care by specialists in highly complex areas. The transportation process must offer the critical pediatric patient a standard of care similar to that offered in said Unit. This standard is achieved with a team trained in pediatric transport and with the capacity to provide critical care. The decision to transport a patient within the same hospital or to another institution is based on the evaluation of the potential benefits weighed against potential risks, since there is an increase in morbidity and mortality during transport. The recommendations presented in this document are intended to try to improve the transfer of critical patients in our country. Key words: transportation, pediatric, critical care, patient transfer.

https://www.sap.org.ar/uploads/archivos/general/files_supl_emergencias_21-12-18pdf_1544216780.pdf