Dr Sola has disclosed that he is the Vice President of Medical Affairs with Masimo Corporation. Drs Fariña and Mir have disclosed no financial relationships relevant to the article. Dr Golombek has disclosed that he is on the speakers' bureau with Mallinckrodt and a consultant with Prolacta. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. El Dr Sola es VP de Medical Affairs de Masimo Corporation. Los Dres. Fariña y Mir declaran ausencia de conflicto de interés. El Dr Golombek pertenece al Speakers' Bureau de Mallinckrodt, y es Consultor de Prolacta. Este artículo no contiene una discusión sobre el uso no aprobado / investigativo de un producto / dispositivo comercial. En este Consenso participaron 48 profesionales de 12 países de Latinoamérica y España. La coordinación y revisión estuvo a cargo de los investigadores principales Dres. Fariña, Mir y Sola quienes han condensado todo el material trabajado. Los participantes del Consenso por orden alfabético fueron:
Suspected neonatal sepsis is one of the most common diagnoses made in newborns (NBs), but very few NBs actually have sepsis. There is no international consensus to clearly define suspected neonatal sepsis, but each time that this suspected diagnosis is assumed, blood samples are taken, venous accesses are used to administer antibiotics, and the mother-child pair is separated, with prolonged hospital stays. X-rays, urine samples, and a lumbar puncture are sometimes taken. This is of concern, as generally <10% and no more than 25%-30% of the NBs in whom sepsis is suspected have proven neonatal sepsis. It seems easy to start antibiotics with suspicion of sepsis, but stopping them is difficult, although there is little or no support to maintain them. Unfortunately, the abuse of antibiotics in inpatient and outpatient NBs is foolish. Its negative impact on neonatal health and the economy is a public health problem of epidemiological and even epidemic proportions. This manuscript is a shortened version of the 10 th Clinical Consensus of the Ibero-American Society of Neonatology (SIBEN) on suspected neonatal sepsis at the end of 2018, updated with publications from its completion to February 2020. This manuscript describes useful strategies for everyday neonatal practice when neonatal sepsis is suspected, along with important aspects about the indisputable value of clinical evaluation of the NB and about obtaining and interpreting blood cultures, urine cultures, and other cultures. Likewise, the low value of laboratory tests in suspected neonatal sepsis is demonstrated with evidence and clinical recommendations are made on the appropriate use of antibiotics. EDITOR'S NOTEIn 2003, a group of physicians in Latin America observed that there was a discrepancy between neonatal delivery of care and outcomes in the Latin American region compared with other areas of the world. They formed SIBEN, the Ibero-AUTHOR DISCLOSURE Dr Golombek has been a speaker for Mallinkrodt and has a grant from Chiesi. Dr Sola receives funding from Masimo. Drs Mir, Lemus, Fariña, and Ortiz have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
RESUMEN El complejo de esclerosis tuberosa es una afección genética, aproximadamente dos tercios de los casos ocurren esporádicamente; se caracteriza por lesiones y tumores benignos (hamartomas) en múltiples sistemas orgánicos. La detección prenatal precisa es importante para el pronóstico, una decisión sobre el resultado del embarazo y el asesoramiento. Se reporta el caso de una gestante sana y su feto con diagnóstico presuntivo de esclerosis tuberosa, por hallazgo de masas intracardiacas en ecografía prenatal, confirmados luego del nacimiento, con afectación de otros órganos, cumpliendo con criterios mayores de diagnóstico. El caso presentado es el primero registrado en el Departamento de Neonatología y tiene el objetivo de mostrar la aproximación diagnóstica prenatal y postnatal de una enfermedad relativamente rara. Correspondencia: Patricia Desvars, Correo: patydesro@hotmail.com Conflicto de interés: Los autores declaran no poseer conflicto de interés. Recibido: 17/09/2020 Aceptado:30/09/2020
en el límite (4). El 57%> (29/51) nuligesta, 20%> primigesta, nacieron por cesárea el 52%> de los RN. Peso de nacimiento promedio 3189g. DS ± 593, edad gestacional promedio 38 semanas DS ± 2, 41%> fueron RN casi de término y limítrofe (35-37 sem.). 63%> masculinos, el 100%> presentaron Apgar de 8/9. Edad media al alta 3 días ± 1, el 100%> con lactancia materna exclusiva, días de vida al reingreso 9.3 ± 4. Los diagnósticos principales fueron: hiperbilirrubinemia 59%>, de los cuales el 90%> fue sin incompatibilidad y sin hemolisis, el 99%o requirió sólo luminoterapia y un paciente exanguinotrasfusión. El 18%> reingresó por mala técnica alimentaría, el 16%> (8) con diagnóstico de malformaciones congénitas mayores, dos pacientes fallecieron, constituyendo el 3.9%> del total. Conclusiones: Las causas de readmisión hospitalaria en este grupo de RN fueron hiperbilirrubinemia y mala técnica alimentaría; la gravedad de la readmisión se asoció a diagnóstico de infecciones y malformaciones congénitas.]]>
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