Programa de estimulación temprana Síndrome X Frágil

La Estimulación Temprana es el conjunto de técnicas utilizadas para potenciar al máximo el desarrollo y las habilidades de socialización, lenguaje, autoayuda, cognitivas y psicomotrices. Este trabajo tiene como objetivo la planificación y posterior ejecución de un programa de Estimulación Temprana, dirigido en este caso concreto a un niño de 4 años y 4 meses diagnosticado con el Síndrome X Frágil. Tras el estudio de la patología y el establecimiento de la línea base de intervención, se decide intervenir en el área de socialización de usuario. Para ello, se han establecido diversas actividades centradas en potenciar las conductas de interacción social del niño, como el saludo y la despedida, la sonrisa social, las conductas de aproximación y el lenguaje. Los resultados obtenidos muestran una buena progresión con respecto a los objetivos planteado inicialmente, sin embargo, será necesaria la planificación de un nuevo programa de intervención puesto que no se han logrado en su totalidad los objetivos propuestos.Early Stimulation is a group of techniques used to improve the development and the abilities of socialization, language, self-help, cognitive and psychomotor. The objective of this project is the planning and subsequent execution of an early stimulation program, directed to a four years old boy with a diagnosis of fragile X syndrome. After studying the pathology and establishing the baseline intervention, it is decided to intervene in the socialization area. To do this, several activities are established focused on improve and promote interaction behavior, such as greeting, farewell, social smile, approach behavior and language. The results show an improvement in relation to the objectives. However, it will be necessary the planning of a new intervention program, in order to achieve the objectives totally

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research