Estudio de caso único de un paciente de 12 años diagnosticado con un Trastorno de Atención con Hiperactividad presentación hiperactiva-impulsiva

El trastorno por déficit de atención e hiperactividad (TDAH) es un trastorno del neurodesarrollo muy frecuente en niños y adolescentes. Consiste en una disfunción neurobiológica, de origen cerebral, que afecta a la capacidad del niño, adolescente o adulto para prestar atención, regular su actividad motriz (hiperactividad) y frenar sus comportamientos (impulsividad). Tiene repercusiones conductuales, académicas, psicológicas y sociales muy importantes, y afecta considerablemente la vida tanto del que lo padece como de su familia (Nicolau, Díez, & Soutullo, 2014). Se caracteriza no solo por sus disfunciones cognitivas sino también por la existencia de importantes alteraciones afectivas, tanto motivacionales como emocionales. Según el Manual Diagnóstico DSM-V, (2014), hablar de TDAH supone que el/la niño/a presenta un conjunto de conductas persistentes en cuanto a la desatención, hiperactividad e impulsividad con mayor frecuencia e intensidad de lo que es habitual según la edad y el desarrollo del niño/a. Estas conductas interfieren de forma significativa en el rendimiento escolar, en sus actividades cotidianas, y en la manera de relacionarse con sus pares y su entorno en general

Análisis de los factores humanos que contribuyen a la sobreocupación del servicio de urgencias en un hospital de IV nivel de Bogotá 2022.

En los servicios de Urgencias se ha hecho una constante encontrar un volumen de pacientes que supera la capacidad instalada de los mismos. Esta situación constituye una problemática que, de persistir, trae consigo bastantes riesgos tanto para el paciente como para la institución. Para los pacientes porque implica inoportunidad en re-valoraciones, administración de medicamentos, retraso en programación de estudios, etc; y para la institución ya que la probabilidad de complicaciones, eventos adversos, mal clima laboral, y problemas legales es mayor, así como la fatiga extrema de personas que trabajan en la prestación de servicios humanos, asociado a la pérdida del idealismo y de pasión por el trabajo debido a demanda excesiva de energía fuerza o recursos junto con la disminución de la calidad de la relación médico paciente. Este trabajo de grado, identifica los factores humanos que influyen en la sobreocupación del servicio de Urgencias de un hospital de IV nivel de complejidad de Bogotá, mediante la implementación de la evaluación EDCO y NEDOCS como herramientas gerenciales , contrastando/ analizando? la información recolectada y generando una serie de recomendaciones que sugieren factibilidad para la elaboración y construcción de planes de mejora.EspecializaciónEspecialista en Gerencia de la Salu

Aparece en Colombia... El leasing habitacional

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Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care