ABSTRACT
Pneumonia is an inflammatory disease, generally of infectious character that affects the units of gaseous exchange, and produces various degrees of alteration in the diffusion and alveolar ventilation that may set in risk the patients life. The term of community acquiredpneumonia (CAP) is given to the infection of the pulmonary parenchyma that occurs in children who have not been hospitalized in the last week or that appears 48 hours after hospitalization, accompanied or not by symptoms and/or respiratory signs of less than 15 days of evolution. All patients with some type of serious immunodeficiency or patients with chronic pathology, as well as those patients with pulmonary tuberculosis and neonatal pneumonia should be excluded from this group.
La neumonía es una enfermedad inflamatoria, generalmente de carácter infeccioso, que afecta las unidades de intercambio gaseoso y que llega a producir diversos grados de alteración en la difusión y/ o ventilación alveolar, pudiendo llegar a poner en peligro la vida del paciente. El término de neumonía adquirida en la comunidad (NAC) se le da a la infección del parénquima pulmonar que ocurre en niños que no han estado hospitalizados en la última semana o que aparece después de 48 horas del egreso hospitalario, que se acompaña o no de síntomas y/o signos respiratorios de menos de 15 días de evolución. Se excluye de este grupo a todo paciente con algún tipo de inmunodeficiencia o patología crónica graves que predispongan a ser vulnerables a la enfermedad al igual que pacientes con tuberculosospulmonar y neumonía neonatal.
Subject(s)
Child , Infections , Pneumonia , Lung , Risk Factors , Respiratory TherapyABSTRACT
Simulation is a technique used for formal medical education for more than 40 years. Itsapplication has allowed a better training of medical and nursing students, as well asspecialists in different clinical and surgical residences and the improvement of invasiveand surgical techniques. In addition, by using simulation labs it has been possible to havea more objective education, given the fact that sometimes the access of the student to thepatient is limited by ethical, social, administrative or legal parameters. Finally simulationtogether with the critical reasoning and education based on the resolution of problems hasallowed improving and understanding the deep meaning of the competitions. As a technique,simulation offers an objective and a control way to understand the real importance of trialand error as an important pillar for the improvement of skills; besides it represents a methodthat allows a quality control over education and surgical techniques.
Subject(s)
Humans , Aptitude , Clinical Competence , Simulation Exercise , Patient Care , Quality Control , Education, MedicalABSTRACT
El tumor de Wilms o nefroblastoma representa el 6 por ciento de los cánceres infantiles y se considera laformación abdominal y renal maligna más frecuente en la edad pediátrica. En Estados Unidosse diagnostican aproximadamente 500 nuevos casos por año, siendo más frecuente el hallazgoa los 36 meses de edad, aunque es posible encontrarlo en momentos tan tempranos como elnacimiento, e incluso hasta los 15 años de edad, con igual probabilidad de encontrarlo en niñasy niños a cualquier edad. Es un tumor agresivo, tiene la capacidad de alcanzar gran tamaño eincluso hacer metástasis a distancia.Se presenta por su inusual manifestación inicial el caso de un paciente de 28 meses de edad,sexo masculino, que consultó al servicio de urgencias por dolor en rodilla izquierda de 24 horasde evolución, acompañado de imposibilidad para la marcha. Al examen físico inicial se encontrópresencia de masa abdominal./ Wilms tumor or nephroblastoma represents 6 percent of pediatric cancer and it is considered the mostcommon childhood renal and abdominal malignancy. In the United States 500 new cases arediagnosed per year, and this tumor is most frecuently found at 36 months of age. However thislesion can be found from birth until 15 years of age with similar frequency between males andfemales. Wilms tumor is an aggressive neoplasia, being able to reach big sizes, and capable ofproducing metastasizes.In this paper we present the case of a 28 months old male that arrived to the emergencyservice due to left knee pain of 24 hours of evolution and march difficulty. Physical examinationrevealed an abdominal mass