Trastorno por déficit atencional e hiperactividad (TDAH) y su relación con el síndrome de apnea obstructiva del sueño (SAOS) en pediatría / Attention deficit hyperactivity disorder (ADHD) and its relationship with obstructive sleep apnea syndrome (OSAS) in pediatrics

La importancia de la patología psiquiátrica en la infancia y la adolescencia ha ido en ascenso, debido al aumento en su diagnóstico y a sus implicancias socioculturales. El Trastorno por Déficit Atencional e Hiperactividad es el trastorno neurobiológico más diagnosticado en la práctica clínica infanto-juvenil, tanto así que debe ser conocido y manejado en la Atención Primaria por los médicos generales. Se ha descrito cierto grado de sobrediagnóstico influenciado, entre otros motivos, por las altas expectativas sociales respecto del rendimiento escolar/conductual de los niños, así como la presencia de otras patologías que se pueden manifestar con síntomas TDAH-like. En este sentido, la relación entre SAOS y TDAH, cobra gran relevancia, puesto que ambas patologías presentan una amplia prevalencia en nuestro país y un alto nivel de comorbilidad psiquiátrica/médica, además de relacionarse a través de una compleja y aún no muy bien conocida interacción neuropsicológica.

The importance of psychiatric disorders in childhood and adolescence has been increasing due to the increase in its diagnosis and its cultural implications. The Attention Deficit Hyperactivity Disorder is the neurobiological disorder most commonly diagnosed in the child-adolescent clinical practice, so much so that must be managed in primary care. It described some degree of overdiagnosis influenced by high school-social expectations and behavioral performance of children, and the presence of other conditions. In this sense, the relationship between OSA and ADHD, is very relevant, because both disorders share a wide prevalence in our country and a high level of psychiatric and medical comorbidity. In adittion, these interact through a complex and still not well known neuropsychological mechanism.

Tromboprofilaxis farmacológica en pacientes oncológicos quirúrgicos en el Hospital Clínico de la Universidad de Chile / Pharmacological thromboprophylaxis in surgical oncology patients in Hospital Clínico Universidad de Chile

The aim of this study is to evaluate the use of thromboprophylaxis in surgical oncology patients in HCUCH in 2011. Method: Retrospective analysis of patients with cancer undergoing surgery in 2011. Was defined as adequate pharmacological thromboprophylaxis the correct dose, mechanical prophylaxis in case of drug contraindications and beginning on day 0 or 1. Results: 131 medical records were reviewed. Main neoplasms were colorectal (21.3 percent), prostate (12.9 percent), gallbladder (8.3 percent) and stomach (6.9 percent). Of the patients requiring pharmacologic thromboprophylaxis (n = 110) were rated as adequate 52 patients (47 percent), 47 inadequate (43 percent) and 11 absent (10 percent). The causes of inappropriate use of pharmacological thromboprophylaxis included 27 late onset (58 percent), 10 lower doses (21 percent), 3 late onset associated with lower dose (6 percent), 6 incomplete thromboprophylaxis (13 percent) and 1 dose increased (2 percent). Factors significantly associated with pharmacological thromboprophylaxis absent were: <40 years of age (p = 0.002), head and neck cancer (p < 0.001), and hospital stay <7 days (p < 0.001). Conclusions: The absence of pharmacological thromboprophylaxis is associated with lower absolute risk factors for VTE: Age less than 40 years old, head and neck cancer, hospital stay less than 7 days...