Shock séptico de foco respiratorio por Pasteurella multocida en un paciente inmunocompetente. Caso Clínico / Septic shock originating from a pulmonary focus caused by Pasteurella multocida. Report of one case

Pasteurella multocida is a gram-negative coccobacillus bacterium found as a commensal in the oropharynx of domestic animals such as cats and dogs and some farm animals. Soft tissue infections and occasionally bacteremia in immunocompromised patients with direct contact with animals are described. We report a 61 year old male with a history of scratches and close contact with domestic cats, with a septic shock originating from a pulmonary focus, requiring mechanical ventilation and vasopressors. Blood cultures disclosed the presence of Pasteurella multocida. He responded successfully to antimicrobials.

Reformulación conversacional en adultos mayores / Conversational Reformulation in Older Adults

El presente trabajo tiene como objetivo determinar los tipos de actividades de reformulación conversacional que aparecen en conversaciones en adultos mayores con diferentes niveles de desempeño cognitivo: normales y trastorno cognitivo leve, a partir de una tarea de construcción de un discurso narrativo-argumentativo. Desde una perspectiva de investigación cualitativa, se obtuvo un corpus de 4 entrevistas, que fue codificado con la ayuda del software ATLAS.ti lo que permitió la generación de conceptos y el desarrollo de explicaciones a partir de los datos, los que fueron contrastados con el marco teórico disponible. Los resultados indicaron que los hablantes realizaron actividades de auto-reformulación auto-iniciada, auto-reformulación iniciada por otro y hetero-reformulación derivada del auto-inicio. Las dos primeras se redujeron en los hablantes identificados con trastorno cognitivo leve, mientras que el último tipo de actividad fue el más frecuente y dominante en la conversación. Los hablantes con trastorno cognitivo leve realizaron reformulaciones que no corregían o adecuaban el discurso, por lo que no cumplieron con la finalidad de la reparación.

This study aimed to determine the types of activities of conversational reformulation that occur during oral dialogues with older adults who have varying levels of cognitive performance. Study participants, who ranged between normal cognitive function and mild cognitive impairment, were given the task of constructing a narrative-argumentative dialogue. For qualitative investigation purposes, a corpus of four interviews was obtained. Each series of interviews were encoded using ATLAS.ti software which generated linked concepts and explanations from the data. Findings were then compared with the available theoretical framework. The results indicated that participants exhibited three modes of reformulation technique: self-initiated self-reformulation activities; self-reformulation started by another person; and hetero-reformulation derived from self-start. The first two were reduced in speakers exhibiting mild cognitive impairment, while the latter was the most frequent and dominant mode in the conversation. Speakers with mild cognitive impairment executed reformulations that did not correct or enhance the speech, and as such did not meet the purpose of reformulation.