[Analysis of causes and factors associated with hospital readmission in mild and moderate polythraumatism: An observational study]. / Análisis de las causas y los factores asociados al reingreso hospitalario en politraumatismo leve-moderado: estudio observacional.

BACKGROUND: Early readmissions (ER) occur during the 30 days after discharge, ER are common and expensive, associated with a decrease in the quality of care. The rate of ER in polytraumatic patients (PTP) is estimated between 4.3-15%. Our objective was to identify those factors associated with ER and its characteristics after suffering mild-moderate trauma in our area. MATERIAL AND METHOD: This is a retrospective observational study, including data of patients with (PTP) mild or moderate admitted between July 2012 and June 2017 in our institution and their ER in public hospitals and/or outpatient centers. Demographic variables, diagnoses, procedures and characteristics of readmissions were collected. After a bivariant analysis was done, a Logistic regression had benn performed to determine risk factors for ER. RESULTS: 1013 patients were included, with median age of 38 years, ISS of 3 points and initial hospital stay of 1 day. 185 patients were readmitted (18.3%). Independent factors associated with ER were: injury mechanism, especially bicycle accident (OR 2.26), comorbidities highlighting HBP (OR 1.83) and COPD (OR 1.98), fracture immobilization (OR 1.99) and hospital admission in the initial care (OR 0.56). The causes of ER were: pain 61.6%, wound infection 15.1%, scheduled cures and deferred interventions 12.97%, medical 6.4% and psychiatric decompensation. 2.7% CONCLUSION: The ERs in mild-moderate PTP are multifactorial, our results show an association between factors such as injury mechanism, the presence of comorbidities and the procedures performed in the sentinel episode and the rate of ER. The implementation of simple interventions at discharge could reduce its incidence clearly.

Technovigilance and risk management as tools to improve patient safety in colombian health care institutions / La tecnovigilancia y la gestión de riesgos como herramientas para mejorar la seguridad de los pacientes en las instituciones de salud colombianas / A tecnovigilância e a gestão de riscos como ferramentas para melhorar a segurança dos pacientes nas instituições de saúde colombianas

This paper presents the results of a survey about technovigilance carried out in 21 clinical institutions from the southwest of Colombia. It also provides an analysis of how these programs take into account different risk management methodologies in order to create awareness of the importance of patient safety in all members of the staff and improve the quality of the health services provided.

Este trabajo presenta los resultados de una encuesta acerca de la vigilancia tecnológica llevada a cabo en 21 instituciones de salud del suroeste de Colombia. Adicionalmente proporciona un análisis de cómo estos programas consideran diferentes metodologías de manejo de riesgos para crear conciencia en todos los empleados de la importancia de la seguridad de los pacientes y así mejorar la calidad de los servicios de salud prestados.

Este trabalho apresenta os resultados de uma pesquisa a respeito da vigilância tecnológica levada a cabo em 21 instituições de saúde do sudoeste da Colômbia. Adicionalmente proporciona uma análise de como estes programas consideram diferentes metodologias do controle de riscos para criar consciência em todos os empregados da importância da segurança dos pacientes e assim melhorar a qualidade dos serviços de saúde emprestados.

Encefalopatías espongiformes transmisibles.Bases moleculares, diagnóstico y perspectivasterapéuticas / Transmissible spongiform encephalopathies. Molecular biology, diagnosis and therapeutic approaches

Las encefalopatías espongiformes transmisibles constituyen un grupo de enfermedades neurodegenerativas que están asociadas a la presencia en el tejido nervioso de agregados insolubles constituidos por una isoforma anómala de una proteína denominada prión. Esta isoforma se produce por un cambio conformacional en una molécula que puede transmitirse a otras proteínas priónicas normales. Las proteínas modificadas pierden su actividad biológica, desencadenándose la muerte de las neuronas por apoptosis. Los cambios conformacionales de los priones que derivan en enfermedad pueden deberse a la existencia de mutaciones que disminuyan la estabilidad de las formas celulares. Existe susceptibilidad genética, por tanto, a padecer tipos hereditarios de la enfermedad o adquiridos por infección con isoformas priónicas anormales. En la actualidad se están perfeccionando métodos sensibles de diagnóstico basados en la detección de las isoformas anormales de la proteína priónica. Todavía no existen tratamientos curativos para estas enfermedades aunque se están diseñando métodos terapéuticos que bloqueen los cambios conformacionales que conducen a la precipitación de la proteína priónica (AU)