Validation of the National Early Warning Score (NEWS)-2 for adults in the emergency department in a tertiary-level clinic in Colombia: Cohort study.

ABSTRACT: The National Early Warning Score (NEWS)-2 is an early warning scale that is used in emergency departments to identify patients at risk of clinical deterioration and to help establish rapid and timely management. The objective of this study was to determine the validity and prediction of mortality using the NEWS2 scale for adults in the emergency department of a tertiary clinic in Colombia.A prospective observational study was conducted between August 2018 and June 2019 at the Universidad de La Sabana Clinic.The nursing staff in the triage classified the patients admitted to the emergency room according to Emergency Severity Index and NEWS2. Demographic data, physiological variables, admission diagnosis, mortality outcome, and comorbidities were extracted.Three thousand nine hundred eighty-six patients were included in the study. Ninety-two (2%) patients required intensive care unit management, with a mean NEWS2 score of 7. A total of 158 patients died in hospital, of which 63 were women (40%). Of these 65 patients required intensive care unit management. The receiver operating characteristic curve for NEWS2 had an area of 0.90 (CI 95%: 0.87-0.92). A classification and score equivalency analysis was performed between triage and the NEWS2 scale in terms of mortality. Of the patients classified as triage I, 32.3% died, and those who obtained a NEWS2 score greater than or equal to 10 had a mortality of 38.6%.Among our population, NEWS2 was not inferior in its area under the receiver operating characteristic curve when predicting mortality than triage, and the cutoff point for NEWS2 to predict in-hospital mortality was higher.

Implantes cocleares: Nuestra experiencia / Cochlear implants: our experience

El implante coclear es un dispositivo electrónico que ayuda a escuchar a las personas con hipoacusias profundas que no se benefician con el uso de audífonos. El éxito de la implantación depende de varios factores, principalmente de la correcta selección de candidatos y la edad temprana de realización de la cirugía.Objetivo: Reportar nuestra experiencia en el manejo de pacientes con hipoacusia e indicación de implante coclear. Material y Métodos: Estudio descriptivo de 24 casos, atendidos e intervenidos quirúrgicamente en el Servicio de ORL del HIGA Eva Perón, desde Octubre de 2011 hasta Marzo de 2014. Resultados: Se realizaron 31 Implantes cocleares en 24 pacientes con hipoacusia neurosensorial profunda bilateral (7 bilaterales). 6 fueron de sexo masculino y 18 femeninos, con edades comprendidas entre los 1 y 46 años. En la gran mayoría se detectó la hipoacusia previo a los 3 años, y contaban con equipamiento audioprotésico desde edades tempranas. Se realizó la colocación del implante coclear en edades previas a los 6 años en el 83% de los pacientes. La etiología de la hipoacusia fue variable, de tipo prenatal, peri o posnatal, incluso de causa desconocida. El beneficio audiológico post implantación fue notable, promediando los 20-30 decibeles en la audiometría tonal post implante. Conclusiones: La atención de pacientes con indicación de Implante coclear es un largo proceso que requiere de la dedicación de un equipo multidisciplinario

O implante coclear é um dispositivo eletrônico que ajuda para que possam escutar as pessoa com hipoacusia profunda que não se beneficiam com o uso aparelhos auditivos. O êxito depende de vários fatores, principalmente da correta seleção de candidatos e da idade precoce de realização da cirurgia. Objetivo: Fazer o relatório de nossa experiência no tratamento de pacientes com hipoacusia e indicação de implante coclear. Materiais e Métodos: Estudo descritivo de 24 casos, atendidos e tratados cirurgicamente no Serviço de ORL do HIGA Eva Perón, desde Outubro de 2011 até Março de 2014. Resultados: ealizaram-se 31 Implantes cocleares em 24 pacientes com hipoacusia neurossensorial profunda bilateral (7 bilaterais). 6 foram de sexo masculino e 18 femininos, com idades compreendidas entre 1 e 46 anos. Na grande maioria de casos, detectou-se a hipoacusia prévia aos 3 anos, e possuíam equipamento áudio protético desde curta idade. Realizou-se a colocação do implante coclear em idades prévias aos 6 anos em 83% dos pacientes. A etiologia da hipoacusia foi variável, de tipo pré-natal, péri ou pós-natal, inclusive de causa desconhecida. O benefício auditivo pós-implantação foi notável, de uma média de 20-30 decibéis na audiometria tonal pós-implante. Conclusões: A atenção do pacientes com indicação de Implante coclear é um longo processo que requer da dedicação de uma equipe multidisciplinar

Cochlear implants are small electronic devices developed to help audition in persons suffering serious hearing loss and that do not receive benefit from common audition devices. Results depend on several factors, principally the correct candidate selection and early age to offer implantation. Objective: to show our experience in severe hearing loss patients in whom cochlear implant is indicated. Material and methods: Descriptive study of 24 cases, assisted and surgically treated in HIGA Eva Perón´s ORL Service from October 2011 to march 2014. Results: We have made 31 cochlear implants in 24 patients with profound neurosensory hearing loss (7 bilateral). 6 were males and 18 females, with ages between 1 and 46 years old. In most of them, hipoacusia was detected 3 years previously and were using prosthetic audio equipment. Cochlear implant was possible in patients of less than 6 years old in 83% of this group. Lessional etiology was diverse: prenatal or postnatal and even unknown. The benefit obtained from the implant was evident: showing 20 -30 decibels in postoperative tonal audiometry. Conclusions: Care of patients that may benefit from cochlear implants is a long process that requires a multidisciplinary team dedication

Fractura de cuello de cóndilo mandibular en paciente lactante: reporte de un caso / Fracture of neck of cóndilo mandibular in patient nursling: reports a case

La incidencia de fracturas de cuello de cóndilo mandibular es de 2 por ciento entre los traumatismos faciales en niños, alterando muchas veces el funcionalismo temporo mandibular (ATM). Existe controversia en el tratamiento. Presentamos el caso de una lactante de 18 meses con fractura dislocada de cuello de cóndilo mandibular que evolucionó satisfactoriamente con tratamiento conservador en seis meses. Revisando la literatura concluimos que el mejor tratamiento es el conservador, con buena evolución clínica a corto plazo y radiológica a largo plazo, haciendo hincapié en el seguimiento estricto, considerando que a menor edad, mejor remodelación de la ATM

Extracción laparoscópica de diu untraabdominal: revisión de la literatura y reporte de un caso / Extraction laparoscopic of diu intraabdominal: review of the literature and report of a case

Se presenta el caso de una paciente femenina de 28 años, con cuadro de dolor abdominal, diagnósticándole DIU intraabdominal por radiografía, cuyo abordaje laparoscópico demostró su localización en epiplon. La técnica laparoscopica permitió remover el dispositivo sin dificultad, evitando así la lapatorotomía