ABSTRACT
Introduction: Bone and Joint Infections (BJI) have high morbidity. Methicillin resistant Staphylococcus aureus (MRSA) has increased. Culture-based diagnosis has difficult to recovering fastidious bacteria and detecting polymicrobial infections, molecular methods offer a promising improvement for the diagnosis of BJI with reduced time to result. The aim of the study was to determine the correlation between culture results and the Biofire joint infection panel (BJIP) in a cohort of pediatric patients with BJI. Materials and methods: Descriptive study. Patients admitted with probable o confirmed BJI between July 1, 2019 and February 28, 2021 at HOMI. Blood cultures, synovial and bone fluid samples were taken. Samples were kept at -70 °C. On September 2022, the panel was performed. Results: 32 patients were included. The average age was 83m (RIQ: 32-145). 23 (71.8%) patients had a positive culture. The most frequent microorganism were S. aureus 19 (83%), 11/19 (57.9%) Staphylococci isolates were MRSA. 24/32 (75%) were positive by panel, 20 positive detections were concordant with culture, there were 6 additional isolates by panel (2 S. aureus, 2 S. pyogenes, 1 K. kingae and 1 C. albicans), three microorganisms were isolated in culture but not in the panel. (2 S. aureus and 1 S. agalactiae). Two patients with coinfection were detected. All MRSA were detected by culture and panel. In 26 (81.3%) patients the etiology was documented by any method. Conclusion: These results showed a moderate level of agreement between BJIP and culture (κ = 0.47). The panel allowed the detection of fastidious bacteria including K. kingae and polymicrobial samples. There was a very good level of agreement between the panel and culture for the MRSA detection (κ = 1).
ABSTRACT
Background: To date, there is a lack of published information on the utilization of the Deliberative dialogue methodology and the right to a dignified death in minors under 18 years of age in Colombia and Latin America. Objective: To examine the issue of children and adolescents' entitlement to a dignified death, including the criteria for exclusion, and to formulate a comprehensive plan for pediatric palliative care. A public policy document will be created with the aim of supporting the implementation of Resolution 825/2018. Methods: Participatory Action Research utilizing a Deliberative dialogue methods that has been adapted based on feminist epistemological principles. Results: The outcome of the exercise was the production of a document containing Public Policy recommendations regarding euthanasia in minors and its submission to the Ministry of Health and Social Protection of Colombia a few days prior to the release of the Resolution regulating the right to a dignified death for this population. Additionally, the conclusions of this event enabled the creation of a guide for the implementation of (Cabildos Ciudadanos) Citizen Council, in which girls, boys, and adolescents are included, trans-disciplinarity is encouraged, and feminist epistemological foundations are explored. Conclusions: The deliberative dialogue method may serve as a cost-efficient alternative to replace or complement participatory approaches utilized in the development of public health guidelines and policies.
Antecedentes: En Colombia y Latinoamérica no se cuenta con registros publicados de temas abordados desde los metodos del diálogo deliberativo frente a temas de salud sobre la población pediátrica. Objetivo: El diálogo deliberativo fue utilizado para deliberar sobre el derecho a la muerte digna en niñas, niños y adolescentes, sus criterios de exclusión, y el marco de acción de los cuidados paliativos pediátricos. Métodos: Investigación acción participativa recurriendo a la metodología Deliberative Poll. Resultados: Redacción de un documento de recomendaciones de Política Pública en torno a la eutanasia en población pediátrica y entrega del mismo al Ministerio de Salud y Protección Social de Colombia días previos a la expedición de la Resolución que reglamentó el derecho a morir con dignidad para esta población; así mismo, las conclusiones de este ejercicio posibilitaron la estructuración de una guía metodológica para la realización de Cabildos Ciudadanos en donde se integra a niñas, niños y adolescentes. Conclusiones: el diálogo deliberativo puede constituirse en una alternativa costo-eficiente para reemplazar o complementar metodologías de participación empleadas en la construcción de lineamientos y políticas públicas en salud.
ABSTRACT
Resumen (analítico) El artículo describe la implementación del cabildo ciudadano sobre eutanasia en niños, niñas y adolescentes en Colombia. Se realizó un estudio cualitativo exploratorio, de tipo investigación-acción-participativa. En la primera fase se conformaron tres paneles: formador, implicados y ciudadanos, y se llevaron a cabo dos etapas de deliberación: formativa y pública. En la fase de análisis de contenido (orientada por preguntas dirigidas a los ciudadanos), se caracterizó al minipúblico involucrado. Se destaca como hallazgos centrales la transformación de la opinión de las y los ciudadanos participantes, así como de sus capacidades deliberativas, lo que permitió dar cuenta de la efectividad de la metodología para facilitar que las y los ciudadanos formulen recomendaciones consensuadas en temas complejos y contribuyan en procesos de formación en democracia y participación social en salud.
Abstract (analytical) The article describes the implementation of the Citizen Council on euthanasia in children and adolescents in Colombia. An exploratory qualitative study using the participatory action research methodology was carried out. In the first phase, three panels were created with trainers, stakeholders and citizens, and two deliberative stages (formative and public) were carried out. In another phase involving content analysis -guided by questions addressed to citizens- a characterization of the minipublic involved in the deliberative exercise was made. The transformation of the opinions of the participating citizens, as well as their deliberative capacities, is a central finding of the study. The authors identified the effectiveness of the methodology to facilitate citizen's design of consensual recommendations about complex issues, as well as contributing to pedagogical processes related to democracy and social participation in health training.
Resumo (analítico) O artigo descreve a implementação do Conselho Cidadão sobre a eutanásia nas crianças e adolescentes na Colômbia. Foi realizado um estudo qualitativo exploratório de pesquisa-ação-participativa. Na primeira fase foram criados três painéis, formadores, intervenientes e cidadãos, e realizadas duas fases de deliberação (formativa e pública). Numa outra fase, de análise de conteúdo -orientada por questões dirigidas aos cidadãos-, foi feita a caracterização do mini público envolvido no exercício deliberativo. A transformação da opinião dos cidadãos participantes, bem como das suas capacidades deliberativas, destaca-se como descoberta central, o que permitiu perceber a eficácia da metodologia para facilitar a formulação de recomendações consensuais sobre questões complexas pelos cidadãos, assim como para contribuir no desenvolvimento de processos pedagógicos de formação em democracia e participação social em saúde.
Subject(s)
Euthanasia , Social ParticipationABSTRACT
Background: To date, there is a lack of published information on the utilization of the Deliberative dialogue methodology and the right to a dignified death in minors under 18 years of age in Colombia and Latin America. Objective: To examine the issue of children and adolescents' entitlement to a dignified death, including the criteria for exclusion, and to formulate a comprehensive plan for pediatric palliative care. A public policy document will be created with the aim of supporting the implementation of Resolution 825/2018. Methods: Participatory Action Research utilizing a Deliberative dialogue methods that has been adapted based on feminist epistemological principles. Results: The outcome of the exercise was the production of a document containing Public Policy recommendations regarding euthanasia in minors and its submission to the Ministry of Health and Social Protection of Colombia a few days prior to the release of the Resolution regulating the right to a dignified death for this population. Additionally, the conclusions of this event enabled the creation of a guide for the implementation of (Cabildos Ciudadanos) Citizen Council, in which girls, boys, and adolescents are included, trans-disciplinarity is encouraged, and feminist epistemological foundations are explored. Conclusions: The deliberative dialogue method may serve as a cost-efficient alternative to replace or complement participatory approaches utilized in the development of public health guidelines and policies.
Antecedentes: En Colombia y Latinoamérica no se cuenta con registros publicados de temas abordados desde los metodos del diálogo deliberativo frente a temas de salud sobre la población pediátrica. Objetivo: El diálogo deliberativo fue utilizado para deliberar sobre el derecho a la muerte digna en niñas, niños y adolescentes, sus criterios de exclusión, y el marco de acción de los cuidados paliativos pediátricos. Métodos: Investigación acción participativa recurriendo a la metodología Deliberative Poll. Resultados: Redacción de un documento de recomendaciones de Política Pública en torno a la eutanasia en población pediátrica y entrega del mismo al Ministerio de Salud y Protección Social de Colombia días previos a la expedición de la Resolución que reglamentó el derecho a morir con dignidad para esta población; así mismo, las conclusiones de este ejercicio posibilitaron la estructuración de una guía metodológica para la realización de Cabildos Ciudadanos en donde se integra a niñas, niños y adolescentes. Conclusiones: el diálogo deliberativo puede constituirse en una alternativa costo-eficiente para reemplazar o complementar metodologías de participación empleadas en la construcción de lineamientos y políticas públicas en salud.
Subject(s)
Euthanasia , Health Policy , Male , Female , Humans , Adolescent , Child , Policy Making , ColombiaABSTRACT
El absceso del músculo psoas es una piomiositis infrecuente en la población pediátrica, convirtiéndose en un gran reto diagnóstico. Esta condición debe sospecharse en todo niño con fiebre, malestar general o dolor abdominal, lumbar o de cadera con evolución mayor a una semana. Suele confundirse con artritis séptica u otras enfermedades osteomusculares, por lo que se requiere de la realización de imágenes diagnósticas; el desconocimiento de esta patología retrasa el inicio del tratamiento y genera gran morbimortalidad. Se presenta un caso atendido en un centro hospitalario pediátrico de tercer nivel de Bogotá, D.C. y se hace una revisión de la literatura enfatizando sus claves diagnósticas y el manejo terapéutico.
Psoas Abscess is a pyomyositis rarely present, which in turn makes its diagnosis a real challenge. This condition must be a differential diagnosis in children presenting fever, general malaise, lumbalgia, abdominal or hip pain for more than a week. It is frequently confused with septic arthritis or other musculoskeletal diseases, which is why radiographic studies or ultrasonography are necessary. Unawareness of this pathology delays its treatment, thus producing high levels of morbidity and mortality. A clinical case treated in a pediatric hospital from Bogotá, Colombia, is presented, as well as a literature review emphasizing in Psoas Abscess key issues and treatment.
