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1.
Rev. Hosp. El Cruce ; (24): 1-7, 18/07/2019.
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1006642

RESUMO

OBJETIVO: Este trabajo presenta el inicio de un proyecto de largo término que analiza la dinámica local de circulación de pacientes y colaboración profesional entre el conjunto de efectores localizados en los partidos de Florencio Varela, Berazategui, Alte. Brown y Quilmes, denominado la Red del Sudeste Bonaerense. Ésta articula efectores de primer, segundo y tercer nivel de atención (169 en total), asiste a 2 millones de personas anualmente en una de las áreas con mayor población del país y con altos niveles de necesidades básicas insatisfechas. METODOLOGÍA: La metodología se plantea desde los métodos mixtos que articulan técnicas cualitativas y cuantitativas para la recolección, procesamiento y análisis de la información de los efectores de la Red, a partir de: registros de pacientes pediátricos, datos epidemiológicos y trabajo de campo etnográfico. Complementariamente, se articulan tres líneas multi-disciplinarias: Análisis de sistemas y servicios de salud en red; Análisis espacial entre centros de salud; Análisis de redes sociales (identifica estructuras y dinámicas de flujo y colaboración). RESULTADOS: Los resultados sugieren: a) la estructura de derivaciones la HEC tiene una forma de "estrella", b) mayor cantidad de derivaciones desde los distritos de la Red del Sudeste que de otros efectores, c) Coeficiente de Jaccard es bajo, d) dificultades en el mecanismo de contra-referencia, e) la estructura de colaboración entre 25 especialidades es un modelo "centro/periferia", f) emergen subgrupos de acuerdo a las patologías derivadas. CONCLUSIÓN: Se concluye con una discusión sobre la importancia de la interacción estructural entre las especialidades para la atención compleja de patologías pediátricas. Finalmente, la centralidad del HEC en la dinámica de derivaciones pediátricas se corresponde con su condición de único efector de tercer nivel de la región, su robusta comunicación con los efectores en el territorio así como por su posicionamiento como referente nacional de derivación por patologías específicas.


OBJECTIVE: This paper presents the beginning of a long-term project that analyses local dynamics of patient transfers and professional collaboration among a formal assistance network of health providers called the "Southeastern Network" localized in four districts in the Metropolitan Area of Buenos Aires: F. Varela, Berazategui, Alte. Brown y Quilmes. This network connects primary, secondary and tertiary care levels (169 in total) and assists over 2 million people annually in the region, one of the most populated and deprived areas in Argentina. METHODS: Methodological strategies point toward a mixed methods approach, which articulates qualitative and quantitative methods for collecting, processing and analyzing the information from the network care providers: patients institutional registers, epidemiological data and ethnographic field work.Additionally, we follow three multi-disciplinary lines: health systems and services analysis, special analysis regarding care providers, Social Network Analysis (identifying structures and dynamics of patients flow and professional collaboration). RESULTS: Suggest: a) the structure of patients' referral is "star" model b) there are more referrals from the Network's districts than from other areas c) Jaccard Coefficient is low, d) there are some difficulties in counter-referral mechanisms e) professional collaboration structure among 25 medical specialties is a "center/periphery" model f) some subgroups emerge from assisting certain pathologies. CONCLUSIONS: We conclude with a discussion on the importance of structural interaction among medical specialties for complex pediatric care. Finally, the centrality of El Cruce Hospital within pediatric referrals in this area correspond to the fact that it is the only tertiary care provider, it maintains robust communications with other care providers and it is positioned as national reference for specific pathologies referral.


Assuntos
Encaminhamento e Consulta , Níveis de Atenção à Saúde , Pesquisa Qualitativa , Atenção à Saúde , Sistemas Nacionais de Saúde , Hospitais Pediátricos
2.
Arch Argent Pediatr ; 114(1): e5-8, 2016 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-26914088

RESUMO

Stroke in childhood is considered rare. It may be ischemic or hemorrhagic. Its presentation is often acute and it is a leading cause of mortality in pediatrics. The aim of our work is to present the general features of stroke of 18 patients under 15 years of age admitted to the Hospital El Cruce, between July 2009 and June 2014, and their clinical outcome a year later. We observed a predominance of male patients and the median age of 5 years. The main clinical features were hemiparesis, seizures, headache and vomiting and sensory impairment. The most frequent type was ischemic and the middle cerebral artery territory was the most commonly involved. Twelve patients had no sequelae. The signs and symptoms were guiding stroke, neuroimaging studies were essential for diagnosis and patients evolved favorably with low number of recurrence and death.


Assuntos
Acidente Vascular Cerebral/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Fatores de Risco
3.
Arch. argent. pediatr ; 114(1): e5-e8, feb. 2016. tab
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-838166

RESUMO

La enfermedad cerebrovascular en la infancia es poco frecuente. Su presentación es aguda y constituye una de las 10 causas de mortalidad en pediatría. El objetivo de nuestro estudio es presentar las características de la enfermedad de 18 pacientes menores de 15 años ingresados en el Hospital El Cruce entre julio de 2009 y junio de 2014, y su evolución clínica al año del evento. Observamos un predominio de sexo masculino y una mediana de edad de 5 años. La forma de presentación en orden de frecuencia fue hemiparesia, convulsiones, cefalea y vómitos, y deterioro del sensorio. La forma isquémica fue la más frecuente y el territorio más afectado fue el de la arteria cerebral media. Doce pacientes no presentaron secuelas. Los signos y síntomas fueron orientadores de enfermedad cerebrovascular; los estudios de neuroimágenes, esenciales para su diagnóstico; y los pacientes evolucionaron favorablemente con bajo número de recurrencia y fallecidos.


Stroke in childhood is considered rare. It may be ischemic or hemorrhagic. Its presentation is often acute and it is a leading cause of mortality in pediatrics. The aim of our work is to present the general features of stroke of 18 patients under 15 years of age admitted to the Hospital El Cruce, between July 2009 and June 2014, and their clinical outcome a year later. We observed a predominance of male patients and the median age of 5 years. The main clinical features were hemiparesis, seizures, headache and vomiting and sensory impairment. The most frequent type was ischemic and the middle cerebral artery territory was the most commonly involved. Twelve patients had no sequelae. The signs and symptoms were guiding stroke, neuroimaging studies were essential for diagnosis and patients evolved favorably with low number of recurrence and death.


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Paresia , Convulsões , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico
4.
Arch Argent Pediatr ; 112(4): e152-5, 2014 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-24955915

RESUMO

Infectious due to methicillin-resistant community acquired Staphylococcus aureus is a public health problem of varying magnitude in different geographical areas of the world, representing a major burden on health systems. The debate on the initial empiric antibiotic therapy remains open. We present a case series of hospitalized patients with severe Staphylococcus aureus infections admitted to the pediatric intermediate care unit of Hospital El Cruce. Between May 2008 and December 2010, 43 patients were admitted. Sixty nine percent of isolated Staphylococcus aureus were methicillin-resistant. Although the difference was not statistically significant, methicillin-resistant Staphylococcus aureus infections required more days of hospitalization in critical care unit and developed more secondary sites of infection. Vancomycin, rifampicin and clindamycin were the most commonly prescribed antibiotics. There was a high resistance of Staphylococcus aureus to p-lactams in the series.


Assuntos
Antibacterianos/uso terapêutico , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Antibacterianos/farmacologia , Pré-Escolar , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Índice de Gravidade de Doença
5.
Arch. argent. pediatr ; 112(4): e152-5, 2014 Aug.
Artigo em Espanhol | BINACIS | ID: bin-133512

RESUMO

Infectious due to methicillin-resistant community acquired Staphylococcus aureus is a public health problem of varying magnitude in different geographical areas of the world, representing a major burden on health systems. The debate on the initial empiric antibiotic therapy remains open. We present a case series of hospitalized patients with severe Staphylococcus aureus infections admitted to the pediatric intermediate care unit of Hospital El Cruce. Between May 2008 and December 2010, 43 patients were admitted. Sixty nine percent of isolated Staphylococcus aureus were methicillin-resistant. Although the difference was not statistically significant, methicillin-resistant Staphylococcus aureus infections required more days of hospitalization in critical care unit and developed more secondary sites of infection. Vancomycin, rifampicin and clindamycin were the most commonly prescribed antibiotics. There was a high resistance of Staphylococcus aureus to p-lactams in the series.

6.
Rev Esc Enferm USP ; 46(3): 650-6, 2012 Jun.
Artigo em Português | MEDLINE | ID: mdl-22773486

RESUMO

The objective of this study was to understand the strengths and limitations of the process of nursing work at a health center in terms of recognizing the health needs of the population. The methodological framework used was social research in the qualitative perspective, with discourse analysis based on hermeneutics-dialectics and founded on the Theory of Praxis Interpretation of Community Health Nursing. The data were collected by means of semi-structured interviews, and the working processes of the teams were examined according to the Analyzing Flowchart of the Model of a Health Care Service. In conclusion, there are limitations in the daily working process of the nursing team regarding the recognition of the health needs of the population. Coping with these needs consisted of the identification of complications, relegating the social determinants of the poor life conditions associated with the health-disease process to a secondary concern.


Assuntos
Centros Comunitários de Saúde , Enfermagem em Saúde Comunitária/organização & administração , Saúde da Família , Pessoal de Saúde , Necessidades e Demandas de Serviços de Saúde , Política , Brasil , Humanos
7.
Rev. Esc. Enferm. USP ; 46(3): 650-656, jun. 2012.
Artigo em Português | LILACS | ID: lil-640404

RESUMO

Este estudo teve como objetivo compreender as potencialidades e limitações do processo de trabalho da enfermagem de uma Unidade Básica de Saúde para o reconhecimento das necessidades de saúde da população. A vertente metodológica utilizada foi a pesquisa social, na perspectiva qualitativa, tendo como base de análise dos discursos a hermêutica-dialética, e como alicerce a Teoria da Interpretação Práxica da Enfermagem em Saúde Coletiva. Os dados foram coletados por meio da entrevista semiestruturada e os processos de trabalho das equipes foram analisados através do Fluxograma Analisador do Modelo de Atenção de um Serviço de Saúde. Concluiu-se que há limitações no cotidiano do processo de trabalho da equipe de enfermagem à medida em que o reconhecimento e enfrentamento das necessidades de saúde perpassavam pela identificação de agravos instalados, deixando em segundo plano os determinantes sociais das más condições de vida associadas ao processo saúde-doença.


The objective of this study was to understand the strengths and limitations of the process of nursing work at a health center in terms of recognizing the health needs of the population. The methodological framework used was social research in the qualitative perspective, with discourse analysis based on hermeneutics-dialectics and founded on the Theory of Praxis Interpretation of Community Health Nursing. The data were collected by means of semi-structured interviews, and the working processes of the teams were examined according to the Analyzing Flowchart of the Model of a Health Care Service. In conclusion, there are limitations in the daily working process of the nursing team regarding the recognition of the health needs of the population. Coping with these needs consisted of the identification of complications, relegating the social determinants of the poor life conditions associated with the health-disease process to a secondary concern.


Estudio que objetivó comprender las potencialidades y limitaciones del proceso de trabajo de una Unidad Básica de Salud, para reconocer las necesidades de salud de la población. La vertiente metodológica utilizada fue la investigación social en perspectiva cualitativa, teniendo como base de análisis de los discursos la hermenéutica-dialéctica, y como fundamento, la Teoría de la Interpretación Práxica de Enfermería en Salud Colectiva. Datos recolectados mediante entrevista semiestructurada, los procesos de trabajo de los equipos fueron analizados por Flujograma Analizador del Modelo de Atención de un Servicio de Salud. Se concluye en que existen limitaciones en el cotidiano del proceso de trabajo del equipo de enfermería, en la medida en que el reconocimiento y enfrentamiento de las necesidades de salud apenas pasaban por la identificación de padecimientos instalados, dejando en segundo plano los determinantes sociales de las malas condiciones de vida asociadas al proceso salud-enfermedad.


Assuntos
Humanos , Centros Comunitários de Saúde , Enfermagem em Saúde Comunitária/organização & administração , Saúde da Família , Pessoal de Saúde , Necessidades e Demandas de Serviços de Saúde , Política , Brasil
8.
In. Bustos, Raúl; Toledo, Alfredo; Quesada, Gustavo. Adolescencia: salud integral y embarazo precoz. Montevideo, Uruguay. Ministerio de Salud Pública/UNICEF, 1994. p.63-78.
Monografia em Espanhol | LILACS | ID: lil-182315
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