Background: Some reports suggest differences regarding health needs between the population affili... more Background: Some reports suggest differences regarding health needs between the population affiliated to subsidized health insurance scheme (SS) compared to the contributory health insurance scheme (CS) in Colombia. Therefore, the objective of this study was to identify the epidemiological profile of the population affiliated to the SS in Colombia, to establish if there are differences compared to CS in terms of: incident diseases, prevalent diseases, and use of health services and to estimate the magnitude of the differences from statistical analyzes of the data retrieved in a systematic review of data published in the literature and other sources of information. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. The search was made from 1993, with none other restriction. The information was synthesized in five categories according to the most important risk populations. We estimated combined incidences from epidemiologic...
Introducción. El cutting es un comportamiento de autolesión no suicida cada vez más frecuente en ... more Introducción. El cutting es un comportamiento de autolesión no suicida cada vez más frecuente en menores de 15 años; sin embargo, en Colombia aún no se han realizado estudios que reporten la prevalencia de esta conducta en población pediátrica.Objetivo. Describir las características sociodemográficas y clínicas, y los factores de riesgo de la población pediátrica (0 a 14 años) con diagnóstico de cutting atendida en el servicio de urgencias de una clínica de cuarto nivel en Bogotá D.C., Colombia.Materiales y métodos. Estudio observacional descriptivo de corte transversal en el que se revisaron las historias clínicas de los pacientes menores de 15 años atendidos entre los años 2011 y 2017 con los códigos diagnósticos CIE 10 Z91.5, F32, F33, F99, F19, F41, F43, T742 y X60, con el fin de identificar aquellos casos que cumplieran con los criterios diagnósticos de cutting.Resultados. Se incluyeron 85 historias clínicas de niños entre 10 y 14 años. La prevalencia de cutting fue de 0.15% en...
Revista Colombiana de Obstetricia y Ginecología, 2021
P atient safety has been defined by the World Health Organization (WHO) as the "Management of pro... more P atient safety has been defined by the World Health Organization (WHO) as the "Management of processes that results in the reduction to an acceptable minimum of the risk of causing unnecessary harm in medical care" (1, p.15). Acceptable minimum is understood to mean "any harm that is inevitable in light of current knowledge, available resources and the context in which care is provided, which is in contrast with the risk of receiving no treatment or a different treatment" (1, p.15). Harm to a patient is the undesired effect derived more from healthcare than from the underlying disease (2), and it is known as an adverse event or a reportable event with undesired effects-REUE-(3). The Royal Spanish Academy defines a patient as the "person who experiences bodily and physical suffering and, in particular, the person who is receiving medical care" or "person who is or will be medically examined" (4). This concept includes both the person suffering from an illness as well as the healthy individual who comes into contact with healthcare services. It includes the widely researched concept of subjects with pathological conditions receiving care during hospitalization (5,6), as well as individuals receiving outpatient care (7) and people in good health such as children who are monitored for growth and development, or women in prenatal care. The aim of prenatal care visits is to verify the normal course of pregnancy and ensure early detection of potential pathological conditions that may affect
Revista Colombiana de Obstetricia y Ginecología, 2021
Resumen Introducción y objetivo: Una importante proporción de pacientes hospitalizados presenta d... more Resumen Introducción y objetivo: Una importante proporción de pacientes hospitalizados presenta deterioro clínico severo que puede terminar en eventos adversos, paro cardíaco no esperado, o muerte; para reducir su frecuencia y prevenir sus consecuencias se han creado los equipos de respuesta rápida (ERR). El objetivo de esta revisión de alcance es describir la conformación, funcionamiento y resultados de la implementación de los ERR en el contexto hospitalario, con énfasis en los servicios de cirugía ginecológica y atención obstetricia. Materiales y métodos: Se llevó a cabo una búsqueda en las bases de datos de literatura médica Medline vía Pubmed, Embase vía OVID, LILACS, Cochrane Library y Open Gray. Se incluyeron estudios observacionales descriptivos y analíticos, estudios experimentales y estudios cualitativos que incluyeron ERR en instituciones de salud de alta complejidad u hospitales universitarios. Dos investigadores seleccionaron los estudios y extrajeron los datos respecto...
Introducción: La obesidad en niños y adolescentes es un problema de salud pública que puede pasar... more Introducción: La obesidad en niños y adolescentes es un problema de salud pública que puede pasar desapercibido, si no se caracteriza de manera temprana en centros de atención primaria.Objetivo: Determinar la prevalencia de sobrepeso y obesidad en niños de 5 a 10 años que asistieron a la consulta externa de pediatría, en un centro de atención primaria en Bogotá, entre los años 2017 y 2018.Metodología: Estudio de corte transversal. Se incluyeron todos los pacientes entre 5 y 10 años que asistieron al consultorio de pediatría del Clinicentro Calle 80. Se realizó muestreo consecutivo estricto. Los participantes fueron pesados y tallados y se calculó el índice de masa corporal. Se aplicó una encuesta para registrar factores de riesgo asociados al sobrepeso y a la obesidad.Resultados: Se incluyeron 300 pacientes, 148 niñas (49.33%) y 152 niños (50.66%). La mediana de edad fue de 7 años. El 70% de ambos sexos tuvo un peso adecuado para la edad, el 14.86% de las niñas y el 12.5% de los niñ...
Introduction: A broad range of practices aimed at improving the effectives and safety of this pro... more Introduction: A broad range of practices aimed at improving the effectives and safety of this process have been documented over the past few years. Objective: to establish the effectiveness, safety and results of the implementation of these strategies in adult patients in university hospitals. Methodology: A review of systematic reviews was conducted, in addition to a database search in the Cochrane Library of Systematic Reviews, Embase, Epistemonikos, LILACS and gray literature. Any strategy aimed at reducing prescription-associated risks was included as intervention. This review followed the protocol registered in the International Prospective Registry of Systematic Reviews (PROSPERO): CRD42020165143. Results: 7,637 studies were identified, upon deleting duplicate references. After excluding records based on titles and abstracts, 111 full texts were assessed for eligibility. Fifteen studies were included in the review. Several interventions grouped into 5 strategies addressed to t...
Introducción: el SAHOS secundario a malformaciones craneofaciales conlleva aumento en la morbilid... more Introducción: el SAHOS secundario a malformaciones craneofaciales conlleva aumento en la morbilidad y deterioro en la calidad de vida del paciente. Objetivo: describir las características prequirúrgicas y cambios posquirúrgicos en la vía aérea, en pacientes sometidos a cirugía de avance maxilomandibular por SAHOS secundario a malformaciones craneofaciales. Metodología: Estudio observacional descriptivo en adultos con SAHOS secundario a malformaciones craneofaciales sometidos a cirugía de avance maxilomandibular entre diciembre del 2013 y octubre del 2018. Se analizaron las medidas prequirúrgicas y posquirúrgicas, así como la magnitud del cambio postintervención. Resultados: En la muestra se encontró el 57,17 % de los pacientes con 2 a 4 malformaciones, seguido del 42,86 % con 5 o más. Los reparos anatómicos con cambios significativos en las medidas posquirúrgicas, en el primer grupo fueron: espacio faríngeo superior, 4,78 mm (DE 1,92); espacio faríngeo inferior, 4,5 mm (DE 3,25); ba...
INTRODUCTION Reducing the incidence of reportable events with undesirable effects (REUE) is a pri... more INTRODUCTION Reducing the incidence of reportable events with undesirable effects (REUE) is a priority in the hospital environment, which is why reporting systems have been implemented to identify and manage them. Information is required regarding the performance of reporting systems, barriers, or facilitators for reporting and strategies that improve passive reporting. METHODOLOGY Systematic scoping review of the literature that included studies performed in the population exposed to the occurrence of REUE in the health system (teams, patients, and family). A search was performed in Cochrane Database of Systematic Reviews, Epistemonikos, MEDLINE (PubMed), MEDLINE In-Process and MEDLINE Daily Update, EMBASE, LILACS, and databases of the World Health Organization and Pan-American Health Organization. RESULTS Fifteen studies were found, 1 systematic review, 2 clinical trials, 8 observational studies, 3 qualitative studies, and 1 mixed study. In 4 of them, the effectiveness of active versus passive reporting systems was compared. The measures to improve the passive systems were education about REUE, simplification of the reporting format, activities focused on increasing the motivation for self-report, adoption of self-report as an obligatory institutional policy, and using specific report formats for each service. CONCLUSIONS There is information that allows to find differences between the performance of the active and passive reporting systems. The reviewed research articles found that passive techniques significantly underreported adverse events. It is recommended that institutions adopt both active and passive techniques in adverse event surveillance. New studies should be directed to answer the comparative efficiency of the reporting systems.
The impact of pharmacologic prophylaxis for venous thromboembolism in patients undergoing neurosu... more The impact of pharmacologic prophylaxis for venous thromboembolism in patients undergoing neurosurgical intervention remains uncertain. We reviewed the efficacy and safety of pharmacologic compared with nonpharmacologic thromboprophylaxis in neurosurgical patients. Three databases were searched through April 2018, including those for randomized controlled trials (RCTs) and for nonrandomized controlled studies (NRSs). Independent reviewers assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Seven RCTs and 3 NRSs proved eligible. No studies reported on symptomatic proximal and distal deep vein thrombosis (DVT). Two RCTs reported on screening-detected proximal and distal DVTs. We used the findings of these 2 RCTs as the closest surrogate outcomes to inform the proximal and distal DVT outcomes. These 2 RCTs suggest that pharmacologic thromboprophylaxis may decrease the risk of developing asymptomatic proximal D...
Revista Colombiana de Obstetricia y Ginecología, 2020
Objetivo: presentar a los clínicos la evidencia que soporta los procesos más seguros y efectivos ... more Objetivo: presentar a los clínicos la evidencia que soporta los procesos más seguros y efectivos en la inserción y el mantenimiento del catéter venoso central (CVC), como estrategia en la prevención de las infecciones del torrente sanguíneo asociadas a catéter. Materiales y métodos: a partir de preguntas clínicas dirigidas a mejorar la seguridad y efectividad de los procesos de inserción y mantenimiento de catéter venoso, en los momentos clave, se hicieron búsquedas de literatura en las bases de datos Medline vía PubMed, Embase, Central y Lilacs. Se utilizó la metodología de revisión sistemática rápida de la literatura. Los estudios identificados fueron evaluados desde el punto de vista de la calidad con las herramientas para estudios cualitativos, cuantitativos y revisiones sistemáticas del Joanna Briggs Institute (JBI). Las guías de práctica clínicas fueron evaluadas con el instrumento AGREE II. La evidencia se presenta como recomendaciones clínicas basadas en la evidencia, a las ...
Introduction: Reporting systems (RSs) are the rst step to improve patient safety in health instit... more Introduction: Reporting systems (RSs) are the rst step to improve patient safety in health institutions, consequently determining their performance is relevant. Objective: To determine the performance in terms of positive predictive value (PPV), the concordance, and the coincidence of passive and active RSs in the detection of true clinical incidents and reportable events with unwanted effects (REUWEs), in a teaching hospital in Bogota, Colombia. Methods: Cross-sectional study, assembled in a retrospective cohort, consistingofhospitalizedpatients (>12hours) in thesurgery service, between May and July 2017. The PPV was calculated for the detection of patients with clinical incidents or REUWE in both RS. Concordance and coincidence between RS were determined. Results: The incidence of REUWE from the passive RS was lower than the incidence from the active RS (2% vs 11.8%), the PPV for the identication of patients with clinical incidents and REUWE was similar (PPV patients with clinical incidents: passive 95% condence interval [CI] 34.6–66.2 vs active 95% CI 45.1–71.7; and PPV patients with REUWE: passive 95% CI 36.8–65.4 vs active 95% CI 29.3–54.9). Concordance was acceptable (Kappa 0.38) and the coincidence of patients and their REUWEs was 15.38%. Conclusion: In the active and passive RSs, the detection of true clinical incidents and REUWE (PPV) was similar and the concordance in the detection of subjects with REUWE was acceptable. However, the coincidence between the REUWEs in the patients detected by each RS was substantially different and should be considered when analyzing the information coming from one or another RS.
El Parque Nacional Natural Selva de Florencia es considerado uno de los últimos fragmentos de bos... more El Parque Nacional Natural Selva de Florencia es considerado uno de los últimos fragmentos de bosque pluvial andino de la cordillera Central de Colombia. Con el propósito de actualizar el estado del conocimiento de la avifauna del Parque recopilamos información obtenida mediante monitoreos realizados desde 2012 y registros de dos expediciones realizadas entre 2017 y 2018. Registramos 357 especies, de las cuales 11 son endémicas y 20 tienen alguna categoría de amenaza. Reportamos 18 nuevas especies para el departamento, con ampliaciones en el rango de su distribución para 12 de ellas. El contacto de ensamblajes de especies de bosques montanos con los de especies de influencia del valle del Magdalena medio, sumado al buen estado de conservación y regeneración de los ecosistemas, en gran medida producto del restringido acceso generado por el conflicto armado, podrían explicar la gran riqueza de especies de aves en la zona (≈20% de las especies de Colombia en menos del 0.01% del territo...
We develop hypothesis testing for active information-the averaged quantity in the Kullback-Lieble... more We develop hypothesis testing for active information-the averaged quantity in the Kullback-Liebler divergence. To our knowledge, this is the first paper to derive exact probabilities of type-I errors for hypothesis testing in the area.
Objective: The objective of the study was to clarify how the Grading of Recommendations Assessmen... more Objective: The objective of the study was to clarify how the Grading of Recommendations Assessment, Development and Evaluation (GRADE) concept of certainty of evidence applies to certainty ratings of test accuracy. Study Design and Setting: After initial brainstorming with GRADE Working Group members, we iteratively refined and clarified the approaches for defining ranges when assessing the certainty of evidence for test accuracy within a systematic review, health technology assessment, or guideline.
Introduction: Foreign accent syndrome (FAS) is a rare speech disorder. It is becoming increasingl... more Introduction: Foreign accent syndrome (FAS) is a rare speech disorder. It is becoming increasingly common to find reports of cases about alterations different from the suprasegmental aspects of speech, although these reports are not frequent in Spanish-speaking patients.Case presentation: 48-year-old female patient from Colombia diagnosed with FAS, segmental and suprasegmental speech alterations, and changes in cognitive domains (executive functions and language). The woman also presented with motor and affective changes. Brain imaging studies ruled out structural involvement and follow-up at one year did not show significant changes in speech.Discussion: This case presents the neurological, neuropsychological and speech features of a Spanish-speaking patient with FAS. Greater alteration in vowels than in consonants, alteration in pronunciation time, variation in rhythm and intonation of words and phrases, decrease of time between syllables, and insertion of vowels are common elemen...
Background: Some reports suggest differences regarding health needs between the population affili... more Background: Some reports suggest differences regarding health needs between the population affiliated to subsidized health insurance scheme (SS) compared to the contributory health insurance scheme (CS) in Colombia. Therefore, the objective of this study was to identify the epidemiological profile of the population affiliated to the SS in Colombia, to establish if there are differences compared to CS in terms of: incident diseases, prevalent diseases, and use of health services and to estimate the magnitude of the differences from statistical analyzes of the data retrieved in a systematic review of data published in the literature and other sources of information. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. The search was made from 1993, with none other restriction. The information was synthesized in five categories according to the most important risk populations. We estimated combined incidences from epidemiologic...
Introducción. El cutting es un comportamiento de autolesión no suicida cada vez más frecuente en ... more Introducción. El cutting es un comportamiento de autolesión no suicida cada vez más frecuente en menores de 15 años; sin embargo, en Colombia aún no se han realizado estudios que reporten la prevalencia de esta conducta en población pediátrica.Objetivo. Describir las características sociodemográficas y clínicas, y los factores de riesgo de la población pediátrica (0 a 14 años) con diagnóstico de cutting atendida en el servicio de urgencias de una clínica de cuarto nivel en Bogotá D.C., Colombia.Materiales y métodos. Estudio observacional descriptivo de corte transversal en el que se revisaron las historias clínicas de los pacientes menores de 15 años atendidos entre los años 2011 y 2017 con los códigos diagnósticos CIE 10 Z91.5, F32, F33, F99, F19, F41, F43, T742 y X60, con el fin de identificar aquellos casos que cumplieran con los criterios diagnósticos de cutting.Resultados. Se incluyeron 85 historias clínicas de niños entre 10 y 14 años. La prevalencia de cutting fue de 0.15% en...
Revista Colombiana de Obstetricia y Ginecología, 2021
P atient safety has been defined by the World Health Organization (WHO) as the "Management of pro... more P atient safety has been defined by the World Health Organization (WHO) as the "Management of processes that results in the reduction to an acceptable minimum of the risk of causing unnecessary harm in medical care" (1, p.15). Acceptable minimum is understood to mean "any harm that is inevitable in light of current knowledge, available resources and the context in which care is provided, which is in contrast with the risk of receiving no treatment or a different treatment" (1, p.15). Harm to a patient is the undesired effect derived more from healthcare than from the underlying disease (2), and it is known as an adverse event or a reportable event with undesired effects-REUE-(3). The Royal Spanish Academy defines a patient as the "person who experiences bodily and physical suffering and, in particular, the person who is receiving medical care" or "person who is or will be medically examined" (4). This concept includes both the person suffering from an illness as well as the healthy individual who comes into contact with healthcare services. It includes the widely researched concept of subjects with pathological conditions receiving care during hospitalization (5,6), as well as individuals receiving outpatient care (7) and people in good health such as children who are monitored for growth and development, or women in prenatal care. The aim of prenatal care visits is to verify the normal course of pregnancy and ensure early detection of potential pathological conditions that may affect
Revista Colombiana de Obstetricia y Ginecología, 2021
Resumen Introducción y objetivo: Una importante proporción de pacientes hospitalizados presenta d... more Resumen Introducción y objetivo: Una importante proporción de pacientes hospitalizados presenta deterioro clínico severo que puede terminar en eventos adversos, paro cardíaco no esperado, o muerte; para reducir su frecuencia y prevenir sus consecuencias se han creado los equipos de respuesta rápida (ERR). El objetivo de esta revisión de alcance es describir la conformación, funcionamiento y resultados de la implementación de los ERR en el contexto hospitalario, con énfasis en los servicios de cirugía ginecológica y atención obstetricia. Materiales y métodos: Se llevó a cabo una búsqueda en las bases de datos de literatura médica Medline vía Pubmed, Embase vía OVID, LILACS, Cochrane Library y Open Gray. Se incluyeron estudios observacionales descriptivos y analíticos, estudios experimentales y estudios cualitativos que incluyeron ERR en instituciones de salud de alta complejidad u hospitales universitarios. Dos investigadores seleccionaron los estudios y extrajeron los datos respecto...
Introducción: La obesidad en niños y adolescentes es un problema de salud pública que puede pasar... more Introducción: La obesidad en niños y adolescentes es un problema de salud pública que puede pasar desapercibido, si no se caracteriza de manera temprana en centros de atención primaria.Objetivo: Determinar la prevalencia de sobrepeso y obesidad en niños de 5 a 10 años que asistieron a la consulta externa de pediatría, en un centro de atención primaria en Bogotá, entre los años 2017 y 2018.Metodología: Estudio de corte transversal. Se incluyeron todos los pacientes entre 5 y 10 años que asistieron al consultorio de pediatría del Clinicentro Calle 80. Se realizó muestreo consecutivo estricto. Los participantes fueron pesados y tallados y se calculó el índice de masa corporal. Se aplicó una encuesta para registrar factores de riesgo asociados al sobrepeso y a la obesidad.Resultados: Se incluyeron 300 pacientes, 148 niñas (49.33%) y 152 niños (50.66%). La mediana de edad fue de 7 años. El 70% de ambos sexos tuvo un peso adecuado para la edad, el 14.86% de las niñas y el 12.5% de los niñ...
Introduction: A broad range of practices aimed at improving the effectives and safety of this pro... more Introduction: A broad range of practices aimed at improving the effectives and safety of this process have been documented over the past few years. Objective: to establish the effectiveness, safety and results of the implementation of these strategies in adult patients in university hospitals. Methodology: A review of systematic reviews was conducted, in addition to a database search in the Cochrane Library of Systematic Reviews, Embase, Epistemonikos, LILACS and gray literature. Any strategy aimed at reducing prescription-associated risks was included as intervention. This review followed the protocol registered in the International Prospective Registry of Systematic Reviews (PROSPERO): CRD42020165143. Results: 7,637 studies were identified, upon deleting duplicate references. After excluding records based on titles and abstracts, 111 full texts were assessed for eligibility. Fifteen studies were included in the review. Several interventions grouped into 5 strategies addressed to t...
Introducción: el SAHOS secundario a malformaciones craneofaciales conlleva aumento en la morbilid... more Introducción: el SAHOS secundario a malformaciones craneofaciales conlleva aumento en la morbilidad y deterioro en la calidad de vida del paciente. Objetivo: describir las características prequirúrgicas y cambios posquirúrgicos en la vía aérea, en pacientes sometidos a cirugía de avance maxilomandibular por SAHOS secundario a malformaciones craneofaciales. Metodología: Estudio observacional descriptivo en adultos con SAHOS secundario a malformaciones craneofaciales sometidos a cirugía de avance maxilomandibular entre diciembre del 2013 y octubre del 2018. Se analizaron las medidas prequirúrgicas y posquirúrgicas, así como la magnitud del cambio postintervención. Resultados: En la muestra se encontró el 57,17 % de los pacientes con 2 a 4 malformaciones, seguido del 42,86 % con 5 o más. Los reparos anatómicos con cambios significativos en las medidas posquirúrgicas, en el primer grupo fueron: espacio faríngeo superior, 4,78 mm (DE 1,92); espacio faríngeo inferior, 4,5 mm (DE 3,25); ba...
INTRODUCTION Reducing the incidence of reportable events with undesirable effects (REUE) is a pri... more INTRODUCTION Reducing the incidence of reportable events with undesirable effects (REUE) is a priority in the hospital environment, which is why reporting systems have been implemented to identify and manage them. Information is required regarding the performance of reporting systems, barriers, or facilitators for reporting and strategies that improve passive reporting. METHODOLOGY Systematic scoping review of the literature that included studies performed in the population exposed to the occurrence of REUE in the health system (teams, patients, and family). A search was performed in Cochrane Database of Systematic Reviews, Epistemonikos, MEDLINE (PubMed), MEDLINE In-Process and MEDLINE Daily Update, EMBASE, LILACS, and databases of the World Health Organization and Pan-American Health Organization. RESULTS Fifteen studies were found, 1 systematic review, 2 clinical trials, 8 observational studies, 3 qualitative studies, and 1 mixed study. In 4 of them, the effectiveness of active versus passive reporting systems was compared. The measures to improve the passive systems were education about REUE, simplification of the reporting format, activities focused on increasing the motivation for self-report, adoption of self-report as an obligatory institutional policy, and using specific report formats for each service. CONCLUSIONS There is information that allows to find differences between the performance of the active and passive reporting systems. The reviewed research articles found that passive techniques significantly underreported adverse events. It is recommended that institutions adopt both active and passive techniques in adverse event surveillance. New studies should be directed to answer the comparative efficiency of the reporting systems.
The impact of pharmacologic prophylaxis for venous thromboembolism in patients undergoing neurosu... more The impact of pharmacologic prophylaxis for venous thromboembolism in patients undergoing neurosurgical intervention remains uncertain. We reviewed the efficacy and safety of pharmacologic compared with nonpharmacologic thromboprophylaxis in neurosurgical patients. Three databases were searched through April 2018, including those for randomized controlled trials (RCTs) and for nonrandomized controlled studies (NRSs). Independent reviewers assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Seven RCTs and 3 NRSs proved eligible. No studies reported on symptomatic proximal and distal deep vein thrombosis (DVT). Two RCTs reported on screening-detected proximal and distal DVTs. We used the findings of these 2 RCTs as the closest surrogate outcomes to inform the proximal and distal DVT outcomes. These 2 RCTs suggest that pharmacologic thromboprophylaxis may decrease the risk of developing asymptomatic proximal D...
Revista Colombiana de Obstetricia y Ginecología, 2020
Objetivo: presentar a los clínicos la evidencia que soporta los procesos más seguros y efectivos ... more Objetivo: presentar a los clínicos la evidencia que soporta los procesos más seguros y efectivos en la inserción y el mantenimiento del catéter venoso central (CVC), como estrategia en la prevención de las infecciones del torrente sanguíneo asociadas a catéter. Materiales y métodos: a partir de preguntas clínicas dirigidas a mejorar la seguridad y efectividad de los procesos de inserción y mantenimiento de catéter venoso, en los momentos clave, se hicieron búsquedas de literatura en las bases de datos Medline vía PubMed, Embase, Central y Lilacs. Se utilizó la metodología de revisión sistemática rápida de la literatura. Los estudios identificados fueron evaluados desde el punto de vista de la calidad con las herramientas para estudios cualitativos, cuantitativos y revisiones sistemáticas del Joanna Briggs Institute (JBI). Las guías de práctica clínicas fueron evaluadas con el instrumento AGREE II. La evidencia se presenta como recomendaciones clínicas basadas en la evidencia, a las ...
Introduction: Reporting systems (RSs) are the rst step to improve patient safety in health instit... more Introduction: Reporting systems (RSs) are the rst step to improve patient safety in health institutions, consequently determining their performance is relevant. Objective: To determine the performance in terms of positive predictive value (PPV), the concordance, and the coincidence of passive and active RSs in the detection of true clinical incidents and reportable events with unwanted effects (REUWEs), in a teaching hospital in Bogota, Colombia. Methods: Cross-sectional study, assembled in a retrospective cohort, consistingofhospitalizedpatients (>12hours) in thesurgery service, between May and July 2017. The PPV was calculated for the detection of patients with clinical incidents or REUWE in both RS. Concordance and coincidence between RS were determined. Results: The incidence of REUWE from the passive RS was lower than the incidence from the active RS (2% vs 11.8%), the PPV for the identication of patients with clinical incidents and REUWE was similar (PPV patients with clinical incidents: passive 95% condence interval [CI] 34.6–66.2 vs active 95% CI 45.1–71.7; and PPV patients with REUWE: passive 95% CI 36.8–65.4 vs active 95% CI 29.3–54.9). Concordance was acceptable (Kappa 0.38) and the coincidence of patients and their REUWEs was 15.38%. Conclusion: In the active and passive RSs, the detection of true clinical incidents and REUWE (PPV) was similar and the concordance in the detection of subjects with REUWE was acceptable. However, the coincidence between the REUWEs in the patients detected by each RS was substantially different and should be considered when analyzing the information coming from one or another RS.
El Parque Nacional Natural Selva de Florencia es considerado uno de los últimos fragmentos de bos... more El Parque Nacional Natural Selva de Florencia es considerado uno de los últimos fragmentos de bosque pluvial andino de la cordillera Central de Colombia. Con el propósito de actualizar el estado del conocimiento de la avifauna del Parque recopilamos información obtenida mediante monitoreos realizados desde 2012 y registros de dos expediciones realizadas entre 2017 y 2018. Registramos 357 especies, de las cuales 11 son endémicas y 20 tienen alguna categoría de amenaza. Reportamos 18 nuevas especies para el departamento, con ampliaciones en el rango de su distribución para 12 de ellas. El contacto de ensamblajes de especies de bosques montanos con los de especies de influencia del valle del Magdalena medio, sumado al buen estado de conservación y regeneración de los ecosistemas, en gran medida producto del restringido acceso generado por el conflicto armado, podrían explicar la gran riqueza de especies de aves en la zona (≈20% de las especies de Colombia en menos del 0.01% del territo...
We develop hypothesis testing for active information-the averaged quantity in the Kullback-Lieble... more We develop hypothesis testing for active information-the averaged quantity in the Kullback-Liebler divergence. To our knowledge, this is the first paper to derive exact probabilities of type-I errors for hypothesis testing in the area.
Objective: The objective of the study was to clarify how the Grading of Recommendations Assessmen... more Objective: The objective of the study was to clarify how the Grading of Recommendations Assessment, Development and Evaluation (GRADE) concept of certainty of evidence applies to certainty ratings of test accuracy. Study Design and Setting: After initial brainstorming with GRADE Working Group members, we iteratively refined and clarified the approaches for defining ranges when assessing the certainty of evidence for test accuracy within a systematic review, health technology assessment, or guideline.
Introduction: Foreign accent syndrome (FAS) is a rare speech disorder. It is becoming increasingl... more Introduction: Foreign accent syndrome (FAS) is a rare speech disorder. It is becoming increasingly common to find reports of cases about alterations different from the suprasegmental aspects of speech, although these reports are not frequent in Spanish-speaking patients.Case presentation: 48-year-old female patient from Colombia diagnosed with FAS, segmental and suprasegmental speech alterations, and changes in cognitive domains (executive functions and language). The woman also presented with motor and affective changes. Brain imaging studies ruled out structural involvement and follow-up at one year did not show significant changes in speech.Discussion: This case presents the neurological, neuropsychological and speech features of a Spanish-speaking patient with FAS. Greater alteration in vowels than in consonants, alteration in pronunciation time, variation in rhythm and intonation of words and phrases, decrease of time between syllables, and insertion of vowels are common elemen...
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