Luis Ernesto Hernandez Gamboa | Universidad Autónoma de Chiapas (original) (raw)
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Papers by Luis Ernesto Hernandez Gamboa
Terra, 2000
Terra Nueva Etapa. Universidad Central de Venezuela. vial2ss@cantv.net. ISSN (Versión impresa): 1... more Terra Nueva Etapa. Universidad Central de Venezuela. vial2ss@cantv.net. ISSN (Versión impresa): 1012-7089. VENEZUELA. 2000. Laura Delgado / Luis Gamboa L. / Napoleón León. ASPECTOS GEOGRÁFICOS RELACIONADOS ...
Rev Med Imss, Feb 1, 1994
I. INTRODUCCIÓN Y ANTECEDENTES a) Definición e historia Pediatría, compuesta etimológicamente por... more I. INTRODUCCIÓN Y ANTECEDENTES a) Definición e historia Pediatría, compuesta etimológicamente por los vocablos griegos paidos e iatros, significa literalmente medicina del niño. En la definición actual, es la rama de la medicina que estudia al ser humano durante sus etapas de crecimiento somático y de desarrollo funcional, psicológico y social, siempre correlacionados con el ambiente en el que se desenvuelve. Urgencia, desde la perspectiva clínica, se define como una situación grave que se plantea súbitamente y amenaza la vida o la salud de una persona o de un grupo de individuos. Desde el enfoque médico-legal, la Ley General de Salud, en su Reglamento en Materia de Prestación de Servicios de Atención Médica, plantea en su ARTICULO 72: " Se entiende por urgencia, todo problema médico-quirúrgico agudo, que ponga en peligro la vida, un órgano o una función y que requiera atención inmediata ". La medicina de urgencias surgió en la década de 1960, en los países desarrollados, ...
La seguridad de los pacientes se ha convertido en un tema importante para los sistemas de salud a... more La seguridad de los pacientes se ha convertido en un tema importante para los sistemas de salud a nivel mundial. En octubre del 2004 la OMS conjuntamente con líderes mun-diales de salud, presentaron una alianza para reducir el número de enfermedades, lesiones y muertes derivadas de errores en la atención de la salud. Un estudio de la Univer-sidad de Harvard indica que el 70% de los efectos adversos, producto de errores en la atención médica deriva en discapacidades temporarias y un 14% de ellos en la muerte del paciente, teniendo un impacto económico importante. Pero también puede sufrir otro tipo de afectaciones como las de carácter social, familiar y emocional. En otros estudios se menciona como consecuencia la prolongación de días de estancia hospitalaria, las demandas judiciales, las infecciones intrahospitalarias, la discapacidad y el costo de gastos médicos que de acuerdo al país oscila entre los 6 y 29 mil millones de dólares al año. 1 El Comité de Calidad en el Cuidado de la...
Cirugía y cirujanos
&... more "To err is human" (Institute of Medicine, 1999) begun the Patients' Safety movement worldwide. We undertook this study to determine the frequency of patient complaints related to adverse events in the National Health Services. The National Commission of Medical Arbitration and the Vice-Ministry for Innovation and Quality has the aim of determining the frequency of real adverse events as a reason for complaints by patients and relatives against healthcare professionals and health services. The Emergency Department registered the highest number of events. Negligence and absence of protocols account for more than half of the adverse events. Management protocols in emergency departments are areas of opportunity for improvement that must be considered.
![Research paper thumbnail of [Exploratory study of ethics, norms and communication skills in medical residents]](https://attachments.academia-assets.com/93106857/thumbnails/1.jpg)
](Cirugía y cirujanos
Medical schools teach technical-scientific knowledge more than social abilities. Confidence in th... more Medical schools teach technical-scientific knowledge more than social abilities. Confidence in the doctor-patient relationship is obtained through appropriate communication. The predominant medical education model assumes that communication abilities are acquired by the experienced physician in clinical practice. The present study presents a first approach and exploration of three central subjects for the development of a suitable doctor-patient relationship. We observed that the integration of evaluated knowledge was low: communication 21.1%, ethics 40.5%, legal issues 0.1% and doctor-patient conflicts 1.5%. In the analysis of communication models by genre, we found that women were more paternalist and men were more deliberative; the predominant model of communication is paternalism (40.2%). Physicians between 21 and 25 years of age integrated the knowledge better (communication, ethics and doctor-patient conflicts) than at other ages. Physicians between 41 and 45 years of age inte...
Cirugía y cirujanos
defensive medicine, has been recognized as a problem for health services in several countries of ... more defensive medicine, has been recognized as a problem for health services in several countries of the world. It is defined as the application of treatments, tests and procedures with the main intention to defend the doctor of critic's and to avoid controversies, regarding diagnosis or patient's treatment. There are multiple causes of the defensive medicine: the fundamental is patient doctor relationship without the necessary trust. the present reports it is a observational, cross-sectional and descriptive study of exploratory nature, with the objective to consider the dimension of the defensive medicine (MD) in Mexico. A survey was designed to pilot an application with Likert scale in a representative sample. 613 doctors participated to national level, with index of confidence of 95% and maximum error of 5% (p < 0.05). The questions explore the level in agreement or disagreement with perceptions, specific attitudes and conducts that are related to the MD practice. categori...
Summary Background: To err is human (Institute of Medicine, 1999) begun the Patients' Safety ... more Summary Background: To err is human (Institute of Medicine, 1999) begun the Patients' Safety movement worldwide. We undertook this study to determine the frequency of patient complaints related to adverse events in the National Health Services. Methods: The National Commission of Medical Arbitration and the Vice-Ministry for Innovation and Quality has the aim of determining the frequency of real adverse
Summary Medical schools teach technical-scientific knowledge more than social abilities. Confiden... more Summary Medical schools teach technical-scientific knowledge more than social abilities. Confidence in the doctor-patient relation- ship is obtained through appropriate communication. The pre- dominant medical education model assumes that communi- cation abilities are acquired by the experienced physician in clinical practice. The present study presents a first approach and exploration of three central subjects for the development of a suitable
Neonatology is the speciality of pediatrics dedicated to attend both healthy and ill newborns. Po... more Neonatology is the speciality of pediatrics dedicated to attend both healthy and ill newborns. Posnatal affections (since newborn until first month of extrauterine life) represents 7th cause of general mortality and first of infantile mortality in 2001. Perinatal and infantile morbidity and mortality are indirect indicators of health conditions of a population, medical attention quality and development state of a nation. This study analyzes the complaints were received in CONAMED between January 1997 and December 2001; they correspondes 17.5% of all pediatrics attention complaints. CONAMED specialists analyze this results and generate a serie of recommendations, validated in a second phase, by a external validation group, integrated by opinion leaders of Pediatrics and Neonatology. Five specific recommendations were agreed: 1) Attend the newborn in integral and opportune way in delivery room; 2) Know and apply the main diagnosis and treatment protocols in neonatology; 3) Identify high risk-newborns and treat them appropriately; 4) Apply clinical criteria for enter patients to neonatal intensive care unit, and 5) Assure an optimal transfer.
Orthopedics is one of the specialties with more number of dissents received at CONAMED (National ... more Orthopedics is one of the specialties with more number of dissents received at CONAMED (National Medical Arbitration Commission of México). The cases related to this specialty were analyzed. Results: 28% of involved doctors didn't have any board certification; deforming and degenerative were the main causes of application of service; the most frequent dissent reasons were delay of medical attention and delay or negation of diagnostics auxiliaries. The communication problems in the doctor-patient relationship reached 87.3% of the cases. The most outstanding deviation by frequency was a deficient diagnosis plan (40.9%). A group of prestigious specialist analyzed those results and emitted by Consensus these General Recommendations to improve the Practice of Orthopedics: 1) Have the board certification and re-certifications indispensable to exercise Orthopedics specialty, 2) Maintain appropriate medical communication with the patient and its responsible relative, 3) Assure the understanding and acceptance of the proposed diagnostic and therapeutic procedures, 4) Value the patient integrally, to structure diagnostic and establish treatments or opportune therapeutic measures, 5) Assure from the first contact the injured patient' s integral valuation, 6) Define and meditate with opportunity the handling for each case. They also emitted Specific Recommendations for the patient' s attention with Low Back Pain and with Sprain in extremities, because these were the most frequent sufferings found in the dissents.
Los defectos congénitos son anomalías morfológicas, estructurales, funcionales o moleculares del ... more Los defectos congénitos son anomalías morfológicas, estructurales, funcionales o moleculares del feto, que son responsables del 10% de muertes infantiles en México. Pueden diagnosticarse oportunamente mediante el diagnóstico prenatal. El diagnóstico prenatal incluye detecciones clínicas, bioquímicas o de imagen que se aplican durante la vida embrionaria-fetal para conocer el estado de salud del producto, descubrir un defecto congénito y poder dirigir mejor el manejo en los casos de enfermedad o alteración fetal. Se analizaron las inconformidades relacionadas con Diagnóstico Prenatal recibidas ante CONAMED. La desviación más frecuente fue una explicación incompleta del diagnóstico, pronóstico y plan de manejo. Dos tercios de los asuntos se resolvieron a través de una explicación al paciente en un lenguaje sencillo o con el compromiso del médico a proporcionar la atención médica especializada. Un grupo integrado por reconocidos médicos especialistas en Gineco-obstetricia, Genética Clínica, Medicina Materno Fetal, Patología Clínica y Psicología, revisaron las inconformidades y emitieron las siguientes Recomendaciones: 1) Ofrecer una atención profesional de alta calidad, 2) Valorar integralmente cada caso y establecer el mejor plan de diagnóstico prenatal, 3) Proporcionar información adecuada, 4) Limitar en lo posible los riesgos inherentes, 5) Procurar la mejor atención durante el embarazo ante el diagnóstico prenatal y 6) Documentar todo el proceso de atención y obtener el Consentimiento Válidamente Informado.
Salud pública de México
The prevention of HIV infection in school and university communities acquires great importance in... more The prevention of HIV infection in school and university communities acquires great importance in adolescents and young adults where the risk of HIV infection is caused by age, occupation, location, and also adjoining relations with other groups of high incidence of infection, such as teachers and administrative employees. Adequate strategies for specific groups are needed. This paper focuses on the strategies developed at the National Autonomous University of Mexico. An interdisciplinary health commission for the prevention and control of AIDS was established to inform the student body. Other activities performed by this commission include providing medical and psychological attention for AIDS victims, as well as detecting and carrying out follow-up studies of infected students. Efforts in health education have also been made by training professors to include preventive measures against this disease as part of their subject matter. Specific, organized, and immediate action must be ...
Terra, 2000
Terra Nueva Etapa. Universidad Central de Venezuela. vial2ss@cantv.net. ISSN (Versión impresa): 1... more Terra Nueva Etapa. Universidad Central de Venezuela. vial2ss@cantv.net. ISSN (Versión impresa): 1012-7089. VENEZUELA. 2000. Laura Delgado / Luis Gamboa L. / Napoleón León. ASPECTOS GEOGRÁFICOS RELACIONADOS ...
Rev Med Imss, Feb 1, 1994
I. INTRODUCCIÓN Y ANTECEDENTES a) Definición e historia Pediatría, compuesta etimológicamente por... more I. INTRODUCCIÓN Y ANTECEDENTES a) Definición e historia Pediatría, compuesta etimológicamente por los vocablos griegos paidos e iatros, significa literalmente medicina del niño. En la definición actual, es la rama de la medicina que estudia al ser humano durante sus etapas de crecimiento somático y de desarrollo funcional, psicológico y social, siempre correlacionados con el ambiente en el que se desenvuelve. Urgencia, desde la perspectiva clínica, se define como una situación grave que se plantea súbitamente y amenaza la vida o la salud de una persona o de un grupo de individuos. Desde el enfoque médico-legal, la Ley General de Salud, en su Reglamento en Materia de Prestación de Servicios de Atención Médica, plantea en su ARTICULO 72: " Se entiende por urgencia, todo problema médico-quirúrgico agudo, que ponga en peligro la vida, un órgano o una función y que requiera atención inmediata ". La medicina de urgencias surgió en la década de 1960, en los países desarrollados, ...
La seguridad de los pacientes se ha convertido en un tema importante para los sistemas de salud a... more La seguridad de los pacientes se ha convertido en un tema importante para los sistemas de salud a nivel mundial. En octubre del 2004 la OMS conjuntamente con líderes mun-diales de salud, presentaron una alianza para reducir el número de enfermedades, lesiones y muertes derivadas de errores en la atención de la salud. Un estudio de la Univer-sidad de Harvard indica que el 70% de los efectos adversos, producto de errores en la atención médica deriva en discapacidades temporarias y un 14% de ellos en la muerte del paciente, teniendo un impacto económico importante. Pero también puede sufrir otro tipo de afectaciones como las de carácter social, familiar y emocional. En otros estudios se menciona como consecuencia la prolongación de días de estancia hospitalaria, las demandas judiciales, las infecciones intrahospitalarias, la discapacidad y el costo de gastos médicos que de acuerdo al país oscila entre los 6 y 29 mil millones de dólares al año. 1 El Comité de Calidad en el Cuidado de la...
Cirugía y cirujanos
&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;... more &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;To err is human&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; (Institute of Medicine, 1999) begun the Patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; Safety movement worldwide. We undertook this study to determine the frequency of patient complaints related to adverse events in the National Health Services. The National Commission of Medical Arbitration and the Vice-Ministry for Innovation and Quality has the aim of determining the frequency of real adverse events as a reason for complaints by patients and relatives against healthcare professionals and health services. The Emergency Department registered the highest number of events. Negligence and absence of protocols account for more than half of the adverse events. Management protocols in emergency departments are areas of opportunity for improvement that must be considered.
Cirugía y cirujanos
Medical schools teach technical-scientific knowledge more than social abilities. Confidence in th... more Medical schools teach technical-scientific knowledge more than social abilities. Confidence in the doctor-patient relationship is obtained through appropriate communication. The predominant medical education model assumes that communication abilities are acquired by the experienced physician in clinical practice. The present study presents a first approach and exploration of three central subjects for the development of a suitable doctor-patient relationship. We observed that the integration of evaluated knowledge was low: communication 21.1%, ethics 40.5%, legal issues 0.1% and doctor-patient conflicts 1.5%. In the analysis of communication models by genre, we found that women were more paternalist and men were more deliberative; the predominant model of communication is paternalism (40.2%). Physicians between 21 and 25 years of age integrated the knowledge better (communication, ethics and doctor-patient conflicts) than at other ages. Physicians between 41 and 45 years of age inte...
Cirugía y cirujanos
defensive medicine, has been recognized as a problem for health services in several countries of ... more defensive medicine, has been recognized as a problem for health services in several countries of the world. It is defined as the application of treatments, tests and procedures with the main intention to defend the doctor of critic's and to avoid controversies, regarding diagnosis or patient's treatment. There are multiple causes of the defensive medicine: the fundamental is patient doctor relationship without the necessary trust. the present reports it is a observational, cross-sectional and descriptive study of exploratory nature, with the objective to consider the dimension of the defensive medicine (MD) in Mexico. A survey was designed to pilot an application with Likert scale in a representative sample. 613 doctors participated to national level, with index of confidence of 95% and maximum error of 5% (p < 0.05). The questions explore the level in agreement or disagreement with perceptions, specific attitudes and conducts that are related to the MD practice. categori...
Summary Background: To err is human (Institute of Medicine, 1999) begun the Patients' Safety ... more Summary Background: To err is human (Institute of Medicine, 1999) begun the Patients' Safety movement worldwide. We undertook this study to determine the frequency of patient complaints related to adverse events in the National Health Services. Methods: The National Commission of Medical Arbitration and the Vice-Ministry for Innovation and Quality has the aim of determining the frequency of real adverse
Summary Medical schools teach technical-scientific knowledge more than social abilities. Confiden... more Summary Medical schools teach technical-scientific knowledge more than social abilities. Confidence in the doctor-patient relation- ship is obtained through appropriate communication. The pre- dominant medical education model assumes that communi- cation abilities are acquired by the experienced physician in clinical practice. The present study presents a first approach and exploration of three central subjects for the development of a suitable
Neonatology is the speciality of pediatrics dedicated to attend both healthy and ill newborns. Po... more Neonatology is the speciality of pediatrics dedicated to attend both healthy and ill newborns. Posnatal affections (since newborn until first month of extrauterine life) represents 7th cause of general mortality and first of infantile mortality in 2001. Perinatal and infantile morbidity and mortality are indirect indicators of health conditions of a population, medical attention quality and development state of a nation. This study analyzes the complaints were received in CONAMED between January 1997 and December 2001; they correspondes 17.5% of all pediatrics attention complaints. CONAMED specialists analyze this results and generate a serie of recommendations, validated in a second phase, by a external validation group, integrated by opinion leaders of Pediatrics and Neonatology. Five specific recommendations were agreed: 1) Attend the newborn in integral and opportune way in delivery room; 2) Know and apply the main diagnosis and treatment protocols in neonatology; 3) Identify high risk-newborns and treat them appropriately; 4) Apply clinical criteria for enter patients to neonatal intensive care unit, and 5) Assure an optimal transfer.
Orthopedics is one of the specialties with more number of dissents received at CONAMED (National ... more Orthopedics is one of the specialties with more number of dissents received at CONAMED (National Medical Arbitration Commission of México). The cases related to this specialty were analyzed. Results: 28% of involved doctors didn't have any board certification; deforming and degenerative were the main causes of application of service; the most frequent dissent reasons were delay of medical attention and delay or negation of diagnostics auxiliaries. The communication problems in the doctor-patient relationship reached 87.3% of the cases. The most outstanding deviation by frequency was a deficient diagnosis plan (40.9%). A group of prestigious specialist analyzed those results and emitted by Consensus these General Recommendations to improve the Practice of Orthopedics: 1) Have the board certification and re-certifications indispensable to exercise Orthopedics specialty, 2) Maintain appropriate medical communication with the patient and its responsible relative, 3) Assure the understanding and acceptance of the proposed diagnostic and therapeutic procedures, 4) Value the patient integrally, to structure diagnostic and establish treatments or opportune therapeutic measures, 5) Assure from the first contact the injured patient' s integral valuation, 6) Define and meditate with opportunity the handling for each case. They also emitted Specific Recommendations for the patient' s attention with Low Back Pain and with Sprain in extremities, because these were the most frequent sufferings found in the dissents.
Los defectos congénitos son anomalías morfológicas, estructurales, funcionales o moleculares del ... more Los defectos congénitos son anomalías morfológicas, estructurales, funcionales o moleculares del feto, que son responsables del 10% de muertes infantiles en México. Pueden diagnosticarse oportunamente mediante el diagnóstico prenatal. El diagnóstico prenatal incluye detecciones clínicas, bioquímicas o de imagen que se aplican durante la vida embrionaria-fetal para conocer el estado de salud del producto, descubrir un defecto congénito y poder dirigir mejor el manejo en los casos de enfermedad o alteración fetal. Se analizaron las inconformidades relacionadas con Diagnóstico Prenatal recibidas ante CONAMED. La desviación más frecuente fue una explicación incompleta del diagnóstico, pronóstico y plan de manejo. Dos tercios de los asuntos se resolvieron a través de una explicación al paciente en un lenguaje sencillo o con el compromiso del médico a proporcionar la atención médica especializada. Un grupo integrado por reconocidos médicos especialistas en Gineco-obstetricia, Genética Clínica, Medicina Materno Fetal, Patología Clínica y Psicología, revisaron las inconformidades y emitieron las siguientes Recomendaciones: 1) Ofrecer una atención profesional de alta calidad, 2) Valorar integralmente cada caso y establecer el mejor plan de diagnóstico prenatal, 3) Proporcionar información adecuada, 4) Limitar en lo posible los riesgos inherentes, 5) Procurar la mejor atención durante el embarazo ante el diagnóstico prenatal y 6) Documentar todo el proceso de atención y obtener el Consentimiento Válidamente Informado.
Salud pública de México
The prevention of HIV infection in school and university communities acquires great importance in... more The prevention of HIV infection in school and university communities acquires great importance in adolescents and young adults where the risk of HIV infection is caused by age, occupation, location, and also adjoining relations with other groups of high incidence of infection, such as teachers and administrative employees. Adequate strategies for specific groups are needed. This paper focuses on the strategies developed at the National Autonomous University of Mexico. An interdisciplinary health commission for the prevention and control of AIDS was established to inform the student body. Other activities performed by this commission include providing medical and psychological attention for AIDS victims, as well as detecting and carrying out follow-up studies of infected students. Efforts in health education have also been made by training professors to include preventive measures against this disease as part of their subject matter. Specific, organized, and immediate action must be ...