Trabajo de Clinica Del Caso

 

Ds`oedturd Kcáe`kd. Hb Kdsis Vbedcbs y Xrdes`ti

dcuaei/d Xdt`ded Jdrsdcci

gbkmd. :6-6=-:6:4

Kie jdsb, dc v`hbi v`sti y s`ou`behi cis c`ebda`betis qub eis p`hb cd prbsbetb tdrbd,  pihbais bapbzdr bapbzdr h`k`behi y bv`hbek`dehi bv`hbek`dehi bc kdsi hb cis mbradei mbradeiss Abeàehbz, cd eikmb eikmb hbc :6 hb doisti hb 40=0 cis bspisis Lisà y N`tty Abcàehbz gubrie dsbs`edhis be su ades`ûe hb Jbvbrcy M`ccs cd pic`kád hb is Äeobcbs rbk`j`û cd ccdadhd dc itri cdhi hbc tbcàgiei bstdjd Cycb Abeàehbz sbôdcdehi qub su pdhrb mdjád s`hi dsbs`edhi pir pdrtb hb cis dsbs`eis, kiegueh`behi titdcabetb d cd pic`kád y g`skdcád hb bsd pir ccbvdrcbs ei sici d qub sb tiabe t`bapi be cd dvbr`oudk`ûe a`sad hbc dsbs`edti, s`ei tdaj`àe h`strdád h`str dád be cd `evbst`o `evbst`odk`ûe dk`ûe,, be ue pr`ab pr`abrr aiab aiabeti eti cd pic`kád pr`abri bspbkucû bspbkucû qub cd adg`d bstdjd hbträs hbc `ek`hbetb hbj`hi d cbs`iebs be cds rih`ccds be dajis cdhis, ci kudc bs kdrdktbrást`ki hb cd adg`d. Kie ci yd bstuh`dhi pihbais pihbais sbôdcdr cis puetis kcdris ccbv ccbvdhis dhis pir pdrtb hb g`skdcád be kietrd hb cis mbradeis Abeàehbz cd prubjds dktudhds be bc lu`k`i tdeti tbst`aie`dcbs, kiai pbr`k`dcbs yd qub sb ccbvdrie bxpbrtis qub bstuh`drie bc kiapirtda`beti psáqu`ki y ps`kicûo`ki hb cds dktirbs hbc kr`abe be rbcdk`ûe dc dsbs`edti hb sus pdhrbs cis sbôirbs Abeàehbz cis kudcbs be cáebds aäs dhb dhbcdetb cdetb `rbais dedc`zdehi ci dktudhi dktudhi pir pdrtb hb g`skdcád be tirei dc tbad qub `rbais dedc`zdehi kiai pueti hb pdrt`hd eis begikdrbais qub< Hurdetb Hurde tb ued `evbst` `evbst`odk`û odk`ûee hb sb`s absb absbs, s, cd pic`k pic`kád ád hbskujr`û hbskujr`û qub su adhrb, N`tty, `ekcusi `ekcu si mdjá mdjádd kbrrd kbrrdhi hi cd pubr pubrtd td hb su hira hira`tir`i `tir`i,, tba`b tba`behi ehi qub su m`li puh`brd puh`brd sbr ue dsbs`ei, d ued ps`qu`dtrd. Be cis absbs pistbr`irbs d cis dsbs`edtis, dsbs`edtis, cis mbradeis ccbvdrie ued v`hd hb hbrrikmb hb h`ebri, ci qub duabetû cds sispbkmds hb cis `evbst`odhirbs sijrb su pdrt`k`pdk`ûe be cd aubrtb hb sus pdhrbs. Vir rdzûe qub cis his mbradeis kiabt`brie brrirbs cis a`sais

 

qub ccdadrie cd dtbek`ûe d cd pic`kád m`k`brie a`rdr d itrd h`rbkk`ûe sijrb cis dsbs`eis hb cis sbôirbs Abeàehbz kiai pueti hb pdrt`hd sijrb cds dkk`iebs pir cis mbradeis Abeàehbz, pir cis odstis hbldehi cd pic`kád hbld hb cdhi d cd adg`d y cds sispbkmds ccbvi d kiekbetrdrsb be cd prip`d gda`c`d, ei qu`s`brie mdkbrsb eitdr b `ekcusi kiaprdrie ue rbstdurdetb pdrd v`v`r dc aäx`ai. [b bst`ad qub sb odstû aäs hb $ 4 a`ccûe be trbs absbs

pdrd

v`dldr

s`e

bskdcds

y

ccbvdr

ued

v`hd

culisd.

Br`k cuboi kieg`bsd bc dsbs`edti d su ps`qu`dtrd. Duequb Cycb ci dabedzû kie hbk`r dcoi, bc ps`qu`dtrd gub d cd pic`kád, cb h`li qub bc pdk`betb cb mdjád kiegbsdhi, y kudehi s`et`û qub su v`hd bstdjd be lubo luboi, i, bc aàh` aàh`ki, ki, cis aàh` aàh`kis kis y cis pdk`be pdk`betbs tbs puh`brie mdjbr  mdjbr   pdsdhi pir dcti dcti cis dkubrhis hb ei h`vucodk`ûe h`vucodk`ûe.. Cd pic`kád kietdjd kie prubjds tdcbs kiai Cycb kiaprdrie ue kistisi rbcil Zicbx, ue Virskmb 044, y bc Kmukn's [pr`eo [trbbt Kdgb,; ue rbstdurdetb hb juggdci w`eos be Vr`ekbtie. Br`n tdaj`àe kietrdtû d ue betrbedhir hb tbe`s d t`bapi kiapcbti y kiap`t`û be ued sbr`b hb tirebis kiai prigbs`iedc be @srdbc. Hbldrie cd ades`ûe hb Eirtm Bca Hr`vb y sb auhdrie d his hbpdrtdabetis pbetmiusb sbpdrdhis be Adr`ed hbc Zby. W`dldrie dcrbhbhir hb Cis Äeobcbs be bc Abrkbhbs-Jbez [C kievbrt`jcb hb su h`guetd adhrb, sb dc`abetdjde hb kia`hds kdrds, y sb gubrie hb v`dlb dc bxtrdelbri, v`s`tdehi bc Kdr`jb y Ciehrbs.hb bstd adebrd cd g`skdcád dcboû pistbr`irabetb qub cis mbradeis odstdrie dcrbhbhir hb 4 a`ccûe hb hûcdrbs be cis pr`abris sb`s absbs kiai muàrgdeis. Br`n kiegbsû cis dsbs`edtis d su ps`qu`dtrd, qu`be, hbspuàs hb mdjbr s`hi dabedzdhi pir  Cycb Cy cb s` cis cis hbcd hbcdtd tdjd jd,, dk dkuh uh`û `û d cd pic` pic`ká kád. d. Vd Vdrd rd bv bv`t `tdr drsb sb aä aäss pr prij ijcb cbad adss tb tbra ra`e `eûû kietäehici tihi ued hb cds bxkbpk`iebs d cd kieg`hbek`dc`hdh betrb aàh`ki y pdk`betb sb  prihukb kudehi kudehi bc pdk`betb pi pieb eb be pbc`ori ddcc tbrdpbutd. Dmird j`be, sdj`behi qub bsticd pic`kád y cd g`skdcád sbôdcde qub bc dsbs`edti hbc [r. Abeàehbz y sus pdhrbs kieaik`ieû d cis bstdhiue`hbesbs kudehi Kiurt XW trdesa`t`û bc lu`k`i be 400;. Cd djiodhd hb su mbradei, Cbsc`b Djrdasie, sb m`zi kieik`hd pir su hbgbesd, dcbodehi qub àc juskdjd cd v`hd. [us pdhrbs, `ekcu`hi bc djusi sbxudc hb su  pdhrb, Lisà. D pbsdr hb cd tbirád hb cd hbgbesd, cis detbkbhbetbs detbkbhbetbs pbedcbs hbc mbradei adyir ei sb dlustdjde d cd tbirád hbc "bskdpb hb cd v`icbek`d hb cis pdhrbs". Bc lu`k`i tbra`eû kie his lurdhis dtrdpdhis (his mbradeis gubrie luzodhis luetis, pbri kdhd uei ijtuvi

ue

lurdhi

sbpdrdhi).

 

 pir itri cdhi, bc g`skdc hbc h`str`ti hbc kiehdhi hb Cis Äeobcbs, O`c Odrkbtt`, deuek`û  piki hbspuàs hb qub sb rbp`t`brd bc lu`k`i hb cis mbradeis. Bc sbouehi `etbeti bs abeis kieik`hi, yd qub bc lubz [tdecby _b`sjbro sb eboû d piebr cd käadrd be cd kirtb. Vbri cd ¸pic`k ¸pi c`kád ád sb be betbr tbrûû hb cd bx`s bx`stbe tbek`d k`d hb cd cdss k`et k`etds ds ord ordjd jdhds hds rbdc`z rbdc`zdhd dhdss pir qub àc  ps`kûcioi Lbrbkab Lbrbkab Iz`bc, cds kudcbs sbetbek`de sbetbek`de cds kiegbs`iebs kiegbs`iebs sb pubhb bv`hbek`dr bv`hbek`dr qub bstis mbradeis kiabt`brie bc kr`ab kr`abee prbgbkti kudeh kudehii dsbs`edrie d ssus us pdhrbs pir ci kudc cd g`skdcád sb b bekda`edrde bekda`edrde d cd bskbed hbc kr`abe kr`abe,, y bsti cbs rbsuctdjd aäs h`gák`c, dc pr`ek`p`i yd quà bc trdjdli pdrd cd pic`kád y g`skdcád, yd qub sb bekietrdjde, s` sb  pihrád hbk`r, ci qub bv`hbek`djd i hdjd aubstrds qub cd bskbed hbc kr`abe yd ei brd hb aukmd dyuhd pdrd cds `evbst`odk`ieb `evbst`odk`iebs. s. Bs dsá qub be bc kr`abe kie bc qub bap`bzd bc v`hbi, y be bc kudc sb hd ued ccdadhd hbc  prbsueti dktir hb ue hbc`ti hb dsbs`edti, y bc qu`be mdjcd sijrb cd aubrtb hb sus pdhrbs, yd qub bc h`kmi hbc`ti gub kiabt`hi kudehi cis m`lis hb cis sbôirbs Abeàehbz ei sb bekietrdjde be kdsd pdsdehi ued mird y abh`d hbspuàs hbc dsbs`edti pdrd qub cd pic`kád rb rbk` k`j` j`rs rsbb h` h`km kmdd ccda ccdadh dhd, d, y bs pi pirr bs bsii qub qub ci ciss kr kr`a `a`e `edc dcbs bs sd sdjá jáde de kû kûai ai tb tbeb ebrc rcbs bs kiegueh`his d cd pic`kád y g`skdcád, y bs pir bcci qub pihbais mdjcdr i hbk`r qub aäs gub cd dstuk`d hb cis kr`a`edcbs qub bc trdjdli hb cd pic`kád y g`skdcád. Vubs j`be, ei pir ci bxpubsti be cáebds detbr`irbs sb vd d lust`g`kdr hb e`eoued adebrd hb qub cd pic`kád y cd g`skdcád, y kie cds prubjds hikuabetdcbs y bc tbst`aie`i hb cis mbra mbrade deis is Ab Abeà eàeh ehbz bz puh` puh`br brie ie ccbo ccbodr dr kie kie kucp kucpdj djcb cbss hb kr kr`a `abe be.. Pd qu qubb ki kiai ai sb bv`hbek`d be bc v`hbi, tdaj`àe kie cd ¸prbpdrdk`ûe y kiekbetrdk`ûe hb pdrtb hb cd  pic`kád, dc sbr aäs ijlbt`vis y ei h`strdbrsb i betrdr dc luboi hb cis dsbs`eis, qub brd ci qub bccis qubráde prbtbeháde y ciordrie. Hdhi tihds bstds prubjds qub brde dha`s`jcbs cd pic`kád puhi bcdjirdr ued bstrdtbo`d ordk`ds d cis brrirbs hb kiabt`his pir cis mbradeis y cd ordjdk`ûe hb sus hbkcdrdk`iebs ciordrie hbaistrdr d cis vbrhdhbris dsbs`eis y riap`behi ued aäskdrd gdcsd sijrb  piháde ccbvdr hb ued adebrd aäs dkbrtdhd cd `evbst`odk`ûe `evbst`odk`ûe.. Vir tdc bstis mbradeis rbkieikáde qub mdjáde dsbs`edhi d sus pdhrbs dg`radehi qub mdjád s`si be hbgbesd  prip`d yd qub mdjáde s`si djusdhis d e`vbc gás`ki, ps`kicûo`ki baik`iedc y sbxudc. Vbri cd g`skdcád sbôdci qub ei sb mdjád prihuk`hi djusis qub cis mbradeis mdjáde dktudhi bapuldhis pir cd kih`k`d. kie cd hbk`s`ûe hbc lubz [tdcby _b`sjbro kievikdhi ue lurdhi h`st`eti pdrd kdhd mbradei.

 

Hbspuàs hb dôis hb `evbst`odk`ûe hb cd rbkip`cdk`ûe hb cds prubjds, drouabetis sb dedc`zdrie cis ait`vis pdrd bc dsbs`edti cis g`skdcbs drouabetdrie dajis mbradeis brde kucpd kuc pdjcb jcb hb cis kdr kdrois ois hb ds dsbs` bs`edt edtii be pr`ab pr`abrr ord ordhi hi y kiesp` kiesp`rdk rdk`ûe `ûe pdrd kiabtbr  kiabtbr  dsbs`edti, due qub pdsdrie dôis pdrd qub bstis mbradeis sbde hbkcdrdhis kucpdjcb ,dsá cd gdsb hb cd sbetbek`d hbc lu`k`i pbra`t`behi b cis mbradeis pdsdrde be cd kärkbc bs hbk`r bc lurdhi ei dpiydjd cd pbed hb aubrtb pir qub e`eouei hb cis mbradeis pisbád detbk det bkbhb bhbetb etbss pbe pbedcb dcbs. s. Gub ds dsáá qub be bc dôi 400 400:, :, cis mbrade mbradeis is Abeàe Abeàehbz hbz gubrie gubrie dkusdh dku sdhis is pir bc Ord Ordee Lur Lurdhi dhi hbc ki kiehd ehdhi hi Bc = hb h`k`bajr h`k`bajrbb hb 400:, bc mbrade mbradeii Abeàehbz gub dkusdhi pir bc Orde Lurdhi hbc Kiehdhi hb Cis Äeobcbs pir bc dsbs`edti hb sus pdhrbs.

Dsá qub ei gub mdstd bc dôi hb 4007 qub _b`sjbro kiehbei d cis mbradeis kdhbed  pbrpbtud s`e pis`j`c`hdh kieh`k`iedc kdjb hbskdrtdr qub hurdetb cd gdsb hb sbetbek`d hbc  lu`k`i pir bc dsbs`edti cd djiodhd hb cd hbgbesd kiabt`û ue brrir a`sai qub pbra`t`û qub bc luzodhi y bc lubz kiehbedrde d bstis lûvbebs. Bc gdtdc kr`abe kiabt`hi pir cis mbradeis Cycb y Br`n Abeàehbz, gubrie cis dktirbs  pr`ek`pdcbs hbc mbkmi hbc dsbs`edti dsbs`edti hb sus pdhrbs cis kudcbs sb dpbodjde dpbodjde i sb adebldjde kie cis a`sais c`ebda`betis y cd hbsv`dk`ûe hb kiegus`ûe hb pdrtb hb cd pic`kád y g`skdcád pdrd adetbebrcbs ikupdhis y h`strdáhis, pdrd bstis krbbr qub sb kiabt`û bc kr`abe pbrgbkti vdcb tdaj`àe hbk`r, qub kiai sb bv`hbek`d bv`hbek`d ci qub md sukbh`û sukbh`û bc :6 hb doisti hb 40=, sb pubhb bv`hbek`dr qub cd tbirád hbc kdsi hb cds drouabetdk`iebs y cds  prubjds qub gubrie g ubrie deuek`dhds y prijdhds pir cd g`skdcád duequb gub tdrhád s`baprb sb begikû be cd tbirád rbdc`zdhd pir cd pic`kád y cd gdctd hb kiipbrdk`ûe hb cd pdrtb hbadehdhd cd dstuk`d y prbpdrdk`ûe hb cd djiodhd hb cd hbgbesd mdk`d piebr be huhd ci dktudhi pir cd g`skdcád bs hbk`r qub cis a`bajris hbc lurdhi sb sbetáde kieaiv`his pir  cds hbkcdrdk`iebs hb Cycb y Br`n Abeàehbz cuboi hb vdr`is dôis cd ¸pic`kád kie adyir  bsgubrzi y cd hbtbra`edk`ûe hb cd pisturd hb cd g`skdcád y bc kdräktbr g`rab hbc lubz cior ciordr drie ie ccbo ccbode de d kuca kuca`e `edr dr cd pdrt pdrtbb g`ed g`edcc hb bs bstb tb lu lu`k `k`i `i

ci cior orde dehi hi hb hbtb tbra ra`e `edr dr cd

kucpdj`c`hdh hbc hbc`ti kiabt`hi hb cis mbradeis Abeàehbz mdk`d sus pdhrbs. G`edcabetb, be ue kr`tbr`i pbrsiedc, pihbais mdkbr rbgbrbek`d qub be cd dktudc`hdh cd obetb aäs i abeis md tbe`hi bc a`sai kiapirtda`beti hb dmird, bc hb ei kicdjirdr hb ued adebrd jubed d cds `evbst`odk`iebs, y dsá pbra`t`r qub cis kr`a`edcbs be vbz hb

 

vbrcbs kiai ued adcd pbrsied pdrd cd sik`bhdh, tbra`ede s`behi `hicdtrdhis pir su `etbc`obek`d y v`vbzd adc ut`c`zdhd. Kdjb rbsdctdr qub cd hb prbpdrdk`ûe y hb rbkursis d cis a`bajris hb cd pic`kád cbs hd cd kdpdk`hdh hb pihbr hbsv`rtudr cds prubjds y sbôdcdr  ue pueti kcdvb be hdr adtbr`dc qub bv`hbek`d sijrb bc mbkmi hbc`kt`vi, yd qub cd kiirh`edk`ûe bs hbk`r qub mde hb cd adei hb pdrtb hb cd pic`kád, cis a`bajris hbc lurdhi y bc lubz ccbvde d hdr pir kiekcu`hi bc kdsi kuapc`behi ci qub bstdjcbkb cd cby y dpc`kdehi cd a`sad kdst`odehi d cis kucpdjcbs hb ue kr`abe.