Universidad Nacional de la PlataAngemalucea en gmail com Resumen La sintaxis de una lengua se halla motivada semántica y pragmáticamente. La dimensión pragmática establece qué formas lingüísticas -y sus significados-son más apropiadas para qué contexto. En este trabajo intentamos mostrar cómo el lenguaje es modelado por la cultura cuando lo pragmático es etnopragmático. Los sesgos en la frecuencia relativa de uso de los clíticos de tercera persona en distintas variedades del español americano constituyen un ámbito adecuado. La naturaleza deíctica de los clíticos del español hace que se pongan en juego al menos dos tipos de dimensión pragmática: la dimensión referencial y la dimensión relacional. El valor que cobra la referencia es, ciertamente, cultural, asignado por la comunidad. En efecto, es esperable que diferentes grupos culturales asignen diferentes valores a los mismos referentes y que estos valores culturales influyan en la conformación de los paradigmas de la lengua. Ejemplificaremos la propuesta mediante la observación de la expansión del empleo de le y la ausencia del clítico en el campo de los acusativos en el
Objective. Pediatric thyroidectomy is an infrequent, complex surgery, with high risk of complications. Complication rates and oncological results of non-protocolized thyroidectomy in a secondary pediatric hospital were compared with those from reference institutions.Materials and methods. A retrospective study of patients under 15 years old undergoing thyroidectomy ± cervical lymphadenectomy by low volume pediatric surgeons (<30 cervical endocrine surgeries annually) in a pediatric hospital from January 2010 to January 2020 was carried out.Results. 11 patients undergoing 12 surgeries (mean age: 9.8 years; 63% female) were analyzed. Thyroid nodules were the main surgical indication (50%), and prevalence of genetic mutations was 45%. 1 patient had transient hypocalcemia, and there were 2 cases of transient recurrent laryngeal nerve neuropraxia (16.6%). No permanent complications were noted. 66.6% of pathological reports showed malignancy. Mean hospital stay was 2.35 days (range: 1.25-5), with an overall complication rate of 25%, similar to that reported by high-volume institutions. After a mean follow-up of 4 years, tumor recurrence has not been observed in any patient.Conclusions. In our view, an experienced pediatric surgeon specialized in pediatric and neonatal general surgery -even if below the high volume threshold -acquires the skills required in pediatric thyroid surgery without an increase in morbidity and mortality. Perioperative management should be agreed and protocolized by the various specialists involved to improve results.
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