Valvuloplastia pulmonar con balón resultados a corto y largo plazo del complexo Hospitalario Universitario a Coruña

Evaluar los resultados a corto y largo plazo de la valvuloplastia pulmonar con balón en el Complexo Hospitalario Universitario A Coruña. Metodología: Revisión de las historias clínicas, datos hemodinámicos y seguimiento ecocardiográfico de los pacientes sometidos a valvuloplastia pulmonar en nuestra institución entre marzo de 1998 y marzo de 2011. Resultados: En 13 años, se han realizado 81 valvuloplastias pulmonares, de las cuales 67 fueron evaluadas. 56.7% fueron mujeres, con una mediana de edad de 2 meses y un peso de 4.7 kg. 25% de los casos tenían otras malformaciones cardiacas asociadas y en el 65% se encontró una válvula pulmonar en cúpula. El procedimiento fue exitoso en el 82% de los casos, con una morbilidad del 1.49% y sin mortalidad asociada en nuestra serie. Los resultados a largo plazo muestran una incidencia de reestenosis del 23%, la cual se asocio a un gradiente pico post valvuloplastia > 30 mmHg (p <0.001). La insuficiencia pulmonar fue observada en el 86.5% de los casos, siendo leve en la mayoría de ellos. La mortalidad global de nuestra seria fue del 4.5%. Discusión: La valvuloplastía pulmonar con balón, es para nuestra población, el tratamiento de elección en la estenosis pulmonar, con buenas tasas de éxito y baja morbilidad asociada al procedimiento. A largo plazo, la incidencia de lesiones residuales (estenosis y/o insuficiencia) así como los tiempos libres de reintervención, son comparables con los publicados en la literatura.

New Generation Antidepressants in Painful Diabetic Neuropathy

The incidence of diabetic neuropathy increases with the duration of diabetes and the degree of hyperglycaemia. Pain is one of the most common and incapacitating symptoms of diabetic neuropathy and its pharmacological control is complex. The effectiveness of antidepressive agents has been described in different types of neuropathic pain, but their effectiveness, when used as analgesics in painful diabetic neuropathy, still remains controversial. Objective: To review the possible role of new-generation antidepressive agents in the treatment of pain in diabetic peripheral neuropathy. This work has thus consisted of a meta-analysis for determining which antidepressive agent had the best analgesic potential in managing pain in patients suffering from painful diabetic neuropathy. Methods: This search covered the Cochrane, MEDLINE, EMBASE and LILACS databases, between January 2000 and August 2007. The following information was obtained from each article: criteria for diagnosing diabetic neuropathy, patients' age average, antidepressant drug received and dose, sample size, duration of the disease and treatment follow-up, outcome measurement, evaluation of pain and rescue medication. Results: A combined RR: 1.67 (95% CI 1.38 - 2.02) was obtained; this result indicated that the antidepressive agent duloxetine, was effective for controlling pain in diabetic neuropathy. The corresponding NNT for Duloxetine was established, according to our interests; NNT = 6 (95% CI 5- 8) for achieving greater than 50% analgesia in patients suffering from painful diabetic neuropathy. Discussion: Antidepressive agents are frequently employed in the specific case of diabetic neuropathy; their analgesic benefit has been demonstrated.

Implementation of ‘School Back’ by the ‘Core’ technique in a factory of geotextiles to prevent back pain

Introduction: This article aims to show an alternative intervention for the prevention and control of back pain to the people of a production plant of geotextiles for the construction exposed to handling and awkward postures through the implementation of the Back School using the CORE technique. This technique being understood as trainer of the stability musculature of the spine; whose benefit is proportionate the muscular complex of the back, stability and avoid osteomuscular lesions and improved posture. Objective: To present the results about the implementation of the back school by the CORE technique for prevention of back pain in a population of forty-eight male collaborators. Materials and methods: The back school began with talks of awareness by the occupational health physician explaining the objectives and benefits of it to all participants. Once this activity was done, was continued to evaluate all plant employees to establish health status through the PAR-Q questionnaire, who were surveyed for the perception of pain using visual analog scale (VAS) and stability was determined column through the CORE assessment, to determine the training plan. Then, were made every six months the revaluations and implementation of a survey of assistant public perception to identify the impact of the implementation of the school back on the two variables referred (pain perception and stability of column). Results: The pain perception according VAS increased in the number of workers asymptomatic in 12% and based in the satisfaction survey 94% of population reported that with the development of this technique decrease the muscle fatigue in lumbar level; and 96% of population reported an improvement in the performance of their work activities. Discussion: Posterior to the analysis of all results, it is interpreted that back schools practice through CORE technique, contributes to the prevention and / or control of symptoms at the lumbar level in population of productive sector exposed to risks derived from the physical load, provided that ensure its continuously development and supervised for a competent professional.

Globalization and urban policy at the periphery of capitalism

Este artigo discute um tema complexo como é o planejamento urbano e que está passando por uma grande mudança no mundo revolucionado pela reestruturação da produção capitalista iniciada no fi nal do século XX. Esta análise permite uma série de recomendações: dar visibilidade a cidade real ou desconstruir a cidade virtual edifi cada pelo marketing urbano e interessesglobais, dar visibilidade aos confl itos, contruir reforma administrativa, capacitar agentes para o planejamento da ação, desenvolver reforma fundiária.

Dictamen clínico de embriaguez alcohólica en urgencias como predictor de violencia física intrafamiliar

Desde la adopción de un significado integral de salud por la Organización mundial de la salud (OMS) donde esta es definida como “…un estado de completo bienestar físico, mental y social, y no solamente la ausencia de enfermedad… 1948”, ha sido fundamental entender las motivaciones colectivas e individuales que se involucran como determinantes del proceso de bienestar y enfermedad, estos mismos hacen que se torne el estado de salud en una compleja sinfonía de variables dinámicas que se transforman de lugar a lugar o de individuo a individuo. Desde allí, el entorno, en todos sus aspectos ha mostrado gran importancia imprimiendo patrones en las conductas comunes e individuales que se transfiguran finalmente sobre el individuo.