Allergy medical care network: a new model of care for specialties.

UNLABELLED: In 2005 the Althaia Foundation Allergy Department performed its daily activity in the Hospital Sant Joan de Deu of Manresa. Given the increasing demand for allergy care, the department's performance was analysed and a strategic plan (SP) for 2005-2010 was designed. The main objective of the study was to assess the impact of the application of the SP on the department's operations and organisational level in terms of profitability, productivity and quality of care. MATERIAL AND METHODS: Descriptive, retrospective study which evaluated the operation of the allergy department. The baseline situation was analysed and the SP was designed. Indicators were set to perform a comparative analysis after application of the SP. RESULTS: The indicators showed an increase in medical care activity (first visits, 34%; successive visits, 29%; day hospital treatments, 51%), high rates of resolution, reduced waiting lists. Economic analysis indicated an increase in direct costs justified by increased activity and territory attended. Cost optimisation was explained by improved patient accessibility, minimised absenteeism in the workplace and improved cost per visit. CONCLUSIONS: After application of the SP a networking system was established for the allergy speciality that has expanded the territory for which it provides care, increased total activity and the ability to resolve patients, optimised human resources, improved quality of care and streamlined medical costs.

[Camptocormia: an infrequent muscular disease]. / Camptocormia: una enfermedad muscular infrecuente.

The camptocormia is an entity characterized by a kyphosis lumbar reductible in supine decubitus, associated to dysfunctions in computed tomography scans and histologics in the paravertebrals muscles of the lumbar segment. We contribute a new case corresponding to a 70 year-old woman with chronic lumbar pain and kyphosis dorsolumbar reductible, in who the on-line tomography showed compatible images with fatty degeneration and atrophy of the lumbar musculature, discoveries that were confirmed in the histologic study.

[Muscular metastasis in a patient with adenocarcinoma of the colon. An infrequent complication]. / Metástasis muscular en paciente afecta de adenocarcinoma de colon. Una complicación infrecuente.

Muscular metastases are unusual. Primary neoplasm use to be breast or lung, although any neoplastic process can have muscular metastatic potential. The usual location in psoas and paravertebral muscles. For its diagnosis we need a high index of suspicion, and can be helpful, electromyography and magnetic nuclear resonance. The follow up of a patient with colon adenocarcinoma and muscular metastases and a review of the subject is presented.