ABSTRACT
La Ética es la parte de la filosofía práctica que se ocupa del hecho moral y de los problemas filosóficos que nacen de la conducta humana, la bioética resulta la rama de la ética que se dedica a proveer los principios para la correcta conducta humana; respecto a la vida. En el proceso de atención a los pacientes con enfermedades reumáticas se emplean variados procedimientos. Las nuevas tecnologías han mejorado notablemente su tratamiento integral; estos adelantos científicos deben ser empleados con la intención fundamental de no producir daño y previo consentimiento informado; por lo que resulta necesario argumentar acerca de las implicaciones bioéticas que resultan del empleo de los avances científico-tecnológicos en el tratamiento a los pacientes con enfermedades reumáticas(AU)
Ethics is the part of Practical Philosophy that deals with moral facts and philosophical problems that have their roots in human behavior. Bioethics is the branch of Ethics devoted to providing the principles for correct human behavior, with respect to life. Various procedures are used when treating patients with rheumatic diseases. New technologies have considerably improved their integral treatment; these scientific advances must be used with the main purpose of causing no harm and with prior informed consent. Therefore, it is necessary to argue on the bioethical implications that turn out from the use of scientific-technological advances in the treatment of patients with rheumatic diseases(AU)
Subject(s)
Humans , Rheumatic Diseases/diet therapy , Rheumatic Diseases/drug therapy , Rheumatic Diseases/prevention & control , Rheumatic Diseases/radiotherapy , Rheumatic Diseases/surgery , Rheumatic Diseases/therapy , Bioethics , Review Literature as TopicABSTRACT
Fundamento: la bursopatía olecraneana asociada a espolón por tracción, de etiología traumática mínima, roce continuado, actividades o recreaciones asociadas a vigorosa extensión del codo, ha tenido poca información investigativa. Objetivo: describir los resultados operatorios en esta afección, donde el tratamiento conservador no fue satisfactorio, en pacientes atendidos en el Hospital General Docente Dr. Ernesto Guevara de la Serna de Las Tunas, de diciembre de 2010 a julio de 2016. Métodos: se realizó un estudio observacional en pacientes con diagnóstico de bursitis olecraneana en sus diferentes variedades, atendidos en la institución y tiempo ya declarados. El universo estuvo conformado por la totalidad de los casos con dolor y deformidad en región posterior del codo y la muestra por 28 pacientes seleccionados al azar. El tratamiento quirúrgico estuvo condicionado a la clasificación de la lesión en grados, según características macroscópicas de la bursa, adherencias, tabiques, hipertrofia esclerótica, recidivas o fractura del espolón. Resultados: el promedio de edad fue de 33,6 años; más frecuente en el sexo masculino en relación de 8:1. Los procederes operatorios empleados fueron la resección de la bursa, resección del espolón y resección del espolón con hueso olecraneano indemne, la complicación encontrada fue el retardo de la cicatrización. Los resultados clasifican de excelentes, según Mayo Elbow Performance Index y Escala Visual Analógica, en 98 y 97 por ciento, respectivamente. Conclusiones: los resultados operatorios en pacientes con bursopatía olecraneana asociada a espolón por tracción fueron satisfactorios(AU)
Background: Olecranon bursopathy associated to heel spur by traction with a minimal traumatic etiology, continued friction and activities or leisure pursuits associated to a vigorous spreading of the elbow, has had slender research information. Objective: to describe the operating results for this condition, where the conservative treatment was not satisfactory, on patients attended to at the Dr. Ernesto Guevara de la Serna General Teaching Hospital of Las Tunas, from December 2010 to July 2016. Methods: an observational study was carried out with patients diagnosed with olecranon bursitis in its different types, attended to at the institution and during the period herein mentioned. The universe was made up of the whole of the cases with pain and deformity in the posterior region of the elbow and the sample consisted of 28 patients chosen at random. The surgical treatment was conditioned to the classification of the lesion in degrees, according to the macroscopic characteristics of the bursa, the adherences, septa, sclerotic hypertrophy, relapses or heel spur fractures. Results: the age average was 33,6 years; it was more frequent in the male sex with an 8:1 relation. The surgical procedures used were bursal resection, heel spur resection and unharmed-olecranon-bone heel spur resection. Cicatrization delay was the main complication. The results were excellent according Mayo Elbow Performance Index and Analogical Visual Scale on 98 percent and 97 percent respectively. Conclusions: the operating results on patients with olecranon bursitis associated to heel spur by traction were satisfactory(AU)
Subject(s)
Humans , Rheumatic Diseases/surgery , Rheumatic Diseases/therapy , Osteophyte , Olecranon Process , Tendons , Observational StudyABSTRACT
UNLABELLED: The objective of this study is to assess the clinical and radiologic results of patients with rheumatic forefoot who underwent metatarsophalangeal arthrodesis of the first ray and arthroplastic resection of the second to fifth metatarsal heads at the National Rehabilitation Institute. MATERIAL AND METHODS: This is a prospective comparative study of the clinical and radiological status before and after the surgical procedure; it is a descriptive, observational single-group study. From April 2006 to December 2011, 31 surgical procedures were performed in 29 female and two male patients. The SPSS 17.0 software was used for the statistical analysis. Efficacy and quality of life indicators were compared using mean comparison tests (Student t test), the indicator of patient safety by means of frequency analysis, and the comparative analysis of the occurrence of complications throughout time. RESULTS: The mean preoperative visual analog scale score was 6.2 +/- 1.3, with an average of 1.6 +/- 2.5, with statistical significance, with p < 0.0001 and t = 7.97. Radiographic measurements of the hallux valgus angle showed a remarkable improvement. CONCLUSIONS: The surgical procedure described is reliable and efficacious, as patients had an important improvement in quality of life, with pain relief and adaptation to their activities of daily living after surgery.
Subject(s)
Arthrodesis/methods , Arthroplasty/methods , Foot Deformities, Acquired/surgery , Hallux/surgery , Metatarsal Bones/surgery , Rheumatic Diseases/surgery , Adult , Aged , Female , Foot Deformities, Acquired/diagnostic imaging , Foot Deformities, Acquired/etiology , Foot Deformities, Acquired/psychology , Hallux/diagnostic imaging , Hallux Valgus/diagnostic imaging , Hallux Valgus/etiology , Hallux Valgus/surgery , Hallux Varus/diagnostic imaging , Hallux Varus/etiology , Hallux Varus/surgery , Humans , Male , Metatarsal Bones/diagnostic imaging , Middle Aged , Pain Measurement , Pain, Postoperative , Prospective Studies , Quality of Life , Radiography , Rheumatic Diseases/complications , Rheumatic Diseases/diagnostic imaging , Severity of Illness Index , Treatment OutcomeSubject(s)
Humans , Rheumatic Diseases/surgery , Rheumatic Diseases/complications , Rheumatic Diseases/diagnosis , Rheumatic Diseases/therapy , Emergencies , Rheumatology/education , Rheumatology/methods , Antirheumatic Agents/adverse effects , Antirheumatic Agents/pharmacology , Radiology/educationABSTRACT
Entre todas as doenças reumáticas existentes, a artrite reumatóideé a que mais necessita de múltiplos procedimentos cirúrgicos.As articulações mais acometidas na artrite reumatóide são: ospunhos, as metacarpofalângicas e interfalângicas proximais,metatarsofalângicas e joelhos sendo que, outras articulaçõessão envolvidas com a evolução da doença. Com a progressão doquadro, ocorre a extensão do processo infl amatório para estruturasperiarticulares do tecido conjuntivo, como tendões e ligamentos e, issoassociado ao acometimento osteo-cartilaginoso, leva a instabilidadesarticulares e deformidades ósseas secundárias. Logo, o tratamentocirúrgico visa tratar não somente o comprometimento articular,mas também as deformidades e as instabilidades. Sinovectomiasabertas ou artroscópicas levam ao alívio da dor, enquanto tenotomiase transferências tendinosas visam à correção de deformidades e àrecuperação funcional da articulação. As artroplastias são excelentesopções para manter a amplitude de movimento da articulação e teruma articulação funcional sem dor. As artrodeses são usadas, quandoexiste um intenso comprometimento articular e não há indicaçõespara a artroplastia e apesar de limitarem a amplitude de movimento,apresentam um bom alívio da dor, podendo ser funcionais quandofeitas na posição correta de fl exo-extensão.
Subject(s)
Humans , Male , Female , Aged , Arthrodesis , Arthroplasty , Arthritis, Rheumatoid/surgery , Rheumatic Diseases/surgeryABSTRACT
Os pacientes portadores de doenças reumáticas crônicas freqüentemente requerem algum tipo de intervenção cirúrgica durante o curso de suas vidas, e a presença destas doenças (ex.: artrite reumatóide) pode aumentar o risco cirúrgico dos mesmos. Este artigo tem como objetivo revisar os principais aspectos clínicos da avaliação pré-operatória, assim como a estratificação de risco cirúrgico dos pacientes portadores de doenças reumáticas crônicas