Efectividad de la rehabilitación en la esclerosis múltiple / Effectiveness of rehabilitation in multiple sclerosis

Objetivo: Evaluar la efectividad del tratamiento rehabilitador en la esclerosis múltiple. Estrategia de búsqueda: Revisión sistemática de la literatura en las principales bases de datos. Artículos en español e inglés publicados entre 1997 y 2012. Selección de los estudios: Ensayos clínicos aleatorizados, ensayos clínicos no aleatorizados, metaanálisis, revisiones sistemáticas y guías de práctica clínica. Se seleccionaron un total de 35 artículos. Existe evidencia científica a favor del tratamiento rehabilitador en el manejo terapéutico de la esclerosis múltiple. Existen distintos grados de evidencia sobre la efectividad de cada uno de los componentes del equipo multidisciplinar cuando se analizan por separado. El tratamiento rehabilitador mejora la discapacidad y la minusvalía en pacientes con esclerosis múltiple (AU)

Objective: To evaluate the effectiveness of rehabilitation treatment in multiple sclerosis. Search strategy: A systematic revision of the literature of articles in Spanish and English from 1997 to 2012 in the main databases was performed. Study selection: A total of 35 articles on randomized clinical trials, non-randomized clinical trails, meta-analysis, systematic reviews and clinic practice guidelines were selected for the study. There is scientific evidence supporting rehabilitation therapy of multiple sclerosis. There are different levels of evidence regarding the effectiveness of each one of the components of the multidisciplinary team when they are analyzed separately. Rehabilitation treatment improves disability and disablement in patients with multiple sclerosis (AU)

[Comparison of Goldmann tonometry, pneumotonometry and the effect of the central corneal thickness]. / Comparación del tonómetro de Goldmann, neumotonómetro de contacto y el efecto del grosor corneal.

PURPOSE: To compare the intraocular pressure (IOP) measurements using the Goldmann applanation tonometer (GAT) and contact pneumotonometer (NTC), and to evaluate the effects of central corneal thickness (CCT) on the readings. METHODS: This was a prospective, observational clinical study, which included 96 eyes of 49 patients, 40 glaucomatous, 29 ocular hypertensive and 27 normal subjects. The IOP measurements were performed with each tonometer. The CCT was also measured. RESULTS: A strong correlation coefficient between GAT and the NTC was found (Pearson=0.922, p<0.001). The mean of paired differences between GAT and NTC was 0.72 ± 2.82 mmHg. The mean difference between GAT and NTC was low at lower levels of PIO and higher at higher levels of IOP. Readings with the GAT showed a mean increase in IOP of 0.47 mmHg for every 10 µm of CCT, and the NTC 0.34 mmHg for every 10 µm, the diference was not statistically significant. CONCLUSIONS: The contact pneumotonometer is a reliable method in diagnosis and follow up of our population. The effect of the central corneal thickness was more important for the Goldmann applanation tonometer.

Comparación del tonómetro de Goldmann, neumotonómetro de contacto y el efecto del grosor corneal / Comparison of Goldmann tonometry, pneumotonometry and the effect of the central corneal thickness

Propósito: Comparar la medición de la presióintraocular (PIO) usando el ton¨®metro de aplanaci¨®n de Goldmann (GAT) y el neumotonómetro de contacto (NTC), y evaluar el efecto del grosor corneal central (CCT) en las mediciones. Método: Estudio prospectivo, clínico observacional. Se incluyeron 96 ojos de 49 pacientes 40 glaucomatosos, 29 hipertensos oculares y 27 controles. La PIO se midió con cada uno de los tonómetros. Además se midió el CCT. Resultados: Se observó un coeficiente de correlación fuerte entre GAT y el NTC (Pearson=0,922, p<0,001). La media de las diferencias pareadas entre GAT y el NTC fue de 0,72¡À2,82mmHg. La media de las diferencias entre GAT y el NTC fue menor a valores bajos de PIO y más alta a valores mayores de PIO. Las mediciones con GAT demostraron un aumento medio de la PIO de 0,47 mmHg por cada 10-Ìm de CCT, y el NTC 0,34 mmHg por cada 10¦Ìm, aunque la diferencia no fue estadísticamente significativa. Conclusiones: La neumotonometría de contacto es un método fiable en el diagnóstico y seguimiento de nuestra población. El efecto del CCT fue mayor para el tonómetro de Goldmann(AU)

PurposeTo compare the intraocular pressure (IOP) measurements using the Goldmann applanation tonometer (GAT) and contact pneumotonometer (NTC), and to evaluate the effects of central corneal thickness (CCT) on the readings.MethodsThis was a prospective, observational clinical study, which included 96 eyes of 49 patients, 40 glaucomatous, 29 ocular hypertensive and 27 normal subjects. The IOP measurements were performed with each tonometer. The CCT was also measured.ResultsA strong correlation coefficient between GAT and the NTC was found (Pearson=0.922, p<0.001). The mean of paired differences between GAT and NTC was 0.72¡À2.82 mmHg. The mean difference between GAT and NTC was low at lower levels of PIO and higher at higher levels of IOP. Readings with the GAT showed a mean increase in IOP of 0.47 mmHg for every 10¦Ìm of CCT, and the NTC 0.34 mmHg for every 10-Ìm, the diference was not statistically significant.ConclusionsThe contact pneumotonometer is a reliable method in diagnosis and follow up of our population. The effect of the central corneal thickness was more important for the Goldmann applanation tonometer(AU)

Pathological findings in the lens capsules and intraocular lens in chronic pseudophakic endophthalmitis: an electron microscopy study.

PURPOSE: The aim of this study was to describe the pathological findings in lens capsules and intraocular lens (IOL) studied by scanning and/or transmission electron microscopy (SEM and TEM, respectively) in a series of four eyes with chronic pseudophakic endophthalmitis (CPE). PATIENTS AND METHODS: We performed a retrospective study of four patients presenting CPE in whom surgical treatment with pars plana vitrectomy, capsulectomy with extraction of the IOL, and intravitreous antibiotic therapy was thereafter performed. The extracted IOL and the capsular remains were studied by SEM and/or TEM and microbiologic analysis of aqueous humour and vitreous aspirate was also carried out in all the cases. RESULTS: The presence of microorganisms was observed in the material analysed in all the cases studied. The use of TEM identified bacterial contamination by Staphylococcus spp and mixed contamination with microorganisms presenting a bacillar morphology suggestive of infection by Propionibacterium acnes in addition to the presence of cocci in the capsular remains. In another two cases, SEM localized colonies of Staphylococcus spp on the surface of the IOL in one case and mixed bacterial colonization with cocci plus filamentous bacteria in the other. The presence of macrophages associated with bacteria was observed in the capsular remains. CONCLUSIONS: Microorganisms were found in the IOL or the capsular material in the four cases studied, thereby explaining the refractoriness and severity of infection. The possible presence of polymicrobial infections, especially in the cases with filamentous bacteria, also explains the recurrence of infection.

Asistencia al personal hospitalario en un servicio de rehabilitación. ¿Cómo es y cuánto cuesta? / Hospital staff care in a rehabilitation department. What it consists of and how much it costs

Introducción. Los servicios de rehabilitación suelen atender a los trabajadores del hospital. Con este estudio se planteó conocer la patología atendida en un servicio de rehabilitación entre el personal hospitalario y obtener una aproximación al coste económico que ha supuesto la atención a este personal sanitario. Métodos. Se realizó un estudio descriptivo retrospectivo de los trabajadores del hospital atendidos durante el año2001 en el servicio de rehabilitación. Se recogieron las siguientes variables: filiación, diagnóstico codificado con la novena edición de la Clasificación Internacional de Enfermedades (CIE-9), número de sesiones, técnicas de tratamiento aplicadas en cada sesión y motivo de alta. Para el cálculo económico, se tuvieron en cuenta los costes de personal, estructurales, de consumo de productos y técnicos, teniendo en cuenta las amortizaciones acumuladas. Resultados. El 18 % del total de los trabajadores del hospital fueron tratados en el servicio. Del total de actividad del servicio, representaron el 6,5 %. Las raquialgias representaron más de la mitad de los diagnósticos. Respecto a los costes, el total se cuantificó en 199.974,43 1, lo cual representó1.666,45 1 por proceso. Conclusión. El coste de la atención al personal de la casa es elevado en nuestro Servicio de Rehabilitación y representa un factor de presión asistencial

Introduction. Rehabilitation departments usually take care of hospital staff. The objectives of this study were to assess the types of pathology treated by the Rehabilitation department within this group of people and to estimate the economic cost. Methods. A descriptive retrospective study of hospital workers treated in the Rehabilitation department during2001. Collected variables were: personal data, diagnosis (coded by ICD-9), number of completed sessions, treatment techniques applied in each session, reasons for cessation of treatment. Concerning the economic estimates, staff, structural costs, products and use of technical equipment were taken into account, with their cumulative amortizations. Results. 18 % of hospital staff were treated in the Rehabilitation department in 2001, representing 6,5 % of our total activity. More than 50 % of our diagnoses were for back pain. The global costs came to 199.974,43 1, a total of 1.666,45 1per process. Conclusion. The cost of staff treatment is high in our Rehabilitation department and is an additional source of pressure