Ciencia y gestión: difícil punto de encuentro. Segunda parte / Science and management: a difficult meeting point. Part two

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Ciencia y gestión: difícil punto de encuentro / Science and management: a difficult meeting point

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Estudio epidemiológico sobre la demanda de rehabilitación en pacientes hospitalizados / Epidemiological study on the demand for rehabilitation in hospitalized patients

Introducción. Los especialistas en Medicina Física y Rehabilitación (MFyR) damos asistencia a pacientes que han perdido su autonomía. Hay un porcentaje considerable de pacientes hospitalizados que adquieren una discapacidad y precisan ser asistidos por terapeutas de Rehabilitación. Hemos desarrollado el presente estudio descriptivo para analizar la demanda de rehabilitación en pacientes ingresados en nuestro hospital. Material y métodos. Se realizó un estudio observacional prospectivo, que incluyó a todos los pacientes ingresados y que fueron valorados por nuestro servicio durante los meses de febrero, marzo y abril de 2008. Resultados. El número de interconsultas realizadas por el Servicio de MFyR durante los meses de febrero-abril de 2008 (60 días laborales) ha sido de 464 para atender a 345 pacientes. La media de interconsultas diaria a nuestro servicio ha sido de 7,73 y el número medio de interconsultas por paciente ha sido de 1,36 (desviación estándar [DE] 0,70; rango 1-7). De los 354 pacientes valorados durante el estudio, 55 no fueron incluidos en terapia por no cumplir los criterios, lo que significa que un 84 % de los pacientes hospitalizados ha precisado tratamiento rehabilitador. Conclusión. El presente estudio nos ha permitido conocer que un porcentaje considerable de pacientes hospitalizados necesita valoración y tratamiento por parte de los servicios de MFyR. Los servicios de Traumatología y Medicina Interna son los que demandan más nuestra asistencia. Solo un grupo minoritario de pacientes precisa continuar tratamiento de forma ambulatoria (AU)

Introduction. Specialists in Physical Medicine and Rehabilitation (FM&R) attend to patients who have lost their autonomy. A large number of hospitalized patients who had acquired a disability need to be attended by rehabilitation therapists. We have developed this descriptive study to analyze demand for rehabilitation in patients admitted to our hospital. Materials and methods. A prospective observational study was performed for all the patients admitted during the months of February, March and April 2008 who were evaluated by our department. Results. In our FM&R Department from February to April 2008 (60 days), there were 464 consultations made by 345 patients. Average daily consultations to our department was 7.73 and average number of consultations per patient was 1.36 (SD 0.70, range 1-7). Of the 354 patients evaluated during the study, 55 were not included in therapy as they did not meet the criteria. Thus 84 % of the hospitalized patients has required rehabilitation. Conclusion. This study has revealed that a considerable number of inpatients need assessment and treatment from FM&R Department. Traumatology and Internal Medicine Departments are those who demand our care the most. Only a minority of patients required outpatient physical therapy treatment (AU)

Artroplastia de rodilla / Knee arthroplasty

La artroplastia de rodilla es hoy en día una de las intervenciones más eficientes y consolidadas en el campo de la cirugía ortopédica. En la mayor parte de los pacientes que son sometidos a este tipo de cirugía se obtienen unos buenos resultados funcionales e importante mejoría del dolor. El avance tecnológico ha conseguido una cada vez mayor longevidad de la prótesis, lo que junto con el progresivo asentamiento de las prótesis unicompartimentales en artrosis no demasiado evolucionada han hecho de esta intervención una opción terapéutica cada vez menos limitada por razones de edad. En este trabajo realizamos una puesta al día de este tema comentando los aspectos de mayor interés para el médico rehabilitador, tanto en lo referente a la fase quirúrgica como a la de los cuidados posteriores

Knee arthroplasty is currently one of the most efficient and supported surgical intervention in orthopedic surgery. Most of the patients who undergo this kind of surgery obtain good functional outcomes and important pain relief. Technological advance has achieved longer longevity of the prosthesis, which, together with the progressive establishment of unicompartimental prosthesis in not too developed arthrosis, has changed this surgery into a therapeutic option less and less restricted according to people¿s age. An update to discuss the most interesting topics for the rehabilitation physician, referring either to the surgical phase and later care, is made in this article

Artroplastia de rodilla / Knee arthroplasty

La artroplastia de rodilla es hoy en día una de las intervenciones más eficientes y consolidadas en el campo de la cirugía ortopédica. En la mayor parte de los pacientes que son sometidos a este tipo de cirugía se obtienen unos buenos resultados funcionales e importante mejoría del dolor. El avance tecnológico ha conseguido una cada vez mayor longevidad de la prótesis, lo que junto con el progresivo asentamiento de las prótesis unicompartimentales en artrosis no demasiado evolucionada han hecho de esta intervención una opción terapéutica cada vez menos limitada por razones de edad. En este trabajo realizamos una puesta al día de este tema comentando los aspectos de mayor interés para el médico rehabilitador, tanto en lo referente a la fase quirúrgica como a la de los cuidados posteriores (AU)

Knee arthroplasty is currently one of the most efficient and supported surgical intervention in orthopedic surgery. Most of the patients who undergo this kind of surgery obtain good functional outcomes and important pain relief. Technological advance has achieved longer longevity of the prosthesis, which, together with the progressive establishment of unicompartimental prosthesis in not too developed arthrosis, has changed this surgery into a therapeutic option less and less restricted according to people’s age. An update to discuss the most interesting topics for the rehabilitation physician, referring either to the surgical phase and later care, is made in this article (AU)

Neonatal exposure to monosodium glutamate disrupts place learning ability in adult rats.

The activation of glutamatergic NMDA receptors of the hippocampus is closely associated with expression of place learning. Neonatal exposure to monosodium glutamate leads to abnormal expression of NMDA receptor subunits in the hippocampus, but its effect on place learning is unknown. Place learning acquisition and retrieval were assessed in mature adult rats after subcutaneous injection of monosodium glutamate (4 mg/g body weight) in eight neonatal rat pups at postnatal days one, three, five, and seven. Eight untreated rats were used as controls. At four months of age, the rats were challenged over a period of nine days with a place learning task. The task used an acquisition-retrieval paradigm in a Morris maze. Place learning acquisition was impaired in the experimental rats, which were unable to reduce their escape latencies during the nine training days. Controls improved between the fifth and ninth days of training. Test trials showed that retrieval of spatial information was also impaired in the experimental animals. These results show that both place learning acquisition and retrieval abilities in mature rats are impaired by neonatal treatment with monosodium glutamate. These findings may be related to the abnormal expression of NMDA receptor subunits in the hippocampus.

Density, but not shape, of hippocampal dendritic spines varies after a seizure-inducing acute dose of monosodium glutamate in rats.

Dendritic spines are the main postsynaptic neuronal targets of excitatory inputs in cortical neurons, and both spine density and shape possess a well known adaptive synaptic-stimulation-dependent plastic capacity. Eighteen Sprague-Dawley adult male rats were used. Monosodium glutamate-treated rats (4 g/kg of body weight, i.p.) showed tonic and clonic epileptic seizures, as well as less dendritic spines in the apical arborization of their hippocampal CA1 pyramidal cells, compared to both control groups. No changes were seen in the proportional density of thin, stubby, mushroom-shaped, wide, or ramified spines between groups. Excessive glutamate-mediated excitatory activity on receptors could have led dendritic spines to shrink until they disappeared, while the spine-type proportion may be kept balanced as an adaptive response.

Síndrome del latigazo cervizal y pruebas radiológicas. Respuesta de los autores / Cervical whiplash syndrome ans x-ray tests

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¿Síndrome de latigazo cervical? / Cervical whiplash syndrome?

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