[Post-myocardial infarction depression]. / La depresión tras el infarto agudo de miocardio.

Major depression is a common finding among patients recovering from a myocardial infarction. Additionally, clinically significant depressive symptoms are present in other patients whose symptom severity or duration does not meet established criteria for a diagnosis of major depression. Over the last decade, increasing evidence suggests that in addition to its effect on patient s quality of life, post-MI depression also deserves attention because of a reported relation to increased morbidity and mortality. This evidence report reviews the studies that have studied depression or depressive symptoms in patients after an MI and focuses on the prevalence, clinical significance, treatment, and methods of evaluating this condition. A large number of studies have evaluated various aspects of post-MI depression including prevalence, its association with mortality, and major adverse events, and treatment.

Artroplastia de muñeca y mano / Arthroplasty of the wrist and hand

Las manos son el principal órgano para la manipulación física del medio y la principal fuente de información táctil sobre el entorno. La especialización de los hemisferios cerebrales ha determinado que en el ser humano se produzca la dominancia de una mano para actividades de destreza, habilidad y/o fuerza sobre la otra. La cirugía de la mano es una de las ramas de la cirugía que con mayor rapidez se ha desarrollado desde la Segunda Guerra Mundial, como tantos otros conocimientos médicos y quirúrgicos. La historia de las artroplastias está ligada al tratamiento del dolor y al intento de recuperar la funcionalidad de las articulaciones y, en el caso de las manos, a las graves de formaciones, secundarias a enfermedades inflamatorias crónicas invalidantes, como la artritis reumatoide (AR), o secuelas traumáticas. La indicación de artroplastia en la mano (interfalángica proximal, interfalángica distal, metacarpofalángica y trapecio metacarpiana) y la muñeca entraña una gran complejidad, por la estrecha relación funcional existente entre las articulaciones. La función de una articulación depende de las demás, y por lo tanto cualquier procedimiento practicado en una articulación incide en la actividad de las otras, y además la delicadeza de los tejidos blandos (tendones, ligamentos, etc.) complica notablemente las probabilidades de una rehabilitación adecuada. La rehabilitación y los cuidados postoperatorios desempeñan un papel muy importante en el éxito de la artroplastia. El objetivo fundamental es conseguir una movilidad precoz protegida. En función de la articulación y del tipo de artroplastia practicada se indican distintos procedimientos terapéuticos (AU)

The hands are the main organ for physicalmanipulation of the setting and primary source of tactile informationon the surroundings. The specialization of the cerebral hemisphere has determined that there is dominance of one hand for activities of skills, aptitudes and/or force over the other hand in the human being. Hand surgery is one of the branches of surgery with the fastest development since the Second World War, as other medical and surgical knowledge. The history of arthroplastiesis linked to treatment of pain and attempt to recover functionality of the joints and in the case of the hands, to the serious deformations, secondary to chronic, invalidating inflammatory diseases such as rheumatoid arthritis or traumatic sequels. The indication of arthroplasty in the hand (IPJ, PIP, MCP,TMJ) and wrist, entails great complexity due to the close functional relationship existing between the joints. The function of a joint depends on the others and thus any procedure performed in a joint affects the activity of the others and also the delicacy of the soft tissues (tendons, ligaments, etc.) significantly complicates the likelihoods of adequate rehabilitation. Rehabilitation and post-operative cares play a very important role in the success of the arthroplasty. The fundamental purpose is to achieve early protected mobility. Based on the joint and type of arthroplasty performed, different therapeutic procedures are indicated (AU)

[Acoustic analysis of the normal voice in nonsmoking adults]. / Análisis acústico de la voz normal en adultos no fumadores.

Acoustic analysis was made of 154 voices of healthy non-smokers adults. A sustained vowel /a/ was recorded on a mini-disc. Acoustic analysis was carried out with Dr. Speech Science software. Fundamental frequency (F0), standard deviation of the fundamental frequency (SD F0), jitter PPQ (%), shimmer APQ (%), harmonic-to-noise ratio (HNR), and normalized noise energy (NNE) were estimated. Mean F0 was 201 Hz in women and 129 Hz in men. F0 increased with age in men. In women, changes in F0 with age were not statistically significant. Age, sex and F0 did not significantly influence jitter, shimmer or HNR. An acceptable normal threshold is 0.5% jitter. Three percent shimmer excludes 13% of healthy persons. Our HNR values were higher than those reported elsewhere (95th percentile: 18 dB). An NNE threshold of -10 dB is unacceptable because it excludes 38% of healthy persons. NNE differed with sex (mean difference: 3-5 dB). Methodology, sample characteristics and the vowel /a/ may account for some of the differences in results.