Telemedicina en cirugía maxilofacial / Telemedicine in maxillofacial surgery

En nuestra especialidad el cáncer oral, debido a su elevada mortalidad,así como otras patologías de menor gravedad pero de gran morbilidady presión asistencial como la cirugía oral y la patología de la articulacióntemporomandibular, nos obligan a minimizar las demoras optimizandolos recursos de que disponemos. Dentro de estos recursos, la aplicaciónde las nuevas tecnologías a la medicina se está imponiendo en todaslas especialidades. Entre estas nuevas tecnologías, está adquiriendo un papelprotagonista la telemedicina. Creemos que ésta nos puede servir como sistemaóptimo y eficaz de cribado y derivación de pacientes desde atenciónprimaria (AP) hasta el nivel hospitalario. En el presente artículo describimostodos los detalles relacionados con el desarrollo, la utilización y las ventajasde una teleconsulta como herramienta integrante de una unidad degestión clínica para el proceso diagnóstico y terapéutico de la patología dela articulación temporomandibular valorando de esta forma su aplicabilidaden otros ámbitos de la cirugía oral y maxilofacial(AU)

There is a group of pathologies that tolerate little delayand require optimal use of the resources available to us in our dailywork as oral and maxillofacial surgeons. For instance, oral cancerhas a high mortality and other pathologies, which otherwise arenot serious, have a high morbidity and care burden, e.g., oral surgeryand temporomandibular joint dysfunction.Among these resources, the use of new technologies in medicinehas become routine practice in every specialty. Among thesetechnologies, telemedicine is becoming prominent. We believe thattelemedicine could be an optimal system for screening patientsfor referral from primary care to hospitals. The development, use,and advantages of teleconsultation as a tool used in a clinicalmanagement unit for the diagnosis and treatment oftemporomandibular joint disorders is described. The potential useof teleconsultation in other fields of oral and maxillofacial surgeryis evaluated(AU)

Analysis by digital simulation of the peripheral and renal resistance in hypovolemic hypotension.

A haemorrhage was simulated and analysis of dynamic behaviour of renal resistance, renal nervous activity and peripheral resistances were processed, with the aim of studying the paradoxical behaviour of renal resistance as opposed to peripheral resistances and the increase of sympathetic activity in hypovolemic shock situations using both non-linear models of the renal blood flow and arterial pressure and body fluids. The following conclusions can be made after comparing the results obtained by simulation with data related to animal experimentation models: the model is useful for its use in the analysis of nervous activity, resistance and renal flow in hypovolemic shock situations in humans and the control structure it puts forward can explain the paradoxical behaviour of renal vascular resistance as opposed to the peripheral resistances and the increase in the renal nervous activity in the aforementioned circumstances.

[A new proposal on the neural component of the control system of renal blood flow. Analysis using digital simulation]. / Nueva propuesta del componente neural del sistema de control del flujo sanguíneo renal. Análisis por simulación digital.

A mathematical, non-lineal model for digital simulation of the neural control of blood renal flow (BRF) has been built, by using the system dynamic techniques. The control mechanisms considered have been the BRF regulation by means of a renal intrinsic system, and by means of an RNA-dependent system, being the latter a product of the peripheral sympathetic activity, of a tonic inhibitory system with a central origin, and of a system that inhibits this last one, which has an intrarenal origin. For the validation of the model, a spinal section has been simulated, and the data have been compared with the reported in the bibliography. The use of this model permits an approach to the study of different variables in physiological or pathological circumstances in man, especially of those involved in the neural regulation of the BFR, obviating the technical and ethical obstacles of experimental techniques and leading to the design of new animal trials.