AFA, patología invalidante a los 40 años / FAI, disabling disease at the age of 40

El atrapamiento femoroacetabular es una patología que puede ser causa de artrosis precoz en pacientes jóvenes. Se trata de una anomalía morfológica en el acetábulo (AFA tipo PINCER), en el fémur (AFA tipo CAM) o en ambos (AFA tipo mixto). Un paciente joven que consulta repetidas veces por limitación de movimientos, por dolor inguinal con la rotación de la cadera en sedestación, durante o tras la realización de ejercicio físico y/o dolor trocantéreo con irradiación a la cara externa del muslo, debe alertar al médico de familia. Una buena anamnesis y una correcta exploración física orientan al diagnóstico, junto con radiología simple. Por ello es importante reconocerlo en la práctica clínica diaria para su derivación hospitalaria precoz con el objetivo de comenzar el estudio etiológico y tratamiento adecuado

The femoroacetabular impingement is a pathology that can cause early degenerative osteoarthritis in young patients.It involves a morphological anomaly in the acetabulum (PINCER-type FAI), in the femur (CAM-type FAI), or in both (mixed-type FAI). A young patient who consults repeatedly for limited mobility, for inguinal pain with hip rotation while sitting, and during or after physical exercise,and/or trochanteric pain with radiation to the outside of the thigh, must alert the Family doctor. A good anamnesis and a correct physical exploration guide the diagnosis, together with simple radiology. Therefore it is important to recognize it in everyday clinical practice for early hospital referralin order to begin the etiological study and a suitable treatment

Comparison of alternating pressure mattresses and overlays for prevention of pressure ulcers in ventilated intensive care patients: a quasi-experimental study.

AIM: To compare the effectiveness of alternating pressure air mattresses vs. overlays to prevent pressure ulcers in mechanically ventilated patients in intensive care units. BACKGROUND: Pressure ulcers prevention is an important issue in the nursing of critically ill patients. It is not clear whether alternating pressure air mattresses are more effective than overlays to prevent pressure ulcers. DESIGN: Prospective quasi-experimental study. METHODS: A prospective quasi-experimental study was conducted among patients in the medical-surgery intensive care unit of a university hospital on mechanical ventilation ≥24 hours during two time periods (2001 and 2006). Overlays were used in 2001 and mattresses in 2006. Primary outcome was the incidence of pressure ulcers grade ≥II (according to the European Pressure Ulcer Advisory Panel) during intensive care unit stay. RESULTS: The study included 221 patients (116 in 2001 and 105 in 2006). Baseline characteristics were similar between groups except for a higher Acute Physiology and Chronic Health Evaluation III score, total and first-day respiratory Sequential Organ Failure Assessment Score on day 1 in overlay group. There was significantly lower incidence density in the mattress vs. overlay group (12·41 cases/1000 days vs. 18·67 cases/1000 days of stay). The multivariate analyses showed the use of the mattress to be a protective factor against pressure ulcer onset. CONCLUSION: This quasi-experiment study that alternative pressure air mattresses were more effective than alternating pressure air overlays in preventing pressure ulcers in mechanically ventilated critical care patients.