ABSTRACT
RESUMEN En el niño, la microcirculación cutánea (MCC) experimenta cambios desde sus primeros días de vida hasta la adolescencia. Mediante la video capilaroscopia (VC), se puede acceder a la visualización in vivo e incruenta de la MCC, en niños de cualquier edad. El sitio de elección es el pliegue peri ungular de los dedos de las manos. Se observan las asas capilares, dispuestas en corona sobre la matriz peri ungular y el plexo vascular superficial. Los recién nacidos presentan una red primitiva. Posteriormente, evolucionaalcanzando alrededor de los 10 años, los parámetros similares al adulto.El conocimiento de los parámetros de la MCC preservada en niños,será de gran importancia en la exploración diagnóstica de las patologías que afectan este territorio vascular, como las enfermedades reumáticas.
SUMMARY The child's skin microcirculation (MCC) undergoes changes from the first days of life until adolescence. Through video capillaroscopy (VC), in vivo and non-invasive visualization of the CCM is accessed in children of any age. The site of the election is the nail fold of the fingers of the hands. The capillary loops arranged in a crown over the nail matrix and the superficial vascular plexus are observed. The newborns present a primitive network, which later evolves reaching around 10 years the parameters similar to the adult. There are structural differences in MCC if the findings in children are compared with those of adults. In children the capillary density per linear millimeter is lower, the tortuosity index is higher, the superficial vascular plexus is more visible and bizarre capillary forms are found Knowledge of the parameters of MCC preserved in children will be of great importance in the diagnostic exploration of pathologies that affect this vascular territory such as rheumatic diseases.
ABSTRACT
La capilaroscopía periungular es una técnica de estudio, de la microcirculación cutánea in vivo. Es de elección en el diagnóstico diferencial entre Raynaud primario y secundario. Presentamos la descripción de los hallazgos capilaroscópicos mediante imágenes, en una adolescente que padece fenómeno de Raynaud. Se hallan alteraciones estructurales y funcionales de los capilares. En los meses posteriores la paciente desarrolla lupus eritematoso sistémico. La presencia de estos hallazgos previos al desarrollo de enfermedad lúpica, no es frecuente.
Nailfold capillaroscopy is a technique to visualize the skin microcirculation in vivo. This is of the utmost importance to establish the differential diagnosis between primary and secondary Raynaud. We hereby present the capillaroscopic image of the alterations, both structural and functional, detected in a female adolescent with Raynaud's phenomenon. In the next months the patient developed a systemic lupus erythematosus. The presence of these prior to the development of lupus disease is rare findings.
ABSTRACT
A method is described for developing a health situation index based on an analysis of factors combined with conjoint analysis. First, the principal components analysis is used to identify the relevant attributes-i.e., those indicators on which the overall index is to be based. Then a group of experts, public health physicians in this case, meet in front of a computer terminal and conduct an interactive assessment of multiattribute preferences. The computer program presents pairs of attributes for comparison, and the experts make judgements of preference or nonpreference; in this way, the weight of each indicator is determined. After a sufficient number of comparisons have been made, the software calculates the weights, which are a coherent reflection of the assessment made by the group of experts and will constitute the value function thereof. The resulting health index makes it possible to draw comparisons between human groups, to arrange them in order, and to identify those groups that require greater attention. The method was used, for example, to establish the health index for the 13 regions of Chile during the period 1977-1983. This method could be applied to more specific áreas, such as maternal and child health or health of adults. Its characteristics are such that it can be adapted to the individual situation in each country