ABSTRACT
Resumen Antecedentes: La obesidad es un trastorno multifactorial caracterizado por un aumento en la adiposidad corporal, de amplia prevalencia en nuestro país, a cualquier edad y ligada a grandes consecuencias adversas, incluyendo el desarrollo de cardiopatías. Los programas de rehabilitación cardiaca (RC) son intervenciones interdisciplinarias encaminadas no solo a restaurar la funcionalidad perdida de los pacientes que han sufrido un desenlace cardiovascular, sino también a corregir aquellos factores de riesgo que lo propiciaron y que interfieren en los resultados adaptativos del mismo. La obesidad contribuye a perpetuar el riesgo de cardiopatía y suele ser resistente a las modificaciones del estilo de vida de manera convencional. Objetivo: Establecer pautas en el reconocimiento de la obesidad con directrices de atención al paciente con cardiopatía dentro de los programas de RC y su abordaje interdisciplinario. Método: A través de una extensiva revisión bibliográfica y después de una discusión interdisciplinaria, se elaboró el presente documento para fijar una postura sobre el abordaje de la obesidad en el contexto de los programas de RC en pacientes con cardiopatía. Resultados y conclusiones: Nuestra Sociedad reconoce el abordaje interdisciplinario de los pacientes con obesidad y cardiopatía en su prevención primaria y secundaria, insta a la precisión en su diagnóstico y valoración, y recomienda que su eje primario debe estar basado en primera instancia en las modificaciones del estilo de vida (entrenamiento físico, atención nutricional e intervención psicoemocional), en tanto que la terapia farmacológica y la cirugía bariátrica pudieran ser coadyuvantes en la optimización de los resultados en pacientes selectos.
Abstract Background: Obesity is a multifactorial disorder characterized by increased body adiposity with a wide prevalence in our country, at any age, and linked to major adverse consequences, including the development of heart disease. Cardiac rehabilitation (CR) programs are interdisciplinary interventions aimed not only at restoring the lost functionality of patients who have suffered a cardiovascular outcome, but also at correcting those risk factors that led to it and that interfere with its adaptive results. Obesity contributes to perpetuating heart disease risk and is often resistant to conventional lifestyle modifications. Objective: Establish guidelines in the recognition of obesity with care guidelines for patients with heart disease within CR programs and their interdisciplinary approach. Method: Through an extensive bibliographical review and after an interdisciplinary discussion, this document was prepared to establish a position on the approach to obesity in the context of CR programs in patients with heart disease. Results and conclusions: Our Society recognizes the interdisciplinary approach of our patients with obesity and heart disease in its primary and secondary prevention, urges precision in its diagnosis and assessment, recommends that its primary axis must be based in the first instance on lifestyle modifications (physical training, nutritional care and psycho-emotional intervention), while pharmacological therapy and bariatric surgery could be coadjuvants in optimizing the results in selected patients.
ABSTRACT
For several reasons, cerebral visual impairment (CVI) is emerging as a major cause of visual impairment among children in the developing world and we are seeing an increasing number of such children in our clinics. Owing to lack of early training about CVI and it being a habilitation orientated subject, we need to become equipped to optimally help the affected children. In this paper we have explained our pragmatic approach in addressing children who present with low functioning CVI. Initially we explain briefly, how vision is processed in the brain. We then present what should be specifically looked for in these children in regular clinics as a part of their comprehensive ophthalmic examination. We discuss the process of functional vision evaluation that we follow with the help of videos to explain the procedures, examples of how to convey the conclusions to the family, and how to use our findings to develop intervention guidelines for the child. We explain the difference between passive vision stimulation and vision intervention, provide some common interventions that may be applicable to many children and suggest how to infuse interventions in daily routines of children so that they become relevant and meaningful leading to effective learning experiences.
ABSTRACT
Aims: For the orthodontic treatment of the complex cases, the interdisciplinary team work is of utmost importance, which leads to the predictable outcome with excellent treatment. The prime aim of this rare case report is to demonstrate the combined orthodontic-surgical-endodonticprosthodontic interdisciplinary management. Presentation of Case: This report describes the case of a 19 years old Malay male patient with the clinical problems of median diastema, mesio-buccally rotated maxillary left 1st premolar, mild mandibular incisor crowding along with impacted maxillary left lateral incisor and canine. Discussion: With the advantages of the orthodontic fixed appliance, auto-transplantation of maxillary upper left lateral incisor and canine, the case was completed in an ideal orthodontic occlusion along with improved oral condition, masticatory function and esthetics. The treatment outcomes were due to orthodontic-surgical-endodontic-prosthodontic treatment with stable occlusion in sequels visits. Conclusion: An Interdisciplinary management achieved successful functional and esthetic results in the present case.