COVID-19 y cronicidad. Una oportunidad de reinventar los servicios de Medicina Física y Rehabilitación / COVID-19 and chronic diseases. An opportunity to reinvent the services of Physical Medicine and Rehabilitation

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[Occupational disability due to locomotor pathology in the Foral Community of Navarra. Epidemiological aspects]. / Incapacidad laboral por patología del aparato locomotor en la Comunidad Foral de Navarra. Aspectos epidemiológicos.

INTRODUCTION: Disability produced by locomotor pathology causes a loss in working hours and indirect costs that are increasing at a growing rate. The aims of this study are to estimate the costs in total working hours lost caused by this pathology in two health areas of Navarra with 441,600 inhabitants, to obtain standards for the duration and incidence of sick leave and to study the relation between the average duration of sick leave and variables such as the geographical accessibility of the rehabilitation services, residence in a rural or urban milieu, and between the different health areas. METHODS: We study all the processes of temporary disability due to pathology of the locomotor system in Health Areas I and III of Navarra in 1997 and 1998, taking different variables into account. We make a descriptive study of the pathologies, counting the working days lost. We calculate the annual incidence of sick leave because of pathologies. We compare average duration with other variables. RESULTS: These represent 221,054 lost working days per year. Low back pain and sprained ankles are the most frequent processes. We find an increase in the incidence of temporary disability due to low back pain and lumbar/sciatica in the basic rural areas of the middle region. There are no statistically significant differences with a p<0.05 in the duration of temporary disability according to Health Area, rural or urban milieu or geographical accessibility to the Rehabilitation Services. A statistically significant fall can be observed in the first year of operation of a temporary disability management program.

Incapacidad laboral por patología del aparato locomotor en la Comunidad Foral de Navarra. Aspectos epidemiológicos / Occupational disability due to locomotor pathology in the Foral Community of Navarra. Epidemiological aspects

Introducción. La discapacidad producida por la patologíadel aparato locomotor ocasiona una pérdida de horas de trabajoy unos costes indirectos que están aumentando a un ritmocreciente. Los objetivos de este estudio son estimar los costesen horas de trabajo totales perdidas ocasionadas por la patologíadel aparato locomotor en 2 áreas sanitarias de Navarra con 441.600 habitantes, obtener estándares de duración e incidenciade bajas y estudiar la relación entre duración media de las bajasy variables como la accesibilidad geográfica a los servicios derehabilitación, vivir en entorno rural o urbano y entre diferentesáreas sanitarias.Material y métodos. Se han estudiado todos los procesosde incapacidad temporal por patología del aparato locomotoren las Áreas Sanitarias I y III de Navarra en 1997 y 1998, recogiendodiferentes variables. Se ha realizado un estudio descriptivode las patologías, contabilizando las jornadas laborales perdidas.Calculamos la incidencia anual de bajas por patologías.Comparamos duración media con otras variables.Resultados. La discapacidad producida por la patología delaparato locomotor supone pérdidas de 221.054 jornadas de trabajo/año. La lumbalgia, el esguince de tobillo son los procesosmás frecuentes. Encontramos un aumento en la incidencia deincapacidad temporal por lumbalgia y lumbociatalgia en laszonas básicas rurales de la zona media. No existen diferenciasestadísticamente significativas con una p<0,05 en la duración dela incapacidad temporal según área sanitaria, entorno rural ourbano ni accesibilidad geográfica a los servicios de rehabilitación.Se observa un descenso significativo estadísticamente elprimer año de funcionamiento de un programa de gestión deincapacidad temporal

pahtology causes a loss in working hours and indirect coststhat are increasing at a growing rate. The aims of this studyare to estimate the costs in total working hours lost caused bythis pathology in two health areas of Navarra with 441,600inhabitants, to obtain standards for the duration andincidence of sick leave and to study the relation between theaverage duration of sick leave and variables such as thegeographical accessibility of the rehabilitation services,residence in a rural or urban milieu, and between the differenthealth areas.Methods. We study all the processes of temporarydisability due to pathology of the locomotor system in HealthAreas I and III of Navarra in 1997 and 1998, taking differentvariables into account. We make a descriptive study of thepathologies, counting the working days lost. We calculate theannual incidence of sick leave because of pathologies. Wecompare average duration with other variables.Results. These represent 221,054 lost working days peryear. Low back pain and sprained ankles are the most frequentprocesses. We find an increase in the incidence of temporarydisability due to low back pain and lumbar/sciatica in the basicrural areas of the middle region. There are no statisticallysignificant differences with a p<0.05 in the duration oftemporary disability according to Health Area, rural or urbanmilieu or geographical accessibility to the RehabilitationServices. A statistically significant fall can be observed in thefirst year of operation of a temporary disability managementprogram

[Outpatient rehabilitation in the Foral community of Navarra: 1972-1997]. / Rehabilitación extrahospitalaria en la Comunidad Foral de Navarra: 1972-1997.

Rehabilitation care for persons with disabilities who live in zones distant from the hospital of reference represents a challenge even for the Health Services of the most advanced countries. The requirements of the principles of "Health for All in the Year 2000" of the 1981 WHO Assembly, fully assumed by Foral Law 10/1990 (integral conception of health, efficiency, equity, decentralisation, quality and humanisation in the service) have stimulated the initiatives proceeding from the Rehabilitation Service of the "Virgen del Camino" Hospital orientated towards the pragmatic application of those principles to the reality our Community. The result has been the creation of an outpatient care network with units in both the Specialties Units and the Health Centres. As in other neighbouring Communities, we are witnessing a growing increase in the demand for rehabilitation treatment; to a great extent this is due to the increasing age of the population. This must be regulated in order to guarantee access to quality rehabilitation for every person who requires it. In order to achieve the complete fulfillment of the objectives of the WHO we propose the co-ordination between levels of attention (Primary care and Specialised care), consolidation of the figure of the rehabilitation doctor as a specialised individual providing support to Primary care in the whole community, and the realisation of certain protocols for rehabilitation referral agreed upon with the Primary care doctors

[Sebaceous carcinoma of salivary gland. Report of two cases of infrequent location]. / Carcinoma sebáceo de glándula salivar. A propósito de dos casos de localización infrecuente.

Sebaceous carcinoma is an infrequent tumor of tardy increase, locally aggressive, potentially recurrent, with natural propensity for metastasize, both loco-regional or remote (lymphogenous or hematogenus metastases). Principal sitting are the annexed glands to ocular sense (Zeis glands and specially Meibomian's). Its origin in salivary glands is exceedingly uncommon, only those arising in the parotid have been reported. Our contribution are 2 cases which source were the sublingual gland and a minor palatine salivary gland, respectively. The perusal of the literature has been negative: no one previous case of sebaceous carcinoma could be discovered in the literature.