Modelos de rehabilitación en atención primaria y comunitaria. Revisión bibliográfica / Rehabilitation models in primary and community care. A literature review

El objetivo de este artículo es presentar las distintas tendencias y modelos de aplicación de la rehabilitación en atención primaria que se han producido a lo largo de estos 30 años a través de las publicaciones de la literatura. Se ha realizado una búsqueda bibliográfica en los buscadores PubMed, CINAHL y MEDLINE, literatura gris y motores de búsqueda generales. Se han seleccionado los artículos más relevantes para nuestro objetivo. Se presentan los principales modelos de rehabilitación en atención primaria que aparecen en la literatura: médico rehabilitador como médico de atención primaria de los discapacitados, modelos para la integración de rehabilitación y atención primaria (modelo clínico, servicios de soporte, programas de automanejo, rehabilitación basada en la comunidad, gestión de casos y modelo de cuidado compartido), modelos de rehabilitación integrados en la comunidad y el modelo comunitario (AU)

This article discusses the various tendencies and models for providing rehabilitation services in primary care through a review of the literature published in the past 30 years. A literature search was conducted using PubMed, CINAHL and MEDLINE, as well as grey literature and less specifi c search engines. The most relevant articles were selected. The following key models for providing rehabilitation in primary care are presented: the physiatrist as a general practitioner for the disabled; integrating rehabilitation in primary care services (clinical model, outreach, self-management, community-based rehabilitation, case management, and shared care); models for integrating the community; and the World Health Organization’s proposal for a community-based model (AU)

Metastatic arthropathy report of two cases and review of the literature.

Metastatic arthropathy has been rarely reported as a manifestation of solid tumors. It is characterized by a monoarticular involvement and is frequently the first feature of the malignant process; therefore, it may pose a diagnostic challenge. We report two new cases of metastatic carcinomatous arthritis: a patient with right-knee monoarthritis as a presenting feature of pancreatic carcinoma and another one with right-elbow monoarthritis, preceded by constitutional and pulmonary symptoms, secondary to metastasis of undifferentiated carcinoma. We also review the literature for well documented cases of metastatic arthropathy secondary to solid tumors. Metastatic arthropathy indicates a poor prognosis because of a wide spread of the tumor when it is diagnosed. We emphasize the need for increasing awareness of cancer as a cause of monoarthritis.