Análisis y tratamiento de las barreras motrices de la cadera según el concepto Sohier. A propósito de un caso / Analysis and treatment of motor barriers of the hip according to the sohier method. A case report

El objetivo del trabajo se basa en comparar la eficacia del tratamiento mediante fisioterapia, ejercicios isométricos y técnicas analíticas según el concepto Sohier en la articulación coxofemoral, respecto a la fisioterapia sin emplear rearmonizaciones en un paciente con rotura fibrilar recidivante del recto anterior. El sujeto de estudio fue un futbolista profesional de 33 años al que se le valoró el dolor, antes y después de las dos fases de que consta el tratamiento, mediante la Escala Visual Analógica (EVA), la amplitud articular de la cadera derecha mediante goniómetro manual de dos ramas y el índice de esfuerzo percibido (IEP) mediante la escala adaptada del índice de esfuerzo percibido para los músculos activos (Borg¿s RPE Scale). Como resultados destacamos la reducción del dolor en ambas fases (mayor en la fase 2) y aumento y estabilización en cantidad y/o calidad de la movilidad coxofemoral en la fase 2(AU)

This work has aimed to compare the effectiveness of treatment through physical therapy, isometric exercises and analytical techniques according to the Sohier method in the hip joint compared with physical therapy without using resets in a patient with recurrent muscle fiber strain of the rectus femoris. The study subject was a 33-year old professional football player who was studied prior to and following the two treatment phases. The study included pain with the Visual Analog Scale (VAS), amplitude of the right hip joint through two manual goniometer arms and the Borg's perceived exertion scale (PES), using the modified rate of perceived exertion scale for active muscles (Borg's RPE Scale). Standing out among the results are reduction of pain in both phases (higher in phase 2) and increase and stabilization in quantity or quality of hip mobility in phase 2(AU)

Manifestaciones psicopatológicas en pacientes con cervicalgia aguda antes y después del tratamiento rehabilitador / Psychopathological manifestations in patients with acute cervicalgia before and after rehabilitation treatment

El presente estudio ha ido encaminado a analizar las manifestaciones psicopatológicas de un grupo de pacientes con cervicalgia aguda antes y después del tratamiento rehabilitador, es decir, en el momento del dolor agudo y tras una mejoría significativa del mismo. La muestra ha estado compuesta por 50 pacientes afectos de cervicalgia aguda, nueve varones y 41 mujeres, con edades comprendidas entre los 17 y los 71 años. Estos pacientes realizaron tratamiento sintomático en una clínica de rehabilitación, que consistió básicamente en masoterapia, tracciones y microonda cervical. Todos los pacientes completaron 'la Sympton Checklist 90 revised' (SCL-90-R) en dos ocasiones: antes de comenzar el tratamiento, y al finalizar el mismo. Esta escala valora la severidad de la psicopatología presentada a distintos niveles: somatización, obsesivo-compulsivo, ansiedad, depresión, sensitividad interpersonal, hostilidad, ansiedad fóbica, ideación paranoide y psicoticismo. Al comparar los resultados observamos una reducción en las puntuaciones de todos estos factores psicopatológicos, siendo estadísticamente significativa en el caso de somatización, ansiedad, ansiedad fóbica y psicoticismo, así como en el 'Índice Global de Severidad'. Por tanto, la mejoría de la cervicalgia aguda tras el tratamiento rehabilitador, implica una mejoría a nivel psicopatológico, y una mejora de la calidad de vida a nivel no sólo orgánico sino también psicosocial (AU)

[Biphasic graft preservation for lung transplantation]. / Preservación bifásica del injerto en el trasplante pulmonar.

The standard, most widely applied way of preserving a lung for transplantation is infusion through the pulmonary artery (PA) of a pulmonaryplegic solution. In this prospective study, we analyzed the initial function of the pulmonary and cardiac graft after biphasic infusion of a solution introduced retrograde through the left auricle and antegrade through the PA. Twenty-six heart and lung grafts (9 unilateral and 17 bilateral) were preserved by cardioplegia and pulmonaryplegia (biphasic) between January 1996 and March 1997. Indicators of graft viability recorded were the ratio of arterial oxygen pressure (PaO2) to inspired fraction (FiO2), mean systemic pressure (MSP), mean pulmonary artery pressure (MPAP) cardiac output, pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR). The variables were recorded upon arrival of the grafts in the intensive care unit and in the first 24 h. Morbidity and mortality after heart transplants were recorded throughout a follow-up period of one month. After transplantation, most patients had a oxygenation coefficient (PaO2/FiO2) greater than 252 mmHg in the first 48 h. Hemodynamic parameters were also kept within normal ranges immediately after surgery and 24 h later. Mean ischemic time was 245 min for unilateral transplants, 215 for the first lung in double lung transplants, and 300 min for the second lung. In the early postoperative period, 3 patients suffered lung graft dysfunction, which was treated satisfactorily with nitric oxide (NO). No heart transplant patient suffered primary heart failure or left ventricular dilatation. We conclude that biphasic pulmonary preservation achieves satisfactory initial functional viability of the graft. Heart grafts removed simultaneously functioned successfully in the transplanted patient without additional pharmacological or mechanical support.

[Surgical treatment of hypertrophic myocardiopathy using a video-assisted technique. Apropos of a case]. / Tratamiento quirúrgico de la miocardiopatía hipertrófica mediante técnica vídeo-asistida. A propósito de un caso.

The use of endoscopic technology is gaining more and more popularity within cardiac surgery. We present a case employing endoscopic instruments in the resection of the interventricular septum in a patient with hypertrophic cardiomyopathy unresponsive to medical treatment. Advantages of this technique are discussed.

[Revascularization surgery in the acute phase of myocardial infarct]. / Cirugía de revascularización en la fase aguda del infarto agudo de miocardio.

Hospital deaths from acute myocardial infarction are the consequence of cardiac arrhythmias and cardiac pump failure. However, for a limited period of time following the interruption of the coronary blood flow, a significant portion of the myocardium remains in a situation of "reversibility", which means that if the coronary flow is reestablished, the infarcted area is reduced. Pos-acute myocardial infarction reperfusion methods include thrombolytic therapy, percutaneous transluminal coronary angioplasty and surgical revascularization of the myocardium. The indications for the latter method, which is employed when procedures such as thrombolysis and percutaneous transluminal coronary angioplasty have failed, are analyzed and the results are discussed in terms of the time elapsed since the onset of acute myocardial infarction, ejection fraction, the number of vessels involved, the type of infarction and the concurrence of cardiogenic shock. The advisability of adopting different strategies and priorities for surgical revascularization in certain situations is indicated.

[Multiple organ transplants]. / Trasplantes multiorgánicos.

The authors review the literature dealing with heart transplantation in combination with that of other extrathoracic solid organs. Heart-lung transplantation was not considered in this review as it is a well-defined procedure that does not strictly fit the concept of multiorgan transplantation. We present the experience of the first case of heart-liver transplantation involving organs from two different donors reported in the world medical literature. The recipient was a 9-year-old boy with type II homozygous familial hypercholesterolemia. Nine years later, the activity of the patient is normal, as are his liver and heart functions. Our series consists of fours cases of heart-kidney transplantation in patients who were undergoing periodic hemodialysis to treat glomeruloangiosclerosis and presented concomitant end-stage heart disease. On two occasions, both heart and kidney were transplanted during the same surgical procedure with organs from a single donor. The first to be performed was heart transplantation, and the kidney transplantation procedure was undertaken once hemodynamic stability was achieved. The remaining two patients had undergone kidney transplantation two and three years prior to heart transplantation. All the patients are alive, with NYHA class I, and present good ventricular and kidney function. The mean follow-up period is 5 years.