Mucocele bucal: enfoque multiprofesional / Oral mucocele: a multiprofessional approach

El mucocele (MC) es la lesión más común de la mucosa bucal, como consecuencia de una alteración de las glándulas salivales menores. El tratamiento habitual es quirúrgico y consiste en la resección de la lesión. El objetivo de esta comunicación es presentar una modalidad de intervención multiprofesional no quirúrgica para el tratamiento del MC. Se presenta un estudio de caso que describe el proceso de atención psicológica - fonoaudiológica - odontológica, empleando una pantalla bucal con el propósito de reducir el trauma sobre la lesión del MC, que desaparece sin necesidad de recurrir al tratamiento quirúrgico(AU)

Mucocele bucal: enfoque multiprofesional / Oral mucocele: a multiprofessional approach

El mucocele (MC) es la lesión más común de la mucosa bucal, como consecuencia de una alteración de las glándulas salivales menores. El tratamiento habitual es quirúrgico y consiste en la resección de la lesión. El objetivo de esta comunicación es presentar una modalidad de intervención multiprofesional no quirúrgica para el tratamiento del MC. Se presenta un estudio de caso que describe el proceso de atención psicológica - fonoaudiológica - odontológica, empleando una pantalla bucal con el propósito de reducir el trauma sobre la lesión del MC, que desaparece sin necesidad de recurrir al tratamiento quirúrgico

[Variability in walk test conditions in pulmonary rehabilitation programs in Latin America and on the Iberian peninsula]. / Variabilidad en las condiciones de la prueba de la marcha realizada en el contexto de programas de rehabilitación pulmonar en América Latina y en la Península Ibérica.

OBJECTIVE: 1) To determine the frequency of use of the 6-minute walk test in pulmonary rehabilitation programs in Latin America and on the Iberian Peninsula; 2) to identify how the test is performed and possible variations from center to center. MATERIALS AND METHODS: A questionnaire was sent to 55 pulmonary rehabilitation centers in Latin America, Portugal, and Spain. RESULTS: Forty-nine (89.1%) centers answered the questionnaire. Forty-seven (95.9%) perform a walk test lasting 6 minutes; 22 (46.8%) take the longest distance of 2 tests as the real one; and 35 (74.5%) carry out the test in a corridor. The course distance ranged from 17 to 90 meters, but in 21 (44.7%) centers, the corridor was between 17 and 30 meters long. In 29 (61.7%) centers, the patients are routinely informed about the time that had elapsed during the test. Verbal encouragement is used in 44 (93.6%) centers. Thirty-eight (80.8%) use supplemental oxygen when a patient needs it. An increase in absolute values in the distance covered is used as a parameter indicating improvement at 21 (46.7%) sites while at 15 (33.3%) other centers the percentage increase is taken as a measure of improvement. CONCLUSIONS: The 6-minute walk test is widely used for the evaluation of the exercise capacity at the pulmonary rehabilitation centers of Latin America and the Iberian Peninsula. However, there is great variability in the way the test is performed.

Variabilidad en las condiciones de la prueba de la marcha realizada en el contexto de programas de rehabilitación pulmonar en América Latina y en la Península Ibérica / Variability in walk test conditions in pulmonary rehabilitation programs in Latin America and on the Iberian Peninsula

Objetivos: Determinar la frecuencia de utilización de la prueba de la marcha de 6 min en el contexto de los programas de rehabilitación pulmonar que se llevan a cabo en América Latina y en la Península Ibérica. Definir la forma con la que se realiza esta prueba y las posibles variaciones que presenta en los distintos centros. Material y métodos: Se remitió un cuestionario a 55 centros de rehabilitación pulmonar localizados en América Latina, Portugal y España. Resultados: Respondieron al cuestionario 49 centros (89,1%); en 47 (95,9%) se realizó la prueba de la marcha con una duración de 6 min; en 22 (46,8%) se aceptó la mayor distancia recorrida por el paciente en 2 pruebas como el valor real de la prueba de la marcha; en 35 (74,5%) se realizó la prueba de la marcha en un pasillo; la distancia recorrida osciló entre 17 y 90 m, pero en 21 centros (44,7%) el pasillo tenía una longitud de 17 a 30 m. En 29 centros (61,7%) se informó sistemáticamente a los pacientes del tiempo transcurrido durante la prueba de la marcha; en 44 (93,6%) se animó verbalmente al paciente mientras realizaba la prueba; en 38 (80,8%) se utilizó oxígeno suplementario cuando el paciente lo necesitó. El incremento de los valores absolutos en la distancia recorrida se utilizó como parámetro para determinar la mejoría en 21 centros (46,7%), mientras que en otros 15 (33,3%) se utilizó como parámetro de mejoría el porcentaje de incremento en la distancia recorrida. Conclusiones: La prueba de la marcha de 6 min se utiliza con mucha frecuencia para la evaluación de la capacidad de ejercicio de los pacientes en los centros de rehabilitación pulmonar de América Latina y de la Península Ibérica. Sin embargo, hay grandes variaciones en la forma con la que se lleva a cabo la prueba

Objective: 1) To determine the frequency of use of the 6-minute walk test in pulmonary rehabilitation programs in Latin America and on the Iberian Peninsula; 2) to identify how the test is performed and possible variations from center to center. Materials and methods: A questionnaire was sent to 55 pulmonary rehabilitation centers in Latin America, Portugal, and Spain. Results: : Forty-nine (89.1%) centers answered the questionnaire. Forty-seven (95.9%) perform a walk test lasting 6 minutes; 22 (46.8%) take the longest distance of 2 tests as the real one; and 35 (74.5%) carry out the test in a corridor. The course distance ranged from 17 to 90 meters, but in 21 (44.7%) centers, the corridor was between 17 and 30 meters long. In 29 (61.7%) centers, the patients are routinely informed about the time that had elapsed during the test. Verbal encouragement is used in 44 (93.6%) centers. Thirty-eight (80.8%) use supplemental oxygen when a patient needs it. An increase in absolute values in the distance covered is used as a parameter indicating improvement at 21 (46.7%) sites while at 15 (33.3%) other centers the percentage increase is taken as a measure of improvement. Conclusions: The 6-minute walk test is widely used for the evaluation of the exercise capacity at the pulmonary rehabilitation centers of Latin America and the Iberian Peninsula. However, there is great variability in the way the test is performed

The multipurpose surveillance-oriented medical record: a tool for quality of care management.

Medical records were oriented towards quality of care surveillance by adding dedicated sections to the progress notes in which to list admission problems, medical interventions and adverse events (AEs). Two types of simple code were used: indication codes, which identify the indication for any given medical intervention; and attribution codes, which indicate the causes of any AE. During the first 6 months (302 patients), 24 AEs were attributed to drugs, three to procedures, and 42 were unexplained. The incidence of 7.9 suspected adverse drug reactions per 100 patients exceeds that obtained with other hospital-based adverse drug reporting programmes. Unexplained events are kept under constant statistical control to detect possible alerting signals. As a tool for quality of care management, the surveillance-oriented record can be used to monitor the appropriateness of medical interventions, identify "high risk" areas and deduce outcome indicators which constitute useful screens for the identification of potential problems.

Immobilization of endo-polygalacturonase from Aspergillus niger on various types of macromolecular supports.

Endo-polygalacturonase (endo-PG) was immobilized on a wide range of natural and synthetic macromolecular supports and their modified derivatives representing many chemical classes, including esters, amides, phenols, alkyl- and arylamines, and carboxyl derivatives. The immobilization entailed methods of adsorption alone as well as covalent bond formation using glutaraldehyde or carbodiimide or via the diazo-coupling reaction. The most promising system proved to be immobilization on trimalehylchitosan (TMC) via adsorption followed by treatment with glutaraldehyde (GA). The binding capacity of the support is on the order of 13,000 IU/g, half of which is active. Various properties of immobilized endo-PG were evaluated. The optimum pH of the enzyme shifted to the alkaline side. The relative catalytic activity was considerably high even at room temperature and remained so above 70 degrees C. The thermal stability at pH 3-4 was notably improved by immobilization, the half-time doubling. Finally, the apparent K(m) was greater for immobilized endo-PG than for native enzyme, while the V(max) was smaller for the immobilized enzyme.