Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Autoimmune pancreatitis is a chronic inflammatory disease of unknown etiology, which affects mainly adults between 50 and 70 years old. It is characterized by presenting obstructive jaundice and hypergammaglobulinemia (IgG4). The diagnosis is suspected due to  clinical characteristic findings and is confirmed by imaging criteria and specific serologies. It can be classified into two subtypes, type 1 and type 2 autoimmune pancreatitis, according to the histological pattern and associated clinical presentation. Treatment is based on steroids, and comprises two stages, induction of remission and maintenance, it has a good prognosis if it responds to treatment.

.

Introduction: Pulmonary rehabilitation is a multidisciplinary intervention, which main goals are to lessen respiratory symptoms, augment exercise tolerance and, therefore, enhance health related life quality on patients with chronic pulmonary diseases, such as Lung Cancer.   Objective: To establish the relevance of pulmonary rehabilitation, facilitate the construction of rehab programs that are focused on oncology patients, this with the creation of evaluation and intervention algorithms, all of this within the walls of the National Cancer Institute. Materials and methods: Descriptive study of a bibliographic review taking in account resources as: Academic Google, PubMed, Reveu des Maladies and some others. For the online research the keywords were “pulmonary rehabilitation”, “respiratory therapy”, “pulmonary rehabilitation program” and “cardiovascular and pulmonary rehabilitation”, all of them published between 2009 and 2019, written in Spanish, English or French. Based on this research we proposed evaluation and intervention algorithms for lung cancer patients.  Results: The insertion of a specialized pulmonary rehabilitation program can be highly significant with the outcomes of patients with Chronic pulmonary. This can be notices on short term by the patient (who retakes activities and reintegrates within his environment) and their family. The program also slows down the progression of the pathology, therefore diminishing sickness and mortality rates. This can be checked out with close monitoring and assessment of the patient. A pulmonary rehabilitation program must come with a full assessment, so we can track down the progression or regression of the patient, bibliography suggests that this assessments should be performed at least once every three months. In this review we present a suggestion for a pulmonary rehabilitation program for three months, within this period of time the patient will have a physical activity program that takes in account cardiovascular activity as much as strength exercise, all of this supervised by an interdisciplinary team; every month the dosage exercise will be adjusted and, at the end of the third month there will be a reevaluation.  Conclusions: Pulmonary rehabilitation has proved to be an excellent source for the management of patients with Chronic Pulmonary Diseases, it would be promising to take this new programs into practice.

Introduction: Respiratory and cardiac diseases are on the increase every year, which is why they are a major problem in hospital systems, mainly in emergency and critical care services. The Respiratory Therapist is a key member of the medical teams of the hospital shock services that provide care to these patients. The objective of this study was to determine the procedures and time required in a quality care in Respiratory Therapy in emergency care services, intermediate care and intensive care in the third level care centers of the Eje Cafetero in Colombia, during the year 2019. Materials and Methods: An observational, descriptive, cross-sectional study was designed. Through a survey we investigated sociodemographic variables and procedures and the time needed for them, randomly selecting the respiratory therapists that worked in the described care units, from the thirteen third level care centers of the Eje Cafetero in Colombia, in the cities of Armenia, Pereira and Manizales, of which eight care centers were included in the study.  Additionally, respiratory therapy coordinators and key informants such as the head of nursing, area supervisors, and medical chiefs were surveyed to evaluate the quality of respiratory therapy services. A Likert scale was used for this last point. The Statistical Package for Social Sciences (SPSS) software, version 25.0 for Windows, was used for data editing and reduction.  Results:  The population surveyed was 50 Respiratory Therapy professionals out of a total of 278 working in the services described above. On average, there is one Respiratory Therapist per shift (12 hours) in the different care services (hospitalization, intensive care, intermediate care, emergencies) which must be in charge of an average of 18 beds.  The average of patients occupying respiratory therapy per day is 14, and according their disease they should have 2 or 3 therapies per day.  In addition, on average 15 patients are admitted per shift. The city with the highest total number of therapists was Manizales (one for every 13 beds). It was determined that in a single admission of a patient to the Intensive Care Unit, implementing each clinical procedure performed by the therapist, an average time of 285 minutes is required. The average duration of respiratory therapy procedures per patient in the hospitalization area was 321 minutes and 684 in neonatal ICU.  Conclusion: It could be evidenced that in the surveyed institutions there was a deficit of Respiratory Therapy professionals, which leads to not offering quality care.

Introduction: In breast cancer is one of the most frequent in women, it brings with it several complications after treatment. one of them is painful ghost breast syndrome (PGBS), which is the subjective experience of perceiving and detecting the presence of all or part of the breast accompanied by pain. In Costa Rica, there is no protocol or guide for the physiotherapeutic approach in women with PPBS. Objective: To establish the pathophysiological characteristics of the PPBS to achieve its understanding and thus prepare a proposal for physiotherapeutic intervention based on the effects of physical agents on the body. Materials and methods: Descriptive study of bibliographic review, considering digital resources such as PubMed, LILACS, Scielo, Elsevier, RefSeek, Google Scholar, Dialnet, Academia, Base, Springer Link, ERIC and Redalyc as sources, using the words neoplasm of breast AND mastectomy OR syndrome of ghost limb OR pain AND physiotherapy OR rehabilitation. Documents published from 1990 to 2020 are included, in Spanish, English and Portuguese. Based on the published evidence, physiotherapeutic intervention algorithms are proposed in women with PPBS. Results: A physiotherapeutic intervention proposal for PGBS is elaborated, based on the theories found that show the cause, symptoms and signs of the syndrome. Physiotherapeutic modalities are established with evidence and scientific support that can be safely used under professional judgment and knowledge to address PGBS or similar syndromes such as phantom pain. TENS, superficial thermotherapy and cryotherapy are established as physiotherapeutic techniques to treat pain; in addition some manual techniques such as Trigger Point Release, therapeutic massage and neurodynamics to treat myofascial and nervous tissue affected by the surgery; in addition to the use of neuromuscular bandage to improve the affected mechano-sensitivity in women with this GPBS. Conclusion: Physiotherapists with knowledge in oncological rehabilitation can generate great contributions in the health and quality of life of women with GPBS, using physiotherapy based in evidence.

Introduction: In Costa Rica, the objective of the Intensive Care Units is to reduce the mortality and morbidity of critically ill users. Occupational Therapy can integrate the work team since its objective is to help control and prevent pathologies for recovery of people in the unit. Objective: Determine the actions and benefits that the Occupational Therapist's intervention provides in the functional alterations that adults present in the Intensive Care Unit. Materials and methods: Descriptive study of bibliographic review, use of databases such as EBSCOHOST, Dialnet, Pubmed, Science Direct and Google Scholar. A search was made with the following descriptors “Occupational Therapy, AND Critical Care AND Therapeutics”; published between 2012 and 2019, in Spanish, English and Portuguese languages. Results: The Occupational Therapist through different intervention processes will improve the clinical evolution, physiological parameters and behaviors indicative of an awakening of the coma. It achieves that the individual involves a large number of neural networks, post lateralized and medial regions of the brain, prevents deformities, edema, joint and muscle contractures; organic failures, hemodialysis continues and days of hospitalization going from 20.6 to 10.4; as well as 43% less the average time in bed. This lies in a gross annual savings of $ 2.2 million for the hospital institution. Conclusions: OT is fundamental in this process of rehabilitation in critical patients, since through the actions that it carries out it promotes the integral attention of the individual and the most apt to perform the same in all the spheres of human occupation. Research by occupational therapists is necessary in all health care problems.

Introduction. Never before in the history and evolution of national health and social security systems has the need for a thorough critical reflection on the administrative efficiency of current models of care in the provision, quality and safety of health services, concentrated by the nature of the epidemiological profile of the population, demand behaviour and the limitations of their management, almost exclusively, in disease care; the classic paradigm of attention based on the theory of the biomedical model, which establishes risk factors as variables at the individual level, based on the principle that diseases and their symptoms and signs, come from an anomaly or from an evil functioning of organic systems. As is observed, even in today's times, in the absence of a systematic and more rigorous analysis of new historical contexts and constant changes in the social, economic and cultural determinants of the modern world, they have been designed and developed public policies that have generally failed to ensure fairness in people's rights to timely and comprehensive attention to their health-maintaining needs and quality of life, especially in the growing population of people older adulthood. Methodology: For the realization of this editorial, a bibliographic review was carried out, with selection of articles in different databases, such as PsycInfo, Scopus, Google Scholar, Medline, PubMed, EBSCO Health, Cochrane, among others, in order to establish the relationship between the great challenge of the world's current population demographic sprees, their impact on the demand for public services, and the need to rethink public policies structural determinants of health. Results: It is possible to identify the magnitude and complexity of the phenomenon of human aging and the need to rethink the process of formulating social policy in health, from the perspective of the determinants health and care for the true needs of the elgrowing population. Within the framework of these results, this editorial is aimed at objectively drawing attention to the phenomenon of population ageing, its impact on public health policies and the need to rethink the political management of health services with an emphasis on health promotion. 

A treatment based on the Bobath Concept is proposed for the rehabilitation of Cerebral Vascular Disease, mainly for the improvement of postural control in the selective movement of limbs and the performance of activities of daily living. The case report refers to a 49-year-old female patient who suffered a cerebral vascular disease with intracranial and intraventricular hemorrhage complicated with meningitis at 38 years of age, due to a cerebellar arteriovenous genetic malformation diagnosed from 4 years of age. She presented herself to the Physical Therapy service 10 years after the event and 6 years after her last rehabilitation therapy.  She presented an ataxic gait and loss of balance in both dynamic and static. The treatment consisted of rehabilitation therapy based on the principles of the Bobath Concept for two weeks, with a total of 8 sessions to perform a total of 10 sessions between assessment and revaluation. The neurological rehabilitation demonstrates a short-term improvement in their daily life activities and movement control for their performance.

The Speech Language Therapy is known as a specialty that belongs to both the area of ​​health sciences and the educational area. The speech therapists are the professionals specialized of evaluating, diagnosing, treating, preventing and observing pathologies at communication, language, speech and voice; as well as alterations in feeding and motor. Throughout history, the discipline of speech therapy has given progress and empowerment in different areas where it was not considered and currently plays an important role within an interdisciplinary team. The main objective of this article is to gather important aspects throughout the history of Speech Language Therapy in the world and how it has impacted Costa Rica, in education and health.