RESUMEN
En la actualidad, la ortodoncia desempeña un papel muy importante en la vida de los pacientes. Han salido muchos sistemas ortodónticos al mercado tratando de que el tratamiento de ortodoncia sea más rápido, cómodo y eficaz. Sin duda alguna, el sistema de autoligado viene a revolucionar la ortodoncia, debido a que es un sistema pensado en la comodidad del paciente, así como reducir el tiempo disminuyendo la fricción. El lapso de tratamiento es un factor clave, ya que se puede dar estabilidad postretención, aun cuando este haya sido corto. Se presenta una paciente de 21 años, con clase II esquelético, hiperdivergente, clase I molar bilateral, clase I canina bilateral, mordida abierta anterior, mordida cruzada del segundo premolar superior derecho, caninos fuera de arco, apiñamiento moderado superior y leve inferior, líneas medias dentales desviadas superior de 1 mm a la derecha, e inferior de 0,5 mm a la izquierda hipoplasia generalizada del esmalte. Terceros molares ausentes. Se le realizó el tratamiento de alineación, nivelación, suavizado interproximal, detallado y retención.
Today, orthodontics plays a very important role in the lives of patients. There is many orthodontic systems market trying to orthodontic treatment faster, convenient and effective. The self-ligating system will revolutionize orthodontics because it is a thought system patient comfort and reduce time reducing friction. The treatment time is a key factor, because it can provide stability post retention, even when there has been short. A 21 years old female patient is presented with a skeletal class II, hyperdivergent, molar and canine bilateral class I, anterior open bite, second right premolar in crossbite, canines outside arc, moderated upper crowding and light lower crowding. Deviated lower midline 0.5 mm to left, widespread enamel hipoplasia. Third molars absent. She underwent in alighment, leveling, stripping, detailing and retention treatment. Keywords: Class II, cross bite, moderated crowding. Trainer.
RESUMEN
BACKGROUND: The need of designing clinical practice guidelines in the context of the evidence based medicine relates to different aspects concerning the characteristics of the clinical condition, the health care context, the utilization of health services, and the existing knowledge about the topic of study. The objective of this study was to review the guideline development method for managing depression in care and its implications in clinical practice. MATERIAL AND METHODS: Review and classification of scientific articles published between 1990 and 1997 about depression guidelines according to its method of development. RESULTS: Between 1990 and 1997, 2 clinical practice guidelines on the management of depression were published using systematic review, 3 guidelines were developed through unsystematic review, 4 guidelines were developed from experts' consensus, and 19 published articles reviewed the applicability of the existing guidelines in the primary health care sector. Different points of view about the use of these guidelines had been detected. CONCLUSIONS: In the context of the evidence-based medicine, one should take into account that the overall goal of guidelines development is to ensure its validity in different health care levels, as well as to gather professionals' acceptance of its use and applicability.
Asunto(s)
Depresión/diagnóstico , Depresión/terapia , Guías de Práctica Clínica como Asunto/normas , Medicina Basada en la Evidencia , HumanosRESUMEN
OBJECTIVE: The description of three cases of reflex sympathetic dystrophy. DESIGN: Retrospective clinical observations. SETTING: Gòtic basic Health Area, Barcelona. PATIENTS AND OTHER PARTICIPANTS: Two women and a man (aged 75, 65 and 56) with mechanical pain and inflammation in the extremities. Two of the cases had a case history of trauma. Radiological signs of mottled osteoporosis were observed in the affected extremities of all the patients. In one there was gammagraphic pick-up. They were diagnosed as suffering reflex sympathetic dystrophy. INTERVENTIONS: Rehabilitation, non-steroid anti-inflammatories and treatment with Calcitonin. MEASUREMENTS AND MAIN RESULTS: Clinical and complementary diagnostic trials. CONCLUSIONS: Describing the clinical presentation and the necessary complementary trials to be able to reach an early diagnosis of this illness, which provides a better prognosis.