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RESUMEN Objetivo: Reportar la sensibilidad al cambio e interpretabilidad de la versión argentina de la escala de catastrofización del dolor (PCS-Arg, por sus siglas en inglés) en una muestra de sujetos con dolor lumbar crónico (DLC). Materiales y métodos: Estudio prospectivo, observacional y longitudinal. Se reclutaron sujetos con DLC derivados a la unidad de kinesiología de un hospital público de la Ciudad Autónoma de Buenos Aires. Inicialmente, se registraron los datos demográficos y las puntuaciones de la PCS-Arg, así como la intensidad del dolor, discapacidad, calidad de vida y depresión mediante cuestionarios autoadministrados. En una segunda instancia, al mes o alta del tratamiento, se repitieron los cuestionarios junto con una escala global de cambio. La sensibilidad al cambio fue evaluada mediante la validez de constructo longitudinal. La interpretabilidad se calculó mediante el método basado en el ancla, y se reportaron la diferencia mínima clínicamente importante (DMCI) y el beneficio clínico sustancial (BCS). Resultados: Se incluyeron 102 sujetos en el estudio. La PCS-Arg demostró una sensibilidad al cambio aceptable. La DMCI fue de 10 puntos, con un área bajo la curva (AUC) de 0,65 y un intervalo de confianza del 95 % (IC 95 % 0,47-0,83). El BCS fue de 17 puntos, con un AUC de 0,66 (IC 95 % 0,55-0,77). Conclusión: La PCS-Arg es un instrumento sensible al cambio. La capacidad discriminativa de los valores para identificar la DMCI y el BCS fue pobre. Estos resultados permitirán interpretar el impacto de diferentes terapéuticas orientadas a modificar el catastrofismo, así como potenciar futuros ensayos clínicos que incluyan sujetos con DLC.

ABSTRACT Objective: To report the responsiveness and interpretability of the Argentine version of the Pain Catastrophizing Scale (PCS-Arg) in a sample of subjects with chronic low back pain (CLBP). Materials and methods: A prospective, observational, and longitudinal study was conducted. Subjects with CLBP referred to the physical therapy unit of a public hospital in the Autonomous City of Buenos Aires were recruited. At baseline, demographic data and PCS-Arg scores, as well as pain intensity, disability, quality of life, and depression were recorded through self-reported questionnaires. In a second instance, at one month or discharge, the same variables were collected, along with a Global Rating Of Change (GROC) scale. Responsiveness was assessed using longitudinal construct validity. Interpretability was calculated using the anchor-based method, and the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) were reported. Results: A total of 102 subjects were included in the study. The PCS-Arg showed acceptable responsiveness. The MCID score was 10 points, with an area under the curve (AUC) of 0.65 and a confidence interval of 95 % (95 % CI 0.47-0.83). The SCB score was 17 points, with an AUC of 0.66 (95 % CI 0.55-0.77). Conclusion: The PCS-Arg is a responsive instrument. The discriminative ability of the values to identify the MCID and SCB was poor. These results will allow for interpreting the impact of different treatments aimed at targeting catastrophizing, as well as enhancing future clinical trials on subjects with CLBP.

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RESUMEN Objetivo: Describir las características clínico-demográficas de sujetos internados luego de una intervención quirúrgica que recibieron asistencia kinésica (AK) en la sala de cirugía general de un hospital público de la Ciudad Autónoma de Buenos Aires (CABA). El objetivo secundario consiste en describir el uso de dispositivos de oxigenoterapia, el desarrollo de complicaciones pulmonares postoperatorias (CPP) y el tiempo transcurrido hasta la AK. Materiales y métodos: Se incluyeron datos extraídos de fichas kinésicas de sujetos que se sometieron a una intervención quirúrgica abdominal, torácica o pélvica y recibieron AK entre enero de 2019 y diciembre de 2022. Se registraron datos demográficos y clínicos, motivo de consulta kinésica, desarrollo de CPP, cantidad de días de AK y uso de dispositivos de oxigenoterapia. Resultados: Se incluyeron 151 fichas kinésicas. Del total, 15 sujetos (9,9 %) desarrollaron CPP. En este grupo, la mediana de días transcurridos entre el procedimiento quirúrgico y el comienzo de la AK fue de 8 días (RIQ 4-16), mientras que para los sujetos que no desarrollaron complicaciones fue de 4 días (RIQ 2-7). Un total de 57 sujetos (37,5 %) requirieron oxigenoterapia, de los cuales 3 requirieron ventilación mecánica invasiva y 1 no invasiva. Conclusión: Se describieron las características clínico-demográficas de sujetos postquirúrgicos internados en la sala de cirugía general de un hospital general de agudos de la CABA. Aquellos sujetos con CPP recibieron más días de AK y requirieron oxígeno suplementario durante un período más extenso. Los sujetos que no desarrollaron CPP recibieron AK en una etapa más temprana, en comparación con los que desarrollaron complicaciones.

ABSTRACT Objective: To describe the clinical-demographic characteristics of subjects who were hospitalized after a surgical intervention and received physical therapy (PT) in the general surgery ward of a public hospital in the Autonomous City of Buenos Aires (CABA). The secondary objective is to describe the use of oxygen therapy devices, the development of postoperative pulmonary complications (PPC), and the time elapsed until PT. Materials y methods: We included data from the PT records of subjects who underwent abdominal, thoracic, or pelvic surgical interventions and received PT between January 2019 and December 2022. Demographic and clinical data, reason for PT consultation, development of PPC, number of days of PT, and use of oxygen therapy devices were recorded. Results: A total of 151 records were included; of them, 15 subjects (9.9 %) developed PPC. In this group, the median number of days elapsed between the surgical intervention and the onset of PT was 8 days (IQR 4-16), while for subjects who did not develop complications, it was 4 days (IQR 2-7). A total of 57 subjects (37.5 %) needed oxygen therapy, with 3 subjects requiring invasive mechanical ventilation and 1 requiring non-invasive mechanical ventilation. Conclusion: We described the clinical-demographic characteristics of postoperative subjects hospitalized in the general surgery ward of a general acute hospital in the CABA. Subjects with PPC received PT over an extended period and required supplemental oxygen for a longer period. Subjects who did not develop PPC received PT earlier, compared with those who developed complications.

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This study presents the design and implementation of an electronic system aimed at capturing vibrations produced during truck operation. The system employs a graphical interface to display vibration levels, ensuring the necessary comfort and offering indicators as a solution to mitigate the damage caused by these vibrations. Additionally, the system alerts the driver when a mechanical vibration that could potentially impact their health is detected. The field of health is rigorously regulated by various international standards and guidelines. The case of mechanical vibrations, particularly those transmitted to the entire body of a seated individual, is no exception. Internationally, ISO 2631-1:1997/Amd 1:2010 oversees this study. The system was designed and implemented using a blend of hardware and software. The hardware components comprise a vibration sensor, a data acquisition card, and a graphical user interface (GUI). The software components consist of a data acquisition and processing library, along with a GUI development framework. The system underwent testing in a controlled environment and demonstrated stability and robustness. The GUI proved to be intuitive and could be integrated into modern vehicles with built-in displays. The findings of this study suggest that the proposed system is a viable and effective method for capturing vibrations in trucks and informing drivers about vibration levels. This system has the potential to enhance the comfort and safety of truck drivers.

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OBJECTIVE: Strongyloidiasis is a parasitic infection classified by the World Health Organization as a neglected tropical disease. Although predominantly asymptomatic, it can become a life-threatening disease in an immunocompromised host. Epidemiologic studies in the Western Hemisphere are scarce, but even more scarce are descriptions of the natural course of this disease. Our objectives were to identify the different manifestations and outcomes of Strongyloides stercoralis infection in the Hispanic veteran population in Puerto Rico. We also discuss the importance of pursuing a timely diagnosis in high-risk patients migrating from or traveling to endemic areas, regardless of their symptomatic status. METHODS: This was a single-center, retrospective record review study involving patients diagnosed with S. stercoralis via serology, stool samples, or organ biopsies, from 2008 through 2014. RESULTS: A total of 270 patients tested positive; 210 (77.8%) were asymptomatic. The mean age at diagnosis was 75.4 years old. Symptomatic patients had pulmonary (n = 25), gastrointestinal (n = 21), and dermatologic (n = 5) symptoms; 9 had multiple symptoms. Five had hyperinfection, mostly after treatment with systemic steroids or preexisting immunosuppression. The most common laboratory abnormality was eosinophilia. Reasons for testing were eosinophilia, asthma, diarrhea, screening for parasites, and unexplained skin rash. CONCLUSION: Our study highlights the importance of being aware of this potentially fatal infection, especially when treating patients traveling from endemic countries. It also highlights the importance of timely screening, diagnosis, and treatment of S. stercoralis infection in order to prevent potentially fatal outcomes, especially when considering immunosuppressive drugs.

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Chronic intestinal pseudo-obstruction is a rare syndrome with high morbidity and mortality. The pathophysiology is not well understood, although it is postulated that it involves some sort of neuropathic and/or myopathic dysfunction resulting in intestinal dysmotility. We present the first case of chronic intestinal pseudo-obstruction secondary to a paraneoplastic syndrome associated with a primary small cell prostate cancer.

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Introducción: el acceso transradial ha surgido como una alternativa atractiva a la vía femoral para realizar coronariografías e intervenciones coronarias. Describimos nuestra experiencia, y comparamos el acceso radial con una cohorte de acceso femoral en un periodo de tiempo. Objetivo: identificar las complicaciones vasculares relacionadas con la coronariografía en pacientes de la unidad de dolor torácico de una institución de alta complejidad de la ciudad de Medellín. Materiales y métodos: estudio epidemiológico observacional, analítico, de una cohorte retrospectiva de pacientes mayores de 18 años que ingresaron a la unidad de dolor torácico del hospital Universitario San Vicente Fundación con diagnóstico de síndrome coronario agudo con y sin elevación del ST, y a los cuales se les realizó coronariografía por acceso radial y femoral. Resultados: se evaluaron 675 pacientes, de los cuales 59.6% (n=402) se les realizó acceso femoral y 40.4% (n=273) acceso radial con diferencias, en relación al sexo y aspectos personales como el tabaquismo y la enfermedad renal crónica. Respecto a las complicaciones según el tipo de acceso, se hallaron diferencias significativas en la presencia de hematoma femoral (OR= 5.6; IC 95%: 1.28; 24.63) y el espasmo radial (p<0.05). Conclusión: los accesos radial y femoral son seguros y efectivos, sin embargo la disminución significativa de las complicaciones vasculares puede ser una razón para preferir el acceso radial como técnica de elección en la mayoría de estos pacientes. (Acta Med Colomb 2015; 40: 209-217).

Introduction: the transradial access has emerged as an attractive alternative to the femoral access for coronary angiography and coronary interventions. We describe our experience, and compare the radial access with a cohort of femoral access in a time period. Objective: to identify vascular complications related to coronary angiography in patients of the chest pain unit of a high complexity institution of the city of Medellin. Materials and Methods: epidemiological, observational, analytical study of a retrospective cohort of patients over 18 years admitted to the chest pain unit of the University Hospital San Vicente Foundation with diagnosis of acute coronary syndrome with and without ST elevation in which coronary angiography by radial and femoral access was performed. Results: 675 patients were evaluated. 59.6% (n = 402) underwent femoral access, and 40.4% (n = 273) radial access with differences in relation to sex and personal aspects such as smoking and chronic kidney disease. Regarding complications according to the type of access, significant differences were found in regard to the presence of femoral hematoma (OR = 5.6; 95% CI: 1.28; 24.63) and radial artery spasm (p <0.05). Conclusion: the radial and femoral accesses are safe and effective; however, the significant decrease in vascular complications may be a reason to prefer the radial access as technique of choice in most of these patients. (Acta Med Colomb 2015; 40: 209-217).

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Food security (a pressing issue for all nations) faces a threat due to population growth, land availability for growing crops, a changing climate (leading to increases in both abiotic and biotic stresses), heightened consumer awareness of the risks related to the use of agrichemicals, and also the reliance on depleting fossil fuel reserves for their production. Legislative changes in Europe mean that fewer agrichemicals will be available in the future for the control of crop pests and pathogens. The need for the implementation of a more sustainable agricultural system globally, incorporating an integrated approach to disease management, has never been more urgent. To that end, the Valorizing Andean Microbial Diversity (VALORAM) project (http://valoram.ucc.ie), funded under FP7, examined the role of microbial communities in crop production and protection to improve the sustainability, food security, environmental protection, and productivity for rural Andean farmers. During this work, microbial volatile organic compounds (mVOCs) of 27 rhizobacterial isolates were identified using gas chromatography/mass spectrometry (GC/MS), and their antifungal activity against Rhizoctonia solani was determined in vitro and compared to the activity of a selection of pure volatile compounds. Five of these isolates, Pseudomonas palleroniana R43631, Bacillus sp. R47065, R47131, Paenibacillus sp. B3a R49541, and Bacillus simplex M3-4 R49538 trialled in the field in their respective countries of origin, i.e., Bolivia, Peru, and Ecuador, showed significant increase in the yield of potato. The strategy followed in the VALORAM project may offer a template for the future isolation and determination of putative biocontrol and plant growth-promoting agents, useful as part of a low-input integrated pest management system.

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The Central Andean Highlands are the center of origin of the potato plant (Solanum tuberosum). Ages of mutualism between potato plants and soil bacteria in this region support the hypothesis that Andean soils harbor interesting plant growth-promoting (PGP) bacteria. Therefore, the aim of this study was to isolate rhizobacteria from Andean ecosystems, and to identify those with PGP properties. A total of 585 bacterial isolates were obtained from eight potato fields in the Andes and they were screened for suppression of Phytophthora infestans and Rhizoctonia solani. Antagonistic mechanisms were determined and antagonistic isolates were further tested for phosphate solubilization, 1-aminocyclopropane-1-carboxylate (ACC) deaminase activity, and production of NH3- and indole-3-acetic acid (IAA). PGP was studied in healthy and R. solani diseased plantlets under growth room conditions. Performance was compared to the commercial strain B. subtilis FZB24(®) WG. Isolates were dereplicated with matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS), and identified with 16S rRNA gene sequencing and multi locus sequence analysis (MLSA). A total of 10% of the isolates were effective antagonists, of which many were able to solubilize phosphate, and produce IAA, ACC deaminase, NH3 and hydrogen cyanide (HCN). During growth room experiments, 23 antagonistic isolates were associated with plant growth-promotion and/or disease suppression. Ten isolates had a statistically significant impact on test parameters compared to the uninoculated control. Three isolates significantly promoted plant growth in healthy plantlets compared to the commercial strain, and seven isolates outperformed the commercial strain in in vitro R. solani diseased plantlets.

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Introducción: El objetivo de este trabajo es destacar la frecuencia e importancia de las perdidas óseas glenoideas que no fueron consideradas por mucho tiempo y las posibilidades terapéuticas teniendo en cuenta dicha lesión. Presentar nuestra experiencia en el tratamiento estandarizado de las luxaciones recurrentes anteriores del hombro, vírgenes de cirugía previa, enfatizando en las pérdidas óseas antero inferiores del reborde glenoideo. Objetivo: Determinar la importancia de las pérdidas óseas de la glenoides en inestabilidades recurrentes de hombro. Material y Métodos: Se estudiaron 22 pacientes sin tratamiento quirúrgico previo por la patología descripta, con edades entre 18 y 45 años, con un claro predominio del sexo masculino (proporción 8 a 2). Se operaron con la técnica abierta modificada de Bristow Latarjet. La base de nuestro enfoque es la correcta selección de los pacientes, la técnica aplicada y el programa de rehabilitación precoz. La serie la consideramos de homogeneidad aceptable entre sus integrantes, así como los procedimientos quirúrgicos y la evaluación efectuada. Resultados: Se realizó una evaluación retrospectiva objetiva y subjetiva de los resultados a los dos años en una cohorte de 22 pacientes. Se valoraron de acuerdo con exámenes físico, imagenológico y de resultados, por cuestionarios completados por médicos y pacientes con el Score de Constant y de la ASES. Las cifras obtenidas fueron: 86% presentó hombros estables, indoloros o con poco dolor con una mínima pérdida de la rotación externa considerada entre los 6 y 8°, con limitaciones menores para las actividades por encima de la cabeza. No observamos re luxaciones o problemas con la consolidación de la coracoides ni tampoco artrosis temprana. Los consideramos resultados excelentes o buenos. Los mismos encuentran su principal objeción en la falta de verificaciones a largo plazo, que es cuando puede observarse la aparición de artrosis secundaria...

Background: Treatment of recurrent anterior shoulder instability isin continuous development. This disabling condition requires allthe possible knowledge, skills and broad experience to be solved. The purpose of this study was emphasized the importance of the glenoid bone loss and to verify th e hypothesis that the open coracoid transfer as described by Bristow Latarjet is a highly successful for treating recurrent glenohumeral instability associated with glenoid bone losses.Objectives: To determine glenoid bone losses importance inshoulder recurrent instability. Material and Methods:We selected a cohort of 22 patients, ages between 18 and 45 y.o. with predominance of males over females (rate 8 to 2), with recurrent anterior glenohumeral instability. All of them were treated with open Bristow Latarjet technique. We considered there is acceptable homogeneity in this cohort as wellas in the surgical procedure and the final evaluation methods.Results: Our results were obtained with an average outcome of 2 years. We perform physical examination, images screening, surveys between patients performed by physicians, and the Constan and ASES scores. 85% showed a stable shoulder, painless, with minimal external rotation loss (between 6 and 8...

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Introducción: El objetivo de este trabajo es destacar la frecuencia e importancia de las perdidas óseas glenoideas que no fueron consideradas por mucho tiempo y las posibilidades terapéuticas teniendo en cuenta dicha lesión. Presentar nuestra experiencia en el tratamiento estandarizado de las luxaciones recurrentes anteriores del hombro, vírgenes de cirugía previa, enfatizando en las pérdidas óseas antero inferiores del reborde glenoideo. Objetivo: Determinar la importancia de las pérdidas óseas de la glenoides en inestabilidades recurrentes de hombro. Material y Métodos: Se estudiaron 22 pacientes sin tratamiento quirúrgico previo por la patología descripta, con edades entre 18 y 45 años, con un claro predominio del sexo masculino (proporción 8 a 2). Se operaron con la técnica abierta modificada de Bristow Latarjet. La base de nuestro enfoque es la correcta selección de los pacientes, la técnica aplicada y el programa de rehabilitación precoz. La serie la consideramos de homogeneidad aceptable entre sus integrantes, así como los procedimientos quirúrgicos y la evaluación efectuada. Resultados: Se realizó una evaluación retrospectiva objetiva y subjetiva de los resultados a los dos años en una cohorte de 22 pacientes. Se valoraron de acuerdo con exámenes físico, imagenológico y de resultados, por cuestionarios completados por médicos y pacientes con el Score de Constant y de la ASES. Las cifras obtenidas fueron: 86% presentó hombros estables, indoloros o con poco dolor con una mínima pérdida de la rotación externa considerada entre los 6 y 8°, con limitaciones menores para las actividades por encima de la cabeza. No observamos re luxaciones o problemas con la consolidación de la coracoides ni tampoco artrosis temprana. Los consideramos resultados excelentes o buenos. Los mismos encuentran su principal objeción en la falta de verificaciones a largo plazo, que es cuando puede observarse la aparición de artrosis secundaria... (AU)

Background: Treatment of recurrent anterior shoulder instability isin continuous development. This disabling condition requires allthe possible knowledge, skills and broad experience to be solved. The purpose of this study was emphasized the importance of the glenoid bone loss and to verify th e hypothesis that the open coracoid transfer as described by Bristow Latarjet is a highly successful for treating recurrent glenohumeral instability associated with glenoid bone losses.Objectives: To determine glenoid bone losses importance inshoulder recurrent instability. Material and Methods:We selected a cohort of 22 patients, ages between 18 and 45 y.o. with predominance of males over females (rate 8 to 2), with recurrent anterior glenohumeral instability. All of them were treated with open Bristow Latarjet technique. We considered there is acceptable homogeneity in this cohort as wellas in the surgical procedure and the final evaluation methods.Results: Our results were obtained with an average outcome of 2 years. We perform physical examination, images screening, surveys between patients performed by physicians, and the Constan and ASES scores. 85% showed a stable shoulder, painless, with minimal external rotation loss (between 6 and 8...(AU)

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Conclusión: No se ha podido demostrar aun la bondad de un método de tratamiento sobre otro. La tendencia actual es actuar en cada caso en particular, disponiendo de todas las variantes terapéuticas, aisladas o combinadas (10,7). No obstante lo señalado creemos que la posibilidad de la reducción abierta y la osteosíntesis con la placa volar bloqueada es una realidad en cuanto a la solución de muchos de los problemas que presentan las estas fracturas.

Conclusions: No treatment has been proven to be better than others. At present, the tendency is to act in each particular case, having available all therapeutic variants, whether isolated or combined (10,7). Despite the abovementioned, we believe that open reduction and osteosynthesis with locked volar plate is a reality as regards solving many of the problems these fractures present.

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Conclusión: No se ha podido demostrar aun la bondad de un método de tratamiento sobre otro. La tendencia actual es actuar en cada caso en particular, disponiendo de todas las variantes terapéuticas, aisladas o combinadas (10,7). No obstante lo señalado creemos que la posibilidad de la reducción abierta y la osteosíntesis con la placa volar bloqueada es una realidad en cuanto a la solución de muchos de los problemas que presentan las estas fracturas. (AU)

Conclusions: No treatment has been proven to be better than others. At present, the tendency is to act in each particular case, having available all therapeutic variants, whether isolated or combined (10,7). Despite the abovementioned, we believe that open reduction and osteosynthesis with locked volar plate is a reality as regards solving many of the problems these fractures present. (AU)

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The number of percutaneous interventions with stent implantation has increased dramatically in recent years, although the frequent use of this device in reports of infections is extremely rare. In this article we report two cases of mycotic aneurysm after implantation of stents with different clinical presentations and outcomes.

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O número de intervenções percutâneas com implante de stents tem aumentado dramaticamente nos últimos anos, apesar da frequência no uso do dispositivo nos relatos de infecções serem extremamente raros. Neste artigo relatamos dois casos de aneurisma micótico após implante de stents com diferentes apresentações clínicas e evolução.

The number of percutaneous interventions with stent implantation has increased dramatically in recent years, although the frequent use of this device in reports of infections is extremely rare. In this article we report two cases of mycotic aneurysm after implantation of stents with different clinical presentations and outcomes.

El número de intervenciones percutáneas con implantación de stents ha incrementado dramáticamente en los últimos años, a pesar del gran auge del dispositivo los reportes de infecciones son extremadamente raros. En el presente artículo reportamos dos casos de aneurismas micoticos luego de la implantación de stents con presentación y evolución clínicas diferentes.

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Naccobus aberrans is a major pest of the potato crop in the Andean regions of Argentina, Bolivia, and Perú. It is endemic in northwest Argentina and is also found in lowlands. The resistance of eleven Andean potato landraces and three accessions of the wild tuber-bearing species Solanum acaule, S. infundibuliforme, and S. megistacrolobum were evaluated against a population of N. aberrans from Coctaca, Jujuy province, while Solanum tuberosum ssp. tuberosum 'Spunta', 'Kennebec', and 'Frital INTA' were evaluated against a population from the southeast of Buenos Aires province. The presence, the number of galls, and the number of individuals were recorded. In addition, a reproduction factor was calculated and races were determined. Results showed that the N. aberrans population from Coctaca corresponded to race 2 and the population from the lowlands belonged to the sugar beet group. Landrace Azul, one genotype of S. megistacrolobum, and two genotypes of S. acaule showed resistance towards the race from Coctaca while no infection was recorded in potato cultivars with the Naccobus race from the lowland area.

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Respiratory rehabilitation (RR) is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and patient autonomy. It is particularly indicated in chronic obstructive pulmonary disease (COPD) patients with exercise intolerance. The objectives of respiratory rehabilitation are: reduction in symptoms and exercise intolerance, improvement of health-related quality of life, and reduction of health costs. A group of neumonologists, nutritionists and physical therapists performed a systematic review of the evidence in RR to update previous local guidelines. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up and resources needed are defined. Training characteristics are recommended regarding frequency of the visits, intensity, progression and duration of the exercise training. Aerobic training was recommended for lower limb (1A), upper limb (1B). Strength training must be added (1B). Respiratory muscle training and other physiotherapy techniques were recommended only for specific patients (1C). In addition recommendations have been made for educational objectives of the program including smoking cessation, nutritional and psychological support. The positive impact of RR on reductions of health care costs and reductions on hospitalizations (Evidence A) and mortality (Evidence B) were analized. Respiratory rehabilitation is a key component in the modern treatment of COPD patients. This consensus statement was prepared based on the most recent scientific evidence and adjusted to the local environment with the aim of being implemented nationally.

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La rehabilitación respiratoria (RR) es un tratamiento multidisciplinario para pacientes con enfermedad respiratoria crónica, adaptado individualmente y diseñado para optimizar la capacidad física, la actividad social y la autonomía de los mismos. Está especialmente indicado en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). Los objetivos de la RR son: reducir los síntomas, mejorar la tolerancia al ejercicio físico y la calidad de vida. Un grupo de neumonólogos, nutricionistas y kinesiólogos realizó un análisis sistemàtico de la evidencia científica con el objetivo de actualizar las normativas anteriores de RR. Se definieron los criterios de inclusión y exclusión, la evaluación inicial y de seguimiento como así también los elementos y material necesarios. Las características del entrenamiento en cuanto a la frecuencia de las visitas, la intensidad, progresión y duración del ejercicio han sido revisadas. Se recomendó el entrenamiento de los miembros inferiores (1A), miembros superiores (1B), complementando el entrenamiento de fuerza (1B). El entrenamiento de músculos respiratorios, otras técnicas kinesiológicas y pautas nutricionales se recomiendan sólo para casos particulares (1C). Se fijan también objetivos educativos para los programas de rehabilitación que incluyen la cesación de fumar, aspectos nutricionales y apoyo psicológico. La RR ha demostrado reducir las exacerbaciones, hospitalizaciones y costos (Evidencia A), y mejoraría la sobrevida (Evidencia B). La RR es un componente fundamental en el tratamiento moderno de la EPOC. Estas pautas basadas en la más reciente evidencia científica, adaptadas al medio local tienen por objetivo que la RR pueda aplicarse en todo el país.

Respiratory rehabilitation (RR) is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and patient autonomy. It is particularly indicated in chronic obstructive pulmonary disease (COPD) patients with exercise intolerance. The objectives of respiratory rehabilitation are: reduction in symptoms and exercise intolerance, improvement of health-related quality of life, and reduction of health costs. A group of neumonologists, nutritionists and physical therapists performed a systematic review of the evidence in RR to update previous local guidelines. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up and resources needed are defined. Training characteristics are recommended regarding frequency of the visits, intensity, progression and duration of the exercise training. Aerobic training was recommended for lower limb (1A), upper limb (1B). Strength training must be added (1B). Respiratory muscle training and other physiotherapy techniques were recommended only for specific patients (1C). In addition recommendations have been made for educational objectives of the program including smoking cessation, nutritional and psychological support. The positive impact of RR on reductions of health care costs and reductions on hospitalizations (Evidence A) and mortality (Evidence B) were analized. Respiratory rehabilitation is a key component in the modern treatment of COPD patients. This consensus statement was prepared based on the most recent scientific evidence and adjusted to the local environment with the aim of being implemented nationally.

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La microlitiasis alveolar pulmonar (MAP) es una enfermedad rara caracterizada por la presencia difusa y bilateral de microlitos de fosfato de calcio en el interior de los espacios alveolares. La progresión de esta enfermedad potencialmente letal, es lenta y la mayoría de los pacientes permanecen asintomáticos por años o décadas, resultando en deterioro lento de sus funciones pulmonares. El hallazgo de la radiografía de tórax en “tormenta de arena” es característico de la entidad. Recientemente se identificaron mutaciones en el gen SLC34A2, que codifica para el cotransportador tipo IIb de fosfato sódico, como responsable de la enfermedad. De los casi 600 casos, sólo seis han sido reportados en Colombia. Nosotros presentamos un caso de microlitiasis alveolar pulmonar en un hombre de 27 años, con dificultad respiratoria progresiva, cuyo diagnóstico se hizo por los hallazgos radiográficos y se confirmó por biopsia transbronquial. En el seguimiento durante dos años, evolucionó hacia el deterioro de su función respiratoria y es candidato a trasplante de pulmón.

Pulmonary alveolar microlithiasis (PAM) is a rare disease characterized by the diffuse and bilateral presence of calcium phosphate microlite in the alveolar spaces. The progression of this potentially lethal disease is show and most of the patients remain asymptomatic during years or decades, resulting in a show deterioration of the pulmonary function. The typical fi nding of the “sand storm” in the chestX-ray is characteristic of this entity. Mutations in the SLC34A2 gene that does the coding for the typeII co-transporter of sodium phosphate were identifi ed as responsible for this disease. Of the almost 600 cases, only 6 have been reported in Colombia. We are presenting a case of pulmonary alveolarmicrolite in a 27 year old man, with progressive respiratory distress whose diagnosis was made by the X-ray fi ndings and confi rmed by trans bronchial biopsy. In the 2 years follow-up, shows evolution towards deterioration of his respiratory function making him a candidate for lung transplantation.

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Se reportan cinco casos de miopatías inflamatorias idiopáticas con presentaciones clínicas heterogéneas en el contexto de patologías autoinmunes distintas. Estos casos ilustran la complejidad en la presentación y la historia natural de la enfermedad muscular inflamatoria, mostrando el beneficio de la terapia inmunosupresora con esteroides e inmunoglobulina como inductora de remisión en esta entidad.Objetivos: ilustrar la complejidad en la presentación y la historia natural de la enfermedad muscular inflamatoria, mostrando el beneficio de la terapia inmunosupresora con esteroides e inmunoglobulina como inductora de remisión en esta entidad...

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