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Introduction: COVID-19 is a disease with gaps in its knowledge. It is required to explore its clinical manifestations over time and consequences for performance in the working population. Objective: To identify the clinico-epidemiological characteristics and the fitness to work in health workers convalescing from COVID-19. Material and Methods: A prospective longitudinal study was carried out on health workers in Havana. The population consisted of 40 workers who attended the COVID-19 convalescent consultation and were followed up in May 2022. Results: Dyspnea (18.8 %), insomnia (18.8 %), and arthralgia (12.5 %) persisted at the end of the year. Hypertension, obesity and bronchial asthma were the main comorbidities. In addition, 100 % of workers were fit for work. Conclusions: PostCOVID-19 symptoms deceased considerably 8 months after the onset of the disease; dyspnea, arthralgia, and insomnia persisted at the end of the year., Introducción: La COVID-19 es una enfermedad con brechas en su conocimiento. Se requiere explorar sus manifestaciones clínicas en el tiempo y consecuencias para el desempeño en la población trabajadora. Objetivo: Identificar características clínica-epidemiológicas y aptitud para el trabajo en trabajadores de la salud convalecientes de la COVID-19. Material y Métodos: Se realizó un estudio longitudinal prospectivo con trabajadores de la salud de La Habana. La población estuvo constituida por 40 trabajadores, quienes acudieron a consulta de convalecientes de la COVID-19 en mayo de 2021, a los que se les dio seguimiento hasta mayo de 2022. Resultados: Persistieron al cierre del año, la disnea (18,8 %), insomnio (18,8 %), artralgia (12,5 %). La hipertensión arterial, obesidad y asma bronquial fueron las principales comorbilidades. Aptos para el puesto trabajo, 100 % de los trabajadores. Conclusiones: Los síntomas postCOVID-19 disminuyeron considerablemente a partir de los 8 meses del inicio de la enfermedad y persistieron la disnea, artralgia e insomnio al cierre del año.

Musculoskeletal pathology is a very frequent reason for consultation. Thinking about its possible etiologies is essential for an adequate medical approach. It is important to recognize them in order to make better both the prognosis and the quality of life of our patients. It is extremely important to make adequate differential diagnoses and be aware of the clues that can guide us towards an adequate diagnosis. We will review juvenile idiopathic arthritis (JIA) as the most common cause of rheumatological disease in childhood. This review article aims to highlight the importance of knowing rheumatic diseases in order to refer on time to a specialized consultation and request the necessary complementary tests, La patología musculoesquelética constituye un motivo de consulta muy frecuente. Tener presente sus posibles etiologías, nos permitirá realizar un adecuado abordaje. El enfoque diagnóstico de las enfermedades reumáticas supone un reto para el Pediatra de Atención Primaria siendo fundamental su conocimiento para reconocerlas y así influir tanto en el pronóstico como en la calidad de vida de nuestros pacientes. Es de suma importancia hacer adecuados diagnósticos diferenciales y estar pendientes de las pistas que nos puedan orientar hacia un diagnóstico adecuado. Revisaremos la artritis idiopática juvenil (AIJ) como causa más frecuente de enfermedad reumática en la infancia. Con este artículo de revisión, queremos poner de relieve la importancia que tiene su conocimiento para derivar a tiempo o bien, ir iniciando si es preciso pruebas complementarias

Patients refer their symptoms in a variety of terms such as: “I amtired”, “my joints hurt”, “my body itches”, “my mouth is dry”,among others. Given these symptoms, the doctor automaticallythinks in a limited number of pathologies that are familiar to him,but there are many other causes to these symptoms that are not takeninto account. The lack of knowledge of the doctor causes the patientto be dissatisfied by not having a correct diagnosis and adequatetreatment, this leads to multiple visits and the doctor comes to askhimself “will this patient have a psychiatric diagnosis?”. This articlelists the frequent causes of these symptoms, describes causes thatare rarely suspected and the clinical keys for the doctor to diagnosethem. The first part will address the symptoms: fatigue, paresthesia,pruritus, arthralgia, anxiety and changes in behavior. The second partwill develop the symptoms: intolerance to food, xerostomia, syncope,dysphagia and manifestations in patients with bariatric surgery, Los pacientes refieren sus síntomas en una gran variedad de términos como: "estoy cansado", "me duelen las articulaciones", "me pica todo el cuerpo", "tengo la boca seca", entre otros. Ante estos síntomas el médico piensa de manera automática en un número limitado de patologías que le son familiares, pero existen muchas otras causas a estos síntomas que no se tienen en cuenta. El desconocimiento del médico hace que en el paciente se genere inconformidad al no tenerse un diagnóstico correcto y un tratamiento adecuado, esto lleva a múltiples consultas y que el médico llegue a preguntarse a sí mismo “¿será que este paciente tiene un diagnóstico psiquiátrico?”. En este artículo se enumeran las causas frecuentes de estos síntomas mencionados, se describen causas que son pocas veces sospechadas y las claves clínicas para que el médico pueda hacer el diagnóstico de éstas. La primera parte desarrollará los síntomas: fatiga, parestesias, prurito, artralgias, ansiedad y cambios en el comportamiento. La segunda parte desarrollará los síntomas: intolerancia a los alimentos, xerostomía, síncope, disfagia y manifestaciones en pacientes con cirugía bariátrica.

Patients refer their symptoms in a variety of terms such as: “I amtired”, “my joints hurt”, “my body itches”, “my mouth is dry”,among others. Given these symptoms, the doctor automaticallythinks in a limited number of pathologies that are familiar to him,but there are many other causes to these symptoms that are not takeninto account. The lack of knowledge of the doctor causes the patientto be dissatisfied by not having a correct diagnosis and adequatetreatment, this leads to multiple visits and the doctor comes to askhimself “will this patient have a psychiatric diagnosis?”. This articlelists the frequent causes of these symptoms, describes causes thatare rarely suspected and the clinical keys for the doctor to diagnosethem. The first part will address the symptoms: fatigue, paresthesia,pruritus, arthralgia, anxiety and changes in behavior. The second partwill develop the symptoms: intolerance to food, xerostomia, syncope,dysphagia and manifestations in patients with bariatric surgery, Los pacientes refieren sus síntomas en una gran variedad de términos como: "estoy cansado", "me duelen las articulaciones", "me pica todo el cuerpo", "tengo la boca seca", entre otros. Ante estos síntomas el médico piensa de manera automática en un número limitado de patologías que le son familiares, pero existen muchas otras causas a estos síntomas que no se tienen en cuenta. El desconocimiento del médico hace que en el paciente se genere inconformidad al no tenerse un diagnóstico correcto y un tratamiento adecuado, esto lleva a múltiples consultas y que el médico llegue a preguntarse a sí mismo “¿será que este paciente tiene un diagnóstico psiquiátrico?”. En este artículo se enumeran las causas frecuentes de estos síntomas mencionados, se describen causas que son pocas veces sospechadas y las claves clínicas para que el médico pueda hacer el diagnóstico de éstas. La primera parte desarrollará los síntomas: fatiga, parestesias, prurito, artralgias, ansiedad y cambios en el comportamiento. La segunda parte desarrollará los síntomas: intolerancia a los alimentos, xerostomía, síncope, disfagia y manifestaciones en pacientes con cirugía bariátrica.

Patients refer their symptoms in a variety of terms such as: “I amtired”, “my joints hurt”, “my body itches”, “my mouth is dry”,among others. Given these symptoms, the doctor automaticallythinks in a limited number of pathologies that are familiar to him,but there are many other causes to these symptoms that are not takeninto account. The lack of knowledge of the doctor causes the patientto be dissatisfied by not having a correct diagnosis and adequatetreatment, this leads to multiple visits and the doctor comes to askhimself “will this patient have a psychiatric diagnosis?”. This articlelists the frequent causes of these symptoms, describes causes thatare rarely suspected and the clinical keys for the doctor to diagnosethem. The first part will address the symptoms: fatigue, paresthesia,pruritus, arthralgia, anxiety and changes in behavior. The second partwill develop the symptoms: intolerance to food, xerostomia, syncope,dysphagia and manifestations in patients with bariatric surgery, Los pacientes refieren sus síntomas en una gran variedad de términos como: "estoy cansado", "me duelen las articulaciones", "me pica todo el cuerpo", "tengo la boca seca", entre otros. Ante estos síntomas el médico piensa de manera automática en un número limitado de patologías que le son familiares, pero existen muchas otras causas a estos síntomas que no se tienen en cuenta. El desconocimiento del médico hace que en el paciente se genere inconformidad al no tenerse un diagnóstico correcto y un tratamiento adecuado, esto lleva a múltiples consultas y que el médico llegue a preguntarse a sí mismo “¿será que este paciente tiene un diagnóstico psiquiátrico?”. En este artículo se enumeran las causas frecuentes de estos síntomas mencionados, se describen causas que son pocas veces sospechadas y las claves clínicas para que el médico pueda hacer el diagnóstico de éstas. La primera parte desarrollará los síntomas: fatiga, parestesias, prurito, artralgias, ansiedad y cambios en el comportamiento. La segunda parte desarrollará los síntomas: intolerancia a los alimentos, xerostomía, síncope, disfagia y manifestaciones en pacientes con cirugía bariátrica.

Los pacientes refieren sus síntomas en una gran variedad de términos como: "estoy cansado", "me duelen las articulaciones", "me pica todo el cuerpo", "tengo la boca seca", entre otros. Ante estos síntomas el médico piensa de manera automática en un número limitado de patologías que le son familiares, pero existen muchas otras causas a estos síntomas que no se tienen en cuenta. El desconocimiento del médico hace que en el paciente se genere inconformidad al no tenerse un diagnóstico correcto y un tratamiento adecuado, esto lleva a múltiples consultas y que el médico llegue a preguntarse a sí mismo “¿será que este paciente tiene un diagnóstico psiquiátrico?”. En este artículo se enumeran las causas frecuentes de estos síntomas mencionados, se describen causas que son pocas veces sospechadas y las claves clínicas para que el médico pueda hacer el diagnóstico de éstas. La primera parte desarrollará los síntomas: fatiga, parestesias, prurito, artralgias, ansiedad y cambios en el comportamiento. La segunda parte desarrollará los síntomas: intolerancia a los alimentos, xerostomía, síncope, disfagia y manifestaciones en pacientes con cirugía bariátrica.

Patients refer their symptoms in a variety of terms such as: “I amtired”, “my joints hurt”, “my body itches”, “my mouth is dry”,among others. Given these symptoms, the doctor automaticallythinks in a limited number of pathologies that are familiar to him,but there are many other causes to these symptoms that are not takeninto account. The lack of knowledge of the doctor causes the patientto be dissatisfied by not having a correct diagnosis and adequatetreatment, this leads to multiple visits and the doctor comes to askhimself “will this patient have a psychiatric diagnosis?”. This articlelists the frequent causes of these symptoms, describes causes thatare rarely suspected and the clinical keys for the doctor to diagnosethem. The first part will address the symptoms: fatigue, paresthesia,pruritus, arthralgia, anxiety and changes in behavior. The second partwill develop the symptoms: intolerance to food, xerostomia, syncope,dysphagia and manifestations in patients with bariatric surgery, Los pacientes refieren sus síntomas en una gran variedad de términos como: "estoy cansado", "me duelen las articulaciones", "me pica todo el cuerpo", "tengo la boca seca", entre otros. Ante estos síntomas el médico piensa de manera automática en un número limitado de patologías que le son familiares, pero existen muchas otras causas a estos síntomas que no se tienen en cuenta. El desconocimiento del médico hace que en el paciente se genere inconformidad al no tenerse un diagnóstico correcto y un tratamiento adecuado, esto lleva a múltiples consultas y que el médico llegue a preguntarse a sí mismo “¿será que este paciente tiene un diagnóstico psiquiátrico?”. En este artículo se enumeran las causas frecuentes de estos síntomas mencionados, se describen causas que son pocas veces sospechadas y las claves clínicas para que el médico pueda hacer el diagnóstico de éstas. La primera parte desarrollará los síntomas: fatiga, parestesias, prurito, artralgias, ansiedad y cambios en el comportamiento. La segunda parte desarrollará los síntomas: intolerancia a los alimentos, xerostomía, síncope, disfagia y manifestaciones en pacientes con cirugía bariátrica.

Objetives: Identify putative functional variants in the CYP11A1 and CYP17A1 genes associated with musculoskeletal effects (accelerated bone mass loss and arthralgia) derived from treatment with aromatase inhibitors (AI). Material and methods: The B-ABLE cohort is a prospective study of postmenopausal women with breast cancer undergoing AI treatment. Bone mineral density in the lumbar spine and femoral neck was measured by densitometry and joint pain using visual analogue scale. From single-nucleotide polymorphisms (SNPs) in genes CYP11A1 (rs4077581, rs11632698 and rs900798) and CYP17A1 (rs4919686, rs4919683, rs4919687, rs3781287, rs10786712, rs6163, rs743572), previously associated with musculoskeletal events, haplotypes were constructed for each pacient from the cohort, and those haplotypes that showed greatest phenotypic differences were chosen (p<0.05). Within each haplotype, patients with extreme phenotypes were chosen for the sequencing of respective genes and identifying functional genetic variants. Finally, a multiple linear regression analysis was carried out considering the models of dominant, recessive and additive genetic inheritance. Results: No mutation was found in coding regions. A genetic variant (D15S520), in the basal promoter region of gene CYP11A1, was found associated with femoral neck bone loss at 24 month of AI treatment. Conclusions: Variants in regulatory regions of the CYP11A1 gene could modulate the expression of this gene, thus explaining part of the phenotypic variability found in bone loss of patients undergoing AI treatment., Objetivos: Identificar putativas variantes funcionales en los genes CYP11A1 y CYP17A1 asociadas a efectos musculoesqueléticos (pérdida acelerada de la masa ósea y artralgias) derivados del tratamiento con inhibidores de la aromatasa (IA). Material y métodos: La cohorte B-ABLE es un estudio prospectivo de mujeres postmenopáusicas con cáncer de mama en tratamiento con IA. La densidad mineral ósea en columna lumbar y cuello femoral se midió mediante densitometría, y el dolor articular mediante escala analógica visual. A partir de polimorfismos de cambio de un nucleótido (SNPs) en los genes CYP11A1 (rs4077581, rs11632698 y rs900798) y CYP17A1 (rs4919686, rs4919683, rs4919687, rs3781287, rs10786712, rs6163, rs743572), asociados previamente con eventos musculoesqueléticos, se construyeron los haplotipos para cada paciente de la cohorte, y se seleccionaron aquellos que mostraron mayor diferencia fenotípica (p<0,05). Dentro de cada haplotipo, se eligieron aquellas pacientes con fenotipos extremos para la secuenciación de los respectivos genes y la identificación de variantes genéticas funcionales. Finalmente, se realizó un análisis de regresión lineal múltiple contemplando los modelos de herencia genética dominante, recesivo y aditivo. Resultados: No se encontró ninguna mutación en las regiones codificantes. En la región del promotor basal del gen CYP11A1 se encontró una variante genética (D15S520) asociada a la pérdida de masa ósea del cuello de fémur a los 24 meses de tratamiento con IA. Conclusiones: Variantes en regiones reguladoras del gen CYP11A1 podrían modular la expresión de este gen, explicando así parte de la variabilidad fenotípica encontrada en la pérdida de hueso de las pacientes en tratamiento con IA.

The objective of this article is to take a look to physiotherapist as a professional in health intervention in patients diagnosed with Chikungunya, within the clinical course of the patient´s functionality which is affected, which not only affects the patient´s health but also his/her professional and personal actions. This paper presents Chikungunya from Epidemiology, the natural history of the disease, the etiology and patokinesiology. The purpose of the physiotherapy intervention is to improve the functionality of the patient and to contribute to the development in the quality of life of whom may suffer from this disease., Se pretende dar una mirada al rol del fisioterapeuta como profesional de la salud en la intervención de los pacientes diagnosticados con la enfermedad de chikungunya, dentro del curso clínico de la enfermedad pues se afecta la funcionalidad y por ende la participación social del individuo en sus ámbitos escolares y laborales. Esta reflexión presenta una mirada de la enfermedad por chikungunya desde la epidemiologia, la historia natural de la enfermedad, la etiología y la patokinesiologia con la finalidad de presentar una propuesta de intervención fisioterápica por objetivos a fin de mejorar la funcionalidad y contribuir al mejoramiento de la calidad de vida de quien padece la sintomatología limitante de ésta entidad.

The objective of this article is to take a look to physiotherapist as a professional in health intervention in patients diagnosed with Chikungunya, within the clinical course of the patient´s functionality which is affected, which not only affects the patient´s health but also his/her professional and personal actions. This paper presents Chikungunya from Epidemiology, the natural history of the disease, the etiology and patokinesiology. The purpose of the physiotherapy intervention is to improve the functionality of the patient and to contribute to the development in the quality of life of whom may suffer from this disease., Se pretende dar una mirada al rol del fisioterapeuta como profesional de la salud en la intervención de los pacientes diagnosticados con la enfermedad de chikungunya, dentro del curso clínico de la enfermedad pues se afecta la funcionalidad y por ende la participación social del individuo en sus ámbitos escolares y laborales. Esta reflexión presenta una mirada de la enfermedad por chikungunya desde la epidemiologia, la historia natural de la enfermedad, la etiología y la patokinesiologia con la finalidad de presentar una propuesta de intervención fisioterápica por objetivos a fin de mejorar la funcionalidad y contribuir al mejoramiento de la calidad de vida de quien padece la sintomatología limitante de ésta entidad.

The objective of this article is to take a look to physiotherapist as a professional in health intervention in patients diagnosed with Chikungunya, within the clinical course of the patient´s functionality which is affected, which not only affects the patient´s health but also his/her professional and personal actions. This paper presents Chikungunya from Epidemiology, the natural history of the disease, the etiology and patokinesiology. The purpose of the physiotherapy intervention is to improve the functionality of the patient and to contribute to the development in the quality of life of whom may suffer from this disease., Se pretende dar una mirada al rol del fisioterapeuta como profesional de la salud en la intervención de los pacientes diagnosticados con la enfermedad de chikungunya, dentro del curso clínico de la enfermedad pues se afecta la funcionalidad y por ende la participación social del individuo en sus ámbitos escolares y laborales. Esta reflexión presenta una mirada de la enfermedad por chikungunya desde la epidemiologia, la historia natural de la enfermedad, la etiología y la patokinesiologia con la finalidad de presentar una propuesta de intervención fisioterápica por objetivos a fin de mejorar la funcionalidad y contribuir al mejoramiento de la calidad de vida de quien padece la sintomatología limitante de ésta entidad.

Chikungunya virus has drawn worldwide attention due to its recent reemergence causing considerable morbidity and suffering. A number of chikungunya outbreaks have occurred in Asia, Africa, and Europe, and since late 2013, the virus is present in Americas. The mosquitoes in the genus Aedes, the main disease vectors of chikungunya, have a broad distribution throughout the Americas. Therefore, there is a high risk to the virus invasion and spread in South America region. Currently, there is neither a vaccine nor an antiviral treatment available for chikungunya virus infection. The clinical presentation of chikungunya is often confused with dengue fever, especially in tropical and subtropical areas where this infection is frequent, so doing an appropriate differential diagnosis between both is crucial to ensure an appropriate clinical management. This review include a general view of the chikungunya virus, from the epidemiology, the causative agent, the vectors, the signs and symptoms of the disease, the clinical diagnosis and laboratory and the epidemiological surveillance. This information is important to preparation and response before the eventual introduction of chikungunya in our population, which will probably happen in the near future., El virus chikunguña ha llamado la atención mundial debido a su reciente reemergencia, la cual ha provocado considerable morbilidad y sufrimiento. Este virus ha causado importantes epidemias en Asia, África y Europa y, desde finales de 2013, se encuentra presente en las Américas. Debido a que los mosquitos del género Aedes, vectores de la enfermedad, se encuentran ampliamente distribuidos en el continente americano, existe un alto riesgo de introducción, invasión y diseminación del virus chikunguña por toda la región de Suramérica. Actualmente no existe vacuna ni tratamiento antiviral para la infección por chikunguña y su presentación clínica suele confundirse con la producida por el virus dengue, principalmente en las zonas tropicales y subtropicales donde éste último es frecuente; sin embargo, es de vital importancia realizar el diagnóstico diferencial entre ambas entidades para garantizar un manejo clínico adecuado. En esta revisión se realiza un abordaje general del virus chikunguña, desde la epidemiología, el agente causal, los vectores, los signos y síntomas de la enfermedad, el diagnóstico clínico y por laboratorio, y la vigilancia epidemiológica; información importante para la preparación y la respuesta ante la eventual aparición de casos de chikunguña en nuestra población, como se espera suceda en un futuro cercano.

Background:Chikungunya is a viral disease transmitted by mosquitoes, endemic in Caribbean countries. It is characterizedby the onset of fever, conjunctivitis and arthralgia. Description of the case: We report two siblings aged 8 and 12 years withfever and arthralgia, arrived in Spain three days before from Dominican Republic , with a history of insect sting in that country.The Chikungunya PCR investigation (Polymerase chain reaction) was positive in both cases and they were treated withantipyretics and rest showing a good clinical evolution. Conclusions:The development of epidemiological alerts conducted inour community was a key fact in the identification and control of the disease., Antecedentes: La fiebre Chikungunya es una enfermedad vírica transmitida por mosquitos, endémica en países del Caribe y que se caracteriza por la aparición de fiebre, conjuntivitis y artralgias. Descripción del caso clínico:Presentamos el caso de dos hermanos de 8 y 12 años con fiebre y artralgias, llegados a España tres días antes desdeRepública Dominicana, con antecedente de picadura de insecto en dicho país. El estudio mediante PCR (Reacciónen Cadena de la Polimerasa) para virus de Chikungunya resultó positivo en ambos casos, siendo tratados con anti-térmicos y reposo con evolución favorable. Conclusiones:El desarrollo de alertas epidemiológicas llevado a cabo ennuestra comunidad resultó fundamental en la identificación y control de la infección.

Introduction and Objetive: The treatment of the internal disorders of the temporomandibular joint has had multiple approaches and it has been made of diverse ways. The surgery of the joint is considered like last alternative for reluctant cases to the preservative treatment, nevertheless it does not have been free of controversy by the risks that displays for the patient, the complications which they are possible to be presented and by the results that can be obtained in the long term. The objective was to assess the success of surgical procedure (meniscal plication and eminectomy) in patients with internal derangement of the temporomandibular joint (TMJ). Materials and Methods: Twenty patients in a retrospective clinical study design. The maximal opening, noise/clicking, and joint pain was recorded preoperatively. Completed visual analogue scales of pain at the time of follow up and the patient satisfaction were evaluated. Results: Decrease in TMJ pain after surgery was reported by 70% of the patients. Joint sounds persisted in a 60%, 15% improve in noise/clicking. Postoperative findings relating to open mouth showed 65% of the patients with normal opening. The patient satisfaction with this TMJ surgery was 90%. Conclusion: TMJ meniscal placation and eminectomy improve pain and dysfunction after surgery enhancing quality of life., Introducción y Objetivo: El tratamiento de los desarreglos internos de la articulación temporomandibular ha tenido múltiples enfoques y se ha realizado de diversas maneras. La artrotomía de la articulación es considerada como última alternativa para casos renuentes al tratamiento conservador, sin embargo no ha estado exenta de controversia por los riesgos que presenta para el paciente, las complicaciones que eventualmente se pueden presentar y por los resultados que se pueden obtener a largo plazo. El objetivo es medir el éxito del procedimiento quirúrgico (artroplastia y eminectomía) en pacientes con desarreglos internos de la articulación temporomandibular (ATM). Materiales y Métodos: Se trata de un estudio clínico descriptivo retrospectivo con 20 pacientes que evaluó apertura máxima, ruidos y dolor articular. El dolor se evaluó con escala visual análoga; asimismo, valoró la satisfacción general de los pacientes que habían sido sometidos a cirugía de ATM. Resultados: Se encontró disminución significativa del dolor en 70% de los pacientes; los ruidos articulares persistieron en el 60% de los casos y el 15% mejoró en cuanto al ruido; 65% de los pacientes tuvieron apertura normal y hubo satisfacción del 90%. Conclusión: La cirugía de ATM con Artroplastia y eminectomía mejoran el dolor y disfunción de ATM en la población estudiada.

Introduction and Objetive: The treatment of the internal disorders of the temporomandibular joint has had multiple approaches and it has been made of diverse ways. The surgery of the joint is considered like last alternative for reluctant cases to the preservative treatment, nevertheless it does not have been free of controversy by the risks that displays for the patient, the complications which they are possible to be presented and by the results that can be obtained in the long term. The objective was to assess the success of surgical procedure (meniscal plication and eminectomy) in patients with internal derangement of the temporomandibular joint (TMJ). Materials and Methods: Twenty patients in a retrospective clinical study design. The maximal opening, noise/clicking, and joint pain was recorded preoperatively. Completed visual analogue scales of pain at the time of follow up and the patient satisfaction were evaluated. Results: Decrease in TMJ pain after surgery was reported by 70% of the patients. Joint sounds persisted in a 60%, 15% improve in noise/clicking. Postoperative findings relating to open mouth showed 65% of the patients with normal opening. The patient satisfaction with this TMJ surgery was 90%. Conclusion: TMJ meniscal placation and eminectomy improve pain and dysfunction after surgery enhancing quality of life., Introducción y Objetivo: El tratamiento de los desarreglos internos de la articulación temporomandibular ha tenido múltiples enfoques y se ha realizado de diversas maneras. La artrotomía de la articulación es considerada como última alternativa para casos renuentes al tratamiento conservador, sin embargo no ha estado exenta de controversia por los riesgos que presenta para el paciente, las complicaciones que eventualmente se pueden presentar y por los resultados que se pueden obtener a largo plazo. El objetivo es medir el éxito del procedimiento quirúrgico (artroplastia y eminectomía) en pacientes con desarreglos internos de la articulación temporomandibular (ATM). Materiales y Métodos: Se trata de un estudio clínico descriptivo retrospectivo con 20 pacientes que evaluó apertura máxima, ruidos y dolor articular. El dolor se evaluó con escala visual análoga; asimismo, valoró la satisfacción general de los pacientes que habían sido sometidos a cirugía de ATM. Resultados: Se encontró disminución significativa del dolor en 70% de los pacientes; los ruidos articulares persistieron en el 60% de los casos y el 15% mejoró en cuanto al ruido; 65% de los pacientes tuvieron apertura normal y hubo satisfacción del 90%. Conclusión: La cirugía de ATM con Artroplastia y eminectomía mejoran el dolor y disfunción de ATM en la población estudiada.

Objetivos: Analisar a eficácia da Acupuntura como terapia complementar no tratamento da Gonartrose, no que se refere ao alívio dor, redução da rigidez e melhora da capacidade física funcional, em conjunto com mudanças na qualidade de vida nos pacientes. Delineamento: Estudo randomizado, controlado, duplo-cego, com avaliação cega e análise estatística dos resultados. Local: O estudo foi realizado no ambulatório do Instituto de Geriatria e Gerontologia do Hospital Universitário São Lucas da Pontifícia Universida Católica do Rio Grande do Sul – PUCRS, no período de um ano. Participantes: 52 pacientes externos ao serviço apresentando gonartrose. Intervenção: Os pacientes foram randomicamente separados em dois grupos, um recebendo tratamento pela acupuntura (n=26) e o outro recebendo acupuntura simulada (n=26). Variáveis de medida e desfechos: As variáveis clínicas de desfecho primário foram as modificações nos escores funcionais e de Dor da Western Ontário and McMaster Universities Osteoarthrites index (WOMAC); os desfechos secundários foram as modificações nos escores de componentes físicos de qualidade de vida: 36 - Item Short-Form Health Survey (SF-36) physycal component Score Resultados: Todos os pacientes incluídos completaram o estudo. Os escores WOMAC index apresentaram uma modificação significativa na redução da dor no grupo que foi tratado com acupuntura quando comparado ao grupocontrole. (P=0,025) A acupuntura produziu significativas modificações nos escores de componentes físicos de qualidade de vida SF-36 no que se refere a vitalidade (P=0,022) Conclusões: Acupuntura, como terapia complementar, foi efetiva no tratamento da dor em pacientes portadores de gonartrose. Acupuntura promoveu também melhora na qualidade de vida, no que se refere a vitalidade., Objectives: To analyze the effectiveness of acupuncture as a complementary therapy in treating gonarthrosis, to relieve pain, reduce stiffness and improve functional physical capacity, together with changes in quality of life of elderly patients. Design: Randomized, controlled, double-blind study with blind evaluation and statistical analysis of the results. Place of study: The study was performed at the outpatient clinic of the Instituto de Geriatria e Gerontologia (Institute of Geriatrics and Gerontology), Hospital Universitário São Lucas of the Pontifical Catholic University of Rio Grande do Sul (PUCRS) during one year. Participants: All the patients were outpatients and had gonarthrosis. Intervention: The patients were randomly separated into two groups, one treated with acupuncture (n-26) and the other with simulated acupuncture (n=26). Measure and outcome variables: The primary clinical outcome variables were the modifications in the functional and pain scores of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): the secondary outcomes were the modifications in the scores of physical components of quality of life: 36- Item Short-Form Health Survey (SF-36) physical component score. Results: 52 patients completed the study. In the analysis the WOMAC Index scores presented a significant change in pain reduction in the intervention group compared to the control group (P=0. 025). The results also indicated that acupuncture produced significant changes in the physical component scores of SF-36 quality of life as regards vitality (P=0. 022. Conclusions: Acupuncture as complementary therapy was effective to treat pain in patients with gonarthroses. Acupuncture also promoted changes in the quality of life of these patients, as regards vitality.

Objetivos: Analisar a eficácia da Acupuntura como terapia complementar no tratamento da Gonartrose, no que se refere ao alívio dor, redução da rigidez e melhora da capacidade física funcional, em conjunto com mudanças na qualidade de vida nos pacientes. Delineamento: Estudo randomizado, controlado, duplo-cego, com avaliação cega e análise estatística dos resultados. Local: O estudo foi realizado no ambulatório do Instituto de Geriatria e Gerontologia do Hospital Universitário São Lucas da Pontifícia Universida Católica do Rio Grande do Sul – PUCRS, no período de um ano. Participantes: 52 pacientes externos ao serviço apresentando gonartrose. Intervenção: Os pacientes foram randomicamente separados em dois grupos, um recebendo tratamento pela acupuntura (n=26) e o outro recebendo acupuntura simulada (n=26). Variáveis de medida e desfechos: As variáveis clínicas de desfecho primário foram as modificações nos escores funcionais e de Dor da Western Ontário and McMaster Universities Osteoarthrites index (WOMAC); os desfechos secundários foram as modificações nos escores de componentes físicos de qualidade de vida: 36 - Item Short-Form Health Survey (SF-36) physycal component Score Resultados: Todos os pacientes incluídos completaram o estudo. Os escores WOMAC index apresentaram uma modificação significativa na redução da dor no grupo que foi tratado com acupuntura quando comparado ao grupocontrole. (P=0,025) A acupuntura produziu significativas modificações nos escores de componentes físicos de qualidade de vida SF-36 no que se refere a vitalidade (P=0,022) Conclusões: Acupuntura, como terapia complementar, foi efetiva no tratamento da dor em pacientes portadores de gonartrose. Acupuntura promoveu também melhora na qualidade de vida, no que se refere a vitalidade., Objectives: To analyze the effectiveness of acupuncture as a complementary therapy in treating gonarthrosis, to relieve pain, reduce stiffness and improve functional physical capacity, together with changes in quality of life of elderly patients. Design: Randomized, controlled, double-blind study with blind evaluation and statistical analysis of the results. Place of study: The study was performed at the outpatient clinic of the Instituto de Geriatria e Gerontologia (Institute of Geriatrics and Gerontology), Hospital Universitário São Lucas of the Pontifical Catholic University of Rio Grande do Sul (PUCRS) during one year. Participants: All the patients were outpatients and had gonarthrosis. Intervention: The patients were randomly separated into two groups, one treated with acupuncture (n-26) and the other with simulated acupuncture (n=26). Measure and outcome variables: The primary clinical outcome variables were the modifications in the functional and pain scores of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): the secondary outcomes were the modifications in the scores of physical components of quality of life: 36- Item Short-Form Health Survey (SF-36) physical component score. Results: 52 patients completed the study. In the analysis the WOMAC Index scores presented a significant change in pain reduction in the intervention group compared to the control group (P=0. 025). The results also indicated that acupuncture produced significant changes in the physical component scores of SF-36 quality of life as regards vitality (P=0. 022. Conclusions: Acupuncture as complementary therapy was effective to treat pain in patients with gonarthroses. Acupuncture also promoted changes in the quality of life of these patients, as regards vitality.

Objetivos: Analisar a eficácia da Acupuntura como terapia complementar no tratamento da Gonartrose, no que se refere ao alívio dor, redução da rigidez e melhora da capacidade física funcional, em conjunto com mudanças na qualidade de vida nos pacientes. Delineamento: Estudo randomizado, controlado, duplo-cego, com avaliação cega e análise estatística dos resultados. Local: O estudo foi realizado no ambulatório do Instituto de Geriatria e Gerontologia do Hospital Universitário São Lucas da Pontifícia Universida Católica do Rio Grande do Sul – PUCRS, no período de um ano. Participantes: 52 pacientes externos ao serviço apresentando gonartrose. Intervenção: Os pacientes foram randomicamente separados em dois grupos, um recebendo tratamento pela acupuntura (n=26) e o outro recebendo acupuntura simulada (n=26). Variáveis de medida e desfechos: As variáveis clínicas de desfecho primário foram as modificações nos escores funcionais e de Dor da Western Ontário and McMaster Universities Osteoarthrites index (WOMAC); os desfechos secundários foram as modificações nos escores de componentes físicos de qualidade de vida: 36 - Item Short-Form Health Survey (SF-36) physycal component Score Resultados: Todos os pacientes incluídos completaram o estudo. Os escores WOMAC index apresentaram uma modificação significativa na redução da dor no grupo que foi tratado com acupuntura quando comparado ao grupocontrole. (P=0,025) A acupuntura produziu significativas modificações nos escores de componentes físicos de qualidade de vida SF-36 no que se refere a vitalidade (P=0,022) Conclusões: Acupuntura, como terapia complementar, foi efetiva no tratamento da dor em pacientes portadores de gonartrose. Acupuntura promoveu também melhora na qualidade de vida, no que se refere a vitalidade., Objectives: To analyze the effectiveness of acupuncture as a complementary therapy in treating gonarthrosis, to relieve pain, reduce stiffness and improve functional physical capacity, together with changes in quality of life of elderly patients. Design: Randomized, controlled, double-blind study with blind evaluation and statistical analysis of the results. Place of study: The study was performed at the outpatient clinic of the Instituto de Geriatria e Gerontologia (Institute of Geriatrics and Gerontology), Hospital Universitário São Lucas of the Pontifical Catholic University of Rio Grande do Sul (PUCRS) during one year. Participants: All the patients were outpatients and had gonarthrosis. Intervention: The patients were randomly separated into two groups, one treated with acupuncture (n-26) and the other with simulated acupuncture (n=26). Measure and outcome variables: The primary clinical outcome variables were the modifications in the functional and pain scores of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): the secondary outcomes were the modifications in the scores of physical components of quality of life: 36- Item Short-Form Health Survey (SF-36) physical component score. Results: 52 patients completed the study. In the analysis the WOMAC Index scores presented a significant change in pain reduction in the intervention group compared to the control group (P=0. 025). The results also indicated that acupuncture produced significant changes in the physical component scores of SF-36 quality of life as regards vitality (P=0. 022. Conclusions: Acupuncture as complementary therapy was effective to treat pain in patients with gonarthroses. Acupuncture also promoted changes in the quality of life of these patients, as regards vitality.

Objetivos: Analisar a eficácia da Acupuntura como terapia complementar no tratamento da Gonartrose, no que se refere ao alívio dor, redução da rigidez e melhora da capacidade física funcional, em conjunto com mudanças na qualidade de vida nos pacientes. Delineamento: Estudo randomizado, controlado, duplo-cego, com avaliação cega e análise estatística dos resultados. Local: O estudo foi realizado no ambulatório do Instituto de Geriatria e Gerontologia do Hospital Universitário São Lucas da Pontifícia Universida Católica do Rio Grande do Sul – PUCRS, no período de um ano. Participantes: 52 pacientes externos ao serviço apresentando gonartrose. Intervenção: Os pacientes foram randomicamente separados em dois grupos, um recebendo tratamento pela acupuntura (n=26) e o outro recebendo acupuntura simulada (n=26). Variáveis de medida e desfechos: As variáveis clínicas de desfecho primário foram as modificações nos escores funcionais e de Dor da Western Ontário and McMaster Universities Osteoarthrites index (WOMAC); os desfechos secundários foram as modificações nos escores de componentes físicos de qualidade de vida: 36 - Item Short-Form Health Survey (SF-36) physycal component Score Resultados: Todos os pacientes incluídos completaram o estudo. Os escores WOMAC index apresentaram uma modificação significativa na redução da dor no grupo que foi tratado com acupuntura quando comparado ao grupocontrole. (P=0,025) A acupuntura produziu significativas modificações nos escores de componentes físicos de qualidade de vida SF-36 no que se refere a vitalidade (P=0,022) Conclusões: Acupuntura, como terapia complementar, foi efetiva no tratamento da dor em pacientes portadores de gonartrose. Acupuntura promoveu também melhora na qualidade de vida, no que se refere a vitalidade., Objectives: To analyze the effectiveness of acupuncture as a complementary therapy in treating gonarthrosis, to relieve pain, reduce stiffness and improve functional physical capacity, together with changes in quality of life of elderly patients. Design: Randomized, controlled, double-blind study with blind evaluation and statistical analysis of the results. Place of study: The study was performed at the outpatient clinic of the Instituto de Geriatria e Gerontologia (Institute of Geriatrics and Gerontology), Hospital Universitário São Lucas of the Pontifical Catholic University of Rio Grande do Sul (PUCRS) during one year. Participants: All the patients were outpatients and had gonarthrosis. Intervention: The patients were randomly separated into two groups, one treated with acupuncture (n-26) and the other with simulated acupuncture (n=26). Measure and outcome variables: The primary clinical outcome variables were the modifications in the functional and pain scores of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): the secondary outcomes were the modifications in the scores of physical components of quality of life: 36- Item Short-Form Health Survey (SF-36) physical component score. Results: 52 patients completed the study. In the analysis the WOMAC Index scores presented a significant change in pain reduction in the intervention group compared to the control group (P=0. 025). The results also indicated that acupuncture produced significant changes in the physical component scores of SF-36 quality of life as regards vitality (P=0. 022. Conclusions: Acupuncture as complementary therapy was effective to treat pain in patients with gonarthroses. Acupuncture also promoted changes in the quality of life of these patients, as regards vitality.