An Sist Sanit Navar
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An Sist Sanit Navar · Sep 2011
Case ReportsPost traumatic retroperitoneal fibrosis as a cause of low-back pain.
We present the case of a male patient with post traumatic retroperitoneal fibrosis whose main clinical expression was low-back pain. Diagnosis was established using CAT-scan and MRI, which revealed a large mass of soft tissue that almost entirely enveloped the abdominal aorta. ⋯ Treatment was continued for one year. Two and a half years later the patient remains symptom-free, with no recurrence of his condition.
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An Sist Sanit Navar · May 2011
Case Reports[Right aortic arch, Kommerell's diverticulum and aberrant left subclavian artery].
The right aberrant subclavian artery or "arteria lusoria" is the most common anatomical variant of the embryonic development of the aorta and its branches, with a presence in 0.5-2% of the population. Less frequently, a right aortic arch with aberrant left subclavian artery may be present. These anatomical variations should be included in the differential diagnosis of superior mediastinal widening seen on chest radiographs. In this report, we present a right aortic arch with left aberrant subclavian artery dilated at its origin (Kommerell's diverticulum) as a cause of superior mediastinal widening detected incidentally on a chest radiograph.
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"Triage" is a process that enables us to manage clinical risk in order to safely and suitably handle patient flows when demand and clinical needs exceed resources. At present, triage systems that are employed are structured according to five levels of priority. Levels are allocated according to the concept that what is urgent is not always serious and that what is serious is not always urgent. ⋯ We also discuss the system of triage devised in Navarre--integrated in the computerised clinical history--and used in the hospital network of Navarre. All are multidisciplinary systems based on the reasons and urgency of consultation, but not on diagnoses, and are carried out by nursing staff with medical support when required. In addition, they all include monitoring of the quality of the accident and emergency service itself, and can be applied in the outpatient field.
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Health research is consubstantial with clinical excellence, a fact that is also inherent in urgency and emergency medicine (UEM). Besides, the specific characteristics of the Spanish health CARE system and the organisation of hospital emergency CARE offer a probably unique scenario, offering unique opportunities for their scientific analysis and study. ⋯ To increase scientific production in UEM there is a need to solve some aspects that hinder this task, such as: the lack of a scientific culture, doubtless united to the lack of a recognised specialty; the limited training in research methodology; the lack of explicit recognition of scientific work; the limited scientific infrastructure; the practically 100% dedication to the work of care tasks; the scarce participation in national grants for research projects; and the absence in Spain of an indexed journal specialising in UEM. Besides, we believe that it is necessary to promote and interrelate the research groups of different hospitals and emergency medical systems, both locally and amongst the different autonomous communities, so that they work in a coordinated way and thus obtain the necessary critical mass that will enable the formation of a thematic network of cooperative research.