Download Electrocardiografia Practica by Dale Dubin, Dubin, Roberto Folch Fabre PDF

By Dale Dubin, Dubin, Roberto Folch Fabre

Este libro se presenta como un curso programado rápido. Guía básica para l. a. interpretación de electrocadiogramas. Ejercicios prácticos de autoevaluación.

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Sample text

MULLER-FASSBENDER Summary The significance of degenerative joint disorders in rheumatic disease is stressed in this paper. First, the differences between inflammatory and degenerative diseases are discussed and subsequently the similarity between former disease and the activated degenerative processes is demonstrated. The chapter deals first with those joints prone to degenerative joint processes. Further on, the possibility of therapy with chondroprotective substances is stressed with special reference to the problem of demonstrating the effectiveness of the actual treatment.

Kinds of pain typical of arthrosis are start-up pain, pain due to fatigue, and loading pain. Start-up pain obviously occurs in the hip, knee, and ankle joints. As a result of the joint changes, it can also occur while at rest. In addition, the pain in the surrounding structures, especially the musculature and the tendon attachments, may be potentiated. Swelling of the joints, as in inflammatory rheumatic diseases, occurs only in the activated state, becoming manifest here in the form of a hyperthermia.

In some patients pain is due to noninflammatory causes such as periosteal elevation associated with osteophyte formation or subchondral trabecular microfractures, as previously noted. In these patients analgesic agents such as acetaminophen and propoxyphene hydrochloride alone may be efficacious. Although acetaminophen is a generally safe drug, total daily doses should be limited so as to avoid hepatic toxicity; a dose of 2400 mg/day on a regular basis should generally not be exceeded. Lower doses or avoidance of the drug are essential if the patient has known liver disease.

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