Blind IAI proved safe and accurate when performed by a trained professional. Significant improvement was seen in the VAS for pain at rest and during movement, VAS for oedema and morning stiffness.

Compare the medium-term effectiveness and tolerance between joint lavage (JL) in combination with triamcinolone hexacetonide (TH) intra-articular injection (IAI) and IAI with TH alone for treatment of primary osteoarthritis (OA) of the knee. A randomized, double-blind, controlled study was carried out on 60 patients with primary OA of the knee, randomized into two intervention groups: JL/TH group, joint lavage in combination with TH intra-articular injection and TH group, TH intra-articular injection. Patients were followed for 12 weeks by a blind observer using the following outcome measurements: visual analogue scale for pain at rest and in movement, goniometry, WOMAC, Lequesne's index, timed 50-ft walk, perception of improvement, Likert scale for improvement assessment, use of nonsteroidal anti-inflammatory drugs and analgesics, and local side effects. There were no statistical differences in the inter-group analysis for any of the variables studied over the 12-week period. Although both groups demonstrated statistical improvement in the intra-group evaluation (except for Likert scale according to patient and the use of anti-inflammatory drugs). In the Kellgren-Lawrence scale (KL) 2 and 3 sub-analysis, there was a statistical difference regarding joint flexion among patients classified as KL 2, favoring the TH group (p=0.03). For the KL 3 patients, there were statistical differences favoring the JL/TH group regarding Lequesne (p=0.021), WOMAC pain score (p=0.01), and Likert scale according to the patient (p=0.028) and the physician (p=0.034). The combination of joint lavage and IAI with TH was not more effective than IAI with TH alone in the treatment of primary OA of the knee. However, KL 3 patients may receive a major benefit from this combination.

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Objective: Determine average time of delivery of childbirth in pregnants with joint hypermobility and compare with the average time of delivery of childbirth in pregnants without it. Patients and Methods: One hundred ninety-one pregnants distributed in 2 groups were studied, a group included 64 pregnants with joint hypermobility (exposed group) and other of 127 pregnants without it (non exposed group), assisted in the Obstetrician service from Hospital Regional Docente de Trujillo. We applied Beighton's Test to determine joint hypermobility. T-student Test was used, assuming that the difference is significant among the groups (P Ͻ 0.05). Results: The average time of delivery total childbirth in exposed group was 7.01 Ϯ 2.15 and the non exposed group was 8.89 hours Ϯ 3.5 (P Ͻ 0.001). The average time delivery of the childbirth in active stage in the exposed group was 4.05 hours Ϯ 2.15 and in the non exposed group was 5.94 Ϯ 3.46 (P Ͻ 0.001). Conclusions:The time of childbirth work is smaller in pregnants, with joint hypermobility that in those pregnants without it, with difference highly significant statistic.Objetivos: Demostrar a través de un análisis de los costos que realizan durante el primer mes en su tratamiento, los pacientes con A.R, OAD, y RPB, el potencial encarecimiento de su presupuesto, y de la marcada disminución en la capacidad adquisitiva de servicios básicos, de salud, vivienda, alimentación, vestido, trasporte y recreación, al compararlos con el estimado gubernamental para la canasta básica mensual, que dichos costos representan en Guatemala. Metodología: Se analizan 3 grupos de pacientes con los padecimientos reumáticos más frecuentes: Artritis Reumatoide (AR), Osteo-artritis Degenerativa (OAD) y Reumatismo de partes blandas (RPB), cada grupo compuesto de 30 pacientes, de una clínica priada, clínicas AGAR y consulta externa de un hospital local.Para tal objeto se diseñó un instrumento de recolección de datos, las respuestas de los gastos realizados fueron divididas entre. Gastos Directos: todos aquellos que se relacionan propiamente con el diagnóstico y tratamiento de la patología articular. Indirectos: los que se relacionan con la vida diaria y las adaptaciones que el paciente realiza a la misma como consecuencia de la enfermedad. El sueldo mínimo fijado por el gobierno para este año para el área agrícola es de Q957.00 ($119.62) y para el área no agrícola de Q1,026.00 ($128.25); es decir $1435.44 years $1539.00 respectivamente al año (Fuente: ACUERDO GUBERNATIVO No. 459-2002 Departamento Nacional del Salario, Ministerio de Trabajo y Previsión social de Guatemala). Resultados: El 85% de los pacientes no cuentan con la capacidad económica para un adecuado control y seguimiento de su enfermedad. La dependencia familiar corresponde a 58% hijos, cónyuges 30%, padres 3%, hermanos 5%. Mensualmente los Guatemaltecos, en base a su salario pueden realizar una inversión del 5.48% en salud (Instituto Nacional de Estadística, Indice de precios al consumidor, Boletín Marzo 2004) es decir Q69.92 ($8.75) resu...

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