Objective To evaluate the impact of the routine use of musculoskeletal ultrasound (MSUS) in rheumatology clinics by comparing one clinic with on-site MSUS (REU 1) and four clinics without this resource, which need to refer patients for the MSUS exams (REU 2–5). Methods The electronic medical records of all new patients at five rheumatology clinics during a 12-month period were reviewed. The impact of MSUS was analysed by comparing the percentage of direct discharges of patients from the different clinics, as an outcome of effectiveness, and the number and cost of radiology referrals for imaging exams (MSUS and MRI), as an outcome of cost-saving. Results The medical records of 4923 patients were included in the study, distributed as follows: REU 1, 1464 (29.7%); REU 2, 1042 (21.2%); REU 3, 1089 (22.1%); REU 4, 579 (11.8%); and REU 5, 749 (15.2%). There were more direct discharges from REU 1 (34.4%) than from REU 2–5 (15.6%) (P<0.001). REU 1 made radiological referrals for X-rays, MRIs or MSUS exams in 773 (52.8%) patients, compared with 2626 (75.9%) patients in REU 2–5 (P<0.001). An estimation of costs for the clinical assessment of 1000 new patients revealed a cost-saving in REU 1 of €21 413 in MSUS and of €877 in MRI exams. Conclusion The implementation of on-site MSUS in a new-patient rheumatology clinic is cost-effective, facilitating the direct discharge of patients and reducing the number and cost of radiological referrals for imaging exams.

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La Mucositis oral (MO) es una de las complicaciones más frecuentes y graves entre los pacientes sometidos a tratamientos de radioterapia y/o quimioterapia. Su impacto como evento adverso (EA) afecta directamente a las necesidades básicas, derivando incluso en la interrupción o retraso del tratamiento oncológico.   Este trabajo de revisión crítica de la literatura pretende analizar la efectividad de diferentes medidas no farmacológicas como alternativa en la prevención de la MO. La metodología llevada a cabo sigue un proceso planificado y estructurado con la pertinente búsqueda exhaustiva en diversas bases de datos y revistas científicas, tales como: Medline (OVID), Cinhal, Cochrane y Cuiden.   Existen numerosas medidas recogidas en la literatura para abordar la prevención de la MO tales como la crioterapia oral, miel, melaza de morera negra, silimarina, propóleo, polen de palmera datilera, enjuagues de clorhexidina y povidona yodada. La evidencia obtenida resulta inconcluyente, siendo necesario realizar más investigaciones.   Palabras Clave: Mucositis oral, Prevención primaria, Radioterapia, Quimioterapia, Crioterapia, Miel, Silimarina, Polen de palmera datilera, Propóleo, enjuagues bucales, Canela.     ABSTRACT:   Oral Mucositis (OM) is one of the most frequent and serious complications of patients undergoing radiotherapy and / or chemotherapy treatments. Its impact as an adverse event (AE) directly affects basic needs, even leading to the interruption or delay of cancer treatment.   A bibliographic search has been done in order to analyze the effectiveness of different non-pharmacological measures as an alternative in preventing OM. The methodology carried out follows a planned and structured process with an exhaustive search in several databases and scientific journals, for example: Medline (OVID), Cinhal, Cochrane and Cuiden.   There are numerous measures collected in the literature to prevent OM such as:  oral cryotherapy, honey, black mulberry molasses, silymarin, propolis, date palm pollen, chlorhexidine and povidone-iodine rinses. The evidence obtained is inconclusive, and further research is needed.   Key words: Oral mucositis/stomatitis, Primary prevention, Radiotherapy, Drug therapy, Cryotherapy, Honey, Silymarin, Pollen, Propolis, mouthwashes, Cinnamomum osmophloeum.