ABSTRACT The chronic inflammatory process of rheumatic diseases constitutes a factor that causes affectation in other organs and organ systems. The affectation can produce metaplasia of the mucosa of different tissues and condition the appearance of neoplastic diseases. Patients with Sjögren's syndrome have a 40% increased risk of developing a tumor disease compared to healthy patients or other non-inflammatory chronic diseases. The objective of this study is to present the clinical-imaging characteristics that made the diagnosis of a Klatskin tumor possible in a 57-year-old female patient with a 5-year history of Sjögren's syndrome. Endoscopic retrograde cholangiopancreatography was performed to remove the tumor. Three days after the surgical intervention, the patient showed a favorable evolution, so it was decided to discharge from the hospital with follow-up by outpatient consultation of specialties of general surgery and rheumatology indistinctly. Treatment for the patient's underlying disease was maintained throughout the procedure. Currently the patient is incorporated into her daily activities and with a favorable evolution of her state of health.

RESUMEN El proceso inflamatorio crónico de las enfermedades reumáticas constituye un factor que causa afectación en otros órganos y sistemas de órganos. La afectación puede llegar a producir metaplasia de la mucosa de distintos tejidos y condicionar la aparición de enfermedades neoplásicas. Los pacientes con síndrome de Sjögren tienen un 40 % de aumento de riesgo de padecer una enfermedad tumoral con respecto a los pacientes sanos o con otras enfermedades crónicas no inflamatorias. El objetivo del presente estudio es dar a conocer las características clínico-imagenológicas que posibilitaron el diagnóstico de un tumor de Klatskin en una paciente femenina de 57 años de edad con antecedentes de 5 años de evolución del síndrome de Sjögren. Se realizó una colangiopancreatografía retrógrada endoscópica para eliminar el tumor. A los tres días de la intervención quirúrgicamente la paciente muestra una evolución favorable por lo que se decide dar alta hospitalaria con seguimiento por consulta externa de especialidades de cirugía general y reumatología indistintamente. Durante todo el procedimiento se mantuvo el tratamiento para la enfermedad de base de la paciente. Actualmente la paciente se encuentra incorporada a sus actividades cotidianas y con una evolución favorable de su estado de salud.

ABSTRACT The surgical act constitutes an element of stress, mainly in patients with rheumatic diseases in whom the surgical activity presents distinctive characteristics. Maintaining adequate control of the clinical activity of patients with rheumatic disease constitutes a fundamental pillar for the post-surgical recovery of people undergoing elective surgery. For this, it is necessary to correctly guide rheumatic patients both preoperatively and postoperatively. Only from this will an adequate surgical recovery be achieved without jeopardizing the control of the rheumatic disease. The objective of the following report is to describe the pre and post-surgical recommendations for elective surgery in patients with rheumatic diseases, which will allow people to be correctly oriented and reduce the morbidity related to the performance of surgical procedures in patients diagnosed with rheumatic diseases.

RESUMEN El acto quirúrgico constituye un elemento de estrés, principalmente en pacientes con enfermedades reumáticas en los que la actividad quirúrgica presenta características distintivas. Mantener un adecuado control de la actividad clínica de los pacientes con enfermedad reumática constituye un pilar fundamental para la recuperación posquirúrgica de las personas sometidas a cirugía electiva. Para ello es necesario orientar correctamente a los pacientes reumáticos tanto en el preoperatorio como en el posoperatorio. Solo de esta forma se logrará una adecuada recuperación quirúrgica sin poner en riesgo el control de la enfermedad reumática. El siguiente reporte tiene como objetivo describir las recomendaciones pre- y posquirúrgicas de la cirugía electiva en pacientes con enfermedades reumáticas, lo que permitirá orientar correctamente a las personas y disminuir la morbilidad relacionada con la realización de procedimientos quirúrgicos en los pacientes diagnosticados con enfermedades reumáticas.

ABSTRACT INTRODUCTION Population aging is a worldwide phenomenon. It is estimated that by 2050, one of five persons will be aged ≥60 years. In Chile, 15.8% of the population is now aged ≥60 years, and this figure will reach 30.7% by 2050. In 2006, a national program was implemented to provide assistive devices to older adults aged ≥65 years with limited mobility or difficulty performing activities of daily living. To date, there have been no assessments of the program’s effectiveness. OBJECTIVE Assess the effectiveness of an assistive devices policy in Chile on improving functional capacity of older adults aged ≥65 years, and beneficiaries’ perceptions of the services received, including changes in their quality of life. METHODS This was a before–after longitudinal study. A cohort of 309 persons was recruited, consisting of patients who received care at a public hospital in Santiago, Chile during 2014–2015. They were assessed before delivery of assistive devices, then followed for seven months, with repeated evaluations made in their homes. The following indicators were measured: functional capacity (Tinetti scale and Barthel Index); changes in perceived quality of life related to use of assistive devices; and other sociodemographic, clinical and protocol-compliance variables. A longitudinal analysis of before–after progress was carried out, as well as a description of service delivery and medical followup. RESULTS Sixty-eight percent of those surveyed were women; median age was 74 years, average schooling was 6 years, and 93% had low income (monthly income <US$398). Assistive devices increased independence in activities of daily living, improved mobility and perceived quality of life, and decreased fall risk and pain. One hundred percent felt satisfied with the service received, 91% were trained in use of the device, and delivery deadlines were met in 83% of cases, but only 2% were followed up. One negative aspect is that the program covers only 25% of estimated need. CONCLUSIONS This assistive device program helps improve functional capacity and perceived quality of life in vulnerable patients who are able to access it. It addresses a real need and is highly valued by patients. Although delivery schedules were fulfilled, followup care schedules were not.

En este artículo, se presenta la construcción de un "museo de la psicología" como estrategia para la elaboración de la historia oral de la disciplina. En primer lugar, el debate entre psicología e historia constituye el marco para considerar el puesto que pueden ocupar los relatos de la experiencia de la práctica psicológica, en relación con la constitución de la historia de esta disciplina. A continuación, se describen los elementos fundamentales de la estrategia llamada "museo de la psicología", diseñada para elicitar historias orales. Para finalizar, a manera de ilustración, se consideran ventajas y limitaciones que emergen de la aplicación de la estrategia.

In this article the construction of a "museum of psychology" is presented as a strategy for the elaboration of the oral history of the discipline. First of all, the debate between history and psychology constitutes the framework to consider the place of psychological practices as regards the construction of the history of psychology. Then, the fundamental elements of the strategy called "the museum of psychology" are introduced. Finally, as an illustration, the advantages and the limitations of the strategy are presented.

Recientemente han venido ocurriendo una serie de transformaciones en la composición del "complejo psi" en el trabajo (Ingleby, 1985; Rose, 1985). De considerar, tangencialmente, aspectos de la salud de los trabajadores en la psicología convencional, se está pasando a una relación entre, la salud, el trabajo y la psicología, en la cual ocupan un lugar central una serie de perspectivas que prescriben el trabajo como riesgo y los riesgos del trabajo como problemas psicosociales. En consecuencia en este inter-juego entre perspectivas psicológicas se han configurado nuevos procesos de patologización y despatologización del trabajo y del trabajador. A partir de la ficción del "trabajador libre" como aquella figura de la subjetividad que toma para sí la psicología convencional, en este artículo se presentan y analizan tres formas en las cuales se ha recompuesto el "complejo psi" para constituir al trabajador saludable de acuerdo con los cambios radicales de la organización del trabajo.

Recently, there have been a series of transformations in the configuration of the "psi complex" at work (Ingleby, 1985; Rose, 1985). From being concerned with aspects of the workers' health in mainstream psychology, there has been a shift towards looking into the existing relationship between health, work, and psychology, in which a series of perspectives that prescribe work as risk, and the risks of work as psychosocial problems, have become a main concern. In this interplay between those psychological perspectives, new processes of pathologization and dephatologization of work and workers are produced. Taking as a point of departure the fiction of the "free worker" as the figure of subjectivity that conventional psychology takes for itself, this article aims at discussing three ways in which "psi complex" is recomposed to constitute the healthy worker according to the radical changes taking place in labour organization.

Alrededor del mundo, las organizaciones del sector salud se han tenido que adaptar a las prescripciones nacionales e internacionales que regulan tanto el trabajo como la salud. Este proceso ha sido acompañado de la introducción, en las áreas de recursos humanos, de conocimientos y prácticas guiadas por los principios provenientes de las Ciencias Sociales y Administrativas. En este encuentro entre las reformas liberales y las maneras de administrar la fuerza laboral, juegan un papel fundamental las significaciones que circulan en las organizaciones, puesto que de ellas depende, en gran medida, el éxito de agendas, programas e intervenciones dirigidas a la administración de los trabajadores. En este artículo, se presentan significaciones que están circulando acerca de trabajo, trabajador, organización, gestión humana y contratación, en un área de recursos humanos, compuesta por catorce trabajadores, de un hospital universitario en la ciudad de Bogotá, Colombia. El diseño cualitativo utilizado buscó recoger tanto las significaciones circulantes como su correlato emocional.

Around the world, healthcare organizations have had to accommodate to national and international regulations governing work and health. This process has been accompanied by the introduction of knowledge and practices coming from social and administrative sciences. In this encounter between the liberal reforms and the particular ways of managing the workforce, the circulating meanings play an important role because, to a large extent, the agendas, programs and interventions geared to towards workforce management depend on these circulating meanings to succeed. In this paper, meanings about work, worker, organization, human resources management and hiring that are currently circulating in a human resources department of a university hospital in Bogotá, Colombia, are presented. The qualitative design used in this paper aimed to collect the circulating meanings as well as their emotional correlative elements.

En esta entrevista Teresa Cabruja considera los orígenes y el desarrollo de la Psicología crítica en España, así como el lugar de su trabajo en relación con la constitución de este campo. A lo largo de la entrevista emergen momentos claves en los cuales se va configurando un conocimiento psicológico, que se aparta de las visiones convencionales de la disciplina. Se resalta la importancia que tienen los nodos locales para la producción de las perspectivas críticas, así como los encuentros internacionales para la expansión y cimentación de estas visiones alternativas al conocimiento psicológico convencional.

In this interview Teresa Cabruja traces the origins and development of crítical psychology in Spain and considers the place of her own work as regards the constitution of this field. During the interview some key moments that configured crítical psychology emerged. The importance of local nodes for the production of knowledge, as well as the international meetings for the expansion and consolidation of alternative views to the mainstream psychology are pointed out.