Merino Hilario. Service of Osteopathy, Musculo-skeletal, C.M. Rusiol. Introduction It represents a reason for very frequent consultation. It is fundamental to realise one complete clinical history, similarly, is essential to carry out a detailed exploration of the mobility of the neck and the neurological deficits. Soon to diagnose.
The cervialgia can have a: Mechanical problems They appear between the base of the skull and the first vertebrae of high the cervical column, represented by the joints occipito-atlanto-axoidea and third cervical one. That it presents/displays syndromes painful by direct or indirect traumatisms, efforts, incorrect positions. That they pay attention to muscles later of the neck. Inferiors plane in and superior are subdivided in their same. – Inferiors: They are located below the third cervical one to surface and deep. – Superiors: Where it affects is to occipito-atloidea, atloido-axoidea joint along with the nerves and glasses of the region. The cervical pains that constitute the crvico-cefalalgias in intimate relation with the occipito-atloidea joint.
Neuronal problems The migraines are a common symptom that the person suffers who them presents/displays a psychic picture distressed, sad, little kind. In advanced cases one would be little thoughtful or coordinated, it does not allow him to rest well, it undergoes intense mareos, you feel nauseous All these causes with due to vasomotor manifestations which will mainly take part in the vertebral artery and the likeable one, which they accompany the cervical roots. Mobility of the artery is alterations of likeable sanguineous irrigation along with the disturbance of the glass, that regulates the circulation of the brain and the encephalic axis. In relation to the elements I tilt nervous of the oriented transverse channel towards the affected cervical vertebral portion. Also they generate the compression of the package I tilt nervous when happening through plexo brachial and to go downwards from the furrow of the transverse apophysis that produces irritations by the nervous roots.
For Hohenthal (1960), the Tux not only has the same origin of the Truk, but they are remaining Cajur, originating the Cabrob region and Saint Maria of the Boa Vista. In 1759, they were seated in the opposing edge to the mouth of the Paje, together with the Peri. was the first to reply. Linguistic, they said an isolated language, today extinct (Urban 1998). Of the aboriginal peoples who inhabited the San Francisco remains the Pankararu, the Tux, the Atikum and the Truk living in areas that had belonged to it in the past, even so others are trying the recognition> legal of its ethnic identity, as the Jeripank, ace edges of the Moxot. In the end of century XVIII, a great portion of land, left edge of the San Francisco, between Cabrob and Santa Maria of the Boa Vista and that it was extended until the mountain range of the Araripe, already had been vendida to a probable leaseholder, D. Brgida Maria of the Virgins Alencar, natural of Cabrob, whose name would be remembered in the stream that discharges in the next San Francisco the Oroc.
In the following century, to the resold being this territory in 1816 the Joo Pear tree Goulart and Dona Goulart Maria, in it was installed the Tamboril farm, the east of which would appear the city of Ouricuri, in the place of the Aricuri small farm that if it forms in this property (Aquino, 1982). As well as these, diverse dates of land already would have been vendidas for you of the House of the Tower for this occasion, beyond the dismemberment of the territory of this in villages and towns. In century XIX the development of the region would only justify the signature of License in 15 of January of 1810, creates ndo the Judicial district of Avila. Next the Saint Maria existed seven aboriginal villages, having been erected a mission in the island of this n ome, the second of the region rank that the mission of the Pontal was under its jurisdiction.
Pharmaceutical reps put on the business advice of their customers the pharmaceutical industry is in transition, and also sales staffs in their size are reduced. At the same time the competition in the battle for the customer “is increasing. These developments left its mark pass the pharmaceutical reps, especially not to those who take care of physicians. They rated in 2009 as the result of an investigation by the Institute for economic analysis, consulting and strategy development (IFABS) in Dusseldorf at 390 pharmaceutical consultants – their general work situation with a value of 2.9 “(scale of 1” = very positive “to 6” = very negative “”), so is the judgment value 2010 only on 3.7 “. The main challenge of the work is customer loyalty. The odds for this 2009 with a value of 2.9 “classified (scale of 1″= absolutely straightforward”up to 6″= almost excluded”), worsened the assessment in the” current year level point 3.4.
But there is also a clear counter-strategy: 2009 only 12% of employees indicated that their work in addition to the classic product discussion – on the support of entrepreneurial activity by practice owners focus, there are 33% with the perspective of 2011. It helps in improving the Organization, hedgehog support, the development and implementation of marketing activities and the implementation of practice analyses are in the focus of activities. With its customers, the pharmaceutical sales force with this strategy meets open arms: every third doctor are now need professional assistance with entrepreneurial questions. A complementary study of the Institute went the question of how these offers of pharmaceutical sales representative when compared to their counterparts from consultancy to assess the quality of are and how big is the benefits for practitioners. The conclusion of the analysis: even if the consultants from pharmaceutical companies not the entire Consulting range, she nevertheless points compared to their counterparts from consultancies with a well-defined performance including after-sales service at low cost and with high benefits for doctors. Especially their practical experience make them a real alternative, if doctors need assistance in terms of practice management”. Practice advice therefore represent an essential part in the change of the pharmaceutical sales force. The experience gained here can be used combined with an indicative expertise – also in key account management, i.e. for cooperation with doctor networks, MVZ and outpatient inpatient collaborations.