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.
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.