sábado, 26 de septiembre de 2015

Nutrición en el niño, obesidad y su desenlace en el adulto

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 30 Septiembre 2015 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Nutrición en el niño, obesidad y su desenlace en el adulto” por la “Dra. Alicia Robledo Galván”, Pediatra, Neonatologo de la Cd. De México DF. La sesión inicia puntualmente las 21 hrs.
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador http://connectpro60196372.adobeconnect.com/nutricion_obesidad/
2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia
6.- Recomendamos que dejes tu Nombre Completo, Correo electrónico y que participes.


Henrys


Dr. Enrique Mendoza López Webmaster: CONAPEME Coordinador Nacional: Seminario Ciberpeds-Conapeme Av La clinica 2520-310 Colonia Sertoma ,Mty N.L. México CP 64710 Tel-Fax 52 81 83482940 y 52 81 81146053 Celular 8183094806 www.conapeme.org www.pediatramendoza.com enrique@pediatramendoza.com emendozal@yahoo.com.mx

Medwave: Boletin eCampus y Edición Septiembre 2015



Medwave <medwave2011@medwave.cl>






Tenemos el agrado de informarle que Aún se encuentran abiertas las inscripciones para el curso de “Calidad en los procesos asistenciales”. Detalles e inscripciones enhttp://ecampus.medwave.cl/?page_id=746




Nuevo ciclo del curso de “Prevención y control de infecciones asociadas a la atención en salud”. Inicio 07 de octubre, información en http://ecampus.medwave.cl/?page_id=764



Los últimos artículos publicados en Medwave son los siguientes


ESTUDIOS PRIMARIOS


Duloxetina para el tratamiento de la neuropatía diabética periférica dolorosa en Venezuela: evaluación económica

Fernando Carlos, Luis Espejel, Diego Novick, Rubén López, Daniel Flores (Multinacional)

Medwave 2015 Sep;15(8):e6265




Medwave 2015 Sep;15(8):e6265

http://dx.doi.org/10.5867/10.5867/medwave.2015.08.6265


Movilización posterior glenohumeral versus tratamiento kinésico convencional en la capsulitis adhesiva primaria: ensayo clínico aleatorizado

Héctor Joaquín Gutiérrez Espinoza, Francisco Pavez, Cristopher Guajardo, Manuel Acosta (Chile)




Medwave 2015 Sep;15(8):e6267

http://dx.doi.org/10.5867/10.5867/medwave.2015.08.6267




REPORTE DE CASO



Pileflebitis: reporte de caso y revisión de literatura

Lizeth Flores Anaya, Cinthia León Lozada, William Torres Damas (Perú)


Medwave 2015 Sep;15(8):e6258

http://dx.doi.org/10.5867/10.5867/medwave.2015.08.6258







CARTA A LA EDITORA
¿Pueden los estudiantes de medicina realizar estudios multicéntricos?

Reneé Pereyra-Elías, Juan José Montenegro-Idrogo, Percy Mayta-Tristán (Perú)


Medwave 2015 Sep;15(8):e6268

http://dx.doi.org/10.5867/10.5867/medwave.2015.08.6268


Para mayor información sobre envío de manuscritos, revisión y como publicar en Medwave escribir directamente a rodrigo.nunez@gmail.com





Cupos disponibles para nuevo curso de “Estadística descriptiva e introducción a la estadística inferencial aplicada a las ciencias de la salud” a realizarse entre el 14 de octubre y el 22 de enero de 2016.

Mayores detalles en http://ecampus.medwave.cl/?page_id=1288

Para mayor información sobre cursos y capacitación escribir a mguillen@medwave.cl


PORTADA MEDWAVE

http://www.medwave.cl



PORTADA eCAMPUS

http://www.medwave.cl/link.cgi/eCampus/Capacitacion

viernes, 25 de septiembre de 2015

Diferentes escenarios de Anemia en el niño

Excelente conferancia por e Dr Euler Chargoy Vivaldo Hematologo de Oaxaca
nnos da un enfoque de regreso a lo básico y lo aplica a diferentes escenarios de Anemia en el niño, disfruten





Ciberpeds: http://bit.ly/1wAplUD
Conapeme: http://bit.ly/1BekGtR
Registo a Coferencias off line: http://bit.ly/19ApWtR



--

Dr. Enrique Mendoza López
Webmaster: CONAPEME
Coordinador Nacional: Seminario Ciberpeds-Conapeme
Av La Clinica 2520-310 col Sertoma
Monterrey N.L. CP 64718
Tel (81) 83482940, (81) 83485701
Cel 0448183094806
www.pediatramendoza.com
www.conapeme.org
www.ciberpeds.org

Teléfonos móbiles/Mobile phones

Septiembre 25, 2015. No. 2096
Anestesia y Medicina del Dolor



Teléfonos móbiles. Reservorios para la trasmisión de patógenos nosocomiales
Mobile phones: Reservoirs for the transmission of nosocomial pathogens
Pal S, Juyal D, Adekhandi S, Sharma M, Prakash R, Sharma N, et al.
Adv Biomed Res 2015;4:144.
Background: Global burden of hospital-associated infection (HAI) is on the rise and contributes significantly to morbidity and mortality of the patients. Mobile phones are indispensible part of communication among doctors and other health care workers (HCWs) in hospitals. Hands of HCWs play an important role in transmission of HAI and mobile phones which are seldom cleaned and often touched during or after the examination of patients without hand washing can act as a reservoir for transmission of potent pathogens. This study aimed to investigate the rate of bacterial contamination of mobile phones among HCWs in our tertiary care hospital and to compare it with personal mobile phones of non-HCWs (control group). Materials and Methods: The mobile phones and dominant hands of 386 participants were sampled from four different groups, hospital doctors and staff (132), college faculty and staff (54), medical students (100) and control group (100). Informed consent and questionnaire was duly signed by all the participants. Samples were processed according to standard guidelines. Results: 316 mobile phones (81.8%) and 309 hand swab samples (80%) showed growth of bacterial pathogens. The most predominant isolates were Coagulase-negative Staphylococcus, Staphylococcus aureus, Acinetobacter species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas species and Enterococcus species. Conclusion: Hundred percent contamination was found in mobile phones and hands of HCWs indicating mobile phones can be the potential source of nosocomial pathogens. Our study results suggest that use of mobile phones in health care setup should be restricted only for emergency calls. Strict adherence to infection control policies such as proper hand hygiene practices should be followed.
Evaluación de los teléfonos celulares para riesgo potencial de infecciones nosocomiales en operadores dentales y auxiliares
Evaluation of Cellular Phones for Potential Risk of Nosocomial Infection amongst Dental Operators and Auxiliary Staff.
J Int Oral Health. 2015 Apr;7(4):51-3.
Abstract
BACKGROUND: This study evaluates cellular phones for potential risk of nosocomial infection amongst dental operators and auxiliary staff in a dental school. MATERIALS AND METHODS:
Each participant's mobile phone was first cleaned with 70% isopropyl alcohol swab. Following the cleansing protocol, the partakers were asked to make a short phone call. The mobile phones were then washed aseptically by rotating damp cotton swabs with sterile normal saline. Bacterial growth was identified on sheep blood agar and McConkey's agar plates. Sabouraud dextrose agar media was used for fungi species. Descriptive statistics was established with the data statistically explored with SPSS version 17.0. RESULTS: About 50% of dental professionals had shown active bacterial and fungal growth in which 35% (n=35) were dental operators and 15% (n=15) were dental nurses. 53% Gram-positive organisms, 2% Gram-negative organisms, and 3% fungi were identified growths on cellular phones. CONCLUSION: Thus, it can be concluded that the cellular phones of dental operators as compared to auxiliaries can act as a potential source of nosocomial infection.
KEYWORDS: Dentists; dental auxiliary; infectious disease transmission; nosocomial infection

Los teléfonos móviles llevan el microbioma personal de sus propietarios.
Mobile phones carry the personal microbiome of their owners.
PeerJ. 2014 Jun 24;2:e447. doi: 10.7717/peerj.447. eCollection 2014.Author information
Abstract
Most people on the planet own mobile phones, and these devices are increasingly being utilized to gather data relevant to our personal health, behavior, and environment. During an educational workshop, we investigated the utility of mobile phones to gather data about the personal microbiome - the collection of microorganisms associated with the personal effects of an individual. We characterized microbial communities on smartphone touchscreens to determine whether there was significant overlap with the skin microbiome sampled directly from their owners. We found that about 22% of the bacterial taxa on participants' fingers were also present on their own phones, as compared to 17% they shared on average with other people's phones. When considered as a group, bacterial communities on men's phones were significantly different from those on their fingers, while women's were not. Yet when considered on an individual level, men and women both shared significantly more of their bacterial communities with their own phones than with anyone else's. In fact, 82% of the OTUs were shared between a person's index and phone when considering the dominant taxa (OTUs with more than 0.1% of the sequences in an individual's dataset). Our results suggest that mobile phones hold untapped potential as personal microbiome sensors.
KEYWORDS:
Built environment; Cell phone; Human microbiome; Indoor microbiology; Mobile phone; Personal microbiome; Quantified self
Los teléfonos celulares en la práctica clínica. Reduciendo el riesgo de contaminación bacteriana
Mobile phones in clinical practice: reducing the risk of bacterial contamination.
Int J Clin Pract. 2014 Sep;68(9):1060-4. doi: 10.1111/ijcp.12448. Epub 2014 May 18.
Abstract
BACKGROUND: Mobile smart phones have become increasingly integrated into the practice of doctors and allied medical professionals. Recent studies suggest them to represent reservoirs for pathogens with potential to cause nosocomial infections. This study aimed to investigate the level of contamination on phones used on surgical wards and identify strategies for their safe use within clinical areas. METHODS: Fifty mobile phones were taken from members of the multidisciplinary team working in a surgical unit. Phones were swabbed by two trained investigators using a standardised technique and samples streaked out using an automated specimen inoculator onto two types of culture media (Columbia blood agar and MacConkey agar). Colonies were identified and counted by a single trained investigator in a blinded fashion. Simultaneously a questionnaire investigating usage levels of phones was given to 150 healthcare workers. RESULTS: Sixty per cent of phones sampled had some form of contaminant isolated from their phone. Thirty-one (62%) of phones had only three colonies or less isolated on medium. No pathogenic or drug resistant strains of bacteria were identified. A total of 88% of individuals sampled by questionnaire used their phone within the workplace of which 55% used it for clinical purposes. Sixty-three per cent expected there to be some form of contaminant on their phone with only 37% admitting to cleaning it regularly. Seventy-five per cent of people did not view a ban on phones as a practical solution was they found to be an infection risk.
CONCLUSION: Touch screen smart phones may be used safely in a clinical environment, with a low risk of cross-contamination of nosocomial bacteria to patients, in the setting of effective adherence to hand hygiene policies.
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Modulo CEEA Leon, Gto. Curso CEEA Tijuana  XII Congreso Virtual Mexicano de Anestesiologia


          
Anestesiología y Medicina del Dolor
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lunes, 21 de septiembre de 2015

Sufental intratecal en cesárea/Intrathecal sufentanil in C-sectio

No. 2034                                                                                 
Raquia hiperbárica con ropivacaína coadministrada con sufentanil en cesárea. Estudio dosis-respuesta
Hyperbaric spinal anesthesia with ropivacaine coadministered with sufentanil for cesarean delivery: a dose-response study.
Int J Clin Exp Med. 2015 Apr 15;8(4):5739-45. eCollection 2015.
Abstract
Adjuvant sufentanil could achieve effective spinal anesthesia with low dose of hyperbaric ropivacaine for cesarean delivery. Two previous studies had calculated the 50% effective dose (ED50) of intrathecal ropivacaine coadministered with sufentanil for cesarean delivery. However, the 95% effective dose (ED95) of intrathecal hyperbaric ropivacaine coadministered with sufentanil for cesarean delivery remains uncertain. This study determined the ED95 of intrathecal hyperbaric ropivacaine coadministered with sufentanil for cesarean delivery. 80 ASA physical status I or II parturients undergoing elective cesarean delivery were enrolled in this prospective, randomized, double-blind investigation. A combined spinal and epidural anesthesia was performed at the L3-L4 interspace. Patients received a dose of spinal ropivacaine coadministered with sufentanil 5 μg diluted to 3.0 ml with normal saline and 0.5 ml of 10% dextrose: 7.5 mg (n = 20), 9.0 mg (n = 20), 10.5 mg (n = 20), or 12 mg (n = 20). An effective dose was defined as a dose that provided bilateral sensory block to T7 within 10 min after intrathecal drug administration and required no epidural top-up for surgery to be completed. The ED50 and ED95 values for successful anesthesia were determined using a logistic regression model. The ED50 (95% confidence interval [CI]) for successful anesthesia was 8.4 (4.0-9.8) mg and the ED95 (95% CI) was 11.4 (9.7-13.9) mg. The results show that the ED95 of intrathecal hyperbaric ropivacaine coadministered with sufentanil 5 μg for cesarean delivery was 11.4 mg. The addition of sufentanilcould significantly reduce the dosage of ropivacaine.
KEYWORDS: Cesarean delivery; ropivacaine; spinal anesthesia; sufentanil

Estudio comparativo con ondansetron y dosis subhipnóticas de propofol intravenosos en el control y tratamiento del prurito inducido por sufentanil intratecal en cesarean electiva
The comparative study of intravenous Ondansetron and sub-hypnotic Propofol dose in control and treatment of intrathecal Sufentanil-induced pruritus in elective caesarean surgery.
J Res Pharm Pract. 2015 Apr-Jun;4(2):57-63. doi: 10.4103/2279-042X.155751.
Abstract
OBJECTIVE: Pruritus is a common and disturbing side effect of neuraxial opioids after cesarean section. The purpose of this study was to compare the efficacy of intravenous ondansetron and sub-hypnotic dose of propofol in control and treatment of intrathecal sufentanil induced pruritus in cesarean surgery. METHODS: Totally, 90 parturient with American Society of Anesthesiology physical status grade I-II, undergoing spinal anesthesia with 2.5 μg sufentanil and 10 mg bupivacaine 0.5% were enrolled to this randomized, prospective, double-blind study. The women were randomly assigned to two groups who received 8 mg ondansetron or 10 mg propofol to treat pruritus grade ≥3. The patient was evaluated after 5 min and in the lack of successful treatment, the doses of two drugs repeated and if the pruritus is on-going, the exact treatment with naloxone was done. FINDINGS: The incidence of pruritus was 69.3%. Both groups were well-matched. The peak time pruritus was 30-75 min after injection. The percentage of individuals consumed naloxone were 6.8% and 15.9% in ondansetron and propofol groups, respectively (P = 0.18). The mean score of satisfaction (according to visual analog scale criteria) was 9.09 ± 1.1 in ondansetron group and 9.3 ± 1.07 in the propofol group (P = 0.39). CONCLUSION: Ondansetrone and sub-hypnotic dose of propofol are both safe and well-tolerated. Due to their same efficacy in the treatment of intrathecal sufentanil-induced pruritus, they can be widely used in clinical practice.
KEYWORDS: Caesarean surgery; Ondansetron; Propofol; intrathecal opioid; pruritus
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Atentamente
Anestesia y Medicina del Dolor

Sugammadex

No. 2035                                                                                  
Uso de sugammadex en quemados. Estudio descriptivo
Use of sugammadex on burn patients: descriptive study.
Braz J Anesthesiol. 2015 Jul-Aug;65(4):240-3. doi: 10.1016/j.bjane.2014.10.001. Epub 2015 Jun 7.
Abstract
OBJECTIVES: A burn patient is a challenge for any anesthesiologist, undergoing several surgeries during admission, and requiring general anesthesia and muscle relaxation most of the times. The victim may have respiratory system impairment and a response to muscle relaxants that differs from the healthy patient, thus proper monitoring and reversal is crucial. We analyzed sugammadex effectiveness and safety in this population. MATERIALS AND METHODS: It was a prospectively descriptive study, including 4 patients, and all of them were considered major burn patients, who underwent escharotomy with general anesthesia and neuromuscular relaxation. The main variable was the time for recovery of a TOF higher than 0.9 after the administration of sugammadex before extubation. RESULTS: Mean time of recovery from a TOF ratio higher than 0.9 following the administration of Sugammadex was of 4.95min 95% CI (3.25-6.64, p=.53). CONCLUSIONS: The reversion of neuromuscular relaxation with sugammadex appears to be effective and safe in the burn patient. More analytical, comparative studies of larger populations would be necessary to confirm these data.
KEYWORDS: Bloqueio neuromuscular; Burn injury; Cyclodextrin; Gama-Ciclodextrinas; Neostigmina; Neostigmine; Neuromuscular block; Queimaduras; Rocuronium; Rocurônio; Sugammadex

La influencia de hipotermia moderada sobre la reversión del bloqueo neuromuscular profundo por rocuronio con sugammadex
The influence of mild hypothermia on reversal of rocuronium-induced deep neuromuscular block with sugammadex.
BMC Anesthesiol. 2015 Jan 21;15:7. doi: 10.1186/1471-2253-15-7.
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Beneficios y riesgos de sugammadex
Benefits and risks of sugammadex.
Korean J Anesthesiol. 2015 Feb;68(1):1-2. doi: 10.4097/kjae.2015.68.1.1.
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Atentamente
Anestesia y Medicina del Dolor
Safe Anesthesia World Wide