Revisiones bibliográficas. Documentación científica en Ortopedia y Traumatología, medicina deportiva, artroscopia, artroplastia y de todas las patologías del sistema Músculo-Esquelético
LA OSTEOARTRITIS UN PROBLEMA DE SALUD PÚBLICA, EPIDEMIOLOGÍA Y DIAG./ GUIAS DE DIAGNOSTICO Y TRATAMIENTO DE LA OSTEOARTRITIS DR FERNANDO TORRES/ dvd27 CADERA XXVII JORNADA NACIONAL DE ORTOPEDIA 58° REUNIÓN ANUAL 2013 1° AL 5 DE MAYO, MÉXICO
Estimado Ciberpediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 14 de Agosto 2013 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Vasculitis en Pediatría” por el “Dr. Manuel Esquer Navarro“ Pediatra, de la Cd. Culiacán , Sinaloa 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
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.
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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
Controversies, principles and essentials of enteral and parenteral nutrition in critically ill-patients. Bajwa SJ, Sachin S J Med Nutr Nutraceut [serial online] 2013 [cited 2013 Jul 6];2:77-83. Abstract Nutritional management in critically ill-patients is always a challenging task as malnutrition can have a direct impact on the prognosis. Besides assessing for nutritional requirement, the underlying severe illness and co-morbidities have to be given due consideration. Nutritional assessment has to be individualized, and nutritional plan should be formulated by involving a dedicated nutritionist. Early initiation of nutrition definitely improves the outcome in critically ill patients. Facts and principles of enteral and parenteral nutrition must be disseminated among all physicians and nursing staff working in intensive care units. Majority of old controversies related to parenteral and enteral nutrition have been settled with the intervention of various national and international committees such as Alliance and Espen. Nutritional disorders such as malnutrition, overfeeding and negative energy balance are highly associated with increased morbidity and mortality. Enteral nutrition though always preferred can always be supplemented with parenteral nutrition so as to optimize nutrition and energy status in critically ill patients. Keywords: Critically ill-patients, enteral nutrition, parenteral nutrition
» Se Presentó el Congreso Internacional CMO 2013, Artroscopía y Medicina del Fútbol Esta tarde, en las instalaciones de la Federación Mexicana de Fútbol se llevó a cabo una presentación del Congreso Internacional CMO “Artroscopía y Medicina del Fútbol” en homenaje al Dr. Aurelio Pérez Teuffer, el cual estará dirigido a Fisiatras, Kinesiólogos, Médicos Generales, Médicos Ortopedistas, Médicos de medicina física y Médicos del deporte. VER NOTA COMPLETA:http://www.femexfut.org.mx/portalv2/aspx/WEB_DetalleNoticia.aspx?pnIDNtca=41161 » Doctores mejorarán cuidado a futbolistas Los especialistas buscan profesionalizar el cuidado de los jugadores desde fuerzas básicas VER NOTA COMPLETA: http://www.extremodeportivo.com/nacional/doctores-mejoraran-cuidado-a-futbolistas/ » Anuncian Congreso Internacional de Artroscopía y Medicina Hoy las fases de recuperación y rehabilitación son más cortas: Guzmán. Jugadores profesionales y héroes de fin de semana, los beneficiados VER NOTA COMPLETA: http://www.jornada.unam.mx/2013/07/05/deportes/a14n1dep » Promueve Liga MX especialización médica Con el aval de la FIFA y el apoyo de la Liga MX, doctores especialistas en lesiones y temas futbolísticos celebrarán un Congreso en septiembre próximo en Cancún, con la presencia de los médicos de los 18 equipos de Primera División, así como de Confederaciones como CONCACAF, UEFA y CONMEBOL. VER NOTA COMPLETA: http://www.teleformula.com.mx/notas.asp?Idn=336846 » Doctores mejorarán cuidado a futbolistas En beneficio de los futbolistas que militan en el mercado mexicano, ayer se convocó a la celebración del Congreso Internacional de “Artroscopía y Medicina del Futbol”. VER NOTA COMPLETA: http://www.yancuic.com/yancuic/noticia/27352 » VER NOTA COMPLETA: http://calibre800.com/tendran-mas-cuidados-con-lesiones-de-futbolistas/
Los cinco mejores lectores de ebooks para Mac ← Misiongeek Geek Admin Como probablemente saben, somos fanáticos de los ebooks o libros digitales. Les hemos contado cuáles son los mejores sitios para descargarlos, cuáles son ...Misiongeek
Estimación preoperatoria del filtrado glomerular como predictor de la evolución postoperatoria: Revisión sistemática y meta-análisis
Preoperative Estimates of Glomerular Filtration Rate as Predictors of Outcome after Surgery: A Systematic Review and Meta-analysis Mooney, John F. M.B.B.S.; Ranasinghe, Isuru M.B.Ch.B., M.Med.(Clin. Epi.); Chow, Clara K. M.B.B.S., Ph.D.; Perkovic, Vlado M.B.B.S., Ph.D.; Barzi, Federica B.Sc., Ph.D.; Zoungas, Sophia M.B.B.S., Ph.D.; Holzmann, Martin J. M.D., Ph.D.; Welten, Gijs M. M.D., Ph.D. Biancari, Fausto M.D., Ph.D.; Wu, Vin-Cent M.D., Ph.D.; Tan, Timothy C. M.B.B.S., Ph.D.; Cass, Alan M.B.B.S., Ph.D.; Hillis, Graham S. M.B.Ch.B., Ph.D. Anestesiology April 2013 - Volume 118 - Issue 4 - p 809-824 doi: 10.1097/ALN.0b013e318287b72c
Abstract Background: Kidney dysfunction is a strong determinant of prognosis in many settings. Methods: A systematic review and meta-analysis was undertaken to explore the relationship between estimated glomerular filtration rate (eGFR) and adverse outcomes after surgery. Cohort studies reporting the relationship between eGFR and major outcomes, including all-cause mortality, major adverse cardiovascular events, and acute kidney injury after cardiac or noncardiac surgery, were included. Results: Forty-six studies were included, of which 44 focused exclusively on cardiac and vascular surgery. Within 30 days of surgery, eGFR less than 60 ml*min*1.73 m−2 was associated with a threefold increased risk of death (multivariable adjusted relative risk [RR] 2.98; 95% confidence interval [CI] 1.95-4.96) and acute kidney injury (adjusted RR 3.13; 95% CI 2.22-4.41). An eGFR less than 60 ml*min*1.73 m−2 was associated with an increased risk of all-cause mortality (adjusted RR 1.61; 95% CI 1.38-1.87) and major adverse cardiovascular events (adjusted RR 1.49; 95% CI 1.32-1.67) during long-term follow-up. There was a nonlinear association between eGFR and the risk of early mortality such that, compared with patients having an eGFR more than 90 ml*min*1.73 m−2 the pooled RR for death at 30 days in those with an eGFR between 30 and 60 ml*min*1.73 m−2 was 1.62 (95% CI 1.43-1.80), rising to 2.85 (95% CI 2.49-3.27) in patients with an eGFR less than 30 ml*min*1.73 m−2 and 3.75 (95% CI 3.44-4.08) in those with an eGFR less than 15 ml*min*1.73 m−2. Conclusion: There is a powerful relationship between eGFR, and both short- and long-term prognosis after, predominantly cardiac and vascular, surgery.
Les hago entrega de esta platica que se llevo a cabo en la pasada jornada de ortopedia en Acapulco......
LA EDUCACIÓN GERIÁTRICA EN LA ORTOPEDIA/ DR PEDRO ANTONIO BRAVO/ dvd51 2 ORTOPEDIA GERIÁTRICA XXVII JORNADA NACIONAL DE ORTOPEDIA 58°REUNIÓN ANUAL 2013 1° AL 5 DE MAYO ACAPULCO GRO. MÉXICO
Talleres en la Biblioteca de Los Polvorines | Malviticias Malviticias La Biblioteca de Los Polvorines invita a inscribirse en los tres nuevos cursos culturales que comenzarán en el mes de agosto. - Taller “Arte para todos”: ...Malviticias
Tratamiento actual y consideraciones anestésicas para la diabetes mellitus
Current therapeutic agents and anesthetic considerations for diabetes mellitus. Kang H. Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University, Seoul, Korea. Korean J Anesthesiol. 2012 Sep;63(3):195-202. doi: 10.4097/kjae.2012.63.3.195. Epub 2012 Sep 14. Abstract As the incidence of diabetes mellitus (DM) continues to increase worldwide, more diabetic patients will be presented for surgery and anesthesia. This increase of DM is a consequence of the rise in new patients of type 2 DM, and is likely attributable to rapid economic development, improved living standards, aging population, obesity, and lack of exercise. The primary goal of management in DM is to delay, or prevent the macro- and microvascular complications by achieving good glycemic control. More understanding of the pathophysiology of DM has contributed to the advance of new pharmacological approaches. In addition to the conventional therapy for DM, glucagon-like peptide-1 (GLP-1) mimetics, dipeptidyl peptidase-4 (DPP-4) inhibitors, thiazolidinediones (TZDs), and insulin analogues are currently available effective hypoglycemic agents for the management of the patients with DM in the perioperative period and also consider the adverse effects of newly introduced agents that need more clinical observations. KEYWORDS: Anesthesia, Diabetes mellitus, Glucose, Hypoglycemia, Treatment
Guías para la inyección de insulina en el perioperatorio y en pacientes graves Insulin injection guidelines for peri-operative and critically ill patients. Bajwa SJ, Kalra S, Baruah M, Bajwa SK. J Sci Soc [serial online] 2013 [cited 2013 Jul 23];40:68-75.
Abstract Anesthesiologists and intensivists are encountering increasing number of diabetic patients in daily clinical practice. Majority of such patients may require insulin injections for control of hyperglycemia. Advancements in diabetes management have led to usage of newer insulin injections ranging from human insulin and insulin analogs to glucagon-like peptides-1 analogs. The adequacy of glycemic control and successful outcome with such therapeutic interventions depends upon the adoption of correct injection techniques and procedures. Peri-operative and critically ill diabetic patients are highly prone to develop acute complications of diabetes if appropriate therapeutic strategies are not formulated and implemented. As such, the in-depth knowledge and awareness about various injection technique guidelines is essential from the patient care and healthcare provider's perspective in the operative and critical care settings. This description is an abridged version of the Forum for Injection Techniques, India: The first Indian recommendations for best practice in insulin injection technique and their significance in peri-operative period and critically ill patients in intensive care units (ICU). These insulin injection techniques are based on evidence-based recommendations and are meant to improve the management of diabetes by the attending staff and physicians in operative and critical care arenas. Keywords: Critically ill, diabetes, injection sites, insulin, insulin analogues, needle length, peri-operative, skin folds http://www.jscisociety.com/text.asp?2013/40/2/68/115473
Una gran necesidad de conocimiento de las pautas de inyección de insulina en unidades de cuidados intensivos y operatorias. An acute need for awareness of insulin injection guidelines in operative and intensive care units. Bajwa SJ, Kalra S, Baruah MP, Bajwa SK. Anesth Essays Res [serial online] 2013 [cited 2013 Jul 23];7:1-3.
Abstract The ever increasing number of peri-operative and critically ill diabetic patients in clinical settings have become a cause of serious concern. Invariably, such patients present with uncontrolled hyperglycemia which can be managed only with insulin therapy. [1],[2] Besides the existing challenges in the management of uncontrolled diabetes and its related complications, another difficulty which is commonly faced by the nursing staff and the physicians, is the lack of awareness regarding insulin injection techniques. Inappropriate insulin injection practices can lead to various clinical complications such as poor glycemic control, pain, bleeding and bruising, breaking and lodging of needle tip beneath the skin, contamination leading to infection, lipohypertrophy, and inaccurate dose administration
Anaemia and pregnancy: Anaesthetic implications. Grewal A. Department of Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Indian J Anaesth. 2010 Sep;54(5):380-6. doi: 10.4103/0019-5049.71026. Abstract Anaemia in pregnancy defined as haemoglobin (Hb) level of < 10 gm/dL, is a qualitative or quantitative deficiency of Hb or red blood cells in circulation resulting in reduced oxygen (O2)- carrying capacity of the blood. Compensatory mechanisms in the form of increase in cardiac output (CO), PaO(2), 2,3 diphosphoglycerate levels, rightward shift in the oxygen dissociation curve (ODC), decrease in blood viscosity and release of renal erythropoietin, get activated to variable degrees to maintain tissue oxygenation and offset the decreases in arterial O(2) content. Parturients with concomitant medical diseases or those with acute ongoing blood losses may get decompensated, leading to serious consequences like right heart failure, angina or tissue hypoxemia in severe anaemia. Preoperative evaluation is aimed at assessing the severity and cause of anaemia. The concept of an acceptable Hb level varies with the underlying medical condition, extent of physiological compensation, the threat of bleeding and ongoing blood losses. The main anaesthetic considerations are to minimize factors interfering with O(2) delivery, prevent any increase in oxygen consumption and to optimize the partial pressure of O(2) in the arterial blood. Both general anaesthesia and regional anaesthesia can be employed judiciously. Monitoring should focus mainly on the adequacy of perfusion and oxygenation of vital organs. Hypoxia, hyperventilation, hypothermia, acidosis and other conditions that shift the ODC to left should be avoided. Any decrease in CO should be averted and aggressively treated. KEYWORDS: Anaemia, anaesthetic considerations, compensatory mechanisms, pregnancy
Terapia con hierro sucrosa intravenoso para anemia moderada a severa en el embarazo
Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy. Kriplani A, Mahey R, Dash BB, Kulshreshta V, Agarwal N, Bhatla N. Indian J Med Res [serial online] 2013 [cited 2013 Aug 6];138:78-82. Abstract Background & objectives: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement. In India, women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate anaemia are to be treated with parentral iron therapy. This study was undertaken to evaluate the response and effect of intravenous iron sucrose complex (ISC) given to pregnant women with IDA. Methods: A prospective study was conducted (June 2009 to June 2011) in the department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. One hundred pregnant women with haemoglobin between 5-9 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron sucrose complex in a dose of 200 mg twice weekly schedule after calculating the dose requirement. Results: The mean haemoglobin raised from 7.63 ± 0.61 to 11.20 ± 0.73 g% (P<0.001) after eight wk of therapy. There was significant rise in serum ferritin levels (from 11.2 ± 4.7 to 69 ± 23.1 μg/l) (P<0.001). Reticulocyte count increased significantly after two wk of starting therapy (from 1.5 ± 0.6 to 4.6±0.8%). Other parameters including serum iron levels and red cell indices were also improved significantly. Only one woman was lost to follow up. No major side effects or anaphylactic reactions were noted during study period. Interpretation & conclusions: Parentral iron therapy was effective in increasing haemoglobin, serum ferritin and other haematological parameters in pregnant women with moderate anaemia. Intravenous iron sucrose can be used in hospital settings and tertiary urban hospitals where it can replace intramuscular therapy due to injection related side effects. Further, long-term comparative studies are required to recommend its use at peripheral level. Keywords: Anaemia - iron deficiency - iron sucrose complex - parentral iron therapy - serum ferritin
Anemia, uso de hierro prenatal, y riesgos adversos del embarazo: revisión sistemática y meta-análisis Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW; Nutrition Impact Model Study Group (anaemia). Departments of Epidemiology and Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. BMJ. 2013 Jun 21;346:f3443. doi: 10.1136/bmj.f3443. Abstract OBJECTIVES: To summarise evidence on the associations of maternal anaemia and prenatal iron use with maternal haematological and adversepregnancy outcomes; and to evaluate potential exposure-response relations of dose of iron, duration of use, and haemoglobin concentration in prenatal period with pregnancy outcomes..... CONCLUSIONS: Daily prenatal use of iron substantially improved birth weight in a linear dose-response fashion, probably leading to a reduction in risk of low birth weight. An improvement in prenatal mean haemoglobin concentration linearly increased birth weight.
Biomarcadores para el manejo de la eclampsia en embarazadas
Biomarkers for the management of pre-eclampsia in pregnant women. Petla LT, Chikkala R, Ratnakar K S, Kodati V, Sritharan V. Indian J Med Res [serial online] 2013 [cited 2013 Aug 6];138:60-7. Abstract Pre-eclampsia (PE) is a pregnancy related disorder characterized by hypertension and proteinuria noticeable after 20 wk of gestation. It is a leading cause of maternal and foetal mortality and morbidity worldwide. The aetiology of the disease is unknown, but recent studies have revealed that this disorder appears to originate in placenta and is characterized by widespread maternal endothelial dysfunction. Till date, delivery of placenta is the only cure for the disease. So, there is a need for the identification of highly specific and sensitive biochemical markers that would allow early identification of patients at risk and thus help in providing proper prenatal care. Several promising biomarkers have been proposed, alone or in combination, that may help in predicting women who are likely to develop PE. Maternal serum concentrations of these biomarkers either increase or decrease in PE during gestation. This review focuses on the various biomarkers available and their utility in predicting pre-eclampsia. Keywords: Angiogenic factors - biomarkers - NGAL - pre-eclampsia - placenta - proteinuria
Concentraciones plasmáticas maternas de factores angiogénicos/antiangiogénicos son de valor pronóstico en los pacientes en el áera de triage con sospechas de preeclampsia
Maternal plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in patients presenting to the obstetrical triage area with the suspicion of preeclampsia. Chaiworapongsa T, Romero R, Savasan ZA, Kusanovic JP, Ogge G, Soto E, Dong Z, Tarca A, Gaurav B, Hassan SS. Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA. tchaiwor@med.wayne.edu J Matern Fetal Neonatal Med. 2011 Oct;24(10):1187-207. doi: 10.3109/14767058.2011.589932. Epub 2011 Aug 9. Abstract OBJECTIVE: To determine whether maternal plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng), soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and -2 could identify patients at risk for developing preeclampsia (PE) requiring preterm delivery.STUDY DESIGN: Patients presenting with the diagnosis "rule out PE" to the obstetrical triage area of our hospital at <37 weeks of gestation (n = 87) were included in this study. Delivery outcomes were used to classify patients into four groups: I) patients without PE or those with gestational hypertension (GHTN) or chronic hypertension (CHTN) who subsequently developed PE at term (n = 19); II): mild PE who delivered at term (n = 15); III): mild disease (mild PE, GHTN, CHTN) who subsequently developed severe PE requiring preterm delivery (n = 26); and IV): diagnosis of severe PE (n = 27). Plasma concentrations of PlGF, sEng, sVEGFR-1 and -2 were determined at the time of presentation by ELISA. Reference ranges for analytes were constructed by quantile regression in our laboratory (n = 180; 1046 samples). Comparisons among groups were performed using multiples of the median (MoM) and parametric statistics after log transformation. Receiver operating characteristic curves, logistic regression and survival analysis were employed for analysis. RESULTS: The mean MoM plasma concentration of PlGF/sVEGFR-1, PlGF/sEng, PlGF, sVEGFR-1 and -2, and sEng in Group III was significantly different from Group II (all p < 0.05). A plasma concentration of PlGF/sVEGFR-1 ≤ 0.05 MoM or PlGF/sEng ≤0.07 MoM had the highest likelihood ratio of a positive test (8.3, 95% CI 2.8-25 and 8.6, 95% CI 2.9-25, respectively), while that of PlGF ≤0.396 MoM had the lowest likelihood ratio of a negative test (0.08, 95% CI 0.03-0.25). The association between low plasma concentrations of PlGF/sVEGFR-1 (≤0.05 MoM) as well as that of PlGF/sEng (≤0.07 MoM) and the development of severe PE remained significant after adjusting for gestational age at presentation, average systolic and diastolic blood pressure, and a history of chronic hypertension [adjusted odds ratio (OR) = 27 (95% CI 6.4-109) and adjusted OR 30 (95% CI 6.9-126), respectively]. Among patients who presented <34 weeks gestation (n = 59), a plasma concentration of PlGF/sVEGFR-1 < 0.033 MoM identified patients who delivered within 2 weeks because of PE with a sensitivity of 93% (25/27) and a specificity of 78% (25/32). This cut-off was associated with a shorter interval-to-delivery due to PE [hazard ratio = 6 (95% CI 2.5-14.6)]. CONCLUSIONS: Plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in the obstetrical triage area. These observations support the value of these biomarkers in the clinical setting for the identification of the patient at risk for disease progression requiring preterm delivery.
Biblioteca Nacional trabaja para activar depósito legal electrónicoCanalPatrimonio La directora de la Biblioteca Nacional de España (BNE), Ana Santos Aramburo, ha afirmado que uno de sus proyectos es poner en marcha el depósito legal ...Canal Patrimonio Realizarán reformas edilicias en la Biblioteca Ameghino | Luján en ...luen2 Leonardo Boto junto a los miembros de la Asociación Cultural Biblioteca ... las autoridades de laBiblioteca Florentino Ameghino anunciaron que la entidad ...Luján en línea Biblioteca Facultad de Enfermería Universidad de la RepúblicaBiblioteca Facultad de Enfermería Los usuarios que ya tramitaron la Tarjeta de Biblioteca pueden pasar a retirarla en nuestro horario de atención al público. Publicado por Biblioteca Facultad de ...Biblioteca Facultad de Enfermería Universidad de la República Nuevas adquisiciones en la Biblioteca Mediateca: Fondo ...Editor Han llegado a la Biblioteca / Mediateca del CCEN, nuevas publicaciones para el Fondo Bibliográfico de Feminismos. Entre las nuevas adquisiciones ...Centro Cultural de España en Nicaragua Álvaro Sotillo protagoniza exposición en la Biblioteca Los Palos ...Smarys Galvis Álvaro Sotillo protagoniza exposición en la Biblioteca Los Palos Grandes. Posted by: Smarys Galvis Posted date: August 05, 2013 In: Entretenimiento.Twitradio.me Taller gratuito de Camilo Marks en la Biblioteca Nacional | Los DiezKarachay El escritor chileno Camilo Marks realizará un taller gratuito en la Biblioteca Nacional durante todos los martes del mes de agosto, en el que se concentrará en la ...Los Diez
Lanzamiento de Biblioteca CSIC | Patio | Facultad de Arquitectura ... Patio Farq Se difunde el lanzamiento de la Biblioteca CSIC. Se trata de un proyecto que pone a disposición del público en general libros de descarga gratuita financiados ...Patio | Facultad de Arquitectura | UdelaR ESCUELA SECUNDARIA Nº 41 Biblioteca Escolar WIPALA ... Profe En la fotocopiadora de la esquina dejé el práctico del modelo económico de la dictadura militar. Realizar un mapa conceptual con la información proporcionada ...ESCUELA SECUNDARIA Nº 41 Biblioteca Escolar WIPALA
Dexmedetomidina en el embarazo: Revisión de la literatura y posibles usos
Dexmedetomidine in pregnancy: Review of literature and possible use. Nair AS, Sriprakash K. J Obstet Anaesth Crit Care [serial online] 2013 [cited 2013 Jul 1];3:3-6.
Abstract
Dexmedetomidine is a highly selective α-2 agonist, which when used in recommended dose in the form of an infusion, has several desirable properties like sedation, anxiolysis, sympatholysis, analgesia, decreased anesthetic requirements, maintains cardiovascular stability and provides a smooth recovery. Anesthesiologists have used this drug with great reluctance in parturients due to possible uteroplacental transfer, thereby, causing undesirable effects in the baby. However, literature shows that as dexmedetomidine has a high placental extraction, it doesn't ge transferred to the baby. We tried to review the available literature so as to find in what circumstances it has been used in parturients and in future what are the possible indications of its use in labor analgesia, cesarean section, and non-obstetric surgeries. Keywords: Cesarean section, dexmedetomidine, labor analgesia, parturient, uteroplacental transfer http://www.joacc.com/text.asp?2013/3/1/3/114253
Farmacología básica de los opioides: Una actualización
Basic opioid pharmacology: an update Hasan Pathan and John Williams British Journal of Pain 2012 6: 11 Abstract Opioids are a group of analgesic agents commonly used in clinical practice. There are three classical opioid receptors (DOP, KOP and MOP), while the novel NOP receptor is considered to be a non-opioid branch of the opioid receptor family. Opioids can act at these receptors as agonists, antagonists or partial agonists. Opioid agonists bind to G-protein coupled receptors to cause cellular hyperpolarisation. Most clinically relevant opioid analgesics bind to MOP receptors in the central and peripheral nervous system in an agonist manner to elicit analgesia. Opioids may also be classified according to their mode of synthesis into alkaloids, semi-synthetic and synthetic compounds. Keywords: Analgesics, opioid/pharmacology, opioid classification, pharmacokinetics
Opioids and endocrine dysfunction Oliver Seyfried and Joan Hester British Journal of Pain 2012 6: 17 Abstract The endocrine effects of opioids used for the management of persistent pain are poorly understood by clinicians and patients, and hormone levels are rarely measured. It is recognized that opioids exert this effect via the hypothalamic-pituitary-gonadal axis. Additional effects on adrenal hormones, weight, blood pressure and bone density may also occur. Symptoms and signs of sex hormone deficiency occur in both men and women but are under-reported and are often clinically unrecognized. The potential effects of long term opioid therapy on the endocrine system should be explained to patients before opioid therapy is commenced. Monitoring of sex hormones is recommended; if there are deficiencies opioids should be tapered and withdrawn, if this is clinically acceptable. If opioid therapy has to continue, hormone replacement therapy should be initiated and monitored by an endocrinologist. Keywords; Opioids, endocrine, sex hormones, hypogonadism, testosterone, hormone replacement
Por fortuna la hipertermia maligna es una entidad rara durante la anestesia. Sin embargo, cuando esta se presenta se hace necesario establecer el diagnóstico y manejo oportunos para poder rescatar a nuestros pacientes. La poca disponibilidad y el elevado costo del único fármaco útil en esta patología hacen que en la mayoría de los quirófanos el riesgo de muerte persista para los pacientes susceptibles de HM. Se envía información que pueda ser de utilidad al respecto y se hace hincapié en la necesidad de establecer protocolos locales que ayuden a resolver este remoto pero mortal problema. Fortunately, malignant hyperthermia is a rare entity during anesthesia. However, when MH occurs it is necessary to establish diagnosis and prompt appropriate management in order to rescue our patients. The limited availability and high cost of the only drug useful in this pathology yield in most operating rooms to risk patients who are MH susceptible. In the next links you will find information that may be useful in this respect. We do emphasize the need for local protocols to help solve this remote but deadly problem.
Felizmente hipertermia maligna é rara durante a anestesia. No entanto, quando se descobriu que é necessário para estabelecer o diagnóstico e tratamento adequado, a fim de resgatar nossos pacientes. A limitada disponibilidade e alto custo do único medicamento útil nesta patologia fazer na maioria das salas de cirurgia persistindo o risco de morte para pacientes suscetíveis HM. Ele envia a informação que pode ser útil a este respeito e enfatiza a necessidade de protocolos locais para ajudar a resolver este problema remoto, mas mortal. Información sobre hipertermia maligna Links on malignat hyperthermia
