Transplante de hígado/Liver transplant

Octubre 30, 2015. No. 2130Octubre, mes de lucha contra cáncer de mama.

Transplante hepático para enfermedades hepáticas por alcoholismo. Lecciones aprendidas y temas no resueltos Liver transplantation for alcoholic liver disease: Lessons learned and unresolved issues. Ursic-Bedoya J, Faure S, Donnadieu-Rigole H, Pageaux GP. World J Gastroenterol. 2015 Oct 21;21(39):10994-1002. doi: 10.3748/wjg.v21.i39.10994. Abstract The use of liver transplantation (LT) as a treatment for alcoholic liver disease (ALD) has been highly controversial since the beginning. The ever increasing shortage of organs has accentuated the low priority given to patients suffering from ALD, which is considered a "self-inflicted" condition. However, by improving the long-term survival rates, making them similar to those from other indications, and recognizing that alcoholism is a primary disease, ALD has become one of the most common indications for LT in Europe and North America, a situation thought unfathomable thirty years ago. Unfortunately, there are still many issues with the use of this procedure for ALD. There are significant relapse rates, and the consequences of excessive drinking after LT range from asymptomatic biochemical and histological abnormalities to graft failure and death. A minimum three-month period of sobriety is required for an improvement in liver function, thus making LT unnecessary, and to demonstrate the patient's commitment to the project, even though a longer abstinence period does not guarantee lower relapse rates after LT. Recent data have shown that LT is also effective for severe alcoholic hepatitis when the patient is unresponsive to corticosteroids therapy, with low relapse rates in highly selected patients, although these results must be confirmed before LT becomes a standard procedure in this setting. Finally, LT for ALD is accompanied by an increased risk of de novo solid organ cancer, skin cancer, and lymphoproliferative disorders, which has a large impact on the survival rates. KEYWORDS: Alcoholic hepatitis; Alcoholic liver disease; Cirrhosis; Liver transplantation; Relapse; Six-month rule; Sobriety; Solid organ cancer; Survival rates  PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Trauma

Octubre 25, 2015. No. 2125Octubre, mes de lucha contra cáncer de mama.

Operabilidad en trauma Operability in polytrauma. Amaefule KE, Lawal DI. Arch Int Surg 2015;5:131-6 PDF   Neumonía asociada a trauma: tiempo para redefinir la neumonía asociada a la ventilación en pacientes con traumatismos. Trauma-associated pneumonia: time to redefine ventilator-associated pneumonia in trauma patients. Mangram AJ, Sohn J, Zhou N, Hollingworth AK, Ali-Osman FR, Sucher JF, Moyer M, Dzandu JK. Am J Surg. 2015 Sep 18. pii: S0002-9610(15)00480-8. doi: 10.1016/j.amjsurg.2015.06.029. [Epub ahead of print] PDF Trauma de tórax. Una revisión Chest trauma: an overview. Whizar-Lugo V, Sauceda-Gastelum A, Hernández-Armas A, Garzón-Garnica F, Granados-Gómez M. J Anesth Crit Care Open Access 2015;3(1):00082. PDF Derivación y validación de dos instrumentos de decisión para TAC torácica selectiva en trauma contuso: Un estudio multicéntrico observacional prospectivo (NEXUS TAC de tórax). Derivation and Validation of Two Decision Instruments for Selective Chest CT in Blunt Trauma: A Multicenter Prospective Observational Study (NEXUS Chest CT). Rodriguez RM, Langdorf MI, Nishijima D, Baumann BM, Hendey GW, Medak AJ, Raja AS, Allen IE,Mower WR. PLoS Med. 2015 Oct 6;12(10):e1001883. doi: 10.1371/journal.pmed.1001883. eCollection 2015. PDF  Factores de riesgo que afectan el pronóstico de pacientes con contusión pulmonar después de trauma de tórax. Risk Factors Affecting the Prognosis in Patients with Pulmonary Contusion Following Chest Trauma. J Clin Diagn Res. 2015 Aug;9(8):OC17-9. doi: 10.7860/JCDR/2015/13285.6375. Epub 2015 Aug 1Abstract PDF Precisión diagnóstica de la ecografía en la detección de traumatismo abdominal cerrado y la comparación de la ecografía temprana y tardía de 24 horas después del trauma. Diagnostic accuracy of ultrasonography in detection of blunt abdominal trauma and comparison of early and late ultrasonography 24 hours after trauma. Feyzi A, Rad MP, Ahanchi N, Firoozabadi J. Pak J Med Sci. 2015 Jul-Aug;31(4):980-3. doi: 10.12669/pjms.314.6614. PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Libro sobre enfermedades y cirugía hepática / Free book on liver diseases and surgery

Octubre 29, 2015. No. 2129Octubre, mes de lucha contra cáncer de mama.

Avances recientes en enfermedades y cirugía hepática Recent Advances in Liver Diseases and Surgery Edited by Ahmed El-Shaarawy, Tary Salman and Hesham Abdeldayem, ISBN 978-953-51-2193-0, 328 pages, Publisher: InTech, Chapters published October 28, 2015 under CC BY 3.0 license   This book presents the most recent advances in the field of liver diseases and surgery, including the remarkable advances in Hepatitis C therapy, liver tumors, injuries, cysts, resections, transplantation, and preoperative management of patients with liver diseases. The editors are the dean and vice deans of the National Liver Institute, Menoufia University, a dedicated international center of excellence and a leading medical institution in the Middle East for the diagnosis and management of liver diseases and advanced training and research in hepatobiliary sciences. The authors are leading experts from four continents across the globe (North America, Europe, Asia, and Africa). In other words, the book team reflects an international dream team of experts in the area of liver diseases. Libro/Book

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Bloqueo peridural en ortopedia / Epidural block in orthopedics

Octubre 26, 2015. No. 2126Octubre, mes de lucha contra cáncer de mama.

Comparación de fentanil vs meperidina como suplementos de clonidina-bupivacaína en pacientes de cirugía ortopédica de la extremidad inferior con anestesia espinal-peridural combinada Comparison of fentanyl versus meperidine as supplements to epidural clonidine-bupivacaine in patients with lower limb orthopedic surgery under combined spinal epidural anesthesia. Yousef AA, Atef AM, Awais WM. BMC Anesthesiol. 2015 Oct 14;15(1):146. doi: 10.1186/s12871-015-0126-5. CONCLUSION: The combined administration of epidural clonidine and meperidine provided better intraoperative hemodynamics and prolonged postoperative analgesia than epidural clonidine fentanyl combination in patients undergoing lower limb orthopedic surgery. PDF Estudio comparativo sobre la eficacia y seguridad de anestesia peridural-espinal combinada vs. raquia en ancianos de alto riesgo para cirugías alrededor de la cadera A comparative study-efficacy and safety of combined spinal epidural anesthesia versus spinal anesthesia in high-risk geriatric patients for surgeries around the hip joint. Tummala V, Rao LN, Vallury MK, Sanapala A. Anesth Essays Res. 2015 May-Aug;9(2):185-8. doi: 10.4103/0259-1162.153764.  CONCLUSION: CSEA is a safe, effective, reliable technique with better hemodynamic stability along with the provision of prolonging analgesia compared to spinal anesthesia for high-risk geriatric patients undergoing surgeries around the hip joint. PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015