martes, 10 de mayo de 2016

Feliz Día de las Madres/Happy Mother's Day

No.2322                                                                                   Mayo 10, 2016

La decisión que toma la mujer para estudiar medicina y posteriormente tener una triple actividad como madre, esposa y doctora las convierte en supermujeres para cada día de su vida: cuando tiene hijos es la supermamá que vela con amor minuto a minuto por el cuidado de sus hijos en un quehacer de alta demanda que inicia muy temprano cada día. Luego se convierte en superdoctora para cuidar de cada paciente por largas horas de cada día, para después cambiar su papel al de superesposa y atender las múltiples actividades de su supercasa, sin dejar de estudiar temas de Familia y Medicina que son parte de esta rutina de entrega personal muy propia de cada mujer profesionista, en especial de las superdoctoras.
Anestesiología y Medicina del Dolor se complace en FELICITAR a todas esas MAMÁS que hoy celebran su día y les deseamos lo mejor para hoy y cada día de su vida en compañía de su Familia, amigos y compañeros de trabajo. 

Feliz día de las Madres 

 ¿Es seguro para las profesionales de la salud embarazadas manejar los fármacos citotóxicos? Una revisión de la literatura y recomendaciones.
Is it safe for pregnant health-care professionals to handle cytotoxic drugs? A review of the literature and recommendations.
Ecancermedicalscience. 2014 Apr 10;8:418. doi: 10.3332/ecancer.2014.418. eCollection 2014.
The information related to health risks to foetuses due to the handling of chemotherapeutic agents by nurses during pregnancy is limited. The risks involved can be reduced significantly if nurses adhere to standard safety precautions while handling cytotoxic drugs. Nurses in patient areas where chemotherapy is administered are at constant low-level risk of exposure. The authors tried to gather evidence in this article from the recent literature to help to formalise policies for pregnant mothers working in these settings.
KEYWORDS: chemotherapy; health-care professional; nurse; pregnant
Esclerosis multiple y embarazo
Multiple sclerosis and pregnancy: current considerations.
ScientificWorldJournal. 2014;2014:513160. doi: 10.1155/2014/513160. Epub 2014 Apr 7.
Multiple sclerosis is the most common neurological disease of young adults that causes major disability. In Romania, it is estimated that this disease has a prevalence of 35-40 per 100,000 inhabitants. It is a disease that begins at the age of 20-40 years and is 2-3 times more common in women than in men. More than half of patients with MS develop the disease in their fertile period of life; therefore, MS patients use contraceptive methods while being under our treatment. Since several therapeutic options have been implemented with good efficiency in the disease stabilization, increasingly more patients begin to wonder about the possibility of having a child and about the possible risks of pregnancy. The evolution during pregnancy and the lactation period has been favorable, with lower relapses and side effects comparable to those in the general population. In addition, babies born to mothers with MS have not had a significantly different mean gestational age or birth weight compared to babies born to healthy mothers
La cardiomiopatía periparto: Un rompecabezas más cerca de la solución.
Peripartum cardiomyopathy: A puzzle closer to solution.
World J Cardiol. 2014 Mar 26;6(3):87-99. doi: 10.4330/wjc.v6.i3.87.
Peripartum cardiomyopathy (PPCM) represents new heart failure in a previously heart-healthy peripartum patient. It is necessary to rule out all other known causes of heart failure before accepting a diagnosis of PPCM. The modern era for PPCM in the United States and beyond began with the report of the National Institutes of Health PPCM Workshop in 2000, clarifying all then-currently known aspects of the disease. Since then, hundreds of publications have appeared, an indication of how devastating this disease can be to young mothers and their families and the urgent desire to find solutions for its cause and better treatment. The purpose of this review is to highlight the important advances that have brought us nearer to the solution of this puzzle, focusing on what we have learned about PPCM since 2000; and what still remains unanswered. Despite many improvements in outcome, we still do not know the actual triggers that initiate the pathological process; but realize that cardiac angiogenic imbalances resulting from complex pregnancy-related immune system and hormonal changes play a key role.
KEYWORDS: Heart failure; Peripartum cardiomyopathy; Pregnancy
Vasopresores en anestesia obstétrica
Vasopressors in obstetric anesthesia: A current perspective.
World J Clin Cases. 2015 Jan 16;3(1):58-64. doi: 10.12998/wjcc.v3.i1.58.
Vasopressors are routinely used to counteract hypotension after neuraxial anesthesia in Obstetrics. The understanding of the mechanism of hypotension and the choice of vasopressor has evolved over the years to a point where phenylephrine has become the preferred vasopressor. Due to the absence of definitive evidence showing absolute clinical benefit of one over the other, especially in emergency and high-risk Cesarean sections, our choice of phenylephrine over the other vasopressors like mephentermine, metaraminol, and ephedrine is guided by indirect evidence on fetal acid-base status. This review article evaluates the present day evidence on the various vasopressors used in obstetric anesthesia today.
KEYWORDS: Cesarean section; Hypotension; Obstetrics; Spinal anesthesia; Vasopressor agents
Evaluación de la altura del bloqueo para cesárea en las últimas tres décadas: las tendencias de la literatura.
Assessing the height of block for caesarean section over the past three decades: trends from the literature.
Anaesthesia. 2015 Apr;70(4):421-8. doi: 10.1111/anae.12927. Epub 2014 Nov 10.Abstract
There are multiple methods of assessing the height of block before caesarean section under regional anaesthesia, and surveys of practice suggest considerable variation in practice. So far, little emphasis has been placed on the guidance to be gained from published research literature or textbooks. We therefore set out to investigate the methods of block assessment documented in published articles and textbooks over the past 30 years. We performed two searches of PubMed for randomised clinical trials with caesarean section and either spinal anaesthesia or epiduralanaesthesia as major Medical Subject Headings. A total of 284 papers, from 1984 to 2013, were analysed for methods of assessment of sensory and motor block, and the height of block deemed adequate for surgery. We also examined 45 editions of seven anaesthetic textbooks spanning 1950-2014 for recommended methods of assessment and height of block required for caesarean section. Analysis of published papers demonstrated a wide variation in techniques, though there has been a trend towards the increased use of touch, and an increased use of a block height of T5 over the study period. Only 115/284 (40.5%) papers described the method of assessing motor block, with most of those that did (102/115; 88.7%) describing it as the 'Bromage scale', although only five of these (4.9%) matched the original description by Bromage. The required height of block recommended by textbooks has risen over the last 30 years to T4, although only four textbooks made any recommendation about the preferred sensory modality. The variation in methods suggested by surveys of practice is reflected in variation in published trials, and there is little consensus or guidance in anaesthetic textbooks.
VIII Foro Internacional de Medicina del Dolor y Paliativa 
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Junio 9-11, Ciudad de México
Dra. Argelia Lara Solares
Tel. 5513 3782 
Anestesia y Medicina del Dolor
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