sábado, 17 de diciembre de 2016

Costo-Efectividad de la artroplastia total de hombro inverso versus la reparación artroscopica del manguito rotador para las roturas grandes y masivas del manguito rotador

Costo-Efectividad de la artroplastia total de hombro inverso versus la reparación artroscopica del manguito rotador para las roturas grandes y masivas del manguito rotador

Resultados clínicos de la artroscopia de cadera en pacientes de 60 o más años de edad: un mínimo de 2 años de seguimiento

Resultados clínicos de la artroscopia de cadera en pacientes de 60 o más años de edad: un mínimo de 2 años de seguimiento

Manejo prehospitalario de la vía aérea / Prehospital airway management

Diciembre 8,  2016. No. 2532






Avances en el manejo prehospitalario de la vía aérea
Advances in prehospital airway management.
Int J Crit Illn Inj Sci. 2014 Jan;4(1):57-64. doi: 10.4103/2229-5151.128014.
Abstract
Prehospital airway management is a key component of emergency responders and remains an important task of Emergency Medical Service (EMS) systems worldwide. The most advanced airway management techniques involving placement of oropharyngeal airways such as the Laryngeal Mask Airway or endotracheal tube. Endotracheal tube placement success is a common measure of out-of-hospital airway management quality. Regional variation in regard to training, education, and procedural exposure may be the major contributor to the findings in success and patient outcome. In studies demonstrating poor outcomes related to prehospital-attempted endotracheal intubation (ETI), both training and skill level of the provider are usually often low. Research supports a relationship between the number of intubation experiences and ETI success. National standards for certification of emergency medicine provider are in general too low to guarantee good success rate in emergency airway management by paramedics and physicians. Some paramedic training programs require more intense airway training above the national standard and some EMS systems in Europe staff their system with anesthesia providers instead. ETI remains the cornerstone of definitive prehospital airway management, However, ETI is not without risk and outcomes data remains controversial. Many systems may benefit from more input and guidance by the anesthesia department, which have higher volumes of airway management procedures and extensive training and experience not just with training of airway management but also with different airway management techniques and adjuncts.
KEYWORDS: Airway; anesthesiology; emergency; management; prehospital
Manejo prehospitalario de la vía aérea
Prehospital Airway Management
Flavia Petrini, Maurizio Menarini,  and Elena Bigi2
University of Chieti-Pescara
Bologna, Italy
Emergency Medicine - An International Perspective
Neumonía de inicio temprano en paro cardiaco no temprano fuera de hospital con atención especial en el manejo prehospitalario de la vía aérea
Early-Onset Pneumonia in Non-Traumatic Out-of-Hospital Cardiac Arrest Patients with Special Focus on Prehospital Airway Management.
Med Sci Monit. 2016 Jun 13;22:2013-20.
Abstract
BACKGROUND More than half of all non-traumatic out-of-hospital cardiac arrest (OHCA) patients die in the hospital. Early-onset pneumonia (EOP) has been described as one of the most common complications after successful cardiopulmonary resuscitation. However, the expanded use of alternative airway devices (AAD) might influence the incidence of EOP following OHCA. MATERIAL AND METHODS We analyzed data from all OHCA patients admitted to our hospital between 1 January 2008 and 31 December 2014. EOP was defined as proof of the presence of a pathogenic microorganism in samples of respiratory secretions within the first 5 days after hospital admission. RESULTS There were 252 patients admitted: 155 men (61.5%) and 97 women (38.5%), with a mean age of 69.1±13.8 years. Of these, 164 patients (77.6%) were admitted with an endotracheal tube (ET) and 62 (27.4%) with an AAD. We found that 36 out of a total of 80 respiratory secretion samples (45.0%) contained pathogenic microorganisms, with Staphylococcus aureus as the most common bacteria. Neither bacterial detection (p=0.765) nor survival rates (p=0.538) differed between patients admitted with ET and those with AAD. CONCLUSIONS Irrespective of increasing use of AAD, the incidence of EOP remains high.
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
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Anestesiología y Medicina del Dolor

52 664 6848905

Copyright © 2015

Revisión por pares / Peer review

Diciembre 10,  2016. No. 2534





Realizar la revisión científica por pares
Make peer review scientific
 Thirty years on from the first congress on peer review, Drummond Rennie reflects on the improvements brought about by research into the process - and calls for more.
NATURE 7 J U LY 2016 | VOL 535
La carga global de las revistas con revisión por pares en la literatura biomédica: Fuerte desequilibrio en la empresa colectiva
The Global Burden of Journal Peer Review in the Biomedical Literature: Strong Imbalance in the Collective Enterprise.
Kovanis M1,2, Porcher R1,2,3, Ravaud P1,2,3,4,5, Trinquart L1,4.
PLoS One. 2016 Nov 10;11(11):e0166387. doi: 10.1371/journal.pone.0166387. eCollection 2016.
Abstract
The growth in scientific production may threaten the capacity for the scientific community to handle the ever-increasing demand for peer review of scientific publications. There is little evidence regarding the sustainability of the peer-review system and how the scientific community copes with the burden it poses. We used mathematical modeling to estimate the overall quantitative annual demand for peer review and the supply in biomedical research. The modeling was informed by empirical data from various sources in the biomedical domain, including all articles indexed at MEDLINE. We found that for 2015, across a range of scenarios, the supply exceeded by 15% to 249% the demand for reviewers and reviews. However, 20% of the researchers performed 69% to 94% of the reviews. Among researchers actually contributing to peer review, 70% dedicated 1% or less of their research work-time to peer reviewwhile 5% dedicated 13% or more of it. An estimated 63.4 million hours were devoted to peer review in 2015, among which 18.9 million hours were provided by the top 5% contributing reviewers. Our results support that the system is sustainable in terms of volume but emphasizes a considerable imbalance in the distribution of the peer-review effort across the scientific community. Finally, various individual interactions between authors, editors and reviewers may reduce to some extent the number of reviewers who are available to editors at any point.
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
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Anestesiología y Medicina del Dolor

52 664 6848905

Copyright © 2015

Analgesia obstétrica/ Labor analgesia

Diciembre 16,  2016. No. 2540





Actualización en analgesia moderna para trabajo de parto. Revisión de la literatura de los últimos 5 años
Update on modern neuraxial analgesia in labour: a review of the literature of the last 5 years.
Anaesthesia. 2011 Mar;66(3):191-212. doi: 10.1111/j.1365-2044.2010.06616.x.
Abstract
Several strategies and alternative therapies have been used to provide analgesia for labour pain. Over the last few years, a number of improvements have enhanced the efficacy and safety of neuraxial analgesia and ultimately have improved mothers' satisfaction with their birth experience. As labour analgesia is a field of obstetric anaesthesia that is rapidly evolving, this review is an update, from a clinical point of view, of developments over the last 5-7 years. We discuss advantages and controversies related to combined spinal-epidural analgesia, patient controlled epidural analgesia and the integration of computer systems into analgesic modalities. We also review the recent literature on future clinical and research perspectives including ultrasound guided neuraxial block placement, epidural adjuvants and pharmacogenetics. We finally look at the latest work with regards to epidural analgesia and breastfeeding.
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

Copyright © 2015