viernes, 13 de enero de 2017

Revisión de estudios recientes sobre la reconstrucción de las extremidades superiores para condiciones degenerativas del codo, fracturas, inestabilidad y síndrome del túnel cubital.

¿Debería retrasarse el retorno al deporte hasta 2 años después de la reconstrucción del ligamento cruzado anterior? Consideraciones biológicas y funcionales

¿Debería retrasarse el retorno al deporte hasta 2 años después de la reconstrucción del ligamento cruzado anterior? Consideraciones biológicas y funcionales

http://www.lesionesdeportivas.com.mx/academia/deberia-retrasarse-el-retorno-al-deporte-hasta-2-anos-despues-de-la-reconstruccion-del-ligamento-cruzado-anterior-consideraciones-biologicas-y-funcionales/

¿Debería retrasarse el retorno al deporte hasta 2 años después de la reconstrucción del ligamento cruzado anterior? Consideraciones biológicas y funcionales

Categorías:

academia, Lesiones deportivas

(Editar Entrada)

Por admin

Should Return to Sport be Delayed Until 2 Years After Anterior Cruciate Ligament Reconstruction? Biological and Functional Considerations

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27402457

http://link.springer.com/article/10.1007%2Fs40279-016-0584-z

De:

Nagelli CV^1,^2,^3,⁴, Hewett TE^5,^6,^7,^8,⁹.

Todos los derechos reservados para:

© 2017 Springer International Publishing AG. Part of Springer Nature.

Abstract

Anterior cruciate ligament (ACL) tears are common knee injuries sustained by athletes during sports participation. A devastating complication of returning to sport following ACL reconstruction (ACLR) is a second ACL injury. Strong evidence now indicates that younger, more active athletes are at particularly high risk for a second ACL injury, and this risk is greatest within the first 2 years following ACLR. Nearly one-third of the younger cohort that resumes sports participation will sustain a second ACL injury within the first 2 years after ACLR. The evidence indicates that the risk of second injury may abate over this time period. The incidence rate of second injuries in the first year after ACLR is significantly greater than the rate in the second year. The lower relative risk in the second year may be related to athletes achieving baseline joint health and function well after the current expected timeline (6-12 months) to be released to unrestricted activity. This highlights a considerable debate in the return to sport decision process as to whether an athlete should wait until 2 years after ACLR to return to unrestricted sports activity. In this review, we present evidence in the literature that athletes achieve baseline joint health and function approximately 2 years after ACLR. We postulate that delay in returning to sports for nearly 2 years will significantly reduce the incidence of second ACL injuries.

Resumen

Las rupturas del ligamento cruzado anterior (LCA) son lesiones comunes de rodilla sostenidas por atletas durante la participación deportiva. Una complicación devastadora de regresar al deporte después de la reconstrucción del LCA (ACLR) es una segunda lesión del LCA. Una evidencia fuerte indica que los atletas más jóvenes y activos tienen un riesgo particularmente alto de sufrir una segunda lesión del LCA, y este riesgo es mayor en los primeros 2 años después de la ACLR. Casi un tercio de la cohorte más joven que reanuda la participación deportiva sufrirá una segunda lesión del LCA dentro de los primeros 2 años después de la ACLR. La evidencia indica que el riesgo de una segunda lesión puede disminuir durante este período de tiempo. La tasa de incidencia de las segundas lesiones en el primer año después de ACLR es significativamente mayor que la tasa en el segundo año. El menor riesgo relativo en el segundo año puede estar relacionado con que los atletas alcancen la salud de las articulaciones de base y funcionen bien después de que el plazo esperado actual (6-12 meses) sea liberado a la actividad sin restricciones. Esto pone de relieve un debate considerable en el proceso de decisión de retorno al deporte, en cuanto a si un atleta debe esperar hasta 2 años después de ACLR para volver a la actividad deportiva sin restricciones. En esta revisión, presentamos evidencia en la literatura de que los atletas logran la salud y la función articular basales aproximadamente 2 años después de la ACLR. Se postula que el retraso en el regreso a los deportes durante casi 2 años reducirá significativamente la incidencia de las lesiones del segundo ACL.

PMID: 27402457 DOI: 10.1007/s40279-016-0584-z

[PubMed – as supplied by publisher]

Mientras que #backpain bajo es a menudo una fuente de #stress, el estrés también puede estar provocando su dolor de espalda

Mientras que #backpain bajo es a menudo una fuente de #stress, el estrés también puede estar provocando su dolor de espalda

http://www.ortopediaycolumna.com.mx/columna/mientras-que-backpain-bajo-es-a-menudo-una-fuente-de-stress-el-estres-tambien-puede-estar-provocando-su-dolor-de-espalda/

While lower #backpain is often a source of #stress, stress may also be provoking your lower back pain https://t.co/ACrl0CUh09 pic.twitter.com/xmdj1HKtIt

— The Osteo (@the_osteo)
13 de enero de 2017

Revisión totalmente artroscópica del Procedimiento de Eden-Hybinette para la Cirugía de inestabilidad fallida : una buena técnica

Revisión totalmente artroscópica del Procedimiento de Eden-Hybinette para la Cirugía de inestabilidad fallida : una buena técnica

mihombroycodo.com.mx

Revisión totalmente artroscópica del Procedimiento de Eden-Hybinette para la Cirugía de inestabilidad fallida : una buena técnica

All-Arthroscopic Revision Eden-Hybinette Procedure for Failed Instability Surgery: Technique and Preliminary Results Fuente Este artículo es originalmente publicado en: …

http://www.mihombroycodo.com.mx/congresos/revision-totalmente-artroscopica-del-procedimiento-de-eden-hybinette-para-la-cirugia-de-inestabilidad-fallida-una-buena-tecnica/

All-Arthroscopic Revision Eden-Hybinette Procedure for Failed Instability Surgery: Technique and Preliminary Results

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/labs/articles/27432589/

https://www.ncbi.nlm.nih.gov/pubmed/?term=All-Arthroscopic+Revision+Eden-Hybinette+Procedure+for+Failed+Instability+Surgery%3A+Technique+and+Preliminary+Results

http://www.arthroscopyjournal.org/article/S0749-8063(16)30255-9/abstract

De:

Giannakos A1, Vezeridis PS2, Schwartz DG2, Jany R2, Lafosse L2.

Todos los derechos reservados para:

Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Abstract

PURPOSE:

To describe the technique of an all-arthroscopic Eden-Hybinette procedure in the revision setting for treatment of a failed instability procedure, particularly after failed Latarjet, as well as to present preliminary results of this technique.

CONCLUSIONS:

An all-arthroscopic Eden-Hybinette procedure in the revision setting for failed instability surgery, although technically demanding, is a safe, effective, and reproducible technique. Although the learning curve is considerable, this procedure offers all the advantages of arthroscopic surgery and allows reconstruction of glenoid defects and restoration of shoulder stability in this challenging patient population. In our hands, this procedure yields good or excellent results in 67% of patients. Successful outcome is correlated with bony healing of the iliac crest graft to the glenoid.

Resumen

PROPÓSITO:

Describir la técnica de un procedimiento todo-artroscópico de Eden-Hybinette en el ajuste de revisión para el tratamiento de un procedimiento de inestabilidad fallido, particularmente después de un fallido Latarjet, así como presentar los resultados preliminares de esta técnica.

CONCLUSIONES:

Un procedimiento todo-artroscópico de Eden-Hybinette en el ajuste de revisión para la cirugía de inestabilidad fallida, aunque técnicamente exigente, es una técnica segura, eficaz y reproducible. Aunque la curva de aprendizaje es considerable, este procedimiento ofrece todas las ventajas de la cirugía artroscópica y permite la reconstrucción de los defectos glenoides y la restauración de la estabilidad del hombro en esta población de pacientes desafiantes. En nuestras manos, este procedimiento produce buenos o excelentes resultados en el 67% de los pacientes. El resultado exitoso se correlaciona con la curación ósea del injerto de cresta ilíaca con el glenoide.

LEVEL OF EVIDENCE:

Level IV, therapeutic case series.

Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

PMID: 27432589 DOI:

10.1016/j.arthro.2016.05.021

[PubMed – in process]

Fuente: mihombroycodo.com.mx

#artroscopia #cirugia de inestabilidad fallida #cresta ilíaca #Eden-Hybinette #glenoide

Seguridad del paciente / Patient safety

Enero 9, 2017. No. 2564

Seguridad de los pacientes ambulatorios

Patient Safety in Ambulatory Settings

Editors

Shekelle PG, Sarkar U, Shojania K, Wachter RM, McDonald K, Motala A, Smith P, Zipperer L, Shanman R.

Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Oct. Report No.: 16(17)-EHC033-EF.
BACKGROUND: Even though most medical care occurs in ambulatory settings, the patient safety movement originated in, and has been mainly focused on, adverse events in hospitalized patients. However, it is increasingly clear that the ambulatory setting is critically important. Ambulatory care differs substantially from inpatient care in ways that affect patient safety hazards and interventions. To better understand the scope of ambulatory care safety issues and the types of evaluations that have been reported for ambulatory patient safety practice (PSP), we have been tasked by AHRQ to provide an overview of key issues relating to the interventions. PURPOSE: This Technical Brief had the following guiding questions: What are the evidence-based hospital patient safety practices that may be applicable to the ambulatory care setting? What are the ambulatory care patient safety practices that have been studied in the literature? Which ones have not been broadly implemented or studied beyond a single ambulatory care center? What tools, settings, and other factors (such as implementation of Patient-Centered Medical Home and team-based care) may influence the implementation and spread of ambulatory care patient safety practices? METHODS: We integrated insights from discussions with eight Key Informants (KIs) with a literature scan of 28 safety topics/strategies. FINDINGS: KIs identified medication safety, diagnosis, transitions, referrals, and testing as important ambulatory care safety topics, and strategies that addressed communications, health IT, teams, patient engagement, organizational approaches, and safety culture as the most important strategies. The literature search found a moderate number of published intervention evaluations for e-prescribing, medication errors and adverse events, pharmacist-based interventions, and transitions from hospital to ambulatory care. There were few published evaluations of interventions for other targets/strategies. These results will assist AHRQ in developing a research agenda in ambulatory patient safety. SUMMARY AND IMPLICATIONS: Both key informant interviews and the literature scan reveal important differences between inpatient and ambulatory safety. There are significant gaps in ambulatory safety research, including a notable lack of studies on patient engagement and timely and accurate diagnosis. Key informants recommend prospective, large-scale studies in diverse ambulatory settings to develop and test ambulatory safety interventions.

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Sistemas de informe de incidentes: estudio comparativo de dos hospitales

Incident reporting systems: a comparative study of two hospital divisions.

Hewitt T1, Chreim S2, Forster A3.

Arch Public Health. 2016 Aug 15;74:34. doi: 10.1186/s13690-016-0146-8. eCollection 2016.

Abstract

BACKGROUND: Previous studies of incident reporting in health care organizations have largely focused on single cases, and have usually attended to earlier stages of reporting. This is a comparative case study of two hospital divisions' use of an incident reporting system, and considers the different stages in the process and the factors that help shape the process. METHOD: The data was comprised of 85 semi-structured interviews of health care practitioners in general internal medicine, obstetrics and neonatology; thematic analysis of the transcribed interviews was undertaken. Inductive and deductive themes are reported. This work is part of a larger qualitative study found elsewhere in the literature. RESULTS: The findings showed that there were major differences between the two divisions in terms of: a) what comprised a typical report (outcome based vs communication and near-miss based); b) how the reports were investigated (individual manager vs interdisciplinary team); c) learning from reporting (interventions having ambiguous linkages to the reporting system vs interventions having clear linkages to reported incidents); and d) feedback (limited feedback vs multiple feedback). CONCLUSIONS: The differences between the two divisions can be explained in terms of: a) the influence of litigation on practice, b) the availability or lack of interprofessional training, and c) the introduction of the reporting system (top-down vs bottom-up approach). A model based on the findings portraying the influences on incident reporting and learning is provided. Implications for practice are addressed.

KEYWORDS: Internal medicine; Medical errors; Neonatology; Obstetrics; Patient safety; Qualitative research

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Mejorando los informes sobre eventos de seguridad entre residentes y profesores

Improving Patient Safety Event Reporting Among Residents and Teaching Faculty.

Louis MY1, Hussain LR2, Dhanraj DN1, Khan BS1, Jung SR1, Quiles WR1, Stephens LA1, Broering MJ1, Schrand KV1, Klarquist LJ1.

Ochsner J. 2016 Spring;16(1):73-80Abstract

BACKGROUND:

A June 2012 site visit report from the Accreditation Council for Graduate Medical Education Clinical Learning Environment Review revealed that residents and physicians at TriHealth, Inc., a large, nonprofit independent academic medical center serving the Greater Cincinnati area in Ohio, had an opportunity to improve their awareness and understanding of the hospital's system for reporting patient safety concerns in 3 areas: (1) what constitutes a reportable patient safety event, (2) who is responsible for reporting, and (3) how to use the hospital's current reporting system. METHODS: To improve the culture of patient safety, we designed a quality improvement project with the goal to increase patient safety event reporting among residents and teaching faculty. An anonymous questionnaire assessed physicians' and residents' attitudes and experience regarding patient safety event reporting. An educational intervention was provided in each graduate medical education program to improve knowledge and skills related to patient safety event reporting, and the anonymous questionnaire was distributed after the intervention. We compared the responses to the preintervention and postintervention questionnaires and tracked monthly patient safety event reports for 1 year postintervention. RESULTS: The number of patient safety event reports increased following the educational intervention; however, we saw wide variability in reporting per month. On the postintervention questionnaire, participants demonstrated improved knowledge and attitudes toward patient safety event reporting. CONCLUSION: The goal of this unique project was to increase patient safety event reporting by both residents and teaching faculty in 6 residency programs through education. We achieved this goal through an educational intervention tailored to the institution's new event reporting system delivered to each residency program. We clearly understand that improvements in quality and patient safety require ongoing effort. The keys to ongoing sustainability include (1) developing patient safety faculty and resident experts in each training program to teach patient safety and to be role models, (2) working toward decreasing the barriers to reporting, and (3) providing timely feedback and system changes.

KEYWORDS: Education-graduate-medical; hospital incident reporting; medical errors; patient safety; quality improvement; risk management

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5to Curso Internacional de Anestesiología cardiotorácica, vascular, ecocardiografía y circulación extracorpórea. SMACT

Mayo 4-6, 2017, Mexicali, México

Informes Dr. Hugo Martínez Espinoza bajamed@hotmail.com

Regional Anesthesiology and Acute Pain Medicine Meeting

April 6-8, 2017, San Francisco, California, USA

ASRA American Society of Regional Anesthesia and Pain Medicine

Información / Information

California Society of Anesthesiologists

Annual Meeting April 27-30, 2017

San Francisco California