viernes, 17 de febrero de 2017

Control de daños en ortopedia


Damage Control Orthopaedics

Fuente
Este artículo es originalmente publicado en:
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SICOT ICL organised by Dr Hitesh Gopalan
by Prof N Rajagopalan
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Inestabilidad del Antebrazo: Anatomía, Biomecánica y Opciones de Tratamiento


Forearm Instability: Anatomy, Biomechanics, and Treatment Options

Fuente
Este artículo es originalmente publicado en:
De:
J Hand Surg Am. 2017 Jan;42(1):47-52. doi: 10.1016/j.jhsa.2016.10.017.
Todos los derechos reservados para:
Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Abstract
The forearm unit consists of the radius and ulna, a complex and interrelated set of joints (distal radioulnar joint, proximal radioulnar joint) and the soft tissue stabilizers between the 3 bones. Distally, this is represented by the triangular fibrocartilage complex at the wrist, proximally by the annular ligament at the elbow, and in the forearm by the interosseous membrane. Disruptions in any of these structures may lead to forearm instability, with consequences at each of the remaining structures.
Resumen
La unidad del antebrazo consiste en el radio y el cúbito, un conjunto complejo e interrelacionado de articulaciones (articulación radioulnar distal, articulación radioulnar proximal) y los estabilizadores de tejido blando entre los 3 huesos. Distalmente, esto está representado por el complejo triangular fibrocartílago en la muñeca, proximalmente por el ligamento anular en el codo y en el antebrazo por la membrana interósea. Las interrupciones en cualquiera de estas estructuras pueden conducir a inestabilidad del antebrazo, con consecuencias en cada una de las estructuras restantes.
Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
Essex Lopresti; Forearm instability; Galeazzi fracture; Monteggia fracture
PMID: 28052828   DOI:  
[PubMed – in process]

Conceptos sobre columna, conducto lumbar estrecho


Spine Concepts , Lumbar Spinal Stenosis
Fuente
Este artículo es originalmente publicado en:
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Courtesy: Nabil Ebraheim, University of Toledo, Ohio, USAPublicado el 16 feb. 2017
Dr. Ebraheim animated video illustrates spine concepts associated wilumbar spinal stenosis.
Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund:
https://www.utfoundation.org/foundati…
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Una comparación de las lesiones en jugadores de élite masculinos y femeninos: un estudio prospectivo de 5 temporadas


A comparison of injuries in elite male and female football players: A 5-Season prospective study

Fuente
Este artículo es originalmente publicado en:
De:
2017 Feb 16. doi: 10.1111/sms.12860. [Epub ahead of print]
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This article is protected by copyright. All rights reservedCopyright © 1999 – 2017
All Rights ReservedAbstract
The aim was to compare the epidemiology of injuries between elite male and female football players from the same club. Injuries and individual exposure time in a male team and a female team, both playing in the Spanish first division, were prospectively recorded by the club’s medical staff for five seasons (2010-2015) following the FIFA consensus statement. Total, training and match exposure hours per player-season were 20% higher for men compared to women (P < 0.01). Total, training and match injury incidence were 30-40% higher in men (P ≤ 0.04) mainly due to a 4.82 [95% confidence interval (CI) 2.30-10.08] times higher incidence of contusions, as there were no differences in the incidence of muscle and joint/ligament injuries (P ≥ 0.44). The total number of absence days was 21% larger in women owing to a 5.36 (95% CI 1.11-25.79) times higher incidence of severe knee and ankle ligament injuries. Hamstring strains and pubalgia cases were 1.93 (95% CI 1.16-3.20) and 11.10 (95% CI 1.48-83.44) times more frequent in men, respectively; whereas quadriceps strains, anterior cruciate ligament ruptures and ankle syndesmosis injuries were 2.25 (95% CI 1.22-4.17), 4.59 (95% CI 0.93-22.76) and 5.36 (95% CI 1.11-25.79) times more common in women, respectively. In conclusion, prevention strategies should be tailored to the needs of male and female football players, with men more predisposed to hamstring strains and hip/groin injuries, and women to quadriceps strains and severe knee and ankle ligament injuries.
This article is protected by copyright. All rights reserved.
Resumen
El objetivo era comparar la epidemiología de las lesiones entre los jugadores de elite masculinos y femeninos del mismo club. Las lesiones y el tiempo de exposición individual en un equipo masculino y un equipo femenino, ambos jugando en la primera división española, fueron registrados prospectivamente por el personal médico del club durante cinco temporadas (2010-2015) después de la declaración de consenso de la FIFA. Las horas de exposición totales, de entrenamiento y de coincidencia por jugador-temporada fueron 20% más altas para los hombres que para las mujeres (P <0.01). La incidencia total de lesiones por entrenamiento y por complicaciones fue 30-40% mayor en los hombres (P ≤ 0.04) debido principalmente a una incidencia de contusiones de 4.82 [intervalo de confianza del 95% (IC) 2.30-10.08], ya que no hubo diferencias en el Incidencia de lesiones musculares y de articulaciones / ligamentos (P ≥ 0,44). El número total de días de ausencia fue 21% mayor en las mujeres debido a una incidencia de 5,36 (IC 95%: 1,11-25,79) veces mayor de lesiones severas en los ligamentos de rodilla y tobillo. Las lesiones isquiotibiales y los casos de pubalgia fueron 1,93 (IC 95% 1,16-3,20) y 11,10 (IC 95%: 1,48-83,44) veces más frecuentes en hombres, respectivamente; Mientras que las cepas del cuádriceps, las rupturas del ligamento cruzado anterior y las lesiones de syndesmosis del tobillo fueron 2,25 (IC del 95%: 1,22-4,17), 4,59 (IC del 95%: 0,93-22,76) y 5,36 (IC del 95%: 1,11-25,79). En conclusión, las estrategias de prevención deben adaptarse a las necesidades de los jugadores de fútbol masculino y femenino, con los hombres más predispuestos a lesiones de la corva y de la cadera / de la ingle, ya las mujeres a las cepas del cuádriceps ya las lesiones graves del ligamento de rodilla y tobillo.
Este artículo está protegido por derechos de autor. Todos los derechos reservados.
This article is protected by copyright. All rights reserved.
KEYWORDS:
man ; sex ; soccer ; woman
PMID: 28207979  DOI:
[PubMed – as supplied by publisher]

Pulmón, fumar y anestesia / Lung, smoking and anesthesia

Febrero 14 2017. No. 2600






Valoración preoperatoria de pacientes con enfermedades pulmonares programados para cirugía no cardiotorácica
Perioperative Evaluation of Patients with Pulmonary Conditions Undergoing Non-Cardiothoracic Surgery.
Health Serv Insights. 2016 Nov 9;9(Suppl 1):9-23. eCollection 2016.
Abstract
This review describes the perioperative management of patients with suspected or established pulmonary conditions undergoing non-cardiothoracic surgery, with a focus on common pulmonary conditions such as obstructive airway disease, pulmonary hypertension, obstructive sleep apnea, and chronic hypoxic respiratory conditions. Considering that postoperative pulmonary complications are common and given the increasing number of surgical procedures and the size of the aging population, familiarity with current guidelines for preoperative risk assessment and intra- and postoperative patient management is recommended to decrease the morbidity and mortality. In particular, smoking cessation and pulmonary rehabilitation are perioperative strategies for improving patients' short- and long-term outcomes. Understanding the potential risk for pulmonary complications allows the medical team to appropriately plan the intra- and postoperative care of each patient.
KEYWORDS: chronic obstructive pulmonary disease; intraoperative care; obstructive sleep apnea; postoperative complications; pulmonary; pulmonary hypertension
Efectos de fumar y dejar de fumar sobre la cirugía de columna. Revisión sistemática de la literatura
The Effects of Smoking and Smoking Cessation on Spine Surgery: A Systematic Review of the Literature.
Global Spine J. 2016 Nov;6(7):695-701. Epub 2016 Jan 15.
Tabaquismo y Efecto de la Dexmedetomidina y del Fentanil en la Intubación Traqueal
Kemal Gulsoy 1, Serpil Deren 1, Semih Baskan 1, Dilsen Ornek 1, Bayazit Dikmen
Rev Bras Anestesiol 2012; 62: 2: 141-153

Cese del tabaquismo preoperatorio a corto plazo y complicaciones postoperatorias: revisión sistemática y meta-análisis
Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis.
Can J Anaesth. 2012 Mar;59(3):268-79. doi: 10.1007/s12630-011-9652-x. Epub 2011 Dec 21.
Abstract
PURPOSE: The literature was reviewed to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications and to derive the minimum duration of preoperative abstinence from smoking required to reduce such complications in adult surgical patients. SOURCE: We searched MEDLINE, EMBASE, Cochrane, and other relevant databases for cohort studies and randomized controlled trials that reported postoperative complications (i.e., respiratory, cardiovascular, wound-healing) and mortality in patients who quit smoking within six months of surgery. Using a random effects model, meta-analyses were conducted to compare the relative risks of complications in ex-smokers with varying intervals of smoking cessation vs the risks in current smokers. PRINCIPAL FINDINGS: We included 25 studies. Compared with current smokers, the risk of respiratory complications was similar in smokers who quit less than two or two to four weeks before surgery (risk ratio [RR] 1.20; 95% confidence interval [CI] 0.96 to 1.50 vs RR 1.14; CI 0.90 to 1.45, respectively). Smokers who quit more than four and more than eight weeks before surgery had lower risks of respiratory complications than current smokers (RR 0.77; 95% CI 0.61 to 0.96 and RR 0.53; 95% CI 0.37 to 0.76, respectively). For wound-healing complications, the risk was less in smokers who quit more than three to four weeks before surgery than in current smokers (RR 0.69; 95% CI 0.56 to 0.84). Few studies reported cardiovascular complications and there were few deaths.
CONCLUSION: At least four weeks of abstinence from smoking reduces respiratory complications, and abstinence of at least three to four weeks reduces wound-healing complications. Short-term (less than four weeks) smoking cessation does not appear to increase or reduce the risk of postoperative respiratory complications.
5to curso internacional Anestesiologia cardiotoracica_ vascular_ ecocardiografia y circulaci_n extracorporea.


Curso sobre Anestesia en Trasplantes, Cirugía abdominal, Plástica, Oftalmología y Otorrinolaringología.
Committee for European Education in Anaesthesiology (CEEA) 
y el Colegio de Anestesiólogos de León A.C.
Abril 7-9, 2017, León Guanajuato, México

Informes  (477) 716 06 16, kikinhedz@gmail.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
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