viernes, 11 de agosto de 2017

Linfohistiociosis Hemogofagocítica

Estimado Ciberpediatra  te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. Continuamos el Programa 2017, el día 16 agosto  las 21hrs (Centro, México DF, Guadalajara Liima Perú) a la Conferencia: “Linfohistiociosis Hemogofagocítica”, por el  “Dr. Euler Chargoy Vivsldo“  Hematólogo Pediátra  de la Cd de Oaxaca”. La sesión inicia puntualmente a las 21 hrs. 
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador 
  
 
2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco 
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia                                                                                                                            
6.- Recomendamos que dejes tu Nombre Completo, Correo electrónico y que participes.
7.- Recientemente te solicita para emtar en la patafoem un add in, que es un parche bajalo de la  siguiente liga:  https://adobe.ly/2r4SSag

Henrys

-- 
Dr. Enrique Mendoza López
Webmaster: CONAPEME
Coordinador Nacional: Seminario Ciberpeds-Conapeme
Av La Clinica 2520-310 col Sertoma
Monterrey N.L. CP 64718
Tel (81) 83482940, (81)81146053
 Cel 0448183094806

Fracturas de tibia en niños


Fractures Of the Tibia in Children
Fuente
Este artículo y/o video es originalmente publicado en:
De y todos los derechos reservados para:
Courtesy: Kaye Wilkins MD, Lynn Staheli MD www.global-help.orgPublicado el 9 ago. 2017
By Dr. Kaye Wilkins. A talk about the fractures that may occur in the proximal metaphysis and shaft of the tibia. For more information and videos, please visit http://global-help.org and http://www.pedorthoacademy.org.
  • Categoría
  • Licencia

Bloqueo axilar del plexo braquial / Axillary brachial plexus block

Agosto 11, 2017. No. 2777



  


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La importancia de la posición de la extremidad superior para un bloqueo axilar seguro y efectivo. Estudio comparativo
Importance of the Upper Extremity Position for a Safe and Effective Axillary Block: a Comparative Study.
Turk J Anaesthesiol Reanim. 2017 Jun;45(3):164-168. doi: 10.5152/TJAR.2017.33349. Epub 2017 Feb 1.
Abstract
OBJECTIVE: Our aim was to determine the ideal position of upper extremities during ultrasonography guidance for axillary block. The position that provides the shortest distance between the median and musculocutaneous nerves was assumed to be the most appropriate position for axillary block. METHODS: In this cross-sectional study, 120 (45 female and 75 male) patients were placed in a position with a shoulder at 90° / elbow 90° (position 1) and a shoulder 90° / elbow 0° (position 2). The intersection point of the biceps brachii muscle with the lower border of the pectoralis major muscle is defined as the proximal level (P). Distal level (D) is reffered as 5 cm below the proximal level. In the positions described above, the distance between median and musculocutaneous nerves was measured proximal (positions 1P and 2P) and distal levels (positions 1D and 2D). It was investigated whether these measurements differed between the groups and whether the body mass index or the gender. RESULTS: The shortest mean distance (10.24±3.95 mm) between the two nerves was determined when the shoulder position 90°/elbow position 0° at the distal level (1D) and the longest mean distance (13.41±4.26 mm) was determined when shoulder position 90°/elbow position 90° at the proximal level (2P). In all four cases, there was no difference in the results between men and women. There was no relationship between the measurement results and the body mass indexes and age of the patients. CONCLUSION: Appropriate positioning of the upper extremities is important for achieving optimal position during axillary block. Thereby, the procedure can be safely and effectively performed with lesser amounts of local anaesthetic solution and a decreased number of manoeuvres with needle during infiltration.
KEYWORDS: Axillary block; median nerve; musculocutaneous nerve; ultrasound guidance
Influencia de la posición del brazo en la visibilidad ultrasónica del plexo braquial axilar.
Influence of arm position on ultrasound visibility of the axillary brachial plexus.
Eur J Anaesthesiol. 2015 Nov;32(11):771-80. doi: 10.1097/EJA.0000000000000293.
Abstract
BACKGROUND: Contemporary axillary brachial plexus block is performed by separate injections targeting radial, median, ulnar and musculocutaneous nerve. These nerves are arranged around the axillary artery, making ultrasound visualisation sometimes challenging. In particular, the radial nerve can be difficult to localise deep to the artery. CONCLUSION: The visibility of the radial nerve was not improved by varying positions of the arm. S180°/E0° provided the best overall visibility and accessibility of nerves.

XIV Congreso Virtual Mexicano de Anestesiología 2017
Octubre 1-Diciembre 31, 2017
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California Society of Anesthesiologists
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Anestesiología y Medicina del Dolor

52 664 6848905

martes, 8 de agosto de 2017

Dolor / Pain

Agosto 1, 2017. No. 2767



  


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Formación reticular y dolor: El pasado y el futuro.
Reticular Formation and Pain: The Past and the Future.
Martins I1,2,3,4, Tavares I1,2,3,4.
Front Neuroanat. 2017 Jul 5;11:51. doi: 10.3389/fnana.2017.00051. eCollection 2017.
Abstract
The involvement of the reticular formation (RF) in the transmission and modulation of nociceptive information has been extensively studied. The brainstem RF contains several areas which are targeted by spinal cord afferents conveying nociceptive input. The arrival of nociceptive input to the RF may trigger alert reactions which generate a protective/defense reaction to pain. RF neurons located at the medulla oblongata and targeted by ascending nociceptive information are also involved in the control of vital functions that can be affected by pain, namely cardiovascular control. The RF contains centers that belong to the pain modulatory system, namely areas involved in bidirectional balance (decrease or enhancement) of pain responses. It is currently accepted that the imbalance of pain modulation towards pain facilitation accounts for chronic pain. The medullary RF has the peculiarity of harboring areas involved in bidirectional pain control namely by the existence of specific neuronal populations involved in antinociceptive or pronociceptive behavioral responses, namely at the rostroventromedial medulla (RVM) and the caudal ventrolateral medulla (VLM). Furthermore the dorsal reticular nucleus (also known as subnucleus reticularis dorsalis; DRt) may enhance nociceptive responses, through a reverberative circuit established with spinal lamina I neurons and inhibit wide-dynamic range (WDR) neurons of the deep dorsal horn. The components of the triad RVM-VLM-DRt are reciprocally connected and represent a key gateway for top-down pain modulation. The RVM-VLM-DRt triad also represents the neurobiological substrate for the emotional and cognitive modulation of pain, through pathways that involve the periaqueductal gray (PAG)-RVM connection. Collectively, we propose that the RVM-VLM-DRt triad represents a key component of the "dynamic pain connectome" with special features to provide integrated and rapid responses in situations which are life-threatening and involve pain. The new available techniques in neurobiological studies both in animal and human studies are producing new and fascinating data which allow to understand the complex role of the RF in pain modulation and its integration with several body functions and also how the RF accounts for chronic pain.
KEYWORDS: analgesics; cognition; connectome; emotions; noradrenaline; opioids; serotonin

Avances recientes en la comprensión y manejo del dolor por cáncer.
Recent advances in understanding and managing cancer pain.
F1000Res. 2017 Jun 20;6:945. doi: 10.12688/f1000research.10817.1. eCollection 2017.Abstract
Cancer pain remains a significant clinical problem worldwide. Causes of cancer pain are multifactorial and complex and are likely to vary with an array of tumor-related and host-related factors and processes. Pathophysiology is poorly understood; however, new laboratory research points to cross-talk between cancer cells and host's immune and neural systems as an important potential mechanism that may be broadly relevant to many cancer pain syndromes. Opioids remain the most effective pharmaceuticals used in the treatment of cancer pain. However, their role has been evolving due to emerging awareness of risks of chronic opioid therapy. Despite extensive research efforts, no new class of analgesics has been developed. However, many potential therapeutic targets that may lead to the establishment of new pharmaceuticals have been identified in recent years. It is also expected that the role of non-pharmacological modalities of treatment will grow in prominence. Specifically, neuromodulation, a rapidly expanding field, may play a major role in the treatment of neuropathic cancer pain provided that further technological progress permits the development of non-invasive and inexpensive neuromodulation techniques.
KEYWORDS: biology of cancer pain; cancer pain; cancer-induced bone pain; cannabis; chemotherapy-induced peripheral neuropathy; intrathecal analgesia; medical marijuana; neuromodulation; opioids; scrambler therapy; spinal cord stimulation
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El Comité Ejecutivo de la IASP insta a Venezuela a centrarse en el acceso a medicamentos para el dolor a la luz de escasez crítica
IASP Executive Committee Urges Venezuela to Focus on Access to Pain Medications in Light of Critical Shortages
As the leading global organization that brings together scientists, clinicians, health-care providers, and policymakers to stimulate and support the study of pain with the goal of improved pain relief worldwide, the International Association for the Study of Pain (IASP) has been made aware that difficult conditions in Venezuela have resulted in inadequate access to pain treatment.

XIV Congreso Virtual Mexicano de Anestesiología 2017
Octubre 1-Diciembre 31, 2017
Información / Information
California Society of Anesthesiologists
Reuniones / Events
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