viernes, 9 de marzo de 2018

¿Por qué una persona debe obtener una prótesis reversa en lugar de un reemplazo estándar del hombro?



 Fuente
Este artículo es publicado originalmente en:

https://www.hopkinsmedicine.org/orthopaedic-surgery/specialty-areas/shoulder/treatments-procedures/reverse-prosthesis.html#why-get


De y todos los derechos reservados para:

 © The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. All rights reserved.

jueves, 8 de marzo de 2018

LA BUENA SALUD DEL HOMBRO

http://www.lesionesdeportivas.com.mx/academia/la-buena-salud-del-hombro/

Dr. Michell Ruiz – Traumatólogo Alta especialidad en Hombro, Codo y Rodilla


🔵 LA BUENA SALUD DEL HOMBRO


Aprender cómo cuidar el hombro para evitar ejercer tensión adicional es indispensable si se tienen molestias en la zona causadas por alguna lesión o mala posición …. e incluso para evitarlas.
Algunas sugerencias para cuidar bien del hombro incluyen:
✔️ Al dormir, acostarse boca arriba o cambiar alternativamente de lado de hombro cada noche.
✔️ Al sentarse, hay que adoptar una buena postura. Mantener la cabeza por encima del hombro y colocar una toalla o almohada por detrás de la región lumbar si se tiene molestias. Mantener los pies ya sea horizontales en el suelo o subidos en un banco para pies.
✔️ Procurar tener una buena postura para mantener los tendones y músculos del manguito de los rotadores en su posición adecuada.
❌ NO cargar un morral o bolso sólo sobre un hombro.
❌ NO trabajar con los brazos por encima del nivel del hombro por mucho tiempo. De ser necesario, utilizar un banco para pies o una escalera.
✔️ Levantar y cargar los objetos cerca del cuerpo. Tratar de no alzar cargas pesadas lejos del cuerpo o por encima de la cabeza.
✔️ Tomar descansos regulares para cualquier actividad que se esté haciendo de manera repetitiva.
✔️ Al alcanzar algo con el brazo, el dedo pulgar debe estar apuntando hacia arriba.
✔️ Guardar los artículos cotidianos que se usen, en lugares que se puedan alcanzar fácilmente.

✔️ Mantener consigo o cerca las cosas que se usen mucho, como el teléfono, para evitar estirar las manos y lesionar el hombro.

Recuerda que puedo atender tus dudas básicas en
📩 hola@drmichellruiz.com
✅ Traumatología
✅ Ortopedia
✅ Artroscopia
✅ Artroplastia (Prótesis)
🔴 Hombro 🔴 Rodilla 🔴 Codo
📞 Puedes pedir cita al (55) 55.64.28.70
🏨 Mi Consultorio es el #730 del Hospital Angeles Metropolitano en Tlacotalpan #59 en la #CDMX
#MiPrioridadTuMovilidad #Traumatologo #TraumatologíaDeportiva #Hombro #Codo #Rodilla #CDMX

Drogadicción en anestesia / Substance abuse in anaesthetists

Marzo 7, 2018. No. 3015
Abuso de drogas entre los anestesiólogos
Substance abuse in anaesthetists
RM Mayall BSc MBChB MRCP FRCA FANZCA
Abuso de Fármacos Anestésicos por parte de los Anestesiólogos
Flavia Serebrenic Jungerman, Hamer Nastasy Palhares Alves, Maria José Carvalho Carmona, Nancy Brisola Conti, André Malbergier
Adicción y anestesiología
Dra. Dania Elena Escamilla-Ríos
Curso Regional de Anestesiología en Obstetricia y Pediatría
Colegio de Anestesiólogos de León AC y FMCA, AC
Mayo 17-19, 2018. León Guanajuato, México
Informes con el Dr. Enrique Hernández Cortez  
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
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Anestesiología y Medicina del Dolor

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Día Internacional de la Mujer / International Women's Day

Marzo 8, 2018. No. 3016

Las mujeres, además de ser Madres, Esposas, Abuelas o Hijas, han luchado por su preparación cultivando actividades fuera de sus quehaceres caseros: son profesionistas de éxito, científicas renombradas, artistas que siguen conquistando al mundo, políticas que norman destinos de millones de seres humanos y muchas más actividades que por siglos parecían ser solo propias de hombres. Estos logros, sus logros, no han sido fáciles y muchas de ellas aun viven dificultades para lograr sus metas de vida, o simplemente no pueden desarrollarlas por factores ajenos a su voluntad.
Nos complace enviarle una breve colección de escritos publicados que manifiestan lo que ha pasado en la ciencia, en especial en medicina y como las mujeres han ido conquistando sus derechos, la igualdad y la justicia. Falta mucho por hacer, pero por ahora podemos celebrar con ellas sus logros y desearles que cada instante de su vida sea un momento especial para cada mujer.
Women, in addition to being Mothers, Wives, Grandmothers or Daughters, have fought for their preparation by cultivating activities outside of their household chores: they are successful professionals, renowned scientists, artists who continue to conquer the world, politicians that regulate the destinies of millions of human beings and many other activities that for centuries seemed to be exclusive to men. These achievements, their successes, have not been easy and many of them are still struggling to achieve their life goals, or simply cannot develop them due to factors beyond their control.
We are pleased to send you a brief collection of published writings that show what has happened in science, especially in medicine and how women have been conquering their rights, equality and justice. There is still a long way to go, but for now we can celebrate their achievements with them and wish them every moment of their lives a special moment for each woman.
Educación médica de mujeres: la calificación de médicos femeninos.
Medical Education of Women: The Qualification of Female Physicians.
Br Med J. 1894 Sep 1;2(1757):490-1.
Royal College of Physicians: la admisión de mujeres a la licenciatura.
Royal College of Physicians: The Admission of Women to the Licentiateship.
Br Med J. 1895 Nov 2;2(1818):1121-2.
PDF
DISCURSO ENTREGADO POR LA DOCTORA EMMA L. MERRITT EN UN BANQUETE DADO POR WOMEN PHYSICIANS, 11 DE OCTUBRE DE 1924, EN HONOR DEL 83 CUMPLEAÑOS DE LA DRA. LUCY MARIA CAMPO WANZER.
ADDRESS DELIVERED BY DR. EMMA L. MERRITT AT A BANQUET GIVEN BY WOMENPHYSICIANS, OCTOBER 11, 1924, IN HONOR OF THE EIGHTY-THIRD BIRTHDAY OF DR. LUCY MARIA FIELD WANZER.
Cal West Med. 1925 May;23(5):599-601.
Mujeres en medicina los primeros años.
Women in medicine: the early years.
Postgrad Med J. 1951 Jul;27(309):355-7.
Mujeres en medicina
Women in medicine.
Postgrad Med J. 1951 Aug;27(310):396-402.
El Hospital Marie Curie 1925-68
The Marie Curie Hospital 1925-68.
Br Med J. 1968 Nov 16;4(5628):444-6.
Nuestra señora Asclepiads.
Our lady asclepiads.
J Natl Med Assoc. 1968 Mar;60(2):136-7
Estudiantes de medicina de Glasgow: algunos hechos y cifras.
Glasgow women medical students: some facts and figures.
Br Med J. 1971 Apr 24;2(5755):216-8.
Abstract
A questionaire was sent to 343 women medical undergraduates at the University of Glasgow, and 317 replied. Of the respondents, 36% had a member of their family in medicine and 15% had either one or both parents a doctor: 45% had a working mother. Half of all the students had doubts about medicine as a career, and the proportion of these rose with seniority. Doubts were mainly due to the length of the medical course but the girls also recognized the difficulty of combining a medical career with family life. There was a significant correlation between having doubts about a medical career and having a mother who worked. Half the girls said they would prefer to work in hospital after qualification-the favourite specialties being paediatrics and obstetrics; only a quarter said they would like to do general practice. The need for careers advice which links actual career openings and the wish of most women to combine medical work with marriage and child-rearing is emphasized. The majority of the students saw a doctor's primary role as the giving of advice and reassurance.
PDF 
Las personalidades de dos mujeres médicas pioneras: Elizabeth Blackwell y Elizabeth Garrett Anderson.
The personalities of two pioneer medical women: Elizabeth Blackwell and Elizabeth Garrett Anderson.
Bull N Y Acad Med. 1971 Jan;47(1):67-79.
Problemas de profesionales de las doctoras.
Career problems of women doctors.
Br Med J. 1976 Sep 4;2(6035):574-7.
Abstract
Information was received from 61 women doctors who were having difficulty continuing with medical careers. Two main problems were disclosed. Firstly, despite the special arrangements made for women doctors, it is difficult to obtain postgraduate training. The provision of supernumerary posts does not seem to offer a satisfactory solution. Secondly, doctors who have completed postgraduate training but cannot yet return to full-time work are unable to obtain posts at an appropriate level. Both of these problems stem primarily from the need for part-time work by the mothers of young children. Most of the doctors wish to return to full-time or nearly full-time work when family responsibilities are fewer. In view of the increasing proportion of women doctors it seems important that large numbers are not unnecessarily lost from professional work. Some possible approaches to solving the problems are suggested.
Mano de obra médica: II - mujeres en medicina.
Medical manpower: II--women in medicine.
Br Med J. 1976 Jan 10;1(6001):78-82.
Doctoras desaprovechadas
Wasted women doctors.
Br Med J. 1978 Jan 14;1(6105):95-6.
Explorando el Atractivo de las Ciencias Básicas para las Doctoras.
Exploring Attractiveness of the Basic Sciences for Female Physicians.
Tohoku J Exp Med. 2018 Jan;244(1):7-14. doi: 10.1620/tjem.244.7.
Abstract
In Japan, traditional gender roles of women, especially the role of motherhood, may cause early career resignations in female physicians and a shortage of female researchers. Besides this gender issue, a general physician shortage is affecting basic science fields. Our previous study suggested that female physicians could be good candidates for the basic sciences because such work offers good work-life balance. However, the attractiveness for female physicians of working in the basic sciences, including work-life balance, is not known. In a 2012 nationwide cross-sectional questionnaire survey, female physicians holding tenured positions in the basic sciences at Japan's medical schools were asked an open-ended question about positive aspects of basic sciences that clinical medicine lacks, and we analyzed 58 respondents' comments. Qualitative analysis using the Kawakita Jiro method revealed four positive aspects: research attractiveness, priority on research productivity, a healthy work-life balance, and exemption from clinical duties. The most consistent positive aspect was research attractiveness, which was heightened by medical knowledge and clinical experience. The other aspects were double-edged swords; for example, while the priority on research productivity resulted in less gender segregation, it sometimes created tough competition, and while exemption from clinical duties contributed to a healthy work-life balance, it sometimes lowered motivation as a physician and provided unstable income. Overall, if female physicians lack an intrinsic interest in research and seek good work-life balance, they may drop out of research fields. Respecting and cultivating students' research interest is critical to alleviating the physician shortage in the basic sciences.
KEYWORDS: Japan; Kawakita Jiro method; basic sciences; female physicians; research interest
Aportaciones de la mujer a la medicina
Leticia Rodríguez-Pimentel, Rodolfo Silva-Romo
LAS MUJERES Y LA MEDICINA EN LA EDAD MEDIA Y PRIMER RENACIMIENTO
Bertha M. Gutiérrez Rodilla Universidad de Salamanca
Cuadernos del CEMyR, 23; marzo 2015, pp. 121-135; ISSN: 1135-125X
PDF
Las Mujeres en la Ciencia
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
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Anestesiología y Medicina del Dolor

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martes, 6 de marzo de 2018

Mascarilla i-gel® / i-gel® LM

Marzo 5, 2018. No. 3013
Dosis óptima de propofol para la inserción de mascarilla i-gel® en pacientes sanos paralizados
Optimal propofol dosage for i-gel® insertion in healthy paralyzed patients.
Korean J Anesthesiol. 2018 Feb;71(1):22-29. doi: 10.4097/kjae.2018.71.1.22. Epub 2017 Jul 4.
Abstract
BACKGROUND: Propofol is used for supraglottic airway device insertion, often with the i-gel. However, the propofol requirement for i-gelinsertion has not been explored in paralyzed patients. This study was performed to explore hemodynamic changes and sedation level with different propofol doses in healthy paralyzed patients when the i-gel was inserted. METHODS: A total of 141 patients undergoing a urologic operation were randomly allocated to three groups depending on the propofol dose (1.5, 2, and 2.5 mg/kg; Groups P1.5, P2, and P2.5, respectively). After patients had been administered each propofol dose and rocuronium, the i-gel was inserted and changes in hemodynamic parameters and bispectral index were evaluated. RESULTS: Group P2 showed a lower incidence of complications (17%) such as hemodynamic instability and inadequate sedation than Group P1.5 (55.3%, P < 0.001) or Group P2.5 (40.4%, P = 0.012). The incidence and dose of additional propofol increased in Group P1.5 (51%, median [range]; 20 [0-50]) compared with those in the other groups (0%, 0 [0-0] in Group P2 and 8.5%, 0 [0-50] in Group P2.5, all P < 0.001), and the incidence and dose of additional ephedrine were significantly higher in Group P2.5 (31.9%; 0 [0-20]) than in Group P1.5 (10.6%, P = 0.012; 0 [0-5], P = 0.007, respectively). CONCLUSIONS: For the stable maintenance of hemodynamic parameters and proper sedation level during i-gel insertion, 2 mg/kg propofol has an advantage over 1.5 mg/kg or 2.5 mg/kg propofol in healthy paralyzed patients.
KEYWORDS: Hemodynamics; Propofol; Rocuronium; i-gel
Los efectos del tubo endotraqueal y el dispositivo supraglótico de vía aérea i-gel® en la impedancia respiratoria: un estudio observacional prospectivo.
The Effects of Endotracheal Tube and i-gel® Supraglottic Airway Device on Respiratory Impedance: A Prospective Observational Study.
Anesth Pain Med. 2016 Nov 22;7(1):e42964. doi: 10.5812/aapm.42964. eCollection 2017 Feb.
Abstract
BACKGROUND: The forced oscillation technique (FOT) is a non-invasive means of measuring respiratory resistance and reactance. We tested our hypothesis that endotracheal intubation would cause more substantial preoperative increases in FOT parameters than a supraglottic airway device (SGD). METHODS: Forty patients requiring general anesthesia and mechanical ventilation for transurethral bladder tumor resection underwent spirometry the day before surgery. Forced oscillation was measured using a MostGraph-01 device the day before surgery and immediately after removal of the airway adjunct. Changes in respiratory resistance and reactance were compared between those intubated and those who used SGD. RESULTS: The trachea was intubated in 23 patients and SGD was used in the remaining 17 patients. Both airway adjuncts caused significant increases in preoperative respiratory resistance and reactance; however, the magnitude of the changes was significantly greater in the intubated patients. CONCLUSIONS: The SGD appears to cause less pulmonary injury than tracheal intubation. Further study is needed to illuminate the influence of mechanical ventilation, and longer-term consequences and clinical significance of the changes we found in this study. Spontaneous ventilation through an SGD may be preferable in patients with severe respiratory disease.
KEYWORDS: Endotracheal Intubation; Forced Oscillation Technique; Respiratory Impedance; Supraglottic Airway Device
Comparación de la presión de fuga orofaríngea y el rendimiento clínico de LMA ProSeal ™ e i-gel® en adultos: metanálisis y revisión sistemática.
Comparison of oropharyngeal leak pressure and clinical performance of LMA ProSeal™ and i-gel® in adults: Meta-analysis and systematic review.
J Int Med Res. 2016 Jun;44(3):405-18. doi: 10.1177/0300060515607386. Epub 2016 Mar 23.
Abstract
BACKGROUND: A meta-analysis and systematic review of randomized controlled trials to compare the oropharyngeal leak pressure (OLP) and clinical performance of LMA ProSeal™ (Teleflex® Inc., Wayne, PA, USA) and i-gel® (Intersurgical Ltd, Wokingham, UK) in adults undergoing general anesthesia...... CONCLUSION: LMA ProSeal™ provides superior airway sealing compared to i-gel®.
KEYWORDS: Airway sealing; equipment; i-gel®; laryngeal mask airway proseal; leak; meta-analysis
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
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Anestesiología y Medicina del Dolor

52 664 6848905