Exceso de mortalidad después de la fractura de cadera en ancianos de Europa y Estados Unidos

http://www.altaespecialidadenortopedia.com.mx/academia/exceso-de-mortalidad-despues-de-la-fractura-de-cadera-en-ancianos-de-europa-y-estados-unidos/

Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project.

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28093824

http://onlinelibrary.wiley.com/doi/10.1111/joim.12586/abstract;jsessionid=EDDC180EA72BC08DA5D8A9E0A51B7A3A.f03t01?systemMessage=PPV+on+Wiley+Online+Library+will+be+unavailable+on+Saturday+11th+March+from+05%3A00-14%3A00+GMT+%2F+12%3A00-09%3A00+EST+%2F+13%3A00-22%3A00+SGT+for+essential+maintenance.++Apologies+for+the+inconvenience.

De:

Katsoulis M1, Benetou V2, Karapetyan T1, Feskanich D3, Grodstein F3, Pettersson-Kymmer U4, Eriksson S5, Wilsgaard T6, Jørgensen L7, Ahmed LA7,8, Schöttker B9, Brenner H9, Bellavia A10, Wolk A10, Kubinova R11, Stegeman B12, Bobak M12, Boffetta P1,13, Trichopoulou A1.

J Intern Med. 2017 Mar;281(3):300-310. doi: 10.1111/joim.12586. Epub 2017 Jan 17.

Abstract

BACKGROUND:

Hip fractures are associated with diminished quality of life and survival especially amongst the elderly.

OBJECTIVE:

All-cause mortality after hip fracture was investigated to assess its magnitude.

CONCLUSION:

In this large population-based sample of older persons across eight cohorts, hip fracture was associated with excess short- and long-term all-cause mortality in both sexes.

© 2017 The Association for the Publication of the Journal of Internal Medicine.

KEYWORDS:

CHANCES; ageing; bone; hip fracture; mortality

Resumen

ANTECEDENTES:

Las fracturas de cadera se asocian con la disminución de la calidad de vida y la supervivencia, especialmente entre los ancianos.

OBJETIVO:

Se investigó la mortalidad por todas las causas después de la fractura de cadera para evaluar su magnitud.

CONCLUSIÓN:

En esta gran muestra poblacional de personas mayores a lo largo de ocho cohortes, la fractura de cadera se asoció con un exceso de mortalidad por todas las causas a corto y largo plazo en ambos sexos.

© 2017 La Asociación para la Publicación de la Revista de Medicina Interna.

PALABRAS CLAVE:

Posibilidad; envejecimiento; hueso; fractura de cadera; mortalidad

PMID: 28093824 DOI: 10.1111/joim.12586

#fractura #cadera #ancianos #mortalidad #envejecimiento #hueso #traumatología

Suplementación nutricional para el tratamiento posterior de fractura de cadera en personas mayores

Suplementación nutricional para el tratamiento posterior de fractura de cadera en personas mayores

bibliomanazteca

ortopediaytrauma.com.mx

Suplementación nutricional para el tratamiento posterior de fractura de cadera en personas mayores

Nutritional supplementation for hip fracture aftercare in older people Fuente Este artículo es originalmente publicado en: De: Avenell A1, Smith TO, Curtain JP, Mak JC, Myint P…

http://www.ortopediaytrauma.com.mx/academia/suplementacion-nutricional-para-el-tratamiento-posterior-de-fractura-de-cadera-en-personas-mayores/

Nutritional supplementation for hip fracture aftercare in older people

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27898998

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001880.pub6/abstract?systemMessage=WOL+Usage+report+download+page+will+be+unavailable+on+Friday+27th+January+2017+at+23%3A00+GMT%2F+18%3A00+EST%2F+07%3A00+SGT+%28Saturday+28th+Jan+for+SGT%29++for+up+to+2+hours+due+to+essential+server+maintenance.+Apologies+for+the+inconvenience.

De:

Avenell A¹, Smith TO, Curtain JP, Mak JC, Myint PK.

Todos los derechos reservados para:

Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

AbstractBACKGROUND:

Older people with hip fractures are often malnourished at the time of fracture, and subsequently have poor food intake. This is an update of a Cochrane review first published in 2000, and previously updated in 2010.

OBJECTIVES:

To review the effects (benefits and harms) of nutritional interventions in older people recovering from hip fracture.

AUTHORS’ CONCLUSIONS:

There is low-quality evidence that oral multinutrient supplements started before or soon after surgery may prevent complications within the first 12 months after hip fracture, but that they have no clear effect on mortality. There is very low-quality evidence that oral supplements may reduce ‘unfavourable outcome’ (death or complications) and that they do not result in an increased incidence of vomiting and diarrhoea. Adequately sized randomised trials with robust methodology are required. In particular, the role of dietetic assistants, and peripheral venous feeding or nasogastric feeding in very malnourished people require further evaluation.

Resumen

ANTECEDENTES:
Las personas mayores con fracturas de cadera a menudo están desnutridas en el momento de la fractura y, posteriormente, tienen una mala ingesta de alimentos. Esta es una actualización de una revisión Cochrane publicada por primera vez en 2000 y actualizada previamente en 2010.

OBJETIVOS:
Revisar los efectos (beneficios y daños) de las intervenciones nutricionales en las personas mayores que se recuperan de la fractura de cadera.

CONCLUSIONES DE LOS AUTORES:
Existe evidencia de baja calidad de que los suplementos de multinutrientes orales iniciados antes o poco después de la cirugía pueden prevenir complicaciones dentro de los primeros 12 meses después de la fractura de cadera, pero que no tienen un efecto claro en la mortalidad. Existe evidencia de muy baja calidad de que los suplementos orales pueden reducir el “resultado desfavorable” (muerte o complicaciones) y que no dan lugar a una mayor incidencia de vómitos y diarrea. Se requieren ensayos aleatorios de tamaño adecuado con metodología robusta. En particular, el papel de los asistentes dietéticos y la alimentación venosa periférica o la alimentación nasogástrica en personas muy desnutridas requieren mayor evaluación.

Update of

• Nutritional supplementation for hip fracture aftercare in older people.[Cochrane Database Syst Rev. 2010]

PMID: 27898998   DOI:  

10.1002/14651858.CD001880.pub6

[PubMed – indexed for MEDLINE]

Fuente:ortopediaytrauma.com.mx

#suplementación nutricional#cadera#ancianos

Más de opioides / More on opioids

Enero 14, 2017. No. 2569

Oxicodona DETERx®: una nueva opción de analgésico de liberación prolongada para el tratamiento de pacientes con dolor crónico. Oxycodone DETERx®: A Novel Abuse-Deterrent, Extended-Release Analgesic Option for the Treatment of Patients with Chronic Pain. Gudin J1. Pain Ther. 2016 Dec;5(2):171-186. Epub 2016 Nov 21. Abstract BACKGROUND: Extended-release (ER) opioid analgesics are commonly used to provide safe and effective pain relief to treat pain severe enough to require around-the-clock, long-term dosing. These ER opioid formulations usually contain more drug per dosage unit than immediate-release (IR) agents, and therefore bring with them challenges related to both opioid abuse and misuse, often through manipulation of the dosage form. Oxycodone DETERx® (Xtampza® ER, Collegium Pharmaceutical, Inc.) is a novel abuse-deterrent, ER formulation developed to deter common methods of manipulation. In addition to having abuse-deterrent properties, oxycodone DETERx was developed to provide alternative modes of administration for patients with chronic pain and difficulty swallowing. SCOPE: Using published articles, abstracts, and prescribing information, data supporting the use of oxycodone DETERx are reviewed. FINDINGS: Oxycodone DETERx was effective at reducing chronic pain in patients enrolled in a pivotal clinical trial, and had a tolerability profile expected of opioids. In addition to administration of the intact capsule, oxycodone DETERx can also be administered by sprinkling directly into the mouth from a dosing cup, onto soft foods, or through nasogastric or gastrostomy tubes, thus providing flexible dosing options for patients who have difficulty swallowing. In vitro studies demonstrated the reduced ability of oxycodone DETERx to be manipulated by common techniques used by abusers to defeat the ER characteristics or prepare the formulation for injection. Pharmacokinetic studies demonstrated that the ER characteristics of oxycodone DETERx are maintained if chewed or crushed. As a result, oxycodone DETERx is currently the only ER-formulated opioid without a boxed warning against crushing or chewing. Human abuse-potential studies conducted in a population of recreational opioid users demonstrated lower drug-liking scores for oxycodone DETERx administered intranasally and orally when compared with IR oxycodone. KEYWORDS: Abuse deterrence; Chronic pain; Drug abuse; Extended-release opioids; Opioid analgesics; Oxycodone PDF   ¿Es el tapentadol diferente a los opioides clásicos? Revisión de la evidencia Is tapentadol different from classical opioids? A review of the evidence. Langford RM1, Knaggs R2, Farquhar-Smith P3, Dickenson AH4. Br J Pain. 2016 Nov;10(4):217-221. Epub 2016 Jul 25. Abstract Tapentadol is a single molecule able to deliver analgesia by two distinct mechanisms, a feature which differentiates it from many other analgesics. Pre-clinical data demonstrate two mechanisms of action: mu-opioid receptor agonist activity and noradrenaline re-uptake inhibition. From these, one may predict that tapentadol would be applicable across a broad spectrum of pain from nociceptive to neuropathic. The evidence in animal models suggests that norepinephrine re-uptake inhibition (NRI) is a key mechanism and may even predominate over opioid actions in chronic (and especially neuropathic) pain states, reinforcing that tapentadol is different to classical opioids and may, therefore, be an a priori choice for the treatment of neuropathic and mixed pain. The clinical studies and subsequent practice experience and surveillance support the concept of opioid and non-opioid mechanisms of action. The reduced incidence of some of the typical opioid-induced side effects, compared to equianalgesic doses of classical opioids, supports the hypothesis that tapentadol analgesia is only partially mediated by opioid agonist mechanisms. Both the pre-clinical and clinical profiles appear to be differentiated from those of classical opioids. KEYWORDS: Tapentadol; analgesic mechanisms of action; analgesics; opioids; pain pharmacology PDF Papel de los opioides en el manejo de los ancianos con dolor The Role of Opioid Analgesics in Geriatric Pain Management. Naples JG1, Gellad WF2, Hanlon JT3. Clin Geriatr Med. 2016 Nov;32(4):725-735. doi: 10.1016/j.cger.2016.06.006. Epub 2016 Aug 9. Abstract When possible, chronic noncancer pain (CNCP) in older adults should be managed by nonpharmacologic modalities in conjunction with nonopioid analgesics. If moderate-to-severe pain persists despite these approaches, however, nonparenteral opioids may be considered as adjunctive therapy. This article reviews the epidemiology of opioid use and their effectiveness for CNCP in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly. Finally, to assist clinicians with selecting appropriate therapy, the article concludes with an evidence-based approach to optimize opioid prescribing in older adults with CNCP. KEYWORDS: Adverse drug event; Aged; Opioid; Pharmacokinetics PDF Farmacología de los analgésicos opioides PDF Analgésicos opioides Opioid Analgesics Maree T. Smith, Wei H. Goh PDF 5to Curso Internacional de Anestesiología cardiotorácica, vascular, ecocardiografía y circulación extracorpórea. SMACT Mayo 4-6, 2017, Ciudad de 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 Información / Information

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