Cardiopatía periparto / Peripartum cardiomyopathy

Agosto 20, 2017. No. 2786

Cardiopatía periparto. Una revisión sistemática Peripartum Cardiomyopathy: A Systematic Review Viviana Aursulesei and Mihai Dan Datcu PDF Cardiopatía periparto desde una perspepectiva genética Peripartum Cardiomyopathy From a Genetic Perspective. Kamiya CA1, Yoshimatsu J, Ikeda T. Author information Circ J. 2016 Jul 25;80(8):1684-8. doi: 10.1253/circj.CJ-16-0342. Epub 2016 Jul 6. Abstract Peripartum cardiomyopathy (PPCM) is a rare, but life-threatening condition that occurs during the peripartum period in previously healthy women. Although its etiology remains unknown, potential risk factors include hypertensive disorders during pregnancy, such as preeclampsia, advanced maternal age, multiparity, multiple gestation, and African descent. Several cohort studies of PPCM revealed that the prevalence of these risk factors was quite similar. Clinically, approximately 40% of PPCM patients are complicated with hypertensive disorders during pregnancy. Because PPCM is a diagnosis of exclusion, heterogeneity is a common element in its pathogenesis. Recent genetic research has given us new aspects of the disease. PPCM and dilated cardiomyopathy (DCM) share genetic predisposition: 15% of PPCM patients were found to have genetic mutations that have been associated with DCM, and they showed a lower recovery rate. Other basic research using PPCM model mice suggests that predisposition genes related to both hypertensive and cardiac disorders via angiogenic imbalance may explain common elements of hypertensive disorders and PPCM. Furthermore, hypertensive disorders during pregnancy are now found to be a risk factor of not only PPCM, but also cardiomyopathy in the future. Understanding genetic variations allows us to stratify PPCM patients and to guide therapy. (Circ J 2016; 80: 1684-1688). PDF Reducción fisiológica de la función contráctil del ventrículo izquierdo en mujeres postparto sanas: Posible superposición con miocardiopatía periparto. Physiological Reduction in Left Ventricular Contractile Function in Healthy Postpartum Women: Potential Overlap with Peripartum Cardiomyopathy. Khan SG1,2, Melikian N1,2, Mushemi-Blake S1,2, Dennes W3, Jouhra F2, Monaghan M1,2, Shah AM1,2. Author information PLoS One. 2016 Feb 9;11(2):e0147074. doi: 10.1371/journal.pone.0147074. eCollection 2016. Abstract AIMS: Peripartum cardiomyopathy is a potentially life-threatening cause of heart failure, commoner in Afro-Caribbean than Caucasian women. Its diagnosis can be challenging due to physiological changes in cardiac function that also occur in healthy women during the early postpartum period. This study aimed to (i) establish the overlap between normal cardiac physiology in the immediate postpartum period and pathological changes in peripartum cardiomyopathy ii) identify any ethnicity-specific changes in cardiac function and cardiac biomarkers in healthy postpartum women. METHODS AND RESULTS: We conducted a cross-sectional study of 58 healthy postpartum women within 48 hours of delivery and 18 matched non-pregnant controls. Participants underwent cardiac assessment by echocardiography and strain analysis, including 3D echocardiography in 40 postpartum women. Results were compared with 12 retrospectively studied peripartum cardiomyopathy patients. Healthy postpartum women had significantly higher left ventricular volumes and mass, and lower ejection fraction and global longitudinal strain than non-pregnant controls. These parameters were significantly more impaired in peripartum cardiomyopathy patients but with overlapping ranges of values. Healthy postpartum women had higher levels of adrenomedullin, placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt1) compared to controls. The postpartum state, adrenomedullin, sFlt1 and the sFlt1:PlGF ratio were independent predictors of LV remodelling and function in healthy postpartum women. CONCLUSION: Healthy postpartum women demonstrate several echocardiographic indicators of left ventricular remodelling and reduced function, which are associated with altered levels of angiogenic and cardiac biomarkers. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información/Information Videoclip

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Falla pulmonar aguda perioperatoria / Perioperative acute lung injury

Agosto 21, 2017. No. 2787

Lesión pulmonar aguda "remota" perioperatoria: actualización reciente Perioperative "remote" acute lung injury: recent update. Jin Z1, Chun Suen K1, Ma D1. Author information J Biomed Res. 2017 Jan 19;31(3):197-212. doi: 10.7555/JBR.31.20160053. Abstract Perioperative acute lung injury (ALI) is a syndrome characterised by hypoxia and chest radiograph changes. It is a serious post-operative complication, associated with considerable mortality and morbidity. In addition to mechanical ventilation, remote organ insult could also trigger systemic responses which induce ALI. Currently, there are limited treatment options available beyond conservative respiratory support. However, increasing understanding of the pathophysiology of ALI and the biochemical pathways involved will aid the development of novel treatments and help to improve patient outcome as well as to reduce cost to the health service. In this review we will discuss the epidemiology of peri-operative ALI; the cellular and molecular mechanisms involved on the pathological process; the clinical considerations in preventing and managing perioperative ALI and the potential future treatment options. La lesión pulmonar aguda perioperatoria (ALI) es un síndrome caracterizado por hipoxia y cambios en la radiografía de tórax. Se trata de una complicación postoperatoria grave, asociada a una mortalidad y morbilidad considerables. Además de la ventilación mecánica, el insulto a órganos remotos también podría desencadenar respuestas sistémicas que inducen ALI. Actualmente, existen limitadas opciones de tratamiento disponibles más allá del apoyo respiratorio conservador. Sin embargo, el aumento de la comprensión de la fisiopatología de ALI y las vías bioquímicas implicadas ayudará al desarrollo de nuevos tratamientos y a mejorar el resultado del paciente, así como reducir los costos para el servicio de salud. En esta revisión se discutirá la epidemiología de la ALI perioperatoria, los mecanismos celulares y moleculares implicados en el proceso patológico, las consideraciones clínicas en la prevención y manejo de ALI perioperatoria y las posibles opciones de tratamiento en el futuro. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información/Information Videoclip

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Biomecánica de la artroplastia reversa de hombro

http://www.lesionesdeportivas.com.mx/academia/biomecanica-de-la-artroplastia-reversa-de-hombro/

Biomechanics of reverse total shoulder arthroplasty

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/25441574

http://www.jshoulderelbow.org/article/S1058-2746(14)00450-9/fulltext

De:

Berliner JL1,Regalado-Magdos A2,Ma CB2,Feeley BT2.

J Shoulder Elbow Surg.

2015 Jan;24(1):150-60. doi: 10.1016/j.jse.2014.08.003. Epub 2014 Oct 29.

Todos los derechos reservados para:

Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Abstract

Reverse total shoulder arthroplasty is an effective procedure for treatment of glenohumeral joint disease among patients with severe rotator cuff deficiency. Improvements in prosthetic design are the result of an evolved understanding of both shoulder and joint replacement biomechanics. Although modern generations of the reverse shoulder prosthesis vary in specific design details, they continue to adhere to Grammont’s core principles demonstrated by his original Delta III prosthesis. This review article discusses the biomechanics of reverse total shoulder arthroplasty with a focus on elements of implant design and surgical technique that may affect stability, postoperative complications, and functional outcomes.

Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Reverse total shoulder arthroplasty; biomechanics; functional outcomes; implant design; instability; scapular notching; surgical technique

Resumen

La artroplastia total del hombro reverso es un procedimiento eficaz para el tratamiento de la enfermedad de las articulaciones glenohumeral en pacientes con deficiencia severa del manguito rotador. Las mejoras en el diseño protésico son el resultado de una comprensión evolucionada de la biomecánica del reemplazo del hombro y de las articulaciones. Aunque las generaciones modernas de la prótesis de hombro inversa varían en detalles de diseño específicos, siguen cumpliendo con los principios básicos de Grammont demostrados por su prótesis original Delta III. Este artículo de revisión discute la biomecánica de la artroplastia total reversa del hombro con un enfoque en los elementos del diseño del implante y la técnica quirúrgica que puede afectar la estabilidad, las complicaciones postoperatorias y los resultados funcionales.

Copyright © 2015 Revista de Cirugía de Hombro y Codo Junta de Fideicomisarios. Publicado por Elsevier Inc. Todos los derechos reservados.

PALABRAS CLAVE:
Artroplastia total del hombro invertida; biomecánica; Resultados funcionales; Diseño de implantes; inestabilidad; Muesca escapular; Técnica quirúrgica

PMID:   25441574   DOI:  

10.1016/j.jse.2014.08.003

[Indexed for MEDLINE]

#Artroplastia reversa de hombro#biomecánica