Obesidad

Junio 23, 2017. No. 2728

¿El síndrome metabólico predice complicaciones quirúrgicas? Un protocolo para una revisión sistemática y meta-análisis. Does metabolic syndrome predict surgical complications? A protocol for a systematic review and meta-analysis. Norris P1, Ralph N2,3, Moloney C1. Syst Rev. 2017 Jun 17;6(1):115. doi: 10.1186/s13643-017-0515-6. Abstract BACKGROUND: Metabolic syndrome (MetS) is defined by an accumulation of risk factors that include cardiovascular disease, diabetes, chronic high blood pressure, obesity, and hypercholesterolaemia which results in an increased risk of developing serious chronic diseases. MetS is widespread as it is estimated to affect up to 30% of the global population. For people with MetS who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with non-affected populations. Surgical patients with MetS are at significantly higher risk of a range of adverse outcomes including death, morbid cardiovascular events, coma, stroke, renal failure, myocardial infarction, and surgical site infections. Increased complication rates result in prolonged hospital stays, a greater need for post-hospitalisation care, and reduced effectiveness of surgical interventions. METHODS/DESIGN: We will search the following electronic bibliographic databases: MEDLINE, EMBASE, ScienceDirect, and CINAHL, and the reference lists of included articles. We will also search for unpublished literature. Two authors will screen titles and abstract information independently and select studies according to established inclusion and exclusion criteria. Data will be extracted by the study investigators using Review Manager 5 and will include information on demographics, incidence, prevalence, and outcome variables. Subgroup analysis and sensitivity analysis will be performed to assess the heterogeneity of included studies. Meta-analysis will also be carried out if appropriate study groups are identified. A descriptive narrative for statistical data will also be provided to highlight findings of the systematic review and meta-analysis. DISCUSSION: This study will report and summarise adverse outcomes among adult patients with MetS undergoing surgery across a range of surgical specialties. Developing insights into outcomes of this population of interest is necessary to develop guidelines towards better management of surgical patients with metabolic syndrome. KEYWORDS: Adverse events; Complications; Metabolic syndrome; Prevalence; Risk; Safety; Surgery PDF  Aspectos de la calidad de vida afectados en pacientes obesos mórbidos que decidieron someterse a cirugía bariátrica: Un estudio cualitativo para diseñar un cuestionario nativo. Aspects of quality of life affected in morbidly obese patients who decided to undergo bariatric surgery: A qualitative study to design a native questionnaire. Keleidari B1, Jamalouee SD2, Mahmoudieh M1, Zolfaghari B3, Gharzi M2. J Res Med Sci. 2017 Apr 26;22:56. doi: 10.4103/jrms.JRMS_931_16. eCollection 2017. Abstract BACKGROUND: Obesity is a known prevalent major health issue. The aim of this study is to assay Iranian patients' problems with obesity and their expectations of bariatric surgery. MATERIALS AND METHODS: In this study, we included patients who have used different medical noninvasive treatments and were unsuccessful in losing weight from the obesity clinic in Al Zahra Hospital, Isfahan, from 2014 to 2015. Morbidly obese patients were interviewed using some open-ended questions, and then, directional content analysis of data was done. RESULTS: Analysis of data showed five main categories including (1) physical health, (2) psychological health, (3) social relationships, (4) environment, and (5) "about the causes of obesity" with some subcategories for each category. CONCLUSION: This study is the first step of designing a quality of life questionnaire while we focused on spiritual and cultural states of Iranian people. KEYWORDS: Bariatric surgery; morbid obesity; qualitative studies; quality of life; questionnaire PDF Desafíos clínicos en las neoplasias malignas gastrointestinales superiores después de la cirugía bariátrica. Clinical Challenges in Upper Gastrointestinal Malignancies after Bariatric Surgery. Tse WHW1, Kroon HM, van Lanschot JJB. Dig Surg. 2017 May 30. doi: 10.1159/000477267. [Epub ahead of print]Abstract BACKGROUND/AIMS: The incidence of morbid obesity has exponentially increased over the last decades. Bariatric surgery (BS) has been proven effective in inducing weight loss and resolving comorbidities associated with morbid obesity. However, BS can also lead to major diagnostic and treatment challenges in patients who develop upper gastrointestinal malignancies. It is important to create awareness of this rising problem. METHODS: Relevant literature was searched in PubMed. RESULTS: (Formerly) obese patients are more prone to develop upper gastrointestinal malignancies, mainly adenocarcinoma of the distal esophagus, since obesity induces a chronic pro-inflammatory state due to endocrinological changes. When an upper gastrointestinal malignancy develops after BS, diagnosis is often delayed and challenging due to a different presentation of complaints and the altered anatomy following the earlier surgery. Also, a potentially curative resection is often more complex and reconstruction of the gastrointestinal continuity can be seriously hampered. CONCLUSION: Due to the growing incidence of obesity and the increasing number of bariatric surgical procedures that are performed each year, it is expected that over the years to come, more post-BS patients will be diagnosed with upper gastrointestinal malignancies, providing great diagnostic and treatment challenges. Clinicians should be aware of this rising problem. KEYWORDS: Bariatric surgery; Esophageal cancer; Gastric cancer; Upper gastrointestinal malignancies; Upper gastrointestinal surgery PDF Mejoría de la función diastólica del ventrículo izquierdo y la morfología del corazón izquierdo en mujeres jóvenes con obesidad mórbida seis meses después de la cirugía bariátrica. Improvement of left ventricular diastolic function and left heart morphology in young women with morbid obesity six months after bariatric surgery. Kurnicka K1, Domienik-Karłowicz J, Lichodziejewska B, Bielecki M, Kozłowska M, Goliszek S, Dzikowska-Diduch O, Lisik W, Kosieradzki M, Pruszczyk P. Cardiol J. 2017 May 25. doi: 10.5603/CJ.a2017.0059. [Epub ahead of print] Abstract BACKGROUND: Obesity contributes to left ventricular diastolic dysfunction (LVDD) and may lead to diastolic heart failure. Weight loss (WL) after bariatric surgery (BS) may influence LV morphology and function. Using echocardiography, this study assessed the effect of WL on LV diastolic function (LVDF) and LV and left atrium (LA) morphology 6 months after BS in young women with morbid obesity. METHODS: Echocardiography was performed in 60 women with BMI ≥ 40kg/m², aged 37.1 ± 9.6 years prior to and 6 months after BS. In 38 patients, well-controlled arterial hypertension was present. Heart failure, coronary artery disease, atrial fibrillation and mitral stenosis were exclusion criteria. Parameters of LV and LA morphology were obtained. To evaluate LVDF, mitral peak early (E) and atrial (A) velocities, E-deceleration time (DcT), pulmonary vein S, D and A reversal velocities were measured. Peak early diastolic mitral annular velocities (E') and E/E' were assessed. RESULTS: Mean WL post BS was 35.7 kg (27%). A postoperative decrease in LV wall thickness was observed, LV mass (mean 183.7 to 171.5 g, p = 0.001) and LA parameters (area, volume). LVDD was diagnosed in 3 patients prior to and in two of them subsequent to the procedure. An improvement in LVDF Doppler indices were noted: increased E/A, D and E' lateral, and decreased S/D and lateral E/E'. None of the patients showed increased LV filling pressure. No significant correlations between hypertension and echo-parameters were demonstrated. CONCLUSIONS: Six months after bariatric surgery weight loss resulted in the improvement of LVDF and left heart morphology in morbidly obese women. KEYWORDS: bariatric surgery; echocardiography; left atrium; left ventricular diastolic function; morbid obesity PDF  XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información

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

2016 Declaración de consenso sobre el retorno al deporte del Primer Congreso Mundial de Fisioterapia Deportiva, Berna

http://www.lesionesdeportivas.com.mx/academia/2016-declaracion-de-consenso-sobre-el-retorno-al-deporte-del-primer-congreso-mundial-de-fisioterapia-deportiva-berna/

2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27226389

http://bjsm.bmj.com/content/50/14/853

De:

Ardern CL1,Glasgow P2,Schneiders A3,Witvrouw E4,Clarsen B5,Cools A6,

Gojanovic B7,Griffin S8,Khan KM9,Moksnes H5,Mutch SA10,Phillips N11,

Reurink G12,Sadler R13,Silbernagel KG14,Thorborg K15,Wangensteen A16,

Wilk KE17,Bizzini M18.

Br J Sports Med. 2016 Jul;50(14):853-64. doi: 10.1136/bjsports-2016-096278. Epub 2016 May 25.

Todos los derechos reservados para:

Abstract

Deciding when to return to sport after injury is complex and multifactorial—an exercise in risk management. Return to sport decisions are made every day by clinicians, athletes and coaches, ideally in a collaborative way. The purpose of this consensus statement was to present and synthesise current evidence to make recommendations for return to sport decision-making, clinical practice and future research directions related to returning athletes to sport. A half day meeting was held in Bern, Switzerland, after the First World Congress in Sports Physical Therapy. 17 expert clinicians participated. 4 main sections were initially agreed upon, then participants elected to join 1 of the 4 groups—each group focused on 1 section of the consensus statement. Participants in each group discussed and summarised the key issues for their section before the 17-member group met again for discussion to reach consensus on the content of the 4 sections. Return to sport is not a decision taken in isolation at the end of the recovery and rehabilitation process. Instead, return to sport should be viewed as a continuum, paralleled with recovery and rehabilitation. Biopsychosocial models may help the clinician make sense of individual factors that may influence the athlete’s return to sport, and the Strategic Assessment of Risk and Risk Tolerance framework may help decision-makers synthesise information to make an optimal return to sport decision. Research evidence to support return to sport decisions in clinical practice is scarce. Future research should focus on a standardised approach to defining, measuring and reporting return to sport outcomes, and identifying valuable prognostic factors for returning to sport.

Resumen
Decidir cuándo volver al deporte después de una lesión es complejo y multifactorial: un ejercicio de gestión del riesgo. El regreso a las decisiones deportivas se toman cada día por los clínicos, atletas y entrenadores, idealmente de manera colaborativa. El propósito de esta declaración de consenso fue presentar y sintetizar la evidencia actual para hacer recomendaciones para el retorno a la toma de decisiones deportivas, la práctica clínica y las direcciones de investigación futuras relacionadas con el regreso de los atletas al deporte. Se realizó una reunión de medio día en Berna, Suiza, después del Primer Congreso Mundial de Fisioterapia Deportiva. 17 expertos clínicos participaron. Se acordaron inicialmente 4 secciones principales, luego los participantes eligieron unirse a 1 de los 4 grupos-cada grupo se centró en una sección de la declaración de consenso. Los participantes en cada grupo discutieron y resumieron los temas claves para su sección antes de que el grupo de 17 miembros se reuniera nuevamente para discusión para llegar a un consenso sobre el contenido de las 4 secciones. El regreso al deporte no es una decisión tomada aisladamente al final del proceso de recuperación y rehabilitación. En cambio, el retorno al deporte debe ser visto como un continuo, paralelo a la recuperación y rehabilitación. Los modelos biopsicosociales pueden ayudar al clínico a comprender los factores individuales que pueden influir en el regreso del deportista al deporte, y el marco de la Evaluación Estratégica de Riesgo y Tolerancia al Riesgo puede ayudar a los tomadores de decisiones a sintetizar la información para obtener una decisión óptima de regreso al deporte. La evidencia de la investigación para apoyar las decisiones sobre el retorno al deporte en la práctica clínica es escasa. La investigación futura debe enfocarse en un enfoque estandarizado para definir, medir e informar el retorno a los resultados del deporte, e identificar factores pronósticos valiosos para regresar al deporte.

Palabras clave:

Declaración de consenso; Deporte; Deportes y medicina del ejercicio; Fisioterapia deportiva

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

KEYWORDS:

Consensus statement; Sport; Sports and exercise medicine; Sports physiotherapy

PMID:  27226389  DOI:  

10.1136/bjsports-2016-096278

[Indexed for MEDLINE]

#Declaración de consenso#deporte#fisioterapia deportiva

Hemimelia tibial: nueva clasificación y opciones reconstructivas

http://www.traumayortopedia.space/academia/hemimelia-tibial-nueva-clasificacion-y-opciones-reconstructivas/

Tibial hemimelia: new classification and reconstructive options

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/27909860

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5145835/

http://online.boneandjoint.org.uk/doi/full/10.1007/s11832-016-0785-x

De:

Paley D¹.

J Child Orthop. 2016 Dec;10(6):529-555. Epub 2016 Dec 1.

Todos los derechos reservados para:

Dror Paley

Copyright © The Author(s) 2016

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (

http://creativecommons.org/licenses/by/4.0/

), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Abstract

Tibial hemimelia is a rare congenital lower limb deficiency presenting with a wide spectrum of associated congenital anomalies, deficiencies and duplications. Reconstructive options have been limited, and the gold standard for treatment has remained amputation with prosthetic fitting. There is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia. Armed with this knowledge, I present here a new classification to guide treatment and prognosis and then discuss new treatment strategies and techniques for limb reconstruction based on this new classification scheme.

KEYWORDS:

Brown centralization of fibula; Clubfoot; Paley classification; Tibial aplasia; Tibial hemimelia; Weber patelloplasty

Resumen

La hemimelia tibial es una rara deficiencia congénita de extremidad inferior que presenta un amplio espectro de anomalías congénitas asociadas, deficiencias y duplicaciones. Las opciones de reconstrucción han sido limitadas, y el estándar de oro para el tratamiento se ha mantenido amputación con ajuste protésico. Ahora hay una mejor comprensión de la genética, etiología y pathoanatomía de la hemimelia tibial. Armado con este conocimiento, presento aquí una nueva clasificación para guiar el tratamiento y el pronóstico y luego discutir nuevas estrategias de tratamiento y técnicas para la reconstrucción de los miembros sobre la base de este nuevo esquema de clasificación.

PALABRAS CLAVE:
Centralización de los peronales; Pie equinovaro; Clasificación Paley; Aplasia tibial; Hemimelia tibial; Pateloplastia de Weber

PMID:  27909860   PMCID:  

PMC5145835  

DOI:  

10.1007/s11832-016-0785-x

Free PMC Article

#Pie equinovaro#Clasificación Paley#Aplasia tibial#hemimelia tibial#Pateloplastia de Weber#ortopediainfantil

Sesión conjunta de la SMMCP y el Capítulo de Residentes en Ortopedia del CMO

http://www.cirugiadepieytobillo.com.mx/academia/sesion-conjunta-de-la-smmcp-y-el-capitulo-de-residentes-en-ortopedia-del-cmo/

Reanudamos las sesiones mensuales conjuntas del capítulo de Residentes. En esta ocasión será fuera del colegio, en el Hopital German Díaz Lombardo, con capítulo de Pie y tobillo del CMO. Será el día miércoles 21 de junio a las 8.30 horas. Contamos con su presencia!
https://www.facebook.com/capituloderesidentesortopedia/posts/1391880937533461:0

#SMMC#CMO#pie y tobillo