Teléfonos inteligentes y tabletas electrónicas / Smartphones and e-tablets

Octubre 21, 2017. No. 2888

Teléfonos inteligentes y tabletas electrónicas en medicina perioperatoria Smartphones and e-tablets in perioperative medicine. Michard F1. Author information Korean J Anesthesiol. 2017 Oct;70(5):493-499. doi: 10.4097/kjae.2017.70.5.493. Epub 2017 Sep 28. Abstract Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments). During surgery, Apps may help to rationalize fluid management and estimate blood loss. After surgery, smartphones and/or connected sensors (pulse oximeter, adhesive path, electronic tattoo, bioimpedance necklace) can be used to monitor body temperature, heart rate, heart rate variability (detection of cardiac arrhythmia), respiratory rate, arterial oxygen saturation and thoracic fluid content. Therefore, these tools have potential for the early detection of infectious, cardiac and respiratory complications in the wards and from home. When connected to echo probes, smartphones and e-tablets can also be used as ultrasound devices during central venous catheter insertion, for peripheral nerve blocks, and to perform echocardiography in patients developing cardiac complications. Finally, electronic checklists now exist as Apps to enhance communication between patients and healthcare professionals, and to track and record step by step each element of the surgical journey. Studies are now urgently needed to investigate whether this digital revolution can translate into a better outcome, an earlier detection of postoperative complications, a decrease in hospital readmissions and in health care costs. KEYWORDS: Digital application; Electronic tablet; Perioperative medicine; Smartphone; Surgical complication; Wearable sensor PDF XXVII Congreso Peruano de Anestesiología Lima, Noviembre 2-4, 2017 Informes / Informataion LI Congreso Mexicano de Anestesiología Mérida Yucatán, Noviembre 21-25, 2017 Información / Information

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

La reparación previa del manguito rotador se asocia con resultados clínicos inferiores después de una artroplastia total de hombro reversa

http://www.lesionesdeportivas.com.mx/academia/la-reparacion-previa-del-manguito-rotador-se-asocia-con-resultados-clinicos-inferiores-despues-de-una-artroplastia-total-de-hombro-reversa/

Previous Rotator Cuff Repair Is Associated With Inferior Clinical Outcomes After Reverse Total Shoulder Arthroplasty

Fuente

Este artículo es publicado originalmente en:

https://www.ncbi.nlm.nih.gov/pubmed/29051900

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637974/

http://journals.sagepub.com/doi/10.1177/2325967117730311

De:

Shields EJW1,Koueiter DM1,Maerz T2,Schwark A1,Wiater JM1.

Orthop J Sports Med.

2017 Oct 5;5(10):2325967117730311. doi: 10.1177/2325967117730311. eCollection 2017 Oct.

Todos los derechos reservados para:

Copyright and License information ▼

Copyright

© The Author(s) 2017

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License (http://www.creativecommons.org/licenses/by-nc-nd/3.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Abstract

BACKGROUND:

Although recent evidence suggests that any prior shoulder surgery may cause inferior shoulderarthroplasty outcomes, there is no consensus on whether previous rotator cuff repair (RCR) is associated with inferior outcomes after reverse total shoulder arthroplasty (RTSA).

PURPOSE:

To retrospectively compare outcomes in patients who underwent RTSA with and without previous RCR.

CONCLUSION:

Patients with previous RCR attempts may experience fewer short-term gains in functional andsubjective outcome scores after RTSA compared with patients with no history of shouldersurgery who undergo RTSA. However, the differences between groups were small and below the minimal clinically important differences for the outcome measures analyzed.

KEYWORDS:

functional outcomes; range of motion; reverse total shoulder arthroplasty; rotator cuff repair

Resumen

ANTECEDENTES:
Aunque la evidencia reciente sugiere que cualquier cirugía de hombro previa puede causar resultados inferiores de artroplastia de hombro, no hay consenso sobre si la reparación previa del manguito rotador (RCR) se asocia con resultados inferiores después de la artroplastia total de hombro reversa (RTSA).

PROPÓSITO:
Comparar retrospectivamente los resultados en pacientes sometidos a RTSA con y sin RCR previa.

CONCLUSIÓN:
Los pacientes con intentos previos de RCR pueden experimentar menos ganancias a corto plazo en los puntajes de resultado funcionales y subjetivos después de RTSA en comparación con los pacientes sin antecedentes de cirugía de hombro sometidos a RTSA. Sin embargo, las diferencias entre los grupos fueron pequeñas y por debajo de las mínimas diferencias clínicamente importantes para las medidas de resultado analizadas.

PALABRAS CLAVE:
resultados funcionales; Rango de movimiento; artroplastia total de hombro reversa; reparación del manguito de los rotadores

PMID: 29051900   PMCID:  PMC5637974    DOI:   10.1177/2325967117730311

#resultados funcionales#Rango de movimiento#artroplastia total de hombro reversa#manguito rotador

Infarto agudo al miocardio

Octubre 22, 2017. No. 2889

Metas incumplidas en el tratamiento del infarto agudo de miocardio: revisión. Unmet goals in the treatment of Acute Myocardial Infarction: Review. Farah A1, Barbagelata A2,3. Author information F1000Res. 2017 Jul 27;6. pii: F1000 Faculty Rev-1243. doi: 10.12688/f1000research.10553.1. eCollection 2017. Abstract Reperfusion therapy decreases myocardium damage during an acute coronary event and consequently mortality. However, there are unmet needs in the treatment of acute myocardial infarction, consequently mortality and heart failure continue to occur in about 10% and 20% of cases, respectively. Different strategies could improve reperfusion. These strategies, like generation of warning sign recognition and being initially assisted and transferred by an emergency service, could reduce the time to reperfusion. If the first electrocardiogram is performed en route, it can be transmitted and interpreted in a timely manner by a specialist at the receiving center, bypassing community hospitals without percutaneous coronary intervention capabilities. To administer thrombolytic therapy during transport to the catheterization laboratory could reduce time to reperfusion in cases with expected prolonged transport time to a percutaneous coronary intervention center or to a center without primary percutaneous coronary intervention capabilities with additional expected delay, known as pharmaco-invasive strategy. Myocardial reperfusion is known to produce damage and cell death, which defines the reperfusion injury. Lack of resolution of ST segment is used as a marker of reperfusion failure. In patients without ST segment resolution, mortality triples. It is important to note that, until recently, reperfusion injury and no-reflow were interpreted as a single entity and we should differentiate them as different entities; whereas no-reflow is the failure to obtain tissue flow, reperfusion injury is actually the damage produced by achieving flow. Therefore, treatment of no-reflow is obtained by tissue flow, whereas in reperfusion injury the treatment objective is protection of susceptible myocardium from reperfusion injury. Numerous trials for the treatment of reperfusion injury have been unsuccessful. Newer hypotheses such as " controlled reperfusion", in which the interventional cardiologist assumes not only the treatment of the culprit vessel but also the way to reperfuse the myocardium at risk, could reduce reperfusion injury. KEYWORDS: Controlled reperfusion; Myocardial Infarction; Reperfusion; Reperfusion Injury PDF Infarto del miocardio en UCIs. Revisión sistemática del diagnóstico y tratamiento Myocardial infarction in intensive care units: A systematic review of diagnosis and treatment. Carroll I1, Mount T2, Atkinson D2. Author information J Intensive Care Soc. 2016 Nov;17(4):314-325. doi: 10.1177/1751143716656642. Epub 2016 Jul 1. Abstract INTRODUCTION: Patients in the intensive care unit are vulnerable to myocardial injury from a variety of causes, both ischaemic and non-ischaemic. It is challenging for ICU clinicians to apply the conventional guidance concerning diagnosis and treatment. We conducted this review to examine the evidence concerning diagnosis and treatment of myocardial infarction in the ICU. METHODS: A systematic review was performed to identify relevant studies. RESULTS: 19 studies concerning use of ECG, cardiac enzymes, echocardiography and angiography were identified. 4 studies considered treatment of myocardial infarction. CONCLUSIONS: Regular 12 lead ECG or 12 lead ECG monitoring is more sensitive than 2 lead monitoring, regular measurement of cardiac enzymes is more sensitive than when provoked by symptoms. Coronary angiography rarely identifies treatable lesions, without regional wall motion abnormality on echocardiography. Evidence relating to treatment was limited. A potential strategy to diagnose myocardial infarctions in the ICU is proposed. KEYWORDS: Myocardial infarcation; critical care; PDFelectrocardiography; myocardial ischemia; troponin El valor pronóstico del índice de shock para los resultados de pacientes con infarto agudo de miocardio: una revisión sistemática y un meta-análisis. The prognostic value of shock index for the outcomes of acute myocardial infarction patients: A systematic review and meta-analysis. Zhang X1, Wang Z, Wang Z, Fang M, Shu Z. Author information Medicine (Baltimore). 2017 Sep;96(38):e8014. doi: 10.1097/MD.0000000000008014. Abstract BACKGROUND: Several studies have revealed that high shock index (SI) is a risk factor for acute myocardial infarction (AMI) patients. These studies do not give a systematic review in this issue. Therefore, we conducted a systematic review and meta-analysis to determine the effect of high SI on the prognosis of AMI patients.  CONCLUSION: High SI may increase the in-hospital mortality, short-term, and long-term adverse outcomes in AMI patients. PDF XXVII Congreso Peruano de Anestesiología Lima, Noviembre 2-4, 2017 Informes / Informataion LI Congreso Mexicano de Anestesiología Mérida Yucatán, Noviembre 21-25, 2017 Información / Information

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

Tratamiento quirúrgico artroscópico de la epicondilitis medial

http://www.mihombroycodo.com.mx/academia/tratamiento-quirurgico-artroscopico-de-la-epicondilitis-medial/

Arthroscopic surgical treatment of medial epicondylitis

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/29054383

http://www.jshoulderelbow.org/article/S1058-2746(17)30525-6/fulltext

De:

do Nascimento AT1,Claudio GK2.

J Shoulder Elbow Surg.

2017 Oct 17. pii: S1058-2746(17)30525-6. doi: 10.1016/j.jse.2017.08.019. [Epub ahead of print]

Todos los derechos reservados para:

Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.AbstractBACKGROUND:

The study purpose was to evaluate the outcomes of patients who received arthroscopic surgical treatment for medial epicondylitis refractory to conservative treatment.

CONCLUSION:

Arthroscopic surgical treatment for medial epicondylitis of the elbow exhibits good outcomes and is safe and effective.

Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Elbow; arthroscopic surgery; common flexor tendon; functional outcomes; medial epicondylitis; repetitive strain injury

Resumen

ANTECEDENTES:
El objetivo del estudio fue evaluar los resultados de los pacientes que recibieron tratamiento quirúrgico artroscópico para la epicondilitis medial refractaria al tratamiento conservador.

CONCLUSIÓN:
El tratamiento quirúrgico artroscópico para la epicondilitis medial del codo exhibe buenos resultados y es seguro y efectivo.

Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Publicado por Elsevier Inc. Todos los derechos reservados.

PALABRAS CLAVE:
Codo; cirugía artroscópica; tendón flexor común; resultados funcionales; epicondilitis medial; lesión por esfuerzo repetitivo

PMID:  29054383  DOI:  

10.1016/j.jse.2017.08.019

#codo#artroscopia#tendón flexor#epicondilitis