Marihuana y mortalidad / Marijuana and mortality

Agosto 29, 2017. No. 2795

El riesgo de muerte por hipertensión es tres veces mayor en los adultos que consumen marihuana, en comparación con los no usuarios, sobre la base de datos de un estudio retrospectivo de 1.213 adultos. The risk of death from hypertension is three times greater in adults who use marijuana, compared with nonusers, based on data from a retrospective study of 1,213 adults. O risco de morte por hipertensão é três vezes maior em adultos que usam maconha, em comparação com não usuários, com base em dados de um estudo retrospectivo de 1.213 adultos. Efecto del consumo de marihuana sobre la mortalidad cardiovascular y cerebrovascular: un estudio que utiliza la encuesta nacional de salud y nutrición vinculada archivo de mortalidad. Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file. Yankey BA1, Rothenberg R1, Strasser S1, Ramsey-White K1, Okosun IS1. Author information Eur J Prev Cardiol. 2017 Jan 1:2047487317723212. doi: 10.1177/2047487317723212. [Epub ahead of print] Abstract Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortalityare scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation. KEYWORDS: Marijuana; cannabis; cardiovascular mortality; delta-9-tetrahydrocannabinol; hypertension PDF Efectos adversos cardiovasculares, cerebrovasculares y vasculares periféricos de la inhalación de marihuana: lo que los cardiólogos necesitan saber. Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know. Thomas G1, Kloner RA2, Rezkalla S3. Author information Am J Cardiol. 2014 Jan 1;113(1):187-90. doi: 10.1016/j.amjcard.2013.09.042. Epub 2013 Oct 5. Abstract Marijuana is the most widely used illicit drug, with approximately 200 million users worldwide. Once illegal throughout the United States, cannabis is now legal for medicinal purposes in several states and for recreational use in 3 states. The current wave of decriminalization may lead to more widespread use, and it is important that cardiologists be made aware of the potential for marijuana-associated adverse cardiovascular effects that may begin to occur in the population at a greater frequency. In this report, the investigators focus on the known cardiovascular, cerebrovascular, and peripheral effects of marijuana inhalation. Temporal associations between marijuana use and serious adverse events, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis have been described. In conclusion, the potential for increased use of marijuana in the changing legal landscape suggests the need for the community to intensify research regarding the safety of marijuana use and for cardiologists to maintain an awareness of the potential for adverse effects. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018 para Mexicanos y extranjeros. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Informes (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de Ciudad de México).  Informes / Information XXXIV Congreso Latinoamericano de Anestesiología. CLASA 2017 Octubre 8-11. Uruguay Informes / Information

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

Dolor de espalda baja en artritis reumatoide

http://www.cirugiavertebral.com.mx/academia/dolor-de-espalda-baja-en-artritis-reumatoide/

Low back pain in rheumatoid arthritis

Fuente

Este artículo es publicado originalmente en:

https://www.ncbi.nlm.nih.gov/pubmed/28875320

https://link.springer.com/article/10.1007%2Fs00393-017-0363-8

De:

Kothe R1.

Z Rheumatol.

2017 Sep 5. doi: 10.1007/s00393-017-0363-8. [Epub ahead of print]

Todos los derechos reservados para:

Copyright information

© Springer Medizin Verlag GmbH 2017

Abstract

Low back pain (LBP) in patients with rheumatoid arthritis (RA) has so far been of little concern in clinical investigations. The main focus of scientific publications on spinal problems in RA was the cervical spine. In a recent study, we could demonstrate that LBP in RA patients leads to a significantly higher degree of disability and depression as well as to a reduction in quality of life compared to RA patients without LBP. If there is a specific reason for the additional symptom of LBP, such as spinal stenosis or segmental instability, surgical treatment may be indicated to improve disability and quality of life. For a successful outcome of spinal surgery it is important to address the specific aspects of RA patients, such as poor bone quality and the immunosuppressive effect of antirheumatic drug treatment. Whenever possible, minimally invasivesurgical techniques should be used and the immunosuppressive medication should be stopped before surgery.

KEYWORDS:

Function; Lumbar spinal canal stenosis; Lumbar spine; Quality of life; Surgical procedures

Resumen

El dolor lumbar (LBP) en pacientes con artritis reumatoide (RA) hasta ahora ha sido de poca preocupación en las investigaciones clínicas. El foco principal de las publicaciones científicas sobre los problemas de la columna vertebral en la AR fue la columna cervical. En un estudio reciente, podríamos demostrar que la LBP en pacientes con AR conduce a un grado significativamente mayor de discapacidad y depresión, así como a una reducción en la calidad de vida en comparación con los pacientes con AR sin LBP. Si hay una razón específica para el síntoma adicional de LBP, como la estenosis espinal o la inestabilidad segmentaria, el tratamiento quirúrgico puede ser indicado para mejorar la discapacidad y la calidad de vida. Para un resultado exitoso de la cirugía de columna es importante abordar los aspectos específicos de los pacientes con AR, como la mala calidad ósea y el efecto inmunosupresor del tratamiento antirreumático. Siempre que sea posible, deben usarse técnicas quirúrgicas mínimamente invasivas y la medicación inmunosupresora debe detenerse antes de la cirugía.

PALABRAS CLAVE:
Función; Estenosis del canal espinal lumbar; Espina lumbar; Calidad de vida; Procedimientos quirúrgicos

PMID:  28875320   DOI:  

10.1007/s00393-017-0363-8

#conducto lumbar estrecho#columna lumbar#calidad de vida

Más de ventilación perioperatoria / More on perioperative ventilation

Septiembre 7, 2017. No. 2804

Efectos de la ventilación mecánica intraoperatoria y de la ventilación de protección pulmonar en el paciente quirúrgico adulto Peris-Montalt R, Cruz-García-Dihinx I, Errando C, Granell M. MÉD.UIS. 2015;28(1):65-78. PDF Conceptos actuales de ventilación protectora durante la anestesia general. Current concepts of protective ventilation during general anaesthesia. Serpa Neto A1, Schultz MJ2, Slutsky AS3. Author information Swiss Med Wkly. 2015 Nov 12;145:w14211. doi: 10.4414/smw.2015.14211. eCollection 2015. Abstract Mechanical ventilation with high tidal volumes (VT) has been common practice in operating theatres because this strategy recruits collapsed lung tissue and improves ventilation-perfusion mismatch, thus decreasing the need for high inspired oxygen concentrations. Positive end-expiratory pressure (PEEP) was not used routinely because it was thought to impair cardiovascular function. Over the past two decades there have been advances in our understanding of the causes and importance of ventilation-induced lung injury based on studies in animals with healthy lungs, and trials in critically ill patients with and without acute respiratory distress syndrome. Recent data from randomised controlled trials in patients receiving ventilation during general anaesthesia for surgery have demonstrated that lung-protective strategies (use of low VT, use of PEEP if indicated, and avoidance of excessive oxygen concentrations) are also of importance during intraoperative ventilation. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018 para Mexicanos y extranjeros. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Informes (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de Ciudad de México).  Informes / Information California Society of Anesthesiologists Reuniones / Events Informacion / Information

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

Envejecimiento y antienvejecimiento / Aging and anti-aging

Agosto 30, 2017. No. 2796

MECANISMOS EN ENDOCRINOLOGÍA: Envejecimiento y antienvejecimiento: una visión general en combo-endocrinología. MECHANISMS IN ENDOCRINOLOGY: Aging and anti-aging: a Combo-Endocrinology overview. Diamanti-Kandarakis E1, Dattilo M2, Macut D3, Duntas L4,5, Gonos ES6, Goulis DG7, Gantenbein CK8, Kapetanou M6, Koukkou E9, Lambrinoudaki I10, Michalaki M11, Eftekhari-Nader S12, Pasquali R13, Peppa M14, Tzanela M15, Vassilatou E16, Vryonidou A17; COMBO ENDO TEAM: 2016. Author information Eur J Endocrinol. 2017 Jun;176(6):R283-R308. doi: 10.1530/EJE-16-1061. Epub 2017 Mar 6. Abstract Aging and its underlying pathophysiological background has always attracted the attention of the scientific society. Defined as the gradual, time-dependent, heterogeneous decline of physiological functions, aging is orchestrated by a plethora of molecular mechanisms, which vividly interact to alter body homeostasis. The ability of an organism to adjust to these alterations, in conjunction with the dynamic effect of various environmental stimuli across lifespan, promotes longevity, frailty or disease. Endocrine function undergoes major changes during aging, as well. Specifically, alterations in hormonal networks and concomitant hormonal deficits/excess, augmented by poor sensitivity of tissues to their action, take place. As hypothalamic-pituitary unit is the central regulator of crucial body functions, these alterations can be translated in significant clinical sequelae that can impair the quality of life and promote frailty and disease. Delineating the hormonal signaling alterations that occur across lifespan and exploring possible remedial interventions could possibly help us improve the quality of life of the elderly and promote longevity. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018 para Mexicanos y extranjeros. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Informes (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de Ciudad de México).  Informes / Information XXXIV Congreso Latinoamericano de Anestesiología. CLASA 2017 Octubre 8-11. Uruguay Informes / Information

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