Liposucción tumescente: guías estandarizadas de cuidado

Liposucción tumescente: guías estandarizadas de cuidado Tumescent liposuction: Standard guidelines of care.  Indian J Dermatol Venereol Leprol [serial online] 2008 [cited 2012 May 21];74:54-60.  Mysore V. Definition : Tumescent liposuction is a technique for the removal of subcutaneous fat under a special form of local anesthesia called tumescent anesthesia. Physician's qualifications : The physician performing liposuction should have completed postgraduate training in dermatology or a surgical specialty and should have had adequate training in dermatosurgery at a center that provides training in cutaneous surgery. In addition, the physician should obtain specific liposuction training or experience at the surgical table ("hands on") under the supervision of an appropriately trained and experienced liposuction surgeon. In addition to the surgical technique, training should include instruction in fluid and electrolyte balance, potential complications of liposuction, tumescent and other forms of anesthesia as well as emergency resuscitation and care. Facility : Liposuction can be performed safely in an outpatient day care surgical facility, or a hospital operating room. The day care theater should be equipped with facilities for monitoring and handling emergencies. A plan for handling emergencies should be in place with which all nursing staff should be familiar. A physician trained in emergency medical care and acute cardiac emergencies should be available in the premises. It is recommended but not mandatory, that an anesthetist be asked to stand by. Indications: Liposuction is recommended for all localized deposits of fat. Novices should restrict themselves to the abdomen, thighs, buttocks and male breasts. Arms, the medial side of the thigh and the female breast need more experience and are recommended for experienced surgeons. Liposuction may be performed for non-cosmetic indications such as hyperhidrosis of axillae after adequate experience has been acquired, but is not recommended for the treatment of obesity. Preoperative evaluation : Detailed history is to be taken with respect to any previous disease, drug intake and prior surgical procedures. Liposuction is contraindicated in patients with severe cardiovascular disease, severe coagulation disorders including thrombophilia, and during pregnancy. Physical evaluation should be detailed and should include assessment of general physical health to determine the fitness of the patient for surgery, as well as the examination of specific sites that need liposuction to check for potential problems. Preoperative Informed consent : The patient should sign a detailed consent form listing details about the procedure and possible complications. The consent form should specifically state the limitations of the procedure and should mention whether more procedures are needed for proper results. The patient should be provided with adequate opportunity to seek information through brochures, computer presentations, and personal discussions. Preoperative laboratory studies to be performed include Hb%, blood counts including platelet counts, bleeding and clotting time (or prothrombin and activated partial thromboplastin time) and blood chemistry profile; ECG is advisable. Liver function tests, and pregnancy test for women of childbearing age are performed as mandated by the individual patient's requirements. Ultrasound examination is recommended in cases of gynecomastia. Preoperative medication : Preoperative antibiotics and non-sedative analgesics such as paracetamol are recommended. The choice of antibiotic and analgesic agents depends on the individual physician's preference and the prevailing local conditions. Type of anesthetic employed : Lidocaine is the preferred local anesthetic; its recommended dose is 35-45 mg/kg and doses should not exceed 55 mg/kg wt. The recommended concentration of epinephrine in tumescent solutions is 0.25-1.5 mg/L. The total dosage of epinephrine should be minimized and should not exceed 50 µg/kg. Surgical technique/procedure It is always advisable not to combine liposuction with other procedures to avoid exceeding the recommended dosage of lignocaine. However, such combinations may be attempted if the total required dose of lignocaine does not exceed the maximum dose indicated above. The recommended cannula size for liposuction is not to be larger than 3.5 mm in diameter. The recommended volume of fat removed is in proportion to the fat content and/or size and/or weight of the patient being treated. It is recommended that the volume of fat removed not exceed 5000 mL in a single operative session.Large volume liposuctions or mega-liposuctions are not recommended. Intraoperative and postoperative monitoring : Baseline vital signs including blood pressure and heart rate, are recorded pre- and postoperatively. Pulse oximeter monitoring is essential in all cases. Postoperative care: Postoperative antibiotics should be selected by the physician and taken for five days. Postoperative antiinflammatory drugs such as Cox 2 Inhibiters may be given for 5-7 days; specialized compression garments, binders, and tape help to reduce bruising, hematomas, seromas, and pain. Generally, compression is recommended for two weeks although this is variable according to the needs of the individual patient. Keywords: Fat extraction, Body shape, Sculpturing, Liposuction, Tumescent anesthesia http://www.ijdvl.com/article.asp?issn=0378-6323;year=2008;volume=74;issue=7;spage=54;epage=60;aulast=Mysore http://www.ijdvl.com/text.asp?2008/74/7/54/42290

Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Apretón del trapezio como indicador de la profundidad de la anestesia para la inserción de mascarilla laríngea en niños

Apretón del trapezio como indicador de la profundidad de la anestesia para la inserción de mascarilla laríngea en niños Hooda S, Kaur K, Rattan KN, Thakur AK, Kamal K. Trapezius squeeze test as an indicator for depth of anesthesia for laryngeal mask airway insertion in children. J Anaesthesiol Clin Pharmacol [serial online] 2012 [cited 2012 May 27];28:28-31. Available from: http://www.joacp.org/text.asp?2012/28/1/28/92430

Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Notiweb

NOTIWEB MADRI+D · BOLETÍN DE NOTICIAS DE I+D 08/06/2012 NÚMERO DE SUSCRIPTORES: 60301 "La imaginación es más importante que el conocimiento" (EINSTEIN, ALBERT) 1879-1955

El Sincrotrón Alba, el acelerador de partículas español, comienza a funcionar El Sincrotrón Alba, un acelerador de partículas ubicado en Cerdanyola del Vallés (Barcelona), capaz de observar estructuras moleculares como si fuera un grandioso microscopio, ha comenzado a funcionar dos años después de su presentación oficial ante el mundo. Identifican parte del sistema de inmunidad que mata la malaria en mosquitos Un circuito de proteínas en el sistema de inmunidad de los mosquitos permite que los insectos maten a los parásitos que causan la malaria en los humanos, según un artículo que difunde Pathogens, una revista de Public Library of Science (PLoS). La percepción visual mejora con la estimulación magnética Lo que vemos no es siempre lo que obtenemos, y contrariamente a la creencia popular, las personas con una visión ocular perfecta no perciben en realidad todo lo que acontece frente a ellos. El Profesor Nazario Martin recibe el Premio Jaime I 2012 en Investigación Básica La Fundación Premios Rey Jaime I ha galardonado al Profesor Nazario Martin director Adjunto de IMDEA Nanociencia dentro de una de las seis categorías que configuran estos premios por 'sus extraordinarias contribuciones en el campo de la química supramolecular, particularmente en la combinación de la química de fullerenos con la nanotecnología'. La noche de los investigadores La Comisión Europea ha concedido un año más a la Fundación madri+d el proyecto de la Noche de los Investigadores de Madrid, 2012. España: el interior abocado a la aridez y el litoral a inundaciones En una entrevista con Efe, María José Estrela, directora de la Unidad Mixta del Centro de Estudios Ambientales del Mediterráneo (CSIC) y la Universidad de Valencia, dibuja el siguiente panorama: en la costa aumentarán las inundaciones debido a la mayor frecuencia de las lluvias torrenciales, y el interior registrará un proceso de sequedad y una pérdida de recarga de acuíferos. Desarrollan una pantalla táctil capaz de generar botones físicos bajo demanda Tactus Technology, una startup radicada en California, ha desarrollado una tecnología capaz de devolver las sensaciones de los botones físicos a los gadgets. Una demanda de muchos consumidores desde el advenimiento de las pantallas táctiles capacitivas. Una empresa española fabrica nanopartículas para proteger de bacterias a los hospitales Nunca antes se había logrado una partícula tan pequeña, de menos de un nanómetro (la millonésima parte de un milímetro), con fines comerciales. Begoña Cristeto: Queremos atraer capital extranjero para que invierta en empresas españolas Entrevista a Begoña Cristeto, CEO de ENISA, Empresa Nacional de Innovación. La agencia pública dependiente del Ministerio de Industria, se convertirá en la principal herramienta de atracción de capital extranjero en la inversión en startups. El reputado paleoantropólogo sudafricano Phillip Tobias fallece a los 86 años El paleoantropólogo sudafricano Phillip Tobias, autor del descubrimiento de la especie humana Homo Habilis y una de las máximas autoridades mundiales en el campo del origen humano, falleció en Johannesburgo a los 86 años. Blog del día: Emprendedores de Base Tecnológica. 'Ciencia para Directivos'. Superdordenadores generadores de riqueza Cómo en ocasiones anteriores, os presentamos el programa de Ciencia para Directivos, pero, ¿Qué es Ciencia para Directivos?

suplemento «iberoamérica» Elaborado en colaboración con Noticias Semana de la Ciencia y la Tecnología en Entre Ríos Argentina Instituto de ciencia y tecnología de París estrecha relaciones con São Paulo Brasil Baja el perfil a resolución de enigma de Newton Chile Paneles solares para secar café Colombia Aprovechan lirio acuático para obtener insumos agrícolas y combustibles México Facilitan acceso de pymes al mercado de valores Perú La solución para la alta velocidad está en camino Portugal + NOTICIAS Eventos Encuentros Mundo Mobile en ORT ENERMIN Innovación y Emprendimiento Feria Nacional Infantil y Juvenil de Ciencia, Tecnología e Innovación Promoción de la Innovación para la mejora de la Competitividad Enlaces Asociación Bonaerense de Científicos Comisión Nacional del Agua CAPATEC

Shock cardiogénico secundario a infarto del miocárdico: diagnóstico, monitoreo y tratamiento. Guía Alemana-Austriaca S3

Shock cardiogénico secundario a infarto del miocárdico: diagnóstico, monitoreo y tratamiento. Guía Alemana-Austriaca S3 Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment. A German-Austrian S3 guideline. Werdan K, Ruß M, Buerke M, Delle-Karth G, Geppert A, Schöndube FA. Dtsch Arztebl Int 2012; 109(19): 343-51. DOI: 10.3238/arztebl.2012.0343 SUMMARY Introduction: Infarction-related cardiogenic shock (ICS) is usually due to leftventricular pump failure. With a mortality of 30% to 80%, ICS is the most common cause of death from acute myocardial infarction. The S3 guideline presented here characterizes the current evidence-based treatment of ICS: early revascularization, treatment of shock, and intensive care treatment of multi-organ dysfunction syndrome (MODS) if it arises. The success or failure of treatment for MODS determines the outcome in ICS. Methods: Experts from eight German and Austrian specialty societies analyzed approximately 3600 publications that had been retrieved by a systematic literature search. Three interdisciplinary consensus conferences were held, resulting in the issuing of 111 recommendations and algorithms for this S3 guideline. Results: Early revascularization of the occluded vessel, usually with a percutaneous coronary intervention (PCI), is of paramount importance. The medical treatment of shock consists of dobutamine as the inotropic agent and norepinephrine as the vasopressor of choice and is guided by a combination of pressure and flow values, or by the cardiac power index. Levosimendan can be given in addition to treat catecholamine-resistant shock. For patients with ICS who are treated with PCI, the current S3 guideline differs from the European and American myocardial infarction guidelines with respect to the recommendation for intra-aortic balloon pulsation (IABP): Whereas the former guidelines give a class I recommendation for IABP, this S3 guideline states only that IABP "can" be used in this situation, in view of the poor state of the evidence. Only for patients being treated with systemic fibrinolysis is IABP weakly recommended (IABP "should" be used in such cases). With regard to the optimal intensive care interventions for the prevention and treatment of MODS, recommendations are given concerning ventilation, nutrition, erythrocyte-concentrate transfusion, prevention of thrombosis and stress ulcers, follow-up care, and rehabilitation. Discussion: The goal of this S3 guideline is to bring together the types of treatment for ICS that lie in the disciplines of cardiology and intensive-care medicine, as patients with ICS die not only of pump failure, but also (and even more frequently) of MODS. This is the first guideline that adequately. http://www.aerzteblatt.de/int/archive/article/125566

Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

June 8, 2012 Books Update

On the Cover of Sunday's Book Review 'Canada' By RICHARD FORD Reviewed by ANDRE DUBUS III In Richard Ford's novel, a teenage boy's life is changed when his parents make the unlikely decision to rob a bank.  Up Front: Andre Dubus III Also in the Book Review 'People Who Eat Darkness' By RICHARD LLOYD PARRY Reviewed by SUSAN CHIRA An account of the murder of a young British woman in Japan. 'A Difficult Woman: The Challenging Life and Times of Lillian Hellman' By ALICE KESSLER-HARRIS Reviewed by DONNA RIFKIND A historian's study of the dramatist with a genius for the concise phrase and the provocative gesture. 'College: What It Was, Is, and Should Be' By ANDREW DELBANCO Reviewed by MICHAEL S. ROTH A professor deplores the current state of colleges. 'The Man Who Changed the Way We Eat' By THOMAS MCNAMEE Reviewed by CORBY KUMMER Thomas McNamee traces the career of Craig Claiborne, the food critic who expanded the culinary horizons of American home cooks. 'Private Empire: ExxonMobil and American Power' By STEVE COLL Reviewed by ADAM HOCHSCHILD Steve Coll examines the worldwide operations and political influence of Exxon Mobil. 'The Hunger Angel' By HERTA MULLER Reviewed by RICHARD STERN Herta Müller's novel of a Soviet labor camp. 'The Chaperone' By LAURA MORIARTY Reviewed by JENNY HENDRIX In Laura Moriarty's novel, a Midwestern matron accompanies young Louise Brooks to New York in the summer of 1922. 'The Lair' By NORMAN MANEA Reviewed by STEVEN HEIGHTON Norman Manea explores the implications of exile in this novel about Romanian intellectuals living in the United States. 'The Undertow' By JO BAKER Reviewed by LOUISA THOMAS This novel follows four generations of a British family, from World War I to the present. 'The Last Hundred Days' By PATRICK McGUINNESS Reviewed by FRANCINE PROSE The British narrator of Patrick McGuinness's first novel is an uneasy witness to the collapse of the Ceausescu regime. 'As Texas Goes: How the Lone Star State Hijacked the American Agenda' By GAIL COLLINS Reviewed by LLOYD GROVE For Gail Collins, Texas is the home of guns, deregulation and right-wing dogma. 'Power and Constraint: The Accountable Presidency After 9/11' By JACK GOLDSMITH Reviewed by CHRISTOPHER CALDWELL How presidential actions are scrutinized. 'Simon: The Genius in My Basement' By ALEXANDER MASTERS Reviewed by JORDAN ELLENBERG Alexander Masters writes about meeting Simon Norton, an eccentric British mathematician. 'The Most Expensive Game in Town' By MARK HYMAN Reviewed by GORDON MARINO How much are parents shelling out to give their children a leg up in sports? A heck of a lot, Mark Hyman discov

BEST SELLERS Combined Print & E-Book Fiction Combined Print & E-Book Nonfiction Hardcover Fiction Hardcover Nonfiction Paperback Trade Fiction Paperback Mass-Market Fiction Paperback Nonfiction All the Lists John Irving: By the Book The author, most recently, of the novel "In One Person" has little desire to meet other writers. "It's better to read a good writer than meet one," he says.  By the Book: Archive Inside the List By GREGORY COWLES Jeff Shaara, whose Civil War novel "Blaze of Glory" hits the hardcover fiction list at No. 7, follows a friend's advice: "If you expect me to read your books, you've gotta hook me in Chapter 1." Editors' Choice Recently reviewed books of particular interest. Paperback Row By IHSAN TAYLOR Paperback books of particular interest. Book Review Podcast This week, Richard Ford discusses his new novel, "Canada"; Julie Bosman has notes from the field; Mark Hyman talks about the rising cost of youth sports; and Gregory Cowles has best-seller news. Sam Tanenhaus is the host. Wilson Quarterly to End Print Publication Among the Autograph Hounds at BEA Tickets Available for Maurice Sendak Memorial REVIEWS BY THE TIMES'S CRITICS 'Beautiful Ruins' by Jess Walter A Dark Tale of Tokyo That Only Gets Darker 'Confront and Conceal' by David E. Sanger 'Barack Obama: The Story' by David Maraniss 'Mission to Paris' by Alan Furst The World Out There ARCHIVE Crime Columns Children's Books The New York Times Book Review: Back Issues Editor's Note Thanks for taking the time to read this e-mail. Feel free to send feedback; I enjoy hearing your opinions and will do my best to respond. John Williams Books Producer The New York Times on the Web

¿Quién domina Internet en los diversos países del mundo?

« Facebook introduce nuevas características de seguridad para la protección de cuentas a través de dispositivos móviles

Kanban2go: Un genial gestor de tareas visual »

¿Quién domina Internet en los diversos países del mundo?

Es posible que muchos de vosotros piensen que Google domina del todo Internet, pero resulta que esto no es del todo cierto ya que Yandex,Mail.Ru, Baidu entre otros, son también servicio populares en algunas partes del mundo.

Incluso Baidu puede llegar a dejar bien atras a Google, también tenemos a otras estrellas que nacieron mucho después de Google como la red social Facebook y que también tiene sus países que domina.

Pero esto lo verás más claro en la siguiente distribución demográfica, donde nos enseñan el mapa de empresas que dominan Internet en el mundo.

Para ver en tamaño gigante haz click sobre la imagen!

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1. Bitacoras.com Says: 8 junio, 2012 at 11:59
   Información Bitacoras.com…
   Valora en Bitacoras.com: Es posible que muchos de vosotros piensen que Google domina del todo Internet, pero resulta que esto no es del todo cierto ya que Yandex, Mail.Ru, Baidu entre otros, son también servicio populares en algunas partes del mundo……