Obesidad / Obesity

Octubre 2, 2017. No. 2829

El papel del aumento del índice de masa corporal en la evolución de la sepsis. Una revisión sistemática y meta-análisis. The role of increased body mass index in outcomes of sepsis: a systematic review and meta-analysis. Wang S1,2, Liu X3, Chen Q4, Liu C1, Huang C5, Fang X6. Author information BMC Anesthesiol. 2017 Aug 31;17(1):118. doi: 10.1186/s12871-017-0405-4. Abstract BACKGROUND: The role of increased body mass index (BMI) in sepsis is controversial. We aimed to evaluate the associations between overweight (25 kg/m2 < BMI ≤ 29.9 kg/m2), obese (30 kg/m2 < BMI ≤ 39.9 kg/m2) and morbidly obese (BMI > 40 kg/m2) BMIs and outcomes in septic patients. METHODS: We searched the PubMed, Embase, Web of Science, Cochrane Library and ClinicalTrials.gov databases for studies published by December 1, 2016. Electronic database searches yielded 3713 articles, eight of which were included in this meta-analysis. Data were independently extracted by two reviewers, and a third reviewer participated in making decisions as needed. We used Review Manager to conduct the analysis, and the outcomes were reported with odds ratios (ORs) or mean differences (MDs). The primary outcome was mortality, and the secondary outcome was length of stay (LOS) in the intensive care unit (ICU) or the hospital. RESULTS: Data from eight studies involving a total of 9696 patients were pooled in our final analysis. Compared with patients with normal BMI (18.5 kg/m2 < BMI ≤ 24.9 kg/m2), patients with BMI ≥ 25 kg/m2 exhibited decreased mortality (OR 0.81; 95% confidence interval (CI), 0.74-0.89, P < 0.0001). In subgroup analysis, compared with normal-weight patients, overweight patients had lower mortality (OR 0.87; 95% CI 0.77-0.97, P = 0.02), whereas obese (OR 0.89, 95% CI 0.72-1.10, P = 0.29) and morbidly obese (OR 0.64, 95% CI 0.38-1.08, P = 0.09) patients did not exhibit significantly reduced mortality. CONCLUSIONS: In sepsis cases, overweight, but not obesity or morbid obesity, was associated with lower mortality. Further prospective studies are needed to clarify this relationship. KEYWORDS: Body mass index; Length of stay; Mortality; Obesity; Sepsis PDF Aumento del índice de masa corporal y la mortalidad ajustada en pacientes en UCI con sepsis o choque séptico: una revisión sistemática y meta-análisis. Increased body mass index and adjusted mortality in ICU patients with sepsis or septic shock: a systematic review and meta-analysis. Pepper DJ1, Sun J2, Welsh J3, Cui X2, Suffredini AF2, Eichacker PQ2. Author information Crit Care. 2016 Jun 15;20(1):181. doi: 10.1186/s13054-016-1360-z. Abstract BACKGROUND: At least 25 % of adults admitted to intensive care units (ICU) in the United States have an overweight, obese or morbidly obese body mass index (BMI). The effect of BMI on adjusted mortality in adults requiring ICU treatment for sepsis is unclear. We performed a systematic review of adjusted all-cause mortality for underweight, overweight, obese and morbidly obese BMIs relative to normal BMI for adults admitted to the ICU with sepsis, severe sepsis, and septic shock.  CONCLUSIONS: This is the first meta-analysis to show that overweight or obese BMIs reduce adjusted mortality in adults admitted to the ICU with sepsis, severe sepsis, or septic shock. More rigorous studies that address these limitations are needed to clarify the impact of BMI on sepsis ICU outcomes. KEYWORDS: Body mass index; Meta-analysis; Mortality; Obesity; Overweight; Sepsis PDF Obesidad simple y función renal. Simple obesity and renal function. Sikorska D1,2, Grzymislawska M3, Roszak M4,5, Gulbicka P6, Korybalska K4, Witowski J4. Author information J Physiol Pharmacol. 2017 Apr;68(2):175-180. Abstract Increasing evidence accumulate to suggest that obesity increases the risk of chronic kidney disease independently of dyslipidemia, diabetes, and hypertension. This so-called obesity-related glomerulopathy is characterized at early stages by glomerular hypertrophy with or without secondary focal segmental glomerulosclerosis. Since, however, kidney biopsies are usually not performed at this phase, an early diagnosis of the disease is often difficult. Here, we review new developments in the pathophysiology of obesity-associated kidney dysfunction and discuss the potential of appropriate monitoring of glomerular filtration rate and albuminuria for early detection of the disease. We also present the benefits conferred by even moderate dietary restriction on the course of the disease. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo XXVII Congreso Peruano de Anestesiología Lima, Noviembre 2-4, 2017 Informes / Informataion

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

Surgical Skills Cuso de Hombro en espécimen biológico Lab

http://www.artroscopiayreemplazos.com.mx/academia/surgical-skills-cuso-de-hombro-cadaver-lab/
13 y 14 de octubre de 2017
Informes: 5526253111

#hombro#artroscopia#artroscopiadehombro#espécimen biológico

Origen y Tratamiento del Pie Equinovaro (Pie Zambo)

http://www.ortopediainfantil.com.mx/academia/origen-y-tratamiento-del-pie-equinovaro-pie-zambo/

Entrevista al aire para el lunes 02 de octubre del 2017 a las 10:00 horas por TV Canal 21.2 ‘El Canal de la Asamblea Legislativa’ con la conducción de Pita Ojeda quien hablará sobre el tema de “Origen y Tratamiento del Pie Equinovaro (Pie Zambo)” con la participación del Dr. Juan Agustín Valcarce León, Médico Ortopedista Pediatra adscrito al Servicio de Pie y Tobillo en el Hospital de Ortopedia “Dr. Victorio de la Fuente Narváez”. La cita es en Av. Insurgentes Sur No. 1605, Col. San José Insurgentes, décimo piso de la Torre MURAL. (Junto al Teatro de los Insurgentes).

#pie equinovaro#pie zambo

Metabolómica y otros avances en la composición de la Leche Materna

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. Continuamos el Programa 2017, el día 4 de Octubrebre las 21hrs (Centro, México DF, Guadalajara Liima Perú) a la Conferencia: “Metabolómica y otros avances en la composición de la Leche Materna”, por los “Dres. Daniel Fuentes Lugo y Horacio Reyes Vázquez“ Pediatras de la Cd del Carmen Campeche y CD de México”. La sesión inicia puntualmente a las 21 hrs.
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador

http://connectpro60196372.adobeconnect.com/metabolomica_lm/



2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia 6.- Recomendamos que dejes tu Nombre Completo, Correo electrónico y que participes.

7.- Recientemente te solicita para emtar en la patafoem un add in, que es un parche bajalo de la siguiente liga: https://adobe.ly/2r4SSag



--

Dr. Enrique Mendoza López
Webmaster: CONAPEME
Coordinador Nacional: Seminario Ciberpeds-Conapeme
Av La Clinica 2520-310 col Sertoma
Monterrey N.L. CP 64718
Tel (81) 83482940, (81)81146053
Cel 0448183094806

Resucitación prehospitalaria / Prehospital resuscitation

Septiembre 28, 2017. No. 2825

Resucitación prehospitalaria Prehospital Resuscitation Tobin, Joshua M. MD, Lockey, David J. MBBS MD (Res) International Anesthesiology Clinics: Summer 2017 - Volume 55 - Issue 3 - p 36-49 doi: 10.1097/AIA.0000000000000145 The role of prehospital resuscitation has evolved from the early days of Napoleon's army in which the wounded were evacuated to aid stations on horse drawn carriages. Before that, soldiers often died in the field before having received any kind of medical care. Modern American Emergency Medical Services (EMS) developed with the return of military veterans from the Vietnam War. Trained medical providers brought previously unavailable care to patients before arrival in hospital. In recent years the development of technology, training, and resource allocation to early trauma care has provided the potential for another period of growth for prehospital resuscitation. As data from recent conflicts are analyzed, a refined understanding of the pathophysiology of shock may facilitate delivery of critical care-level resuscitation in the field. A recent analysis found that critical care procedures were performed frequently on patients transported in Operation Enduring Freedom/Afghanistan.1 In addition, biomarkers for resuscitation and coagulation in troops transported from the point of injury were deranged very early after injury. A critical care-capable transportation platform that "brings the trauma bay to the patient" may offer a therapeutic advantage in carefully selected patients. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo XXVII Congreso Peruano de Anestesiología Lima, Noviembre 2-4, 2017 Informes / Informataion

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

Síndrome de embolia grasa y el cirujano de ortopedia y traumatología: lecciones aprendidas y recomendaciones clínicas

http://www.traumaysiniestros.com.mx/traumatologia/sindrome-de-embolia-grasa-y-el-cirujano-de-ortopedia-y-traumatologia-lecciones-aprendidas-y-recomendaciones-clinicas/

Fat emboli syndrome and the orthopaedic trauma surgeon: lessons learned and clinical recommendations

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28555248

https://link.springer.com/article/10.1007%2Fs00264-017-3507-1

De:

Dunn RH1,Jackson T1,Burlew CC2,Pieracci FM2,Fox C2,Cohen M2,

Campion EM2,Lawless R2,Mauffrey C3.

Int Orthop.

2017 May 30. doi: 10.1007/s00264-017-3507-1. [Epub ahead of print]

Todos los derechos reservados para:

Copyright information

© SICOT aisbl 2017

Abstract

PURPOSE:

Fat emboli syndrome is a rare but well-described complication of long-bone fractures classically characterised by a triad of respiratory failure, mental status changes and petechial rash. In this paper, we present the case of a patient who sustained bilateral femoral fractures and subsequently developed FES. Our aim was to review and summarise the current literature regarding the pathophysiology and management of fat emboli syndrome (FES) and propose an algorithm for treating patients with bilateral femoral fractures to reduce the risk of FES.

CONCLUSIONS:

Our algorithm for managing bilateral femoral fractures prioritises early stabilisation with external fixation, staged intramedullary nailing and conversion to plate fixation if FES develops. This protocol is meant to be the basis of future investigations of optimal treatment strategies.

KEYWORDS:

Bilateral femur fractures; Complication; Damage control orthopaedics; Fat emboli syndrome; Femur shaft fracture

Resumen

PROPÓSITO:
El síndrome de embolia grasa es una complicación rara pero bien descrita de fracturas de hueso largo caracterizadas clásicamente por una tríada de insuficiencia respiratoria, cambios en el estado mental y erupción petequial. En este artículo presentamos el caso de un paciente que sostuvo fracturas femorales bilaterales y posteriormente desarrolló FES. Nuestro objetivo fue revisar y resumir la literatura actual sobre fisiopatología y manejo del síndrome de embolia grasa (FES) y proponer un algoritmo para el tratamiento de pacientes con fracturas femorales bilaterales para reducir el riesgo de FES.

CONCLUSIONES:
Nuestro algoritmo para el manejo de fracturas femorales bilaterales prioriza la estabilización temprana con fijación externa, clavado intramedular escalonado y conversión a fijación de placa si FES se desarrolla. Este protocolo está destinado a ser la base de futuras investigaciones de estrategias de tratamiento óptimo.
PALABRAS CLAVE:
Fracturas bilaterales del fémur; Complicación; control de daños en ortopedia; Síndrome de embolia grasa; Fractura del fémur

PMID:  28555248   DOI:  

10.1007/s00264-017-3507-1

#Fracturas bilaterales del fémur#control de daños en ortopedia#Síndrome de embolia grasa#fémur#fracturas