Post and perimortem cesarean section / Cesárea peri y postmortem

Octubre 14, 2017. No. 2841

La cesárea perimortem fuera del hospital como histerotomía de reanimación en paro cardíaco postraumático materno Out-of-Hospital Perimortem Cesarean Section as Resuscitative Hysterotomy in Maternal Posttraumatic Cardiac Arrest. Gatti F1, Spagnoli M1, Zerbi SM1, Colombo D2, Landriscina M1, Kette F3. Author information Case Rep Emerg Med. 2014;2014:121562. doi: 10.1155/2014/121562. Epub 2014 Oct 30. Abstract The optimal treatment of a severe hemodynamic instability from shock to cardiac arrest in late term pregnant women is subject to ongoing studies. However, there is an increasing evidence that early "separation" between the mother and the foetus may increase the restoration of the hemodynamic status and, in the cardiac arrest setting, it may raise the likelihood of a return of spontaneous circulation (ROSC) in the mother. This treatment, called Perimortem Cesarean Section (PMCS), is now termed as Resuscitative Hysterotomy (RH) to better address the issue of an early Cesarean section (C-section). This strategy is in contrast with the traditional treatment of cardiac arrest characterized by the maintenance of cardiopulmonary resuscitation (CPR) maneuvers without any emergent surgical intervention. We report the case of a prehospital perimortem delivery by Caesarean (C) section of a foetus at 36 weeks of gestation after the mother's traumatic cardiac arrest. Despite the negative outcome of the mother, the choice of performing a RH seems to represent up to date the most appropriate intervention to improve the outcome in both mother and foetus. PDF Cesárea postmortem y perimortem. ¿Cuáles son las indicaciones? Postmortem and perimortem caesarean section: what are the indications? Whitten M1, Irvine LM. J R Soc Med. 2000 Jan;93(1):6-9. 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

Falla aguda de corticoesteroides en pacientes graves / Critical illness-related corticosteroid insufficiency

Octubre 8, 2017. No. 2835

Directrices para el diagnóstico y tratamiento de la insuficiencia de corticoesteroides relacionada con la enfermedad crítica (CIRCI) en pacientes críticamente enfermos (Parte I): Sociedad de Medicina de Cuidados Críticos (SCCM) y Sociedad Europea de Medicina Intensiva (ESICM) 2017. Guidelines for the diagnosis and management of critical illness-related corticosteroidinsufficiency (CIRCI) in critically ill patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Annane D1, Pastores SM2, Rochwerg B3, Arlt W4, Balk RA5, Beishuizen A6, Briegel J7, Carcillo J8, Christ-Crain M9, Cooper MS10, Marik PE11, Umberto Meduri G12, Olsen KM13, Rodgers S14, Russell JA15, Van den Berghe G16. Author information Intensive Care Med. 2017 Sep 21. doi: 10.1007/s00134-017-4919-5. [Epub ahead of print] Abstract OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroidinsufficiency (CIRCI) in adult and pediatric patients.  PARTICIPANTS: A multispecialty task force of 16 international experts in Critical Care Medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The strength of each recommendation was classified as strong or conditional, and the quality of evidence was rated from high to very low based on factors including the individual study design, the risk of bias, the consistency of the results, and the directness and precision of the evidence. Recommendation approval required the agreement of at least 80% of the task force members. RESULTS: The task force was unable to reach agreement on a single test that can reliably diagnose CIRCI, although delta cortisol (change in baseline cortisol at 60 min of <9 µg/dl) after cosyntropin (250 µg) administration and a random plasma cortisol of <10 µg/dl may be used by clinicians. We suggest against using plasma free cortisol or salivary cortisol level over plasma total cortisol (conditional, very low quality of evidence). For treatment of specific conditions, we suggest using intravenous (IV) hydrocortisone <400 mg/day for ≥3 days at full dose in patients with septic shock that is not responsive to fluid and moderate- to high-dose vasopressor therapy (conditional, low quality of evidence). We suggest not using corticosteroids in adult patients with sepsis without shock (conditional recommendation, moderate quality of evidence). We suggest the use of IV methylprednisolone 1 mg/kg/day in patients with early moderate to severe acute respiratory distress syndrome (PaO2/FiO2 < 200 and within 14 days of onset) (conditional, moderate quality of evidence). Corticosteroids are not suggested for patients with major trauma (conditional, low quality of evidence). CONCLUSIONS: Evidence-based recommendations for the use of corticosteroids in critically ill patients with sepsis and septic shock, acute respiratory distress syndrome, and major trauma have been developed by a multispecialty task force. KEYWORDS: Acute respiratory distress syndrome; Corticosteroids; Critical illness; Glucocorticoids; Major trauma; Sepsis; Septic shock 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

Surgical Skills Cuso avanzado de artroscopia de Hombro en espécimen biológico Lab

http://www.artroscopiayreemplazos.com.mx/academia/surgical-skills-cuso-de-hombro-cadaver-lab/

CURSO AVANZADO TEORICO-PRACTICO DE ARTROSCOPIA DE HOMBRO EN MODELO CADAVERICO

13 Y 14 DE OCTUBRE DE 2017

Número de alumnos: 12 CUPO LIMITADO

Modalidad: presencial

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SURGICAL SKILLS es un establecimiento dedicado al entrenamiento médico para la adquisición de competencias profesionales y su evaluación a través de innovadoras metodologías de simulación médico-quirúrgica aplicadas en escenarios realistas y controladas por expertos en cada materia.


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Controversias en el manejo quirúrgico de la inestabilidad del hombro: Procedimientos asociados al tejido blando.

http://www.mihombroycodo.com.mx/academia/controversias-en-el-manejo-quirurgico-de-la-inestabilidad-del-hombro-procedimientos-asociados-al-tejido-blando/

Controversies In The Surgical Management Of Shoulder Instability: Associated Soft Tissue Procedures.

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28979603

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5612025/

https://benthamopen.com/ABSTRACT/TOORTHJ-11-989

De:

Marco SM1,Lafuente JLÁ1,Ibán MAR1,Heredia JD1.

Open Orthop J.

2017 Aug 31;11:989-1000. doi: 10.2174/1874325001711010989. eCollection 2017.

Todos los derechos reservados para:

Copyright and License information ▼

Copyright

© 2017 Santos Moros Marco.This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at:

https://creativecommons.org/licenses/by/4.0/legalcode

. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

BACKGROUND:

The glenohumeral joint is a ball-and-socket joint that is inherently unstable and thus, susceptible to dislocation. The traditional and most common anatomic finding is the Bankart lesion (anterior-inferior capsule labral complex avulsion), but there is a wide variety of anatomic alterations that can cause shoulder instability or may be present as a concomitant injury or in combination, including bone loss (glenoid or humeral head), complex capsule-labral tears, rotator cuff tears, Kim´s lesions (injuries to the posterior-inferior labrum) and rotator interval pathology.

CONCLUSION:

Physicians must be familiarized with all the lesions involved in shoulder instability, and should be able to recognize and subsequently treat them to achieve the goal of a stable non-painful shoulder. Unrecognized or not treated lesions may result in recurrence of instability episodes and pain while overuse of some of the techniques previously described can lead to stiffness, thus the importance of an accurate diagnosis and treatment when facing a shoulder instability.

KEYWORDS:

Instability copathology; Shoulder dislocation; Shoulder instability; Soft tissue

Resumen

ANTECEDENTES:
La articulación glenohumeral es una articulación esférica que es inherentemente inestable y, por lo tanto, susceptible de dislocación. El hallazgo anatómico tradicional y más común es la lesión de Bankart (avulsión del complejo labrural de la cápsula anterior-inferior), pero existe una amplia variedad de alteraciones anatómicas que pueden causar inestabilidad en los hombros o pueden estar presentes como lesión concomitante o en combinación, incluyendo pérdida ósea (cabeza glenoidea o humeral), desgarros complejos de la cápsula-labrum, desgarros del manguito rotador, lesiones de Kim (lesiones en el labrum posterior-inferior) y patología del intervalo de los rotadores.

CONCLUSIÓN:
Los médicos deben familiarizarse con todas las lesiones involucradas en la inestabilidad del hombro, y deben ser capaces de reconocerlas y posteriormente tratarlas para lograr el objetivo de un hombro estable y no doloroso. Las lesiones no reconocidas o no tratadas pueden resultar en recurrencia de episodios de inestabilidad y dolor, mientras que el uso excesivo de algunas de las técnicas previamente descritas puede conducir a rigidez, por lo tanto la importancia de un diagnóstico y tratamiento precisos frente a una inestabilidad del hombro.

PALABRAS CLAVE:
Inestabilidad copatología; Dislocación del hombro; Inestabilidad del hombro; Tejido blando

PMID:  28979603   PMCID:  PMC5612025   DOI:  10.2174/1874325001711010989

Free PMC Article

#manejo quirúrgico#Dislocación del hombro#inestabilidad del hombro#tejido blando

Programa de Alta Especialidad para Médicos Especialistas en Traumatología Deportiva y Artroscopia. Concurso de Selección

http://www.lesionesdeportivas.com.mx/academia/programa-de-alta-especialidad-para-medicos-especialistas-en-traumatologia-deportiva-y-artroscopia-concurso-de-seleccion/

Hospital Ángeles MetropolitanoInvitan a los Médicos Especialistas en Ortopedia a participar en el concurso de

selección para ingresar al Programa de Alta Especialidad para Médicos

Especialistas en Traumatología Deportiva y Artroscopia con reconocimiento de

la División de Estudios de Posgrado de la Facultad de Medicina de la UNAM.

Número de plazas: 2 (Apoyo económico equivalente a media beca de

residente de alta especialidad en secretaria de salud)

Profesor Titular: Dr. Antonio Miguel L.
Profesor Adjunto: Dr. Michell Ruiz S.

#traumatología deportiva#artroscopia