lunes, 23 de octubre de 2017

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.
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
Infarto del miocardio en UCIs. Revisión sistemática del diagnóstico y tratamiento
Myocardial infarction in intensive care units: A systematic review of diagnosis and treatment.
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.
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.


XXVII Congreso Peruano de Anestesiología
Lima, Noviembre 2-4, 2017
LI Congreso Mexicano de Anestesiología
Mérida Yucatán, Noviembre 21-25, 2017
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Tratamiento quirúrgico artroscópico de la epicondilitis medial


Arthroscopic surgical treatment of medial epicondylitis

Fuente
Este artículo es originalmente publicado en:
De:
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:  

Libros sobre ECG / Books on EKG Buzón

Octubre 23, 2017. No. 2890

  


Interpretación de electrogramas cardíacos: de la piel al endocardio
Interpreting Cardiac Electrograms - From Skin to Endocardium
Edited by Kevin A. Michael, ISBN 978-953-51-3572-2, Print ISBN 978-953-51-3571-5, 192 pages, Publisher: InTech, Chapters published October 18, 2017 under CC BY 3.0 license
DOI: 10.5772/65202
Edited Volume
This is a reference book aimed at cardiologists, electrophysiologists and fellows in training. 
It presents an expansive review of cardiac electrogram interpretation in a collation of manuscripts that represent clinical studies, relevant anecdotal cases and basic science chapters evaluating cardiac signal processing pertaining to persistent atrial fibrillation. A diagnostic approach to arrhythmias using a standard ECG, the signal average ECG and fetal ECG is highlighted. Intracardiac ICD electrograms are also explored in terms of trouble shooting and device programming.
Avances en electrocardiografía. Aplicaciones clínicas
Advances in Electrocardiograms - Clinical Applications
Edited by Richard M. Millis, ISBN 978-953-307-902-8, 340 pages, Publisher: InTech, Chapters published January 25, 2012 under CC BY 3.0 license
DOI: 10.5772/1761
Edited Volume
Electrocardiograms have become one of the most important, and widely used medical tools for diagnosing diseases such as cardiac arrhythmias, conduction disorders, electrolyte imbalances, hypertension, coronary artery disease and myocardial infarction. 
This book reviews recent advancements in electrocardiography. The four sections of this volume, Cardiac Arrhythmias, Myocardial Infarction, Autonomic Dysregulation and Cardiotoxicology, provide comprehensive reviews of advancements in the clinical applications of electrocardiograms. This book is replete with diagrams, recordings, flow diagrams and algorithms which demonstrate the possible future direction for applying electrocardiography to evaluating the development and progression of cardiac diseases. The chapters in this book describe a number of unique features of electrocardiograms in adult and pediatric patient populations with predilections for cardiac arrhythmias and other electrical abnormalities associated with hypertension, coronary artery disease, myocardial infarction, sleep apnea syndromes, pericarditides, cardiomyopathies and cardiotoxicities, as well as innovative interpretations of electrocardiograms during exercise testing and electrical pacing.


XXVII Congreso Peruano de Anestesiología
Lima, Noviembre 2-4, 2017
LI Congreso Mexicano de Anestesiología
Mérida Yucatán, Noviembre 21-25, 2017
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Feliz Día del Médico

Octubre 23, 2017. No. 2890-A






Ser médico no es una meta de vida fácil; los primeros 30 años aprendemos a caminar, hablar y a ser médicos, a veces con alguna especialidad. Los siguientes 30 años se disfrutan estudiando y ejerciendo nuestra profesión con orgullo y como una forma de vida para obtener el pan nuestro de cada día. Este ejercicio profesional está pleno de satisfacciones, logros, metas realizadas, fracasos terapéuticos, retos, errores y además se adereza ocasionalmente con premios, menciones, honores y dos que tres demandas por mala práctica profesional.
Es una forma de vida que elegimos para llevarla siempre con nosotros, para disfrutarla día con día  con nuestra Familia, amigos, pacientes y con nosotros mismos. Una forma de vida que implica estudio continuo, dedicación y búsqueda de la ruta hacia la excelencia profesional.
¡Le deseamos un Feliz Día del Médico!

Ser médico não é um objetivo de vida fácil, os primeiros 30 anos, aprendemos a andar, falar e ser médicos, às vezes com uma especialidade. Os próximos 30 anos vão desfrutar de estudar e praticar a nossa profissão com orgulho e como uma forma de vida para o pão nosso de cada dia.Esta prática está cheia de satisfações, realizações, objetivos feitas, falhas de tratamento, desafios, erros e ocasionalmente experientes bem com prêmios, honrarias, homenagens e 2-3 processos de erro médico.
É uma forma de vida que escolhemos para levar sempre conosco, para desfrutar de todos os diascom a nossa família, amigos, pacientes e de nós mesmosUm estilo de vida que envolve o estudocontínuo, dedicação e busca do caminho para a excelência profissional.
!Desejamos-lhe um dia de Doctor feliz!
17h World Congress of Anaesthesiologists, WFSA
Sep 6-11, 2020
Prague, Czech Republic
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