sábado, 4 de febrero de 2012

Muerte cerebral y mas


 Fuente: Doctor Máximo Cuadros  


Muerte cerebral no es un término sinónimo de muerte encefálica

J.J. Egea-Guerrero, J. Revuelto-Rey y E. Gordillo-Escobar


10.1016/j.nrl.2011.07.013

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Muerte cerebral: ¿es un término adecuado?

J. Iriarte, J.A. Palma, E. Kufoy y M.J. de Miguel


10.1016/j.nrl.2010.06.004

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Eficacia del Folrex ® en la rehabilitación motora de los miembros superiores, en pacientes con infarto cerebral agudo

J.L. Giroud Benítez, M.R. Abreu Vázquez, O.G. Rodríguez Miranda, D.E. Loor Alcivar y M. Carrasco García


10.1016/j.rh.2011.10.002

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Migración neuronal, apoptosis y trastorno bipolar

Ezequiel Uribe y Richard Wix


10.1016/j.rpsm.2011.11.005

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Hemorragias intracerebrales en pacientes anticoagulados, ¿qué hacemos después?

A. Vidal-Jordana, I. Barroeta-Espar, M.P. Sáinz Pelayo, J. Mateo, R. Delgado-Mederos y J. Martí-Fàbregas


10.1016/j.nrl.2011.04.020

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Atte.
Dr.Máximo Cuadros Chávez

Documentos de consenso



Programas de optimización de uso de antimicrobianos (PROA) en hospitales españoles: documento de consenso GEIH-SEIMC, SEFH y SEMPSPH

J. Rodríguez-Baño, J.R. Paño-Pardo, L. Alvarez-Rocha, Á. Asensio, E. Calbo, E. Cercenado, J.M. Cisneros, J. Cobo, O. Delgado, J. Garnacho-Montero, S. Grau, J.P. Horcajada, A. Hornero, J. Murillas-Angoiti, A. Oliver, B. Padilla, J. Pasquau, M. Pujol, P. Ruiz-Garbajosa, R. San Juan y R. Sierra


10.1016/j.farma.2011.10.001

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Documento de consenso sobre el tratamiento de las infecciones en el pie del diabético

J.I. Blanes, A. Clará, F. Lozano, D. Alcalá, E. Doiz, R. Merino, J. González del Castillo, J. Barberán, R. Zaragoza y J.E. García Sánchez


10.1016/j.angio.2011.11.001

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Consenso de las Recomendaciones de Actuación diagnóstica y Terapéutica sobre Epilepsia resistente a fármacos antiepilépticos en España (Consenso RATE-España)

J.C. Sánchez-Álvarez, J.A. Mauri-Llerda, A. Gil-Nagel, C. Casas-Fernández, J. Salas-Puig, J. Lahuerta y J. Sancho-Rieger


10.1016/j.nrl.2011.09.006

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Documento Abordaje de la dislipidemia. Sociedad Española de Arteriosclerosis (parte II)

Jesús Millán Núñez-Cortés, Eduardo Alegría, Luis Alvarez-Sala Walther, Juan Ascaso Gimilio, Carlos Lahoz Rallo, Teresa Mantilla Morató, José M. Mostaza Prieto, Juan Pedro-Botet Montoya y Xavier Pintó Sala


10.1016/j.arteri.2011.09.005

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Documento Abordaje de la dislipidemia. Sociedad Española de Arteriosclerosis (parte III)

Jesús Millán Núñez-Cortés, Eduardo Alegría, Luis Alvarez-Sala Walther, Juan Ascaso Gimilio, Carlos Lahoz Rallo, Teresa Mantilla Morató, José M. Mostaza Prieto, Juan Pedro-Botet Montoya y Xavier Pintó Sala


10.1016/j.arteri.2011.09.004

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Recomendaciones para la determinación de biomarcadores en el carcinoma de pulmón no microcítico avanzado. Consenso nacional de la Sociedad Española de Anatomía Patológica y de la Sociedad Española de Oncología Médica

José Javier Gómez, Javier de Castro, Ángel Concha, Enriqueta Felip, Dolores Isla, Fernando López-Ríos, Luis Paz-Ares, José Ramírez, Julián Sanz y Pilar Garrido


10.1016/j.patol.2011.11.002

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Manejo perioperatorio de la enfermedad de Parkinson

Ana Mariscal, Ignacio Hernández Medrano, Araceli Alonso Cánovas, Eduardo Lobo, Carmelo Loinaz, Lydia Vela, Pedro García-Ruiz Espiga y Juan Carlos Martínez Castrillo


10.1016/j.nrl.2010.12.013

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Diagnóstico, tratamiento y seguimiento de la trombocitopenia inmune primaria

Miguel Ángel Sanz, Vicente Vicente García, Antonio Fernández, M. Fernanda López, Carlos Grande, Isidro Jarque, Rafael Martínez, María Eva Mingot, Emilio Monteagudo, Josep M a Ribera y David Valcárcel


10.1016/j.medcli.2011.11.011

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Etiología y diagnóstico de la neumonía adquirida en la comunidad y sus formas complicadas

A. Andrés Martín, D. Moreno-Pérez, S. Alfayate Miguélez, J.A. Couceiro Gianzo, M.L. García García, J. Korta Murua, M.I. Martínez León, C. Muñoz Almagro, I. Obando Santaella y G. Pérez Pérez


10.1016/j.anpedi.2011.09.011

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Pautas para el seguimiento clínico del niño pequeño para la edad gestacional

I. Díez López, A. de Arriba Muñoz, J. Bosch Muñoz, P. Cabanas Rodríguez, E. Gallego Gómez, M.J. Martínez-Aedo Ollero, J.M. Rial Rodríguez, A.C. Rodríguez Dehlia, R. Cañete Estrada y L. Ibáñez Toda


10.1016/j.anpedi.2011.08.003

http:  www.elsevier.es sites default files elsevier eop S         %    %         .pdfDescargar PDF.
 

Aproximación al diagnóstico radiológico de las neumonías intersticiales idiopáticas. Hallazgos en tomografía computarizada de alta resolución

J. Encinas, M.A. Corral, G.C. Fernández, D.S. Águeda y F.J. de Castro


10.1016/j.rx.2011.03.017

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Gestión de la endoscopia digestiva de puertas abiertas y calidad asistencial: equipo de mejora con atención primaria

Juan José Sebastián Domingo, Clara Sánchez Sánchez, Eugenio Galve Royo, Carolina Mendi Metola y Javier Valdepérez Torrubia


10.1016/j.gastrohep.2011.11.004

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Fuente : Doctor Máximo Cuadros



Recomendaciones del Grupo de Trabajo Enfermedades Infecciosas (GTEI) de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) y el Grupo de Estudio de Infecciones en el Paciente Crítico (GEIPC) de la Sociedad Española de Enfermedades Infecciosas y Microbiología clínica (SEIMC) para el diagnóstico y tratamiento de la gripe A/H1N1 en pacientes adultos graves hospitalizados en las Unidades de Cuidados Intensivos

A. Rodríguez, L. Álvarez-Rocha, J.M. Sirvent, R. Zaragoza, M. Nieto, A. Arenzana, P. Luque, L. Socías, M. Martín, D. Navarro, J. Camarena, L. Lorente, S. Trefler, L. Vidaur, J. Solé-Violán, F. Barcenilla, A. Pobo, J. Vallés, C. Ferri, I. Martín-Loeches, E. Díaz, D. López, M.J. López-Pueyo, F. Gordo, F. del Nogal, A. Marqués, S. Tormo, M.P. Fuset, F. Pérez, J. Bonastre, B. Suberviola, E. Navas y C. León


10.1016/j.medin.2011.11.020

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Atte.
Dr.Máximo Cuadros Chávez

Butorfanol


Estudio clinico prospectivo randomizado, doble ciego, controlado comparando butorfanol más corticoides vs corticoides para ciática secundaria a herniación del núcleo pulposo.
A prospective randomized, double-blind, controlled clinical trial comparing epidural butorphanol plus corticosteroid with corticosteroid alone for sciatica due to herniated nucleus pulposus.
Maity A, Mondal BC, Saha D, Roy DS.
Perspect Clin Res 2012;3:16-21
Objective: To compare the efficacy of up to 3 epidural butorphanol plus corticosteroid with corticosteroid alone for sciatica due to herniated nucleus pulposus. Materials and Methods: In a randomized, double-blind controlled clinical trial, we administered up to 3 epidural injections of either 80 mg (2 mL) of methylprednisolone acetate and 1 mg (1 mL) of butorphanol diluted with 7 mL of isotonic saline or 80 mg (2 mL) of methylprednisolone acetate diluted with 8 mL of isotonic saline by a lumbar interlaminar approach under fluoroscopic guidance to 120 patients (60 patients in each group) with sciatica due to a herniated nucleus pulposus lasting for 4 weeks to 1 year. All patients had scores higher than 30 mm on visual analog scale (VAS). Information on the use of paracetamol, intensity of pain on a VAS ranging from 0 (no pain) to 100 mm (worst pain possible), Schober's test (cm), Straight Leg Raising test, neurologic examination assessing sensory deficits, motor deficits and reflex changes, and Oswestry Low Back Pain Disability Questionnaire were evaluated at 3 weeks, 6 weeks, and 3 months after the first injection. Results: There were no significant differences between the 2 groups with regard to baseline characteristics, withdrawals, and complication rate. Three weeks, 6 weeks, and 3 months after the first injection, all the outcome measures in the butorphanol plus corticosteroid group were significantly different from that of the corticosteroid group. Conclusions: Epidural butorphanol plus corticosteroid injections, as compared with corticosteroid alone injections, offered marked improvement in pain, reflex, motor and sensory deficits, and functional status and reduced the need for analgesics. Level of Evidence: Therapeutic Level I.

 Bloqueo de Bier con lidocaina y butorfanol
Bier's block using lignocaine and butorphanol.
Bansal A, Gupta S, Sood D, Kathuria S, Tewari A.
Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, India.
J Anaesthesiol Clin Pharmacol. 2011 Oct;27(4):465-9.
Abstract
BACKGROUND: Opioids are most commonly used as adjuncts in intravenous regional anesthesia (IVRA) to improve the quality of intraoperative and postoperative analgesia. There is paucity of literature on the use of butorphanol in IVRA. AIMS: The aim of this study was to evaluate the likely benefits of addition of butorphanol to lignocaine in Bier's block in terms of onset and duration of sensory block and also for analgesic requirement in postoperative period.SETTINGS AND DESIGN: A randomized double blind study was conducted at Tertiary Care Educational Institute. PATIENTS AND METHODS: A total of 40 adult ASA I or II patients scheduled to undergo upper limb surgery were randomized in two groups (n=20). Group I received 3 mg/kg of lignocaine alone and group II received 1 mg butorphanol in addition to 3 mg/kg lignocaine. Sensory block onset time and time to recovery from sensory block after tourniquet deflation were noted using the pin prick method. Duration of postoperative analgesia was noted using a visual analogue scale. All the patients were compared for the time to first rescue analgesic consumption and total analgesic consumption in first 24 hours postoperatively. STATISTICAL ANALYSIS USED: The statistical analysis was done using unpaired Student's t-test. RESULTS: Our study showed significant prolongation of postoperative analgesia in group II as noted by the time to first analgesic requirement. Total analgesic consumption in first 24 hours postoperatively was less in group II. Sensory block onset time and time to recovery from sensory block after tourniquet deflation, did not show any significant difference between the two groups. CONCLUSIONS: Addition of butorphanol to lignocaine in IVRA significantly prolongs the duration of postoperative analgesia and 24 hours analgesic consumption is less in patients receiving butorphanol along with lignocaine in IVRA. However, there is no effect on sensory block onset time and time to recovery from sensory block
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3214549/?tool=pubmed 

 
Butorfanol: efectos de un analgésico prototipo agonista-antagonista de los receptors kappa
Butorphanol: effects of a prototypical agonist-antagonist analgesic on kappa-opioid receptors.
Commiskey S, Fan LW, Ho IK, Rockhold RW.
Department of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, USA.
J Pharmacol Sci. 2005 Jun;98(2):109-16. Epub 2005 Jun 8.
Abstract
The opioid analgesic, butorphanol (17-cyclobutylmethyl-3,14-dihydroxymorphinan) tartrate is a prototypical agonist-antagonist opioid analgesic agent whose potential for abuse has been the cause of litigation in the United States. With a published affinity for opioid receptors in vitro of 1:4:25 (mu:delta:kappa), the relative contribution of actions at each of these receptors to the in vivo actions of the drug are an issue of active investigation. A body of evidence has been developed which indicates that a substantial selective action of butorphanol on the kappa-opioid receptor mediates the development of tolerance to butorphanol and cross-tolerance to other opioid agonists; to the production of dependence upon butorphanol, particularly in the rodent; and to compensatory alterations in brain opioid receptor-effector systems. This perspective will identify the current state of understanding of the effects produced by butorphanol on brain opioid receptors, particularly on the kappa-opioid receptor subtype, and on the expression of phosphotyrosyl proteins following chronic treatment with butorphanol.
Atentamente
Anestesiología y Medicina del Dolor

Residential Summer Course in Epidemiology



Residential Summer Course in Epidemiology
Florence, Italy, from 25 June to 13 July 2012,
Three week main course
Competing Risks Analysis
Florence, Italy, from 18 June to 21 June 2012,
One week course
EEPE European Educational Programme in Epidemiology
International Epidemiological Association, the WHO Centre for Environment and Health and the Italian Association of Epidemiology
The courses are taught in English by lecturers mostly from European Universities and Research Institutes and are held in residential form in the "Studium" centre on the hills close to Florence .

The main three week course offers in the first two weeks five general modules on epidemiological study design and statistical analysis of epidemiological data. In the third week six special modules, ranging from cancer epidemiology and fertility and pregnancy to the impact of changes of global climatic environment cover topics of current relevance for health (students can choose which modules to follow).

The morning and afternoon sessions include lectures, computer based analyses (using the “Stata” package), exercises and discussion sessions. To follow profitably this course, students are expected to possess some knowledge of epidemiological and statistical methods at introductory level.
 
The one week course on “Competing Risks Analysis” is addressed to students with special interest in these areas and a sound background knowledge of epidemiological and statistical methods.
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All students should have a working knowledge of written and spoken English.
 
 
Content:
Epidemiological methods I :
basic principles and introduction to study design
Franco Merletti, Neil Pearce, Lorenzo Richiardi, Rodolfo Saracci
Statistical methods in epidemiology I : basic principles  - MichaelHills, Bianca De Stavola

Epidemiological methods II :
 case control studies - Manolis Kogevinas, Jørn Olsen, Rodolfo Saracci 

Statistical methods in epidemiology II :

analysis of cross-sectional and case-control studies - Simon Cousens
Computer analysis of epidemiological data sets :
Paco Fernandez, Pietro Ferrari, Manolis Kogevinas, Stefano Mattioli, Jørn Olsen, Jacopo Pasquini, Rodolfo Saracci, Aurelio Tobias
Cancer Epidemiology - Dimitrios Trichopoulos
Fertility and Pregnancy - Allen Wilcox
Epidemiology and environment
Part I : global climatic change and health - Anthony McMichael
Part II :
 local and occupational environment and health - Josep Antó , Jordi Sunyer
Part III :
 social environment and health - Bruna Galobardes

Statistical methods in epidemiology III :

analysis of follow-up studies - Per Kragh Andersen, Michela Baccini, Annibale Biggeri, Corrado Lagazio

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