Bibliotecas. Alerta

Tanzanos entenderán mejor a China gracias a nueva Biblioteca
Pueblo en linea
La biblioteca sobre China forma parte del programa “Experimenta China” en Tanzania, un gran intercambio cultural iniciado por la Oficina de Información del Consejo de Estado de China (OICEC). Está organizado en conjunto por la embajada china en ...
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Pueblo en linea



El Congreso rinde homenaje a las Bibliotecas Populares
Télam
Un homenaje y reconocimiento a las Bibliotecas Populares de diversos puntos del país tendrá lugar a las 17.30 en el Salón de los Pasos Perdidos del Congreso de la Nación, en el marco de los festejos por su día. La ceremonia estará encabezada por la ...
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La biblioteca de La Nación
Clarín.com
De Caballito hasta el Centro, esos libros seguían circulando, pasando de bibliotecasparticulares a libreros, y de ellos a otras bibliotecas particulares y a nuevos libreros... Con el tiempo, gracias a la lectura de sendos textos de Nicolás Cócaro y ...
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Clarín.com


Congreso nacional de bibliotecas públicas en Pachuca
AlianzaTex
Con el tema central “El futuro de las bibliotecas públicas en México”, inició este lunes 24 de septiembre, el XII Congreso Nacional de Bibliotecas Públicas, en el Centro de Convenciones “Tuzoforum”, de Pachuca, Hidalgo. En la ceremonia de inauguración ...
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AlianzaTex



Este martes abre sus puertas la biblioteca pública de Caraballeda
Agencia Venezolana de Noticias
Caracas, 25 Sep. AVN.- Luego de finalizar las labores de remoción y recuperación, la bibliotecapública de Caraballeda, ubicada en la parroquia homónima del estado Vargas, abrirá nuevamente sus puertas a la comunidad este martes, a partir de las 10:00 ...
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Ebooks, tablets y smartphones se toman las bibliotecas de Duoc UC
Mundo en Línea
Hasta hace un par de años, los estudiantes debían imprimir o fotocopiar las guías de estudio que sus profesores les entregaban, lo que generaba un gasto económico y hacía que los alumnos cargaran en sus mochilas peso extra. Con el fin de palear en ...
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Mundo en Línea


Entregan equipo para biblioteca
El Siglo de Torreón
Representantes de Teléfonos de México entregaron de manera formal ayer a las autoridades municipales 20 computadoras que serán parte del mobiliario de la nuevabiblioteca digital del municipio. Más vistas en Regionales. 1 2 3 4 5. Matamoros es la ...
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El Siglo de Torreón


Incrementarán acervo digital en bibliotecas
Sexenio, Extraordinary Life
José Vergara, titular de la Consejo Estatal para la Cultura y las Artes (Cecultah), explicó que es prioritario que atiendan las necesidades de la población en materia de acervos bibliotecarios, esta es la razón por la que se ha incrementado el acervo ...
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Sexenio, Extraordinary Life


Las Bibliotecas Públicas de Telde impulsan 'Los Club de Lectura'
TeldeActualidad.com
Las Bibliotecas Públicas de Telde impulsan 'Los Club de Lectura'. El proyecto será presentado este martes por Catherina Fleitas Medina en la sede de Cruz Roja. LasBibliotecas Públicas de Telde impulsan 'Los Club de Lectura' Catherina Fleitas con un ...
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TeldeActualidad.com


Medellín tiene bibliotecas para la paz « Beyond Access
En el marco del Día Internacional de la Paz, queremos contar la experiencia de la Red de Bibliotecasde Medellín que se desenvuelve como un actor promotor ...
www.beyondaccess.net/.../medellin-tiene-bibliotecas-para-la-p...


Analizarán en Pachuca presente y futuro de las bibliotecas públicas ...
México, 23 Sep. (Notimex).- Bibliotecas digitales y derechos de autor, servicios bibliotecarios en línea y el fomento de la lectura en el entorno digital son ...
es-us.omg.yahoo.com/.../analizarán-pachuca-presente-futuro-b...

El Capitulo de Residentes del Colegio Mexicano de Ortopedia y Traumatología A.C

		CAPÍTULO DE RESIDENTES 2012 – 2013
El Capitulo de Residentes del Colegio Mexicano de Ortopedia y Traumatología A.C., le invita a su reunión mensual que tendrá lugar el jueves 27 de septiembre del 2012 a las 20:00 horas en el WTC México, Montecito 38, piso 25, Oficinas 23 a 27,  Col. Nápoles, C.P. 03810 México, D.F. bajo la siguiente orden del día:
	1.		Presentación de los ponentes y temas a desarrollar, con una duración máxima de 20 min. cada uno, con un periodo de preguntas y respuestas de 15 min. de acuerdo al siguiente listado:
			Indicaciones y contraindicaciones del uso de los clavos de Kirschner. Dr. Rodolfo Corpus Mariscal Médico adscrito Hospital General Regional con UMAE No. 2 Villa Coapa. IMSS
			Fracturas supracondíleas de húmero en niños. Dr. Jorge Gómez Chavarría Médico adscrito al Hospital Shriners para niños
			PEVAC Dr. José Gilberto Ríos Ruiz Médico adscrito al Hospital Shriners para niños
	2.		Invitación para las sesiones del Capítulo de Residentes a realizarse a las 19:45 hrs del día jueves último de cada mes, teniendo verificativo la siguiente el día jueves 25 de octubre de 2012, por la Dra. Nayeli Suárez Reyes, Secretario del Capítulo de Residentes.
	3.		Invitación para formar parte del Capítulo de Residentes del Colegio Mexicano de Ortopedia y Traumatología A.C.
	4.		Invitación para pre-registrarse al 6° Congreso Nacional de Residentes en Ortopedia a realizarse el 8, 9 y 10 de marzo de 2013, con el fin de planificar la asistencia estimada.
	5.		Información sobre incentivos para inscripción y participación en el congreso, así como premios a los primeros lugares.
	6.		Agradecimiento y entrega de reconocimiento a ponentes
	7.		Clausura de la sesión
	8.		Ambigú
Atentamente
Dr. Eduardo Antonio Rodríguez Becerril Titular del Capítulo
www.smo.edu.mx Colegio Mexicano de Ortopedia y Traumatología A.C. World Trade Center México, Montecito #38, col. Nápoles, piso 25, oficinas 23 a 27, C.P. 03810, México, D.F. Tel y Fax ( ) (55) 9000 2790 al 94

novena Sesión Reglamentaria CMO

SESIÓN REGLAMENTARIA 09/2012


El Consejo Directivo del Colegio Mexicano de Ortopedia y Traumatología A.C., atentamente le invita y convoca a su novena Sesión Reglamentaria, que tendrá verificativo el miércoles 3 de octubre de 2012 a las 20:30 horas, en el auditorio de nuestra sede, ubicado en el WTC México, Montecito No. 38, piso 25, Oficinas 23 a 27, Col. Nápoles, 03810 México, D.F., bajo la siguiente:

ORDEN DEL DÍA



1. Palabras de bienvenida del Presidente del Colegio.
2. Lectura del acta de la sesión anterior, celebrada el 5 de septiembre de 2012.
3. Comunicaciones de la Presidencia.
4. Entrega de diplomas a nuevos miembros.
5. Asuntos generales.
6. Panel Foro:



CODO REUMÁTICO
Coordinador: Dr. M. Iván Encalada Díaz
Titular del Capítulo de Especialización en Hombro y Codo


a) Generalidades
Dr. Rolando Espinosa Morales
Presidente del Colegio Mexicano de Reumatología, A.C. ................ 10 ’


b) Evaluación preoperatoria del codo reumático.
Dr. Josué Giovanni Escutia García
Alumno de posgrado para Especialistas en Reconstrucción Articular de Hombro y Codo, INR-UNAM
................ 10 ’


c) Sinovectomia artroscopica del codo.
Dr. Michell Ruiz Suárez
Médico Adscrito al Instituto Nacional de Rehabilitación de la Secretaría de Salud. ................ 10 ’


d) Artroplastia de interposición del codo.
Dr. M. Iván Encalada Díaz
Titular del Capítulo de Especialización en Hombro y Codo. ................ 10 ’


e) Sustitución protésica del codo.
Dr. Fernando Sergio Valero González
Jefe del Servicio de Reconstrucción Articular de Hombro y Codo del INR,
Profesor Titular del Posgrado para Médicos Especialistas en Reconstrucción Articular de Hombro y Codo INR-UNAM. ................ 10 ’


f) Preguntas y comentarios. ................ 10 ’



7. Convivio ofrecido por Lilly


Atentamente



Dr. Salvador O. Rivero Boschert
Presidente

Dr. Arturo Gutiérrez Meneses
I Secretario Propietario

XIV Curso Internacional de Cirugía Artroscópica y Artroplastías de Rodilla y Hombro

XIV Curso Internacional de Cirugía Artroscópica y Artroplastías de Rodilla y Hombro


XIV Curso Internacional de Cirugía Artroscópica y Artroplastías de Rodilla y Hombro
Cancún, Quintana Roo, México
Sede: Hotel J.W. Marriot
Avalado por CMOT y CMO


Para mayor información:
Dr. Gonzalo Vázquez Vela Sánchez
Hospital Angeles del Pedregal
Camino a Sta. Teresa 1055 608
México, D.F. C.P. 10700
TEL. 55-68-24-22/55-6840-81
Fax. 55-68-08-21
gvvknee@terra.com.mx

Capitulo de Residentes del Colegio Mexicano de Ortopedia y Traumatología A.C.

Capitulo de Residentes del Colegio Mexicano de Ortopedia y Traumatología A.C.
El Capitulo de Residentes del Colegio Mexicano de Ortopedia y Traumatología A.C., le invita a su reunión mensual que tendrá lugar el jueves 27 de septiembre del 2012 a las 20:00 horas en el WTC México, Montecito 38, piso 25, Oficinas 23 a 27, Col. Nápoles, C.P. 03810 México, D.F.
Atentamente

Dr. Eduardo Antonio Rodríguez Becerril
Titular del Capítulo

Ketamina en analgesia postoperatoria

La ketamina (compuesto CI-581) es un derivado la fenciclidina, formulado como mezcla racémica donde los dos estereoisómeros tienen diferente potencia anestésica-analgésica, pero cinética similar. Es una droga fantástica que fue introducida en anestesia por Corssen en 1966. Posee efectos anestésicos, sedantes, amnésicos, neuroprotectivos, analgésicos y recreacionales. Este fármaco ha sido redescubierto en forma reciente cuando se conocieron sus interacciones con el receptor NMDA y ahora se utiliza por diversas vías (iv, im, oral, bucal, rectal, neuroaxial, nasal), no solo en anestesia, sino en dolor agudo y en dolor crónico oncológico y no oncológico


Ketamine (compound CI-581) is a phencyclidine derivative, formulated as a racemic mixture where the two stereoisomers have different anesthetic-analgesic potency, but similar kinetics. It's a great drug that was introduced in 1966 by Corssen in clinical anesthesia. It has anesthetic, sedative, amnesic, neuroprotective, analgesic and recreational effects. This drug has been rediscovered recently due to its interactions with the NMDA receptor and is now used by various routes (iv, im, oral, buccal, rectal, neuraxial, nasal), not only in anesthesia, but also in post operative pain, chronic cancer pain and noncancer chronic pain.

Ketamina perioperatoria con infusión ambulatoria con bomba infusión como coadyuvante en el tratamiento del dolor agudo postoperatorio por fusión espinal en adultos: estudio prospectivo aleatorizado


Peri-operative ketamine with the ambulatory elastometric infusion pump as an adjuvant to manage acute postoperative pain after spinal fusion in adults: a prospective randomized trial.
Yeom JH, Chon MS, Jeon WJ, Shim JH.
Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea.
Korean J Anesthesiol. 2012 Jul;63(1):54-8. Epub 2012 Jul 24.
Abstract
BACKGROUND: In this study, we assessed the effectiveness of ketamine as an alternative to non-steroidal anti-inflammatory drugs (NSAID), to manage acute postoperative pain after spinal fusion when given intravenously via a patient-controlled analgesia (PCA) pump in which the dose was proportional to that of fentanyl. METHODS: Forty patients undergoing 1-2 level spinal fusion were enrolled in this study. Patients were intraoperatively randomized into two groups to receive intravenous PCA consisting either of fentanyl 0.4 µg/ml/kg (control group) or fentanyl 0.4 µg/ml/kg with ketamine 30 µg/ml/kg (ketamine group) after intravenous injection of a loading dose. The loading dose in the control group was fentanyl 1 µg/kg with normal saline equal to ketamine volume and in the ketamine group it was fentanyl 1 µg/kg with ketamine 0.2 mg/kg. The verbal numerical rating scale (NRS), fentanyl and ketamine infusion rate, and side effects were evaluated at 1, 24, and 48 hours after surgery. RESULTS: There were no significant differences in patient demographics, duration of surgery and anesthesia or intra-operative opioids administration. We did not find any significant differences in the mean infusion rate of intraoperative remifentanil or postoperative fentanyl or in the side effects between the groups, but we did find a significant difference in the NRS between the groups. CONCLUSIONS: Based on our results, we conclude that a small dose of ketamine (0.5-2.5 µg/kg/min) proportional to fentanyl is not only safe, but also lowers postoperative pain intensity in patients undergoing spinal fusion, although the opioid-sparing effects of ketamine were not demonstrated.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3408516/?tool=pubmed



Comparación del efecto preventivo de la ketamina rectal y del acetaminofen rectal después de amigdalectomía en niños
Comparison of the Preventive Analgesic Effect of Rectal Ketamine and Rectal Acetaminophen after Pediatric Tonsillectomy.
Heidari SM, Mirlohi SZ, Hashemi SJ.
Department of Anesthesiology and Intensive Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2012 Mar;3(Suppl1):S150-S155.
Abstract
OBJECTIVES: There is a little data about rectal administration of Ketamine as a postoperative analgesic, so we compared the efficacy of rectal ketamine with rectal acetaminophen, which is applied routinely for analgesia after painful surgeries like tonsillectomy.METHODS: In this single-blinded comparative trial, we enrolled 70 children undergoing elective tonsillectomy, and divided them randomly in two groups. Patients received rectal ketamine (2 mg / kg) or rectal acetaminophen (20 mg / kg) at the end of surgery. The children's Hospital of Eastern Ontario Pain scale was used to estimate pain in children. Also the vital signs, Wilson sedation scale, and side effects in each group were noted and compared for 24 hours. RESULTS: The ketamine group had a lower pain score at 15 minutes and 60 minutes after surgery in Recovery (6.4 ± 0.8, 7.4 ± 1 vs. 7.1 ± 1.2, 7.8 ± 1.2 in the acetaminophen group, P < 0.05) and one hour and two hours in the ward (7.2 ± 0.7, 7 ± 0.5 vs. 7.9 ± 1.2, 7.5 ± 1.2 in the acetaminophen group, P < 0.05), with no significant differences till 24 hours. Dreams and hallucinations were not reported in the ketamine group. Systolic blood pressure was seen to be higher in the ketamine group (104.4 ± 7.9 vs. 99.8 ± 7.7 in the acetaminophen group) and nystagmus was reported only in the ketamine group (14.2%). Other side effects were equivalent in both the groups. CONCLUSIONS: With low complications, rectal ketamine has analgesic effects, especially in the first hours after surgery in comparison with acetaminophen, and it can be an alternative analgesic with easy administration in children after tonsillectomy.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399302/?tool=pubmed



Comparación de los efectos de la infiltración peritonsilar de ketamina y tramadol sobre el dolor post amigadalectomía: estudio doble ciego, randomizado, controlado y placebo


Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial.
Ayatollahi V, Behdad S, Hatami M, Moshtaghiun H, Baghianimoghadam B.
Department of Anesthesiology, Shahid Sadoughi Hospital, Bou ali BLVD, 8916886938 Yazd, Iran.
Croat Med J. 2012 Apr;53(2):155-61.
Abstract
AIM: To assess the effect of peritonsillar infiltration of ketamine and tramadol on post tonsillectomy pain and compare the side effects. METHODS: The double-blind randomized clinical trial was performed on 126 patients aged 5-12 years who had been scheduled for elective tonsillectomy. The patients were randomly divided into 3 groups to receive either ketamine, tramadol, or placebo. They had American Society of Anesthesiologists physical status class I and II. All patients underwent the same method of anesthesia and surgical procedure. The three groups did not differ according to their age, sex, and duration of anesthesia and surgery. Post operative pain was evaluated using CHEOPS score. Other parameters such as the time to the first request for analgesic, hemodynamic elements, sedation score, nausea, vomiting, and hallucination were also assessed during 12 hours after surgery. RESULTS: Tramadol group had significantly lower pain scores (P=0.005), significantly longer time to the first request for analgesic (P=0.001), significantly shorter time to the beginning of liquid regimen (P=0.001), and lower hemodynamic parameters such as blood pressure (P=0.001) and heart rate (P=0.001) than other two groups. Ketamine group had significantly greater presence of hallucinations and negative behavior than tramadol and placebo groups. The groups did not differ significantly in the presence of nausea and vomiting. CONCLUSION: Preoperative peritonsillar infiltration of tramadol can decrease post-tonsillectomy pain, analgesic consumption, and the time to recovery without significant side effects.
http://neuron.mefst.hr/docs/CMJ/issues/2012/53/2/cmj_53_2_ayatollahi_22522994.pdf




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

Bibliotecas. Alerta

El Instituto de Arqueología Ibérica de la UJA nutre de información de ...
Europa Press
En este encuentro de trabajo han participado otras instituciones como la Subdirección General de Coordinación de Bibliotecas del Ministerio de Cultura, The Science and Technology in Archaeology Research Center (Chipre), el Instituto Andaluz de ...
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Europa Press



Las bibliotecas populares festejan su día en Tecnópolis
Télam
Personalidades de la cultura como Juan Sasturain, Lola Berthet, Tomás Fonzi, Darío Sztajnszrajber, Tom Lupo y Lito Cruz pusieron su voz a textos propios y de autores latinoamericanos para celebrar el Día de las Bibliotecas Populares en Tecnópolis, ...
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La Biblioteca Virtual Miguel de Cervantes incluirá revistas culturales ...
Asociación Revistas Culturales de España
Manuel Ortuño, Presidente de la Asociación de Editores de Revistas Culturales de España (ARCE), y Manuel Bravo, Director general de la Fundación Biblioteca Virtual Miguel de Cervantes, han suscrito un convenio de colaboración para la digitalización de ...
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Asociación Revistas Culturales de España



El top 5 de las bibliotecas más importantes
DESDElared
Aguascalientes, Ags.- Por su función, las bibliotecas son cruciales para el desarrollo del sistema educativo y de la investigación pues éstas contienen libros, textos y documentos valiosos para la humanidad. Dichos lugares datan de hace más de cuatro ...
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'Letragones en su tinta' divierte a los más pequeños en la biblioteca
segoviaudaz.es
'Letragones en su tinta' divierte a los más pequeños en la biblioteca. El nuevo blog de laBiblioteca Pública de Segovia está destinado a los pequeños de hasta 12 años, y puede utilizarse en la sala infantil.
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segoviaudaz.es



ebooks, tablets y smartphones se toman las bibliotecas de Duoc UC
TransMedia.cl
Éste consiste en el uso gradual de ebooks, tablets y smartphones en las bibliotecas de todas sus sedes. Así, en el transcurso del año, la institución ha implementado ebooks en sedes como Alonso de Ovalle, donde la adopción por parte de los estudiantes ...
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SEMINARIO “BIBLIOTECAS BARRIALES Y CULTURA POPULAR”
Periodico Noticias Paceñas
Se realizara este martes 25 de septiembre, el seminario “Bibliotecas barriales y cultura popular (Francia – Argentina)”, a cargo de Denis Merklen y Charlotte Desaux. El mismo se realizará en el SUM de la UBYD, Biblioteca de la Universidad Nacional de ...
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Periodico Noticias Paceñas


Invierten un millón 300 mil pesos para biblioteca modelo en Jerez
NTR Zacatecas .com
La Dirección General de Bibliotecas entregó un millón 300 mil pesos a la coordinación de la Red Estatal de Bibliotecas, para el equipamiento de la biblioteca modelo de Jerez. Eduardo Mendoza Villalpando, coordinador general de la red estatal, dijo que ...
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NTR Zacatecas .com



Registro de personas para votar en las bibliotecas públicas de ...
Voluntarios del programa Future Vote y del Comité de Enlaces Comunitario de la Junta Electoral del condado de Montgomery realizará una campaña los ...
metrolatinousa.com/.../registro-de-personas-para-votar-en-las-...




El congreso rinde homenaje a las bibliotecas populares - Yahoo ...
Un homenaje y reconocimiento a las Bibliotecas Populares de diversos puntos del país tendrá lugar mañana a las 17.30 en el Salón de los Pasos Perdidos del ...
ar.finanzas.yahoo.com/.../congreso-rinde-homenaje-biblioteca...




Bibliotecas sin libros | Letras Libres
Casi todas las bibliotecas de la Nueva España fueron conventuales, o de obispos y religiosos: para uso interno o personal. Hubo algunas abiertas al público.
www.letraslibres.com/blogs/articulos.../bibliotecas-sin-libros


Sesión Pública: Horario de Servicio de las Bibliotecas :: Biblioteca ...
El Library Preservation Fund, renovado en noviembre del 2007 en la Proposition D, requiere que la Comisión de la Biblioteca valore y modifique, si es ...
sfpl.org/index.php?pg=2000563502&amp;sl=2

Health Situation in the Americas . Basic Indicators 2012

Health Situation in the Americas . Basic Indicators 2012


Pan American Health Organization/World Health Organization (PAHO/WHO) - 2012

presents the latest available information on health indicators for 48 countries/territories in the Region of the Americas.


Available online at: http://bit.ly/NxsA7Q


“…..This edition highlights the mortality due to external causes (EC); those causes of death different from natural causes and recognized as avoidable such as suicides, homicides and accidents. From the data reported by the countries, it is estimated that over 5.5 million people died from EC in the Region between 1999 and 2009.

Three and a half million deaths (64%) occurred among the young and adult population (10-49 years old) with an average of 319,000 deaths per year; 84% of the deaths happened among males, five times more deaths among men than women. The most frequent causes were homicides (33%) and land transport accidents (26%).


Mortality from land transport accidents and homicides might be associated with economic, educational, political, social, and cultural factors. Also, they overburden the health care systems and pose a high cost on society, in addition to the suffering of the victims and their families6. In several countries of the Region the proportion of population in productive ages regarding the number of the youngest and the oldest are increasing, favoring their economic growth.


The negative potential impact of these deaths over this “demographic bonus” is an important call to countries for action given the preventability of these outcomes.

The information presented in this brochure has been compiled, processed and reviewed by PAHO/WHO technical staff in collaboration with ministries of health and national statistics offices from countries of the Americas ….”



KMC/2012/HSD
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Más sobre analgesia con ketamina

Efecto de ketamina intravenosa en analgesia controlada por el paciente utilizando hidromorfona y ketorolaco después de cirugía de Nuss en infantes


Effect of ketamine on intravenous patient-controlled analgesia using hydromorphone and ketorolac after the Nuss surgery in pediatric patients.
Min TJ, Kim WY, Jeong WJ, Choi JH, Lee YS, Kim JH, Park YC.
Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Ansan, Korea.
Korean J Anesthesiol. 2012 Feb;62(2):142-7. Epub 2012 Feb 20.
Abstract
BACKGROUND: Nuss surgery is preferred in pectus excavatum repair because this procedure produces excellent cosmetic results and prevents postoperative distressed pulmonary function. However, the procedure causes severe pain due to thoracic expansion. This study was designed to investigate the analgesic effect of small doses of ketamine on an intravenous patient-controlled analgesia (IV-PCA) using hydromorphone and ketorolac for pain control after Nuss surgery. METHODS: Forty-four patients undergoing elective Nuss surgery were randomly assigned to receive hydromorphone 3 µg/kg/hr, ketorolac 0.05 mg/kg/hr and ondansetron 0.1 mg/kg/day (Group HO, n = 22) or hydromorphone 3 µg/kg/hr, ketorolac 0.05 mg/kg/hr, ondansetron 0.1 mg/kg/day and ketamine 0.15 mg/kg/hr (Group HK, n = 22) via an IV-PCA pump after surgery. A blind observer evaluated each patient using the Modified Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) for the assessment of pain control. The total administered PCA volume, side effects and parents satisfaction with pain control were assessed at postoperative 1, 4, 8, 12, 24, and 48 hours. RESULTS: There were no significant differences in Modified CHEOPS between the groups during postoperative 48 hours. The total PCA volume in group HK was significantly lower than that in group HO (P < 0.05). The side effects in both groups did not significantly differ except for pruritus. The levels of satisfaction from the parents were not significantly different between the groups. CONCLUSIONS: A small dose of ketamine on IV-PCA reduced the total administered dose of IV-PCA with hydromorphone and ketorolac and reduced the incidence of pruritus after the Nuss procedure in pediatric patients.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3284736/pdf/kjae-62-142.pdf


Efecto de dosis bajas de ketamina intravenosa sobre analgesia intercostal continua en toracotomía


The effect of low-dose intravenous ketamine on continuous intercostal analgesia following thoracotomy.
Yazigi A, Abou-Zeid H, Srouji T, Madi-Jebara S, Haddad F, Jabbour K.
Department of Anaesthesia and Surgical Intensive Care, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.ritalama@idm.net.lb
Ann Card Anaesth. 2012 Jan-Mar;15(1):32-8.
Abstract
Ketamine, a noncompetitive N-methyl-d-aspartate antagonist, provides analgesia and prevents chronic pain following thoracotomy. The study was aimed to assess the effect of intravenous low-dose ketamine on continuous intercostal nerve block analgesia following thoracotomy. The study was a prospective, randomized, double-blinded, and placebo-controlled clinical study, performed in a single university hospital. Sixty patients, undergoing elective lobectomy through an open posterolateral thoracotomy, were included. For postoperative pain, all patients received a continuous intercostal nerve block with bupivacaine plus intravenous paracetamol and ketoprofen. In addition, patients were randomized to have intravenous ketamine (0.1 mg/kg as a preincisional bolus followed by a continuous infusion of 0.05 mg/kg/h) in group 1 or intravenous placebo in group 2. Patients reporting a visual analog scale pain score at rest ≥40 mm received intravenous morphine sulfate as rescue analgesia. The following parameters were assessed every 6 hours for 3 postoperative days: Visual analog scale pain scores at rest and during coughing, requirement of rescue analgesia with morphine, Ramsay sedation scores and psychomimetic adverse effects. Both the groups were statistically comparable regarding visual analog scale pain scores at rest (P=0.75) and during coughing (P=0.70), number of morphine deliveries (P=0.17), cumulative dose of rescue morphine (P=0.2), sedation scores (P=0.4), and psychomimetic adverse effects (P=0.09). Intravenous low-dose ketamine, when combined with continuous intercostal nerve block, did not decrease acute pain scores and supplemental morphine consumption following thoracotomy.

http://www.annals.in/article.asp?issn=0971-9784;year=2012;volume=15;issue=1;spage=32;epage=38;aulast=Yazigi






Efectos benéficos de agregar ketamina intravenosa con fentanilo a la analgesia controlada por paciente después del procedimiento de Nuss en pediatría
Beneficial effects of adding ketamine to intravenous patient-controlled analgesia with fentanyl after the Nuss procedure in pediatric patients.
Cha MH, Eom JH, Lee YS, Kim WY, Park YC, Min SH, Kim JH.
Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, Korea.
Yonsei Med J. 2012 Mar;53(2):427-32. doi: 10.3349/ymj.2012.53.2.427.
Abstract
PURPOSE: The aim of this prospective, double-blind, randomized study was to investigate the analgesic effects of low-dose ketamine on intravenous patient-controlled analgesia (IV-PCA) with fentanyl for pain control in pediatric patients following the Nuss procedure for pectus excavatum. MATERIALS AND METHODS: Sixty pediatric patients undergoing the Nuss procedure were randomly assigned to receive fentanyl (Group F, n=30) or fentanyl plus ketamine (Group FK, n=30). Ten minutes before the end of surgery, following the loading dose of each solution, 0.5 μg/kg/hr of fentanyl or 0.5 μg/kg/hr of fentanyl plus 0.15 mg/kg/hr of ketamine was infused via an IV-PCA pump (basal rate, 1 mL/hr; bolus, 0.5 mL; lock out interval, 30 min). Fentanyl consumption, pain score, ketorolac use, nausea/vomiting, ondansetron use, pruritus, respiratory depression, hallucination, dreaming, and parent satisfaction with pain control were measured throughout the 48 hours following surgery. RESULTS: The pain scores, ketorolac use, and fentanyl consumption of Group FK were significantly lower than in Group F (p<0.05). The incidence of nausea/vomiting and ondansetron use in Group FK was significantly lower than in Group F (p<0.05). There were no reports of respiratory depression, hallucination or dreaming. Parent satisfaction with pain control was similar between the two groups. CONCLUSION: We concluded that low-dose ketamine added to IV-PCA with fentanyl after the Nuss procedure in pediatric patients can reduce pain scores, consumption of fentanyl, and incidence of nausea/vomiting without increasing side effects.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282966/pdf/ymj-53-427.pdf





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

Anafilaxia perioperatoria

Anafilaxia perioperatoria

Peri-operative anaphylaxis.
Nel L, Eren E.
Department of Anaesthetics, Southampton University Hospitals NHS Trust, Tremona Road, Southampton, United Kingdom.
Br J Clin Pharmacol. 2011 May;71(5):647-58. doi: 10.1111/j.1365-2125.2011.03913.x.
Abstract
Peri-operative anaphylaxis is an important cause for mortality and morbidity associated with anaesthesia. The true incidence is unknown and is most likely under reported. Diagnosis can be difficult, particularly as a number of drugs are given simultaneously and any of these agents can potentially cause anaphylaxis. This review covers the clinical features, differential diagnosis and management of anaphylaxis associated with anaesthesia. The investigations to confirm the clinical suspicion of anaphylaxis and further tests to identify the likely drug(s) are examined. Finally the salient features of common and rare causes including non-drug substances are described.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093071/pdf/bcp0071-0647.pdf


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

Cetrería

La cetrería es el arte de cazar con aves rapaces, especialmente con halcones, azores y otras aves de presa, en esta entrada veremos una obra escrita en francés de 1853, con 16 grabados, que trata de este arte.

Enlace al post:
http://www.odisea2008.com/2012/09/cetreria.html

Telemedicina. Alerta

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Jets Lose Revis to Torn Knee Ligament

http://www.nytimes.com/2012/09/25/sports/jets-lose-darrelle-revis-to-torn-acl-in-left-knee.html?_r=1&nl=nyregion&emc=edit_ur_20120925

Jets Lose Revis to Torn Knee Ligament

Rhona Wise/Associated Press

After missing this previous week's game because of a concussion, Darrelle Revis suffered a knee injury against the Dolphins and is expected to have surgery in the coming weeks.

By BEN SHPIGEL

Published: September 24, 2012

FLORHAM PARK, N.J. — After uttering the words he hoped he would not have to say, Rex Ryan looked down at the lectern and away from the cameras. A second went by. Then two. Then three, as if by taking time to collect his thoughts Ryan would somehow reverse the harsh sentence rendered Monday, when tests confirmed that the All-Pro cornerback Darrelle Revis had torn the anterior cruciate ligament in his left knee and would require surgery, ending his season after three games.

Related

• Jets 23, Dolphins 20 (Overtime): Jets Make the Most of a Second Chance (September 24, 2012)

• N.F.L. Fast Forward: Coaches Taking Out Frustration on Officials (September 25, 2012)

• Sports of The Times: Helicopter Coaching Hurts Could-Be Leaders (September 24, 2012)

Lynne Sladky/Associated Press

Darrelle Revis after he was injured Sunday against the Dolphins.

Lynne Sladky/Associated Press

Kyle Wilson, who will start in place of Darrelle Revis, was called for interference against the Dolphins’ Davone Bess on this play.

“I don’t know what else to say about it,” Ryan said.

Ryan just stood there, his face ashen, but the words eventually flowed from the coach’s mouth like a lazy river. He spoke of resilience and teamwork and adversity, how he and his coaching staff accepted Revis’s injury as “a personal challenge” to revitalize a team that had lost its best and most indispensable player. But Ryan did not address, at least not directly, that murky area between popular perception and harsh reality — that Revis’s absence deals the 2-1 Jets a potentially devastating blow, weakening not only their defense but also their playoff hopes.

“I have all the respect in the world for Tom Brady and Aaron Rodgers and Peyton Manning, but Darrelle’s the best player in the league,” said the former San Francisco cornerback Eric Davis, an analyst on NFL Network. “No other player goes out with those expectations on him every single week and produces like he does. No one has a tougher assignment week in, week out than Revis. Brady and Rodgers and Manning throw interceptions. Revis doesn’t make mistakes.”

He didn’t, at least, before his knee buckled while he made a cut in the third quarter of the Jets’ 23-20 overtime victory against Miami on Sunday. Their aggressive defense relies heavily on Revis, a neutralizing force in one-on-one coverage; according to the statistical Web siteProFootballFocus.com, which last season rated him as the best cornerback in the N.F.L., receivers caught only a league-low 41.2 percent of passes thrown while Revis was covering them.

By erasing the opposition’s top receiving threat, effectively eliminating a huge swath of the field, Revis allows Ryan to deploy the other 10 defenders in exotic ways — in creative blitz packages, in bracket coverage and in space, prowling other areas of the field.

“All that changes dramatically moving forward,” said Brian Billick, the former Ravens coach who works as an analyst for Fox Sports and NFL Network.

In the coming weeks, some of the N.F.L.’s most dangerous receivers — including Larry Fitzgerald, Andre Johnson and Reggie Wayne — visit MetLife Stadium, where Revis would surely have shadowed them. Instead, that burden falls to Antonio Cromartie — or, more likely, to his fellow defensive backs and him because the Jets are unlikely to trust Cromartie the same way they did Revis. With Revis sidelined, opponents are almost certain to emphasize their No. 1 receivers, devising game plans that funnel passes toward them.

Tom Moore, the former Indianapolis offensive coordinator who worked as a consultant last season for the Jets, said he always took Revis into account when calling plays, telling his players to “play smart, not scared.” In the Jets’ 2011 playoff victory against the Colts, Revis held Wayne to one reception for a single yard. The details have faded for Moore, but he said of Revis, “You always knew he was there.”

To compensate, Billick said the Jets could start playing more zone coverage, which would alleviate the pressure on Cromartie and Kyle Wilson, elevated from nickel corner to starter in Revis’s absence. When injuries diluted the Ravens’ secondary heading into a 2007 game in Seattle, Ryan, reluctantly, kept the defensive backs in a two-deep zone for much of the game, Billick said, “even though it killed him.”

“To do anything else would have been a mistake,” said Billick, who was Ryan’s boss in Baltimore for nine seasons. “He’s not in that dire straits now, because he has good people behind Revis. Rex’s nature is always to bring pressure — that’s his answer to everything. But you might be a little bit more tentative about bringing five- or six- or seven-man pressure knowing that your back end’s going to be more vulnerable.”

Ryan disagreed. Instead of taking a more conservative approach, as many would probably expect, Ryan said he might be more aggressive, mentioning how his father, Buddy, coached teams in Chicago that harassed quarterbacks despite an anonymous secondary.

In theory, that strategy makes sense: if the Jets feel exposed at cornerback, increasing their pressure would be a way of preventing the quarterback from dissecting the diminished secondary. In practice, the counterargument is fierce; the Jets, supported by three weeks of evidence, have struggled at generating a consistent pass rush, recording 3 sacks and 10 quarterback hits — 5 across their last two games.

“We’ve got to get 1,000 times better,” said linebacker Calvin Pace, who lamented the Jets’ inability to stop the run (148.7 yards a game) and generosity in third-down situations, yielding a 55.8 percent conversion rate. “It’s hard to rush the passer when you get third-and-4. The offense can pretty much do what they want.”

Ryan said: “Maybe we play some opponents differently. There’s different ways to skin a cat. You can’t just take away their best receiver with one guy. Again, we’ll find a way.”

A version of this article appeared in print on September 25, 2012, on page B11 of the New York edition with the headline: Revis Will Miss the Rest of the Season.