Books Update. NYT

October 26, 2012 Books Update

On the Cover of Sunday's Book Review 'Back to Blood' By TOM WOLFE Reviewed by THOMAS MALLON Tom Wolfe's new novel is built around the gaudy clash of Miami's different ethnic and financial populations Also in the Book Review John Grisham: By the Book The author, most recently, of "The Racketeer" wishes President Obama would read "Fifty Shades of Grey": "Maybe it would loosen him up a bit."  By the Book: Archive 'The Casual Vacancy' By J. K. ROWLING Reviewed by AMANDA FOREMAN J. K. Rowling turns from children's fantasy to a novel of social ills.  Up Front: Amanda Foreman 'Sorry Please Thank You' By CHARLES YU Reviewed by DOUGLAS WOLK Charles Yu's collection examines reality through the lens of science fiction. 'Short Nights of the Shadow Catcher' By TIMOTHY EGAN Reviewed by DEBORAH SOLOMON A biography of Edward Curtis, who spent three decades documenting the stories and rituals of Native American tribes. 'San Miguel' By T. CORAGHESSAN BOYLE Reviewed by TATJANA SOLI Two families - one in the 1880s, one in the 1930s - pursue dreams of self-reliance in T. Coraghessan Boyle's historical novel. 'The Twelve' By JUSTIN CRONIN Reviewed by JOSEPH SALVATORE The enemy has evolved in Justin Cronin's postapocalyptic novel. 'The Fifty Year Sword' By MARK Z. DANIELEWSKI Reviewed by DANIEL HANDLER Voices haunt Mark Z. Danielewski's ghost story. 'The World Without You' By JOSHUA HENKIN Reviewed by MALENA WATROUS In this novel, a journalist's death shakes his family. 'Waging Heavy Peace: A Hippie Dream' By NEIL YOUNG Reviewed by HOWARD HAMPTON Neil Young looks to the future and contemplates the past. 'Who I Am: A Memoir' By PETE TOWNSHEND Reviewed by ROBERT CHRISTGAU Pete Townshend - guitarist, songwriter and founding member of the Who - tells his story. 'Bunch of Amateurs: A Search for the American Character' By JACK HITT Reviewed by AMY FINNERTY Is amateurism bred into the American character?  ArtsBeat Q. & A.: Jack Hitt Daily Devotions By DAVID ORR Jack Gilbert believes that poetry is worthy of devotion, that it ought not be subordinated to the things that clutter up day-to-day life. 'A Pimp's Notes' By GIORGIO FALETTI. Translated by ANTONY SHUGAAR. Reviewed by CHRISTOPHER R. BEHA Giorgio Faletti's antihero is caught up in a drama that involves the Mafia, the Red Brigades and the Italian government.

BEST SELLERS Combined Print & E-Book Fiction Combined Print & E-Book Nonfiction Hardcover Fiction Hardcover Nonfiction Paperback Trade Fiction Paperback Mass-Market Fiction Paperback Nonfiction All the Lists Back Page True to Character By KURT ANDERSEN Kurt Vonnegut in six decades of his letters. Inside the List By GREGORY COWLES Kate Morton, whose novel "The Secret Keeper" enters the list at No. 8, is Australia's most successful literary export since Colleen McCullough's "Thorn Birds" stormed the world in 1977. Editors' Choice Recently reviewed books of particular interest. Paperback Row By IHSAN TAYLOR Paperback books of particular interest. Book Review Podcast This week, Robert Christgau talks about Pete Townshend's new memoir; Amanda Foreman discusses J. K. Rowling's novel "The Casual Vacancy"; and Gregory Cowles has best-seller news. Sam Tanenhaus is the host. Book Review Podcast: Pete Townshend's Rock Memoir The Past Is Never Dead: A Faulkner Quote in 'Midnight in Paris' Results in a Lawsuit Random House and Penguin May Be Combined REVIEWS BY THE TIMES'S CRITICS 'The Richard Burton Diaries' 'The Story of Ain't' by David Skinner 'The Signal and the Noise' by Nate Silver 'The Oath' by Jeffrey Toobin 'The Hungry Ear' Children's Books: Be Brave, Little One ARCHIVE Crime Columns Children's Books The New York Times Book Review: Back Issues Editor's Note Thanks for taking the time to read this e-mail. Feel free to send feedback; I enjoy hearing your opinions and will do my best to respond. John Williams Books Producer The New York Times on the Web

Telemedicina. Alerta

Innovador centro de telemedicina inicia su actividad en el Hospital ...
El Acontecer Diario
Innovador centro de telemedicina inicia su actividad en el Hospital Penza en breve. El Hospital Penza, junto a otras once instituciones de asistencia en salud del país, son parte de un innovador sistema de telemedicina que pondrá en red a las mismas.
Ver todos los artículos sobre este tema »
El Acontecer Diario



Implementar la telemedicina y modelo especial de salud pidió el ...
Según el congresista, los servicios especiales serían para la población carcelaria a través de una ...
www.senado.gov.co/.../15426-implementacion-de-telemedicin...

Telemedicina - Fundación Peluffo Giguens
Los pasados días Jueves 11 y Viernes 12 de Octubre se realizó la presentación del Plan de Integración de Telemedicina en distintos departamentos del interior ...
www.fpg.com.uy/telemedicina_noticias_despelgado.php?id...

Tecnología Intel aplicada a la Telemedicina
Cada día más se están desarrollando dispositivos, más allá de la PC, con capacidades de cómputo y ...
newsroom.intel.com/.../tecnología-intel-aplicada-a-la-telemedi...

Video de la sesión de la platica de: revisión radiográfico de tumores óseos.

http://colegiomexicanodeortopediaytrauma.blogspot.mx/2012/10/sesion-de-residentes-de-octubre2012.html


Sesión de residentes de octubre_2012/ revisión radiográfica de tumores óseos

Platica y taller sobre la revisión radiográfica de tumores óseos, impartida por el doctor
Ernesto Delgado / medico adscrito al servicio de tumores óseos del INR, en la ciudad de México.

Watch live streaming video from bibliomanazteca_platicas_medicas at livestream.com

Complicaciones en neurocirugía

Complicaciones pulmonares en neurocirugía


Pulmonary complications in neurosurgical patients.
Guleria R, Madan K.
Indian J Neurosurg [serial online] 2012 [cited 2012 Oct 11];1:175-80.


Abstract
Pulmonary complications are a major cause of morbidity and mortality in neurosurgical patients. The common pulmonary complications in neurosurgical patients include pneumonia, postoperative atelectasis, respiratory failure, pulmonary embolism, and neurogenic pulmonary edema. Postoperative lung expansion strategies have been shown to be useful in prevention of the postoperative complications in surgical patients. Low tidal volume ventilation should be used in patients who develop acute respiratory distress syndrome. An antibiotic use policy should be put in practice depending on the local patterns of antimicrobial resistance in the hospital. Thromboprophylactic strategies should be used in nonambulatory patients. Meticulous attention should be paid to infection control with a special emphasis on hand-washing practices. Prevention and timely management of these complications can help to decrease the morbidity and mortality associated with pulmonary complications.
Keywords: Neurosurgery, post-operative, pulmonary complications
http://www.ijns.in/text.asp?2012/1/2/175/102299



Papel de la flora oral patógena en la neumonía postoperatoria después de cirugía cerebral.
Role of pathogenic oral flora in postoperative pneumonia following brain surgery.
Bágyi K, Haczku A, Márton I, Szabó J, Gáspár A, Andrási M, Varga I, Tóth J, Klekner A.
Department of Neurosurgery, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. bagyi@med.unideb.hu
BMC Infect Dis. 2009 Jun 29;9:104.
Abstract
BACKGROUND:
Post-operative pulmonary infection often appears to result from aspiration of pathogens colonizing the oral cavity. It was hypothesized that impaired periodontal status and pathogenic oral bacteria significantly contribute to development of aspiration pneumonia following neurosurgical operations. Further, the prophylactic effects of a single dose preoperative cefazolin on the oral bacteria were investigated. METHODS: A matched cohort of 18 patients without postoperative lung complications was compared to 5 patients who developed pneumonia within 48 hours after brain surgery. Patients waiting for elective operation of a single brain tumor underwent dental examination and saliva collection before surgery. Bacteria from saliva cultures were isolated and periodontal disease was scored according to type and severity. Patients received 15 mg/kg cefazolin intravenously at the beginning of surgery. Serum, saliva and bronchial secretion were collected promptly after the operation. The minimal inhibitory concentrations of cefazolin regarding the isolated bacteria were determined. The actual antibiotic concentrations in serum, saliva and bronchial secretion were measured by capillary electrophoresis upon completion of surgery. Bacteria were isolated again from the sputum of postoperative pneumonia patients. RESULTS: The number and severity of coexisting periodontal diseases were significantly greater in patients with postoperative pneumonia in comparison to the control group (p = 0.031 and p = 0.002, respectively). The relative risk of developing postoperative pneumonia in high periodontal score patients was 3.5 greater than in patients who had low periodontal score (p < 0.0001). Cefazolin concentration in saliva and bronchial secretion remained below detectable levels in every patient. CONCLUSION: Presence of multiple periodontal diseases and pathogenic bacteria in the saliva are important predisposing factors of postoperative aspiration pneumonia in patients after brain surgery. The low penetration rate of cefazolin into the saliva indicates that its prophylactic administration may not be sufficient to prevent postoperative aspiration pneumonia. Our study suggests that dental examination may be warranted in order to identify patients at high risk of developing postoperative respiratory infections
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709628/pdf/1471-2334-9-104.pdf





Incidencia de complicaciones tromboembólicas en cirugía de columna lumbar en 1,111 pacientes


Incidence of thromboembolic complications in lumbar spinal surgery in 1,111 patients.
Nicol M, Sun Y, Craig N, Wardlaw D.
Department of Orthopaedics, Grampian Hospitals NHS Trust, Aberdeen, UK. malcolmnicol@hotmail.com
Eur Spine J. 2009 Oct;18(10):1548-52. Epub 2009 May 30.
Abstract
Deep venous thrombosis (DVT) and pulmonary embolism (PE) cause significant morbidity and mortality in orthopaedic surgical practice, although the incidence following surgery to the lumbosacral spine is less than following lower limb surgery. Our objective was to compare our rate of thromboembolic complications with those published elsewhere and investigate whether the adoption of additional pharmacological measures reduced the incidence of clinically evident DVT and PE. This retrospective study was undertaken to investigate the incidence of DVT/PE during the 10 years from 1 January 1985 to 31 December 1994, and then to assess the effectiveness of an anticoagulant policy introduced during 1995 using low dose aspirin or LMH in high risk cases. All records for spinal operations were reviewed for thrombo-embolic complications by reference to the Scottish Morbidity Record form SMR1. To ensure that all patients were compliant with the policy, data for the whole of 1995 was omitted and the period 1 January 1996 to 31 December 2003 was taken to assess its effectiveness. Surgery was done with the patient in the kneeling, seated prone position which leaves the abdomen free and avoids venous kinking in the legs. Records of a total of 1,111 lumbar spine operations were performed from 1 January 1985 to 31 December 2004 were reviewed. The overall incidence of thrombo-embolic complications was 0.29%. A total of 697 operations were performed from 1 January 1985 to 31 December 1994 with two cases of DVT and no cases of PE giving thromboembolic complication rate of 0.29%. During the period 1 January 1996 to 31 December 2003, 414 operations resulted in one case of DVT and no cases of PE, a rate of 0.24%. The incidence of symptomatic thrombo-embolic complications in lumbar spinal surgery is low in the kneeling, seated prone operating position, whether or not anticoagulation is used
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899370/pdf/586_

2009_Article_1035.pdf



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

Cirugía mínima invasiva de pie

Publicado el 24/10/2012 por MagdalenadeS


Plática impartida por la Dra. Ana Cristina King Martínez, el 24 de octubre 2012 como parte de los días Académicos del Servicio de Ortopedia Mixta, del Hospital de Ortopedia "Dr. Victorio de la Fuente Narváez"(antes Magdalena de las Salinas) de la Ciudad de México Distrito Federal.

http://youtu.be/FV6aIdvK93Q

Gabapeptinoides en neuralgia postherpética

Monodosis diara de gabapentina en el tratamiento de neuralgia postherpética: una revisión


Gabapentin for once-daily treatment of post-herpetic neuralgia: a review.
Beal B, Moeller-Bertram T, Schilling JM, Wallace MS.
Division of Pain Medicine, Department of Anesthesiology, University of California, San Diego, CA, USA.
Clin Interv Aging. 2012;7:249-55. Epub 2012 Jul 12.
Abstract
Post-herpetic neuralgia is a neuropathic pain syndrome resulting from an insult to the peripheral and central nervous systems caused by the varicella zoster virus. Spontaneous pain may result in the persistent sensation of burning, tingling, or aching and may be associated with thermally or mechanically provoked pain, resulting in hyperalgesia or allodynia. The majority of cases occur in patients over the age of 50 years. Gabapentin is a structural analog of gamma aminobutyric acid that binds to the α(2)-δ site of voltage-dependent calcium channels and modulates the influx of calcium, with a resulting reduction in excitatory neurotransmitter release. Gabapentin is effective in reducing neuropathic pain due to post-herpetic neuralgia when given at least three times per day, due to its short half-life, resulting in demonstrable fluctuations in plasma levels. Gabapentin has dose-limiting side effects that prevent some patients from achieving therapeutic plasma levels, such as somnolence (27.4%), dizziness (23.9%), and ataxia (7.1%). Gralise™ is a once-daily extended-release formulation of gabapentin that has been developed using AcuForm™ technology. AcuForm is a polymer-based drug delivery system that retains the tablet in the stomach and upper gastrointestinal tract for a sustained period of time. Once-daily dosing has been shown to provide comparable drug exposure with an identical daily dose of the immediate-release formulation when administered three times daily. Participants given Gralise 1800 mg daily had a statistically significant reduction in average daily pain intensity scores compared with placebo, reduced sleep interference due to pain, and a greater percent of participants reporting being much or very much improved on the patient global impression of change. An analysis comparing the efficacy and safety profiles in the aging population (≥65 years) with those younger than 65 years showed that Gralise is effective and well tolerated in both age groups.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3410680/pdf/cia-7-249.pdf

http://www.dovepress.com/gabapentin-for-once-daily-treatment-of-post-herpetic-neuralgia-a-revie-peer-reviewed-article-CIA


Tolerabilidad y seguridad de las tabletas gastroretentivas de gabapentina para dosis diaria en el manejo de la neuralgia postherpética
Tolerability and safety of gastroretentive once-daily gabapentin tablets for the treatment of postherpetic neuralgia.
Irving GA, Sweeney M.
Swedish Pain and Headache Center, Seattle, WA, USA.
J Pain Res. 2012;5:203-8. Epub 2012 Jun 25.
Abstract
OBJECTIVE: An immediate-release formulation of gabapentin is approved for treatment of postherpetic neuralgia (PHN). This formulation, however, requires multiple daily dosing, usually three times per day, and is associated with a high incidence of somnolence and dizziness. We assessed the tolerability and safety of a once-daily gastroretentive formulation of gabapentin (G-GR) in phase 3 clinical trials in patients with PHN.RESEARCH DESIGN AND METHODS: Data were pooled from two placebo-controlled studies involving 723 patients (G-GR 1800 mg, n = 359; placebo, n = 364). Patients (43% male, mean age 66 years) with PHN pain >4 (0-10 scale) for ≥3 months were enrolled. Summary statistics for the incidence of treatment-emergent adverse events (AEs) were performed. Laboratory parameters and vital signs were assessed. RESULTS:
Treatment-emergent AEs were reported in 48% of patients (G-GR, 54%; placebo, 42%) and led to discontinuation in 8% of patients (G-GR, 10%; placebo, 7%). The most frequent (≥3% in any group) AEs were dizziness (G-GR, 11%; placebo, 2%), somnolence (G-GR, 5%; placebo, 3%), headache (G-GR, 4%; placebo, 4%), peripheral edema (G-GR, 4%; placebo, <1%), and diarrhea (G-GR, 3%; placebo, 3%). Serious AEs were reported in seven patients in the G-GR group (2%) and ten patients in the placebo group (3%). There were two deaths, both in the placebo group. No serious AEs were considered related to treatment. Mean values for laboratory parameters and vital signs at the end of each study were similar between groups. CONCLUSION: G-GR was safe and well tolerated for the treatment of PHN.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392710/pdf/jpr-5-203.pdf





Tratamiento de neuralgia postherpética: atención a pregabalina


Treatment of postherpetic neuralgia: focus on pregabalin.
Cappuzzo KA.
The Geriatric Pharmacotherapy Program, Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia 23298-0533, USA.kacappuzzo@vcu.edu
Clin Interv Aging. 2009;4:17-23. Epub 2009 May 14.
Abstract
Postherpetic neuralgia (PHN) is a devastating, chronic pain syndrome that can develop following an outbreak of herpes zoster and becomes increasingly common as patients age. PHN can be difficult to treat and often requires trials of multiple agents to achieve significant pain relief. Pregabalin is the newest agent to gain approval for PHN. Data suggest efficacy for relief of pain and sleep disturbance secondary to PHN in affected patients. Although there are no head-to-head comparisons, pregabalin appears comparable to gabapentin and other first-line agents for treating PHN.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685221/pdf/cia-4-017.pdf



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

CETOACIDOSIS DIABETICA

Diabetic ketoacidosis and
hyperglycaemic hyperosmolar
syndrome – clinical guidelines

Archivo 1 de 1
CETOACIDOSIS DIABETICA.pdf

Revisión radiográfica de tumores óseos

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 25 de octubre 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:
			Revisión radiográfica de tumores óseos Dr. Ernesto Delgado Cedillo
			Invitación para pre-registrarse al 6° Congreso Nacional de Residentes en Ortopedia a realizarse el 15, 16 y 17 de febrero de 2013, con el fin de planificar la asistencia estimada y concretar la sede en la que se realizará.
			Información sobre incentivos para inscripción y participación en el congreso, así como premios a los primeros lugares.
			Clausura de la sesión
			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

Bibliotecas. Alerta

Conferencias, exposiciones y música para celebrar el Día de las ...
ABC.es
El Gobierno de Cantabria ha diseñado un intenso programa de conferencias, exposiciones y música, en la Biblioteca Central, para conmemorar el Día de las Bibliotecas que se celebra mañana. Durante todo este mes, la consejería de Educación, Cultura y ...
Ver todos los artículos sobre este tema »



Casa Natal de Picasso se incorpora a la Red Centros de ...
La Vanguardia
La biblioteca y centro de documentación de la Fundación Picasso-Museo Casa Natal se ha incorporado a la Red de Centros de Documentación y Bibliotecas Especializadas de Andalucía, tras la reciente aprobación del convenio de colaboración entre la ...
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La biblioteca pública central “Margarita Maza de Juárez” realiza el ...
DIARIOAXACA
El jueves 25, a partir de las 11:00 horas, la doctora Georgina Torres, investigadora de contenidos ybibliotecas de la UNAM, expondrá: “Pautas para el diseño e implementación de una biblioteca digital académica”, después Alan Lazalde, de la UAM, ...
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La Biblioteca se convierte esta semana en el punto de encuentro de ...
Faro de Vigo
M. MÉNDEZ - O GROVE Los grovenses tienen una cita con la Rede de Bibliotecas de la localidad. A lo largo de toda la semana se despliegan variadas actividades, para todos los gustos y todas las edades, con las que, una vez más, fomentar la lectura, ...
Ver todos los artículos sobre este tema »
Faro de Vigo

SEE promueve lectura en bibliotecas del estado
Reporte Digital
Durante el presente ciclo escolar (2012-2013), la Dirección de Educación Artística y Cultura de la Secretaría de Educación (SEE), impartirá 72 mil 230 talleres permanentes de lectura en las 233bibliotecas de la entidad. La directora de Educación ...
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La Biblioteca celebrará, este jueves, su Día con un homenaje al ...
Ceuta al día
La Biblioteca Pública, dependiente de la Consejería de Educación, Cultura y Mujer, ha organizado una conferencia sobre la vida y obra del novelista y escritor de culto tangerino Ángel Vázquez. Será este jueves a las 20.00 horas en el Salón de Actos del ...
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Ceuta al día

Representantes de bibliotecas del Instituto Cervantes visitarán Alcalá
Portal Local
Casi 50 responsables de las bibliotecas del Instituto Cervantes en todo el mundo acudirán mañana miércoles a Alcalá de Henares, donde mantendrán una reunión de trabajo que será abierta por la concejala de Cultura y visitarán la Casa de Cervantes y la ...
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Anuncia actividades para el mes de noviembre la Red Estatal de ...
Sipse.com
CHETUMAL, Q.Roo.- Una interesante programación anuncia la Red Estatal deBibliotecas Públicas para el mes de noviembre en donde se propone llegar a la comunidad y aumentar en ella el hábito de la lectura, así como expandir los diferentes servicios ...
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Artículos interesantes sobre trauma pediátrico

Artículos interesantes sobre trauma pediátrico

https://www.box.com/s/wpvqbdim7umjlcbxhf79



Posttraumatic seizures in children with severe traumatic brain injury.

Arango, J.I. et al.

Childs Nervous System. 2012; 28(11): 1925 – 9.



Paediatric and adolescent trauma care within an integrated trauma system

Conor Deasy et al.

Injury, Int. J. Care Injured: 43(12): 2006-2011



Serum troponin-I as an indicator of clinically significant myocardial injury in paediatric trauma patients

Gurinder S. Sangha et al.

Injury, Int. J. Care Injured: 43(12): 2046-2050



Resuscitation volume in paediatric non-haemorrhagic blunt trauma

Abdullah Al-Sharif et al.

Injury, Int. J. Care Injured: 43(12): 2078-2082



Head injuries in children under 3 years

Louise M. Crowe et al.

Injury, Int. J. Care Injured: 43(12): 2141-2145



Dr. Douglas Umbría

Jefe de Emergencia de Pediatría

Hospital Chiquinquirá

Maracaibo. Edo. Zulia

Miércoles Académicos de la mixta

http://colegiomexicanodeortopediaytrauma.blogspot.mx/2012/10/miercoles-academicos-de-la-mixta_24.html

Miércoles Académicos de la mixta

Siguiendo con los miércoles académicos del servicio de ortopedia mixta, en el hospital
Victorio de la Fuente Narvaéz ( Magdalena de las Salinas) del IMSS en la ciudad de México, Hoy tendremos como invitada a la doctora Ana Cristina King, del hospital Manuel Gea Gonzalez, también, en la ciudad de México, nos impartirá una sesión sobre: cirugía percutanea del pie, hoy a las 6:30 pm hora del centro de México, mismo uso horario que en el Perú, para nuestros amigos sudamericanos, así es que los invitamos a que nos acompañen a escuchar esta platica que nos dará esta especialista de la cirugía percutanea del pie.

La liga es la siguiente:

http://www.livestream.com/ortopediamixta

Ligandos gabapetinoides

Gabapentina y pregabalina son estructuralmente similares al neurotrasmisor GABA, aunque estos fármacos no interactúan con el receptor GABA y su efecto terapéutico no se revierte con los antagonistas GABA. Se acepta que ambas drogas interactúan con las subunidades de los canales de calcio α2δ en sus isoformas 1 y 2. El resultado de esta interacción es la reducción de la liberación de neurotrasmisores con un efecto de disminución de la hiperexitabilidad neuronal. Todo esto ocurre de forma presináptica induciendo la baja del influjo de calcio, disminución de glutamato, de sustancia P y de norepinefrina en la sinapsis.


Gabapentin and pregabalin are structurally similar to the neurotransmitter GABA, but these drugs do not interact with the GABA receptor and its therapeutic effect is not reversed by GABA antagonists. It is accepted that both drugs interact with calcium channels in α2δ isoforms 1 and 2. The result of this interaction is to reduce the release of neurotransmitters with an effect of decreasing neuronal hiperexitabilidad. All this occurs lowering presynaptic calcium influx, decreased glutamate, substance P and norepinephrine in synapses.

Gabapentina y pregabalina ligandos A2delta: implicaciones futuras en la clínica diaria


A2delta ligands gabapentin and pregabalin: future implications in daily clinical practice.
Tzellos TG, Papazisis G, Toulis KA, Sardeli Ch, Kouvelas D.
Department of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Greece.
Hippokratia. 2010 Apr;14(2):71-5.
Abstract
Gabapentin (GP) and pregabalin (PB) are structurally related compounds and their predominant mechanism of action is the inhibition of calcium currents via high-voltage-activated channels containing the a2d-1 subunit. A2delta ligands are approved for the treatment of pain of diabetic neuropathy and post-herpetic neuralgia in adults and as adjunctive therapy of partial seizures in children. Recently, pregabalin has been approved for treatment of anxiety disorders in Europe. Besides their already approved indications both drugs are promising treatment options for a number of different serious and debilitating diseases, as fibromyalgia, neuropathic pain of spinal cord injury, hot flushes, and essential tremor. In the present review, the unique mechanism of action of the above drugs is critically analyzed and evidence for their future use is provided. Gabapentin and pregabalin can be treatment options for these disorders, however, a clear comparison between the two drugs can not be performed, since there is no direct comparison study. The most common side effects are dizziness and somnolence which are also the most frequent reasons for withdrawal. Recommendations for future studies should include assessment of ideal titration period for GP and PB to reduce incidence of somnolence and dizziness and increase tolerability, cost-effectiveness and dose-response analysis of PB and GP and direct comparison of the two drugs.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895293/pdf/hippokratia-14-71.pdf

Mediciones amperométricas de la liberación del glutamato modulada por gabapentina y pregabalina en muestras neocorticales de ratas: papel de la subunidad voltage sensitiva Ca2+ α2δ-1


Amperometric measurement of glutamate release modulation by gabapentin and pregabalin in rat neocortical slices: role of voltage-sensitive Ca2+ α2δ-1 subunit.
Quintero JE, Dooley DJ, Pomerleau F, Huettl P, Gerhardt GA.
Morris K Udall Parkinson's Disease Research Center of Excellence, Center for Microelectrode Technology, Department ofAnatomy and Neurobiology, University of Kentucky, Lexington, Kentucky 40536, USA.george.quintero@uky.edu
J Pharmacol Exp Ther. 2011 Jul;338(1):240-5. Epub 2011 Apr 4.
Abstract
Gabapentin (GBP; Neurontin) and pregabalin (PGB; Lyrica, S-(+)-3-isobutylgaba) are used clinically to treat several disorders associated with excessive or inappropriate excitability, including epilepsy; pain from diabetic neuropathy, postherpetic neuralgia, and fibromyalgia; and generalized anxiety disorder. The molecular basis for these drugs' therapeutic effects are believed to involve the interaction with the auxiliary α(2)δ subunit of voltage-sensitive Ca(2+) channel (VSCC) translating into a modulation of pathological neurotransmitter release. Glutamate as the primary excitatory neurotransmitter in the mammalian central nervous system contributes, under conditions of excessive glutamate release, to neurological and psychiatric disorders. This study used enzyme-based microelectrode arrays to directly measure extracellular glutamate release in rat neocortical slices and determine the modulation of this release by GBP and PGB. Both drugs attenuated K(+)-evoked glutamate release without affecting basal glutamate levels. PGB (0.1-100 μM) exhibited concentration-dependent inhibition of K(+)-evoked glutamate release with an IC(50) value of 5.3 μM. R-(-)-3-Isobutylgaba, the enantiomer of PGB, did not significantly reduce K(+)-evoked glutamate release. The decrease of K(+)-evoked glutamate release by PGB was blocked by the l-amino acid l-isoleucine, a potential endogenous ligand of the α(2)δ subunit. In neocortical slices from transgenic mice having a point mutation (i.e., R217A) of the α(2)δ-1 (subtype) subunit of VSCC, PGB did not affect K(+)-evoked glutamate release yet inhibited this release in wild-type mice. The results show that GBP and PGB attenuated stimulus-evoked glutamate release in rodent neocortical slices and that the α(2)δ-1 subunit of VSCC appears to mediate this effect.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3126634/pdf/zpt240.pdf



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

Creatividad: un pequeño detalle que lo cambia todo

El caparazón: Creatividad: un pequeño detalle que lo cambia todo




Creatividad: un pequeño detalle que lo cambia todo

Posted: 23 Oct 2012 02:39 AM PDT


Resultan interesantes tanto el libro como el curso completo sobre Creatividad de Standford con la profesora Tina Seelig en el que andamos últimamente. Como muestra, la infografía que os dejo, intentando describir de forma holística el proceso de la innovación, lo que puede denominarse la máquina creativa.

En el interior de tenemos la imaginación, el conocimiento, la actitud:
El conocimiento es el combustible de la imaginación.
La imaginación es la que transformará el conocimiento en nuevas ideas.
La actitud es la chispa que pone la máquina en movimiento.

En el exterior tenemos los recursos, el hábitat, la cultura:
Los recursos son aquello de lo que contamos en nuestra comunidad.
El habitat incluye a la gente en nuestros equipos (o redes, añadiría), las reglas, los premios y el espacio físico (o virtual, en la época actual, añado también).
La cultura son las creencias colectivas, los valores y comportamientos en la comunidad.







Solo recordar en este punto cómo lo que ha motivado esta entrada, lo que la ha ubicado en este blog es reconocer que el conocimiento, lo que Tina entiende como materia prima de la creatividad, las ideas que luego se interconectarán de formas novedosas puede estar también en la red, fuera de nuestros cerebros. Eso indica, de hecho, mucha de la investigación al respecto, cómo de importante es la memoria de trabajo (su tamaño correlaciona altísimamente con inteligencia general), más que la memoria de almacenamiento, en cuanto a la imaginación.

Si pensamos en internet como banco mayor de objetos que llevar a la conciencia, como entorno para el aprendizaje aumentado, entenderemos al 100% a qué nos referimos cuando hablamos de la revolución creativa actual.



El vídeo a continuación, extracto de la charla en inglés de la profesora, deja tremendamente claro cómo de importante es ser creativo. Atención a la música del vídeo, un publireportaje sobre el embotellado de Coca-Cola en blanco y negro… que se repite en la secuencia que he seleccionado …



¿Cambia la cosa, no?

Todo es, sin lugar a dudas, del color del cristal con que lo miramos…