Books Update: Grand Bargainer NYT

November 9, 2012 Books Update

On the Cover of Sunday's Book Review 'Thomas Jefferson: The Art of Power' By JON MEACHAM Reviewed by JILL ABRAMSON Jon Meacham's biography of Thomas Jefferson looks at how the Founding Father balanced his ideals with pragmatism while also bending others to his will. Also in the Book Review Orhan Pamuk: By the Book The author of "The Innocence of Objects" and "Silent House" believes all American presidents should read "Zen and the Art of Motorcycle Maintenance."  By the Book: Archive 'She Loves Me Not' By RON HANSEN Reviewed by SVEN BIRKERTS Ron Hansen's stories highlight his birthplace, which Oscar Wilde visited in 1882. 'Ancient Light' By JOHN BANVILLE Reviewed by CHRISTOPHER BENFEY John Banville's hero stars in a movie version of events long past. 'Flight Behavior' By BARBARA KINGSOLVER Reviewed by DOMINIQUE BROWNING A Tennessee town grapples with the consequences of a miracle that turns out to have environmental causes. 'The Testament of Mary' By COLM TOIBIN Reviewed by MARY GORDON Colm Toibin's novella portrays a Mary we do not recognize from the Gospels. 'Gone to the Forest' By KATIE KITAMURA Reviewed by ROB NIXON An unnamed colonial country is threatened by civil war in Katie Kitamura's novel. 'Oddly Normal' By JOHN SCHWARTZ Reviewed by DAVID SHEFF A journalist combines the story of his son's struggle to embrace his sexuality with a report about research on LGBT teenagers. 'Too Good to Be True: A Memoir' By BENJAMIN ANASTAS Reviewed by DEB OLIN UNFERTH A rejected book, an affair, a shattered marriage, a mountain of debt. Benjamin Anastas tells his story.  ArtsBeat Q. & A.: Benjamin Anastas 'Giving Up the Ghost' By ERIC NUZUM Reviewed by RICK MOODY Eric Nuzum's memoir opens a door to the emotional lives of America's young. 'The Secret Race' By TYLER HAMILTON and DANIEL COYLE Reviewed by GEOFFREY WHEATCROFT Tyler Hamilton, who rode with Lance Armstrong, tells of drug use in cycling. Children's Books Carry On By LEONARD S. MARCUS Peter Rabbit, Toad and the Boxcar Children are cast in sequels. Keeping Hope Alive By CHARLAYNE HUNTER-GAULT Three books highlight the struggle for racial equality in America. Topsy-Turvy By CHRIS VAN ALLSBURG Jon Agee and Oliver Jeffers embrace the absurd in two new picture books. Swimmies By ROGER SUTTON An industrious tugboat and a mischievous fish discover that life is full of surprises. 'The Paladin Prophecy' By MARK FROST Reviewed by MARIE LU An elite school is part of a centuries-old battle against evil forces. 'Endangered' By ELIOT SCHREFER Reviewed by VICKI CONSTANTINE CROKE Amid an African coup, a girl and a baby ape are on the run. 'The Other Normals' By NED VIZZINI Reviewed by SAM LIPSYTE Ned Vizzini's teenage hero faces challenges in two realms. Bookshelf: Rhapsody By PAMELA PAUL Picture books about music by Wynton Marsalis, Marvin Hamlisch and more.    Slide Show 'The Raven Boys' By MAGGIE STIEFVATER Reviewed by ANNA HOLMES A teenage heroine uncovers mysteries at an all-male academy. Whose Body Is It Anyway? By ALLY CONDIE Two dystopian young adult novels challenge readers' conceptions. Bookshelf: Great Lives By PAMELA PAUL Picture books about Florence Mills, Helen Keller, Benjamin Franklin, Noah Webster and the Brontë sisters.    Slide Show Tastes of Victory By LISA BROWN In three books, enemies are vanquished, European style. Tech Trouble By MAUREEN JOHNSON Two young adult novels imagine worlds affected by alarming technology. Histories of War By MARC ARONSON The race to build the bomb and Jewish resistance in World War II are the subjects of two nonfiction books. Spitfires By LISA VON DRASEK These plucky heroines are determined to preserve the power of enchantment. 'The Great Unexpected' By SHARON CREECH Reviewed by ELIZABETH WEIL Girls who have lost their parents wonder where they fit in. 'Keeping Safe the Stars' By SHEILA O’CONNOR Reviewed by WHITNEY JOINER Three orphans learn to get by without their grandfather. Bookshelf: Dig In! By PAMELA PAUL Picture books about a picky eater, a hungry fox, a lemonade stand and more.    Slide Show 'Jepp, Who Defied the Stars' By KATHERINE MARSH Reviewed by KATHRYN HARRISON This young adult novel's hero succeeds because of his character. 'The Story of the Blue Planet' By ANDRI SNAER MAGNASON. Illustrated by ASLAUG JONSDOTTIR. Translated by JULIAN MELDON D'ARCY. Reviewed by AMANDA LITTLE A world run by children is upended in this environmental tale. 'The Warrior's Heart' By ERIC GREITENS Reviewed by KEVIN POWERS A Rhodes scholar and Iraq war veteran urges us to find "a better way to walk in the world." 'Little White Duck: A Childhood in China' By NA LIU and ANDRÉS VERA MARTÍNEZ. Illustrated by ANDRÉS VERA MARTÍNEZ. Reviewed by GENE LUEN YANG Stories of a girl's upbringing, with graphic-art illustrations. Snowy Days By SUSAN DOMINUS Three picture books explore the eternal childhood delights of cold, snow and ice.

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 Children's Books SLIDE SHOW: Best Illustrated Books The New York Times Best Illustrated Children's Books of 2012, with sample artwork from each. Back Page An Author Can Dream By WALTER KIRN (If only all book reviews were really like this.) Inside the List By GREGORY COWLES Danielle Steel has two new books on the best-seller lists, including a memoir about her quiet but steady efforts to help the homeless population in San Francisco. Editors' Choice Recently reviewed books of particular interest. Paperback Row By IHSAN TAYLOR Paperback books of particular interest. Book Review Podcast This week, Jon Meacham discusses his new book, "Thomas Jefferson: The Art of Power"; Pamela Paul talks about the year's best illustrated children's books; Sam Tanenhaus explains the prescient politics of John Updike's "Rabbit Redux"; and Gregory Cowles has best-seller news. Sam Tanenhaus is the host. Authors Stage 'Defiance' to Benefit Red Hook New Interactive App for 'Goodnight Moon' Art and War: Pat Barker Talks About 'Toby's Room' REVIEWS BY THE TIMES'S CRITICS 'Poems 1962-2012' 'Mr. Penumbra's 24-Hour Bookstore' by Robin Sloan 'Bruce' by Peter Ames Carlin 'Heads in Beds' by Jacob Tomsky 'Sweet Tooth' Children's Books: Animal Catastrophe 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

Enfermedad por Reflujo Gastroesofágico

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 14 de Noviembre 2012 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Enfermedad por Reflujo Gastroesofágico” por los “Dr. Ricardo Manuel Ordorica Flores.” Cirujano Pediatra, de la Cd de México DF. La sesión inicia puntualmente las 21 hrs.
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador

http://connectpro60196372.adobeconnect.com/refllujo_cirugia/

2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia 6.- Recomendamos que dejes tu Nombre Completo, Correo electrónico y que participes.

Henrys


Dr. Enrique Mendoza López
Webmaster: CONAPEME
Coordinador Nacional: Seminario Ciberpeds-Conapeme
Av La clinica 2520-310
Colonia Sertoma ,Mty N.L. México
CP 64710
Tel-Fax 52 81 83482940 y 52 81 81146053
Celular 8183094806
www.conapeme.org
www.pediatramendoza.com
enrique@pediatramendoza.com
emendozal@yahoo.com.mx

Bibliotecas. Alerta

La Biblioteca de la US registra en 2011 un número de descargas de ...
Giralda Informacion
Mi Reina de Sevilla. Anonimo comentó: estoy deacuerdo en todo, pero no se puede equilibrar la valanza, porque queramos decir que es la virgen maria, estamos ante la que sin duda es la que representa la ciudad, y eso solo puede ser una y solo una, ...
Ver todos los artículos sobre este tema »
Giralda Informacion



Biblioteca municipal tendrá una sección dedicada a personas que ...
Radio FmBolivia
Wenceslao Marquez, jefe de la Unidad de Museos y Bibliotecas del Gobierno Municipal, informó que los funcionarios de esta dependencia se encuentran en una etapa de recopilación de libros para implementar una sección con textos en lenguaje Braille ...
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Satisfacción por la aprobación de tarjetas de identificación en Los ...
holaciudad Washington DC
Grupos defensores de los derechos de los inmigrantes mostraron hoy su satisfacción después de que el Concejo de Los Ángeles aprobase ayer un plan para crear una tarjeta de identificación para lasbibliotecas públicas de la ciudad. Satisfacción por la ...
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El Reina Sofía acoge la primera retrospectiva de Heimo Zobernig
Lainformacion.com
El Museo Reina Sofía presenta la primera exposición retrospectiva realizada en España del artista austriaco Heimo Zobernig (Mauthen, 1958). La muestra, que se inaugura en el Palacio de Velázquez, reúne aproximadamente cuarenta obras (pinturas, ...
Ver todos los artículos sobre este tema »
Lainformacion.com



El festival Spain Now reivindica en Londres el dibujo ...
Lainformacion.com
Londres, 8 nov.- El festival de arte Spain Now reivindicó hoy en Londres el valor del dibujo contemporáneo español con la inauguración de la exposición "Nulla dies sine Linea", una ecléctica muestra de 23 artistas de esta disciplina. Ubicada en la ...
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Hopper es tan tóxico como cinco conciertos de U2
Lainformacion.com
La exposición de arte 'La Huella de Hopper', que acogió el Museo Thyssen-Bornemisza, ha generado un total de 3.575 toneladas de CO2 durante los tres meses que estuvo expuesta --entre junio y septiembre--, según el estudio de medición de la huella de ...
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Lainformacion.com


¿Qué esconde Candela Ferrández en su jardín?
Lainformacion.com
La ilustradora Candela Ferrández (Zaragoza, 1979) propone un poético viaje por los pequeños secretos que oculta el jardín en su exposición 'Regreso al Jardín', que podrá verse del 9 al 30 de noviembre en el espacio artístico Habitar la Línea, del ...
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Lainformacion.com





La cifra de usuarios de la Biblioteca Juan Soca aumenta un 136%...
El Día de Córdoba
La estadística es requerida anualmente por la Consejería de Cultura para conocer el estado de la red debibliotecas públicas andaluzas, que en el caso de Cabra "se convierte en un puro servicio público a la ciudad", como aseguró el concejal de Cultura, ...
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La Biblioteca de Villacañas (Toledo) acogerá este viernes y sábado ...
La Cerca
La Biblioteca Municipal de Villacañas acogerá este viernes y este sábado actividades literarias y de lectura de la IX edición de 'De cabeza. Una lectura sin libros', que como cada año en fechas próximas al Día Mundial de las Bibliotecas organiza el ...
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Distribuirán 'El camino real de tierra adentro' en bibliotecas de ...
NTR Zacatecas .com
La Coordinación Estatal de Bibliotecas, recibirá de la delegación del Instituto Nacional de Antropología e Historia (INAH) un lote de libros de El camino real de tierra adentro, que se distribuirá entre todas las bibliotecas de la entidad. El evento de ...
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NTR Zacatecas .com



Segunda fase de implementaciones de Koha-Kobli en bibliotecas ...
según nanigs
Tras el éxito de las primeras implantaciones de Koha-Kobli en diferentes bibliotecas de la AGE, comenzamos una segunda fase en otras 6 bibliotecas de la Administración General del Estado. La Subdirección General de Coordinación ...
Koha-Kobli



Las bibliotecas contribuyen con ocho objetivos de desarrollo del ...
El pasado mes, la Biblioteca Nacional de Perú lanzó el programa 'Semillas para el Desarrollo', el cual tiene el objetivo de construir bibliotecas en zonas poco ...
www.beyondaccess.net/.../las-bibliotecas-contribuyen-con-och...




Bibliotecas y colaboración ciudadana
Llevamos ya tiempo discutiendo sobre la conveniencia de acabar con un modelo de gestión institucional que no tenía en cuenta a los usuarios más que para ...
www.madrimasd.org/blogs/futurosdellibro/2012/11/.../135159


Revisiones_bibliográficas: Bibliotecas. Alerta
La Dirección de Bibliotecas y Archivo, a cargo de la Prof. Celia Sarquís, que depende de la Secretaría de Estado de Cultura, recibió una donación de libros ...
paveca3.blogspot.com/2012/11/bibliotecas-alerta.html

Actualización en el manejo perioperatorio del niño asmático

Actualización en el manejo perioperatorio del niño asmático


Update on perioperative management of the child with asthma.
Dones F, Foresta G, Russotto V.
Department of Anesthesia and Intensive Care AOUP, University of Palermo, Italy.
Pediatr Rep. 2012 Apr 2;4(2):e19. Epub 2012 Apr 5.
Abstract
Asthma represents the leading cause of morbidity from a chronic disease among children. Dealing with this disease during the perioperative period of pediatric surgical procedures is, therefore, quite common for the anesthesiologist and other professionalities involved. Preoperative assessment has a key role in detecting children at increased risk of perioperative respiratory complications. For children without an optimal control of symptoms or with a recent respiratory tract infection elective surgery should be postponed, if possible, after the optimization of therapy. According to clinical setting, loco-regional anesthesia represents the desirable option since it allows to avoid airway instrumentation. Airway management goals are preventing the increase of airflow resistance during general anesthesia along with avoiding triggers of bronchospasm. When their use is possible, face mask ventilation and laringeal mask are considered more reliable than tracheal intubation for children with asthma. Sevoflurane is the most commonly used anesthetic for induction and manteinance. Salbutamol seems to be useful in preventing airflow resistance rise after endotracheal intubation. Mechanical ventilation should be tailored according to pathophysiology of asthma: an adequate expiratory time should be setted in order to avoid a positive end-expiratory pressure due to expiratory airflow obstruction. Pain should be prevented and promptly controlled with a loco-regional anesthesia technique when it is possible. Potential allergic reactions to drugs or latex should always be considered during the whole perioperative period. Creating a serene atmosphere should be adopted as an important component of interventions in order to guarantee the best care to the asthmatic child.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3395977/pdf/pr-2012-2-e19.pdf



Atentamente
Dr. Enrique Hernández-Cortez
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

[Identidad Bibliotecaria] [Bibliópolis: ...] El arte de Discutir y Argumentar

Enrique Campang Chang (Desde Guatemala. Especial para ARGENPRESS CULTURAL)


Discutir y argumentar son parte del conocimiento para formular conclusiones, recomendaciones y acciones; pero también es algo fuerte que atrae, apasiona, que en no pocas oportunidades puede ser molesto y una pérdida de tiempo.


Discutir y argumentar debe ser un arte, pero para otros una forma de simplemente llevar la contraria, hostigar o ganas de fastidiar. El argumento es improvisado, poco sólido, se aborda desde el defecto en vez de la virtud, o la visión fecal de las cosas.


Es una discusión necia, entre fanáticos, pobre en argumentos; en círculo vicioso, que degenera en insultos y ataques personales; es una forma de discusión que llamo DENTRO DE AGUAS TURBIAS Y AGITADAS, donde no se escucha al otro; un monólogo; no se llega a nada, (entre fanáticos palestinos y judíos).

Estas son las más frecuentes en política, religión, o deportes; entre inmaduros o tercos. Donde cada uno ya tiene su criterio; no se acepta discusión alguna, es el esfuerzo de imponer sus ideas a otro; o si no, se les descalifica. Es imposible discutir entre impacientes que demandan argumentos en pocas palabras en una competencia de egos ofuscados.

Es una discusión estéril, sobre temas difíciles que no comprenden; cada opinión revuelve más las aguas; no hay serenidad, empatía; no se quedan conformes hasta que el otro dice lo que quiere oír.


En las reuniones, cuando se discute en aguas turbias o agitadas, sobre el fútbol, las modas, religión o política, por salud mental es mejor verlas desde afuera. Son discusiones que no llevan a nada.

Otro tipo es la DISCUSIÓN SIN SALIRSE DEL AGUA, se discute con respeto, pero cada postura está comprometida a no modificarla; hay límites entre los grupos de intereses; donde no es posible ir más allá de la línea oficial. Se sabe cuándo es el momento de no seguir. Se evita tocar temas a fondo, dogmas, sus limitaciones o intereses ocultos.

Es donde el religioso, político, subalterno están atados. Hay condiciones que restringen la libertad del argumento en temas delicados. Son llamados al orden si se apartan. Se aplica con rigor el peso de los libros, las citas del Diccionario de la RAE y las normas formales de la APA. Con procedimientos técnicamente correctos, pero posiblemente falsos o superficiales. Se mantienen dentro del círculo.

Es la discusión donde se evitan los temas tabú, prohibidos o incómodos. El capitalista, comunista, cristiano o musulmán hablan dentro de su ideología o credo, cuidándose de no tocar sus temas controversiales, eso si, pueden atacar a otros.
En una reunión de vegetarianos, nadie habla a favor de comer un delicioso asado de res.

Se mantiene la altura, pero con sus limitaciones, que termina con un discreto cambio de tema, cuando seguir resulta incómodo. Son discusiones con argumentos “cuadrados” política o moralmente correctos. No se pone en duda nada, se evitan las ideas escandalosas. Toda autoridad desde el presidente de los Estados Unidos a los papas debe mantenerse dentro del agua, no pueden salirse.

Son argumentos en refrito: repetición y machacado de ideas viejas, de autores encumbrados, en variaciones sobre los mismos temas; no se permiten las ideas propias; el que se atreve a salirse de la olla es regresado por los otros cangrejos…

Luego, la DISCUSIÓN ENCIMA DEL AGUA, es la de alto nivel, es la discusión amplia, productiva, libre, donde se pueden criticar esquemas, es creativa; cuando las partes pueden admitir su error; trascienden las posturas personales, se abre a ideas nuevas, sin insultos, pueden parecer irreverentes, romper con paradigmas, dogmas o posturas históricamente aceptadas pero equivocadas. Estas discusiones por sus aportes novedosos pueden caer dentro de lo subversivo, herético, profético o peligroso.

Se llega a niveles superiores; diferentes a la discusión de aguas turbias; las personas no se sienten ofendidas, hay entusiasmo, acompañamiento, inquietud sana. Hay atrevimiento, riesgo de enfrentarse a niveles desconocidos, de alterar esquemas propios. Se marcan caminos nuevos,

Cuando Jesús rompe con la tradición religiosa y política de sus tiempos; habla de temas revolucionarios como el amor al prójimo, el bien común, la dignidad de las personas, la atención por los pobres. Está encima del agua, libera a las personas de los errores tradicionales, se eleva en el sentido de la parábola de caminar sobre las aguas.

Los pensamientos revolucionarios e innovadores son por encima de las aguas, Es el nivel verdaderamente superior de la discusión y argumentación. Los conceptos tradicionales se corrigen, amplían o adaptan a los nuevos contextos.

Unos que llegan al nivel de estar por encima de las aguas como Buda, Lao Tse, Confucio, Giordano Bruno, Galileo, Newton, Darwin, Marx, Freud, son incomprendidos o perseguidos; o se dan cuenta que se quedan hablando solos. Son despreciados por los que no se atreven a salir de sus pensamientos, reglas o costumbres que les dan seguridad; y como decía una amiga: “muchas herejías e ideas subversivas son pensamientos antes de su tiempo”.

En las universidades y centros de decisión los espacios de discusión y argumentación de altura son necesarios para romper los estancamientos intelectuales. La humanidad pierde al no convertir la discusión y argumentación en un arte. En la política de muchos países se maneja la discusión en su nivel más bajo, con ignorancia, insultos y amenazas. (Ej. Congreso de Guatemala).

No se trata de discutir por discutir, se tiene que saber el nivel en que se está metiendo.

En: http://cultural.argenpress.info/2012/11/el-arte-de-discutir-y-argumentar.html

Medicamentos para la obesidad: pasado, presente y futuro

Medicamentos para la obesidad: pasado, presente y futuro


Anti-obesity drugs: past, present and future.
Rodgers RJ, Tschöp MH, Wilding JP.
Behavioural Neuroscience Laboratory, Institute of Psychological Sciences, University of Leeds, LS2 9JT, UK. r.j.rodgers@leeds.ac.uk
Dis Model Mech. 2012 Sep;5(5):621-6. doi: 10.1242/dmm.009621.

Abstract
The ideal anti-obesity drug would produce sustained weight loss with minimal side effects. The mechanisms that regulate energy balance have substantial built-in redundancy, overlap considerably with other physiological functions, and are influenced by social, hedonic and psychological factors that limit the effectiveness of pharmacological interventions. It is therefore unsurprising that anti-obesity drug discovery programmes have been littered with false starts, failures in clinical development, and withdrawals due to adverse effects that were not fully appreciated at the time of launch. Drugs that target pathways in metabolic tissues, such as adipocytes, liver and skeletal muscle, have shown potential in preclinical studies but none has yet reached clinical development. Recent improvements in the understanding of peptidergic signalling of hunger and satiety from the gastrointestinal tract mediated by ghrelin, cholecystokinin (CCK), peptide YY (PYY) and glucagon-like peptide-1 (GLP-1), and of homeostatic mechanisms related to leptin and its upstream pathways in the hypothalamus, have opened up new possibilities. Although some have now reached clinical development, it is uncertain whether they will meet the strict regulatory hurdles required for licensing of an anti-obesity drug. However, GLP-1 receptor agonists have already succeeded in diabetes treatment and, owing to their attractive body-weight-lowering effects in humans, will perhaps also pave the way for other anti-obesity agents. To succeed in developing drugs that control body weight to the extent seen following surgical intervention, it seems obvious that a new paradigm is needed. In other therapeutic arenas, such as diabetes and hypertension, lower doses of multiple agents targeting different pathways often yield better results than strategies that modify one pathway alone. Some combination approaches using peptides and small molecules have now reached clinical trials, although recent regulatory experience suggests that large challenges lie ahead. In future, this polytherapeutic strategy could possibly rival surgery in terms of efficacy, safety and sustainability of weight loss.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424459/


http://dmm.biologists.org/content/5/5/621.full.pdf



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

Bibliotecas. Alerta

13:40 Biblioteca Mario Vargas Llosa entregará 1000 libros a ...
Andina
Arequipa, nov. 03 (ANDINA). Con el propósito de motivar en los adolescentes y jóvenes de Arequipa el hábito de la lectura, la biblioteca regional "Mario Vargas Llosa" distribuirá 1,000 libros en diversas instituciones educativas de la provincia ...
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Tras la utopía de la biblioteca universal
Mercado
Tras la utopía de la biblioteca universal. El problema principal para crear este reservorio del conocimiento global tiene poco que ver con la tecnología. La dificultad surge de la espinosa maraña de temas legales, comerciales y políticos que rodea el ...
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Guatemala: Biblioteca como punto de partida para revitalizar la ...
Global Voices en español
Localizada en el corazón de la ciudad de San Juan la Laguna, Guatemala, la Biblioteca comunitaria Rija'tzuul Na'ooj tiene generalmente muchísima actividad. En un rincón de la biblioteca, un área nueva provee espacio destinado a los niños para ...
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'Una biblioteca con sostenibilidad ambiental'
Diario del Huila
En el segundo trimestre de 2013 abrirá sus puertas al público la nueva biblioteca del Banco de la República en la capital opita, la cual se convertirá en un referente nacional del manejo de recursos eco-sostenibles. En el momento la obra se encuentra ...
Ver todos los artículos sobre este tema »
Diario del Huila

Cultura destina más dinero a pagar premios al mérito cultural que a ...
levante.emv.com
J. R. S. Bien es cierto que la parcela cultural será una de las más afectadas por los recortes económicos aplicados por el Consell para 2013, pero dentro de esa gran isla es, sin duda, el área de libros, archivos y bibliotecas la que sufre una nueva y ...
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Neiva tendrá la mejor biblioteca del país
La Nación.com.co
El proyecto que tiene un costo de 9.800 millones de pesos y que tiene un avance de obra del 85 por ciento será modelo a nivel nacional, pues su infraestructura cumple con los más altos estándares en términos de operación, tecnología y arquitectura, ...
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Momentos de delicadeza exhibe Nueva Biblioteca Ciudadela: Lynn ...
RadioFórmula
Fue inaugurada la Nueva Ciudadela donde habrán cinco bibliotecas, que albergarán 220 mil volúmenes que forman parte de Alí Chumacero, Jaime García Terrés, José Luis Martínez, Antonio Castro Leal y Carlos Monsiváis. El edificio que se encuentra ...
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Los vecinos de Parque Goya recogen libros para hacer una biblioteca
Heraldo de Aragon
La Biblioteca de Los Vecinos. Este es el nombre que recibirá, cuando entre en funcionamiento, el nuevo servicio de prestación de libros que la Asociación de Vecinos Parque Goya acaba de poner en marcha. Se trata de una iniciativa que pretende hacer las...
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Heraldo de Aragon


Bibliotecas norteamericanas ante la web social | blok de bid
¿Están usando las bibliotecas de los Estados Unidos las herramientas de la web social? Las que lo hacen, ¿con qué intenciones? ¿A través de qué tipo de ...
www.ub.edu/.../bibliotecas-norteamericanas-ante-la-web-social

Estudio observacional sobre la elección de anestesia y la evolución de las pacientes con pre-eclampsia severa y cesárea urgente

Estudio observacional sobre la elección de anestesia y la evolución de las pacientes con pre-eclampsia severa y cesárea urgente


Observational study of choice of anaesthesia and outcome in patients with severe pre-eclampsia who present for emergency Caesarean section
Kiran Keerath, L Cronje
South Afr J Anaesth Analg 2012;18(4):206-212
Abstract
Objectives: Recent evidence in the literature suggests that regional anaesthesia may be the preferred choice over general anaesthesia for patients with severe pre-eclampsia who present for a Caesarean section. This study was conducted to determine if this applied to our population and to assess outcomes. Design: A retrospective comparative observational study was conducted. Setting and subjects: The study was carried out at the King Edward VIII Hospital and included patients with severe preeclampsia who presented for emergency Caesarean section. Eighty-four charts were analysed. Outcome measures: The type of anaesthetic that was administered was determined and compared for maternal intraoperative haemodynamic changes and maternal and neonatal outcomes. Results: Sixty-nine per cent of patients received spinal anaesthesia and 25% general anaesthesia (GA). Intraoperative systolic blood pressures of < 100 mmHg were recorded in 19% of GA and in 27.6% of spinal anaesthesia cases. A > 20% fall in mean arterial pressure from baseline was noted in 66.7% of GA and in 75.9% of spinal anaesthesia cases. There was no maternal mortality and one case of morbidity (a spinal anaesthesia case). An Apgar score of < 7 was recorded in 66.7% of GA cases and in 19% of spinal anaesthesia cases. Neonatal morbidity and mortality occurred in 33.3% of GA and in 10.3% of spinal anaesthesia cases. Conclusion: Maternal morbidity and mortality were not significantly different between the two groups. Neonatal outcomes were poorer in the GA group, but neonates in the GA group had significantly lower birthweights and gestational ages. Their mothers also had more severe disease. This study supports spinal anaesthesia as an appropriate anaesthetic choice in patients with severe pre-eclampsia.
http://www.ajol.info/index.php/sajaa/article/viewFile/82330/72486


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

Novedades en anestésicos locales

Bupivacaína liposomal: revisión de una nueva formulación de bupivacaína


Liposomal bupivacaine: a review of a new bupivacaine formulation.
Chahar P, Cummings KC 3rd.
Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
J Pain Res. 2012;5:257-64. doi: 10.2147/JPR.S27894. Epub 2012 Aug 14.
Abstract
Many attempts have been made to increase the duration of local anesthetic action. One avenue of investigation has focused on encapsulating local anesthetics within carrier molecules to increase their residence time at the site of action. This article aims to review the literature surrounding the recently approved formulation of bupivacaine, which consists of bupivacaine loaded in multivesicular liposomes. This preparation increases the duration of local anesthetic action by slow release from the liposome and delays the peak plasma concentration when compared to plain bupivacaine administration. Liposomal bupivacaine has been approved by the US Food and Drug Administration for local infiltration for pain relief after bunionectomy and hemorrhoidectomy. Studies have shown it to be an effective tool for postoperative pain relief with opioid sparing effects and it has also been found to have an acceptable adverse effect profile. Its kinetics are favorable even in patients with moderate hepatic impairment, and it has been found not to delay wound healing after orthopedic surgery. More studies are needed to establish its safety and efficacy for use via intrathecal, epidural, or perineural routes. In conclusion, liposomal bupivacaine is effective for treating postoperative pain when used via local infiltration when compared to placebo with a prolonged duration of action, predictable kinetics, and an acceptable side effect profile. However, more adequately powered trials are needed to establish its superiority over plain bupivacaine.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442744/pdf/jpr-5-257.pdf


Bupivacaína liposomal; inovativo analgésico local no opioide para el manejo del dolor postoperatorio
Liposomal bupivacaine: an innovative nonopioid local analgesic for the management of postsurgical pain.
Candiotti K.
University of Miami Miller School of Medicine, Miami, Florida.
Pharmacotherapy. 2012 Sep;32(9 Pt 2):19S-26S. doi: 10.1002/j.1875-9114.2012.01183.x.
Abstract
Local anesthetics are a cornerstone of multimodal pain control strategies in the surgical setting as they have a long history of use and an established safety profile. Although effective, their duration of action is relatively short, which usually leads to the use of other agents, such as opioids, for effective postsurgical pain control in most patients. A medical need exists to extend the duration of analgesia with local anesthetics to help reduce the reliance on opioids in the postsurgical setting. Liposomal bupivacaine uses a product delivery platform to release bupivacaine slowly over 96 hours after infiltration at the surgical site. Liposomal bupivacaine was compared with placebo in two pivotal, multicenter, randomized, double-blind, parallel-group trials in 189 adults undergoing soft-tissue surgery (hemorrhoidectomy) and 193 adults undergoing orthopedic surgery (bunionectomy). Among patients undergoing hemorrhoidectomy, liposomal bupivacaine significantly reduced cumulative pain scores for up to 72 hours (primary end point) as measured by the area under the curve of pain scores on the numeric rating scale (p<0.0001), reduced overall opioid consumption (p≤0.0006), increased the proportion of patients who did not receive opioids (p<0.0008), delayed time to first opioid by more than 13 hours (p<0.0001), and was associated with significantly higher rates of patient satisfaction (p=0.0007) compared with placebo. Similarly, in patients undergoing bunionectomy, liposomal bupivacaine significantly reduced total consumption of rescue opioids (p=0.0077) and cumulative pain scores as measured by the area under the curve of pain scores on the numeric rating scale (p=0.0005) during the first 24 postsurgical hours (primary end point) relative to placebo. Furthermore, liposomal bupivacaine also significantly delayed the time to first use of opioid rescue (p<0.0001) and increased the proportion of patients requiring no rescue opioid treatment (p≤0.0404) compared with placebo. The most common adverse events with liposomal bupivacaine were nausea, vomiting, and constipation. No adverse effects on the QTc interval or cardiac safety signal have been detected in the clinical trial development program (823 patients) when liposomal bupivacaine was infiltrated into the surgical site. The beneficial effects of liposomal bupivacaine on postsurgical pain management and opioid use, significantly reducing both, are likely to translate into improved clinical and economic outcomes.
http://onlinelibrary.wiley.com/doi/10.1002/j.1875-9114.2012.01183.x/pdf





Articaína: revisión de su uso para anestesia local y regional


Articaine: a review of its use for local and regional anesthesia.
Snoeck M.
Department of Anaesthesia, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
Local Reg Anesth. 2012;5:23-33. Epub 2012 Jun 5.
Abstract
Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects were not generally significantly different from those of other short-acting local anesthetics like lidocaine, prilocaine, and chloroprocaine, and there is no conclusive evidence demonstrating above-average neurotoxicity. Articaine proved to be suitable and safe for procedures requiring a short duration of action in which a fast onset of anesthesia is desired, eg, dental procedures and ambulatory spinal anesthesia, in normal and in special populations.


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3417979/pdf/lra-5-023.pdf





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

Vía aérea en obesidad

Impactos de la súper obesidad versus la obesidad mórbida sobre la mecánica respiratoria y los parámetros hemodinámicos simples durante la cirugía bariátrica


The Impacts of Super Obesity Versus Morbid Obesity on Respiratory Mechanics and Simple Hemodynamic Parameters During Bariatric Surgery.
Salihoglu T, Salihoglu Z, Zengin AK, Taskin M, Colakoglu N, Babazade R.
Department of Anesthesiology and Reanimation, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey, tsalihoglu@hotmail.com.
Obes Surg. 2012 Oct 3. [Epub ahead of print]
Abstract
BACKGROUND: This study was designed to determine the impact of the degree of obesity on respiratory mechanics and simple hemodynamic parameters at laparoscopic bariatric surgery. METHODS: The patients were divided into two groups, each of which included 24 patients (a morbidly obese group and a super obese group) undergoing laparoscopic bariatric surgery. Dynamic respiratory compliance, respiratory resistance, and peak inspiratory pressures were measured at four time points: 10 min after anesthesia induction (T1: induction), 10 min after pneumoperitoneum (T2: pneumoperitoneum), 10 min after terminating pneumoperitoneum (T3: end-pneumoperitoneum), and before extubation (T4: extubation). The systolic, diastolic, and mean arterial pressures and the heart rate values were measured noninvasively in T0 (10 min before operation). RESULTS: Obesity was found to cause a statistically significant increase in respiratory resistance and a peak inspiratory pressure and a decrease in dynamic respiratory compliance. In the morbidly obese group, the lowest dynamic respiratory compliance was 37mL/cm H(2)O, but it was 33mL/cm H(2)O in the super obese group. The systolic pressure, diastolic pressure, and mean arterial pressure were found to decrease significantly in both groups. CONCLUSIONS: Morbid obesity and super obesity have negative effects on hemodynamics and respiratory mechanics.
http://www.springerlink.com/content/uq123946442l8103/fulltext.pdf

Efectos del neumoperitoneo sobre la mecánica respiratoria durante cirugía bariátrica


The Effects of Pneumoperitoneum on Respiratory Mechanics During Bariatric Surgery
Sener Demiroluk, MD1; Ziya Salihoglu, MD1; Kagan Zengin, MD2; Yildiz
Kose, MD1; Mustafa Taskin, MD2
University of Istanbul, Cerrahpasa Medical School, Department of 1Anaesthesiology and 2General Surgery, Istanbul, Turkey
Obesity Surgery, 12, 376-379
Background: The aim of this study was to investigate the influence of laparoscopic and conventional open surgery on respiratory mechanics, and blood gases, and to determine convenient techniques from the point of view of intraoperative respiratory mechanics, for bariatric surgery. Method: 40 morbidly obese patients were divided into 2 groups, patients undergoing laparoscopy Group 1, and patients undergoing conventional open surgery Group 2. Resistance of airway, dynamic compliance, and peak inspiratory pressure were measured. Measurement was performed in 4 periods: a) after anesthesia induction, b) after pneumoperitoneum in the Group 1 and after incision in the Group 2, c) after gastric band placement, d) and 5 min before extubation. Blood gases were recorded concomitantly. Results: There was no significant difference between the 2 groups in values of blood gases and respiratory mechanics. Conclusion: In the morbidly obese, laparoscopic and open surgery did not cause a significant difference for respiratory mechanics when compared with each other.
Key words: Morbid obesity, laparotomy, pneumoperitoneum, respiratory mechanics, compliance, bariatric
surgery
http://www.springerlink.com/content/l46m466075335353/fulltext.pdf

Desafíos en la evaluación del riesgo pulmonar y el manejo perioperatorio en pacientes sometidos a cirugía bariátrica


Challenges in pulmonary risk assessment and perioperative management in bariatric surgery patients.
Kaw R, Aboussouan L, Auckley D, Bae C, Gugliotti D, Grant P, Jaber W, Schauer P, Sessler D.
Department of Hospital Medicine, Cleveland Clinic Foundation, 9500 Euclid Avenue-S70, Cleveland, OH 44195, USA. Kawr@ccf.org
Obes Surg. 2008 Jan;18(1):134-8. Epub 2007 Nov 16.
Abstract
Bariatric surgery has serious associated medical comorbidity and procedure-related risks and is, thus, considered an intermediate-to-high-risk non-cardiac surgery. Altered respiratory mechanics, obstructive sleep apnea (OSA), and less often, pulmonary hypertension and postoperative pulmonary embolism are the major contributors to poor pulmonary outcomes in obese patients. Attention to posture and positioning is critical in patients with OSA. Suspected OSA patients requiring intravenous narcotics should be kept in a monitored setting with frequent assessments and naloxone kept at the bedside. Use of reverse Tredelenburg position, preinduction, maintenance of positive end-expiratory pressure, and use of continuous positive airway pressure can help improve oxygenation in the perioperative period.

ttp://www.springerlink.com/content/u333063w537375kj/fulltext.pdf





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

Ketamina, inflamación y analgesia

Revisión sistemática de ketamina intravenosa para analgesia postoperatoria


A systematic review of intravenous ketamine for postoperative analgesia.
Laskowski K, Stirling A, McKay WP, Lim HJ.
Department of Anesthesiology, Perioperative Medicine and Pain Management, College of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada. kevin.laskowski@usask.ca
Can J Anaesth. 2011 Oct;58(10):911-23. Epub 2011 Jul 20.
Abstract
PURPOSE: Perioperative intravenous ketamine may be a useful addition in pain management regimens. Previous systematic reviews have included all methods of ketamine administration, and heterogeneity between studies has been substantial. This study addresses this issue by narrowing the inclusion criteria, using a random effects model, and performing subgroup analysis to determine the specific types of patients, surgery, and clinical indications which may benefit from perioperative ketamine administration. SOURCE: We included published studies from 1966 to 2010 which were randomized, double-blinded, and placebo-controlled using intravenous ketamine (bolus or infusion) to decrease postoperative pain. Studies using any form of regional anesthesia were excluded. No limitation was placed on the ketamine dose, patient age, or language of publication. PRINCIPAL FINDINGS: Ninety-one comparisons in seventy studies involving 4,701 patients met the inclusion criteria (2,652 in ketamine groups and 2,049 in placebo groups). Forty-seven of these studies were appropriate for evaluation in the core meta-analysis, and the remaining 23 studies were used to corroborate the results. A reduction in total opioid consumption and an increase in the time to first analgesic were observed across all studies (P < 0.001). The greatest efficacy was found for thoracic, upper abdominal, and major orthopedic surgical subgroups. Despite using less opioid, 25 out of 32 treatment groups (78%) experienced less pain than the placebo groups at some point postoperatively when ketamine was efficacious. This finding implies an improved quality of pain control in addition to decreased opioid consumption. Hallucinations and nightmares were more common with ketamine but sedation was not. When ketamine was efficacious for pain, postoperative nausea and vomiting was less frequent in the ketamine group. The dose-dependent role of ketamine analgesia could not be determined. CONCLUSION: Intravenous ketamine is an effective adjunct for postoperative analgesia. Particular benefit was observed in painful procedures, including upper abdominal, thoracic, and major orthopedic surgeries. The analgesic effect of ketamine was independent of the type of intraoperative opioid administered, timing of ketamine administration, and ketamine dose.
http://www.oana.org/pdf/Canadian%20Article.pdf


La administración continua de S-(+)-ketamina durante el bypass coronario electivo atenua la respuesta proinflamatoria de las citokinas durante y después del cortocircuito cardiopulmonar


Continuous S-(+)-ketamine administration during elective coronary artery bypass graft surgery attenuates pro-inflammatory cytokine response during and after cardiopulmonary bypass.
Welters ID, Feurer MK, Preiss V, Müller M, Scholz S, Kwapisz M, Mogk M, Neuhäuser C.
Department of Anaesthesiology, Intensive Care and Pain Therapy, Universitätsklinikum Gießen und Marburg, Standort Gießen, D-35392 Giessen, Germany.
Br J Anaesth. 2011 Feb;106(2):172-9. Epub 2010 Dec 7.

CONCLUSION: Our data demonstrate that S-(+)-ketamine possesses anti-inflammatory potential. Anaesthesia with S-(+)-ketamine may have beneficial effects in attenuating the CPB-induced systemic inflammatory response.


http://bja.oxfordjournals.org/content/106/2/172.full.pdf




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