Revisiones_bibliográficas TyO

viernes, 8 de marzo de 2013

Más sobre inyección subdural/More on subdural injection

Inicio súbito de bloqueo subaracnoideo después de cateterización subdural. ¿Un caso de ruptura de aracnoides?

Sudden onset of subarachnoid block after subdural catheterization: a case of arachnoid rupture?
D W Elliott, F Voyvodic and P Brownridge
Br. J. Anaesth. (1996) 76 (2): 322-324. doi: 10.1093/bja/76.2.322
We describe a patient who received an apparently uneventful extradural block in labour but developed rapid extension of neural block within minutes of receiving her first incremental dose 2 h later. Computed contrast tomography revealed radio-opaque dye within both the subdural and subarachnoid spaces, but none within the extradural space. This case report demonstrates that subdural spread of low-dose local anaesthetics is not always clinically distinguishable from extradural analgesia and that the arachnoid membrane may subsequently perforate with potentially serious consequences.
http://bja.oxfordjournals.org/content/76/2/322.full.pdf

Afasia transitoria despues de anestesia raquídea en un paciente ortopédico

Transient aphasia following spinal anaesthesia in an orthopaedic patient
Bindra Tripat, Gupta Ruchi, Thukral Sonika
South Afr J Anaesth Anlg 2012; 18(6): 346-347
Abstract
A 50-year-old male [American Society of Anesthesiologists (ASA) grade II] was scheduled for lower limb orthopaedic surgery. The subarachnoid space was localised with difficulty at L3/4 interspace and 3 ml of hyperbaric bupivacaine was given. Within a few minutes, the patient developed aphasia with a very high sensory block extending to C2 dermatome, followed by apnoea. The patient remained haemodynamically stable throughout surgery and respiration resumed within five minutes. Inadvertent subdural deposition of local anaesthetic was speculated to be the cause of this unusual presentation.
http://www.sajaa.co.za/index.php/sajaa/article/view/984/1177

Presentación rara de bloqueo subdural accidental en anestesia epidural para parto

Case Report: Rare Presentations of Accidental Subdural Block in Labor Epidural Anesthesia
Song, Shah & Ramachandran
Open Journal of Anesthesiology, 2012, 2, 142-145
Abstract
The incidence of accidental injection or catheterization of the subdural space during performance of a neuroaxial block has recently increased. It can occur even when an experienced practitioner performs the neuraxial procedure. The presentation of numerous unexplainable clinical signs in the process of continuous epidural anesthesia, which do not fit the clinical picture of subarachnoid or intravascular injection, should envoke a high suspicion for unintentional subdural block. We report two cases of patients who achieved prolonged labor analgesia via epidural technique with only half the initial loading dose of local anesthetic. Both patients also had short episodes of hypotension. Additionally, one patient presented with severe hypoxemia and mild motor block of both upper and lower extremities. The other patient presented with transit unresponsiveness without motor block. Both patients rapidly responded to vasopressors. Desaturation in one patient, however, was persistent lasting for more than four hours. Her bedside chest X-ray was inconclusive "possible pulmonary edema" and the follow up Chest CT Scan on the second day revealed aspiration pneumonia. Based on the clinical findings, these two cases were suggestive of subdural block with cranial nerve involvement.
http://www.scirp.org/journal/PaperInformation.aspx?paperID=22246

Bloqueo subdural-otros puntos

Subdural block-further points
Anaesthesia, 1994, Volume 49, pages 794-795
Summary
An obstetric epidural performed for analgesia showed a changing pattern of neurological block. The original features suggestive of a subdural block were complicated when aspiration of cerebrospinal fluid from the catheter became possible. Subsequent management as a continuous subarachnoid catheter allowed delivery.
Keywords: Anaesthetic techniques, regional;epidural. Complications;subdural; hypotension
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1994.tb04455.x/pdf

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

Books Update NYT

March 8, 2013
Books Update
http://www.nytimes.com/indexes/2013/03/08/books/booksupdate/index.html

On the Cover of Sunday's Book Review

'Lean In: Women, Work, and the Will to Lead'
By SHERYL SANDBERG with NELL SCOVELL
Reviewed by ANNE-MARIE SLAUGHTER

In "Lean In," Sheryl Sandberg, the chief operating officer of Facebook, encourages women to make their voices heard at the workplace.

Up Front: Anne-Marie Slaughter

Also in the Book Review

Marilynne Robinson: By the Book

The author of "Gilead" says that after "Housekeeping," her greatest fear was writing "a fraudulent book simply to escape the embarrassments of having written only one novel."

By the Book: Archive

'The Great Agnostic'
By SUSAN JACOBY
Reviewed by JENNIFER MICHAEL HECHT

The 19th-century freethinker Robert Ingersoll drew crowds with his brilliant oratory.

'The Dinner'
By HERMAN KOCH. Translated by SAM GARRETT.
Reviewed by CLAIRE MESSUD

In Herman Koch's novel, two Dutch couples struggle with the hardest decision of their lives - over the course of one meal.

'The Good House'
By ANN LEARY
Reviewed by J. COURTNEY SULLIVAN

In Ann Leary's novel, an alcoholic real estate agent pretends to be sober, with disastrous consequences.

'P. G. Wodehouse: A Life in Letters'
Edited by SOPHIE RATCLIFFE
Reviewed by CHARLES McGRATH

The collected letters - many previously unpublished - of the great comic writer P. G. Wodehouse.

'The Blue Book'
By A. L. KENNEDY
Reviewed by WENDY LESSER

On a trans-Atlantic cruise, a former psychic examines the tricky deceptions of magic, relationships and language itself.

'I Do and I Don't'
By JEANINE BASINGER
Reviewed by JUDITH NEWMAN

It's difficult to make marriage in the movies interesting, Jeanine Basinger's survey argues.

'Ghana Must Go'
By TAIYE SELASI
Reviewed by NELL FREUDENBERGER

Taiye Selasi's first novel follows a splintered Ghanaian-Nigerian family across continents and generations.

CRIME
Bodies for Hire
By MARILYN STASIO

"The Boyfriend," by Thomas Perry, is a thriller about a retired homicide detective investigating a series of unsolved murders of high-priced prostitutes.

'Benediction'
By KENT HARUF
Reviewed by PAUL ELIE

Kent Haruf continues his cycle of novels set in the high plains of Colorado, where a close-knit community is pushed to the brink.

'Weird Life'
By DAVID TOOMEY
Reviewed by RICHARD FORTEY

A search for hidden organisms finds some that thrive in extreme conditions, and some that may live only in the imagination.

ArtsBeat Q. & A.: David Toomey

Children's Books

You're Special
By MICHAEL IAN BLACK

Three picture books explore the theme of individuality.

'Eleanor & Park'
By RAINBOW ROWELL
Reviewed by JOHN GREEN

This novel's title characters are an unlikely couple.

'Hold Fast'
By BLUE BALLIETT
Reviewed by ABBY McGANNEY NOLAN

A man vanishes in Chicago, and his family struggles to survive.

Rising Stars
By BOB BALABAN

In two middle-grade novels, boys pursue a passion for show business.

Bookshelf: Bats and Baskets
By PAMELA PAUL

New picture books include a look at baseball in Japan and biographies of Willie Mays and Babe Ruth.

Bibliotecas. Alerta

Biblioteca en Almere / Concrete Architectural Associates
Plataforma Arquitectura
A petición del cliente hemos contribuido al desarrollo de la tienda-concepto: un enfoque comercial, muy diferente a un posicionamiento y una estructura de una biblioteca estándar , donde los libros se presentan a un “cliente” y donde la biblioteca en ...
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Biblioteca Pedro Mir en la UASD con filtraciones y plafones rotos
El Masacre
SANTO DOMINGO, República Dominicana.- Estudiantes de la Universidad Autónoma de Santo Domingo (UASD) denunciaron las filtraciones en el edificio de la Biblioteca Pedro Mir. Unas imágenes muestran el derrumbe de unos de los plafones en el ...
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La biblioteca del vaticano digitalizará 2.8 petabytes de material escrito
RedUSERS
Es una de las bibliotecas más antiguas del mundo, fue fundada en 1448. Tiene más de 80 mil manuscritos y más de 1 millón de libros. La biblioteca del Vaticano será digitalizada gracias al servicio de almacenamiento y tecnología que proveerá EMC.
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RedUSERS

Problemas edilicios en la biblioteca de Stefenelli
rionegro.com.ar
ROCA (AR).- El primer diagnóstico de los técnicos de la empresa Ferrosur es que las instalaciones de la vieja estación de Padre Alejandro Stefenelli presenta deficiencias edilicias y no pueden ser utilizadas como biblioteca. La noticia impactó no sólo ...
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En mayo habrá biblioteca
El Meridiano de Córdoba
Lorica. La construcción de la nueva biblioteca municipal que ha avanzado en más de un 60%, deberá estar terminada en el mes de mayo. Así lo confirmó el secretario de Planeación Municipal, Maruen Jabib Janna, quien aseguró que los trabajos van a ...
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Cine fórum en la Biblioteca
avilared.com
La Biblioteca Pública de Ávila ha programado ciclos de cine fórum bajo el nombre 'Jueves de cine', dentro de la planificación semestral 'NueB'. Clásicos, cine independiente, cine español del primer tercio del siglo XX, documentales o películas que ...
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La biblioteca móvil, en la plaza de Maipú
Los Andes (Argentina)
(Gentileza). El móvil de la biblioteca móvil que recorre el país, con el objetivo de incentivar la lectura y la escritura en los niños mediante juegos, talleres y exposiciones, se encuentra en la ciudad de Maipú. Hasta hoy estará ubicado junto al ...
Ver todos los artículos sobre este tema »

Los Andes (Argentina)

Reclaman la apertura de la biblioteca del Guido
NoticiasNet
La biblioteca, fundada casi con la construcción del barrio Guido, no prestó sus servicios durante el mes de febrero cuando varios de los adolescentes acudían para recibir apoyo escolar de cara a los exámenes previos al inicio de las clases. Sin embargo ...
Ver todos los artículos sobre este tema »

Primera etapa de digitalización de textos de la biblioteca del ...
Radio Santiago
La Biblioteca Apostólica Vaticana –una de las bibliotecas más antiguas del mundo con más de 80.000 códices y 1,1 millones de libros impresos que fue creada en 1448 y se encuentra en la Ciudad del Vaticano– anunció que planea digitalizar la mayoría de ...
Ver todos los artículos sobre este tema »
Radio Santiago

Primera etapa de digitalización de textos de la Biblioteca ...
según Esteban Zamorano
La Biblioteca Apostólica Vaticana –una de las bibliotecas más antiguas del mundo con más de 80.000 códices y 1,1 millones de libros impresos que fue creada en 1448 y se encuentra en la Ciudad del Vaticano– anunció que planea ...
FayerWayer

Biblioteca - Presentación - Universidad Pública de ... - Pamplona
Página web de la Universidad Pública de Navarra. Te encuentras en Biblioteca. Presentación.
www.unavarra.es/biblioteca/presentacion?contentId=132750

Noticias Monterrey Salinas » Incendio afecta biblioteca
Salinas, CA., Anoche se reportó un incendio el cual supuestamente provocaría que la Biblioteca John Steinbeck permanezca cerrada por varios días.
www.ksmstv.com/2013/03/07/incendio-afecta-biblioteca/

El Blog de Batman: "Mi Biblioteca de Cómics":“Robin: Year One ...
Al estar trascurriendo este mes tan especial debido al trágico suceso ocurrido en las páginas del Morrisoniano ”Batman Inc”, en “Mi biblioteca del Comic” ...
brucewayneisthebatman.blogspot.com/.../mi-biblioteca-de-co...

Bibliotecas. Alerta

Se cumplen cien años de la primera española bibliotecaria
Te Interesa
Este año se cumplen cien años de la aparición de la primera mujer bibliotecaria, Angelita García Rives, que aprobó el ingreso en el Cuerpo Facultativo de ...

Cultura y Deporte convoca el Plan 2013 de formación de ...
Ivecinos
Asimismo, se celebrarán unas jornadas sobre la 'Memoria Digital Local de Andalucía' y los EncuentrosBibliotecarios en cada una de las provincias andaluzas.

El número de bibliotecarias triplica el de sus compañeros masculinos
Madridpress.com
Este año se cumplen cien años de la designación para el puesto de trabajo de la primera mujerbibliotecaria, Angelita García Rives, que aprobó el ingreso en ...

jueves, 7 de marzo de 2013

Inyección subdural/Subdural injection

La falla de anestesia raquídea raquia puede llegar al 3-4%, siendo la inyección subdural una de las explicaciones. Se manifiesta por una extensión inadecuada del bloqueo sensitivo, con duración breve. En ocasiones se han reportado bloqueos altos y de corta duración o falla total de la anestesia espinal o peridural. Hay tres explicaciones para la aspiración de LCR y falla de la anestesia raquídea: Alteraciones anatómicas de la aracnoides que permiten LCR en el espacio subdural. Otra posibilidad es que el bisel de la aguja de raquia, en especial las de tipo punta de lápiz, se coloque en el espacio subdural y en el subaracnoideo, lo cual hace posible la salida de LCR a través de la aguja espinal. El anestésico local inyectado se difunde en ambos espacios resultando en una raquia fallida e insuficiente. Por último, la punción accidental de la duramadre durante intento de bloqueo peridural puede facilitar la salida de LCR al espacio subdural y la colocación inadecuada del catéter peridural en este espacio.

Failure of spinal anesthesia can reach 3 to 4%, subdural injection being one explanation. It is manifested by inadequate extension of sensory block, with short duration. Sometimes high blockages have been reported, with short duration or total failure of spinal or epidural anesthesia. There are three explanations for CSF aspiration and failure of spinal anesthesia: Arachnoid anatomical malformations that allow the presence of CSF in the subdural space. Another possibility is that the bevel of the spinal needle, especially the pencil tip type, is placed in the subdural space and into the subarachnoid simultaneously, which makes possible the CSF outflow through the spinal needle. The injected local anesthetic diffuses into both spaces resulting in a failed spinal anesthesia. Finally, the accidental dural puncture during attempted epidural block may facilitate the exit of CSF subdural space and improper placement of the epidural catheter in this space

Bloqueo subdural y el anestesiólogo

SUBDURAL BLOCK AND THE ANAESTHETIST
D Agarwal, M Mohta, A Tyagi, AK Sethi
Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg. Bahadur Hospital, Delhi, India
Anaesthesia and Intensive Care, 2010,Vol 38, No. 1
SUMMARY
There are a number of case reports describing accidental subdural block during the performance of subarachnoid or epidural anaesthesia. However, it appears that subdural drug deposition remains a poorly understood complication of neuraxial anaesthesia. The clinical presentation may often be attributed to other causes. Subdural injection of local anaesthetic can present as high sensory block, sometimes even involving the cranial nerves due to extension of the subdural space into the cranium. The block is disproportionate to the amount of drug injected, often with sparing of sympathetic and motor fibres. On the other hand, the subdural deposition can also lead to failure of the intended block. The variable presentation can be explained by the anatomy of this space. High suspicion in the presence of predisposing factors and early detection could prevent further complications. This review aims at increasing awareness amongst anaesthetists about inadvertent subdural block. It reviews the relevant anatomy, incidence, predisposing factors, presentation, diagnosis and management of unintentional subdural block during the performance of neuraxial anaesthesia.

http://www.csen.com/subdural.pdf

Inyección subdural. ¿Cual es el estándar de oro?

Subdural injection: what's the gold standard?
Hogan QH, Mark L.
Reg Anesth Pain Med. 2009 Jan-Feb;34(1):10-1
. doi: 10.1097/AAP.0b013e31819268a0.
Epidural anesthesia is an act of faith. We insert the epidural needle, typically without radiological guidance, to a depth that is determined by inferred rather than directly witnessed endpoints. A catheter is passed that cannot be steered but can only be controlled by the single parameter of how far it is advanced. The distribution of the injected solution is likewise not under direct control except by the single parameter of how much is injected. In addition to these considerations, the contents of the epidural space are highly heterogenous,1,2 so it is understandable that the anesthetic effect is variable. Possibilities include excessive or inadequate anesthetic spread, brief anesthetic duration, excessive hemodynamic changes, and variable motor block. When the actual events in a particular case fall outside the range of expected possibilities, a good clinician will ponder the pathophysiological options.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872160/pdf/nihms107315.pdf

Inyección intradural accidental durante el intento de bloqueo peridural. Informe de un caso

Accidental intradural injection during attempted epidural block -A case report-.
Yun JS, Kang SY, Cho JS, Choi JB, Lee YW.
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2011 Mar;60(3):205-8. doi: 10.4097/kjae.2011.60.3.205. Epub 2011 Mar 30.
Abstract
Several cases of accidental subdural injection have been reported, but only few of them are known to be accidental intradural injection during epidural block. Therefore we would like to report our experience of accidental intradural injection. A 68-year-old female was referred to our pain clinic due to severe metastatic spinal pain. We performed a diagnostic epidural injection at T9/10 interspace under the C-arm guided X-ray view. Unlike the usual process of block, onset was delayed and sensory dermatomes were irregular range. We found out a dense collection of localized radio-opaque contrast media on the reviewed X-ray findings. These are characteristic of intradural injection and clearly different from the narrow wispy bands of contrast in the subdural space.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071485/pdf/kjae-60-205.pdf

¿Bloqueo subdural complicando anestesia espinal?

Subdural Block Complicating Spinal Anesthesia?
Baljit Singh, MD and Puneet Sharma, MD
Anesth Analg 2002;94:1007-9.
IMPLICATIONS:Features suggestive of subdural block appeared after an apparently normal subarachnoid block. The long bevel of the reusable Quincke-type spinal needle may have contributed to the development of this complication. We propose that spinal needles should have a smaller bevel to minimize the possibility of such a complication.
Spread of local anesthetic in the subdural space, as a complication of epidural anesthesia, is well known. It can be clinically diagnosed or at least strongly suspected on the basis of characteristic features of extensive spread, slow onset of neural block, relative lack of sympathetic block, progressive respiratory depression, and incoordination, rather than apnea (1). We report a case of probable subdural block as a complication of subarachnoid anesthesia. Leak of local anesthetic into the subdural space during subarachnoid injection of local anesthetic has not been reported.
http://www.anesthesia-analgesia.org/content/94/4/1007.full.pdf

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

Manejo de Pecho Excavado

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 13 de Marzo 2013 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Manejo de Pecho Excavado” por el “Dr. José Refugio Mora Foll.” 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/pecho_excavado/

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

QUE SABER Y COMO MANEJAR LA DEFICIENTE CALIDAD ÓSEA EN EL PACIENTE ORTOPÉDICO. ASPECTOS PRÁCTICOS

http://www.smo.edu.mx/

Sesión completa del CMO del día 6/III/2013
QUE SABER Y COMO MANEJAR LA DEFICIENTE CALIDAD ÓSEA EN EL
PACIENTE ORTOPÉDICO. ASPECTOS PRÁCTICOS
Coordinador: Dr. José Gustavo Legorreta Cuevas
Titular del Capítulo de Especialización en Metabolismo Óseo

Introducción
Dr. José Gustavo Legorreta Cuevas
Hospital Shriners para Niños de México
Que saber del paciente, sus huesos y terapéuticas para mejorar mi cirugía ortopédica
Dr. Rafael Gerardo Santibañez Cabero.
Consecuencia de no tratar la osteoporosis en pacientes ortopédicos.
Análisis prospectivo
Dra. Ariana Alvarado Ceballos
Hospital Ángeles Mocel.
Además de cirugía, es útil tratar médicamente la osteogenesis imperfeta y
Legg Calve Perthes
Dr. J. Gilberto Ríos Ruiz
Hospital Shriners para Niños de México.

http://livestre.am/4n4mu

Watch live streaming video from bibliomanazteca_platicas_medicas at livestream.com

miércoles, 6 de marzo de 2013

Falla de anestesia neuroaxial/Failed neuroaxial anesthesia

http://www.smo.edu.mx/anuncio_residentes6.htm

Malposición de catéter en anestesia epidural confirmada por tomografía computada

Epidural catheter malposition in a failed epidural anesthesia confirmed by computed tomography.
Lee SJ, Kim SH, Park SY, Kim MG, Jung BI, Ok SY.
Department of Anesthesiology and Pain Medicine, College of Medicine, Soonchunhyang University, Seoul, Korea.
Korean J Pain. 2011 Mar;24(1):44-7. doi: 10.3344/kjp.2011.24.1.44. Epub 2011 Feb 25.
Abstract
We report a case of failed epidural anesthesia despite successful identification of the epidural space, loss of resistance technique, hanging drop method and drip infusion. This case evaluated the use of computed tomography to confirm epidural catheter position, which showed the catheter accidentally positioned at the T2 lamina. Because epidural anesthesia can even after successful procedure using standardized techniques such as loss of resistance, we recommend performing the procedure under fluoroscopic guidance to improve success rate and patient safety.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049976/pdf/kjpain-24-44.pdf

¿Por que los bloqueos epidurales no siempre funcionan?

Why Epidurals Do Not Always Work?
Katherine Arendt, MD, Scott Segal, MD
Department of Anesthesiology, Mayo Clinic, Rochester, MN; Department of Anesthesiology, Perioperative
and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
Rev Obstet Gynecol. 2008;1(2):49-55.
The overwhelming majority of epidural catheters placed for labor provide satisfactory analgesia. There are, however, times when the catheter is not sited within the epidural space correctly, the patient's neuraxial anatomy is problematic, or a patient's labor progresses more quickly than expected by the anesthesiologist, and the epidural block does not set up on time. In this article, the basics of neuraxial labor analgesia, the causes of its failure, and the strategies anesthesiologists employ to rescue poorly functioning catheters are reviewed.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505163/pdf/RIOG001002

_0049.pdf

Enlaces de utilidad

Links:

http://www.csaol.cn/img/Hypertextbook/a/c94.htm

http://www.anesthesia.utoronto.ca/edu/cme/courses/m14/Failed_Epidural

_Options_CS.htm

http://www.allaboutepidural.com/main-content/epidural-side-effects-malfunction

http://cdigital.uv.mx/bitstream/123456789/29805/1/FERMANSUAREZ

JUANJORGE.pdf

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

lunes, 4 de marzo de 2013

McKenzie Method Assessment

http://www.smo.edu.mx/anuncio_residentes6.htm
http://colegiomexicanodeortopediaytrauma.blogspot.mx/2013/03/mckenzie-method-assessment.html

Spine-health
Do you compensate for your back or neck pain by assuming different positions? You may be a candidate for the McKenzie Method Assessment.

During the McKenzie physical examination, patients are taken through provocative loading strategies (movements) that help classify the patient and determine the best treatment approach.

http://www.spine-health.com/wellness/exercise/videos
Back Exercise Video Directory

Back exercise is a vital part of maintaining proper spine health and is often a regular part of any back treatment program for conditions such as sciatica, degenerative disc disease and other back disorders. Browse our back exercise videos which provide informative instuctions and tips on the proper techniques and exercises to perform to help alleviate back pain and assure a strong and healthy back and spine.

Hamstring Exercises for Low Back Pain Relief Video
A visual demonstration of the correct exercises and stretches for the hamstring muscles that are designed to bring relief for lower back pain.

Sciatica Exercises for Degenerative Disc Disease Video
See how to perform exercises to relieve sciatica from degenerative disc disease. Beginning and advanced techniques are demonstrated.

Sciatica Exercises for Piriformis Syndrome Video
An informative visual demonstration of correct exercises and stretching techniques to help relieve sciatica pain caused by piriformis syndrome.

Sciatica Exercises for Spinal Stenosis Video
Learn the correct technique for performing stretches and exercises to increase back strength and relieve sciatica caused by spinal stenosis.

http://www.spine-health.com/wellness/exercise/mckenzie-method-assessment

McKenzie Method Assessmentwww.spine-health.com
-AA+A By: Thomas E. (Ted) Dreisinger, PhDArticle has been peer reviewedTweetprintWhen a patient’s pain symptoms can be made better or worse by adopting various, differentiated active positions, it is said that a

domingo, 3 de marzo de 2013

Apnea obstructiva del sueño/Sleep obstructive apnea

http://www.smo.edu.mx/anuncio_residentes6.htm

Apnea obstructiva del sueño/Sleep obstructive apnea

Apnea obstructiva del sueño y diabetes tipo 2: ¿Hay un enlace?

Obstructive sleep apnea and type 2 diabetes: is there a link?
Pamidi S, Tasali E.
Respiratory Division, Department of Medicine, McGill University Montreal, QC, Canada.
Front Neurol. 2012;3:126. Epub 2012 Aug 13.
Abstract
Type 2 diabetes is a chronic illness that is increasing in epidemic proportions worldwide. Major factors contributing to the development of type 2 diabetes include obesity and poor lifestyle habits (e.g., excess dietary intake and limited physical activity). Despite the proven efficacy of lifestyle interventions and the use of multiple pharmacological agents, the economic and public health burden of type 2 diabetes remains substantial. Obstructive sleep apnea (OSA) is a treatable sleep disorder that is pervasive among overweight and obese adults, who represent about two thirds of the U.S. population today. An ever-growing number of studies have shown that OSA is associated with insulin resistance, glucose intolerance and type 2 diabetes, independent of obesity. Evidence from animal and human models that mimic OSA provides potential mechanisms for how OSA may alter glucose metabolism. Up to 83% of patients with type 2 diabetes suffer from unrecognized OSA and increasing severity of OSA is associated with worsening glucose control. However, it is still unclear whether OSA may lead to the development of diabetes over time. More data from large-scale longitudinal studies with rigorous assessments of diabetes and OSA are needed. In addition, there is still controversy whether continuous positive airway pressure (CPAP) treatment of OSA improves glucose metabolism. Large-scale randomized-controlled trials of CPAP treatment of OSA with well-validated assessments of insulin sensitivity and glucose tolerance are needed. These studies may reveal that OSA represents a novel, modifiable risk factor for the development of prediabetes and type 2 diabetes.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3449487/pdf/fneur-03-00126.pdf

Apnea obstructiva del sueño como riesgo para ateroesclerosis-implicaciones preventivas y de tratamiento personalizado

Obstructive sleep apnoea as a risk factor for atherosclerosis - implication for preventive and personalised treatment.
Tuleta I, Pabst S, Juergens UR, Nickenig G, Skowasch D.
University of Bonn, Bonn, Germany.
EPMA J. 2011 Mar;2(1):39-47. doi: 10.1007/s13167-011-0070-5. Epub 2011 Mar 26.Abstract
Atherosclerosis with its manifestations and associated diseases is a main cause of morbidity and mortality in industrial countries. The pathomechanisms underlying atherosclerosis are complex and comprise exogenous factors as well as genetic predisposition. Beyond the well-defined risk factors for the development of atherosclerosis, obstructive sleep apnoea (OSA) merits more and more attention. A growing body of evidence has associated OSA with vascular pathologies. Although the exact mechanisms involved are not known, the occurrence of intermittent hypoxia typical for OSA may lead to oxidative stress, inflammation, metabolic and neural changes which in turn are responsible for vessel dysfunction underlying atherosclerosis. It has been demonstrated that therapy with continuous positive airway pressure (CPAP) plays a vasoprotective role. This review summarises data resulting from epidemiological and clinical studies with emphasis on the possible mechanisms linking OSA with atherosclerosis, predictive biomarkers helping identify OSA patients at high cardiovascular risk and personalised treatment approaches.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405376/pdf/13167_2011

_Article_70.pdf

Atentamente
Dr. Juan C. Flores-Carrillo
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

Más sobre apnea obstructiva del sueño/More on OSA

http://www.smo.edu.mx/anuncio_residentes6.htm

Avances recientes en el manejo de la apnea obstructivo del sueño: perspectiva dental

Recent advances in the management of obstructive sleep apnea: The dental perspective.
Prabhat KC, Goyal L, Bey A, Maheshwari S.
Department of Orthodontics and Dental Anatomy, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.
J Nat Sci Biol Med. 2012 Jul;3(2):113-7. doi: 10.4103/0976-9668.101877.
Abstract
Obstructive sleep apnea (OSA) is common in adult population. OSA shows detrimental effects on health, neuropsychological development, quality-of-life, and economic potential and now it is recognized as a public health problem. Despite the availability of expanded therapeutic options, polysomnography and nasal continuous positive airway pressure (CPAP) are the gold standards for the diagnosis and treatment for OSA. Recently, American Academy of Sleep Medicine has recommended oral appliances for OSA. Hence the therapeutic interventions that are directed at the site of airway obstruction in the maxillofacial region are within the scope of dentistry. Treatment of OSA can improve vitality, social and daytime functioning, family life and mental health of a person and hence the quality-of-life. Obesity is the main predisposing factor for OSA. Other than obesity, craniofacial abnormalities such as micrognathia and retrognathia, age, ethnic background and genetic predisposition, consumption of alcohol, smoking, and sedatives may also predispose to OSA. Treatment modalities for OSA are behavior modification, diet and medication, CPAP devices, surgical (maxillo-mandibular advancement surgery), and oral appliances. Treatment of a patient with OSA not only improves the physical health of the patients but also the mental and social well-being.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510903/

Apnea obstructiva del sueño e hígado graso no alcohólico: ¿Es el hígado otro órgano blanco?

Obstructive sleep apnea and non-alcoholic Fatty liver disease: is the liver another target?
Mirrakhimov AE, Polotsky VY.
I.K. Akhunbaev Kyrgyz State Medical Academy Bishkek, Kyrgyzstan.
Front Neurol. 2012;3:149. doi: 10.3389/fneur.2012.00149. Epub 2012 Oct 17.
Abstract
Obstructive sleep apnea (OSA) is recurrent obstruction of the upper airway during sleep leading to intermittent hypoxia (IH). OSA has been associated with all components of the metabolic syndrome as well as with non-alcoholic fatty liver disease (NAFLD). NAFLD is a common condition ranging in severity from uncomplicated hepatic steatosis to steatohepatitis (NASH), liver fibrosis, and cirrhosis. The gold standard for the diagnosis and staging of NAFLD is liver biopsy. Obesity and insulin resistance lead to liver steatosis, but the causes of the progression to NASH are not known. Emerging evidence suggests that OSA may play a role in the progression of hepatic steatosis and the development of NASH. Several cross-sectional studies showed that the severity of IH in patients with OSA predicted the severity of NAFLD on liver biopsy. However, neither prospective nor interventional studies with continuous positive airway pressure treatment have been performed. Studies in a mouse model showed that IH causes triglyceride accumulation in the liver and liver injury as well as hepatic inflammation. The mouse model provided insight in the pathogenesis of liver injury showing that (1) IH accelerates the progression of hepatic steatosis by inducing adipose tissue lipolysis and increasing free fatty acids (FFA) flux into the liver; (2) IH up-regulates lipid biosynthetic pathways in the liver; (3) IH induces oxidative stress in the liver; (4) IH up-regulates hypoxia inducible factor 1 alpha and possibly HIF-2 alpha, which may increase hepatic steatosis and induce liver inflammation and fibrosis. However, the role of FFA and different transcription factors in the pathogenesis of IH-induced NAFLD is yet to be established. Thus, multiple lines of evidence suggest that IH of OSA may contribute to the progression of NAFLD but definitive clinical studies and experiments in the mouse model have yet to be done.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473309/pdf/fneur-03-00149.pdf

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