SE INVITA AL CURSO"PEDI@TÍPS ORTOPÉDICOS" México, 26/27/28/2013INP ,ATTE. DR. JOSE CORTES GOMEZ twitter.com/bibliomanaztec…
— Victor Ravens (@bibliomanazteca) 24 de mayo de 2013
Revisiones bibliográficas. Documentación científica en Ortopedia y Traumatología, medicina deportiva, artroscopia, artroplastia y de todas las patologías del sistema Músculo-Esquelético
viernes, 24 de mayo de 2013
CURSO "PEDI@TÍPS ORTOPÉDICOS"
#hip #arthroscopy
#hip #arthroscopy "the patient must be properly positioned for the procedure to go well. Poor positioning will assure a difficult procedure"
— Dr. David Maldonado (@traumatologoalD) 22 de mayo de 2013
Ketamina para depresión/Ketamine and depression
Ketamina oral para tratamiento rápido de la depresión y ansiedad en pacientes que reciben manejo en hospicios
Oral ketamine for the rapid treatment of depression and anxiety in patients receiving hospice care.
Irwin SA, Iglewicz A.
Institute for Palliative Medicine at San Diego Hospice, Palliative Care Psychiatry, San Diego, California 92103, USA. sirwin@sdhospice.org
J Palliat Med. 2010 Jul;13(7):903-8. doi: 10.1089/jpm.2010.9808.
Abstract
Depression is prevalent and undertreated in patients receiving hospice care. Standard antidepressants do not work rapidly or often enough to benefit most of these patients. Here, two cases are reported in which a single oral dose of ketamine provided rapid and moderately sustained symptom relief for both depression and anxiety. In addition, no adverse effects were noted. Further investigation with randomized, controlled clinical trials is necessary to firmly establish the effectiveness of oral ketamine for the treatment of depression and anxiety in patients receiving hospice care. Ketamine may be a promising safe, effective, and cost-effective rapid treatment for depression and anxiety in this population.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120058/pdf/jpm.2010.9808.pdf
El bloqueo del receptor NMDA en reposo desencadena respuestas antidepresivas conductuales rápidas
NMDA receptor blockade at rest triggers rapid behavioural antidepressant responses.
Autry AE, Adachi M, Nosyreva E, Na ES, Los MF, Cheng PF, Kavalali ET, Monteggia LM.
Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9111, USA.
Nature. 2011 Jun 15;475(7354):91-5. doi: 10.1038/nature10130.
Abstract
Clinical studies consistently demonstrate that a single sub-psychomimetic dose of ketamine, an ionotropic glutamatergic NMDAR (N-methyl-D-aspartate receptor) antagonist, produces fast-acting antidepressant responses in patients suffering from major depressive disorder, although the underlying mechanism is unclear. Depressed patients report the alleviation of major depressive disorder symptoms within two hours of a single, low-dose intravenous infusion of ketamine, with effects lasting up to two weeks, unlike traditional antidepressants (serotonin re-uptake inhibitors), which take weeks to reach efficacy. This delay is a major drawback to current therapies for major depressive disorder and faster-acting antidepressants are needed, particularly for suicide-risk patients. The ability of ketamine to produce rapidly acting, long-lasting antidepressant responses in depressed patients provides a unique opportunity to investigate underlying cellular mechanisms. Here we show that ketamine and other NMDAR antagonists produce fast-acting behavioural antidepressant-like effects in mouse models, and that these effects depend on the rapid synthesis of brain-derived neurotrophic factor. We find that the ketamine-mediated blockade of NMDAR at rest deactivates eukaryotic elongation factor 2 (eEF2) kinase (also called CaMKIII), resulting in reduced eEF2 phosphorylation and de-suppression of translation of brain-derived neurotrophic factor. Furthermore, we find that inhibitors of eEF2 kinase induce fast-acting behavioural antidepressant-like effects. Our findings indicate that the regulation of protein synthesis by spontaneous neurotransmission may serve as a viable therapeutic target for the development of fast-acting antidepressants.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172695/pdf/nihms313008.pdf
Abordajes innovadores para el manejo de la depresión refractaria. La historia de la ketamina
Innovative approaches to treatment - refractory depression: The ketamine story.
Rao TS, Andrade C.
Indian J Psychiatry. 2010 Apr;52(2):97-9. doi: 10.4103/0019-5545.64573.
Antidepressant drugs have traditionally addressed the monoamine triumvirate: serotonin, noradrenaline, and dopamine. There have been predominantly two mechanisms recruited in drug action - inhibition of monoamine reuptake and inhibition of intravesicular monoamine catabolism. Tianeptine, which increases the synaptic reuptake of serotonin, and mirtazapine, which blocks alpha-2 adrenergic autoreceptors and heteroreceptors, are examples of the very few drugs which have other mechanisms of action. Yet, even these two antidepressants target the traditional neurotransmitters in psychiatry
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927899/
Ketamina para el tratamiento de la depresión
Ketamine for the treatment of depression
Robert H. Howland
Journal of Psychosocial Nursing * Vol. 51, No. 1, 2013
http://www.healio.com/~/media/Journals/JPN/2013/1_January/10_3928_02793695
_20121219_01/10_3928_02793695_20121219_01.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Oral ketamine for the rapid treatment of depression and anxiety in patients receiving hospice care.
Irwin SA, Iglewicz A.
Institute for Palliative Medicine at San Diego Hospice, Palliative Care Psychiatry, San Diego, California 92103, USA. sirwin@sdhospice.org
J Palliat Med. 2010 Jul;13(7):903-8. doi: 10.1089/jpm.2010.9808.
Abstract
Depression is prevalent and undertreated in patients receiving hospice care. Standard antidepressants do not work rapidly or often enough to benefit most of these patients. Here, two cases are reported in which a single oral dose of ketamine provided rapid and moderately sustained symptom relief for both depression and anxiety. In addition, no adverse effects were noted. Further investigation with randomized, controlled clinical trials is necessary to firmly establish the effectiveness of oral ketamine for the treatment of depression and anxiety in patients receiving hospice care. Ketamine may be a promising safe, effective, and cost-effective rapid treatment for depression and anxiety in this population.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120058/pdf/jpm.2010.9808.pdf
El bloqueo del receptor NMDA en reposo desencadena respuestas antidepresivas conductuales rápidas
NMDA receptor blockade at rest triggers rapid behavioural antidepressant responses.
Autry AE, Adachi M, Nosyreva E, Na ES, Los MF, Cheng PF, Kavalali ET, Monteggia LM.
Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9111, USA.
Nature. 2011 Jun 15;475(7354):91-5. doi: 10.1038/nature10130.
Abstract
Clinical studies consistently demonstrate that a single sub-psychomimetic dose of ketamine, an ionotropic glutamatergic NMDAR (N-methyl-D-aspartate receptor) antagonist, produces fast-acting antidepressant responses in patients suffering from major depressive disorder, although the underlying mechanism is unclear. Depressed patients report the alleviation of major depressive disorder symptoms within two hours of a single, low-dose intravenous infusion of ketamine, with effects lasting up to two weeks, unlike traditional antidepressants (serotonin re-uptake inhibitors), which take weeks to reach efficacy. This delay is a major drawback to current therapies for major depressive disorder and faster-acting antidepressants are needed, particularly for suicide-risk patients. The ability of ketamine to produce rapidly acting, long-lasting antidepressant responses in depressed patients provides a unique opportunity to investigate underlying cellular mechanisms. Here we show that ketamine and other NMDAR antagonists produce fast-acting behavioural antidepressant-like effects in mouse models, and that these effects depend on the rapid synthesis of brain-derived neurotrophic factor. We find that the ketamine-mediated blockade of NMDAR at rest deactivates eukaryotic elongation factor 2 (eEF2) kinase (also called CaMKIII), resulting in reduced eEF2 phosphorylation and de-suppression of translation of brain-derived neurotrophic factor. Furthermore, we find that inhibitors of eEF2 kinase induce fast-acting behavioural antidepressant-like effects. Our findings indicate that the regulation of protein synthesis by spontaneous neurotransmission may serve as a viable therapeutic target for the development of fast-acting antidepressants.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172695/pdf/nihms313008.pdf
Abordajes innovadores para el manejo de la depresión refractaria. La historia de la ketamina
Innovative approaches to treatment - refractory depression: The ketamine story.
Rao TS, Andrade C.
Indian J Psychiatry. 2010 Apr;52(2):97-9. doi: 10.4103/0019-5545.64573.
Antidepressant drugs have traditionally addressed the monoamine triumvirate: serotonin, noradrenaline, and dopamine. There have been predominantly two mechanisms recruited in drug action - inhibition of monoamine reuptake and inhibition of intravesicular monoamine catabolism. Tianeptine, which increases the synaptic reuptake of serotonin, and mirtazapine, which blocks alpha-2 adrenergic autoreceptors and heteroreceptors, are examples of the very few drugs which have other mechanisms of action. Yet, even these two antidepressants target the traditional neurotransmitters in psychiatry
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2927899/
Ketamina para el tratamiento de la depresión
Ketamine for the treatment of depression
Robert H. Howland
Journal of Psychosocial Nursing * Vol. 51, No. 1, 2013
http://www.healio.com/~/media/Journals/JPN/2013/1_January/10_3928_02793695
_20121219_01/10_3928_02793695_20121219_01.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Excitación retardada
Excitación retardada
Delayed arousal.
Anastasian ZH, Ornstein E, Heyer EJ.
Division of Neurosurgical Anesthesiology, Department of Anesthesiology, Columbia University, New York, NY 10032, USA. zh2114@columbia.edu
Anesthesiol Clin. 2009 Sep;27(3):429-50. doi: 10.1016/j.anclin.2009.07.007.
Abstract
Elderly patients have medical and psychological problems affecting all major organ systems. These problems may alter the pharmacokinetics and/or pharmacodynamics of medications, or expose previous neurologic deficits simply as a result of sedation. Delayed arousal, therefore, may arise from structural problems that are pre-existent or new, or metabolic or functional disorders such as convulsive or nonconvulsive seizures. Determining the cause of delayed arousal may require clinical, chemical, and structural tests. Structural problems that impair consciousness arise from a small number of focal lesions to specific areas of the central nervous system, or from pathology affecting the cerebrum. In general, focal or multifocal lesions can be identified by computerized tomography, or diffusion-weighted imaging. An algorithm is presented that outlines a workup for an elderly patient with delayed arousal.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3036001/pdf/nihms-158134.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Levobupivacaína/Levobupivacaine
Levobupivacaína para el tratamiento de dolor postoperatorio en la circuncisión: bloqueo caudal o dorsal del pene
Levobupivacaine for postoperative pain management in circumcision: caudal blocks or dorsal penile nerve block.
Kazak Bengisun Z, Ekmekci P, Haliloğlu AH.
Department of Anesthesiology and Reanimation, Ufuk University, Faculty of Medicine, Ankara, Turkey. kazakzuleyha@yahoo.com
Agri. 2012 Oct;24(4):180-6. doi: 10.5505/agri.2012.21931.
Abstract
OBJECTIVES: In this study, we evaluated the analgesic efficacy and adverse effect profile of levobupivacaine in caudal and DPNB in postcircumcision pediatric patients. METHODS: Sixty boys between 2-10 years of age undergoing circumcision were enrolled. The patients were divided into two groups: Group C (n=30) and Group P (n=30) were applied caudal block or dorsal penile nerve block (DPNB), respectively. Blocks were performed before surgery as a supplement to general anesthesia with 1 mL kg(-1) 0.25% levobupivacaine. Postoperative pain and sedation scores were assessed on the 10th and 30th minutes, and hours 1-6. The number of pain free patients in the first 6 hours, the duration of analgesia, time to first analgesic administration, walking, micturition, and total paracetamol demands, and length of stay were recorded. RESULTS: Demographic data were similar between groups. The number of children who spent the first 6 hours pain-free was larger in Group C than Group P (p=0.0001). The time to first analgesic (p=0.000033) and walking (p=0.004) were longer in Group C. There were 14 patients with motor block in Group C (p=0.00007). In view of AUC, FPRS, OPS and MPOPS were significantly better in Group C on the first postoperative 6 hours. CONCLUSION: Caudal block done using levobupivacaine for postoperative pain management in circumcision is more successful than penile block, however there is a significant delay in time to first walking and as might be expected there is an increased risk of motor block.
http://www.journalagent.com/pubmed/linkout.asp?ISSN=1300-0012&PMID=23364781
Características clínicas de levobupivacaína espinal: hiperbárica comparada con solución isobárica
Clinical characteristics of spinal levobupivacaine: hyperbaric compared with isobaric solution.
Sanansilp V, Trivate T, Chompubai P, Visalyaputra S, Suksopee P, Permpolprasert L, von Bormann B.
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
ScientificWorldJournal. 2012;2012:169076. doi: 10.1100/2012/169076. Epub 2012 Apr 24.
Abstract
We performed a prospective, double-blinded study in 20 patients undergoing gynecologic surgery with lower abdominal incision, to investigate characteristics of intrathecal hyperbaric levobupivacaine compared with isobaric levobupivacaine. We randomly assigned them to receive 3 ml of either isobaric or hyperbaric 0.42% levobupivacaine intrathecally We found that hyperbaric levobupivacaine, compared with isobaric levobupivacaine, spread faster to T10 level (2.8 ± 1.1 versus 6.6 ± 4.7 minutes, P = 0.039), reached higher sensory block levels at 5 and 15 minutes after injection (T8 versus L1, P = 0.011, and T4 versus T7, P = 0.027, resp.), and had a higher peak level (T4 versus T8, P = 0.040). Isobaric levobupivacaine caused a wider range of peak levels (L1 to C8) compared with hyperbaric form (T7 to T2). The level of T4 or higher reached 90% in the hyperbaric group compared with 20% in the isobaric group (P = 0.005). Our results suggest that hyperbaric levobupivacaine was more predictable for sensory block level and more effective for surgical procedures with lower abdominal approach. Hyperbaric levobupivacaine seems to be suitable, but the optimal dosage needs further investigation.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349113/pdf/TSWJ2012-169076.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Levobupivacaine for postoperative pain management in circumcision: caudal blocks or dorsal penile nerve block.
Kazak Bengisun Z, Ekmekci P, Haliloğlu AH.
Department of Anesthesiology and Reanimation, Ufuk University, Faculty of Medicine, Ankara, Turkey. kazakzuleyha@yahoo.com
Agri. 2012 Oct;24(4):180-6. doi: 10.5505/agri.2012.21931.
Abstract
OBJECTIVES: In this study, we evaluated the analgesic efficacy and adverse effect profile of levobupivacaine in caudal and DPNB in postcircumcision pediatric patients. METHODS: Sixty boys between 2-10 years of age undergoing circumcision were enrolled. The patients were divided into two groups: Group C (n=30) and Group P (n=30) were applied caudal block or dorsal penile nerve block (DPNB), respectively. Blocks were performed before surgery as a supplement to general anesthesia with 1 mL kg(-1) 0.25% levobupivacaine. Postoperative pain and sedation scores were assessed on the 10th and 30th minutes, and hours 1-6. The number of pain free patients in the first 6 hours, the duration of analgesia, time to first analgesic administration, walking, micturition, and total paracetamol demands, and length of stay were recorded. RESULTS: Demographic data were similar between groups. The number of children who spent the first 6 hours pain-free was larger in Group C than Group P (p=0.0001). The time to first analgesic (p=0.000033) and walking (p=0.004) were longer in Group C. There were 14 patients with motor block in Group C (p=0.00007). In view of AUC, FPRS, OPS and MPOPS were significantly better in Group C on the first postoperative 6 hours. CONCLUSION: Caudal block done using levobupivacaine for postoperative pain management in circumcision is more successful than penile block, however there is a significant delay in time to first walking and as might be expected there is an increased risk of motor block.
http://www.journalagent.com/pubmed/linkout.asp?ISSN=1300-0012&PMID=23364781
Características clínicas de levobupivacaína espinal: hiperbárica comparada con solución isobárica
Clinical characteristics of spinal levobupivacaine: hyperbaric compared with isobaric solution.
Sanansilp V, Trivate T, Chompubai P, Visalyaputra S, Suksopee P, Permpolprasert L, von Bormann B.
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
ScientificWorldJournal. 2012;2012:169076. doi: 10.1100/2012/169076. Epub 2012 Apr 24.
Abstract
We performed a prospective, double-blinded study in 20 patients undergoing gynecologic surgery with lower abdominal incision, to investigate characteristics of intrathecal hyperbaric levobupivacaine compared with isobaric levobupivacaine. We randomly assigned them to receive 3 ml of either isobaric or hyperbaric 0.42% levobupivacaine intrathecally We found that hyperbaric levobupivacaine, compared with isobaric levobupivacaine, spread faster to T10 level (2.8 ± 1.1 versus 6.6 ± 4.7 minutes, P = 0.039), reached higher sensory block levels at 5 and 15 minutes after injection (T8 versus L1, P = 0.011, and T4 versus T7, P = 0.027, resp.), and had a higher peak level (T4 versus T8, P = 0.040). Isobaric levobupivacaine caused a wider range of peak levels (L1 to C8) compared with hyperbaric form (T7 to T2). The level of T4 or higher reached 90% in the hyperbaric group compared with 20% in the isobaric group (P = 0.005). Our results suggest that hyperbaric levobupivacaine was more predictable for sensory block level and more effective for surgical procedures with lower abdominal approach. Hyperbaric levobupivacaine seems to be suitable, but the optimal dosage needs further investigation.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349113/pdf/TSWJ2012-169076.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Bibliotecas. Alerta
La Biblioteca Nacional lleva a cabo su octava recolección de la web ...
ABC.es
La Biblioteca Nacional de España ha cumplido trescientos años, pero día a día sigue mirando al futuro o a lo que ya es presente digital. En este sentido, desde finales de este mes y a lo largo del mes de junio, la institución va a llevar a cabo la ...
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El biógrafo de los Beatles dona canciones de Lennon a la Biblioteca ...
EFE
Londres, 23 may (EFE).- El aclamado biógrafo de los Beatles Hunter Davies ha donado cartas y canciones manuscritas por John Lennon a la Biblioteca Británica, que las expondrá en la galería de los Tesoros junto a obras de Beethoven y Shakespeare.
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La biblioteca de Lalín, la gran olvidada
Faro de Vigo
Hace poco más de dos años, una interesante iniciativa surgía en una conocida red social con el principal objetivo de solicitar cambios en la estructura y organización de la biblioteca municipal de Lalín y contar así de una vez por todas con una ...
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Las termitas cierran la biblioteca en exámenes
Faro de Vigo
La Biblioteca Pública Central permanece cerrada esta semana "por motivos de seguridad". El tratamiento contra las terminas que se está aplicando al edificio de Joaquín Yáñez ha dejado sin sala de estudio a docenas de estudiantes que por estas fechas ...
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La Biblioteca de las Palomas se queda sin luz... y sin explicaciones
Granada Hoy
Cuando el pasado mes de diciembre los vecinos cantaron victoria porque pensaban que el cambio de titularidad del inmueble de la Biblioteca de las Palomas del Ayuntamiento de Granada a la Junta de Andalucía había supuesto la recuperación del ...
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El complejo El Águila celebra su X aniversario con la exposición ...
Lainformacion.com
Madrid, 22 may (EFE).- El Complejo El Aguila, sede del Archivo y de la Biblioteca regional Joaquín Leguina, acoge hasta el próximo 28 de julio la exposición "Descubre Madrid", una selección de 132 manuscritos, publicaciones, dibujos originales, mapas o ...
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La UCAB inauguró edificio para crear e investigar
El Nacional.com
En la Universidad Católica Andrés Bello hay razones para celebrar. Ayer en la mañana fue inaugurado el centro cultural Padre Carlos Guillermo Plaza: una edificación de 14.000 metros cuadrados y 4 niveles que alberga la sede de una nueva biblioteca, ...
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Las Bibliotecas generan actividades para cumplir con su fin y ...
Diario El Argentino
Las actividades culturales y sociales que generan las propias Bibliotecas populares dejan ingresos que ayudan a solventar el día a día, pero esto no es suficiente. Como se anunció, en el marco del Café de las Artes de la Biblioteca Sarmiento, se ...
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La primera biblioteca sin libros del mundo
BBC Mundo
Una biblioteca sin libros suena a chiste, excepto para los que pronto inaugurarán en Texas, Estados Unidos, la que se considera es la primera biblioteca pública sin libros de papel del mundo. La llamada BiblioTech es un ambicioso proyecto que se ...
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Gian Marco en impecable presentación en tributo a Carole King
Radio Programas del Perú
Créditos: Armando Gallardo. Biblioteca del Congreso de Estados Unidos le entregó la distinción 2013 Library of Congress Gershwin Priza for Popular Song en una ceremonia con más de mil invitados.
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Biblioteca Rne | Facebook
Biblioteca Rne is on Facebook. Join Facebook to connect with Biblioteca Rne and others you may know. Facebook gives people the power to share and makes ...
www.facebook.com/biblioteca.sollorne?hc_location=stream
Revision of UKA: Is There a Difference Compared to Primary TKA and Revision TKA?
Revision of UKA: Is There a Difference Compared to Primary TKA and Revision TKA?Faculty: Jean-Noel Argensonicjr.net/media/video.39…
— Victor Ravens (@bibliomanazteca) 24 de mayo de 2013
jueves, 23 de mayo de 2013
El condroitín sulfato ha demostrado actuar sobre las tres estructuras de la articulación..…
El condroitín sulfato ha demostrado actuar sobre las tres estructuras de la articulación..…exicanodeortopediaytrauma.blogspot.mx/2013/05/el-con… twitter.com/bibliomanaztec…
— Victor Ravens (@bibliomanazteca) 24 de mayo de 2013
El condroitín sulfato ha demostrado actuar sobre las tres estructuras de la articulación afectadas
El condroitín sulfato ha demostrado actuar sobre las tres estructuras de la articulación afectadas por la… condroprotectores.es/el-condroitin-…
— Victor Ravens (@bibliomanazteca) 24 de mayo de 2013
Contaminación y anestesia/Contamination and anesthesia
Seguridad microbiológica y costo-efectividad del cambio semanal del circuito ventilatorio en combinación con cambio de filtros de calor húmedo. Estudio clínico prospectivo longitudinal
Microbiological safety and cost-effectiveness of weekly breathing circuit changes in combination with heat moisture exchange filters: a prospective longitudinal clinical survey.
Hübner NO, Daeschlein G, Lehmann C, Musatkin S, Kohlheim U, Gibb A, Assadian O, Kobayashi H.
Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
GMS Krankenhhyg Interdiszip. 2011;6(1):Doc15. doi: 10.3205/dgkh000172. Epub 2011 Dec 15.
Abstract
Aim: To assess the safety and cost effectiveness of a usage for seven days of breathing circuit systems (BCSs) in combination with heat moisture exchanger filters (HMEF) in operation room anesthesia. Method: In a prospective longitudinal clinical study, the contamination on high-risk surfaces (HMEF together with inner and outer surface of BCS) was monitored over 1, 2, 5, and 7 days. Results of endogenous respiratory patient flora and contamination flora of BCS, HMEF and bag were compared. Costs of prolonged use of BCS together with HMEF up to 7 days were calculated. Results: Neither physiological respiratory flora nor colonizing pathogens of the oropharynx of the ventilated patients were transmitted through the filters at any time. None of the included patients developed a postoperative pneumonia. Using the BCS for 24 hours provides a cost savings of up to 40% versus single use. Extending the change interval from 24 hours to 48 hours saved over 50% compared to change after each patient, and an additional 19% compared to change after 24 hours. In combination with a HMEF BCS can be used up to 7 days without clinical risk on multiple patients in operation room settings.Conclusion: Expanding the usage of berating in combination with usage of moist exchange filters is feasible, microbiologically safe and cost effective, as 41% of material costs per ventilation may be saved. Further research is needed to confirm these results.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252668/pdf/KHI-06-15.pdf
Contaminación bacteriana de los circuitos ventilatorios internos de la máquina de anestesia
Bacterial contamination of anesthesia machines' internal breathing-circuit-systems.
Spertini V, Borsoi L, Berger J, Blacky A, Dieb-Elschahawi M, Assadian O.
Clinical Institute for Hospital Hygiene, Medical University of Vienna, Vienna, Austria.
GMS Krankenhhyg Interdiszip. 2011;6(1):Doc14. doi: 10.3205/dgkh000171. Epub 2011 Dec 15.
Abstract
Background: Bacterial contamination of anesthesia breathing machines and their potential hazard for pulmonary infection and cross-infection among anesthetized patients has been an infection control issue since the 1950s. Disposable equipment and bacterial filters have been introduced to minimize this risk. However, the machines' internal breathing-circuit-system has been considered to be free of micro-organisms without providing adequate data supporting this view. The aim of the study was to investigate if any micro-organisms can be yielded from used internal machines' breathing-circuit-system. Based on such results objective reprocessing intervals could be defined.Methods: The internal parts of 40 anesthesia machines' breathing-circuit-system were investigated. Chi-square test and logistic regression analysis were performed. An on-site process observation of the re-processing sequence was conducted. Results: Bacterial growth was found in 17 of 40 machines (43%). No significant difference was ascertained between the contamination and the processing intervals. The most common contaminants retrieved were coagulase negative Staphylococci, aerobe spore forming bacteria and Micrococcus species. In one breathing-circuit-system, Escherichia coli, and in one further Staphylococcus aureus were yielded.Conclusion: Considering the availability of bacterial filters installed on the outlet of the breathing-circuit-systems, the type of bacteria retrieved and the on-site process observation, we conclude that the contamination found is best explained by a lack of adherence to hygienic measures during and after re-processing of the internal breathing-circuit-system. These results support an extension of the re-processing interval of the anesthesia apparatus longer than the manufacturer's recommendation of one week. However, the importance of adherence to standard hygienic measures during re-processing needs to be emphasized.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252669/pdf/KHI-06-14.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Dolor y marihuana/Pain and cannabis
Prescribiendo cannabis para reducir daños
Prescribing cannabis for harm reduction.
Collen M.
PainExhibit,com, 9008 El Cajon Way, #4, Sacramento, CA, 95826, USA.Mark@PainExhibit.com.
Harm Reduct J. 2012 Jan 1;9(1):1. doi: 10.1186/1477-7517-9-1.
Abstract
Neuropathic pain affects between 5% and 10% of the US population and can be refractory to treatment. Opioids may be recommended as a second-line pharmacotherapy but have risks including overdose and death. Cannabis has been shown to be effective for treating nerve pain without the risk of fatal poisoning. The author suggests that physicians who treat neuropathic pain with opioids should evaluate their patients for a trial of cannabis and prescribe it when appropriate prior to using opioids. This harm reduction strategy may reduce the morbidity and mortality rates associated with
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295721/pdf/1477-7517-9-1.pdf
El consumo de cannabis en pacientes con fibromialgia: efecto sobre los síntomas de alivio de la salud y la calidad de vida
Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.
Fiz J, Durán M, Capellà D, Carbonell J, Farré M.
Human Pharmacology and Neurosciences Unit, Institut de Recerca Hospital del Mar-IMIM, Parc de Salut Mar, Barcelona, Spain.
PLoS One. 2011 Apr 21;6(4):e18440. doi: 10.1371/journal.pone.0018440.
Abstract
BACKGROUND: The aim of this study was to describe the patterns of cannabis use and the associated benefits reported by patients with fibromyalgia (FM) who were consumers of this drug. In addition, the quality of life of FM patients who consumed cannabis was compared with FM subjects who were not cannabis users. METHODS: Information on medicinal cannabis use was recorded on a specific questionnaire as well as perceived benefits of cannabis on a range of symptoms using standard 100-mm visual analogue scales (VAS). Cannabis users and non-users completed the Fibromyalgia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI) and the Short Form 36 Health Survey (SF-36). RESULTS: Twenty-eight FM patients who were cannabis users and 28 non-users were included in the study. Demographics and clinical variables were similar in both groups. Cannabis users referred different duration of drug consumption; the route of administration was smoking (54%), oral (46%) and combined (43%). The amount and frequency of cannabis use were also different among patients. After 2 hours of cannabis use, VAS scores showed a statistically significant (p<0.001) reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well being. The mental health component summary score of the SF-36 was significantly higher (p<0.05) in cannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI. CONCLUSIONS: The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080871/pdf/pone.0018440.pdf
La actividad de la amígdala contribuye al efecto disociativo de cannabis sobre la percepción del dolor
Amygdala activity contributes to the dissociative effect of cannabis on pain perception.
Lee MC, Ploner M, Wiech K, Bingel U, Wanigasekera V, Brooks J, Menon DK, Tracey I.
Centre for Functional MRI ofBrain (FMRIB), Department of Clinical Neurology, University of Oxford, Oxford, UK. mlee@fmrib.ox.ac.uk
Pain. 2013 Jan;154(1):124-34. doi: 10.1016/j.pain.2012.09.017.
Abstract
Cannabis is reported to be remarkably effective for the relief of otherwise intractable pain. However, the bases for pain relief afforded by this psychotropic agent are debatable. Nonetheless, the frontal-limbic distribution of cannabinoid receptors in the brain suggests that cannabis may target preferentially the affective qualities of pain. This central mechanism of action may be relevant to cannabinoid analgesia in humans, but has yet to be demonstrated. Here, we employed functional magnetic resonance imaging to investigate the effects of delta-9-tetrahydrocannabinol (THC), a naturally occurring cannabinoid, on brain activity related to cutaneous ongoing pain and hyperalgesia that were temporarily induced by capsaicin in healthy volunteers. On average, THC reduced the reported unpleasantness, but not the intensity of ongoing pain and hyperalgesia: the specific analgesic effect on hyperalgesia was substantiated by diminished activity in the anterior mid cingulate cortex. In individuals, the drug-induced reduction in the unpleasantness of hyperalgesia was positively correlated with right amygdala activity. THC also reduced functional connectivity between the amygdala and primary sensorimotor areas during the ongoing-pain state. Critically, the reduction in sensory-limbic functional connectivity was positively correlated with the difference in drug effects on the unpleasantness and the intensity of ongoing pain. Peripheral mechanisms alone cannot account for the dissociative effects of THC on the pain that was observed. Instead, the data reveal that amygdala activity contributes to interindividual response to cannabinoid analgesia, and suggest that dissociative effects of THC in the brain are relevant to pain relief in humans.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549497/
Marihuana médica: Necesidad médica vs agenda política
Medical marijuana: medical necessity versus political agenda.
Clark PA, Capuzzi K, Fick C.
Jesuit Community, St Joseph's University, Philadelphia, PA 19131, USA.pclark@sju.edu
Med Sci Monit. 2011 Dec;17(12):RA249-61.
Abstract
Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government's stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628147/pdf/medscimonit-17-12-ra249.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Prescribing cannabis for harm reduction.
Collen M.
PainExhibit,com, 9008 El Cajon Way, #4, Sacramento, CA, 95826, USA.Mark@PainExhibit.com.
Harm Reduct J. 2012 Jan 1;9(1):1. doi: 10.1186/1477-7517-9-1.
Abstract
Neuropathic pain affects between 5% and 10% of the US population and can be refractory to treatment. Opioids may be recommended as a second-line pharmacotherapy but have risks including overdose and death. Cannabis has been shown to be effective for treating nerve pain without the risk of fatal poisoning. The author suggests that physicians who treat neuropathic pain with opioids should evaluate their patients for a trial of cannabis and prescribe it when appropriate prior to using opioids. This harm reduction strategy may reduce the morbidity and mortality rates associated with
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3295721/pdf/1477-7517-9-1.pdf
El consumo de cannabis en pacientes con fibromialgia: efecto sobre los síntomas de alivio de la salud y la calidad de vida
Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.
Fiz J, Durán M, Capellà D, Carbonell J, Farré M.
Human Pharmacology and Neurosciences Unit, Institut de Recerca Hospital del Mar-IMIM, Parc de Salut Mar, Barcelona, Spain.
PLoS One. 2011 Apr 21;6(4):e18440. doi: 10.1371/journal.pone.0018440.
Abstract
BACKGROUND: The aim of this study was to describe the patterns of cannabis use and the associated benefits reported by patients with fibromyalgia (FM) who were consumers of this drug. In addition, the quality of life of FM patients who consumed cannabis was compared with FM subjects who were not cannabis users. METHODS: Information on medicinal cannabis use was recorded on a specific questionnaire as well as perceived benefits of cannabis on a range of symptoms using standard 100-mm visual analogue scales (VAS). Cannabis users and non-users completed the Fibromyalgia Impact Questionnaire (FIQ), the Pittsburgh Sleep Quality Index (PSQI) and the Short Form 36 Health Survey (SF-36). RESULTS: Twenty-eight FM patients who were cannabis users and 28 non-users were included in the study. Demographics and clinical variables were similar in both groups. Cannabis users referred different duration of drug consumption; the route of administration was smoking (54%), oral (46%) and combined (43%). The amount and frequency of cannabis use were also different among patients. After 2 hours of cannabis use, VAS scores showed a statistically significant (p<0.001) reduction of pain and stiffness, enhancement of relaxation, and an increase in somnolence and feeling of well being. The mental health component summary score of the SF-36 was significantly higher (p<0.05) in cannabis users than in non-users. No significant differences were found in the other SF-36 domains, in the FIQ and the PSQI. CONCLUSIONS: The use of cannabis was associated with beneficial effects on some FM symptoms. Further studies on the usefulness of cannabinoids in FM patients as well as cannabinoid system involvement in the pathophysiology of this condition are warranted
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3080871/pdf/pone.0018440.pdf
La actividad de la amígdala contribuye al efecto disociativo de cannabis sobre la percepción del dolor
Amygdala activity contributes to the dissociative effect of cannabis on pain perception.
Lee MC, Ploner M, Wiech K, Bingel U, Wanigasekera V, Brooks J, Menon DK, Tracey I.
Centre for Functional MRI ofBrain (FMRIB), Department of Clinical Neurology, University of Oxford, Oxford, UK. mlee@fmrib.ox.ac.uk
Pain. 2013 Jan;154(1):124-34. doi: 10.1016/j.pain.2012.09.017.
Abstract
Cannabis is reported to be remarkably effective for the relief of otherwise intractable pain. However, the bases for pain relief afforded by this psychotropic agent are debatable. Nonetheless, the frontal-limbic distribution of cannabinoid receptors in the brain suggests that cannabis may target preferentially the affective qualities of pain. This central mechanism of action may be relevant to cannabinoid analgesia in humans, but has yet to be demonstrated. Here, we employed functional magnetic resonance imaging to investigate the effects of delta-9-tetrahydrocannabinol (THC), a naturally occurring cannabinoid, on brain activity related to cutaneous ongoing pain and hyperalgesia that were temporarily induced by capsaicin in healthy volunteers. On average, THC reduced the reported unpleasantness, but not the intensity of ongoing pain and hyperalgesia: the specific analgesic effect on hyperalgesia was substantiated by diminished activity in the anterior mid cingulate cortex. In individuals, the drug-induced reduction in the unpleasantness of hyperalgesia was positively correlated with right amygdala activity. THC also reduced functional connectivity between the amygdala and primary sensorimotor areas during the ongoing-pain state. Critically, the reduction in sensory-limbic functional connectivity was positively correlated with the difference in drug effects on the unpleasantness and the intensity of ongoing pain. Peripheral mechanisms alone cannot account for the dissociative effects of THC on the pain that was observed. Instead, the data reveal that amygdala activity contributes to interindividual response to cannabinoid analgesia, and suggest that dissociative effects of THC in the brain are relevant to pain relief in humans.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549497/
Marihuana médica: Necesidad médica vs agenda política
Medical marijuana: medical necessity versus political agenda.
Clark PA, Capuzzi K, Fick C.
Jesuit Community, St Joseph's University, Philadelphia, PA 19131, USA.pclark@sju.edu
Med Sci Monit. 2011 Dec;17(12):RA249-61.
Abstract
Marijuana is classified by the Drug Enforcement Agency (DEA) as an illegal Schedule I drug which has no accepted medical use. However, recent studies have shown that medical marijuana is effective in controlling chronic non-cancer pain, alleviating nausea and vomiting associated with chemotherapy, treating wasting syndrome associated with AIDS, and controlling muscle spasms due to multiple sclerosis. These studies state that the alleviating benefits of marijuana outweigh the negative effects of the drug, and recommend that marijuana be administered to patients who have failed to respond to other therapies. Despite supporting evidence, the DEA refuses to reclassify marijuana as a Schedule II drug, which would allow physicians to prescribe marijuana to suffering patients. The use of medical marijuana has continued to gain support among states, and is currently legal in 16 states and the District of Columbia. This is in stark contrast to the federal government's stance of zero-tolerance, which has led to a heated legal debate in the United States. After reviewing relevant scientific data and grounding the issue in ethical principles like beneficence and nonmaleficence, there is a strong argument for allowing physicians to prescribe marijuana. Patients have a right to all beneficial treatments and to deny them this right violates their basic human rights.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3628147/pdf/medscimonit-17-12-ra249.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Transfusión Sanguinea en Pediatría
Estimado Ciberpediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 29 de Mayo 2013 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia:“Transfusión Sanguinea en Pediatría ” por el “Dres. Euler Chagoy Vivaldo y Oscar González Llanas“ Hematológos Pediatra s de las ciudades de Oaxaca y Monterrey 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/transfusion_sanguinea/
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
Más sobre cannabioides/More on cannabinoids
| ||||||
Displasia del desarrollo de la cadera
Como todos los miércoles se realizo la platica en el departamento de ortopedia mixta,
saludos cordiales a todos los integrantes del servicio enviadoles una felicitación y un afectuoso abrazo por la labor realizada.
¿En donde? en la mixta pues!!!
Plática impartida por el Dr. Jose Luis Aguilera Soriano, como parte de las Actividades de los Días Académicos del Servicio de Ortopedia Mixta del Hospital de Ortopedia "Dr. Victorio de la Fuente Narvaez (antes Magdalena de las Salinas) del Instituto Mexicano del Seguro Social, Ciudad de México Distrito Federal.
Contacto: aguileragm@hotmail.com
http://youtu.be/Cq-8H5P1UY8
ebooks. Alerta
EEUU: la venta de eBooks genera US$ 3 billones
InfoBAE.com
El informe anual de la Asociación Americana de Editores y el Estudio de la Industria del Libro muestra que los ingresos por la venta de eBooks creció 44% en 2012, respecto del año anterior. La industria editorial, si se incluyen los libros de texto del ...
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Cómo negociar derechos de autor para eBooks
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Descarga eBooks de manera legal y gratuita
MuyComputer
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Increíbles eBooks gratuitos sobre fotografía por tiempo limitado
eju.tv
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Los e-books recaudan el 20% de los ingresos del sector editorial en ...
Media-Tics
Un crecimiento que se debe especialmente al aumento de ventas de e-books infantiles o juveniles en más de un 117% y de libros electrónicos de ficción en un 42%. Por su parte, los de no ficción registraron un aumento de las ventas del 22%, al igual que ...
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Apple y Amazon cautivan a los usuarios de sus 'ebooks' con ...
Materia
Dos investigadores alemanes han analizado los formatos de los ebooks que hay en la tienda de Amazon y en la iBookstore de Apple y los han comparado con el estándar abierto EPUB3. En sus resultados (PDF), presentados en la conferencia anual de la ...
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Web 5 resultados nuevos de E-Books
Las bibliotecas municipales de Sevilla ofrecen 1.800 ebooks gratuitos
Las bibliotecas municipales de Sevilla facilitan la descarga gratuita de 1.823 libros electrónicos. En los dos últimos años se han producido 76.000 descargas.
blogs.elpais.com/.../las-bibliotecas-municipales-de-sevilla-ofre...
Amazon.es: Foros de debate: Pasar e-books al ordenador
Mi pregunta es como puedo pasar e-books de Kindle de un iPad a un Mac. Gracias. Denunciar abuso ¿Crees que esta entrada aporta algo al debate? Sí · No ...
www.amazon.es/forum/kindle?_encoding=UTF8...
E-books gratuitos y legales « Biblioteca UM: Noticias
Les dejamos esta selección, realizada por el blog “La viga en mi ojo” de 37 webs donde se pueden descargar e-book. El autor de este post aclara que gratuito ...
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32 webs para descargar e-books de forma gratuita y legal - Menéame
Javi de Rios ha recopilado en un listado sitios web que ofrecen descargas de libros electrónicos de forma legal.
www.meneame.net/.../32-webs-descargar-books-forma-gratuit...
Apple y Amazon cautivan a los usuarios de sus 'ebooks' con ...
Un informe revela que el estándar abierto EPUB3 es mejor tecnológica y funcionalmente que los cerrados, y asegura que que los autores que quieren publicar ...
www.tendencias21.net/Apple-y-Amazon-cautivan-a-los-usuari...
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