Implicaciones de anestesia en niños con síndrome de QT-largo
Implications of anesthesia in children with long QT syndrome.
Nathan AT, Berkowitz DH, Montenegro LM, Nicolson SC, Vetter VL, Jobes DR.
Division of Cardio-Thoracic Anesthesia, The Children's Hospital of Philadelphia, 12 NW 40, 3400 Civic Center Blvd., Philadelphia, PA 19104, USA.
Erratum in
Anesth Analg. 2011 Dec;113(6):1458.
Anesth Analg. 2011 May;112(5):1163-8. doi: 10.1213/ANE.0b013e3182121d57. Epub 2011 Feb 23
Abstract
BACKGROUND: Patients with congenital long QT syndrome (LQTS) are susceptible to an episodic malignant ventricular tachyarrhythmia known as torsade de pointes, which can result in a cardiac arrest and death. Patients can suffer severe cardiac events resulting in syncope, seizures, and sudden cardiac death during times of physical and emotional stress and when exposed to certain drugs including anesthetics. We describe the occurrence of perioperative adverse events (AEs) related to arrhythmias in children with congenital LQTS exposed to volatile general anesthesia and describe associated risk factors. METHODS: We performed a retrospective cohort study of children with LQTS undergoing general anesthesia for noncardiac surgery or device implant, or revision for cardiac rhythm management. This study was a retrospective chart review with data collection from computerized and electronic patient medical records. RESULTS: Seventy-six patients with congenital LQTS were identified who had a total of 114 anesthetic encounters. Of the 114 anesthetic encounters, there were 3 AEs, 2 definite and 1 probable AE, for an incidence of 2.6%. The events occurred in boys (aged 11, 13, and 15 years) while undergoing noncardiac surgery under volatile general anesthesia. All were receiving β-blocker therapy preoperatively. The AEs occurred in close proximity to the administration of reversal drugs (anticholinesterase/anticholinergic combinations) and the antiemetic ondansetron. The events occurred during emergence from anesthesia, and exclusively in the group of patients who received both reversal drugs and ondansetron. All were treated successfully with short-term antiarrhythmic drug therapy and discharged the next morning. CONCLUSIONS: There is an increased risk of AEs during periods of enhanced sympathetic activity, especially emergence. This risk seems to be further enhanced if drugs are administered at this time that are known either to prolong the corrected QT interval or the transmural dispersion of repolarization or increase the incidence of tachycardia. Restriction of medications that adversely affect ion channels and intense vigilance and monitoring during this time and in the postoperative phase could help prevent occurrence or progression of AEs.
http://www.anesthesia-analgesia.org/content/112/5/1163.full.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Shoulder Dislocation Inferior Luxatio Erecta - Everything You Need To Know - Dr. Nabil Ebraheim
Publicado el 25/06/2013
Educational video an describing inferior dislocation of the shoulder.
http://youtu.be/aGlNj1d-lC4
Consecuencias ambientales de los gases anestésicos
Environmental implications of anesthetic gases.
Yasny JS, White J.
The Mount Sinai School of Medicine, New York, NY, USA.jeffrey.yasny@mountsinai.org
Anesth Prog. 2012 Winter;59(4):154-8. doi: 10.2344/0003-3006-59.4.154.
Abstract
For several decades, anesthetic gases have greatly enhanced the comfort and outcome for patients during surgery. The benefits of these agents have heavily outweighed the risks. In recent years, the attention towards their overall contribution to global climate change and the environment has increased. Anesthesia providers have a responsibility to minimize unnecessary atmospheric pollution by utilizing techniques that can lessen any adverse effects of these gases on the environment. Moreover, health care facilities that use anesthetic gases are accountable for ensuring that all anesthesia equipment, including the scavenging system, is effective and routinely maintained. Implementing preventive practices and simple strategies can promote the safest and most healthy environment
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3522493/pdf/i0003-3006-59-4-154.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 26 de Junio 2013 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Impacto emocional en el adolescente por violencia intrafamiliar” por la “Dra. Gabriela Bastarrachea.“ Pediatra, especialista en Medicina del Adolescente de la Cd. de Mérida Yuc. 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/violencia_intrafamiliar/
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
Biblioteca personal de C. Monsiváis, a 3 años de su partida
Protestante Digital
Esta gran Biblioteca Personal representa la oportunidad para acceder al trasfondo vital de una obra que aún está en proceso de comprenderse cabalmente. 22 DE JUNIO DE 2013. La Biblioteca de México José Vasconcelos ...
Ver todos los artículos sobre este tema »
El Cabildo de Tenerife financiará con 70.000 euros el equipamiento ...
Europa Press
El Cabildo de Tenerife financiará con 70.000 euros el equipamiento de la biblioteca municipal de Puerto de la Cruz, propuesta que será analizada en la sesión plenaria que celebrará la Corporación insular el próximo viernes. Este inmueble, localizado en ...
Ver todos los artículos sobre este tema »
El traslado de la Biblioteca Provincial al Convento de la Trinidad ...
El Mundo.es
Es más, fuentes de la Consejería de Cultura reconocen que todo lo relacionado con la biblioteca está pendiente de una negociación con el Ministerio de Cultura, ya que el equipamiento es de titularidad estatal, y que todavía no se ha empezado a hablar, ...
Ver todos los artículos sobre este tema »
La biblioteca se trasladará al palacio de justicia
Hoy Digital
En el caso del convento santiaguista del siglo XIII, en el que se enclava el centro cultural San Antonio, Díaz de la Peña reconoció que urge una solución para el acceso de ciudadanos a la bibliotecamunicipal. Eso lo tienen claro desde hace años los ...
Ver todos los artículos sobre este tema »
Detenido por acosar a menores desde el ordenador de una ...
El Mundo.es
El arrestado actuaba desde la conexión a internet de una biblioteca pública para "dificultar su localización por parte de la Policía" aunque los investigadores descubrieron su identidad y la ubicación de su domicilio, y procedieron a su detención como ...
Ver todos los artículos sobre este tema »
Biblioteca Franciscana: La digitalización de un fondo antiguo
Poblanerías en línea
La Biblioteca Franciscana de la Universidad de las Américas-Puebla (UDLA-P) ha digitalizado 141 libros de su fondo antiguo, como parte de las acciones para facilitar el acceso a la información. La Dra. Circe Hernández, coordinadora de este Departamento ...
Ver todos los artículos sobre este tema »
El antiguo juzgado albergará la biblioteca y archivo municipal
El Periódico Extremadura
El principal motivo que ha llevado a decantarse por este uso es la accesibilidad del edificio. Actualmente, la biblioteca no cumple con la normativa porque se encuentra en una primera planta de un edificio sin ascensor. La protección del inmueble ...
Ver todos los artículos sobre este tema »
Entran a saquear una biblioteca del centro
Diario de Cuyo
Una biblioteca situada en pleno centro capitalino fue escenario de un robo. Los delincuentes entraron por la puerta principal y se llevaron dos computadoras de escritorio y revolvieron la documentación. El ataque se produjo ayer en la madrugada contra ...
Ver todos los artículos sobre este tema »
TECHO posibilita la apertura de biblioteca
El Debate
La ONG TECHO que opera en toda Latinoamérica y busca solucionar la situación de miles de personas que viven en asentamientos precarios, inaugurará próximamente una biblioteca po-pular en Barrio la Ilusión. Nuevas oportunidades. La ONG TECHO ...
Ver todos los artículos sobre este tema »
Arrestado un hombre que pedía fotos sexuales a menores usando ...
Diario de Sevilla
Agentes de la Policía Nacional han detenido en la provincia de Sevilla a un hombre de 41 años que supuestamente contactaba a través de la conexión a Internet de una biblioteca pública con menores de edad, a quienes les solicitaba imágenes de carácter ...
Ver todos los artículos sobre este tema »
![]()
Reabre la biblioteca pública de Chicago - Univision Chicago
Tras un proyecto de remodelación, ahora cuenta con 5 mil pies cuadrados adicionales, nuevas ...
univisionchicago.univision.com/.../reabre-biblioteca-publioca-...
Biblioteca escolar: del aislamiento a la red documental educativa ...
Siguiendo el modelo desarrollado por las bibliotecas públicas en España y teniendo la posibilidad de optimizar los recursos ya implementados en la creación ...
www.comunidadbaratz.com/.../biblioteca-escolar-del-aislamien...
Prolongación no usual de la anestesia raquídea despues de levobupicacaína 0.5%
An unusually prolonged duration of spinal anaesthesia following 0.5% Levobupivacaine
Fatma Ertugrul, Zekiye Bigat, Nurten Kayacan, Bilge Karsli
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
J Pak Med Assoc Vol. 62, No. 11, November 2012
Abstract
Spinal anaesthesia is the method of choice for elective caesarean delivery. Levobupivacaine may produce a sensory and motor block that is different from that produced by bupivacaine, the most popular local anaesthetic for parturients undergoing caesarean section (CS). We present a case of unexpectedly prolonged spinal anaesthesia following a successful spinal block with levobupivacaine. There was no evidence of any neurological injury in this patient during injection.
Keywords: Anaesthesia: spinal, Anaesthetics: local.
http://www.jpma.org.pk/PdfDownload/3811.pdf
Prolongación dosis dependiente de la raquianestesia con bupivacaína hiperbárica con dexmedetomidina
Dose-Related Prolongation of Hyperbaric Bupivacaine Spinal Anesthesia by dexmedetomidine
Hala E A Eid MD, Mohamed A Shafie MD, Hend Youssef MD.
Department of Anesthesiology, Intensive Care and Pain Management
Faculty of Medicine, Ain Shams University, Cairo, Egypt
Ain Shams Journal of Anesthesiology Vol 4-2; July 2011
Abstract
Background and Objectives: This study aims to investigate the effect of intrathecal administration of dexmedetomidine on the duration of sensory and motor block and postoperative analgesic requirements produced by spinal bupivacaine. Methods: Forty eight adult patients scheduled for anterior cruciate ligament reconstruction were randomized to one
of three groups. Each patient was given 3.5 ml spinal injectate that consisted of 3 ml 0.5% hyperbaric bupivacaine and 0.5 ml containing either 10 μg dexmedetomidine (Group D1), 15 μg dexmedetomidine (D2) or normal saline (Group B). Heart rate, arterial blood pressure,
sensory level, motor block, pain and level of sedation were assessed intraoperatively and up to 24 hours after spinal anesthesia. The incidence of adverse effects was recorded. Results: Dexmedetomidine significantly prolonged time to two segment regression, sensory regression to S1, regression of motor block to modified Bromage 0 and time to first rescue analgesic. In addition, it significantly decreased postoperative pain scores. The effects were greater in group D2 than in group D1. In addition, group D2 patients had higher sedation scores and
lower postoperative analgesic requirements than Group D1 or B. Hemodynamic stability was maintained in the three groups. Conclusion: Intrathecal dexmedetomidine in doses of 10 μg and 15 μg significantly prolong the anesthetic and analgesic effects of spinal hyperbaric
bupivacaine in a dose-dependent manner. A fifteen μg dose may be of benefit for prolonged complex lower limb surgical procedures.
http://asja-eg.com/articles/149.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
TIVA para cirugía mayor de quemaduras
Total intravenous anesthesia for major burn surgery.
Cancio LC, Cuenca PB, Walker SC, Shepherd JM.
U.S. Army Institute of Surgical Research Fort Sam Houston, Texas, USA.
Int J Burns Trauma. 2013 Apr 18;3(2):108-14. Print 2013.
Abstract
Total intravenous anesthesia (TIVA) is frequently used for major operations requiring general anesthesia in critically ill burn patients. We reviewed our experience with this approach. METHODS: During a 22-month period, 547 major burn surgeries were performed in this center's operating room and were staffed by full-time burn anesthesiologists. The records of all 123 TIVA cases were reviewed; 112 records were complete and were included. For comparison, 75 cases were selected at random from a total of 414 non-TIVA general anesthetics. Some patients had more than one operation during the study: as appropriate for the analysis in question, each operation or each patient was entered as an individual case. For inter-patient analysis, exposure to 1 or more TIVAs was used to categorize a patient as member of the TIVA group.
RESULTS: Excision and grafting comprised 78.2% of the operations. 14 TIVA regimens were used, employing combinations of 4 i.v. drugs: ketamine (K, 91 cases); i.v. methadone (M, 62); fentanyl (F, 58); and propofol (P, 21). The most common regimens were KM (34 cases); KF (26); KMF (16); and K alone (8). Doses used often exceeded those used in non-burn patients. TIVA was preferred for those patients who were more critically ill prior to surgery, with a higher ASA score (3.87 vs. 3.11). Consistent with this, inhalation injury (26.7 vs. 1.6%), burn size (TBSA, 36.3 vs. 15.8%), and full-thickness burn size (FULL, 19.8 vs. 6.5%) were higher in TIVA than in non-TIVA patients. Despite this, intraoperative pressor use was as common in TIVA as in non-TIVA cases (23.9 vs. 22.7%). CONCLUSIONS: TIVA was used in patients whose inhalation injury rate and TBSA were greater than those of non-TIVA patients. TIVA cases were not associated with increased hemodynamic instability. TIVA is a viable approach to general anesthesia in critically ill burn patients.
KEYWORDS: Total intravenous anesthesia (TIVA), burn, surgery
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3636662/pdf/ijbt0003-0108.pdf
Manejo de la vía aérea en pacientes con cicatrices contráctiles postquemaduras mentoesternal y periorales
Managing difficult airway in patients with post-burn mentosternal and circumoral scar contractures
Tae-Hyung Han, Hana Teissler, Richard J Han, Joshua D Gaines, and Tho Qynh Nguyen
Int J Burns Trauma. 2012; 2(2): 80-85.
Abstract
Securing the airway is a crucial aspect during reconstructive surgeries of patients with extensive post-burn mentosternal scar contractures; however, the American Society of Anesthesiologists Difficult Airway Management Algorithm recommendation of initial direct laryngoscopy may not be appropriate for these complicated patients. Consequently, there is a significant risk for failure of intubation and airway emergency. We suggest that initial attempts at securing the airway be made with indirect laryngoscopy. Many airway techniques have been effectively used in burn patients, but the role of awake blind or fiberoptic bronchoscopy, although well established in the non-burn population, has yet to be evaluated in burn patients. We report a case series of successful management of difficult airways with fiberoptic bronchoscopy in patients with varying degrees of post-burn head and neck scar contractures.
Keywords: Burn airway, neck contracture, fiberoptic bronchoscopy, laryngeal mask airway
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462526/
Infiltración tumescente de lidocaína y adrenalina para cirugía de quemados
Tumescent infiltration of lidocaine and adrenaline for burn surgery.
Gümüs N.
Plastic, Reconstructive and Aesthetic Surgery Department, Cumhuriyet University Medical Faculty, Sivas, Turkeya.
Ann Burns Fire Disasters. 2011 Sep 30;24(3):144-8.
Abstract
Tumescent infiltration is a widely used type of regional anaesthesia for cutaneous surgery. This technique makes it possible to administer high doses of lidocaine and adrenaline within the safety limits, leading to reduction in pain and bleeding during the operation. In this study, tumescent infiltration of lidocaine and adrenaline was used in routine procedures of burn surgery such as escharectomy, debridement, tangential excision, and skin grafting. In 17 patients with scald and flame burns, tumescent infiltration was performed prior to surgical procedures under either general anaesthesia or intravenous sedation. After 15 minutes, escharectomy, debridement of necrotic tissues, tangential excision of the burned skin, removal of the granulation tissue, and harvesting of the skin graft were performed. No complications occurred. All vital signs remained within safety limits during the operations. Haemorrhage was minimal and the operations were thus performed easily and rapidly. During removal of granulation tissue, very little blood loss occurred so that both the excision of granulation tissue and skin grafting were accomplished rapidly because of the minimal need of severe haemostasis. The duration of surgery was considerably reduced. No haematoma or bruising developed after surgery. No blood transfusions were required as the decline in haematocrit levels was not more than 3%. Postoperative analgesia was excellent for the first 8 h, eliminating the need of additional measures. Tumescent infiltration of adrenaline and lidocaine is a simple, effective and safe technique which facilitates anaesthesia in large areas of the burned body surface and leads to less bleeding and easy surgical dissection and hydrodissection, allowing fast, easy and painless burn surgery.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3293232/pdf/Ann-Burns-and-Fire-Disasters-24-144.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Intubación traqueal con GlideScope® con y sin relajantes musculares. Estudio clínico prospectivo y randomizado
GlideScope® Tracheal Intubation with and without Muscle Relaxation: A Prospective, Randomized Clinical Trial
Kay B. Leissner, Sascha Beutler, Luca Bigatello and Venkatesh Srinivasa
VA Boston Healthcare System and Massachusetts General Hospital, USA
The Open Anesthesiology Journal, 2013, 7, 5-11
Abstract:
Purpose: GlideScope® videolaryngoscope (GVL, Verathon Medical Inc., Bothell, WA, USA) assisted orotracheal intubation is a useful technique for patients who are difficult to intubate, but who can be mask ventilated. The effect of muscle relaxants on the success of GVL intubation has not been evaluated. The authors conducted a prospective, placebo-controlled study to assess the effectiveness and incidence of complications of GVL-assisted tracheal intubation performed
during general anesthesia with and without the use of a muscle relaxant in patients with seemingly normal airway anatomy. Material and Methods: 52 patients who required orotracheal intubation were prospectively included. Anesthesia was induced using midazolam (0.01-0.03 mg/kg), fentanyl (1-3 μg/kg) and propofol (1-3 mg/kg). Patients were randomly assigned to one of two groups to receive rocuronium 0.6 mg/kg (n = 26 for rocuronium group) or saline intravenously (n = 26 for placebo group). GVL-assisted intubation was initiated after 90 s. The number of successful intubations, the number of attempts and their duration were recorded. Events during the procedure, such as airway trauma, blood pressure changes and movements were also recorded. Results: The success rate of GVL intubation was 100% in the placebo group and 100% in the rocuronium group. Patients in both groups received the same number of intubation attempts and the intubation time were alike (53± 15 vs. 55 ± 18 s; p=0.63). The Placebo group experienced a greater incidence of events during intubation (81 vs. 35%; P < 0.001) than patients in the rocuronium group. Conclusions: Omitting muscle relaxants in patients with apparently normal airways is not associated with a higher failure rate, increased intubation attempts or intubation time when performing GVL assisted orotracheal intubation, but is associated with a higher rate of patient movement.
Keywords: Airway, Airway Management, GlideScope, Muscular Relaxation, Tracheal Intubation, Video Laryngoscope.
http://www.benthamscience.com/open/toatj/articles/V007/5TOATJ.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Meningitis iatrogénica despues de anestesia raquídea
IATROGENIC MENINGITIS AFTER SPINAL ANESTHESIA
R. Hashemi and A. Okazi
UNESCO Chair of Human Rights, Peace and Democracy, Bioethics Group, Shahid Beheshiti University, Tehran, Iran. Medicolegal Organization of Mazandaran, Sari, Iran
Acta Medica Iranica 2008; 46(5): 434-436.
Abstract.
Bacterial meningitis after spinal and epidural anesthesia is a very rare but serious complication. We report a case of meningitis developing a number of hours after a spinal block for Caesarean section. No organism was grown but the CSF pattern was suggestive of bacterial meningitis. Severe neurological sequelae were present after three months of hospitalization. Meningitis is a serious complication and its early diagnosis and effective treatment is essential. Meningitis should always be considered as a possible differential diagnosis in patients suspected of having post spinal headache, convulsion and changes in mental statues. A thorough knowledge and practice of aseptic techniques is crucial in performing spinal and epidural anesthesia.
Key words: Bacterial meningitis, spinal anesthesia, epidural anesthesia
http://journals.tums.ac.ir/upload_files/pdf/_/12267.pdf
Meningitis despues de raquianestesia
Meningitis after spinal anaesthesia.
SEBRECHTS J.
Br Med J. 1947 Aug 9;2(4518):226.
SIR,-Dr. C. A. Vuylsteke (B.M.J., Feb. 1, p. 179) reported four cases of pseudomonas meningitis following spinal anaesthesia. Three of these, caused by the melanogenes variety of Ps. pyocyanea, were fatal; one, caused by true Ps. pyocyanea, recovered after sulphathiazole treatment. Patients had been operated upon by three different surgeons at two surgical clinics whose nursing personnel belonged to the same school.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2055521/pdf/brmedj03741-0032f.pdf
Hematoma subaracnoideo despues de raquianestesia
Spinal subarachnoid hematoma after spinal anesthesia.
Jeon SB, Ham TI, Kang MS, Shim HY, Park SL.
Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul, Korea.
Korean J Anesthesiol. 2013 Apr;64(4):388-9. doi: 10.4097/kjae.2013.64.4.388.
Moen et al. reported that spinal hematoma occurred in 8 out of 1,260,000 cases of spinal anesthesia in Sweden, and subarachnoid hematoma is known to be very rare. We report a case of subarachnoid hematoma after spinal anesthesia in a patient without coagulopathy.
http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-64-388.pdf
Tratamiento conservador de un hematoma despues de anestesia espinal: informe de caso y revisión de la literatura
Conservative treatment of hematoma after spinal anesthesia: case report and literature review.
Segabinazzi D, Brescianini BC, Schneider FG, Mendes FF.
FFCMPA.
Rev Bras Anestesiol. 2007 Apr;57(2):188-94.
Abstract
BACKGROUND AND OBJECTIVES: Spinal anesthesia caries the risk of bleeding. Compression of nervous tissue secondary to the formation of a hematoma can cause neurological damage, which, if not diagnosed and treated in a timely fashion, can be permanent. The identification of risk factors, diagnosis, and early treatment are important for the prognosis. The objective of this report was to describe the case of a hematoma after spinal anesthesia treated conservatively, and review the literature. CASE REPORT: Male patient, 73 years old, 65 kg, 1.67 m, and ASA physical status III, underwent spinal anesthesia for removal of a peritoneal dialysis catheter. During the puncture, the patient experienced paresthesia of the right lower limb. Fifteen milligrams of 0.5% hyperbaric bupivacaine without vasoconstrictor were administered. Twenty-four hours later, saddle anesthesia and lumbar pain persisted and, after 48 hours, the patient presented urinary incontinence. An MRI demonstrated the presence of an expansive subarachnoid process compressing the nerve roots (L4 and S1). After evaluation by the neurosurgeon, conservative treatment was instituted. The patient was discharged from the hospital on the 18th postoperative day, asymptomatic. CONCLUSIONS: The case reported here presented a good evolution with the conservative treatment.
http://www.scielo.br/pdf/rba/v57n2/en_08.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
http://www.medigraphic.com/pdfs/orthotips/ot-2009/ot091j.pdf
Prevención de lesiones deportivas
Mariano Fernández Fairen,* José María Busto Villarreal**
POR QUÉ SE LESIONAN LOS ATLETAS
Las lesiones deportivas se pueden dividir en tres grandes categorías, atendiendo
a cómo se han producido: por contacto, cuando colabora activamente otro deportista, antagonista o no del lesionado; por autoagresión, cuando es el propio lesionado el que se lesiona, y por sobrecarga, cuando la lesión es debida a la repetición cíclica de un gesto deportivo por encima de la capacidad resistiva de los
tejidos solicitados. Las dos primeras clases obedecen a un episodio en el que se dispensa alta energía y dan pie a lesiones agudas, en tanto que las últimas ocurren después de un cierto tiempo de práctica deportiva y suelen tener un fondo de cronicidad.1
Hay deportes que favorecen la producción de lesiones de quienes los practican por la energía dispensada en el mismo, por su violencia, o por la frecuencia e inevitabilidad del contacto.2,3 Hay que citar, como ejemplos, el motociclismo, la equitación o el esquí, el boxeo y las diferentes modalidades de lucha; también el baloncesto, en los que grandes masas entran en contacto violento permanentemente. Además, puede haber también una cierta especificidad según sexo en la causalidad de accidentes en un determinado deporte.3,4 En la figura 1 se aprecian claramente esas diferencias, quedando clara la pasión con la que la mujer se ha incorporado al mundo del fútbol, como ejemplo de deporte de contacto, donde incluso hay mayor porcentaje de lesiones que entre los hombres.5
* Médico adscrito al Instituto de Cirugía Ortopédica y Traumatología de Barcelona, España.
** Médico adscrito a la Clínica de Medicina Deportiva del Club de Fútbol Pachuca, México.
Dirección para correspondencia:
Dr. José María Busto Villarreal.
Libramiento Circuito de la Concepción Km 2 s/n, Col. La Concepción, 42160 San Agustín Tlaxiaca, Hidalgo. Correo electrónico: jose.busto@tuzos.com.mx
BUAP | Biblioteca Lafragua se abre a la tecnología
YouTube
En esta antigua biblioteca del Colegio del Espíritu Santo se realiza un catálogo de tercer nivel y con 90 mil volúmenes que proteger su apuesta es hacia el uso de la tecnología para cumplir los requerimientos de investigación y divulgación a los que se ...
Ver todos los artículos sobre este tema »
Barcelona estrena una Biblioteca Funeraria con un fondo de 3.600 ...
ABC.es
Más de 3.600 libros y documentos relacionados con la muerte y los rituales funerarios de diversos países y civilizaciones conforman la Biblioteca Funeraria, la más grande de España y la segunda de Europa de esta temática, que hoy se ha inaugurado en el ...
Ver todos los artículos sobre este tema »
El Ayuntamiento propone para la biblioteca San Juan un « espacio ...
Diario Vasco
La futura biblioteca. La infografía muestra, en la parte superior, de izquierda a derecha, lasbibliotecas de bebé, juvenil e infantil; en la zona central la biblioteca 'clásica' más el acceso a ordenadores; a la derecha, la zona de estudio, y a la ...
Ver todos los artículos sobre este tema »
El presidente de la FIL, nombrado patrono de la Biblioteca virtual ...
EFE
San Vicente del Raspeig (España), 12 jun (EFE).- El presidente de la Feria Internacional del Libro (FIL) de Guadalajara (México), Raúl Padilla López, fue elegido hoy nuevo patrono de la Biblioteca Virtual Miguel de Cervantes (BVMC). La relación de la ...
Ver todos los artículos sobre este tema »
Rockumentales en la Biblioteca Popular: “Escribir, Componer ...
Misiones OnLine
“Escribir, Componer & Cautivar” es el nombre del nuevo ciclo de rockumentales que se proyectan en el cine club de la Biblioteca Popular y que esta noche ofrecerá su segunda entrega con “Who is Harry Nilsson (And Why is Everybody Talkin' About Him)?
Ver todos los artículos sobre este tema »
Biblioteca de Montegrande es desalojada por orden de ministerio ...
radio Universidad de Chile
Los gestores de la biblioteca pública MonteGabriela, ubicada en la localidad de Montegrande, informaron que el ministerio de Bienes Nacionales solicitó que desalojen la casa que ocupan desde 2002 para realizar una serie de actividades. La secretaría de ...
Ver todos los artículos sobre este tema »
Abrirán muestra del Fonca en la Biblioteca Vasconcelos
Milenio.com
... pintura y video, las que se exhibirán hasta el 25 de agosto. Mini Caire, acompañada de Daniel Goldin, director de la Biblioteca Vasconcelos, destacó la colaboración para concretar este proyecto entre las instituciones que representan ambos y el ...
Ver todos los artículos sobre este tema »
La Biblioteca Municipal amplía su horario con apertura los fines de ...
Almería 24h
La Biblioteca Municipal Gabriel Espinar de Huércal-Overa ha ampliado sus horario recientemente y de cara los exámenes finales y la selectividad con apertura los fines de semana. Una decisión que según detalló el Alcalde, Domingo Fernández, “timamos a ...
Ver todos los artículos sobre este tema »
BIBLIOTECA HERMéTICA | círculo d.m. - Amsterdam
La biblioteca de Pablo Garrido. ¿Qué libro estás leyendo ahora? Dos, uno de un escritor norteamericano: John Ray Grisham, “La Confesión” traducido al ...
circulo-dilecto.blogspot.com/2013/.../biblioteca-hermetica.htm...
La biblioteca del Monasterio de Strahov. Praga | Flickr - Photo ...
flickrAward (post1 – award 5) *Thankyou for giving awards that let people know you like their photo. *Please post your photo to flickr Award 5+ thread if you ...
www.flickr.com/photos/aitana64/9024491345/
El presidente de la FIL, nombrado patrono de la Biblioteca virtual ...
La FIL de Guadalajara es uno de los acontecimientos más importantes celebrados en el mundo con la literatura en español como protagonista.
www.informador.com.mx/.../el-presidente-de-la-fil-nombrado...
ORT COAÑA BIBLIOTECA LIBROS NUEVOS 12-06-2013 - YouTube
La biblioteca de Coaña ha recibido un lote de libros de la sección de Coordinación Bibliotecaria ...
www.youtube.com/watch?v=T8lK-xxCkCQ
El presidente de la FIL, nombrado patrono de la Biblioteca virtual ...
San Vicente del Raspeig (España); 12 jun (EFE).- El presidente de la Feria Internacional del Libro (FIL) de Guadalajara (México); Raúl Padilla López; fue ...
noticias.latino.msn.com/.../el-presidente-de-la-fil-nombrado-pa...
Aparición tardía de aracnoiditis espinal tras un bloqueo caudal
Delayed occurrence of spinal arachnoiditis following a caudal block.
Na EH, Han SJ, Kim MH.
School of Medicine, Ewha Womans University, Seoul, Republic of Korea.
J Spinal Cord Med. 2011 Nov;34(6):616-9. doi:10.1179/2045772311Y.0000000035.
Abstract
CONTEXT: Spinal arachnoiditis is a rare disease caused by fibrosis and adhesion of the arachnoid membrane due to chronic inflammation. The causes of arachnoiditis are infection, spinal surgery, intraspinal injection of steroid or myelography dye, and spinal anesthesia. METHOD: Case report.FINDINGS: A 60-year-old woman presented with progressive weakness and sensory change of both legs and urinary symptoms. She had received a single caudal block 6 months before symptom onset. Magnetic resonance imaging of the thoraco-lumbar spine showed an intradural extramedullary tumor at the T5-T7 level. She underwent laminectomy and tumor resection. The pathological finding was arachnoiditis. After surgery, a rehabilitation program of strengthening exercises of both lower extremities and gait training was started. At 2-month follow-up, she was able to walk with orthoses and performed daily activities with minimal assistance. CONCLUSION: Symptoms of spinal arachnoiditis occurred 6 months after a single caudal block in this woman. Clinicians should be aware of this possible delayed complication.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237290/pdf/scm-34-616.pdf
Bloqueo epidural obstétrico y aracnoiditis crónica adhesiva
Obstetric epidurals and chronic adhesive arachnoiditis.
Rice I, Wee MYK, Thomson K.
Br J Anaesth 2004; 92: 109-20
It has been suggested that obstetric epidurals lead to chronic adhesive arachnoiditis (CAA). CAA is a nebulous disease entity with much confusion over its symptomatology. This review outlines the pathological, clinical, and radiological features of the disease. The proposed diagnostic criteria for CAA are: back pain that increases on exertion, with or without leg pain; neurological abnormality on examination; and characteristic MRI findings. Using these criteria, there is evidence to show that epidural or subarachnoid placement of some contrast media, preservatives and possibly vasoconstrictors, may lead to CAA. No evidence was found that the preservative-free, low concentration bupivacaine with opioid mixtures or plain bupivacaine currently used in labour lead to CAA.
http://bja.oxfordjournals.org/content/92/1/109.full.pdf
Aracnoiditis crónica adhesiva
Chronic adhesive arachnoiditis
J. A. Aldrete
Birmingham, AL, USA
British Journal of Anaesthesia 93 (2): 301-7 (2004)
Editor-The review on the topic of 'chronic adhesive arachnoiditis' (CAA) from obstetric epidurals by Rice and colleagues1 was apparently triggered by a series of articles that appeared in one of the London tabloids, fostered by some of the members of the Arachnoiditis Trust. These articles were unreasonable to many of us that remember the statistics of maternal deaths in the 1970s in the UK,2 when general anaesthesia was the predominant form of analgesia; aspiration of gastric contents and difficulty with tracheal intubation were the main culprits. I also feel that it is the right of women in labour to ask for pain relief, and anaesthetists ought to provide it for them. But we cannot deny that neuroaxial anaesthesia produces morbidity and that neurological deficits are probably one of the most serious. Unfortunately, the authors of the review lost the opportunity to assess the subject of neurological deficit and arachnoiditis (ARC) after epidural anaesthesia. Instead of being impartial, they attempted to prove that adhesive arachnoiditis does not happen as frequently as the patrons of the 'Trust' claimed it did and, when it does occur, they dismissed it as irrelevant.
http://bja.oxfordjournals.org/content/93/2/301.full.pdf+html
Aracnoiditis. Sumario breve de la literatura
Arachnoiditis. A brief summary of the literature
Peter Day
This report is a brief descriptive summary review on arachnoiditis in the form of a background paper. A comprehensive and evidence-based systematic review of the literature is not presented here. This review is a synthesis of information available in the literature that addresses the following: a summary of available literature, the nature and etiology of arachnoiditis, the characteristics of diagnosis, estimates of the prevalence and incidence of arachnoiditis, prognosis, treatment and future outlook for the condition, prevention, and arachnoiditis as a public health concern in New Zealand. The report was commissioned by the Ministry of Health.
http://www.otago.ac.nz/christchurch/otago014038.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
