http://colegiomexicanodeortopediaytrauma.blogspot.mx/2013/08/valoracion-morfofuncional-de.html
VALORACIÓN MORFOFUNCIONAL DE FUTBOLISTAS JUVENILES DEL ESTADO DE MONAGAS. VENEZUELA. MACROCICLO 2009-2010
Rev. Cub. Med. Dep. & Cul. Fís. 2012; Vol. 7, Núm. 3
ISSN: 1728-922X
Eugenio A. Rodríguez Leal 1, Leonor M. Catneitto2
1 Instituto de Medicina del Deporte, Habana, Cuba.
2 Universidad Experimental de los Llanos Rómulo Gallegos, San Juan de los Morros. Guárico. Venezuela. 2009.
RESUMEN
Los valores de potencia aerobias alcanzados en la presente investigación son inferior a los reportados por la literatura internacional para esta disciplina. Se comprueban que el somatotipo dominante fue el Mesoendomòrfico, lo cual no difiere en lo encontrado en futbolistas de elite. El mejor comportamiento de la fuerza explosiva correspondió a los porteros y delanteros. Los mediocampista y delanteros alcanzan los mejores resultados en la potencia anaerobia alactácidas. Contrariamente a lo que se plantea en cuanto a composición corporal en esta disciplina, el mayor % de grasa correspondió a los defensas y no a los porteros como suele suceder. Solo se comprobó un alto nivel de correlación entre la MCA y la fuerza explosiva en miembros inferiores en los sujetos estudiados.
El desarrollo de la presente investigación y los resultados obtenidos han permitido sugerir que se continúe esta investigación en un estudio longitudinal con la finalidad de establecer valores referenciales que permitan la caracterización de la población de futbolistas venezolanos de categoría sub 20 y trasladar estos resultados a otras categorías con igual finalidad.
Palabras claves: Fútbol, potencia anaerobia, alactácida, somatotipo
http://www.imd.inder.cu/adjuntos/article/296/Valoraci%C3%B3n%20morfofuncional%20de%20futbolistas%20juveniles.pdf
http://colegiomexicanodeortopediaytrauma.blogspot.mx/2013/08/perl-funcional-y-morfologico-en.html
martes, 13 de agosto de 2013
Perfil funcional y morfológico en jugadores de fútbol amateur de Mendoza, Argentina
http://www.apunts.org/ficheros/eop/S1886-6581(12)00015-1.pdf
Perfil funcional y morfológico en jugadores de fútbol amateur de Mendoza, Argentina
Nahuel Búaa,b,∗, Andrea Vanina Rodríguez c y Gastón César Garcíac,d
Resumen
Introducción: El propósito de este estudio fue determinar el perfil morfológico y funcional en
futbolistas adultos amateur de la provincia de Mendoza (Argentina).
Material y métodos: Setenta y un jugadores fueron evaluados en 3 ocasiones, al final del periodo preparatorio. La muestra fue categorizada de acuerdo a la posición de juego: arqueros, defensores, mediocampistas y delanteros. Para el perfil morfológico se midieron 25 variables antropométricas. Se calculó la composición corporal a través del método de 5 componentes.
Para el perfil funcional se utilizaron 11 test de campo. Para el cálculo del VO2máx predictivo se aplicó el Course Navette (20m-SRT). Para la valoración de la fuerza de los miembros inferiores se aplicaron 5 test de saltos (Abalakov, Squat jump, Counter movement jump, Bounce jump, Rocket jump). Para la velocidad de aceleración y máxima, se aplicó el test de 30m con intervalos cada 10m. Obtuvimos elrango de movimiento a través del goniómetro en miembros inferiores. El análisis de la varianza (ANOVA)fue utilizado para determinarlas diferencias entre posiciones.
Resultados: Los mediocampistas presentaron menor peso corporal, masa muscular en kilogramos, IMC y endomorfismo. En el perfil funcional presentaron mayor VO2máx predictivo y menor altura en el salto Bounce jump, siendo estas diferencias estadísticamente significativas(p<0,05).
Conclusión: Las diferencias encontradas en función de las posiciones de juego fueron menores que en futbolistas de elite. La batería de test propuesta es útil para obtener el perfil funcional y morfológico en futbolistas amateur. Es de bajo costo, masiva y de fácil aplicación.
© 2012 Consell Català de l’Esport. Generalitat de Catalunya. Publicado por Elsevier España,
S.L. Todos los derechos reservados.
Efectos analgésicos diferentes de la adenosina entre dolor postoperatorio y dolor neuropático
Different analgesic effects of adenosine between postoperative and neuropathic pain.
Yamaoka G, Horiuchi H, Morino T, Miura H, Ogata T.
Spine Center, Ehime University Hospital, Tohon, Ehime 791-0295, Japan.
J Orthop Sci. 2013 Jan;18(1):130-6. doi: 10.1007/s00776-012-0302-0. Epub 2012 Sep 21.
Abstract
BACKGROUND: Adenosine is an endogenous neuromodulator in both the peripheral and central nervous systems. Adenosine inhibits pain signals by hyperpolarizing neuronal membrane. METHODS: To clarify the effects of adenosine on pain signals, we tested intrathecal adenosine injection in two neuropathic pains (spinal cord compression and chronic constriction of sciatic nerve) and postoperative pain (plantar incision). RESULTS: In all three kinds of pain models, significant shortening of withdrawal latencies to thermal stimulation were detected from 24 h to 1 week after the surgery. Significant improvements of pain sensation were observed in all three models after intrathecal injection of Cl-adenosine 24 h after surgery. At 72 h after surgery, intrathecal Cl-adenosine injection inhibited hyperalgesia in the two neuropathic pain models but not in the postoperative pain model. Adenosine A1R messenger RNA (mRNA) expression significantly decreased in the plantar incision model. Adenosine A1R protein levels also decreased compared with the other two models and normal control. CONCLUSIONS: These results suggest that adenosine effectively inhibits pain signals in neuropathic pain but is less effective in postoperative pain because of the decrease in adenosine A1 receptors.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3553403/pdf/776_2012_Article_302.pdf
Adenosina A oral activa agonista de los receptores con efectos antinociceptivos en ratones
Orally active adenosine A(1) receptor agonists with antinociceptive effects in mice.
Korboukh I, Hull-Ryde EA, Rittiner JE, Randhawa AS, Coleman J, Fitzpatrick BJ, Setola V, Janzen WP, Frye SV, Zylka MJ, Jin J.
Center for Integrative Chemical Biology and Drug Discovery, Division of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
J Med Chem. 2012 Jul 26;55(14):6467-77. doi: 10.1021/jm3004834. Epub 2012 Jul 16.
Abstract
Adenosine A(1) receptor (A(1)AR) agonists have antinociceptive effects in multiple preclinical models of acute and chronic pain. Although numerous A(1)AR agonists have been developed, clinical applications of these agents have been hampered by their cardiovascular side effects. Herein we report a series of novel A(1)AR agonists, some of which are structurally related to adenosine 5'-monophosphate (5'-AMP), a naturally occurring nucleotide that itself activates A(1)AR. These novel compounds potently activate A(1)AR in several orthogonal in vitro assays and are subtype selective for A(1)AR over A(2A)AR, A(2B)AR, and A(3)AR. Among them, UNC32A (3a) is orally active and has dose-dependent antinociceptive effects in wild-type mice. The antinociceptive effects of 3a were completely abolished in A(1)AR knockout mice, revealing a strict dependence on A(1)AR for activity. The apparent lack of cardiovascular side effects when administered orally and high affinity (K(i) of 36 nM for the human A(1)AR) make this compound potentially suitable as a therapeutic.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3501123/pdf/nihms-415626.pdf
AMP es un agonista del receptor A1 de adenosina
AMP is an adenosine A1 receptor agonist.
Rittiner JE, Korboukh I, Hull-Ryde EA, Jin J, Janzen WP, Frye SV, Zylka MJ.
Department of Cell and Molecular Physiology, University of North Carolina Neuroscience Center, Chapel Hill, North Carolina 27599, USA.
J Biol Chem. 2012 Feb 17;287(8):5301-9. doi: 10.1074/jbc.M111.291666. Epub 2012 Jan 3.
Abstract
Numerous receptors for ATP, ADP, and adenosine exist; however, it is currently unknown whether a receptor for the related nucleotide adenosine 5'-monophosphate (AMP) exists. Using a novel cell-based assay to visualize adenosine receptor activation in real time, we found that AMP and a non-hydrolyzable AMP analog (deoxyadenosine 5'-monophosphonate, ACP) directly activated the adenosine A(1) receptor (A(1)R). In contrast, AMP only activated the adenosine A(2B) receptor (A(2B)R) after hydrolysis to adenosine by ecto-5'-nucleotidase (NT5E, CD73) or prostatic acid phosphatase (PAP, ACPP). Adenosine and AMP were equipotent human A(1)R agonists in our real-time assay and in a cAMP accumulation assay. ACP also depressed cAMP levels in mouse cortical neurons through activation of endogenous A(1)R. Non-selective purinergic receptor antagonists (pyridoxalphosphate-6-azophenyl-2',4'-disulfonic acid and suramin) did not block adenosine- or AMP-evoked activation. Moreover, mutation of His-251 in the human A(1)R ligand binding pocket reduced AMP potency without affecting adenosine potency. In contrast, mutation of a different binding pocket residue (His-278) eliminated responses to AMP and to adenosine. Taken together, our study indicates that the physiologically relevant nucleotide AMP is a full agonist of A(1)R. In addition, our study suggests that some of the physiological effects of AMP may be direct, and not indirect through ectonucleotidases that hydrolyze this nucleotide to adenosine.
http://www.jbc.org/content/287/8/5301.full.pdf+html
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
LA OSTEOARTRITIS UN PROBLEMA DE SALUD PÚBLICA, EPIDEMIOLOGÍA Y DIAG./
GUIAS DE DIAGNOSTICO Y TRATAMIENTO DE LA OSTEOARTRITIS
DR FERNANDO TORRES/ dvd27
CADERA
XXVII JORNADA NACIONAL DE ORTOPEDIA
58° REUNIÓN ANUAL 2013
1° AL 5 DE MAYO, MÉXICO
http://youtu.be/yPIoBpZJ3T4
Estimado Ciberpediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 14 de Agosto 2013 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Vasculitis en Pediatría” por el “Dr. Manuel Esquer Navarro“ Pediatra, de la Cd. Culiacán , Sinaloa 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/vasculitis_pediatria/
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
Controversies, principles and essentials of enteral and parenteral nutrition in critically ill-patients.
Bajwa SJ, Sachin S
J Med Nutr Nutraceut [serial online] 2013 [cited 2013 Jul 6];2:77-83.
Abstract
Nutritional management in critically ill-patients is always a challenging task as malnutrition can have a direct impact on the prognosis. Besides assessing for nutritional requirement, the underlying severe illness and co-morbidities have to be given due consideration. Nutritional assessment has to be individualized, and nutritional plan should be formulated by involving a dedicated nutritionist. Early initiation of nutrition definitely improves the outcome in critically ill patients. Facts and principles of enteral and parenteral nutrition must be disseminated among all physicians and nursing staff working in intensive care units. Majority of old controversies related to parenteral and enteral nutrition have been settled with the intervention of various national and international committees such as Alliance and Espen. Nutritional disorders such as malnutrition, overfeeding and negative energy balance are highly associated with increased morbidity and mortality. Enteral nutrition though always preferred can always be supplemented with parenteral nutrition so as to optimize nutrition and energy status in critically ill patients.
Keywords: Critically ill-patients, enteral nutrition, parenteral nutrition
http://www.jmnn.org/text.asp?2013/2/2/77/114731
Atentamente
Dr. Juan C. Flores-Carrillo
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
http://www.convention-center.net/artroscopia2013/
https://www.convention-center.net/artroscopia2013/evento/
https://www.convention-center.net/artroscopia2013/hotel/
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Estimación preoperatoria del filtrado glomerular como predictor de la evolución postoperatoria: Revisión sistemática y meta-análisis
Preoperative Estimates of Glomerular Filtration Rate as Predictors of Outcome after Surgery: A Systematic Review and Meta-analysis
Mooney, John F. M.B.B.S.; Ranasinghe, Isuru M.B.Ch.B., M.Med.(Clin. Epi.); Chow, Clara K. M.B.B.S., Ph.D.; Perkovic, Vlado M.B.B.S., Ph.D.; Barzi, Federica B.Sc., Ph.D.; Zoungas, Sophia M.B.B.S., Ph.D.; Holzmann, Martin J. M.D., Ph.D.; Welten, Gijs M. M.D., Ph.D. Biancari, Fausto M.D., Ph.D.; Wu, Vin-Cent M.D., Ph.D.; Tan, Timothy C. M.B.B.S., Ph.D.; Cass, Alan M.B.B.S., Ph.D.; Hillis, Graham S. M.B.Ch.B., Ph.D.
Anestesiology April 2013 - Volume 118 - Issue 4 - p 809-824
doi: 10.1097/ALN.0b013e318287b72c
Abstract
Background: Kidney dysfunction is a strong determinant of prognosis in many settings.
Methods: A systematic review and meta-analysis was undertaken to explore the relationship between estimated glomerular filtration rate (eGFR) and adverse outcomes after surgery. Cohort studies reporting the relationship between eGFR and major outcomes, including all-cause mortality, major adverse cardiovascular events, and acute kidney injury after cardiac or noncardiac surgery, were included. Results: Forty-six studies were included, of which 44 focused exclusively on cardiac and vascular surgery. Within 30 days of surgery, eGFR less than 60 ml*min*1.73 m−2 was associated with a threefold increased risk of death (multivariable adjusted relative risk [RR] 2.98; 95% confidence interval [CI] 1.95-4.96) and acute kidney injury (adjusted RR 3.13; 95% CI 2.22-4.41). An eGFR less than 60 ml*min*1.73 m−2 was associated with an increased risk of all-cause mortality (adjusted RR 1.61; 95% CI 1.38-1.87) and major adverse cardiovascular events (adjusted RR 1.49; 95% CI 1.32-1.67) during long-term follow-up. There was a nonlinear association between eGFR and the risk of early mortality such that, compared with patients having an eGFR more than 90 ml*min*1.73 m−2 the pooled RR for death at 30 days in those with an eGFR between 30 and 60 ml*min*1.73 m−2 was 1.62 (95% CI 1.43-1.80), rising to 2.85 (95% CI 2.49-3.27) in patients with an eGFR less than 30 ml*min*1.73 m−2 and 3.75 (95% CI 3.44-4.08) in those with an eGFR less than 15 ml*min*1.73 m−2.
Conclusion: There is a powerful relationship between eGFR, and both short- and long-term prognosis after, predominantly cardiac and vascular, surgery.
http://journals.lww.com/anesthesiology/Fulltext/2013/04000/Preoperative_Estimates_of_Glomerular_Filtration.16.aspx?utm_source=exacttarget&utm_medium=email&utm_term=Article1&utm_content=j01&src=Week%2026%20-%20ASA%20CME%20-%20Anesthesiology&et_cid=170203&et_rid=vwhizar@anestesia-dolor.org
Les hago entrega de esta platica que se llevo a cabo en la pasada jornada de ortopedia en Acapulco......
LA EDUCACIÓN GERIÁTRICA EN LA ORTOPEDIA/ DR PEDRO ANTONIO BRAVO/ dvd51 2
ORTOPEDIA GERIÁTRICA
XXVII JORNADA NACIONAL DE ORTOPEDIA
58°REUNIÓN ANUAL 2013
1° AL 5 DE MAYO ACAPULCO GRO. MÉXICOhttp://youtu.be/zvKFduIOds8
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Tratamiento actual y consideraciones anestésicas para la diabetes mellitus
Current therapeutic agents and anesthetic considerations for diabetes mellitus.
Kang H.
Department of Anesthesiology and Pain Medicine, Eulji General Hospital, Eulji University, Seoul, Korea.
Korean J Anesthesiol. 2012 Sep;63(3):195-202. doi: 10.4097/kjae.2012.63.3.195. Epub 2012 Sep 14.
Abstract
As the incidence of diabetes mellitus (DM) continues to increase worldwide, more diabetic patients will be presented for surgery and anesthesia. This increase of DM is a consequence of the rise in new patients of type 2 DM, and is likely attributable to rapid economic development, improved living standards, aging population, obesity, and lack of exercise. The primary goal of management in DM is to delay, or prevent the macro- and microvascular complications by achieving good glycemic control. More understanding of the pathophysiology of DM has contributed to the advance of new pharmacological approaches. In addition to the conventional therapy for DM, glucagon-like peptide-1 (GLP-1) mimetics, dipeptidyl peptidase-4 (DPP-4) inhibitors, thiazolidinediones (TZDs), and insulin analogues are currently available effective hypoglycemic agents for the management of the patients with DM in the perioperative period and also consider the adverse effects of newly introduced agents that need more clinical observations.
KEYWORDS:
Anesthesia, Diabetes mellitus, Glucose, Hypoglycemia, Treatment
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460146/pdf/kjae-63-195.pdf
Guías para la inyección de insulina en el perioperatorio y en pacientes graves
Insulin injection guidelines for peri-operative and critically ill patients.
Bajwa SJ, Kalra S, Baruah M, Bajwa SK.
J Sci Soc [serial online] 2013 [cited 2013 Jul 23];40:68-75.
Abstract
Anesthesiologists and intensivists are encountering increasing number of diabetic patients in daily clinical practice. Majority of such patients may require insulin injections for control of hyperglycemia. Advancements in diabetes management have led to usage of newer insulin injections ranging from human insulin and insulin analogs to glucagon-like peptides-1 analogs. The adequacy of glycemic control and successful outcome with such therapeutic interventions depends upon the adoption of correct injection techniques and procedures. Peri-operative and critically ill diabetic patients are highly prone to develop acute complications of diabetes if appropriate therapeutic strategies are not formulated and implemented. As such, the in-depth knowledge and awareness about various injection technique guidelines is essential from the patient care and healthcare provider's perspective in the operative and critical care settings. This description is an abridged version of the Forum for Injection Techniques, India: The first Indian recommendations for best practice in insulin injection technique and their significance in peri-operative period and critically ill patients in intensive care units (ICU). These insulin injection techniques are based on evidence-based recommendations and are meant to improve the management of diabetes by the attending staff and physicians in operative and critical care arenas.
Keywords: Critically ill, diabetes, injection sites, insulin, insulin analogues, needle length, peri-operative, skin folds
http://www.jscisociety.com/text.asp?2013/40/2/68/115473
Una gran necesidad de conocimiento de las pautas de inyección de insulina en unidades de cuidados intensivos y operatorias.
An acute need for awareness of insulin injection guidelines in operative and intensive care units. Bajwa SJ, Kalra S, Baruah MP, Bajwa SK.
Anesth Essays Res [serial online] 2013 [cited 2013 Jul 23];7:1-3.
Abstract
The ever increasing number of peri-operative and critically ill diabetic patients in clinical settings have become a cause of serious concern. Invariably, such patients present with uncontrolled hyperglycemia which can be managed only with insulin therapy. [1],[2] Besides the existing challenges in the management of uncontrolled diabetes and its related complications, another difficulty which is commonly faced by the nursing staff and the physicians, is the lack of awareness regarding insulin injection techniques. Inappropriate insulin injection practices can lead to various clinical complications such as poor glycemic control, pain, bleeding and bruising, breaking and lodging of needle tip beneath the skin, contamination leading to infection, lipohypertrophy, and inaccurate dose administration
http://www.aeronline.org/text.asp?2013/7/1/1/113976
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Anemia y embarazo; implicaciones anestésicas
Anaemia and pregnancy: Anaesthetic implications.
Grewal A.
Department of Anaesthesiology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Indian J Anaesth. 2010 Sep;54(5):380-6. doi: 10.4103/0019-5049.71026.
Abstract
Anaemia in pregnancy defined as haemoglobin (Hb) level of < 10 gm/dL, is a qualitative or quantitative deficiency of Hb or red blood cells in circulation resulting in reduced oxygen (O2)- carrying capacity of the blood. Compensatory mechanisms in the form of increase in cardiac output (CO), PaO(2), 2,3 diphosphoglycerate levels, rightward shift in the oxygen dissociation curve (ODC), decrease in blood viscosity and release of renal erythropoietin, get activated to variable degrees to maintain tissue oxygenation and offset the decreases in arterial O(2) content. Parturients with concomitant medical diseases or those with acute ongoing blood losses may get decompensated, leading to serious consequences like right heart failure, angina or tissue hypoxemia in severe anaemia. Preoperative evaluation is aimed at assessing the severity and cause of anaemia. The concept of an acceptable Hb level varies with the underlying medical condition, extent of physiological compensation, the threat of bleeding and ongoing blood losses. The main anaesthetic considerations are to minimize factors interfering with O(2) delivery, prevent any increase in oxygen consumption and to optimize the partial pressure of O(2) in the arterial blood. Both general anaesthesia and regional anaesthesia can be employed judiciously. Monitoring should focus mainly on the adequacy of perfusion and oxygenation of vital organs. Hypoxia, hyperventilation, hypothermia, acidosis and other conditions that shift the ODC to left should be avoided. Any decrease in CO should be averted and aggressively treated.
KEYWORDS: Anaemia, anaesthetic considerations, compensatory mechanisms, pregnancy
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991646/
http://www.ijaweb.org/temp/IndianJAnaesth545380-3543212_095032.pdf
Terapia con hierro sucrosa intravenoso para anemia moderada a severa en el embarazo
Intravenous iron sucrose therapy for moderate to severe anaemia in pregnancy.
Kriplani A, Mahey R, Dash BB, Kulshreshta V, Agarwal N, Bhatla N.
Indian J Med Res [serial online] 2013 [cited 2013 Aug 6];138:78-82.
Abstract
Background & objectives: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy. Prophylactic oral iron is recommended during pregnancy to meet the increased requirement. In India, women become pregnant with low baseline haemoglobin level resulting in high incidence of moderate to severe anaemia in pregnancy where oral iron therapy cannot meet the requirement. Pregnant women with moderate anaemia are to be treated with parentral iron therapy. This study was undertaken to evaluate the response and effect of intravenous iron sucrose complex (ISC) given to pregnant women with IDA. Methods: A prospective study was conducted (June 2009 to June 2011) in the department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. One hundred pregnant women with haemoglobin between 5-9 g% with diagnosed iron deficiency attending antenatal clinic were given intravenous iron sucrose complex in a dose of 200 mg twice weekly schedule after calculating the dose requirement. Results: The mean haemoglobin raised from 7.63 ± 0.61 to 11.20 ± 0.73 g% (P<0.001) after eight wk of therapy. There was significant rise in serum ferritin levels (from 11.2 ± 4.7 to 69 ± 23.1 μg/l) (P<0.001). Reticulocyte count increased significantly after two wk of starting therapy (from 1.5 ± 0.6 to 4.6±0.8%). Other parameters including serum iron levels and red cell indices were also improved significantly. Only one woman was lost to follow up. No major side effects or anaphylactic reactions were noted during study period. Interpretation & conclusions: Parentral iron therapy was effective in increasing haemoglobin, serum ferritin and other haematological parameters in pregnant women with moderate anaemia. Intravenous iron sucrose can be used in hospital settings and tertiary urban hospitals where it can replace intramuscular therapy due to injection related side effects. Further, long-term comparative studies are required to recommend its use at peripheral level.
Keywords: Anaemia - iron deficiency - iron sucrose complex - parentral iron therapy - serum ferritin
http://www.ijmr.org.in/text.asp?2013/138/1/78/116208
http://www.ijmr.org.in/temp/IndianJMedRes138178-3451514_093515.pdf
Anemia, uso de hierro prenatal, y riesgos adversos del embarazo: revisión sistemática y meta-análisis
Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis.
Haider BA, Olofin I, Wang M, Spiegelman D, Ezzati M, Fawzi WW; Nutrition Impact Model Study Group (anaemia).
Departments of Epidemiology and Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
BMJ. 2013 Jun 21;346:f3443. doi: 10.1136/bmj.f3443.
Abstract
OBJECTIVES: To summarise evidence on the associations of maternal anaemia and prenatal iron use with maternal haematological and adversepregnancy outcomes; and to evaluate potential exposure-response relations of dose of iron, duration of use, and haemoglobin concentration in prenatal period with pregnancy outcomes.....
CONCLUSIONS: Daily prenatal use of iron substantially improved birth weight in a linear dose-response fashion, probably leading to a reduction in risk of low birth weight. An improvement in prenatal mean haemoglobin concentration linearly increased birth weight.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3689887/pdf/bmj.f3443.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Biomarcadores para el manejo de la eclampsia en embarazadas
Biomarkers for the management of pre-eclampsia in pregnant women.
Petla LT, Chikkala R, Ratnakar K S, Kodati V, Sritharan V.
Indian J Med Res [serial online] 2013 [cited 2013 Aug 6];138:60-7.
Abstract
Pre-eclampsia (PE) is a pregnancy related disorder characterized by hypertension and proteinuria noticeable after 20 wk of gestation. It is a leading cause of maternal and foetal mortality and morbidity worldwide. The aetiology of the disease is unknown, but recent studies have revealed that this disorder appears to originate in placenta and is characterized by widespread maternal endothelial dysfunction. Till date, delivery of placenta is the only cure for the disease. So, there is a need for the identification of highly specific and sensitive biochemical markers that would allow early identification of patients at risk and thus help in providing proper prenatal care. Several promising biomarkers have been proposed, alone or in combination, that may help in predicting women who are likely to develop PE. Maternal serum concentrations of these biomarkers either increase or decrease in PE during gestation. This review focuses on the various biomarkers available and their utility in predicting pre-eclampsia.
Keywords: Angiogenic factors - biomarkers - NGAL - pre-eclampsia - placenta - proteinuria
http://www.ijmr.org.in/text.asp?2013/138/1/60/116198
http://www.ijmr.org.in/temp/IndianJMedRes138160-3442067_093340.pdf
Concentraciones plasmáticas maternas de factores angiogénicos/antiangiogénicos son de valor pronóstico en los pacientes en el áera de triage con sospechas de preeclampsia
Maternal plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in patients presenting to the obstetrical triage area with the suspicion of preeclampsia.
Chaiworapongsa T, Romero R, Savasan ZA, Kusanovic JP, Ogge G, Soto E, Dong Z, Tarca A, Gaurav B, Hassan SS.
Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA. tchaiwor@med.wayne.edu
J Matern Fetal Neonatal Med. 2011 Oct;24(10):1187-207. doi: 10.3109/14767058.2011.589932. Epub 2011 Aug 9.
Abstract
OBJECTIVE: To determine whether maternal plasma concentrations of placental growth factor (PlGF), soluble endoglin (sEng), soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) and -2 could identify patients at risk for developing preeclampsia (PE) requiring preterm delivery.STUDY DESIGN: Patients presenting with the diagnosis "rule out PE" to the obstetrical triage area of our hospital at <37 weeks of gestation (n = 87) were included in this study. Delivery outcomes were used to classify patients into four groups: I) patients without PE or those with gestational hypertension (GHTN) or chronic hypertension (CHTN) who subsequently developed PE at term (n = 19); II): mild PE who delivered at term (n = 15); III): mild disease (mild PE, GHTN, CHTN) who subsequently developed severe PE requiring preterm delivery (n = 26); and IV): diagnosis of severe PE (n = 27). Plasma concentrations of PlGF, sEng, sVEGFR-1 and -2 were determined at the time of presentation by ELISA. Reference ranges for analytes were constructed by quantile regression in our laboratory (n = 180; 1046 samples). Comparisons among groups were performed using multiples of the median (MoM) and parametric statistics after log transformation. Receiver operating characteristic curves, logistic regression and survival analysis were employed for analysis. RESULTS: The mean MoM plasma concentration of PlGF/sVEGFR-1, PlGF/sEng, PlGF, sVEGFR-1 and -2, and sEng in Group III was significantly different from Group II (all p < 0.05). A plasma concentration of PlGF/sVEGFR-1 ≤ 0.05 MoM or PlGF/sEng ≤0.07 MoM had the highest likelihood ratio of a positive test (8.3, 95% CI 2.8-25 and 8.6, 95% CI 2.9-25, respectively), while that of PlGF ≤0.396 MoM had the lowest likelihood ratio of a negative test (0.08, 95% CI 0.03-0.25). The association between low plasma concentrations of PlGF/sVEGFR-1 (≤0.05 MoM) as well as that of PlGF/sEng (≤0.07 MoM) and the development of severe PE remained significant after adjusting for gestational age at presentation, average systolic and diastolic blood pressure, and a history of chronic hypertension [adjusted odds ratio (OR) = 27 (95% CI 6.4-109) and adjusted OR 30 (95% CI 6.9-126), respectively]. Among patients who presented <34 weeks gestation (n = 59), a plasma concentration of PlGF/sVEGFR-1 < 0.033 MoM identified patients who delivered within 2 weeks because of PE with a sensitivity of 93% (25/27) and a specificity of 78% (25/32). This cut-off was associated with a shorter interval-to-delivery due to PE [hazard ratio = 6 (95% CI 2.5-14.6)]. CONCLUSIONS: Plasma concentrations of angiogenic/anti-angiogenic factors are of prognostic value in the obstetrical triage area. These observations support the value of these biomarkers in the clinical setting for the identification of the patient at risk for disease progression requiring preterm delivery.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384532/pdf/nihms379361.pdf
http://informahealthcare.com/doi/pdf/10.3109/14767058.2011.589932
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org