Libro sobre Herpes virus

Libro sobre Herpes virus


Herpesviridae - A Look Into This Unique Family of Viruses
Edited by George D. Magel and Stephen Tyring, ISBN 978-953-51-0186-4, Hard cover, 320 pages, Publisher: InTech, Chapters published March 07, 2012 under CC BY 3.0 license
DOI: 10.5772/1207
In order to fully understand the nature of viruses, it is important to look at them from both, their basic science and clinical, standpoints. Our goal with this book was to dissect Herpesviridae into its biological properties and clinical significance in order to provide a logical, as well as practical, approach to understanding and treating the various conditions caused by this unique family of viruses. In addition to their up-to-date and extensive text, each chapter is laced with a variety of diagrams, tables, charts, and images, aimed at helping us achieve our goal. We hope that this book will serve as a reference tool for clinicians of various specialties worldwide.

http://www.intechopen.com/books/herpesviridae-a-look-into-this-unique-family-of-viruses


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

Casos raros/Rare cases

Efecto aditivo de propofol y fentanilo precipitando shock cardiogénico


Additive effect of propofol and fentanyl precipitating cardiogenic shock.
Prabhakaran AJ.
J Pharmacol Pharmacother [serial online] 2013 [cited 2013 Jul 5];4:217-9.
Abstract

intravenous administration of propofol and fentanyl has become a common practice in a variety of clinical settings including outpatient dermatologic, cosmetic and oral surgery. The combination provides both systematic sedation and analgesia with low incidence of unwanted side effects. The cardiogenic shock is very uncommon in healthy individuals. The cardiovascular depressive effect of propofol and fentanyl has been well established, but the development of cardiogenic shock is very rare when these drugs are used together. Hence the awareness of this effect is advantageous to the patients undergoing such surgeries
Keywords: Echocardiography, left ventricular ejection fraction, myocardial infarction
http://www.jpharmacol.com/text.asp?2013/4/3/217/114612

Obstrucción aguda de la vía aérea secundaria a un quiste epiglótico congénito

Acute airway obstruction secondary to a congenital epiglottic cyst.
Al Eid H.
Health Spec [serial online] 2013 [cited 2013 Jul 5];1:97-9.
Abstract
Congenital epiglottic cysts are a rare cause of respiratory tract obstruction in neonates and infants with an incidence of 1.82 per 100,000 live births. The majority arise from the vallecula, aryepiglottic fold, and from the saccule of the ventricle and rarely from the epiglottis. This uncommon entity requires prompt diagnosis and treatment. Traditionally, such cysts are treated surgically via endoscopic excision or marsupialization. Recurrence occurs if excision incomplete and multiple procedures may be necessary. Some authors favour an open surgical approach for more extensive cysts. The patient presented here underwent endoscopic excision and was discharged 3 days later
Keywords: Airway obstruction, congenital, epiglottic cyst


http://www.thejhs.org/text.asp?2013/1/2/97/114686



Injerto de arteria coronaria: factor precipitante para cetoacidosis diabética perioperatoria
Coronary artery bypass grafting: a precipitating factor for perioperative diabetic ketoacidosis.
Sehgal V, Jit Singh Bajwa S, Kitabchi A.
Regional Hospital of Scranton, The Commonwealth Medical College Scranton, PA, USA.
Int J Endocrinol Metab. 2013 Spring;11(2):126-8. doi: 10.5812/ijem.7183. Epub 2013 Apr 1.
Abstract
Non-Insulin Dependent Diabetes Mellitus (NIDDM) is a common disease entity in patients with Coronary Artery Disease (CAD). Diabetic Ketoacidosis (DKA) is not only one of the major complications of Diabetes Mellitus but also a significant challenging clinical entity for the patients undergoing any elective or emergency surgery. Coronary Artery Bypass Grafting (CABG) being done in a patient with DKA has not been reported. We are presenting a rare case with DKA in whom CABG was carried out in a hospital devoted exclusively to cardiac cases. Insulin was given in very large doses as a part of therapeutic regimen and the outcome was favorable. This report concludes that if a patient undergoing urgent cardiac surgery incidentally develops DKA after induction of anesthesia, then the operation can be carried out provided DKA is managed aggressively. Also, major stress factors like cardio pulmonary bypass (CPB) and hypothermia should be avoided and care should be taken to avoid cerebral edema.
KEYWORDS:
Coronary Artery Bypass Grafting, Diabetes Mellitus, Diabetic Ketoacidosis, Insulin

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693665/pdf/ijem-11-126.pdf




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

11° Curso Taller de Patología Quirúrgica del Pie, México, 2013

una publicación de Victor Ravens.

Bibliotecas. Alerta

Biblioteca Popular “Francisco Hernández López Jordán” Diario El Argentino
Lotería Familiar:La comisión directiva y el personal de la institución están organizando con mucho entusiasmo una lotería familiar en la que podrán disfrutar de ...Ver todos los artículos sobre este tema »
Biblioteca Nacional con Pebre: “¿Qué se sirve?” El Mostrador
Ver todos los artículos sobre este tema »


El Mostrador

La formidable Biblioteca Nacional de Francia EL Peruano
La ciudad de París tiene 71 bibliotecas municipales de acceso libre, abiertas a todos, inclusive a los visitantes extranjeros, sean becarios o turistas.Ver todos los artículos sobre este tema »
La biblioteca de Guadalajara manda 80 cajas con libros a Lima nueva alcarria
Hace unos días la Biblioteca Pública de Guadalajara envió a Perú, como hace periódicamente, libros donados por sus usuarios. Salieron con ese destino 80 ...Ver todos los artículos sobre este tema »
Recuperaron la biblioteca municipal El Tiempo
Puerto Píritu.- Mediente un convenio con la Alcaldía de Peñalver, la Red de Bibliotecas del estado Anzoátegui recuperó la sede de la Felipe Rafael Martínez de ...Ver todos los artículos sobre este tema »
Cierra la Biblioteca Enrique Apolinar por falta de recursos económicos 7dias.com.do
La Biblioteca Enrique Apolinar Henríquez, especializada exclusivamente en temas dominicanos y caribeños, con más de 15.000 volúmenes, ha cerrado ...Ver todos los artículos sobre este tema »


7dias.com.do

Modernizan la Biblioteca Pública Central Ciudadania Express
El encargado del despacho de la Secretaría de las Culturas y Artes de Oaxaca (SECULTA) Emilio de Leo Blanco, realizó un recorrido por la Biblioteca Pública ...Ver todos los artículos sobre este tema »


Ciudadania Express

Inauguran Biblioteca en honor a Aquiles Nazoa en Bolivia Ciudadccs
22/08/13.- La Embajada de Venezuela en Bolivia inauguró la Biblioteca Aquiles Nazoa como un homenaje a este escritor, periodista, poeta y humorista ...Ver todos los artículos sobre este tema »
Mañana comienza el “I Encuentro de Agentes de Bibliotecas y ... Misiones OnLine
Se trata de una actividad libre y gratuita organizada por la Biblioteca Pública De ... Bajo el tópico “Nuevos desafíos en Bibliotecas”, la Biblioteca Pública De Las ...Ver todos los artículos sobre este tema »
La Biblioteca Pública José Manuel Lara ofrece nuevo horario Ayuntamiento de Mairena del Alcor
Las instalaciones de la Biblioteca Pública José Manuel Lara, insertas en la Villa del Conocimiento y las Artes de Mairena del Alcor, han permanecido abiertas ...Ver todos los artículos sobre este tema »


Blogs 2 resultados nuevos para Biblioteca

¿Qué dicen los lectores de la Biblioteca? | ALQUIBLA Eva
Durante el día a día se ha comprobado, que para saber que se espera del trabajo de bibliotecaria hay que escuchar con atención y anotar las funciones y ...ALQUIBLA
Nuevas tecnologías y mejores espacios para usuarios de la ... memo47
El encargado del despacho de la Secretaría de las Culturas y Artes de Oaxaca (SECULTA) Emilio de Leo Blanco, realizó un recorrido por la Biblioteca Pública ...Lic. Gabino Cué Monteagudo

Más sobre NPH/More on PHN

Diagnóstico y tratamiento de la neuralgia postherpética


Diagnosing and managing postherpetic neuralgia.
Nalamachu S, Morley-Forster P.
International Clinical Research Institute, Inc., Overland Park, KS 66210, USA. nalamachu@yahoo.com
Drugs Aging. 2012 Nov;29(11):863-9. doi: 10.1007/s40266-012-0014-3.
Abstract
Postherpetic neuralgia (PHN) represents a potentially debilitating and often undertreated form of neuropathic pain that disproportionately affects vulnerable populations, including the elderly and the immunocompromised. Varicella zoster infection is almost universally prevalent, making prevention of acute herpes zoster (AHZ) infection and prompt diagnosis and aggressive management of PHN of critical importance. Despite the recent development of a herpes zoster vaccine, prevention of AHZ is not yet widespread or discussed in PHN treatment guidelines. Diagnosis of PHN requires consideration of recognized PHN signs and known risk factors, including advanced age, severe prodromal pain, severe rash, and AHZ location on the trigeminal dermatomes or brachial plexus. PHN pain is typically localized, unilateral and chronic, but may be constant, intermittent, spontaneous and/or evoked. PHN is likely to interfere with sleep and daily activities. First-line therapies for PHN include tricyclic antidepressants, gabapentin and pregabalin, and the lidocaine 5 % patch. Second-line therapies include strong and weak opioids and topical capsaicin cream or 8 % patch. Tricyclic antidepressants, gabapentinoids and strong opioids are effective but are also associated with systemic adverse events that may limit their use in many patients, most notably those with significant medical comorbidities or advanced age. Of the topical therapies, the topical lidocaine 5 % patch has proven more effective than capsaicin cream or 8 % patch and has a more rapid onset of action than the other first-line therapies or capsaicin. Given the low systemic drug exposure, adverse events with topical therapies are generally limited to application-site reactions, which are typically mild and transient with lidocaine 5 % patch, but may involve treatment-limiting discomfort with capsaicin cream or 8 % patch. Based on available clinical data, clinicians should consider administering the herpes zoster vaccine to all patients aged 60 years and older. Clinicians treating patients with PHN may consider a trial of lidocaine 5 % patch monotherapy before resorting to a systemic therapy, or alternatively, may consider administering the lidocaine 5 % patch in combination with a tricyclic antidepressant or a gabapentinoid to provide more rapid analgesic response and lower the dose requirement of systemic therapies.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693437/pdf/40266_2012_Article_14.pdf


Bloqueo del nervio infraorbitario con radiofrecuencia de pulso guiado con ultrasonido para el tratamiento de neuralgia postherpética intratable. Informe de caso

Ultrasound-guided infraorbital nerve pulsed radiofrequency treatment for intractable postherpetic neuralgia - a case report.
Lim SM, Park HL, Moon HY, Kang KH, Kang H, Baek CH, Jung YH, Kim JY, Koo GH, Shin HY.
Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.
Korean J Pain. 2013 Jan;26(1):84-8. doi: 10.3344/kjp.2013.26.1.84. Epub 2013 Jan 4.
Abstract
A 60-year-old man presented with pain on the left cheek and lateral nose. The patient had been diagnosed with facial herpes zoster in the left V2 area 6 months previously. Medical treatment was prescribed for 6 months but it had little effect. We blocked the left infraorbital nerve under ultrasound guidance, but pain relief was short term. Therefore, we performed pulsed radiofrequency treatment on the left infraorbital nerve under ultrasound guidance. Six months after the procedure, the reduction of pain was still maintained, and there was no need for further management.
KEYWORDS: infraorbital nerve, radiofrequency, ultrasound




http://pdf.medrang.co.kr/paper/pdf/Jkp/Jkp026-01-16.pdf



Tratamiento y prevención del herpes zoster: perspectiva canadiense
Management and prevention of herpes zoster: A Canadian perspective.
Boivin G, Jovey R, Elliott CT, Patrick DM.
Research Centre in Infectious Diseases of the Centre Hospitalier Universitaire de Québec and Laval University, Quebec City, Quebec;
Can J Infect Dis Med Microbiol. 2010 Spring;21(1):45-52.
Abstract
Varicella-zoster virus reactivation leads to herpes zoster - the main complication of which is postherpetic neuralgia (PHN). Rapid antiviral therapy initiated within 72 h of rash onset has been shown to accelerate rash healing, reduce the duration of acute pain and, to some extent, attenuate the development and duration of PHN. Other adjunctive therapies such as analgesics, antidepressants and some anticonvulsants are frequently required in the management of severe PHN. A live, attenuated zoster vaccine has been recently shown to significantly decrease herpes zoster incidence, PHN and the overall burden of illness when administered to adults older than 60 years of age. This new prophylactic modality has been reported to be cost-effective in the Canadian context, especially in the 60- to 75-year-old age group.
KEYWORDS: Antivirals, Postherpetic pain, Prevention, Vaccine, Zoster

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2852282/pdf/idmm21045.pdf




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

TUMOR DE CELULAS GIGANTES, CEMENTACIÓN ACRILICA

Continuando con algunas de las platicas, llevadas a cabo durante las pasadas jornadas en Acapulco, tenemos ahora:

TUMOR DE CELULAS GIGANTES, CEMENTACIÓN ACRILICA

/DR MORENO HOYOS/ dvd47 3

http://youtu.be/EgrShsnBAc8

“Tos en pediatría ¿es igual a los 5ª que a los 14ª años de edad?”

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 21 de Agosto 2013 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Tos en pediatría ¿es igual a los 5ª que a los 14ª años de edad?” por el “Dr. Jesús Guajardo“ Pediatra, Alergólogo, Neumólogo, de la Cd. San Antonio Tx USA. 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/tos_en_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

Bibliotecas. Alerta

Egipto: Islamistas atacan la Biblioteca de Alejandría LaRepública.pe
Seguidores de los Hermanos Musulmanes atacaron hoy la Biblioteca de Alejandría, en el norte de Egipto, durante los disturbios que se desencadenaron en ...Ver todos los artículos sobre este tema »


LaRepública.pe

Islamistas atacaron la Biblioteca de Alejandría, según televisión ... La Voz del Interior
Seguidores de los Hermanos Musulmanes atacaron hoy la Biblioteca de ... La antigua Biblioteca de Alejandría, que inspiró la actual, fue fundada en el año 295 ...Ver todos los artículos sobre este tema »
Ataque a la Biblioteca de Alejandría El Correo
Seguidores de los Hermanos Musulmanes han atacado este miércoles la Biblioteca de Alejandría, en el norte de Egipto, durante los disturbios que se ...Ver todos los artículos sobre este tema »
Los islamistas atacan la biblioteca de Alejandría levante.emv.com
El Cairo Seguidores de los Hermanos Musulmanes atacaron hoy la Biblioteca de Alejandría, en el norte de Egipto, durante los disturbios que se ...Ver todos los artículos sobre este tema »
Biblioteca bloquea Hamlet por ser demasiado violento ComputerHoy
Mark Forsyth es un escritor que estaba preparando su libro en el propio edificio de la Biblioteca Británica, la Biblioteca Nacional del Reino Unido, y también una ...Ver todos los artículos sobre este tema »


ComputerHoy

La Biblioteca Popular Juan Bautista Alberdi cumplió 100 años Diario La Ciudad de Avellaneda
La Biblioteca Popular «Juan Bautista Alberdi» de Limay 1234 (Gerli) cumplió cien años y lo celebrará en octubre junto a la Sociedad de Fomento «Villa ...Ver todos los artículos sobre este tema »
La biblioteca pública municipal celebrará su 67° aniversario Crónica Digital
El próximo viernes 16 de agosto, la Biblioteca Pública y Popular de la Municipalidad de Comodoro Rivadavia, realizará un brindis con motivo de conmemorar ...Ver todos los artículos sobre este tema »


Crónica Digital

Biblioteca Nacional cumple 200 años 24 Horas
“El primer paso que dan los pueblos para ser sabios, es darse grandes bibliotecas”, dice la proclama de la Junta de Gobierno al fundar, el 18 de agosto de ...Ver todos los artículos sobre este tema »
Viaje a la Biblioteca Nacional: el disco duro del país El Pais - Cali Colombia
Este año se conmemoran 75 años de la construcción de la sede de la Biblioteca Nacional, una buena excusa para sumergirnos en esta entidad que custodia ...Ver todos los artículos sobre este tema »
EL TIEMPO dona su biblioteca ElTiempo.com
El acto oficial de entrega tendrá lugar hoy, a las 10 de la mañana, en la dirección de la Biblioteca Nacional, con la presencia de Roberto Pombo, director de ...Ver todos los artículos sobre este tema »

Casa Editorial El Tiempo entrega su Biblioteca a la Biblioteca ...
La Biblioteca Nacional de Colombia recibió de Casa Editorial El Tiempo el ofrecimiento de la colección de la Biblioteca de El Tiempo. Se trata de una biblioteca ...Ministerio De Cultura
Islamistas atacan la Biblioteca de Alejandría, según la televisión ...
El Cairo, 14 ago (EFE).- Seguidores de los Hermanos Musulmanes atacaron hoy la Biblioteca de Alejandría, en el norte de Egipto, durante los disturbios que se ...Lo último de noticias Noticias, vídeos y fotos en lainformacion.com
¡Lo logramos!: #Biblioteca llegó a ser Trending Topic mundial en ... Víctor V. Valera
Pues si, a la quinta fue la vencida y tal y como me aventuraba a pronosticar en el post anterior, el hashtag #Biblioteca fue Tendencia global este pasado lunes ...El Content Curator - Víctor V. Valera
Cursos en la Biblioteca Bernardino Rivadavia | Todas las voces Puan admin
La Biblioteca Bernardino Rivadavia de Puan informa que en agosto se comenzarán a dictar los cursos de Computación. Como es característico en este tipo de.Todas las voces Puan
el-infocomunicador: El incendio de la Biblioteca Nacional del Perú ... Jason Enrique Mori
El viernes 9 de agosto del presente año, el Director de la Biblioteca Nacional del Perú (BNP), Ramón Mujica Pinilla, fue entrevistado por Jaime de Althaus en el ...el-infocomunicador

Dolor y mastectomía/Pain and mastectomy

Efecto del flurbiprofeno intravenoso sobre el dolor crónico postmastectomía


Effect of perioperative intravenous flurbiprofen axetil on chronic postmastectomy pain.
Sun M, Liao Q, Wen L, Yan X, Zhang F, Ouyang W.
Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha 410013; Department of Anesthesiology, Henan Provincial People Hospital, Zhengzhou 450000, Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013 Jul;38(7):653-60. doi: 10.3969/j.issn.1672-7347.2013.07.001.
Abstract
Objective: To explore whether perioperative intravenous flurbiprofen axetil can reduce the incidence and intensity of chronic pain for breast cancer after surgical treatment. Methods: This randomized, double-blind, controlled trial enrolled 60 patients undergoing mastectomy and axillary lymph node dissection under general anesthesia. All patients accepted Hospital Anxiety and Depression Scale (HAD) tests the day before the surgery to evaluate depression and anxiety. The patients were randomly assigned to receive either 50 mg flurbiprofen axetil intravenously 15 minutes before the surgical incision and 6 hours later (group F) or intravenous 5 mL intralipid as a control (group C). All patients received patient-controlled intravenous analgesia (PCIA) with fentanyl postoperatively. Peripheral venous blood samples were drawn before the surgery, at 4 and 24 h after the surgery to detect the plasma level of PGE2 and tumor necrosis factor-α (TNF-α). Postoperative fentanyl consumption, Numerical Rating Scale (NRS) scores and adverse effects were recorded at 2, 6, 12, 24 and 48 h after the surgery. The duration and intensity of pain were followed up by telephone at the 2nd-12th month after the surgery. Results: The incidence of pain at 2, 4, 6, and 12 months after the breast surgery was 33%, 20%, 15%, and 10%, respectively, and the average pain score was 0.77, 0.57, 0.28, and 0.18, respectively. Compared with group C, the scores of pain in group F were significantly lower at 2, 4, 6 and 12 months postoperatively (F=7.758, P=0.007). The incidence of pain in group F was significantly lower at 2, 4 and 6 months postoperatively (P<0.05). There was no significant difference in the incidence of pain between the groups at 12 months postoperatively (P>0.05). Preoperatively and at 4 and 24 h after the surgery, there was no significant difference in the level of TNF-α between the two groups (F=0.530, P=0.470); but plasma concentration of PGE2 in group F was significantly lower than that in group C (F=5.646, P=0.021). No patients developed abnormal bleeding, peptic ulcer, impaired liver or renal function and respiratory depression. Conclusion: Perioperative intravenous infusion of 100 mg flurbiprofen axetil can decrease the intensity and incidence of chronic pain for breast cancer after surgical treatment.
http://xbyx.xysm.net/xbwk/fileup/PDF/201307653.pdf




Síndrome de dolor postmastectomía: estudio epidemiológico sobre su prevalencia
The postmastectomy pain syndrome: an epidemiological study on the prevalence of chronic pain after surgery for breast cancer.
Vilholm OJ, Cold S, Rasmussen L, Sindrup SH.
Department of Neurology, Odense University Hospital, Sdr. Boulevard 29, Odense 5000, Denmark. Vilholm@dadlnet.dk
Br J Cancer. 2008 Aug 19;99(4):604-10. doi: 10.1038/sj.bjc.6604534.
Abstract
The prevalence of the postmastectomy pain syndrome (PMPS) and its clinical characteristics was assessed in a group of patients who had undergone surgery for breast cancer at the Department of Surgery, Odense University Hospital, within the period of 1 May 2003 to 30 April 2004. The study included 258 patients and a reference group of 774 women. A questionnaire was mailed to the patients 1 1/2 year after surgery and to the women in the reference group. The PMPS was defined as pain located in the area of the surgery or ipsilateral arm, present at least 4 days per week and with an average intensity of at least 3 on a numeric rating scale from 0 to 10. The prevalence of PMPS was found to be 23.9%. The odds ratio of developing PMPS was 2.88 (95% confidence interval 1.84-4.51). Significant risk factors were as follows: having undergone breast surgery earlier (OR 8.12), tumour located in the upper lateral quarter (OR 6.48) and young age (OR 1.04). This study shows that, although recent advances in the diagnostic and surgical procedures have reduced the frequency of the more invasive surgical procedures, there still is a considerable risk of developing PMPS after treatment of breast cancer.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527825/pdf/6604534a.pdf



Síndrome doloroso postmastectomía: la magnitud del problema
Post-mastectomy pain syndrome: the magnitude of the problem.
Couceiro TC, Menezes TC, Valênça MM.
Responsável pela Residência Médica em Anestesiologia do Instituto de Medicina Integral Professor Fernando Figueira; Mestre em Neuropsiquiatria e Ciência do Comportamento, pela Universidade Federal de Pernambuco. taniacouceiro@yahoo.com.br
Rev Bras Anestesiol. 2009 May-Jun;59(3):358-65.
Abstract
BACKGROUND AND OBJECTIVES: Breast cancer is the most frequent neoplastic tumor in women, and surgical treatment is indicated in most patients. Complications related to this treatment, such as post-mastectomy pain syndrome (PMPS), a persistent pain that develops after surgery, have been reported. Although the genesis of the pain is multifactorial, sectioning of the intercostobrachial nerve is the nerve lesion diagnosed more often. The objective of this study was to review the etiopathogeny, diagnosis, presentation, aggravating or attenuating factors, and risk factors related with the post-mastectomy pain syndrome. CONTENTS: Provides the definition of the post-mastectomy pain syndrome and the knowledge to facilitate its diagnosis and prevention. CONCLUSIONS: The approach to patients undergoing surgery for breast cancer requires pre- and postoperative follow-up by a multidisciplinary team. This approach can provide a rational choice of surgical technique, identify patients with risk factors, minimize or eliminate risk factors whenever possible, diagnose beforehand the post-mastectomy pain syndrome, and provide adequate treatment to improve the quality of life for this specific patient population.



http://www.scielo.br/pdf/rba/v59n3/en_12.pdf



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

Detección y precauciones preoperatorias de HIV, VHB y VHV/Preop HIV, HBC and HCV

La detección universal frente a las precauciones universales en el contexto de la detección preoperatoria para el VIH, el VHB, el VHC en la India


Universal screening versus universal precautions in the context of preoperative screening for HIV, HBV, HCV in India.
Ahmed R, Bhattacharya S.
Indian J Med Microbiol [serial online] 2013 [cited 2013 Jul 25];31:219-25.


Abstract
In the Indian context, there is a convention of doing pre-operative screening for HIV, hepatitis B virus and hepatitis C viruses for all patients as a routine pre-intervention investigation. This approach is justified in some instances in the best interest of the patient. However, as routine screening is not the standard care internationally and as there is a significant divergence of views about the merits and demerits of this practice, this issue needs to be debated in a rational manner with an evidence-based approach. The present article is authored by a surgeon and a microbiologist from a new cancer care centre in eastern India, who has attempted to address this contentious issue. The various available options have been explored, and advantages and disadvantages of the different approach have been discussed. An algorithm for infection prevention and control has been presented so that surgeons and medical microbiologists could manage infection control challenges satisfactorily.
Keywords: HBV, HCV, HIV, pre-operative screening, universal precautions

http://www.ijmm.org/text.asp?2013/31/3/219/115623


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

¿El grosor del cartílago femoral puede utilizarse para detectar la severidad de la artrosis?

Blog de la Condroprotección has posted a new item, '¿El grosor del cartílago
femoral puede utilizarse para detectar la severidad de la artrosis?'

La medición del grosor del cartílago femoral, con el uso de la resonancia
magnética, ha aportado importantes conocimientos sobre las características de
la artrosis de rodilla. Sin embargo, este método de cuantificación presenta
una capacidad limitada para diferenciar entre los niveles de gravedad de la
enfermedad.

El objetivo de un estudio publicado en el Journal of [...]

You may view the latest post at
http://www.condroprotectores.es/el-grosor-del-cartilago-femoral-puede-utilizarse-para-detectar-la-severidad-de-la-artrosis/

¿El grosor del cartílago femoral puede utilizarse para detectar la severidad de la artrosis?

www.condroprotectores.es

La medición del grosor del cartílago femoral, con el uso de la resonancia magnética, ha aportado importantes conocimientos sobre 

Envejecimiento/Aging

Los telómeros en la investigación sobre envejecimiento


Hallmarks of telomeres in ageing research
JW Shay and WE Wright
University of Texas Southwestern Medical Center, Department of Cell Biology, Dallas, TX 75390-9039, USA
Journal of Pathology J Pathol 2007; 211: 114-123
Abstract
Telomeres are repetitive DNA sequences at the ends of linear chromosomes. Telomerase, a cellular reverse transcriptase, helps maintain telomere length in human stem cells, reproductive cells and cancer cells by adding TTAGGG repeats onto the telomeres. However, most normal human cells do not express telomerase and thus each time a cell divides some telomeric sequences are lost. When telomeres in a subset of cells become short (unprotected), cells enter an irreversible growth arrest state called replicative senescence. Cells in senescence produce a different constellation of proteins compared to normal quiescent cells. This may lead to a change in the homeostatic environment in a tissue-specific manner. In most instances cells become senescent before they can become cancerous; thus, the initial growth arrest induced by short telomeres may be thought of as a potent anti-cancer protection mechanism. When cells can be adequately cultured until they reach telomerebased replicative senescence, introduction of the telomerase catalytic protein component (hTERT) into telomerase-silent cells is sufficient to restore telomerase activity and extend cellular lifespan. Cells with introduced telomerase are not cancer cells, since they have not accumulated the other changes needed to become cancerous. This indicates that telomeraseinduced telomere length manipulations may have utility for tissue engineering and for dissecting the molecular mechanisms underlying genetic diseases, including cancer.
Keywords: ageing; cancer; telomeres; telomerase

http://www4.utsouthwestern.edu/cellbio/shay-wright/publications/J%20Pathology%202007.pdf




El envejecimiento biológico no es mas un problema sin resolver

Biological Aging Is No Longer an Unsolved Problem
LEONARD HAYFLICK
Department of Anatomy, University of California, San Francisco, School
of Medicine, The Sea Ranch, California 95497, USA
Ann. N.Y. Acad. Sci. 1100: 1-13 (2007). C 2007 New York Academy of Sciences. doi: 10.1196/annals.1395.001

ABSTRACT: The belief that aging is still an unsolved problem in biology is no longer true. Of the two major classes of theories, the one class that is tenable is derivative of a single common denominator that results in only one fundamental theory of aging. In order to address this complex subject, it is necessary to first define the four phenomena that characterize the finitude of life. These phenomena are aging, the determinants of longevity, age-associated diseases, and death. There are only two fundamental ways in which age changes can occur. Aging occurs either as the result of a purposeful program driven by genes or by events that are not guided by a program but are stochastic or random, accidental events. The weight of evidence indicates that genes do not drive the aging process but the general loss of molecular fidelity does. Potential longevity is determined by the energetics of all molecules present at and after the time of reproductive maturation. Thus, every molecule, including those that compose the machinery involved in turnover, replacement, and repair, becomes the substrate that experiences the thermodynamic instability characteristic of the aging process. However, the determinants of the fidelity of all molecules produced before and after reproductive maturity are the determinants of longevity. This process is governed by the genome. Aging does not happen in a vacuum. Aging must be the result of changes that occur in molecules that have existed at one time with no age changes. It is the state of these pre-existing molecules that governs longevity determination. The distinction between the aging process and age-associated disease is not only based on the molecular definition of aging described above but it is also rooted in several practical observations. Unlike any disease, age changes (a) occur in every multicellular animal that reaches a fixed size at reproductive maturity, (b) cross virtually all species barriers, (c) occur in all members of a species only after the age of reproductive maturation, (d) occur in all animals removed from the wild and protected by humans even when that species probably has not experienced aging for thousands or even millions of years, (e) occur in virtually all animate and inanimate matter, and (f) have the same universal molecular etiology, that is, thermodynamic instability. Unlike aging, there is no disease or pathology that shares these six qualities. Because this critical distinction is poorly understood, there is a continuing belief that the resolution of age-associated diseases will advance our understanding of the fundamental aging process. It will not. The distinction between disease and aging is also critical for establishing science policy because although policy makers understand that the funding of research on age-associated diseases is an unquestioned good, they also must understand that the resolution of age-associated diseases will not provide insights into understanding the fundamental biology of age changes. They often believe that it will and base decisions on that misunderstanding. The impact has been to fund research on age-associated diseases at several orders of magnitude greater than what is available for research on the biology of aging. There is an almost universal belief by geriatricians and others that the greatest risk factor for all of the leading causes of death is old age. Why then are we not devoting significantly greater resources to understanding more about the greatest risk factor for every age-associated pathology by attempting to answer this fundamental question-"What changes occur in biomolecules that lead to the manifestations of aging at higher orders of complexity and then increase vulnerability to all age-associated pathology?"
KEYWORDS: aging; age-associated disease; longevity


http://ibgwww.colorado.edu/pdf/hayflick_1.pdf





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

Más sobre dolor en cáncer de mama/More on breast cancer pain

Más sobre dolor en cáncer de mama/More on breast cancer pain

Prevalencia y factores asociados con el dolor persistente después de cirugía oncológica de mama


Prevalence of and factors associated with persistent pain following breast cancer surgery.
Gärtner R, Jensen MB, Nielsen J, Ewertz M, Kroman N, Kehlet H.
Department of Breast Surgery, Rigshospitalet 2101, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. runegartner@gmail.com
JAMA. 2009 Nov 11;302(18):1985-92. doi: 10.1001/jama.2009.1568.
Abstract
CONTEXT: Persistent pain and sensory disturbances following surgical treatment for breast cancer is a significant clinical problem. The pathogenic mechanisms are complex and may be related to patient characteristics, surgical technique, and adjuvant therapy. OBJECTIVE: To examine prevalence of and factors associated with persistent pain after surgical treatment for breast cancer. DESIGN, SETTING, AND PATIENTS: A nationwide cross-sectional questionnaire study of 3754 women aged 18 to 70 years who received surgery and adjuvant therapy (if indicated) for primary breast cancer in Denmark between January 1, 2005, and December 31, 2006. A study questionnaire was sent to the women between January and April 2008. MAIN OUTCOME MEASURES: Prevalence, location, and severity of persistent pain and sensory disturbances in 12 well-defined treatment groups assessed an average of 26 months after surgery, and adjusted odds ratio (OR) of reported pain and sensory disturbances with respect to age, surgical technique, chemotherapy, and radiotherapy. RESULTS: By June 2008, 3253 of 3754 eligible women (87%) returned the questionnaire. A total of 1543 patients (47%) reported pain, of whom 201 (13%) had severe pain, 595 (39%) had moderate pain, and 733 (48%) had light pain. Factors associated with chronic pain included young age (18-39 years: OR, 3.62; 95% confidence interval [CI], 2.25-5.82; P < .001) and adjuvant radiotherapy (OR, 1.50; 95% CI, 1.08-2.07; P = .03), but not chemotherapy (OR, 1.01; 95% CI, 0.85-1.21; P = .91). Axillary lymph node dissection (ALND) was associated with increased likelihood of pain (OR, 1.77; 95% CI, 1.43-2.19; P < .001) compared with sentinel lymph node dissection. Risk of sensory disturbances was associated with young age (18-39 years: OR, 5.00; 95% CI, 2.87-8.69; P < .001) and ALND (OR, 4.97; 95% CI, 3.92-6.30; P < .001). Pain complaints from other parts of the body were associated with increased risk of pain in the surgical area (P < .001). A total of 306 patients (20%) with pain had contacted a physician within the prior 3 months for pain complaints in the surgical area. CONCLUSION: Two to 3 years after breast cancer treatment, persistent pain and sensory disturbances remain clinically significant problems among Danish women who received surgery in 2005 and 2006.
http://jama.jamanetwork.com/article.aspx?articleid=184861




Efecto de la adición de clonidina a la bupivacaína local sobre el dolor agudo y crónico después de mastectomía
Effect of the addition of clonidine to locally administered bupivacaine on acute and chronic postmastectomy pain
Mohamed SA, Abdel-Ghaffar HS.
Department of Anesthesia and Intensive Care, Faculty of Medicine, South Egypt Cancer Institute, Assiut University, Egypt.
J Clin Anesth. 2013 Feb;25(1):20-7. doi: 10.1016/j.jclinane.2012.05.006.
Abstract
STUDY OBJECTIVES: To investigate the analgesic effect of adding clonidine to topical bupivacaine for acute and chronic postmastectomy pain. DESIGN: Randomized, prospective, double-blinded study. SETTING: Cancer institute and university hospital. PATIENTS: 140 ASA physical status 1 and II women, aged 30 to 50 years, scheduled for modified radical mastectomy with axillary dissection for breast carcinoma. INTERVENTIONS: Patients were divided into 4 groups of 35 patients each, to receive either saline 0. 9% (control group), plain bupivacaine 0.5% (Bupivacaine group), plain bupivacaine 0.5% and 150 μg of clonidine (Clonidine150 group), or plain bupivacaine 0.5% and 250 μg of clonidine (Clonidine250 group). Study drugs were irrigated into the surgical field before skin closure. MEASUREMENTS AND MAIN RESULTS: Pain severity, time to first request of rescue analgesia, analgesic consumption, hemodynamics, and side effects were recorded in the first 48 hours postoperatively. The frequency of neuropathic pain was assessed using the Douleur Neuropathique 4-question survey (DN4) in the first and second postoperative months. Mean time to first postoperative analgesic request was significantly prolonged in the Bupivacaine (5.76 ± 0.85 hrs), Clonidine150 (11.6 ± 2.38 hrs), and Clonidine250 (17.4 ± 3.27 hrs) groups compared with the control group (1.86 ± 0.65 hrs). Postoperative tramadol consumption and visual analog scores (VAS) were significantly reduced in the Bupivacaine, Clonidine150, and Clonidine250 groups. Clonidine250 group patients had the lowest VAS scores from 2 to 48 hours postoperatively. Lower mean DN4 scores (P = 0.000) and a significantly reduced frequency of neuropathic pain (P < 0.04) were recorded in the Bupivacaine, Clonidine150, and Clonidine250 groups, with a nonsignificant difference noted among the treatment groups. CONCLUSIONS:
The addition of clonidine to topical bupivacaine accentuated its early postoperative analgesic efficacy.


http://download.journals.elsevierhealth.com/pdfs/journals/0952-8180/PIIS0952818012003200.pdf


Síndrome de mama fantasma
Phantom breast syndrome.
Ramesh, Shukla NK, Bhatnagar S.
Department of Surgical Oncology, Dr. BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Indian J Palliat Care. 2009 Jul;15(2):103-7. doi: 10.4103/0973-1075.58453.
Abstract
Phantom breast syndrome is a type of condition in which patients have a sensation of residual breast tissue and can include both non-painful sensations as well as phantom breast pain. The incidence varies in different studies, ranging from approximately 30% to as high as 80% of patientsafter mastectomy. It seriously affects quality of life through the combined impact of physical disability and emotional distress. The breast cancerincidence rate in India as well as Western countries has risen in recent years while survival rates have improved; this has effectively increased the number of women for whom post-treatment quality of life is important. In this context, chronic pain following treatment for breast cancer surgery is a significantly under-recognized and under-treated problem. Various types of chronic neuropathic pain may arise following breast cancer surgery due to surgical trauma. The cause of these syndromes is damage to various nerves during surgery. There are a number of assumed factors causing or perpetuating persistent neuropathic pain after breast cancer surgery. Most well-established risk factors for developing phantom breast pain and other related neuropathic pain syndromes are severe acute postoperative pain and greater postoperative use of analgesics. Based upon current evidence, the goals of prophylactic strategies could first target optimal peri-operative pain control and minimizing damage to nerves during surgery. There is some evidence that chronic pain and sensory abnormalities do decrease over time. The main group of oral medications studied includes anti-depressants, anticonvulsants, opioids, N-methyl-D-asparate receptor antagonists, mexilitine, topical lidocaine, cannabinoids, topical capsaicin and glysine antagonists. Neuromodulation techniques such as motor cortex stimulation, spinal cord stimulation, and intrathecal drug therapies have been used to treat various neuropathic pain syndromes.
KEYWORDS: Breast cancer, Phantom breast syndrome, Quality of life

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902108/




Dolor y otros síntomas durante el primer año despues de cirugía conservadora y radical para cáncer de mama

Pain and other symptoms during the first year after radical and conservative surgery for breast cancer.
Tasmuth T, von Smitten K, Kalso E.
Department of Anaesthesia, Helsinki University Central Hospital, Finland.
Br J Cancer. 1996 Dec;74(12):2024-31.
Abstract
This study assessed pain, neurological symptoms, oedema of the ipsilateral arm, anxiety and depression occurring in women treated surgically forbreast cancer, the impact of these symptoms on daily life and how they evolved during the 1 year follow-up. Ninety-three consecutive patients with non-metastasised breast cancer who were treated during 1993-94 were examined before surgery and after 1, 6 and 12 months. They were asked about pain, neurological symptoms and oedema in the breast scar region and/or ipsilateral arm. Sensory testing was performed, and gripping force and the circumference of the arm were measured. Anxiety and depression were evaluated. One year after surgery, 80% of the women had treatment-related symptoms in the breast scar region and virtually all patients had symptoms in the ipsilateral arm. The incidence of chronic post-treatment painwas higher after conservative surgery than after radical surgery (breast area: 33% vs 17%, NS; ipsilateral arm: 23% vs 13%, NS). Numbness occurred in 75% and oedema of the ipsilateral arm in over 30% of the patients after both radical and conservative surgery. Phantom sensations in the breastwere reported by 25% of the patients. No difference in psychic morbidity was detected after the two types of surgery. Both the anxiety and depression scores were highest before surgery, decreasing with time, and were significantly correlated with preoperative stressful events.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2074824/pdf/brjcancer00028-0174.pdf



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

¿Las guías sobre eutanasia y suicidio asistido por médicos reflejan la ley en los hospitales y hospicios alemanes? Un análisis de contenido

¿Las guías sobre eutanasia y suicidio asistido por médicos reflejan la ley en los hospitales y hospicios alemanes? Un análisis de contenido


Do guidelines on euthanasia and physician-assisted suicide in Dutch hospitals and nursing homes reflect the law? A content analysis
B A M Hesselink,1 B D Onwuteaka-Philipsen,1 A J G M Janssen,2 H M Buiting,1
M Kollau,1 J A C Rietjens,3 H R W Pasman
J Med Ethics 2012;38:35e42. doi:10.1136/jme.2010.041020
ABSTRACT
To describe the content of practice guidelines on euthanasia and assisted suicide (EAS) and to compare differences between settings and guidelines developed before or after enactment of the euthanasia law in 2002 by means of a content analysis. Most guidelines stated that the attending physician is responsible for the decision to grant or refuse an EAS request. Due care criteria were described in the majority of guidelines, but aspects relevant for assessing these criteria were not
always described. Half of the guidelines described the role of the nurse in the performance of euthanasia. Compared with hospital guidelines, nursing home guidelines were more often stricter than the law in excluding patients with dementia (30% vs 4%) and incompetent patients (25% vs 4%). As from 2002, the guidelines were less strict in categorically excluding patients groups (32% vs 64%) and in particular incompetent patients (10% vs 29%). Healthcare institutions should accurately state the boundaries of the law, also when they prefer to set stricter boundaries for their own institution. Only then can guidelines provide adequate support for physicians and nurses in the difficult EAS decision-making process.
http://jme.bmj.com/content/38/1/35.full.pdf+html



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

CMO congreso Internacional. Artroscopia y Medicina del Fútbol, Cancún QR México, 2013

http://www.convention-center.net/artroscopia2013/