Bibliotecas. Alerta

Biblioteca
Notificaciones diarias ⋅ 29 de julio de 2014
NOTICIAS


El Universal

Biblioteca Nacional de México, el gran pendiente del siglo XXI
El Universal
La Biblioteca Nacional de México, que es el más valioso archivo bibliográfico nacional, el próximo 6 de agosto celebrará 80 años de estar bajo el ...


Biblioteca Palafoxiana será sede de la Reunión del Programa Memoria del Mundo
proceso.com.mx
La Biblioteca Palafoxiana de Puebla será sede de la XV Reunión Anual del Comité Regional para América Latina y el Caribe del Programa Memoria ...




Europa Press

Las bibliotecas de Málaga y Shanghái firman un convenio para promocionar las culturas española ...
Europa Press
Las bibliotecas de Málaga y la de Shanghái (China) han establecido un convenio de colaboración para el fomento de las culturas española y china.




Latercera

Biblioteca de Santiago celebra los 75 años de Batman con actividad gratuita
Latercera
La Biblioteca de Santiago celebrará este sábado 2 de agosto los 75 años de Batman, a través del evento gratuito Batman 75 Chile, que contará con ...




Diario Veloz

¿Biblioteca o tribunales? Pareja separada deberá leer el Principito a su hijo
Diario Veloz
También también tendrán que leerle la Convención de los Derechos del Niño y Etica para Amador. ¿Biblioteca o tribunales? Pareja separada deberá ...




EntornoInteligente

Biblioteca Nacional celebrará natalicio de Chávez con muestra fotográfica y bibliográfica
EntornoInteligente
ENTORNOINTELIGENTE.COM / La Biblioteca Nacional de Venezuela (BNV) celebrará este lunes 28 de julio, a partir de las 11 de la mañana, ...



Biblioteca de Miraflores ofrece obras literarias en Braille | El Comercio Perú
El Comercio
Dieciocho obras de literatura peruana e internacional en Braille, están ahora a disposición de los usuarios con discapacidad visual en la Biblioteca ...



La Biblioteca Central cierra hasta octubre por la reparación de la montera
Diario de Jerez
La reparación de la montera de la Biblioteca Central comenzará a ejecutarse a partir del próximo lunes 4 de agosto, una vez adjudicada la obra a la ...




Zacatecas en Línea

Bibliotecas municipales fomentan el acercamiento a la lectura en sus cursos de verano
El Sol de la Laguna - OEM
Torreón, Coahuila.- El programa "Mis Vacaciones en la Biblioteca", representa año con año una gran oportunidad para que los niños de Torreón ...




Europa Press

El Gobierno prevé un incremento "significativo" de los ingresos de laBiblioteca Nacional con el ...
Europa Press
El Gobierno prevé un "significativo" aumento de los ingresos de la Bliblioteca Nacional de España (BNE) gracias a la aprobación de la Ley ...


BLOGS

Telefónica impulsa la digitalización de los archivos de la Biblioteca Nacional con la firma de un

Think Big ⋅ Chema Amate
La Biblioteca Nacional y Telefónica continúan con su firme compromiso de que la cultura sea accesible para todo el mundo. Gracias al nuevo ...



Referencias en la Biblioteca Digital Cubana de Geociencias

Emilio Ichikawa ⋅ ei
(RC)-Una tercera versión de la Biblioteca Digital Cubana de Geociencias ya puede ser consultada en la dirección ...


WEB

San Juan de Arama: El pueblo que volvió a nacer gracias a su biblioteca pública
Biblioteca Nacional de Colombia
Luego de sufrir los rigores del conflicto armado del país, y de ver destruida su iglesia por “cilindros bomba”, esta población del Meta muestra con ...

Analgesia con ketamina en cesárea/Ketamine analgesia in C-Section

Efecto analgésico de dosis bajas de ketamina antes y después de cesárea


Analgesic effect of low dose subcutaneous ketamine administration before and after cesarean section.
Behaeen K, Soltanzadeh M, Nesioonpour S, Ebadi A, Olapour A, Aslani SM.
Iran Red Crescent Med J. 2014 Mar;16(3):e15506. doi: 10.5812/ircmj.15506. Epub 2014 Mar 5.
Abstract
BACKGROUND:Pain is considered as an importantissue after cesarean section. Multimodal approach to post cesarean pain management may not only enhance analgesia but also reduce side effects after the surgery. OBJECTIVES: This study was aimed to evaluate the clinical efficacy of subcutaneous injection of low dose ketamine at the incision site to reduce cesarean section pain. PATIENTS AND METHODS: Sixty patients, aged between 18 and 25 years old, scheduled for elective cesarean section, were enrolled to this double-blind randomized controlled trial study. Patients were divided into three groups of 20 patients each group one (k-pre) received 0.5 mg/kg ketaminebefore skin incision and normal saline after skin closure, group two (k-post) received normal saline before skin incision and 0.5 mg/kg ketamine after skin closure and group three (C) received normal saline before skin incision and after skin closure; subcutaneously at the incision site. The firstanalgesic request, the amount of analgesic and the pain intensity were evaluated for 24 hours. RESULTS: The first time analgesic requested was longer and the amount of analgesic used during the first 24 hours was significantly lower in groups K-pre and K-post compared with group C (P < 0.05). Pain intensity was significantly lower at 2, 4, 6 and 12 hours in groups K-pre and K-post compared with group C (P < 0.05). Nevertheless, pain intensity was not significantly different at 18 and 24 hours in group C (P > 0.05). The first requested time, total used amount of analgesicand pain intensity were not meaningfully different in K-pre and K-post groups (P > 0.05). CONCLUSIONS:Patients who were given ketamine before or after cesarean section subcutaneously at incision site had lower pain intensity and less analgesic consumption than patients who were given placebo.
KEYWORDS:Caesarean Section; Diclofenac; Ketamine; Pain, Postoperative
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005445/pdf/ircmj-16-15506.pdf



Evaluación del efecto analgésico de ketamina como aditivo de bupivacaína intratecal en cesárea


Evaluation of the analgesic effect of ketamine as an additive to intrathecal bupivacaine in patients undergoing cesarean section.
Khezri MB, Ghasemi J, Mohammadi N.
Acta Anaesthesiol Taiwan. 2013 Dec;51(4):155-60. doi: 10.1016/j.aat.2013.12.004. Epub 2014 Jan 21
Abstract
OBJECTIVE:Nowadays, conventional analgesic agents, which are widely used for pain relief after cesarean section, provide suboptimal analgesia with occasional serious side effects. We designed a randomized, double-blind, placebo-controlled study to evaluate the analgesic efficacy of intrathecal ketamine added to bupivacaine after cesarean section. METHODS:Sixty patients scheduled for cesarean section under spinal anesthesia were randomly allocated to one of the two groups to receive either bupivacaine 10 mg combined with 0.1 mg/kg ketamine, or bupivacaine 10 mg combined with 0.5 mL distilled water intrathecally. The time to the firstanalgesic request, analgesic requirement in the first 24 hours after surgery, onset times of sensory and motor blockades, the durations of sensory and motor blockades, and the incidences of adverse effects such as hypotension, ephedrine requirement, bradycardia, and hypoxemia, were recorded. RESULTS:Patients who received ketamine had a significantly prolonged duration of anesthesia compared with those who did not in the control group [95% confidence intervals (CI) 195-217; p = 0.001]. The mean time to the first analgesic request was also significantly longer in ketamine group (95% CI 252.5-275; p < 0.001). The total analgesic consumption in the 24 hours following surgery significantly lessened in the ketamine group compared with that of the control group (95% CI 2-2.5; p < 0.001). The two groups did not differ significantly in intraoperative and postoperative side effects. CONCLUSION:Intrathecal ketamine 0.1 mg/kg co-administered with spinal bupivacaine elongated the time to the first analgesic request and lessened the total analgesic consumption in the first 24 postoperative hours in comparison with bupivacaine alone in the control group following elective cesarean delivery.

http://www.e-aat.com/article/S1875-4597(13)00128-8/pdf

Efecto analgésico de ketamina iv durante raquia para operación cesárea

Analgesic Effects of Intravenous Ketamine during Spinal Anesthesia in Pregnant Women Undergone Caesarean Section; A Randomized Clinical Trial.
Behdad S, Hajiesmaeili MR, Abbasi HR, Ayatollahi V, Khadiv Z, Sedaghat A.
Anesth Pain Med. 2013 Sep;3(2):230-3. doi: 10.5812/aapm.7034. Epub 2013 Sep 1.
Abstract
BACKGROUND:Suitable analgesia after cesarean section helps mothers to be more comfortable and increases their mobility and ability to take better care of their infants. OBJECTIVES:Pain relief properties of ketamine prescription were assessed in women with elective cesarean section who underwent spinal anesthesia with low dose intravenous ketamine and midazolam and intravenous midazolam alone. PATIENTS AND METHODS:Sixty pregnant women scheduled for spinal anesthesia for cesarean section were randomized into two study groups.Ketamine (30 mg) + midazolam (1 mg = 2CC) or 1mg midazolam (2CC) alone, was given immediately after spinal anesthesia. Pain scores at first, second and third hours after CS operation, analgesic requirement and drug adverse effects were recorded in all patients. RESULTS: Ketamine group had significant pain relief properties in compare with control group in first hours after cesarean section (0.78 ± 1.09 vs. 1.72 ± 1.22, VAS score, P = 0.00). Total dose of meperidine consumption in women of ketamine group was significantly lower than women of control group (54.17 ± 12.86 vs. 74.44 ± 33.82 mg, P = 0.02). There were no significant drug side effects in participated patients. CONCLUSIONS: Intravenous low-dose ketamine combined with midazolam for sedation during spinal anesthesia for elective Caesarean section provides more effective and long lasting pain relief than control group.
KEYWORDS:Analgesia; Anesthesia, Spinal; Cesarean Section; Ketamine; Pain Clinics

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833040/pdf/aapm-03-230.pdf




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

http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=61013&origen=notiweb&dia_suplemento=jueves

Nacen más hombres zurdos en ciertos meses del año

Ellas, además, según el mismo estudio, cuentan con un mayor porcentaje de diestras que de zurdas. Los hombres nacidos en noviembre, diciembre o enero, meses tradicionalmente fríos en el hemisferio norte, donde se ha llevado a cabo esta investigación, tienen mayores probabilidades de ser zurdos que los nacidos durante el resto del año. Diversas tareas manuales en la vida cotidiana requieren el uso de la mano derecha o están optimizadas para los diestros. Alrededor de 9 de cada 10 personas de la población en general son diestras, y sólo 1 de cada 10 es zurda. El estudio de Ulrich Tran, Stefan Stieger y Martin Voracek, de la Universidad de Viena en Austria, se hizo sobre la base de dos muestras grandes e independientes de casi 13.000 adultos de Austria y Alemania. En total, el 7,5 por ciento de las mujeres y el 8,8 por ciento de los hombres eran zurdos. La sorpresa para los científicos vino al comprobar que este desequilibrio era debido en buena parte a que nacían más hombres zurdos durante noviembre, diciembre y enero. Como promedio mensual, el 8,2 por ciento de los hombres zurdos nacían durante el período de febrero a octubre. Durante el periodo de noviembre a enero, este número se elevó hasta un 10,5 por ciento. Estudios anteriores sobre el tema proporcionaron pruebas incongruentes y confusas. No había una indicación clara de qué estación tenía algún efecto, o si la estacionalidad afecta a hombres, mujeres o ambos sexos de igual manera. Según los hallazgos actuales, existe un efecto, pequeño pero claro y reproducible, de estacionalidad en el nacimiento como zurdo o diestro, que afecta sólo a hombres. Los resultados son coherentes con una base hormonal para el fenómeno, lo que corrobora una vieja y controvertida teoría. Sin embargo, la forma exacta en que esto se produce deberá ser investigada en estudios futuros.

neumonía adquirida en la comunidad

Estimados Pediatras la conferencia del Dr Elias Kassisse sobre neumonía adquirida en la comunidad
la verdad excelente la disfrute mucho anoche, véanla y el Dr Kassisse solicita retroalimentación y comentarios de su conferencia

Ciberpeds: http://bit.ly/KcJV5S

Conapeme: http://bit.ly/1mNqcpS
registro a conferencias: http://bit.ly/19ApWtR



henrys

Dr. Enrique Mendoza López
Webmaster: CONAPEME
Coordinador Nacional: Seminario Ciberpeds-Conapeme
Av La Clinica 2520-310 col Sertoma
Monterrey N.L. CP 64718
Tel (81) 83482940, (81) 83485701
Cel 0448183094806
www.pediatramendoza.com
www.conapeme.org
www.ciberpeds.org

Embarazo/Pregnancy

Embarazada con tumor cerebral. Revisando evidencias para obtener guías de manejo de los meningiomas intracraneales durante el embarazo

A pregnant female with a large intracranial mass: Reviewing the evidence to obtain management guidelines for intracranial meningiomas during pregnancy.
Kasper EM, Hess PE, Silasi M, Lim KH, Gray J, Reddy H, Gilmore L, Kasper B.
Surg Neurol Int. 2010 Dec 25;1:95. doi: 10.4103/2152-7806.74242.

Abstract
INTRODUCTION:Non-obstetric surgery for intracranial meningioma is uncommon during pregnancy and poses significant risks to both the mother and the fetus. We present a case of a parturient that presented with acute mental status changes and we illustrate the decision making process that resulted in a best-possible outcome. CASE DESCRIPTION: A woman at 29-week gestation presented with acute language and speech deficits and deteriorating mental status after 2 weeks of headache. Imaging demonstrated a large intracranial mass. A multidisciplinary meeting was held to determine the best treatment plan. The decision was to proceed with caesarean delivery under epidural anesthesia to allow intraoperative monitoring of neurological function. Six hours after successful delivery, the patient had acute mental status changes and she was taken to the operating room immediately for resection of her tumor, which turned out to be a clear cell meningioma. DISCUSSION: Cerebral meningioma is usually a slow-growing tumor; however, during pregnancy, the mass may expand rapidly due to hormonal receptor expression. The presentation of this patient would have normally led to urgent resection of the mass. But the complicating factor was her 29-week pregnancy as standard intraoperative treatment during neurosurgery is known to adversely affect the fetus. A multidisciplinary meeting was critical for this patient's care, and is recommended by us when treating such patients.
KEYWORDS: Caesarean delivery; meningioma; pregnancy; resection
http://www.surgicalneurologyint.com/downloadpdf.asp?issn=2152-7806;year=2010;volume=1;issue=1;spage=95;epage=95;aulast=Kasper;type=2




Guías 2010 de la CCS para el diagnóstico y manejo de falla cardiaca: Minorias étnicas, Embarazo, manejo de la enfermedad, y mejoría de la calidad¨


The 2010 Canadian Cardiovascular Society guidelines for the diagnosis and management of heart failure update: Heart failure in ethnic minority populations, heart failure and pregnancy, disease management, and quality improvement/assurance programs.
Howlett JG, McKelvie RS, Costigan J, Ducharme A, Estrella-Holder E, Ezekowitz JA, Giannetti N, Haddad H, Heckman GA, Herd AM, Isaac D, Kouz S, Leblanc K, Liu P, Mann E, Moe GW, O'Meara E, Rajda M, Siu S, Stolee P, Swiggum E, Zeiroth S; Canadian Cardiovascular Society.
Can J Cardiol. 2010 Apr;26(4):185-202.
Abstract
Since 2006, the Canadian Cardiovascular Society heart failure (HF) guidelines have published annual focused updates for cardiovascular care providers. The 2010 Canadian Cardiovascular Society HF guidelines update focuses on an increasing issue in the western world - HF in ethnic minorities - and in an uncommon but important setting - the pregnant patient. Additionally, due to increasing attention recently given to the assessment of how care is delivered and measured, two critically important topics - disease management programs in HF and quality assurance - have been included. Both of these topics were written from a clinical perspective. It is hoped that the present update will become a useful tool for health care providers and planners in the ongoing evolution of care for HF patients in Canada.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886538/



Abordar la obesidad en el embarazo: ¿Qué recomiendan los proveedores obstétricos?

Addressing obesity in pregnancy: what do obstetric providers recommend?
Herring SJ, Platek DN, Elliott P, Riley LE, Stuebe AM, Oken E.
J Womens Health (Larchmt). 2010 Jan;19(1):65-70. doi: 10.1089/jwh.2008.1343.
Abstract
OBJECTIVE: Maternal obesity is associated with adverse pregnancy outcomes. To improve outcomes, obstetric providers must effectively evaluate and manage their obese pregnant patients. We sought to determine the knowledge, attitudes, and practice patterns of obstetric providers regarding obesity in pregnancy. METHODS: In 2007-2008, we surveyed 58 practicing obstetricians, nurse practitioners, and certified nurse-midwives at a multispecialty practice in Massachusetts. We administered a 26-item questionnaire that included provider self-reported weight, sociodemographic characteristics, knowledge, attitudes, and management practices. We created an 8-point score for adherence to 8 practices recommended by the American College of Obstetricians and Gynecologists (ACOG) for the management of obese pregnant women. RESULTS: Among the respondents, 37% did not correctly report the minimum body mass index (BMI) for diagnosing obesity, and most reported advising gestational weight gains that were discordant with 1990 Institute of Medicine (IOM) guidelines, especially for obese women (71%). The majority of respondents almost always recommended a range of weight gain (74%), advised regular physical activity (74%), or discussed diet (64%) with obese mothers, but few routinely ordered glucose tolerance testing during the first trimester (26%), planned anesthesia referrals (3%), or referred patients to a nutritionist (14%). Mean guideline adherence score was 3.4 (SD 1.9, range 0-8). Provider confidence (beta = 1.0, p = 0.05) and body satisfaction (beta = 1.5, p = 0.02) were independent predictors of higher guideline adherence scores. CONCLUSIONS: Few obstetric providers were fully compliant with clinical practice recommendations, defined obesity correctly, or recommended weight gains concordant with IOM guidelines. Provider personal factors were the strongest correlates of self-reported management practices. Our findings suggest a need for more education around BMI definitions and weight gain guidelines, along with strategies to address provider personal factors, such as confidence and body satisfaction, that may be important predictors of adherence to recommendations for managing obese pregnant women.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828196/pdf/jwh.2008.1343.pdf






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

http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=61211&origen=notiweb&dia_suplemento=lunes

Estudian nuevas técnicas para la descontaminación de las aguas residuales industriales

El proyecto se encuentra actualmente en el ecuador de su desarrollo; por parte de la UPV participan el Grupo de Procesos de Oxidación Avanzada del campus de Alcoy y el Instituto de Tecnología Química (UPV-CSIC). Según destacan los investigadores, a día de hoy las principales fuentes de contaminación de las aguas son las actividades industriales. "Más de un 80% de los residuos peligrosos del mundo se producen en los países industrializados, mientras que en las naciones en vías de desarrollo un 70% de los residuos industriales se vierten al agua sin ningún tipo de tratamiento previo, contaminando así los recursos hídricos", apunta Ana Amat, investigadora del campus de Alcoy de la Universitat Politècnica de València. El proyecto Aquafotox se centra en las aguas procedentes de la industria del corcho y en los lixiviados de vertedero. El objetivo de los investigadores es ofrecer un nuevo tratamiento que permita degradar los contaminantes de ambos, en un tiempo y con un coste reducido y obtener así un efluente de mayor calidad y menor impacto ambiental. Para ello, están analizando la utilidad de nuevos tratamientos aplicando fotocatálisis solar-aprovechar la luz solar para la depuración de las aguas- u ozono. Actualmente, en el Campus de Alcoy se evalúan 30 tratamientos diferentes -15 con luz solar y otros 15 con ozono- con el objetivo de determinar cuál sería el más adecuado para la detoxificación de estas aguas y su posible aplicación industrial, en la PSA se investiga la optimización del tratamiento con aguas reales en planta piloto y en el ITQ se realizan los estudios mecanísticos de estos procesos . "Desarrollamos exhaustivos estudios biológicos de toxicidad con biomarcadores para analizar su incidencia en algas, crustáceos, bacterias, gusanos de tierra y peces. Analizamos cada muestra de agua sometida al proceso de detoxificación y, a partir de los resultados obtenidos, valoramos su idoneidad para mejorar la calidad de efluente tratado y, por tanto, reducir el impacto sobre estas y otras especies una vez se vierte. Los biomarcadores permiten prever los efectos dañinos y el estado de salud como una señal potencial de alteraciones a largo plazo, como carcinogénesis, disminución de la capacidad reproductiva, etc.", concluye Ana Amat.

Predictores de vía aérea/Airway predictors

Validation of modified Mallampati test with addition of thyromental distance and sternomental distance to predict difficult endotracheal intubation in adults. Patel B, Khandekar R, Diwan R, Shah A. Indian J Anaesth. 2014 Mar;58(2):171-5. doi: 10.4103/0019-5049.130821. Abstract BACKGROUND AND AIMS:Intubation is often a challenge for anaesthesiologists. Many parameters assist to predict difficult intubation. The present study was undertaken to assess the validity of different parameters in predicting difficult intubation for general anaesthesia (GA) in adults and effect of combining the parameters on the validity.METHODS:The anaesthesiologist assessed oropharynx of 135 adult patients. Modified Mallampati test (MMT) was used and the thyromentaldistance (TMD) and sternomental distances (SMD) for each of the patients were also measured. The Cormack and Lehane laryngoscopic grading was assessed following laryngoscopy. The validity parameters such as sensitivity, specificity, false positive and negatives values, positive and negative predictive values were calculated. The effect of combining different measurements on the validity was also studied. Univariate analysis was performed using the parametric method. RESULTS:The study group comprised of 135 patients. The sensitivity and specificity of MMT were 28.6% and 93%, respectively. The TMD (<6.5 CM) had sensitivity and specificity of 100% and 75.8%, respectively. The SMD (<12.5 CM) had sensitivity and specificity of 91% and 92.7%, respectively. Combination of MMT grading and TMD and SMD measurements increased the validity (sensitivity of 100% and specificity of 92.7%).CONCLUSION:MMT had high specificity. The validity of combination of MMT, SMD and TMD as compared to MMT alone was very high in predicting difficult intubation in adult patients. All parameters should be used in assessing an adult patient for surgery under GA. KEYWORDS:Anaesthesia; endotracheal intubation; modified Mallampatti test; validity  http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2014;volume=58;issue=2;spage=171;epage=175;aulast=Patel;type=2 Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Biblioteca. Alarma

Biblioteca
Notificaciones diarias ⋅ 20 de julio de 2014
NOTICIAS

La biblioteca de Mondariz lleva 7 años cerrada y está provisional en otro edificio
La Voz de Galicia
La biblioteca municipal de Mondariz sigue estando cerrada al público desde hace siete años y pendiente de una reforma integral para la que no hay ...



Alta satisfacción de los usuarios sobre el servicio de biblioteca
Diario Vasco
Los usuarios de la biblioteca Juan San Martin de Eibar muestran un elevado grado de satisfacción por los servicios ofrecidos y la forma de funcionar ...



Dan banderazo en Ascensión a 'Mis vacaciones en la biblioteca'
Diario Digital Juárez
Este lunes dio inicio la actividad “Mis vacaciones en la biblioteca” dando el banderazo de arranque el Presidente Municipal Sergio González Sarabia ...



La biblioteca cumple 40 años
La Opinión de Murcia
L. O. La biblioteca de San Javier está preparando su 40 aniversario y entre otras iniciativas ha puesto en marcha la recogida de historias personales ...




Aporrea.org

Ortega Díaz: Leopoldo López tiene en su celda “biblioteca, computadora, Blu-ray y una jaula con ...
Aporrea.org
Explicó que igualmente se verificó el espacio en el que permanece recluido el mencionado ciudadano, el cual “tiene una poltrona, una biblioteca, ...
Ortega Díaz: Leopoldo López tiene en su celda “biblioteca, computadora, Blu-ray y una jaula con ...- Alba Ciudad 96.3 FM
Cobertura total de la noticia



Borja Sánchez expone su muestra 'Intrínseco' en la biblioteca municipal
Sur Digital (Andalucía)
Las instalaciones de la biblioteca municipal de la Villa acogen la exposición 'Intrínseco', una introspectiva del ser humano realizada por el artista ...



Cuentacuentos estivales en la Biblioteca Pública
El Periódico Extremadura
EL PUBLICO infantil tiene una cita semanal en la biblioteca. Durante todo el verano se desarrollarán dos ciclos de cuentacuentos: Gazpacho de ...




Vanguardia Liberal

Llega la novedosa colección de libros a la Antonia Santos
Vanguardia Liberal
Un total de 678 libros fueron donados por el Ministerio de Cultura y la Biblioteca Nacional, las cuales están a disposición de la comunidad educativa, ...



Inician talleres en las bibliotecas
El Siglo de Torreón
El día de mañana lunes 21 de julio, arranca en las tres bibliotecas públicas del municipio de San Pedro, el programa Mis vacaciones en la biblioteca, ...




La Verdad de Tamaulipas

Invertirán15 mdp en remodelar plaza principal de Reynosa
Milenio.com
El alcalde de la ciudad fronteriza, José Elías Leal informó que entre otros proyectos se contempla la remodelación de la biblioteca principal y la calle ...


BLOGS

Biblioteca Nacional recibió 1.250 libros de la Gran Misión Vivienda Venezuela

Alba Ciudad 96.3 FM ⋅ Luigino Bracci
En el marco de la celebración del 181° Aniversario de la creación de la primera biblioteca pública de Caracas, el Ministerio del Poder Popular para la ...



“Mis vacaciones en la Biblioteca” en todo el estado

Noticias de Guanajuato | IGETEO Seamos uno ⋅ Igeteo Cultura
Guanajuato, Gto. 19 de julio de 2014.- El pasado viernes inició el programa “Mis vacaciones en la Biblioteca” en todas las bibliotecas de la entidad.


WEB

Homenaje a Noé Jitrik
Biblioteca Nacional | Agenda
La Asociación Argentina de Retórica rinde homenaje a la trayectoria del crítico, escritor e investigador argentino, Noé Jitrik. Reconocido ...



Registro
Gobierno de Navarra
Crónicas irreales del Reyno de Navarra / Mikel Zuza Viniegra ; [ilustraciones, José Luis Blanco Aguirre]. Editorial: Donostia : Ttarttalo, [2008].

Predictores de vía aérea/Airway predictors

La sensibilidad del signo de impresión de la palma en la predicción de laringoscopia difícil en la diabetes. Comparación con otros índices de vía aérea


Sensitivity of palm print sign in prediction of difficult laryngoscopy in diabetes: A comparison with other airway indices.
Hashim K, Thomas M.
Indian J Anaesth. 2014 May;58(3):298-302. doi: 10.4103/0019-5049.135042.
Abstract
BACKGROUND AND AIMS: Diabetic patients are prone for the limited joint mobility syndrome. The atlanto-occipital joint involvement limits adequate extension of head and neck during laryngoscopy making intubation difficult. The collagen glycosylation starts in the fourth and fifth inter-phalangeal joints. The degree of inter-phalangeal involvement can be assessed by scoring the ink impression made by the palm of the dominant hand (palm print [PP] sign) The aim of our study was to evaluate the PP sign as a screening tool for predicting difficult laryngoscopy in diabetic patients. METHODS:A total of 60 diabetic patients undergoinggeneral anaesthesia with endotracheal intubation were assessed pre-operatively for their airway indices using the modified Mallampati test, thyromental distance, degree of head extension, the PP test and the prayer sign and their corresponding Cormack-Lehane scores were noted. Statistical analysis was performed using Fischer exact test. RESULTS: Of the 60 patients, 15 had positive PP sign. Of the 13 difficult laryngoscopies encountered, 10 patients had a positive PP sign. PP sign was the most sensitive index in predicting difficult laryngoscopy. P =0.000 was obtained and considered as statistically significant. The sensitivity was 76.9%, specificity 89.4%, positive and negative predictive value 71.4% and 91.3% and accuracy 86.7%, respectively. The other signs were not significant in predicting difficult laryngoscopy.CONCLUSION:The PP test appears to be the most sensitive and specific in the prediction of difficult laryngoscopy in diabetic patients.
KEYWORDS:Diabetes; difficult intubation; limited joint mobility
http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2014;volume=58;issue=3;spage=298;epage=302;aulast=Hashim;type=2



Características anatómicas del cuello como marcadores predictivos de dificultad para laringoscopia directa en los hombres y las mujeres: un estudio prospectivo.

Anatomic features of the neck as predictive markers of difficult direct laryngoscopy in men and women: A prospective study.
Chara L, Eleftherios V, Maria M, Anastasia T, Chryssoula S.
Indian J Anaesth. 2014 Mar;58(2):176-82. doi: 10.4103/0019-5049.130822.
Abstract
BACKGROUND AND AIMS: Difficult airway assessment is based on various anatomic parameters of upper airway, much of it being concentrated on oral cavity and the pharyngeal structures. The diagnostic value of tests based on neck anatomy in predicting difficult laryngoscopy was assessed in this prospective, open cohort study.
METHODS: We studied 341 adult patients scheduled to receive general anaesthesia. Thyromental distance (TMD), sternomental distance (STMD), ratio of height to thyromental distance (RHTMD) and neck circumference (NC) were measured pre-operatively. The laryngoscopic view was classified according to the Cormack-Lehane Grade (1-4). Difficult laryngoscopy was defined as Cormack-Lehane Grade 3 or 4. The optimal cut-off points for each variable were identified by using receiver operating characteristic analysis. Sensitivity, specificity and positive predictive value and negative predictive value (NPV) were calculated for each test. Multivariate analysis with logistic regression, including all variables, was used to create a predictive model. Comparisons between genders were also performed. RESULTS: Laryngoscopy was difficult in 12.6% of the patients. The cut-off values were: TMD ≤7 cm, STMD ≤15 cm, RHTMD >18.4 and NC >37.5 cm. The RHTMD had the highest sensitivity (88.4%) and NPV (95.2%), while TMD had the highest specificity (83.9%). The area under curve (AUC) for the TMD, STMD, RHTMD and NC was 0.63, 0.64, 0.62 and 0.54, respectively. The predictive model exhibited a higher and statistically significant diagnostic accuracy (AUC: 0.68, P < 0.001). Gender-specific cut-off points improved the predictive accuracy of NC in women (AUC: 0.65). CONCLUSIONS: The TMD, STMD, RHTMD and NC were found to be poor single predictors of difficult laryngoscopy, while a model including all four variables had a significant predictive accuracy. Among the studied tests, gender-specific cut-off points should be used for NC.
KEYWORDS:Height-to-thyromental distance ratio; laryngoscopy; neck circumference; sternomental distance; thyromental distance

http://www.ijaweb.org/downloadpdf.asp?issn=0019-5049;year=2014;volume=58;issue=2;spage=176;epage=182;aulast=Chara;type=2


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

CardiomiopatÍa y anestesia

Cardiomiopatia y anestesia
http://ceaccp.oxfordjournals.org/content/9/6/189.full.pdf



Quimioterapia anticáncer y sus implicaciones en anestesia

Anticancer Chemotherapy and it's Anaesthetic Implications(Current Concepts)
http://medind.nic.in/iad/t09/i1/iadt09i1p18.pdf



Consideraciones anestésicas en pacientes con cardiomiopatías

ANESTHETIC CONSIDERATIONS IN PATIENTS WITH CARDIOMYOPATHIES
http://www.meja.aub.edu.lb/downloads/20_3/p347_354.pdf



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

Neumonía adquirida en la comunidad abordaje práctico

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 30 de Julio 2014 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: 

“Neumonía adquirida en la comunidad abordaje práctico”

 por “Dr. Elias Kassisse”, Neumólogo Pediatra, de Venezuela. 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/neumonia_comunidad/
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

Biblioteca
Notificaciones diarias ⋅ 25 de julio de 2014
NOTICIAS

La Biblioteca Santa Ana abre al público con 5.000 fondos bibliográficos
ABC.es
La Biblioteca Pública Municipal Santa Ana de Badajoz ha abierto esta mañana sus puertas, en el edificio rehabilitado que durante muchos años ...




Región Digital

La biblioteca de Santa Ana de Badajoz abre con 5.500 títulos y 78 puestos de lectura
El Periódico Extremadura
La Biblioteca de Santa Ana ya está abierta. Desde ayer, los ciudadanos que lo deseen tienen a su disposición más de 5.500 títulos, 47 referencias de ...



La biblioteca Rafael Azcona, "cerrada y con deficiencias"
Rioja2.com
El concejal del PSOE en el Ayuntamiento de Logroño, Carlos Navajas, criticó ayer el cierre de la Biblioteca Municipal Rafael Azcona durante el ...




Radio Santa Fe

Polémica por nombre de biblioteca deportiva en El Campín
Terra Colombia
BibloRed, de la Secretaría de Cultura, Recreación y Deporte, lanzó un concurso en línea para darle nombre a la biblioteca que se abrió en el estadio ...



La Biblioteca de Valdeluz triplica su superficie
Guadaque
Esta mañana se ha restablecido la normalidad en la biblioteca municipal de Valdeluz tras permanecer cerrada al público durante una semana.



La Biblioteca María Moliner y el Archivo Municipal reciben una donación de fondos privados
La Verdad
El Archivo municipal de Orihuela y la Biblioteca María Moliner han recibido una donación por parte de los herederos de Mariano Sevilla. Estos han ...




El Acontecer Diario

Se reinauguró Biblioteca Plamaguay en nuevo local frente a Plaza Artigas
El Acontecer Diario
Una biblioteca es esencialmente un punto donde se adquiere conocimiento, además de ser un punto de encuentro. Adquirir conocimientos no va a ...



Se inauguró la biblioteca del Consejo de Lonkos
InfoPico.com
Esta jornada se enmarca dentro de las actividades entre el Consejo de Lonkos y el Consejo Provincial Aborigen, en conmemoración del Día del ...



Biblioteca Digital Telmex en Durango
Uno TV Noticias
En la dinámica de la Biblioteca Digital de Fundación Telmex, cuyo acceso es totalmente gratuito, entran grupos de 30 personas cada 30 minutos.



Tintas de puño y letra: Biblioteca Nacional anuncia la creación de su propio sello editorial
Latercera
En octubre pasado, la jefa del Departamento de Cultura y Comunicaciones de la Biblioteca Nacional, Daniela Correa, quiso retomar la antigua ...


BLOGS

Movistar ofrece a sus clientes de Fusión acceso gratis a la biblioteca online de Nubico durante un ...

Xataka On ⋅ P. Rodriguez
Movistar ha anunciado una nueva promoción para sus clientes de Fusión y móvil que consiste en acceso gratuito al catálogo de libros digitales...



Comentarios

Novedades BNM ⋅ Equipo Procesos Técnicos
Historia y bibliotecas: Mariano José de Arce. Mariano José de Arce. Nació en Arequipa, Perú en 1781 y falleció en Lima, en 1852. Fue sacerdote ...



Biblioteca Nacional: desculturizar la cultura

Kabila ⋅ RGAlmazán
Naturalmente, hoy a los 58 bibliotecarios de la empresa Ever Team Spain que llevaban haciendo este trabajo durante años en la Biblioteca, les ha ...


WEB

Leer más
Biblioteca Nacional | Agenda
Durante las vacaciones de invierno la Biblioteca Nacional propone teatro en el Auditorio Borges con la Compañía La Chicharra. Teatro Espontáneo.



Biblioteca Pública Municipal Santa Ana
Ayuntamiento de Badajoz
La Biblioteca de Santa Ana es concebida desde su creación como cabecera de la Red de Bibliotecas Municipales del Ayuntamiento de Badajoz.



Semana del Cine Colombiano en BibloRed
Red Capital de Bibliotecas Públicas
La Red Capital de Bibliotecas Públicas – BibloRed de la Secretaría de Cultura, Recreación y Deporte (SCRD), será escenario de la quinta versión de ...



Jornadas académicas 60 años de la Televisión colombiana
Biblioteca Nacional de Colombia
Jornadas académicas 60 años de la Televisión, en la Biblioteca Nacional. La Radio Televisión Nacional de Colombia y la Fundación Patrimonio ...

La vía aérea es siempre una incógnita a la que todo médico se enfrenta con frecuencia variable. Normal o difícil, es un reto que debemos de manejar en forma correcta. Hoy se inicia una serie de envios con información elemental y novedosa de los índices predictivos que se deben de utilizar al evaluar la vía aérea de cada paciente. Deseamos le sean de utilidad. The airway is always a question to which every physician faces with varying frequency. Normal or difficult, it is a challenge we must handle properly. Today we start several e-mails with basic and fresh information of predictive indexes, that must be used to assess each patient's airway. We hope you find them useful. راه هوایی یک سوال که هر پزشک با فرکانس های مختلف مواجه است همیشه. عادی یا دشوار است، آن را یک چالش ما باید به درستی رسیدگی است. امروز تعدادی از ابتدایی و تازه با اطلاعات جدید از شاخص های پیش بینی شده است که باید به ارزیابی راه هوایی شروع می شود هر بیمار استفاده می شود. ما امیدواریم که شما پیدا کردن آنها مفید است. Validez de los predictores de vía aérea en pacientes externos Validity of airway predictors in outpatient medicine. Mateos Rodríguez A, Navalpotro Pascual J, Pardillos Ferrer L, Fernández Domínguez J, Barragán Chávez J, Martínez González E. An Sist Sanit Navar. 2014 Jan-Apr;37(1):91-8. Abstract Isolation of the airway sometimes determines the survival or death of the patient. To anticipate the presence of a difficult airway (DA) there are a number of indicators that are validated for hospitals: Mallampati, sternum and thyromental distance, interdental distance and Cormack grade. The aim of this study is to evaluate the use of these indicators in the ambulatory setting and to know the incidence of DA. This data was collected from 324 intubations. Most patients were males (65.2%). The average age of the population was 63 years and no significant difference in age between DA and DA was found. A DA presence of 20.7% was objectified and an alternative device utilization of 21.4%. The thyromental distance was abnormal in 59% of patients and sternomentonal distance in 56.4% but neither showed an association with the presence of DA (p = 0.681 and p = 0.415 respectively). Interdental distance was less than 3 cm if presence is associated with DA (p = 0.005). The sensitivity and specificity of all measures are low. According to our series the sternum and thyromental distance are not useful in the ambulatory setting, but interdental distance is useful for predicting a DA. http://recyt.fecyt.es/index.php/ASSN/article/view/23289/15545 Predicción de laringoscopía difícil. Puntuación de Mallampati extendida versus MMT, ULBT y RHTDM Mallampati Extended puntuación frente al MMT, ULBT y RHTMD. Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD. Safavi M, Honarmand A, Amoushahi M. Adv Biomed Res. 2014 May 28;3:133. doi: 10.4103/2277-9175.133270. eCollection 2014. Abstract BACKGROUND:Preoperative using of anatomical landmarks detects potentially difficult laryngoscopies. The main object of the present study was to evaluate the predictive power of Extended Mallampati Score (EMS) in comparison with modified Mallampati test (MMT), the ratio of height tothyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT) in isolation and combination. MATERIALS AND METHODS:Four hundred seventy sixadult patients who candidate for elective surgery under general anesthesia requiring endotracheal intubation were included in this study and evaluated based of all four factors before surgery. This study was randomized prospective double - blind. After that, laryngoscopy was performed by an anesthesiologist who didn't involve in preoperative airway assessment and graded based on Cormack and Lehane's classification. We calculated sensitivity, specificity, and area under receiver-operating characteristic (ROC) (AUC) for each score. RESULTS:The AUCof the ROC was significantly more for the ULBT (AUC = 0.820, P = 0.049) and RHTMD score (AUC = 0.845, P = 0.033) than the EMS (AUC = 0.703). This variable was significantly higher for the EMS compared with MMT (0.703 vs. 0.569, P = 0.046 respectively). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score (P = 0.685). The optimalcut-off point for the RHTMD for predicting difficult laryngoscopy was 29.3. CONCLUSION:EMS predicted difficult laryngoscopy better than MMT while both ULBT and RHTMD had more power than EMS and MMT in this regard. ULBT and RHTMD had similar predictive value for prediction of difficult laryngoscopy in general population. KEYWORDS: Difficult laryngoscopy; extended mallampati score; modified mallampati; ratio of patient's height to thyromental distance; upper lip bite test http://www.advbiores.net/downloadpdf.asp?issn=2277-9175;year=2014;volume=3;issue=1;spage=133;epage=133;aulast=Safavi;type=2 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063103/ Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

La vía aérea es siempre una incógnita a la que todo médico se enfrenta con frecuencia variable. Normal o difícil, es un reto que debemos de manejar en forma correcta. Hoy se inicia una serie de envios con información elemental y novedosa de los índices predictivos que se deben de utilizar al evaluar la vía aérea de cada paciente. Deseamos le sean de utilidad.

The airway is always a question to which every physician faces with varying frequency. Normal or difficult, it is a challenge we must handle properly. Today we start several e-mails with basic and fresh information of predictive indexes, that must be used to assess each patient's airway. We hope you find them useful.

راه هوایی یک سوال که هر پزشک با فرکانس های مختلف مواجه است همیشه. عادی یا دشوار است، آن را یک چالش ما باید به درستی رسیدگی است. امروز تعدادی از ابتدایی و تازه با اطلاعات جدید از شاخص های پیش بینی شده است که باید به ارزیابی راه هوایی شروع می شود هر بیمار استفاده می شود. ما امیدواریم که شما پیدا کردن آنها مفید است.


Validez de los predictores de vía aérea en pacientes externos


Validity of airway predictors in outpatient medicine.
Mateos Rodríguez A, Navalpotro Pascual J, Pardillos Ferrer L, Fernández Domínguez J, Barragán Chávez J, Martínez González E.
An Sist Sanit Navar. 2014 Jan-Apr;37(1):91-8.
Abstract
Isolation of the airway sometimes determines the survival or death of the patient. To anticipate the presence of a difficult airway (DA) there are a number of indicators that are validated for hospitals: Mallampati, sternum and thyromental distance, interdental distance and Cormack grade. The aim of this study is to evaluate the use of these indicators in the ambulatory setting and to know the incidence of DA. This data was collected from 324 intubations. Most patients were males (65.2%). The average age of the population was 63 years and no significant difference in age between DA and DA was found. A DA presence of 20.7% was objectified and an alternative device utilization of 21.4%. The thyromental distance was abnormal in 59% of patients and sternomentonal distance in 56.4% but neither showed an association with the presence of DA (p = 0.681 and p = 0.415 respectively). Interdental distance was less than 3 cm if presence is associated with DA (p = 0.005). The sensitivity and specificity of all measures are low. According to our series the sternum and thyromental distance are not useful in the ambulatory setting, but interdental distance is useful for predicting a DA.
http://recyt.fecyt.es/index.php/ASSN/article/view/23289/15545






Predicción de laringoscopía difícil. Puntuación de Mallampati extendida versus MMT, ULBT y RHTDM

Mallampati Extended puntuación frente al MMT, ULBT y RHTMD.
Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD.
Safavi M, Honarmand A, Amoushahi M.
Adv Biomed Res. 2014 May 28;3:133. doi: 10.4103/2277-9175.133270. eCollection 2014.
Abstract
BACKGROUND:Preoperative using of anatomical landmarks detects potentially difficult laryngoscopies. The main object of the present study was to evaluate the predictive power of Extended Mallampati Score (EMS) in comparison with modified Mallampati test (MMT), the ratio of height tothyromental distance (RHTMD) and the Upper-Lip-Bite test (ULBT) in isolation and combination. MATERIALS AND METHODS:Four hundred seventy sixadult patients who candidate for elective surgery under general anesthesia requiring endotracheal intubation were included in this study and evaluated based of all four factors before surgery. This study was randomized prospective double - blind. After that, laryngoscopy was performed by an anesthesiologist who didn't involve in preoperative airway assessment and graded based on Cormack and Lehane's classification. We calculated sensitivity, specificity, and area under receiver-operating characteristic (ROC) (AUC) for each score. RESULTS:The AUCof the ROC was significantly more for the ULBT (AUC = 0.820, P = 0.049) and RHTMD score (AUC = 0.845, P = 0.033) than the EMS (AUC = 0.703). This variable was significantly higher for the EMS compared with MMT (0.703 vs. 0.569, P = 0.046 respectively). There was no significant difference between the AUC of the ROC for the ULBT and the RHTMD score (P = 0.685). The optimalcut-off point for the RHTMD for predicting difficult laryngoscopy was 29.3. CONCLUSION:EMS predicted difficult laryngoscopy better than MMT while both ULBT and RHTMD had more power than EMS and MMT in this regard. ULBT and RHTMD had similar predictive value for prediction of difficult laryngoscopy in general population.
KEYWORDS: Difficult laryngoscopy; extended mallampati score; modified mallampati; ratio of patient's height to thyromental distance; upper lip bite test

http://www.advbiores.net/downloadpdf.asp?issn=2277-9175;year=2014;volume=3;issue=1;spage=133;epage=133;aulast=Safavi;type=2

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063103/



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

Miocardiopatía periparto

Miocarditis periparto
Peripartum Myocarditis
Marina Deljanin Ilic and Dejan Simonovic
Institute of Cardiology, Niska Banja, University of Nis Faculty of Medicine, Serbia
http://cdn.intechopen.com/pdfs-wm/44500.pdf


Miocardiopatía periparto
Diego Felipe Polanía Ardila, Solón Navarrete Hurtado, Edgar Mariano Acuña Osorio, Rafael Alberto Álvarez Rosero
http://www.insuficienciacardiaca.org/pdf/4_vol4_09/177-%20Miocardiopatia.pdf


Miocardiopatía periparto
http://www.medigraphic.com/pdfs/revmedcoscen/rmc-2013/rmc133m.pdf



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

Miocardiopatía y cáncer / cardiomyopathy and cancer

Tratamiento de la cardiomiopatía inducida por quimioterapia


Management of chemotherapy induced cardiomyopathy.
Saidi A, Alharethi R.
Curr Cardiol Rev. 2011 Nov;7(4):245-9.
Abstract
Chemotherapy related cardiac dysfunction (CRCD) is a serious complication of anticancer therapy. CRCD can be classified into two types. Type I CRCD is exemplified by anthracyline- induced cardiac dysfunction and type II CRCD is exemplified by trastuzumab- induced cardiac dysfunction. The mechanism of cardiac toxicity in both types is not well defined. Certain risk factors may play a role in developing the cardiac injury, most importantly, the cumulative dose when dealing with anthracycline induced cardiotoxicity. Establishing an early diagnosis and initiating early treatment may be an important step in preventing irreversible cardiac injury especially in type I CRCD. Currently there are no guidelines developed specifically for the treatment of chemotherapy induced cardiomyopathy (CIC), however a few small studies support the use of neurohormonal antagonists in the treatment and prevention of CIC. Large multi- centers trials are needed to establish guidelines for CIC. Until then, we advocate following the American College of Cardiology/ American Heart Association (ACC/AHA) and Heart Failure Society of America (HFSA) guidelines. Additionally, a close collaboration between the patient's cardiologist and oncologist is strongly recommended in order to establish a long term plan for the patient.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322442/pdf/CCR-7-245.pdf



La prevención de enfermedad cardiovascular en sobrevivientes de cáncer


The prevention of cardiovascular disease in cancer survivors.
Daher IN, Daigle TR, Bhatia N, Durand JB.
Tex Heart Inst J. 2012;39(2):190-8.
Abstract
The number of cancer survivors in the United States has exceeded 12 million and is increasing. After secondary malignancies, cardiovascular disease is the leading cause of late morbidity and death among cancer survivors. The cardiovascular needs of cancer survivors have not been described. We describe the clinical characteristics of 53 patients seen during the first year of our Cardiovascular Prevention in Cancer Survivors clinic. The mean age of the patients was 40.1 ± 13.7 years. The mean survival since cancer diagnosis was 13.9 years. A history of chemotherapy-induced cardiomyopathywas present in 21%, and 5.7% had known atherosclerotic disease. One fourth had hypertension; 32.1%, dyslipidemia; and 13%, diabetes mellitus. Three quarters had received anthracycline chemotherapy, while half had received radiation. Half had an abnormal echocardiogram (55%), and 11 of 18 had an abnormal carotid ultrasonogram. The mean Framingham risk score for patients older than 30 years (n=37) was 8.4, yielding a 10-year risk of cardiovascular disease of 7.6%. The mean vascular age was 54.3 years, and the mean chronological age was 46.3 years. The mean follow-up duration was 566 ± 213 days. There were significant improvements in serum triglycerides and high-density lipoprotein levels, as well as trends toward improved blood pressure control. Cardiovascular risk factors are prevalent in cancer survivors. There is an immediate need for the widespread availability of cardiovascular preventive services to reduce the late adverse effects of chemotherapy and radiation. Early intervention might help to improve the cardiovascular risk profile.
KEYWORDS: Anthracyclines/adverse effects; antineoplastic agents/adverse effects; atherosclerosis; calcinosis/etiology; cancer;cardiomyopathies/etiology/prevention & control; cardiotoxins; cardiovascular diseases/chemically induced/prevention & control; carotid artery diseases; disease progression; heart failure/etiology; heart/drug effects; heart/radiation effects; monitoring, physiologic; radiation injuries; risk factors; survivorship

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384047/pdf/20120400s00006p190.pdf



Cardiomiopatía inducida por quimioterapia: patogénesis, monitoreo y manejo 

Chemotherapy induced cardiomyopathy: pathogenesis, monitoring and management.
Shakir DK, Rasul KI.
J Clin Med Res. 2009 Apr;1(1):8-12. doi: 10.4021/jocmr2009.02.1225. Epub 2009 Mar 24.
Abstract
The survival rate of cancer patients has greatly increased over the last 20 years. However, to achieve this result, a considerable price has been paid in terms of the side effects associated with the intensive anticancer treatment. The most common adverse effect is cardiotoxicity which may compromise the clinical effectiveness of chemotherapy, affecting the patient's survival and quality of life independently of the oncological prognosis. There are 2 types of cardiac toxicities, type I which is more serious and result in permanent damage to the myocardium and type II which is usually reversible. Chemotherapies varies in their incidence of inducing cardiomyopathy, and the onset which may occur acutely (during or shortly after treatment), sub-acutely (within days or weeks after completion of chemotherapy) or chronically (weeks to months after drug administration). Cardiac events associated with chemotherapy may consist of mild blood pressure changes, thrombosis, Electrocardiographic (ECG) changes, arrhythmias, myocarditis, pericarditis, myocardial infarction, cardiomyopathy, cardiac failure (left ventricular failure), and congestive heart failure (CHF). The risk for such effects depends upon: cumulative dose, rate of drug administration, mediastinal radiation, advanced age, younger age, female gender, pre-existing heart disease and hypertension. Serial measurements of LVEF and fractional shortening are the most common indices monitored to assess left ventricular systolic function and cardiotoxicity. This can be achieved by 2-dimensional, M-mode and color Doppler echocardiographic examination; also Cardiac troponins as a biological marker for myocardial damage can be used for monitoring in patients received anthracyclines. Angiotensin-converting enzyme (ACE) inhibitors (ACEIs) have been shown to slow the progression of left ventricular dysfunction in several different clinical settings, including anthracycline-induced cardiomyopathy. Carvedilol and probably with anti-oxidants like Probucol and vitamin E benefits also.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318862/pdf/jocmr-01-08.pdf




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