Daño cerebral y el pulmón / Brain damage and lung interacction

Marzo 10, 2016. No. 2261

Interacción cerebro- pulmón: implicaciones para los pacientes de cuidados neurocrítico. Brain-lung crosstalk: Implications for neurocritical care patients. Mrozek S, Constantin JM, Geeraerts T. World J Crit Care Med. 2015 Aug 4;4(3):163-78. doi: 10.5492/wjccm.v4.i3.163. eCollection 2015. Abstract Major pulmonary disorders may occur after brain injuries as ventilator-associated pneumonia, acute respiratory distress syndrome or neurogenic pulmonary edema. They are key points for the management of brain-injured patients because respiratory failure and mechanical ventilation seem to be a risk factor for increased mortality, poor neurological outcome and longer intensive care unit or hospital length of stay. Brain and lung strongly interact via complex pathways from the brain to the lung but also from the lung to the brain. Several hypotheses have been proposed with a particular interest for the recently described "double hit" model. Ventilator setting in brain-injured patients with lung injuries has been poorly studied and intensivists are often fearful to use some parts of protective ventilation in patients with brain injury. This review aims to describe the epidemiology and pathophysiology of lung injuries in brain-injured patients, but also the impact of different modalities of mechanical ventilation on the brain in the context of acute brain injury. KEYWORDS: Brain injury; Brain-lung crosstalk; Double hit model; Lung injury; Protective ventilation PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Bibliotecas. Noticias

bibliotecas
Notificaciones diarias ⋅ 2 de marzo de 2016
NOTICIAS


ElEspectador.com

Fuerza Aérea realiza entrega de cinco bibliotecas en el Vichada
ElEspectador.com
En un trabajo conjunto con la Fundación Bancolombia, la Fuerza Aérea Colombiana (FAC) hizo entrega de cinco bibliotecas en Cumaribo y Puerto ...
COLOMBIA: Fuerza Aérea realiza entrega de cinco bibliotecas en el Vichada -EntornoInteligente
Cobertura total de la noticia




Europa Press

Érase una vez* ¡Todo en orden!
Lainformacion.com
MADRID, 2 (CHANCE) "Érase una vez una habitación siempre ordenada..." ¿Qué mamá no ha soñado alguna vez con ese cuento? A medida que los ...




Murcia.com

Los "Encuentros con Autor" de las Bibliotecas Municipales de Lorca traerán a tres escritores ...
Murcia.com
El Concejal de Educación del Ayuntamiento de Lorca, Francisco Montiel, ha anunciado la celebración de nuevos "Encuentros con Autor" durante las ...




Artez

Gobierno de Aragón y Teatro Arbolé organizan una campaña de animación a la lectura en ...
Gente Digital
El Gobierno autonómico, a través de la Biblioteca de Aragón, y la compañía zaragozana Teatro Arbolé han organizado una campaña de animación a ...



Cuentacuentos en la Biblioteca Pública de Segovia
segoviaaldia
La Biblioteca de Segovia retoma su programación de cuentacuentos con ... el portal de bibliotecas de la Junta de Castilla y León bibliotecas.jcyl.es, ...




Imagen de Zacatecas, el periódico de los zacatecanos (Sátira) (Comunicado de prensa) (Registro)

​Entrega Minera Frisco biblioteca en Ojocaliente
Imagen de Zacatecas, el periódico de los zacatecanos (Sátira) (Comunicado de prensa) (Registro)
Dijo que un espacio como lo es la biblioteca pública, representa a un agente de promoción y desarrollo humano, cumpliendo con lo estipulado en el ...




Huelva Información

CSIF denuncia la "precaria situación" de la Biblioteca debido...
Huelva Información
Unos datos que la colocan, según indicó esta organización, como la biblioteca con la situación "más precaria" de personal técnico en comparación ...
La Biblioteca Provincial más precaria de Andalucía: diez de sus trece plazas sin cubrir - Huelva24
Cobertura total de la noticia




Artez

El Gobierno de Aragón y Teatro Arbolé organizan una campaña de animación a la lectura en las ...
Artez
El Gobierno de Aragón, a través de la Biblioteca de Aragón, y la compañía zaragozana Teatro Arbolé han organizado una campaña de animación a ...




El Universal (Venezuela)

El principito, Madame Bovary y Drácula viajan en los buses de Lima
El Universal (Venezuela)
El colectivo peruano Chup de Mango tomó esta iniciativa con libros que son de dominio público porque en Lima "no hay muchas bibliotecas, no hay ...



Libros para Pueblos lleva la lectura a comunidades oaxaqueñas
DIARIOAXACA
La Asociación Civil Libros Para Pueblos realizó el sábado 27 de febrero su VII encuentro anual de capacitación para encargados de bibliotecas, ...


WEB

Jornadas de transferencias II
Red de Bibliotecas del CSIC
Jornadas de transferencias II: Bibliotecas y Archivos. Madrid, 11 y 12 de marzo de 2016. Volver a la página índice. ANABAD organiza los próximos ...



Biblioteca electrónica
Instituto Cervantes
Biblioteca electrónica en el Instituto Cervantes: Miles de libros y recursos digitales en español donde y cuando quieras. Todo sobre el español y sus ...



Apertura de bibliotecas municipales sábados y domingos
Decide Madrid - Ayuntamiento de Madrid
Es necesario que se amplíe el horario de apertura de las Bibliotecas Municipales de Madrid, ya que las pocas que abren los sábados, domingos y ...



Promotores, Tutores y mentores son “embajadores de palabras de paz”
Biblioteca Nacional de Colombia
Los líderes de la Red Nacional de Bibliotecas Públicas son “embajadores de palabras de paz”. “La labor realizada por los promotores, tutores y ...

“Accesos vasculares guiados por ultrasonido”

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 9 Marzo 2016 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: 

“Accesos vasculares guiados por ultrasonido” 

 por el “Dr. Fernando Felix Montes Tapia”, Crujano Pediatra de la Cd. de Monterrey N.L. 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/accesosvasculares_ultrasonido/
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

Seguridad en anestesia / Anesthesia safety

Marzo 6, 2016. No. 2257

Papel del anestesiólogo en la seguridad perioperatoria del paciente The role of the anesthesiologist in perioperative patient safety. Wacker J, Staender S. Curr Opin Anaesthesiol. 2014 Dec;27(6):649-56. doi: 10.1097/ACO.0000000000000124. Abstract PURPOSE OF REVIEW: Despite the benefits of rapidly advancing therapeutic and diagnostic possibilities, the perioperative setting still exposes patients to significant risks of adverse events and harm. Anesthesiologists are in midstream of perioperative care and can make significant contributions to patient safety and patient outcomes. This article reviews recent research results outlining the current trends of perioperative patient harm and summarizes the evidence in favor of patient safety practices. RECENT FINDINGS: Adverse events and patient harm continue to be frequent in the perioperative period. Adverse events occur in about 30% of hospital admissions, are associated with higher mortality, and may be preventable in more than 50%. Evidence-based recommendations are available for many patient safety issues. No magic bullet practices exist, but promising targets include the prevention and limitation of perioperative infections and of complications of airway and respiratory management, the maintenance of achieved safety standards, the use of checklists, and others. SUMMARY: Current research provides growing evidence for the effectiveness of several patient safety practices designed to prevent or diminish perioperative adverse events and patient harm. Future investigations will hopefully fill the numerous persisting knowledge gaps. PDF Manejo del peligro y errores para los anestesiólogos: una taxonomía de riesgopredictivo. Threat and error management for anesthesiologists: a predictive risk taxonomy. Ruskin KJ, Stiegler MP, Park K, Guffey P, Kurup V, Chidester T. Curr Opin Anaesthesiol. 2013 Dec;26(6):707-13. doi: 10.1097/ACO.0000000000000014. Abstract PURPOSE OF REVIEW: Patient care in the operating room is a dynamic interaction that requires cooperation among team members and reliance upon sophisticated technology. Most human factors research in medicine has been focused on analyzing errors and implementing system-wide changes to prevent them from recurring. We describe a set of techniques that has been used successfully by the aviation industry to analyze errors and adverse events and explain how these techniques can be applied to patient care. RECENT FINDINGS: Threat and error management (TEM) describes adverse events in terms of risks or challenges that are present in an operational environment (threats) and the actions of specific personnel that potentiate or exacerbate those threats (errors). TEM is a technique widely used in aviation, and can be adapted for the use in a medical setting to predict high-risk situations and prevent errors in the perioperative period. A threat taxonomy is a novel way of classifying and predicting the hazards that can occur in the operating room. TEM can be used to identify error-producing situations, analyze adverse events, and design training scenarios. SUMMARY: TEM offers a multifaceted strategy for identifying hazards, reducing errors, and training physicians. A threat taxonomy may improve analysis of critical events with subsequent development of specific interventions, and may also serve as a framework for training programs in risk mitigation. PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Errores médicos / Medical errors

Marzo 4, 2016. No. 2255

Reducción de errores se asocia a su registro prospectivo A reduction in errors is associated with prospectively recording them. Oremakinde AA, Bernstein M. J Neurosurg. 2014 Aug;121(2):297-304. doi: 10.3171/2014.5.JNS132341. Epub 2014 Jun 13. Abstract OBJECT: Error recording and monitoring is an important component of error prevention and quality assurance in the health sector given the huge impact of medical errors on the well-being of patients and the financial loss incurred by health institutions. With this in mind, assessing the effect of reporting errors should be a cause worth pursuing. The object in this study was to examine the null hypothesis that recording and publishing errors do not affect error patterns in a clinical practice. METHODS: Intraoperative errors and their characteristics were prospectively recorded between May 2000 and May 2013 in the neurosurgical practice of the senior author (M.B.). The error pattern observed between May 2000 and August 2006, which has been previously described (Group A), was compared with the error pattern observed between September 2006 and May 2013 (Group B). RESULTS: A total of 1108 cases in Group A and 974 cases in Group B were surgically treated. A total of 2684 errors were recorded in Group A, while 1892 errors were recorded in Group B. The ratios of cranial to spinal procedures performed in Groups A and B were 3:1 and 10:1, respectively, while the ratios of general to local anesthesia in the two groups were 2:1 and 1.3:1, respectively (p < 0.0001 for both). There was a significantly decreased proportion of cases with error (87% to 83%, p < 0.006), mean errors per case (2.4 to 1.9, p < 0.0001), proportion of error-related complications (16.7% to 5.5%, p < 0.002), and clinical impacts of error (2.7% to 1.0%, p < 0.0001) in Group B compared with Group A. Errors in Group B tended to be more preventable than those in Group A (85.8% vs 78.5%, p < 0.0001). A significant reduction was also noticed with most types of error. A descending trend in the mean errors per case was demonstrated from the years 2001 to 2012; however, an increased severity of errors (22.6% to 29.5%, p < 0.0001) was recorded in Group B compared with Group A. CONCLUSIONS: Data in this study showed that the act of recording errors might alter behaviors, resulting in fewer errors. KEYWORDS: ASA = American Society of Anesthesiologists; error recording; intraoperative error; neurosurgery; prospective study PDF Errores de cognición detectados en anestesiología. Revisión de la literatura y estudio piloto Cognitive errors detected in anaesthesiology: a literature review and pilot study. Stiegler MP, Neelankavil JP, Canales C, Dhillon A. Br J Anaesth. 2012 Feb;108(2):229-35. doi: 10.1093/bja/aer387. Epub 2011 Dec 8. Abstract BACKGROUND: Cognitive errors are thought-process errors, or thinking mistakes, which lead to incorrect diagnoses, treatments, or both. This psychology of decision-making has received little formal attention in anaesthesiology literature, although it is widely appreciated in other safety cultures, such as aviation, and other medical specialities. We sought to identify which types of cognitive errors are most important in anaesthesiology. METHODS: This study consisted of two parts. First, we created a cognitive error catalogue specific to anaesthesiology practice using a literaturereview, modified Delphi method with experts, and a survey of academic faculty. In the second part, we observed for those cognitive errors during resident physician management of simulated anaesthesiology emergencies. RESULTS: Of >30 described cognitive errors, the modified Delphi method yielded 14 key items experts felt were most important and prevalent in anaesthesiology practice (Table 1). Faculty survey responses narrowed this to a 'top 10' catalogue consisting of anchoring, availability bias, premature closure, feedback bias, framing effect, confirmation bias, omission bias, commission bias, overconfidence, and sunk costs (Table 2). Nine types of cognitive errors were selected for observation during simulated emergency management. Seven of those nine types of cognitive errorsoccurred in >50% of observed emergencies (Table 3). CONCLUSIONS: Cognitive errors are thought to contribute significantly to medical mishaps. We identified cognitive errors specific to anaesthesiology practice. Understanding the key types of cognitive errors specific to anaesthesiology is the first step towards training in metacognition and de-biasing strategies, which may improve patient safety. PDF Manejo de los recursos en la crisis intraoperatoria durante cirugía toracoscópica asistida por video en pacientes sin intubar. Intraoperative crisis resource management during a non-intubated video-assisted thoracoscopic surgery. Navarro-Martínez J, Gálvez C, Rivera-Cogollos MJ, Galiana-Ivars M, Bolufer S, Martínez-Adsuar F. Ann Transl Med. 2015 May;3(8):111. doi: 10.3978/j.issn.2305-5839.2015.04.14. Abstract The management of surgical and medical intraoperative emergencies are included in the group of high acuity (high potential severity of an event and the patient impact) and low opportunity (the frequency in which the team is required to manage the event). This combination places the patient into a situation where medical errors could happen more frequently. Although medical error are ubiquitous and inevitable we should try to establish the necessary knowledge, skills and attitudes needed for effective team performance and to guide the development of a critical event. This strategy would probably reduce the incidence of error and improve decision-making. The way to apply it comes from the application of the management of critical events in the airline industry. Its use in a surgical environment is through the crisis resource management (CRM) principles. The CRM tries to develop all the non-technical skills necessary in a critical situation, but not only that, also includes all the tools needed to prevent them. The purpose of this special issue is to appraise and summarize the design, implementation, and efficacy of simulation-based CRM training programs for a specific surgery such as the non-intubated video-assisted thoracoscopic surgery. KEYWORDS: Crisis; anesthesia; intraoperative complications; thoracic surgery PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015