Libros con acceso abierto / Free access books

Marzo 3, 2016. No. 2254-A

Nuevos aspectos de los mecanismos moleculares y celulares de la carcinogénesis humana New Aspects in Molecular and Cellular Mechanisms of Human Carcinogenesis Edited by Dmitry Bulgin, ISBN 978-953-51-4382-6, 192 pages, Publisher: InTech, Chapters published March 02, 2016 under CC BY 3.0 license Edited Volume Written by an international team of experts in the field of human carcinogenesis, this book discusses recent advances in cancer research, which include the following topics: basic molecular and cellular mechanisms behind cancer growth, new approaches in cancer therapy, and cancer diagnostic. The book serves as a useful source of reference for cancer biologists, medical doctors, and clinical researchers in the fields of cancer diagnosis, prevention, and treatment. Libro / Book   Cánceres ginecológicos. Ciencias básicas, clínica y perspectivas terapéuticas Gynecologic Cancers - Basic Sciences, Clinical and Therapeutic Perspectives Edited by Samir A. Farghaly, ISBN 978-953-51-4278-2, 338 pages, Publisher: InTech, Chapters published March 02, 2016 under CC BY 3.0 license Edited Volume Gynecologic cancers include malignancies of the female genital tract involving the vulva, vagina, cervix, uterus, fallopian tubes or ovaries. In the USA, 98,280 women had gynecological cancers in 2015, and 30,440 died of these cancers. World wide, the number of women who had cancers of the female genital tract was 1,085,900, in 2012 and the number of deaths was 417,600. Cancers of the uterus, cervix and ovary are most common. Widespread screening with the Pap test has allowed physicians to find per-cancerous changes in the cervix and vagina. This has assisted in identifying some invasive cancers early. Multidisciplinary team of experts includes specialists in medical oncology, gynecologic oncology, radiology, urology, radiotherapy, and surgery who work together to determine the best treatment approach for the patient. Recent progress in the development of new surgical techniques has transformed the treatment of gynecologic cancers, resulting in greater surgical precision and fewer complications. In addition targeted adjuvant therapy has become useful in improving the oncologic outcome of patients with these cancers. Libro / Book Avances en cirugía oftalmológica Advances in Eye Surgery Edited by Patricio A. Pacheco, ISBN 978-953-51-2249-4, 302 pages, Publisher: InTech, Chapters published February 24, 2016 under CC BY 3.0 license DOI: 10.5772/59216 Edited Volume This is a comprehensive, practical guidebook that provides a clear overview and update of current modern techniques of ocular surgery. The chapters will be of interest to a wide audience. The chapters are written by experts with special interest and extensive clinical experience in the topics. Libro / Book

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

Neumonía / Pneumonia

Marzo 7, 2016. No. 2258

Manejo de la neumonía por Pseudomona aeuruginosa asociada al ventilador Pseudomonas aeruginosa ventilator-associated pneumonia management. Ramírez-Estrada S, Borgatta B, Rello J. Infect Drug Resist. 2016 Jan 20;9:7-18. doi: 10.2147/IDR.S50669. eCollection 2016. Abstract Ventilator-associated pneumonia is the most common infection in intensive care unit patients associated with high morbidity rates and elevated economic costs; Pseudomonas aeruginosa is one of the most frequent bacteria linked with this entity, with a high attributable mortality despite adequate treatment that is increased in the presence of multiresistant strains, a situation that is becoming more common in intensive care units. In this manuscript, we review the current management of ventilator-associated pneumonia due to P. aeruginosa, the most recent antipseudomonal agents, and new adjunctive therapies that are shifting the way we treat these infections. We support early initiation of broad-spectrum antipseudomonal antibiotics in present, followed by culture-guided monotherapy de-escalation when susceptibilities are available. Future management should be directed at blocking virulence; the role of alternative strategies such as new antibiotics, nebulized treatments, and vaccines is promising. KEYWORDS: ICU; adjunctive-therapies; care-bundles; multidrug-resistant; new-antibiotics PDF Valor pronóstico de procalcitonina en neumonía. Revisión sistemática y meta-análisis Prognostic value of procalcitonin in pneumonia: A systematic review and meta-analysis. Liu D, Su LX, Guan W, Xiao K, Xie LX. Respirology. 2016 Feb;21(2):280-8. doi: 10.1111/resp.12704. Epub 2015 Dec 10. For critically ill patients, an elevated PCT level was associated with an increased risk of mortality (RR 4.18, 95% CI: 3.19-5.48). The prognostic performance was nearly equal between patients with ventilator-associated pneumonia (VAP) and patients with CAP. KEYWORDS: meta-analysis; mortality; pneumonia; procalcitonin; prognosis PDF

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

[Identidad Bibliotecaria] Resumen semanal

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Más de neumonía / More on pneumonia

Marzo 8, 2016. No. 2259

Antibióticos nebulizados en NAV. Revisión sistemática y meta-análisis Nebulized antibiotics for ventilator-associated pneumonia: a systematic review and meta-analysis. Zampieri FG, Nassar AP Jr, Gusmao-Flores D, Taniguchi LU, Torres A, Ranzani OT. Crit Care. 2015 Apr 7;19:150. doi: 10.1186/s13054-015-0868-y. CONCLUSIONS: Nebulized antibiotics seem to be associated with higher rates of clinical cure in the treatment of ventilator-associated pneumonia. However, the apparent benefit in the clinical cure rate observed by traditional meta-analysis does not persist after trial sequential analysis. Additional high-quality studies on this subject are highly warranted. TRIAL REGISTRATION NUMBER: CRD42014009116 . Registered 29 March 2014. PDF Colistina para infección pulmonar. Una actualización Colistin for lung infection: an update. Gurjar M. These finding stresses to use high loading as well as high maintenance dose of intravenous colistin. It is not only suboptimal plasma concentration of colistin but also poor lung tissue concentration, which has been demonstrated in recent studies, poses major concern in using intravenous colistin. Combination therapy mainly with carbapenems shows synergistic effect. In recent studies, inhaled colistin has been found promising in treatment of lung infection due to MDR gram-negative bacteria. New evidence shows less toxicity than previously reported. KEYWORDS: Colistin; Critically ill; Lung infection; Pneumonia; Ventilator-associated pneumonia PDF ¿Como evitar microaspiración? Un element clave en la prevención de NAV en pacientes intubados en UCI How to avoid microaspiration? A key element for the prevention of ventilator-associated pneumonia in intubated ICU patients. Blot SI, Poelaert J, Kollef M. BMC Infect Dis. 2014 Nov 28;14:119. doi: 10.1186/1471-2334-14-119. Abstract Microaspiration of subglottic secretions through channels formed by folds in high volume-low pressure poly-vinyl chloride cuffs of endotracheal tubes is considered a significant pathogenic mechanism of ventilator-associated pneumonia (VAP). Therefore a series of prevention measures target the avoidance of microaspiration. However, although some of these can minimize microaspiration, benefits in terms of VAP prevention are not always obvious. Polyurethane-cuffed endotracheal tubes successfully reduce microaspiration but high quality data demonstrating VAP rate reduction are lacking. An analogous conclusion can be made regarding taper-shaped cuffs compared with classic barrel-shaped cuffs. More clinical data regarding these endotracheal tube designs are needed to demonstrate clinical value in addition to in vitro-based evidence. The clinical usefulness of endotracheal tubes developed for subglottic secretions drainage is established in multiple studies and confirmed by meta-analysis. Any change in cuff design will fail to prevent microaspiration if the cuff is insufficiently inflated. At least one well-designed trial demonstrated that continuous cuff pressure monitoring and control decrease the risk of VAP. Gel lubrication of the cuff prior to intubation temporarily hampers microaspiration through sludging the channels formed by folds in high volume-low pressure cuffs. As the beneficial effect of gel lubrication is temporarily, its potential to reduce VAP risk is probably nonsignificant. A minimum positive end-expiratory pressure of at least 5 cmH2O can be recommended as it reduces the risk of microaspiration in vitro and in vivo. One randomized controlled study demonstrated a reduced risk of VAP in patients ventilated with PEEP (5-8 cmH2O). Regarding head-of-bed elevation, it can be recommended to avoid supine positioning. Whether a 45° head-of-bed elevation is to be preferred above 25-30° head-of-bed elevation remains unproven. Finally, the routine monitoring of gastric residual volumes in mechanically ventilated patients receiving enteral nutrition cannot be recommended. PDF

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