Como criar a un genio / How to raise a genius

Octubre 22, 2016. No. 2486

Como criar a un genio How to raise a genius A long-running study of exceptional children reveals what it takes to produce the scientists who will lead the twenty-first century. Tom Clynes Nature 2016;537 PDF XIII Congreso Virtual Mexicano de Anestesiología Inscripciones Abiertas Octubre a Diciembre 2016 Información / Information L Congreso Mexicano de Anestesiología Noviembre 2-6, 2016 Información / Information 17h World Congress of Anaesthesiologists, WFSA Sep 6-11, 2020 Prague, Czech Republic Informes / Information

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Transplante hepático y embarazo / Liver transplant and pregnancy

Octubre 15, 2016. No. 2479

Consideraciones anestésicas en parturientas con transplante hepático Anesthetic considerations in parturients with liver transplant. Agarwal A, Jha A, Baidya DK, Trikha A J Obstet Anaesth Crit Care 2014;4:4-11 Abstract Advances in the surgical technique, safer anesthetic agents, improved hemodynamic monitoring, better pre-operative optimization of cirrhotic patients and postoperative critical care facilities have led to drastic improvement in the outcomes following orthotopic liver transplantation (OLT). Reproductive dysfunction in patients with end-stage liver disease can be corrected within months of successful orthotopic liver transplantation. Consequently, there is a worldwide increase in the number of women of childbearing potential after orthotopic liver transplantation. Successful pregnancies are now increasingly being reported in these patients. These are high-risk pregnancies as increased medical and obstetric complications and adverse maternal and fetal effects of immunosuppressant medications are likely to be encountered in these patients following liver transplantation. Optimal antenatal and perioperative management in these parturients warrant a multidisciplinary approach and meticulous planning. There is little evidence available regarding anesthetic concerns in this high-risk pregnant population. This review is aimed at addressing important perioperative issues in parturients, who have undergone a successful liver transplantation. Keywords: Anesthetic considerations, liver transplantation, pregnancy post-transplant PDF Enfermedades hepáticas en el embarazo. Transplante de hígado Liver diseases in pregnancy: liver transplantation in pregnancy. Hammoud GM1, Almashhrawi AA, Ahmed KT, Rahman R, Ibdah JA. World J Gastroenterol. 2013 Nov 21;19(43):7647-51. doi: 10.3748/wjg.v19.i43.7647. Abstract Pregnancy in patients with advanced liver disease is uncommon as most women with decompensated cirrhosis are infertile and have high rate of anovulation. However, if gestation ensued; it is very challenging and carries high risks for both the mother and the baby such as higher rates of spontaneous abortion, prematurity, pulmonary hypertension, splenic artery aneurysm rupture, postpartum hemorrhage, and a potential for life-threatening variceal hemorrhage and hepatic decompensation. In contrary, with orthotopic liver transplantation, menstruation resumes and most women of childbearing age are able to conceive, give birth and lead a better quality of life. Women with orthotopic liver transplantation seekingpregnancy should be managed carefully by a team consultation with transplant hepatologist, maternal-fetal medicine specialist and other specialists. Pregnant liver transplant recipients need to stay on immunosuppression medication to prevent allograft rejection. Furthermore, these medications need to be monitored carefully and continued throughout pregnancy to avoid potential adverse effects to mother and baby. Thus delaying pregnancy 1 to 2 years after transplantation minimizes fetal exposure to high doses of immunosuppressants. Pregnant female livertransplant patients have a high rate of cesarean delivery likely due to the high rate of prematurity in this population. Recent reports suggest that with close monitoring and multidisciplinary team approach, most female liver transplant recipient of childbearing age will lead a successfulpregnancy. KEYWORDS: Acute fatty liver; Cirrhosis; Hemolysis elevated liver low platelets; Liver; Liver transplantation; Pregnancy PDF XIII Congreso Virtual Mexicano de Anestesiología Octubre a Diciembre 2016 Inscripciones Abiertas Información / Information L Congreso Mexicano de Anestesiología Noviembre 2-6, 2016 Información / Information 17h World Congress of Anaesthesiologists, WFSA Sep 6-11, 2020 Prague, Czech Republic Informes / Information

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

Ketamina en asma / Ketamine for asthma

Octubre 17, 2016. No. 2481

Ketamina versus aminofilina en asma aguda en niños. Estudio aleatorizado, controlado Ketamine versus aminophylline for acute asthma in children: A randomized, controlled trial. Tiwari A, Guglani V, Jat KR. Ann Thorac Med 2016;11:283-8 Abstract Background: There is a lack of consensus regarding second-line therapy in children with acute asthma who fail to the standard therapy. Ketamine had bronchodilator property and may be useful in the treatment of acute asthma. Objective: The objective of this study was to evaluate the efficacy and safety of ketamine as compared to aminophylline in children with acute asthma who respond poorly to the standard therapy. Methods: This randomized controlled trial included patients with acute asthma having Pediatric Respiratory Assessment Measure (PRAM) score ≥5 at 2 h of standard therapy. The enrolled patients received either intravenous (IV) ketamine or IV aminophylline. Primary outcome measure was change in PRAM score at the end of intervention. Secondary outcome measures included adverse effects, change in PO2and PCO2, need for mechanical ventilation, and duration of hospital stay. Results: The trial included 24 patients each in ketamine and aminophylline groups. The baseline parameters were similar between the groups. The primary outcome was similar in both the groups with a change in PRAM score of 4.00 ± 1.25 and 4.17 ± 1.68 (P = 0.699) in ketamine and aminophylline groups, respectively. The secondary outcomes were not different between the groups. Conclusion: Ketamine and aminophylline were equally effective for children with acute asthma who responded poorly to the standard therapy. Keywords: Acute asthma, aminophylline, children, ketamine PDF   ¿Es la ketamina salvadora en los infantes con asma severa aguda? Is ketamine a lifesaving agent in childhood acute severe asthma? Hendaus MA1, Jomha FA2, Alhammadi AH1. Ther Clin Risk Manag. 2016 Feb 22;12:273-9. doi: 10.2147/TCRM.S100389. eCollection 2016. Abstract Children with acute severe asthma exacerbation are at risk of developing respiratory failure. Moreover, conventional aggressive management might be futile in acute severe asthma requiring intubation and invasive ventilation. The aim of this review is to detail evidence on the use of ketamine in childhood asthma exacerbations. A search of the MEDLINE, EMBASE, and Cochrane databases was performed, using different combinations of the following terms: ketamine, asthma, use, exacerbation, and childhood. In addition, we searched the references of the identified articles for additional articles. We then reviewed titles and included studies that were relevant to the topic of interest. Finally, the search was limited to studies published in English and Spanish from 1918 to June 2015. Due to the scarcity in the literature, we included all published articles. The literature reports conflicting results of ketamine use foracute severe asthma in children. Taking into consideration the relatively good safety profile of the drug, ketamine might be a reasonable option in the management of acute severe asthma in children who fail to respond to standard therapy. Furthermore, pediatricians and pediatric emergency clinicians administering ketamine should be knowledgeable about the unique actions of this drug and its potential side effects. KEYWORDS: asthma; children; ketamine PDF XIII Congreso Virtual Mexicano de Anestesiología Octubre a Diciembre 2016 Información / Information L Congreso Mexicano de Anestesiología Noviembre 2-6, 2016 Información / Information 17h World Congress of Anaesthesiologists, WFSA Sep 6-11, 2020 Prague, Czech Republic Informes / Information

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