lunes, 26 de diciembre de 2016

Amor / Love

Diciembre 24,  2016. No. 2548



  


Neuroendocrinología del amor
The neuroendocrinology of love.
Indian J Endocrinol Metab. 2016 Jul-Aug;20(4):558-63. doi: 10.4103/2230-8210.183479.
Abstract
Romantic love could be considered as a collection of activities associated with the acquisition and retention of emotions needed to survive and reproduce. These emotions change the individual's behavioural strategies in a way that will increase the likelihood of achieving these goals. Love may be defined as an emergent property of an ancient cocktail of neuropeptides and neurotransmitters. It appears that lust, attachment and attraction appear to be distinct but intertwined processes in the brain each mediated by its own neurotransmitters and circuits. These circuits feed on and reinforce each other. Sexual craving is mediated by testosterone and oestrogen and has the amygdala as an important centre. Attraction is mediated by hormones of stress and reward including dopamine, norepinephrine cortisol and the serotinergic system and has the nucleus accumbens the ventral tegmental area as key mediators.
KEYWORDS: Love; monogamy; neuroendocrine; oxytocin; prairie vole; vasopressin
Regulación de los sentimientos del amor romántico: Preconcepciones, Estrategias y Factibilidad.
Regulation of Romantic Love Feelings: Preconceptions, Strategies, and Feasibility.
PLoS One. 2016 Aug 16;11(8):e0161087. doi: 10.1371/journal.pone.0161087. eCollection 2016.
Abstract
Love feelings can be more intense than desired (e.g., after a break-up) or less intense than desired (e.g., in long-term relationships). If only we could control our love feelings! We present the concept of explicit love regulation, which we define as the use of behavioral and cognitive strategies to change the intensity of current feelings of romantic love. We present the first two studies on preconceptions about, strategies for, and the feasibility of love regulation. Questionnaire responses showed that people perceive love feelings as somewhat uncontrollable. Still, in four open questions people reported to use strategies such as cognitive reappraisal, distraction, avoidance, and undertaking (new) activities to cope with break-ups, to maintain long-term relationships, and to regulate love feelings. Instructed up-regulation of love using reappraisal increased subjective feelings of attachment, while love down-regulation decreased subjective feelings of infatuation and attachment. We used the late positive potential (LPP) amplitude as an objective index of regulation success. Instructed love up-regulation enhanced the LPP between 300-400 ms in participants who were involved in a relationship and in participants who had recently experienced a romantic break-up, while love down-regulation reduced the LPP between 700-3000 ms in participants who were involved in a relationship. These findings corroborate the self-reported feasibility of love regulation, although they are complicated by the finding that love up-regulation also reduced the LPP between 700-3000 ms in participants who were involved in a relationship. To conclude, although people have the preconception that love feelings are uncontrollable, we show for the first time that intentional regulation of love feelings using reappraisal, and perhaps other strategies, is feasible. Love regulation will benefit individuals and society because it could enhance positive effects and reduce negative effects of romantic love.
El amor romántico vs. drogadicción puede inspirar un nuevo tratamiento para la adicción.
Romantic Love vs. Drug Addiction May Inspire a New Treatment for Addiction.
Front Psychol. 2016 Sep 22;7:1436. eCollection 2016.
Abstract
Drug addiction is a complex neurological dysfunction induced by recurring drug intoxication. Strategies to prevent and treat drug addiction constitute a topic of research interest. Early-stage romantic love is characterized by some characteristics of addiction, which gradually disappear as the love relationship progresses. Therefore, comparison of the concordance and discordance between romantic love and drug addiction may elucidate potential treatments for addiction. This focused review uses the evidences from our recent studies to compare the neural alterations between romantic love and drug addiction, moreover we also compare the behavioral and neurochemical alterations between romantic love and drug addiction. From the behavioral comparisons we find that there are many similarities between the early stage of romantic love and drug addiction, and this stage romantic love is considered as a behavioral addiction, while significant differences exist between the later stage of romantic love and drug addiction, and this stage of romantic love eventually developed into a prosocial behavior. The neuroimaging comparisons suggest that romantic love and drug addiction both display the functional enhancement in reward and emotion regulation network. Except the similar neural changes, romantic love display special function enhancement in social cognition network, while drug addiction display special dysfunction in cognitive control network. The neurochemical comparisons show that there are many similarities in the dopamine (DA) system, while significant differences in oxytocin (OT) system for romantic love and drug addiction. These findings indicate that the functional alterations in reward and emotion regulation network and the DA system may be the neurophysiological basis of romantic love as a behavioral addiction, and the functional alterations in social cognition network and the OT system may be the neurophysiological basis of romantic love as a prosocial behavior. It seems that the OT system is a critical factor for the development of addiction. So we then discuss strategies to treat drug addiction with OT, and suggest that future research should further investigate OT system interventions aiming to improve cognitive control and/or social cognition functions, in order to develop strategies designed to more effectively treat drug addiction.
KEYWORDS: drug addiction; drug addiction treatment; oxytocin; resting-state functional connectivity; romantic love; social cognition system
5to Curso Internacional de Anestesiología cardiotorácica, vascular, ecocardiografía y circulación extracorpórea. SMACT
Mayo 4-6, 2017, Mexicali, México
Informes Dr. Hugo Martínez Espinoza bajamed@hotmail.com
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
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Anestesiología y Medicina del Dolor

52 664 6848905

Copyright © 2015

Pie equinovaro asociado con hemimelia tibial y fibular

Pie equinovaro asociado con hemimelia tibial y fibular



Pie equinovaro asociado con hemimelia tibial y fibular

Clubfoot associated with tibial and fibular hemimelia
Fuente
Este artículo es originalmente publicado en:
.
Z Orthop Unfall. 2012 Oct;150(5):525-32. doi: 10.1055/s-0032-1314997. Epub 2012 Oct 17.
Todos los derechos reservados para:
© 2016 Georg Thieme Verlag KGAbstractAIM:
Clubfoot is rarely associated with tibial or fibular hemimelia. Treatment is complex and in most of the cases extensive surgery is required. At present experience with Ponseti casting is limited. We describe casting and surgical treatment of 10 clubfeet associated with tibial and fibular hemimelia.
CONCLUSION:
Treatment of clubfoot associated with tibial or fibular hemimelia with the Ponseti technique is limited because of complex hindfoot deformities including tarsal coalitions. Nevertheless treatment after birth starts with casting. Only mild cases of hemimelia without coalition can be corrected with the Ponseti technique. In a case of tibiofibular diastasis successful casting is possible, but extensive surgery is often necessary. In more severe cases we do not recommend casting. In these cases surgical treatment, including posteromedial release, osteotomies for the hindfoot, resection of coalitions or complex osteotomies with Ilisarov or TSF frame is the treatment of choice.
Resumen
OBJETIVO:
El pie equinovaro rara vez se asocia con hemimelia tibial o fibular. El tratamiento es complejo y en la mayoría de los casos se requiere cirugía extensa. En la actualidad la experiencia con yesos de Ponseti es limitada. Describimos el método Ponseti y el tratamiento quirúrgico de 10 pies equinovaros con hemimelia tibial y fibular.
CONCLUSIÓN:
El tratamiento del pie zambo asociado con la hemimelia tibial o fibular con la técnica de Ponseti está limitado debido a las deformidades complejas del retroceso incluyendo coaliciones tarsales. Sin embargo, el tratamiento después del nacimiento comienza con el método Ponseti. Sólo los casos leves de hemimelia sin coalición pueden ser corregidos con la técnica de Ponseti. En un caso de diastasis tibiofibular, es posible el método Ponseti exitoso, pero a menudo es necesaria una cirugía extensiva. En casos más severos no recomendamos el lanzamiento. En estos casos, el tratamiento quirúrgico, incluyendo la liberación posteromedial, osteotomías para el retropié, resección de coaliciones o osteotomías complejas con marco Ilisarov o TSF es el tratamiento de elección.
Georg Thieme Verlag KG Stuttgart · New York.
PMID: 23076751  DOI:
[PubMed – indexed for MEDLINE]

Tratamiento Artroscópico de la Condromatosis Sinovial en Tobillo. Reporte de Caso y Revisión de la Literatura

Tratamiento Artroscópico de la Condromatosis Sinovial en Tobillo. Reporte de Caso y Revisión de la Literatura

Opioides / Opioids

Diciembre 26,  2016. No. 2550






Documento de posición de la Federación Europea del Dolor sobre el uso apropiado de opiáceos en el tratamiento del dolor crónico.
European Pain Federation position paper on appropriate opioid use in chronic pain management.
Eur J Pain. 2017 Jan;21(1):3-19. doi: 10.1002/ejp.970.
Abstract
Poorly controlled pain is a global public health issue. The personal, familial and societal costs are immeasurable. Only a minority of European patients have access to a comprehensive specialist pain clinic. More commonly the responsibility for chronic painmanagement and initiating opioid therapy rests with the primary care physician and other non-specialist opioid prescribers. There is much confusing and conflicting information available to non-specialist prescribers regarding opioid therapy and a great deal of unjustified fear is generated. Opioid therapy should only be initiated by competent clinicians as part of a multi-faceted treatment programme in circumstances where more simple measures have failed. Throughout, all patients must be kept under close clinical surveillance. As with any other medical therapy, if the treatment fails to yield the desired results and/or the patient is additionally burdened by an unacceptable level of adverse effects, the overall management strategy must be reviewed and revised. No responsible clinician will wish to pursue a failed treatment strategy or persist with an ineffective and burdensome treatment. In a considered attempt to empower and inform non-specialist opioid prescribers, EFIC convened a European group of experts, drawn from a diverse range of basic science and relevant clinical disciplines, to prepare a position paper on appropriate opioid use in chronicpain. The expert panel reviewed the available literature and harnessed the experience of many years of clinical practice to produce these series of recommendations. Its success will be judged on the extent to which it contributes to an improved pain management experience for chronic pain patients across Europe. SIGNIFICANCE: This position paper provides expert recommendations for primary care physicians and other non- specialist healthcare professionals in Europe, particularly those who do not have ready access to specialists in pain medicine, on the safe and appropriate use of opioid medications as part of a multi-faceted approach to pain management, in properly selected and supervised patients.
Las bases farmacológicas de los opioides
The pharmacological basis of opioids.
Clin Cases Miner Bone Metab. 2015 Sep-Dec;12(3):219-21.
Abstract
An opioid is a chemical that binds to opioid receptors, which are widely distributed in the central and peripheral nervous system and gastrointestinal tract. The different effects elicited by activation of these receptors are due to their specific neuronal and extraneuronal distribution. The painkiller effect of opioids is induced by the synergy of the two events, namely reduction of pain threshold and emotional detachment from pain. The opioid effects transcending analgesia include sedation, respiratory depression, constipation and a strong sense of euphoria. There are opioid-like substances endogenously produced by the body. Naturally occurring peptides, called enkephalins, have opioid-like activities but are not derived from opium and exert opioid-like effects by interacting with opioid receptors on cell membranes. Yet, animals do contain the same morphine precursors and metabolites as opium poppy and are able to synthesize endogenous morphine alkaloid. Experimental and clinical studies show that opioids, at doses comparable to those of endogenous opioids, can activate pronociceptive systems, leading to pain hypersensitivity and short-term tolerance, a phenomenon encountered in postoperative pain management by acute opioid administration. Whether endogenous opioids play a role in the acute pain necessary to the survival of the individual, remains an open question.
KEYWORDS: analgesia; morphine; opioids; pain
5to Curso Internacional de Anestesiología cardiotorácica, vascular, ecocardiografía y circulación extracorpórea. SMACT
Mayo 4-6, 2017, Mexicali, México
Informes Dr. Hugo Martínez Espinoza bajamed@hotmail.com
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
Like us on Facebook   Follow us on Twitter   Find us on Google+   View our videos on YouTube 
Anestesiología y Medicina del Dolor

52 664 6848905

Copyright © 2015