Feliz 2017 / Feliç 2017 /m Happy 2017 / lycklig 2017

Enero 1, 2017. No. 2556

Hoy iniciamos este año felices de estar cumpliendo nuestra meta educativa y a la vez enviar un afectuoso saludo a todos nuestros amigos y colegas deseándoles un 2017 lleno de Salud, Amor y Éxitos en compañía de sus seres queridos y de cada uno de sus pacientes. La información con acceso abierto ha crecido en forma logarítmica y ahora es gratuito actualizarse en cualquier tema del saber humano. Hoy cumplimos 7 años de haber iniciado nuestro Programa Alfa de Actualización Continua en Medicina haciendo llegar a la computadora de 4,646 colegas localizados en los 5 continentes información relevante de diversos temas. Esta información se selecciona y se envía diariamente de acuerdo al interés de cada colega inscrito en este programa. Desde enero 1, 2010 se han enviado 2,556 correos electrónicos con 1 o más artículos completos en PDF, HTLM, revistas, libros, imágenes o videoclips con información actualizada o temas clásicos. Se le invita a enviarnos sugerencias para mejorar este programa educativo y una vez más le agradecemos su valioso apoyo. Today we start this year happy to be fulfilling our educational goal and at the same time sending a warm greeting to all our friends and colleagues wishing them a 2017 full of Health, Love and Success in the company of their loved ones and each of their patients. Information with open access has grown logarithmic and is now free to update on any subject of the human knowledge. Today is our seventh year since we started our Alpha Program of Continuous Updating in Medicine, reaching the computer of 4,646 colleagues located in the 5 continents with relevant information on various topics. This information is selected and sent daily according to the interest of each colleague enrolled in this program. Since January 1, 2010 we have sent 2,556  e-mails with 1 or more complete articles in PDF, HTLM, journals, books, images or video clips with updated information or classic themes. You are invited to send us suggestions to improve this educational program and once again we thank you for your valuable support. Σήμερα θα ξεκινήσουμε αυτό το έτος να είναι ευτυχισμένο εκπλήρωση των εκπαιδευτικών μας στόχος και ταυτόχρονα να στείλει θερμούς χαιρετισμούς σε όλους τους φίλους και τους συνεργάτες μας να σας ευχηθώ μια γεμάτη υγεία, αγάπη και την επιτυχία το 2017 στην εταιρεία των αγαπημένων και κάθε ένα από τους ασθενείς τους. Οι πληροφορίες ανοικτή πρόσβαση έχει αυξηθεί λογαριθμικά και είναι πλέον δωρεάν αναβάθμιση για οποιοδήποτε θέμα της ανθρώπινης γνώσης. Σήμερα συναντηθήκαμε 7 έτη μετά την έναρξη Πρόγραμμα Συνεχούς μας Άλφα Ενημέρωση στην Ιατρική φτάνοντας 4.646 συναδέλφους υπολογιστή που βρίσκεται στις 5 ηπείρους σχετικές πληροφορίες για διάφορα θέματα. Αυτές οι πληροφορίες είναι επιλεγμένο και αποστέλλονται καθημερινά, σύμφωνα με το συμφέρον του κάθε συνάδελφο που εγγράφονται σε αυτό το πρόγραμμα. Από την 1η Ιανουαρίου 2010 έχουν σταλεί 2.556 emails με 1 ή περισσότερα πλήρη άρθρα σε μορφή PDF, Htlm, περιοδικά, βιβλία, φωτογραφίες ή βίντεο κλιπ με ενημερωμένες πληροφορίες ή κλασική θέματα. Μπορείτε καλούνται να αποστείλουν προτάσεις για τη βελτίωση αυτού του εκπαιδευτικού προγράμματος και για άλλη μια φορά να σας ευχαριστήσω για την πολύτιμη υποστήριξή σας. Avui iniciem aquest any feliços d'estar complint la nostra meta educativa i alhora enviar una afectuosa salutació a tots els nostres amics i col·legues desitjant-los 1 2017 ple de Salut, Amor i Èxits en companyia dels seus éssers estimats i de cadascun dels seus pacients. La informació amb accés obert ha crescut en forma logarítmica i ara és gratuït actualitzar-se en qualsevol tema del saber humà. Avui complim 7 anys d'haver iniciat el nostre Programa Alfa d'Actualització Contínua en Medicina fent arribar a l'ordinador de 4,646 col·legues localitzats en els 5 continents informació rellevant de diversos temes. Aquesta informació es selecciona i s'envia diàriament d'acord a l'interès de cada col·lega inscrit en aquest programa. Des de gener 1, 2010 s'han enviat 2,556 correus electrònics amb 1 o més articles complets en PDF, HTLM, revistes, llibres, imatges o clips de vídeo amb informació actualitzada o temes clàssics. Se li convida a enviar-nos suggeriments per millorar aquest programa educatiu i una vegada més li agraïm el seu valuós suport. Neuroplasticidad en la práctica clínica. Construyendo poder cerebral para la salud Neuroplasticity and Clinical Practice: Building Brain Power for Health. Shaffer J1. Front Psychol. 2016 Jul 26;7:1118. doi: 10.3389/fpsyg.2016.01118. eCollection 2016. Abstract The focus of this review is on driving neuroplasticity in a positive direction using evidence-based interventions that also have the potential to improve general health. One goal is to provide an overview of the many ways new neuroscience can inform treatment protocols to empower and motivate clients to make the lifestyle choices that could help build brain power and could increase adherence to healthy lifestyle changes that have also been associated with simultaneously enhancing vigorous longevity, health, happiness, and wellness. Another goal is to explore the use of a focus in clinical practice on helping clients appreciate this new evidence and use evolving neuroscience in establishing individualized goals, designing strategies for achieving them and increasing treatment compliance. The timing is urgent for such interventions with goals of enhancing brain health across the lifespan and improving statistics on dementia worldwide. KEYWORDS: brain plasticity; cognition; cognitive; computerized cognitive training; health psychology; healthy aging; neurogenesis; neuroplasticity PDF La Felicidad y El Arte de Ser Bhagavan Sri Ramana PDF Trabajo y equilibrio de vida "Si no somos felices tanto en el trabajo como fuera del trabajo, no podemos proporcionar felicidad a los demás". Work and Life Balance "If We Are Not Happy Both in Work and out of Work, We Cannot Provide Happiness to Others". Kimura D1. Front Pediatr. 2016 Feb 17;4:9. doi: 10.3389/fped.2016.00009. eCollection 2016. KEYWORDS: burnout; happiness; other industries; pediatric critical care medicine; professional; work-life balance PDF Felicidad y salud: Los factores biológicos. Revisión sistemática Happiness & Health: The Biological Factors- Systematic Review Article. Dfarhud D1, Malmir M2, Khanahmadi M3. Iran J Public Health. 2014 Nov;43(11):1468-77. Abstract Happiness underlying factors are considerable from two dimensions: endogenic factors (biological, cognitive, personality and ethical sub-factors) and exogenic factors (behavioral, socialcultural, economical, geographical, life events and aesthetics sub-factors). Among all endogenic factors, biological sub-factors are the significant predictors of happiness. Existence of significant differences in temperament and happiness of infants is an indicator of biological influences. Therefore, this study aimed to consider biological factors that underlie happiness. At the first, all of the biological factors in relation with happiness were searched from following websites: PubMed, Wiley& Sons, Science direct (1990-2014). Then, the articles divided into five sub-groups (genetic, brain and neurotransmitters, endocrinology and hormones, physical health, morphology and physical attractiveness). Finally, a systematic review performed based on existing information. Results of studies on genetic factors indicated an average effectiveness of genetic about 35 -50 percent on happiness. In spite of difficulties in finding special genes, several genes distributed to emotion and mood. Neuroscience studies showed that some part of brain (e.g. amygdala, hipocamp and limbic system) and neurotransmitters (e.g. dopamine, serotonin, norepinefrine and endorphin) play a role in control of happiness. A few studies pointed to the role of cortisol and adrenaline (adrenal gland) and oxitocin (pituitary gland) in controlling happiness. Physical health and typology also concluded in most related studies to have a significant role in happiness. Therefore, according to previous research, it can be said that biological and health factors are critical in underlying happiness and its role in happiness is undeniable. KEYWORDS: Biological factors; Happiness; Health PDF 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

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

Videos On-line de artroscopias en hombro.

Videos On-line de artroscopias en hombro.

Testigos de Jehová / Jehovah's Witnesses

Enero 2, 2017. No. 2557

El tratamiento con dosis bajas de eritropoyetina no está asociado con los beneficios clínicos en los Testigos de Jehová gravemente anémicos: una súplica para un cambio. Low-dose erythropoietin treatment is not associated with clinical benefits in severely anaemic Jehovah's Witnesses: a plea for a change. Beliaev AM1, Allen SJ2, Milsom P1, Nand P1, Smith WM3, Bergin CJ4. Blood Transfus. 2016 Nov 15:1-10. doi: 10.2450/2016.0085-16. [Epub ahead of print] Abstract BACKGROUND: Jehovah's Witnesses who refuse blood transfusion have high mortality. Erythropoietin (EPO) has been used as an alternative to blood transfusion. The optimal dosing of EPO in anaemic Jehovah's Witnesses is unknown. The aim of our study was to evaluate the clinical benefits of treatment with a low dose (<600 IU/kg/week) of epoietin beta (EPO-β). MATERIALS AND METHODS: This was an observational study, retrospectively considering a 10-year period during which 3,529 adult Jehovah's Witnesses with a total of 10,786 hospital admissions were identified from databases of four major public hospitals in New Zealand. Patients with severe symptomatic anaemia (haemoglobin <80 g/L) who were unable to tolerate physical activity were included in the study. Patients treated without EPO were assigned to the conventional therapy group and those treated with EPO to the EPO treatment group. RESULTS: Ninety-one Jehovah's Witnesses met the eligibility criteria. Propensity score matching yielded a total of 57 patients. Patients treated with conventional therapy and those treated with EPO had similar durations of severe anaemia (average difference 6.25 days, 95% confidence interval [CI]: -3.77-16.27 days; p=0.221). The mortality rate among Jehovah's Witnesses treated with conventional therapy was 4.68 per year (95% CI: 2.23-9.82), while that in those treated with EPO was 2.77 per year (95% CI: 0.89-8.60). Treatment with EPO was associated with a mortality ratio of 0.59 (95% CI: 0.1-2.6; p=0.236). Both groups of patients had similar in-hospital survival (p=0.703). DISCUSSION: Treatment with low-dose EPO-β was not associated with either shorter duration of severe anaemia or a reduction in mortality. PDF Perioperatorio de los Testigos Jehová: una revisión. Perioperative Jehovah's Witnesses: a review. Lawson T1, Ralph C2. Br J Anaesth. 2015 Nov;115(5):676-87. doi: 10.1093/bja/aev161. Epub 2015 Jun 11. Abstract There are many patient groups who may refuse blood products; the most well known amongst them is the Jehovah's Witness faith. Treatment of anaemia and bleeding in such patients presents a challenge to medical, anaesthetic, and surgical teams. This review examines the perioperative issues and management of Jehovah's Witnesses. The history and beliefs of Jehovah's Witnesses are outlined together with their impact on ethics and the law, and different management options throughout the perioperative period are discussed. KEYWORDS: Jehovah's Witness; blood; coagulopathy; ethics; transfusion PDF El deber ético y legal de los anestesiólogos en relación con el paciente Testigo de Jehová: protocolo de atención. Ethical and legal duty of anesthesiologists regarding Jehovah's Witness patient: care protocol. Takaschima AK1, Sakae TM2, Takaschima AK3, Takaschima RD4, Lima BJ5, Benedetti RH6. Braz J Anesthesiol. 2016 Nov - Dec;66(6):637-641. doi: 10.1016/j.bjane.2015.03.012. Epub 2016 Sep 12. Abstract BACKGROUND AND OBJECTIVES: Jehovah's Witnesses patients refuse blood transfusions for religious reasons. Anesthesiologists must master specific legal knowledge to provide care to these patients. Understanding how the Law and the Federal Council of Medicine treat this issue is critical to know how to act in this context. The aim of this paper was to establish a treatment protocol for the Jehovah's Witness patient with emphasis on ethical and legal duty of the anesthesiologist. CONTENT: The article analyzes the Constitution, Criminal Code, resolutions of the Federal Council of Medicine, opinions, and jurisprudence to understand the limits of the conflict between the autonomy of will of Jehovah's Witnesses to refuse transfusion and the physician's duty to provide the transfusion. Based on this evidence, a care protocol is suggested. CONCLUSIONS: The Federal Council of Medicine resolution 1021/1980, the penal code Article 135, which classifies denial of care as a crime and the Supreme Court decision on the HC 268,459/SP process imposes on the physician the obligation of blood transfusion when life is threatened. The patient's or guardian's consent is not necessary, as the autonomy of will manifestation of the Jehovah's Witness patient refusing blood transfusion for himself and relatives, even in emergencies, is no not forbidden. KEYWORDS: Anestesiologia; Anesthesiology; Bioethics; Bioética; Blood; Blood products; Direito; Hemoderivados; Rights; Sangue; Transfusion; Transfusão PDF Cirugía torácica mayor en el Testigo de Jehová: Un caso de enfoque multidisciplinario. Major thoracic surgery in Jehovah's witness: A multidisciplinary approach case report. Rispoli M1, Bergaminelli C2, Nespoli MR3, Esposito M4, Mattiacci DM5, Corcione A6, Buono S7. Int J Surg Case Rep. 2016;23:116-9. doi: 10.1016/j.ijscr.2016.04.024. Epub 2016 Apr 19. Abstract INTRODUCTION: A bloodless surgery can be desirable also for non Jehovah's witnesses patients, but requires a team approach from the very first assessment to ensure adequate planning. PRESENTATION OF THE CASE: Our patient, a Jehovah's witnesses, was scheduled for right lower lobectomy due to pulmonary adenocarcinoma. Her firm denies to receive any kind of transfusions, forced clinicians to a bloodless management of the case. DISCUSSION: Before surgery a meticulous coagulopathy research and hemodynamic optimization are useful to prepare patient to operation. During surgery, controlled hypotension can help to obtain effective hemostasis. After surgery, clinicians monitored any possible active bleeding, using continuous noninvasive hemoglobin monitoring, limiting the blood loss due to serial in vitro testing. The optimization of cardiac index and delivery of oxygen were continued to grant a fast recovery. CONCLUSION: Bloodless surgery is likely to gain popularity, and become standard practice for all patients. The need for transfusion should be targeted on individual case, avoiding strictly fixed limit often leading to unnecessary transfusion. KEYWORDS: Bleeding monitoring; Bloodless surgery; Case report; Jehovah's witness surgery; Thoracic surgery PDF 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 Información / Information California Society of Anesthesiologists Annual Meeting April 27-30, 2017 San Francisco California Información / Information

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

¿La cápsula de cadera permanece cerrada después de la artroscopia de cadera con cierre capsular de rutina para el choque femoroacetabular? Un análisis de imágenes por resonancia magnética en pacientes postoperatorios sintomáticos





http://www.ortopediapediatricaisunza.com.mx/academia/la-capsula-de-cadera-permanece-cerrada-despues-de-la-artroscopia-de-cadera-con-cierre-capsular-de-rutina-para-el-choque-femoroacetabular-un-analisis-de-imagenes-por-resonancia-magnetica-en-paci/

¿La cápsula de cadera permanece cerrada después de la artroscopia de cadera con cierre capsular de rutina para el choque femoroacetabular? Un análisis de imágenes por resonancia magnética en pacientes postoperatorios sintomáticos

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Por admin

Does the Hip Capsule Remain Closed After Hip Arthroscopy With Routine Capsular Closure for Femoroacetabular Impingement? A Magnetic Resonance Imaging Analysis in Symptomatic Postoperative Patients

Fuente
Este artículo es originalmente publicado en:



https://www.ncbi.nlm.nih.gov/pubmed/27720303

http://www.arthroscopyjournal.org/article/S0749-8063%2816%2930525-4/fulltext



De:

Weber AE¹, Kuhns BD², Cvetanovich GL², Lewis PB³, Mather RC⁴, Salata MJ⁵, Nho SJ².



Todos los derechos reservados para:

Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Abstract

PURPOSE:

The purpose of this study was to examine the hip capsule in a subset of symptomatic patients who underwent capsular closure during hip arthroscopy.

CONCLUSIONS:

In a subset of symptomatic patients after hip arthroscopy for FAI, the majority (92.5%) of the repaired hip capsules remained closed at greater than 1 year of follow-up. The hip capsule adjacent to the capsulotomy and subsequent repair is thickened compared with the same location on the contralateral, nonoperative hip. Aside from gender, patient-related and FAI(femoroacetabular impingement)-related factors do not correlate with capsular thickness nor do they seem to correlate with the propensity to develop a capsular defect.

Resumen

PROPÓSITO:
El propósito de este estudio fue examinar la cápsula de cadera en un subconjunto de pacientes sintomáticos sometidos a cierre capsular durante la artroscopia de cadera.


CONCLUSIONES:
En un subgrupo de pacientes sintomáticos después de artroscopia de cadera por FAI (pinzamiento femoroacetabular), la mayoría (92,5%) de las cápsulas de cadera reparadas permanecieron cerradas en más de 1 año de seguimiento. La cápsula de cadera adyacente a la capsulotomía y la reparación posterior se espesa en comparación con la misma localización en la cadera contralateral no operatoria. Aparte del sexo, los factores relacionados con el paciente y FAI no se correlacionan con el espesor capsular ni parecen correlacionarse con la propensión a desarrollar un defecto capsular.

LEVEL OF EVIDENCE:

Level IV, prognostic case series.

Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

PMID: 27720303 DOI: 10.1016/j.arthro.2016.07.022

[PubMed – in process]

Resección artroscópica de los gangliones palmares del borde radial de la muñeca

http://www.clinicademano.com.mx/academia/reseccion-artroscopica-de-los-gangliones-palmares-del-borde-radial-de-la-muneca/



Resección artroscópica de los gangliones palmares del borde radial de la muñeca



Fuente
Este artículo es originalmente publicado en:

http://www.revistaartroscopia.com/index.php/ediciones-anteriores/2003/volumen-10-numero-1/31-volumen-05-numero-1/volumen-10-numero-1/515-reseccion-artroscopica-de-los-gangliones-palmares-del-borde-radial-de-la-muneca



De:

Dr. Carlos R. Zaidenberg, Dr. Gabriel A. Clembosky, Dr. Christian J. Perrotto, Dr. Alvaro J. Muratore



Todos los derechos reservados para:

ASOCIACIÓN ARGENTINA DE ARTROSCOPÍA

RESUMEN:

Entre Noviembre de 1997 y Junio de 2002 se realizó la resección artroscópica de gangliones palmares a diecinueve pacientes, doce mujeres y siete varones, con un seguimiento promedio de once meses.

El diagnostico fue clínico, identificando una tumoración de tamaño moderado o mínimo en borde radial de muñeca. La resonancia nuclear magnética fue usada en trece pacientes mientras que a los seis restantes se les realizó artrografía, en todos los casos se localizó el origen de la lesión.

La artroscopia permitió identificar el pedículo del ganglión en la articulación radio carpiana entre los ligamentos radio-hueso grande y radio-escafoideo en cinco pacientes, en el borde radial del ligamento radio-hueso grande en tres pacientes y en un caso en la articulación escafo-lunar. Siete gangliones provenían de la articulación medio carpiana (trapecio- escafoidea) y en tres casos artroscópicamente no observamos el origen del ganglión.

La resección artroscópica consistió en una pequeña sinovectomía del área involucrada. La artroscopía se presenta como una herramienta confiable en el tratamiento de los gangliones palmares del borde radial de la muñeca que provienen de la articulación radio y medio carpiana.

ABSTRACT:

Between November 1997 and June 2002 we performed arthroscopic resections of 19 palmar ganglions, twelve in women and 7 in men. The average follow-up was 11 months.

We used magnetic resonance in 13 patients and arthrography in the remaining six, identifying the origin of the ganglia in all of them.

Arthroscopy allowed us to identify the stalk in the radiocarpal joint between the radio-capitate and radio- scaphoid ligaments in 5 patients, on the radial border of the radio-capitate ligament in three patients, and in one case we found it in the scapho-lunate joint. The remaining seven came from the midcarpal joint (trapecio-scaphoid), and we were unable to identify the stalk in three cases.

In the arthroscopic procedure, we performed a small synovectomy on the stalk area. The arthroscopy has shown to be a reliable tool in the treatment of palmar ganglions of the radial border of the wrist coming from the radio carpal and midcarpal joint.