Pulmón, fumar y anestesia / Lung, smoking and anesthesia

Febrero 14 2017. No. 2600

Valoración preoperatoria de pacientes con enfermedades pulmonares programados para cirugía no cardiotorácica Perioperative Evaluation of Patients with Pulmonary Conditions Undergoing Non-Cardiothoracic Surgery. Diaz-Fuentes G1, Hashmi HR2, Venkatram S3. Health Serv Insights. 2016 Nov 9;9(Suppl 1):9-23. eCollection 2016. Abstract This review describes the perioperative management of patients with suspected or established pulmonary conditions undergoing non-cardiothoracic surgery, with a focus on common pulmonary conditions such as obstructive airway disease, pulmonary hypertension, obstructive sleep apnea, and chronic hypoxic respiratory conditions. Considering that postoperative pulmonary complications are common and given the increasing number of surgical procedures and the size of the aging population, familiarity with current guidelines for preoperative risk assessment and intra- and postoperative patient management is recommended to decrease the morbidity and mortality. In particular, smoking cessation and pulmonary rehabilitation are perioperative strategies for improving patients' short- and long-term outcomes. Understanding the potential risk for pulmonary complications allows the medical team to appropriately plan the intra- and postoperative care of each patient. KEYWORDS: chronic obstructive pulmonary disease; intraoperative care; obstructive sleep apnea; postoperative complications; pulmonary; pulmonary hypertension PDF Efectos de fumar y dejar de fumar sobre la cirugía de columna. Revisión sistemática de la literatura The Effects of Smoking and Smoking Cessation on Spine Surgery: A Systematic Review of the Literature. Jackson KL 2nd1, Devine JG2. Global Spine J. 2016 Nov;6(7):695-701. Epub 2016 Jan 15. PDF Tabaquismo y Efecto de la Dexmedetomidina y del Fentanil en la Intubación Traqueal Kemal Gulsoy 1, Serpil Deren 1, Semih Baskan 1, Dilsen Ornek 1, Bayazit Dikmen Rev Bras Anestesiol 2012; 62: 2: 141-153 PDF Cese del tabaquismo preoperatorio a corto plazo y complicaciones postoperatorias: revisión sistemática y meta-análisis Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis. Wong J1, Lam DP, Abrishami A, Chan MT, Chung F. Can J Anaesth. 2012 Mar;59(3):268-79. doi: 10.1007/s12630-011-9652-x. Epub 2011 Dec 21. Abstract PURPOSE: The literature was reviewed to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications and to derive the minimum duration of preoperative abstinence from smoking required to reduce such complications in adult surgical patients. SOURCE: We searched MEDLINE, EMBASE, Cochrane, and other relevant databases for cohort studies and randomized controlled trials that reported postoperative complications (i.e., respiratory, cardiovascular, wound-healing) and mortality in patients who quit smoking within six months of surgery. Using a random effects model, meta-analyses were conducted to compare the relative risks of complications in ex-smokers with varying intervals of smoking cessation vs the risks in current smokers. PRINCIPAL FINDINGS: We included 25 studies. Compared with current smokers, the risk of respiratory complications was similar in smokers who quit less than two or two to four weeks before surgery (risk ratio [RR] 1.20; 95% confidence interval [CI] 0.96 to 1.50 vs RR 1.14; CI 0.90 to 1.45, respectively). Smokers who quit more than four and more than eight weeks before surgery had lower risks of respiratory complications than current smokers (RR 0.77; 95% CI 0.61 to 0.96 and RR 0.53; 95% CI 0.37 to 0.76, respectively). For wound-healing complications, the risk was less in smokers who quit more than three to four weeks before surgery than in current smokers (RR 0.69; 95% CI 0.56 to 0.84). Few studies reported cardiovascular complications and there were few deaths. CONCLUSION: At least four weeks of abstinence from smoking reduces respiratory complications, and abstinence of at least three to four weeks reduces wound-healing complications. Short-term (less than four weeks) smoking cessation does not appear to increase or reduce the risk of postoperative respiratory complications. PDF Curso sobre Anestesia en Trasplantes, Cirugía abdominal, Plástica, Oftalmología y Otorrinolaringología. Committee for European Education in Anaesthesiology (CEEA)  y el Colegio de Anestesiólogos de León A.C. Abril 7-9, 2017, León Guanajuato, México Informes  (477) 716 06 16, kikinhedz@gmail.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

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

¿Cómo debemos evaluar los resultados para el uso de biológicos en la rodilla?

http://www.artroscopiayreemplazos.com.mx/academia/como-debemos-evaluar-los-resultados-para-el-uso-de-biologicos-en-la-rodilla/

                                                               

How should we evaluate outcomes for use of biologics in the knee?

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/25260033

https://www.thieme-connect.com/DOI/DOI?10.1055/s-0034-1390028

De:

LaPrade CM1,James EW1,LaPrade RF1,Engebretsen L2.

J Knee Surg.

2015 Feb;28(1):35-44. doi: 10.1055/s-0034-1390028. Epub 2014 Sep 26.

Todos los derechos reservados para:

© 2017 Georg Thieme Verlag KG

Abstract

In recent years, the use of biologics for the primary treatment and augmentation of treatment in patients with knee pathology has increased substantially. Techniques and applications for biologic preparations such as platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) have been developed and refined to increase the healing response in bone, ligaments, cartilage, meniscal tissue, and other areas of the knee. Beginning with basic science and animal models, and finally proceeding to clinical human trials, the effect of biologics on clinical outcomes has been widely studied; however, many results have been inconclusive on their true effectiveness. The purpose of this article is to review current strategies for evaluating outcomes after biologic treatment and to propose new recommendations for assessing outcomes following the use of biologics in the knee. In addition, the importance of study design, current challenges, and future directions will be reviewed to describe the current standards for future studies to follow.

Resumen

En los últimos años, el uso de productos biológicos para el tratamiento primario y el aumento del tratamiento en pacientes con patología de rodilla ha aumentado sustancialmente. Se han desarrollado y refinado técnicas y aplicaciones para preparaciones biológicas tales como plasma rico en plaquetas (PRP) y células madre mesenquimatosas (MSCs) para aumentar la respuesta de curación en hueso, ligamentos, cartílago, tejido meniscal y otras áreas de la rodilla. Comenzando con la ciencia básica y los modelos animales, y finalmente procediendo a ensayos clínicos en seres humanos, el efecto de los biológicos sobre los resultados clínicos ha sido ampliamente estudiado; Sin embargo, muchos resultados no han sido concluyentes sobre su verdadera eficacia. El propósito de este artículo es revisar las estrategias actuales para evaluar los resultados después del tratamiento biológico y proponer nuevas recomendaciones para evaluar los resultados después del uso de biológicos en la rodilla. Además, se revisará la importancia del diseño del estudio, los retos actuales y las direcciones futuras para describir las normas actuales para futuros estudios a seguir.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

PMID:25260033DOI:

10.1055/s-0034-1390028

[PubMed – indexed for MEDLINE]

#rodilla#biológicos#PRP#células madre

Inestabilidad traumática del codo

http://www.manoytrauma.com.mx/academia/inestabilidad-traumatica-del-codo/

Traumatic elbow instability – Assessment (OTA lecture series IV u06a)

Fuente
Este artículo es originalmente publicado en:

https://youtu.be/oBxkd7MasG0

De y Todos los derechos reservados para:

Courtesy:

Saqib Rehman MD

Director of Orthopaedic Trauma

Temple University

Philadelphia

Pennsylvania

USA

www.orthoclips.comPublicado el 21 ene. 2017

Narrated, annotated lecture 1 of 3 on traumatic elbow instability (“complex” fracture dislocations involving radial head and coronoid) from the OTA resident lecture series (narrated by Saqib Rehman, MD), from Orthoclips.com.

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#Inestabilidad traumática#codo