Más de US de vía aérea / More on airway ultrasound

Marzo 8, 2017. No. 2622

Ultrasonografía. Una herramienta viable para la evaluación de las vías respiratorias Ultrasonography - A viable tool for airway assessment. Reddy PB1, Punetha P1, Chalam KS1. Indian J Anaesth. 2016 Nov;60(11):807-813. Abstract BACKGROUND AND AIMS: Accurate prediction of the Cormack-Lehane (CL) grade preoperatively can help in better airway management of the patient during induction of anaesthesia. Our aim was to determine the utility of ultrasonography in predicting CL grade. METHODS: We studied 100 patients undergoing general endotracheal anaesthesia. Mallampati (MP) class, thyromental distance (TMD) and sternomental distance (SMD) were noted. Ultrasound measurements of the anterior neck soft tissue thickness at the level of the hyoid (ANS-Hyoid), anterior neck soft tissue thickness at the level of the vocal cords (ANS-VC) and ratio of the depth of the pre-epiglottic space (Pre-E) to the distance from the epiglottis to the mid-point of the distance between the vocal cords (E-VC) were obtained. CL grade was noted during intubation. Chi-square test was employed to determine if there was any statistical difference in the measurements of patients with different CL grades. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated for the various parameters. RESULTS: The incidence of difficult intubation was 14%. An ANS-VC >0.23 cm had a sensitivity of 85.7% in predicting a CL Grade of 3 or 4, which was higher than that of MP class, TMD and SMD. However, the specificity, PPV and accuracy were lower than the physical parameters. The NPV was comparable. CONCLUSION: Ultrasound is a useful tool in airway assessment. ANS-VC >0.23 cm is a potential predictor of difficult intubation. ANS-Hyoid is not indicative of difficult intubation. The ratio Pre-E/E-VC has a low to moderate predictive value. KEYWORDS: Airway; Cormack-Lehane grade; direct laryngoscopy; physical assessment; ultrasonography PDF Papel del ultrasonido en la vía aérea y endobronquial en medicina perioperatoria The Role of Airway and Endobronchial Ultrasound in Perioperative Medicine. Votruba J1, Zemanová P1, Lambert L2, Vesela MM3. Biomed Res Int. 2015;2015:754626. doi: 10.1155/2015/754626. Epub 2015 Dec 14. Abstract Recent years have witnessed an increased use of ultrasound in evaluation of the airway and the lower parts of the respiratory system. Ultrasound examination is fast and reliable and can be performed at the bedside and does not carry the risk of exposure to ionizing radiation. Apart from use in diagnostics it may also provide safe guidance for invasive and semi-invasive procedures. Ultrasound examination of the oral cavity structures, epiglottis, vocal cords, and subglottic space may help in the prediction of difficult intubation. Preoperative ultrasound may diagnose vocal cord palsy or deviation or stenosis of the trachea. Ultrasonography can also be used for confirmation of endotracheal tube, double-lumen tube, or laryngeal mask placement. This can be achieved by direct examination of the tube inside the trachea or by indirect methods evaluating lung movements. Postoperative airway ultrasound may reveal laryngeal pathology or subglottic oedema. Conventional ultrasound is a reliable real-time navigational tool for emergency cricothyrotomy or percutaneous dilational tracheostomy. Endobronchial ultrasound is a combination of bronchoscopy and ultrasonography and is used for preoperative examination of lung cancer and solitary pulmonary nodules. The method is also useful for real-time navigated biopsies of such pathological structures. 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 4° Congreso Internacional de Control Total de la Vía Aérea Asociación Mexicana de Vía  Aérea Difícil, AC Ciudad de México 21, 22 y 23 de Abril 2017 Informes: amvadmexico@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 © 2017

Cirujanos traumatológos ortopedistas y artroplastia total de cadera anterior directa

http://www.lesionesdeportivas.com.mx/academia/cirujanos-traumatologos-ortopedistas-y-artroplastia-total-de-cadera-anterior-directa-evaluacion-de-la-curva-de-aprendizaje-en-una-institucion-academica-de-nivel-i/

Orthopaedic trauma surgeons and direct anterior total hip arthroplasty: evaluation of learning curve at a level I academic institution.

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28258304

https://link.springer.com/article/10.1007%2Fs00590-017-1937-5

De:

York PJ1,Logterman SL1,Hak DJ2,Mavrogenis A3,Mauffrey C4.

Eur J Orthop Surg Traumatol.

2017 Mar 3. doi: 10.1007/s00590-017-1937-5. [Epub ahead of print]

Todos los derechos reservados para:

© Springer-Verlag France 2017

Abstract

BACKGROUND:

Interest in the direct anterior approach for total hip arthroplasty has increased over recent years; however, the potential for substantial complications exists, especially during the surgeon’s learning curve. We evaluated the change in various metrics to help identify a single surgeon’s learning curve. Additionally, we examined whether the learning curve was different for primarily arthroplasty versus trauma-trained surgeons.

CONCLUSION:

Our data support that surgeons who perform primarily joint arthroplasty will likely have a decreased surgical time, but similar EBL compared to those who include arthroplasty as only a portion of their practice, however, a number of confounding variables do exist, and additional investigation is warranted.

KEYWORDS:

Direct anterior approach; Learning curve; Total hip arthroplasty

Resumen

ANTECEDENTES:

El interés en el abordaje anterior directo para la artroplastia total de cadera ha aumentado en los últimos años; Sin embargo, existe la posibilidad de complicaciones sustanciales, especialmente durante la curva de aprendizaje del cirujano. Evaluamos el cambio en varias métricas para ayudar a identificar la curva de aprendizaje de un solo cirujano. Además, se examinó si la curva de aprendizaje fue diferente para la artroplastia, en primer lugar, versus trauma cirujanos entrenados.

CONCLUSIÓN:

Nuestros datos apoyan que los cirujanos que realizan principalmente artroplastia articular probablemente tendrán un menor tiempo quirúrgico, pero EBL similar en comparación con aquellos que incluyen artroplastia como sólo una parte de su práctica, sin embargo, existen varias variables de confusión y se requiere investigación adicional .

PALABRAS CLAVE:

Abordaje anterior directo; Curva de aprendizaje; Artroplastia total de cadera

PMID: 28258304 DOI: 10.1007/s00590-017-1937-5

#cirujanos#traumatologos#ortopedistas#abordaje anterior directo#curva de aprendizaje#artroplastia total de cadera

Exceso de mortalidad después de la fractura de cadera en ancianos de Europa y Estados Unidos

http://www.altaespecialidadenortopedia.com.mx/academia/exceso-de-mortalidad-despues-de-la-fractura-de-cadera-en-ancianos-de-europa-y-estados-unidos/

Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project.

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28093824

http://onlinelibrary.wiley.com/doi/10.1111/joim.12586/abstract;jsessionid=EDDC180EA72BC08DA5D8A9E0A51B7A3A.f03t01?systemMessage=PPV+on+Wiley+Online+Library+will+be+unavailable+on+Saturday+11th+March+from+05%3A00-14%3A00+GMT+%2F+12%3A00-09%3A00+EST+%2F+13%3A00-22%3A00+SGT+for+essential+maintenance.++Apologies+for+the+inconvenience.

De:

Katsoulis M1, Benetou V2, Karapetyan T1, Feskanich D3, Grodstein F3, Pettersson-Kymmer U4, Eriksson S5, Wilsgaard T6, Jørgensen L7, Ahmed LA7,8, Schöttker B9, Brenner H9, Bellavia A10, Wolk A10, Kubinova R11, Stegeman B12, Bobak M12, Boffetta P1,13, Trichopoulou A1.

J Intern Med. 2017 Mar;281(3):300-310. doi: 10.1111/joim.12586. Epub 2017 Jan 17.

Abstract

BACKGROUND:

Hip fractures are associated with diminished quality of life and survival especially amongst the elderly.

OBJECTIVE:

All-cause mortality after hip fracture was investigated to assess its magnitude.

CONCLUSION:

In this large population-based sample of older persons across eight cohorts, hip fracture was associated with excess short- and long-term all-cause mortality in both sexes.

© 2017 The Association for the Publication of the Journal of Internal Medicine.

KEYWORDS:

CHANCES; ageing; bone; hip fracture; mortality

Resumen

ANTECEDENTES:

Las fracturas de cadera se asocian con la disminución de la calidad de vida y la supervivencia, especialmente entre los ancianos.

OBJETIVO:

Se investigó la mortalidad por todas las causas después de la fractura de cadera para evaluar su magnitud.

CONCLUSIÓN:

En esta gran muestra poblacional de personas mayores a lo largo de ocho cohortes, la fractura de cadera se asoció con un exceso de mortalidad por todas las causas a corto y largo plazo en ambos sexos.

© 2017 La Asociación para la Publicación de la Revista de Medicina Interna.

PALABRAS CLAVE:

Posibilidad; envejecimiento; hueso; fractura de cadera; mortalidad

PMID: 28093824 DOI: 10.1111/joim.12586

#fractura #cadera #ancianos #mortalidad #envejecimiento #hueso #traumatología

Diagnóstico y tratamiento de la articulación sacroilíaca

http://www.cirugiavertebral.com.mx/academia/diagnostico-y-tratamiento-de-la-articulacion-sacroiliaca/

Diagnosis and Treatment of the Sacroiliac Joint

Fuente
Este artículo es originalmente publicado en:

https://www.spineuniverse.com/resource-center/si-bone-implant/diagnosis-treatment-sacroiliac-joint?utm_source=FBSIB45814

De y todos los derechos reservados para:

© 1999-2017 Vertical Health, LLC
This information is not designed to replace a physician’s independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions or back problem. SpineUniverse does not provide medical advice, diagnosis or treatment. Use of the SpineUniverse.com site is conditional upon your acceptance of our User Agreement

US de vía aérea / Airway ultrasound

Marzo 7, 2017. No. 2621

Ultrasonido laringotraqueal para confirmar la colocación correcta del tubo endotraqueal y ML Laryngo-tracheal ultrasonography to confirm correct endotracheal tube and laryngeal mask airway placement. Wojtczak JA1, Cattano D2. J Ultrason. 2014 Dec;14(59):362-6. doi: 10.15557/JoU.2014.0037. Epub 2014 Dec 30. Abstract Waveform capnography was recommended as the most reliable method to confirm correct endotracheal tube or laryngeal mask airway placements. However, capnography may be unreliable during cardiopulmonary resuscitation and during low flow states. It may lead to an unnecessary removal of a well-placed endotracheal tube, re-intubation and interruption of chest compressions. Real-time upper airway (laryngo-tracheal) ultrasonography to confirm correct endotracheal tube placement was shown to be very useful in cadaveric models and during emergency intubation. Tracheal ultrasonography does not interrupt chest compressions and is not affected by low pulmonary flow or airway obstruction, but is limited by ultrasonography scattering and acoustic artifacts generated in air - mucosa interfaces. Sonographic upper airway assessment emerges as a rapid and easily available method to predict difficult intubation, to assess the laryngeal and hypopharyngeal size and visualize the position of the laryngeal mask airway in situ. This study demonstrates that the replacement of air with saline in endotracheal tube or laryngeal mask airway cuffs and the use of the contrast agents enables detection of cuffs in the airway. It also allows visualization of the surrounding structures or tissues as the ultrasound beam can be transmitted through the fluid - filled cuffs without being reflected from air - mucosal interfaces. KEYWORDS: endotracheal intubation; laryngeal mask airway; upper airway sonography PDF  Ultrasonido: Una herramienta prometedora para el manejo contemporáneo de las vías respiratorias. Ultrasound: A promising tool for contemporary airway management. Garg R1, Gupta A1. World J Clin Cases. 2015 Nov 16;3(11):926-9. doi: 10.12998/wjcc.v3.i11.926. Abstract Airway evaluation and its management remains an ever emerging clinical science. Present airway management tools are static and do not provide dynamic airway management option. Visualized procedures like ultrasound (US) provide point of care real time dynamic views of the airway in perioperative, emergency and critical care settings. US can provide dynamic anatomical assessment which is not possible by clinical examination alone. US aids in detecting gastric contents and the nature of gastric contents (clear fluid, thick turbid or solid) as well. US can help in predicting endotracheal tube size by measuring subglottic diameter and diameter of left main stem bronchus. US was found to be a sensitive in detecting rotational malposition of LMA in children. Also, US is the fastest and highly sensitive tool to rule out a suspected intraoperative pneumothorax. In intensive care units, US helps torule out causes of inadequate ventilation, determine the tracheal width and distance from the skin to predict tracheotomy tube size and shape and assist with percutaneous dilatational tracheostomy. US can help in confirming the correct tracheal tube placement by dynamic visualisation of the endotracheal tube insertion, widening of vocal cords (children), and bilateral lung-sliding and diaphragmatic movement. Thus, ultrasonography has brought a paradigm shift in the practise of airway management. With increasing awareness, portability, accessibility and further sophistication in technology, it is likely to find a place in routine airway management. We are not far from the time when all of us will be carrying a pocket US machine like stethoscopes to corroborate our clinical findings at point of care. KEYWORDS: Airway; Difficult; Evaluation; Management; Ultrasound 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 4° Congreso Internacional de Control Total de la Vía Aérea Asociación Mexicana de Vía  Aérea Difícil, AC Ciudad de México 21, 22 y 23 de Abril 2017 Informes: amvadmexico@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

XVI Curso Internacional de Cirugía de la Mano / Homenaje al Dr. Luis Scheker / CDMX 2017

http://www.clinicademano.com.mx/academia/xvi-curso-internacional-de-cirugia-de-la-mano-homenaje-al-dr-luis-scheker-cdmx-2017/

XVI Curso Internacional de Cirugía de la Mano / Homenaje al Dr. Luis Scheker / CDMX 2017

Los costos financieros y humanos asociados con fracturas osteoporóticas aumentarán exponencialmente si no se adoptan medidas preventivas

http://www.traumaysiniestros.com.mx/traumatologia/los-costos-financieros-y-humanos-asociados-con-fracturas-osteoporoticas-aumentaran-exponencialmente-si-no-se-adoptan-medidas-preventivas/

Los costos financieros y humanos asociados con fracturas osteoporóticas aumentarán exponencialmente si no se adoptan medidas preventivas. pic.twitter.com/SKUd38EqIX

— Osteoamigos (@Osteoamigos) 6 de marzo de 2017