lunes, 10 de abril de 2017

Paro cardiaco en el embarazo / Cardiac arrest in pregnancy

Abril 10, 2017. No. 2655






Declaración de consenso de la Sociedad para la Anestesia Obstétrica y la Perinatología sobre el manejo del paro cardíaco durante el embarazo.
The Society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy.
Anesth Analg. 2014 May;118(5):1003-16. doi: 10.1213/ANE.0000000000000171.
Abstract
This consensus statement was commissioned in 2012 by the Board of Directors of the Society for Obstetric Anesthesia and Perinatology to improve maternal resuscitation by providing health care providers critical information (including point-of-care checklists) and operational strategies relevant to maternal cardiac arrest. The recommendations in this statement were designed to address the challenges of an actual event by emphasizing health care provider education, behavioral/communication strategies, latent systems errors, and periodic testing of performance. This statement also expands on, interprets, and discusses controversial aspects of material covered in the American Heart Association 2010 guidelines.

Paro cardiaco en el embarazo. Una declaración científica de la American Heart Association.
Cardiac Arrest in Pregnancy: A Scientific Statement From the American Heart Association.
Circulation. 2015 Nov 3;132(18):1747-73. doi: 10.1161/CIR.0000000000000300. Epub 2015 Oct 6.
Abstract
This is the first scientific statement from the American Heart Association on maternal resuscitation. This document will provide readers with up-to-date and comprehensive information, guidelines, and recommendations for all aspects of maternal resuscitation. Maternal resuscitation is an acute event that involves many subspecialties and allied health providers; this document will be relevant to all healthcare providers who are involved in resuscitation and specifically maternal resuscitation.
KEYWORDS: AHA Scientific Statements; cardiopulmonary resuscitation; heart arrest; pregnancy

Manejo del paro cardíaco materno en el tercer  trimestre del embarazo: Estudio piloto basado en la simulación.
Management of Maternal Cardiac Arrest in the Third Trimester of Pregnancy: A Simulation-Based Pilot Study.
Crit Care Res Pract. 2016;2016:5283765. doi: 10.1155/2016/5283765. Epub 2016 Jul 31.
Abstract
Objective. To evaluate confidence, knowledge, and competence after a simulation-based curriculum on maternal cardiac arrest in an Obstetrics & Gynecologic (OBGYN) residency program. Methods. Four simulations with structured debriefing focusing on high yield causes and management of maternal cardiac arrest were executed. Pre- and post-individual knowledge tests (KT) and confidence surveys (CS) were collected along with group scores of critical performance steps evaluated by content experts for the first and final simulations. Results. Significant differences were noted in individual KT scores (pre: 58.9 ± 8.9 versus post: 72.8 ± 6.1, p = 0.01) and CS total scores (pre: 22.2 ± 6.4 versus post: 29.9 ± 3.4, p = 0.007). Significant differences were noted in airway management, p = 0.008; appropriate cycles of drug/shock-CPR, p = 0.008; left uterine displacement, p = 0.008; and identifying causes of cardiac arrest, p = 0.008. Nonsignificant differences were noted for administration of appropriate drugs/doses, p = 0.074; chest compressions, p = 0.074; bag-mask ventilation before intubation, p = 0.074; and return of spontaneous circulation identification, p = 0.074. Groups remained noncompetent in team leader tasks and considering therapeutic hypothermia. Conclusion. This study demonstrated improved OBGYN resident knowledge, confidence, and competence in the management of third trimester maternal cardiac arrest. Several skills, however, will likely require more longitudinal curricular exposure and training to develop and maintain proficiency.
Vacante para Anestesiología Pediátrica
El Hospital de Especialidades Pediátricas de León, Guanajuato México 
ofrece un contrato laboral en el departamento de anestesiología 
Informes con la Dra Angélica García Álvarez 
angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028
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Anestesiología y Medicina del Dolor

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jueves, 6 de abril de 2017

La fuerza de rotación externa de la cadera predice el rendimiento del salto después de la reconstrucción del ligamento cruzado anterior.



Hip external rotation strength predicts hop performance after anterior cruciate ligament reconstruction.

Fuente
Este artículo es originalmente publicado en:
De:
2017 Apr 4. doi: 10.1007/s00167-017-4534-6. [Epub ahead of print]
Todos los derechos reservados para:

Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2017

Abstract
PURPOSE:
Quadriceps strength and single-leg hop performance are commonly evaluated prior to return to sport after anterior cruciate ligament reconstruction (ACLR). However, few studies have documented potential hip strength deficits after ACLR, or ascertained the relative contribution of quadriceps and hip strength to hop performance.
CONCLUSIONS:
After ACLR, patients have persistent HER (hip external rotation) strength, knee extension strength, and hop test deficits in the operative limb compared to the control and non-operative limbs, even after starting sport-specific drills. Importantly, HER strength independently predicted hop performance. Based on these findings, to resolve between-limb deficits in strength and hop performance clinicians should include HER strengthening exercises in post-operative rehabilitation.
LEVEL OF EVIDENCE:
Prognostic Study, Level II.
KEYWORDS:
ACL; Hip strength; Quadriceps; Rehabilitation
Resumen
PROPÓSITO:
La fuerza del cuádriceps y el rendimiento del salto de una pierna se evalúan comúnmente antes de regresar al deporte después de la reconstrucción del ligamento cruzado anterior (ACLR). Sin embargo, pocos estudios han documentado los posibles déficits de la fuerza de la cadera después de la ACLR, o han comprobado la contribución relativa del cuadriceps y la fuerza de la cadera al rendimiento del salto.
CONCLUSIONES:
Después de la ACLR, los pacientes tienen una fuerza persistente de HER (rotación externa de la cadera), fuerza de extensión de la rodilla y déficit de la prueba de salto en la extremidad operativa en comparación con los miembros control y no quirúrgicos, incluso después de iniciar ejercicios específicos para el deporte. Es importante destacar que su fuerza predijo independientemente el rendimiento del salto. Sobre la base de estos hallazgos, para resolver los déficits entre miembros en la fuerza y el desempeño hop clínicos deben incluir HER ejercicios de fortalecimiento en la rehabilitación post-operatorio.
NIVEL DE EVIDENCIA:
Estudio Pronóstico, Nivel II.
PALABRAS CLAVE:
ACL; Resistencia a la cadera; Cuadríceps; Rehabilitación
PMID:   28378137   DOI:  

Tendencias en la cirugía del nervio



                                                                                                                                                         

Trends in nerve surgery

Fuente
Este artículo es originalmente publicado en:
De Y todos los derechos reservados para:
Courtesy: Dominic Power, Consultant Hand Surgeon, Birmingham, UK
This talk details the decision making process and reconstructive options for peripheral nerve injury dependent on the timing of presentation and surgery.
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Principios de la transferencia de tendones



Principles of tendon transfer

Fuente
Este artículo es originalmente publicado en:
De y todos los derechos reservados para:
Courtesy: Dominic Power, Consultant Hand Surgeon, Birmingham, UK
Tendon transfers may reconstruct loss of function through injury, disease or congenital absence. The principles are simple and should be adhered to wherever possible to ensure reliable outcomes for patients.
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Las funciones de la mano


Fuente
Este artículo es originalmente publicado en:
De y Todos los derechos reservados para:
Courtesy: Dominic Power, Consultant Hand Surgeon, Birmingham, UK
The functions of the hand must be assessed from the patient’s perspective. Damage or loss will compromise function and a knowledge of the hand functions will help in planning reconstruction and rehabilitation after injury
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