lunes, 31 de julio de 2017

Revisión de una hemiartroplastia fallida de hombro a una artroplastia total reversa: análisis de 157 implantes revisados


Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants

Fuente
Este artículo es originalmente publicado en:
De:
2017 Jul 24. pii: S1058-2746(17)30387-7. doi: 10.1016/j.jse.2017.06.038. [Epub ahead of print]
Todos los derechos reservados para:

Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.


Abstract
BACKGROUND:
There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulderarthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA.
CONCLUSION:
Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes.
Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
Shoulder; failed hemiarthroplasty; glenoid wear; reverse total arthroplasty; revision; rotator cuff



Resumen

ANTECEDENTES:
Sigue habiendo una escasez de estudios que examinan la conversión de la hemiartroplastia fallida (HA) a una  artroplastia total del hombro reversa (RTSA). Por lo tanto, el propósito de este estudio fue examinar una gran serie de revisión HA a RTSA.
CONCLUSIÓN:
Los pacientes experimentan un alivio satisfactorio del dolor y una recuperación de la función razonable del hombro después de la revisión RTSA de una HA fallida. Hubo una tasa de revisión relativamente baja, siendo las causas más comunes el aflojamiento glenoideo y la inestabilidad.
Copyright © 2017 Revista de Cirugía de Hombro y Codo Junta de Fideicomisarios. Publicado por Elsevier Inc. Todos los derechos reservados.
PALABRAS CLAVE:
Hombro; Hemiartroplastia fallida; Desgaste glenoide; Artroplastia total reversa; revisión; Manguito rotador
PMID:  28751094   DOI:  

Mas de salud y viajes aereos / More on health and air travel

Julio 31, 2017. No. 2766





Visite M_xico
Manejo de emergencias médicas en vuelo: ¿están preparados los estudiantes de medicina para responder a esta necesidad de la comunidad?
Management of in-flight medical emergencies: are senior medical students prepared to respond to this community need?
West J Emerg Med. 2014 Nov;15(7):925-9. doi: 10.5811/westjem.2014.9.22569. Epub 2014 Oct 21.
Abstract
INTRODUCTION: In-flight medical emergencies on commercial aircraft are common in both domestic and international flights. We hypothesized that fourth-year medical students feel inadequately prepared to lend assistance during in-flight medical emergencies. This multicenter study of two U.S. medical schools obtains a baseline assessment of knowledge and confidence in managing in-flight medicalemergencies. METHODS: A 25-question survey was administered to fourth-year medical students at two United States medical schools. Questions included baseline knowledge of in-flight medicine (10 questions) and perceived ability to respond to in-flight medical emergencies. RESULTS: 229 participants completed the survey (75% response rate). The average score on the fund of knowledge questions was 64%. Responses to the 5-point Likert scale questions indicated that, on average, students did not feel confident or competent responding to an in-flight medical emergency. Participants on average also disagreed with statements that they had adequate understanding of supplies, flight crew training, and ground-based management. CONCLUSION: This multicenter survey indicates that fourth-year medical students do not feel adequately prepared to respond to in-flightmedical emergencies and may have sub-optimal knowledge. This study provides an initial step in identifying a deficiency in current medicaleducation.
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¿Es seguro el transporte aéreo para aquellos con enfermedades pulmonares?
Is air travel safe for those with lung disease?
Abstract
Airlines commonly report respiratory in-flight emergencies; flight outcomes have not been examined prospectively in large numbers of respiratory patients. The current authors conducted a prospective, observational study of flight outcomes in this group. UK respiratory specialists were invited to recruit patients planning air travel. Centres undertook their usual pre-flight assessment. Within 2 weeks of returning, patients completed a questionnaire documenting symptoms, in-flight oxygen use and unscheduled healthcare use. In total, 616 patients were recruited. Of these, 500 (81%) returned questionnaires. The most common diagnoses were airway (54%) and diffuse parenchymal lung disease (23%). In total, 12 patients died, seven before flying and five within 1 month. Pre-flight assessment included oximetry (96%), spirometry (95%), hypoxic challenge (45%) and walk test (10%). Of the patients, 11% did not fly. In those who flew, unscheduled respiratory healthcare use increased from 9% in the 4 weeks prior to travel to 19% in the 4 weeks after travel. However, when compared with self-reported data during the preceding year, medical consultations increased by just 2%. In patients flying after careful respiratory specialist assessment, commercial air travel appears generally safe.
Cuestiones de salud de los viajes aéreos.
Health issues of air travel.
Annu Rev Public Health. 2003;24:133-51. Epub 2002 Oct 23.
Abstract
Every day in the United States the airline industry boards over 1.7 million passengers for a total of 600 million passengers per year. As these passengers enter the cabin of their aircraft few are aware of the artificial environment that will protect them from the hazards of flight. Passengers are exposed to reduced atmospheric pressure, reduced available oxygen, noise, vibration, and are subject to below zero temperatures that are only a quarter inch away-the thickness of the aircraft's skin. Over the past decade there have been both technical and lay articles written on the perception of poor cabin air quality. Studies have, in part, supported some of those concerns, but, in general, the air quality exceeds that found in most enclosed spaces on terra firma. Since the events of September 11th, passengers have not only been exposed to the physical stress of flight, but also to social and emotional stress preceding departure. There has been a significant increase in air rage on board aircraft, which poses a threat to flight safety and a fear of harm to passengers and crew. The phrase "economy class syndrome" has received popular press attention and refers to the possibility of deep vein thrombosis (DVT) in the tight confines of an aircraft cabin. Studies have been conducted that demonstrate DVT can occur in flight just as it occurs in other modes of transportation or with prolonged sitting. In part, because of the stress related to commercial flight it is not a mode of transportation for everyone. Certain cardiovascular, pulmonary, and neuropsychiatric conditions are best left on the ground. Although medical problems and death are rare in flight, they do occur, and one major airline reported 1.52 medical diversions per billion revenue passenger miles flown. To provide medical support at 36,000 ft (11,000 m) most airlines now carry on-board medical kits as well as automatic external defibrillators. A recent survey conducted by a major airline revealed that there was at least one physician on 85% of all its flights. Both passenger and cargo aircraft have proven to be vectors of disease in that they transport humans, mosquitoes, and other insects and animals who, in turn, transmit disease. Transmission to other passengers has occurred with tuberculosis and influenza. Vectors for yellow fever, malaria, and dengue have been identified on aircraft. Although there are numerous health issues associated with air travel they pale in comparison to the enormous benefits to the traveler, to commerce, to international affairs, and to the public's health.

XIV Congreso Virtual Mexicano de Anestesiología 2017
Octubre 1-Diciembre 31, 2017
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California Society of Anesthesiologists
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Anestesiología y Medicina del Dolor

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miércoles, 26 de julio de 2017

Los medios sociales en la ortopedia pediátrica


Social Media in Pediatric Orthopaedics

Fuente
Este artículo es publicado originalmente en:
De:
Todos los derechos reservados para:
Copyright © 2016 Ovid Technologies, Inc., and its partners and affiliates. All Rights Reserved.
Some content from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Abstract
BACKGROUND:
Internet searches and social media utilization in health care has exploded over the past 5 years, and patients utilize it to gain information on their health conditions and physicians. Social media has the potential to serve as a means for education, communication, and marketing in all health care specialties. Physicians are sometimes reluctant to engage because of concerns of privacy, litigation, and lack of experience with this modality. Many surgical subspecialties have capitalized on social media but no study to date has examined the specific footprint of pediatric orthopaedic surgeons in this realm. We aim to quantify the utilization of individual social media platforms by pediatric orthopaedic surgeons, and identify any differences between private and hospital-based physicians, but also regional differences.
CONCLUSIONS:
The rapid expansion of social media usage by patients and their family members is an undeniable force affecting the health care industry. The Internet and social media platforms provide all physicians with a means to educate patients, collaborate with colleagues, and promote their practice and areas of interest. Our survey indicates that pediatric orthopaedic surgeons may be underutilizing their potential social media presence.
LEVELS OF EVIDENCE:
Level IV.
PMID:  28719545    DOI:  


Resumen

ANTECEDENTES:

Las búsquedas en Internet y la utilización de los medios sociales en el cuidado de la salud han explotado en los últimos 5 años, y los pacientes lo utilizan para obtener información sobre sus condiciones de salud y los médicos. Los medios de comunicación social tienen el potencial de servir como un medio para la educación, comunicación y marketing en todas las especialidades de salud. Los médicos son a veces reacios a participar debido a las preocupaciones de privacidad, litigios, y la falta de experiencia con esta modalidad. Muchas subespecialidades quirúrgicas han capitalizado en las redes sociales, pero ningún estudio hasta la fecha ha examinado la huella específica de los cirujanos ortopédicos pediátricos en este ámbito. Nuestro objetivo es cuantificar la utilización de las plataformas de medios sociales individuales por los cirujanos ortopédicos pediátricos, e identificar las diferencias entre los médicos privados y los hospitales, pero también las diferencias regionales.
CONCLUSIONES:
La rápida expansión del uso de los medios de comunicación social por los pacientes y sus familiares es una fuerza innegable que afecta a la industria del cuidado de la salud. La Internet y las plataformas de medios sociales proporcionan a todos los médicos un medio para educar a los pacientes, colaborar con sus colegas y promover su práctica y áreas de interés. Nuestra encuesta indica que los cirujanos ortopédicos pediátricos pueden estar subutilizando su potencial presencia en los medios sociales.

NIVELES DE EVIDENCIA:
Nivel IV.

PMID: 28719545 DOI: 10.1097 / BPO.0000000000001032