Libro digital sobre Resucitación / E-Book on Resucitation

Diciembre 11, 2017. No. 2929

Aspectos de resucitación Resuscitation Aspects Edited by Theodoros Aslanidis, ISBN 978-953-51-3664-4, Print ISBN 978-953-51-3663-7, 196 pages, Publisher: InTech, Chapters published December 06, 2017 under CC BY 3.0 license DOI: 10.5772/66212 Edited Volume In an era of transition from "classic" Cardiopulmonary resuscitation (CPR) to assisted device-CPR or hemodynamic driven CPR, this book, published by InTechOpen, highlights some interesting aspects of resuscitation. Divided in three sections, the research presented emphasizes the details of resuscitation in special circumstances to possible future applications in the field. The authors offer us not only a "vigorous" review of the current literature but also a research road map for further advancement. Libro / Book International Anesthesia Research Society Annuals Meetings USA Informes / Information

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

Recidiva de Hallux valgus (juanete)

http://www.clinicadeartroscopia.com.mx/uncategorized/recidiva-de-hallux-valgus-juanete/


Recidiva de Hallux valgus (juanete) por hipermovilidad cuneo-metatarsal se procede a realizar artrodesis tipo lapidus con grapas de compresión y artrodesis 2, 3 dedo por dedos en garra con tornillo de compresión

III REUNIÓN NACIONAL DE PROFESORES TITULARES DE RESIDENCIA EN ORTOPEDIA

http://www.bibliomanazteca.com.mx/academia/iii-reunion-nacional-de-profesores-titulares-de-residencia-en-ortopedia/

CONVOCADA POR EL CONSEJO MEXICANO DE ORTOPEDIA

1 y 2 Diciembre 2017, WTC, CDMX

Sedación en urgencias / Sedation in emergency department

Diciembre 4, 2017. No. 2922

Incidencia de eventos adversos en adultos sometidos a sedación para procedimientos en el servicio de urgencias: revisión sistemática y metaanálisis. Incidence of Adverse Events in Adults Undergoing Procedural Sedation in the Emergency Department: A Systematic Review and Meta-analysis. Bellolio MF1,2, Gilani WI1, Barrionuevo P3,2, Murad MH3,2, Erwin PJ4, Anderson JR1, Miner JR5,6, Hess EP1,2. Acad Emerg Med. 2016 Feb;23(2):119-34. doi: 10.1111/acem.12875. Epub 2016 Jan 22. Author information Abstract OBJECTIVES: This was a systematic review and meta-analysis to evaluate the incidence of adverse events in adults undergoing procedural sedation in the emergency department (ED). METHODS: Eight electronic databases were searched, including MEDLINE, EMBASE, EBSCO, CINAHL, CENTRAL, Cochrane Database of Systematic Reviews, Web of Science, and Scopus, from January 2005 through 2015. Randomized controlled trials and observational studies of adults undergoing procedural sedation in the ED that reported a priori selected outcomes and adverse events were included. Meta-analysis was performed using a random-effects model and reported as incidence rates with 95% confidence intervals (CIs). RESULTS: The search yielded 2,046 titles for review. Fifty-five articles were eligible, including 9,652 procedural sedations. The most common adverse event was hypoxia, with an incidence of 40.2 per 1,000 sedations (95% CI = 32.5 to 47.9), followed by vomiting with 16.4 per 1,000 sedations (95% CI = 9.7 to 23.0) and hypotension with 15.2 per 1,000 sedations (95% CI = 10.7 to 19.7). Severe adverse events requiring emergent medical intervention were rare, with one case of aspiration in 2,370 sedations (1.2 per 1,000), one case of laryngospasm in 883 sedations (4.2 per 1,000), and two intubations in 3,636 sedations (1.6 per 1,000). The incidence of agitation and vomiting were higher with ketamine (164.1 per 1,000 and 170.0 per 1,000, respectively). Apnea was more frequent with midazolam (51.4 per 1,000), and hypoxia was less frequent in patients who received ketamine/propofol compared to other combinations. The case of laryngospasm was in a patient who received ketamine, and the aspiration and intubations were in patients who received propofol. When propofol and ketamine are combined, the incidences of agitation, apnea, hypoxia, bradycardia, hypotension, and vomiting were lower compared to each medication separately. CONCLUSIONS: Serious adverse events during procedural sedation like laryngospasm, aspiration, and intubation are exceedingly rare. Quantitative risk estimates are provided to facilitate shared decision-making, risk communication, and informed consent. PDF Ketamina-Propofol versus propofol para la sedación de procedimiento en el servicio de urgencias: una revisión sistemática y metanálisis. Ketamine-Propofol Versus Propofol Alone for Procedural Sedation in the Emergency Department: A Systematic Review and Meta-analysis. Yan JW1,2, McLeod SL1,2, Iansavitchene A2. Author information Acad Emerg Med. 2015 Sep;22(9):1003-13. doi: 10.1111/acem.12737. Epub 2015 Aug 20. Abstract OBJECTIVES: Propofol is an agent commonly used for procedural sedation and analgesia (PSA) in the emergency department (ED), but it can cause respiratory depression and hypotension. The combination of ketamine-propofol (K-P) is an alternative that theoretically provides a reduction in adverse events compared to propofol. The primary objective of this review was to determine if K-P has a lower frequency of adverse respiratory events in patients undergoing PSA in the ED than propofol alone. Secondary objectives were to compare the proportion of overall adverse events, sedation time, procedure time, and recovery time between K-P and propofol. METHODS: Electronic searches of Medline, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL were conducted and reference lists were hand-searched. Randomized controlled trials (RCTs) published in English comparing the use of K-P to propofol alone for PSA in the ED were included. RESULTS: Six RCTs were included with a combined total of 932 patients (K-P = 520, propofol = 412). Five RCTs reported the proportion of adverse respiratory events; the pooled estimate revealed fewer adverse respiratory events with K-P compared to propofol (29.0% vs. 35.4%; risk ratio [RR] = 0.82; 95% confidence interval [CI] = 0.68 to 0.99). There was no significant difference with respect to the proportion of overall adverse events (38.8% vs. 42.5%; RR = 0.88; 95% CI = 0.75 to 1.04). Procedure time was similar when the groups were compared. CONCLUSIONS: The premise of combining ketamine with propofol is based on the many synergies that theoretically exist between these two agents. In this study, K-P had a lower frequency of adverse respiratory events in patients undergoing PSA in the ED compared to propofol alone. PDF Jornadas de Trabajo Social y Psicología en los Cuidados Paliativos Dicienbre 7-8, 2017. Guadalajara, México Informes en tszoquipan@hotmail.com XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo International Anesthesia Research Society Annuals Meetings USA Informes / Information

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

Si buscas en Google: artroplastia reversa de hombro….

http://www.lesionesdeportivas.com.mx/academia/si-buscas-en-google-artroplastia-reversa-de-hombro/

Sale esto…

#artroplastia reversa de hombro

EXPOSICION DEL GLENOIDES EN LA ARTROPLASTIA TOTAL DEL HOMBRO

http://www.lesionesdeportivas.com.mx/academia/exposicion-del-glenoides-en-la-artroplastia-total-del-hombro/

GLENOID EXPOSURE IN TOTAL SHOULDER ARTHROPLASTY

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/29155311

https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1877056817303237?returnurl=http:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1877056817303237%3Fshowall%3Dtrue&referrer=https:%2F%2Fwww.ncbi.nlm.nih.gov%2Fpubmed%2F29155311

De:

Nové-Josserand L1,Clavert P2.

Orthop Traumatol Surg Res.

2017 Nov 16. pii: S1877-0568(17)30323-7. doi: 10.1016/j.otsr.2017.10.008. [Epub ahead of print]

Todos los derechos reservados para:

Orthopaedics & Traumatology: Surgery & Research, Copyright © 2017

Copyright © 2017 Elsevier, Inc. All rights reserved.

Abstract

Glenoid exposure is agreed to be a difficult step, but is also a key step in total shoulderarthroplasty, both anatomic and reverse. It conditions unhindered use of the ancillary instrumentation and thus correct glenoid component positioning. The main stages comprise arthrotomy, by opening the rotator cuff, humeral head cut, and inferior glenohumeral release, enabling shifting of the humerus and good exposure of the glenoid cavity. The two main approaches are deltopectoral and anterosuperior transdeltoid. Using the deltopectoral approach, arthrotomy is performed through the subscapularis muscle, by various techniques. This approach enables extensive inferior glenohumeral release and thus an approach to the inferior apex of the glenoid cavity, which is a key area for glenoid implant positioning. The main drawbacks are postoperative shoulder instability and limited access to the posterior part of the glenoid in case of significant retroversion. Moreover, subscapularis healing is uncertain, which can impair the clinical outcomes, with risk of glenoid component loosening. Advantages, on the other hand, include the fact that it can be implemented in all cases, even the most difficult ones, and that the deltoid muscle is respected. The transdeltoid approach has the advantage of being simple, providing direct exposure of the glenoid cavity through a rotator cuff tear after passing through the deltoid. It is therefore especially indicated for reverse prosthesis in case of rotator cuff tear, and in traumatology. However, the approach to the inferior part of the glenoid cavity can be restricted, with insufficient exposure and a risk of glenoid component malpositioning (superior tilt). The preoperative assessment is essential, to detect at-risk situations such as severe stiffness and anticipate difficulties in glenoid exposure.

KEYWORDS:

Arthroplasty; Deltopectoral; Glenoid cavity; Shoulder; Transdeltoid

Resumen

La exposición glenoidea se considera un paso difícil, pero también es un paso clave en la artroplastia total del hombro, tanto anatómica como reversa. Condiciona el uso sin obstáculos de la instrumentación auxiliar y, por lo tanto, corrige el posicionamiento del componente glenoideo. Las etapas principales comprenden la artrotomía, al abrir el manguito de los rotadores, el corte de la cabeza del húmero y la liberación glenohumeral inferior, lo que permite el desplazamiento del húmero y una buena exposición de la cavidad glenoidea. Los dos abordajes principales son deltopectoral y anterosuperior transdeltoide. Usando el abordaje deltopectoral, la artrotomía se realiza a través del músculo subescapular, por diversas técnicas. Este abordaje permite una liberación glenohumeral inferior extensa y, por lo tanto, un acercamiento al ápice inferior de la cavidad glenoidea, que es un área clave para el posicionamiento de los implantes glenoideos. Los principales inconvenientes son la inestabilidad postoperatoria del hombro y el acceso limitado a la parte posterior de la cavidad glenoidea en caso de retroversión significativa. Además, la cicatrización del subescapular es incierta, lo que puede perjudicar los resultados clínicos, con riesgo de aflojamiento del componente glenoideo. Las ventajas, por otro lado, incluyen el hecho de que puede implementarse en todos los casos, incluso los más difíciles, y que se respeta el músculo deltoides. El abordaje transdeltoide tiene la ventaja de ser simple y proporciona una exposición directa de la cavidad glenoidea a través de una rotura del manguito rotador después de atravesar el deltoides. Por lo tanto, está especialmente indicado para prótesis reversas en caso de rotura del manguito de los rotadores y en traumatología. Sin embargo, el acceso a la parte inferior de la cavidad glenoidea puede restringirse, con una exposición insuficiente y un riesgo de mala posición del componente glenoideo (inclinación superior). La evaluación preoperatoria es esencial para detectar situaciones de riesgo como rigidez severa y anticipar dificultades en la exposición glenoidea.

PALABRAS CLAVE:

Artroplastia; Deltopectoral; Cavidad glenoidea; Hombro; Transdeltoide

PMID:  29155311   DOI:  10.1016/j.otsr.2017.10.008

#artroplastia#deltopectoral#cavidad glenoidea#hombro#transdeltoide