Cirugía globalizada / Global surgery

Agosto 27, 2017. No. 2793

Cirugía global 2030: un mapa de ruta para los actores de los países de altos ingresos. Global Surgery 2030: a roadmap for high income country actors. Ng-Kamstra JS, Greenberg SLM, Abdullah F,et al. BMJ Glob Health. 2016 Apr 6;1(1):e000011. doi: 10.1136/bmjgh-2015-000011. eCollection 2016 Apr. Abstract The Millennium Development Goals have ended and the Sustainable Development Goals have begun, marking a shift in the global health landscape. The frame of reference has changed from a focus on 8 development priorities to an expansive set of 17 interrelated goals intended to improve the well-being of all people. In this time of change, several groups, including the Lancet Commission on Global Surgery, have brought a critical problem to the fore: 5 billion people lack access to safe, affordable surgical and anaesthesia care when needed. The magnitude of this problem and the world's new focus on strengthening health systems mandate reimagined roles for and renewed commitments from high income country actors in global surgery. To discuss the way forward, on 6 May 2015, the Commission held its North American launch event in Boston, Massachusetts. Panels of experts outlined the current state of knowledge and agreed on the roles of surgical colleges and academic medical centres; trainees and training programmes; academia; global health funders; the biomedical devices industry, and news media and advocacy organisations in building sustainable, resilient surgical systems. This paper summarises these discussions and serves as a consensus statement providing practical advice to these groups. It traces a common policy agenda between major actors and provides a roadmap for maximising benefit to surgical patients worldwide. To close the access gap by 2030, individuals and organisations must work collectively, interprofessionally and globally. High income country actors must abandon colonial narratives and work alongside low and middle income country partners to build the surgical systems of the future. PDF Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018 para Mexicanos y extranjeros. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Informes en el teléfono (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de México).  Informes / Information XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information XXXIV Congreso Latinoamericano de Anestesiología. CLASA 2017 Octubre 8-11. Uruguay Informes / Information

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

Neuronas adictivas / Addictive neurons

Agosto 28, 2017. No. 2794

Neuronas adictivas Addictive neurons. Kodirov SA1,2,3,4,5. Author information Ther Targets Neurol Dis. 2017;4. pii: e1498. Epub 2017 Jan 30. Abstract Since the reward center is considered to be the area tegmentalis ventralis of the hypothalamus, logically its neurons could mainly be responsible for addiction. However, the literature asserts that almost any neurons of CNS can respond to one or another addictive compound. Obviously not only addictive nicotine, but also alcohol, amphetamine, cannabis, cocaine, heroin and morphine may influence dopaminergic cells alone in VTA. Moreover, paradoxically some of these drugs ameliorate symptoms, counterbalance syndromes, cure diseases and improve health, not only those related to the CNS and in adults, but also almost all other organs and in children, e.g. epilepsy. KEYWORDS: ADP; AHP; LTD; LTP; amygdala; lateral septum; medial prefrontal cortex; paired pulse facilitation; rebound action potential; spike PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018 para Mexicanos y extranjeros. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Informes en el teléfono (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de México).  Informes / Information XXXIV Congreso Latinoamericano de Anestesiología. CLASA 2017 Octubre 8-11. Uruguay Informes / Information

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

Marihuana y mortalidad / Marijuana and mortality

Agosto 29, 2017. No. 2795

El riesgo de muerte por hipertensión es tres veces mayor en los adultos que consumen marihuana, en comparación con los no usuarios, sobre la base de datos de un estudio retrospectivo de 1.213 adultos. The risk of death from hypertension is three times greater in adults who use marijuana, compared with nonusers, based on data from a retrospective study of 1,213 adults. O risco de morte por hipertensão é três vezes maior em adultos que usam maconha, em comparação com não usuários, com base em dados de um estudo retrospectivo de 1.213 adultos. Efecto del consumo de marihuana sobre la mortalidad cardiovascular y cerebrovascular: un estudio que utiliza la encuesta nacional de salud y nutrición vinculada archivo de mortalidad. Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file. Yankey BA1, Rothenberg R1, Strasser S1, Ramsey-White K1, Okosun IS1. Author information Eur J Prev Cardiol. 2017 Jan 1:2047487317723212. doi: 10.1177/2047487317723212. [Epub ahead of print] Abstract Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortalityare scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation. KEYWORDS: Marijuana; cannabis; cardiovascular mortality; delta-9-tetrahydrocannabinol; hypertension PDF Efectos adversos cardiovasculares, cerebrovasculares y vasculares periféricos de la inhalación de marihuana: lo que los cardiólogos necesitan saber. Adverse cardiovascular, cerebrovascular, and peripheral vascular effects of marijuana inhalation: what cardiologists need to know. Thomas G1, Kloner RA2, Rezkalla S3. Author information Am J Cardiol. 2014 Jan 1;113(1):187-90. doi: 10.1016/j.amjcard.2013.09.042. Epub 2013 Oct 5. Abstract Marijuana is the most widely used illicit drug, with approximately 200 million users worldwide. Once illegal throughout the United States, cannabis is now legal for medicinal purposes in several states and for recreational use in 3 states. The current wave of decriminalization may lead to more widespread use, and it is important that cardiologists be made aware of the potential for marijuana-associated adverse cardiovascular effects that may begin to occur in the population at a greater frequency. In this report, the investigators focus on the known cardiovascular, cerebrovascular, and peripheral effects of marijuana inhalation. Temporal associations between marijuana use and serious adverse events, including myocardial infarction, sudden cardiac death, cardiomyopathy, stroke, transient ischemic attack, and cannabis arteritis have been described. In conclusion, the potential for increased use of marijuana in the changing legal landscape suggests the need for the community to intensify research regarding the safety of marijuana use and for cardiologists to maintain an awareness of the potential for adverse effects. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018 para Mexicanos y extranjeros. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Informes (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de Ciudad de México).  Informes / Information XXXIV Congreso Latinoamericano de Anestesiología. CLASA 2017 Octubre 8-11. Uruguay Informes / Information

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

Dolor de espalda baja en artritis reumatoide

http://www.cirugiavertebral.com.mx/academia/dolor-de-espalda-baja-en-artritis-reumatoide/

Low back pain in rheumatoid arthritis

Fuente

Este artículo es publicado originalmente en:

https://www.ncbi.nlm.nih.gov/pubmed/28875320

https://link.springer.com/article/10.1007%2Fs00393-017-0363-8

De:

Kothe R1.

Z Rheumatol.

2017 Sep 5. doi: 10.1007/s00393-017-0363-8. [Epub ahead of print]

Todos los derechos reservados para:

Copyright information

© Springer Medizin Verlag GmbH 2017

Abstract

Low back pain (LBP) in patients with rheumatoid arthritis (RA) has so far been of little concern in clinical investigations. The main focus of scientific publications on spinal problems in RA was the cervical spine. In a recent study, we could demonstrate that LBP in RA patients leads to a significantly higher degree of disability and depression as well as to a reduction in quality of life compared to RA patients without LBP. If there is a specific reason for the additional symptom of LBP, such as spinal stenosis or segmental instability, surgical treatment may be indicated to improve disability and quality of life. For a successful outcome of spinal surgery it is important to address the specific aspects of RA patients, such as poor bone quality and the immunosuppressive effect of antirheumatic drug treatment. Whenever possible, minimally invasivesurgical techniques should be used and the immunosuppressive medication should be stopped before surgery.

KEYWORDS:

Function; Lumbar spinal canal stenosis; Lumbar spine; Quality of life; Surgical procedures

Resumen

El dolor lumbar (LBP) en pacientes con artritis reumatoide (RA) hasta ahora ha sido de poca preocupación en las investigaciones clínicas. El foco principal de las publicaciones científicas sobre los problemas de la columna vertebral en la AR fue la columna cervical. En un estudio reciente, podríamos demostrar que la LBP en pacientes con AR conduce a un grado significativamente mayor de discapacidad y depresión, así como a una reducción en la calidad de vida en comparación con los pacientes con AR sin LBP. Si hay una razón específica para el síntoma adicional de LBP, como la estenosis espinal o la inestabilidad segmentaria, el tratamiento quirúrgico puede ser indicado para mejorar la discapacidad y la calidad de vida. Para un resultado exitoso de la cirugía de columna es importante abordar los aspectos específicos de los pacientes con AR, como la mala calidad ósea y el efecto inmunosupresor del tratamiento antirreumático. Siempre que sea posible, deben usarse técnicas quirúrgicas mínimamente invasivas y la medicación inmunosupresora debe detenerse antes de la cirugía.

PALABRAS CLAVE:
Función; Estenosis del canal espinal lumbar; Espina lumbar; Calidad de vida; Procedimientos quirúrgicos

PMID:  28875320   DOI:  

10.1007/s00393-017-0363-8

#conducto lumbar estrecho#columna lumbar#calidad de vida