Libro sobre Cardiomiopatias / Book on Cardiomyopathies

Septiembre  11, 2018. No. 3183

Viaje Culinario en Chiapas Cardiomiopatías. Tipos y manejos Cardiomyopathies Types and Treatments Edited by Kaan Kırali Sakarya University, Turkey Cardiomyopathies are the most featured cardiac pathologies in the twenty-first century, that threaten public health and burden healthcare budgets. This book is composed of the main topics on pathophysiology, general forms and specific types of cardiomyopathies and it also introduces new research in the field. Specific forms with or without genetic inheritance are discussed separately to attract the readers' attention on these topics. Well-known medical follow-up strategies occur ineffective at the end-stage heart failure, however, new surgical approaches can be an alternative for these patients to get a chance at the last crossroad and to improve their life quality and survival and also to gain or prolong time until possible heart transplantation. Libro / Book / Livre Cardiomiopatías y anestesia Cardiomyopathies and anaesthesia. Juneja R1, Nambiar PM1. Author information Indian J Anaesth. 2017 Sep;61(9):728-735. doi: 10.4103/ija.IJA_385_17. Abstract Cardiomyopathy is considered as a heart muscle disease of multiple aetiologies, unlike other cardiac diseases related to a definitive pathophysiology. With more and more research and with the advent of genetic analysis pin pointing the disease causing mutations, causative factors have been defined and classifications and definitions have changed over time. Patients with these conditions present to anaesthesiologists in elective and emergency situations, placement of automated internal cardioverter defibrillator (AICD) devices or biventricular pacing but may also be diagnosed at anaesthetic pre-assessment. We describe cardiomyopathies such as dilated cardiomyopathy, hypertrophic cardiomyopathy, post-partum cardiomyopathy and Takotsubo cardiomyopathy in brief and their anaesthetic management. KEYWORDS: Anaesthesiologist; cardiomyopathy; hypertrophic cardiomyopathy PDF Anestesia en pacientes con cardiomiopatía dilatada para cirugía no cardiaca Anesthetic management of patients with dilated cardiomyopathy for noncardiac surgery. Chen CQ1, Wang X, Zhang J, Zhu SM. Author information Eur Rev Med Pharmacol Sci. 2017 Feb;21(3):627-634.Abstract Anesthetic management of patients with dilated cardiomyopathy (DCM) is a challenge to the anesthesiologist, due to poor left systolic function, ventricular enlargement, risk of malignant arrhythmias and sudden cardiac death. Therefore, preoperative assessment and appropriate anesthetic management are important in patients with DCM. This review describes the preoperative evaluation and anesthesiaconsiderations of patients with DCM undergoing non-cardiac surgery. Patient pathophysiology and clinical status, such as ventricular function, degree of myocardial fibrosis, resting heart rate and high-sensitivity C-reactive protein can affect survival rates. Advanced monitoring devices, such as transesophageal echocardiography and cardiac resynchronization therapy can be used to assess ventricular function and myocardial fibrosis. Thoracic epidural blockade can improve ventricular function. In summary, the optimal anesthetic management of patients with dilated cardiomyopathy requires good preoperative assessment, close perioperative monitoring, suitable anesthetic, optimization fluid management, and stable hemodynamic status. PDF Inscripciones Abiertas Información / Information Curso de Alta Especialidad en Medicina del Dolor y Paliativa 2019 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México Convocatoria / Announcement  Congresos Médicos por Especialidades en todo Mundo Medical Congresses by Specialties around the World Información / Information Safe Anaesthesia Worldwide Delivering safe anaesthesia to the world's poorest people Informes / Information

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

Un metanálisis sobre la reconstrucción del ligamento cruzado anterior: ¿la técnica transtibial modificada es inferior a las técnicas de perforación independientes?

http://www.clinicadeartroscopia.com.mx/academia/un-metanalisis-sobre-la-reconstruccion-del-ligamento-cruzado-anterior-la-tecnica-transtibial-modificada-es-inferior-a-las-tecnicas-de-perforacion-independientes/


Este informe, respectivamente, comparó la técnica transtibial estándar (sTT) con las técnicas de perforación independiente (ID) aplicadas a la reconstrucción del ligamento cruzado anterior (LCA). También hizo una comparación entre los resultados clínicos de la técnica transtibial modificada (mTT) y de las técnicas de ID. Se obtuvieron de varias bases de datos estudios prospectivos sobre técnicas transtibiales (TT) e ID para la reconstrucción del LCA y se realizó un análisis de subgrupos para comparar la técnica de sTT con las técnicas de ID y el mTT con las técnicas de ID. Además, se realizó una comparación de la prueba de Lachman, la prueba de cambio de pivote, las evaluaciones subjetivas y objetivas del Comité Internacional de Documentación de la Rodilla (IKDC), el puntaje de Lysholm y la escala de actividad de Tegner.
En comparación con la técnica de sTT, las técnicas de mTT e ID son más adecuadas para la reconstrucción del LCA porque pueden presentar mejores sensaciones subjetivas. Además, considerando que la técnica de TT es familiar para los cirujanos y que la técnica de mTT puede brindar sensaciones subjetivas favorables y resultados clínicos objetivos, la técnica de mTT muestra un mayor potencial de utilización.


PALABRAS CLAVE:
reconstrucción anatómica; ligamento cruzado anterior; metaanálisis; técnica transtibial modificada

Fuente
https://www.ncbi.nlm.nih.gov/pubmed/30186403
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6122342/
https://www.spandidos-publications.com/10.3892/etm.2018.6395
Zhang Q¹, Kou Y², Yuan Z³.
Exp Ther Med. 2018 Sep;16(3):1790-1799. doi: 10.3892/etm.2018.6395. Epub 2018 Jul 3.

PMID: 30186403 PMCID: PMC6122342 DOI: 10.3892/etm.2018.6395

Copyright : © Zhang et al.

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made

Evaluación y tratamiento del dolor de hombro

El dolor de hombro es un síntoma común en la población adulta. La causa más común de dolor en el hombro es el síndrome de pinzamiento subacromial, que refleja un problema con el manguito de los rotadores o la bolsa subacromial. La determinación de la causa del dolor de un paciente generalmente es un diagnóstico clínico basado en una cuidadosa toma de antecedentes y un examen físico. Se necesitará un uso limitado de estudios de imagen en el contexto de un trauma, una posible artritis glenohumeral o cuando se sospeche una rotura completa del tendón. La terapia se basa en el control del dolor y ejercicios terapéuticos en casi todos los casos. A pesar de la prevalencia de dolor en el hombro, no hay consenso sobre la mejor manera de lograr el control del dolor o sobre el tipo de ejercicio que con mayor probabilidad logrará una recuperación rápida.

Fuente

https://www.ncbi.nlm.nih.gov/pubmed/24758957

https://www.sciencedirect.com/science/article/pii/S0025712514000315?via%3Dihub

Greenberg DL¹.

Med Clin North Am. 2014 May;98(3):487-504. doi: 10.1016/j.mcna.2014.01.016. Epub 2014 Mar 22.

PMID: 24758957 DOI: 10.1016/j.mcna.2014.01.016

[Indexed for MEDLINE]

Copyright © 2014 Elsevier Inc. All rights reserved.

Dr Carlos Cortés Soy Médico en GNP Julio 2018

¿Es factible realizar una reconstrucción del ligamento cruzado posterior de dos pares completamente epifisarios en pacientes esqueléticamente inmaduros? Un estudio de modelado asistido por computadora

Este modelo de diseño asistido por computadora demostró que los túneles epifisarios de 5 mm, 6 mm y 7 mm se pueden colocar dentro de la base del ligamento cruzado posterior  mientras se evita la lesión directa de la fisis femoral, el cartílago articular, ligamento colateral medial y  el ligamento patelofemoral medial. Al comprender la ubicación y la trayectoria de la colocación del túnel y el encaje, la reconstrucción del ligamento cruzado posterior con doble túnel  puede realizarse en rodillas esqueléticamente inmaduras sin causar daño a la fisis distal del fémur y a las bases del ligamento de la superficie.

Fuente

https://jisakos.bmj.com/content/3/1/17?hootPostID=291042cd1493fa1d17e782904211c564

1. Connor G Richmond1, Peter C Cannamela2, Peter D Fabricant3, Theodore J Ganley4, James T Beckmann1, Allen F Anderson5, Kevin G Shea1

http://dx.doi.org/10.1136/jisakos-2017-000170

Copyright information:

© International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (unless otherwise stated in the text of the article) 2018. All rights reserved.

Transferencia del tendón dorsal ancho asistida por artroscopia para las roturas masivas del manguito rotador: una revisión sistemática.

La transferencia artroscópica asistida dorsal ancho (LDTT) ha mostrado resultados prometedores con buenos resultados en pacientes con desgarros masivos del manguito rotador (MRCT), según lo informado por estudios individuales. Sin embargo, hasta donde llega el conocimiento de los autores, no se ha realizado ninguna revisión sistemática para evaluar los resultados colectivos de estos estudios individuales.
La LDTT asistida por artroscopia para MRCT proporciona a los pacientes una mejoría marcada en el dolor, la fuerza y la función del hombro, y el procedimiento se asocia con un bajo riesgo de complicaciones. Se necesitan más estudios comparativos de alta calidad para validar estos hallazgos en comparación con otras técnicas quirúrgicas.
PALABRAS CLAVE:
cirugía artroscópica; transferencia del tendón dorsal ancho; rotura masiva del manguito rotador; resultados

Fuente

https://www.ncbi.nlm.nih.gov/pubmed/29942816

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6009089/

http://journals.sagepub.com/doi/10.1177/2325967118777735

Memon M¹, Kay J¹, Quick E², Simunovic N³, Duong A¹, Henry P⁴, Ayeni OR¹.

Orthop J Sports Med. 2018 Jun 11;6(6):2325967118777735. doi: 10.1177/2325967118777735. eCollection 2018 Jun.

PMID: 29942816 PMCID: PMC6009089 DOI: 10.1177/2325967118777735

Free PMC Article

Copyright © The Author(s) 2018

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Transfusión en trauma craneoencefálico / Transfusion traumatic brain injury

Julio 16, 2018. No. 3143

Lo Mejor de Octavio Paz. PDF Trasfusión en trauma craneoencefálico Transfusion practices in traumatic brain injury Curr Opin Anaesthesiol. 2018 Apr;31(2):219-226. doi: 10.1097/ACO.0000000000000566. East JM1, Viau-Lapointe J1, McCredie VA1,2. Author information Abstract PURPOSE OF REVIEW: The aim of this review is to summarize the recent studies looking at the effects of anemia and red blood cell transfusion in critically-ill patients with traumatic brain injury (TBI), describe the transfusion practice variations observed worldwide, and outline the ongoing trials evaluating restrictive versus liberal transfusion strategies for TBI. RECENT FINDINGS: Anemia is common among critically-ill patients with TBI, it is also thought to exacerbate secondary brain injury, and is associated with an increased risk of poor outcome. Conversely, allogenic red blood cell transfusion carries its own risks and complications, and has been associated with worse outcomes. Globally, there are large reported differences in the hemoglobin threshold used for transfusion after TBI. Observational studies have shown differential results for improvements in cerebral oxygenation and metabolism after red blood cell transfusion in TBI. SUMMARY: Currently, there is insufficient evidence to make strong recommendations regarding which hemoglobin threshold to use as a transfusion trigger in critically-ill patients with TBI. There is also uncertainty whether the restrictive transfusion strategy used in general critical care can be extrapolated to acutely brain injured patients. Ultimately, the consequences of anemia-induced cerebral injury need to be weighed up against the risks and complications associated with red blood cell transfusion. PDF Lesión hemorrágica progresiva después de una lesión cerebral traumática grave: efecto de los umbrales de transfusión de hemoglobina. Progressive hemorrhagic injury after severe traumatic brain injury: effect of hemoglobin transfusion thresholds. Vedantam A1, Yamal JM2, Rubin ML2, Robertson CS1, Gopinath SP1. Author information J Neurosurg. 2016 Nov;125(5):1229-1234. Epub 2016 Mar 4. Abstract OBJECT. There is limited literature available to guide transfusion practices for patients with severe traumatic brain injury (TBI). Recent studies have shown that maintaining a higher hemoglobin threshold after severe TBI offers no clinical benefit. The present study aimed to determine if a higher transfusion threshold was independently associated with an increased risk of progressive hemorrhagic injury (PHI), thereby contributing to higher rates of morbidity and mortality. METHODS The authors performed a secondary analysis of data obtained from a recently performed randomized clinical trial studying the effects of erythropoietin and blood transfusions on neurological recovery after severe TBI. Assigned hemoglobin thresholds (10 g/dl vs 7 g/dl) were maintained with packed red blood cell transfusions during the acute phase after injury. PHI was defined as the presence of new or enlarging intracranial hematomas on CT as long as 10 days after injury. A severe PHI was defined as an event that required an escalation of medical management or surgical intervention. Clinical and imaging parameters and transfusion thresholds were used in a multivariate Cox regression analysis to identify independent risk factors for PHI. RESULTS Among 200 patients enrolled in the trial, PHI was detected in 61 patients (30.5%). The majority of patients with PHI had a new, delayed contusion (n = 29) or an increase in contusion size (n = 15). The mean time interval between injury and identification of PHI was 17.2 ± 15.8 hours. The adjusted risk of severe PHI was 2.3 times higher for patients with a transfusion threshold of 10 g/dl (95% confidence interval 1.1-4.7; p = 0.02). Diffuse brain injury was associated with a lower risk of PHI events, whereas higher initial intracranial pressure increased the risk of PHI (p < 0.001). PHI was associated with a longer median length of stay in the intensive care unit (18.3 vs 14.4 days, respectively; p = 0.04) and poorer Glasgow Outcome Scale scores (42.9% vs 25.5%, respectively; p = 0.02) at 6 months. CONCLUSIONS A higher transfusion threshold of 10 g/dl after severe TBI increased the risk of severe PHI events. These results indicate the potential adverse effect of using a higher hemoglobin transfusion threshold after severe TBI. KEYWORDS: EPO = erythropoietin; ER = emergency room; GCS = Glasgow Coma Scale; GOS = Glasgow Outcome Scale; ICP = intracranial pressure; PHI = progressive hemorrhagic injury; PT = prothrombin time; PTT = partial thromboplastin time; RCT = randomized controlled trial; TBI = traumatic brain injury; hemoglobin transfusion threshold; progressive hemorrhagic injury; secondary brain injury; severe traumatic brain injury PDF Efecto de la eritropoyetina y el umbral de transfusión en la recuperación neurológica después de la lesión cerebral traumática: un ensayo clínico aleatorizado. Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: a randomized clinical trial. Robertson CS1, Hannay HJ2, Yamal JM3, Gopinath S1, Goodman JC4, Tilley BC3; Epo Severe TBI Trial Investigators, Baldwin A1, Rivera Lara L1, Saucedo-Crespo H1, Ahmed O1, Sadasivan S1, Ponce L1, Cruz-Navarro J1, Shahin H1, Aisiku IP5, Doshi P5, Valadka A5, Neipert L2, Waguspack JM2, Rubin ML3, Benoit JS3, Swank P3. Author information JAMA. 2014 Jul 2;312(1):36-47. doi: 10.1001/jama.2014.6490. Abstract IMPORTANCE: There is limited information about the effect of erythropoietin or a high hemoglobin transfusion threshold after a traumatic brain injury. OBJECTIVE: To compare the effects of erythropoietin and 2 hemoglobin transfusion thresholds (7 and 10 g/dL) on neurological recovery after traumatic brain injury. ...Intravenous erythropoietin (500 IU/kg per dose) or saline. Transfusion threshold maintained with packed red blood cells. ....CONCLUSIONS AND RELEVANCE: In patients with closed head injury, neither the administration of erythropoietin nor maintaining hemoglobin concentration of greater than 10 g/dL resulted in improved neurological outcome at 6 months. The transfusion threshold of 10 g/dL was associated with a higher incidence of adverse events. These findings do not support either approach in this setting. PDF Curso de Alta Especialidad en Medicina del Dolor y Paliativa 2019 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Ciudad de México Convocatoria / Announcement  Ver Programa Información / Information Congresos Médicos por Especialidades en todo Mundo Medical Congresses by Specialties around the World Información / Information Curso Regional de Sur Sureste de Medicina del Dolor y Cuidados Paliativos Agosto 24-25. Oaxaca, México Informacion / Information Safe Anaesthesia Worldwide Delivering safe anaesthesia to the world's poorest people Informes / Information

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