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Revisiones bibliográficas. Documentación científica en Ortopedia y Traumatología, medicina deportiva, artroscopia, artroplastia y de todas las patologías del sistema Músculo-Esquelético
lunes, 13 de diciembre de 2010
Cómo detectar alergias a tiempo
mi+dtv: tres noticias en tres minutos
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Ponente: José Antonio López Guerrero
La bacteria hormigoneraEl confeti plástico invade los océanos
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Salvar a niños de la ceguera
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En este día...
 | Monday, December 13th The 347th day of 2010. There are 18 days left in the year. |
 |
Today's Highlights in History |  | ||
 See a larger version of this front page. | On Dec. 13, 1981, authorities in Poland imposed martial law in a crackdown on the Solidarity labor movement. Martial law formally ended in 1983. (Go to article.) | ||
 | On December 13, 1879, Harper's Weekly featured a cartoon about John Sherman, the treasury secretary and former (and future) U.S. senator. (See the cartoon and read an explanation.) | ||
On this date in: | |
| 1642 | Dutch navigator Abel Tasman arrived in present-day New Zealand. |
| 1769 | Dartmouth College in New Hampshire received its charter. |
| 1862 | Confederate forces dealt Union troops a major defeat at the Battle of Fredericksburg in Virginia. |
| 1918 | President Woodrow Wilson arrived in France to attend the post-World War I peace conference at Versailles, becoming the first chief executive to visit Europe while in office. |
| 1988 | PLO chairman Yasser Arafat addressed the U.N. General Assembly in Geneva, where it had reconvened after the United States refused to grant Arafat a visa to visit New York. |
| 1989 | South African President F.W. de Klerk met for the first time with imprisoned African National Congress leader Nelson Mandela, at de Klerk's office in Cape Town. |
| 1996 | The U.N. Security Council chose Kofi Annan of Ghana to be the world body's seventh secretary-general. |
| 2000 | Republican George W. Bush claimed the presidency 36 days after Election Day. |
| 2001 | The Pentagon released a captured videotape of Osama bin Laden in which the al-Qaida leader said the deaths and destruction achieved by the Sept. 11 attacks exceeded his "most optimistic" expectations. |
| 2001 | Five suspected Islamic militants killed nine people in an attack on India's parliament before being killed themselves. |
| 2001 | President George W. Bush served formal notice that the United States was pulling out of the 1972 Anti-Ballistic Missile Treaty with Russia. |
| 2002 | Cardinal Bernard Law resigned as Boston archbishop because of the priest sex abuse scandal. |
| 2003 | Ousted Iraqi leader Saddam Hussein was captured by U.S. forces while hiding in a hole under a farmhouse in Adwar, near his hometown of Tikrit. |
| 2007 | Shareholders of Dow Jones & Co., publisher of The Wall Street Journal, approved a takeover by Rupert Murdoch's News Corp. |
| 2007 | The Mitchell Report on performance-enhancing drugs in baseball was released, implicating seven MVPs and 31 All-Stars. |
| Current Birthdays | ||||||||||||||||||||||||||||||||||||||
| Taylor Swift turns 21 years old today. | ||||||||||||||||||||||||||||||||||||||
 AP Photo/Evan Agostini Country singer Taylor Swift turns 21 years old today. | ||||||||||||||||||||||||||||||||||||||
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| Historic Birthdays | |
| Carlos Montoya | |
 12/13/1903 - 3/3/1993 Spanish-American flamenco guitarist (Go to obit.) | |
| 85 | Carlos Gozzi 12/13/1720 - 4/4/1806 Italian poet and dramatist |
| 72 | Sir William Hamilton 12/13/1730 - 4/6/1803 English diplomat and archaeologist |
| 68 | Joseph Howe 12/13/1804 - 6/1/1873 Canadian statesman and publisher |
| 86 | Lawrence Lowell 12/13/1856 - 1/6/1943 American lawyer, educator, and president of Harvard University (1909-1933) |
| 73 | Emily Carr 12/13/1871 - 3/2/1945 Canadian painter and writer |
| 76 | Alvin York 12/13/1887 - 9/2/1964 American military hero of World War I |
| 90 | Marc Connelly 12/13/1890 - 12/21/1980 American playwright and journalist |
| 84 | Archie Moore 12/13/1913 - 12/9/1998 American boxer |
Go to a previous date.
SOURCE: The Associated Press
Front Page Image Provided by UMI
El caparazón: Inteligencia colectiva (4 enlaces, 5 videopropuestas) de la semana
El caparazón: Inteligencia colectiva (4 enlaces, 5 videopropuestas) de la semana
Posted: 13 Dec 2010 05:11 AM PST- Todavía pienso en ello….con lo convencidos/as que estamos en Twitter de que el mundo gira alrededor de nuestros gorjeos y resulta que en España deberíamos preocuparnos muy, muy seriamente: ¿Badoo es la tercera red social en estos lares????? ¿Alguien puede/quiere explicarlo?
- El último informe PISA, imprescindible para cualquier comparación sobre sistemas educativos y cumplimiento de objetivos “estandar” (matemáticas, lectura y ciencia). No es nuevo que los países hispanos estemos en posiciones mejorables pero tampoco creo que lo que miden sea comprehensivo y configure lo que cualquier ciudadano tiene que saber, ya no para encontrar trabajo sino para ser responsable en la sociedad en la que vive y feliz en ella. No sé si tienen demasiado sentido ya este tipo de mediciones…. Dos vídeos más abajo creo que dejan claro el porqué´.
- Sobre todo son:
- Jóvenes adultos – de 18a 29 años, más que adultos mayores.
- Afro-Americanos y Latinos – Los usuarios de internet pertenecientes a minorías son en el caso de twitter el doble.
- Urbanitas – También los que viven en las ciudades tienen el doble de probabilidad de usar twitter.
- Finalmente, mujeres y personas con estudios superiores parecen mantener el ligero predominio que ya se había observado.
- Sobre Google e-books, el primer Vídeo de la tanda:
- Fue en Julio de este año cuando me entrevistaban en el CCCB sobre Innovación. Ayer se emitió el excelente programa, dirigido por Juan Insúa, en la 2. Parafraseando a Albert Sierra, ya he salido en la 2 y Radio 3, ya soy una intelectual
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Bromas a parte no os perdáis el documental, es excelente:
- Punset entrevista a Prensky en Redes, por si no la habéis visto ya.
- Aunque mucho antes ya Asimov parecía, como nos recordaba @erchache2000, afín al movimiento Edupunk:
- Por último, otra perla del fenómeno trasnmediático: La navidad en lenguaje 2.0. No os lo perdáis, es buenísimo.
domingo, 12 de diciembre de 2010
Novel Imaging Technique May Reduce Lymphedema in Breast Cancer Patients
Novel Imaging Technique May Reduce Lymphedema in Breast Cancer Patients
Saturday, December 11, 2010
SAN ANTONIO — With guidance from a specialized scan, radiation oncologists at Mayo Clinic were able to reduce by 55 percent the number of lymph nodes critical for removing fluid from the arm that received damaging radiation doses.
VIDEO ALERT: Additional audio and video resources, including excerpts from an interview with Dr. Andrea Cheville and other researchers presenting at San Antonio Breast Cancer Symposium, are available on theMayo Clinic News Blog. These materials also are subject to embargo, but may be accessed in advance by journalists for incorporation into stories. The password is sanantonio1.
The researchers report that integrating single photon emission computed tomography(SPECT) with thecomputerized tomography(CT) scans utilized for breast cancer radiotherapy planning may offer patients substantial protection against lymphedema, an incurable, chronic swelling of tissue that results from damage to lymph nodes sustained during breast cancer radiation. The SPECT-CT scan pinpoints the precise locations of the lymph nodes that are critical for removing fluid from the arm, allowing physicians to block them, as much as possible, from X-ray beams delivered to the chest.
These findings were presented at the 33rd Annual CTRC-AACR San Antonio Breast Cancer Symposium.
"In an effort to deliver therapeutic doses of radiation to the breast, lymph nodes under the arm are innocent bystanders that often are irrevocably harmed. Minimizing harm to these nodes during breast cancer treatment is the most effective way we have seen to reduce women's risk of developing lymphedema," says the study's lead investigator, Andrea Cheville, M.D., a consultant in Physical Medicine and Rehabilitation at Mayo Clinic in Rochester, Minn., who specializes in lymphedema management.
"Lymphedema is a critical concern of breast cancer survivors, so developing a more individualized approach to irradiation is greatly needed," she adds.
This ongoing prospective cohort study includes 30 women with early-stage, low-risk breast cancer who had completed surgery to remove tumors and were scheduled for radiotherapy to the affected breast. These patients either had no lymph nodes that were known to be positive (meaning the cancer had not spread to these sites), or had only micrometastasis to lymph nodes. Thus, radiation to the lymph nodes in the armpit was not warranted in these patients.
The technique the researchers developed to shield lymph nodes from radiation involved merging SPECT scans with the CT images utilized in radiation treatment planning.
"We can know exactly where the critical lymph nodes are under the armpit," Dr. Cheville says, adding that critical nodes are the ones that drain the arm. "While a person can have as many as 62 lymph nodes under the arm, only a few are responsible for that function."
"We can use this information to personalize the fields of radiation such that the tumor bed in the breast is therapeutically treated while the lymph nodes that drain the arm are maximally blocked from radiation and thereby spared," she says.
The researchers created two treatment plans for each patient — a standard plan and one adapted for lymph node sparing based on the SPECT-CT scans. When they compared lymph node radiation between the plans, they noted dramatic reductions in radiation to critical lymph nodes in the SPECT-CT-adapted plans.
Using the SPECT-CT images, the researchers identified all of the critical lymph nodes in the patients. They found that 65 percent of these nodes would have been located within the standard radiation treatment fields if they were not blocked.
They also found that among the 25 patients with at least one critical lymph node within the radiation treatment field, at least some blocking was possible for all of them. Researchers calculated that the number of lymph nodes receiving a moderate dose of radiation was reduced from 26 percent to 4 percent with blocking.
Because lymphedema development can take a matter of years, the researchers will continue to monitor these patients. No cases of lymphedema have yet been reported.
Dr. Cheville says that the technique of locating critical lymph nodes and blocking them from radiation may prove most useful for patients who require surgical removal of the lymph nodes in the armpit but do not require radiation targeting any remaining nodes. These patients' risk of developing lymphedema may be as high as 50 percent without blocking, and measures that preserve the function of their lymphatic systems may be critical to their long-term quality of life, she says.
The study was funded by the Department of Defense's Congressionally Directed Medical Research Program.
Oxigenación con membrana extracorpórea (ECMO) en la neumonía por gripe A (H1N1)
REMI envía todos sus contenidos gratuitamente por correo electrónico a más de 8.700 suscriptores. [Suscripción]
Artículo nº 1581. Vol 12, diciembre 2010.
Autor: Miguel Ángel González Gallego
Autor: Miguel Ángel González Gallego
Oxigenación con membrana extracorpórea (ECMO) en la neumonía por gripe A (H1N1)
Artículo original: Extracorporeal membrane oxygenation for severe influenza A (H1N1) acute respiratory distress syndrome: a prospective observational comparative study. Roch A, Lepaul-Ercole R, Grisoli D, Bessereau J, Brissy O, Castanier M, Dizier S, Forel JM, Guervilly C, Gariboldi V, Collart F, Michelet P, Perrin G, Charrel R, Papazian L. Intensive Care Med 2010; 36(11): 1899-1905. [Resumen] [Artículos relacionados]
Introducción: Durante 2009 la pandemia de gripe A provocó la aparición de numerosos casos de neumonía y síndrome de dificultad respiratoria aguda (SDRA), algunos de los cuales fueron tratados con dispositivos de ECMO. Esta técnica no ha estado exenta de controversia, aunque con la mejoría técnica que ha experimentado se han empezado a publicar series [1] con buenos resultados, por lo que se ha propuesto su uso para el SDRA grave, rápidamente progresivo y refractario, como el observado en la mencionada pandemia.
Resumen: Los autores desarrollaron un protocolo de aplicación de ECMO en pacientes con SDRA grave secundario a neumonía por virus de la gripe A (H1N1). Los requisitos fueron: sedo-relajación de los enfermos, uso de ventilación protectora y niveles de PEEP >= 10 cm H2O. La proporción pO2/FiO2 debía estar por debajo de 70 con FiO2 de 1 (o por debajo de 100 si la Pplat era >= 35 cm H2O), o bien si existía acidosis respiratoria (pH <= 7,15 a pesar de frecuencia respiratoria >= 35/min). Se consideraban contraindicaciones para la técnica la imposibilidad para el uso de heparina, una enfermedad crónica con mala evolución previsible en los siguientes 5 años, SOFA > 16 o tener más de 70 años. De los 18 pacientes con SDRA secundario a gripe A (H1N1), 9 reunieron los criterios descritos para la utilización de la ECMO frente a 9 que siguieron tratamiento convencional. De los pacientes sometidos a la técnica, 6 lo fueron en su hospital de primera asistencia por un equipo formado por cirujano cardíaco, intensivista y enfermera perfusionista, y posteriormente trasladados. A pesar de que el SAPS II fue menor en los pacientes no sometidos a ECMO, la mortalidad hospitalaria fue la misma en ambos grupos (56%).
Comentario: El máximo beneficio de la ECMO se obtiene cuando el inicio es precoz en la lesión pulmonar aguda; de hecho varios estudios muestran como la supervivencia disminuye cuanto mayor es el tiempo de ventilación mecánica previo a la instauración de la técnica [2]. Es difícil extrapolar resultados en un estudio como éste con un tamaño muestral tan pequeño; sin embargo la conclusión más importante sería que la ECMO puede ser un eficaz tratamiento de rescate para los pacientes con SDRA grave y que es posible iniciarlo de forma precoz aunque en el centro no se disponga del mismo utilizando equipo y material desplazados desde un centro de referencia, ofreciendo esta alternativa terapéutica a pacientes que no se podrían haber beneficiado de ella de otro modo.
Introducción: Durante 2009 la pandemia de gripe A provocó la aparición de numerosos casos de neumonía y síndrome de dificultad respiratoria aguda (SDRA), algunos de los cuales fueron tratados con dispositivos de ECMO. Esta técnica no ha estado exenta de controversia, aunque con la mejoría técnica que ha experimentado se han empezado a publicar series [1] con buenos resultados, por lo que se ha propuesto su uso para el SDRA grave, rápidamente progresivo y refractario, como el observado en la mencionada pandemia.
Resumen: Los autores desarrollaron un protocolo de aplicación de ECMO en pacientes con SDRA grave secundario a neumonía por virus de la gripe A (H1N1). Los requisitos fueron: sedo-relajación de los enfermos, uso de ventilación protectora y niveles de PEEP >= 10 cm H2O. La proporción pO2/FiO2 debía estar por debajo de 70 con FiO2 de 1 (o por debajo de 100 si la Pplat era >= 35 cm H2O), o bien si existía acidosis respiratoria (pH <= 7,15 a pesar de frecuencia respiratoria >= 35/min). Se consideraban contraindicaciones para la técnica la imposibilidad para el uso de heparina, una enfermedad crónica con mala evolución previsible en los siguientes 5 años, SOFA > 16 o tener más de 70 años. De los 18 pacientes con SDRA secundario a gripe A (H1N1), 9 reunieron los criterios descritos para la utilización de la ECMO frente a 9 que siguieron tratamiento convencional. De los pacientes sometidos a la técnica, 6 lo fueron en su hospital de primera asistencia por un equipo formado por cirujano cardíaco, intensivista y enfermera perfusionista, y posteriormente trasladados. A pesar de que el SAPS II fue menor en los pacientes no sometidos a ECMO, la mortalidad hospitalaria fue la misma en ambos grupos (56%).
Comentario: El máximo beneficio de la ECMO se obtiene cuando el inicio es precoz en la lesión pulmonar aguda; de hecho varios estudios muestran como la supervivencia disminuye cuanto mayor es el tiempo de ventilación mecánica previo a la instauración de la técnica [2]. Es difícil extrapolar resultados en un estudio como éste con un tamaño muestral tan pequeño; sin embargo la conclusión más importante sería que la ECMO puede ser un eficaz tratamiento de rescate para los pacientes con SDRA grave y que es posible iniciarlo de forma precoz aunque en el centro no se disponga del mismo utilizando equipo y material desplazados desde un centro de referencia, ofreciendo esta alternativa terapéutica a pacientes que no se podrían haber beneficiado de ella de otro modo.
Miguel Ángel González Gallego
Hospital Clínico San Carlos. Madrid
©REMI, http://remi.uninet.edu. Diciembre 2010.
Enlaces:
Hospital Clínico San Carlos. Madrid
©REMI, http://remi.uninet.edu. Diciembre 2010.
Enlaces:
- Extracorporeal life support for severe acute respiratory distress syndrome in adults. Hemmila MR, Rowe SA, Boules TN, Miskulin J, McGillicuddy JW, Schuerer DJ, Haft JW, Swaniker F, Arbabi S, Hirschl RB, Bartlett RH. Ann Surg 2004; 240(4): 595-605; discussion 605-607. [PubMed]
- Mortality is directly related to the duration of mechanical ventilation before the initiation of extracorporeal life support for severe respiratory failure. Pranikoff T, Hirschl RB, Steimle CN, Anderson HL 3rd, Bartlett RH. Crit Care Med 1997; 25(1): 28-32. [PubMed]
- Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, Hibbert CL, Truesdale A, Clemens F, Cooper N, Firmin RK, Elbourne D; CESAR trial collaboration. Lancet 2009; 374(9698): 1351-1363. [PubMed]
Búsqueda en PubMed:
- Enunciado: Ensayos clínicos de ECMO en el SDRA
- Sintaxis: "extracorporeal membrane oxygenation"[mh] AND "respiratory distress syndrome, adult"[mh] AND randomized controlled trial[ptyp]
- [Resultados]
Palabras clave: Síndrome de dificultad respiratoria aguda, Gripe A(H1N1), Oxigenación con membrana extracorpórea.
En este día...
| Sunday, December 12th The 346th day of 2010. There are 19 days left in the year. |
|
| Today's Highlights in History | | ||
 See a larger version of this front page. | On Dec. 12, 1963, Kenya gained its independence from Britain. (Go to article.) | ||
| On December 12, 1863, Harper's Weekly featured a cartoon about the Chattanooga campaign during the Civil War. (See the cartoon and read an explanation.) | ||
On this date in: | |
| 1745 | John Jay, statesman and the first chief justice of the Supreme Court, was born in New York City. |
| 1787 | Pennsylvania became the second state to ratify the U.S. Constitution. |
| 1870 | Joseph H. Rainey of South Carolina took his seat in the U.S. House of Representatives, becoming the first black congressman. |
| 1897 | "The Katzenjammer Kids," the pioneering comic strip by Rudolph Dirks, debuted in the New York Journal. |
| 1914 | The New York Stock Exchange re-opened for the first time since July 30. The market had shut down when World War I broke out. |
| 1915 | Singer Frank Sinatra was born in Hoboken, N.J. |
| 1917 | Father Edward Flanagan founded Boys Town outside Omaha, Neb. |
| 1925 | The first motel, the Motel Inn, opened, in San Luis Obispo, Calif. |
| 1947 | The United Mine Workers union withdrew from the American Federation of Labor. |
| 1975 | Sara Jane Moore pleaded guilty to trying to kill President Gerald R. Ford. |
| 1998 | The House Judiciary Committee approved a fourth article of impeachment against President Bill Clinton and submitted the case to the full House. |
| 2000 | A divided U.S. Supreme Court halted the presidential recount in Florida, effectively making Republican George W. Bush the winner. |
| 2003 | Keiko, the killer whale made famous by the "Free Willy" movies, died in a Norwegian fjord. |
| 2009 | Houston became the largest U.S. city to elect an openly gay mayor, with voters handing a solid victory to City Controller Annise Parker. |
| Current Birthdays | ||||||||||||||||||||
| Jennifer Connelly turns 40years old today. | ||||||||||||||||||||
 AP Photo/Dan Steinberg Actress Jennifer Connelly turns 40 years old today. | ||||||||||||||||||||
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| Historic Birthdays | |
| Frank Sinatra | |
 12/12/1915 - 5/14/1998 American actor and singer (Go to obit.) | |
| 61 | Alvaro de Bazan Santa Cruz 12/12/1526 - 2/9/1588 Spanish naval commander |
| 83 | John Jay 12/12/1745 - 5/17/1829 First chief justice of the United States |
| 73 | William Lloyd Garrison 12/12/1805 - 5/24/1879 American abolitionist |
| 64 | Stand Watie 12/12/1806 - 9/9/1871 Cherokee chief |
| 67 | Gustave Flaubert 12/12/1821 - 5/8/1880 French novelist |
| 80 | Edvard Munch 12/12/1863 - 1/23/1944 Norweigan painter |
| 72 | Arthur Garfield Brisbane 12/12/1864 - 12/25/1936 American editor and writer |
| 51 | Alvin Kraenzlein 12/12/1876 - 1/6/1928 American Olympic athlete; first competitor to win four gold medals in a single Olympics |
| 73 | Arthur Garfield Hays 12/12/1881 - 12/14/1954 American lawyer and defender of civil liberties |
| 79 | Edward G. Robinson 12/12/1893 - 1/26/1973 American actor and singer |
| 85 | Henry Armstrong 12/12/1912 - 10/24/1988 American boxer |
| 65 | John Osborne 12/12/1929 - 12/24/1994 English playwright |
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