viernes, 13 de julio de 2012

Guía Breve sobre Hepatitis C 2012


Guía Breve sobre Hepatitis C 2012

2012 Short Guide to Hepatitis C,
Mauss − Berg − Rockstroh − Sarrazin − Wedemeyer
http://www.operationflyingpublisher.com/pdf/FPG_011_HepatitisCGuide_2012.pdf


Atentamente
Anestesiología y Medicina del Dolor

jueves, 12 de julio de 2012

1 er Congreso internacional y 10 curso taller de patología quirúrgica del pie 2012


Ahora si con un poco mas de calma quiero difundir el 1 er Congreso internacional y 10 curso taller de patología quirúrgica del pie, organizado por la sociedad mexicana de medicina y cirugía del pie AC, cuya organizadora es la doctora Patricia Parra, adscrita del servicio de pie y tobillo del instituto nacional de rehabilitación.

Tenemos 30 becas del 75% para asistir a este congreso y la mecánica es la siguiente: toda solicitud de beca se tiene que dirigir a : bibliomanazteca@yahoo.com.mx , se les enviará la forma de pre inscripción y el número de cuenta para que cubran en 25% restante, 500 pesos, con el pre registro lleno y un escaneo de la forma de pago, me la hacen llegar nuevamente a: bibliomanazteca@yahoo.com.mx y recibidos estos documentos se les confirma su beca.
Este año, mas que en ninguno de los anteriores se a invitado a 9 profesores extranjeros al congreso:

Dr. Sergio Fernández (Chile)
Expresidente FLAMECIPP
Dr. Pablo Fernandez de Retana( España)
Jefe de servicio Hospital Sant Rafael Barcelona
Dr. Ernesto Maceira Suárez (España)
Profesor Universidad Complutense de Madrid
Dr. Alberto Macklin Vadell (Argentina)
Vicepresidente FLAMECIPP Dr. Xavier Martín Oliva (España)
Presidente AEMCP
Dr. Mariano Núñez-Samper Pizarroso (España)
Profesor Universidad Complutense de Madrid Dr. Lew Shon (Baltimore, USA)
Vicepresidente AOFAS
Dr. Ramón Viladot Pericé (Barcelona).
Expresidente de la AEMCP
Dr. Antonio Viladot Voegeli (Barcelona)
Presidente de la EFFAS.

En días posteriores y con cierta regularidad seguiremos la difusión de este congreso,
esperando su amable respuesta quedamos de ustedes.


Book My Cloud, disco duro virtual en la nube con espacio ilimitado y gratuito

LA SEEIC RECLAMA PROFESIONALES CUALIFICADOS Y FORMADOS PARA QUE LA TELEMEDICINA AVANCE

http://noticiadesalud.blogspot.mx/2012/07/la-seeic-reclama-profesionales.html

LUNES, 9 DE JULIO DE 2012

LA SEEIC RECLAMA PROFESIONALES CUALIFICADOS Y FORMADOS PARA QUE LA TELEMEDICINA AVANCE


La telemedicina es uno de los campos en los que se ha centrado y se centrarán los grandes avances en tecnología sanitaria.“Aunque ya se han dado importantes pasos, aún tenemos mucho que avanzar, sobre todo a nivel de seguridad, para lo que precisamos de profesionales cualificados, con formación específica en este campo”, asegura Jesús Lucinio Manzanares, presidente de la Sociedad Española de Electromedicina e Ingeniería Clínica (SEEIC).
En España, la telemedicina ya es una realidad, y algunos programas sanitarios, tanto públicos como privados, la contemplan. “Los pacientes con problemas cardiacos, respiratorios o renales, son algunos de los colectivos que más se están beneficiando de la medicina a distancia”, comenta Manzanares.
Para llevarla a cabo, ha sido fundamental la implantación y desarrollo de las nuevas tecnologías, desde la telefonía convencional y la videoconferencia, pasando por las comunicaciones por satélite, hasta Internet o la telefonía móvil. Gracias a estos sistemas, inherentes a la propia tecnología sanitaria, se puede establecer una comunicación bidireccional entre el paciente y el médico y, a su vez, este último puede recibir datos, constantes vitales e imágenes diagnósticas del paciente. Así, el facultativo puede vigilar su estado y, en sentido inverso, enviar órdenes electrónicas para que los dispositivos conectados al paciente en su domicilio realicen un seguimiento diagnóstico o apliquen un tratamiento terapéutico, para un control más efectivo.
“La telemedicina permite realizar el seguimiento de pacientes que portan un marcapasos o vigilar a astronautas a miles de kilómetros de la Tierra. Sus posibilidades son numerosas y de grandes magnitudes”, explica el experto.

“Sin duda –continúa-, todos estos avances deben ser regulados y ordenados, tratando su expansión y evolución con rigor, con el fin de prestar un servicio asistencial eficiente y de calidad, que repercutirá positivamente en el estado de bienestar del conjunto de la población”.
Retos de la Telemedicina
La medicina a distancia podría ayudar a combatir las consecuencias de la falta de profesionales que experimentan muchos sistemas sanitarios de nuestro entorno, incluido el nuestro, sobre todo en aquellas zonas alejadas de los grandes hospitales. Asimismo, en una población cada vez más envejecida y con un número de pacientes crónicos en aumento, la telemedicina se convierte en una opción que cada vez debe tenerse más en cuenta.
“Una disminución en el número de consultas, de las visitas a domicilio y de las hospitalizaciones supondría un importante ahorro para un sistema sanitario en crisis, volviéndolo más eficiente y efectivo. Además, la comodidad y el incremento en la calidad de vida de los pacientes puede ser notable”, explica el presidente de la SEEIC.
“No obstante, -apunta- tenemos varios retos que cumplir en la implantación de la telemedicina. La seguridad, el coste-efectividad, el desconocimiento de las nuevas tecnologías por parte de la población mayor, en algunos casos, o el grado de aceptación de médicos y pacientes, son aspectos pendientes de evaluación. Por ello, debemos tomarla con cautela e implicar a los profesionales indicados y formados en el campo de las tecnologías sanitarias”, inciden desde la sociedad.
En este sentido, “las tecnologías sanitarias deben estar gestionadas por profesionales formados y con experiencia en la instalación, evaluación y mantenimiento de las mismas. Si se lleva a cabo de la forma correcta, contando con personal cualificado para ello, el ahorro de los costes y la optimización de la tecnología será aún mayor”, concluye Jesús Manzanares.
La telemedicina será uno de los temas a tratar durante el X Congreso Nacional de la SEEIC, que se celebra del 26 al 28 de septiembre en Barcelona

El estado de hidratación despues de ayuno nocturno medido por la osmolaridad de la orina no altera la magnitud de la hipotensión arterial durante anestesia general en pacientes de bajo riesgo


El estado de hidratación despues de ayuno nocturno medido por la osmolaridad de la orina no altera la magnitud de la hipotensión arterial durante anestesia general en pacientes de bajo riesgo 
Hydration status after overnight fasting as measured by urine osmolality does not alter the magnitude of hypotension during general anesthesia in low risk patients.
Osugi T, Tatara T, Yada S, Tashiro C.
Department of Anesthesiology, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
Anesth Analg. 2011 Jun;112(6):1307-13. Epub 2011 Mar 17.
Abstract
BACKGROUND: The increased distribution of crystalloid solution into the interstitial space may decrease the effectiveness of intravascular volume loading in patients. We investigated whether preoperative hydration status after overnight fasting affects interstitial fluid redistribution and thus the magnitude of hypotension during general anesthesia. METHODS:
Sixty ASA physical status I/II patients undergoing tympanoplasty fasted from midnight. Anesthesia was induced by fentanyl and propofol and maintained with sevoflurane and remifentanil. Coinciding with the induction of anesthesia, 15 mL/kg acetated Ringer solution was infused IV over 60 minutes followed by 1 mL/kg acetated Ringer solution over the next 30 minutes. Urine osmolalities after induction of anesthesia and during the study period (pre-U(osm), post-U(osm)) and percent decreases of whole-body bioelectrical resistance for extracellular fluid relative to baseline at the end of the study period (ΔR(e)) were measured. Patients with a pre-U(osm) < the 25th percentile or with a pre-U(osm) > the 75th percentile of pre-U(osm) were categorized in the hydrated or the dehydrated group, respectively. A range of variables, including mean arterial blood pressure during the 30- to 90-minute period relative to baseline, and ΔR(e), were compared between the groups. RESULTS: The dehydrated group (pre-U(osm) >759.5 mOsm/kg, n = 15) had a lower age (44 vs 52 years, P = 0.049) and had a higher post-U(osm) (181 vs 55 mOsm/kg, P = 0.001) compared with the hydrated group (pre-U(osm) <378.5 mOsm/kg, n = 15). Mean arterial blood pressure during the 30- to 90-minute period relative to baseline (0.67 vs 0.67, P = 0.85) with 95% confidence interval for the difference of means (-0.070 to 0.084) and ΔR(e) (5.6% vs 6.0%, P = 0.58) with 95% confidence interval for the difference of means (-1.85% to 1.06%) were similar for the hydrated and dehydrated groups.
CONCLUSIONS:  Preoperative dehydration after overnight fasting as measured by urine osmolality did not alter the magnitude of hypotension during general anesthesia. This finding suggests that intravascular volume loading with crystalloid solution to prevent hypotension during general anesthesia is an unfounded practice for low risk patients after overnight fasting.



Atentamente
Anestesiología y Medicina del Dolor

Tapentadol; un novel analgésico con acción dual


Interacción sinérgica entre los dos mecanismos de de acción del tapentadol en analgesia
Synergistic interaction between the two mechanisms of action of tapentadol in analgesia.
Schröder W, Tzschentke TM, Terlinden R, De Vry J, Jahnel U, Christoph T, Tallarida RJ.
Global Preclinical Research and Development, Department of Pharmacology, Grünenthal GmbH, Zieglerstrasse 6, 52078 Aachen, Germany. wolfgang.schroeder@grunenthal.com
J Pharmacol Exp Ther. 2011 Apr;337(1):312-20. Epub 2011 Jan 24.
Abstract
The novel centrally acting analgesic tapentadol [(-)-(1R,2R)-3-(3-dimethylamino-1-ethyl-2-methyl-propyl)-phenol hydrochloride] combines two mechanisms of action, μ-opioid receptor (MOR) agonism and noradrenaline reuptake inhibition (NRI), in a single molecule. Pharmacological antagonism studies have demonstrated that both mechanisms of action contribute to the analgesic effects of tapentadol. This study was designed to investigate the nature of the interaction of the two mechanisms. Dose-response curves were generated in rats for tapentadol alone or in combination with the opioid antagonist naloxone or the α(2)-adrenoceptor antagonist yohimbine. Two different pain models were used: 1) low-intensity tail-flick and 2) spinal nerve ligation. In each model, we obtained dose-effect relations to reveal the effect of tapentadol based on MOR agonism, NRI, and unblocked tapentadol. Receptor fractional occupation was determined from tapentadol's brain concentration and its dissociation constant for each binding site. Tapentadol produced dose-dependent analgesic effects in both pain models, and its dose-effect curves were shifted to the right by both antagonists, thereby providing data to distinguish between MOR agonism and NRI. Both isobolographic analysis of occupation-effect data and a theoretically equivalent methodology determining interactions from the effect scale demonstrated very pronounced synergistic interaction between the two mechanisms of action of tapentadol. This may explain why tapentadol is only 2- to 3-fold less potent than morphine across a variety of preclinical pain models despite its 50-fold lower affinity for the MOR. This is probably the first demonstration of a synergistic interaction between the occupied receptors for a single compound with two mechanisms of action

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364495/?tool=pubmed
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3364495/pdf/zpt312.pdf 

 
Tapentadol de liberación rápida: una nueva opción de tratamiento en dolor agudo 
Tapentadol immediate release: a new treatment option for acute pain management.
Afilalo M, Stegmann JU, Upmalis D.
Sir Mortimer B. Davis Jewish General Hospital, Montréal, Canada
J Pain Res. 2010 Feb 8;3:1-9.
Abstract
The undertreatment of acute pain is common in many health care settings. Insufficient management of acute pain may lead to poor patient outcomes and potentially life-threatening complications. Opioids provide relief of moderate to severe acute pain; however, therapy with pure μ-opioid agonists is often limited by the prevalence of side effects, particularly opioid-induced nausea and vomiting. Tapentadol is a novel, centrally acting analgesic with 2 mechanisms of action, μ-opioid receptor agonism and norepinephrine reuptake inhibition. The analgesic effects of tapentadol are independent of metabolic activation and tapentadol has no active metabolites; therefore, in theory, tapentadol may be associated with a low potential for interindividual efficacy variations and drug-drug interactions. Previous phase 3 trials in patients with various types of moderate to severe acute pain have shown that tapentadol immediate release (IR; 50 to 100 mg every 4 to 6 hours) provides analgesia comparable to that provided by the pure μ-opioid agonist comparator, oxycodone HCl IR (10 or 15 mg every 4 to 6 hours), with a lower incidence of nausea, vomiting, and constipation. Findings suggest tapentadol may represent an improved treatment option for acute pain.
Atentamente
Anestesiología y Medicina del Dolor

Bosón de Higgs para Dummies

http://cienciaaldia.wordpress.com/2011/07/26/boson-de-higgs-para-dummies/

De: Carlos A. Morales P. 


Bosón de Higgs para Dummies

Al parecer queda poco más de un año para que salgamos de dudas sobre la existencia o inexistencia de esta partícula tan controvertida.
Pero, ¿qué es el Bosón de Higgs? Al parecer le llaman la Partícula de Dios porque gracias a él todos los fermiones tienen masa. ¿Y cómo es esto posible?
Si teneis 3 minutos y un poco de curiosidad os recomiendo este video que os sacará de dudas con una explicación realmente asequible para todos y con algo de buen humor.


After Russian Floods, Grief, Rage and Deep Mistrust


http://www.nytimes.com/2012/07/11/world/europe/after-russian-floods-grief-rage-and-deep-mistrust.html?pagewanted=2&nl=todaysheadlines&emc=edit_th_20120711


After Russian Floods, Grief, Rage and Deep Mistrust

James Hill for The New York Times
The new graveyard for Krymsk, Russia, hit by flooding on Saturday. The official death count had risen to 172 by Tuesday.More Photos »
KRYMSK, Russia — Forty-six new graves were cut on Tuesday in a field outside this city, where catastrophic flooding has left behind a slime of mud and anger.
Multimedia


Related in Opinion

Sergey Ponomarev/Associated Press
The distribution center in Krymsk, Russia, about 750 miles south of Moscow, on Tuesday. Donations have poured in to help survivors of the flooding. More Photos »
Everyone here had a story of the pitch-black hours of Saturday morning, of being trapped inside homes as water rose to 6 and then to 8 and 10 feet, listening to the screams of neighbors and fear-maddened animals.
So it came as a shock, and then as the focus of anger, when officials acknowledged that they had been aware of a threat to Krymsk at 10 the previous night, but had not taken measures to rouse its sleeping residents.
The flood in this city of 57,000 in southern Russia is the first disaster to hit the country since Vladimir V. Putinreturned to the presidency, amid uncertain public support for his government. Its aftermath has riveted national attention as a measure of the state’s effectiveness, including visits from celebrities and volunteer efforts backed by pro-government and opposition political parties.
Mr. Putin has been damaged in the past by appearing indifferent to disasters — most acutely in 2000, when he failed to immediately return from a vacation to handle the sinking of a nuclear-powered submarine, the Kursk. Russia declined initial rescue offers from other countries, and all 118 sailors trapped onboard died.
The official death count in the floods had risen to 172 by Tuesday. Inside a ruined pastry shop, which had the sickly smell of something rotting, Sergei Viktorovich, 45, described waking in the darkness to the sensation of moisture in his bed, then reaching for his phone on a bedside table to find that it was already lost in the water.
“If they knew at 11, why didn’t they warn us? What are we, hunks of meat? Are we not people?” he said, offering his patronymic, not his surname, because he said he feared retribution from the police. “We are the young people, so we swam, but what about our grandmothers? How many grandmothers drowned?”
He said those emotions were barely restrained when the region’s governor, Aleksandr Tkachev, met with residents on Sunday. “If there weren’t so many police around,” he said, “they would have thrown rocks at him.”
Whatever the ultimate repercussions — firings, compensation, criminal charges — a visit to Krymsk offers a view of the gap that has opened between Russians and their government. Rumors have taken on such force that, on Monday, word of a second wave of water sent many people running.
“Even if Tkachev was saying the same things as the people standing in line for humanitarian aid, they still wouldn’t believe him,” said the journalist Oleg Kashin in a commentary on Kommersant FM radio. “Because this is not about the fact that the official story is different from the victims’ story, but that people don’t trust the authorities, on any subject — on natural disasters, or elections, or soccer.”
Mr. Putin has made clear efforts to avoid repeating earlier mistakes — as well as unscripted scenes like one during the 2010 forest fires, when he visited a burned village to offer monetary compensation and a woman began yelling angrily: “We asked for help! We trusted you!”
He reviewed damage from the air on Saturday, and has demanded a full investigation by the end of this week.
The federal authorities have since acknowledged that failing to warn residents was a major mistake, and the head of the region, Vasily Krutko, was dismissed on Monday. They have sent teams of psychologists, and donations of food and clothing have poured in.
That has not appeased many people in Krymsk, who spent Tuesday scraping mud from their floors and walls, and lining the roads with fetid piles of ruined belongings. Lyudmila Dmitriyevna, 64, said she awoke early Saturday to the sound of voices, stepping onto her third-floor balcony and peering into the gloom.
“It was as if I were looking at a stream of clay,” she said. “It was so loud, there were people screaming in the water, and metal barrels, and animals. It boiled and boiled, it covered the streets and the yards, it was all you could see.”
Like many residents interviewed, she said she suspected that the raging flow was a result of an official decision to release some water from a swollen reservoir in the hills above the city — a theory rebutted by scientists from Russia’s environmental monitoring service, who said Friday’s rains swelled nearby rivers with the equivalent of six months’ average precipitation.
The New York Times
Multimedia

But those explanations, like the overtures of officials, have done little to win back Ms. Dmitriyevna’s trust. “Putin came, Tkachev came, the mayor came,” she said. “They deny everything. They are protecting their own interests. Why would they protect ordinary people?”
Her husband then took her by the hand and pulled her away from a reporter, saying that if she gave her full name, “they’ll take you out and shoot you.”
At a cemetery on the edge of town, a small procession of mourners, some in flip-flops and housedresses, were gathered around the last of the day’s 46 burials. Many were for multiple family members who had drowned together, like the mother and child whose deaths caused a flash of pain and exhaustion to pass over the face of the Rev. Valery Chernenko, from the nearby town of Ilsky.
Mr. Chernenko said he thought there would be far more burials on Wednesday, maybe 100. He said many residents were struggling with their religious faith; as for their faith in the government, he said, they never had much to begin with.
“People stopped believing in the authorities a long time ago,” he said. “They are starting to shape their relationship to the authorities in a different way.”
As she stood over the grave of her godmother, a former collective-farm worker, a woman named Yelena could not keep from fuming. She had been searching for her godmother with increasing frustration since Saturday, interviewing enough neighbors to know that the woman and her husband had lighted candles and were moving around in their home as the waters rose.
Asked about the role of the authorities, Yelena grimaced, and declined to be quoted by her full name. “We have been furious since the seventh,” the night of the flood, she said. “People are still in shock now. I don’t know what will happen after they are no longer in shock.

Primera foto de la sombra de un átomo


Primera foto de la sombra de un átomo
La importancia del descubrimiento del bosón de Higgs ha dejado en la sombra otro curioso hallazgo que, siendo menor en comparación, también tiene un gran interés científico.
FUENTE | ABC Periódico Electrónico S.A.11/07/2012

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Un equipo de la Universidad de Griffith en Brisbane (Australia) ha sido capaz de fotografiar la sombra de un átomo por primera vez. No se trata solo de una curiosidad. El logro supone llegar al límite extremo de la microscopía. «No se puede ver nada más pequeño que un átomo utilizando la luz visible», afirman los científicos implicados en la hazaña, para la que han trabajado durante cinco años. Además, la investigación, que aparece publicada en Nature Communications, puede facilitar futuros avances en la física atómica, la computación cuántica y la biología. 

«Queríamos investigar cómo se requieren unos pocos átomos para producir una sombra y hemos demostrado que se necesita solo uno», dice el profesor Dave Kielpinski, del Centro de Dinámica Cuántica de la Universidad de Griffith en Brisbane.

Los investigadores lograron observar la sombra del átomo con un microscopio de superalta resolución, que consigue que la sombra sea suficientemente oscura para ser vista. Ninguna otra institución en el mundo tiene la capacidad de obtener imágenes ópticas tan extremas, según asegura la universidad en un comunicado.

El átomo estaba aislado dentro de una cámara y se mantenía en el espacio libre por las fuerzas eléctricas. El Profesor Kielpinski y sus colegas atraparon iones atómicos individuales del elemento iterbio y los expusieron a una frecuencia específica de luz. Bajo esta luz la sombra del átomo fue enviada a un detector, y una cámara digital fue capaz de capturar la imagen. 

«PRECISIÓN CASI INIMAGINABLE»

«La precisión de este proceso es casi inimaginable», dicen los investigadores. «Si cambiamos la frecuencia de la luz que brilla en el átomo solo una parte, la imagen ya no puede ser vista», apunta Kielpinski.

Este hallazgo puede tener importantes implicaciones en la física atómica y la computación cuántica. También puede influir en la medición de muestras biológicas muy frágiles y diminutas, como las hebras de ADN, donde la exposición a la luz ultravioleta excesiva o a rayos X puedan dañar el material. Ahora, los investigadores podrán predecir la cantidad de luz necesaria para observar los procesos dentro de las células sin que estas se destruyan.

Conservacion y preservacion digital


Conservamos. Guía técnica de preservación en bibliotecas. Vol 3, Nº 3 (2008).Sandra M. Angulo Méndez
Pautas para la digitalizaciónn de documentos análogos en papel y audio.

  • Medidas preventivas para la preservación de la información en materiales impresos. Alfonso Cid Munguía.
    Informe académico presentado en la Facultad de filosofía y Letras Colegio de Bibliotecología de la UNAM, 2008. Trata sobre las causas del deterioro en materiales impresos, factores que intervienen y medidas preventivas para la conservación. Incluye un glosario de deterioros y términos más usuales en la preservación de los materiales.www.filos.unam.mx/.../cid-munguia-alfonso.pdf

    • MEDIDAS PREVENTIVAS PARA LA CONSERVACION DE LA DOCUMENTACION Y COLECCIONES. Una estupenda presentación para ilustrar este tema. En:www//prezi.com

Guía de preservación en bibliotecas
http://www.bibliopos.es/temario/t-biblioteconomia.htm#8

Lupanar. La palabra del día


 
Museo del Louvre, una antigua lobera
lupanar
Registrada por primera vez en español en el Diccionario de autoridades(1734), esta palabra proviene del latín lupanar, que designaba la "casa de la prostituta", debido a que esas mujeres eran llamadas en latín vulgar lupa'loba', aunque los clásicos prefirieran usar el más refinado meretrix 'la que se gana la vida por sí misma'. 

En el español actual, como también en portugués, lupanar significa 'prostíbulo'. Curiosamente, Louvre, el nombre de uno de los museos más famosos del mundo, tiene un origen semejante, pues proviene del latín lupara'lobera', 'albergue para lobos'. En efecto, el palacio donde está emplazado el célebre museo parisién fue originalmente una fortificación construida en una de las márgenes del Sena, comparada en su tiempo con una guarida de lobos. 

Uso médico de la marihuana


Marihuana medicinal: despejando el humo
Medical marijuana: clearing away the smoke.
Grant I, Atkinson JH, Gouaux B, Wilsey B.
Center for Medicinal Cannabis Research; University of California, San Diego; San Diego, CA, USA.
Open Neurol J. 2012;6:18-25. Epub 2012 May 4.
Abstract
Recent advances in understanding of the mode of action of tetrahydrocannabinol and related cannabinoid in-gredients of marijuana, plus the accumulating anecdotal reports on potential medical benefits have spurred increasing re-search into possible medicinal uses of cannabis. Recent clinical trials with smoked and vaporized marijuana, as well as other botanical extracts indicate the likelihood that the cannabinoids can be useful in the management of neuropathic pain, spasticity due to multiple sclerosis, and possibly other indications. As with all medications, benefits and risks need to be weighed in recommending cannabis to patients. We present an algorithm that may be useful to physicians in determining whether cannabis might be recommended as a treatment in jurisdictions where such use is permitted.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358713/pdf/TONEUJ-6-18.pdf 

 
Efectos adversos de los canabinoides de uso médico: revisión sistemática 
Adverse effects of medical cannabinoids: a systematic review.
Wang T, Collet JP, Shapiro S, Ware MA.
Department of Epidemiology , McGill University, Montréal, Que.
CMAJ. 2008 Jun 17;178(13):1669-78.
Abstract
BACKGROUND:
The therapeutic use of cannabis and cannabis-based medicines raises safety concerns for patients, clinicians, policy-makers, insurers, researchers and regulators. Although the efficacy of cannabinoids is being increasingly demonstrated in randomized controlled trials, most safety information comes from studies of recreational use. METHODS: We performed a systematic review of safety studies of medical cannabinoids published over the past 40 years to create an evidence base for cannabis-related adverse events and to facilitate future cannabis research initiatives. We critically evaluated the quality of published studies with a view to identifying ways to improve future studies. RESULTS: A total of 321 articles were eligible for evaluation. After excluding those that focused on recreational cannabis use, we included 31 studies (23 randomized controlled trials and 8 observational studies) of medical cannabis use in our analysis. In the 23 randomized controlled trials, the median duration of cannabinoid exposure was 2 weeks (range 8 hours to 12 months). A total of 4779 adverse events were reported among participants assigned to the intervention. Most (4615 [96.6%]) were not serious. Of the 164 serious adverse events, the most common was relapse of multiple sclerosis (21 events [12.8%]), vomiting (16 events [9.8%]) and urinary tract infection (15 events [9.1%]). The rate of nonserious adverse events was higher among participants assigned to medical cannabinoids than among controls (rate ratio [RR] 1.86, 95% confidence interval [CI] 1.57-2.21); the rates of serious adverse events did not differ significantly between these 2 groups (RR 1.04, 95% CI 0.78-1.39). Dizziness was the most commonly reported nonserious adverse event (714 events [15.5%]) among people exposed to cannabinoids. INTERPRETATION: Short-term use of existing medical cannabinoids appeared to increase the risk of nonserious adverse events. The risks associated with long-term use were poorly characterized in published clinical trials and observational studies. High-quality trials of long-term exposure are required to further characterize safety issues related to the use of medical cannabinoids.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2413308/?tool
=pubmed
pdf/20080617s00017p1669.pdf 
Uso médico de la marihuana y canabinoides sintéticos 
Aquiles J. Roncoroni
Instituto de Investigaciones Médicas Alfredo Lanari, Facultad de Medicina, Universidad de Buenos Aires. e-mail: ajr@movi.com.ar
Medicina (B. Aires) v.63 n.6 Buenos Aires nov./dic. 2003
Mientras la marihuana (MHN) se usó médicamente en EE.UU entre 1842 y 1937 la Marijuana Tax Act aprobada ese año por el poder legislativo de EE.UU, contra la opinión del representante de la Asociación Médica Americana, cambió totalmente la situación. Esta ley fue propuesta por H. Anslinger, director de la oficina federal de narcóticos atribuyéndole provocación de conducta violenta e insanía. Curiosamente el mismo Anslinger en 1967, atribuía a su consumo la conducta «cobarde» de los jóvenes americanos que eludían la convocatoria a luchar en Vietnam.
http://www.scielo.org.ar/pdf/medba/v63n6/v63n6a13.pdf

 
Atentamente
Anestesiología y Medicina del Dolor