Bloqueo interescalénico/Interscalene block

http://www.smo.edu.mx/pdf/cursos_SEMEFO2013.pdf

Bloqueo interescalénico posterior: Serie de casos guiados con ultrasonido y visión general de historia, anatomía y técnicas  Posterior interscalene block: an ultrasound-guided case series and overview of history, anatomy and techniques. McNaught A, McHardy P, Awad IT. Department of Anesthesia, Sunnybrook Health Sciences Centre and Holland Orthopedic and Arthritic Centre, University of Toronto, Toronto, Ontario, Canada. Pain Res Manag. 2010 Jul-Aug;15(4):219-23. Abstract BACKGROUND: The posterior interscalene block has been described as an alternative to the lateral interscalene block. However, this technique has not gained popularity because of the close proximity of the approach to vascular and central neural structures. OBJECTIVE: To describe the posterior interscalene block technique using ultrasound imaging, and to review the history of its evolution. METHODS: The use of ultrasound imaging to facilitate the insertion of interscalene catheters using the posterior approach in 11 patients undergoing total shoulder arthroplasty is described. RESULTS: All 11 patients had satisfactory analgesia in the first 24 h of the postoperative period. None of the patients complained of neck pain, as had been found in earlier techniques using the posterior approach. CONCLUSIONS: This modification of the posterior approach is a safe and effective method for the insertion of interscalene brachial plexus catheters. These catheters are also comfortable for patients and, in the present study, none of the catheters inadvertently fell out. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2935721/pdf/prm15219.pdf     Bloqueo interescalénico posterior del plexo braquial guiado con ultrasonido: estudio randomizado, ciego triple, placebo controlado.  Continuous interscalene brachial plexus block via an ultrasound-guided posterior approach: a randomized, triple-masked, placebo-controlled study. Mariano ER, Afra R, Loland VJ, Sandhu NS, Bellars RH, Bishop ML, Cheng GS, Choy LP, Maldonado RC, Ilfeld BM. Department of Anesthesiology, University of California, San Diego Medical Center, San Diego, California 92037-7651, USA. Anesth Analg. 2009 May;108(5):1688-94. doi: 10.1213/ane.0b013e318199dc86. Abstract BACKGROUND:  The posterior approach for placing continuous interscalene catheters has not been studied in a controlled investigation. In this randomized, triple-masked, placebo-controlled study, we tested the hypothesis that an ultrasound-guided continuous posterior interscalene block provides superior postoperative analgesia compared to a single-injection ropivacaine interscalene block after moderately painful shoulder surgery. METHODS: Preoperatively, subjects received a stimulating interscalene catheter using an ultrasound-guided, in-plane posterior approach. All subjects received an initial bolus of ropivacaine. Postoperatively, subjects were discharged with oral analgesics and a portable infusion device containing either ropivacaine 0.2% or normal saline programmed to deliver a perineural infusion over 2 days. The primary outcome was average pain on postoperative day (POD) 1 (scale: 0-10). Secondary outcomes included least and worst pain scores, oral opioid requirements, sleep disturbances, patient satisfaction, and incidence of complications. RESULTS: Of the 32 subjects enrolled, 30 perineural catheters were placed per protocol. Continuous ropivacaine perineural infusion (n = 15) produced a statistically and clinically significant reduction in average pain (median [10th-90th percentile]) on POD 1 compared with saline infusion (n = 15) after initial ropivacaine bolus (0.0 [0.0-5.0] versus 3.0 [0.0-6.0], respectively; P < 0.001). Median oral opioid consumption (oxycodone) was lower in the ropivacaine group than in the placebo group on POD 1 (P = 0.002) and POD 2 (P = 0.002). Subjects who received a ropivacaine infusion suffered fewer sleep disturbances than those in the placebo group (P = 0.005 on POD 0 and 1 nights) and rated their satisfaction with analgesia higher than subjects who received normal saline (P < 0.001). CONCLUSIONS: Compared to a single-injection interscalene block, a 2-day continuous posterior interscalene block provides greater pain relief, minimizes supplemental opioid requirements, greatly improves sleep quality, and increases patient satisfaction after moderate-to-severe painful outpatient shoulder surgery. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745838/pdf/nihms131871.pdf    Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Analgesia opioide periférica/Peripheral opioid analgesia

http://www.smo.edu.mx/pdf/cursos_cadaver2013.pdf

Apertura transitoria de la barrera perineural para administración de fármacos  Transient opening of the perineurial barrier for analgesic drug delivery. Hackel D, Krug SM, Sauer RS, Mousa SA, Böcker A, Pflücke D, Wrede EJ, Kistner K, Hoffmann T, Niedermirtl B, Sommer C, Bloch L, Huber O, Blasig IE, Amasheh S, Reeh PW, Fromm M, Brack A, Rittner HL. Department of Anesthesiology, University Hospitals Wurzburg, Julius Maximilians University, 97080 Würzburg, Germany. Proc Natl Acad Sci U S A. 2012 Jul 17;109(29):E2018-27. doi: 10.1073/pnas.1120800109. Epub 2012 Jun 25. Abstract Selective targeting of sensory or nociceptive neurons in peripheral nerves remains a clinically desirable goal. Delivery of promising analgesic drugs is often impeded by the perineurium, which functions as a diffusion barrier attributable to tight junctions. We used perineurial injection of hypertonic saline as a tool to open the perineurial barrier transiently in rats and elucidated the molecular action principle in mechanistic detail: Hypertonic saline acts via metalloproteinase 9 (MMP9). The noncatalytic hemopexin domain of MMP9 binds to the low-density lipoprotein receptor-related protein-1, triggers phosphorylation of extracellular signal-regulated kinase 1/2, and induces down-regulation of the barrier-forming tight junction protein claudin-1. Perisciatic injection of any component of this pathway, including MMP9 hemopexin domain or claudin-1 siRNA, enables an opioid peptide ([D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin) and a selective sodium channel (NaV1.7)-blocking toxin (ProToxin-II) to exert antinociceptive effects without motor impairment. The latter, as well as the classic TTX, blocked compound action potentials in isolated nerves only after disruption of the perineurial barrier, which, in return, allowed endoneurally released calcitonin gene-related peptide to pass through the nerve sheaths. Our data establish the function and regulation of claudin-1 in the perineurium as the major sealing component, which could be modulated to facilitate drug delivery or, potentially, reseal the barrier under pathological conditions. http://www.pnas.org/content/109/29/E2018.full.pdf+html     Coadministración de agonistas de los receptores δ- y μ promueve función de receptores periféricos opioides  Co-administration of δ- and μ-opioid receptor agonists promotes peripheral opioid receptor function. Schramm CL, Honda CN. Department of Neuroscience and Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN 55455, USA. Pain. 2010 Dec;151(3):763-70. doi: 10.1016/j.pain.2010.09.009. Abstract Enhancement of peripheral opioid analgesia following tissue injury or inflammation in animal models is well-documented, but clinical results of peripheral opioid therapy remain inconsistent. Previous studies in the central nervous system have shown that co-administration of μ- and δ-opioid receptor agonists can enhance analgesic outcomes; however, less is known about the functional consequences of opioid receptor interactions in the periphery. The present study examines the effects of intraplantar injection of the μ- and δ-opioid receptor agonists, morphine and deltorphin, alone and in combination on behavioral tests of nociception in naïve rats and on potassium-evoked release of CGRP from sciatic nerves of naïve rats. Neither drug alone affected nociceptive behaviors or CGRP release. Two separate measures of mechanical nociceptive sensitivity remained unchanged after co-administration of the two drugs. In contrast, when deltorphin was co-injected with morphine, dose-dependent and peripherally restricted increases in paw withdrawal latencies to radiant heat were observed. Similarly, concentration-dependent inhibition of CGRP release was observed when deltorphin and morphine were administered in sequence prior to potassium stimulation. However, no inhibition was observed when morphine was administered prior to deltorphin. All combined opioid effects were blocked by co-application of antagonists. Deltorphin exposure also enhanced the in vivo and in vitro effects of another μ-opioid receptor agonist, DAMGO. Together, these results suggest that under normal conditions, δ-opioid receptor agonists enhance the effect of μ-opioid receptor agonists in the periphery, and local co-administration of δ- and μ-opioid receptor agonists may improve results of peripheral opioid therapy for the treatment of pain http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2978509/pdf/nihms-249520.pdf    Opioides con acción periférica y sus implicaciones en el manejo del dolor  Peripherally acting opioids and clinical implications for pain control. Sehgal N, Smith HS, Manchikanti L. University of Wisconsin School of Medicine and Public Health, Madison, WI 53595, USA. NSehgal@uwhealth.org Pain Physician. 2011 May-Jun;14(3):249-58. Abstract Opioid receptors are widely expressed in the central and peripheral nervous system and in the non-neuronal tissues. Data from animal and human clinical studies support the involvement of peripheral opioid receptors in analgesia, especially in the presence of inflammation. Inflammation has been shown to increase the synthesis of opioid receptors in the dorsal root ganglion neurons and enhance transport and accumulation of opioid receptors in the peripheral terminals of sensory neurons. Under the influence of chemokines and adhesion molecules, opioid peptide-containing immune cells extravasate and accumulate in the injured tissues. Stress, chemokines, cytokines, and other releasing factors in inflamed tissues stimulate these granulocytes to release opioid peptides. Once secreted, opioid peptides bind to and activate peripheral opioid receptors on sensory nerve fibers and produce analgesia by decreasing the excitability of sensory nerves and/or inhibiting release of pro-inflammatory neuropeptides. Research has revealed that local application of exogenous opioid agonists produces a potent analgesic effect by activating peripheral opioid receptors in inflamed tissues. The analgesic activity occurs without activation of opioid receptors in the central nervous system (CNS), and therefore centrally mediated side effects, such as respiratory depression, mental clouding, altered consciousness, or addiction, are not associated with peripheral opioid activity. This discovery has stimulated research on developing peripherally restricted opioid agonists that lack CNS effects. In addition, it has been recognized that opioid receptors modulate inflammation, and that opioids have anti-inflammatory effects. The anti-inflammatory actions of opioids are not well known or understood. Conflicting reports on mu-opioids suggest both anti-inflammatory and pro-inflammatory effects. This article will present the basis for peripheral opioid analgesia and describe current research directed at developing novel treatments for pain with improved side effect profiles. http://www.painphysicianjournal.com/2011/may/2011;14;249-258.pdf    Mecanismos periféricos del dolor y de analgesia       Peripheral mechanisms of pain and analgesia. Stein C, Clark JD, Oh U, Vasko MR, Wilcox GL, Overland AC, Vanderah TW, Spencer RH. Department of Anesthesiology and Critical Care Medicine, Charité Campus Benjamin Franklin, Freie Universität Berlin, Germany. Brain Res Rev. 2009 Apr;60(1):90-113 . doi: 10.1016/j.brainresrev.2008.12.017. Epub 2008 Dec 31. Abstract This review summarizes recent findings on peripheral mechanisms underlying the generation and inhibition of pain. The focus is on events occurring in peripheral injured tissues that lead to the sensitization and excitation of primary afferent neurons, and on the modulation of such mechanisms. Primary afferent neurons are of particular interest from a therapeutic perspective because they are the initial generator of noxious impulses traveling towards relay stations in the spinal cord and the brain. Thus, if one finds ways to inhibit the sensitization and/or excitation of peripheral sensory neurons, subsequent central events such as wind-up, sensitization and plasticity may be prevented. Most importantly, if agents are found that selectively modulate primary afferent function and do not cross the blood-brain-barrier, centrally mediated untoward side effects of conventional analgesics (e.g. opioids, anticonvulsants) may be avoided. This article begins with the peripheral actions of opioids, turns to a discussion of the effects of adrenergic co-adjuvants, and then moves on to a discussion of pro-inflammatory mechanisms focusing on TRP channels and nerve growth factor, their signaling pathways and arising therapeutic perspectives.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730351/pdf/nihms112893.pdf

Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

Conferencia Fórmulas Infantiles ¿Cual utilizar?

Estimado Ciberpediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 15 de Mayo 2013 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Formulas Infantiles ¿Cuál utilizar?” por la “Dra. Leticia Abundis Castro” Gastroenterologa Pediatra de Cd Obregon Son.. La sesión inicia puntualmente las 21 hrs.
Para entrar a la Sala de Conferencia:
1.- hacer click en la siguiente liga, o cópiala y escríbela en tu buscador

http://connectpro60196372.adobeconnect.com/formulas_infantiles/

2.- “Entra como Invitado” Escribes tu nombre y apellido en el espacio en blanco
3.- Hacer click en el espacio que dice “Entrar en la Sala”
5.- A disfrutar la conferencia 6.- Recomendamos que dejes tu Nombre Completo, Correo electrónico y que participes.

Henrys


Dr. Enrique Mendoza López
Webmaster: CONAPEME
Coordinador Nacional: Seminario Ciberpeds-Conapeme
Av La clinica 2520-310
Colonia Sertoma ,Mty N.L. México
CP 64710
Tel-Fax 52 81 83482940 y 52 81 81146053
Celular 8183094806
www.conapeme.org
www.pediatramendoza.com
enrique@pediatramendoza.com
emendozal@yahoo.com.mx

Artrogriposis

Artrogriposis


Recordando que hoy es miércoles académico del servicio de ortopedia mixta,
Desde el hospital Dr Victorio Narvaez de la Fuente, IMSS, Cd de México
con el tema artrogriposis, nuestro ponente es el doctor Barcarcel

la transmisión en la siguiente liga:

http://www.livestream.com/ortopediamixta

http://livestre.am/1h07u

Watch live streaming video from ortopediamixta at livestream.com

Cirugía postbariátrica/Post bariatric surgery

                               http://www.smo.edu.mx/pdf/cursos_cadaver2013.pdf

Satisfacción con la cirugía post bariátrica y la consideración cirugía del contorno corporal después de pérdida masiva de peso  Post-bariatric surgery satisfaction and body-contouring consideration after massive weight loss. Aldaqal SM, Makhdoum AM, Turki AM, Awan BA, Samargandi OA, Jamjom H. North Am J Med Sci [serial online] 2013 [cited 2013 Apr 11];5:301-5. Background: Following a bariatric surgery and massive weight-loss, the outcome is usually sullied by consequences on the body's contour and redundant skin. Aims: We aimed to record the frequency of contour irregularities and quantify patients' satisfaction with appearance and anticipations from body contouring surgery. Materials and Methods: The ethical committee at King Abdulaziz University Hospital approved the study, and patients were consented. A cross-sectional study targeting the post-bariatric patients from May 2011 to April 2012 was conducted at our hospital. We used post-massive weight loss Satisfaction Questionnaire. Results: The total numbers of patients were 64 (51 women and 13 men), of which 57 patients (89.2%) developed sagging skin. Most patients were dissatisfied with their appearance after weight loss. The most common zones were the upper arms (50%) and abdomen (45%). Considerably more women (36.2%) than men (24%) were dissatisfied with certain body areas. The most noticeable expectation of patients from body contouring surgery was improved cosmetic appearance (65.6%) and self-confidence (64.1%). More women (70.58%) than men (46.15%) expected a better cosmetic appearance after body contouring (P = 0.003). Conclusion: After bariatric surgery, sagging excess skin is an unsatisfactory problem. Therefore, body contouring surgery must be included in morbid obesity management. Keywords: Bariatric surgery, Body contouring surgery, Expectation, Satisfaction, Weight loss http://www.najms.org/text.asp?2013/5/4/301/110442 Anestesia para procedimientos de cirugía plástica en pacientes con obesidad mórbida previa  Anesthesia for plastic surgery procedures in previously morbidly obese patients. Whizar-Lugo V, Cisneros-Corral R, Reyes-Aveleyra MA, Campos-León J. Domínguez J. Anest Mex 2009;21:186-193. Abstract Obese patients that have undergone bariatric surgery and have lost considerable amounts of weight tend to seek the assistance of plastic surgeons for body contour surgery to improve their physical appearance as well as their self esteem. This growing patient population tends to retain a certain amount of excess weight, as well as some of the co morbidities of obesity, such as arterial hypertension, mixed cardiopathy, pulmonary hypertension and hyperglycemia, among other pathologies. They should be examined thoroughly, in search of these co morbidities, as well as to obtain a complete list of medications they take or have taken in the past. The anesthetic management plan should be contingent upon the patient's physical condition, anatomic and physiologic changes, psychological condition and the surgical plan. Anemia is a frequent complication of some bariatric procedures and should be compensated with appropriate anticipation. Preanesthetic medications may include benzodiazepines and alfa-2 agonists, as long as precautions are taken against nausea and vomiting. Droperidol is the drug of choice. Regional anesthesia should be employed whenever possible, especially subarachnoid block, since it is deeper and has fewer adverse effects. General anesthesia should be left as the last choice, and may be combined with regional techniques. It is prudent to use conscious sedation for facial and neck surgery, maintaining stringent monitoring, especially with respect to airway management. Thromboprophylaxis is mandatory in these patients, and should continue for several days postoperatively. Key words: previously obese, plastic surgery, anesthesia http://www.anestesiaenmexico.org/RAM9/RAM2009-21-3/007.pdf    Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Bibliotecas. Alerta

http://www.smo.edu.mx/pdf/cursos_SEMEFO2013.pdf



La Biblioteca de C-LM hace ´socio de honor´ al filósofo toledano ...
20minutos.es
Con este motivo la Biblioteca ha organizado un 'centro de interés' con todos los títulos (más de 30) de que dispone de este reconocido autor, que están accesibles en préstamo para los usuarios que quieran leerlos, ha informado en nota de prensa la ...
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Biblioteca preserva la obra del poeta argentino Evaristo Carriego
La Crónica de Hoy
Su obra y contribución continúan en la Biblioteca que lleva su nombre, ubicada en el barrio de Palermo en Buenos Aires, edificada en lo que fuera la casa de Evaristo Carriego, en cuyos anaqueles hay libros de poesía argentina y extranjera, ensayos y ...
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Carmen Posadas, este martes en el ciclo 'en su tinta' en la ...
Europa Press
La escritora hispano-uruguaya Carmen Posadas participará este martes en 'Escritores en su tinta' en el habitual encuentro que los autores mantienen con sus lectores. Esta charla será como siempre a las 20.00 horas en la Biblioteca Salvador García ...
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Europa Press


Documentos de Hemingway en Cuba a Biblioteca JFK
El Nuevo Herald
Las copias digitales serán transferidas a la Biblioteca John F. Kennedy en Boston. Esta es la primera vez que alguien en Estados Unidos ha podido examinar estas pertenencias del escritor guardadas por años en su casa en Cuba, la Finca Vigía.
Ver todos los artículos sobre este tema »
El Nuevo Herald

La Biblioteca Virtual andaluza digitaliza más de 300 documentos de ...
La Voz de Almería
Consultar un poema escrito a mano por Francisco Villaespesa (Laujar de Andarax, 1877-Madrid, 1936) ahora está al alcance de cualquiera. La Biblioteca Virtual de Andalucía, dependiente de la Junta, ha digitalizado casi 300 libros y folletos locales ...
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La Nebrija transforma Colón en una biblioteca al aire libre para que ...
La Vanguardia
La Universidad Nebrija transforma Colón hasta el 12 de mayo en una biblioteca al aire libre para que un centenar de estudiantes de Bachillerato y 4º de la ESO preparen sus exámenes de 10 a 20 horas, una actividad gratuita que cuenta con el apoyo del ...
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La Biblioteca Pública de Requena gana nuevamente el premio de ...
El periódico de aquí
Una vez más la Biblioteca Pública de Requena ha sido seleccionada como una de lasbibliotecas ganadoras de la Campaña de Animación Lectora “María Moliner” que convoca el Ministerio de Educación, Cultura y Deporte, la Federación Española de ...
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El periódico de aquí

La Biblioteca de C-LM hace 'socio de honor' al filósofo toledano ...
Terra España
La Biblioteca de C-LM hace 'socio de honor' al filósofo toledano José Antonio Marina. La Biblioteca de Castilla-La Mancha ha decidido nombrar 'socio de honor' de la misma al filósofo toledano José Antonio Marina Torres. Esta distinción le será ...
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Las bibliotecas acogen un ciclo de conferencias de escritores ...
El Periódico de Aragón
María Frisa, Sergio del Molino y Juan Bolea, entre otros, protagonizarán un ciclo de conferencias y performances que tendrá lugar a lo largo del mes de mayo en las bibliotecas municipales de Zaragoza, organizado por el grupo Hélice en colaboración con ...
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El Inversor: El valor simbólico de las bibliotecas
Pijama Surf
La biblioteca doméstica, en su presencia o en su ausencia, es un símbolo poderoso de la formación personal, un espacio que aguarda pacientemente a que lo descubramos o lo construyamos, a que lo volvamos parte indeleble de nuestro propio ser. biblio ...
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El Instituto de Estudios Hispánicos organiza un curso sobre gestión ...
eldia.es
El Instituto de Estudios Hispánicos de Canarias (IEHCAN), con sede en el Puerto de la Cruz, organiza durante el próximo mes de junio un curso titulado "Bibliotecas públicas: gestión de un espacio para todos", destinado a bibliotecarios, animadores ...
Ver todos los artículos sobre este tema »
eldia.es

Los contenedores de ropa van a desaparecer de las calles
Cadena Ser
De los más de 500 que actualmente hay instalados en nuestras calles, sólo quedarán 60, con fines realmente benéficos, que irán ubicados en instalaciones municipales como mercados o bibliotecas. Votar. Sin interés Poco interesante De interés Muy ...
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Punta Arenas - Martes, 07 de Mayo de 2013
radiopolar.com
Los talleres cuentan con el apoyo de monitores de las bibliotecas municipales, que dependen de la Unidad de Gestión Cultural del Municipio de Punta Arenas, además de un equipamiento consistente en 8 equipos notebook y conexión wifi para 20 equipos ...
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Firma presidente chileno proyecto para crear el Ministerio de Cultura
Milenio.com
La iniciativa busca jerarquizar e integrar el Consejo Nacional de la Cultura con otros organismos como la Dirección de Bibliotecas, Archivos y Museos y el Consejo de Monumentos Nacionales, que actualmente dependen del Ministerio de Educación.
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Milenio.com


¿Alguien me puede decir los nombres de las bibliotecas que hay en ...
Bueno Pues Una De Las Mas Importantes En La Universidad Rafael Landivar Es Fue La Unica Que Encontre. hace 2 días; Reportar abusos. Calificación de la ...
espanol.answers.yahoo.com/question/index?qid...

Dos bibliotecas de Fuenlabrada abren las 24 horas para facilitar la ...
http://www.sermadridsur.com/noticias/dos-bibliotecas-de-fuenlabrada-abren-las- 24 ...
www.youtube.com/watch?v=DgpWwKbWeOE

Bibliotecas en acción. La biblioteca ayuda a su comunidad. La ...
José A. Merlo Vega wrote a note titled Bibliotecas en acción. La biblioteca ayuda a su comunidad. La comunidad ayuda a su biblioteca. Read the full text here.
www.facebook.com/notes/.../10152140832132788
¿porque ahora los peña boots, se dedican a quemar bibliotecas ...
Los desórdenes registrados en el barrio Nueva Esperanza, del Ejido Petalcingo, derivaron en la muerte de Jonás “N” y la quema de la biblioteca pública y la ...
espanol.answers.yahoo.com/question/index?qid...

Bibliotecas. Alerta

Una biblioteca ejemplar
El Mundo.es
En Orihuela no había biblioteca municipal y la Concejal de Cultura, Ana Mas y su equipo, tuvieron la buena idea de proponer la rehabilitación de un antiguo hospital para dar cabida a una biblioteca que fuera al mismo tiempo una casa común, ...
Ver todos los artículos sobre este tema »La Biblioteca Regional sombra socio de honor al filósofo toledano ...
ABC.es
Según ha informado hoy la entidad cultural, tras este acto, Marina abrirá el ciclo "El Toledo que queremos, el Toledo que soñamos" que ha organizado la Biblioteca Regional en el contexto de los actos para conmemorar su 15ª aniversario y que se ...
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Carmen Posadas, el próximo martes 'en su tinta' en la Biblioteca ...
Europa Press
La escritora hispano-uruguaya Carmen Posadas llega el martes 7 de mayo a 'Escritores en su tinta' en el habitual encuentro que los autores mantienen con sus lectores, como siempre en la Biblioteca Salvador García Aguilar de Molina de Segura, a las ...
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Europa Press

Caballero Bonald da su nombre a la 7ª biblioteca y dice que el ...
Europa Press
El Premio Cervantes José Manuel Caballero Bonald ha participado este lunes en un acto previo a la inauguración de la séptima biblioteca municipal de Fuenlabrada, que llevará su nombre, alegando que el escritor "como persona debe ser un crítico del ...
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Europa Press
La biblioteca de El Padul celebra su XXV aniversario con ...
Radio Granada
La delegada territorial en Granada de Educación, Cultura y Deporte, Ana Gámez, ha asistido, junto al alcalde de Padul, Manuel Alarcón, a la celebración del XXV aniversario de la apertura de la BibliotecaPública Municipal, en el que han participado ...
Ver todos los artículos sobre este tema »Esos libros del fondo de biblioteca
Faro de Vigo
Dicen que Borges, lector incansable, imaginaba el cielo como una biblioteca inmensa. Con inabarcables hileras de anaqueles, repletos de volúmenes de todos los géneros, temas, épocas y encuadernaciones. Mucho más grande que el cementerio de los ...
Ver todos los artículos sobre este tema »La Biblioteca Pública de Badajoz acoge un taller de cuentacuentos
digitalextremadura.com
La Biblioteca Pública del Estado “Bartolomé José Gallardo” de Badajoz acoge el taller de cuentacuentos “Se vende varita mágica”, de Isabel de Ron, una actividad está dirigida a niños y niñas de edades comprendidas entre los 3 y los 8 años y que tendrá ...
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Bibliotecas. Alerta

Ususarios de bibliotecas podrán renovar y reservar también desde ...
Diario Vasco
Los usuarios de las bibliotecas públicas pueden efectuar ahora las renovaciones de libros prestados y reservas desde su teléfono móvil, tal y como venían haciéndolo hasta ahora a través de su ordenador. Permite, además, como usuarios identificados, ...
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Colaboración de las bibliotecas municipales con el CS de ...
Faro de Vigo
Durante el presente mes de mayo, y tras la positiva experiencia desarrollada en 2012 entre lasbibliotecas de Redondela y el Ciclo Superior de Educación Infantil del IES Chapela, se acometerán una serie de interesantes actividades para promover sus ...
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Entrega de material didáctico a la biblioteca del Penal de Batán
Diario Más
con la Comunidad, Diego Zarlenga, entregó el material al director del penal, Horacio Falcone, y a la titular de la Biblioteca del Penal, Rita Galassi. Los usuarios de la Biblioteca son detenidos que cursan estudios primarios, secundarios y las carreras ...
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Bibliotecarios populares copan la Feria: se llevan historia y erotismo
Revista Ñ
Se trata del Programa Libro %, a través del cual la Comisión Nacional de BibliotecasPopulares (Conabip) reparte 10 millones de pesos, que sirven para pagar los libros, el traslado y el alojamiento de 2.400 bibliotecarios. La misma escena se repetirá ...
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Revista Ñ

Cuentacuentos sobre la UE para niños hospitalizados
ABC.es
Además, en los hospitales se repartirán publicaciones y materiales didácticos sobre este asunto para que puedan ser consultados por los pacientes y formen parte de los fondos de las bibliotecas. A lo largo del año la Comunidad de Madrid ofrece charlas ...
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Manuel Ruiz Luque: «Por el olor se sabe la vida de un libro»
ABC Córdoba
La misma que le ha empujado durante décadas a reunir una de las bibliotecas privadas más valiosas de toda Andalucía compuesta por casi 35.000 volúmenes. Por eso, quizás, en su discurso aparece recurrentemente el verbo enamorar para referirse a ese ...
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Quino, amigo de las bibliotecas populares - YouTube
Luego de una importante participación en la convocatoria para la elección del Amigo de las ...
www.youtube.com/watch?v=SgrN8yYDlMA

Literatura hondureña es escasa en bibliotecas nacionales
Don Horacio Elvir Rojas en vida ofreció este lote de libros cuyo autor es su hermano, también fallecido, Felipe Elvir Rojas, al Instituto Departamental de...
www.latribuna.hn/.../literatura-hondurena-es-escasa-en-bibliot...

Obesidad/Obesity

Cambios en la actividad física pre y postoperatorios en pacientes de cirugía bariátrica: autoreporte vs mediciones objetivas  Pre- to Postoperative Physical Activity Changes in Bariatric Surgery Patients: Self-Report vs. Objective Measures Dale S. Bond, John M. Jakicic, Jessica L. Unick, Sivamainthan Vithiananthan, Dieter Pohl, G. Dean Roye, Beth A. Ryder, Harry C. Sax and Rena R. Wing Obesity (2010) 18, 2395-2397. doi:10.1038/oby.2010.88 Bariatric surgery patients report significant pre- to postoperative increases in physical activity (PA). However, it is unclear whether objective measures would corroborate these changes. The present study compared self-reported and accelerometer-based estimates of changes in moderate-to-vigorous intensity PA (MVPA) from pre- (pre-op) to 6 months postsurgery (post-op). Twenty bariatric surgery (65% laparoscopic-adjustable gastric banding, 35% gastric bypass) patients (46.2 ± 9.8 years, 88% female, pre-op BMI = 50.8 ± 9.7 kg/m2) wore RT3 accelerometers as an objective measure of MVPA and completed the Paffenbarger Physical Activity Questionnaire (PPAQ) as a subjective measure before and 6 months after bariatric surgery. Time (min/week) spent in MVPA was calculated for the PPAQ and RT3 (≥1-min and ≥10-min bouts) at pre-op and post-op. Self-reported MVPA increased fivefold from pre-op to post-op (44.6 ± 80.8 to 212.3 ± 212.4 min/week; P < 0.005). By contrast, the RT3 showed nonsignificant decreases in MVPA for both ≥1-min (186.0 ± 169.0 to 151.2 ± 118.3 min/week) and ≥10-min (41.3 ± 109.3 to 39.8 ± 71.3 min/week) bouts. At pre-op, the percentage of participants who accumulated ≥150-in/week of MVPA in bouts ≥10-min according to the PPAQ and RT3 was identical (10%). However, at post-op, 55% of participants reported compliance with the recommendation compared to 5% based on RT3 measurement (P = 0.002). Objectively-measured changes in MVPA from pre-op to 6 months post-op appear to be much smaller than self-reported changes. Further research involving larger samples is needed to confirm these findings and to determine whether self-report and objective PA measures are differentially associated with surgical weight loss outcomes. http://onlinelibrary.wiley.com/doi/10.1038/oby.2010.88/pdf     Disfunción vascular en apnea obstructive del sueño y diabetes mellitus tipo 2  Vascular Dysfunction in Obstructive Sleep Apnea and Type 2 Diabetes Mellitus Susie Yim-Yeh, Shilpa Rahangdale, Anh Tu Duy Nguyen, Karen E. Stevenson, Victor Novack, Aristidis Veves  and Atul Malhotra Obesity (2011) 19, 17-22. doi:10.1038/oby.2010.116 Despite the high prevalence of obstructive sleep apnea (OSA) in type 2 diabetes mellitus (DM), the attributable vascular risk from each condition is unknown. We hypothesize that OSA may have a similar effect on vascular function as type 2 diabetes does. Healthy normal-weight subjects, healthy obese subjects, subjects with type 2 diabetes, and obese subjects with OSA were enrolled. Vascular function was assessed with brachial artery ultrasound for flowmediated dilatation (FMD) and in skin microcirculation by laser Doppler flowmetry. One hundred fifty-three subjects were studied: healthy normal-weight controls (NCs) (n = 14), healthy obese controls (OCs) (n = 33), subjects with DM (n = 68), and obese subjects with OSA (n = 38). The DM group did not undergo sleep study and thus may have had subclinical OSA. The OSA and type 2 diabetes groups had impaired FMD as compared to both the normal-weight and OC groups (5.8 ± 3.8%, 5.4 ± 1.6% vs. 9.1 ± 2.5%, 8.3 ± 5.1%, respectively, P < 0.001, post hoc Fischer test). When referenced to the NC group, a multiple linear regression model adjusting for covariates found that baseline brachial artery diameter (β = −3.75, P < 0.001), OSA (β = −2.45, P = 0.02) and type 2 diabetes status (β = −2.31, P = 0.02), negatively predicted % FMD. OSA status did not seem to affect nitroglycerin-induced vasodilation (endotheliumindependent) of the brachial artery or vascular function in the skin microcirculation. OSA impairs endothelial function in the brachial artery to a similar degree as type 2 diabetes does. OSA, however, does not appear to affect brachial endothelium-independent vasodilation or skin microcirculatory function. Treatment of OSA in patients with concomitant type 2 diabetes, therefore, may be a potential therapeutic option to improve macro-, but not microvascular outcomes. http://onlinelibrary.wiley.com/doi/10.1038/oby.2010.116/pdf  El efecto de la actividad física de 18 meses sobre el cambio de peso en adultos con sobrepeso meses   The Effect of Physical Activity on 18-Month Weight Change in Overweight Adults John M. Jakicic, Amy D. Otto, Wei Lang, Linda Semler, Carena Winters, Kristen Polzien and Kara I. Mohr Obesity (2011) 19, 100-109. doi:10.1038/oby.2010.122 Few studies have been conducted that have examined the long-term effect of different doses of physical activity (PA) on weight change in overweight adults without a prescribed reduction in energy intake. This study examined the effect of different prescribed doses of PA on weight change, body composition, fitness, and PA in overweight adults. Two hundred seventy-eight overweight adults (BMI: 25.0-29.9 kg/m2; age: 18-55 years) with no contraindications to PA were randomized to one of three intervention groups for a period of 18 months. MOD-PA was prescribed 150 min/week and HIGH-PA 300 min/week of PA. Self-help group (SELF) was provided a self-help intervention to increase PA. There was no recommendation to reduce energy intake. MOD-PA and HIGH-PA were delivered in a combination of in-person and telephone contacts across 18 months. 18-month percent weight change was −0.7 ± 4.6% in SELF, −0.9 ± 4.7% in MOD-PA, and −1.2 ± 5.6% in HIGH-PA. Subjects were retrospectively grouped as remaining within ±3% of baseline weight (WT-STABLE), losing >3% of baseline weight (WT-LOSS), or gaining >3% of baseline weight (WT-GAIN) for secondary analyses. 18-month weight change was 0.0 ± 1.3% for WT-STABLE, +5.4 ± 2.6% for WT-GAIN, and −7.4 ± 3.6% for WT-LOSS. 18-month change in PA was 78.2 ± 162.6 min/week for WT-STABLE, 74.7 ± 274.3 for WT-GAIN, and 161.9 ± 252.6 min/week for WT-LOSS. The weight change observed in WT-LOSS was a result of higher PA combined with improved scores on the Eating Behavior Inventory (EBI), reflecting the adoption of eating behaviors to facilitate weight loss. Strategies to facilitate the maintenance of these behaviors are needed to optimize weight control. http://onlinelibrary.wiley.com/doi/10.1038/oby.2010.122/pdf  Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Casos interesantes/Interesting cases

http://www.smo.edu.mx/jornada2013/






Ceguera postcarniectomía en posición supina: ¿Improbable o ignorada?


Post-craniotomy blindness in the supine position: Unlikely or ignored?.
Vahedi P, Meshkini A, Mohajernezhadfard Z, Tubbs R S.
Asian J Neurosurg [serial online] 2013 [cited 2013 Apr 8];8:36-41.



Immediate visual loss following craniotomy in the supine position is a disastrous complication in neurosurgical patients. The incidence is unknown and little is known on the definite pathogenesis. Also, preventive or restorative interventions are unclear. We describe the rare case of post-craniotomy optic neuropathy and sudden visual loss after craniotomy in the supine position for an olfactory groove meningioma, discuss the possible pathophysiology and review the literature on the pathogenesis, risk factors, and outcome. Although rare, neurosurgeons, as well as neuroanesthesiologists should be aware of the possibility of this devastating complication in the high-risk group of patients.
Keywords: Craniotomy, ischemic optic neuropathy, papilledema, pathophysiology, visual loss
http://www.asianjns.org/text.asp?2013/8/1/36/110278

Bloqueo del nervio popliteo guiado con ultrasonido en un paciente con degeneración maligna de neurofibromatosis 1
Ultrasound-guided popliteal nerve block in a patient with malignant degeneration of neurofibromatosis 1.
Desai A, Carvalho B, Hansen J, Hill J.
Department of Anesthesia, H3580, Stanford University School of Medicine, Stanford, CA 94305, USA.
Case Rep Anesthesiol. 2012;2012:753769. doi: 10.1155/2012/753769. Epub 2012 May 9.
Abstract
A 41-year-old female patient with neurofibromatosis 1 presented with new neurologic deficits secondary to malignant degeneration of a tibial lesion. Ultrasound mapping of the popliteal nerve revealed changes consistent with an intraneural neurofibroma. Successful popliteal nerve blockade was achieved under ultrasound guidance.
http://www.hindawi.com/crim/anesthesiology/2012/753769/



Lo más raro de lo raro
Rarer in a Rare.
Taksande B, Patil M M, Banode P, Deshpande R.
Ann Med Health Sci Res [serial online] 2013 [cited 2013 Mar 25];3:125-6.
Though moya moya disease is a disease of Asian origin, it is one of the very rare causes of stroke in India. It is a rare disease mainly characterized by progressive cerebrovascular episode due to the slowly progressive stenosis of supraclinoid segment of bilateral internal carotid arteries, the anterior and the middle cerebral arteries, and very rarely, posterior cerebral arteries. We hereby report a case of a young female who presented to us with the psychiatric complaints and refractory headache since her childhood. Therefore, we are reporting rarer (headache and neuropsychiatric) manifestations in the rare (moya moya) disease.
Keywords: Headache, Moya moya, Neuropsychiatry, Stroke
http://www.amhsr.org/text.asp?2013/3/1/125/109482


Afonía inducida por infartos bilaterales simultáneos de núcleo putamen: informe de caso y revisión de la literatura

Aphonia induced by simultaneous bilateral ischemic infarctions of the putamen nuclei: a case report and review of the literature
Vladimir V Senatorov1, Shirish Satpute1, Katherine Perry2, David M Kaylie3 and John W Cole
Journal of Medical Case Reports 2013, 7:83
Introduction
Isolated aphonia induced by acute stroke is a rare phenomenon with only a few cases reported in the literature. Case presentation. We report an unusual case of a 44-year-old African-American man with a history of hypertension, smoking and cocaine use who developed acute aphonia secondary to simultaneous ischemic infarctions of the bilateral putamen nuclei. Conclusion. We describe the clinical presentation of acute aphonia induced by bilateral putamen nuclei ischemic infarctions, correlating clinical symptoms with injury localization. We further highlight the anatomic and functional organization of the neural pathways involved.
http://www.jmedicalcasereports.com/content/pdf/1752-1947-7-83.pdf



Bloqueo del nervio frénico guiado con ultrasonido para el tratamiento del hipo: informe de caso

Phrenic nerve block with ultrasound-guidance for treatment of hiccups: a case report.
Kuusniemi K, Pyylampi V.
Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, Turku University Hospital, Luolavuorentie 2, Turku 20700, FI-20520, Finland. kristiina.kuusniemi@tyks.fi.
J Med Case Rep. 2011 Oct 3;5:493. doi: 10.1186/1752-1947-5-493.
Abstract
INTRODUCTION: Persistent hiccups can be more than a simple and short-lived nuisance and therefore sometimes call for serious consideration. Hiccupping episodes that last only a few minutes may be annoying, but persistent hiccups may initiate many major complications.
CASE PRESENTATION: A 72-year-old Caucasian man with spinal stenosis presented for L4-5 laminectomy under spinal anesthesia. The surgery and anesthesia, as well as the perioperative period, passed without any incident, except for persistent postoperative hiccups not responding to conservative and pharmacological treatment. Hiccups resulted in a prolonged hospital stay as they lasted until the seventh postoperative day. On that day, a right-sided ultrasound-guided phrenic nerve block with 5 ml of bupivacaine 5 mg/ml with epinephrine was performed successfully with a single-injection technique. Ten minutes after the procedure the hiccups vanished and a partial sensomotoric block of his right shoulder developed. No adverse effect occurred; our patient could be discharged on the same day and the hiccups did not return. CONCLUSION: Ultrasound provides us with non-invasive information regarding anatomy and allows anesthesiologists to visualize needle insertion, to identify the exact location of the injected solution and to avoid such structures as arteries or veins. As such, this method should be actively utilized. In cases where both pharmacological and non-pharmacological treatments prove to be ineffective when treating persistent hiccups, a single-shot ultrasound-guided technique should be considered before the patient becomes exhausted.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193825/pdf/1752-1947-5-493.pdf





Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

Bibliotecas. Alerta

http://www.smo.edu.mx/jornada2013/



El alimento de las bibliotecas populares
Página 12
La Conabip aumentó a 10 millones de pesos el presupuesto para que unos 2800 bibliotecarios de todo el país adquieran libros a mitad de precio en los stands adheridos de la Feria del Libro. Y Quino recibirá el Premio Amigo de las Bibliotecas Populares.
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Página 12

Las bibliotecas de Badalona organizan tertulias 'on line'
La Vanguardia
Badalona. (Redacción). – Este martes empiezan las tertulias en línea de la web de las bibliotecas de Badalona. Se harán tres tertulias dedicadas a jóvenes, niños y adultos y a libros en inglés. El objetivo es trabajar en cada caso, durante dos meses ...
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Dos bibliotecas abrirán todos los fines de semana hasta julio
Gente Digital
El Ayuntamiento viene, desde hace años, abriendo las bibliotecas durante el día y la noche de los fines de semana, a lo largo del curso académico. Serán alrededor de 3.500 estudiantes los que harán uso de estos equipamientos municipales que ...
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El libro de la memoria visita bibliotecas populares
Crónica Digital
En esta oportunidad la red de bibliotecas populares solicitó ser parte de la iniciativa. El jueves pasado el Libro estuvo en la biblioteca “De Puerto Madryn” que preside Carlos Pascuariello (h), quien destacó la posibilidad de plasmar de esta manera ...
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Crónica Digital

Entregan paquetes de 551 Libros a bibliotecas públicas del Oriente
Cambio (Michoacán)
Gregorio García comentó que el material deberá de ser clasificado. En aquellas bibliotecas en donde el espacio sea insuficiente, se recomienda realizar acciones de descarte de libros en desuso y de aquel que ya está muy deteriorado, para dejar espacio ...
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Molina dice que el PSOE vuelve a dar otra lección de cinismo con el ...
Noticias de la Villa
El concejal de Bibliotecas, Manuel Molina, ha contestado este mediodía a la denuncia que ha hecho el PSOE de Los Barrios donde califica de “total dejadez” en el mantenimiento de la nueva BibliotecaMunicipal. Molina dice que el PSOE vuelve a dar otra ...
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La Diputación de Cáceres fomenta la lectura en 14 localidades de ...
Lainformacion.com
Un total de 14 municipios de la provincia se verán beneficiados con la campaña de animación 'Tesoros de Papel 2013' que la Diputación de Cáceres y la Asociación de Gestores Culturales de Extremadura han diseñado con el objetivo de promocionar el ...
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El carné de bibliotecas permitirá obtener descuentos en las ...
Madridpress.com
Los usuarios de la tarjeta de la red de bibliotecas del Ayuntamiento de Madrid podrán acceder a descuentos en entradas de teatro y otros espectáculos municipales, como ha anunciado este lunes la alcaldesa de la capital, Ana Botella. Fuentes del área de ...
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Bibliotecas para manipular la historia - DesEquiLIBROS
Hay bibliotecas cuyo principal objetivo es manipular la historia. Este es el caso de la George W. Bush Library.
desequilibros.blogspot.com/.../bibliotecas-para-manipular-la-hi...