Investigación clínica en México

Google investiga en unas lentillas inteligentes para diabéticos

Started by María de los Ángeles Hernández Castellón, Desempleada en Busqueda activa de empleo mariangelescuba@hotmail.com

La «música secreta de la vida», al descubierto

Started by María de los Ángeles Hernández Castellón, Desempleada en Busqueda activa de empleo mariangelescuba@hotmail.com

Una nueva combinación de fármacos cura los peores casos de hepatitis C

Started by MARTÍN GALÁN GALÁN martitraskybis@hotmail.com, Relaciones Públicas en Bioplatan

El secreto de la longevidad humana: gastar pocas calorías

Started by María de los Ángeles Hernández Castellón, Desempleada en Busqueda activa de empleo mariangelescuba@hotmail.com

Conferencia Sarcomas de tejidos blandos en pediatria

Pueden revisarla en las siguientes ligas:

Ciberpeds: http://bit.ly/KcJV5S
Conapeme: http://bit.ly/KVieQp

Para su registro si la ven off line: http://bit.ly/19ApWtR

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

VIKTOR FRANKL-EL SENTIDO DE LA VIDA

VIKTOR FRANKL-EL SENTIDO DE LA VIDA.-

SAMUEL BERNARDO TEITELMANMedico Especialista Consultor en Psiquiatría y Psicología Medica en Consultorio PRIVADOContribuidor principal
reproducir vídeo

Entrevista al Dr Viktor Frankl El sentido de la vida.wmv youtube.com

Entrevista al Dr Viktor Frankl (1905-1997), neurólogo y psiquiatra austriaco, fundador de la Logoterapia. Superviviente desde 1942 hasta 1945 a campos de concentración nazis como Auschwitz y Dachau. Autor de la prestigiosa obra "El hombre en busca de sentido".

El poderoso efecto antioxidante del pimentón de la Vera

http://www.abc.es/salud/noticias/20140113/abci-pimenton-antioxidantes-201401131730.html?goback=%2Egde_3704735_member_5828899543143444483#%21

El poderoso efecto antioxidante del pimentón de la Vera

María de los Ángeles Hernández CastellónDesempleada en Busqueda activa de empleo mariangelescuba@hotmail.comContribuidor principal

El poderoso efecto antioxidante del pimentón de la Vera via @abc_es abc.es

Un estudio, publicado en la revista «Journal of Food», evidencia la capacidad del pimentón de la Vera para activar las enzimas encargadas de desintoxicar el...

Ensayan un dispositivo que permite analizar la sangre sin extraerla

http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=59166&origen=notiweb&dia_suplemento=martes

Ensayan un dispositivo que permite analizar la sangre sin extraerla


"Este dispositivo consiste en colocar dos biosensores en el cuello, dos en las axilas y uno en el ombligo del paciente, que se conectan a un ordenador y calibran la temperatura corporal de la persona", ha explicado el jefe de investigación e innovación de BSA, Antoni Sicras.
A partir de los cambios bioquímicos que se producen en el organismo del paciente y de fórmulas matemáticas, el dispositivo puede revisar hasta 131 parámetros de la sangre sin necesidad de extraer muestras y obtener los resultados en un tiempo de 6 a 8 minutos.

El bioquímico y colaborador en el desarrollo de este autoanalizador, Peter Jusko, ha asegurado que el mayor beneficio es "la rapidez en el proceso del diagnóstico", ya que, empleando este método "no invasivo" no es necesario que el paciente vuelva otro día a recoger los resultados, que se ofrecen al momento.

UNA PRUEBA PILOTO CON 30 PACIENTES

Jusko ha insistido en que este dispositivo ayudará a mejorar la diagnosis porque resuelve la dificultad a la que se enfrentan los médicos al tomar decisiones cuando llegan los resultados días más tarde ya que "el estado del paciente puede haber cambiado".

Sicras también ha señalado que esta técnica ya está comercializada y disponible para los hospitales y los centros médicos y que BSA estudia ahora la fiabilidad del aparato. Para ello, BSA ha llevado a cabo una prueba piloto realizada con 30 pacientes, además de un estudio que se empezará a practicar con 100 voluntarios más a los que se someterá a la prueba con biosensores, así como a una extracción de sangre convencional para comparar los resultados.

Sicras también ha señalado que este autoanalizdor se basa en tecnología aeroespacial y ha sido diseñado por miembros de la Academia Rusa de Ciencias Naturales, la Universidad de Massachusetts y el National Space Biomedical Research Institute.

Which Country is Leading Online Education?

http://interactyx.com/social-learning-blog/which-country-is-leading-online-education/

Which Country is Leading Online Education?
by Jodi Harrison on June 28, 2012

Online education, and the debate about, it is one of the hottest topics in education; whether you are an academic institution or a corporation looking to train your employees with a learning management system (LMS).

I think it’s interesting to look around the globe and see how different countries are embracing a new delivery method for education. Our friends at www.onlineuniverstities.com recently wrote a blog about the 8 leading nations for online learning.

Some of the results were surprising.

“The ease and convenience it offers learners appeal to people just about everywhere, especially those who are trying to balance work, family, and other obligations. Yet certain nations have embraced online education more than others, leading the way both in terms of the number and variety of programs and new innovations to online learning itself. Here, www.onlineuniverstities.com highlighted some of the nations that are really stepping up the game when it comes to online education, though with the proliferation of high-speed internet connections and a growing need for highly educated people in technical positions around the world, other nations likely aren’t far behind.”
United States:

The US is the undisputed leader in online education in the world today, with hundreds of online colleges and thousands of online courses available to students. A 2011 study by the Sloan Consortium found that 6 million students in the US are taking at least one online course, nearly one third of all those enrolled in higher education. In fact, enrollments in online courses are outpacing those of higher education as a whole; with a 10% increase in online students between 2010 and 2011 compared to a just 2% rise overall. Of course, the US isn’t just the leader in terms of sheer numbers. It’s also been the model to follow in developing online delivery systems. Most prestigious universities in the US offer at least some courses online, and some have fully developed online degree programs, even at the master’s and doctoral levels. Even more influential are US open educational programs like those offered at MIT, which have been the international model to emulate.
India:

India is playing a major role in the growth of online learning opportunities that are popping up throughout Asia. Over the past few decades, India has developed numerous world-class universities and colleges which are fast becoming destinations for some of Asia’s best and brightest, and their online programs are experiencing a similar boom. Part of the explosion of interest has stemmed from economic concerns, as many simply can’t afford to take two or more years off of work to attend a traditional college. Online schools help to solve that problem, and with programs expecting to bring in a whopping $1 billion in revenue by the end of the decade, it’s clear that distance learning has staying power in India. While home-based schools are doing well, including the popular IITs and private schools like Sikkm-Manipal University, American universities are also bringing online ed to India, offering courses at MIT, Carnegie Mellon, and Cornell to Indian students.
China:

Currently, China is home to almost 70 different online colleges, a number that will likely grow in the coming years in order to meet the high demand for online learning opportunities. China has a long history of distance education, beginning in the 1960s with courses that were delivered via radio and television, but the nation is fast becoming a leader in online education as well. While problems with internet access in rural areas and a proliferation of diploma mills have slowed progress being made in China, several major online education companies are seeing rapid growth, due largely to the increased demand for highly trained members of the global workforce coming from China. The online learning industry is expected to grow by leaps and bounds over the next few years, and with steady growth since 2006, it’s looking to meet all expectations.
South Korea:

When it comes to advancements in e-learning in Asian nations, South Korea is leading the pack, spurred on by the nation’s strong and growing high-tech industry and widespread high-speed internet access. In recent years, a number of universities in South Korea have begun offering online courses, and the country currently has 17 online colleges, all of which boast state-of-the-art facilities and software. Yet there have been some roadblocks to the success of online education in South Korea, largely stemming from the stigma online education still holds in South Korean society, where face-to-face education is highly valued. That may not stand in the way of development in this nation’s online education programs, however, as it plans to use its resources to not only teach Korean students, but those in other countries around the world, offering more courses in English and promoting their ability to deliver what they’re calling “smart learning.” They’re also working to encourage more Korean students to enroll, pairing online courses with non-virtual activities on campus or in social settings. Time will tell whether or not the investment pays off for this tech-focused nation.
Malaysia:

Malaysia may not be the first place that comes to mind when you think of online education, but the small Asian nation is forging ahead at full speed when it comes to opening up new opportunities for learning online. One of the nation’s biggest e-learning schools is Asia e University, based out of Kuala Lumpur. It has been a boon for people in underserved areas, many of which have abundant access to the internet but not universities or higher level degree programs. Asia e University doesn’t just reach Malaysians, however, offering education to 31 different Asian nations and partnering with an impressive number of schools to deliver blended and fully online programs, even developing an MBA program through the International Business School of Scandinavia in Denmark. While online education in Malaysia and Asia as a whole still has a long way to go, it’s clear that the country is going to be making waves in distance education for some time to come.
United Kingdom:

Online education in the U.K. has been around for quite some time, but it was only in 2011 that it started to see a real boost in interest. The government’s Online Learning Task Force recommended an investment of nearly $159 million dollars in online education in order to help the nation build its brand, develop better online educational resources, and become a major international player in the distance learning market. The funding recommendation is partly in response to increasing tuition costs in the U.K., much of which used to be covered by the government but now is turning many students away from higher education. The government hopes that more convenient and cheaper educational options will stem that trend. Currently, a few private, for-profit providers and the Open University are leading the charge in online education, but new funding could make public programs more successful and accessible to students.
Australia:

Distance education has become an increasingly popular option for Australians who want to head back to school without putting careers on hold, growth that was driven up even more by the economic downturn in 2008 and 2009. Over the past five years, the online education market in Australia has grown by almost 20% and is expected to be worth an estimated $4.68 billion this year. Currently, the major players in the Australian market are Kaplan, Seek Learning, and Open Universities Australia, though many smaller schools are also bringing in a fair amount of students as well. Even more growth is projected in online programs based in Australia that teach students from Asia, with the international market expected to grow to millions of students during the next 10 years, which if it comes to fruition will make Australia one of the world’s leading providers of online education.
South Africa:

South Africa is one nation that has begun to capitalize on all the benefits that digital education can offer. They’ve developed nationwide online resources like EduNet and Thutong and offer online courses at both the high school and college levels through institutions all over the country. In the past few years, the online higher education sector in South Africa has seen steady growth, but the demand for highly qualified teachers, which the country sorely needs, may drive online programs in teacher training much faster than other sectors. Currently, online education is still in its infancy in South Africa, but the government has demonstrated a dedication to improving and expanding distance learning opportunities and programs like GetSmarter and UNISA Online are showing that these goals are viable in the current marketplace.

How are organizations around the world moving to online learning technologies? They are employing easy-to-use, software as a service (SaaS) solutions that are focused on keeping users engaged. The days of siloed online content have passed with the realization of the value of informal learning and social learning tools (see Social Learning Value Explained).

The award winning TOPYX Social LMS is right in the “thick of things” and as corporations and educational institutions continue to move into online education, TOPYX is there to assist with their initiatives by bringing a robust LMS wrapped in award-winning collaborative tools, which also supports many languages, quickly and cost effectively.

To learn more about TOPYX please review our website (http://interactyx.com) for lots of helpful information and when you’re ready request an LMS demo to learn more.



Jodi Harrison
Vice President, Business Development
jodi.harrison@interactyx.com

Interactyx Limited
interactyx.comThis entry was posted in LMS & eLearning. Bookmark the permalink.

Bibliotecas. Alerta

Bibliotecas de LA ofrecerán diploma GED La Opinión
La Biblioteca de la Ciudad de Los Ángeles (LAPL) anunció que lanzará un programa de estudios para aquellas personas que deseen obtener su ...
Ver todos los artículos sobre este tema »

Bibliotecas de Iurreta, Mota del Cuervo y San Javier, Premios a la ... Lainformacion.com
Madrid, 10 ene (EFE).- Las bibliotecas públicas de los municipios de Iurreta (Vizcaya), Mota del Cuervo (Cuenca) y San Javier (Murcia) han recibido ...
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eldiadigital.es

Bibliotecas de Madrid amplían horario para alumnos que preparan ... ABC.es
Los estudiantes universitarios de la Comunidad de Madrid que deban preparar sus exámenes de febrero dispondrán de doce bibliotecaspúblicas ...
Ver todos los artículos sobre este tema »



El Faro del Guadarrama

Responsables bibliotecas participarán este jueves en una jornada ... 20minutos.es
Responsables de telecentros y bibliotecas participarán este jueves en una jornada para mejorar y modernizar el acceso público a Internet, que se ...
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Tres bibliotecas de vizcaya, cuenca y murcia, ganadoras de los ... elEconomista.es
Con esta iniciativa, el Ministerio de Cultura quiere reconocer los mejores proyectos de bibliotecas públicas orientados al fomento de la lectura en ...
Ver todos los artículos sobre este tema »

Las bibliotecas de Dos Hermanas, en servicio 24 horas para el ... abcdesevilla.es
Es, por ello, que en Dos Hermanas tanto el complejo de Huerta Palacios -de la Biblioteca Municipal Pedro Laín Entralgo-, como el Miguel Delibes de ...
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Las bibliotecas de Siero suspenden durante dos días el servicio de ... La Nueva España
Pola de Siero, Manuel NOVAL MORO Todas las bibliotecas de la red municipal de Siero suspenderán el lunes 13 y el martes 14 de enero el servicio ...
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La Nueva España

Cierre de bibliotecas científicas preocupa a investigadores en Canadá ecodiario
El cierre de las bibliotecas del Ministerio de Pesca y Océanos en Canadá y la posible destrucción de la literatura científica que contenían ha ...
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Bibliotecas de Tula acrecentarán acervo Sexenio, Extraordinary Life
Luego de una gestión exitosa, el Centro Estatal para la Cultura y las Artes (CECULTAH), a través de su Dirección General de Bibliotecas, aprobó la ...
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Sexenio, Extraordinary Life

Las bibliotecas de Colmenar Viejo comienzan el año animándonos ... SER Madrid Norte
En enero las tres bibliotecas municipales son anfitrionas de diversas propuestas para todos los públicos. A los habituales cuentacuentos, clubes de ...
Ver todos los artículos sobre este tema »



SER Madrid Norte


Visita del IAPB a bibliotecas en Santiago « IAPB IAPB
Visitar Santiago para conocer tres bibliotecas distintas y diversas entre sí. El propósito de la visita fue observar in situ el funcionamiento de distintas ...
IAPB

eVoke: portal sobre políticas de libros electrónicos para bibliotecas ... julio
Evoke http://evoke.cvlsites.org/ Colorado's eBook Manifesto un documento para orientar a las bibliotecas sobre políticas profesionales y editoriales.
Universo Abierto

Horario de Bibliotecas especial exámenes de Enero de 2014 ... CuencaON
Horario de bibliotecas y aulas habilitadas durante el mes de enero. IMPRESCINDIBLE CARNÉ UNIVERSITARIO (este servicio se ofrece solo a los ...
CuencaOn

El gran cambio: estrategias de bibliotecas públicas para el acceso a ... julio
El 24 de enero de 2013, OCLC, los asesores del programa y equipo del programa se reunieron con con 30 directores de la bibliotecas públicas en la ...
Universo Abierto

El presente de los ebooks en las bibliotecas públicas españolas ... Francisco
Es enero, principio de año y toca hacer predicciones de lo que va a pasar a lo largo de estos próximos 365 días. En estos momentos el tema estrella ...
FranciscoGonzálezLlopis

Las Tablas Digital: Horario especial de las bibliotecas para facilitar ... Alberto Fernandez Quintana
La Comunidad de Madrid anunció ayer un nuevo horario especial en determinadas bibliotecas públicas para facilitar la preparación de las pruebas.
Las Tablas Digital

Biblioteca Digital del Patrimonio Iberoamericano (BDPI) Jesús Hernández
La Biblioteca Digital del Patrimonio Iberoamericano (BDPI) es un proyecto de la Asociación de Bibliotecas Nacionales de Iberoamérica (ABINIA).
Crea y aprende con Laura

Cómo la lectura nos modela el cerebro

http://www.elcastellano.org/ns/edicion/2014/enero/cerebro.html

Cómo la lectura nos modela el cerebro





Jacqueline Howard, The Huffington Post

Para nadie es un secreto que la lectura es buena para el cerebro, pero hasta ahora no sabíamos exactamente qué es lo que ocurre en él cuando leemos una novela. «Las narraciones le dan forma a nuestra mente y, en algunos casos, definen a una persona», afirmó el Dr. Gregory S. Berns, director del Centro de Neuropolíticas de la Universidad de Emory, en Atlanta, Georgia. «Queremos saber cómo entran las narraciones al cerebro y que efecto ejercen luego sobre él», agregó.

Ahora podemos tener una idea un poco más clara al respecto, gracias a las investigaciones de Berns y su equipo, quienes trabajaron con imágenes de Resonancia Magnética Funcional (RMf) tomadas de los cerebros de 21 estudiantes de grado mientras estos descansaban. Luego se les pidió que leyeran capítulos de la novela de suspenso Pompeya, de Robert Harris, durante nueve noches. Los cerebros de los jóvenes fueron escaneados todas las mañanas posteriores a cada noche de lectura, y luego durante los cinco días posteriores a la finalización de la lectura del libro.

Los escaneos revelaron un inesperado aumento de la conectividad en los cerebros de los estudiantes en las cinco mañanas siguientes a la lectura y los investigadores observaron que los cambios persistieron durante cinco días después de haber terminado la obra. Las áreas de mayor conectividad fueron la corteza del lóbulo temporal izquierdo, un área asociada con la comprensión del lenguaje, y la circunvolución prerrolándica, en la parte posterior del lóbulo frontal, que se asocia a sensaciones y movimiento.

«La parte anterior del surco de Rolando contiene neuronas que controlan el movimiento de partes del cuerpo», le explicó Berns a The Huffington Post. «La parte posterior del surco contiene neuronas que reciben información sensorial de diversas partes del cuerpo. El incremento de la conectividad fue una sorpresa que implica que, tal vez, el acto de leer pone al lector mentalmente en el cuerpo del protagonista».

¿Cuánto tiempo duran estos cambios?. Berns respondió que eso no está tan claro, pero aventuró una primera conclusión: «Como mínimo, podemos decir que la lectura de narraciones —especialmente aquellas de historias más fuertes— reconfiguran las redes cerebrales al menos durante algunos días, lo que muestra la forma en que las narraciones permanecen con nosotros. Esto puede tener profundas implicaciones en el efecto de la lectura en los niños y la forma como les modela el cerebro», concluyó.

El artículo Berns et alii, en inglés, está en:

http://online.liebertpub.com/doi/pdf/10.1089/brain.2013.0166

Envejecimiento y enfermedades crónicas por Petra Juffer, PhD

una publicación de Anatomía & Fisioterapia - Español.

Humanismo científico

una publicación de Humanismo Científico.

La revista Anesthesia Analgesia January 2013 - Volume 116 - Issue 1

La revista Anesthesia Analgesia January 2013 - Volume 116 - Issue 1

se encuentra con acceso libre completo

Free articles on Anesthesia Analgesia January 2013 - Volume 116 - Issue 1
http://journals.lww.com/anesthesia-analgesia/toc/2013/01000


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

Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies

Sleep. 2010 May;33(5):585-92.

Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies.

Cappuccio FP, D'Elia L, Strazzullo P, Miller MA.
Author information
Abstract
BACKGROUND:
Increasing evidence suggests an association between both short and long duration of habitual sleep with adverse health outcomes.
OBJECTIVES:
To assess whether the population longitudinal evidence supports the presence of a relationship between duration of sleep and all-cause mortality, to investigate both short and long sleep duration and to obtain an estimate of the risk.
METHODS:
We performed a systematic search of publications using MEDLINE (1966-2009), EMBASE (from 1980), the Cochrane Library, and manual searches without language restrictions. We included studies if they were prospective, had follow-up >3 years, had duration of sleep at baseline, and all-cause mortality prospectively. We extracted relative risks (RR) and 95% confidence intervals (CI) and pooled them using a random effect model. We carried out sensitivity analyses and assessed heterogeneity and publication bias.
RESULTS:
Overall, the 16 studies analyzed provided 27 independent cohort samples. They included 1,382,999 male and female participants (followup range 4 to 25 years), and 112,566 deaths. Sleep duration was assessed by questionnaire and outcome through death certification. In the pooled analysis, short duration of sleep was associated with a greater risk of death (RR: 1.12; 95% CI 1.06 to 1.18; P < 0.01) with no evidence of publication bias (P = 0.74) but heterogeneity between studies (P = 0.02). Long duration of sleep was also associated with a greater risk of death (1.30; [1.22 to 1.38]; P < 0.0001) with no evidence of publication bias (P = 0.18) but significant heterogeneity between studies (P < 0.0001).
CONCLUSION:
Both short and long duration of sleep are significant predictors of death in prospective population studies.
PMID: 20469800 [PubMed - indexed for MEDLINE] PMCID: PMC2864873 Free PMC Article
http://www.ncbi.nlm.nih.gov/pubmed/20469800

Sleep duration and all-cause mortality: a systematic r... [Sleep. 2010] - PubMed - NCBI

www.ncbi.nlm.nih.gov

Increasing evidence suggests an association between both short and long duration of habitual sleep with adverse health outcomes.

Cirugía bariátrica/Bariatric surgery

Resultados a corto y mediano tiempo entre bypass gástrico en Y de Roux y manga gástrica laparoscópica para el tratamiento de obesidad mórbida


Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity.
Albeladi B, Bourbao-Tournois C, Huten N.
J Obes. 2013;2013:934653. doi: 10.1155/2013/934653. Epub 2013 Sep 2.
Abstract
BACKGROUND:Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures today, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular in Europe. The aim of this study was to compare short- and midterm results between LRYGB and LSG. METHODS: An observational retrospective study from a database of patients undergoing LRYGB and LSG between January 2008 and June 2011. Seventy patients (mean age 39 years) were included. Patients were followed at 6, 12, and 18 months. Operative time, length of stay, weight loss, comorbidity improvement or resolution, postoperative complications, reinterventions and mortality were evaluated. ... CONCLUSIONS: Both LRYGB and LSG are safe procedures that provide good results in weight loss and resolution of comorbidities at 18 months
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775408/pdf/JOBES2013-934653.pdf





Cirugía bariátrica versus manejo no quirúrgico para la obesidad: revisión sistemática y meta-análisis de estudios controlados randomizados

Bariatric surgery versus non-surgical treatment for obesity: a systematic review and meta-analysis of randomised controlled trials.
Gloy VL, Briel M, Bhatt DL, Kashyap SR, Schauer PR, Mingrone G, Bucher HC, Nordmann AJ.
BMJ. 2013 Oct 22;347:f5934. doi: 10.1136/bmj.f5934.
Abstract
OBJECTIVE:To quantify the overall effects of bariatric surgery compared with non-surgical treatment for obesity. DESIGN:Systematic review and meta-analysis based on a random effects model. DATA SOURCES:Searches of Medline, Embase, and the Cochrane Library from their inception to December 2012 regardless of language or publication status.ELIGIBILITY CRITERIA: Eligible studies were randomised controlled trials with ≥ 6 months of follow-up that included individuals with a body mass index ≥ 30, compared current bariatric surgery techniques with non-surgical treatment, and reported on body weight, cardiovascular risk factors, quality of life, or adverse events. RESULTS:The meta-analysis included 11 studies with 796 individuals (range of mean body mass index at baseline 30-52). Individuals allocated tobariatric surgery lost more body weight (mean difference -26 kg (95% confidence interval -31 to -21)) compared with non-surgical treatment, had a higher remission rate of type 2 diabetes (relative risk 22.1 (3.2 to 154.3) in a complete case analysis; 5.3 (1.8 to 15.8) in a conservative analysis assuming diabetes remission in all non-surgically treated individuals with missing data) and metabolic syndrome (relative risk 2.4 (1.6 to 3.6) in complete case analysis; 1.5 (0.9 to 2.3) in conservative analysis), greater improvements in quality of life and reductions in medicine use (no pooled data). Plasma triglyceride concentrations decreased more (mean difference -0.7 mmol/L (-1.0 to -0.4) and high density lipoprotein cholesterol concentrations increased more (mean difference 0.21 mmol/L (0.1 to 0.3)). Changes in blood pressure and total or low density lipoprotein cholesterol concentrations were not significantly different. There were no cardiovascular events or deaths reported after bariatric surgery. The most common adverse events after bariatric surgery were iron deficiency anaemia (15% of individuals undergoing malabsorptive bariatric surgery) and reoperations (8%). CONCLUSIONS:Compared with non-surgical treatment of obesity, bariatric surgery leads to greater body weight loss and higher remission rates of type 2 diabetes and metabolic syndrome. However, results are limited to two years of follow-up and based on a small number of studies and individuals.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3806364/pdf/bmj.f5934.pdf



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

Sobre la necesidad de fomentar la lectura crítica de la información médica - See more at: http://medicina-general-familiar.blogspot.mx/2014/01/sobre-la-necesidad-de-fomentar-la.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+blogspot/cRSlP+(Medicina+General+y+Familiar)#sthash.tIQHhQ4d.3FdgOCh5.dpuf

http://medicina-general-familiar.blogspot.mx/2014/01/sobre-la-necesidad-de-fomentar-la.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+blogspot/cRSlP+(Medicina+General+y+Familiar)

una publicación de Victor Ravens.

Sepsis y corazón/Sepsis and cardiac dysfunction

Inflamación y disfunción cardiaca durante la sepsis, distrofia muscular y miocarditis


Inflammation and cardiac dysfunction during sepsis, muscular dystrophy, and myocarditis.

Li Y, Ge S, Peng Y, Chen X.
Burn Trauma [serial online] 2013 [cited 2013 Dec 27];1:109-21.
Abstract
Inflammation plays an important role in cardiac dysfunction under different situations. Acute systemic inflammation occurring in patients with severe burns, trauma, and inflammatory diseases causes cardiac dysfunction, which is one of the leading causes of mortality in these patients. Acute sepsis decreases cardiac contractility and impairs myocardial compliance. Chronic inflammation such as that occurring in Duchenne muscular dystropshy and myocarditis may cause adverse cardiac remodeling including myocyte hypertrophy and death, fibrosis, and altered myocyte function. However, the underlying cellular and molecular mechanisms for inflammatory cardiomyopathy are still controversial probably due to multiple factors involved. Potential mechanisms include the change in circulating blood volume; a direct inhibition of myocyte contractility by cytokines (tumor necrosis factor (TNF)-a, interleukin (IL)-1b); abnormal nitric oxide and reactive oxygen species (ROS) signaling; mitochondrial dysfunction; abnormal excitation-contraction coupling; and reduced calcium sensitivity at the myofibrillar level and blunted b-adrenergic signaling. This review will summarize recent advances in diagnostic technology, mechanisms, and potential therapeutic strategies for inflammation-induced cardiac dysfunction.
Keywords: Burn, inflammation, sepsis, Duchenne muscular dystrophy, cardiac dysfunction, contractility
http://www.burnstrauma.com/text.asp?2013/1/3/109/123072





Monitoreo e identificación de la sepsis a través de una medida compuesta de la variabilidad del ritmo cardíaco

Monitoring and identification of sepsis development through a composite measure of heart rate variability.
Bravi A, Green G, Longtin A, Seely AJ.
PLoS One. 2012;7(9):e45666. doi: 10.1371/journal.pone.0045666. Epub 2012 Sep 19.
Abstract
Tracking the physiological conditions of a patient developing infection is of utmost importance to provide optimal care at an early stage. This work presents a procedure to integrate multiple measures of heart rate variability into a unique measure for the tracking of sepsis development. An early warning system is used to illustrate its potential clinical value. The study involved 17 adults (age median 51 (interquartile range 46-62)) who experienced a period of neutropenia following chemoradiotherapy and bone marrow transplant; 14 developed sepsis, and 3 did not. A comprehensive panel (N = 92) of variability measures was calculated for 5 min-windows throughout the period of monitoring (12 ± 4 days). Variability measures underwent filtering and two steps of data reduction with the objective of enhancing the information related to the greatest degree of change. The proposed composite measure was capable of tracking the development of sepsis in 12 out of 14 patients. Simulating a real-time monitoring setting, the sum of the energy over the very low frequency range of the composite measure was used to classify the probability of developing sepsis. The composite revealed information about the onset of sepsis about 60 hours (median value) before of sepsis diagnosis. In a real monitoring setting this quicker detection time would be associated to increased efficacy in the treatment of sepsis, therefore highlighting the potential clinical utility of a composite measure of variability.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446945/pdf/pone.0045666.pdf


Cardiomiopatía inducida por sepsis
Sepsis-induced cardiomyopathy.
Romero-Bermejo FJ, Ruiz-Bailen M, Gil-Cebrian J, Huertos-Ranchal MJ.
Curr Cardiol Rev. 2011 Aug;7(3):163-83.
Abstract
Myocardial dysfunction is one of the main predictors of poor outcome in septic patients, with mortality rates next to 70%. During the sepsis-induced myocardial dysfunction, both ventricles can dilate and diminish its ejection fraction, having less response to fluid resuscitation and catecholamines, but typically is assumed to be reversible within 7-10 days. In the last 30 years, It's being subject of substantial research; however no explanation of its etiopathogenesis or effective treatment have been proved yet. The aim of this manuscript is to review on the most relevant aspects of the sepsis-induced myocardial dysfunction, discuss its clinical presentation, pathophysiology, etiopathogenesis, diagnostic tools and therapeutic strategies proposed in recent years.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3263481/pdf/CCR-7-163.pdf




Sepsis y riesgo de enfermedad cardiovascular
Dr. Pedro Villarroel González-Eliper. Pedro Villarroel González-Elipe
Médico especialista en Medicina Interna. Coordinador del Servicio de Urgencias del Hospital Clínico San Carlos, Madrid.
Profesor asociado de Medicina de la Universidad Complutense de Madrid
Introducción a la sepsis y el riesgo cardiovascular
Diferentes microbios pueden invadir el torrente circulatorio y afectar a distintos órganos, entre otros el corazón, a través de una serie de eventos tóxicos, debidos a la liberación de productos del microorganismo y del propio huésped, que interaccionan y pueden dañar la funcionalidad
del músculo cardíaco, lo que sucede en el caso de algunas situaciones tratadas en este capítulo, y que son conocidas como sepsis.

http://www.fbbva.es/TLFU/microsites/salud_cardio/fbbva_libroCorazon_Cap_20.html?gOrri=1




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