domingo, 26 de enero de 2014

Bibliotecas. Alerta


Biblioteca
Notificaciones diarias ⋅ 24 de enero de 2014
NOTICIAS

La Biblioteca cierra su etapa en el Banco de España con otra caída ...
El Correo - La Biblioteca Municipal de Haro despide la etapa del Banco de España con un retroceso sustancial en el número de usuarios registrados a lo largo ...
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Vive Campoo

La Biblioteca Central acoge la muestra "Nueva taxonomía del ...
Vive Campoo - La Biblioteca Central de Cantabria acogerá desde este viernes, día 24, una nueva exposición que se incluye dentro del programa de actividades ...
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La biblioteca municipal de Loeches aumenta sus recursos gracias a ...
El Correo - Loeches, 23 ene (EFE).- La biblioteca municipal de Loeches ha incrementado de forma notable su fondo bibliográfico al hacerse efectivo el premio ...
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Pagina66

La biblioteca de Alcoy recibe dos libros de poesía del ibense ...
Información - Josep Lluís Ripoll Silvestre y Enrique S. Rivelles han donado a la Biblioteca de Alcoy dos libros del poeta Pascual Pla y Beltrán. En concreto son un ...
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Gonzoo

Encerrados por una biblioteca abierta las 24 horas
Gonzoo - Un grupo de entre 40 y 60 estudiantes permanecen encerrados en la biblioteca María Zambrano de la Universidad Complutense de Madrid para ...
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Hallan en una biblioteca española una obra inédita de Lope de Vega
ElLitoral.com - La Biblioteca Nacional de España (BNE) anunció hoy el hallazgo en sus fondos de una copia manuscrita de una obra inédita de Lope de Vega, ...
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Publico.es

Hallada en la Biblioteca Nacional una obra inédita de Lope de Vega
Publico.es - La Biblioteca Nacional de España (BNE) ha descubierto una copia manuscrita de una obra inédita de Lope de Vega, Mujeres y criados, que los ...
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Biblioteca Vasconcelos realizará homenaje a Nelson Mandela
SDP Noticias - "Más allá de la biblioteca, consideramos que la figura de Mandela crece y crece, y es un ejemplo de cómo convertir en verdad, un conflicto, en una ...
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Pagina66

Donación a la biblioteca de dos libros de 1929 y 1935
Pagina66 - Josep Lluís Ripoll Silvestre y Enrique S. Rivelles han donado a la Biblioteca Municipal dos poemarios obra del poeta proletario republicano Pascual ...
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Hallan una copia manuscrita de la comedia inédita de Lope de Vega
Heraldo de Aragon - El manuscrito, con la firma Mss/16915, entró en la Biblioteca Nacional en 1886 como parte de la compra de la biblioteca de Osuna, tiene 56 páginas y ...
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BLOGS

Consejos para cuidar la biblioteca de la casa | RINCON DEL ...
RINCON DEL BIBLIOTECARIO (noreply@blogger.com (Ernesto Della Riva)) - Como cualquier otro objeto, para que un libro dure toda la vida hay que cuidarlo, colocándolo en una biblioteca con buena iluminación, a una ...
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Realizarán homenaje a Nelson Mandela en la Biblioteca ...
emeequis (redactorawebAS) - “Más allá de la biblioteca, consideramos que la figura de Mandela crece y crece, y es un ejemplo de cómo convertir en verdad, un conflicto, en una .

Propofol

Exponente alomérico dependiente del peso corporal para escalar la eliminación a través de la duración de la vida humana


A bodyweight-dependent allometric exponent for scaling clearance across the human life-span.
Wang C, Peeters MY, Allegaert K, Blussé van Oud-Alblas HJ, Krekels EH, Tibboel D, Danhof M, Knibbe CA.
Division of Pharmacology, LACDR, Leiden University, Leiden, the Netherlands.
Pharm Res. 2012 Jun;29(6):1570-81. doi: 10.1007/s11095-012-0668-x.
Abstract
PURPOSE:To explore different allometric equations for scaling clearance across the human life-span using propofol as a model drug. METHODS: Data from seven previously published propofol studies ((pre)term neonates, infants, toddlers, children, adolescents and adults) were analysed using NONMEM VI. To scale clearance, a bodyweight-based exponential equation with four different structures for the exponent was used: (I) 3/4 allometric scaling model; (II) mixture model; (III) bodyweight-cut-point separated model; (IV) bodyweight-dependent exponent model. RESULTS: Model I adequately described clearance in adults and older children, but overestimated clearance of neonates and underestimated clearance of infants. Use of two different exponents in Model II and Model III showed significantly improved performance, but yielded ambiguities on the boundaries of the two subpopulations. This discontinuity was overcome in Model IV, in which the exponent changed sigmoidally from 1.35 at a hypothetical bodyweight of 0 kg to a value of 0.56 from 10 kg onwards, thereby describing clearance of all individuals best. CONCLUSIONS: A model was developed for scaling clearance over the entire human life-span with a single continuous equation, in which the exponent of the bodyweight-based exponential equation varied with bodyweight.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349030/pdf/11095_2012_Article_668.pdf







Propofol en emulsión lipídica atenúa menos la regulación de la temperatura corporal que la microemulsión de propofol o el sevoflurano en los ancianos.

Lipid-emulsion propofol less attenuates the regulation of body temperature than micro-emulsion propofol or sevoflurane in the elderly.
Jeong CW, Ju J, Lee DW, Lee SH, Yoon MH.
Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea.
Yonsei Med J. 2012 Jan;53(1):198-203. doi: 10.3349/ymj.2012.53.1.198.
Abstract
PURPOSE: Anesthesia and surgery commonly cause hypothermia, and this caused by a combination of anesthetic-induced impairment of thermoregulatory control, a cold operation room environment and other factors that promote heat loss. All the general anesthetics markedly impair normal autonomic thermoregulatory control. The aim of this study is to evaluate the effect of two different types of propofol versus inhalation anesthetic on the body temperature. MATERIALS AND METHODS: In this randomized controlled study, 36 patients scheduled for elective laparoscopic gastrectomy were allocated into three groups; group S (sevoflurane, n=12), group L (lipid-emulsion propofol, n=12) and group M (micro-emulsion propofol, n=12). Anesthesia was maintained with typical doses of the study drugs and all the groups received continuous remifentanil infusion. The body temperature was continuously monitored after the induction of general anesthesia until the end of surgery. RESULTS: The body temperature was decreased in all the groups. The temperature gradient of each group (group S, group L and group M) at 180 minutes from induction of anesthesia was 2.5 ± 0.6°C, 1.6 ± 0.5°C and 2.3 ± 0.6°C, respectively. The body temperature of group L was significantly higher than that of group S and group M at 30 minutes and 75 minute after induction of anesthesia, respectively. There were no temperature differences between group S and group M. CONCLUSION: The body temperature is maintained at a higher level in elderly patients anesthetized with lipid-emulsion propofol.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250313/pdf/ymj-53-198.pdf


Mecanismo GABAergico de la toxicidad de propofol en neuronas inmaduras
GABAergic mechanism of propofol toxicity in immature neurons.
Kahraman S, Zup SL, McCarthy MM, Fiskum G.
Department of Anesthesiology, University of Maryland, Baltimore, MD 21201, USA.
J Neurosurg Anesthesiol. 2008 Oct;20(4):233-40. doi: 10.1097/ANA.0b013e31817ec34d.
Abstract
Certain anesthetics exhibit neurotoxicity in the brains of immature but not mature animals. Gamma-aminobutyric acid (GABA), the primary inhibitory neurotransmitter in the adult brain, is excitatory on immature neurons via its action at the GABAA receptor, due to a reversed transmembrane chloride gradient. GABAA receptor activation in immature neurons is sufficient to open L-type voltage-gated calcium channels. As propofol is a GABAA agonist, we hypothesized that it and more specific GABAA modulators would increase intracellular free calcium ([Ca2+]i), resulting in the death of neonatal rat hippocampal neurons. Neuronal [Ca2+]i was monitored using Fura2-AM fluorescence imaging. Cell death was assessed by double staining with propidium iodide and Hoechst 33258 at 1 hour (acute) and 48 hours (delayed) after 5 hours exposure of neurons to propofol or the GABAA receptor agonist, muscimol, in the presence and absence of the GABA receptor antagonist, bicuculline, or the L-type Ca2+ channel blocker, nifedipine. Fluorescent measurements of caspase-3,-7 activities were performed at 1 hour after exposure. Both muscimol and propofol induced a rapid increase in [Ca2+]i in days in vitro (DIV) 4, but not in DIV 8 neurons, that was inhibited by nifedipine and bicuculline. Caspase-3,-7 activities and cell death increased significantly in DIV 4 but not DIV 8 hippocampal neuronal cultures 1 hour after 5 hours exposure to propofol, but not muscimol, and were inhibited by the presence of bicuculline or nifedipine. We conclude that an increase in [Ca2+]i, due to activation of GABAA receptors and opening of L-type calcium channels, is necessary for propofol-induced death of immature rat hippocampal neurons but that additional mechanisms not elicited by GABAA activation alone also contribute to cell death.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730603/pdf/nihms107690.pdf


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

viernes, 24 de enero de 2014

Ultrasonido en trauma/Ultrasonography in trauma

¨Banderas rojas¨ en el ultrasonido en la cama de casos quirúrgicos


Red flags in bedside ultrasonography for surgical cases.
Unlüer EE, Karagöz A.
Interv Med Appl Sci. 2013 Jun;5(2):85-8. doi: 10.1556/IMAS.5.2013.2.6. Epub 2013 Jul 4.
Abstract
Bedside ultrasonography is highly accurate in evaluating hypotension, even if performed by nonradiologist. Here we report three cases presenting with hypotension to the trauma room. In the first case, limited bedside ultrasonography demonstrated dilatation of the inferior vena cava and loss of respiratory variation in diameter. In further evaluation, dilated aortic root, massive pericardial effusion, collapse of right heart chambers, and a dissection flap at the anterior wall of base of ascending aorta were detected. With these findings, the patient was sent to the operation room with a diagnosis of DeBakey type 2 aortic dissection in approximately 15 min. In the second case, bedside ultrasonography demonstrated absence of pleural movements and comet tail artifacts on the right lung region of the patient. Together with deterioration of the vital signs, the patient was diagnosed as right-sided pneumothorax and underwent the tube thoracostomy. In the third case, bedside ultrasonography revealed the presence of free fluid in Morrison's pouch and splenorenal space in a hypotensive patient with a blunt abdominal trauma. He was consulted with general surgery department and was sent to the operation room without further diagnostic evaluation. In these cases, we emphasized the key role of bedsideultrasonography in hypotensive patients.
KEYWORDS: bedside ultrasonography, free fluid in the abdomen, hypotension, pericardial effusion, pneumothorax
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3831800/pdf/IMAS-05-085.pdf


Estudio clínico controlado, randomizado de ¨punto de cuidado¨, de ultrasonografía en trauma en el servicio de urgencias: Primera evaluación del programa sobre la evaluación sonográfica

Randomized controlled clinical trial of point-of-care, limited ultrasonography for trauma in the emergencydepartment: the first sonography outcomes assessment program trial.
Melniker LA, Leibner E, McKenney MG, Lopez P, Briggs WM, Mancuso CA.
Ann Emerg Med. 2006 Sep;48(3):227-35. Epub 2006 Mar 24.
Abstract
STUDY OBJECTIVE: Annually, 38 million people are evaluated for trauma, the leading cause of death in persons younger than 45 years. The primary objective is to assess whether using a protocol inclusive of point-of-care, limited ultrasonography (PLUS), compared to usual care (control), among patients presenting to the emergency department (ED) with suspected torso trauma decreased time to operative care. METHODS: The study was a randomized controlled clinical trial conducted during a 6-month period at 2 Level I trauma centers. The intervention was PLUS conducted by verified clinician sonographers. The primary outcome measure was time from ED arrival to transfer to operative care; secondary outcomes included computed tomography (CT) use, length of stay, complications, and charges. Regression models controlled for confounders and analyzed physician-to-physician variability. All analyses were conducted on an intention-to-treat basis. Results are presented as mean, first-quartile, median, and third-quartile, with multiplicative change and 95% confidence intervals (CIs), or percentage with odds ratio and 95% CIs. RESULTS: Four hundred forty-four patients with suspected torso trauma were eligible; 136 patients lacked consent, and attending physicians refused enrollment of 46 patients. Two hundred sixty-two patients were enrolled: 135 PLUS patients and 127 controls. There were no important differences between groups. Time to operative care was 64% (48, 76) less for PLUS compared to control patients. PLUS patients underwent fewer CTs (odds ratio 0.16) (0.07, 0.32), spent 27% (1, 46) fewer days in hospital, and had fewer complications (odds ratio 0.16) (0.07, 0.32), and charges were 35% (19, 48) less compared to control. CONCLUSION: A PLUS-inclusive protocol significantly decreased time to operative care in patients with suspected torso trauma, with improved resource use and lower charges

http://calgaryem.com/files/FAST.pdf


Ecografía FAST en la evaluación de pacientes traumatizados
FELIPE Catán G, A. DIVA Vilao M, Cristián Astudilo D.
REV. MED. CLIN. CONDES - 2011; 22(5) 633-639]
RESUMEN
El manejo inicial de los pacientes politraumatizados es uno de los mayores desafíos de la práctica clínica, ya que se requiere tomar decisiones muy rápidas basadas principalmente en criterios clínicos. La ecografía FAST ha demostrado ser útil parala detección de sangrado en el tórax y el abdomen, ademásde permitir detectar taponamiento cardiaco en paciente con trauma torácico penetrante y sospechar la presencia de neumotórax. Esto la ha transformado en una herramienta valiosapara la toma de decisiones terapéuticas en pacientes traumáticos,así como para la selección de pacientes en situaciones de catástrofes.
Palabras clave: FAST, ecografía, trauma.



http://www.clinicalascondes.cl/Dev_CLC/media/Imagenes/PDF%20revista%20m%C3%A9dica/2011/5%20sept/ecografia-fast-13.pdf



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

Más sobre FAST/More about FAST

Detección sonográfica de líquido libre abdominal: residentes de urgencias vs. residentes de radiología


Sonographic Detection of Abdominal Free Fluid: Emergency Residents vs Radiology Residents.
Shojaee M, Faridaalaee G, Sabzghabaei A, Safari S, Mansoorifar H, Arhamidolatabadi A, Keyghobadi F.
Trauma Mon. 2013 Winter;17(4):377-9. doi: 10.5812/traumamon.5476. Epub 2013 Jan 15.
Abstract
BACKGROUND: Focused assessment with sonography for trauma (FAST) has become a part of initial examinations in trauma care at emergency departments (ED). OBJECTIVES: The goal of the present study was to evaluate the accuracy of FASTs performed by emergency residents (ER) in detection of abdominal free fluid following blunt trauma. MATERIALS AND METHODS: In this study, the reports of ERs performing FASTs on 286 admitted patients following blunt trauma were compared with those of radiology residents (RR) in relation to presence of abdominal free fluid. In addition, the reports of the two resident groups were compared with the final abdominal outcome, based on the results of abdominal computed tomography (CT) and clinical follow up. RESULTS: The ERs had reported abdominal free fluid in 20 (6.9%) patients while RRs performing FAST had positive results in 22 (7.6%) patients. The reports of FASTs revealed significant correlation between the two resident groups (P < 0.001). ERs performing FASTs had 90% sensitivity and 98.5% specificity in comparison to RRs sonography reports. Furthermore, ER-performed FASTs had 96.5% accuracy in relation to final outcome. CONCLUSIONS: Following training, ED residents can perform FAST with high accuracy and specificity, similar to RR residents, in patients with blunt abdominal trauma.
KEYWORDS: Abdominal Injuries, Trauma, Emergencies, Ultrasonography
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860662/pdf/traumamon-17-377.pdf


Ultrasonido mejorado con medio de contraste en trauma abdominal cerrado

Contrast enhanced ultrasound (CEUS) in blunt abdominal trauma.
Cagini L, Gravante S, Malaspina CM, Cesarano E, Giganti M, Rebonato A, Fonio P, Scialpi M.
Crit Ultrasound J. 2013 Jul 15;5 Suppl 1:S9. doi: 10.1186/2036-7902-5-S1-S9. Epub 2013 Jul 15.
Abstract
In the assessment of polytrauma patient, an accurate diagnostic study protocol with high sensitivity and specificity is necessary. Computed Tomography (CT) is the standard reference in the emergency for evaluating the patients with abdominal trauma. Ultrasonography (US) has a high sensitivity in detecting free fluid in the peritoneum, but it does not show as much sensitivity for traumatic parenchymal lesions. The use of Contrast-Enhanced Ultrasound (CEUS) improves the accuracy of the method in the diagnosis and assessment of the extent of parenchymal lesions. Although the CEUS is not feasible as a method of first level in the diagnosis and management of the polytrauma patient, it can be used in the follow-up of traumatic injuries of abdominal parenchymal organs (liver, spleen and kidneys), especially in young people or children.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3711741/pdf/2036-7902-5-S1-S9.pdf


Revista gratis Critical Ultrasound Journal
Critical ultrasound Journal

http://www.criticalultrasoundjournal.com/content



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

Creación e implementación de las Guías 2013 UCI sobre dolor, agitación, y delirio para pacientes adultos en UCI

Creación e implementación de las Guías 2013 UCI sobre dolor, agitación, y delirio para pacientes adultos en UCI

Creating and Implementing the 2013 ICU Pain, Agitation, and Delirium Guidelines for Adult ICU Patients
Critical Care Medicine September 2013 - Volume 41 -Supplement 19, pp: S1-S145

http://journals.lww.com/ccmjournal/toc/2013/09001


Atentamente
Dr. Juan Carlos Flores-Carrillo
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

Ablación con radiofrecuencia térmica en un mieloma doloroso de clavícula

Ablación con radiofrecuencia térmica en un mieloma doloroso de clavícula


Radiofrequency Thermal Ablation in Painful Myeloma of the Clavicle
Helen Gharaei, Farnad Imani, and Masoud Vakily
Department of Anesthesiology and Pain Medicine, Amirmomenin Hospital, Tehran Azad Islamic University of Medical Science, Anesthesiology and Pain Department, Hematology and Oncology Department, Rasoul-Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
Korean J Pain 2014 January; Vol. 27, No. 1: 72-76

Abstract
A 57-year-old male patient had myeloma. He had severe pain in the left clavicle that did not respond to radiotherapy; therefore, it was treated with radiofrequency thermal ablation (RFTA). Under fluoroscopic guidance, two RF needles at a distance of 1.5 cm from each other were inserted into the mass and conventional radiofrequency (90oC and 60 seconds) at two different depths (1 cm apart) was applied. Then, 2 ml of 0.5% ropivacaine along with triamcinolone 40 mg was injected in each needle. The visual analogue pain score (VAS from 0 to 10) was decreased from 8 to 0. In the next 3 months of follow-up, the patient was very satisfied with the procedure and the mass gradually became smaller. There were no complications. This study shows that RFTA could be a useful method for pain management in painful osteolytic myeloma lesions in the clavicle
http://pdf.medrang.co.kr/paper/pdf/Jkp/Jkp027-01-12.pdf


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

jueves, 23 de enero de 2014

Beneficios de dormir del lado izquierdo


Dr. Ramiro Cuevas. Ortopedista Pediatra INR

Dr Ramiro Cuevas. Ortopedista Pediatra INR

Publicado el 20/01/2014

Un talk show donde los especialistas y el público generan un espacio de interacción rico en propuestas en el que se analizan, desde diferentes ópticas, diversos aspectos de interés de la vida diaria. La idea es generar, juntos, contenidos valiosos que permitan mejorar la calidad de vida de la sociedad, así como contribuir a la toma de decisiones importantes de manera fundamentada y, ante todo: ofrecer alternativas a diferentes problemáticas relacionadas con la salud, la familia, el saber vivir, la pareja y el ámbito social.

http://youtu.be/JKuCradecCQ

miércoles, 22 de enero de 2014

Librerias. Alerta


librerias
Notificaciones semanales ⋅ 20 de enero de 2014
NOTICIAS


El Heraldo (Colombia)

Ir a librerías en pareja, un viaje a otro mundo
El Heraldo (Colombia) - Otras, como la que conforman Edwin Corena y Mábel Flórez, prefieren visitar una librería por lo menos una o dos veces en el mes y según sus ...
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Beta espera facturar unos 7,5 millones en 2014 con el nuevo ...
ecodiario - La cadena sevillana de librerías Beta prevé facturar unos 7,5 millones de euros en 2014, con su nuevo concepto de librerías, 'Beta Book Café' que ...
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Beta incluirá cafeterías en sus librerías y venderá música y regalos
abcdesevilla.es - Beta, la primera cadena andaluza de librerías con siete establecimientos en Sevilla (República Argentina, San Pablo, Sierpes, Luis Montoto, Eduardo ...
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Llega a librerías el libro 'Me enamoré de un Casanova' de la ...
Radio Bío-Bío - María, la hija mayor de la familia De la Cruz de Talca, es la protagonista de la primera novela de Ana Parada, 'Me enamoré de un Casanova', ...
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Cáscara amarga

Vuelve a las librerías 'Alas', del novelista gay ruso Mijaíl Kuzmin
Cáscara amarga - 17/01/2014 - Eduardo Nabal Alas vuelve a las librerías de manos de la comprometida Editorial Quimera la novela más importante de Mijaíl Kuzmin, ...
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Cáscara amarga

Vuelve a las librerías lo mejor del escritor maldito James Purdy
Cáscara amarga - Aunque su periplo es mas accidentado y no tuvo tanto éxito como Tennesse Williams o Truman Capote, James Purdy, fallecido el año pasado, es uno ...
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Periodista Digital

'Efecto Dulcinea' llega a las librerías y un teatro madrileño
El Periódico Extremadura - La comedia se pone en escena los domingos de enero y febrero en TDA. Producción 100% extremeña, tiene como protagonista a una feminista ...
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Sitio Andino

Luego de un 2013 complicado, las librerías esperan revertir la ...
Sitio Andino - En los últimos seis meses del año pasado varias librerías tuvieron que cerrar sus puertas por las bajas ventas, según informaron desde la asociación ...
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Libros a la carta en San Pedro Sula
La Prensa de Honduras - La famosa saga de “Los Juegos del Hambre” de Suzanne Collins está disponible en las librerías de San Pedro. En la novela de aventura se tratan ...
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La guía editada por La Voz se agota en las librerías de Vilagarcía
La Voz de Galicia - Fue uno de los regalos estrella de las pasadas Navidades. La experiencia de muchos años recorriendo las rutas del periodista Cristóbal Ramírez se ...
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BLOGS

Backdoor en las librerías Catalyst OpenCL... - Taringa!
Por Ramón Marquez. El driver privativo AMD Catalyts incluiría un Backdoor en las librerías Catalyst OpenCL. Gente de oclHashcat ha informado que ...
Marcar como no importante


Iglesías de Holanda hechas museos, librerías, antros,pista de ...
Informacion de contacto - Iglesías de Holanda hechas museos, librerías, antros,pista de patinaje,etc. Algo increíble pero cierto...nunca creí que la frase "renovarse o morir ...
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