Magnesio y analgesia/Analgesia and magnesium

Efecto de infusión continua de magnesio sobre las características de la raquia. Estudio prospectivo  Effect of continuous magnesium sulfate infusion on spinal block characteristics: A prospective study. Agrawal A, Agrawal S, Payal AS.  Saudi J Anaesth [serial online] 2014 [cited 2014 Feb 1];8:78-82. Abstract Background: Spinal anesthesia is an established mode of anesthesia for lower limb orthopedic surgeries. The limitations of the technique are short duration of action and limited post-operative analgesia. Concomitant use of intravenous infusion of magnesium sulfate may have an effect on the block characteristics and duration of action of intrathecal bupivacaine. Methods: A total of 80 American Society of Anesthesiologists I and II patients, either sex, 20-60 years of age scheduled for elective orthopedic fixation of fracture of long bones of lower limbs under spinal anesthesia were included. Spinal anesthesia administered with 2.5 ml heavy bupivacaine mixed with 10 mcg fentanyl. The groups were then divided to receive an infusion of injection magnesium sulfate 50 mg/kg/h over 15 min followed by 15 mg/kg/h until the end of the surgery (Group M) and 15 ml of Normal Saline over 15 min followed by 100 ml/h until the end of surgery (Group S). Onset, duration of sensory and motor block and amount of post-operative analgesic were noted. Results: A total of 6 patients (Group M) and seven patients (Group S) had inadequate block and excluded from the study. Mean block height was T6. Time required to achieve block height was 8.82 min versus 7.42 min in Groups M and S respectively (P = 0.04). Mean duration of motor block was longer in group M (160.63 ± 17.76 min) compared with Group S (130.12 ± 20.70 min) (P = 0.000). Time for regression of sensory block to T12/L1was 206.88 ± 20.96 min (Group M) and 163.88 ± 15.46 min (Group S) (P = 0.000). Hemodynamic parameters were similar and statistically not significant. Need for first analgesic requirement was after 262.88 ± 21.11 min in group M and 193.25 ± 17.74 min in the group S (P = 0.000). Mean dosage of tramadol needed in first 24 h was less in group M (190 ± 30.38 mg vs. 265 ± 48.30 mg, P = 0.000). Conclusion: Use of intravenous magnesium with spinal anesthesia reduces post-operative pain and analgesic consumption. Keywords: Intravenous magnesium, post-operative pain, spinal anesthesia  http://www.saudija.org/text.asp?2014/8/1/78/125945 http://www.saudija.org/downloadpdf.asp?issn=1658-354X;year=2014;volume=8;issue=1;spage=78;epage=82;aulast=Agrawal;type=2 Efecto de la infusión i.v. de magnesio durante raquianestesia en cirugía de cadera y su efecto en analgesia postoperatoria. Nuestra experiencia  Intravenous infusion of magnesium sulphate during subarachnoid anaesthesia in hip surgery and its effect on postoperative analgesia: our experience. Pastore A, Lanna M, Lombardo N, Policastro C, Iacovazzo C. Transl Med UniSa. 2013 Jan 4;5:18-21. Print 2013 Jan. Abstract The treatment of degenerative hip joint disease involves modern operative techniques and the use of prosthetic devices individualized on each patient. Being a surgery of considerable importance, great attention is always given by the anaesthesiologist to postoperative analgesia. In general, our goal is to limit the doses of NSAIDs, known to be associated with haemostasis interference and alteration of gastrointestinal apparatus; component of our baseline analgesic protocols after arthroplasty is morphine given parenterally. In order to steadily improve analgesic techniques, which directly impact on patient outcome, we experimented the use of a continuous infusion of magnesium sulphate during subarachnoid anaesthesia. Magnesiumsulphate is the drug of choice in case of eclampsia, and pre-eclampsia (for the risk of evolution in eclampsia). According to the most recent findings, this drug has also analgesic properties: its use as an adjunct to analgesia is based on a non-competitive antagonism towards the NMDA receptor and on the blocking of calcium channels: these properties prevent the mechanisms of central sensitization due to nociceptive stimulation of peripheral nerves. KEYWORDS:Hip Arthroplasty, Magnesium Sulphate, Postoperative Analgesia, Postoperative Pain, Spinal Anaesthesia http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728809/pdf/tm-05-06.pdf    Infusión perioperatoria de magnesio i.v. y dolor postoperatorio: un meta-análisis  Peri-operative intravenous administration of magnesium sulphate and postoperative pain: a meta-analysis. Albrecht E, Kirkham KR, Liu SS, Brull R. Anaesthesia. 2013 Jan;68(1):79-90. doi: 10.1111/j.1365-2044.2012.07335.x. Epub 2012 Nov 1. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.2012.07335.x/pdf    Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Bibliotecas. Alerta

Biblioteca
Notificaciones diarias ⋅ 11 de febrero de 2014
NOTICIAS

Biblioteca Digital Mundial le abre puertas a Eafit
ElTiempo.com
Es la primera universidad del país que ingresa al proyecto que recupera el patrimonio cultural. Desde 2005 la Biblioteca del Congreso de los Estados ...



La Biblioteca Nacional se une a Impact para avanzar en la digitalización
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desdeSoria.es

La Biblioteca Pública acoge un monográfico sobre el escritor soriano Julio Izquierdo
desdeSoria.es
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La Nueva España

La biblioteca de Riaño aumenta sus fondos al lograr un galardón nacional
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Langreo, E. P. La biblioteca pública de Riaño incrementa sus fondos tras ganar el premio "María Moliner" de animación a la lectura en la categoría de ...




Diario C

La Biblioteca Herrera con sus puertas abiertas
Diario C
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Biblioteca empresaria
El Cronista
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La biblioteca, otra vez premiada por su actividad
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Una biblioteca llamada empatía
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RTVE
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BLOGS

Parque Goya su tendrá biblioteca municpal este año - Heraldo de Aragón

RSS :: Heraldo de Aragón
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Biblioteca: Ya somos La Biblioteca de Amelia

Biblioteca ⋅ BGD
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T O D A S_L A S_ M Ú S I C A S: BIBLIOTECA: Blues People, LeRoi Jones (Amiri Baraka)

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La Biblioteca de la EPS en el IV Congreso Nacional de Desarrollo Rural |

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el director de la biblioteca nacional, horacio gonzález llamó a

Colectivo Ex Presos Pol.Y Sobrevivientes - Rosario ⋅ Colectivo Ex P. Pol. Sobrev. Rosario
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Fernando Aramburu, Premio Biblioteca Breve 2014 por “Ávidas pretensiones” | Culturamas, la ...

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Nuevo error en PlayStation 4: Elimina juegos de la biblioteca - Tierra Gamer

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Toracoscopía sin intubación/Nonintubated VATS

Consideraciones anestésicas para cirugía torácica videoasistida (VATS) sin intubación  Anesthetic consideration for nonintubated VATS Jen-Ting Yang, Ming-Hui Hung, Jin-Shing Chen, Ya-Jung Cheng Department of Anesthesiology, Graduate Institute of Clinical Medicine, Division of Thoracic Surgery, Division of Experimental Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan Corresponding to: Ya-Jung Cheng, MD, PhD. Department of Anesthesiology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; 7, Chung-Shan South Road, Taipei 10002, Taiwan. Email: chengyj@ntu.edu.tw. Abstract: In the recent decade, nonintubated-intubated video-assisted thoracoscopic surgery (VATS) has been extensively performed and evaluated. The indicated surgical procedures and suitable patient groups are steadily increasing. Perioperative anesthetic management presents itself as a fresh issue for the iatrogenic open pneumothorax, which is intended for unilateral lung collapse to create a steady surgical field, and the ensuing physiologic derangement involving ventilatory and hemodynamic perspectives. With appropriate monitoring, meticulous employment of regional anesthesia, sedation, vagal block, and ventilatory support, nonintubated VATS is proved to be a safe alternative to the conventional intubated general anesthesia. Keywords: Anesthesia; thoracoscopy; nonintubated; thoracic epidural anesthesia (TEA); intercostal nerve block; bispectral inde  http://www.jthoracdis.com/article/view/1947/pdf Cirugía toracoscópica sin intubación: Estado del arte y direcciones futuras  Nonintubated thoracoscopic surgery: state of the art and future directions. Hung MH, Hsu HH, Cheng YJ, Chen JS. Author information J Thorac Dis. 2014 Jan;6(1):2-9. Abstract Video-assisted thoracoscopic surgery (VATS) has become a common and globally accepted surgical approach for a variety of thoracic diseases. Conventionally, it is performed under tracheal intubation with double lumen tube or bronchial blocker to achieve single lung ventilation. Recently, VATS without tracheal intubation were reported to be feasible and safe in a series of VATS procedures, including management of pneumothorax, wedge resection of pulmonary tumors, excision of mediastinal tumors, lung volume reduction surgery, segmentectomy, and lobectomy. Patients undergoing nonintubated VATS are anesthetized using regional anesthesia in a spontaneously single lung breathing status after iatrogenic open pneumothorax. Conscious sedation is usually necessary for longer and intensively manipulating procedures and intraoperative cough reflex can be effectively inhibited with intrathoracic vagal blockade on the surgical side. The early outcomes of nonintubated VATS include a faster postoperative recovery and less complication rate comparing with its counterpart of intubated general anesthesia, by which may translate into a fast track VATS program. The future directions of nonintubated VATS should focus on its long-term outcomes, especially on oncological perspectives of survival in lung cancer patients. For now, it is still early to conclude the benefits of this technique, however, an educating and training program may be needed to enable both thoracic surgeons and anesthesiologists providing an alternative surgical option in their caring patients. KEYWORDS:Thoracoscopy, intubation, anesthesia, intercostal nerve block, lung cancer, thoracic epidural anesthesia http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3895586/pdf/jtd-06-01-002.pdf   http://www.jthoracdis.com/article/view/1946/pdf     Cirugía toracoscópica sin intubación usando anestesia regional, bloqueo vagal y sedación diana  Nonintubated thoracoscopic surgery using regional anesthesia and vagal block and targeted sedation Ke-Cheng Chen, Ya-Jung Cheng, Ming-Hui Hung, Yu-Ding Tseng, Jin-Shing Chen J Thorac Dis. 2014 Jan;6(1):31-6. doi: 10.3978/j.issn.2072-1439.2014.01.01. Abstract OBJECTIVE: Thoracoscopic surgery without endotracheal intubation is a novel technique for diagnosis and treatment of thoracic diseases. This study reported the experience of nonintubated thoracoscopic surgery in a tertiary medical center in Taiwan. METHODS: From August 2009 through August 2013, 446 consecutive patients with lung or pleural diseases were treated by nonintubatedthoracoscopic surgery. Regional anesthesia was achieved by thoracic epidural anesthesia or internal intercostal blockade. Targeted sedation was performed with propofol infusion to achieve a bispectral index value between 40 and 60. The demographic data and clinical outcomes were evaluated by retrospective chart review. RESULTS: Thoracic epidural anesthesia was used in 290 patients (65.0%) while internal intercostal blockade was used in 156 patients (35.0%). The final diagnosis were primary lung cancer in 263 patients (59.0%), metastatic lung cancer in 38 (8.5%), benign lung tumor in 140 (31.4%), and pneumothorax in 5 (1.1%). The median anesthetic induction time was 30 minutes by thoracic epidural anesthesia and was 10 minutes by internal intercostal blockade. The operative procedures included lobectomy in 189 patients (42.4%), wedge resection in 229 (51.3%), and segmentectomy in 28 (6.3%). Sixteen patients (3.6%) required conversion to tracheal intubation because of significant mediastinal movement (seven patients), persistent hypoxemia (two patients), dense pleural adhesions (two patients), ineffective epidural anesthesia (two patients), bleeding (two patients), and tachypnea (one patient). One patient (0.4%) was converted to thoracotomy because of bleeding. No mortality was noted in our patients. CONCLUSIONS: Nonintubated thoracoscopic surgery is technically feasible and safe and can be a less invasive alternative for diagnosis and treatment of thoracic diseases. KEYWORDS: Anesthesia, lobectomy, lung cancer, segmentectomy, thoracoscopy, tracheal intubation, wedge resection http://www.jthoracdis.com/article/view/1950/pdf  Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Bibliotecas. Alerta

La biblioteca Editor José Manuel Lara se consolida como centro...
Diario de Sevilla - El Ayuntamiento consolidó en 2013 el "carácter educativo y sociocultural" de la biblioteca municipal Editor José Manuel Lara con la promoción de ...




InfonorteDigital

La Biblioteca Insular organiza la segunda edición del curso de ...
InfonorteDigital - La Biblioteca Insular del Cabildo grancanario volverá a organizar, por segundo año consecutivo, el curso de alfabetización informática destinado a ...



La Biblioteca Pública de Valencia inaugura una sección dedicada al ...
Las Provincias - Las bibliotecas están vivas. No están muertas ni las dejan morir. Se adaptan a los nuevos tiempos y formatos. Algunas atesoran miles de volúmnes y ...



La Biblioteca Municipal “Enric Valor” dedica el mes de febrero a la ...
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Ascienden a 410 los kilos de alimentos recogidos en Biblioteca ...
20minutos.es - La Biblioteca Pública Provincial de Sevilla 'Infanta Elena', ubicada en la avenida de María Luisa de la capital hispalense, ha cerrado definitivamente ...




Europa Press

El Polideportivo Municipal de Águilas albergará una biblioteca del ...
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La RAE pone en marcha un club de lectura en torno a su Biblioteca ...
ecodiario - La Biblioteca Clásica ha editado hasta la fecha dieciocho títulos fundamentales de la literatura española en ediciones críticas, con anotación ...



La biblioteca pública recibe más de 40 novedades
El Periódico Extremadura - La biblioteca pública ha recibido a lo largo del presente mes de enero más de cuarenta novedades de otros tantos autores nacionales y extranjeros, ...




Salamanca24horas

La obra del reconocido ilustrador Javier Zabala, expuesta en la ...
Salamanca24horas - La Biblioteca Pública de León acoge Ilustres Embajadores, exposición itinerante, dedicada a la obra de los ilustradores de Castilla y León.



La Biblioteca de Benavente recibe subvención para el suministro de ...
Interbenavente.es - El objetivo del es la contratación de suministro de documentos en soportes audiovisual y electrónico para los Bibliobuses y Bibliotecas Públicas ...


BLOGS

Biblioteca Nacional de España | Docuweb
Docuweb (Jesús Díaz Ruiz - Docuweb) - Concurso: Resolución de la Biblioteca Nacional de España por la que se anuncia procedimiento abierto para el servicio de proceso técnico completo ...

Cirugía Bariátrica

Comparación de manga gástrica vertical versus derivación biliopancreática  Comparison of vertical sleeve gastrectomy versus biliopancreatic diversion.  Sucandy I, Titano J, Bonanni F, Antanavicius G.  North Am J Med Sci [serial online] 2014 [cited 2014 Jan 27];6:35-8. Abstract Background: Vertical sleeve gastrectomy (VSG) was originally performed as the first-stage of biliopancreatic diversion with duodenal switch (BPD/DS) for superobesity as a strategy to reduce perioperative complications and morbidity. VSG is now considered a definitive procedure because of its technical simplicity and promising outcomes. Aims: To analyze the outcomes of laparoscopic VSG and to compare them with those of single-stage laparoscopic BPD/DS. Materials and Methods: A retrospective review of 200 consecutive patients who underwent VSG and BPD/DS between 2008 and 2011. Results: A total of 100 patients underwent laparoscopic VSG and 100 patients underwent laparoscopic BPD/DS. The patients in VSG group were older, but gender distribution and body mass index were comparable. Mean operative time for VSG was significantly shorter compared with that of BPD/DS. A single patient in each groups required open conversion. Staple line leak (n = 1) and intraluminal hemorrhage into the newly-created sleeve (n = 1) occurred in the BPD/DS group. Mean length of stay was shorter after VSG (3.1 vs. 3.9 days). At 6 months postoperatively, excess weight loss between the two groups revealed statistically significant difference, favoring BPD/DS. Conclusions: Despite promising outcomes and technical simplicity of VSG, BPD/DS provides significantly superior excess weight loss in morbidly obese patients. Keywords: Biliopancreatic diversion, biliopancreatic diversion, comparison, sleeve gastrectomy  http://www.najms.org/text.asp?2014/6/1/35/125865  http://www.najms.org/downloadpdf.asp?issn=1947-2714;year=2014;volume=6;issue=1;spage=35;epage=38;aulast=Sucandy;type=2     La derivación biliopancreática es más efectiva de la manga gástrica  Biliopancreatic diversion is more effective than sleeve gastrectomy.  Nanni G.  North Am J Med Sci [serial online] 2014 [cited 2014 Jan 27];6:39-40.  The study by Sucandy and coworkers [1] deals with a frequently neglected topic in bariatric surgery, related to the importance of the results in terms of weight loss in the selection of the procedure to be performed. The recently developed and highly fashionable sleeve gastrectomy (SG) is compared to the time honored and successful biliopancreatic diversion in the duodenal switch version (BPD-DS).. The article presents two series each of 100 obese patients submitted to SG or BPD-DS. A significant percentage of patients have been lost to the follow-up; nevertheless data show that BPD-DS attains greater success in terms of body mass index (BMI) reduction 18 months after surgery. The effects of malabsorption appear very early, with differences between the two procedures already evident after 6 months. The great diffusion of SG is mainly due to its technical ease and to its "natural" ending in patients with inadequate weight loss: being SG the first step of BPD-DS, an eventual failure can be corrected performing the duodenal switch. http://www.najms.org/text.asp?2014/6/1/39/125866   http://www.najms.org/downloadpdf.asp?issn=1947-2714;year=2014;volume=6;issue=1;spage=39;epage=40;aulast=Nanni;type=2 Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Vía aérea difícil con recomendaciones para su manejo. Parte 1: Intubación traqueal difícil en el paciente inconciente/inducido

Vía aérea difícil con recomendaciones para su manejo. Parte 1: Intubación traqueal difícil en el paciente inconciente/inducido  The difficult airway with recommendations for management--part 1--difficult tracheal intubation encountered in an unconscious/induced patient. Law JA, Broemling N, Cooper RM, Drolet P, Duggan LV, Griesdale DE, Hung OR, Jones PM, Kovacs G, Massey S, Morris IR, Mullen T, Murphy MF, Preston R,Naik VN, Scott J, Stacey S, Turkstra TP, Wong DT; Canadian Airway Focus Group. Can J Anaesth. 2013 Nov;60(11):1089-118. doi: 10.1007/s12630-013-0019-3. Epub 2013 Oct 17. Abstract BACKGROUND:Previously active in the mid-1990s, the Canadian Airway Focus Group (CAFG) studied the unanticipated difficult airway and made recommendations on management in a 1998 publication. The CAFG has since reconvened to examine more recent scientific literature on airway management. The Focus Group's mandate for this article was to arrive at updated practice recommendations for management of the unconscious/induced patient in whom difficult or failed tracheal intubation is encountered. METHODS: Nineteen clinicians with backgrounds in anesthesia, emergency medicine, and intensive care joined this iteration of the CAFG. Each member was assigned topics and conducted reviews of Medline, EMBASE, and Cochrane databases. Results were presented and discussed during multiple teleconferences and two face-to-face meetings. When appropriate, evidence- or consensus-based recommendations were made together with assigned levels of evidence modelled after previously published criteria. CONCLUSIONS: The clinician must be aware of the potential for harm to the patient that can occur with multiple attempts at tracheal intubation. This likelihood can be minimized by moving early from an unsuccessful primary intubation technique to an alternative "Plan B" technique if oxygenation by face mask or ventilation using a supraglottic device is non-problematic. Irrespective of the technique(s) used, failure to achieve successful tracheal intubation in a maximum of three attempts defines failed tracheal intubation and signals the need to engage an exit strategy. Failure to oxygenate by face mask or supraglottic device ventilation occurring in conjunction with failed tracheal intubation defines a failed oxygenation, "cannot intubate, cannot oxygenate" situation. Cricothyrotomy must then be undertaken without delay, although if not already tried, an expedited and concurrent attempt can be made to place a supraglottic device.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825644/pdf/12630_2013_Article_19.pdf Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Vía aérea difícil con recomendaciones para su manejo. Parte 2: la vía aérea difícil anticipada

Vía aérea difícil con recomendaciones para su manejo. Parte 2: la vía aérea difícil anticipada The difficult airway with recommendations for management--part 2--the anticipated difficult airway. Law JA, Broemling N, Cooper RM, Drolet P, Duggan LV, Griesdale DE, Hung OR, Jones PM, Kovacs G, Massey S, Morris IR, Mullen T, Murphy MF, Preston R,Naik VN, Scott J, Stacey S, Turkstra TP, Wong DT; Canadian Airway Focus Group. Can J Anaesth. 2013 Nov;60(11):1119-38. doi: 10.1007/s12630-013-0020-x. Epub 2013 Oct 17. Abstract BACKGROUND: Appropriate planning is crucial to avoid morbidity and mortality when difficulty is anticipated with airway management. Many guidelines developed by national societies have focused on management of difficulty encountered in the unconscious patient; however, little guidance appears in the literature on how best to approach the patient with an anticipated difficult airway. METHODS: To review this and other subjects, the Canadian Airway Focus Group (CAFG) was re-formed. With representation from anesthesiology, emergency medicine, and critical care, CAFG members were assigned topics for review. As literature reviews were completed, results were presented and discussed during teleconferences and two face-to-face meetings. When appropriate, evidence- or consensus-based recommendations were made, and levels of evidence were assigned. PRINCIPAL FINDINGS: Previously published predictors of difficult direct laryngoscopy are widely known. More recent studies report predictors of difficult face mask ventilation, video laryngoscopy, use of a supraglottic device, and cricothyrotomy. All are important facets of a complete airway evaluation and must be considered when difficulty is anticipated with airway management. Many studies now document the increasing patient morbidity that occurs with multiple attempts at tracheal intubation. Therefore, when difficulty is anticipated, tracheal intubation after induction of general anesthesia should be considered only when success with the chosen device(s) can be predicted in a maximum of three attempts. Concomitant predicted difficulty using oxygenation by face mask or supraglottic device ventilation as a fallback makes an awake approach advisable. Contextual issues, such as patient cooperation, availability of additional skilled help, and the clinician's experience, must also be considered in deciding the appropriate strategy. CONCLUSIONS: With an appropriate airway evaluation and consideration of relevant contextual issues, a rational decision can be made on whether an awake approach to tracheal intubation will maximize patient safety or if airway management can safely proceed after induction of generalanesthesia. With predicted difficulty, close attention should be paid to details of implementing the chosen approach. This should include having a plan in case of the failure of tracheal intubation or patient oxygenation.  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3825645/pdf/12630_2013_Article_20.pdf Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org

Manejo de dolor en paciente pediatrico

Estimado Pediatra te invito al Seminario de Pediatría, Cirugía Pediátrica y Lactancia Materna. El día 12 de Febrero 2014 las 21hrs (Centro, México DF, Guadalajara y Lima Perú) a la Conferencia: “Manejo de dolor en paciente pediatrico” por “Dra. Erika Romo Ramos” Anestesiologo Pediatra de Guadalajara Jal. 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/manejo_dolor/
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

E-Books. Alerta

E-Books
Notificaciones semanales ⋅ 5 de febrero de 2014
NOTICIAS

eBooks se niegan a morir en un mercado colmado de tabletas
El Financiero Costa Rica
Mientras las ventas de tabletas siguen creciendo, desde hace algunos años las ventas de lectores de libros digitales (eBooks) vienen decayendo.



10 webs donde descargar eBooks de manera gratuita y legal
ComputerHoy
Así, podras descargar eBooks de manera gratuita y legal si entras en su Tienda Kindle y solo navegas por el apartado de eBooks Kindle gratuitos.



Omicrono

Adobe actualiza su DRM para ebooks y abandona a los usuarios
Omicrono
Tarde o temprano debía suceder. Ya sabemos el debate que surgió en su tiempo sobre el DRM en los libros electrónicos cuando el mercado ...



Yo le robé a Pérez-Reverte
InfoBAE.com
Más efectivo que insultar a Rajoy y a la puta madre de los lectores podría ser negociar con la editorial para que los eBooks se vendan como máximo ...




Diario sobre Diarios

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XII Curso de Anatomía Quirúrgica de la Mano. México 2014

Sesión Acádemica del mes de febrero de la asociación Mexicana de Cirugía de la Mano

VOCÊ SABE DORMIR?

http://caespsaude.com.br/voce-sabe-dormir/?goback=%2Egde_3901754_member_5836989690615443457

VOCÊ SABE DORMIR?

05/02/2014 Leave a comment

Você acorda com dor nas costas ou na cervical? Já desperta cansada, ou sem energia para realizar suas atividades?

O problema pode ser a forma que você dorme.

O sono ainda não é totalmente explicado pela ciência, existem, teorias afirmando que ocorra para restaurar os processos químicos e físicos que acontecem durante a vigília, reforçam o sistema imunológico através da liberação de hormônios; tem o efeito de relaxamento muscular e poupa a energia do corpo.

Para facilitar um sono adequado é necessário estar em um local tranquilo, com baixa luminosidade, travesseiro e colchão adequado para cada tipo de pessoa. É importante também, durante as horas de sono manter-se o máximo de tempo possível em uma posição que tenha o menor gasto energético para o corpo e que não ocorram sobrecargas nas estruturas anatômicas.

A melhor posição para dormir é de lado porque a coluna vertebral fica alinhada e a respiração é facilitada, deve-se apenas ter cuidado com a altura do travesseiro para que mantenha a cervical horizontal paralela ao ombro e, de preferência, use um travesseiro entre os joelhos para garantir melhor conforto.

Se a sua opção é dormir de barriga para cima, preste atenção na altura do travesseiro para que a cabeça não fique inclinada e coloque um travesseiro embaixo dos joelhos para tirar a sobrecarga da região lombar.

Dormir de barriga para baixo é uma péssima escolha porque é necessário torcer a cervical para liberar as vias aéreas ocorrendo assim, uma sobrecarga de toda a região. Faça de tudo para evitar essa postura, mas se não for possível coloque um travesseiro na região do ombro do mesmo lado que a cabeça estará virada, essa conduta diminui a torção consequentemente diminui as lesões articulares.

Coloque em ação essas dicas e tenha uma ótima noite!

REFERÊNCIAS

CENTRO DO SONO. Disponível em:

http://centrodosono.com/home/index.php?option=com_content&view=article&id=86:diagnosticotratamento&catid=11:sono&Itemid=19.Acesso em: 14 de março de 2013.

INSTITUTO DO SONO. Disponível em:

http://www.sono.org.br/institutodosono/pesquisa/index.php. Acesso em: 13 de março de 2013.

http://www.madrimasd.org/informacionidi/noticias/noticia.asp?id=59384&origen=notiweb&dia_suplemento=miercoles

Nuevos avances en la comprensión del mecanismo molecular del dolor 

Este descubrimiento, publicado en la revista Nature Communications , podría abrir nuevas vías para el tratamiento del dolor y la inflamación asociado a las infecciones bacterianas, así como los trastornos vasculares del choque séptico, una grave secuela de las infecciones sistémicas producidas por bacterias patógenas. El organismo combate las infecciones bacterianas mediante la activación de distintos elementos del sistema inmune que reconocen componentes estructurales de la bacteria como extraños y activan una cascada de defensa que lleva a la destrucción de los gérmenes. Hasta ahora se pensaba que el dolor asociado a las infecciones era secundario a la respuesta inflamatoria producida por el sistema inmune al entrar en contacto con las bacterias. Utilizando distintos abordajes experimentales, los investigadores han podido demostrar un mecanismo molecular diferente en la génesis del dolor que acompaña a las infecciones. El hallazgo consiste en la demostración de una activación rápida y directa de una población de neuronas del dolor (neuronas nociceptivas, responsables de detectar estímulos dañinos o irritantes) por una endotoxina denominada LPS (lipopolisacárido), que forma parte de la pared de las bacterias Gram negativas y es la responsable principal, cuando se libera, de sus efectos patógenos. El equipo científico ha demostrado que un canal iónico, presente específicamente en esas neuronas del dolor, conocido como TRPA1, es quien actúa como sensor primario del LPS. La fase experimental se ha llevado a cabo en ratones modificados genéticamente para que carecieran del canal iónico TRPA1, los cuales mostraron ausencia de dolor y también menor respuesta inflamatoria que los animales control tras la inyección intradérmica de LPS. Asimismo, los estudios han revelado que la activación por LPS del canal TRPA1 presente en las terminaciones nerviosas produce la liberación de neuropéptidos vasodilatadores. También demuestra que la vasodilatación de las arterias producida por esos mismos productos bacterianos se inicia por un mecanismo dependiente de la activación de TRPA1. En este trabajo, liderado por el Instituto de Neurociencias en Alicante, también han participado científicos de la Universidad Católica de Lovaina (Bélgica), la Universidad de Erlangen-Nürenberg (Alemania), la Universidad de Valladolid y la Universidad de Santiago de Compostela. Yeranddy A. Alpizar, Enoch Luis, Sendoa Tajada, Bristol Denlinger, Otto Fajardo, Jan-Albert Manenschijn, Carlos Fernández-Peña, Arturo Talavera, Tatiana Kichko, Belén Navia, Alicia Sánchez, Rosa Señarís, Peter Reeh, María Teresa Pérez-García, José Ramón López-López, Thomas Voets, Carlos Belmonte, Karel Talavera, Félix Viana. Nature Communications. TRPA1 channels mediate acute neurogenic inflammation and pain produced by bacterial endotoxins. DOI: 10.1038/ncomms4125.