Imagen del mes y Pancreatitis

Septiembre 30, 2015. No. 2100

Ver galería de Imágenes View image gallery La pancreatitis aguda asociada al embarazo es una patología poco frecuente pero de extrema gravedad ya que se asocia a evolución adversa del embarazo y puede favorecer muerte fetal. Suele asociarse a con preeclampsia y con evolución materna complicada; en particular con preeclampsia, y embarazo de pretérmino. El manejo es interdisciplinario y con frecuencia hay que interrumpir el embarazo, lo cual aumenta su morbimortalidad. Acute pancreatitis associated with pregnancy is a rare but extremely serious disease because it is associated with adverse pregnancy outcomes and may favor fetal death. It is usually associated with preeclampsia and maternal severe adverse outcomes; in particular with preeclampsia and preterm pregnancy. The management is interdisciplinary and often has to terminate the pregnancy which increases their mortality. A pancreatite aguda associada à gravidez é uma doença rara, mas extremamente grave, pois está associada a resultados adversos da gravidez e pode favorecer a morte fetal. Geralmente é associado com pré-eclâmpsia e evolução complicada materna; a pré-eclâmpsia, gravidez e parto prematuro. A gestão é interdisciplinar e muitas vezes têm de interromper a gravidez, o que aumenta sua mortalidade. Pancreatitis aguda en el embarazo Acute pancreatitis in pregnancy. Pitchumoni CS, Yegneswaran B. World J Gastroenterol. 2009 Dec 7;15(45):5641-6. PDF  Pancreatitis en el embarazo Pancreatitis in pregnancy. Eddy JJ, Gideonsen MD, Song JY, Grobman WA, O'Halloran P. Obstet Gynecol. 2008 Nov;112(5):1075-81. doi: 10.1097/AOG.0b013e318185a032. PDF Presión intra-abdominal en el tercer trimester del embarazo complicado con pancreatitis aguda. Estudio observacional Intra-abdominal pressure in third trimester pregnancy complicated by acute pancreatitis: an observational study. Sun L, Li W, Sun F, Geng Y, Tong Z, Li J. BMC Pregnancy Childbirth. 2015 Sep 22;15(1):223. PDF  Variaciones genéticas asociadas con hipertrigliceridemia gestacional y pancreatitis Genetic Variants Associated with Gestational Hypertriglyceridemia and Pancreatitis. Xie SL, Chen TZ, Huang XL, Chen C, Jin R, Huang ZM, Zhou MT. PLoS One. 2015 Jun 16;10(6):e0129488. doi: 10.1371/journal.pone.0129488. eCollection 2015. PDF  Error de diagnóstico de dolor abdominal en el embarazo. Pancreatitis aguda Misdiagnosis of abdominal pain in pregnancy: acute pancreatitis. Pallavee P, Samal S, Gupta S, Begum J, Ghose S. J Clin Diagn Res. 2015 Jan;9(1):QD05-6. doi: 10.7860/JCDR/2015/9003.5389. Epub 2015 Jan 1. PDF  Elevación significativa de lipasa sérica en el embarazo con nausea y vomito. ¿Pancreatitis aguda o hiperémesis del embarazo? Significantly elevated serum lipase in pregnancy with nausea and vomiting: acute pancreatitis or hyperemesis gravidarum? Johnson A, Cluskey B, Hooshvar N, Tice D, Devin C, Kao E, Nawabi S, Jones S, Zhang L, Dola C. Case Rep Obstet Gynecol. 2015;2015:359239. doi: 10.1155/2015/359239. Epub 2015 Feb 2. PDF Pancreatitis aguda severa en el embarazo Severe acute pancreatitis in pregnancy. Abdullah B, Kathiresan Pillai T, Cheen LH, Ryan RJ. Case Rep Obstet Gynecol. 2015;2015:239068. doi: 10.1155/2015/239068. Epub 2015 Jan 5. PDF  Pancreatitis aguda idiopática en el embrazo. Caso de estudio Acute idiopathic pancreatitis in pregnancy: a case study. Kim JY1, Jung SH1, Choi HW1, Song DJ1, Jeong CY1, Lee DH1, Whang IS1. World J Gastroenterol. 2014 Nov 21;20(43):16364-7. doi: 10.3748/wjg.v20.i43.16364. PDF  Muerte fetal inesperada a pesar de la "prueba sin estrés" reactiva durante el manejo conservador de pancreatitis aguda en el embarazo. Unexpected fetal demise despite the reactive nonstress test during the conservative management of acute pancreatitis in pregnancy. Avsar AF, Yildirim M, Cinkaya A. Int J Surg Case Rep. 2014;5(12):1047-9. doi: 10.1016/j.ijscr.2014.10.075. Epub 2014 Oct 24. PDF Hígado graso agudo y pancreatitis grave durante el embarazo. Informe de caso Acute fatty liver of pregnancy associated with severe acute pancreatitis: A case report. de Oliveira CV, Moreira A, Baima JP, Franzoni Lde C, Lima TB, Yamashiro Fda S, Coelho KY, Sassaki LY, Caramori CA  Romeiro FG, Silva GF. World J Hepatol. 2014 Jul 27;6(7):527-31. doi: 10.4254/wjh.v6.i7.527. PDF  Pancreatitis aguda durante el embarazo. Experiencia de 7 años en un hospital de tercer nivel Acute pancreatitis during pregnancy, 7-year experience of a tertiary referral center. Vilallonga R, Calero-Lillo A, Charco R, Balsells J. Cir Esp. 2014 Aug-Sep;92(7):468-71. doi: 10.1016/j.ciresp.2013.12.016. Epub 2014 Mar 29. PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Naltrexona y fibromialgia/Nalrexone for fibromyalgi

Octubre 3, 2015. No. 2103

Dosis bajas de naltrexona como un nuevo tratamiento anti-inflamatorio en dolor crónico The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Younger J, Parkitny L, McLain D. Clin Rheumatol. 2014 Apr;33(4):451-9. doi: 10.1007/s10067-014-2517-2. Epub 2014 Feb 15. Abstract Low-dose naltrexone (LDN) has been demonstrated to reduce symptom severity in conditions such as fibromyalgia, Crohn's disease, multiple sclerosis, and complex regional pain syndrome. We review the evidence that LDN may operate as a novel anti-inflammatory agent in the central nervous system, via action on microglial cells. These effects may be unique to low dosages of naltrexone and appear to be entirely independent from naltrexone's better-known activity on opioid receptors. As a daily oral therapy, LDN is inexpensive and well-tolerated. Despite initial promise of efficacy, the use of LDN for chronic disorders is still highly experimental. Published trials have low sample sizes, and few replications have been performed. We cover the typical usage of LDN in clinical trials, caveats to using the medication, and recommendations for future research and clinical work. LDN may represent one of the first glial cell modulators to be used for the management of chronic pain disorders. PDF Los síntomas de fibromialgia se reducen con dosis bajas de naltrexona. Estudio piloto Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study. Younger J, Mackey S. Pain Med. 2009 May-Jun;10(4):663-72. doi: 10.1111/j.1526-4637.2009.00613.x. Epub 2009 Apr 22. Abstract OBJECTIVE: Fibromyalgia is a chronic pain disorder that is characterized by diffuse musculoskeletal pain and sensitivity to mechanical stimulation. In this pilot clinical trial, we tested the effectiveness of low-dose naltrexone in treating the symptoms of fibromyalgia. DESIGN: Participants completed a single-blind, crossover trial with the following time line: baseline (2 weeks), placebo (2 weeks), drug (8 weeks), and washout (2 weeks). PATIENTS: Ten women meeting criteria for fibromyalgia and not taking an opioid medication. INTERVENTIONS: Naltrexone, in addition to antagonizing opioid receptors on neurons, also inhibits microglia activity in the central nervous system. At low doses (4.5 mg), naltrexone may inhibit the activity of microglia and reverse central and peripheral inflammation. OUTCOME MEASURES: Participants completed reports of symptom severity everyday, using a handheld computer. In addition, participants visited the lab every 2 weeks for tests of mechanical, heat, and cold pain sensitivity. RESULTS: Low-dose naltrexone reduced fibromyalgia symptoms in the entire cohort, with a greater than 30% reduction of symptoms over placebo. In addition, laboratory visits showed that mechanical and heat pain thresholds were improved by the drug. Side effects (including insomnia and vivid dreams) were rare, and described as minor and transient. Baseline erythrocyte sedimentation rate predicted over 80% of the variance in drug response. Individuals with higher sedimentation rates (indicating general inflammatory processes) had the greatest reduction of symptoms in response to low-dose naltrexone. CONCLUSIONS: We conclude that low-dose naltrexone may be an effective, highly tolerable, and inexpensive treatment for fibromyalgia. PDF    Efectos de la naltrexona en la sensibilidad al dolor y el estado de humor en la fibromialgia: no hay evidencia de fisiopatología opioide endógena. Effects of naltrexone on pain sensitivity and mood in fibromyalgia: no evidence for endogenous opioid pathophysiology. Younger JW, Zautra AJ, Cummins ET. PLoS One. 2009;4(4):e5180. doi: 10.1371/journal.pone.0005180. Epub 2009 Apr 13. Abstract The pathophysiological mechanisms underlying fibromyalgia are still unknown, although some evidence points to endogenous opioid dysfunction. We examined how endogenous opioid antagonism affects pain and mood for women with and without fibromyalgia. Ten women with fibromyalgia and ten age- and gender-matched, healthy controls each attended two laboratory sessions. Each participant received naltrexone (50mg) at one session, and placebo at the other session, in a randomized and double-blind fashion. Participants were tested for changes in sensitivity to heat, cold, and mechanical pain. Additionally, we collected measures of mood and opioid withdrawal symptoms during the laboratory sessions and at home the night following each session. At baseline, the fibromyalgia group exhibited more somatic complaints, greater sensory sensitivity, more opioid withdrawal somatic symptoms, and lower mechanical and cold pain-tolerance than did the healthy control group. Neither group experienced changes in pain sensitivity due to naltrexone administration. Naltrexone did not differentially affect self-reported withdrawal symptoms, or mood, in the fibromyalgia and control groups. Consistent with prior research, there was no evidence found for abnormal endogenous opioid activity in women with fibromyalgia. PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

Diabetes y cirugía / Surgery and diabetes

Octubre 2, 2015. No. 2102

Manejo perioperatorio del paciente quirúrgico con diabetes 2015. Peri-operative management of the surgical patient with diabetes 2015: Association of Anaesthetists of Great Britain and Ireland. Membership of the Working Party, Barker P, Creasey PE, Dhatariya K, Levy N, Lipp A,Nathanson MH, Penfold N, Watson B, Woodcock T. Anaesthesia. 2015 Sep 29. doi: 10.1111/anae.13233. [Epub ahead of print] Abstract Diabetes affects 10-15% of the surgical population and patients with diabetes undergoing surgery have greater complication rates, mortality rates and length of hospital stay. Modern management of the surgical patient with diabetes focuses on: thorough pre-operative assessment and optimisation of their diabetes (as defined by a HbA1c < 69 mmol.mol-1 ); deciding if the patient can be managed by simple manipulation of pre-existing treatment during a short starvation period (maximum of one missed meal) rather than use of a variable-rate intravenous insulin infusion; and safe use of the latter when it is the only option, for example in emergency patients, patients expected not to return to a normal diet immediately postoperatively, and patients with poorly controlled diabetes. In addition, it is imperative that communication amongst healthcare professionals and between them and the patient is accurate and well informed at all times. Most patients with diabetes have many years of experience of managing their own care. The purpose of this guideline is to provide detailed guidance on the peri-operative management of the surgical patient with diabetes that is specific to anaesthetists and to ensure that all current national guidance is concordant. PDF

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org Copyright © 2015

E-books. Noticias

E-Books
Notificaciones semanales ⋅ 30 de septiembre de 2015
NOTICIAS


Xataka

En EEUU cada vez se venden menos ebooks, pero en España siguen en mejor forma que nunca
Xataka
Hace unos años muchos vieron en la irrupción de los libros electrónicos el principio del fin para sus hermanos de papel. Las ventas de e-books se ...



La gente ya no lee los ebooks que compra
Periodismo.com
La gente ya no lee los ebooks que compra ... presentó un informe que indica que el 60% de los ebooks adquiridos online, nunca se abrieron. Un dato ...




ABC.es

EL PIRATEO DE 'EBOOKS' HA AUMENTADO ESTA LEGISLATURA Y EL DE MÚSICA ...
Te Interesa
... - Según la última encuesta de hábitos culturales del MECD. Las descargas ilegales de libros electrónicos han crecido en los últimos cuatro años, ...
Los lectores 'digitales' se triplican en España, pero aumentan las descargas gratuitas de libros -Europa Press
El pirateo de 'ebooks' ha aumentado esta legislatura y el de música permanece estable - ecodiario
Cobertura total de la noticia




Todo eReaders (blog)

Sigil 0.9 creará ebooks en Epub3 y Epub2
Todo eReaders (blog)
Sigil grande Sigil 0.9 creará ebooks en Epub3 y Epub2 A principios del mes de junio vimos como los desarrolladores de Sigil actualizaban un plugin ...




ENTER.CO

El papel sigue vigente: ventas de los 'ebooks' bajaron 10% este año
ENTER.CO
De hecho, el panorama no es apocalíptico para las librerías, pues además de que las ventas de los 'ebooks' bajaron, desde 2010 las librerías han ...




Merca2.0

Los libros impresos están de vuelta: NYT
Merca2.0
Desde la perspectiva de negocios, el e-book no resta mercado para las librerías realmente, ya que estas también comercializan libros digitales.




Diario del Huila

Proyecto neivano preseleccionado en el Crea Digital
Diario del Huila
... multimedia, preseleccionaron 44 propuestas, 16 en la categoría de juegos de video, 10 en Animación Digital, 8 en eBooks, 10 en Juegos de Video, ...




Estrategia & Negocios

Nace Interebook, el Spotify de libros universitarios y escuelas de negocios
Estrategia & Negocios
Esta plataforma, que fue puesta en marcha por la empresa zaragozana Interebook Solutions, tiene ya más de 3.000 ebooks de materias relacionadas ...



Preseleccionados de convocatoria Crea Digital presentaron sus proyectos
Minuto30.com
Entre los que pasaron el primer corte hay 16 proyectos en la categoría de videojuegos, diez en animación digital, ocho en e-book y 14 en crossmedia.




elEconomista.es

Nace Interebook, el Spotify de los libros universitarios y de escuelas de negocios
elEconomista.es
Esta plataforma, que ha sido puesta en marcha por la empresa zaragozana Interebook Solutions, tiene ya más de 3.000 ebooks de materias ...