TVP y TEP en UCI / DVT and PE in ICU

Marzo 16, 2016. No. 2267

Avances recientes en el manejo del embolismo pulmonar. Enfoque en el paciente grave Recent advances in the management of pulmonary embolism: focus on the critically ill patients. Meyer G, Vieillard-Baron A, Planquette B. Ann Intensive Care. 2016 Dec;6(1):19. doi: 10.1186/s13613-016-0122-z. Epub 2016 Mar 3. Abstract The aim of this narrative review is to summarize for intensivists or any physicians managing "severe" pulmonary embolism (PE) the main recent advances or recommendations in the care of patients including risk stratification, diagnostic algorithm, hemodynamic management in the intensive care unit (ICU), recent data regarding the use of thrombolytic treatment and retrievable vena cava filters and finally results of direct oral anticoagulants. Thanks to the improvements achieved in the risk stratification of patients with PE, a better therapeutic approach is now recommended from diagnosis algorithm and indication to admission in ICU to indication of thrombolysis and general hemodynamic support in patients with shock. Given at current dosage, thrombolytic therapy is associated with a reduction in the combined end-point of mortality and hemodynamic decompensation in patients with intermediate-risk PE, but this is obtained without a decrease in overall mortality and with a significant increase in major extracranial and intracranial bleeding. In patients with high-intermediate-risk PE, thrombolytic therapy should be given in case of hemodynamic worsening. Vena cava filters are of little help when anticoagulant treatment is not contraindicated, even in patients with PE and features of clinical severity. Finally, direct oral anticoagulants have been shown to be as effective as and safer than the combination of low molecular weight heparin and vitamin K antagonist(s) in patients with venous thromboembolism and low- to intermediate-risk PE. KEYWORDS: Pulmonary embolism; Right ventricle; Risk stratification; Thrombolysis  PDF Prevalencia de TVP en pacientes agudos ambulatorios admitidos en UCI no quirúrgica Prevalence of deep vein thrombosis in acutely admitted ambulatory non-surgical intensive care unit patients. Lawall H, Oberacker R, Zemmrich C, Bramlage P, Diehm C, Schellong SM. BMC Res Notes. 2014 Jul 5;7:431. doi: 10.1186/1756-0500-7-431. Abstract BACKGROUND: Data on prevalence rates of venous thromboembolism (VTE) in different patient populations are scarce. Most studies on this topic focus on older patients or patients with malignancies, immobilization or thrombophilia. Less is known about the VTE risk profile of non-surgical patients presenting with a variety of medical diseases of differing severity. Aim of the present study was to investigate VTE prevalence in a pospective cohort study of ambulatory medical intensive care unit patients within 24 h after acute admission. METHODS: Prospective cohort study of 102 consecutive patients after acute admission to medical intensive care unit. Ultrasound compression sonography, APACHE-II-Scoring and laboratory examination was performed within 24 hours after admission.Possible determinants of a high risk of VTE were examined. In all patients with a confirmed diagnosis of DVT or suspicion of PE thoracic computer tomography (CT) was performed. RESULTS: VTE was found in 7.8% out of 102 of patients, mean APACHE-II-Score was 14 (mortality risk of about 15%). Thrombus location was femoropopliteal in 5 patients, iliacal in 2 and peroneal in 1 patient. Five VTE patients had concomitant PE (62.5% of VTE, 4.9% of all patients). No predictors of prevalent VTE were identified from univariable regression analysis although relative risk was high in patients with a history of smoking (RR 3.40), immobility (RR 2.50), and elevated D-Dimer levels (RR 3.49). CONCLUSIONS: Prevalent VTE and concomitant PE were frequent in acutely admitted ICU patients. PDF

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

Libro de cirugía / Book on surgery

Marzo 12, 2016. No. 2263

Cirugía esencial: Prioridades de Control de Enfermedades, tercera edición Essential Surgery: Disease Control Priorities, Third Edition Debas HT, Donkor P, Gawande A, et al., editors April 2015 Libro / Book

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

Bibliotecas. Noticias

bibliotecas
Notificaciones diarias ⋅ 13 de marzo de 2016
NOTICIAS


Faro de Vigo
Senande propone crear bibliotecas en los centros sociales para fomentar la lectura
Faro de Vigo
El Partido Popular de Lalín propone solicitar al gobierno local la implantación de puntos de lectura o pequeñas bibliotecas en los centros sociales ...




ileon.com - Información de León
Las Bibliotecas Municipales celebrarán el Día Mundial de la Poesía
Diario de León
La red de Bibliotecas Municipales celebrará del 14 al 18 de marzo la Semana de la Poesía para conmemorar el Día Mundial de la Poesía, que se ...




ileon.com - Información de León
El Consejo de Cooperación Bibliotecaria se apoya en la Consejería de Cultura y Turismo para ...
ileon.com - Información de León
El Consejo de Cooperación Bibliotecaria se apoya en la Consejería de Cultura y Turismo para desarrollar la función social de las bibliotecas.
Cultura apoya al Consejo de Cooperación Bibliotecaria nacional en su función social -leonoticias.com
El Consejo de Cooperación se apoya en Cultura y Turismo para crear la función social de las ... - desdeSoria.es
Cobertura total de la noticia



Cultura apoya al Consejo de Cooperación Bibliotecaria para desarrollar su función social
leonoticias.com
A través del Plan, se impulsarán las bibliotecas escolares y la formación de los ... Entre ellas, destacan 'Biblioterapia', con lectura fácil en la Biblioteca ...



El Consejo de Cooperación Bibliotecaria solicita colaboración de la Junta para su II Plan Estratégico
Soria Noticias
A través del Plan, se impulsarán las bibliotecas escolares y la formación de los responsables que tienen al frente de su gestión. También se ...




El Colombiano
La casita rural que se volvió una biblioteca
El Colombiano
La casita rural es un proyecto de Diana Londoño, quien donó un lugar de su finca para que se conviertiera en biblioteca de la escuela de la vereda ...




Télam
A 40 AÑOS DEL GOLPE DEL '76
La Voz del Pueblo
Además, desarrolló una gira por el interior del país y cerró en la Biblioteca Nacional el Concurso Latinoamericano "Fernando Báez" sobre ...




Diario Vasco
eLiburutegia, la opción de leer en formato digital de la Biblioteca
Diario Vasco
eLiburutegia, la biblioteca digital de Euskadi, es el servicio de préstamo online de libros digitales creada y puesta en marcha por el Gobierno Vasco ...




TabascoHOY.com
Adiós al ratón de biblioteca
TabascoHOY.com
Para conseguirlos, entras a bibliotecas virtuales, librerías digitales o sitios como ... Lunadecuentos.com, por ejemplo, es una nueva biblioteca virtual ...




La Prensa De Monclova
Se llovió biblioteca del Ejido “La Cruz”
La Prensa De Monclova
FRONTERA, COAH.- La Biblioteca Municipal del Ejido la Cruz sufrió severos daños en su infraestructura por las lluvias que se registraron en días ...


WEB

CCB
Red de Bibliotecas y Archivos del CSIC
El Consejo de Cooperación Bibliotecaria se constituye en marzo de 2008 en las XII Jornadas de Cooperación Bibliotecaria donde se inicia la ...

Paro cardiaco en endoscopías GI / Cardiac arrest in GI endoscopy

Marzo 13, 2016. No. 2264

Paro cardiaco en pacientes sometidos a endoscopía gastrointestinal. Análisis retrospectivo de 73,029 procedimientos Cardiac arrests in patients undergoing gastrointestinal endoscopy: A retrospective analysis of 73,029 procedures. Goudra B, Nuzat A, Singh PM, Gouda GB, Carlin A, Manjunath AK. Saudi J Gastroenterol. 2015 Nov-Dec;21(6):400-11. doi: 10.4103/1319-3767.164202. Abstract BACKGROUND/AIMS: Airway difficulties leading to cardiac arrest are frequently encountered during propofol sedation in patients undergoing gastrointestinal (GI) endoscopy. With a noticeable increase in the use of propofol for endoscopic sedation, we decided to examine the incidence and outcome of cardiac arrests in patients undergoing gastrointestinal (GI) endoscopy with sedation. PATIENTS AND METHODS: In this retrospective study, cardiac arrest data obtained from the clinical quality improvement and local registry over 5 years was analyzed. The information of patients who sustained cardiac arrest attributable to sedation was studied in detail. Analysis included comparison of cardiac arrests due to all causes until discharge (or death) versus the cardiac arrests and death occurring during the procedure and in the recovery area. RESULTS: The incidence of cardiac arrest and death (all causes, until discharge) was 6.07 and 4.28 per 10,000 in patients sedated with propofol, compared with non-propofol-based sedation (0.67 and 0.44). The incidence of cardiac arrest during and immediately after the procedure (recovery area) for all endoscopies was 3.92 per 10,000; of which, 72% were airway management related. About 90.0% of all peri-procedural cardiac arrests occurred in patients who received propofol. CONCLUSIONS: The incidence of cardiac arrest and death is about 10 times higher in patients receiving propofol-based sedation compared with those receiving midazolam-fentanyl sedation. More than two thirds of these events occur during EGD and ERCP. PDF

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

Hipertensión arterial

Marzo 14, 2016. No. 2265

Una revisión sistemática de las intervenciones del estilo de vida para reducir la presión arterial. A systemic review on lifestyle interventions to reduce blood pressure. Vooradi S, Mateti UV. J Health Res Rev 2016;3:1-5 Abstract Hypertension (HTN) is considered a major predominant disease with different comorbidities such as diabetes and cardiovascular and renal disorders. Pharmacological methods in addition to nonpharmacological methods play a major role in reducing high blood pressure (BP) that might also offer safe and effective alternatives to drug therapy. Dietary and behavioral techniques are mainly centered so far by the researchers. The purpose of this article is to achieve positive therapeutic outcomes by reviewing evidence-based nonpharmacological treatments and evaluation of patients with HTN. MEDLINE, PUBMED databases were used to review relevant information. HTN with different comorbidities is not only raising the mortality rates but also health-care costs. The monetary burden for nonpharmacological treatment was considered less cost-effective than drug therapy. It is emphasized that providing patient information leaflet with lifestyle modifications can positively influence patients to marque the lifestyle changes. Keywords: Hypertension, intervention, lifestyle, nonpharmacological PDF

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