Más de anestesia e IAM / More on perioperative myocardial infarction

Junio 7, 2016. No. 2350

Infarto/lesión miocárdica perioperatoria después de cirugía no cardiaca Perioperative myocardial infarction/injury after noncardiac surgery. Puelacher C1, Lurati-Buse G1, Singeisen H1, Dang M1, Cuculi F1, Müller C1. Swiss Med Wkly. 2015 Nov 24;145:w14219. doi: 10.4414/smw.2015.14219. eCollection 2015. Abstract Cardiovascular complications, particularly perioperative myocardial infarction/injury, seem to be major contributors to mortality after noncardiac surgery. With surgical procedures being very frequent (900 000/year in Switzerland), perioperative myocardial injury is common in everyday clinical practice. Over 80% of patients experiencing perioperative myocardial injury do not report symptoms. Therefore perioperative myocardialinjury remains undiagnosed and untreated. Moreover, its silent presentation results in limited awareness among both clinicians and the public. Despite being largely asymptomatic, perioperative myocardial injury increases 30-day mortality nearly 10-fold. This review aims to increase the awareness of perioperative myocardial injury/infarction and give an overview of the emerging evidence, including pathophysiology, clinical presentation, prevention, and potential future treatments. PDF Anestesia para cirugía no cardíaca en el paciente cardiópata. Anestesia y cardiopatía isquémica Dr. Bernardo Javier Fernández-Rivera, Dra. Felipa Acosta-Garduño Rev Mex Anestesisología Vol. 38. Supl. 1 Abril-Junio 2015 pp S81-S89 PDF VIII Foro Internacional de Medicina del Dolor y Paliativa  Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Junio 9-11, Ciudad de México Dra. Argelia Lara Solares Tel. 5513 3782  www.dolorypaliativos.org  Cursos de Anestesiología en Chile, 2016 Facultad de Medicina. Pontificia Universidad Católica de Chile Información

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

Bibliotecas. Noticias

bibliotecas
Notificaciones diarias ⋅ 7 de junio de 2016
NOTICIAS


levante.emv.com
Ribo anuncia una revisión del plan de bibliotecas ante las quejas de los vecinos
levante.emv.com
josé parrilla | valencia El alcalde de Valencia, Joan Ribó, anunció ayer su disposición a negociar con los vecinos los cambios en la red de bibliotecas ...




20minutos.es
Junta premia a la Red de Bibliotecas Municipales de Yebes/Valdeluz (Guadalajara) como la ...
20minutos.es
El 'Mejor programa de fomento cultural y de la lectura', en el tramo de población de hasta 5.000 habitantes ha sido para las Bibliotecas Públicas ...
Junta premia a la Red de Bibliotecas Municipales de Yebes/Valdeluz (Guadalajara) como la ... -Europa Press
Cobertura total de la noticia




Diario El Argentino
Atender a las bibliotecas
Diario El Argentino
La Biblioteca Sarmiento, la primera en fundarse en Gualeguaychú y la provincia, la tercera en el orden nacional, está celebrando los 147 años de ...




Diario Chaco
Las bibliotecas producirán material en braile para estudiantes
Diario NORTE
"También abrimos una mesa técnica que estará coordinada por la Dirección de Bibliotecas, para que los títulos tengan orientación pedagógica, ...




Sipse.com
Bibliotecas reciben el doble de visitantes
Sipse.com
Con un número en promedio de 700 a 800 usuarios al mes en la biblioteca Jaime Torres Bodet y 150 en la Leona Vicario en ese mismo lapso, se ha ...




Ideal Digital
Las bibliotecas del Almanzora
Ideal Digital
El delegado territorial de Cultura, Turismo y Deporte de la Junta de Andalucía, Alfredo Valdivia, ha visitado esta mañana las bibliotecas de Tíjola, ...




www.infosalus.com
Los fisioterapeutas de Madrid crean la primera red virtual de Bibliotecaspara los profesionales de ...
TeleCinco.es
El Colegio Profesional de Fisioterapeutas de la Comunidad de Madrid (CPFCM) ha creado la primera Red virtual de Bibliotecas de Fisioterapeutas ...




eldiadigital.es
La red de Yebes y Valdeluz recibió el Premio 'Biblioteca del Año'
eldiadigital.es
“Ser usuario de las bibliotecas de Yebes y Valdeluz es mucho más que estar en posesión de un carnet; es abrir una ventana a la imaginación y al ...



Dotan de talleres y mobiliario a bibliotecas de Oaxaca
DIARIOAXACA
Fue en la Biblioteca Pública Central “Margarita Maza de Juárez” (BPC) donde el titular de la SECULTA, Alonso Aguilar Orihuela, clausuró el pasado ...
Bibliotecas de Oaxaca son dotadas de talleres y mobiliario - Ciudadania Express
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Remodelan bibliotecas en comisarías
Yucatán a la mano
Lo anterior se realiza a fin de rescatar las bibliotecas de esos lugares, sobre todo ahora que se aproxima el programa “Mis vacaciones en la ...


WEB

Videoconferencia para bibliotecarios y personal docente a cargo de bibliotecas
Gobierno de la Provincia de La Pampa
Está dirigida a bibliotecarios y personal docente a cargo de bibliotecas, en el marco de las acciones de la Dirección de la Biblioteca Nacional de ...



Red de Bibliotecas y Archivos del CSIC
Red de Bibliotecas y Archivos del CSIC
Como resultado de la membresía institucional a DataCite, DIGITAL.CSIC ha incorporado como nueva funcionalidad la asignación de DOIs a los ...

Cardioprotección / Cardiac protection

Junio 8, 2016. No. 2351

Postcondicionamiento isquémico: la protección cardiaca después del evento. Ischaemic postconditioning: cardiac protection after the event. Jivraj N1, Liew F, Marber M. Anaesthesia. 2015 May;70(5):598-612. doi: 10.1111/anae.12974. Epub 2015 Feb 16. Abstract Ischaemic heart disease remains the leading cause of death worldwide. Novel approaches to improve morbidity and mortality in this population are essential. Cardiac ischaemic postconditioning - the technique of applying alternating cycles of sublethal myocardial ischaemia and reperfusion after a sustained insult - is one cardioprotective strategy that can reduce reperfusion injury. Infarct size reduction and improvements in left ventricular ejection fraction have been demonstrated with mechanical or pharmacological postconditioning, both after spontaneous acutemyocardial infarction, and associated with cardiac surgery. Nonetheless, the benefits of postconditioning can be easily attenuated. For maximal benefit, postconditioning demands a particular patient population (large area at risk, with little collateral blood flow), timely application and the measurement of appropriate clinical endpoints. Furthermore, confounders such age, sex and medication, as well as a plethora of co-morbidities common in patients with ischaemic heart disease, all impact on the efficacy of postconditioning. This fragility requires the security of outcomes from large-scale human trials to ensure robust applicability to everyday clinical practice, and to provide assurance of an impact on long-term clinical outcome. This review highlights the development of current postconditioning algorithms, the findings from current proof-of-concept trials, and the barriers that may limit its broad uptake into clinical practice. PDF    Cardioprotección por condicionamiento isquémico remoto. Mecanismos y evidencias clínicas Cardioprotection by remote ischemic conditioning: Mechanisms and clinical evidences. Aimo A1, Borrelli C1, Giannoni A1, Pastormerlo LE1, Barison A1, Mirizzi G1, Emdin M1, Passino C1. World J Cardiol. 2015 Oct 26;7(10):621-32. doi: 10.4330/wjc.v7.i10.621. Abstract In remote ischemic conditioning (RIC), several cycles of ischemia and reperfusion render distant organ and tissues more resistant to theischemia-reperfusion injury. The intermittent ischemia can be applied before the ischemic insult in the target site (remote ischemic preconditioning), during the ischemic insult (remote ischemic perconditioning) or at the onset of reperfusion (remote ischemic postconditioning). The mechanisms of RIC have not been completely defined yet; however, these mechanisms must be represented by the release of humoral mediators and/or the activation of a neural reflex. RIC has been discovered in the heart, and has been arising great enthusiasm in the cardiovascular field. Its efficacy has been evaluated in many clinical trials, which provided controversial results. Our incomplete comprehension of the mechanisms underlying the RIC could be impairing the design of clinical trials and the interpretation of their results. In the present review we summarize current knowledge about RIC pathophysiology and the data about its cardioprotective efficacy. KEYWORDS: Atherosclerosis; Cardiac surgery; Ischemic heart disease; Percutaneous coronary intervention; Remote ischemic conditioning PDF Condicionamiento isquémico: Tropiezos en el camino hacia el uso clínico Ischaemic conditioning: pitfalls on the path to clinical translation. Przyklenk K1. Br J Pharmacol. 2015 Apr;172(8):1961-73. doi: 10.1111/bph.13064. Epub 2015 Feb 27. Abstract The development of novel adjuvant strategies capable of attenuating myocardial ischaemia-reperfusion injury and reducing infarct size remains a major, unmet clinical need. A wealth of preclinical evidence has established that ischaemic 'conditioning' is profoundly cardioprotective, and has positioned the phenomenon (in particular, the paradigms of postconditioning and remote conditioning) as the most promising and potent candidate for clinical translation identified to date. However, despite this preclinical consensus, current phase II trials have been plagued by heterogeneity, and the outcomes of recent meta-analyses have largely failed to confirm significant benefit. As a result, the path to clinical application has been perceived as 'disappointing' and 'frustrating'. The goal of the current review is to discuss the pitfalls that may be stalling the successful clinical translation of ischaemic conditioning, with an emphasis on concerns regarding: (i) appropriate clinical study design and (ii) the choice of the 'right' preclinical models to facilitate clinical translation. PDF  Condicionamiento isquémico: El reto de proteger el corazón diabético Ischemic conditioning: the challenge of protecting the diabetic heart. Wider J1, Przyklenk K1. Cardiovasc Diagn Ther. 2014 Oct;4(5):383-96. doi: 10.3978/j.issn.2223-3652.2014.10.05. Abstract The successful clinical translation of novel therapeutic strategies to attenuate lethal myocardial ischemia-reperfusion injury and limit infarct size has been identified as a major unmet need, and is of particular importance in patients with type-2 diabetes. There is a wealth of preclinical evidence that ischemic conditioning (encompassing the three paradigms of preconditioning, postconditioning and remote conditioning) is profoundly cardioprotective and, via up-regulation of endogenous signaling cascades, renders the heart resistant to infarction. However, current phase II trials aimed at exploiting ischemic conditioning for the clinical treatment of myocardial ischemia-reperfusion injury have yielded mixed results, possibly reflecting the emerging concern that the efficacy of conditioning-induced cardioprotection may be compromised in the diabetic heart. Our goal in this review is to provide a summary of our present understanding of the effect of type-2 diabetes on the infarct-sparing effect of ischemic conditioning, and the challenges of limiting ischemia-reperfusion injury in the diabetic heart. KEYWORDS: Myocardial infarction; diabetes; postconditioning; preconditioning; remote conditioning PDF  VIII Foro Internacional de Medicina del Dolor y Paliativa  Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Junio 9-11, Ciudad de México Dra. Argelia Lara Solares Tel. 5513 3782  www.dolorypaliativos.org  Cursos de Anestesiología en Chile, 2016 Facultad de Medicina. Pontificia Universidad Católica de Chile Información

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