Alfa2 agonistas en UCI / Alpha-2 agonists in ICU

Abril 15, 2017. No. 2660

Sedación de pacientes en ventilación mecánica en UCI Sedation of mechanically ventilated adults in intensive care unit: a network meta-analysis. Zhang Z1, Chen K2, Ni H2, Zhang X2, Fan H2. Sci Rep. 2017 Mar 21;7:44979. doi: 10.1038/srep44979. Abstract Sedatives are commonly used for mechanically ventilated patients in intensive care units (ICU). However, a variety of sedatives are available and their efficacy and safety have been compared in numerous trials with inconsistent results. To resolve uncertainties regarding usefulness of these sedatives, we performed a systematic review and network meta-analysis.  Compared with dexmedetomidine, midazolam was associated with significantly increased risk of delirium (OR: 2.47; 95% CI: 1.17-5.19). Our study shows that dexmedetomidine has potential benefits in reducing duration of MV and lowering the risk of delirium. PDF Alfa2 agonistas para sedación de adultos en ventilación mecánica en UCI. Revisión sistemática Alpha-2 agonists for sedation of mechanically ventilated adults in intensive care units: a systematic review. Cruickshank M1, Henderson L1, MacLennan G1, Fraser C1, Campbell M1, Blackwood B2, Gordon A3, Brazzelli M1. Health Technol Assess. 2016 Mar;20(25):v-xx, 1-117. doi: 10.3310/hta20250. Abstract BACKGROUND: Care of critically ill patients in intensive care units (ICUs) often requires potentially invasive or uncomfortable procedures, such as mechanical ventilation (MV). Sedation can alleviate pain and discomfort, provide protection from stressful or harmful events, prevent anxiety and promote sleep. Various sedative agents are available for use in ICUs. In the UK, the most commonly used sedatives are propofol (Diprivan(®), AstraZeneca), benzodiazepines [e.g. midazolam (Hypnovel(®), Roche) and lorazepam (Ativan(®), Pfizer)] and alpha-2 adrenergic receptor agonists [e.g. dexmedetomidine (Dexdor(®), Orion Corporation) and clonidine (Catapres(®), Boehringer Ingelheim)]. Sedative agents vary in onset/duration of effects and in their side effects. The pattern of sedation of alpha-2 agonists is quite different from that of other sedatives in that patients can be aroused readily and their cognitive performance on psychometric tests is usually preserved. Moreover, respiratory depression is less frequent after alpha-2 agonists than after other sedative agents. CONCLUSIONS: Evidence on the use of clonidine in ICUs is very limited. Dexmedetomidine may be effective in reducing ICU length of stay and time to extubation in critically ill ICU patients. Risk of bradycardia but not of overall mortality is higher among patients treated with dexmedetomidine. Well-designed RCTs are needed to assess the use of clonidine in ICUs and identify subgroups of patients that are more likely to benefit from the use of dexmedetomidine. PDF Vacante para Anestesiología Pediátrica El Hospital de Especialidades Pediátricas de León, Guanajuato México  ofrece un contrato laboral en el departamento de anestesiología  Informes con la Dra Angélica García Álvarez  angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028

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

¿Sigue habiendo un papel para la reconstrucción del injerto osteoarticular en cirugía de tumor musculoesquelético? Un estudio de seguimiento a largo plazo de 38 pacientes y una revisión sistemática de la literatura.

http://www.mishuesosyarticulaciones.com.mx/academia/sigue-habiendo-un-papel-para-la-reconstruccion-del-injerto-osteoarticular-en-cirugia-de-tumor-musculoesqueletico-un-estudio-de-seguimiento-a-largo-plazo-de-38-pacientes-y-una-revision-sistemati/

Is there still a role for osteoarticular allograft reconstruction in musculoskeletal tumour surgery? a long-term follow-up study of 38 patients and systematic review of the literature.

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28385943

http://www.bjj.boneandjoint.org.uk/content/99-B/4/522

De:

Bus MP1,van de Sande MA1,Taminiau AH1,Dijkstra PD1.

Bone Joint J.

2017 Apr;99-B(4):522-530. doi: 10.1302/0301-620X.99B4.BJJ-2016-0443.R2.

Todos los derechos reservados para:

©2017 The British Editorial Society of Bone & Joint Surgery.

Abstract

AIMS:

To assess complications and failure mechanisms of osteoarticular allograft reconstructions for primary bone tumours.

CONCLUSION:

Osteoarticular allograft reconstructions are associated with high rates of mechanical complications. Although comparative studies with alternative techniques are scarce, the risk of mechanical failure in our opinion does not justify routine employment of osteoarticular allografts for reconstruction of large joints after tumour resection. Cite this article: Bone Joint J 2017;99-B:522-30.

©2017 The British Editorial Society of Bone & Joint Surgery.

KEYWORDS:

Limb-salvage surgery; Osteoarticular allografts; Reconstruction after tumour resection

Resumen

OBJETIVOS:
Evaluar complicaciones y mecanismos de fracaso de las reconstrucciones osteoarticulares de los tumores óseos primarios.

CONCLUSIÓN:
Las reconstrucciones osteoarticulares del aloinjerto están asociadas con altas tasas de complicaciones mecánicas. Aunque los estudios comparativos con técnicas alternativas son escasos, el riesgo de falla mecánica en nuestra opinión no justifica el empleo rutinario de aloinjertos osteoarticulares para la reconstrucción de grandes articulaciones después de la resección tumoral.

Citar este artículo: Bone Joint J 2017; 99-B: 522-30.
© 2017 Sociedad Editorial Británica de Cirugía de Huesos y Articulaciones.
PALABRAS CLAVE:
Cirugía de rescate de extremidades; Aloinjertos osteoarticulares; Reconstrucción tras resección tumoral

PMID:  28385943   DOI:  

10.1302/0301-620X.99B4.BJJ-2016-0443.R2

#cirugía de salvamento#cirugía de rescate#estremidades#aloinjertos osteoarticulares#tumores óseos

Ejercicio para Espondilitis Anquilosante

http://www.columnayortopedia.com.mx/columna/ejercicio-para-espondilitis-anquilosante/

 Exercise for Ankylosing Spondylitis

Fuente
Este artículo es originalmente publicado en:

https://www.spineuniverse.com/conditions/spinal-arthritis/ankylosing-spondylitis/exercise-ankylosing-spondylitis

De:

Written by

Stewart G. Eidelson, MD

Todos los derechos reservados para:

© 1999-2017

Vertical Health, LLC

This information is not designed to replace a physician’s independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions or back problem. SpineUniverse does not provide medical advice, diagnosis or treatment. Use of the SpineUniverse.com site is conditional upon your acceptance of our

User Agreement

4 maneras de estar activo incluso cuando sus articulaciones en la espalda o el cuello le duelen

Try these exercises for #ankylosingspondylitis: https://t.co/afusRVg9kwpic.twitter.com/fZnyvDW6Gz

— SpineUniverse (@SpineUniverse)

14 de abril de 2017

#ejercicio#Espondilitis Anquilosante