lunes, 17 de abril de 2017

Una Revisión Sistemática de la Cirugía del Codo de Tenista: Liberación Abierta Versus Artroscópica Versus Percutánea del origen del Extensor Común



A Systematic Review of Tennis Elbow Surgery: Open Versus Arthroscopic Versus Percutaneous Release of the Common Extensor Origin

Fuente
Este artículo es originalmente publicado en:
De:
Arthroscopy. 2017 Apr 12. pii: S0749-8063(17)30116-0. doi: 10.1016/j.arthro.2017.01.042. [Epub ahead of print]
Todos los derechos reservados para:
Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Abstract
PURPOSE:
To compare complications, function, pain, and patient satisfaction after conventional open, percutaneous, or arthroscopic release of the extensor origin for the treatment of lateral epicondylitis.
CONCLUSIONS:
Functional outcomes of open and arthroscopic releases may be superior to those of percutaneous release. In addition, patients may report less pain with arthroscopic and percutaneous techniques. Although the risk of complications is similar regardless of technique, patients may be counseled that their risk of infectious complications may be slightly higher with open releases. However, it is important to note that this statistical difference may not necessarily portend noticeable clinical differences.
Resumen
PROPÓSITO:
Comparar las complicaciones, la función, el dolor y la satisfacción del paciente después de la liberación convencional abierta, percutánea o artroscópica del origen extensor para el tratamiento de la epicondilitis lateral.
CONCLUSIONES:
Los resultados funcionales de liberaciones abiertas y artroscópicas pueden ser superiores a los de la liberación percutánea. Además, los pacientes pueden reportar menos dolor con técnicas artroscópicas y percutáneas. Aunque el riesgo de complicaciones es similar independientemente de la técnica, se puede aconsejar a los pacientes que su riesgo de complicaciones infecciosas puede ser ligeramente mayor con las liberaciones abiertas. Sin embargo, es importante señalar que esta diferencia estadística no necesariamente presagia diferencias clínicas notables.
LEVEL OF EVIDENCE:
Level IV, systematic review of Level III and IV evidence.
Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
PMID:   28412059   DOI:  

Libro sobre cefalea / Book on headache

Abril 16, 2017. No. 2661







Perspectivas actuales sobre aspectos menos conocidos de la cefalea
Current Perspectives on Less-known Aspects of Headache
Edited by Hande Turker, ISBN 978-953-51-3076-5, Print ISBN 978-953-51-3075-8, 164 pages, Publisher: InTech, Chapters published April 12, 2017 under CC BY 3.0 license
DOI: 10.5772/62616
Headache, as a main neurological problem in everyday life, still takes place as a contributor on top of the list of many partially solved neurological conditions. Not only primary headaches but secondary headaches are still clinical concerns of diagnosis, differential diagnosis, and therapy. This book is quite different from classical headache books. First of all, it does not contain the classical schema of a classical headache textbook. Most of the chapters composing this book contain many answers for many unanswered questions about headache in general, for example, "Is headache a genetic condition?", "What do smartphones do to our brains? Do they cause headaches?", and "Does botulinum toxin really improve chronic migraine?". We hope this book will be an interesting read and perhaps a guide in some new aspects of headache and help understand "some interesting headache issues" while stressing some of the less known mentioned above.

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
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Anestesiología y Medicina del Dolor

52 664 6848905

Vía aérea, posición lateral y ML / Airway; Lateral position; Proseal laryngeal mask

Abril 17, 2017. No. 2662



  



Efecto del neumoperitoneo y de la posición lateral sobre las presiones de sello orofaríngeo de LMA Proseal en procedimientos urológicos laparoscópicos.
Effect of Pneumoperitoneum and Lateral Position on Oropharyngeal Seal Pressures of Proseal LMA in Laparoscopic Urological Procedures.
J Clin Diagn Res. 2017 Feb;11(2):UC05-UC09. doi: 10.7860/JCDR/2017/22168.9422. Epub 2017 Feb 1.
Abstract
INTRODUCTION: A sustained and effective oropharyngeal sealing with supraglottic airway is required to maintain the ventilation during laparoscopic surgery. Previous studies have observed the Oropharyngeal Seal Pressure (OSP) for Proseal Laryngeal Mask Airway (PLMA) after pneumoperitoneum in supine and trendelenburg position, where PLMA was found to be an effective airway device. This study was conducted with ProSeal LMA, for laparoscopic Urologic procedures done in lateral position. AIM: To measure OSP in supine and lateral position and to observe the effect of pneumoperitoneum in lateral position on OSP. Secondary objectives were to assess adequacy of ventilation and incidence of adverse events. MATERIALS AND METHODS: A total number of 25 patients of American Society of Anaesthesiologists (ASA) physical status II and I were enrolled. After induction of anaesthesia using a standardized protocol, PLMA was inserted. Ryle's tube was inserted through drain tube. The position of PLMA was confirmed with ease of insertion of Ryle's tube and fibreoptic grading of vocal cords. Patients were then put in lateral position. The OSP was measured in supine position. This value was baseline comparison for OSP in lateral position and that after pneumoperitoneum. We assessed the efficacy of PLMA for ventilation, after carboperitoneum in lateral position (peak airway pressure, End Tidal Carbon dioxide (EtCO2), SPO2). Incidence of adverse effects (displacement of device, gastric insufflation, regurgitation, coughing, sore throat, blood on device, trauma) was also noted. RESULTS: The OSP was above Peak Airway Pressure (PAP) in supine (22.1±5.4 and 15.4±4.49cm of H2O) and lateral position (22.6±5.3 and 16.1±4.6). After pneumoperitoneum, which was in lateral position, there was statistically significant (p-value <0.05) increase in both PAP (19.96±4.015) and OSP (24.32±4.98, p-value 0.03). There was no intraoperative displacement of PLMA. There was no event of suboptimal oxygenation. EtCO2 was always within normal limits. Gastric insufflation was present in one patient. One patient had coughing and blood was detected on device. Three patients had throat discomfort post-operatively.
CONCLUSION: In this study, Oropharyngeal seal pressures with PLMA were found to increase after pneumoperitoneum in lateral position. PLMA forms an effective seal around airway and is an efficient and safe alternative for airway management in urological laparoscopic surgeries done in lateral position.
KEYWORDS: Airway; Lateral position; Proseal laryngeal mask

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Anestesiología y Medicina del Dolor

52 664 6848905

domingo, 16 de abril de 2017

Facitis plantar refractaria en runner (corredor)


Me toco ser el médico de segunda opinión de un Runner (corredor) con fascitis plantar refractaria incluso con faciotomia parcial percutanea MIS, pensé en una Neuritis de Baxter’s, realice hidrodiseccion guiada por ultrasonido y paciente corre nuevamente 10 K este próximo fin de semana

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