Revisiones_bibliográficas TyO

OBJECTIVE.: Determine the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE) in spinal surgery patients receiving no thromboprophylaxis, mechanoprophylaxis, and chemoprophylaxis.

SUMMARY OF BACKGROUND DATA:

The incidence of thromboembolic complications after spinal surgery is not well established. While a variety of effective mechanical and chemical thromboprophylaxis interventions exist, their role in spinal surgery remains unclear. Spinesurgeons are faced with the difficult decision of balancing the risk of death from a thromboembolic complication against the risk of permanent neurological damage from an epidural hematoma.

CONCLUSIONS:

While the incidence of DVT and PE was relatively low regardless of prophylaxis type, the true incidence is difficult to determine given the heterogeneous nature of the small number of studies available in the literature. Our findings suggest there may be a role for chemoprophylaxis given the relatively high rate of fatal PE. Future studies are needed to determine which patient population would benefit most from chemoprophylaxis.

Resumen

DISEÑO DEL ESTUDIO:
Revisión sistemática y metaanálisis

OBJETIVO .: Determinar la incidencia de trombosis venosa profunda (TVP) y embolismo pulmonar (PE) en pacientes de cirugía de columna que no reciben tromboprofilaxis, mecanoprofilaxis y quimioprofilaxis.

RESUMEN DE DATOS ANTERIORES:
La incidencia de complicaciones tromboembólicas después de la cirugía de columna no está bien establecida. Aunque existe una variedad de intervenciones mecánicas y químicas efectivas de tromboprofilaxis, su papel en la cirugía de la columna no está claro. Los cirujanos de columna se enfrentan con la difícil decisión de equilibrar el riesgo de muerte de una complicación tromboembólica contra el riesgo de daño neurológico permanente por un hematoma epidural.

CONCLUSIONES:
Si bien la incidencia de la TVP y la EP fue relativamente baja independientemente del tipo de profilaxis, la verdadera incidencia es difícil de determinar dada la heterogeneidad del pequeño número de estudios disponibles en la literatura. Nuestros hallazgos sugieren que puede haber un papel para la quimioprofilaxis dada la tasa relativamente alta de PE mortal. Se necesitan estudios futuros para determinar qué población de pacientes se beneficiaría más de la quimioprofilaxis.

PMID: 28820759 DOI:

10.1097/BRS.0000000000002379

#Tromboprofilaxis #cirugía de columna #trombosis venosa profunda #embolismo pulmonar #mecanoprofilaxis #quimioprofilaxis

Deformidades de la columna – Llegar a una perspectiva 3D

http://www.cirugiavertebral.com.mx/academia/deformidades-de-la-columna-llegar-a-una-perspectiva-3d/

3D perspective in Spine Deformity by Jean Dubousset

Fuente

Este artículo y/o video es publicado originalmente en:

https://youtu.be/W-HH45J210s

Courtesy: The Seattle Science Foundation, www.seattlesciencefoundation.orgPublicado el 24 jun. 2017

http://www.seattlesciencefoundation.org

Seattle Science Foundation is a non-profit organization dedicated to the international collaboration among physicians, scientists, technologists, engineers and educators. The Foundation’s training facilities and extensive internet connectivity have been designed to foster improvements in health care through professional medical education, training, creative dialogue and innovation.

NOTE: All archived recorded lectures are available for informational purposes only and are only eligible for self-claimed Category II credit. They are not intended to serve as, or be the basis of a medical opinion, diagnosis, prognosis, or treatment for any particular patient.

Categoría
Licencia

Ciencia y tecnología

Licencia de YouTube estándar

#columna vertebral #deformidades 3D

Miocardiopatía periparto / Peripartum cardiomyopathy

Agosto 18, 2017. No. 2784

La miocardiopatía periparto como causa de insuficiencia cardiaca en el embarazo y el puerperio

Margarita Gallardo Arozena, Tania de Ganzo Suarez, Beatriz Contreras Gonzalez, Ivan Bernaldo de Quiros Huguet, Nieves Sierra Medina y Domingo Mendez Mora

Prog Obstet Ginecol. 2015;58(8):363-367

Resumen

La miocardiopatía periparto es una enfermedad con una elevada morbimortalidad y que, a pesar de sus riesgos potenciales, no es posible prevenirla. Por ello, solo podremos actuar sobre los factores de riesgo asociados a su aparición y sobre las complicaciones una vez diagnosticada. Debido a su baja incidencia, es difícil el conocimiento real de esta enfermedad, ya que se basa en artículos publicados sobre series reducidas de casos. El propósito de esta revisión es realizar una descripción de la fisiopatología, las manifestaciones clínicas, el diagnóstico y el tratamiento de la enfermedad, enfocada principalmente en el manejo obstétrico de la gestante

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Tratamiento práctico de la cardiomiopatía periparto

Practical management of peripartum cardiomyopathy.

Kim MJ1, Shin MS2.

Korean J Intern Med. 2017 May;32(3):393-403. doi: 10.3904/kjim.2016.360. Epub 2017 Apr 14.

Abstract

Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy that causes systolic heart failure (HF) in previously healthy young women. Despite latest remarkable achievement, unifying pathophysiologic mechanism is not well established. Considering close temporal relationship to pregnancy, the recent prolactin theory is promising. Abnormal short form of 16-kDa prolactin may be produced in the oxidative stress milieu, show anti-angiogenic effect and damage cardiovascular structure in late pregnancy. Future study is needed to determine whether abnormal prolactin system is useful as a biomarker for diagnosis and therapy of PPCM. Diagnosis is made based on the finding of left ventricular systolic dysfunction after excluding other causes of HF. A multidisciplinary team approach is essential for acute HF, antepartum, labor and postpartum care. Recovery from left ventricular dysfunction is critical for prognosis. As PPCM can recur and cause serious clinical events, subsequent pregnancy is not recommended. This review focuses on the practical management of PPCM.

KEYWORDS: Cardiomyopathies; Heart failure; Peripartum cardiomyopathy; Pregnancy

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Miocardiopatía periparto

Peripartum Cardiomyopathy.

Arany Z1, Elkayam U2.

Circulation. 2016 Apr 5;133(14):1397-409. doi: 10.1161/CIRCULATIONAHA.115.020491.

Abstract

Peripartum cardiomyopathy is a potentially life-threatening pregnancy-associated disease that typically arises in the peripartum period and is marked by left ventricular dysfunction and heart failure. The disease is relatively uncommon, but its incidence is rising. Women often recover cardiac function, but long-lasting morbidity and mortality are not infrequent. Management of peripartum cardiomyopathy is largely limited to the same neurohormonal antagonists used in other forms of cardiomyopathy, and no proven disease-specific therapies exist yet. Research in the past decade has suggested that peripartum cardiomyopathy is caused by vascular dysfunction, triggered by late-gestational maternal hormones. Most recently, information has also indicated that many cases of peripartum cardiomyopathy have genetic underpinnings. We review here the known epidemiology, clinical presentation, and management of peripartum cardiomyopathy, as well as the current knowledge of the pathophysiology of the disease.

KEYWORDS: cardiomyopathies; heart failure; pre-eclampsia; pregnancy

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XIV Congreso Virtual Mexicano de Anestesiología 2017

Octubre 1-Diciembre 31, 2017

Información/Information

Videoclip

Anestesiología y Medicina del Dolor

52 664 6848905

vwhizar@anestesia-dolor.org

anestesia-dolor.org

Daño pulmonar asociado al ventilador / Ventilator-associated lung injury

Agosto 22, 2017. No. 2788

Previniendo lesión pulmonar asociada al ventilador, Perspectiva perioperatoria

Preventing Ventilator-Associated Lung Injury: A Perioperative Perspective.

Kimura S1, Stoicea N1, Rosero Britton BR1, Shabsigh M1, Branstiter A1, Stahl DL1.

Author information

Front Med (Lausanne). 2016 May 30;3:25. doi: 10.3389/fmed.2016.00025. eCollection 2016.

Abstract

INTRODUCTION: Research into the prevention of ventilator-associated lung injury (VALI) in patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU) has resulted in the development of a number of lung protective strategies, which have become commonplace in the treatment of critically ill patients. An increasing number of studies have applied lung protective ventilation in the operating room to otherwise healthy individuals. We review the history of lung protective strategies in patients with acute respiratory failure and explore their use in patients undergoing mechanical ventilation during general anesthesia. We aim to provide context for a discussion of the benefits and drawbacks of lung protective ventilation, as well as to inform future areas of research. METHODS: We completed a database search and reviewed articles investigating lung protective ventilation in both the ICU and in patients receiving general anesthesia through May 2015. RESULTS: Lung protective ventilation was associated with improved outcomes in patients with acute respiratory failure in the ICU. Clinical evidence is less clear regarding lung protective ventilation for patients undergoing surgery. CONCLUSION: Lung protective ventilation strategies, including low tidal volume ventilation and moderate positive end-expiratory pressure, are well established therapies to minimize lung injury in critically ill patients with and without lung disease, and may provide benefit to patients undergoing general anesthesia.

KEYWORDS: acute respiratory distress syndrome; general anesthesia; low tidal volume ventilation; lung protective ventilation; ventilator-associated lunginjury; ventilator-induced lung injury

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Convocatoria para el Curso de Posgrado en Medicina del Dolor y Paliativa 2018, para Mexicanos y extranjeros.

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

Informes en el teléfono (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de México).

Informes / Information

XIV Congreso Virtual Mexicano de Anestesiología 2017

Octubre 1-Diciembre 31, 2017

Información/Information

Videoclip