Todos con México

Septiembre 20, 2017. No. 2817-A

Los huracanes y los terremotos han golpeado a México una manera cruel. La devastación, la muerte y mil desgracias son el tema actual, y nosotros los Mexicanos nos hemos unido en gran apoyo a aquellos que han sido afectados por la Madre Naturaleza. Hurricanes and earthquakes have hit México in a crude way. Devastation, death and a thousand misfortunes are the current theme, and we Mexicans have united in great support for those who have been affected by Mother Nature.  Furacões e terremotos atingiram o México de uma maneira grosseira. A devastação, a morte e mil desgraças são o tema atual, e nós, os mexicanos, nos unimos em grande apoio para aqueles que foram afetados pela Mãe Natureza. Enlaces para donar / Links to donate International Community Foundation(ICF) https://donate.icfdn.org/npo/international-disaster-relief-fund Global Giving https://www.globalgiving.org/projects/mexico-earthquake-and-hurricane-relief-fund/   Red Cross Méxicohttps://www.cruzrojamexicana.org.mx Unicef México https://www.unicef.org/mexico/spanish/ Larga duración del movimiento de tierra en el valle paradigmático de México. Long Duration of Ground Motion in the Paradigmatic Valley of Mexico. Cruz-Atienza VM1, Tago J2, Sanabria-Gómez JD3, Chaljub E4,5, Etienne V6, Virieux J4,5, Quintanar L1. Author information Sci Rep. 2016 Dec 9;6:38807. doi: 10.1038/srep38807. PDF Evacuación de hospitales durante un desastre, establecimiento de un hospital de campo y comunicación. Evacuation of Hospitals during Disaster, Establishment of a Field Hospital, and Communication. Tekin E1, Bayramoglu A2, Uzkeser M2, Cakir Z2. Author information Abstract Eurasian J Med. 2017 Jun;49(2):137-141. doi: 10.5152/eurasianjmed.2017.16102. Epub 2017 Apr 28. The buildings, working personnel, and patients and their relatives may directly or indirectly be affected by the disasters. Here we will discuss evacuation, establishing a field hospital, communication, the role of the media in disasters, and defending against sabotage. The affected individuals should be evacuated and transferred to secure zones safely and rapidly. How the decision for evacuation should be made and how the evacuation triage should be performed are important issues. Field hospitals should be established within the bounds of possibility for continuation of the treatments of evacuated people. The standards for the field hospitals and its sections that may be created according to the needs will be explained. Undoubtedly, since one of the most important subjects in disasters is communication, the types of communication in disasters and their significance will be mentioned. How the relationships with the media should be an aspect of communication and how they can be beneficially used will also be mentioned. As in all organizations and institutions, sabotage attempts may also be present concerning health facilities. For this reason, during the preparation of the hospital disaster plan, defending against sabotage will be discussed, and what should be done at that stage will be mentioned. KEYWORDS: Disaster; evacuation; field hospital PDF Comprensión de la detección de animales de los sonidos precursores del terremoto. Understanding Animal Detection of Precursor Earthquake Sounds. Garstang M1, Kelley MC2. Author information Animals (Basel). 2017 Aug 31;7(9). pii: E66. doi: 10.3390/ani7090066. Abstract We use recent research to provide an explanation of how animals might detect earthquakes before they occur. While the intrinsic value of such warnings is immense, we show that the complexity of the process may result in inconsistent responses of animals to the possible precursor signal. Using the results of our research, we describe a logical but complex sequence of geophysical events triggered by precursor earthquake crustal movements that ultimately result in a sound signal detectable by animals. The sound heard by animals occurs only when metal or other surfaces (glass) respond to vibrations produced by electric currents induced by distortions of the earth's electric fields caused by the crustal movements. A combination of existing measurement systems combined with more careful monitoring of animal response could nevertheless be of value, particularly in remote locations. KEYWORDS: animal behavior; earthquake prediction; electrophonics; infrasound; sound detection PDF Desastres naturales e indicadores de cohesión social. Natural disasters and indicators of social cohesion. Calo-Blanco A1, Kovářík J2,3, Mengel F4, Romero JG5. Author information PLoS One. 2017 Jun 7;12(6):e0176885. doi: 10.1371/journal.pone.0176885. eCollection 2017. Abstract Do adversarial environmental conditions create social cohesion? We provide new answers to this question by exploiting spatial and temporal variation in exposure to earthquakes across Chile. Using a variety of methods and controlling for a number of socio-economic variables, we find that exposure to earthquakes has a positive effect on several indicators of social cohesion. Social cohesion increases after a big earthquake and slowly erodes in periods where environmental conditions are less adverse. Our results contribute to the current debate on whether and how environmental conditions shape formal and informal institutions. PDF

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

Luxación de codo / Elbow dislocation

http://www.mihombroycodo.com.mx/academia/luxacion-de-codo-elbow-dislocation/

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28285907

http://www.elsevier.es/es-revista-semergen-medicina-familia-40-avance-resumen-luxacion-codo-S113835931730031X

De:

de Pablo Márquez B1,Castillón Bernal P2,Bernaus Johnson MC2,

Ibañez Aparicio NM2.

Semergen.

2017 Mar 9. pii: S1138-3593(17)30031-X. doi: 10.1016/j.semerg.2017.01.005. [Epub ahead of print]

Todos los derechos reservados para:

Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.Resumen

La luxación de codo es la luxación más frecuente en extremidad superior tras la luxación glenohumeral. La reducción cerrada en aquellas luxaciones en que no hay lesión ósea asociada es un procedimiento realizable en el ámbito extrahospitalario, por lo que presentamos un repaso de las diferentes técnicas posibles.

Abstract

Elbow dislocation is the most frequent dislocation in the upper limb after shoulder dislocation. Closed reduction is feasible in outpatient care when there is no associated fracture. A review is presented of the different reduction procedures.

Palabras clave

Codo, Luxación, Atención extrahospitalaria

Keywords

Elbow, Dislocation, Outpatient care

PMID:  28285907    DOI: 10.1016/j.semerg.2017.01.005

#codo#luxación#dislocación

Trombocitopenia y embarazo / Thrombocytopenia in pregnancy

Septiembre 19, 2017. No. 2816

Trombocitopenia en el embarazo. Patogénesis y abordaje diagnóstico Thrombocytopenia in pregnancy - pathogenesis and diagnostic approach. Jodkowska A1, Martynowicz H1, Kaczmarek-Wdowiak B1, Mazur G1. Author information Postepy Hig Med Dosw (Online). 2015 Nov 12;69:1215-21. Abstract Thrombocytopenia (TP) affects 7-10% of pregnant women. It occurs 4 times more frequently in pregnancy than in the non-pregnant women population. Women with thrombocytopenia in pregnancy are a heterogeneous and poorly known group. There are several possible causes of thrombocytopenia in pregnancy. The most common are: gestational thrombocytopenia (GE) (60-75%), preeclampsia (PE) and HELLP(hemolysis, elevated liver enzymes, low platelets) syndrome associated TP (21%), and idiopathic immune thrombocytopenia (ITP) (3-10%). Although thrombocytopenia diagnosed in pregnancy in most cases has a mild course, it has also been reported to be associated with a higher rate of preterm birth and premature detachment of the placenta. Some cases of severe thrombocytopenia with systemic involvement are associated with high risk of serious perinatal complications and require early diagnosis, careful clinical monitoring and medical treatment. The differential diagnosis and proper assessment of clinical risk of TP during pregnancy may be of great concern. The article discusses these issues, focusing on pathophysiology of TP in pregnancy. PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo 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 (52) 55 5487 0900 ext. 5011 de lunes a viernes de 9.00 a 14 h (hora de Ciudad de México).  Informes / Information

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

Neumoperitoneo / Pneumoperitoneum

Septiembre 20, 2017. No. 2817

Ensayo clínico aleatorizado que compara los efectos del sevoflurano y el propofol en la embolia de dióxido de carbono durante el neumoperitoneo en la hepatectomía laparoscópica. Randomized clinical trial comparing the effects of sevoflurane and propofol on carbon dioxide embolism during pneumoperitoneum in laparoscopic hepatectomy. Hong Y1, Xin Y2, Yue F2, Qi H3, Jun C1. Author information Oncotarget. 2017 Apr 18;8(16):27502-27509. doi: 10.18632/oncotarget.15492. Abstract Laparoscopic hepatectomy carries a high risk of gas embolism due to the extensive hepatic transection plane and large hepatic vena cava. Here, we compared the influence of inhaled and intravenous anesthetics on gas embolism during laparoscopic hepatectomy. Fifty patients undergoing laparoscopic hepatectomy were divided into two groups to receive sevoflurane anesthesia (group S, n = 25) or intravenous propofol anesthesia (group p, n = 25). During the operation, gas emboli were detected by transesophageal echocardiography and graded according to their size. Venous CO2 emboli were detected in all patients, and the embolism grades did not differ between the two groups. However, the mean embolism episode duration was longer in group S than group P (51.24±23.59 vs. 34.00±17.13 sec, p < 0.05). At the point of the most severe gas embolism, the PTCO2 was higher in group S than group p (44.00±4.47 vs. 41.36±2.77 mmHg, p < 0.05), while the PO2/FiO2 (450.52±54.08 vs. 503.80±63.18, p < 0.05) and pH values (7.35±0.05 vs. 7.38±0.02, p < 0.05) were lower in group S than group P. Patients with a history of abdominal surgery or liver cirrhosis had higher gas embolism grades. Thus volatile anesthetics may lengthen the duration of embolism episodes and worsen hemodynamics and pulmonary blood gas exchange during surgery. KEYWORDS: anesthetics; carbon dioxide embolism; laparoscopic hepatectomy; transesophageal echocardiography PDF Complicaciones circulatorias y respiratorias en la insuflación con dióxido de carbono Circulatory and respiratory complications of carbon dioxide insufflation. Gutt CN1, Oniu T, Mehrabi A, Schemmer P, Kashfi A, Kraus T, Büchler MW. Author information Dig Surg. 2004;21(2):95-105. Epub 2004 Feb 27. Abstract BACKGROUND: Although providing excellent outcome results, laparoscopy also induces particular pathophysiological changes in response to pneumoperitoneum. Knowledge of the pathophysiology of a CO(2) pneumoperitoneum can help minimize complications while profiting from the benefits of laparoscopic surgery without concerns about its safety. METHODS: A review of articles on the pathophysiological changes and complications of carbon dioxide pneumoperitoneum as well as prevention and treatment of these complications was performed using the Medline database. RESULTS: The main pathophysiological changes during CO(2) pneumoperitoneum refer to the cardiovascular system and are mainly correlated with the amount of intra-abdominal pressure in combination with the patient's position on the operating table. These changes are well tolerated even in older and more debilitated patients, and except for a slight increase in the incidence of cardiac arrhythmias, no other significant cardiovascular complications occur. Although there are important pulmonary pathophysiological changes, hypercarbia, hypoxemia and barotraumas, they would develop rarely since effective ventilation monitoring and techniques are applied. The alteration in splanchnic perfusion is proportional with the increase in intra-abdominal pressure and duration of pneumoperitoneum. CONCLUSION: A moderate-to-low intra-abdominal pressure (<12 mm Hg) can help limit the extent of the pathophysiological changes since consecutive organ dysfunctions are minimal, transient and do not influence the outcome. PDF Efectos de los diferentes niveles de presión expiratoria final en la hemodinámica, la mecánica respiratoria y la respuesta al estrés sistémico durante la colecistectomía laparoscópica. Effects of different levels of end-expiratory pressure on hemodynamic, respiratory mechanics and systemic stress response during laparoscopic cholecystectomy. Sen O1, Erdogan Doventas Y2. Author information Braz J Anesthesiol. 2017 Jan - Feb;67(1):28-34. doi: 10.1016/j.bjane.2015.08.015. Epub 2016 Apr 12. Abstract OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum. Basal hemodynamic parameters were recorded, and arterial blood gases (ABG) and blood sampling were done for cortisol, insulin and glucose level estimations to assess the systemic stress response before induction of anesthesia. Thirty minutes after the pneumoperitoneum, the respiratory and hemodynamic parameters were recorded again and ABG and sampling for cortisol, insulin, and glucose levels were repeated. Lastly hemodynamic parameters were recorded; ABG analysis and sampling for stress response levels were taken after 60minutes from extubation. RESULTS: There were no statistical differences between the two groups about hemodynamic and respiratory parameters except mean airway pressure (Pmean). Pmean, compliance and PaO2; pH values were higher in 'PEEP 10 group'. Also, PaCO2 values were lower in 'PEEP 10 group'. No differences were observed between insulin and lactic acid levels in the two groups. But postoperative cortisol level was significantly lower in 'PEEP 10 group'. CONCLUSION: Ventilation with 10cmH2O PEEP increases compliance and oxygenation, does not cause hemodynamic and respiratory complications and reduces the postoperative stress response. KEYWORDS: Hemodinâmica; Hemodynamic; Mecânica respiratória e resposta ao estresse; PEEP; Respiratory mechanics and stress response PDF XIV Congreso Virtual Mexicano de Anestesiología 2017 Octubre 1-Diciembre 31, 2017 Información / Information Video informativo XXVII Congreso Peruano de Anestesiología Lima, Noviembre 2-4, 2017 Informes / Informataion

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