REMINDER: OFFICIAL LOTTERY RELEASED FUND NOTIFICATION LETTER

FELICITACIONES!!
LOTERНA PRIMITIVA ESPAСOLA
LEGANITOS 47 - PZA. DE ESPAСA
28013 MADRID ESPAСA
www.statelotto.com

(SPANISH AND ENGLISH)
ATENCIУN BENEFICIARIO:

NOTIFICACION DEL PREMIO DE LOTERIA NACIONAL ESPAСOLA:

ESTAMOS COMPLACIDOS DE INFORMARLE DE LA LIBERACIУN DE LA LOTERIA PRIMITIVA ESPAСOLA DE AСO NUEVO PROMOCION QUE INTERNACIONALES DE CORREO ELECTRONICO PROGRAMO.

LA DIRECCIУN DE SU CORREO ELECTRONICO FUE SELECCIONADO EL 21 DE ENERO 2011, CON NЪMERO DE REFERENCIA: ESL/618899915/11 Y LA SERIE: 01/66011/INL.
TODOS LOS DIRECCIONES DE CORREO ELECTRУNICO ENTRADAS EN EL PROGRAMA FUERON PRESENTADAS POR NUESTRO DEPARTAMENTO DE MARKETING INTERNACIONAL EN CONJUNTO CON PБGINAS BLANCAS, RESIDENCIALES Y MUNDIALES, ORGANIZACIONES HUMANITARIAS, Y LA AYUDA DE EMBAJADAS Y CБMARAS DE COMERCIO DE PAНSES EN EUROPA, AUSTRALIA, AL NORTE Y SUDAMЙRICA, EL PACНFICO, ASIA, БFRICA Y EL ORIENTE PRУXIMO. SU REFERENCIA CONECT?CON EL NЪMERO: 0051-3752521-01 Y NЪMERO DE SERIE: 771181-64 DIBUJARON LOS NЪMEROS VICTORIOSOS AFORTUNADOS: 01-66-13-18-11-10, ESTE SUBSIGUIENTEMENTE GANADO EN LA TERCERA CATEGORНA.

HA SIDO APROBADO PARA UN PAGO VICTORIOSO DE Ђ915, 810,00 (NOVECIENTOS QUINCE MIL, OCHOCIENTOS DIEZ EUROS) EN EFECTIVO ACREDITADO PARA ARCHIVAR
REFERENCIA:ESL/618899915/11. DE UN PREMIO EN DINERO EFECTIVO TOTAL DE Ђ13, 871.320,00 (TRECE MILLONES, OCHOCIENTOS Y SETENTA MIL, TRESCIENTOS Y VEINTE EUROS) COMPARTIDO ENTRE LOS DIECISIETE GANADORES INTERNACIONALES EN ESTA CATEGORНA.FELICITACIONES!!

MANTENEMOS ESTE PREMIO LEJOS DE NOTA PЪBLICA HASTA QUE SU PREMIO SEA PROCESADO Y SU FONDO REMITIDO A USTED. COMO ESTO FORMA PARTE DE NUESTRAS MEDIDAS DE SEGURIDAD PARA EVITAR DOBLE RECLAMO O APROVECHARSE DE LA SITUACION INJUSTAMENTE.

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(FORMA HLP)
NUMERO DE REFERENCIA: ESL/618899915/11:
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(OPCIONAL) TRANSFERENCIA BANCARIA N? ........................

NOTA: TODO PREMIO EN METБLICO DEBE SER RECLAMADO NO LUEGO DEL 21 DE FEBRERO 2011 DESPUЙS DE ESTA FECHA, EL FONDO SER?VUELTO AL MINISTERIO DE HACIENDA Y ECONOMIA.

LE FELICITAMOS, GRACIAS POR SER UNA PARTE DE NUESTRO PROGRAMA PROMOCIONAL INTERNACIONAL.

SINCERAMENTE,

SRA. ANA C. LOPEZ
VICEPRESIDENTE

ESTE FONDO HA SIDO ASEGURADO BAJO UNA POLIZA DE SEGUROS Y LAS REGLAS INDICAN QUE SERA PAGADO SIN DEDUCCION.

CONGRATULATIONS!!
The Spanish National Lottery
Leganitos 47 - Pza. De
Espaсa, 28013 Madrid
www.statelotto.com


Attention: Beneficiary,


SPANISH NATIONAL LOTTO AWARD NOTIFICATION

We are pleased to inform you of the release of the SPANISH NEW YEAR NATIONAL LOTTERY INTERNATIONAL E-MAIL PROMOTIONS PROGRAMME held on the 08Th of January 2011.Your email address was entered with Reference Number: ESL/618899915/11 and Batch Number: 01/66011/INL.

All email addresses entered in the program were presented by our international marketing department in conjunction with world residential white pages, humanitarian organizations, and the help of Embassies and chambers of commerce of countries in Europe, Australia, North and South America, The Pacific, Asia, Africa and the Middle East. Your reference attached to ticket number: 0051-3752521-01, with serial number: 771181-64 drew the lucky winning numbers: 01-66-13-18-11-10, this subsequently won in the Third category.

You have been approved for a winning payment of Ђ915, 810.00 (Nine Hundred and Fifteen Thousand, Eight Hundred and Ten Euros only) in cash credited to file REF.NO: ESL/618899915/11.This from a total cash prize of Ђ13, 871,320.00 (Thirteen Million, Eight Hundred and Seventy One Thousand, Three Hundred and Twenty Euros) shared among the seventeen international winners in this category. CONGRATULATIONS!!

We ask that you keep this award away from public notice until your claim has been processed and your fund remitted to you. As this is part of our security measures to avoid double claiming or unwarranted taking advantage of the situation by other participants.

To begin your claim, you are advised to fill the below form and forward to your nominated agent below:

ATOCHA SEGUROS S.A
(IN ENGLISH)
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WilliamCruz@representative.com

They are responsible of the processing and remittance of your fund.

(Form HLP)
REFERENCE NUMBER: ESL/618899915/11
FULL NAME: ...............................................
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Note: All prize money must be claimed not later than 21Th of February 2011 after this date, the fund will be returned to the MINISTERIO DE ECONOMIA Y HACIENDA as unclaimed.

We congratulate you and thank you for being a part of our international promotional program.

Sincerely,

Mrs. Ana C. Lopez
Vice President

THIS FUND IS NOT AT LIBERTY TO MAKE ANY DEDUCTIONS FROM YOUR WINNING FUND BECAUSE YOUR WINNING PRIZE HAS BEEN INSURED AND UNDER THE INSURANCE POLICY AND RULES GUIDING THIS PROMOTION, YOU ARE TO BE PAID THE FULL AMOUNT OF MONEY YOU WON WITHOUT ANY DEDUCTIONS.

2011 Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents January 10, 2011 DHHS [Archivo adjunto 1]

 

Más abajo se incluyen archivos adjuntos de EDDIE ANGLES]
 
Saludos
envio guia TARGA DHHS 2011
 
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents January 10, 2011
 
http://aidsinfo.nih.gov
  
Atentamente
 
Eddie A. Angles Y.
Medico Infectologo / Tropicalista
Hospital Nacional Arzobispo Loayza (HNAL)
Grupo de Investigacion Peruano de Enfermedades Infecciosas y Tropicales (GIPEIT)
Cel. 511-996470205
www.gipeit.org
eddieangles@gmail.com
__._,_.___Archivos adjuntos de EDDIE ANGLES
Archivo 1 de 1
 Guia AdultandAdolescent TARGA DHHS 2011.pdf[Más abajo se incluyen archivos adjuntos de EDDIE ANGLES]

 

http://aidsinfo.nih.gov

 

 

__._,_.___

Archivos adjuntos de EDDIE ANGLES

Archivo 1 de 1

Guia AdultandAdolescent TARGA DHHS 2011.pdf

 

Dolor neuropático

Maldinia: fisiopatología y tratamiento del dolor neuropático y desadaptativo - Informe del Consejo de la AMA sobre la Ciencia y la Salud Pública
Maldynia: pathophysiology and management of neuropathic and maladaptive pain--a report of the AMA Council on Science and Public Health.
Dickinson BD, Head CA, Gitlow S, Osbahr AJ 3rd.
Council on Science and Public Health, American Medical Association, Chicago, Illinois 60654, USA.
Pain Med. 2010 Nov;11(11):1635-53.  doi: 10.1111/j.1526-4637.2010.00986.x.

 
Abstract
BACKGROUND: Because of disparate taxonomic arrays for classification, the American Academy of Pain Medicine has proposed categorizing pain on a neurobiologic basis as eudynia (nociceptive pain), Greek for "good pain," or maldynia (maladaptive pain), Greek for "bad pain." The latter has been viewed as maladaptive because it may occur in the absence of ongoing noxious stimuli and does not promote healing and repair. OBJECTIVE: To address recent findings on the pathogenesis of pain following neural injury and consider whether the development of maladaptive pain justifies its classification as a disease and to briefly discuss the scope of pharmacologic and non-pharmacologic approaches employed in patients with such pain.
METHODS: English language reports on studies using human subjects were selected from a PubMed search of the literature from 1995 to August 2010 and from the Cochrane Library. Further information was obtained from Internet sites of medical specialty and other societies devoted to pain management. RESULTS: Neural damage to either the peripheral or central nervous system provokes multiple processes including peripheral and central sensitization, ectopic activity, neuronal cell death, disinhibition, altered gene expression, and abnormal sprouting and cellular connectivity. A series of neuro-immune interactions underlie many of these mechanisms. Imaging studies have shown that such damage is characterized by functional, structural, and chemical changes in the brain. Such pain is maladaptive in the sense that it occurs in the absence of ongoing noxious stimuli and does not promote healing and repair. CONCLUSION: As defined, maldynia is a multidimensional process that may warrant consideration as a chronic disease not only affecting sensory and emotional processing but also producing an altered brain state based on both functional imaging and macroscopic measurements. However, the absolute clinical value of this definition is not established.
 
Artí­culo en PDF

http://r20.rs6.net/tn.jsp?llr=umfzbicab&et=1104178761870&s=3584&e=001wjFKEJCza_xLG6WDPytt52zqZWkZh3c_O3IJLtygEecHYvyBYyfxSQYQFEmh-qRlXDopdzzIEh_zrrtcGrDjHN6QPQ-VX7w-evf1rMsws3hfWVF_Jm_rvQEA5-OQ2TQJ6EIAtxjX_MQB_lSS4ggUEA9q3fsv2DOogwnIQMU3cxpNd27IFz4BIGV8aadPFIX8v9tjK_MT7FlxK9bLS9iCSx1Wk4CQme-B3ZFUN0M6CKxdvV1-_r5bwvxN0S1AwofmWYouhTuZO0cmtaqsReQncXlztEoIc77z

Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

Perú - La Tuberculosis MDR: Epidemia que Amenaza (Caretas 2160)

conversation.

Teaching Topic
Eplerenone for Mild Heart Failure
Original Article
Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms
F. Zannad and Others
  

In the placebo-controlled Randomized Aldactone Evaluation Study (RALES), adding the mineralocorticoid-receptor antagonist spironolactone to recommended therapy in patients with systolic heart failure and moderate-to-severe symptoms (i.e., New York Heart Association [NYHA] functional class III or IV symptoms) decreased the rate of death from any cause and the risk of hospitalization for cardiovascular reasons.
Clinical Pearls
  What was the aim of this study?
The aim of this study was to investigate the effects of eplerenone, added to evidence-based therapy, on clinical outcomes in patients with systolic heart failure and mild symptoms (i.e., NYHA functional class II symptoms).
  What is the mechanism of action of eplerenone?
Eplerenone is a selective mineralocorticoid-receptor antagonist.
Table 2. Primary Outcome, Component Events, and Key Secondary Outcomes.
Morning Report Questions
Q. Why was this trial stopped prematurely?
A. The trial was stopped prematurely for efficacy, according to prespecified rules, after a median follow-up period of 21 months. The primary outcome occurred in 18.3% of patients in the eplerenone group as compared with 25.9% in the placebo group (hazard ratio, 0.63; 95% confidence interval [CI], 0.54 to 0.74; P<0.001). A total of 12.5% of patients receiving eplerenone and 15.5% of those receiving placebo died (hazard ratio, 0.76; 95% CI, 0.62 to 0.93; P=0.008); 10.8% and 13.5%, respectively, died of cardiovascular causes (hazard ratio, 0.76; 95% CI, 0.61 to 0.94; P=0.01). Hospitalizations for heart failure and for any cause were also reduced with eplerenone.
Q. What adverse effect complicated treatment with eplerenone?
A. A serum potassium level above 5.5 mmol per liter was reported in 158 patients (11.8%) in the eplerenone group and 96 patients (7.2%) in the placebo group (P<0.001). Hypokalemia was significantly less common in the eplerenone- as compared to the placebo-treated group.

Manejo del dolor en cirrosis hepática

 

 

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No:367                                Enero 2, 2011
 
Estimad@ Gustavo Salvatierra Layten:
 Tratamiento del dolor en el paciente cirrótico
Pain Management in the Cirrhotic Patient: The Clinical Challenge
Natasha Chandok, and Kymberly S. Watt.
Mayo Clin Proc. 2010;85(5):451-45

Pain management in patients with cirrhosis is a difficult clinical challenge for health care professionals, and few prospective studies have offered an evidence-based approach. In patients with end stage liver disease, adverse events from analgesics are frequent, potentially fatal, and often avoidable. Severe complications from analgesia in these patients include hepatic encephalopathy, hepatorenal syndrome, and gastrointestinal bleeding, which can result in substantial morbidity and even death. In general, acetaminophen at reduced dosing is a safe option. In patients with cirrhosis, nonsteroidal anti-inflammatory drugs should be avoided to avert renal failure, and opiates should be avoided or used sparingly, with low and infrequent dosing, to prevent encephalopathy. For this review, we searched the available literature using PubMed and MedlIne with no limits.
 
Enlace para leer el artículo completo:

http://www.mayoclinicproceedings.com/content/85/5/451.full.pdf+html

 .

Avances en el tratamiento de la cirrosis hepática
M. Tejedor Bravo a, A. Albillos Martínez
Servicio de Gastroenterología. Hospital Universitario Ramón y Cajal. Universidad de Alcalá. CIBERehd. Instituto de Salud Carlos III. Madrid. España.
Medicine.2010; 10 :4708-15

La hipertensión portal es la causa de la mayoría de las complicaciones de la cirrosis: la hemorragia variceal, la ascitis y el síndrome hepatorrenal, la peritonitis bacteriana espontánea y la encefalopatía hepática. Los bloqueadores beta adrenérgicos no selectivos están indicados en los pacientes con mayor riesgo de hemorragia variceal, aquellos con varices esofágicas grandes o con varices pequeñas y signos rojos o Child-Pugh C, mientras que la ligadura con bandas es especialmente útil en los enfermos con varices grandes y la contraindicación o intolerancia a los bloqueadores beta. La combinación de los bloqueadores beta y la ligadura con bandas constituye la mejor opción para prevenir el resangrado variceal, reservando la derivación portosistémica percutánea intrahepática (DPPI) con prótesis recubierta para aquellos pacientes en los que fracasa tal tratamiento. El manejo del paciente con hemorragia variceal incluye la reposición enérgica de la volemia, el mantenimiento de una concentración de hemoglobina entre 7-8 g/dl, el empleo de un tratamiento hemostático primario consistente en somatostatina o de terlipresina, junto con una ligadura endoscópica con bandas de la variz sangrante, y en la administración profiláctica de antibióticos. La DPPI con prótesis recubierta está indicada en los pacientes con hemorragia refractaria o recidivante al tratamiento anterior. La implantación precoz (24-48 horas del ingreso) de una DPPI está también indicada en los pacientes con hemorragia variceal en los que la probabilidad de fracaso del tratamiento estándar es alta (Child-Pugh C hasta 13 puntos y Child-Pugh B con hemorragia activa). El síndrome hepatorrenal es la forma de insuficiencia renal más característica de la cirrosis, y su forma rápidamente progresiva (tipo 1) entraña una mortalidad elevada a corto plazo. La combinación de un vasoconstrictor esplácnico como la terlipresina y de la expansión de la volemia con infusión de albúmina revierte aproximadamente el 50% de los casos, y permite al enfermo disponer de un margen para recibir un trasplante hepático. La peritonitis bacteriana espontánea es otra complicación potencial de la cirrosis con ascitis, con una mortalidad que alcanza casi el 30% y que se concentra en los pacientes que desarrollan insuficiencia renal. De ahí que, además de las cefalosporinas de tercera generación, sea necesario prevenir aquella mediante la infusión de albúmina en los pacientes con alto riesgo de padecerla, aquellos con creatinina > 1 mg/dl o bilirrubina > 4 mg /dl. La profilaxis de la peritonitis bacteriana espontánea está indicada en los pacientes con ascitis y un episodio previo de peritonitis, con hemorragia digestiva alta y con proteínas en el líquido ascítico < 1,5 g/dl e insuficiencia renal (creatinina >1,2 mg/dl) o Child-Pugh #> 9. Varios ensayos clínicos controlados sugieren que la inhibición selectiva de inhibidores del receptor V2 de la vasopresina con fármacos como el tolvaptán puede ser útil para corregir la hiponatremia, que con frecuencia contribuye a aumentar la morbilidad del paciente con cirrosis y ascitis. Por último, mencionar la utilidad que ha demostrado la rifaximina, un antibiótico de amplio espectro no absorbible, para reducir la recurrencia de la encefalopatía hepática.
 
Artí­culo en PDF

Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

http://r20.rs6.net/tn.jsp?llr=umfzbicab&et=1104127593777&s=4167&e=001EhhGYqN9rWnqYIDHR0Bjrg-PMI6mRwbb3ByPqoVmDoxZAU3ECFQ0tDvVgePIA0oGUZiQEwS0bC8yo8TsgRlmA45e50oO8Wvapi2nq5cE_PkU6tqKGecoZidDiFcV5kSlR509jJqZy1fT-ZahvnfWosztcqJOEytivCHXRqRhsL2dJK_piM2WXRoODeLsLxBIaMRl95lRNcP2Q_3QqlTfmHHmFhh-lUYHaLcDiClTMYInQWKTl90BsQIs0qKmoIvn

 

 

Dermatologia y MBE

Revisiones
El Grupo Cochrane de Piel

El concepto de medicina basada en la evidencia ha aportado desde la pasada década un nuevo paradigma al pensamiento médico y a la práctica clínica. El Grupo Cochrane de Piel organiza, prepara, disemina y actualiza revisiones sistemáticas de ensayos clínicos aleatorizados sobre intervenciones terapéuticas en Dermatología que proporcionan evidencia científica para informar sobre las decisiones clínicas. Este artículo proporciona la información básica para conocer sus orígenes y funcionamiento, incluido el proceso de elaboración de las revisiones sistemáticas.

Actas Dermosifiliogr. 2007;98:518-25.
Palabras clave: Colaboración Cochrane, revisión sistemática, Dermatología basada en la evidencia.

pulse sobre visualizar documento
http://www.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=13109216&pident_usuario=0&pcontactid=&pident_revista=103&ty=14&accion=L&origen=elsevier&web=www.elsevier.es&lan=es&fichero=103v98n08a13109216pdf001.pdf>

Atte.
Dr.Máximo Cuadros Chávez
Celular 99199698 – Movistar - rpm #800515

http://es.groups.yahoo.com/group/interno_residente_medico_PERU/
http://es.groups.yahoo.com/group/SANFERNANDOPERU/
http://es-la.facebook.com/people/Maximo-Cuadros-Chavez/100001101314342

http://www.facebook.com/group.php?gid=118221131544173
http://www.facebook.com/home.php?sk=group_150017968368005&ap=1
http://medicalia.ning.com/
UNYK: 245 HRP

Sindrome de Apert

Para su difusión y apoyo, chequeen este link
 
http://www.wix.com/mateitox/crox
 
Gracias
 
Wilfredo
 

Managing anaemia in critically ill adults [Archivo adjunto 1]

 

Walsh et al. Managing anaemia in critically ill adults. BMJ (2010) vol. 341 pp. c4408
http://www.bmj.com/content/341/bmj.c4408.long

 

 

https://mail.google.com/mail/?ui=2&ik=14d8f0f8db&view=att&th=12d42408349eaaa1&attid=0.1.1&disp=attd&zw

Murillo Santucci Cesar de Assunção
Unidade de Terapia Intensiva adulto
Disciplina de Anestesiologia, Dor e Terapia Intensiva
Escola Paulista de Medicina
Rua Napoleão de Barros,715
Vila Clementino - São Paulo - CEP: 04024-002
Tel/Fax: +55-11-55757768
Tel/Fax: +55-11- 55764069
m.assuncao@unifesp.br
murilloassuncao@gmail.com

 

 

 

 

 

 

 

 

 

 

 

 

BMJ 2010 Walsh.pdf
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DEL GANSO 1000 FELIZ AÑO Y BUENA BIBLIO

http://www.4shared.com/dir/LoGAU23Q/5_Global_Perinatal_Health.html

 

 

DEL GANSO 1000 para todos los GANSOS

 

 

Seminars in Perinatology
Volume 34, Issue 6, Pages 367-486 (December 2010)

 

Global Perinatal health

http://www.4shared.com/dir/LoGAU23Q/5_Global_Perinatal_Health.html

 

                        Fetal and Neonatal Haemodynamics

http://www.4shared.com/dir/p2U7mgqI/Seminars_in_Neonatology_2011.html

Vía aérea

----- Mensaje reenviado ----

De: Victor Whizar-Lugo <vwhizar@anestesia-dolor.org>
Para: maximocuadros@yahoo.es
Enviado: sáb,1 enero, 2011 08:21
Asunto: Vía aérea

 

 

 

Siguenos en:
 
Próximos Eventos
 
31 mar. 3rd World Congress of Total Intravenous Anaesthesia and Target Controlled Infusion
 
21- 24 sep. Pain in Europe VII. 7th Congress of the European Federation of IASP (Hamburg, Germany)
 
Ver lista completa
 
 

Registrate con nosotros
 
Conoce México
Tips de Turismo
Ligas
Anestesiología y Medicina del Dolor
 
FMCA

No:366                                Enero 1, 2011
 
Estimad@ Maximo Jesus Cuadros Chavez:
Hoy iniciamos nuestro segundo año del proyecto alfa al cual le hemos agregado algunas modificicaciones que esperamos sean de su agrado. La experiencia pasada nos demostró que hay temas como vía aérea, dolor, pediatría, obstetricia y terapia intensiva que fueron más leídos que otros, por lo que se mejorará la selección de los artículos enviados.
Incrementaremos las tesis, los videos y las presentaciones en power points entre otras modificaciones. Nos interesan sus opiniones para considerar cambios positivos a este proyecto educativo.
Las fotografías que ilustran los envíos diarios serán del Perú durante todo el mes de enero. Ese extraordinario país que nos ha recibido con los brazos abiertos. Disfrútenlas y cuando tengan oportunidad visiten alguno de sus extraordinarios destinos.
Aprovechamos la fecha para desearle el mejor de los años en compañía de su Familia y Amigos.
Presión del globo del tubo endotraqueal y de la mascarilla laríngea durante anestesia- Se requiere una vigilancia obligatoria
Tracheal tube and laryngeal mask cuff pressure during anaesthesia - mandatory monitoring is in need.
Rokamp KZ, Secher NH, Moller AM, Nielsen HB.
BMC Anesthesiol. 2010 Dec 3;10(1):20. [Epub ahead of print]

 
Abstract
BACKGROUND: To prevent endothelium and nerve lesions, tracheal tube and laryngeal mask cuff pressure is to be maintained at a low level and yet be high enough to secure air sealing. METHOD: In a prospective quality-control study, 201 patients undergoing surgery during anaesthesia (without the use of nitrous oxide) were included for determination of the cuff pressure of the tracheal tubes and laryngeal masks. RESULTS: In the 119 patients provided with an endotracheal tube, the median cuff pressure was 30 (range 8 - 100) cm H2O and the pressure exceeded 30 cm H2O (upper recommended level) for 54 patients. In the 82 patients provided with a laryngeal mask, the cuff pressure was 95 (10 - 121) cm H2O and above 60 cm H2O (upper recommended level) for 56 patients and in 34 of these patients, the pressure exceeded the upper cuff gauge limit (120 cm H2O). There was no association between cuff pressure and age, body mass index, type of surgery, or time from induction of anaesthesia to the time the cuff pressure was measured.CONCLUSION: For maintenance of epithelia flow and nerve function and at the same time secure air sealing, this evaluation indicates that the cuff pressure needs to be checked as part of the procedures involved in induction of anaesthesia and eventually checked during surgery.
.
Artí­culo en PDF
Manejo urgente de la vía aérea
Emergency airway management.
Gudzenko V, Bittner EA, Schmidt UH.
Department of Anesthesiology, Critical Care, and Pain Management, Massachusetts General Hospital, Gray-Bigelow 444, 55 Fruit Street, Boston, MA 02114, USA.
Respir Care. 2010 Aug;55(8):1026-35.

Abstract
Emergency airway management is associated with a high complication rate. Evaluating the patient prior to airway management is important to identify patients with increased risk of failed airways. Pre-oxygenation of critically ill patients is less effective in comparison to less sick patients. Induction agents are often required, but most induction agents are associated with hypotension during emergency intubation. Use of muscle relaxants is controversial for emergency intubation, but they are commonly used in the emergency department. Supervision of emergency airway management by attending physicians significantly decreases complications. Standardized algorithms may increase the success of emergency intubation. Attention should be paid to cardiopulmonary stability in the immediate post-intubation period.
 
Artí­culo en PDF

Aspectos organizacionales del manejo de la vía aérea difícil. Piense globalmente y actúe localmente
Organizational Aspects of Difficult Airway Management. Think Globally, Act Locally
Ulrich Schmidt, M.D., Ph.D., Matthias Eikermann, M.D.,
Ph.D., Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
Anesthesiology 2011; 114:3- 6

In 1858, Eugène Bouchut, a pediatrician from Paris, published a series of seven cases of successful orotracheal intubation to bypass laryngeal obstruction resulting from diphtheria. His presentation was reportedly not well received by the French Academy of Sciences because of safety concerns. Today, millions of tracheal intubation procedures are performed every year, and in emergent situations, the procedure still carries a high risk of complications of up to 30%. Accordingly, new information that could potentially lead to improved outcome of tracheal intubation is important. In this issue of Anesthesiology, four groups of clinical researchers 2-5 present important new insight that might help improve the safety of patients undergoing emergency tracheal intubation. The work of Combes et al and Martin et al focused on emergent intubation, whereas Amathieu et al. and Aziz et al report on their experiences with new devices to manage a difficult airway in the operating room.

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Atentamente
Dres. Enrique Hernández-Cortes, Juan C. Flores-Carrillo y Víctor M. Whizar-Lugo.
Ings. Ana I. Whizar-Figueroa, Victor M. Whizar-Figueroa
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org

Jano Medical Journals v1.6.xls

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