Archive for mayo, 2010

Infección por virus Ebstein Barr

The Epstein–Barr virus (EBV) was discovered 36 years ago by electron microscopy of cells cultured from Burkitt’s lymphoma tissue by Epstein, Achong, and Barr. Four years later, in 1968, EBV was shown to be the etiologic agent of heterophile-positive infectious mononucleosis. EBV DNA was detected in tissues from patients with nasopharyngeal carcinoma in 1970.In the 1980s, EBV was found to be associated with non-Hodgkin’s lymphoma and oral hairy leukoplakia in patients with the acquired immunodeficiency syndrome (AIDS). Since then, EBV DNA has been found in tissues from other cancers, including T-cell lymphomas and Hodgkin’s disease.

Ebstein Barr Virus Infection JEFFREY I. COHEN, M.D.  N. Eng J Med Vo l u m e 3 4 3 Nu m b e r 7 Aug u s t 17 , 2 0 0 0

31 mayo, 2010 at 20:19 Deja un comentario

Anestesia y analgesia Epidural y Subaracnoídea

Las técnicas anestésicas neuroaxiales tradicionales son parte fundamental del quehacer anestesiológico hoy en día. Su utilización como técnica anestésica única es indiscutida y su uso como complemento de una anestesia general puede mejorar el resultado perioperatorio de pacientes sometidos a cirugía mayor. Dada su relevancia, es necesario analizar algunos aspectos de la técnica que han sido revisitados con la finalidad de mejorar el resultado perioperatorio y disminuir el riesgo de complicaciones. La presente revisión pretende analizar los últimos avances en términos de anatomía, uso de imágenes, aplicaciones novedosas y algunas sugerencias útiles para cada una de las técnicas neuroaxiales.
Rev. Chil. Anestesia, 36: 93-102 (Junio), 2007
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30 mayo, 2010 at 23:40 Deja un comentario

Diarreas Bacterianas

“Foodborne bacterial diarrhea is an emerging health threat that is attributable to the increased consumption of fresh vegetables and fruits, the challenges associated with producing large quantities of inexpensive foods, the increasing importation of foods from developing regions, and the growing pattern of consumption of foods in public restaurants.1 Of the more than 5.2 million cases of bacterial diarrhea that occur each year in the United States, 80% are a result of foodborne transmission.2 Person to-person spread occurs if only a small amount of a pathogen is required for infection; these pathogens include shigella, Shiga toxin–producing Escherichia coli, and protozoal and viral agents.”

Bacterial Diarrhea duPont, Herbert L. at : n engl j med 361;16  nejm.org  october 15, 2009

29 mayo, 2010 at 23:18 Deja un comentario

Manejo de vía aérea difícil: Recomendaciones ASA (inglés)

Practice guidelines are not intended as standards or absolute requirements. The use of practice guidelines cannot guarantee any specific outcome. Practice guide-lines are subject to revision as warranted by the evolution of medical knowledge, technology, and practice.They provide basic recommendations that are supported by analysis of the current literature and by a synthesis of expert opinion, open forum commentary, and clinical feasibility data.  This revision includes data published since the “Practice Guidelines for Management of the Difficult Airway” were adopted by the American Society of Anesthesiologists in 1992; it also includes data and recommendationsfor a wider range of management techniques than waspreviously addressed
Anesthesiology 2003; 98:1269 –77
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26 mayo, 2010 at 4:39 Deja un comentario

Anestesia Regional en Vía aérea

La anestesia regional de la vía aérea es una técnica que busca ayudar a conseguir las mejores condiciones previas para la realización de procedimientos en la vía aérea con el paciente despierto.
La posibilidad de mantener la ventilación espontánea de los pacientes, con el mejor confort y cooperación de éstos, es requisito fundamental cuando se intenta un abordaje vigil de la vía aérea. Sin una mínima cooperación no es posible realizar el procedimiento con los niveles necesarios de seguridad para el paciente, tasa de éxito e indemnidad de los equipos.
Rev Chil Anest, 2009; 38: 145-151
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25 mayo, 2010 at 3:20 1 comentario

Vía aérea difícil: cuando podemos predecirla

Todo paciente que es sometido a cirugía tiene la posibilidad de presentar un problema en el adecuado control de la vía aérea durante el procedimiento. Las principales consecuencias derivadas de un inadecuado manejo de la vía aérea del paciente van desde los traumatismos de las vías respiratorias, el daño cerebral o miocárdico, hasta la muerte.

Rev Chil Anest, 2009; 38: 84-90
Jaime Escobar D

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24 mayo, 2010 at 3:40 Deja un comentario

Guia Clínica para el Diagnostico y Manejo de Infecciones de Piel y Tejidos Blandos.

Soft-tissue infections are common, generally of mild to modest severity, and are easily treated with a variety of agents. An etiologic diagnosis of simple cellulitis is frequently difficult and generally unnecessary for patients with mild signs and symptoms of illness.

Practice Guidelines for the Diagnosis and Management of Skin and Soft-Tissue Infections Clinical Infectous Diseases 2005:41 (15 November)

20 mayo, 2010 at 20:53 1 comentario

Enfermedad diverticular de Colon Complicada

La enfermedad diverticular del colon tiene una alta prevalencia y sus complicaciones son causa frecuente de consultas de emergencia en gastroenterología. La mayoría de los portadores de divertículos de colon, o diverticulosis de colon, son asintomáticos. Algunos pacientes presentan síntomas asociados a los divertículos o presentan complicaciones, como el sangrado diverticular o la inflamación de la pared del colon, denominada diverticulitis. El término diverticultis complicada se refiere a la perforación libre, la formación de abscesos, fístulas u obstrucciones secundarias al proceso inflamatorio diverticular.
Gastr Latinoam 2004; Vol 15, Nº 2: 95 – 100

18 mayo, 2010 at 2:34 Deja un comentario

Shock Cardiogénico en Niños

“For the myriad practitioners who come into contact with critically ill children, the term
“shock” has acquired a unique lexicon. For example, a call to our pediatric intensive care
unit from a community emergency department physician was highlighted by the com-
ment: “I have a lethargic 3-month-old who looks ‘shocky’ to me.” A frantic page from one
of our residents led to this exchange: “We have a 2-year-old down here who is developing
diffuse petechiae—she really looks ‘septic’.” A 16-year-old admitted for worsening respi-
ratory distress and an increasing oxygen requirement underwent echocardiography, which
was read by the cardiologist as a “moderate-size pericardial effusion with no evidence of
either right atrial compression or cardiac tamponade.” Are these physicians talking about
different pathophysiologic entities in their respective patients? Not really. Each simply is
describing one of the protean manifestations of a diverse and complex syndrome: circula-
tory shock.

Circulatory Shock in Children Christine A. McKiernan and Stephen A. Lieberman Pediatr. Rev. 2005;26;451-460

14 mayo, 2010 at 20:37 Deja un comentario

Manejo de la Meningitis Bacteriana

Patients with bacterial meningitis are usually treated by primary care and emergency medicine physicians at the time of initial presentation, often in consultation with infectious diseases specialists, neurologists, and neurosurgeons. In contrast to many other infectious diseases, the anti microbial therapy for bacterial meningitis is not always based on randomized, prospective, double-blind clinical trials, but rather on data initially obtained from experimental animal models of infections.

Practice Guidelines for the Management of Bacterial Meningitis Clinical Infectious Diseases 2004;39:1267-84

13 mayo, 2010 at 20:52 Deja un comentario

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