Reunión semanal de carácter académico de la Clínica de Dolor de la Fundación Santa Fe, en Bogotá, Colombia. Por motivos de la pandemia ahora los realizamos los martes a las 7:30 pm via zoom. Los invito a alimentar este blog con ideas y casos clínicos.
DECLARACIÓN:
sábado, 28 de noviembre de 2020
Martes Priemero de Diciembre 2020
domingo, 22 de noviembre de 2020
jueves, 12 de noviembre de 2020
MARTES 17 DE NOVIEMBRE 2020
HOLA, ESTE MARTES VAMOS A REVISAR LOS FUNDAMENTOS CIENTÍFICOS DE LA ESTIMULACIÓN DEL GANGLIO DE LA RAÍZ DORSAL
Conferencia dad por el Mg. Matias Nayar, especialista clínico de Neuromodulación para Latinoamérica.
Los objetivos de esta reunión será hablar:
- Indicaciones DRG
- Estudios
- Técnica de Implante DRG
LOS FUNDAMENTOS CIENTÍFICOS DEL GANGLIO DE LA RAIZ DORSAL (GRD)
El GRD es una importante estructura de nervios intrarraquídeos epidurales que aloja los núcleos celulares de las neuronas sensitivas primarias (NSP)2.
Estas NSP constituyen la principal fuente de transmisión de información sensitiva desde la periferia hasta el sistema nervioso central, y además representan un importante punto de procesamiento de la información sensitiva1.
El dolor es un tipo de información sensitiva que se transmite y procesa en las NSP dentro del GRD1. En condiciones normales, el dolor representa una importante experiencia sensitiva con fines de protección; sin embargo, en estados patológicos el dolor se convierte en una afección crónica. En las investigaciones se ha demostrado que las NSP alojadas en el GRD desempeñan un papel fundamental en el desarrollo y la persistencia del dolor crónico1. Asimismo, estas neuronas presentan alteraciones en las propiedades de las membranas, como una mayor excitabilidad y una actividad anómala y ectópica3,4.
Si bien estas alteraciones fisiopatológicas contribuyen al estado de dolor crónico, es probable que a su vez permitan que este tipo de células sea más sensible a la influencia de los tratamientos por neuromodulación (estimulación)1.
1. Krames, E. S. (2014). The Dorsal Root Ganglion in Chronic Pain and as a Target for Neuromodulation: A Review. Neuromodulation: Technology at the Neural Interface, 18(1), 24-32. doi:10.1111/ner.12247.
2. Hasegawa, T., Mikawa, Y., Watanabe, R. y An, H. S. (1996). Morphometric Analysis of the Lumbosacral Nerve Roots and Dorsal Root Ganglia by Magnetic Resonance Imaging. Spine, 21(9), 1005-1009.
doi:10.1097/00007632-199605010-00001.
3. Devor, M. (1999). Unexplained peculiarities of the dorsal root ganglion. Pain, 82. doi:10.1016/s0304-3959(99)00135-9.
4. Chung, J. M. y Chung, K. (2002). Importance of Hyperexcitability of DRG Neurons in Neuropathic Pain. Pain Practice, 2(2), 87-97. doi:10.1046/j.1533-2500.2002.02011.x.
Nos vemos ZOOM 310-7857490 7:30 a 8:30 PM
sábado, 7 de noviembre de 2020
Martes 10 de Noviembre del 2020
lunes, 2 de noviembre de 2020
Martes 3 de Noviembre 2020
domingo, 25 de octubre de 2020
Martes 27 de Octubre 2020
viernes, 9 de octubre de 2020
Martes de Dolor. Martes 20 de Octubre
domingo, 4 de octubre de 2020
MARTES DE DOLOR. 6 DE OCTUBRE 2020.
sábado, 26 de septiembre de 2020
MARTES 29 DE SEPTIEMBRE - PREVENCION DEL DOLOR CRONICO POSTQUIRURGICO
domingo, 20 de septiembre de 2020
VOLVEMOS A LOS MARTES DE DOLOR
martes, 28 de abril de 2020
COVID - 19 - Lo que un anestesiólogo debe saber
CARLOS GUERRERO MD, FIPP
Actualizado el 3 de Septiembre del 2020
TODO LO QUE ESTÁ EN ROJO Y MORADO SON VINCULOS
Como anestesiólogos es NUESTRA RESPONSABILIDAD autoeducarnos y volvernos expertos en el tema. Como me contaba una colega en Madrid: “de un momento a otro no solo somos anestesiólogos sino intensivistas, somos la primera linea de manejo en el proceso de intubación en UCI, nuestro quirófano puede ser pronto una habitación de UCI”.
domingo, 26 de abril de 2020
COVID 19 Y EL MANEJO DEL DOLOR
Kemp, H. I., Corner, E., & Colvin, L. A. (2020). Chronic pain after COVID-19: implications for rehabilitation. British Journal of Anaesthesia. June 21, 2020.
Deer, T., Sayed, D., Pope, J., Chakravarthy, K., Petersen, E., Moeschler, S. M., et al. (2020). Emergence from the COVID-19 Pandemic and the Care of Chronic Pain: Guidance for the Interventionalist. Anesthesia & Analgesia. May 21, 2020.
Coluzzi, F., Marinangeli, F., & Pergolizzi, J. (2020). Managing chronic pain patients at the time of COVID-19 pandemic. Minerva Anestesiologica. May 12, 2020.
Hagedorn, J. M., Moeschler, S., Furnish, T., Sayed, D., & Durbhakula, S. (2020). Impact of COVID-19 on Pain Medicine Fellowship Training. Regional Anesthesia and Pain Medicine. April 27 2020.
ASIPP Risk Stratification of Patients Presenting for Interventional Pain Procedures: Decreasing Morbidity of COVID‐19. April 27, 2020.
ASIPP COVID‐19 Morbidity Risk Mitigation Flow Chart For Interventional Pain Management. April 27, 2020.
MaassenVanDenBrink, A., de Vries, T., & Danser, A. H. J. (2020). Headache medication and the COVID-19 pandemic. The Journal of Headache and Pain, 21(1), 38. April 25, 2020.
EMA advice on the use of NSAIDs for Covid-19. (2020). EMA advice on the use of NSAIDs for Covid-19. Drug and Therapeutics Bulletin, dtb–2020–000021. APRIL 25 2020.
Song, X.-J., Xiong, D.-L., Wang, Z.-Y., Yang, D., Zhou, L., & Li, R.-C. (2020). Pain Management During the COVID-19 Pandemic in China: Lessons Learned. Pain Medicine (Malden, Mass.). April 23, 2020.
Cochrane Special Collections Coronavirus (COVID-19): regional anaesthesia to reduce drug use in anaesthesia and avoid aerosol generation. April 24 2020
ASRA COVID Chronic Pain Best Practice Guidelines. Infographics
Shanthanna, H., Strand, N. H., Provenzano, D. A., Lobo, C. A., Eldabe, S., Bhatia, A., et al. (2020). Caring for patients with pain during the COVID-19 pandemic: consensus recommendations from an international expert panel. Anaesthesia, 6(1). April 5, 2020.
Eccleston, C., Blyth, F. M., Dear, B. F. et al. (2020). Managing patients with chronic pain during the COVID-19 outbreak: considerations for the rapid introduction of remotely supported (eHealth) pain management services. Pain, 161(5), 889–893. April 2 2020
Alexander, G. C., Stoller, K. B., Haffajee, R. L., & Saloner, B. (2020). An epidemic in the midst of a pandemic: opioid use disorder and COVID-19. AnnInternMed. April 2, 2020
Science. Misguided drug advice for COVID-19. March 27, 2020.
Sui An Lie, MBBS, MRCP, MMed . Sook Wai Wong, MBBS. (2020). Practical considerations for performing regional anesthesia: lessons learned from the COVID-19 pandemic. Canadian Journal of Anesthesia. MARCH 24, 2020
miércoles, 22 de abril de 2020
SE PUEDE USAR AINES EN ÉPOCA DE PANDEMIA ?
Pergolizzi, J. V., Varrassi, G., Magnusson, P., LeQuang, J. A., Paladini, A., Taylor, R., et al. (2020). COVID-19 and NSAIDS: A Narrative Review of Knowns and Unknowns. Pain and Therapy, 14(2), 185. May 24, 2020.
Zolk, O., Hafner, S., Schmidt, C. Q., German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT). (2020). COVID-19 pandemic and therapy with ibuprofen or renin-angiotensin system blockers: no need for interruptions or changes in ongoing chronic treatments. Naunyn-Schmiedeberg's Archives of Pharmacology, May 15 2020.
Preckel, B., Schultz, M. J., Vlaar, A. P., Hulst, A. H., Hermanides, J., de Jong, M. D., et al. (2020). Update for Anaesthetists on Clinical Features of COVID-19 Patients and Relevant Management. Journal of Clinical Medicine, May 15, 2020.
de Girolamo, L., Peretti, G. M., Maffulli, N., & Brini, A. T. (2020). Covid-19-The real role of NSAIDs in Italy. Journal of Orthopaedic Surgery and Research, 15(1), 165. May 6 , 2020.
Micallef, J., Soeiro, T., Jonville-Béra, A.-P., French Society of Pharmacology, Therapeutics (SFPT). (2020). Non-steroidal anti-inflammatory drugs, pharmacology, and COVID-19 infection. Therapie. May 5, 2020.
EMA advice on the use of NSAIDs for Covid-19. (2020). EMA advice on the use of NSAIDs for Covid-19. Drug and Therapeutics Bulletin, dtb–2020–000021. APRIL 25 2020.
WHO. The use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients with COVID-19. Scientific Brief. April 19 2020.
NICE. COVID-19 rapid evidence summary: acute use of non-steroidal anti-inflammatory drugs (NSAIDs) for people with or at risk of COVID-19. 14 April 2020
Russell, B., Moss, C., Rigg, A., & Van Hemelrijck, M. (2020). COVID-19 and treatment with NSAIDs and corticosteroids: should we be limiting their use in the clinical setting? Ecancermedicalscience, 14, 1023. April 8 2020.
NEWS: Covid-19: NICE advises against using NSAIDs for fever in patients with suspected cases. The BMJ April 6 2020.
martes, 21 de abril de 2020
Aerosol Box
Clariot, S., Dumain, G., Gauci, E., Langeron, O., & Levesque, É. (2020). Minimising COVID-19 exposure during tracheal intubation by using a transparent plastic box: a randomised prospective simulation study. Anaesthesia Critical Care & Pain Medicine. June 21 2020.
Begley, J. L., Lavery, K. E., Nickson, C. P., & Brewster, D. J. (2020). The aerosol box for intubation in COVID-19 patients: an in-situ simulation crossover study. Anaesthesia .May 13, 2020
Malik, J. S., Jenner, C., & Ward, P. A. (2020). Maximising application of the aerosol box in protecting healthcare workers during the COVID-19 pandemic. Anaesthesia. Apr 20, 2020.
Leyva, M., Leyva, M. E., Leyva, M. F., of, G. J. W. J., 2020. (n.d.). Aerosol box, An Operating Room Security Measure in COVID-19 Pandemic. World J Sur April 26 2020.
Canelli, R., Connor, C. W., Gonzalez, M., Nozari, A., & Ortega, R. (2020). Barrier Enclosure during Endotracheal Intubation. The New England Journal of Medicine, NEJM. April 11 2020.
Tseng, J.-Y., & Lai, H.-Y. (2020). Protecting against COVID-19 aerosol infection during intubation. Journal of the Chinese Medical Association : JCMA. Apr 6 2020
28 DE MARZO. BOSTON MEDICAL CENTER. “Evaluating the Aerosol Box” Robert Canelli MD, et al
sábado, 11 de abril de 2020
COVID 19 - INICIATIVA SU MÉDICO ESPECIALISTA
COVID -19 . TESTIMONIOS DE ESPECIALISTAS EN OTROS PAÍSES
30 de Marzo. Viviana Gonzalez Sotelo Anestesióloga Colombiana en Barcelona. NOs manda un mensaje sobre lo que esta viviendo y lo que ella piensa debemos hacer.
27 de Marzo. Le pregunté a Mario Fajardo MD Especialista de Dolor Cubano al frente de la pandemia en España: Que nos recomienda a los países latinoamericanos que nos estamos preparando ?
COVID -19. VIDEOS /
MAYO 17. Carlos Saavedra. Equipos de Portección Personal. Recomendaciones del Consenso ACIN-IETS.
Ortega, R., Gonzalez, M., Nozari, A., & Canelli, R. (2020). Personal Protective Equipment and Covid-19. The New England Journal of Medicine. May 19, 2020
28 DE MARZO. BOSTON MEDICAL CENTER. “Evaluating the Aerosol Box” Robert Canelli MD, et al
Tseng, J.-Y., & Lai, H.-Y. (2020). Protecting against COVID-19 aerosol infection during intubation. Journal of the Chinese Medical Association : JCMA. Apr 6 2020
COVID -19. CALCULADORAS MÉDICAS
Sequential Organ Failure Assessment (SOFA) Score CALCULATOR
qSOFA (Quick SOFA) Score for Sepsis
CURB-65 Score for Pneumonia Severity
COVID - 19 ARTÍCULOS IMPORTANTES
Mathuria, J. P., Yadav, R., & Rajkumar. (2020). Laboratory diagnosis of SARS-CoV-2 - A review of current methods. Journal of Infection and Public Health. 15 June 2020
Woloshin, S., Patel, N., & Kesselheim, A. S. (2020). False Negative Tests for SARS-CoV-2 Infection - Challenges and Implications. The New England Journal of Medicine, NEJM. June 6, 2020
Velly, L., Gayat, E., Jong, A. D., Quintard, H., Weiss, E., Cuvillon, P., et al. (2020, May 29). Guidelines: Anaesthesia in the context of COVID-19 pandemic. Anaesthesia Critical Care & Pain Medicine. May 29, 2020
Lee, L. Y. W., Cazier, J. B., Starkey, T., Turnbull, C. D., UK Coronavirus Cancer Monitoring Project Team, Kerr, R., & Middleton, G. (2020). COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet May 28, 2020.
WHO Clinical Management of Novel COVID MAY 27 2020.
Mandeep R Mehra, Sapan S Desai, Frank Ruschitzka, Amit N Patel Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis. Lancet May 22, 2020
Watson, J., Whiting, P. F., & Brush, J. E. (2020). Interpreting a covid-19 test result. Bmj, May 12.
Amawi, H., Abu Deiab, G. I., A Aljabali, A. A., Dua, K., & Tambuwala, M. M. (2020). COVID-19 pandemic: an overview of epidemiology, parthenogenesis, diagnostics and potential vaccines and therapeutics. Therapeutic Delivery. May 12, 2020
Matsushita, K., Marchandot, B., Jesel, L., Ohlmann, P., & Morel, O. (2020). Impact of COVID-19 on the Cardiovascular System: A Review. Journal of Clinical Medicine, 9(5), 1407. May 9, 2020.
Liu, Y.-C., Kuo, R.-L., & Shih, S.-R. (2020). COVID-19: the First Documented Coronavirus Pandemic in History. Biomedical Journal. May 8, 2020.
Alanagreh, L., Alzoughool, F., & Atoum, M. (2020). The Human Coronavirus Disease COVID-19: Its Origin, Characteristics, and Insights into Potential Drugs and Its Mechanisms. Pathogens. Apr 27 2020.
Baron, D. M., Franchini, M., Goobie, S. M., Javidroozi, M., Klein, A. A., Lasocki, S., et al. (2020). Patient blood management during the COVID-19 pandemic - a narrative review. Anaesthesia. April 27, 2020.
Peters, A. W., Chawla, K. S., & Turnbull, Z. A. (2020). Transforming ORs into ICUs. The New England Journal of Medicine. APRIL 24 2020.
Siordia, J. A. (2020). Epidemiology and clinical features of COVID-19: A review of current literature. Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology, 127, 104357. May 2020
Baloch, S., Baloch, M. A., Zheng, T., & Pei, X. (2020). The Coronavirus Disease 2019 (COVID-19) Pandemic. The Tohoku Journal of Experimental Medicine, 250(4), 271–278. APRIL 23 2020.
Arias-Reyes C, Zubieta-DeUrioste N, Poma-Machicao L, et al. Does the pathogenesis of SAR-CoV-2 virus decrease at high-altitude? RespirPhysiol Neurobiol. 2020 Apr 22 2020
Jayawardena R, Sooriyaarachchi P, Chourdakis M. Enhancing immunity in viral infections, with special emphasis on COVID-19: A review. Diabetes Metab Syndr. 2020 Apr 16;14(4):367-382
Huang I, Lim MA, Pranata R. Diabetes mellitus is associated with increased mortality and severity of disease in COVID-19 pneumonia - A systematic review,meta-analysis, and meta-regression. Diabetes Metab Syndr. 2020 Apr17 2020.
Dolhnikoff, M., Duarte-Neto, A. N. et al. (2020). Pathological evidence of pulmonary thrombotic phenomena in severe COVID-19. Journal of Thrombosis and Haemostasis : JTH. 15 April 2020.
Verbeek, J. H., Rajamaki, B.., et al. (2020). Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. The Cochrane Database of Systematic Reviews. 15 April 2020
Sanders JM, Monogue M. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19) A Review. JAMA, 13 April 2020
Brücher B.L.D.M, Nigri G, Tinelli A, Lapena Jr J.F.F, Espin-Basany E, et al. 2020. COVID-19: Pandemic surgery guidance. 4open, 3, 1. 10 April 2020
Giannis, D., Ziogas, I. A., & Gianni, P. (2020). Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past. Journal of Clinical Virology. April 9 2020.
Prachand, V. N., Milner, R., Angelos, P., American, M. P. J. O. T., 2020. (n.d.). Medically-necessary, time-sensitive procedures: A scoring system to ethically and efficiently manage resource scarcity and provider risk during the COVID-19. J Am Coll Surg. April 7, 2020.
Alhazzani, W., Møller, M., Arabi, Y., Loeb, M., & Gong, M. (2020). Surviving Sepsis Campaign. guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19) Intensive Care Med. March 20 2020.
COVID -19. MANEJO DE LA VÍA AEREA PACIENTE COVID19
Matava, C. T., Kovatsis, P. G., and, J. S. A., 2020. (n.d.). Pediatric Airway Management in COVID-19 patients – Consensus Guidelines from the Society for Pediatric Anesthesia’s Pediatric Difficult Intubation Collaborative and the Canadian Pediatric Anesthesia Society. Anesthesia & Analgesia Journal April 15 2020.
Yao, W., Wang, T., Jiang, B., Gao, F., Wang, L., Zheng, H., et al. (2020). Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. British Journal of Anaesthesia. Feb 28, 2020