Medicina Familiar

CONSTELLATION Vision System: Recall

July 22nd, 2010 Ruben Roa No comments

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MedWatch logo MedWatch - The FDA Safety Information and Adverse Event Reporting Program

CONSTELLATION Vision System: Recall

AUDIENCE: Eye care, Surgery, Risk Manager

ISSUE: Alcon initiated the recall after it identified both software and hardware problems which have been associated with unexpected system loss of power (shutdowns), unintended system error messages, unresponsive touchscreens, and system setting and infusion performance problems. These events may cause eye injuries, including blindness.

BACKGROUND: The Alcon CONSTELLATION Vision System is an ophthalmic microsurgical system used by eye surgeons to perform various types of eye surgery. All model and catalog numbers are affected by this recall and are listed in the FDA Recall Notice. These devices were manufactured and distributed from September 1, 2008 through April 30, 2010.

Read the complete MedWatch 2010 safety summary, including a link to the FDA Recall Notice, at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm219665.htm

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Categories: MedWatch Tags: Alcon, Constellation, Food and Drug Administration, MedWatch, Ophthalmology, surgery

Diagnostico y manejo de la hiperplasia prostatica benigna

June 8th, 2010 Ruben Roa 1 comment

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Diagnosis and management of benign prostatic hyperplasia.

Edwards JL

May 15, 2008 Vol. 77 No. 10

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Full Text

Benign prostatic hyperplasia is a common condition affecting older men. Typical presenting symptoms include urinary hesitancy, weak stream, nocturia, incontinence, and recurrent urinary tract infections. Acute urinary retention, which requires urgent bladder catheterization, is relatively uncommon. Irreversible renal damage is rare. The initial evaluation should assess the frequency and severity of symptoms and the impact of symptoms on the patient’s quality of life. The American Urological Association Symptom Index is a validated instrument for the objective assessment of symptom severity. The initial evaluation should also include a digital rectal examination and urinalysis. Men with hematuria should be evaluated for bladder cancer. A palpable nodule or induration of the prostate requires referral for assessment to rule out prostate cancer. For men with mild symptoms, watchful waiting with annual reassessment is appropriate. Over the past decade, numerous medical and surgical interventions have been shown to be effective in relieving symptoms of benign prostatic hyperplasia. Alpha blockers improve symptoms relatively quickly. Although 5-alpha reductase inhibitors have a slower onset of action, they may decrease prostate size and alter the disease course. Limited evidence shows that the herbal agents saw palmetto extract, rye grass pollen extract, and pygeum relieve symptoms. Transurethral resection of the prostate often provides permanent relief. Newer laser-based surgical techniques have comparable effectiveness to transurethral resection up to two years after surgery with lower perioperative morbidity. Various outpatient surgical techniques are associated with reduced morbidity, but symptom relief may be less durable. (Am Fam Physician. 2008;77(10):1403-1410, 1413. Copyright © 2008 American Academy of Family Physicians.)

Enlarged Prostate (BPH) May Cause Variety of Urinary Symptoms (seniors-health-medicare.suite101.com)
Homeopathy for Benign Prostatic Hyperplasia (homeopathy.suite101.com)
Prostate Problems (mens-sexual-health.suite101.com)
Prostate Cancer Diagnosis – PSA Blood Test, DRE and Cancer Biopsy (menshealth.suite101.com)
Research finds surgery outperforms drug therapy in treatment of benign prostatic hyperplasia (physorg.com)
What is Benign Prostatic Hypertrophy (BPH) — Symptoms and Signs? (menshealth.suite101.com)
Research Finds Surgery Outperforms Drug Therapy in Treatment of Benign Prostatic Hyperplasia (eon.businesswire.com)
Simbionix to Reveal Two New Products at the Upcoming American Urology Association (AUA) Annual Meeting (newswire.ca)
Enlarged Prostate: Surgery Better Than Drug Therapy (livescience.com)
Prostate Specific Antigen (PSA) Blood Test Screening Reliability (menshealth.suite101.com)

Categories: Articulos de interés, Prostata Tags: Am Fam Physycian, American Family Physician, Articulos de interés, Benign prostatic hyperplasia, Cancer, Diagnostico, hiperplasia, Journals, medicina familiar, medicina general, Prostata, prostate, Rectal examination, seguimiento, surgery, Urinary tract infection

PHTLS 6º Edición

April 29th, 2010 Ruben Roa No comments

ca-pub-5387861572296846

Este manual es la máxima fuente para aprender habilidades y conceptos, básicos y avanzados, del soporte vital prehospitalario. Ahora revisado y expandido para cubrir todos los aspectos del trauma prehospitalario – con nuevos capítulos de quemaduras, trauma ambiental, consideraciones tácticas, armas de destrucción masiva, triage y manejo de desastres.

Formato: PDF
Tamaño: 106 Mb

LINK: www.megaupload.com/?d=XOK1AW95

PASS: peterpan
Via: Rescue Today

Categories: Biblioteca virtual, e-books, emergencia, emergencias, urgencias Tags: Biblioteca virtual, e-book, emergencias, libros, medicine, PHTLS, surgery, trauma

Surgical Clinics of North America Volume 88, Issue 1, February 2008. Advances in Abdominal Wall Hernia Repair

March 23rd, 2010 Roxana Brandt No comments

ca-pub-5387861572296846

Edited by K.M.F. Itani, M. Hawn
In the field of general surgery, hernia surgery remains the most common surgical procedure performed, with inguinal hernias leading the pack. While surgeons spent the early part of the twentieth century improving the technique of primary repair, the latter half was focused on developing techniques of mesh repair, minimizing incisions, and maximizing comfort. As in the majority of studies in general surgery, most hernia reports were observational, retrospective, single center or single surgeon studies. It has not
been until the last 10 years that well planned, prospective randomized trials have started to emerge, providing higher level evidence for the practice of hernia surgery. Despite these clinical trials, there is still no final consensus on timing of treatment, technique to be used, material, and mesh position.

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http://rapidshare.com/files/367228901/Feb_2008.rar.html

Categories: Biblioteca virtual, Cirugia Tags: Clinical trial, Conditions and Diseases, Digestive Disorders, General surgery, Hernia, Intestinal, surgery

Evidence Medicine Update

March 16th, 2010 Ruben Roa No comments

ca-pub-5387861572296846

Maintenance of Long-Term Clinical Benefit With Sirolimus-Eluting Stents in Patients With ST-Segment Elevation Myocardial Infarction 3-Year Results of the SESAMI (Sirolimus-Eluting Stent Versus Bare-Metal Stent In Acute Myocardial Infarction) Trial. J Am Coll Cardiol	Cardiology	5	4
Dietary interventions for phenylketonuria. Cochrane Database Syst Rev	Genetics	6	5
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Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med	Emergency Medicine	7	6
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Ethosuximide, valproic acid, and lamotrigine in childhood absence epilepsy. N Engl J Med	General Practice(GP)/Family Practice(FP)	6	6
First-trimester follistatin-like-3 levels in pregnancies complicated by subsequent gestational diabetes mellitus. Diabetes Care	Obstetrics	6	5
	Endocrine	5	3
Minimal Contribution of Fasting Hyperglycemia to the Incidence of Type 2 Diabetes in Subjects With Normal 2-h Plasma Glucose. Diabetes Care	Endocrine	6	6
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	General Internal Medicine-Primary Care(US)	5	3
Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit. Cochrane Database Syst Rev	Pediatric Neonatology	6	4
The effectiveness of inpatient geriatric evaluation and management units: a systematic review and meta-analysis. J Am Geriatr Soc	Hospital Doctor/Hospitalists	5	6
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Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst Rev	Geriatrics	6	5
The value of serum procalcitonin level for differentiation of infectious from noninfectious causes of fever after orthopaedic surgery. J Bone Joint Surg Am	Surgery – Orthopaedics	6	6
Prospective Multicenter Trial Comparing Push-and-Pull Enteroscopy With the Single- and Double-Balloon Techniques in Patients With Small-Bowel Disorders. Am J Gastroenterol	Gastroenterology	5	5
Umbilical artery catheters in the newborn: effects of heparin. Cochrane Database Syst Rev	Pediatrics (General)	6	5
Surgical sealant for preventing air leaks after pulmonary resections in patients with lung cancer. Cochrane Database Syst Rev	Surgery – Oncology	5	5
Symptomatic treatment of the cough in whooping cough. Cochrane Database Syst Rev	Pediatrics (General)	6	4
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Predictors of colorectal cancer after negative colonoscopy: a population-based study. Am J Gastroenterol	Gastroenterology	6	4
Oral steroids for cystic fibrosis. Cochrane Database Syst Rev	Pediatrics (General)	6	5
Evaluating the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults. J Am Geriatr Soc	Geriatrics	7	4
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The effectiveness and active ingredients of mutual support groups for family caregivers of people with psychotic disorders: a literature review. Int J Nurs Stud	GP/FP/Mental Health	5	4
	General Internal Medicine-Primary Care(US)	3	3
	General Practice(GP)/Family Practice(FP)	3	3
Statins for the Primary Prevention of Cardiovascular Events in Women With Elevated High-Sensitivity C-Reactive Protein or Dyslipidemia. Results From the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) and Meta-Analysis of Women From Primary Prevention Trials. Circulation	General Practice(GP)/Family Practice(FP)	7	4
	General Internal Medicine-Primary Care(US)	7	4
A randomized, double-blind, placebo-controlled trial evaluating the efficacy and safety of ABT-594 in patients with diabetic peripheral neuropathic pain. Pain	Special Interest – Pain — Physician	6	6
	Neurology	5	5
The diagnostic value of provocative clinical tests in ulnar neuropathy at the elbow is marginal. J Neurol Neurosurg Psychiatry	Neurology	6	5
Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal. Cochrane Database Syst Rev	Psychiatry	6	5
Defining high-risk patients for endovascular aneurysm repair. J Vasc Surg	Surgery – Vascular	6	6
	Cardiology	4	4
Placebo interventions for all clinical conditions. Cochrane Database Syst Rev	Allergy and Immunology	6	6
	Psychiatry	6	6
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	Hematology/Thrombosis	4	4
Laparoscopic surgery for subfertility associated with endometriosis. Cochrane Database Syst Rev	Gynecology	6	5
	Obstetrics	6	5
Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet	Oncology – Gynecology	7	5
	Gynecology	6	5
Psychological interventions for symptomatic management of non-specific chest pain in patients with normal coronary anatomy. Cochrane Database Syst Rev	General Practice(GP)/Family Practice(FP)	6	5
	General Internal Medicine-Primary Care(US)	6	5
Outpatient intravenous ketamine for the treatment of complex regional pain syndrome: a double-blind placebo controlled study. Pain	Special Interest – Pain — Physician	7	5
Antiviral drugs for the treatment of influenza: a systematic review and economic evaluation. Health Technol Assess	General Practice(GP)/Family Practice(FP)	6	5
	General Internal Medicine-Primary Care(US)	6	5
Does the early administration of beta-blockers improve the in-hospital mortality rate of patients admitted with acute coronary syndrome?. Acad Emerg Med	Hospital Doctor/Hospitalists	7	5
	Internal Medicine	7	5
	Emergency Medicine	6	5
Progestational agents for treating threatened or established preterm labour. Cochrane Database Syst Rev	Obstetrics	6	5
	GP/FP/Obstetrics	6	4
Reduction of acute anterior dislocations: a prospective randomized study comparing a new technique with the Hippocratic and Kocher methods. J Bone Joint Surg Am	Surgery – Orthopaedics	7	7
The Absence of Coronary Calcification Does Not Exclude Obstructive Coronary Artery Disease or the Need for Revascularization in Patients Referred for Conventional Coronary Angiography. J Am Coll Cardiol	Cardiology	7	7
Habit retraining for the management of urinary incontinence in adults. Cochrane Database Syst Rev	General Practice(GP)/Family Practice(FP)	6	6
	General Internal Medicine-Primary Care(US)	6	6
	Geriatrics	6	3
	Surgery – Urology	4	4
Does the use of TENS increase the effectiveness of exercise for improving walking after stroke? A randomized controlled clinical trial. Clin Rehabil	Physical Medicine and Rehabilitation	7	7
	Neurology	6	5
Antibiotic prophylaxis in clean and clean-contaminated ear surgery. Cochrane Database Syst Rev	Surgery – Ear Nose Throat	7	6
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Prophylactic antibiotics for burns patients: systematic review and meta-analysis. BMJ	Infectious Disease	6	5
	Dermatology	5	5
Parent initiated prednisolone for acute asthma in children of school age: randomised controlled crossover trial. BMJ	General Practice(GP)/Family Practice(FP)	6	6
	Pediatrics (General)	6	6
Umbilical artery catheters in the newborn: effects of catheter materials. Cochrane Database Syst Rev	Pediatrics (General)	6	5
	Pediatric Neonatology	6	4
Half Doses of PEG-ES and Senna vs. High-Dose Senna for Bowel Cleansing Before Colonoscopy: A Randomized, Investigator-Blinded Trial. Am J Gastroenterol	Gastroenterology	5	4
Ultrasound versus `clinical touch` for catheter guidance during embryo transfer in women. Cochrane Database Syst Rev	Gynecology	7	5
Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. Lancet	Hospital Doctor/Hospitalists	6	6
	Internal Medicine	6	6
	Surgery – Orthopaedics	6	6
Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev	Pediatric Emergency Medicine	7	5
	Hospital Doctor/Hospitalists	6	5
	Internal Medicine	6	5
	Public Health	6	4
	General Practice(GP)/Family Practice(FP)	6	4
	General Internal Medicine-Primary Care(US)	6	4