CIRUGIA EN EL ARCO IRIS

Perioperative Medicine

2011-11-06T06:36:00.000-08:00

Perioperative Medicine

Steven L. Cohn (Editor)

Product Description

Perioperative Medicine uses a concise, highly practical, bulleted format designed to ensure rapid comprehension of key concepts and reinforce the reader's understanding of complex topics in perioperative medicine. It contains authoritative, up-to-date coverage of the most essential concepts in perioperative care from preoperative risk assessment to postoperative follow-up. The Editor and his contributors use their expert insight and experience to provide an in-depth review of comorbid conditions, patient and surgery-specific risk assessment, and common postoperative complications.

This new book reviews recent developments in the field, including published guidelines, and emphasizes an evidence-based, cost-effective approach designed to ensure quality, patient safety, and optimal outcomes. It is intended for use by hospitalists, general internists and subspecialists as well as anesthesiologists, surgeons, and residents in training who are caring for patients before and after surgery.

Product Details

Paperback: 588 pages

Publisher: Springer; 1st Edition. edition (July 19, 2011)

Language: English

ISBN-10: 0857294970

ISBN-13: 978-0857294975

Format: HQ PDF with bookmarks, pagination and cover

Size: 3.7 MB
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Bolsa de Bogota.AVI

2011-11-01T22:36:00.000-07:00

BOLSA DE BOGOTA

2011-11-01T22:26:00.000-07:00

USO DE LA BOLSA DE BOGOTA:

Esta es una alternativa quirúrgica co - adyuvante en el tratamiento de la Sepsis Intra - abdominal para tratar de modificar el curso de esta grave enfermedad. Llamada la BOLSA DE BOGOTA.

Esta técnica consiste en el cierre diferido de la cavidad abdominal después de una laparotomía, como alternativa de manejo para los casos de sepsis abdominal traumática y no traumática. El tratamiento del manejo del abdomen abierto ha presentado varias modificaciones desde que se inició su uso, en la segunda guerra mundial, hasta la actualidad.

El objetivo de este procedimiento es evitar la formación de focos sépticos múltiples y proteger la pared disminuyendo el daño que presenta ésta por cierres y lavados intra abdominales sucesivos.

El cierre diferido de la cavidad abdominal mediante el uso de la bolsa de Bogotá, es una técnica quirúrgica ampliamente utilizada, no solo en el tratamiento de los pacientes con abdomen séptico, sino en el de aquellos con trauma grave, o en la prevención del Síndrome Abdominal Compartamental.

El tratamiento de este tipo de paciente con sepsis abdominal requiere de la colaboración multidisciplinaria, que involucra el manejo clínico, soporte nutricional (Nutricio Parenteral Total y entérico) y quirúrgico.

En nuetro medio utilizamos para tal fín las bolsas de plástico grueso de plasma y/o sangre previamente esterilizados y se suturan con Nylon Nº 1 ó 0 al espesor de la piel o a lo que queda de fascia..... Una imagen dice mas que mil palabras ................

ERCP

2011-10-24T21:10:00.000-07:00

ERCP

By Todd H. Baron MD, Richard Kozarek MD, David Leslie Carr-Locke MD FACG FRCP

* Publisher: Saunders

* Number Of Pages: 572

* Publication Date: 2007-10-25

* ISBN-10 / ASIN: 1416042717

* ISBN-13 / EAN: 9781416042716

Product Description:

This is the most comprehensive and user-friendly book yet produced on ERCP. For the first time it combines an in-depth review of this complex topic with easily accessible, detailed and authoritative instructions on how to safely gain access to the biliary and pancreatic ducts and deliver effective therapy. The intricacies of the procedures are shown using beautifully drawn step-by-step illustrations. This book is dedicated to simplifying and explaining everything that you need to know to effectively and safely practice ERCP.

* Uses the clearest, most detailed instructions on performing ERCP produced to date, so you can follow each procedure in-depth.

* Includes stunning, full-color, step-by-step illustrations to guide you through each procedure.

* Organizes information simply and consistently, making finding what you need quick and easy.

* Contains a section on how to ensure that ERCP is the appropriate therapy for your patient.

PDF 61 mb

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Colonoscopy: Principles and Practice

2011-10-24T21:03:00.000-07:00

Colonoscopy: Principles and Practice

By Jerome D. Waye, Douglas K. Rex, Christopher B. Williams

* Publisher: Wiley-Blackwell
* Number Of Pages: 800
* Publication Date: 2009-07-27
* ISBN-10 / ASIN: 1405175990
* ISBN-13 / EAN: 9781405175999

Product Description:

First Edition - Winner of 2004 BMA Medical Book Competition in Gastroenterology

The second edition of this prize winning book is written by some of the world’s foremost experts in the field of colonoscopy and colonic imaging. Every chapter has been updated and 5 new chapters have been added to include the latest information and advances in the field of colonoscopy:
* Capsule Colonoscopy

* Narrow Band Imaging

* Confocal Endomicroscopy

* Endoscopic Submucosal Dissection in the Colon

* New Colonoscopes and Assist Devices

Drawing on the vast experience of the authors it covers every area of medicine that impacts on colonoscopy, including virtual colonography, pathology, techniques for pediatric and adult procedures, and legal aspects concerning colonoscopy.

The book is focused on patient care, and provides explanations on how to perform the procedure effectively and make the best outcome for your patients. It serves as a detailed manual of procedures, extensively illustrated with diagrams and photographs.

This is an invaluable compendium on all aspects of colonoscopy, suitable for use by every grade of practitioner world-wide and an essential reference book for allestablishments with an endoscopy facility.

PDF 26 MB

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Principles and Practice of Gastrointestinal Oncology, 2nd Edition

2011-10-24T20:59:00.000-07:00

Principles and Practice of Gastrointestinal Oncology, 2nd Edition

By David P Kelsen, John M Daly, Scott E Kern, Bernard Levin, Joel E Tepper

Number Of Pages: 1008

Publication Date: 2007-10-01

Product Description:

Thoroughly updated for its Second Edition, this text provides comprehensive, interdisciplinary coverage of gastrointestinal cancer, including molecular biology, diagnosis, medical, surgical, and radiation therapy, and palliative care. The initial section, Principles of Gastrointestinal Oncology, includes an expanded radiation oncology chapter, an extensively revised cancer genetics chapter, and a completely rewritten medical oncology chapter emphasizing new agents. Subsequent sections focus on esophageal, gastric, pancreatic, hepatocellular, biliary tree, and colorectal cancer. Coverage of each anatomic site includes epidemiology, screening, and prevention; molecular biology and genetics; pathology; anatomy and staging; and clinical management. The final section on uncommon cancers includes new chapters on neuroendocrine tumors and small bowel cancers. A companion Website provides instant access to the complete, fully searchable text.

CHM 51 mb
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Pediatric Oncology (M.D. Anderson Cancer Care Series)

2011-10-13T21:41:00.000-07:00

Pediatric Oncology (M.D. Anderson Cancer Care Series)

1 edition

Published May 6, 2005 by Springer .

Written in English.

First Sentence

This chapter describes the diagnostic, therapeutic, and supportive care measures used at M. D. Anderson Cancer in the treatment of pédiatrie patients with acute leukemia.

The Physical Object

Format Paperback

Number of pages 288

Dimensions 8.9 x 5.8 x 0.6 inches

Weight 1 pounds

ID Numbers

Open Library OL9901193M

ISBN 10 0387244700

ISBN 13 9780387244709

Goodreads 1463710

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HARRISON PRINCIPIOS DE MEDICINA INTERNA

2011-10-12T21:06:00.000-07:00

Harrison Principios de Medicina Interna

18va edición
Anthony S. Fauci, Eugene Braunwald, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo, J. Larry Jameson, and Joseph Loscalzo, Eds.

Parte 1. Introducción a la medicina clínica

Capítulo 1 La práctica de la medicina clínica

Capítulo 2 Aspectos mundiales de la medicina

Capítulo 3 Toma de decisiones en medicina clínica

Capítulo 4 Detección sistemática y prevención de enfermedades

Capítulo 5 Principios de farmacología clínica

Capítulo 6 Salud de la mujer

Capítulo 7 Trastornos médicos durante el embarazo

Capítulo 8 Evaluación médica del paciente quirúrgico

Capítulo 9 Medicina geriátrica

Capítulo 10 Medicina complementaria y alternativa

Capítulo 11 Atención paliativa y terminal

Capítulo e1 Seguridad y calidad de la asistencia médica

Capítulo e2 Consideraciones económicas en la práctica de la medicina

Capítulo e3 Desigualdades raciales y étnicas en la atención a la salud

Capítulo e4 Cuestiones éticas en medicina clínica

Parte 2. Síntomas principales y cuadro inicial de las enfermedades

Sección 1. Dolor

Capítulo 12 Dolor: fisiopatología y tratamiento

Capítulo 13 Molestias retroesternales

Capítulo 14 Dolor abdominal

Capítulo 15 Cefalalgia

Capítulo 16 Dolor de espalda y cuello

Sección 2. Alteraciones de la temperatura corporal

Capítulo 17 Fiebre e hipertermia

Capítulo 18 Fiebre y erupciones

Capítulo e5 Atlas de erupciones febriles

Capítulo 19 Fiebre de origen desconocido

Capítulo 20 Hipotermia y congelación

Sección 3. Disfunción del sistema nervioso

Capítulo 21 Síncope

Capítulo 22 Mareo y vértigo

Capítulo 23 Debilidad y parálisis

Capítulo 24 Trastornos de la marcha y el equilibrio

Capítulo 25 Entumecimiento, hormigueo y déficit sensorial

Capítulo 26 Confusión y delirio

Capítulo e6 Pérdida de la memoria

Capítulo 27 Afasia, amnesia y otros trastornos cerebrales focales

Capítulo 28 Trastornos del sueño

Sección 4. Trastornos de los ojos, oídos, nariz y garganta

Capítulo 29 Trastornos oculares

Capítulo 30 Trastornos del olfato, el gusto y la audición

Capítulo 31 Faringitis, sinusitis, otitis y otras infecciones de las vías respiratorias superiores

Capítulo 32 Manifestaciones bucales de enfermedades

Capítulo e7 Atlas de manifestaciones orales de las enfermedades

Sección 5. Alteraciones en las funciones circulatoria y respiratoria

Capítulo 33 Disnea y edema pulmonar

Capítulo 34 Tos y hemoptisis

Capítulo 35 Hipoxia y cianosis

Capítulo 36 Edema

Capítulo e8 Abordaje del paciente con un soplo cardiaco

Capítulo 37 Palpitaciones

Sección 6. Alteraciones de la función gastrointestinal

Capítulo 38 Disfagia

Capítulo 39 Náusea, vómito e indigestión

Capítulo 40 Diarrea y estreñimiento

Capítulo 41 Pérdida de peso

Capítulo 42 Hemorragia de vías digestivas

Capítulo 43 Ictericia

Capítulo 44 Hinchazón abdominal y ascitis

Sección 7. Alteraciones de la función renal y de las vías urinarias

Capítulo 45 Hiperazoemia y alteraciones urinarias

Capítulo e9 Atlas de sedimentos urinarios y biopsias de riñón

Capítulo 46 Alteraciones de líquidos y electrólitos

Capítulo 47 Hipercalciemia e hipocalciemia

Capítulo 48 Acidosis y alcalosi

Sección 8. Alteraciones de la función sexual y reproductora

Capítulo 49 Disfunción sexual

Capítulo 50 Hirsutismo y virilización

Capítulo 51 Trastornos menstruales y dolor pélvico

Sección 9. Alteraciones de la piel

Capítulo 52 Estudio del paciente con trastornos cutáneos

Capítulo 53 Eccema, psoriasis, infecciones cutáneas, acné y otros trastornos cutáneos frecuentes

Capítulo 54 Manifestaciones cutáneas de enfermedades internas

Capítulo 55 Enfermedades cutáneas de mecanismo inmunitario

Capítulo 56 Reacciones cutáneas a medicamentos

Capítulo 57 Fotosensibilidad y otras reacciones a la luz

Capítulo e10 Atlas de manifestaciones cutáneas de las enfermedades internas

Sección 10. Alteraciones hematológicas

Capítulo 58 Anemia y policitemia

Capítulo 59 Hemorragia y trombosis

Capítulo 60 Linfadenopatía y esplenomegalia

Capítulo 61 Trastornos de los granulocitos y monocitos

Capítulo e11 Atlas de hematología y análisis de frotis de sangre periférica

Parte 3. Genética y enfermedades

Capítulo 62 Principios de genética humana

Capítulo 63 Trastornos cromosómicos

Capítulo 64 La genética en la práctica clínica

Capítulo 65 Terapia génica en medicina clínica

Parte 4. Medicina de regeneración

Capítulo 66 Aspectos biológicos de los citoblastos

Capítulo 67 Aplicaciones de las propiedades biológicas de los citoblastos en la medicina clínica

Capítulo 68 Hemocitoblastos

Capítulo 69 Ingeniería hística

Parte 5. Nutrición

Capítulo 70 Necesidades de nutrientes y valoración de la alimentación

Capítulo 71 Deficiencias y excesos de vitaminas y oligoelementos

Capítulo 72 Malnutrición y evaluación nutricional

Capítulo 73 Nutrición enteral y parenteral con fines terapéuticos

Capítulo 74 Biología de la obesidad

Capítulo 75 Evaluación y tratamiento de la obesidad

Capítulo 76 Trastornos de la conducta alimentaria
Parte 6. Oncología y hematología

Sección 1. Enfermedades neoplásicas

Capítulo 77 Estudio del paciente con cáncer

Capítulo 78 Prevención y detección del cáncer

Capítulo 79 Aspectos genéticos del cáncer

Capítulo 80 Biología de la célula cancerosa y angiogénesis

Capítulo 81 Principios del tratamiento del cáncer

Capítulo 82 Infecciones en los pacientes con cáncer

Capítulo 83 Cáncer de piel

Capítulo 84 Cáncer de cabeza y cuello

Capítulo 85 Neoplasias de pulmón

Capítulo 86 Cáncer de mama

Capítulo 87 Cáncer del aparato digestivo

Capítulo 88 Tumores de hígado y vías biliares

Capítulo 89 Cáncer de páncreas

Capítulo 90 Carcinomas de vejiga y de células renales

Capítulo 91 Enfermedades benignas y malignas de la próstata

Capítulo 92 Cáncer testicular

Capítulo 93 Neoplasias ginecológicas malignas

Capítulo 94 Sarcomas de los tejidos blandos y el hueso

Capítulo 95 Carcinoma de origen primario desconocido

Capítulo 96 Síndromes paraneoplásicos: endocrinológicos y hematológicos

Capítulo 97 Síndromes neurológicos paraneoplásicos

Capítulo e12 Timoma

Capítulo e13 Consecuencias tardías del cáncer y su tratamiento

etc etc etc

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¿QUE ES UNA HERNIA?

2011-09-24T04:08:00.000-07:00

DEFINICIÓN DE HERNIA

Una Hernia Externa de la pared abdominal la podemos definir como la protrusión del tejido intra – abdominal, es decir de toda una víscera hueca, de una parte de la misma ó del Epiplón Mayor a través de un orificio pre – formado (embrionariamente) o pre – existente, o como consecuencia de una debilidad de la pared abdominal, pero siempre precedido de un saco denominado “Saco Herniario”.

Esta diferencia es fundamental cuando hablamos de una “Eventración” o “Hernia Incisional” que protruye y puede o no tener saco, en este caso llamado “Saco de Eventración”, como consecuencia de una previa intervención quirúrgica.

¿Qué es el Saco Herniario?

En realidad es el Peritoneo que va empujando a todas las estructuras superficiales de la pared abdominal.

¿Cuáles son las partes del Saco herniario?

Sus partes son:

1. Fondo

2. Cuerpo

3. Cuello

4. Anillo

5. Boca

PARTES CONSTITUTIVAS DE UNA HERNIA:

Las podemos considerar en:

1. Partes Blandas que rodean a la hernia.

1.1. Partes Blandas: Piel, Tejido Celular Subcutáneo.

2. La Hernia propiamente dicha:

Anillo Herniario: Se encuentra formado por los bordes músculos aponeuróticos de la pared abdominal por donde emerge el saco herniario.

Continente: Llamado también Saco Herniario.

Contenido: Son las vísceras contenidas en el Saco Herniario.

CLASIFICACION

Toda hernia presenta un cuello o anillo herniario el cual frecuentemente es bastante estrecho y a través del cual emergen las vísceras desde el interior del abdomen. Esto produce un trastorno potencialmente peligroso, debido a que las vísceras que hacen procidencia en el interior de las hernias pueden obstruirse o estrangularse.

La entrada y salida de las vísceras intra – abdominales al interior del Saco Herniario es lo que se conoce con el nombre de “Fenómeno Herniario”.

1.- TENIENDO EN CONSIDERACIÓN LA PRESENCIA Ó NO DEL FENÓMENO HERNIARIO:

Podemos clasificar a las hernias en:

CLASIFICACION

Hernia Reductible

Hernia Irreductible

Hernia Estrangulada

1.1 HERNIA REDUCTIBLE:

Son aquellas hernias que se caracterizan por la entrada y salida de las vísceras abdominales de la cavidad abdominal al saco herniario cuando se realiza un pequeño esfuerzo físico, y el reingreso de las mismas al termino del esfuerzo físico o cuando se realiza una pequeña presión manual. En realidad este tipo de hernia transcurre en el tiempo y no causa ningún problema excepto la deformidad física. Quedando siempre la posibilidad de complicarse en algún momento.

Este tipo de hernia la podemos sub – clasificar en:

1. Hernia Cohercible: son aquellas hernias reductibles que se caracterizan porque el contenido del saco ingresa del saco herniario a la cavidad abdominal y permanece allí, hasta que se realice un nuevo esfuerzo físico.

2. Hernia Incohercible: son aquellas hernias reductibles que se caracterizan porque el contenido del saco ingresa a la cavidad abdominal, pero inmediatamente regresa al saco herniario. En este caso permanece en la cavidad abdominal unos segundos y sin realizar esfuerzo físico nuevamente vuelve al saco herniario.

1.2 HERNIAS IRREDUCTIBLES – INCARCELADAS – ENCARCELADAS:

Son aquellas hernias que no presentan fenómeno herniario y que se encuentran atrapadas por el cuello estrecho y no pueden reingresar a la cavidad abdominal.

El termino de “incarcelación” no implica obstrucción, inflamación ó isquemia de los órganos comprometidos. Las maniobras que se realizan para reducir una hernia incarcelada se denominan “taxia”.

Cuando la irreductibilidad motiva en el paciente una “oclusión Intestinal” nos encontramos frente a un cuadro de “hernia atascada”. Cuando este cuadro se presenta en forma aguda, la taxia debe ser realizada inmediatamente y jamás 12 horas después de iniciado los síntomas.

Taxia: consiste en colocar al paciente en una camilla en posición decúbito dorsal, ligero tredelenburg. Con la palma de la mano en forma suave, circular y sostenida se trata de introducir el contenido de la hernia. Esto se comprueba por el gorgoteo que origina el asa intestinal al ingresar a la cavidad abdominal y desaparecer la tumoración herniaria. Debemos observar al paciente durante 6 horas posterior a la reducción herniaria con la finalidad de detectar signos y síntomas que indiquen reacción peritoneal.

Si ni se consigue reducir la hernia inguinal con las maniobras de taxia, administramos por vía intramuscular diazepan 10 mg. con atropina 0.25 mg. Observamos por 15 – 20 minutos y solicitamos paralelamente análisis (hemograma, hemoglobina, grupo sanguíneo, radiografía de pulmones y electrocardiograma) por si fuera necesaria la intervención quirúrgica de urgencia. Si la hernia se reduce y los exámenes auxiliares son normales observamos al paciente por 6 horas. Si la hernia no se reduce y los exámenes auxiliares son anormales y/o en la radiografía observamos niveles hidroaéreos debemos intervenir quirúrgicamente en forma urgente.

1.3 HERNIA ESTRANGULADAS:

Son aquellas hernias que no presentan fenómeno herniario y cuyo contenido del saco se encuentra con signos de isquemia o necrosis por estar comprometida la circulación sanguínea de los órganos abdominales atrapados por el cuello estrecho. Esta es la razón principal para operar una hernia ya que las complicaciones de presentarse una estrangulación puede comprometer la vida del paciente.

2.- SEGÚN EL MOMENTO DE SU APARICION

Podemos clasificar a las hernias en:

Clasificación según el

Momento de su aparición

1.- Hernia Simple

2.- Hernia Complicada

HERNIA SIMPLE: Son aquellas hernias que transcurren en el tiempo y evolucionan con una sintomatología simple, discreta y que al paciente no le ocasiona mayor severidad, ni gravedad. Sus estructuras se mantienen indemnes, sin ninguna alteración ni compromiso de los órganos herniados, puede mantenerse así durante mucho tiempo y por lo tanto su tratamiento será quirúrgico electivo.

HERNIA COMPLICADA: Son aquellas hernias que presentan una complicación en sus estructuras tanto en el continente como en su contenido especialmente. Comprometen el estado general del paciente, y presentan además un cuadro agregado que puede ser muy severo y grave como por ejemplo Obstrucción Intestinal, Peritonitis, etc. Este tipo de hernia requiere intervención quirúrgica de urgencia.

En los casos de HERNIA ESTRANGULADA existe compromiso del riego sanguíneo que produce necrosis de su contenido, el cual generalmente es intestinal. Estas hernias son de saco grande y anillo pequeño.

El riego de estrangulación de una hernia crural es de 40 % en comparación con la hernia inguinal directa de solo 3 %.

La instalación de esta complicación puede ser de forma AGUDA cuando existe torsión del contenido del saco con oclusión total de la circulación arterial y venosa; ó de forma SUBAGUDA cuando hay compresión de las venas mesentéricas con oclusión del flujo venoso y linfático. Se presenta edema mesentérico gradual hasta comprometer la circulación arterial (isquemia) que puede llegar a un infarto intestinal. La mortalidad operatoria es del 10 %.

Diagnóstico Clínico: aumento brusco de la tumoración herniaria, acompañado de dolor que aumenta con la palpación y enrojecimiento de la piel. Se acompaña de obstrucción intestinal – sepsis. El tratamiento quirúrgico es de urgencia.

3.- SEGÚN EL COMPARTIMIENTO EN EL CUAL SE LOCALIZAN:
Podemos clasificar a las hernias en:

Clasificación según el compartimiento

1.- Hernia Externa
2.- Hernia Interna

3.1 HERNIA EXTERNA:
Son aquellas hernias que hacen prominencia hacia el exterior y son visibles por el paciente. Se localizan preferentemente en la pared abdominal anterior y lumbar.

3.2 HERNIA INTERNA:
Son aquellas hernias que comunican un compartimiento con otro, por ejemplo de la cavidad abdominal a la cavidad torácica a través del músculo diafragma ó que se forman dentro de la cavidad abdominal a través de un orificio, por ejemplo un ojal a través del omento mayor.

4.- DE ACUERDO A SU ETIOLOGÍA:

Podemos clasificar a las hernias en:

Clasificación de acuerdo a su etiología.

1.- Hernia Congénita
2.- Hernia Adquirida
3.- Hernia Recidivada
4.- Hernia Traumática

4.1 HERNIA CONGENITA:

Son aquellas hernias que se presentan con el nacimiento de la persona, se asientan en un lugar que embriológicamente existió y que debió desaparecer en el nacimiento.

Ejemplo: la hernia umbilical del recién nacido, la hernia inguinal indirecta.

En el caso de la hernia inguinal indirecta se produce por persistencia del conducto peritoneo vaginal en el hombre y persistencia del conducto de Nuck en la mujer.

Hay hernias que aparecen mucho tiempo después del nacimiento, incluso ya en la edad adulta y el ejemplo típico es la hernia inguinal indirecta ó congénita.

4.2 HERNIA ADQUIRIDAS:
Son las que aparecen después del nacimiento y en cuya formación intervienen factores que favorecen la claudicación de la pared abdominal en sus puntos débiles. El ejemplo típico es la hernia umbilical del adulto y la hernia inguinal directa del anciano.

4.3 HERNIA RECIDIVADA:
Son aquellas hernias que aparecen después de haber sido intervenidas quirúrgicamente, el tiempo de aparición generalmente puede ser temprano (inmediato – mediato) ó tardío.

4.4 HERNIA TRAUMATICA:
Son aquellas hernias que se presentan posterior a un traumatismo o quizás cuando se ha realizado un gran esfuerzo físico.

5.- DE ACUERDO AL CONTENIDO DEL SACO

Como su nombre lo indica solo podríamos clasificar estas hernias tras la abertura del saco evidentemente, pero es importante conocerlas a pesar de que hoy en día con el uso de material protésico muchas técnicas quirúrgicas no abren el saco.

POR EL CONTENIDO DEL SACO:
1.- HERNIAS DESLIZADAS

2.- HERNIA DE RITCHER

3.- HERNIA DE LITRE

4.- HERNIA DE MAYDN

6.- HERNIA CON PERDIDA DE DOMICILIO

5.1 HERNIAS DESLIZADAS

Es aquel tipo de hernia generalmente de gran tamaño que se caracteriza por que el contenido del saco esta unido de tal manera a las vísceras (intestino grueso, vejiga, ovarios, trompas etc.) que hace casi imposible su disección. Se pueden presentar complicaciones como fístulas intestinales y recidivas de las mismas.

Son mas frecuentes en varones, aumentando su frecuencia con la edad, obesidad y el tiempo de enfermedad. Es muy raro que en este tipo de hernias se presente estrangulación y esto se explica por el amplio anillo que poseen. Son frecuentes en las hernias inguinales indirectas.

Clasificación:

- Extrasacular: cuando la víscera deslizada no forma parte del saco herniario. Ejemplo: Vejiga.

- Parasacular: cuando la víscera deslizada se convierte en parte del saco herniario. Ejemplo Colon descendente, Sigmoides.

5.2 HERNIA DE RITCHER:

Descrita en 1,785 por el cirujano alemán August Gottlieb Ritcher (1714 – 1812). Denominada también “por pellizcamiento” o “pinzamiento”. Es un tipo de hernia que compromete solo una parte del borde antimesentérico de la pared intestinal (Intestino Grueso o Delgado) ó del Epiplón Mayor atrapada por el cuello herniario. Generalmente este tipo de hernias se presentan en las personas de la tercera edad, sobretodo en las de sexo femenino, localizándose la mayor parte de las veces en la zona Crural o Femoral. También se describen en casos de personas obesas en la zona inguinal produciendo problemas de Obstrucción Intestinal.. Es un tipo de hernia bastante raro pero cuando se presenta puede hacer fácilmente necrosis del asa comprometida, vaciar su contenido dentro del saco y semejar una colección en dicha zona.

Se presenta con mayor frecuencia en la Hernia Crural que en la Hernia Inguinal en la relación de 15 / 1. El Diagnóstico lo podemos hacer durante el acto operatorio, pero también utilizando Ecografía, TAC y RMN.

5.3 HERNIA DE LITRE

Descrita en 1,700 por el cirujano francés Alexis Littre (1,685 – 1,726). Es un tipo especial de hernia, en el cual su contenido es el divertículo de Meckel. Frecuentemente se encuentra en las hernias umbilicales (30%), pero no es exclusividad de estas, ya que se encuentran descritas además en las hernias inguinales (25%), en las hernias crurales (20%) y en otras hernias. Son mas frecuentes en varones que en mujeres.

El Diagnóstico se realiza durante el acto operatorio o utilizando Ecografía, TAC y RMN.

5.4 HERNIA DE MAYDN

Es aquella hernia que tiene por contenido un asa intestinal, parte de esa asa intestinal sale del saco herniario e ingresa a la cavidad abdominal, parte de esa asa vuelve a ingresar al saco herniario y otro segmento sale nuevamente a la cavidad abdominal. Es decir el asa afectada hace una especie de “M” ó “W”.

5.5 HERNIA CON PERDIDA DE DERECHO A DOMICILIO

Son aquellas grandes hernias referidas a su saco y contenido, que han permanecido muchos años fuera de la cavidad abdominal. En el momento de su intervención quirúrgica resulta muy difícil que el contenido reingrese a la cavidad abdominal. Acarreando problemas respiratorio agudo en el post operatorio inmediato por la gran presión intra abdominal producida. Sobre su tratamiento y el neumoperitoneo previo hablaremos más adelante.

6.- FRECUENCIA DE LAS HERNIAS

Las hernias de la pared abdominal anterior, son las entidades quirúrgicas mas frecuentes en nuestro medio, siendo del orden del 10 - 15 % en relación a otras patologías quirúrgicas según diferentes estadísticas.

Ocupa casi un primer lugar en diferentes centros quirúrgicos cuando se trata de intervenciones quirúrgicas electivas, y si las intervenciones son de urgencia o emergencia ocupan un segundo lugar después de las Apendicitis Aguda y sus complicaciones.

7.- ETIOLOGÍA Y PATOGENIA DE LAS HERNIAS

Para que exista la presentación de una hernia hemos considerado la presentación de factores predisponentes y factores desencadenantes.

7.1 FACTORES PREDISPONENTES

7.1.1 HERENCIA: Interviene por factores genéticos o tendencia familiar al tener defecto congénito del orifico pre formado ó de la pared abdominal. Múltiples estudios nos indican que existen antecedentes familiares en los casos de hernias inguinales indirectas.

7.1.2 SEXO: El hombre esta mas predispuesto a la aparición de las hernias inguinales, mientras que la mujer esta mas predispuesta a la presentación de las hernias umbilicales y crurales.

7.1.3 EDAD: Los niños son mas predispuestos a la aparición de las hernia inguinal indirecta, por el contrario en las personas de edad avanzada la predisposición es a la presentación de hernia inguinal directa.

7.1.4 OBESIDAD: Este es uno de los factores que adquieren mayor importancia como factor predisponente en la formación de las hernias por la infiltración grasa en las fibras músculo – aponeuróticas y por infiltración grasa en los órganos, mesos y epiplón, aumentando así la presión intra abdominal.

7.1.5 EMBARAZO: Actúa por distensión de las fibras músculo aponeuróticas y por lo tanto con perdida de la elasticidad y resistencia de la pared abdominal.

7.1.6 DEFICIENCIA MÚSCULO APONEUROTICA: Cuando estas deficiencias de calidad, distribución e inserción se establecen en las zonas que anatómicamente son de menor resistencia como el conducto inguinal o la zona umbilical.

7.2 FACTORES DESENCADENANTES

Sabemos que existen factores que actúan tanto en forma predisponente como desencadenante en algunas oportunidades simultáneamente y en otras en forma sucesiva.

7.2.1 OBESIDAD: Por infiltración grasa intra – abdominal aumentando la presión de la misma, y por ende fuerza la salida de “pelotones” adiposos, con arrastre de peritoneo parietal, a través de soluciones de continuidad de tejidos predispuestos.

7.2.2 EMBARAZO: El desarrollo del feto y el crecimiento del útero determinan definitivamente un aumento de la presión intra abdominal.

7.2.3 OTROS FACTORES DESENCADENANTES: Por situaciones o afecciones que puedan favorecer el desarrollo de hernias, actuando como factores desencadenantes.

Ejemplos de estas afecciones son:

Enfermedades Respiratorias: tosedores crónicos, tuberculosos, asmáticos, enfisematosos, etc.

Enfermedades Urológicas: hipertrofia prostática, prostatitis: enfermedades con retención urinaria en las cuales para poder miccionar tiene que pujar constantemente; de igual manera sucede con las estrecheces uretrales, también se describen en las fimosis, etc.

Enfermedades Digestivas: como en los casos de obstrucción intestinal, vísceromegalia crónica en general (Hígado, Bazo, etc), ascitis, estreñidos crónicos, etc.

8.- SIGNOS Y SINTOMAS

Los signos y síntomas dependen del estado en que se encuentren las hernias, es decir en estado simple o complicado. En los casos de estado simple las hernias tienen síntomas muy discretos pero muy precisos e inconfundibles.

Existen tres datos muy precisos e infalibles en la sintomatología de las hernias que hacen que el diagnóstico de las mismas sea muy simple. Son los siguientes:

a) PRESENCIA DE TUMORACIÓN ó MASA: los pacientes generalmente le dan un nombre muy sui generis llamándolo “bulto”.

b) LOCALIZACIÓN EN LA ZONA DE ANILLOS U ORIFICIOS: son los orificios pre formados embrionariamente.

c) MODIFICACIÓN DE LA TUMORACION CON LOS GRANDES ESFUERZOS: sobretodo al inicio de la presentación de las hernias, ya que en las hernias de larga data, puede no haber ya esta modificación de la tumoración al realizar grandes esfuerzos. Esto, debido a la presencia de adherencias entre los componentes de la hernia (saco y contenido).

Estos tres factores son precisos, infalibles y capaces de diagnosticar por si solo la existencia de una hernia. Concomitantemente puede haber dolor abdominal que se caracteriza por ser difuso e impreciso, ó también se puede presentar dolor local en el sitio de la tumoración que se manifiesta con la aparición de la hernia, pero que cesa al reducirse la hernia o estar el paciente en reposo.

SIGNOS FISICOS: El examen físico del paciente con hernia debe realizarse en las posiciones de pie y de decúbito en una camilla de examen clínico. Los signos que vamos a encontrar son:

Tumoración localizada en la zona de anillos ú orificios que se modifican con el esfuerzo físico. (Aparece con el esfuerzo y desaparece con el reposo ó taxia.)

Debe realizarse la maniobra de Valsalva.

Todas las maniobras manuales deben ser realizadas en forma suave y adecuada tratando de evitar alterar las estructuras de la hernia. Según el contenido del saco podemos encontrar una tumoración blanda, dura, firme o fluctuante. Toda maniobra ó taxia que realicemos en el paciente con hernia deben hacerse con suma delicadeza, sobretodo en las hernias reductibles, evitando en lo máximo posible forzar la reducción si nos encontramos con alguna dificultad en algún momento.

En el caso de una hernia inguinal es importante examinar el anillo inguinal superficial para lo cual debemos con el dedo índice coger piel del escroto, introducir el dedo siguiendo el trayecto del cordón espermático en la zona externa del pubis hasta alcanzar el anillo. Palpar sus características: diámetro, si hay dolor, etc.

Para diferenciar una hernia inguinal directa de una indirecta hay que realizar la maniobra de Landivar que consiste en: reducida la hernia, presionar con el dedo índice la zona donde se encuentra el anillo inguinal profundo y se hace pujar o toser al paciente. Si aparece la hernia esta corresponde a una hernia inguinal directa. Si no aparece la hernia es una hernia inguinal indirecta.

También podemos percutir la tumoración en forma suave, obteniendo un timpanismo o una matidez según sea el contenido del saco, que puede ser una víscera hueca con contenido gaseoso ó liquido, o el epiplón mayor. Podemos auscultar la tumoración buscando la presencia de ruidos hidroaéreos si el contenido fuera un asa intestinal.

A todo paciente que presente un aumento de volumen en la región inguinal debemos realizar un examen semiológico siguiendo los parámetros que a continuación describimos:

1.- Inspección: visualizando las características de la tumoración: tamaño, forma, reductibilidad espontánea, aumento con esfuerzo provocado, su localización etc.

2.- Palpación: si existe reductibilidad, si existe dolor, su consistencia, su superficie etc.

3.- Percusión: diferenciar si existe timpanismo o matidez.

4.- Auscultación: con la finalidad de diferenciar si existe o no ruidos hidroaéreos.

5.- Transiluminación: se coloca una linterna de examen clínico por detrás de las bolsas escrotales con la finalidad de diferenciar la presencia de hidrocele si es translucido, u opaco y que nos diferenciaría la presencia de líquido de un asa intestinal o epiplón.

Dr. EUGENIO VARGAS CARBAJAL
MEDICO CIRUJANO - CIRUJANO GENERAL
CIRUJANO LAPAROSCOPISTA
CMP 11161 - RNE 4368
CONSULTAS: Lun a Sab de 5 a 8 pm
Av. Saenz Peña Nº 354 - B2 CALLAO (PERÚ)
TELEFONO: 4540308

HERNIAS DE LA PARED ABDOMINAL: HISTORIA

2011-09-24T03:17:00.000-07:00

“La Hernia inguinal es una de las patologías quirúrgicas que mas polémica ha suscitado en el tiempo en cuanto a su tratamiento a pesar de ser la zona inguinal una región tan pequeña en nuestro organismo. Por esta misma razón es que existe gran variedad de técnicas en cuanto a su tratamiento. Cuando creemos que ya la hemos resuelto definitivamente este problema con una técnica quirúrgica sui generis, aparece otra técnica que supera a la que ya hemos aprendido”

RESEÑA HISTORICA:

o La más antigua referencia sobre tratamiento de Hernias aparece en el “Papiro de Ebers” (1500 AC) descubierto en 1873 ; en el se describe el tratamiento de la hernia inguinal que consistía en única y exclusivamente colocar vendajes en la zona herniaria.

o Durante la era de Hipócrates (500 AC) en su libro “Corpus Hippocraticum” hay muy escasa referencia sobre hernias y menos aún sobre su tratamiento. Pero ya se señalaba en aquella época que las hernias de la ingle son mas frecuentes que las hernias umbilicales.

o Celso de Medicinae (25 DC) describe una operación de hernia inguinal en la que tras incidir el escroto por debajo del pubis se practicaba la “Quelotomía” ó extirpación del saco, dejando intacto el cordón espermático y testículo.

o Galeno (130 dc) tubo muy poca inclinación por la cirugía por lo que en su obra no aparece comentarios sobre el tratamiento de las hernias. Pero introdujo el concepto de ruptura del peritoneo para explicar su etiopatogenia.

o Paulus de Aegina (S VII DC) médico post galénico dicto normas para el tratamiento de las hernias con extirpación del testículo y que fueron seguidas hasta mediados del Renacimiento. Esta descripción se encuentra en su obra “Epitome”.

o Güy de Chauliac (1363 DC) perteneciente a la hermandad de cirujanos barberos de Montpelliere en su famosa obra “Chirurgia Magna” describe seis tipos de cirugía para hernias; entre las que mas destacan son la cauterización química con arsénico, la castración, y el llamado “cauterium potenciale” en donde pasa una hebra de oro alrededor del cordón para impedir el descenso de la hernia conservando la vascularización del testículo. Esta técnica fue muy utilizada por Ambrosio Paré en 1412.

o En la época del Renacimiento (1453 – 1600) destacó en el campo de la cirugía Ambrosio Paré pero su contribución al tratamiento de las hernias fue casi nulo, aunque describió la hernia diafragmática.

o Durante el periodo Barroco (1,600 – 1740) Percibal Pott describe la hernia congénita y su incarcelación. A pesar de estos avances Camper y Pott continuaron aceptando el uso de bragueros.

o En la época de la Ilustración (1740 – 1800) el profesor de anatomía Gimbernat de la Escuela de Cádiz y de Barcelona en su famosa obra “La Hernia Crural” describe todos los descubrimientos sobre hernias. También exploraron en esa época la región inguinocrural Ritcher y Scarpa quien describió la hernia por deslizamiento.

o En al época del Romanticismo (1800 – 1848) destaca el famoso Astley P. Cooper quien describe a la Fascia Transversalis como la principal barrera para evitar la hernia inguinal indirecta. Describe además el ligamento que lleva su nombre y que la hernia directa aparece por el Triángulo de Hesselbach descrito en 1814. Cabe destacar en esta época a Morton quien describe el Tendón Conjunto en 1841.

o En la época del Positivismo (1848 – 1914) destaca la figura de Eduardo Bassini quien describe la corrección quirúrgica basada en el fortalecimiento del plano posterior del canal inguinal, llevando el arco del transverso al arco de Poupart, restaurando la oblicuidad del canal inguinal al suturar por encima del cordón espermático la aponeurosis del oblicuo mayor. Estaba contra el uso del braguero post operatorio y a favor de la deambulación temprana.

o William Halsted (1852 – 1922) describe la reparación retrofunicular y las incisiones de descarga.

o Alexander Hugh Ferguson (1853 – 1912) describe la reparación prefunicular (Halsted II)

o George Paul la Roque (1876 – 1934) profesor y jefe del departamento de Clínica Quirúrgica en el Medical College of Virginia. Describe y aconseja el acceso trans – abdominal ya que ofrecía la garantía absoluta de lograr la ligadura alta al eliminar el saco herniario desde el interior del abdomen. En la actualidad su procedimiento es aplicable a las grandes hernias por deslizamiento y también a aquellas estranguladas y / o incarceladas.

o George Lenthal Cheatle (1865 – 1951) describe el acceso preperitoneal para la Hernioplastía inguinal a través de la línea media. Posteriormente dicho acceso fue cambiado a una incisión Pfannestiel.

o En la era actual destaca Earle Shouldice (1890 – 1965) describe la técnica quirúrgica que lleva su nombre, también llamada “técnica canadiense” la cual fue desarrollada en Toronto.

o Chester Bidwell Mcvay (1911 – 1987) y su asociado Barry Anson describen el uso del ligamento íleo pectíneo o de Cooper en el tratamiento quirúrgico de las hernias inguinales. La primera descripción de utilizar el ligamento de Cooper en vez del Poupart se atribuye a Georg Lotheissen (1868 – 1935) de Viena quien en 1898 hizo la sugerencia a Albert Narath (1864 – 1935) de Utrecht pero esto paso inadvertido hasta que Mcvay la puso en boga.

o Usher en 1954 publica sus buenos resultados en la reparación de hernias al utilizar malla de polipropileno.

o Irving L. Litchtenstein miembro del American College of Surgeons introduce el concepto de cirugía ambulatoria para las hernias como consecuencia de sus investigaciones publicadas en 1986 en “Hernioplastía libre de Tensión” utilizando malla de polipropileno y fijándola en la cara anterior del oblicuo menor y el ligamento inguinal, dejando pasar el cordón a través de una incisión en la malla. Otra contribución de este autor es el uso del tapón de material protésico para obturar el orificio herniario.

o Con el auge de la Cirugía Laparoscópica se ha ampliado este campo a la reparación quirúrgica de las hernias. Es así que Ger en 1982 reporta el cierre del orificio inguinal interno utilizando únicamente clips, en el año 1989 Bogjavalenski propone ocluir el saco herniario indirecto con una malla de polipropileno, en 1992 Schoultz y Arregui propusieron después de abrir longitudinalmente el peritoneo y liberar el saco, disecar ampliamente los colgajos peritoneales y colocar una malla de polipropileno grande la que se sujetaba con grapas, cubriendo de esta manera los orificios interno, directo y femoral. Se sutura el peritoneo y de esta manera se aísla la malla de la cavidad peritoneal.

o El tratamiento de las hernias especialmente inguinales, se ha modificado a través del tiempo según lo que les he expuesto y siendo este tipo de patología una de las mas frecuentes en Cirugía General todo cirujano debe dominar las técnicas clásicas y aplicarlas en la reparación de una hernia, con un conocimiento perfecto de la anatomía quirúrgica de la zona inguinal, utilizando la nueva tecnología, los mejores materiales de sutura y materiales protésicos adecuados. Todo esto le permitirá abordaje mínimo, reparación sin tensión, evitando de esta manera las recidivas y complicaciones.

Dr. EUGENIO VARGAS CARBAJAL
CIRUJANO GENERAL - LAPAROSCOPISTA
CMP 11161 - RNE 4368
Mg Maestria e Investigacion Universitaria.
CONSULTORIO:
Av. Saenz Peña Nº 354 - B2
Telefono 4540308
CALLAO - PERU
Atencio: Lun a Sab 5pm - 8 pm

Síndrome de Ogilvie: una complicación poscesarea

2011-09-21T21:35:00.000-07:00

Resumen:

El síndrome de Ogilvie es una seudoobstrucción aguda de colón en ausencia de obstrucción mecánica, se trata típicamente de una complicación que aparece tras cirugías, sobretodo de cadera y cesáreas. Es de difícil diagnóstico, sobre todo por tener clínica similar al ileo paralítico, aunque con una gravedad muy superior. Sus complicaciones por excelencia son la isquemia y la perforación, que cuando se establecen pueden tener una mortalidad de hasta el 50%.

Se trata de un caso con evolución tórpida poscesárea y que, a pesar del tratamiento médico, se complicó con perforación de ciego, acabando en una hemicolectomía derecha.

- 2009 SEGO. Publicado por Elsevier España.

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2011-09-18T20:56:00.000-07:00

Clinical Procedures in Emergency Medicine

Publisher: Saunders
Links atualizados

Part 1

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Part 2

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CATETER VENOSO CENTRAL (Ingles)

2011-07-31T00:47:00.000-07:00

Central Venous Catheters

Publisher: Wiley
Language: English
ISBN:0470019948

266 pages

Data: 2009

PDF
6 Mb

Description: This book addresses all the issues a patient may experience prior to receiving a VAD. Selection of equipment, practical aspects of technique, the pros and cons of the various veins, and modifications of technique for certain circumstances are examined. Covereage also includes the roles played by radiologists, anaesthetists, surgeons, nurses, and other team memebers. Throughout the chapters a reference is made to the IV Therapy Standards published by the Royal College of Nursing IV Therapy Forum in 2003. Each chapter is evidence based and fully referenced.

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Frontiers in Clinical Neurotoxicology

2011-07-29T06:59:00.000-07:00

Frontiers in Clinical Neurotoxicology

Neurologic Clinics

August 2011

Volume 29

Issue 3

Edited by Michael R. Dobbs and Daniel Rusyniak

PDF

Content

01. http://www.sciencedirect.com/science/journal/07338619

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2011-07-29T06:55:00.000-07:00

Pineal Region Tumors

Neurosurgery Clinics of North America

July 2011 Volume 22, Issue 3

Edited by Andrew T. Parsa and Jeffrey N. Bruce

Pineal Region Tumors

Guest Editors: Andrew T. Parsa, Jeffrey N. Bruce

Tumors of the pineal region are a challenging clinical entity that comprises a wide range of pathology. The advent of modern neurosurgical techniques, advanced preoperative imaging, endoscopy, and neuronavigation have dramatically improved the outcomes of surgically treated patients. In this issue of Neurosurgery Clinics of North America, the authors provide us with an excellent foundation for health care providers to build on. Historical elements relevant to the evolving management of pineal region tumor patients are discussed, followed by excellent reviews addressing the pathology, preoperative workup, radiosurgical, and surgical approaches to treatment. Outcomes for some of the most common pineal region tumors are elaborated on as well. Collectively we hope this issue serves as a guide for providers to develop a better understanding of these complex tumors.

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01.http://www.sciencedirect.com/science/journal/10423680

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Mechanical Ventilation

2011-07-29T06:41:00.000-07:00

Mechanical ventilation

Skills and techniques

Update 2011

European Society of Intensive Care Medicine

Editor(s): Jonathon D. Truwit, Scott K. Epstein

publisher: wiley interscience

Published Online: 30 MAR 2011 11:46PM EST

Print ISBN: 9780470058077

Online ISBN: 9780470976609

DOI: 10.1002/9780470976609

ISBN-10: 0470058072

ISBN-13: 978-0470058077

A new, case-oriented and practical guide to one of the core techniques in respiratory medicine and critical care.

Concise, practical reference designed for use in the critical care setting

Case-oriented content is organised according to commonly encountered clinical scenarios

Flow charts and algorithms delineate appropriate treatment protocols

PART I

Practical Guide to Mechanical Ventilation part1 - medicalgnosis.com.rar (1.4 MB)

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MANDELL, DOUGLAS, AND BENNETT’S PRINCIPLES AND PRACTICE OF INFECTIOUS DISEASES Seventh Edition

2011-07-29T06:33:00.000-07:00

After thirty years, PPID is still the reference of choice for comprehensive, global guidance on diagnosing and treating the most challenging infectious diseases. Drs. Mandell, Bennett, and Dolin have substantially revised and meticulously updated, this new edition to save you time and to ensure you have the latest clinical and scientific knowledge at your fingertips. With new chapters, expanded and updated coverage, increased worldwide perspectives, and many new contributors, Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th Edition helps you identify and treat whatever infectious disease you see. And, as an Expert Consult title with enhanced online features, this updated 7th edition comes with convenient access to the full text online, regular updates on the new developments in the field and advances in therapy, and more at expertconsult.com.

• Features online access of the entire book’s content- fully searchable-as well as access to regular updates on new developments in the field and advances in therapy, such as the new strain of H1N1, a drug database, downloadable image library, and more at expertconsult.com.

• Provides more in-depth coverage of epidemiology, etiology, pathology, microbiology, immunology, and treatment of infectious agents than you’ll find in any other ID resource so you can get the answers to any questions you have.

• Presents 1,100 exquisite color photographs that reflect real-life patient symptoms for enhanced visual guidance.

• Offers current and up-to-date information on the newly recognized and emerging influenza viruses including Swine and Avian influenzas so you are able to accurately diagnose and treat anything that comes your way.

• Uses a consistent chapter-to-chapter layout for easy navigation.

• Features updated coverage of the emerging influenza viruses, such as the Swine and Avian Influenzas, microbial pathogenesis, infections in cancer patients, MRSA, antibiotic resistance, travel medicine, importation of exotic pets, bioterrorism agents, and much more.

• Includes new chapters on Probiotics, Outbreak Investigation, Infection of Nonvalvular Cardiovascular Devices, and Chlamydophila Pneumonia to keep you up to date on today’s hot topics.

• Incorporates many more new American and International contributors, giving you fresh perspectives and expanded global insights.

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LO GRATIS NO ES ETERNO ............ APROVECHEN

"Handbook of Clinical Anesthesia, 6th Edition"

2011-07-28T18:21:00.000-07:00

Paul G Barash, Bruce F Cullen, Robert K Stoelting, Michael Cahalan, M. Christine Stock, "Handbook of Clinical Anesthesia, 6th Edition"

Lippincott Williams & Wilkins

2009

ISBN: 0781789486
1146 pages

CHM

16,7 MB

This pocket-sized handbook provides quick, easy access to the essential bedside information from Clinical Anesthesia, Sixth Edition. The most practical clinical pearls on what to do and how and when to do it are presented in concise outline format, with hundreds of tables, graphs, and algorithms that summarize and prioritize crucial points. Appendices include formulas, an electrocardiography atlas, a drug list, American Heart Association resuscitation protocols, difficult airway algorithms, and a malignant hyperthermia protocol. This edition has a new full-color design and colorized illustrations. "Doody’s Core Titles 2009."

Summary: Absolutelly fantastic!

Rating: 5

I bought baby Barash and I loved it. It is the best first book you can have, and you can always bring it with you and have it ready. It is easy to find what you need. The information is compacted but enough that you can have a pretty good idea of a particular topic. It is a lovely book!

Summary: Excellent

Rating: 5

A very nice companion to Barash’s 2nd Edition "Big Book". A nice OR quick reference/primer. Also very helpful as a quick summary/review after reading a chapter in the big book.

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ACLS (ADVANCED CARDIAC LIFE SUPPORT) REVIEW

2011-07-17T09:18:00.000-07:00

•Date:November 2007The Password is: MIK Medical Library
•Edition:3rd
•Format:PDF
•Size:6.3 MB
•ISBN:0071492577
•Publisher:McGraw-Hill Companies
OVERVIEW

MAXIMIZE YOUR ACLS SCORE!
A Doody's Core Title!
3 STAR DOODY'S REVIEW
"This book's most impressive aspect is that it presents the core topics in a direct and concise manner, that makes it a quick read and easy to understand."--Doody's Review Service
Pearls of Wisdom ACLS Review, 3e is your most effective weapon in preparing for the American Heart Association's Advanced Cardiac Life Support exam. This rapid, effective review ensures your best possible performance on the exam in the shortest possible study time. There is no easier or faster way to ensure that you perform your best!
FEATURES
■1200+ rapid-fire questions cover all topics on the ACLS exam
■Powered with performance-improving pearls and other potent learning aids
■Updated to reflect the 2005 AMA guidelines
■NEW chapter on child and infant CPR and ventilation

ABOUT THE AUTHORS
Michael Zevitz, MD is Assistant Professor of Medicine in the Division of Cardiology at Chicago Medical School, Chicago, IL.
Scott H. Plantz, M.D. is an Associate Professor at Chicago Medical School in Chicago, Illinois. He is also affiliated with Sinai Medical Center in Chicago, Illinois.

TABLE OF CONTENTS
ACLS Review: Pearls of Wisdom, 3/e

1. Airway management
2. Arrythmias, Defibrillation, and Pacing
3. IV Access, Resuscitation, Circulatin, and Monitoring
4. Child and Infant CPR and Ventilation
5. Practice Test 1
6. Practice Test 2
7. Appedices: Pharmacology, Algorithm Protocols

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McMinn's Color Atlas of Head and Neck Anatomy

2011-07-17T09:05:00.000-07:00

Detailed Info

•Date:December 2003

•Edition:3rd

•Format:PDF

•Size:41 MB

•ISBN:0723431965

•Publisher:Elsevier Health Sciences
McMinn's Color Atlas of Head and Neck Anatomy is the only large format atlas of the human head and neck, incorporating outstanding dissections, osteology, and radiographic and surface anatomy images. Bari M. Logan, Patricia Reynolds, and Ralph T. Hutchings present a "road map" reference to the structures of the head and neck, ideal for study or exam review. New dissections and double page spreads provide detailed depictions for additional and more specific areas. The more complex dissections are accompanied by explanatory artwork and all dissections are accompanied by notes and commentaries. Reference lists and dental anesthesia information are incorporated into appendices at the back of the book. All in all, this is a beautiful and thorough atlas of the whole head and neck region.

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RECUERDA LO GRATIS NO ES ETERNO .................. APROVECHA

Micología médica ilustrada, Roberto Arenas

2011-04-30T21:10:00.000-07:00

Titulo: Micologia Midica Ilustrada

Autor: Roberto Arenas

Paginas: 423

Edicion: 3ª

Año: 2008

Formato: PDF

Idioma: Español

Tamaño: 80MB

Descripcion del Libro

Tercera edición del best seller que incluye lo esencial y lo práctico de la micología actual, partiendo de los datos históricos más sobresalientes.

Incluye las principales características de los diferentes tipos de hongos y su proceso evolutivo, así como morfología microscópica. Aborda las micosis superficiales, subcutáneas y sistémicas, medicamentos, medios de tinción, reactivos y colorantes con un glosario de los términos más importantes.

Está estructurado para su fácil comprensión a través de un sistema de definición, datos epidemiológicos, etiopatogenia, cuadro clínico, estudio micológico, datos de laboratorio, diagnóstico diferencial, tratamiento y pronóstico.

Incluye nuevo material iconográfico y actualidades en organismos y tratamientos farmacológicos.

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PARTE 2
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NETTER: ATLAS PRACTICO DE ANATOMIA ORTOPEDICA

2011-04-30T21:02:00.000-07:00

Según la experiencia del Dr. O. Thompson, los profesionales y, sobre todo residentes, que ejercen en servicios de ortopedia necesitan muchas veces tener a mano algún volumen donde hallar información y conocimiento precisos de algunos procesos o circunstancias clínicas. Pero, al mismo tiempo, es necesario que esta información pueda consultarse de manera fácil y rápida, para conseguir una mayor eficacia. Con esta intención, el Dr. O. Thompson elaboró este Atlas, a fin de dotar a los especialistas de un manual de cómodo formato, estructurado para obtener una inmediata información sobre los diversos aspectos de la anatomía ortopédica, perfectamente detallados e ilustrados. Para ello recurrió a la inapreciable ayuda de 450 imágenes de la colección del Dr. Netter que, con su extraordinaria precisión pedagógica, convierte cada consulta en un ejercicio visual claramente comprensible. Una práctica guía de colores da acceso a cada uno de los nueve capítulos anatómicos, con información desde las manos hasta los pies, pasando por todo el tronco humano. Esta información incluye tablas de ayuda para el diagnóstico y el tratamiento de los pacientes ortopédicos. Este Atlas es el resultado de varios años de experiencia y datos recogidos por el Dr. O. Thompson. Constituye, por tanto, una verdadera fuente de conocimientos anatómicos, didácticos, concretos y sintéticos, que resultan una perfecta referencia para ortopedia práctica.

Nº páginas: 328 pags

Lengua: CASTELLANO

Encuadernación: Tapa blanda

ISBN: 9788445813737

Nº Edición:1ª

Año de edición:2004

Plaza edición: BARCELONA

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Critical Care Clinics from 2006 to 2010 - all issues

2011-02-16T22:22:00.000-08:00

Management of High-Risk Pregnancy

2011-02-16T22:08:00.000-08:00

Management of High-Risk Pregnancy:

Management of High-Risk Pregnancy: An Evidence-Based Approach (MANAGEMENT OF HIGH-RISK PREGNA)

Author:

Publisher: Wiley-Blackwell (2007)

Binding: Hardcover, 488 pages

ISBN-10: 1405127821

editorialreviews

This book is a must-have for all health professionals involved in the care of women with high risk pregnancies. It is a concise and practical resource for all perinatal care and a reference for the diagnosis and management of high risk pregnancy.

The fifth edition of this classic, focuses on factors affecting pregnancy, genetics, practical diagnostic techniques, maternal diseases in pregnancy and pregnancy complications, labor, anesthesia, and neonatal considerations.

Dr Queenan is joined in the the fifth edition by a new editor, Katherine Spong, Head of Perinatology at the National Institutes of Health. The book will take an explicitly evidence-based approach this time around and will expand upon several important areas; genetics, doppler ultrasound, prevention, AIDS, group B streptococcus, preeclampsia, and prematurity.

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TRANSPLANTE DE HIGADO

2011-02-10T20:49:00.000-08:00

Liver Transplantation (Landes Bioscience Medical Handbook (Vademecum)) By Michael R. Lucey

Description

Univ. of Wisconsin, Madison. Pocket-sized handbook for those involved in the care and management of patients who have undergone a liver transplant. Provides an overview of liver transplantation, allograft immune response, immunosuppression after transplantation, graft dysfunction, and pediatric transplantation. Wire-spiral binding. --This text refers to the Spiral-bound edition.

Product Details

* Spiral-bound: 116 pages

* Publisher: Landes Bioscience; 1st edition (March 10, 2003)

* Language: English

* ISBN-10: 1570596514

* ISBN-13: 978-1570596513

* Size: 6.2 Mb

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Emergency Medicine Sonography

2011-02-05T22:12:00.000-08:00

Emergency Medicine Sonography: Pocket Guide to Sonographic Anatomy and Pathology

Dunstan Abraham, Cynthia Silkowski, and Charles Odwin, "Emergency Medicine Sonography: Pocket Guide to Sonographic Anatomy and Pathology"

Jon.s & B.rtlett P.blishers | 2009 | ISBN: 0763765589 | 308 pages | PDF | 37,5 MB

Emergency Medicine Sonography: Pocket Guide to Sonographic Anatomy and Pathology is a quick reference guide that fits in the palm of your hand and is perfect for the clinical emergency setting. This portable resource provides the pertinent information on performing songraphic procedures and interpreting sonographic images. Filled with high quality sonographic images and written in a clear concise style, this is an essential resource for physicians, physician assistants, nurse practitioners, and other health professionals.

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Handbook of Angioplasty and Stenting Procedures

2011-01-26T20:00:00.000-08:00

Handbook of Angioplasty and Stenting Procedures
Editors: Robert A. Morgan · Eric Walser
Publisher: SPRINGER
PDF
ISBN 978-1-84800-398-9
e-ISBN 978-1-84800-399-6
DOI 10.1007/978-1-84800-399-6

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Mayo Clinic Gastrointestinal Imaging Review

2011-01-26T19:56:00.000-08:00

Mayo Clinic Gastrointestinal Imaging Review
C. Daniel Johnson and Grant D. Schmit
ISBN-10: 0849397952
ISBN-13: 978-0849397950
Informa Healthcare

Offering four times the amount of imaging cases offered by competing texts, this reference stands as the foremost guide to common diseases and radiographic presentations found within the gastrointestinal tract-authoritatively covering the entire range of gastrointestinal diseases to include conditions affecting the esophagus, stomach, duodenum, small bowel, colon, liver, biliary tree, gallbladder, pancreas, spleen, peritoneum, and mesentery.

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Mayo Clinic Gastroenterology and Hepatology Board Review

2011-01-26T19:51:00.000-08:00

Mayo Clinic Gastroenterology and Hepatology Board Review, 3rd edition
Stephen C Hauser, Darrell S Pardi, John J Poterucha
Publisher:Informa HealthCare | Pages:528 | 2008-08-26 | ISBN:1420092235 | PDF | 7.1 MB

Gastroenterology and Hepatology encompass a vast anatomic assortment of organs with diverse structure and function and the potential for affliction from a multiplicity of diseases. Completely covering these complex and interrelated systems, Mayo Clinic Gastroenterology and Hepatology Board Review provides an in-depth examination of essential knowledge in gastroenterology, hepatology, and the integral related areas of pathology, endoscopy, nutrition, and radiology. With contributions from experts at MayoClinic who are currently in clinical practice and have a strong commitment to teaching, the book assists physicians-in-training to prepare for the gastroenterology board examination

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ANTIBIOTIC RESISTANCE

2011-01-26T19:47:00.000-08:00

Antibiotic Resistance: Understanding and Responding to an Emerging Crisis By Karl S. Drlica, David S. Perlin
Publisher: F T Press 2011 | 288 Pages | ISBN: 0131387731 | PDF | 3 MB

As pathogenic bacteria evolve, antibiotic resistance is spreading, compromising our ability to control and treat infectious diseases. Antibiotic Resistance thoroughly illuminates this crucial issue for healthcare professionals, researchers, students, and policymakers. Two leading investigators explain what resistance is, how it emerges, which human activities contribute, and how to strengthen our defenses.

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MANUAL OF INFECTION CONTROL PROCEDURES

2011-01-26T19:44:00.000-08:00

Manual of Infection Control Procedures

by N. N. Damani (Author), A. M. Emmerson (Foreword)

Review

'... the Manual of Infection Control Procedures provides a comprehensive overview of the main aspects of infection control ...' Commonwealth Agricultural Bureaux International --This text refers to an out of print or unavailable edition of this title.

Product Description

The prevention of infection in the health care setting remains a key goal for all health care personnel. All health care establishments also have a need to continually improve the quality of care they provide and ensure a safe working environment. Health care-associated infections lengthen patients' hospital stays and increase both morbidity and mortality. In addition, diagnosing and treating these infections is a costly process and places intense pressure on limited health care resources. The new, updated and significantly expanded edition of the Manual of Infection Control Procedures provides a comprehensive overview of the main aspects of infection control, and gives practical, evidence-based recommendations and easy-to-follow advice on strategies to prevent infection in all health care facilities.

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Practical Gastroenterology and Hepatology: Esophagus and Stomach

2011-01-24T20:03:00.000-08:00

Practical Gastroenterology and Hepatology: Esophagus and Stomach
By Nicholas J. Talley, Kenneth R. DeVault, David E. Fleischer
Publisher: Wiley-Blackwell
Number Of Pages: 472
Publication Date: 2010-10-19
ISBN-10 / ASIN: 1405182733

ISBN-13 / EAN: 9781405182737

this comprehensive resource for fellows/trainees and candidates for recertification in gastroenterology summarizes the field in a modern, fresh format. Prominent experts from around the globe write on their areas of expertise, and each chapter follows a uniform structure. The focus is on key knowledge, with the most important clinical facts highlighted in boxes. Color illustrations reinforce the text.

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PANCREATITIS RESEARCH ADVANCES

2011-01-24T19:56:00.000-08:00

PANCREATITIS RESEARCH ADVANCES
Year: 2007
Nova Biomedical Books
New York

Expert Commentaries
Commentary A Bioethics Applied to the Study of Pancreatitis Using Animal
Marcelo Gustavo Binker and Laura Iris Cosen-Binker

Commentary B Challenging Research Items in Diagnosis and Imaging of Chronic Pancreatitis: Differentiating Early Chronic Pancreatitis from (Early) Pancreatic Cancer
Kenneth Coenegrachts, Vincent De Wilde, Vincent Denolin and Hans Rigauts

Commentary C The Pancreas: A Hidden Organ with Many Unknowns
Michael G. Wayne

Commentary D Inflammatory Mediators in Acute Pancreatitis: The Story So Far and Future Directions 15
Madhav Bhatia

Short Communications
A Autoimmune Pancreatitis
Terumi Kamisawa

B Influence of Endosonography in the Evaluation of Idiopathic Acute Pancreatitis
Juan J. Vila, Fernando Borda, F. Javier Jiménez, Erika Borobio, Inmaculada Elizalde and Antonio Arín

Chapter I Post ERCP Pancreatitis
Georgia Lazaraki, Dimitrios Paikos and Panagiotis Katsinelos

Chapter II Morphological and Functional Evaluation with Dynamic MRCP after Secretin Stimulation for Patients with Chronic Pancreatitis 79
Ryo Tamura, Kiyoshi Ishii, Masaru Koizumi, Tadashi Ishibashi and Shoki Takahashi

Chapter III Challenging Items in Diagnosis and Imaging of Chronic Pancreatitis: Early Chronic Pancreatitis and Differentiation with (Early) Pancreatic Cancer
Kenneth Coenegrachts,, Vincent De Wilde, Vincent Denolin and Hans Rigauts

Chapter IV Current Concepts of the Molecular Biology of Tumor Necrosis Factor-Alpha in Experimental Acute Pancreatitis
Giuseppe Malleo, Emanuela Mazzon, Ajith K. Siriwardena and Salvatore Cuzzocrea

Chapter V Prevention of Life-Threatening Complications in Severe Acute Pancreatitis: Results of Our Research
Takeo Yasuda,, Takashi Ueda, Yoshifumi Takeyama, Makoto Shinzeki, Hidehiro Sawa, Takahiro Nakajima and Yoshikazu Kuroda

Chapter VI Diagnosis of Autoimmune Pancreatitis
Takahiro Nakazawa,, Hirotaka Ohara, Hitoshi Sano, Tomoaki Ando, Kazuki Hayashi, Haruhisa Nakao and Takashi Joh

Chapter VII Chronic Pancreatitis and the Development of Pancreatic Cancer
M. Hermanova, J. Trna, P. Dite, A. Sevcikova, J. Feit and I. Zavrelova

Chapter VIII Pathogenesis of Alcoholic Chronic Pancreatitis and Efficacy of Bromhexine Hydrochloride Therapy in Its Treatment
Tatsuhiro Tsujimoto, Hitoshi Yoshiji, Hideto Kawaratani and Hiroshi Fukui

Chapter IX Expression Profiling of Chronic Pancreatitis
Deepak Hariharan and Tatjana Crnogorac-Jurcevic

Chapter X An Inside into the Physiopathogenesis of Acute and Chronic Pancreatitis
Marcelo Gustavo Binker and Laura Iris Cosen-Binker

Chapter XI Acute Pancreatitis: Topics of Interest
Yong-Song Guan, Qing He, Ying Hu, Ming-Quan Wang, Lin Yang and Zi La

Chapter XII Acute Severe Hyperlipidemic Pancreatitis: Management, Follow Up and Prevention
A. V. Kyriakidis, M. Pyrgioti and B. Raitsiou

Chapter XIII Critical Role of Inflammatory Mediators in Acute Pancreatitis
Madhav Bhatia
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HARRISON'S INTERNAL MEDICINE 17 th Edition

2011-01-24T19:44:00.000-08:00

HARRISON'S INTERNAL MEDICINE
17 th EDITION

DOI: 10.1036/0071466339
ISBN ebook 0-07-164114-9
ISBN 0-07-146633-9

PDF

Introducing the most dramatically revised edition of Harrison's ever!

Now with NEW bonus DVD with 37 chapters and more than 500 brand new images and video clips!

MORE THAN TRUSTED, BEYOND ESSENTIAL . . .

The #1 selling medical textbook worldwide, Harrison's has defined internal medicine for millions of clinicians and students. The new Seventeenth Edition retains Harrison's acclaimed balance of pathobiology, cardinal signs and manifestations of disease, and best approaches to patient management, yet has been massively updated to give you an innovative array of bold new features and content. If ever there was one must-have resource for clinicians and students - this is it!

UNMATCHED EXPERTISE AT YOUR FINGERTIPS

As an unprecedented amount of medical information bombards you and your patients, where do you go to sort it out and make sense of it all? When your patients request clarification on something they've “printed off” where do you turn for expert explanations? The same trusted resource physicians and students have turned to for over fifty years: Harrison's Principles of Internal Medicine. Now more than ever, trust Harrison's to filter and clarify the exploding knowledge base, to highlight the breakthroughs, and to deliver a clear, balanced distillation of the best and most current information on which to base clinical decisions.

THE MOST EXCITING AND EXTENSIVELY REVISED EDITION EVER!

Here are just a few of the reasons why the new 17th Edition of Harrison's is the best edition yet:

Bonus companion DVD featuring: 37 new “e-chapters”; over 500 brand-new radiological, laboratory, and clinical images, including complete atlases; state-of-the-art video clips; an Image Bank of nearly all the illustrations contained in the parent text, and much more

Expanded, modernized illustration program with more than 800 brand-new, additional illustrations-a 60% increase over the previous edition

Dozens of brand new chapters on vital topics in medical education and clinical practice: Global Issues in Medicine: Patient Safety and Health Quality; Health Disparities: Atlas of EKGs; Clinical Management of Obesity: Atlas of Hematology: Atlases of Chest, Neurological, and Cardiovascular Radiology, and much more! Also included a complete new Section on biological foundations and emerging clinical applications of regenerative medicine!

Brand new, reader-friendly text design optimizes the full-color format

An expanded, innovative focus on global health

NEW Global Advisory Board comprised of 11 prominent medical experts from Asia, India, Europe, and South America

Revision of the popular On Line Learning Center, which offers more skill-sharpening self-assessment questions and answers, plus additional case studies for helping you apply Harrison's content to the daily care of patients

Harrison's related products are available in a full suite of formats to meet all your educational and clinical needs. Harrison's Practice of Medicine is a complete database of more than 700 clinical topics formatted for use at the point of care. The Harrison's Manual of Medicine is one of the most popular and heavily used handbook-sized resources in internal medicine. The Harrison's Self-Assessment and Board Review features more than 1000 board-type cases and questions and highlights the use of Harrison's as a great board prep resouce.

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Cardiovascular Disease in the Elderly

2011-01-23T20:19:00.000-08:00

Cardiovascular Disease in the Elderly, Fourth Edition (Fundamental and Clinical Cardiology)

By Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich

Publisher: Informa HealthCare

Number Of Pages: 888

Publication Date: 2008-02-27

ISBN-10 / ASIN: 1420061704

ISBN-13 / EAN: 9781420061703

Product Description:

Senior citizens currently account for over eighty percent of all cardiovascular disease related deaths. With advances and breakthrough in modern medicine that are allowing people to live longer, the amount of senior citizens in this country will grow exponentially over the next decade. Physicians, gerontologists, cardiologists, and all clinicians caring for the elderly will require – at the very least – a basic understanding of cardiovascular disease and disorders (hypertension, heart failure, etc.), found specifically in the aging patient. In a new updated fourth edition, each chapter is thoroughly updated by recognized experts to provide an up-to-date and in-depth overview of the epidemiology, pathophysiology, evaluation, and treatment of cardiovascular disorders in older adults published in a single-source text.

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CLINICAL HEMODYNAMICS

2011-01-23T20:15:00.000-08:00

Textbook of Clinical Hemodynamics
Publisher: Saunders; 1 edition | ISBN : 1416040005 | February 22, 2008 | 264 pages | PDF | 9.2MB

“This is an amazing book that explains cardiac hemodynamics for common valve disorders, cardiomyopathies and shock in a very easy to understand fashion. Since the focus is mostly on waveforms and their etiologies, this book is probably best suited for fellows or those that spend time in the cath lab. I highly recommend this text, as it succinctly explains many difficult concepts clearly and with multitudes of diagrams and pictures. It is an essential reference that complements Grossman's perfectly.”

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CARDIOVASCULAR BIOMARKERS

2011-01-23T20:06:00.000-08:00

CARDIOVASCULAR BIOMARKERS
Pathophysiology and Disease Management
Edited by
DAVID A. MORROW, MD, MPH
Cardiovascular Division,
Brigham and Women’s Hospital,
Harvard Medical School,
Boston, MA
Foreword by
ELLIOT ANTMAN, MD
Brigham and Women's Hospital,
Harvard Medical School,
Boston, MA
PDF
Publisher:Humana Press Inc.
eISBN 159745-051-0

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NEWBORN SURGERY - ASSISTED VENTILATION OF THE NEONATE

2011-01-23T19:40:00.001-08:00

ASSISTED VENTILATION OF THE NEONATE

Edition: 5th Revised edition
Author/s: Goldsmith, Jay P.; Karotkin, Edward H.
Publisher: Elsevier - Health Sciences Division

Format: Hardback
Pages: 608 pages
Publication date: 12 November 2010
Dimensions: 222mm (Width), 281mm (Height), 30mm (Spine width)
Weight: 1724g

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GOLDSMITH_5_EDITION - ASSITED VENTILATION OF THE NEONATE

NEWBORN SURGERY

Editorial Reviews

Review

The 97 chapters give a comprehensive account of most conditions that will be encountered in the neonatal period and will be a useful source for quick reference by trainees or surgeons who are in the paediatric field. It is a useful reference source for students and for paediatricians to give an insight into the many conditions discussed. It will be a valuable addition to libraries. -- Journal of Paediatric Surgery 20030522 This second edition represents a very comprehensive text in its scope. Chapters cover the full spectrum of speciality neonatal surgery as well as a comprehensive overview of the guiding principles in part one of the text. In both these regards this text represents one of the best and would be a valuable reference. -- Journal of Paediatrics and Child Health 20040428

Product Description

(Arnold) Univ. College, Dublin, Ireland. Reference on the surgical management of neonatal disorders, providing a comprehensive compendium of their pathophysiology, investigation, and management. For pediatric surgeons and for general surgeons with a pediatric practice. Illustrated. Previous edition: c1996.

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NEWBORN SURGERY 2 EDITION

Handbook of Pathology and Pathophysiology of Cardiovascular Disease

2011-01-23T19:37:00.000-08:00

Editorial Reviews

Product Description

This handbook consists of actual case material with a presentation of the clinical and laboratory data, an extensive discussion and analysis of the differential diagnoses, and a description of the pathology findings. The material, in problem-based format, includes 34 cases, more than 90 illustrations, an anatomy glossary, and laboratory normal values. It is intended for use by medical students in problem-based curricula, but is presented with sufficient sophistication to be useful to residents in pathology and internal medicine, and to pathologists and cardiologists. The book covers the entire spectrum of cardiovascular disease and may be unique, as there is nothing known to the authors that is comparable.

About the Author

Dr. Stephen Factor is a founding member and former president of the Society for Cardiovascular Pathology and the founding editor of the journal `Cardiovascular Pathology'. Dr. Maria Lamberti-Abadi is a diagnostic pathologist and cytopathologist with special interest and publications in cardiovascular disease and gynecologic pathology. Dr. Jacopo Abadi has extensive clinical and research interests in infectious disease.

Product Details

Hardcover: 312 pages
Publisher: Springer; 1st edition (November 14, 2001)
Language: English
ISBN-10: 0792375424
ISBN-13: 978-0792375425
Product Dimensions: 9.7 x 6.2 x 0.9 inches

The book consists of 34 cases in a problem-based (PBL) format. There are about 90 B&W photos and micrographs from post-mortem exams, an anatomy glossary, and laboratory normal values. The book chapters include practical cardiac anatomy, atherosclerotic heart disease and ischemia, diabetes, cardiomyopathies, valve disease, congenital heart disease, endocarditis, myocarditis, cardiac tumors, pericardial disese, aortic aneurysms, collagen vascular diseases and vasculitis, and medicolegal cases.

In reviewing the book, I must state I am biased. Autopsy pathology is being challenged with decreasing numbers of cases for a variety of reasons. This is unfortunate. Autopsy pathology remains an excellent opportunity for learning and clinicopathological correlation. There is simply not enough of this "classical" training in Medicine. The autopsy remains relevant to medical practice. The more one learns about disease, the better one will be able to treat the living.

The book details numerous cases, autopsy findings and discusses the clinical presentation, disease complications and manifestations. It succeeds admirably in this task. One can argue that the cases are a bit dated and some perhaps not reflective of recent medical care (not much in coronary interventions, which are now common place), but the authors do point this out in most cases. I do not feel this distracts from the goal of the book - to encourage active thought of disease pathology and its clinical consequences.

The book obviously focuses upon cardiovascular disease, but I particularly found the discussions of how generalized disorders, including diabetes and endocrine diseases such as thyroid disease, affect the body. In autopsy pathology, one must consider the whole patient and the disease interactions in multiple systems. This is of course also what one must do with the living we are assessing and treating. Dr. Factor is an internationally recognized expert in myocardial disease and thus these sections are particularly strong.

The case mix is generally well chosen. One can point out omissions and criticize inclusion of esoteric disease, but in general the book is well balanced, reflective of most important disease categories, and not meant to be all-inclusive.

Some of the illustrations are dark and a bit hard to interpret. I also personally would have like to see more illustrations, but this must be balanced with the cost of the book.

Who should read this book? The authors state "it is intended for use by medical students in problem-based curricula, but is presented with sufficient sophistication to be useful to residents in pathology and internal medicine, and to pathologists and cardiologists." I agree with this. I plan to use it with medical students and residents doing electives in Cardiovascular and Anatomical Pathology. It would be excellent to give to residents to study during their autopsy rotations. I think it could be valuable for trainees in pathology, cardiac surgery, and cardiology. For my own continuing medical education, I found it interesting and informative, and I plan to revisit my favorite parts.

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Handbook of Acute Coronary Syndromes

2011-01-23T19:32:00.000-08:00

Handbook of Acute Coronary Syndromes
Deepak L Bhatt & Marcus D Flather, Editors
Published by Remedica Publishing
First edition: ISBN 1 901346 65 X
PDF

Editorial Reviews

Product Description

Cleveland Clinic Foundation, OH. Pocket-sized reference discusses the pathophysiology, risk stratification, and treatment of acute coronary syndrome. Offers easy access to practical information on the diagnosis and management strategies. Addresses risk assessment, long-term prevention, anticoagulants, and more. Concise format. For physicians and residents. Softcover.

About the Author

Deepak Bhatt is an interventional cardiologist at the Cleveland Clinic. He is board certified by the American Board of Internal Medicine in internal medicine, cardiovascular diseases, and interventional cardiology, and is a member of the American College of Cardiology, the American College of Physicians, the American Medical Association, and the New York Academy of Sciences. He serves as the Director of the Interventional Cardiology Fellowship and the Associate Director for the Cardiovascular Medicine Fellowship at the Cleveland Clinic Foundation. Marcus Flather has been the Director of the Clinical Trials and Evaluation Unit at the Royal Brompton and Harefield NHS Trust since August 1996. He is also an Honorary Consultant at the Royal Brompton Hospital and Honorary Senior Lecturer at the Imperial College of Science, Technology and Medicine. Prior to this, he worked as a Senior Research Fellow at McMaster University in Canada and at the Clinical Trials Service Unit in Oxford. He is a trained cardiologist whose primary research interest is clinical trials in ACS. Broader interests include clinical trial methods, meta-analysis, and health services research.
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Antithrombotic Drug Therapy in Cardiovascular Disease

2011-01-23T19:28:00.000-08:00

Antithrombotic Drug Therapy in Cardiovascular Disease
Publisher Humana Press
DOI 10.1007/978-1-60327-235-3
Copyright 2010
ISBN 978-1-60327-234-6 (Print) 978-1-60327-235-3 (Online)
Subject Collection Medicine

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Topics in Arrhythmias and Ischemic Heart Disease

2011-01-23T19:23:00.000-08:00

Topics in Arrhythmias and Ischemic Heart Disease
Bruce Lerman, Craig Basson
2010
186 pp Hardback
ISBN 1933864583 / 9781933864587Description

Topics in Ischemic Heart Disease and Arrhythmias In order to provide the latest and most sophisticated treatment the cardiology clinician must have current knowledge of a vast amount of translational research in the pathophysiology of these disorders as well as be aware of recent advances and issues in pharmacogenic and interventional therapies.
Topics in Arrhythmias and Ischemic Heart Disease provides expert reviews and assessment of the most recent clinical research and on current trends in evaluation, diagnosis, and clinical management.

Reviews include assessment of emerging data and indications of likely key advances with signifiacnt impact on clinical research in the near future. This volume is a must-have for every cardiologist needing to be fully current on recent advances in ischemic heart disease and arrhythmic disorders.

Links
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ENDOTHELIAL BIOMEDICINE

2011-01-23T19:18:00.000-08:00

Endothelial Biomedicine
Authors: William C. Aird M.D.
Type of file PDF
Publisher: Cambridge University Press 2007
Language: English
ISBN-10: 0-511-33537-7
ISBN-13: 978-0-511-33537-2
The endothelium, the cell layer that forms the inner lining of blood vessels, is a spatially distributed system that extends to all reaches of the human body. Today, clinical and basic research demonstrates that the endothelium plays a crucial role in mediating homeostasis and is involved in virtually every disease, either as a primary determinant of pathophysiology or as a victim of collateral damage. Indeed, the endothelium has remarkable, though largely untapped, diagnostic and therapeutic potential. This volume endeavors to bridge the bench-to-bedside gap in endothelial biomedicine, with the goal of advancing research and development and improving human health. The book is the first to systematically integrate knowledge about the endothelium from different organ-specific disciplines, including neurology, pulmonary, cardiology, gastroenterology, rheumatology, infectious disease, hematology-oncology, nephrology, and dermatology. Moreover, it is unique in its interdisciplinary approach, drawing on expertise from such diverse fields as evolutionary biology, comparative biology, molecular and cell biology, mathematical modeling and complexity theory, translational research, and clinical medicine.

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FUNDAMENTOS DE CIRUGIA: UROLOGIA

2011-01-15T18:46:00.000-08:00

Fundamentos de Cirugía - Urología

Reseña: En la tercera edición de este libro los autores pretenden que se utilice el mismo como referencia a ginecólogos, cirujanos generales, internistas, pediatras y en general a los especialistas que tengan interés en tópicos de la urología, por lo que para la presente edición se actualizaron todos los temas, se adicionaron fotos, esquemas, tablas y figuras y se incorporaron los capítulos de Disfunción sexual femenina y Cuidados de enfermería para el paciente urológico, este último de gran ayuda para enfermeras y estudiantes de enfermería.

Se espera que el esfuerzo condensado en esta obra contribuya al objetivo de una mejor formación académica para estudiantes, médicos generales y especialistas en un área de la medicina que posee un notable grado de desarrollo y que concentra la atención de expertos y profanos, debido a la alta incidencia de enfermedades bajo su cuidado

Contenido:

Anatomía urológica

Embriología del tracto genitourinario

Fisiología del tracto urinario

Farmacología urológica

Examen clínico del aparato genitourinario

Enfoque general del paciente urológico

Instrumentación, uso de sondas y laparoscopia en urología

Imaginología en urología

Uropatía obstructiva alta y baja

Hiperplasia prostática benigna

Oncología urológica

Derivaciones urológicas

Infecciones urológicas

Enfermedades de los genitales externos

Trauma genitourinario

Urgencias urológicas

Hematuria

Enfermedades quísticas renales

Litiasis urinaria

Infertilidad masculina

Disfunción eréctil

Trastornos de la eyaculación

Disfunción sexual femenina

Climaterio masculino

Uroginecología

Urodinámica clínica

Vejiga neurogénica

Urología pediátrica

Ambigüedad sexual

Cuidado de enfermería al paciente urológico

Laboratorio clínico urológico

Autores: Juan Uribe Arcilla, Férez Florez Silva

Editorial: Corporación para Investigaciones Biológicas - CIB

Edición: 3ª

Año: 2006

Páginas: 562

ISBN: 958-9400-99-X

Tamaño: 119.42 MB

Formato: PDF

Idioma: Español

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Clinical Infections Diseases Volume 51 Supplement 1 August 1, 2010

2010-12-31T08:43:00.000-08:00

Supplement Articles

Executive Summary

o John G. Bartlett,

o Philip S. Barie,

o Michael S. Niederman,

o and Richard G. Wunderink

Workshop on Clinical Trials of Antibacterial Agents for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S1-S3 doi:10.1086/653066

o Brad Spellberg, George Talbot, and for the Infectious Diseases Society of America, American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine

Recommended Design Features of Future Clinical Trials of Antibacterial Agents for Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S150-S170 doi:10.1086/653065

o Steven L. Barriere

Challenges in the Design and Conduct of Clinical Trials for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia: An Industry Perspective

Clin Infect Dis. (2010) 51(Supplement 1): S4-S9 doi:10.1086/653033

o David N. Gilbert

Scenario 1: A Patient with Hospital-Acquired Bacterial Pneumonia—Introduction to Clinical Trial Design Issues

Clin Infect Dis. (2010) 51(Supplement 1): S10-S11 doi:10.1086/653034

o Michael S. Niederman

Hospital-Acquired Pneumonia, Health Care-Associated Pneumonia, Ventilator-Associated Pneumonia, and Ventilator-Associated Tracheobronchitis: Definitions and Challenges in Trial Design

Clin Infect Dis. (2010) 51(Supplement 1): S12-S17 doi:10.1086/653035

o John H. Powers

Recommendations for Improving the Design, Conduct, and Analysis of Clinical Trials in Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S18-S28 doi:10.1086/653036

o Marin H. Kollef

Review of Recent Clinical Trials of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia: A Perspective from Academia

Clin Infect Dis. (2010) 51(Supplement 1): S29-S35 doi:10.1086/653037

o Alfred Sorbello,

o Scott Komo,

o Thamban Valappil,

o and Sumati Nambiar

Registration Trials of Antibacterial Drugs for the Treatment of Nosocomial Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S36-S41 doi:10.1086/653038

o Thomas M. File, Jr.

Recommendations for Treatment of Hospital-Acquired and Ventilator-Associated Pneumonia: Review of Recent International Guidelines

Clin Infect Dis. (2010) 51(Supplement 1): S42-S47 doi:10.1086/653048

o Antoni Torres,

o Miquel Ferrer,

o and Joan Ramón Badia

Treatment Guidelines and Outcomes of Hospital-Acquired and Ventilator-Associated Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S48-S53 doi:10.1086/653049

o Jean Chastre and

o Charles-Edouard Luyt

Other Therapeutic Modalities and Practices: Implications for Clinical Trials of Hospital-Acquired or Ventilator-Associated Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S54-S58 doi:10.1086/653050

o Donald E. Craven and

o Karin I. Hjalmarson

Ventilator-Associated Tracheobronchitis and Pneumonia: Thinking Outside the Box

Clin Infect Dis. (2010) 51(Supplement 1): S59-S66 doi:10.1086/653051

o Lena M. Napolitano

Use of Severity Scoring and Stratification Factors in Clinical Trials of Hospital-Acquired and Ventilator-Associated Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S67-S80 doi:10.1086/653052

o Ronald N. Jones

Microbial Etiologies of Hospital-Acquired Bacterial Pneumonia and Ventilator-Associated Bacterial Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S81-S87 doi:10.1086/653053

o Jean Chastre,

o Jean-Louis Trouillet,

o Alain Combes,

o and Charles-Edouard Luyt

Diagnostic Techniques and Procedures for Establishing the Microbial Etiology of Ventilator-Associated Pneumonia for Clinical Trials: The Pros for Quantitative Cultures

Clin Infect Dis. (2010) 51(Supplement 1): S88-S92 doi:10.1086/653054

o Michael S. Niederman

The Argument against Using Quantitative Cultures in Clinical Trials and for the Management of Ventilator-Associated Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S93-S99 doi:10.1086/653055

o David N. Gilbert

Scenario 2: A Patient with Ventilator-Associated Bacterial Pneumonia—Introduction to Clinical Trial Design Issues

Clin Infect Dis. (2010) 51(Supplement 1): S100-S102 doi:10.1086/653056

o Paul G. Ambrose,

o Sujata M. Bhavnani,

o Evelyn J. Ellis Grosse,

o and George L. Drusano

Pharmacokinetic-Pharmacodynamic Considerations in the Design of Hospital-Acquired or Ventilator-Associated Bacterial Pneumonia Studies: Look before You Leap!

Clin Infect Dis. (2010) 51(Supplement 1): S103-S110 doi:10.1086/653057

o Cynthia F. Kleppinger and

o Leslie K. Ball

Building Quality in Clinical Trials With Use of a Quality Systems Approach

Clin Infect Dis. (2010) 51(Supplement 1): S111-S116 doi:10.1086/653058

o Katherine A. Laessig

End Points in Hospital-Acquired Pneumonia and/or Ventilator-Associated Pneumonia Clinical Trials: Food and Drug Administration Perspective

Clin Infect Dis. (2010) 51(Supplement 1): S117-S119 doi:10.1086/653059

o John G. Muscedere,

o Andrew Day,

o and Daren K. Heyland1

Mortality, Attributable Mortality, and Clinical Events as End Points for Clinical Trials of Ventilator-Associated Pneumonia and Hospital-Acquired Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S120-S125 doi:10.1086/653060

o Richard G. Wunderink

Surrogate Markers and Microbiologic End Points

Clin Infect Dis. (2010) 51(Supplement 1): S126-S130 doi:10.1086/653061

o Marya D. Zilberberg and

o Andrew F. Shorr

Ventilator-Associated Pneumonia: The Clinical Pulmonary Infection Score as a Surrogate for Diagnostics and Outcome

Clin Infect Dis. (2010) 51(Supplement 1): S131-S135 doi:10.1086/653062

o John S. Bradley

Considerations Unique to Pediatrics for Clinical Trial Design in Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S136-S143 doi:10.1086/653063

o George H. Talbot

Considerations in Undertaking a Clinical Development Program for Hospital-Acquired Bacterial Pneumonia and/or Ventilator-Associated Bacterial Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S144-S149 doi:10.1086/653064

o John G. Bartlett,

o Richard G. Wunderink,

o Michael S. Niederman,

o and Philip S. Barie

Workshop on Issues in the Design of Clinical Trials for Antibacterial Drugs for Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia

Clin Infect Dis. (2010) 51(Supplement 1): S171 doi:10.1086/653067

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Liver and Biliary Disease

2010-12-26T07:25:00.000-08:00

Editorial Reviews

Product Description

This comprehensive resource for fellows/trainees and candidates for recertification in gastroenterology summarizes the field in a modern, fresh format. Prominent experts from around the globe write on their areas of expertise, and each chapter follows a uniform structure. The focus is on key knowledge, with the most important clinical facts highlighted in boxes. Color illustrations reinforce the text.

About the Author

Editor-in-Chief:

Nicholas J. Talley, MD, PhD, Chair, Department of Internal Medicine, Mayo Clinic College of Medicine, Jacksonville, Florida, USA

Associate editors:

Sunanda V. Kane, MD, MSPH, Associate Professor of Medicine, Miles and Shirley Fitterman Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN, USA

Michael B. Wallace, MD, MPH, Associate Professor of Medicine, Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA

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Guia basica farmacoterapeutica

2010-12-26T07:01:00.000-08:00

Una Guía Farmacoterapéutica es un documento que contiene una relación limitada de medicamentos recomendados para la prescripción en un ámbito determinado, seleccionada a partir de la oferta farmacéutica en función de unos criterios previamente establecidos, con la participación y el consenso de los profesionales a los que va destinada. La guía establece las bases teóricas para orientar a los médicos en la elección del medicamento más seguro, efectivo y eficiente para el tratamiento de un problema particular en un paciente determinado. Por este motivo, el listado de medicamentos se acompaña de otra información considerada de interés (indicaciones, efectos adversos, presentaciones comerciales, etc.)

El archivo viene comprimido en rar sin contraseña y pesa 5.33 Mb

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Special Tests in Musculoskeletal Examination: An evidence-based guide for clinicians

2010-11-27T20:06:00.000-08:00

Paul Hattam, Alison Smeatham - Special Tests in Musculoskeletal Examination: An evidence-based guide for clinicians

ISBN: 0702030252 | 2010-06-11 | PDF | 292 pages | 5.26 Mb

The proliferation of special tests used in musculoskeletal examination has left the clinician with a vast array of physical tests at their disposal. Special Tests in Musculoskeletal Examination is a handy one-stop guide with over 150 peripheral tests. The clinical context and evidence base is thoroughly explored and the addition of clinical tips and expert opinion will enable the clinician to select the most appropriate tests and interpret the results meaningfully.

- Step-by-step description for each test
- Clear photographic illustrations
- 'At a glance' presentation of the background evidence
- Detailed clinical context
- Comprehensive referencing of orthopaedic special tests

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Handbook of Signs & Symptoms

2010-11-21T18:54:00.000-08:00

Diane Labus, Jennifer Kowalak - Handbook of Signs & Symptoms (4th Edition)Publisher: Lippincott Williams & Wilkins | 2009-03-01 | ISBN: 160547052X | CHM | 768 pages | 40.40 MB

Thoroughly updated for its Fourth Edition, this convenient, portable handbook is a comprehensive guide to the evaluation of more than 530 signs and symptoms. It has all the assessment information busy clinicians need in a single source. Each entry describes the sign or symptom and covers emergency interventions if needed, history and physical examination, medical and other causes with their associated signs and symptoms, and special considerations such as tests, monitoring, treatment, and gender and cultural issues. This edition identifies specific signs and symptoms caused by emerging diseases such as avian flu, monkeypox, respiratory syncytial virus, norovirus, metabolic syndrome, blast lung injury, Kawasaki disease, and popcorn lung disease. New information on patient teaching and obtaining a health history is included.

http://www.filesonic.com/file/31589225/b221-160547052X-chm+.rar

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Textbook of Tinnitus

2010-11-21T18:52:00.000-08:00

Aage R. Moller, Tobias Kleinjung, Berthold Langguth, Dirk DeRidder, "Textbook of Tinnitus"
Publisher: Sp-ger | 2011 | ISBN: 1607611449 | PDF | 700 pages | 15 MB

Groundbreaking, comprehensive, and developed by a panel of leading international experts in the field, Textbook of Tinnitus provides a multidisciplinary overview of the diagnosis and management of this widespread and troubling disorder. Importantly, the book emphasizes that tinnitus is not one disease but a group of rather diverse disorders with different pathophysiology, different causes and, consequently, different treatments. This comprehensive title is written for clinicians and researchers by clinicians and researchers who are active in the field. It is logically organized in six sections and will be of interest to otolaryngologists, neurologists, psychiatrists, neurosurgeons, primary care clinicians, audiologists and psychologists. Textbook of Tinnitus describes both the theoretical background of the different forms of tinnitus and it provides detailed knowledge of the state-of-the-art of its treatment. Because of its organization and its extensive subject index, Textbook of Tinnitus can also serve as a reference for clinicians who do not treat tinnitus patients routinely.

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Clinical Imaging - An Atlas of Differential Diagnosis

2010-11-21T18:50:00.000-08:00

Dr. Eisenberg's best seller is now in its Fifth Edition—with brand-new material on PET and PET/CT imaging and expanded coverage of MRI and CT. Featuring over 3,700 illustrations, this atlas guides readers through the interpretation of abnormalities on radiographs. The emphasis on pattern recognition reflects radiologists' day-to-day needs...and is invaluable for board preparation.

Organized by anatomic area, the book outlines and illustrates typical radiologic findings for every disease in every organ system. Tables on the left-hand pages outline conditions and characteristic imaging findings...and offer comments to guide diagnosis. Images on the right-hand pages illustrate the major findings noted in the tables.

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The Pituitary

2010-11-21T18:48:00.000-08:00

Shlomo MD Melmed, "The Pituitary, Third EditionEdition"
Publisher: Academic Press | 2010 | ISBN: 0123809266 | PDF | 744 pages | 30 MB

The pituitary, albeit a small gland, is known as the "master gland" of the endocrine system and contributes to a wide spectrum of disorders, diseases, and syndromes. Since the publication of the second edition of The Pituitary, in 2002, there have been major advances in the molecular biology research of pituitary hormone production and action and there is now a better understanding of the pathogenesis of pituitary tumors and clinical syndromes resulting in perturbation of pituitary function. There have also been major advances in the clinical management of pituitary disorders. Medical researchers and practitioners now better understand the morbidity and mortality associated with pituitary hormone hyposecretion and hypersecretion. Newly developed drugs, and improved methods of delivering established drugs, are allowing better medical management of acromegaly and prolactinoma. These developments have improved the worldwide consensus around the definition of a "cure" for pituitary disease, especially hormone hypersecretion, and hence will improve the success or lack of success of various forms of therapy. It is therefore time for a new edition of The Pituitary.
The third edition will continue to be divided into sections that summarize normal hypothalamic-pituitary development and function, hypothalamic-pituitary failure, and pituitary tumors; additional sections will describe pituitary disease in systemic disorders and diagnostic procedures, including imaging, assessment of the eyes, and biochemical testing.
The first chapter will be completely new - placing a much greater emphasis on physiology and pathogenesis. Two new chapters will be added on the Radiation and Non-surgical Management of the Pituitary and Other Pituitary Lesions. Other chapters will be completely updated and many new author teams will be invited. The second edition published in 2002 and there have been incredible changes in both the research and clinical aspects of the pituitary over the past 8 years - from new advances in growth hormones to pituitary tumor therapy.
Feature
* Presents a comprehensive, translational source of information about the pituitary in one reference work
* Pituitary experts (from all areas of research and practice) take readers from the bench research (cellular and molecular mechanism), through genomic and proteomic analysis, all the way to clinical analysis (histopathology and imaging) and new therapeutic approaches.
* Clear presentation by endocrine researchers of the cellular and molecular mechanisms underlying pituitary hormones and growth factors as well as new techniques used in detecting lesions (within the organ) and other systemic disorders
* Clear presentation by endocrinologists and neuroendocrine surgeons of how imaging, assessment of the eyes, and biochemical testing can lead to new therapeutic approaches
Benefit
* Saves researchers and clinicians time in quickly accessing the very latest details on a broad range of issues related to normal and diseased pituitary function, as opposed to searching through thousands of journal articles.
* Provides a common language for endocrinologists, neurosurgeons, OB/GYNs, and endocrine researchers to discuss how the pituitary gland and hormones affect each major organ system
* Correct diagnosis (and therefore correct treatment) of pituitary disorders depends on a strong understanding of the pathophysiology of the organ as well as the molecular actions of pituitary hormones - practicing endocrinologists and other interested clinicians will benefit
* Endocrine researchers will gain insight into how clinical observations and practices can feed back into the research cycle and will, therefore, be able to develop more targeted genomic and proteomic assays

http://www.filesonic.com/file/33425727/The%20Pituitary.rar

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Critical Care Obstetrics

2010-11-21T18:45:00.000-08:00

Michael A. Belfort MBBCH MD PhD, George R. Saade MD, Michael R. Foley MD, Jeffrey P. Phelan MD JD, Gary A. Dildy III MD, "Critical Care Obstetrics"
Publisher: Wiley-Blackwell | 2010 | ISBN 1405152737 | PDF | 760 pages | 7.2 MB

Critical Care Obstetrics provides expert clinical guidance throughout on how you can maximize the chances of your patient and her baby surviving trauma.
In this stimulating text, internationally recognized experts guide you through the most challenging situations you as an obstetrician are likely to face, enabling you to skillfully:
* Recognize conditions early-on which might prove life threatening
* Implement immediate life-saving treatments in emergency situations
* Maximize the survival prospects of both the mother and her fetus
The fifth edition of this popular book will help you keep your composure in high risk clinical situations, making it an invaluable resource for any healthcare professional responsible for the care and management of pregnant women and their unborn children.

http://depositfiles.com/es/files/tzrg0xiac

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Metabolic Basis of Obesity

2010-11-21T18:42:00.000-08:00

Rexford S. Ahima, "Metabolic Basis of Obesity"
Publisher: S-ger | 2010 | ISBN: 1441916067 | PDF | 391 pages | 5.8 MB

The obesity epidemic has generated immense interest in recent years due to the wide-ranging and significant adverse health and economic consequences that surround the problem. Much attention has been focused on behaviors that lead to obesity, in particular to over consumption of energy-dense food and to sedentary lifestyle. However, obesity is an extremely complex condition with poorly defined pathogenesis. Thanks to greatly enhanced research in the area, the discovery of pathways in the brain and peripheral organs that mediate energy homeostasis has provided a framework for understanding the biological basis of obesity. Metabolic Basis of Obesity adds an important new dimension to the growing literature on obesity by offering a comprehensive review of specifically how metabolic imbalance culminates in obesity. Developed by a team of expert authors, this important title discusses the principles of energy balance, genetics of body weight regulation, hormones and adipokines, and metabolic pathways in the brain, liver, muscle and fat, to name just several of the areas covered. The book also examines the connection between obesity and diabetes, cardiovascular disease and other complications. Current and future diagnostic and treatment strategies are also reviewed. Comprehensive and timely, Metabolic Basis of Obesity is an essential reference for understanding the burgeoning problem of obesity.

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Surgical Mentoring - Building Tomorrow's Leaders

2010-11-21T18:40:00.000-08:00

John Rombeau, Amy Goldberg, Catherine Loveland-Jones - Surgical Mentoring: Building Tomorrow's Leaders
Springer | ISBN: 1441971904 | 2010-10-01 | PDF | 172 pages | 2.96 Mb

Drs. Rombeau, Goldberg, and Loveland-Jones have written this book on surgical mentoring to fill an obvious need. It is up-to-date, comprehensive, readable, and evidence-based … Surgery is a small world with many satisfying rewards behind each of the many doors. Good mentorship provides the right keys for the right doors for the young surgeon. Both the mentor and mentee should read this book to better understand the who, what, when, where, and how of surgical mentorship in the modern era. What you learn will likely make a difference in your career.

http://www.filesonic.com/file/33078271/A_100917_MedEn_SMBTL.rar

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Textbook of Pediatric Emergency Medicine

2010-11-21T18:38:00.000-08:00

Gary R Fleisher, Stephen Ludwig - Textbook of Pediatric Emergency Medicine, Sixth edition
Lippincott Williams & Wilkins | ISBN: 1605471593 | 2010-05-20 | CHM | 2000 pages | 36.90 Mb

Now in its Sixth Edition, the best-selling Textbook of Pediatric Emergency Medicine is the most comprehensive textbook in this specialty. The editors are considered the founders of pediatric emergency medicine, and this text covers all pediatric emergencies and acute illnesses. All critical emergency information, including shock, resuscitation, and life-threatening conditions, are placed in the front of the book. More than 70 acute pediatric presentations are covered in a signs and symptoms section designed with side tabs for easy access.

This edition's highlights include new chapters on palpitations, cystic fibrosis, travel related emergencies, and ultrasound and a new appendix on practice pathways. The medical, surgical, and trauma sections present topics in alphabetical order for easier access. The contributors have revised and updated every chapter and included contemporary references.

A companion website will offer the fully searchable text, plus online access to interactive practice pathways and journal articles from Pediatric Emergency Care.

http://www.filesonic.com/file/33287701/A_101118_MedEn_ToPEM.rar

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Radiotherapy for Hodgkin Lymphoma

2010-11-21T18:36:00.000-08:00

Lena Specht, Joachim Yahalom - Radiotherapy for Hodgkin Lymphoma
Springer | ISBN: 3540784551 | 2010-09-29 | PDF | 214 pages | 7.17 Mb

This book deals in detail with all aspects of the best practice in modern radiotherapy for Hodgkin lymphoma. It provides the background and rationale for the inclusion of radiotherapy in today’s combined-modality approach, including special clinical situations such as Hodgkin lymphoma in children, in the pregnant patient, and in the elderly. Radiotherapy planning using state-of-the-art imaging, target definition, planning software, and treatment equipment is expounded in detail. Acute and long-term side effects of radiotherapy are analyzed, and the implications for modern radiotherapy approaches in Hodgkin lymphoma are explained.

http://depositfiles.com/es/files/zx3wdkxeh

Minimally Invasive Cancer Management

2010-11-21T18:32:00.000-08:00

Frederick L. Greene, B. Todd Heniford - Minimally Invasive Cancer Management
Springer | ISBN: 1441912371 | 2010-09-01 | PDF | 382 pages | 11.70 Mb

As minimal access approaches to cancer diagnosis, staging, and therapy become more widely used, it is vital for general surgeons, along with laparoscopists, surgical oncologists and medical oncologists, to stay up to date. The editors, a team consisting of a renowned surgical oncologist and a laparoscopic specialist, aim to provide a resource for the practicing general surgeon using basic minimally invasive techniques. The book discusses diagnosis including biopsy with microinstrumentation, staging, and palliative and curative resection. Specific tumor sites are addressed, including esophagus, stomach, spleen, small bowel, pancreato-biliary, hepatic resection, and colo-rectal resection. Minimally invasive approaches to the thoracic and retroperitoneal areas are included. The book provides a thorough overview of basic cancer biology, instrumentation, and ultrasound.

http://www.filesonic.com/file/33087073/A_100917_MedEn_MICM.rar

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Hereditary Colorectal Cancer

2010-11-21T18:30:00.000-08:00

Miguel A. Rodriguez-Bigas, Raul Cutait, Patrick M. Lynch, Ian Tomlinson, Hans F.A. Vasen - Hereditary Colorectal Cancer
Springer | ISBN: 1441966021 | 2010-09-01 | PDF | 627 pages | 11.30 Mb

Colorectal cancer is the third most commonly diagnosed cancer in the US and the third most recently linked to cancer deaths. The national annual incidence rate of colorectal cancer is approximately 148,000+, striking slightly more females than males. The lifetime risk of colorectal cancer is 5-6%, however patients with a familial risk (with two or more first or second degree relatives) make up 20% of the patients. Persons who carry genetic mutations linked to hereditary colorectal cancer are the most likely to develop the disease.

http://depositfiles.com/es/files/rwsb9434f

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Good Clinical Diagnostic Practice - A Guide fro Clinicians in Developing Countries

2010-11-21T18:25:00.000-08:00

Jane Carter; I.H. Muller-Stover; Claus C.Heuck, "Good Clinical Diagnostic Practice: A Guide for Clinicians in Developing Countries"
Publisher: World Health Organization. Regional Office for the Eastern Mediterranean | 2005 | ISBN: 9290213930 | PDF | 220 pages | 1.1 MB

The aim of this book is to bridge the gap between the diagnostic departments and the clinical wards in order to improve the coordination of the different services that are involved in patient care, each service with its specific task and responsibility. It has been written to improve the clinical and diagnostic skills of physicians. The manual assumes that clinicians have been trained in history-taking, physical examination and use of laboratory investigations and also have access to basic clinical diagnostic equipment and to essential laboratory tests.

http://depositfiles.com/es/files/saj6k9rft

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Cardiac CT

2010-11-21T18:23:00.000-08:00

Marc Dewey, "Cardiac CT"
2010 | ISBN: 3642140211 | PDF | 333 pages | 39 MB

Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored.

http://www.filesonic.com/file/33970591/Cardiac%20CT.rar

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Echocardiography

2010-11-21T18:20:00.001-08:00

Petros Nihoyannopoulos, Joseph Kisslo, "Echocardiography"
ISBN: 1848822928 | edition 2009 | PDF | 656 pages | 59.5 mb

As increasing emphasis is placed on evidence-based medicine and the need to a rapid and clinically effective diagnosis of cardiac disease, so echocardiography is ever-more present at the forefront of cardiology. This book represents the current knowledge in the technique of cardiology and is designed to guide the resident and fellow through the most common applications of echocardiography while touching on some of the less often seen echocardiographic diagnoses.

http://turbobit.net/g924n4qcz9zx.html

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The Handbook of Contraception - A Guide for Practical Management

2010-11-21T18:18:00.000-08:00

Donna Shoupe, "The Handbook of Contraception: A Guide for Practical Management (Current Clinical Practice)"
Publisher: Humana Press; 1st Edition. edition | 2010 | ISBN: 1617376701 | PDF | 312 pages | 4.1 MB

The Handbook of Contraception: A Guide for Practical Management provides a comprehensive review of contraception methods for all reproductive-aged women, including those who are young and healthy, postpartum, perimenopausal, adolescent, or who have a medical disease. Because of the vast and diverse list of various contraceptive methods available, this text updates the health care provider with information on safety, practical counseling tools, advantages, and disadvantages of each contraception method. This superb reference offers inclusive information on oral, injectable, emergency, and various cervical barrier contraceptives, as well as behavioral methods of contraception and sterilization methods. An extensive review of currently available laparoscopic and hysterscopic tubal sterilization techniques is also included as well as a chapter introducing the new surgical contraceptive implant, Implanon®.The Handbook of Contraception: A Guide for Practical Management is designed to give the modern health care provider up-to-date information on safety, side effects, advantages, and practical counseling tools.

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http://depositfiles.com/es/files/w2dhbbum4

Sonography of the Liver

2010-11-21T18:14:00.000-08:00

An excellent lecture on sonography of the liver.

Discusses the following:
- Normal liver
- Segmental anatomy of liver
- Doppler hepatic vessels
- Diffuse and focal liver disease
- Portal hypertension.
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http://www.filesonic.com/file/34175911/Sonography%20of%20the%20liver_in%20English.part1.rar
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Orthopaedic Manual Therapy Diagnosis: Spine and Temporomandibular Joints

2010-11-21T18:08:00.000-08:00

Orthopaedic Manual Therapy Diagnosis: Spine and Temporomandibular Joints
Publisher: Jones & Bartlett Publishers; 1 edition (April 30, 2009) | ISBN: 076375594X | Pages: 578 | PDF | 61,86 MB

Orthopaedic Manual Therapy Diagnosis is a comprehensive and easily-accessible compendium of theory and technique related to orthopaedic manual therapy (OMT). This essential resource covers key topics such as spinal anatomy, biomechanics, arthrology, general functional aspects of the spine, definitions, theories, and examination. This text combines a comprehensive discussion of both the pathophysiologic rationale and the applied evidence base with regard to OMT diagnosis. It demonstrates numerous diagnostic techniques used in the clinical practice of manual medicine. Providing an up-to-date analysis of spinal examination, this is an ideal textbook for courses in OMT. It also serves as a reference for all manual medicine practitioners including physical therapists, chiropractors, osteopaths, and medical physicians.

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http://www.filesonic.com/file/33969805/076375594X.pdf

Hospital and Healthcare Security

2010-11-21T18:05:00.000-08:00

Russell L. Colling, Tony W. York, "Hospital and Healthcare Security, Fifth Edition"

B-H | 2009 | ISBN: 1856176134 | 720 pages | PDF | 28 MB

Concerns about healthcare security have proliferated in recent years, with one recent study reporting that 17% of registered nurses surveyed had been physically attacked at work over a 1-year period. From privacy concerns to the mandates of the Health Insurance Portability and Accountability Act (HIPAA) to the rapid growth in the number of aging and ailing baby boomers, healthcare has undergone dramatic change, and security in hospitals and other settings must keep pace. Most educators, healthcare executives, and healthcare agencies and associations agree that Hospital and Healthcare Security, a Butterworth-Heinemann classic, has set the standard of care for healthcare security systems and programs.

Hospital and Healthcare Security, 5th Edition, builds on the solid foundation laid down by Russell Colling in the first four editions, covering the shifts that have occurred in healthcare security since the last edition appeared in 2001. The new co-author, Tony York, is a well-regarded security professional and a past president of the International Association for Hospital Security and Safety (IAHSS). This new edition has been reorganized and rewritten to cover new healthcare security topics and issues, particularly in licensing, regulatory requirements, litigation, and accreditation standards in the US. The authors have added a full range of corresponding examples, not only from the privately funded US system but also from national healthcare systems in UK and Canada.

This new edition expands the scope of Colling's foundational work and focuses its coverage of legal and operational issues to bring this vital information to a new and broaderaudience.

FEATURES AND BENEFITS:

* Practical support for healthcare security professionals, including operationally proven policies, and procedures

* Specific assistance in preparing plans and materials tailored to healthcare security programs

* Summary tables and sample forms bring together key data, facilitating ROI discussions with administrators and other departments

* General principles clearly laid out so readers can apply the industry standards most appropriate to their own environment

NEW TO THIS EDITION:

* Quick-start section for hospital administrators who need an overview of security issues and best practices

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http://uploading.com/files/6d8m945e/1856176134Security.rar/

Neurologic Emergencies

2010-11-21T18:00:00.000-08:00

Gregory Henry, Neal Little, Andy Jagoda, Thomas Pellegrino, Douglas Quint, "Neurologic Emergencies, Third Edition"

MgH | 2010 | ISBN: 0071635211 | 396 pages | CHM | 6,3 MB

Complete guidance on how to diagnose and treat neurologic emergencies in any acute care setting!

Uniquely organized by presenting complaint, Neurologic Emergencies helps you quickly identify, evaluate, stabilize, treat, and manage the full range of neurologic symptoms--from dizziness to trauma. Striking the perfect balance between thoroughness and readability, this trusted classic delivers the authoritative guidance you need to ensure the best possible outcomes possible for patients presenting with neurologic emergencies. The Third Edition has been updated with a valuable primer on neuroimaging technologies and includes the latest evidence-based treatment strategies and expert advice.

Features:

•Organized by presenting symptoms, rather than by disease, for unmatched clinical relevance

•Written by a team of authors highly experienced in managing patients with neurologic complaints

•Numerous algorithms and tables offer immediate access to critical information

•Emphasizes patient history, physical exam, and rapid assessment

•Everything you need to know in the acute care setting:

Review of Basic Neuroanatomy, Neuroimaging, Evaluation of a Neurologic Complaint, Altered States of Consciousness and Coma, Acute Focal Neurological Deficit, Acute Weakness, Movement Disorders, Headache; Acute Double Vision, Blindness, and Abnormal Pupils; Neurologic Trauma, Psychogenic Neurologic Problems, Seizures, Syncope, The Dizzy Patient, Neck and Back Pain

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http://uploading.com/files/7c2fa5m6/0071635211Neurologic3ed.rar/

Infectious Disease Informatics and Biosurveillance

2010-11-21T17:57:00.000-08:00

Daniel Zeng, "Infectious Disease Informatics and Biosurveillance (Integrated Series in Information Systems)"

Publisher: Springer; 1st Edition. edition | 2010 | ISBN: 1441968911 | PDF | 488 pages | 25.3 MB

This book on Infectious Disease Informatics (IDI) and biosurveillance is intended to provide an integrated view of the current state of the art, identify technical and policy challenges and opportunities, and promote cross-disciplinary research that takes advantage of novel methodology and what we have learned from innovative applications. This book also fills a systemic gap in the literature by emphasizing informatics driven perspectives (e.g., information system design, data standards, computational aspects of biosurveillance algorithms, and system evaluation). Finally, this book attempts to reach policy makers and practitioners through the clear and effective communication of recent research findings in the context of case studies in IDI and biosurveillance, providing “hands-on” in-depth opportunities to practitioners to increase their understanding of value, applicability, and limitations of technical solutions. This book collects the state of the art research and modern perspectives of distinguished individuals and research groups on cutting-edge IDI technical and policy research and its application in biosurveillance. The contributed chapters are grouped into three units. Unit I provides an overview of recent biosurveillance research while highlighting the relevant legal and policy structures in the context of IDI and biosurveillance ongoing activities. It also identifies IDI data sources while addressing information collection, sharing, and dissemination issues as well as ethical considerations. Unit II contains survey chapters on the types of surveillance methods used to analyze IDI data in the context of public health and bioterrorism. Specific computational techniques covered include: text mining, time series analysis, multiple data streams methods, ensembles of surveillance methods, spatial analysis and visualization, social network analysis, and agent-based simulation. Unit III examines IT and decision support for public health event response and bio-defense. Practical lessons learned in developing public health and biosurveillance systems, technology adoption, and syndromic surveillance for large events are discussed. The goal of this book is to provide an understandable interdisciplinary IDI and biosurveillance reference either used as a standalone textbook or reference for students, researchers, and practitioners in public health, veterinary medicine, biostatistics, information systems, computer science, and public administration and policy.

DESCARGALO CLIQUEANDO EL SIGUIENTE LINK:

http://www.filesonic.com/file/34216379/1441968911.rar

Atherosclerosis Disease Management

2010-11-21T17:53:00.000-08:00

Jasjit S. Suri, Chirinjeev Kathuria, Filippo Molinari, "Atherosclerosis Disease Management"

Publisher: Springer | 2010 | ISBN: 1441972218 | PDF | 944 pages | 33.8 MB

Atherosclerosis is a degenerative process affecting blood vessels, which determines narrowing of the lumen, plaque growth, and hardening of the walls. It is a risk factor for cardiovascular diseases. The focus of this book is on the management of the atherosclerotic disease. The coverage of this book spans from histological presentation of the various stages of atherosclerotic lesions to the earliest studies in atherosclerosis therapy, from advanced clinical diagnosis to monitoring, follow-up, and home-care of the atherosclerotic patient. The book shows well-established diagnostic techniques covering several medical imaging modalities such as Ultrasounds, IVUS, MRI, Computer Tomography, along with new trends in early and advanced atherosclerosis diagnosis (innovative drugs and tissue characterization procedures). Surgical standards will be presented along with innovative experimental trials for the treatment of the atherosclerotic patient. The book will also cover emerging techniques based on molecular imaging and vibro-acoustics.

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http://depositfiles.com/es/files/muqe5jb2l

CIRUGÍA para el estudiante y el médico general

2010-11-21T17:49:00.000-08:00

CIRUGÍA para el estudiante y el médico general
Páginas: 827
Idioma: spanish
Mendez Editores Mexico

Año: 2004
ISBN 9789685328760

El libro consta de capítulos dedicados a diverso contenido, partiendo por temas básicos como "El instrumental quirúrgico", "Nudos y Suturas", "El ciclo quirúrgico", explica cómo desenvolverse en el quirófano (cómo ponerse guantes, etc.). Luego de estos capítulos introductorios, el libro se centra en temas como el shock séptico, equlibrio ácido-base:

Descargar: 54 mb pdf
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http://rapidshare.com/#!download|524l33|214659417|CIRUG_A_PARA_EL_ESTUDIANTE_Y_EL_M_DICO_GENERAL_optimizado.rar|57067

Learning Cardiac Imaging 2010

2010-11-11T19:52:00.000-08:00

Learning Cardiac Imaging 2010
(Learning Imaging)
Ramón Ribes, Paola Kuschnir, Antonio Luna, Joan C. Vilanova
ISBN-10: 3540790829
ISBN-13: 978-3540790822
Springer

This book is an introduction to cardiac imaging. Written by radiologists, cardiologists, and nuclear medicine physicians in a user-friendly format, it provides the reader with a multidisciplinary selection of the most prevalent cardiac conditions. The book is subdivided into four sections: Cardiac Multislice CT, Echocardiography, Cardiac Magnetic Resonance and Nuclear Cardiology. Each chapter is presented with an introduction to the subspecialty and a selection of cases with illustrations, comments from clinical and radiological standpoints, and bibliographical recommendations.

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http://hotfile.com/dl/34621132/021c5a9/Learning_Cardiac_Imaging_2010_drwhite.rar.html

Cardiovascular Physiology (Lange Physiology Series)

2010-11-11T19:48:00.000-08:00

Cardiovascular Physiology (Lange Physiology Series)
By David E. Mohrman, Lois Jane Heller

* Publisher: McGraw-Hill Medical
* Number Of Pages: 256
* Publication Date: 2006-03-27
* ISBN-10 / ASIN: 0071465618
* ISBN-13 / EAN: 9780071465618
* Binding: Paperback
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100 Questions in Cardiology

2010-11-11T19:46:00.000-08:00

100 Questions in Cardiology

Paperback: 222 pages
Publisher: Blackwell Publishing Limited; 1st edition (May 15, 2001)
Language: English
ISBN-10: 0727914898
ISBN-13: 978-0727914897
File type: PDF

Book Description

A guide to the management of common cardiological scenarios, this book offers the response of leading experts in each field to the more common, and often poorly dealt with problems of cardiology. It is a very useful "how-to" guide, based on sound evidence.

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ERCP

2010-11-07T19:10:00.000-08:00

Todd H. Baron, Richard A. Kozarek, David L. Carr-Locke,

ISBN-10: 1416042717

ISBN-13: 978-1416042716

Elsevier Inc.

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Atlas de Colposcopia

2010-11-07T19:01:00.000-08:00

Más que un libro sobre colposcopía, este atlas es una colección de imágenes de las diversas patologías que afectan el cuello del útero haciendo énfasis en el Cáncer de Cuello Uterino, que es el cáncer más frecuente en los países latinoamericanos. Contiene imágenes algunas de muy buena calidad otras de no tan buena calidad cada una con su respectiva descripción, aunque en algunas estas están en ingles. La colposcopía es un procedimiento médico consistente en la observación microscópica del epitelio cuello uterino, paredes vaginales así como entrada a la vagina, que permite identificar lesiones precancerosas con gran precisión. Este procedimiento permite realizar con mayor exactitud y seguridad el Papanicolau o toma de biopsias ante la presencia de lesiones sospechosas en el cuello uterino La colposcopía no provoca dolor ni sangrado, se realiza en pocos minutos, es seguro, no requiere hospitalización y terminado el estudio, la paciente puede regresar a casa

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Principles of Pulmonary Protection in Heart Surgery

2010-10-17T17:52:00.000-07:00

Edmo Atique Gabriel, Tomas Salerno - Principles of Pulmonary Protection in Heart Surgery
Springer | ISBN: 184996307X | 2010-10-29 | PDF | 350 pages | 14.70 Mb

This book aims to cover all aspects of pulmonary protection in heart surgery including repercussions from cardiopulmonary bypass on the lung, a vast section on lung perfusion, including information on cardioplegic arrest, beating heart surgery, arterial and venous blood and ischemia-reperfusion injury.

From the Back Cover:

Over the past fifty years, advanced techniques and strategies have been developed in the field of myocardial protection during heart surgery requiring cardiopulmonary bypass (CPB), but trials focusing on pulmonary protection have been less frequent. Principles of Pulmonary Protection during Heart Surgery is intended as an useful tool to provide strategies for lung protection during CPB. The many renowned contributors have presented their experience on lung perfusion in both experimental and clinical trials, and have detailed numerous new ideas, concepts and future perspectives to the book. It is thus perfect as a reference for a wide range of professionals, including cardiovascular surgeons, pulmonary surgeons and pulmonologists, transplantation physicians, cardiothoracic anesthesiologists, intensive care physicians, radiologists, basic sciences physicians, cardiologists and cardiothoracic fellows, perfusionists, nurses, and researchers.

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Semiologia General

2010-10-16T20:25:00.000-07:00

Semiologia General
T. Padilla, P. Cossio

Editorial: El Ateneo
Serie: Biblioteca de Semiologia

Paginas: 334
Edicion: 4ª

Contenido:

Interrogatorio

Historia clínica: datos generales, motivo de la consulta, antecedentes familiares,

antecedentes personales. Su redacción.

Tecnica Lenguaje Dolor

INSPECCION

Conformacion corporal

Habito Constitución. Peso. Altura. Facies. Actitud. Decúbito.

Semiologia de la temperatura Fiebre.

Dolor: tipos, localizaciones.

Disnea.

Cianosis.

Semiologia de la piel

Semiologia del prurito y la alergia

Semiologia de tejido celular subcutaneo

Semiología de la piel, Pelo. Uñas.

Edema.

Semiología del sistema linfático.

Semiologia del sistema oseo

Semiologia de las articulaciones.

Exploracion general cabeza craneo cara ojos nariz oido

Semiologia del cuello

Semiologia de la columna vertebral

Semiología de mano y del pie. Semiología de las articulaciones.

Semiología de cabeza, cara y cuello.

Semiologia brazo

antebrazo y mano

Semiologia de las extremidades

Semiologia de los organos gentitales

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How to Read a Paper: The Basics of Evidence-Based Medicine

2010-10-16T20:18:00.000-07:00

How to Read a Paper: The Basics of Evidence-Based Medicine, Fourth Edition
by: Trisha Greenhalgh

•Publisher: BMJ Books
•Number Of Pages: 256
•Publication Date: 2010-06-01
•ISBN-10 / ASIN: 1444334360
•ISBN-13 / EAN: 9781444334364

Product Description:
How to Read a Paper describes the different types of clinical research reporting, and explains how to critically appraise the publications. The book provides the tools to find and evaluate the literature, and implement the findings in an evidence-based, patient-centered way. Written for anyone in the health care professions who has little or no knowledge of evidence-based medicine, it provides a clear understanding of the concepts and how to put them into practice at the basic, clinical level.

Changes for the 4th edition

The fourth edition will include two new chapters on important developments in health care research and delivery, but otherwise retains its original style, size, and scope.

•New chapter on quality improvement – describing papers on quality improvement projects using ebm methods; this will extend the readership to non clinical health care professionals working in hospitals and family practice, and to nurse specialists and practice nurses working in this field

•New chapter on complex interventions - how to set up research projects involving both qualitative and quantitative methodology (known as mixed methods)

•Thorough revision and updating of existing chapters and references

•New illustrations – diagrammatic representations of ebm concepts

http://www.book4doc.com/61115

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"Huesos y Articulaciones en Imagenes Radiologicas" (Spanish Edition) de Resnick

2010-10-13T22:14:00.000-07:00

Huesos y Articulaciones en Imagen - RESNICK

El Dr. Resnick y el Dr. Kransdorf, junto con un equipo de colaboradores de reconocido prestigio, condensan el material básico relacionado con el diagnóstico por la imagen de huesos yarticulaciones, incluyendo las numerosas técnicas de imagen y sus hallazgos, ya que los métodos diagnósticos aplicados actualmente de forma rutinaria en el estudio de los trastornos musculoesqueléticos incluyen no solo las radiografías convencionales, sino también TC, MR, ecografías, gammagrafías y arteriografías.

Su objetivo es presentar, de manera lógica y en un formato de fácil lectura, la información de diagnóstico musculoesquelético por imagen que todo estudiante y profesional que trata estos trastornos necesita conocer. Destaca también su carácter de herramienta para la revisión y actualización de conocimientos en una materia en constante evolución debido al desarrollo y el perfeccionamiento de métodos y técnicas de diagnóstico avanzados. Esta nueva edición incluye algunos temas nuevos, como, por ejemplo, procedimientos intervencionistas de la columna vertebral y desarrolla mucho más aquellos que han ido creciendo en importancia, como, por ejemplo, la RM.

Autor: Donald Resnick
Editorial: Marban
Edición: 2ª
Tamaño: 239.6 MB
Formato: Presto! Wrapper
Idioma: Español

Recuerden que deben bajar las 3 partes para tener el libro
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PARTE 1
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PARTE 2
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PARTE 3
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Jon H. Kaas, "Evolutionary Neuroscience"

2010-10-10T20:39:00.000-07:00

Jon H. Kaas, "Evolutionary Neuroscience"
Academic Press | 2009-10-06 | ISBN: 0123750806 | 1038 pages | PDF | 27 MB

Evolutionary Neuroscience is a collection of articles in brain evolution selected from the recent comprehensive reference, Evolution of Nervous Systems (Elsevier, Academic Press, 2007). The selected chapters cover a broad range of topics from historical theory to the most recent deductions from comparative studies of brains. The articles are organized in sections focused on theories and brain scaling, the evolution of brains from early vertebrates to present-day fishes, amphibians, reptiles and birds, the evolution of mammalian brains, and the evolution of primate brains, including human brains. Each chapter is written by a leader or leaders in the field, and has been reviewed by other experts. Specific topics include brain character reconstruction, principles of brain scaling, basic features of vertebrate brains, the evolution of the major sensory systems, and other parts of brains, what we can learn from fossils, the origin of neocortex, and the evolution of specializations of human brains. The collection of articles will be interesting to anyone who is curious about how brains evolved from the simpler nervous systems of the first vertebrates into the many different complex forms now found in present-day vertebrates. This book would be of use to students at the graduate or undergraduate levels, as well as professional neuroscientists, cognitive scientists, and psychologists. Together, the chapters provide a comprehensive list of further reading and references for those who want to inquire further.

. The most comprehensive, authoritative and up-to-date single volume collection on brain evolution

. Full color throughout, with many illustrations

. Written by leading scholars and experts

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Diagnostico y Tratamiento de Urgencias Pediatricas 4taEd.

2010-10-10T20:03:00.000-07:00

Diagnostico y Tratamiento de Urgencias Pediatricas 4taEd.

F. Javier Benito, Santiago Mintegi ,J. Sánchez Etxaniz

Descripcion del Libro

Han pasado diez años desde la primera edición de este manual y desde entonces ha experimentado cambios muy profundos, parejos a la evolución de nuestro servicio de urgencias y al nacimiento de la subespecialidad de Urgencias en España. Esta progresión ha sido palpable en las sucesivas ediciones, alcanzando, a nuestro entender, una estructura madura en la tercera edición. Siguiendo nuestro compromiso con la actualización de los conocimientos vertidos en esta obra, hemos afrontado la actual edición que no aporta grandes cambios estructurales, pero sí una profunda revisión y actualización de todos los capítulos. Al igual que en la tercera edición, el temario de este manual no sólo abarca la patología medicoquirúrgica, agrupada en bloques por aparatos con las enfermedades y síntomas por los que los niños consultan en urgencias, y los accidentes, grandes protagonistas de los servicios de urgencia de pediatría actuales, sino también las técnicas y procedimientos que se llevan a cabo con mayor frecuencia en estos servicios. Hoy en día, gracias a la profesionalización progresiva del pediatra de urgencias, se han convertido en técnicas que forman parte de su entrenamiento y labor asistencial. Pretendemos que este manual sirva de consulta rápida a cualquier profesional que atienda la consulta urgente en Pediatría, sabiendo de antemano los diferentes grados de experiencia y entrenamiento existentes en cada punto asistencial. Por eso se trata de una guía únicamente orientativa, cuyos planteamientos aconsejamos ampliar con los textos y bibliografía aportada.

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Quemados. Valoración y criterios de actuación

2010-10-10T19:57:00.000-07:00

Editorial Meda

ISBN: 9788492442461

paginas 52

1era Ed.

Quemados. Valoración y criterios de actuación, obra dirigida por el Dr. Ricardo Palao Doménech, médico del Servicio de Cirugía Plástica y Quemados del Hospital Universitari Vall d?Hebrón, con la colaboración de MEDA y la Sociedad Española de Heridas (SEHER), es una de las monografías editadas por Marge Médica Books.

Dentro de los traumatismos que podemos sufrir las personas, las quemaduras son las que mayor repercusión física y psíquica pueden ocasionarnos; sin olvidar que son la segunda causa de muerte accidental en los países desarrollados. En la mayoría de casos las quemaduras son de poca importancia y no implican consecuencias trascendentes para el que las sufre, si bien pueden afectar a las actividades cotidianas, especialmente cuando su tratamiento no se realiza de forma adecuada. Y es que cabe señalar que la mayoría de quemaduras de espesor parcial son tratadas en nuestro sistema sanitario, de forma regular, por personal no especializado y que ejerce en un hospital general o en un área básica de salud, donde este tipo de heridas sólo representa un pequeño porcentaje, con la consiguiente falta que esto supone.

El objetivo de este manual es dar una guía de actuación en el manejo de las quemaduras que pueda ser útil al personal sanitario de hospitales sin unidad de quemados y al de áreas básicas de salud, teniendo en cuenta al personal de urgencias, cirujanos plásticos y generales, traumatólogos, dermatólogos, pediatras, geriatras y miembros de enfermería. Por otro lado, este manual ofrece al cirujano plástico una puesta al día específica en el tratamiento de las quemaduras.

Contenido del Libro

Introducción

Capítulo 1.â€‚
Fisiopatología local y sistémica. Diagnóstico y clínica. Mecanismo y epidemiología de las quemaduras

Capítulo 2.â€‚
Atención inicial prehospitalaria, criterios de derivación y condiciones de traslado del paciente quemado

Capítulo 3.
Cuidados locales de las quemaduras: uso de cremas y apósitos

Capítulo 4.
Cuidados posquemadura: presoterapia, siliconas y otras medidas de apoyo

Capítulo 5.
Sustitutos cutáneos
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Functional Reconstructive Nasal Surgery By Bert H. Huizing

2010-10-10T19:52:00.000-07:00

Functional Reconstructive Nasal Surgery By Bert H. Huizing

Publisher: Thieme Publishing Group 2003 | 400 Pages | ISBN: 3131294116 | DJVU | 10 MB

This title covers the functional reconstructive aspects of nasal surgery. It provides step-by-step details on a wide range of surgical procedures, highlighted by more than 800 detail-revealing illustrations. Beginning with an overview of surgical anatomy, histology, physiology, and diagnostics, the book goes on to cover incisions and approaches for surgery of the septum, pyramid, lobule, turbinate, and nasal cavity. An important section on special considerations addresses paediatric surgery, transplants, acute nasal trauma, mentoplasty; implants; complications; and more. The extensive appendix includes coverage of materials, instruments, nomenclature, and historical developments. All otorhinolaryngologists, maxillofacial surgeons, facial plastic surgeons, and residents who perform functional reconstructive nasal surgery should benefit from this wealth of information.

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Fracturas Infantiles, Conceptos y Principios, 2ed

2010-10-10T19:47:00.000-07:00

Fracturas Infantiles, Conceptos y Principios, 2ed

Descripción:

Como podrá apreciarse en el contenido de los siguientes capítulos, el hueso en la edad infantil presenta una serie de peculiaridades, tanto en su composición como en su fisiología, que son determinantes en la, a menudo, especial morfología de las fracturas en este grupo de edad y dan lugar a unas reacciones ante la fractura características del hueso inmaduro. Estamos asistiendo a tiempos interesantes en lo referente a las fracturas infantiles. Los nuevos instrumentales para las fracturas infantiles están causando un impacto similar al que se produjo con la introducción de la instrumentación raquídea en la escoliosis. Durante años, y con pocas excepciones, las ideas de Blount dominaron en este campo (cualquier cosa es mejor que una operación). Pero el mundo ha cambiado y ahora disponemos de motores quirúrgicos, intensificadores de imagen, fijadores externos, altos costes de hospitalización y padres que trabajan y que con frecuencia, no se fían de la remodelación espontánea de estas fracturas.

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Myofascial Trigger Points

2010-10-10T19:37:00.000-07:00

Jan Dommerholt, Peter Huijbregts, "Myofascial Trigger Points: Pathophysiology and Evidence-Informed Diagnosis and Management"
Jones & Bartlett Publishers | 2009 | ISBN: 0763779741 | 225 pages | PDF | 17,9 MB

Myofascial Trigger Points: Pathophysiology and Evidence-Informed Diagnosis and Management's emphasis is on the etiology of trigger points with a critical overview of current concepts. The contributing authors are the most respected myofascial pain research and practice experts. The authors address the etiology of trigger points, the epidemiology of myofascial pain, clinical management of patients, specific treatment issues, and the role of trigger points in various pain syndromes. This book is an accessible introduction to myofascial trigger points for physicians, therapists, chiropractors, osteopaths, acupuncturists, and massage therapists.

Table of Contents
Pt. 1 Pathophysiology
Ch. 1 Myofascial Trigger Points: Translating Molecular Theory into Manual Therapy
Ch. 2 Myofascial Trigger Points: An Evidence-Informed Review
Ch. 3 Nutritional and Metabolic Perpetuating Factors in Myofascial Pain

Pt. 2 Diagnosis
Ch. 4 Reliability of Myofascial Trigger Point Palpation: A Systematic Review
Ch. 5 Interrater Reliability of Palpation of Myofascial Trigger Points in Three Shoulder Muscles
Ch. 6 Contributions of Myofascial Trigger Points to Chronic Tension-Type Headache

Pt. 3 Management

Ch. 7 Effectiveness of Noninvasive Treatments far Active Myofascial Trigger Point Pain: A Systematic Review

Ch. 8 Trigger Point Dry Needling

Ch. 9 Physical Therapy Diagnosis and Management of a Patient with Chronic Daily Headache: A Case Report

Pt. 4 Future Research Directions

Ch. 10 Myofascial Pain Syndrome: Unresolved Issues and Future Directions

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ABC of Eyes 4th Edition (ABC Series) - Peng T. · Andrew R.

2010-10-03T20:46:00.000-07:00

ABC of Eyes 4th Edition (ABC Series) - Peng T. · Andrew R.
Description:

This best-selling ABC owes its success to its succinct symptom-based approach. With excellent colour photographs and illustrations, it gives clear practical advice on the identification, treatment and management of all the major eye disorders, and when to refer to a specialist. Starting with an excellent outline of how to take a history and perform an examination, the following chapters cover the most commonly encountered ophthalmological complaints. This new edition has been thoroughly updated and contains the latest information on glaucoma, refractive surgery and the management of patients with visual loss, as well as many new illustrations. Already established as the standard guide for general practitioners, medical students and nurses, this ABC will be invaluable to anyone who is the 'first port of call' for patients with eye problems, both in primary care and the emergency department. ABC of Eyes,as a clinical primer,is an excellent introduction to ophthalmology it presents basic ophthalmology with admirable simplicity, authority and clarity.

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