ABSTRACT
La mayoría de la bibliografía mundial sobre la pandemia Covid-19 se ha focalizado en los países del continente asiático, europeo o americano. En África parece que la incidencia es menor. En este artículo se hipotetiza sobre alguna de las posibles causas que han dado lugar a estas diferencias. La pirámide poblacional, la temperatura ambiente, la vulnerabilidad/resistencia de los habitantes del continente o factores sociopolíticos son subrayados. En caso de que la pandemia se extendiera en el continente africano, posiblemente la falta de recursos sanitarios haría que las consecuencias fueran desastrosas y de una magnitud dantesca
Most of the international bibliography published on Covid-19 pandemics is focused in the Asian, European or American continents. It seems that incidence is lower in Africa. In this article we hypothetize on several of the possible causes sustaining these differences. Population pyramid, climate, african population own vulnerability/resistance or sociopolitical factors are underlined. In the case the pandemics will spread in Africa, the lack of basic healthcare resources will perhaps make the consequences disastrous and of a dantesque magnitude
Subject(s)
Humans , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Pandemics , Coronavirus Infections/mortality , Coronavirus Infections/prevention & control , Pneumonia, Viral/mortality , Pneumonia, Viral/prevention & control , Congo/epidemiology , Africa/epidemiology , Age Factors , Incidence , TemperatureABSTRACT
Most of the international bibliography published on Covid-19 pandemics is focused in the Asian, European or American continents. It seems that incidence is lower in Africa. In this article we hypothetize on several of the possible causes sustaining these differences. Population pyramid, climate, african population own vulnerability/resistance or sociopolitical factors are underlined. In the case the pandemics will spread in Africa, the lack of basic healthcare resources will perhaps make the consequences disastrous and of a dantesque magnitude.
Subject(s)
COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Africa/epidemiology , Age Factors , COVID-19/immunology , COVID-19/mortality , COVID-19/prevention & control , Democratic Republic of the Congo/epidemiology , Europe/epidemiology , Humans , Incidence , Malaria/immunology , Physical Distancing , Politics , Social Factors , Temperature , United States/epidemiologyABSTRACT
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Subject(s)
Humans , Male , Female , Competency-Based Education/organization & administration , Competency-Based Education/trends , Pain/therapy , Anesthesia , Competency-Based Education/statistics & numerical data , Competency-Based Education/standards , Anesthesiology/education , 35176 , Faculty , Faculty, Medical/organization & administrationABSTRACT
OBJECTIVES: To compare the efficacy and side effects of three doses of metoclopramide, droperidol or placebo administered every 8 h to prevent nausea and vomiting during the first 24 h after surgery. MATERIAL AND METHODS: Prospective, double blind study of 104 patients scheduled for major intraabdominal gynecological surgery under general anesthesia. The patients were randomly assigned to three groups: group M received 10 mg of metoclopramide, group D received 1.25 mg of droperidol and group P received a saline solution. The patients were premedicated with oral diazepam. All patients were anesthetized using similar techniques, with fentanyl, thiopental, vecuronium, oxygen/nitrogen protoxide and isoflurane. Muscle relaxation was reversed with atropine and neostigmine. Postoperative analgesia was given with endovenous morphine and metamizol. Immediately after surgery each patient received an endovenous dose of the assigned antiemetic drug. Patients were monitored for 24 h and observations were recorded every hour on the following scale: 0, for no emetic symptoms, 1 for nausea and 2 for vomiting. RESULTS: Fifteen patients (42.9%) in group D, 21 (60% in group M and 19 (54.3%) in group P experienced nausea during the 24 h after surgery, with no significant differences. However, the incidence of vomiting was significantly lower in group D, with 7 patients (20%) vomiting in group D versus 11 patients (31.43%) in group M and 17 (50%) in group P. Side effects were mild and required no treatment. CONCLUSIONS: Droperidol at a dose of 1.25 mg every 8 h is effective and safe for preventing postoperative nausea and vomiting and has minimal side effects. Metoclopramide at a dose of 10 mg every 8 h, in our study, was no better for the same purpose than placebo.
Subject(s)
Antiemetics/administration & dosage , Droperidol/administration & dosage , Gynecologic Surgical Procedures , Metoclopramide/administration & dosage , Postoperative Nausea and Vomiting/prevention & control , Adult , Aged , Double-Blind Method , Drug Administration Schedule , Female , Humans , Middle Aged , Preanesthetic Medication , Prospective StudiesABSTRACT
OBJETIVOS. Comparar la eficacia de tres dosis administradas cada 8 h, de metoclopramida, droperidol o placebo, sobre la incidencia de náuseas y vómitos postoperatorios durante las primeras 24 h y valorar sus efectos secundarios. MATERIAL Y MÉTODOS. Estudio prospectivo, doble ciego sobre 104 pacientes programadas para cirugía ginecológica mayor intraabdominal bajo anestesia general. Las pacientes fueron asignadas de forma aleatoria en tres grupos: grupo M (10 mg de metoclopramida); grupo D (1,25 mg de droperidol), y grupo P (suero fisiológico). Las pacientes fueron premedicadas con diazepam por vía oral. Todas las pacientes fueron anestesiadas de forma similar con: fentanilo, tiopental, vecuronio, oxígeno/protóxido de nitrógeno e isoflurano. La relajación muscular se revirtió con atropina y neostigmina. La analgesia postoperatoria se realizó con morfina intravenosa y metamizol. Inmediatamente después de la intervención cada paciente recibió una dosis intravenosa del fármaco antiemético asignado. Las pacientes fueron controladas durante 24 h y las observaciones se recogieron cada hora según la siguiente escala: 0, ausencia de síntomas eméticos; 1, náuseas, y 2, vómitos. RESULTADOS . En las 24 h del postoperatorio tuvieron náuseas 15 pacientes (42,9 por ciento) del grupo D, 21 (60 por ciento) del grupo M y 19 (54,3 por ciento) del grupo P, sin que las diferencias fueran significativas. Sin embargo, la incidencia de vómitos fue significativamente menor en el grupo D, 7 pacientes (20 por ciento), respecto a los otros grupos, 11 pacientes (31,43 por ciento) en el grupo M y 17 (50 por ciento) en el grupo P. Los efectos secundarios fueron leves y no requirieron tratamiento. CONCLUSIONES. El droperidol a dosis de 1,25 mg cada 8 horas es un fármaco útil y seguro en la prevención de las náuseas y vómitos postoperatorios con mínimos efectos secundarios. La metoclopramida a dosis de 10 mg cada 8 h, en nuestro estudio, no demostró ser superior al placebo en la prevención de las náuseas y vómitos postoperatorios (AU)
No disponible
Subject(s)
Middle Aged , Adult , Aged , Female , Humans , Gynecologic Surgical Procedures , Metoclopramide , Preanesthetic Medication , Prospective Studies , Postoperative Nausea and Vomiting , Antiemetics , Double-Blind Method , Drug Administration Schedule , DroperidolSubject(s)
Analgesia , Anesthesia Recovery Period , Anesthesiology , Books , Publishing , Writing , SpainABSTRACT
The frequency of failure to establish and maintain an epidural block is low in Spain for surgery but higher in obstetrics. The reasons are many, but noteworthy factors are the prior experience of the anesthesiologist, the anatomical features of the patient and the type of material used. However, we lack clinical and anatomical studies of the epidural space that would allow us to come to definitive conclusions. To reduce the number of failures in obstetrical analgesia, multi-holed catheters are recommended. Material and catheter permeability should be checked before puncture. The epidural needle should be directed toward the midline, air should not be injected into the epidural space. The anesthesiologist should avoid inserting too much of the epidural catheter and should assure firm support, checking it periodically and taking into account the patient's position. Finally the anesthetic dose should be adjusted to the progress of labor. The risk of incomplete analgesia and the possible need to insert a second epidural catheter must be discussed with the patient during preanesthetic evaluation.
Subject(s)
Analgesia, Epidural , Analgesia, Obstetrical , Anesthesiology , Catheterization/methods , Clinical Competence , Female , Humans , Labor Presentation , Obesity , Pregnancy , Pregnancy Complications , Treatment FailureABSTRACT
No disponible
Subject(s)
Writing , Books , Anesthesia Recovery Period , Anesthesiology , Analgesia , Publishing , SpainABSTRACT
Existe una tasa de fallos en la instauración y mantenimiento del bloqueo epidural cuya frecuencia es baja en los casos quirúrgicos y considerablemente más alta en las pacientes obstétricas. La causa es multifactorial, destacándose la experiencia previa del anestesiólogo, las características anatómicas del paciente y el tipo de material utilizado. Sin embargo, faltan estudios clínicos y anatómicos del espacio epidural para extraer conclusiones definitivas.Para reducir los fallos en analgesia obstétrica se recomienda el uso de catéteres multiperforados, la comprobación del material y de la permeabilidad del catéter antes de la punción, la correcta dirección de la aguja epidural hacia la línea media, evitar introducir aire en el espacio epidural, evitar la excesiva longitud de inserción del catéter epidural, asegurar su firme sujeción y revisión periódica, tener en cuenta la influencia de la posición de la paciente y, finalmente, la adecuación de las dosis anestésicas a la progresión del parto.El riesgo de una posible analgesia incompleta y la potencial necesidad de colocar un segundo catéter epidural debe ser discutido con la paciente durante la evaluación preanestésica (AU)
No disponible
