Dexmedetomidina y analgesia perioperatoria en niños / Dexmedetomidine and perioperative analgesia in children

La dexmedetomidina (DEX) es un agente anestésico que mimetiza el sueño profundo natural y produce una mínima depresión cardiorrespiratoria, convirtiéndose en una opción muy valiosa en el manejo de un paciente tan exigente como es el pediátrico. El objetivo principal de esta mini revisión fue centrarse en el papel de la DEX como analgésico en el período perioperatorio de niños sometidos a anestesia. Se realizó una búsqueda bibliográfica, entre 2010 y 2021, en Google, Pubmed, Embase y Cochrane Library. Se repasaron diferentes aspectos como su farmacología, efectividad, seguridad y la evidencia más reciente sobre su uso clínico como analgésico en anestesia pediátrica. Igualmente se incluyó una estimación de coste del tratamiento analgésico perioperatorio con DEX.(AU)

Dexmedetomidine (DEX) is an anaesthetic agent that mimics natural deep sleep and produces minimal cardiorespiratory depression. As such, it is a very valuable option in the management of such a challenging population as paediatric patients. The main objective of this mini review was to evaluate the role of DEX as a perioperative analgesic in children receiving anaesthesia. We searched Google, Pubmed, Embase and the Cochrane Library for articles published between 2010 and 2021, and reviewed various of aspects of DEX, such as pharmacology, effectiveness, safety, and the most recent evidence on its clinical use as an analgesic in paediatric anaesthesia. We also include a cost estimate of perioperative analgesia with DEX.(AU)

Dexmedetomidine and perioperative analgesia in children.

Dexmedetomidine (DEX) is an anaesthetic agent that mimics natural deep sleep and produces minimal cardiorespiratory depression. As such, it is a very valuable option in the management of such a challenging population as paediatric patients. The main objective of this mini review was to evaluate the role of DEX as a perioperative analgesic in children receiving anaesthesia. We searched Google, Pubmed, Embase and the Cochrane Library for articles published between 2010 and 2021, and reviewed various of aspects of DEX, such as pharmacology, effectiveness, safety, and the most recent evidence on its clinical use as an analgesic in paediatric anaesthesia. We also include a cost estimate of perioperative analgesia with DEX.

Lambs' live weight estimation using 3D images.

The sheep sector has not suffered the technification that other livestock sectors have. The lack of technological knowledge of the farmers and the economic limitations of the sector have made this technification difficult. One of the most widely used technologies is Precision Livestock Farming (PLF). PLF has already been used in other livestock sectors to improve farming efficiency. In the light of the problem that sheep farmers have in weighing lambs and their low precision, this paper proposes a system for estimating weight by means of 3D image capture. Thus, zenithal images of 272 lambs have been recorded. They have been processed using the capture of the upper area and the average depth of the pixels of the lamb. This estimates the weight of the animal with an error of less than 6%. This technology has a low economic cost and is easy to operate, helping farmers to be more willing to use it. This method manages to reduce the duration of the process, the stress of the animal and to improve the overall accuracy in weight estimation. Thus, it will help to have a greater control of the weight of the animal and to improve the economic profitability that the farmer obtains for the lambs.

Dexmedetomidine & perioperative analgesia in children. / Dexmedetomidina & analgesia perioperatoria en niños.

Dexmedetomidine (DEX) is an anaesthetic agent that mimics natural deep sleep and produces minimal cardiorespiratory depression. As such, it is a very valuable option in the management of such a challenging population as paediatric patients. The main objective of this mini review was to evaluate the role of DEX as a perioperative analgesic in children receiving anaesthesia. We searched Google, Pubmed, Embase and the Cochrane Library for articles published between 2010 and 2021, and reviewed various of aspects of DEX, such as pharmacology, effectiveness, safety, and the most recent evidence on its clinical use as an analgesic in paediatric anaesthesia. We also include a cost estimate of perioperative analgesia with DEX.

Odontología Militar en la Operación Balmis. Retos, actividades realizadas y lecciones aprendidas / Military Dentistry in Operation Balmis. Challenges, activities carried out and lessons learned

Revisión sistemática de las actividades relacionadas con la odontología militar española y su intervención directa o indirecta durante la pandemia por SARS-Cov-2. Se describen las actividades realizadas durante la fase de formación específica en la fase de formación técnica de los alféreces odontólogos a distancia. En este artículo se analizan los problemas afrontados en las consultas dentales, las necesidades de adiestramiento y los requerimientos logísticos que requieren los protocolos odontológicos de actuación en una emergencia sanitaria de estas características tanto durante la fase de pandemia como en la postpandemia

Systematic review of activities related to Spanish military dentistry, and its direct or indirect actuation during the SARS-Cov-2 pandemic. The activities carried out during the specific training phase in the technical remote training phase of cadet ensigns curriculum are described. This article analyzes the problems faced in dental consultations, training needs and the logistical requirements demanded by the dental protocols for action in a health emergency of these characteristics, both during the pandemic phase and in the post-pandemic phase

"Safety First": diseño de un checklist anestésico en pediatría / "Safety First": Design of an anesthetic checklist in pediatrics

Introducción: La mejora de la calidad en el cuidado de la salud conlleva el diseño de procesos fiables, que prevengan y mitiguen los errores médicos. Los listados de verificación (checklists) son herramientas cognitivas que reducen dichos errores. El objetivo de este trabajo fue diseñar un checklist anestésico en Pediatría para su posterior implementación en nuestro hospital. Metodología: Se aplicó el método Delphi con 3 rondas de cuestionarios: uno genérico para aportar dimensiones e ítems y 2 específicos para puntuar individualmente los ítems y globalmente el checklist (mediana), y para medir el nivel de consenso intraítem (rango intercuartil relativo) y la fiabilidad (prueba de rangos con signo de Wilcoxon). Resultados: La versión final del checklist obtuvo una elevada puntuación global (Med 9) con un nivel de consenso muy alto (RIR 5%). Se alcanzó el consenso interno en todos los ítems (RIR ≤ 30%). El test de Wilcoxon no encontró diferencias estadísticamente significativas y evidenció la fiabilidad o estabilidad de la respuesta entre rondas consecutivas. Conclusión: El Checklist anestésico en Pediatría ha sido diseñado metódicamente para su implementación y uso en nuestro hospital

Introduction: Quality improvement in health care entails the design of reliable processes which prevent and mitigate medical errors. Checklists are cognitive tools which reduce such errors. The primary objective of this study was to design an anesthetic checklist in Pediatrics to be implemented in our hospital. Methods: Delphi technique was used, with 3 rounds of questionnaire surveys: a generic questionnaire to obtain dimensions and items; and 2 specific ones to score individual items and obtain an overall rating for the checklist (median), and to measure the level of consensus (relative interquartile range) and internal reliability (Wilcoxon signed-rank test). Results: Final version of the checklist obtained a high overall score (Med 9) with a very high consensus (RIR 5%). Internal consensus was reached on all items (RIR ≤ 30%). Wilcoxon signed-rank test found no statistically significant differences, demonstrating reliability or consistency of responses between consecutive rounds. Conclusion: The Anesthetic checklist in Pediatrics has been methodically designed for implementation and use in our hospital

«Safety First¼: Design of an anesthetic checklist in pediatrics. / «Safety First¼: diseño de un checklist anestésico en pediatría.

INTRODUCTION: Quality improvement in health care entails the design of reliable processes which prevent and mitigate medical errors. Checklists are cognitive tools which reduce such errors. The primary objective of this study was to design an anesthetic checklist in Pediatrics to be implemented in our hospital. METHODS: Delphi technique was used, with 3 rounds of questionnaire surveys: a generic questionnaire to obtain dimensions and items; and 2 specific ones to score individual items and obtain an overall rating for the checklist (median), and to measure the level of consensus (relative interquartile range) and internal reliability (Wilcoxon signed-rank test). RESULTS: Final version of the checklist obtained a high overall score (Med 9) with a very high consensus (RIR 5%). Internal consensus was reached on all items (RIR ≤ 30%). Wilcoxon signed-rank test found no statistically significant differences, demonstrating reliability or consistency of responses between consecutive rounds. CONCLUSION: The Anesthetic checklist in Pediatrics has been methodically designed for implementation and use in our hospital.

Rotura parcial de Port-a-Cath(R) en síndrome de «pinch-off» de bajo grado / Port-a-Cath(TM) partial rupture in a low-grade pinch-off syndrome

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Anestesia baja en neurotoxicidad / Low-neurotoxicity anesthesia

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Technical Note: A new device for cervical insemination of sheep - design and field test.

Deep semen deposition, avoiding retrograde flow, lesions and stress, has proved to be very important in the success of sheep AI. The objective of the present study was to develop a new, suitable anti-retrograde flow device for sheep cervical AI (DARIO) that enables deep deposition of semen into the cervix without any modifications to the procedures currently used, and to compare the fertility, fecundity, and prolificacy rates between DARIO and a traditional catheter. Field tests were performed on 16 farms actively participating in the non-profit National Association of Rasa Aragonesa Breeders´ genetic selection scheme and where sheep management was similar. A total of 242 AI lots were considered, including 1,299 ewes; 126 lots (662 ewes) were inseminated using DARIO, and 116 lots (637 ewes) using a traditional commercially-available catheter (control group). Several factors affecting AI results were included in the model for mean comparison between DARIO and control groups (farm and ram as random factors; catheter, year and photoperiod as fixed effects; catheter × photoperiod interaction). The type of catheter had a significant effect on fertility ( < 0.01) and fecundity rates ( < 0.01) but no significant effect was detected on the prolificacy rate ( = 0.45). For fertility rate (percentage of ewes lambing after AI), means ± SE for DARIO and control groups were 59.44 ± 2.13% and 49.60 ± 2.48%, respectively; for fecundity rates, means ± SE for DARIO and control groups were 0.99 ± 0.04 and 0.82 ± 0.05 lambs/inseminated ewe, respectively, and, for prolificacy rates, means ± SE for DARIO and control groups were 1.68 ± 0.04 and 1.63 ± 0.04 lambs/ewe lambing, respectively. Fertility rate was greater in the decreasing photoperiod ( = 0.01). Significant effects were found for both year ( < 0.05) and farm ( < 0.01) on fertility, fecundity, and prolificacy rates. Neither ram nor catheter × photoperiod showed any significant effects on the variables investigated ( > 0.05). Overall, the use of DARIO instead of the traditional commercially-available catheter increased both fertility and fecundity rates; the marginal mean differences were 9.05 pregnant ewes per 100 inseminated and 0.15 lambs per inseminated ewe, respectively.

Fibrilación auricular en paciente de 22 meses durante palatoplastia / Atrial fibrillation in a 22-month-old patient during cleft palate surgery

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Bloqueos centrales en pediatría: una revisión de la literatura actual / Central blockades in pediatrics: a review of current literature

La anestesia neuroaxial pediátrica es una herramienta efectiva que puede ser usada como complemento o alternativa a la anestesia general. Sin embargo, siempre ha generado dudas en cuanto a su utilidad y relación riesgo-beneficio. El propósito de esta revisión es describir el papel actual de los bloqueos centrales en la población pediátrica, actualizar aspectos prácticos y de seguridad, así como repasar los últimos avances tecnológicos aplicados a este procedimiento (AU)

Pediatric neuraxial anesthesia is an effective tool that can be used as a supplement or alternative to general anesthesia. However, there have always been doubts about its usefulness and risk-benefit ratio. The purpose of this review is to describe the current role of central blockades in pediatric patients, upgrade practical and safety aspects, and review the latest technological advances applied to this procedure (AU)

[Central blockades in Pediatrics: A review of current literature]. / Bloqueos centrales en Pediatría: una revisión de la literatura actual.

Pediatric neuraxial anesthesia is an effective tool that can be used as a supplement or alternative to general anesthesia. However, there have always been doubts about its usefulness and risk-benefit ratio. The purpose of this review is to describe the current role of central blockades in pediatric patients, upgrade practical and safety aspects, and review the latest technological advances applied to this procedure.

Carcinoma verrucoso periimplantario. A propósito de un caso / Verrucous carcinoma arund implants. Case report

Introducción: Las rehabilitaciones orales sobre implantes de titanio endoóseos se han convertido en estas últimas décadas en uno de los tratamientos más frecuentes realizados hoy día en odontología con un elevadísima tasa de éxito. Aunque son muy pocos los casos, están descritos cuadros de carcinomas surgidos en tejidos blandos periimplantarios, la mayor parte de ellos como recidivas de un cán-cer oral previo tratado quirúrgicamente y rehabilitado funcionalmente con implantes. Objetivos: Se presenta el caso de un carcinoma verrucoso o tumor se Ackerman, variedad muy infrecuente de carcinoma de células escamosas (1 al 10%), que apareció alrededor de un implante dental sin antecedentes de carcinoma oral previo, lo cual está descrito de forma excepcional en la literatura. Discu-sión: El carcinoma verrucoso es una variante del carcinoma de células escamosas de bajo grado de malignidad. Es más frecuente en hombres por encima de los 50 años, y muy relacionado con el tabaco y el virus del papiloma humano. Su tratamiento es quirúrgico, obteniéndose pocas recidivas. Conclusiones: La simple posibilidad de aparición de esta grave patología, resalta la importancia de la eliminación de factores de riesgo y la realización de biopsias en cualquier lesión oral sospechosa como claves para evitar las graves consecuencias del cáncer oral (AU)

Introduction: Oral rehabilitations with endosseous titanium implants have become in recent decades one of the most common treatments performed today in dentistry with a high rate of success. Although few cases are described, there are some carcinomas arising in peri-implant soft tissues, most of them as a recurrence of a prior oral cancer treated surgically and then functionally reha-bilitated with implants. Objectives: We report the case of a verrucous carcinoma, also know as Ackerman tumor, a very rare variety of squamous cell carcinoma (1 to 10%), which appeared around a dental implant with no history of prior oral carcinoma, which it is very rarely in the literature. Discussion: Verrucous carcinoma is a variant of squamous cell carcinoma with low malignancy. It is more common in men over age 50, and closely related to tobacco and human papillomavirus. Treatment is surgical, yielding few recurren-ces. Conclusions: The mere possibility of occurrence of this serious disease, highlights the importance of eliminating risk factors and biopsies on any suspicious oral lesion as a key to avoid the serious consequences of oral cancer (AU)