Platica de #LCA y #LCP en la Sociedad de Ortopedia de Baja California Norte

Platica de #LCA y #LCP en la Sociedad de Ortopedia de Baja California Norte (Tijuana) pic.twitter.com/4LmtliFXpb
— Dr. Mostaza (@docalmazan) febrero 8, 2014

http://www.regenexx.com/2013-regenexx-patient-outcome-data/?goback=%2Egde_4464752_member_5837999088787808259

2013 Regenexx-SD Stem Cell Procedure Patient Outcome Data 

Regenexx is the only stem cell treatment network to publish this type of analysis of patient stem cell procedure outcome data. The analysis is made possible thanks to the massive numbers that are compiled throughout the years in the Regenexx patient registry, which tracks patient outcomes following all of the stem cell procedures we offer.

Note: This patient outcome data is not part of a controlled trial. Every patient becomes part of a registry to track outcomes and any complications. This data is a compilation of patient input to the Regenexx Patient Registry at regular intervals following their Regenexx Procedure.

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 Knee Patient Outcome Data 

This same-day stem cell treatment outcome data analysis is part of the Regenexx fall 2013 data download of patients who were tracked in the Regenexx advanced patient registry.

View This Knee Outcome Data Here

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 Hip Patient Outcome Data 

This data looks at patient outcomes for same-day stem cell treatments for hip arthritis. The outcome data looks good – especially for those individuals under the age of 55. Additionally, our 2013 data analysis, showed that patients with poor range of motion in their arthritic hip had a slightly less robust outcome.

View This Hip Outcome Data

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 Shoulder / Rotator Cuff Patient Outcome Data 

This outcome information summarizes the 2013 registry data for shoulders treated with the Regenexx-SD (same-day) procedure using the patient’s own stem cells. It was comprised of a mix of patients with rotator cuff tears, arthritis, labral tears, and instability. Rotator cuff tear patients are doing the best in this group.

View This Shoulder / Rotator Cuff Outcome Data

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 Hand and Wrist Patient Outcome Data 

This data was derived from a group of patients with mostly severe thumb arthritis who were injected with their own stem cells. Most of these patients would have been candidates for thumb joint replacement or a surgery where a tendon is coiled up in the joint at the base of the thumb. Both are big surgeries with significant complications.

View This Thumb / Hand / Wrist Data

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 Foot and Ankle Patient Outcome Data 

Most of the foot and ankle patients in this data summary had either moderate or severe main ankle joint arthritis, with many also having either lax ligaments and/or partial tendon tears. A few patients also had sub-talar arthritis. Because this is a smaller data set, all time points were collapsed, such that the last available report was used ( about 17 months post procedure on average).

View This Foot and Ankle Outcome Data

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Note: Any case reports or patient results presented on this web-site are not indicative of all patient results. Like any medical procedure, all regenerative procedures have a success and failure rate.

Sesión Académica del mes de febrero de la Asociación Mexicana de Cirugía de la Mano AC. México 2014

XII Curso de Anatomía Quirúrgica de la Mano

3º FORO REGIONAL MANEJO DE LAS LESIONES DE LA MANO

3º FORO REGIONAL
MANEJO DE LAS LESIONES DE LA MANO.
MAYO 16 Y 17, 2014. HOTEL LAS TROJES.
AGUASCALIENTES, AGS. MEXICO
VALOR CURRICULAR POR EL CMOT 4 PUNTOS
TENDREMOS TALLER DE TENDONES, TALLER DE OSTEOSINTESIS EN MANO Y PRACTICA EN ESPECIMEN

http://www.healio.com/orthotics-prosthetics/health-care-updates/news/online/%7Be9a8a36d-3d4b-4b9d-816d-69daa9187c86%7D/acute-spatial-neglect-impairs-functional-mobility

La Negligencia espacial aguda en pacientes con ictus cerebral derecho tiene un impacto negativo en la recuperación de la movilidad funcional en la comunidad , de acuerdo con los resultados del estudio publicados en el M & R. Negligencia espacial es un trastorno incapacitante de la visión funcional que puede complicar la recuperación después del accidente cerebrovascular cerebro derecho.

Los investigadores evaluaron la negligencia espacial en 31 pacientes con infarto cerebral derecho que demostraron negligencia espacial dentro de 2 meses después de la apoplejía mediante la falta de atención de Prueba de Comportamiento (BIT ) y Catherine Bergego Scale ( CBS) .

Las medidas de resultado incluyen la movilidad de la comunidad , que se define por el grado y la frecuencia de los viajes en el hogar y la comunidad , evaluada con la Universidad de Alabama en Birmingham Estudio de evaluación de ciclo de vida Espacio Envejecimiento ( LSA) después que los participantes regresaron a sus hogares más de 6 meses después del accidente cerebrovascular . Covariables incluyeron la edad , el género , la independencia funcional al inicio del estudio , el intervalo de seguimiento y estado de ánimo depresivo .

Después de controlar por todas las covariables , los investigadores encontraron más baja puntuación de BIT fue un predictor significativo de la menor puntuación de LSA . Los resultados del estudio mostraron un 27,3 % de negligencia aguda moderada y el 72,7 % con una negligencia grave aguda no pudieron viajar de forma independiente más allá de sus hogares.

"Estos hallazgos sugieren una razón más para apoyar la detección precoz y la intervención de la negligencia espacial , " AM Barrett , MD , director de la Carrera de Rehabilitación de Investigación de la Fundación Kessler y jefe de Neurorrehabilitación Programa de Innovación del Instituto Kessler para la Rehabilitación, afirmó . "Incluso cuando la negligencia mejoró , no hubo un impacto en la movilidad de la comunidad 6 meses después. El tratamiento puede ser necesaria para lograr un mejor retorno de la movilidad más adelante " .

Acute spatial neglect impairs functional mobility 

• January 28, 2014

Acute spatial neglect in patients with right brain stroke has a negative impact on regaining of functional mobility in the community, according to study results published in PM&R. Spatial neglect is a disabling disorder of functional vision that can complicate recovery after right brain stroke.

Researchers assessed spatial neglect in 31 patients with right brain stroke who demonstrated spatial neglect within 2 months post stroke using the Behavioral Inattention Test (BIT) and Catherine Bergego Scale (CBS).

Outcome measures included community mobility, defined by the extent and frequency of traveling in home and community, assessed with the University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA) after participants returned home more than 6 months post-stroke. Covariates included age, gender, functional independence at baseline, follow-up interval and depressed mood.

After controlling for all covariates, researchers found lower BIT score was a significant predictor of lower LSA score. Study results showed 27.3% with moderate acute neglect and 72.7% with severe acute neglect were unable to travel independently beyond their homes.

“These findings suggest another reason to support early detection and intervention of spatial neglect,” A.M. Barrett, MD, director of Stroke Rehabilitation Research at Kessler Foundation and chief of Neurorehabilitation Program Innovation at Kessler Institute for Rehabilitation, stated. “Even when neglect improved, there was an impact on community mobility 6 months later.Treatment may be necessary to achieve better return of mobility later on.”

For more information:

Oh-Park M. PMR. 2014;doi:10.1016/j.pmrj.2014.01.002.

Disclosure: This study was supported by grants from the National Institute of Neurological Disorders and Stroke and from the National Institute for Disability and Rehabilitation Research.

Enseñanza en medicina

Punto de vista: Más allá de la medicina basada en evidencias  Viewpoint: Moving beyond evidence-based medicine. Henry SG, Zaner RM, Dittus RS. Acad Med. 2007 Mar;82(3):292-7. Abstract The evidence-based medicine movement has remained both well known and controversial since its inception. The authors reframe the evidence-basedmedicine debate by pointing out an underappreciated epistemological deficiency: evidence-based medicine as currently conceptualized cannot accommodate concepts that resist quantitative analysis and therefore cannot logically differentiate human beings from complex machines. The authors use Michael Polanyi's philosophy of tacit knowing (which refers to the taken-for-granted knowledge at the periphery of attention that allows persons to understand the world and discern meaning in it) as a starting point for rectifying this deficiency and for working towards an improved, person-centered epistemology of medical practice. The authors demonstrate that not only evidence-based medicine but also most traditional theories of medical practice need a concept such as tacit knowing to account for the kinds of knowledge human beings actually use. Polanyi's philosophy of tacit knowing is defined and briefly explained. A medical epistemology that can account for the tacit dimension of human knowledge and recognize physicians and patients as persons requires a revised conception of medical uncertainty and a recognition that clinician-patient interactions are central to medicine. The authors discuss practical implications of tacit knowing for medical practice, education, research, and health care policy and suggest ways for moving beyond evidence-based medicine towards a comprehensive epistemology of medical practice.   http://journals.lww.com/academicmedicine/pages/articleviewer.aspx?year=2007&issue=03000&article=00015&type=abstract  Tips para profesores de medicina basada en evidencias  Tips for teachers of evidence-based medicine: making sense of decision analysis using a decision tree. Lee A, Joynt GM, Ho AM, Keitz S, McGinn T, Wyer PC; EBM Teaching Scripts Working Group. J Gen Intern Med. 2009 May;24(5):642-8. doi: 10.1007/s11606-009-0918-8. Epub 2009 Feb 27 Abstract Decision analysis is a tool that clinicians can use to choose an option that maximizes the overall net benefit to a patient. It is an explicit, quantitative, and systematic approach to decision making under conditions of uncertainty. In this article, we present two teaching tips aimed at helping clinicallearners understand the use and relevance of decision analysis. The first tip demonstrates the structure of a decision tree. With this tree, a clinician may identify the optimal choice among complicated options by calculating probabilities of events and incorporating patient valuations of possible outcomes. The second tip demonstrates how to address uncertainty regarding the estimates used in a decision tree. We field tested the tips twice with interns and senior residents. Teacher preparatory time was approximately 90 minutes. The field test utilized a board and a calculator. Two handouts were prepared. Learners identified the importance of incorporating values into the decision-making process as well as the role of uncertainty. The educational objectives appeared to be reached. These teaching tips introduce clinical learners to decision analysis in a fashion aimed to illustrate principles of clinical reasoning and how patient values can be actively incorporated into complex decision making. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669856/pdf/11606_2009_Article_918.pdf   Vincular la investigación a la práctica: el aumento de la biblioteconomía en ciencias de la salud basada en la evidencia  Linking research to practice: the rise of evidence-based health sciences librarianship. Marshall JG. J Med Libr Assoc. 2014 Jan;102(1):14-21. doi: 10.3163/1536-5050.102.1.005. Abstract PURPOSE: The lecture explores the origins of evidence-based practice (EBP) in health sciences librarianship beginning with examples from the work of Janet Doe and past Doe lecturers. Additional sources of evidence are used to document the rise of research and EBP as integral components of our professional work. METHODS: FOUR SOURCES OF EVIDENCE ARE USED TO EXAMINE THE RISE OF EBP: (1) a publication by Doe and research-related content in past Doe lectures, (2) research-related word usage in articles in the Bulletin of the Medical Library Association and Journal of the Medical Library Association between 1961 and 2010, (3) Medical Library Association activities, and (4) EBP as an international movement. RESULTS: These sources of evidence confirm the rise of EBP in health sciences librarianship. International initiatives sparked the rise of evidence-based librarianship and continue to characterize the movement. This review shows the emergence of a unique form of EBP that, although inspired byevidence-based medicine (EBM), has developed its own view of evidence and its application in library and information practice. IMPLICATIONS: Health sciences librarians have played a key role in initiating, nurturing, and spreading EBP in other branches of our profession. Our close association with EBM set the stage for developing our own EBP. While we relied on EBM as a model for our early efforts, we can observe the continuing evolution of our own unique approach to using, creating, and applying evidence from a variety of sources to improve the quality of health information services. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878930/pdf/mlab-102-01-14.pdf     La medicina basada en la evidencia en la intersección de las líneas de investigación entre los bibliotecarios de ciencias de salud académicos y educadores médicos: una revisión de la literatura  Evidence-based medicine at the intersection of research interests between academic health sciences librarians and medical educators: a review of the literature. Dorsch JL, Perry GJ. J Med Libr Assoc. 2012 Oct;100(4):251-7. doi: 10.3163/1536-5050.100.4.006. Abstract OBJECTIVES: In 2008, the Association of Academic Health Sciences Libraries established an Education Research Task Force (ERTF) to plan research addressing research priorities outlined in key Association of American Medical Colleges reports. ERTF members conducted a literaturereview to describe the state of collaborative research at the intersection of medical education and health sciences librarianship. Analysis of initial results revealed instruction in evidence-based medicine (EBM) was a shared interest and is thus the focus of this review. METHODS: Searches on EBM teaching programs were conducted, and results were posted to a shared online citation management service. Individual articles were assessed and assigned metadata describing subject matter, scope, and format. RESULTS: Article analysis identified key themes. Most papers were descriptive narratives of curricular development. Evaluation studies were also prominent and often based on student satisfaction or self-reported competency. A smaller number of controlled studies provide evidence of impacts of librarian involvement in EBM instruction. CONCLUSIONS: Scholarship of EBM instruction is of common interest between medical educators and health sciences librarians. Coauthorship between the groups and distribution of literature points to a productive collaboration. An emerging literature of controlled studies measuring the impact of cross-disciplinary efforts signals continued progress in the arena of EBM instruction. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484942/pdf/mlab-100-04-251.pdf

Atentamente Anestesiología y Medicina del Dolor www.anestesia-dolor.org