lunes, 28 de junio de 2010

An Introduction to Clinical Emergency Medicine



 

An Introduction to Clinical Emergency Medicine

An Introduction to Clinical Emergency Medicine

818 pages
Publisher: Cambridge University Press; 1 edition (July 11, 2005)
ISBN-10: 0521542596
ISBN-13: 978-0521542593

http://hotfile.com/dl/50887837/e34d371/Clinical_Emergency_Med_drwhite.pdf.html
 

__._,_.___

lunes, 21 de junio de 2010

Brain Protection in Schizophrenia, Mood and Cognitive Disorders



Brain Protection in Schizophrenia, Mood and Cognitive Disorders
Springer | 2010-05-19 | ISBN: 9048185521 | 997 pages | PDF | 7 MB

Neuroprotection is a novel perspective for the treatment of disorders that lead to neurodegeneration and disabilities as a result of deterioration of neurons due to apoptosis, oxidative stress, excitotoxicity, and other mechanisms. These mechanisms have implications not only for neurodegenerative disorders, but also for schizophrenia, mood and cognitive disorders. The purpose of this book is to provide an up-to-date overview of basic and clinical studies concerning the neuroprotective approach, mechanisms, and several compounds with neuroprotective properties that may contribute to more efficacious treatment of major mental health disorders.

The book is divided into two sections. The first section serves as an introduction and overview of conceptual issues of the neuroprotective approach, and some neurobiological advances. Chapters in this section review definitions, perspectives, and issues that provide a conceptual base for the rest of the book. In addition, this part includes chapters in which the authors present and discuss the findings from basic studies of neurodegenerative mechanisms that are associated with the pathogenesis of major mental health disorders. The second section focuses on findings obtained from clinical trials with neuroprotective compounds, and neuromodulatory techniques. The take-home message is that principles of the neuroprotective approach may be applied to treatment of schizophrenia, mood and cognitive disorders. Contributors to this book are among the most active investigators and clinicians in the field who provide new perspectives not only clarifying ongoing controversies but also propose diverse aspects and new insights to neuroprotection.

This book is intended for a broad readership, which includes a broad spectrum of readers including neuroscientists, psychiatrists, neurologists, pharmacologists, clinical psychologists, general practitioners, geriatricians, graduate students, and policy makers in the fields of mental health.

http://sharingmatrix.com/file/8870269/XHb1IcQz9.rar


Best regards

--
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ACLS Review


 

ACLS (Advanced Cardiac Life Support) Review: Pearls of Wisdom, Third Edition
McGraw-Hill/Appleton And Lange | 2007-11-28 | ISBN: 0071492577 | 173 pages | PDF | 5 MB

"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. 3 Stars."--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 American Heart Asssociation's ACLS exam, in the shortest possible study time. There is no easier or faster way to guarantee that you perform your best on the exam!

* 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.

http://sharingmatrix.com/file/8809637/acls__advanced_cardiac_life_support__review_pdf_0071492577.rar


__._,_.___

Uso de Carvedilol en paciente HTA, diabeticos



---------- Mensaje reenviado ----------
De: willy lopez <glopezpv@yahoo.com>
Fecha: 21 de junio de 2010 20:28
Asunto: Uso de Carvedilol en paciente HTA, diabeticos
Para: Jessica Vargas <jpvargas@bagoperu.com.pe>, Victoria Armas Rodriguez <vikyarmas@hotmail.com>, Luis Canchaya Osorio <luis_canchaya@hotmail.com>, Miguel Chipana Osiro <aqua90@gmail.com>, Rodrigo De Pomar <rodrigodepomar@hotmail.com>, Victor Fontinier higa <fontivictor@hotmail.com>, Rolando Fritas Urbizagastegui <rofriu@yahoo.com>, Tomas Gargurevich <tomas_gargurevich@hotmail.com>, Mirian Guevara Paz <myrianguevara@hotmail.com>, Dario Hernandez <sonccodha@yahoo.com>, Victor Herrera Tanaka <viheta@hotmail.com>, Raul Lama Diaz <vrlama@gmail.com>, Marco Lazo Soldevilla <marcolazo77@hotmail.com>, Juan Lema <jjlo49@gmail.com>, Cesar Leon Silva <cleonsilva@hotmail.com>, Cesar Montes <camp318@hotmail.com>, Zoila Moreau <zoila_moreau@yahoo.com>, Claudio Mori <clagui57@gmail.com>, Orlando Nieto Piscolish <jorwet@hotmail.com>, Pedro Nuñez <pedronuneztorres@yahoo.es>, Plinio Obregon <plinioobregon@hotmail.com>, Paola Oliver Rengifo <oliver_pao23@hotmail.com>, Boris Orihuela <boris_orihuela2@hotmail.com>, miguel Ortiz <ortizsamanamudm@yahoo.com>, Walter Paredes <hermanocorazon@hotmail.com>, Andres Paredes <pain10@hotmail.com>, Ursula Peña <ursulajpc@yahoo.com>, Cecilia Peña <cecipena20@yahoo.com>, Carolina Pimentel <caromex@yahoo.com>, Zozimo Pineda <zpinedam@yahoo.es>, Javier Pinto <japico51@gmail.com>, Jesus Poma <jesuspomaclaros@hotmail.com>, Trinidad Quinteros <trinidadquinteros@hotmail.com>, Teodoro Quiñones <cardiouci@hotmail.com>, Carlos Quiroz <carlosquiroz25@yahoo.com>, Alfonso Ramirez <alfonsoarcadio@yahoo.es>, Marco Ramirez <mry852002@yahoo.com>, Noelia Reyes <nolireye@hotmail.com>, Carlos Rios <carlos_rios@yahoo.com>, Fernando Rios <friosca1@hotmail.com>, Yudy Roldan <ymrc@hotmail.com>, Jorge Romero <jromero89@hotmail.es>, Maritza Rosales <malurovi0602@yahoo.com.ar>, Maria Isabel Saldarriaga <dramasain@hotmail.com>, Saul Sanabria <enriquesaulsp@yahoo.es>, Aurelio Sanchez <cardiologiaurelio@yahoo.com>, Wilder Sandoval <wildersandoval@yahoo.es>, Ricardo Santos <ricardosantos@gmail.com>, Gustavo Saravia <cardiolight@hotmail.com>, Cesar Segura <csserveleon@hotmail.com>, Luis Segura <seguis@terra.com.pe>, Cristian Soplopuco Palacios <cisop_1@yahoo.es>, Jose Luis Tapia <jltl55@hotmail.com>, David Telles <datel35@yahoo.com>, Enrique Tordoya <enriquetordoya@speedy.com.pe>, Hugo Torrejon <cardioplastic@hotmail.com>, Ernesto Torres <etr74@hotmail.com>, Fernando Torres <fern.torres@terra.com.pe>, Claudio Euler Torres <cleutorres@intramed.net>, Juan Urquiaga <jurquiaga@hotmail.com>, Gustavo Valderrama Valle <valderramavalle@yahoo.es>, Mario Vargas <mariovar@hotmail.com>, Oscar Vargas <movargase@yahoo.es>, Leonel Vasquez <leovm1@hotmail.com>, Angel Vasquez <angelvasquezvillar@yahoo.es>, Cesar Vecco <cvecco@yahoo.com>, Carlos Velasquez <kalinjvi@hotmail.com>, Marco Ventura <marcoventurag@hotmail.com>, Omar Villanueva <omarvillanueva_dr@msn.com>, Alberto Villegas <albertovc5@hotmail.com>, Wilmer Villegas <wilmervillegas@hotmail.com>, Pablo Vivas <vapean2002@hotmail.com>, Luis Watanabe <lwatanabe@clinicasanfelipe.com>, Hector Zapata <hzapatav@hotmail.com>, James Zepilli <ozeppilli@hotmail.com>, Jhon Zevallos <jazt31077@hotmail.com>, Mario Zubiate <zubiatetalledom@hotmail.com>, Jorge Alania <joralania@hotmail.com>, Martin Correa Flores <mcf1122@hotmail.com>, Julio Durand Velasquez <jrdurandv@hotmail.com>, Pedro Huamani <pedrohp1170@hotmail.com>, Marco La Torre <mlatorreortiz@yahoo.es>, Gisella Mendoza Sanchez <giselamendoza@yahoo.com>, Jorge Martin Mispireta Robles <martinmispireta@hotmail.com>, Marco Pastrana <mpastranac@yahoo.com.ar>, Cesar Valdivieso Roman <calexvr@hotmail.com>


Dr.(a),
Un aporte sobre el uso de Carvedilol
 
Guillermo Lopez Paz-Vergara
Representante Línea Cardiovascular
Laboratorios Bago del Perú S.A.
Nextel: (99)834*4047
https://mail.google.com/mail/?ui=2&ik=14d8f0f8db&view=att&th=1295d44f03c1bfe2&attid=0.1&disp=attd&zw
 


Nicotine


2010/6/20 Vicente Rey <vicente.rey@gmail.com>

Nicotine (Junior Drug Awareness)
Chelsea House Publications | 2008-05 | ISBN: 0791096963 | 120 pages | PDF | 5 MB

Tobacco products are deeply ingrained in our culture, customs, and habits. "Nicotine" provides the facts about tobacco use among teenagers and offers young readers the facts about one of the most prevalent and addictive drugs in the United States. Learn how nicotine addiction has become so widespread and why it is now viewed as a public health crisis.

http://sharingmatrix.com/file/8629533/9780791096963.rar



Best regards

--
welcome to http://www.myescience.com a good password forum, and medcine forum, we provider special resoucres (some passwords) for donators who donate >100 usd, open http://www.myescience.com

you can use paypal to donate, click the orange donate of index, or you can donate will western union (for member's group higher than Sophomores ),
For more options, visit this group at
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--
welcome to http://www.myescience.com a good password forum, and medcine forum, we provider special resoucres (some passwords) for donators who donate >100 usd, open http://www.myescience.com

you can use paypal to donate, click the orange donate of index, or you can donate will western union (for member's group higher than Sophomores ),
For more options, visit this group at
http://groups.google.com/group/medical-passwords?hl=en


falla cardiaca aguda

https://mail.google.com/mail/application/zip:fallacardiacaaguda6.zip:https://mail.google.com/mail/?ui=2&ik=14d8f0f8db&view=att&th=1295d1a6e41cdb16&disp=zip

ACLS Review



---------- Forwarded message ----------
From: Vicente Rey <vicente.rey@gmail.com>
Date: 2010/6/20
Subject: [medical-passwords] ACLS Review
To: medical-passwords <medical-passwords@googlegroups.com>



ACLS (Advanced Cardiac Life Support) Review: Pearls of Wisdom, Third Edition
McGraw-Hill/Appleton And Lange | 2007-11-28 | ISBN: 0071492577 | 173 pages | PDF | 5 MB

"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. 3 Stars."--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 American Heart Asssociation's ACLS exam, in the shortest possible study time. There is no easier or faster way to guarantee that you perform your best on the exam!

* 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.

http://sharingmatrix.com/file/8809637/acls__advanced_cardiac_life_support__review_pdf_0071492577.rar


Best regards

--
welcome to http://www.myescience.com a good password forum, and medcine forum, we provider special resoucres (some passwords) for donators who donate >100 usd, open http://www.myescience.com

you can use paypal to donate, click the orange donate of index, or you can donate will western union (for member's group higher than Sophomores ),
For more options, visit this group at
http://groups.google.com/group/medical-passwords?hl=en


furosemida en ira

http://www.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=13101470&pident_usuario=0&pcontactid=&pident_revista=64&fichero=64v31n02a13101470pdf001.pdf&ty=134&accion=L&origen=elsevier&web=www.elsevier.es&lan=es

lunes, 14 de junio de 2010

Hypertension in Childhood

 



Edwin Villacorta V.
MEDICO PEDIATRA
 
Mi galeria de FOTOS http://evillitaz.hi5.com

BEBÈ SANO
- La mejor web para padres primerizos (machuca en el link)
 
MIEMBRO DE SALUD LORETO (haz click  en el link)


--- El lun, 6/14/10, William Arellano Santillan <williamarellanos@gmail.com> escribió:
Hypertension in Childhood

Description

There is no current standard UK definition of hypertension in children. However, the issue has been researched in some detail in America were a working group in 2004 defined the condition as an average systolic and/or diastolic blood pressure ≥95th percentile for gender, age and height on 3 or more separate occasions.1 The working group also introduced the concept of 'pre-hypertension' which it defines as a blood pressure level ≥90th percentile but <95th percentile.

As with adults, blood pressure is a variable parameter in children. It varies between individuals and within individuals from day to day and at various times of the day. Attention must be paid to correct technique in measuring blood pressure and with small patients this includes the use of a small cuff. The traditional method of auscultation of 1st and 5th Korotkoff sounds, using a mercury sphygmomanometer, gives an accuracy that is second only to direct cannulation of the artery. Nowadays mercury and aneroid instruments are being replaced by electronic or Doppler devices.

White coat hypertension and masked hypertension may be particularly relevant in this patient group. One study found that ambulatory blood pressure measurement correlated quite well with home monitoring2and the latter is becoming a validated method.3 Whatever method is used, the instrument must be regularly checked for accuracy and serviced and used correctly.

Epidemiology

A Department of Health Survey for England in 1996 showed that the mean systolic blood pressure for both boys and girls aged 5 to 15 was 111 mmHg.4 Mean diastolic pressure was 57 mmHg in boys and 58 mmHg in girls. Mean pulse pressure was 58 mmHg in both boys and girls aged 5 to 15. 

An approximate rule of thumb is 80 + (2 x age) for 50th centile, and 100 + (2 x age) for 95th centile.

Blood pressure increases with age in childhood and children who are either heavier or taller or both have higher blood pressure than smaller children of the same age.5 The relationship between body mass and blood pressure in children is stronger than in adults and children who have high blood pressure and are taller and heavier than their peers are more likely to become hypertensive as adults.6

Hypertension is on the increase due to the rise in obesity in children. One study found that organ damage, such as left ventricular hypertrophy, thickening of the carotid vessel wall, retinal vascular changes and even subtle cognitive changes, were detectable in children and adolescents with high blood pressure and the authors of this study considered that hypertension was a common long-term health problem in this age group.7

Risk factors

In the absence of overt disease that will cause hypertension, there are a number of factors known to affect blood pressure in children and young adults. These are:

  • Salt intake - this is very important and targets to reduce our intake may not go far enough.8Processed and convenience foods tend to be very high in salt.
  • Obesity - childhood obesity increases the risk of childhood hypertension. The Bogalusa Heart Study derived figures from several national studies and found that the odds ratios in obese children were 2.4 for raised diastolic blood pressure and 4.5 for raised systolic blood pressure.9
  • Low birth weight - this seems to be a particular risk factor in patients who subsequently have a high BMI.10,11
Presentation12

History

The condition is usually asymptomatic but may be revealed fortuitously during examination in patients with suspected underlying conditions such as kidney disease or coarctation of the aorta.

There are a few presenting features that should raise the possibility of hypertension:

In neonates:

In older children

If the condition is found, enquiry should be made for certain features in the child's history:

Examination

  • Examination of the child starts with looking at the general state of nutrition and apparent state of health. Check height and weight against centile charts.
  • Examination of the pulse precedes measurement of blood pressure. The child should be seated and relaxed or supine if a baby. The cuff is on the right arm at the level of the heart. The rubber blade inside the cloth cover should be long enough to encircle the arm and wide enough to cover approximately ¾ of the distance from shoulder to elbow. Examine the rest of the cardiovascular system. Check for displacement of the apex beat and signs of left ventricular hypertrophy. Heart murmurs in children may be very relevant. Also feel the pulses in the lower limbs. If the amplitude of the pulse is poor this suggests coarctation of the aorta.
  • Look for stigmata of specific diseases:
    • Café au lait spots may suggest pheochromocytoma.
    • Examination of the abdomen will reveal a mass in Wilms' tumour and abdominal bruit may suggest coarctation or other vascular abnormalities including in the renal system.
    • Virilisation will point to congenital adrenal hyperplasia.
Causes

In general, the younger the child and the higher the blood pressure the greater the chance of identifying the cause. 80% are due to renal parenchymal abnormality. The table gives the order of frequency of the various causes of hypertension in 4 age groups:12

Causes of Childhood Hypertension According to Age Group

Age

Causes

1 to 6 years Renal parenchymal disease; renal vascular disease; endocrine causes; coarctation of the aorta; essential hypertension
6 to 12 years Renal parenchymal disease; essential hypertension; renal vascular disease; endocrine causes; coarctation of the aorta; iatrogenic illness
12 to 18 years Essential hypertension; iatrogenic illness; renal parenchymal disease; renal vascular disease; endocrine causes; coarctation of the aorta
Investigations12

Most adults are deemed to have essential hypertension and little or no further investigation is undertaken but in children a cause for the hypertension should be sought. Basic screening tests to detect underlying pathology should be carried out together with investigations to assess co-morbidity and end organ damage. Further testing may be required, depending on individual and family histories, the presence of risk factors and the results of the screening tests.

To identify the cause

  • Urine - check for albumin and blood
  • Urea, electrolytes and creatinine - to assess renal function; low potassium may suggest elevated aldosterone
  • Full blood count - may reveal anaemia consistent with renal disease
  • Renal ultrasound - to exclude abnormalities of renal morphology

To identify co-morbidities

  • Drug screen - this may be relevant in adolescents to exclude ingestion of recreational drugs
  • Fasting lipids and glucose - to rule out hyperlipidaemia, metabolic syndrome, diabetes
  • Polysomnography - to establish the existence of a sleep disorder, which may be linked to hypertension

To identify end-organ damage

  • ECG - may show left ventricular hypertrophy or strain
  • Echocardiography - can show hypertrophy and abnormal function
  • Retinal examination - may identify retinal vascular changes

Additional tests as clinically indicated

  • 24-hour urine for protein and creatinine, creatinine clearance - to exclude chronic renal disease
  • Advanced imaging - magnetic resonance angiogram, duplex Doppler flow studies; 3-dimensional computed tomography; arteriography (classic or digital subtraction) , may be required to exclude renovascular abnormalities
  • Ambulatory blood pressure monitoring - may be needed to exclude white coat hypertension
  • Thyroid function tests - to rule out thyrotoxicosis
  • Plasma aldosterone - a high concentration is diagnostic of hyperaldosteronism
  • Plasma catecholamines or urine catecholamines and catecholamine metabolites - high levels are diagnostic of pheochromocytoma or neuroblastoma
  • Plasma renin levels
    • High plasma renin activity indicates renal vascular hypertension, including coarctation of the aorta.
    • Very low plasma renin activity suggests glucocorticoid remediable aldosteronism or apparent mineralocorticoid excess.
Management1

There are no consensus UK guidelines on the management of hypertension in children. American guidelines suggest that lifestyle modifications should be applied to all hypertensive paediatric patients and that drugs are indicated in patients who fail to respond to lifestyle measures or have secondary hypertension, symptomatic hypertension, co-morbidity or end-organ damage.

Lifestyle modification1,12

This includes weight control, encouragement of exercise, reduction in dietary sodium and fat and, where appropriate, cessation of smoking and alcohol.

Drugs

American guidelines suggest starting with one drug and increasing the dose until a therapeutic effect is achieved or side-effects develop, at which point a second drug should be added. There is little experience in using combination drugs in children. There is little comparative evidence so the choice of drug depends on the physician's preference plus any secondary causes or comorbidities.

  • Thiazides and beta blockers - these have the best track record in terms of safety and efficacy.
  • ACE inhibitors and calcium channel blockers - these are gradually gaining preference as first-line drugs in view of their low side-effect profile. Caution may need to be exerted when using ACE inhibitors in patients with renal disease but they can be helpful in some cases.
  • Angiotensin receptor antagonists - their role is currently being evaluated.14 One study found that the blood pressure reduction of angiotensin- converting enzyme inhibitors, angiotensin II receptor antagonists and calcium-channel blockers was almost identical. In children with pathological proteinuria, angiotensin- converting enzyme inhibitors or angiotensin II antagonists were superior to calcium-channel blockers.15

Management of a hypertensive crisis

An acute hypertensive crisis may be the result of an acute illness, such as glomerulonephritis oracute renal failure, drugs or psychogenic substances, or exacerbation of moderate hypertension. A hypertensive crisis can present with features of cerebral oedema, seizures, heart failure, pulmonary oedema, or renal failure. The accurate assessment of blood pressure is essential when a patient has a seizure, particularly when no epileptic disorder is known. Anticonvulsant drugs are ineffective to treatconvulsions in a hypertensive crisis. Suitable drugs include nifedipine, labetalol and sodiumnitroprusside. Newer rapid-acting drugs such as clevidipine have been developed.16 The aim is to decrease blood pressure to normal within several hours. Close supervision is required to avoid an excessively rapid decrease in blood pressure that may result in underperfusion.17 A Cochrane review concluded that further research was needed to determine which drugs were best for the treatment of hypertensive crisis and their effect on morbidity and mortality.18

Prognosis

This is dependent upon the underlying cause. Experience from adults shows that poorly controlled blood pressure is a risk factor for CHD and is the major risk factor for stroke. There is no definitive data to link childhood blood pressure with cardiovascular risk but extrapolation of other data would suggest that, if hypertension is poorly controlled from an early age, morbidity or mortality will also strike early.12,19


      WILLIAM ARELLANO
               Pediatra
facebook.com/ William.Virgo.
          RPM: #893353
         Cel: 964 713855

mononuleosis infeciosa en pediatria [Archivo adjunto 1]




 
[Más abajo se incluyen archivos adjuntos de =?iso-8859-1?Q?M=E1ximo_Cuadros?=]

Protocolo DX diferencial del síndrome mononucleósico
pulse sobre visualizar documento
Protocolo diagnóstico diferencial del paciente febril con adenopatías
pulse sobre visualizar documento
Mononucleosis infecciosa. Revisión y actualización
va como adjunto

ojala te sirva estos tres aportes

Atte.
MÁXIMO CUADROS
UNYK: 245 HRP

De: lester raymundo dominguez huarcaya <lesterdominguezhuarcaya@yahoo.es>
Para: interno_residente_medico_PERU@yahoogroups.com
Enviado: vie,11 junio, 2010 17:01
Asunto: [interno_residente_medico_PERU] Necesito articulos de revison de mononuleosis infeciosa en pediatria
 

Estimados amigos ,
necesito articulos de revison sobre mononucleosis infecciosa en niños, fueran tan amables de ayuadrme a conseguirlas por favor, sea en español o inglés,gracias de antemano.
Saludos,
lester


__._,_.___

Archivos adjuntos de =?iso-8859-1?Q?M=E1ximo_Cuadros?=

Archivo 1 de 1

 

domingo, 13 de junio de 2010

miércoles, 9 de junio de 2010

El ritalín en debate. Espeluznante



----------
 

May
20
2008

rital.jpg

Ilustración de Natalia Vásquez 
http://natalia.sugarpop.org/

Está de moda desde hace más de 10 años, diagnosticar a los niños inquietos y con problemas de concentración como niños con Síndrome de Deficiencia de Atención o TDAH: Trastorno de Déficit de Atención con Hiperactividad. Una doctora muy amiga mía me dice que cuando no se sabe bien cuál es la enfermedad o cuando esta no existe realmente, se le pone por delante la palabra "síndrome". Otra amiga me cuenta que en algunos colegios caros de Lima, se diagnostica con esta "enfermedad" a los niños más inquietos y se les envía al sicólogo o siquiatra del colegio para que diagnostique y recete una pastilla muy fuerte y muy dañina. Algo, definitivamente, que el niño no tiene opción de rechazar. Y nadie le pregunta si le parece buena o mala idea tomar una droga cuando todavía es menor de edad.

Me han contado, incluso, que en algunos colegios de Lima son los propios profesores quienes administran este fármaco a los niños, a las horas indicadas. A mí me pone los pelos de punta pensar que los niños con Síndrome de Deficiencia de Atención quizás solo necesitan eso: atención o espacios abiertos o un poco más de cariño de sus padres. Pero como no están dispuestos a dárselo y los profesores tampoco están dispuestos a bancarse a un niño que nunca está quieto y no se concentra, entonces la solución es una pepa y así todo el mundo tranquilo, sobre todo el niño...

El autor del blog Alquimia de Letras opina lo siguiente: 
"Ritalín es un psicoestimulante prescrito para el tratamiento de niños con TDAH. Explicaciones científicas al margen, lo que recuerdo de mis sobrinos luego de usar este producto es una impresionante capacidad de enfoque en sus responsabilidades cotidianas, especialmente en tareas de colegio o preparación para exámenes. El efecto dura unas cuatro horas y es realmente sorprendente (aunque ahora hay una variante que dura ocho horas)...
Albert Einstein, Kurt Cobain, Leonardo da Vinci, Thomas Edison, y muchos otros genios tuvieron TDAH. ¿Será esto suficiente como para pensar en una correlación entre una inteligencia superior y el transtorno en mención?"
El blogero plantea una duda legítima: quizás los niños más activos, los más inconformes, sean los más inteligentes, los que no convienen a la sociedad porque no se comportan "civilizadamente", en fin.

Lo cierto es que los fármacos como el Ritalín están causando problemas serios y hasta muertes, y esto no lo digo yo, lo dice un interesante video que me envió la sicóloga infantil Andrea Raffo (andrearaffohanza@hotmail.com) quien conoce muy bien el tema y tiene una terapia alternativa para los niños con TDAH. Andrea tiene una opinión al respecto: "La hiperactividad y el déficit de atención no son enfermedades, son síntomas de una personalidad frágil, incapaz de pensarse a si misma. Estos niños necesitan que alguien los contenga, los acoja y los ayude a "pensarse". Los niños con TDAH tienen muchas dificultades para relacionarse con los demás, generalmente son rechazados y no comprendidos. Hacemos un llamado a los maestros y a los padres para sensibilizarlos con respecto a este tema tan difícil de afrontar pidiéndoles que se cuestionen, averigüen e informen antes de tomar decisiones apresuradas y prematuras de medicar a estos niños."

Yo dejo aquí el tema, ustedes sacarán sus propias conclusiones. Bienvenidos los comentarios.


PEGO UN VIDEO http://www.youtube.com/watch?v=SzdGrUcc_bQ



De: Vlado <jar0k@yahoo.es>
Para: interno_residente_medico_PERU@yahoogroups.com
Enviado: viernes, 17 de julio, 2009 11:12:13
Asunto: [interno_residente_medico_PERU] El ritalín en debate. Espeluznante

 

El ritalin en debate

Escrito por Roberto Bustamante
Fecha de publicación: 18 May, 2009    
Palabras clave: educaciónritalin


Ritalín, un metilfenidato. Fuente: Wikipedia

En los últimos años, el discurso del exitismo se ha impuesto (o busca imponerse) en el Perú. Viene con todo un paquete, desde la seudo-literatura de autoayudamensajes oficialespublicidad, etc. De hecho, parte del discurso del crecimiento económico y la crítica al llamado "perro del hortelano", se basa en este rollo 50% new age, 50% neoliberalismo (para diferenciarlo del liberalismo económico). Sus acólitos son neoyuppies, jóvenes que han vivido en la cresta de la ola, cuando todo en la economía del Perú iba hacia arriba.

¿Y cómo será cuando se lleve este discurso a la vida en familia? ¿Cómo es cuando los neoyuppies se vuelven padres? Eso es un poco lo que ha venido reflexionando Rafo León en sus últimas  columnas en Somos. Copio la primera en su integridad (vía la página de Bibiana Pastor). Algo que debería llamar la atención de pedagogos y políticos involucrados en salud y educación infantil.

RITALIN Y RIVOTRIL: LA FELICIDAD INFANTIL
Por: Rafo León. Somos N°1169 (02/05/09)

Las modernas neurociencias al servicio de la farmacología para los niños.
Así me lo propusiera no podría dejar de adorar a los niños: tengo tres nietas de una año que van paseándose por la vida como quien abre ventanas para que ingrese un poco de aire fresco en habitaciones humedecidas y llenas del polvo, que riegan la rutina y el aburrimiento.

Es genial. Y sin embargo, hace unos días me descubrí aconsejándole a una muchacha recién emparejada que no tuviera hijos, que lo pensara mil veces, que no se puede seguir cometiendo injusticias para con seres que no saben a lo que vienen, porque tampoco nadie sabe a lo que vienen después de un largo umbral de malos augurios. Este diálogo con la joven surgió luego de que a mi vez yo hubiera estado escuchando en una reunión a una chica genial, dueña, directora y maestra de un kinder que conduce con amor, empatía, por eso del país y las maravillas. Alicia está bastante aterrada. En el kinder tiene una cincuentena de niños entre los dos y los cuatro años. Me asegura que más de la mitad está en tratamiento con Ritalin, el famoso metilfenidato que psiquiatras y neurólogos recetan como quien vende lentejitas de D'Onofrio, para controlar el trastorno de Déficit de Atención con Hiperactividad (TDAH). Todas las que escucho salir de los labios de Alicia son palabras nuevas para mí, sobre todo la alta proporción de niños signados por esas palabras, que bien no suenan, seamos sinceros.

Alice in Worderland
Le pregunto a Alicia de dónde sale ese trastorno, en qué consiste y qué peligros comporta para el niño y la familia. Cuidando cada una de sus frases intenta responderme: el TDAH califica a los niños inquietos, traviesos, juguetones que se rehúsan a pasar una hora entera frente a un computador en clase de computación (¡a los cuatro años!). "Hay casos extremos, es cierto, ingobernables, pero no son la mitad de los niños de Lima", sentencia Alicia.

Los peligros, continua, no son para el niño, son para los padres. Resulta que si los chicos no empiezan a rendir como grandes, con estándares de atención, comprensión y desempeño correspondientes a muchachos con el doble de edad, por lo menos , papá y mamá ven allí esfumarse la posibilidad de que ingresen al mejor colegio de la ciudad donde les enseñan a ser unos ganadores, donde se relacionan con los vástagos de lo mejorcito, donde no hay distingo con estar viviendo en Florida, salvo la garúa y un par de lisuras peruanas que sueltan por ahí los jardineros. Entonces, Ritalin.

Another Brick
Con Ritalin el chico está sedado, tranquilo, aparentemente atiende, no hace bulla, no se mueve. Otro ladrillo en la pared, cantaba Pink Floyd. Pero Alicia va más allá: las maestras de los nidos también están felices con el medicamento porque así el establecimiento puede recibir mayor cantidad de matriculados ya que cuando están dopados resultan más manejables. Quedo helado al escuchar a Alicia y le hago la estúpida pregunta "¿Y nadie hace nada para aclarar y combatir esto?". La respuesta es que el mundo hay un intenso debate respecto al soporte ético de estos diagnósticos y, sobre todo, de estas prescripciones farmacológicas tan ligeras. La subversiva antipsiquiatrí a en los Estados Unidos se toca con la conservadora Cienciología en eso de cuidar un poco más la salud de los niños, separándolos de la neurosis exitista de sus padres. En el mundo, pero no en el Perú. "Tengo una niña que me parte el alma", me cuenta Alicia mientras cierra su cartera pues debe partir. "A los tres años ya está tomando Rivotril porque según su mamá, no puede dormir bien".

Le confieso que estoy espantado, sonríe cansada y me retruca: "la próxima vez te puedo contar de los casos de anorexia infantil. Mamás que ven a sus niñitas como unas cerdas sin futuro de pasarela y les inyectan un mensaje letal de que comer hace daño, vieras las loncheras: galletas de agua, un tomate, una botella de Evian". No tengas hijos, muchacha, o antes aprende a vivir.

Espeluznante.



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ULTIMAS PUBLICACIONES CORTESIA CARVEDIL (PUBLICIDAD)







De nuestra estimación:

Sírvase encontrar a continuación las últimas direcciones electrónicas de interés para su especialidad accesibles con un solo clicK de su mouse.

CARDIOLOGIA

DOES VITAMIN D DEFICIENCY PLAY A ROLE IN THE PATHOGENESIS OF CHRONIC HEART FAILURE? DO SUPPLEMENTS IMPROVE SURVIVAL?

LA DEFICIENCIA DE VITAMINA D JUEGA UN ROL EN LA PATOGÉNESIS DE INSUFICIENCIA CARDIACA? LOS SUPLEMENTOS MEJORAN LA SOBREVIDA?

La deficiencia de vitamina D puede jugar un rol en la patogénesis de ICC, pero lo que no está claro es si el suplemento vitamínico para elevar los niveles de vitamina D a rangos normales pueda mejorar la sobrevida.

Cleveland Clinic Journal of Medicine Volume 77 • Number 5 may 2010


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domingo, 6 de junio de 2010

McGraw-Hill's I.V. Drug Handbook by Patricia Dwyer Schull



 

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