Una verdadera vampira !!!

http://en.wikipedia.org/wiki/Elizabeth_B%C3%A1thory

Room cleaning technique decreases transmission of ICU multidrug-resistant organisms

Admission to intensive care unit rooms previously occupied by carriers of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin- resistant enteroccoci (VRE) had been found to confer a 40% increased risk of acquisition, presumably through environmental contamination. These US authors conducted a retrospective cohort study of patients admitted to 10 intensive care units at a 750-bed academic medical center during an enhanced cleaning intervention (from September 1, 2006, through April 30, 2008; n = 9449) vs baseline (from September 1, 2003, through April 30, 2005; n = 8203) periods. The intervention consisted of targeted feedback using a black-light marker, cleaning cloths saturated with disinfectant via bucket immersion, and increased education regarding the importance of repeated bucket immersion during cleaning. Intensive care units included medical, cardiac, burn/trauma, general surgery, cardiac surgery, thoracic surgery, and neurosurgery units.
They found: "Acquisition of MRSA and VRE was lowered from 3.0% to 1.5% for MRSA and from 3.0% to 2.2% for VRE. Patients in rooms previously occupied by MRSA carriers had an increased risk of acquisition during the baseline (3.9% vs 2.9%) but not the intervention (1.5% vs 1.5%) period. In contrast, patients in rooms previously occupied by VRE carriers had an increased risk of acquisition during the baseline (4.5% vs 2.8%,) and intervention (3.5% vs 2.0%) periods."

The authors concluded: "Enhanced intensive care unit cleaning using the intervention methods may reduce MRSA and VRE transmission. It may also eliminate the risk of MRSA acquisition due to an MRSA-positive prior room occupant."

Fuente:  Arch Intern Med 171(6):491-494, 28 March 2011

Acetaminophen Prescription Products Limited to 325 mg Per Dosage Unit: Drug Safety Communication

ISSUE: FDA notified healthcare professionals that it has asked drug manufacturers to limit the strength of acetaminophen in prescription drug products, predominantly combinations of acetaminophen and opioids, to 325 mg per tablet, capsule, or other dosage unit, making these products safer for patients. This action will help to reduce the risk of severe liver injury and allergic reactions associated with acetaminophen. A Boxed Warning highlighting the potential for severe liver injury and a Warning highlighting the potential for allergic reactions (swelling of the face, mouth, and throat, difficulty breathing, itching, or rash) will be added to the label of all prescription drug products that contain acetaminophen.

BACKGROUND: Acetaminophen, one of the most commonly used drugs in the United States, is widely and effectively used in both prescription and over-the-counter (OTC) products to reduce pain and fever. Examples of prescription products that contain acetaminophen include hydrocodone with acetaminophen (Vicodin, Lortab), and oxycodone with acetaminophen (Tylox, Percocet). OTC products containing acetaminophen (e.g., Tylenol) are not affected by this action. Information about the potential for liver injury is already required on the label for OTC products containing acetaminophen. FDA is continuing to evaluate ways to reduce the risk of acetaminophen related liver injury from OTC products. No drug shortages are expected, because the 3-year implementation period should permit adequate time for necessary reformulations.

RECOMMENDATION: Healthcare professionals were reminded to advise patients not to exceed the acetaminophen maximum total daily dose (4 grams/day), and not to drink alcohol while taking acetaminophen-containing medications.


Healthcare professionals were encouraged to inform patients that there is no immediate danger to patients who take these combination pain medications, and patients should continue to take them as directed by their health care provider. The Drug Safety Communication provides additional information for healthcare professionals, information for patients, a data summary and a list of all affected products.

Fuente:  MedWatch safety alert

TENER UN MARIDO ASI NO TIENE PRECIO!!!

El hombre despertó aquella mañana con una tremenda cruda .. La noche anterior se había pegado una parranda fuera de Casa.... bebió como un loco, ni siquiera se acordaba como había regresado a su Casa. Preso de un dolor de cabeza lacerante, dolidos todos Los músculos del cuerpo, la garganta más reseca que lengua de loro; en la boca un sabor a cobre y vinagre. Tenía miedo aún de abrir Los ojos pues lo esperaba, de seguro, la encabronada de su vieja...

Abrió Los ojos como pudo, y lo que vio lo dejó loco. Sobre la mesa de noche estaba una pequeña hielera, llena de cubitos de hielo, con un par de cervezas bien frías. Al lado, había un par de Alka-Seltzers y un vaso de agua. Recargado en el vaso estaba un sobrecito perfumado; el  tipo anonadado, x no decir apendejado, abrió el sobre y en su interior halló un recado que decía:'Amor mío, vida de MI vida: Perdona que no esté aquí para atenderte'...
'Salí un momento, pero regreso al rato para estar contigo. Te he dejado estas cosas sobre la mesita para que alivies el malestar que quizá sientas después de la borrachera de anoche' .. ' Te he preparado un caldo como a ti te gusta, pollo y res, que te espera en el comedor. Le pedí a nuestro hijo que te lo sirva y que esté pendiente de ti, Te dejo un beso con todo MI amor. Tu esposa que te adora '
El hombre no daba crédito a sus ojos. Bebió con deleite Las dos cervezas bien frías, se bañó, se vistió y bajó al comedor. Ahí en efecto lo esperaba su hijo, que lo saludó con cariño y Le sirvió el caldo preparado por  su Madre.Se lo comió en silencio, y el asombrado Padre pensó....'¿Qué esta sucediendo?' ¿Soñaba acaso? ¿Era aquello una vana ilusión de Los sentidos?... era la cruda???

Entonces se atrevió a preguntar con timidez: '¿Qué pasó anoche, hijo?'... 

'Llegaste a Las 3 de la mañana y venías en completo estado de ebriedad. Chocaste el carro en la puerta del garaje; Le diste una patada al gato; te vomitaste en la sala y arruinaste la alfombra que MI mamá acababa de comprar, te miaste en el closet. Luego te caíste en la escalera y ahí quedaste privado, sin sentido. Tuvo que despertarme MI mamá para que la ayudara a llevarte a la cama'.y ... '¿Entonces? -pregunta el señor- ¿por qué todo esto? ¿ por qué Las cervecitas y el amoroso recadito, y el tremendo caldo y todas estas finas atenciones?'
A lo q responde el hijo: - 'Porque mamá te iba a desvestir en la cama y cuando empezó a bajarte Los pantalones TU dijiste:

 '¡¡¡QUIETA PERRA!!! SOY CASADO!!!'

2 Alka-Seltzers: 2 quetzales
2 Cervezas frías : 20 quetzales
Caldo con sopa Maggi: 18 quetzales

Decir Las palabras correctas en el momento preciso... NO TIENE PRECIO!!!

 
no todos los hombres somos infieles, sociables talvez..... piensalo...

El Jubilado !!!

Para la gente que todavía trabaja me pregunta a menudo qué hago cada día, ahora que estoy jubilado...
Pues bien, por ejemplo, el otro día fui al centro y entré en una tienda a recoger una cosa, sin tardar en la gestión ni cinco minutos.

Cuando salí, un policía municipal estaba rellenando una denuncia por estacionamiento prohibido.
Rápidamente me acerqué a él y le dije: ¡Venga hombre, que no he tardado ni cinco minutos...! Haría usted bien si hiciera un pequeño gesto para con los jubilados... Me ignoró olímpicamente y continuó complementando la denuncia.
La verdad es que me pasé un poco y le dije que no tenía vergüenza. Me miró fríamente y empezó a rellenar otra denuncia, alegando que, además, el coche llevaba los neumáticos en mal estado.
Entonces levanté la voz para decirle que me había percatado de que estaba tratando con el rey de los tontos del culo, que cómo le habían dejado entrar en la Academia de Policía....

Él acabó con la segunda denuncia, la colocó debajo del limpiaparabrisas, y empezó con una tercera.

No me achiqué y estuve durante más de 20 minutos llamándole de todo. Él, a cada insulto respondía con una nueva denuncia.

¡En ese instante vino mi autobús, lo aborde y me fui a casa!
Desde mi jubilación, ensayo cada día cómo divertirme un poco. Es importante a mi edad.
 

Statins don’t help evade myocardial infarction when high density lipoprotein cholesterol is low

Many patients who take statins still experience myocardial infarction, despite the fact that their concentrations of low density lipoprotein cholesterol have been successfully lowered before the event. A meta-analysis of large randomised controlled trials has confirmed that statins don’t alter the link between low levels of high density lipoprotein cholesterol and myocardial infarction.

A total of 20 trials were included in this study, with 543 210 person years of follow-up and 7838 recorded myocardial infarctions. There was a significant inverse association between concentrations of high density lipoprotein cholesterol and risk of myocardial infarction and cardiovascular disease, which remained after adjustment for levels of low density lipoprotein cholesterol during statin treatment, age, hypertension, diabetes, and use of tobacco. Every 10 mg/dL (0.26 mmol/L) decrease in high density lipoprotein concentration brought about an increase in myocardial infarctions of 7.1 per 1000 person years among patients treated with statins, compared with 8.3 in patients who did not receive statins. The relation between high density lipoprotein concentration and myocardial infarction did not differ according to statin use (P=0.57).

 

Fuente:  Ann Intern Med 2010;153:800-8

New Drug Offers Alternative to Warfarin

Dabigatran effective in prevention of blood clots for patients with atrial fibrillation

 The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have issued an updated guideline, describing the newly approved medication dabigatran as an alternative to warfarin for patients with atrial fibrillation who need anticoagulation therapy; the guideline update has been published online Feb. 14 in Circulation.
L. Samuel Wann, M.D., of the Wisconsin Heart and Vascular Clinics in Milwaukee, and colleagues, all of whom are members of the ACCF/AHA Task Force on Practice Guidelines, updated the section of the guidelines that addresses the emerging antithrombotic drugs for the management of atrial fibrillation.
The task force members reported that dabigatran was an effective alternative to warfarin for the prevention of stroke and blood clots in patients with paroxysmal or permanent atrial fibrillation, and in those who have risk factors for stroke or blood clots. The recommendations were based on the Randomized Evaluation of Long-Term Anticoagulation Therapy trial, which found that dabigatran offered either noninferior or greater stroke prevention and did not increase or decreased the incidence of major bleeding. They also stated that dabigatran was not for use among patients with prosthetic heart valves, significant heart valve disease, severe renal failure, or advanced liver disease.
"Dabigatran etexilate was approved by the U.S. Food and Drug Administration on Oct. 19, 2010, for marketing in the United States for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Dabigatran is the first new oral anticoagulant to become available for clinical use in more than 50 years," the authors write.
Several of the guideline authors disclosed financial relationships with Boehringer Ingelheim and other pharmaceutical and medical device companies.

2011 ACCF/AHA/HRS Focused Update on the Management

of Patients With Atrial Fibrillation (Update on Dabigatran)

A Report of the American College of Cardiology Foundation/American

Heart Association Task Force on Practice Guidelines

Effectiveness of influenza vaccine in healthy adults

Limited evidence for effectiveness of influenza vaccine in healthy adults

Clinical Question:

Bottom line:

Caveat:

Context:

Cochrane Systematic Review:

Jefferson T et al. Vaccines for preventing influenza in healthy adults. Cochrane Reviews, 2010, Issue 7. Article No. CD001269. DOI: 10.1002/14651858.CD001269.pub4. This review contains 50 studies involving over 80,000 participants. Over 200 viruses cause influenza and influenza-like illness (which produces the same symptoms). At best, vaccines might be effective against only influenza A and B, which represent about 10% of all circulating viruses. Healthy adults are presently targeted for influenza vaccination mainly in North America. These results may be an optimistic estimate because company-sponsored influenza vaccines trials tend to produce results favourable to their products, and some of the evidence came from trials carried out in ideal viral circulation and matching conditions; also because the harms evidence base was limited. Fifteen of the 36 trials in the review were funded by vaccine companies and 4 had no funding declaration. Inactivated influenza vaccines decreased the risk of symptoms of influenza and time off work, but their effects were minimal. In the relatively uncommon circumstance of the vaccine matching the viral circulating strain and high circulation, the NNT* to avoid influenza symptoms was 33. In average conditions (partially matching vaccine) the NNT was 100. There was no evidence vaccines affected hospital admissions, complication rates or transmission. Inactivated vaccines caused local harms (local erythema, tenderness and soreness), and an estimated 1.6 additional cases of Guillain-BarrŽ syndrome per million vaccinations. * NNT= number needed to treat to benefit 1 individual. How effective are vaccines in preventing influenza in healthy adults (aged between 16 and 65 years)?