También conocida como "Cálculos en la Vesícula Biliar" se entiende por la presencia de cálculos en la vesícula biliar o en sus vías. 💡¿Sabías qué? La incidencia de padecer Litiasis Vesicular aumenta con la edad, siendo la incidencia máxima entre la quinta y sexta década de vida👵🧓 sin embargo también puede ser parecida por jóvenes Px.
La etiología de los Cálculos Biliares se define como:
📍Cálculos Biliares con Colesterol en su contenido (75%)
📍Cálculos Pigmentarios: Bilirrubina, Calcio y otros materiales orgánicos (25%)
Su manifestación clínica cursa con:
✔️Dolor tipo cólico en Hipocondrio Derecho el cual puede irradiarse a Espalda y Hombro Derecho
🤓El 80% de los casos de litiasis vesicular cursa de modo asintomático según el Consultor Clínico de Mosby.
👩⚕ #TipDeEmergencia La ecografía de la Vesícula Biliar es un examen complementario fundamental para el Dx de Litiasis Vesicular.
🏥TRATAMIENTO Depende de la presentación clínica de la patología, así:
✔️Los Pxs asintomáticos NO requieren de intervención quirúrgica
✔️Los Px sintomáticos tienen indicación de Intervención Quirúrgica: Colecistectomía, preferiblemente laparoscópica.
⚠️SIN EMBARGO es importante realizar ciertas modificaciones del estilo de vida, entre las cuales se resalta evitar dietas y alimentos ricos en grasas copiosas y poliinsaturadas.
¡Comparte el Conocimiento!
Imagen tomada de Google
After much hype and curiosity, I decided to give Possum a shot. It's dark, grim and dense. Possum itself is damn ugly and creepy, but it's not a monster spider flick. It's not that kind of movie. The trailer shows you that Possum is a psychological thriller. I thought the film was excellent but a bit long. The movie runs less than 90 minutes, but Possum is based on a short story, so as good as everything is (acting, cinematography, set design, sound), you can tell it's padded for time. Since the movie is a two-man show, scenes feel repetitive. I could say a lot about the acting by Sean Harris and Alun Armstrong, but I want to keep this post short. To be brief both actors are 100% believable in the roles they play. Sean Harris' performance is so exceptional that it's almost exhausting. What's really interesting is that it's written and directed by Mathew Holness. You may know him better as the character Garth Marenghi from Garth Marenghi's Dark Place (subtext are for cowards). Pretty wild, huh? I liked it and was impressed by it, but it's not a film for everyone. #possum#seanharris#alunarmstrong#mathewholness#horror#spider#puppet#nurseryrhymes#psychological#trauma#thriller#uk#amazonprime #2018
1 614 minutes ago
✧ Flashbacks: Part 1 ✧ Over the next week, we'll be doing a series on flashbacks - what they are, how they affect survivors, exploring various types, and providing resources and skills to manage them. To start, let's learn what a flashback really is!
Flashbacks are a posttraumatic symptom, so they're experienced by those with PTSD and Complex PTSD. Because of the high comorbidity between PTSD and dissociative disorders, nearly all with Dissociative Identity Disorder (DID) and Otherwise-Specified Dissociative Disorder (OSDD) subtypes also experience flashbacks. The dissociative nature of these conditions may even intensify one's flashbacks, leave them more vulnerable to experiencing one in the first place, or cause additional symptoms to pile on. In the same vein, those with DID or OSDD may also have a harder time reconnecting with the present fully or "putting the memory away" -- particularly if it is one held by other alters/parts of the mind.
Traumatic memories are stored in the brain differently from safe, casual memory. They're intelligently compartmentalized - or 'dissociated' - in one's mind so that the survivor can carry on with their tasks of daily living without having to be aware of these terrible, terrible experiences. However, if triggered, or if the mind believes there's a protective reason to relive this material [often mistakenly or maladaptively], it may be thrust from its secluded space and re-experienced by the survivor against their will. They are, by nature, intrusive, undesired, and often distressing. Flashbacks tend to persist until a person is ready to process the traumatic material through and integrate all of that information, emotion, and pain into their narrative or "story" of their life. Once completed, it becomes just a very bad memory, one able to be thought of willingly or not at all - no longer involuntarily forced upon them.
Another important note is that the traumatic memories themselves can be disjointed, incomplete or scattered pieces - leaving a broken narrative or sensory experience that must be put together. Until then, survivors may relive just one isolated aspect of a trauma with no other context. (Continued below.)
I take self care seriously. I have to. The truth is, we all have to - we’ve either encountered the life circumstances that woke us up to this truth or we haven’t. Yet. .
In the midst of all the stress and trauma a few years ago, I called my doctor and cried about the crippling anxiety and fear I was feeling - that it felt like my life was falling apart, I wasn’t sleeping, my sister had cancer, and a crazy person was hunting me. He met with me and prescribed me all kinds of medication to keep me from drowning. One for sleep, one for anxiety, and one for depression. And for very brief season it was exactly what I needed. .
I started sleeping, which felt nothing short of miraculous. But I also became numb and apathetic. Anyone who knows me knows those attributes are NOT me. I was still in danger, still sad, still fearful - I just didn’t care very much. At all. Then my thinking and my words stopped being in sync as they had been before. That’s when I stopped the meds. This trauma was going to take a lot from me but it wasn’t going to take my brain. .
After that I got creative about finding ways to process the stress better. I came across the concept of near/far infrared light therapy. The research was scientific enough and compelling enough for me to find a way to incorporate it into my healing process. So I found some plans online for a red light board and a handyman who would build it for me. I began using it immediately and consistently and I loved it. Then, when I moved to a new house a few years ago, the previous owner left behind a tanning bed in some unfinished space. So I found the manual online and took out all the long UV bulbs and replaced them with therapeutic red lights as well. Voilà - red light bed! .
For a season, self care meant medication so I could function. Then it meant going off medication and finding other pathways for healing. I’m not advocating one or the other - simply saying that it’s ok to figure out what you need for self care. Maybe it’s something different for you. There isn’t one thing that’s going to change everything - but showing up for yourself will begin to change some things in a meaningful and positive way. ❤️
4. Ain’t saying it no more. Whatever happens comes in galore. Meaning when you lie u give up ur soul, that’s not my place to reLIVE what isn’t my “before” or after, it’s simply the easiest way to remaster #trauma. Unlock a passion. So I gave a ton & #theBest 3 are #war & #growth & #space. Those mean ACCESS TO EVERYTHING ESSENTIAL IN #LIFE
Recently I have been pretty busy and have not had time to write more bits about my story. Since going public and last Friday (sentencing) many people have been contacting me (media) and I have been struggling to keep up with everything. -
As many of you will know George never turned up to sentencing last Friday. He completely avoided facing up to what he had done and quite frankly I believe he should have had no choice. He made it very clear he showed no remorse. George has now admitted to some parts of the abuse (across 3 victims), but still denying many of the charges. -
Instead of pleading guilty from the start (3 years ago) he decided to deny it all, denying abusing the 3 of us - even though he knows exactly what he did. He forced us to face a long 4-5 week trial at Maidstone Crown Court where we had to openly speak out about the abuse we suffered. When taking the stand George denied everything. He claimed he was being blackmailed but could not give any reason why. Him and his defense came up with a 'conspiracy' between all 3 families. Each and everyone of us was told we were 'lying'. How George could sit there and watch knowing exactly what he had done just shows what a dangerous man he is. Not once during that trial or sentencing did he show ANY remorse. He wasn't/isn't sorry for what he did. He is sorry because he has been caught. He is sorry that now he will be spending many years behind bars. In just his first 2 months in prison he is claiming to be 'struggling' and his mental health deteriorating - I'm not surprised, mine would be too knowing I have such a substantial prison sentence. Did he really believe we/anyone would feel sorry for him?
Wearing one of my own crochet creations for the first time lol; although if my niece wants it I’ll let her keep it. .
Polarized sunglasses (prescription) always on bc I have permanent damage in my eyes from years of Iritis since I was a kid and now Uveitis. .
#RBF bc I’m smiling on the inside lol.
It was sunny out earlier, a bit chilly 33 not to bad.
Had a therapy appt with my super awesome therapist...she let me go at my own pace when I first came to her I was so socially anxious I didn’t even go see her alone.
Don’t be ashamed or embarrassed to admit that you need or see a therapist. .
We all need someone to talk to especially a professional. I rather talk to her than anyone that’s going to blab my business to someone, I trust her and know I’m getting sound advice.
From severe social anxiety, depression, extreme ptsd, ocd, adhd/add and just needing someone to talk to she has helped so much.
Get yourself a therapist if you think you can benefit from having one, live your life!
The Temple 🌞
Alex & I were sitting (hiding) on a bench that has wood carvings of the 5 Olympic Rings in his brothers memory. The Temple is here in Parkland, where we may write whatever we’d like, bring whatever we’d like, & leave whatever we need to be burned down with it.
That’s right, this awe inspiring Temple is beautifully made out of thousands of cut pieces of wood, designed & built to be burned down. .
Finished just in time for the one year mark of the shooting, we can leave anything we want that we’re ready to let go of, that hurts to hold on to, that we’re ready to leave behind. What a beautiful gift ☀️
What would you bring?
Today I changed my instagram handle. I discovered a few years ago that writing was a therapeutic outlet for me and in that time I’ve watched not only my writing style grow, but my audience as well. I’ve been overwhelmed by the amount of people who’ve thanked me for sharing my story of loss and gain, and with the support of my family I started to develop the idea for a more collaborative project, and ultimately a book. Social media has been my practice platform and I’ve started putting pen to paper, but the finished product is long way away. I’m nervous and thrilled to announce Floor Nachos & Other Stories: A Journey of Destruction and Repair, and I hope you’ll stick with me to the end. #eatingdisorderrecovery#sexualassaultsurvivor#anorexia#trauma#descent#rise#loss#gain#destruction#repair
• • • • •
*La Promoción XLV de Médicos Cirujanos UCSA* se complace en invitarles a la jornada académica
💉 *"Retos del paciente politraumatizado en la actualidad"* 🗓 *Fecha:* Sábado, 02 de Marzo de 2019
🕖 *Hora:* 7:00am - 4:00pm
📍 *Lugar:* Auditorio de la Cámara de Comercio del Estado Aragua 📋 *Formulario de inscripción online*
_Consulte disponibilidad antes de transferir_
_Para completar el formulario debe realizar el pago primero_ *Para mayor información*: Maria Lucia Contreras 0424-3687137
Betsy Medina 0412-3482264 👩🏻⚕👨🏻⚕ *Temas y ponentes:* 1.- Manejo inicial del paciente politraumatizado: Dr Luis Richard
2.- Ultrasonido del paciente prolitraumatizado: Dr. Yiovanni Contreras
3.- Imagenologia en trauma: Dr. Roberto Guillen
4.- Cirugía de trauma: el papel de un cirujano de emergencia Dr. Luis Richard
5.- Manejo prehospitalario del paciente politraumatizado: Paramédicos Roberto Ali y Jonathan Quantip
6.- Manejo de quemaduras. Innovando con miel de Abeja: Dr. Rómulo Guillen
7.- Generalidades de traumatismo cráneo encefálico: Dra. Carolina Gavorski
8.- Cirugía de trauma: Dr. Luis Richard
8.- Errores en el manejo inicial del paciente politraumatizado -anti MIP-: Dr Pablo Otolino, video conferencia desde Chile 💵 *Precio establecido de entrada*
*Estudiantes 4$ *Médico general, residentes y personal prehospitalario 5$
En efectivo o cambio del día, acordado por el comité organizador, basado en Monitodolarvzla.
Avalado por la *Sociedad Venezolana de Cirugía* y el *Colegio de Médicos del Estado Aragua*. *Patrocinado por:*
Maria F Sanchez M
BANCO DE VENEZUELA
0102 0115 2501 0005 1901
C.I. 25.305.295 *Enviar el comprobante de pago al correo:* [email protected] ¡¡¡No te la puedes perder🙌🏼 te esperamos!!!! #medicina#trauma#aph#estudiantesdemedicina#salvarvidas#paramedicos#tzh#traumaenzonahostil
Spinach, arugula, coconut oil, lemon, pink salt, pepper, pumpkin seed, Norwegian salmon, coconut meat, #ennui, #pain, #joy, #surrender. /// #chronicillness and #trauma are teaching me, relentlessly, that:
There is purpose in pain,
Freedom in despair,
Beauty in suffering,
Stillness in chaos,
Hope despite evidence.
It’s a matter of my willingness to look more closely, to listen more carefully, to wait – wait for myself to be more ok with today, but also wait for tomorrow to [actually] be more ok. ~~~ #HYPERCHILL#foodismedicine
We are taught to numb uncomfortable feelings, and (strangely) at the same time we're also taught to equivocate a feeling with reality; with truth. So, we base our actions in emotional reactions . "I'm anxious when I go to work, so I'll stop going to work " "I'm happy when I watch Netflix, so I'll watch ALL of Netflix. "
As @heytiffanyroe puts it, "feelings are valid, but they aren't necessarily true. "
SO NOW WHAT?
Recognize and validate your emotions; accept them as your initial reactions. They aren't good or bad, they are just perceptions .
Feelings exist to alert you to instinctual needs, so try considering how the emotion is serving you. What does it want? .
THEN, ask yourself what is rationally and objectively going on, and how can you rationally respond .
In other words, just because you're anxious doesn't mean you have to stop working. You may benefit from addressing those TPS reports you've been ignoring .
Just because you're happy doesn't mean you have to binge watch Netflix. You can watch something, and then complete some work .
Comment below 👇👇👇 with how you test the truth of your emotions.
Série: É Fantástico 🎥🏆😱 Regrann from @enfermagemnocomando - Manobra de Valsalva Modificada - Reversão da Taquicardia Supraventricular.
A manobra de Valsalva é recomendada por diretrizes internacionais para tratamento da taquicardia supraventricular em serviços de emergência, porém apresenta baixa efetividade na reversão para ritmo sinusal (cerca de 5-20% dos casos apenas). Pesquisa recente, no entanto, demonstrou que uma simples modificação postural após a manobra de Valsalva tradicional pode aumentar a chance de reversão em quase 4 vezes.
O estudo randomizado, publicado na tradicional revista “Lancet”, demonstrou que a adoção da manobra modificada apresentou reversão em 43% dos casos, comparado com 17% de reversão com a manobra tradicional, apresentando importante relevância estatística (OR ajustada de 3,7; P < 0,0001). A manobra modificada consiste em proceder à expiração forçada por 15 segundos com o paciente em posição semi-recumbente (decúbito dorsal a 45º). Imediatamente após, deita-se o paciente a 0º e eleva-se os membros inferiores a 45º, mantendo-se essa posição também por 15 segundos. Após este período, reposiciona-se o paciente a 45º e checa-se o ritmo.
Técnicas utilizadas classicamente para a expiração forçada podem ser aplicadas: utilizar a borracha do esfigmomanômetro em sua extremidade que se liga ao manguito, ou uma seringa de 10 mL fechada expirando pelo buraco de encaixe da agulha.
A manobra de Valsalva não apresenta riscos e sua adoção aumenta a chance de reversão, diminuindo a necessidade de tratamento medicamentoso de emergência, visto que o uso de adenosina costuma ser bastante desconfortante para o paciente. São pequenas medidas como esta que podem ser adotadas no dia-a-dia, são acessíveis a todos e apresentam resultados satisfatórios.
"Healing is not necessarily about curing. As your inner light grows—anything is possible." ~ Dr. Alberto Villoldo
You don't need to look outside to find health and healing. You only need to look within. You don’t have to accept deterioration with age or chronic illness because you can quite literally grow a new body.
Yes, that’s right. You know you can, because you have already done it once before. Ten fingers, ten toes, all of the exquisite beauty of your physique grew from an egg and a sperm following careful instructions. And to grow a new body, all you have to do is break in to the password-protected regions of your DNA to switch on these same codes.
I know this is possible because I did it myself…Read more of our friend, Dr. Alberto Villoldo's story of healing on Elephant: bit.ly/2stHG78 (or click the link in our bio 👆) .
Get a free guide to reselecting your genetic destiny + a meditation to discover your power animal when you pre-order Dr. Villoldo's new book, Grow a New Body. here: bit.ly/2AKHgxU (or click the link in our bio 👆) .
Artwork by @bymariandrew ❤🙏 Follow her work!
85 731322 hours ago
More thoughts. More musings. More wondering. More understanding. I have almost an entire month's worth of posts to share, yet I still have these little bits buzzing in my mind that I want to share instead! I just have a lot of thoughts and I really love writing about them, and I want to do it all the time.
What resonates? What doesn't? What comes up for you?
Take care, sweet friends, and thanks for reading, as always. ❤️