Monday, February 28, 2011

How To Buy A Retirement Home Gta

Delira Greatness Gaddafi: "Everyone loves me and my people will die for me "

The strength of Libyan dictator Muammar Gaddafi, to abandon the power begins to show signs of exhaustion, while the forces are loyal to him even trying to stop the advancing forces rebels, s ccording chain Al Jazeera, Gadhafi instructed the head of the secret services abroad, Buzid Durda, who tried to talk with leaders of the revolt, which control for days east of the country, for that, Durda should contact the local tribal leaders, a attempt failed, as these leaders refused to negotiate, "All my people love and die for me!" , claimed in an interview, and sta blindness, real or feigned, also extends to what happened in Tripoli, where, according to Gaddafi, has not been "no protest" said, and still leading l Libya continues to defend that the origin of the protests are "drugs that Al Qaeda provided" youth of his country regarding the possibility of leaving, as he calls his people and the international community Gadhafi just laughed when he suggested this possibility.



Given the evidence that their power is challenged Gaddafi seems to be seeking responsible for their failure to tackle the way to the rebels against his overbearing mass Republic, the dictator continues pounding all means available to the revolutionaries, but the rebel leaders are training young people for the battle of Tripoli, a plane Libyan Air Force bombed a weapons depot near the headquarters of Hania, in Edjibiya region, about 200 km west of Benghazi, the second city of the country under rebel control, opponents of Gadhafi turn control Misrata, the third largest city and its airport, near where fighting continues between Gaddafi's detractors and supporters, the rebels shot down a government plane trying to bomb the local radio station that broadcasts messages of the insurgents, the forces Gaddafi also trying to regain control of the military base in this city, which dominate only a small part, the rest is under control of the revolutionaries. On this basis, there is an ammunition depot.

Sunday, February 27, 2011

Rusian Bare Free Clip

Child Abuse Affect Brain Development Macropinna


The Beatings and Brain Development

The first
childhood, the brain develops more rapidly than all other body organs, the age of 5 years, the brain has around 90% of its adult weight, and for 7 years, fully grown, this makes early childhood a very delicate and critical stage of development brain, nervous tension associated with pain and fear caused by spanking can negatively affect development and function of the brain of a child, it is precisely during this period of great plasticity and vulnerability that many children are subjected to physical punishment, the effect can be a derailing natural and healthy growth of the brain that are irreversible abnormalities last a lifetime.

According to Dr. Martin Teicher of McLean Hospital in Belmont, Massachusetts, "We know that an animal exposed to stress and neglect early in life develops the brain is wired to experience fear, anxiety and stress. We believe that the same is true for humans, "in the article" The Neurobiology of Child Abuse, "Scientific American wrote," The new brain imaging and other experiments have shown that child abuse can cause permanent damage to the structure and function neural brain itself as it develops. This grim result suggests that we need much more effort to prevent child abuse and neglect before it does irrevocable harm to millions of young victims ... Society reaps what it sows in the way of raising children, "no responsible parent would knowingly jeopardize the normal brain development of a child, and yet that is precisely what the hit without knowing it.

Thursday, February 24, 2011

How Much Does A Mulberry Bag Cost In America

HISTORY OF MEXICO. SEMINAR


Most of the people who inhabit this vast country called Mexico, we lived cheated the last two centuries. Used and exploited by a handful of abusers who had come forth to this land inhumanely and exploited the native peoples and have ruthlessly plundered its natural resources.


To make this possible, basically the colonists-operators have removed "historical memory to the invaded." That is, in a state have amnesia. Do not know who they are, where they come, much less where they go. An immense mass of ignorant people, deculturalised and forgetful. Trying to be ... what the colonizer imposes it at your convenience. Three hundred years trying to be English and until they put on this earth "New Spain" after one hundred years unsuccessfully pretending to be French and in the last century, we have tried to be unnecessarily Americans. Neglecting one's own and constantly extolling the foreign frantically.



This huge independent culturally mixed people who stubbornly refuses to be indigenous and angrily rejects the mother culture. It claims to be "mestizo" Europeanized "or loss" modern-Gringotization. " Away from the indigenous and never becomes English, French or American. That citizen ignorant, vulgar, conceited. He who builds his existential paradigms television, trademarks, in the "modernity" consumption. That which is basically insecure, violent, suspicious, cruel, fearful, voracious predator. This city will never, nor will respect a line of people, that they pass on the right and passed the high, which is double parking and does not give way to pedestrians. Which littered everywhere and always wants to take personal advantage of others ... that they despise the peasants and indigenous people and foreigners admire. I always thought that above the others. That he knows nothing of the ancient history of the Mother Civilization gives life and substance. That which unfortunately is the majority in this country. This city is a perfect creation of the colonizer-operator, so we want and need us and we make them rich.



Only by having such people, the settlers operators can continue to make great fortunes and live in the most cynical injustice. As almost all major cities in this country are in the hands of "Creole", ie, children of foreigners resident in this country. The wealth of Carlos Slim, his henchmen and his countrymen is directly proportional to the ignorance of the people they exploit. Just under 10% of Mexicans "? (Creole) owns 40% of national wealth. That is, this country belongs to the few and the others are like cattle ... or chicken farm. More nothing.



This "country" was born from a struggle between Creoles and Spaniards for the right to exploit the invasion. Our deep civilizational heritage of seven and a half millennia has been severely curtailed. It imposed a colonial system for 3 centuries and Creoles betrayed their relatives and threw them over the vast mass of poor and hungry native justice. That was the war of "Independence." Any change to stay the same.



The Creoles were invented "the country" who was given undue MEXICO therefore in ancient historical memory is known that these lands are Anahuac. Mexico comes from Mexica, so that the Zapotec, Mixtec, Maya and many others are not Mexica and therefore properly be Mexican!



During the nineteenth century the natives were divided into two camps: Masons Yorkinos-federalist Liberal-Republicans (PRI) and clashed with Scottish Masons-centrist-conservative-monarchist (PAN) in a fratricidal war for power, which were invaded twice and took away more than half of the territory. Neither the Spaniards and the natives have given them a real chance original peoples and Mother Culture in these hundred years of colonization and neo-colonization.



La Colonia and country have always been ... and for them. How have they achieved?, Removing the historical memory to up-invaded. Haciéndale first believe that English and then was suddenly "Mexican." He is descended from English or French, he has nothing to do with the Indian civilization is presumed dead. To be part of the Mother Civilization is something negative, low level, this is to be: naco, YopE, Indian, ignorant, vulgar, poor, it is not the same but is the same.



Deny your culture, its origins, its traditions, its history, its phenotype, its color, dismiss himself and try to be a pioneer of his own people (to have taught that calling him "win"). In a world of predators, in a country where all against all, which does not respect the law, in which corruption is the oil that moves the system in which the more shameless is the smartest in the there is no justice, equity, or mercy ... in a country, is like Carlos Silm may be the richest man in the world. The Colonial System is just that, disorder, corruption, vulgarity, ignorance, the people, because, dear reader, think again, "a raging river, neo Creole settlers gain!



The children of the children of the Old Grandparents hundred years we have been deceived. We have lost our historical memory, our pride of being heirs to one of six world's oldest civilizations. Would have us believe that we were "New Spain" and now we are "Mexicans", but since the invasion have lost ownership and leadership of our nation. Have made us forget (temporarily) that we are sons of Anahuac, which We are holders of an ancient wisdom of how to live in harmony with our neighbors and with nature. We have wasted our knowledge about the world and life. We have removed the sacred and mystical sense of life. We have become insecure, violent, ignorant, dependent. This would explain why Fox ordered removed from the secondary studies ancient history of Mexico.



This country called Mexico does not belong, at least the majority. There is 10% of Creoles who have power and money, another 10% have only 1% of wealth and of course, are the indigenous peoples. And there is an immense mass of 80% of deculturizados mestizos, sons of channel bars and stars. Willing to paint their hair yellow, smeared creams bleach, to put their children foreign names, to be consumers' muuderrnos "to eat junk food and walk in the" moles "to live on credit and fulfill the existential longing go to Disneyland.



Millions of "Mexicans" who live among the sitcoms, football games, news, the "reality shoes" and the gossip of the artists, the philosophy of Ramones, Brozo, Cristina and Skinny and fat. Believing in the farces the crafty electioneering democracy, hoping to take greater advantage and better use corrupt political staff.


People
vulgar, vain, superfluous, which lives only thinking about having money to buy and watch more television. Unresponsive and unconscious people, brutalized, impressionable and easily manageable and exploitable.



The wealth of a few is based precisely on this. On the loss of historical memory, in ignorance of ourselves, in the rejection and contempt that we have learned to "self-ours."



The invader-settler-operator can enable us anything unless we recover THE HISTORICAL memeoria and know who we are, where we came from and where we go, as individuals and as a people. Because that memento is just his power and wealth. This is the reason why Mexicans are "helpless FOREIGN uncultivated OUR OWN LAND." Europe knowledgeable and aware of what color was the white horse of Napoleon, the Colosseum and the Greek Parthenon, but totally ignorant when we go to Teotihuacan, Monte Alban or Chicen Itza.



This is the reason I do not understand what what happens "in our country." We believe that those who have power and money are our brothers and are concerned jointly by us, "people-your people." That share a common improvement project, which bind us the same aspirations, desires and projects. But that is not true, those who have power and money from 1521, only seek to exploit and plunder, to return true land to enjoy their profits, as Slim that is lived in Lebanon.


The great delusion is that "Mexico" is not ours, however, the Anahuac is our future, our own ". We just have to wake up recovering the ancient historical memory. Open your eyes and take a closer look at the bottom of our hearts. (2007)

Cuttting Of Choridar Pajama

microstoma, Fish Head with Eyes and Clear Cylinder

A single fish, one of the rarest animals that can be found, back in evolutionary time is possible to imagine the ancestors of this peculiar fish of the abyssal profundides the Macropinna microstoma is the only fish species of the genus Macropinna, barreleyes belonging to the family, is distinguished by its transparent head as opposed to the opacity the rest of the body, lives between 600 and 800 meters deep, 2 holes are dark on their ducts olfactory mouth, the eyes are the 2 green areas that are inside the skull transparent fish is also known as "Barreleye" or "Ojobarril" because it also has the peculiarity that their eyes are not spherical if cylindrical.

The creature is known to science since 1939, when discovered by Chapman, but whether he had been photographed alive before 2004, the first drawings not showing his head clear, as this decomposed to be removed from the deep sea, has tubular eyes, very sensitive to light and its peculiarity is that they are capable of moving in all directions, while in other species tubular eyes are fixed and anchored to the skull, this allows you to expand the limited field of view typical of tubular eyes, but to move in all directions is necessary that the skull is transparent, this being the reason for this peculiar feature.

Tuesday, February 22, 2011

Blackout Chevy Cobalt

Jehovah's Witnesses: a case that can happen to us ...


came to the Justice
REPORTED AFTER THE DEATH OF JEHOVAH'S WITNESS VICTIM
The victim's sister (pictured) accused the Prosecutor No. 10 to his sister's neglect of person and threats. Representatives Jehovah's Witnesses say, however, that the problem is not the view of the family, but what the patient was established.
16/02/2011 resulted in several lawsuits.
Initially, the sister of the deceased man, Libya Zampini, had submitted an appeal to allow the transfusion that she received, permission, doctors said, came too late. But in addition, Libya denounced the prosecution against 10 for his sister, Claudia Sanchez Mariel Contardo, and other members of the congregation, first by threats against his person, then abandonment of person. Meanwhile, from the religious congregation to which he belonged Zampini, justified its position of refusing to be transfused. They added that the law protects individual decisions of people to whether or not to a particular medical practice. Camilo Orlando Zampini was 36 when he crashed his motorcycle last Friday in Ovidio Lagos 3600. He was immediately taken to the Emergency Hospital Clemente Alvarez (HECA), where doctors will first decompress a brain clot and then instructed that it be submitted to the blood transfusion he had lost in the accident. But professionals met with opposition from his wife, also an adherent of the Jehovah's Witness congregation, who put their trust under the law for the protection of patients' rights promulgated in 2009. According to medical sources, the woman presented a role in determining which consisted of her husband not to be subjected to a transfusion if needed. However, the sister of the victim, Libya Zampini, said the paper was "confused" because "had different colors of ink," and asserted, not demonstrated the signature of his brother Camilo.
Given the refusal of the widow, the woman complainant attempted to file "an appeal in a court of Rosario, but the judge declined jurisdiction," said Libya, which went to court after judge Paula Sanso, who " immediately issued an order to make him a blood transfusion. " According to the story of women, "The doctors said it was too late and that my brother was brain dead and today (yesterday) at 6 am finally died", he said.
is why Libya decided to sue your sister to the courts for dereliction of person and death aggravated by the bond, as for their families, Camilo life might have been saved after receiving the transfusion. Added to this cause, and denounced the threats against the victim's sister. While still "I can not say anything for a gag" Libya told the newspaper The Citizen that appeared yesterday morning outside the prosecutor number 10 because of all the facts occurred in recent days, "they have many targets, many things out of place." He expects you to perform forensic medical expertise for alleged beating in the arm with Libya for a time in court, his claims can be made public. religious views
The member of the liaison committee between the Jehovah's Witnesses and health centers, Alejandro Ocampo, Zampini defended the position and explained that the most important thing to note here is that the problem is not According to relatives, but what the patient was previously established. He added that one can argue in many cases if the blood is necessary for the continuation of life and as the situation may have many medical opinions, "but in 98 percent of cases the issue is resolved without bloodshed. Very few cases in which the blood is essential to preserve life. " He also stressed that Zampini died as a result of the blow he received, not by lack of blood. About

religious foundation not to receive blood, Ocampo explained that is contained in the Council of Jerusalem. "The older men get together and argue that one should abstain from idols and from blood. A rule that had been given to Noah, who said you could eat meat but not the blood. What comes to this council is universal issues that should be taken into account, "said Ocampo. "At that time there were no blood transfusions, but blood gave an almost mystical. It was thought that the blood could improve the person who had epilepsy, the Gladiators took their blood because they thought it was effective. There were some uses of blood, but not now therapeutic. Journalistic documentation of the time he realized the position of Christians over claims that blood should not be used for the body. That is the biblical foundation, "said the priest. PERSONAL DECISION



on the position of receiving or no blood, Ocampo said that is an individual decision of each religious. "Because when you decide to become a Jehovah's Witness are opting for a lifestyle that can accept. Those involved, is because they have agreed to basic principles. The relatives of this person who are not believers, do not understand that a decision not to ratify or rectify, "he added.

Meanwhile, the minister of the congregation, Alejandro Varela, showed a document like the one with the woman in the Heca Zampini. "The Jehovah's Witness is sure to make an advance directive of her will and sign it before a notary to be valid. We all do it we know we can go through a complex situation. The letter gives the possibility to appoint a proxy, the wife was the attorney of Zampini and doctors decided to respect the decision of the patient. But if the wife did not feel the same, and the patient had presented the paper which it is the will of the patient. The only thing that can change that decision is a judicial process, "he said.

On the other hand, the religious judge stressed that did not rule on the defense presented the victim's sister, and when they arrived at hospital and was brain dead Zampini so the case became abstract.

and alleged that they, in the case of illness, do not believe in healing, turn to the doctor and a hospital, but consider that in medicine there are alternatives to transfunsión that can be applied and that they recommend in this type of case.

THE DIRECTOR OF HOSPITAL
Heca
The director Nestor Marchetti said that "this is the case of an adult protected by law."

"The patient had head trauma and collapse," said hospital director, noting that with the advice of doctors to perform blood transfusion "his wife refused because she said she was a Jehovah's Witness and even showed documentation writing to support this decision of her husband. "

Marchetti explained that" in these cases involving adults who express their will or there is a call from a relative if the victim is unconscious, you should respect that decision because there is even a law approved, which covers ".

Moreover, he explained that" these are people that do not support any blood component from another agency and they have spread these rules in all health centers throughout the country to be respected. "

The doctor noted that the hospital "are often such situations occur, though not often with this severity," and explained that "it is of patients used alternative treatment with erythropoietin, a bone marrow stimulant that is used as a substitute for the body to produce red blood cells. But a lot of pictures of blood loss is not immediate response, as in the case of the transfusions. "




In an upcoming post


will discuss it.



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TUXTEPEC, OAXACA


The State Institute for Public Equation Oaxaca through the Department of Indigenous Education and the Head of Supervision Area Number 18, promoted on Saturday February 19 the Seminar "Anahuac essence and root of Mexico" and the Conference "Education Toltec Tuxtepec City, Oaxaca.

With an attendance of over 120 indigenous education teachers Tuxptepec Region, among which were native speakers of different languages \u200b\u200bin the region.
This effort to educate and raise awareness on the revaluation of the mother culture teachers, was organized by Prof. Avelina Yescas Augustine and teachers Felipe Castillo and Victor Rafael Terán.


;

On the assumption that all Mexicans have a "genetic bank of cultural information", which holds all the wisdom and experience of the culture that comes from the individual, the exhibitor, Guillermo Marín presented in a concrete and objective to teachers, seven thousand five hundred years' history, our own "developed by the Old Grandparents. Likewise, presented the main elements of Toltec Education, which used the Old Grandparents Toltecs in the education system the world's oldest.

Indeed, teachers of Indian Education in the Region of Tuxtepec knew the "other view" of history and culture of indigenous peoples, that is, the civilization of Anahuac. The official history of the dominant culture, enhances and highlights the invasion and colonization. In this story Cortes and his followers appear as great civilizing and heroic warriors. And of course, the civilization of the invaded, as primitive, cannibalistic and warlike.

This distorted information about the history has condemned Mexicans in general and indigenous peoples in particular, to the exclusion and devaluation.

The response of the teachers was total concentration despite having to work six hours in both events. This response is an indication that the Indian education teachers are willing and gotten to know a version of history that will dignify the pride of belonging to one of the oldest civilizations of mankind and the only one that managed to create in antiquity, first system of education, compulsory, free public the planet.

This is the information required by the teachers in Oaxaca decolonized and make Indian education a tool to train new generations with a "face himself and a true heart." Proud of what were his old grandmother, strengthened as they are now confident and in what will be tomorrow.


Engagement Card Messages

Protests Libya: Gaddafi Blast

Tripoli - The violence following the popular revolt against the Libyan regime left more than 500 people, most of the casualties occurred in Benghazi, the second largest town, 1,000 km east of Tripoli and the focus of the insurgency, also in Al Baida and Derna, these are the first official figures on victims popular revolt, a few hours before this announcement, Colonel Qaddafi vowed in a televised speech to restore order and brandished the threat of a bloody crackdown , ensuring that the regime had not "still used force", s ccording witness violence first concentrated Benghazi, reached the capital, the organization Human Rights Watch (HRW), quoting 2 hospitals in the capital, the repression has left more than 500 dead in Tripoli, Interior Minister, Abdel Fatah Yunes, announced his resignation and adherence "the revolution" , according to images broadcast by the Qatari Al Jazeera , but the spokesman of the Ministry failed to mention this issue.



The situation in the capital of Libya is of maximum tension, threats of a brutal crackdown against those who protest against the regime are met, military aircraft fired on demonstrators concentrated in Tripoli, also There were bombings in other cities, but due to the gag that exists in this country, there is little information available on the streets of the capital there are corpses lying and heard heavy gunfire, as it has been shown, several witnesses have reported participation in air raids, which opened live ammunition into the crowd ,

"What we are witnessing is unimaginable, warplanes and helicopters are bombing indiscriminately one area after another, there are many, many dead "

Adel Mohamed Saleh Activist

Only 2 pilots have refused to attack the protesters and fled to Malta, the indiscriminate attack against civilians, has been repudiated by the international community, calling for the cessation of violence and concerned about the genocide that is taking place in Libya, remember that the protests were inspired living revolts Tunisia and Egypt, the government threatened that the attempt to overthrow unleash a civil war with a spiral of violence worse than in Iraq, ensure that the army remain loyal Libya and Gaddafi and destroy the protesters

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Interesting article. Do not stop reading.


Rev. Col. Anest. vol.36 no.3 Bogotá July / Sept. 2008




Javier H. Eslava-Schmalbach, MD, MSc, PhD

Associate Professor Faculty of Medicine, National University of Colombia
Anesthesiology since its inception has progressively performing more complex surgical techniques, so that the spectrum of possibilities has expanded since the completion of surgery that initially aimed to improve the patient's life expectancy, until today the completion of surgeries are done to correct problems of self-esteem or having to do with improving self-image, rather than functionality in other organs or tissues that are repaired. Thus currently operating as suitable techniques for patients with morbid obesity, although not classified clearly as such, just overweight; for patients is an expeditious manner to lose weight, have the financial capacity to do so, and there are surgeons and equipment available to do so in any price range.

In either case, whether or not medically indicated surgery, surgeons and anesthesiologists need to interact in interdisciplinary management of these patients. Additionally, in some cases, surgeons in an attitude that goes beyond the interaction between specialists, the anesthesiologist must be involved, the conducting anesthetic techniques or procedures that are cheaper or that reduce blood loss, although in some cases may be accompanied by greater morbidity. This is the case of regional techniques for high mammaplasty (high thoracic epidural or subarachnoid) and controlled hypotension techniques in cosmetic surgery. Although these techniques have been described in literature, in trained hands, and patients referred, sometimes it is clear that beyond a medical indication or anesthesia, is more relevant to the lower total cost of the procedure, and increased economic benefit Finally, the greater the potential morbidity patient.
With situations like these ethical conflicts are obvious. In the specific case of breast augmentation surgery, the anesthesiologist require the performance of a technique with the only argument that is cheaper, it transcends the limits of ethics. Although this technique has been described 1 , the benefit of its widespread use is questionable because it ignores the incidence and magnitude of adverse events related to it. Generally, these adverse events are not published.

same happens with controlled hypotension in performing cosmetic surgery. There are descriptions in which is mentioned use long
2-5, to facilitate the implementation of such procedures with a lower incidence of bleeding in the operative field. This is a condition that benefits the surgeon and the patient if the global bleeding and / or surgical time are lower. In this regard some of these studies contradict those benefits
6 7 . Now, assuming that controlled hypotension is beneficial, its use can not be generalized to all patients. Is not the same hypotensive technique in young subjects than in older and even more so if associated comorbidities (hypertension, hypothyroidism, coronary artery disease). If the benefit hypotensive technique is less than the risk of intraoperative complications, prima net benefit to the patient. In this case the little bleeding in the operative field becomes a secondary problem that can be handled in other ways. The complications have been associated with this technique range from the likely increase in pressure areas to the central organ hypoperfusion such as heart, brain or kidney
8,9,10.
Sometimes in the interests of patient safety will have to choose a technique that is not going to be the surgeon's taste. Additionally, in the case of cosmetic surgery, there are clearly cases of elective surgeries indicated in patients with high potential risks of perioperative morbidity. For example, outpatient surgery tummy tuck on a 71 year old woman with a history of hypertension and hypothyroidism. In this case, the need for surgery is defined by the patient's ability to pay, not the real indication for surgery. Many studies support the potentially underlying psychiatric problems in patients with obesity and cosmetic surgery and should be studied and / or resolved before surgery 11 - 16
with the social pressure is becoming increasingly important, in our field. Other highlights an ethical conflict, to make a procedure in a patient who is not clearly indicated or is contraindicated by the need to resolve the request of a patient who somehow manages to have the ability to pay to support the request. The boundary between ethically contraindicated medically indicated and can only be resolved on the critical and ethical sense of the surgeons involved in these procedures. Obviously, if for no ethical surgeon generates conflict by requiring specific anesthetic technique, riskier but cheaper, or to schedule an outpatient procedure that should be hospitalized in order to save one day of hospitalization, much less will generate conflict when operating a patient with a high probability of underlying psychiatric problems or high risk of complications, but has adequate capacity to pay. Anesthesiologists have the option to act as doctors, always putting the medical and ethical criteria prior to gloss over this type of situation. Today, in Colombia and abroad, job opportunities allow us to be more demanding in the way we interact with surgeons and institutions, thus putting himself in an ethical sense the actions of our life, what is likely to make you feel better and more gratified with our work. course and as it happens everywhere, some people will feel more gratified with the remuneration, without deciding whether the proceedings are adjacent or not an ethical conflict. Improve the interaction between the surgeon and the anesthesiologist will conclude the proceedings in these scenarios where appropriate resolve ethical conflicts. A board, previous surgical and preoperative assessment and allow anestésca discuss these potential conflicts, improve the performance of surgeons and anesthesiologists and give items to enhance patient safety, objectives which ultimately must focus our attention on daily tasks of anesthesiology.




Sunday, February 20, 2011

Anarkali Suit Cutting

patient with a heart works only 15%, could be given anesthesia for the procedure [2]

But ultimately, the prognosis is not very good Kela. We do not know how that heart so weak you can handle the increased blood volume in the last trimester of pregnancy. In addition, she was receiving the drug

amiodarone during the first trimester of pregnancy. As a result, there is possibility of teratogenicity, ie congenital malformation. We were told that there had been a medical board to determine whether to terminate the pregnancy (therapeutic abortion) in order to safeguard the lives of Kela. The two gynecologists and obstetricians present at the meeting felt that there. They argued that at that time the patient was stable from the cardiovascular standpoint. Of course, it was stable in early pregnancy, but did not ask how much "stability" was going to be at the end of it?


With good reason, was scheduled the procedure under local anesthesia. However, cardiovascular anesthesiology was there present, waiting.

All was well until, coincidentally, Kela was seized with a nervous breakdown and single-chamber pacemaker started to fail without even connected the two chambers. The cardiovascular anesthesiologist intervened by providing, first, ventilation and oxygenation as well as the maintenance of hemodynamic stability (blood pressure and heart rate).


Kela was necessary to sedate. But that heart is so weak, with only 15% of function (EF), could easily collapse with minimal dose of sedative.

That comes into play the cardiovascular anesthesiologist experience with this type of highly sensitive patients. First, we had to set a goal: to fall asleep without losing Kela spontaneous ventilation. Second, we had to use a single hypnotic drug, since the combination of two or more can add their cardiac depressant effects.
using propofol infusion at doses ranging from low to moderate Kela we get to sleep, while breathing at any time until the end of the procedure. The good quality of local anesthesia played a decisive role. There were no further incidents.



Kela left the procedure room in good condition. We wish him speedy recovery and a happy ending of her pregnancy, stating that we would accompany her at that time and, if so authorized their treating physicians, call us to be present at their cesarean.
Kela
luck.

Wednesday, February 16, 2011

How Many Dose Menstrogen

From Uruguay: Anesthesiologists and conflicts


October 25, 2010 - Dr. Antonio Turner

Coastal
A friend encouraged me to write some reflections on the conflict fellow anesthesiologists. I met many of the best, and I am friends with several of the old, many of them already dead. They were the pioneers who created the specialty professional stature and size in our country. For ordinary citizens and politicians in general (that will no rating) anesthesiologists are like anyone else, or as a doctor of the heap, that is frequently widespread. Frowns are claiming working conditions and demanding compensation, commensurate with the complexity of their work. But surely it is the ignorance, lies or ambition, if not cruel envy, this simplification leads to hasty.

Anesthesia began to grow since 1846, when a dentist Morton used ether to sleep in a patient who had to make an intervention in the neck. Since then, remained in England, where Queen Victoria had its birth (not the first, but the following) from the birth of Prince Albert, under anesthesia, done by John Snow, who was also an epidemiologist who laid the foundations of epidemiology, through the analysis of epidemic ; cholera in London. Thus arose the technique of anesthesia to the Queen ", consisting of a wire strainer, the kind that are used for tea, with some cotton soaked in ether (Snow used it) falling drop by drop on cotton , which produces a mild sleep and relaxation median. Another midwife, Simpson, that of the forceps, a Scot, used chloroform instead of ether.
But as time passed they realized that the hepato-toxicity of this agent was capitalized and turned the old sulfuric ether. In cowboy movies, it was classic see how a wounded man gave him a shot of whiskey and then extracted the bullet. Anesthesia that was current in the eighteenth and nineteenth centuries in the rural areas.

In the nineteenth and twentieth century, Uruguay, anesthesia Ombredanne the old device, a ball with a key that was more or less dropping ether on a mask which covered his nose and mouth patient, practitioners used it external, internal, or the Sisters of Charity, which abounded in public hospitals.

private
As was the same. A specialty did not exist, and surgery was the queen and mistress of all specialties. Then they were peeling off the ORL, the OFT, the ORT and traumatology, and paediatrics.

But Anesthesiology autonomy began to take after the 2nd. World War, and in our country after 1950, with some great teachers in his youth made anesthesia gases, such as Eduardo C. Palma, Helmut Kasdorf. One ended up being a professor of Clinical Surgery and great anatomist (author of the by-pass which were then common to René Favaloro, applied to other core areas, where Palma were made with saphenous vein for peripheral bridges) and another was the first Professor of Radiotherapy. Or Alfredo Pernin, who left the surgery to go learn anesthesiology in the U.S., or their followers, Walter Fernández Oria, Chertkoff León, Antonio Cañellas, and many other pioneers, who fortunately are still with us, as Henry Barmaimón Tabare Gonzalez, Martin Marx, Samuel Liondas, Mary Caputi Cavalli, etc.

Thanks to advances in anesthesiology, surgeons were able to make interventions more more complex and protracted, and so progress in abdominal surgery, neurosurgery, cardiac surgery, transplants
kidney, heart and liver, large long-term interventions, including surgical equipment change for different times, etc..
evolved also used anesthetic agents, muscle relaxants, and improving techniques and equipment, so today is a specialty of the most sought after in the world, not only because it gives security surgeons, but because it is so complex they could not make it and neither practitioners nor nuns. But above all, because a number of techniques for diagnosis and modern treatment, which have drawn the boundaries of knowledge and therapeutic possibilities are under anesthesia of different magnitude, but with control of an anesthesiologist (TAC MRI, PET, endoscopy of various kinds and various specialists from the Gastro-Esophageal-Duodenal-fiberscope to the Fibro-Colonoscopy, to ENT interventions when the patient is not intubated and bring a fiberscope , etc.).
Of all specialties, that has developed techniques for patient safety (and relative tranquility for the operator) is the world Anesthesiology. This is universally recognized. In this advanced are indisputable.
It has certainly been the big key surgical and medical advances.

But simplification based on ignorance and the ambition (or envy), both medical colleagues and managers of public, politicians and journalists improvised anesthesiologists believe that touch a button and sleep to the patient. Which then wakes up and goes so smugly.

Those who know about the phenomena of which we speak, we know that it is not. And to reach that level of excellence requires a long and laborious preparation, and updating and maintaining of knowledge which means investment, magazines, books, conferences and travel, not for hunting elephants or make sexual misdeeds, but to go to learn more advanced in places of excellence. And that knowledge is constructed and refined professional.

we lost sight of the Anesthesiologists are medical professionals. The professionalism impose certain rules of conduct, which generally are poorly known, even within the profession, because we have digressed too, driven by the consumer society and the ignorance and greed that abound in our time. The consumerism that can do everything, is killing the flame of professional soul in us all.

So when oversimplified, as in this case, it is thought that anesthesiologists only fight for pesos and it is not. Also fighting for decent working conditions that are as or more important than compensation. As with any doctor.

EVERYBODY agrees to work in worse conditions than ideal, is a matter of responsibility. But when required hygienic conditions of work, out of anesthesia from 8 hours to rest, away from the anesthetic agents that are hepatotoxic, and stress, what we seek is to live longer and better our colleagues in that specialty. As
have to worry that each specialty would do the same. Obvio ie whether to work recently, by the delicacy of its function, and not live exhausted to handle the risk of killing patients or leave them with serious consequences, distraction or fatigue, applies to any other specialty.
And that, unfortunately, we are aware.
If there are thousands of patients waiting their turn to be operated, it will be by neglect and failure of health managers, public and private, in every place have failed to solve the problems for decades complex health services face. Since I chiquito (Or rather, since I started working in 1964 at SMU) regularly know that there is no problem with the Pereira Rossell Hospital anesthesiologists, usually in the summer. I never knew how to solve, no anesthesiologists, but the authorities of the MSP, and now the ASSE.
reform role they want to pursue a set of wise monkeys, despised and ignored all these elements, and consequently, the mismanaged, with arrogance and malice. They think that discrediting a specialty, getting people stigmatize them as the bad guys film, do their role better.

That's part of the cross we must carry, unable to endure so many chairs perched on the ministerial and ASSE. Donkeys with title or not, that political accommodation will direct things that neither know nor seek to learn. We are not born knowing, but you can ask, find out and then decide. So go and tell the President this or that bolazo, and he speaks through any stupid goose. That such a President becomes more effective. And to be regarded as revealed truth.

So in summary: Anesthesiologists are right to demand better working conditions and pay. It is by working in a place with a certain remuneration, which in the eyes of the populace may seem high, but compared to what is paid elsewhere, unless there is low, which resolves the problem. Should be analyzed as a whole around the problem and search for anesthesiologists and other professionals (yes PROFESSIONAL) decent working conditions and pay.

is madness to continue working in 3 or 4 places, jumping from one to another site to most delicate things that require attention, concentration, rest and cool head to make decisions on important issues on which they depend. You can not keep doing 24-hour guards, which leaves one to enter another. Or leave a hospital and get on an ambulance. Or stop trading and do a clinic, or get into a CTI. Because here's all mixed up, and colleagues gather good pay, sometimes, gathering many pieces of different workplaces, where every one will pay more or less wrong, but that alone would not stop the pot, its family obligations and their necessary, involving investment of money and time. And yet, sometimes they destroy your life or your family.

So when I hear speak ill of anesthesiologists, I feel sorry for those who do, from the arrogance, envy or ignorance. Since its outmoded and outdated ideological positions, as "the old Carlos Quijano, but allow them to continue living speaking ill of others, disregarding the work of others, and to make matters worse, throwing piles of garbage on their own profession . Do not even know that is such but mistaken for a living.

In 1962 the election was won by the National Party to independent nationalists, grouped in the Democratic White Union (the UBD), which had as its theme: "O rises UBD or business as usual ". The UBD rose, but everything was as it was. And of those powders, came this sludge. Nobody had the courage or attributes to change things. And now that they want change, he had to make the most of the pack burros and have no idea what it is. They want everyone to take the hard way, reviling and reviled, destroying as if it were conquered land.

The 46 anesthesiologists have been in the past three years abroad, where they pay 4 or 5 times, they did so mainly looking for better working conditions for themselves and their families. Where they can live longer, healthier, have a family and make a more orderly life. And not as slaves of the soil, in a country where nothing is respected, and where it is more important to be a big fat INAU official where the boys will escape because they are corrupt criminals, to be a doctor, surgeon, orthopedic surgeon or anesthetist .

So we are flying lower each day until bury us in the middle of the mountain of garbage that we have allowed to build.

Electronic Learning Labs

Population Project Blue Beam: The 'Second Coming' of God will Holographic

Project Blue Beam (Blue Beam) involves 2 things, a technologically simulated "second coming" of God and new projects reesurgimiento Montauk type that have the ability to take an entire group of people as in a "rapture type" and take them like a thunderbolt to Neverland, the creators are convinced that their holographic projections have the potential to change the beliefs of the entire planet to the New World Order This operates on the premise that man, somehow become God in human form, control and issue all actions and thoughts of others, it is likely that the calculated resistance to the new religion and new "Messiah" result in "holy wars", bringing loss of life on a massive scale, could Project Blue Beam considered as the most religious of the New World Order, the "Blue Ray" also can project holograms alien craft, aliens, monsters, angels among others, the satellite coordinate system and start the show.


Tuesday, February 15, 2011

Pokemon Fire Red Shiny

CORRUPTION IN MEXICO a strategy of cultural resistance. (*)



VIII .- FROM THE SELF.

But Mexicans have remained surprisingly some cases intact, and otos, so syncretic, a set of values \u200b\u200bin the field of wealth, which have survived five centuries of denial and exploitation. This set of values \u200b\u200ballowed us to maintain in spite of everything, "its own face and a true heart."



In this way, laws, institutions and authorities of Mexico deep hold a clandestine, non-formal and of little value to the imaginary Mexico, maintain standards of incorruptibility amazing. Indeed, customary law (through the traditions and customs), institutions (such as stewardships, confraternities, cronyism, family, friendship) and authorities (traditional and religious), both in indigenous and peasant communities, and in the slums of cities, are impeccably maintained and incorruptible. In any of these issues when striving word, have greater legal and moral weight to the laws of another culture, the dominant.



Thus the deep Mexico city has a two position against corruption. For the laws, institutions and authorities of the imaginary Mexico has a corrupt attitude, almost cynical, seeking benefits and avoiding their damage, and any opportunity to gain power for use in personal gain. But at the same time maintaining an attitude of immortality for the space that he feels himself and true.



corruption is innate to man, we could not assume that a particular race or culture are more likely to be corrupted.

As discussed corruption is present in both the English and Creole as mestizos and Indians, both in the imaginary Mexico and in deep Mexico, the difference could be established is that, for Mexico imaginary is a way of enrichment and deep Mexico mere residence.

Provided
mean by survival, "the fracture, "" inability "sabotaging the laws issued by the institutions and authorities of the imaginary Mexico civilizing project.



(*) Taken from the book:
CORRUPTION IN MEXICO a strategy of cultural resistance.
Guillermo Marín
The book is available free at:
BOOKS section.

How Much Does Expert Choice Cost?

CHERNOBYL REPORT: 40% European Soil presents High Doses of Radioactive Contamination

European countries have decided to reconsider the nuclear option, after decades of boycott of nuclear energy, oil at exorbitant prices, dependence on Russian energy supplies, instability in Iraq and Iran, China and strong demand India, and climate change as an excuse, have encouraged European politicians dare to reopen the nuclear debate to voters, but this new power of the atom reminded Europeans to Chernobyl, the accident arose from human error that caused the outbreak of reactor number 4 in the former Soviet Union and scattered nuclear poison, still active in the territory of European Union of Environmentalists British study says that 40% of the land of the European Union has a very high dose of radioactive pollution, the toxic cloud of Chernobyl still affects hundreds of thousands of livestock, subject to strict sanitary controls, several European Union countries also maintain restrictions on the movement of certain animal and plant species, which is still contaminated.

The International Energy Agency (IAEA) and World Health Organization (WHO) issued a report with satellite imagery of the toxic cloud, showing how in the days after the tragedy, toured Europe, composed of elements such as cesium 137, with an average life of 30 years, "The highest concentrations of volatile nuclides and fuel particles were in Belarus, Russia and Ukraine, "says the 90-page report, Chernobyl The other report, which handles data collected by the European Commission since 1998, " Close of 3,900,000 square kilometers of Europe were contaminated by cesium-137 (in excess of 4,000 Bq/m2), 40% of the surface of Europa " , Austria was the country most exposed to the radioactive cloud, while Finland and Sweden was contaminated 5% of its territory, at lower levels of contamination, Germany, with 44% of contaminated land and the UK, with 34%, were among the countries that emerged from the old worse off Europe.


British food authorities have issued information to the effect that "due to pollution caused by the accident at Chernobyl, sheep in certain areas of UK still contain levels of radioactivity above safety limits, "the report adds that the cesium-137 passes from the land to grass, and grazed along the UK, the food traffic restrictions remain in Sweden and Finland, which mainly affect the reindeer and forest products, the former NO Soviet Union handled a disaster and minimize tried to hide until the last moment, the war of numbers is served and while critics and proponents of nuclear power take hold of the data that best fit their political choice, in times of Nuclear Renaissance in Europe, do not seem to shed much light on what happened the day the Chernobyl spat their venom to half the world.

Source: Islam Web

Monday, February 14, 2011

Ceiling Two Curtain Rods

patient with a heart that works only 15%, could be given anesthesia for the procedure [1]


in a procedure room of a hospital in the capital, we have the patient "Kela" with the following diagnoses:

1) pregnancy of 17 weeks.
2) dilated cardiomyopathy, ejection fraction 15%
3) wide QRS complex tachycardia with

We explained (as simple as possible).

*
Dilated cardiomyopathy is a disease in which the heart weakens and becomes enlarged and can not pump blood efficiently. Can be caused by infections (HIV, Chagas disease), hypertension, autoimmune diseases, etc.



The ejection fraction (EF) is the percentage of blood that filled the left ventricle can eject the aorta at each systole (contraction). Its normal value is around 60%.


ejection fraction
normal

This means that, if the left ventricle fills with "hundred" and may eject "sixty" (FE = 60%), has adequate force to contract and, therefore, optimal function.

reduced ejection fraction

Now, if the left ventricle fills with "hundred" and can only drive 30 (FE = 30%) means that it has the strength to send an optimum volume of blood to the body. Its function is impaired. * The wide QRS complex tachycardia is a very malignant ventricular arrhythmia, which can lead to heart failure.


According to the cardiologist's assessment may require placement of a pacemaker, or an electrode that electrically stimulate the ventricles to contract at a normal rate. In this case the patient had a pacemaker ventricular intracavitary (unicameral).


This means that one electrode is inside (intracavity) the right ventricle (chamber) to stimulate the heartbeat (ventricular only) at an appropriate frequency.

The reason for the presence of Kela in procedure room is a change of pacemaker. It will put a bicameral (two chambers, atrium and ventricle).


Thus, stimulation of the atrium will cause it to shrink and so will improve cardiac output (volume of blood ejected by a ventricle in a minute), since that, advancing pregnancy, the circulating blood volume pregnant women increased significantly in a few weeks and will be valuable contribution of atrial contraction to maintain adequate perfusion of all organs of the body.

more so if it is a very weak heart.
continue in the next post
.