domingo, 25 de julio de 2010

Advances in the Neuroscience of Addiction

Cynthia M. Kuhn, George F. Koob - Advances in the Neuroscience of Addiction
CRC Press | ISBN: 0849373913 | 2010-04-05 | PDF | 238 pages | 12.40 Mb

Understanding the phenomenon of long-lasting vulnerability to addiction is essential to developing successful treatments. Written by a distinguished international team of contributors who are authorities in their respective fields, Advances in the Neuroscience of Addiction provides an excellent overview of the available and emerging approaches used to investigate the biologic mechanisms of drug addiction. It also delineates the promising research discoveries being made in relapse prevention.

The book begins with current animal models of addiction, which mimic the state of humans entering treatment: recently-abstinent animals that receive common triggers for relapse (classical conditioning, stress, and neuroadaptive dysregulation). Coverage then shifts to the use of electrophysiologic approaches, which enable researchers to characterize the discharge patterns of single neurons during drug self-administration. After exploring advances in voltammetry and enzyme-linked biosensors for measuring glutamate, the book discusses the theoretical background and results of neuroimaging studies related to neuronal networks that are activated by drug-specific cues. It then describes modern genetic approaches to manipulate target proteins that influence addictive behavior.

The book rounds out its coverage by illustrating how a neuroeconomic approach can inform studies of reward processing in general and addiction in particular. It is a comprehensive introduction to the methodologies of the field for students and beginning researchers and an essential reference source for established investigators.

Best regards

jueves, 22 de julio de 2010

¿Qué intervenciones resultan más efectivas para promover entre los profesionales de salud la adhesión al concepto de "toma compartida de decisiones" entre médico y paciente? [Archivo adjunto 1]

[Más abajo se incluyen archivos adjuntos de carlos bada]

Interesante revision






Archivos adjuntos de carlos bada

Archivo 1 de 1


Evaluacion clnica de la rodilla

{emergencias_y_desastres} Critical Care Medicine August 2010 - Volume 38 - Issue 8


Critical Care Medicine August 2010 - Volume 38 - Issue 8

Critical Care Medicine August 2010 - Volume 38 - Issue 8

Feature Articles

A history of resolving conflicts over end-of-life care in intensive care units in the United States *
Luce, John M.
Critical Care Medicine. 38(8):1623-1629, August 2010.

Phase II trial on the use of Dextran 70 or starch for supportive therapy in Kenyan children with severe malaria *
Akech, Samuel O.; Jemutai, Julie; Timbwa, Molline; Kivaya, Esther; Boga, Mwanamvua; Fegan, Greg; Maitland, Kathryn
Critical Care Medicine. 38(8):1630-1636, August 2010.

Cold aortic flush and chest compressions enable good neurologic outcome after 15 mins of ventricular fibrillation in cardiac arrest in pigs *
Janata, Andreas; Weihs, Wolfgang; Schratter, Alexandra; Bayegan, Keywan; Holzer, Michael; Frossard, Martin; Sipos, Wolfgang; Springler, Gregor; Schmidt, Peter; Sterz, Fritz; Losert, Udo M.; Laggner, Anton N.; Kochanek, Patrick M.; Behringer, Wilhelm
Critical Care Medicine. 38(8):1637-1643, August 2010.

Continuing Medical Education Articles

Therapeutic strategies for severe acute lung injury
Diaz, Janet V.; Brower, Roy; Calfee, Carolyn S.; Matthay, Michael A.
Critical Care Medicine. 38(8):1644-1650, August 2010.

A survival benefit of combination antibiotic therapy for serious infections associated with sepsis and septic shock is contingent only on the risk of death: A meta-analytic/meta-regression study
Kumar, Anand; Safdar, Nasia; Kethireddy, Shravan; Chateau, Dan
Critical Care Medicine. 38(8):1651-1664, August 2010.

Continuing Medical Education Questions
Critical Care Medicine. 38(8):1665, August 2010.

Clinical Investigations

Is heart period variability associated with the administration of lifesaving interventions in individual prehospital trauma patients with normal standard vital signs? *
Rickards, Caroline A.; Ryan, Kathy L.; Ludwig, David A.; Convertino, Victor A.
Critical Care Medicine. 38(8):1666-1673, August 2010.

Validity and reliability of an intuitive conscious sedation scoring tool: The nursing instrument for the communication of sedation *
Mirski, Marek A.; LeDroux, Shannon N.; Lewin, John J. III; Thompson, Carol B.; Mirski, Kara T.; Griswold, Michael
Critical Care Medicine. 38(8):1674-1684, August 2010.

A randomized, double-blind, placebo-controlled trial of TAK-242 for the treatment of severe sepsis *
Rice, Todd W.; Wheeler, Arthur P.; Bernard, Gordon R.; Vincent, Jean-Louis; Angus, Derek C.; Aikawa, Naoki; Demeyer, Ignace; Sainati, Stephen; Amlot, Nicholas; Cao, Charlie; Ii, Masayuki; Matsuda, Hideyasu; Mouri, Kouji; Cohen, Jon
Critical Care Medicine. 38(8):1685-1694, August 2010.

Acute renal failure is NOT an "acute renal success"-a clinical study on the renal oxygen supply/demand relationship in acute kidney injury
Redfors, Bengt; Bragadottir, Gudrun; Sellgren, Johan; Swärd, Kristina; Ricksten, Sven-Erik
Critical Care Medicine. 38(8):1695-1701, August 2010.

Laboratory Investigations

Patients with acute pancreatitis complicated by organ failure show highly aberrant monocyte signaling profiles assessed by phospho-specific flow cytometry *
Oiva, Jani; Mustonen, Harri; Kylänpää, Marja-Leena; Kyhälä, Lea; Alanärä, Tiina; Aittomäki, Saara; Siitonen, Sanna; Kemppainen, Esko; Puolakkainen, Pauli; Repo, Heikki
Critical Care Medicine. 38(8):1702-1708, August 2010.

Quantitative assessment of somatosensory-evoked potentials after cardiac arrest in rats: Prognostication of functional outcomes *
Madhok, Jai; Maybhate, Anil; Xiong, Wei; Koenig, Matthew A.; Geocadin, Romergryko G.; Jia, Xiaofeng; Thakor, Nitish V.
Critical Care Medicine. 38(8):1709-1717, August 2010.

Role of regulatory T cells in long-term immune dysfunction associated with severe sepsis
Nascimento, Daniele C.; Alves-Filho, José C.; Sônego, Fabiane; Fukada, Sandra Y.; Pereira, Marcelo S.; Benjamim, Claudia; Zamboni, Dario S.; Silva, João S.; Cunha, Fernando Q.
Critical Care Medicine. 38(8):1718-1725, August 2010.

Cerebral effects of hyperglycemia in experimental cardiac arrest
Lennmyr, Fredrik; Molnar, Maria; Basu, Samar; Wiklund, Lars
Critical Care Medicine. 38(8):1726-1732, August 2010.

Bone marrow-derived mononuclear cell therapy in experimental pulmonary and extrapulmonary acute lung injury
Araújo, Indianara M.; Abreu, Soraia C.; Maron-Gutierrez, Tatiana; Cruz, Fernanda; Fujisaki, Livia; Carreira, Humberto Jr; Ornellas, Felipe; Ornellas, Debora; Vieira-de-Abreu, Adriana; Castro-Faria-Neto, Hugo C.; Muxfeldt Ab'Saber, Alexandre; Teodoro, Walcy R.; Diaz, Bruno L.; Peres DaCosta, Carlos; Capelozzi, Vera L.; Pelosi, Paolo; Morales, Marcelo M.; Rocco, Patricia R. M.
Critical Care Medicine. 38(8):1733-1741, August 2010.


Futility in the intensive care unit: Hard cases make bad law *
Curtis, J. Randall; Burt, Robert A.
Critical Care Medicine. 38(8):1742-1743, August 2010.

Severe malaria and sepsis: Will one fluid strategy suit both? *
Molyneux, Elizabeth
Critical Care Medicine. 38(8):1744-1745, August 2010.

This is cool! Hypothermia, chest compressions, and ventilation can be accomplished in a large animal cardiac arrest model: Paving the way to human clinical trials *
Helfaer, Mark A.; Topjian, Alexis
Critical Care Medicine. 38(8):1745-1746, August 2010.

Half empty or half full? *
Batchinsky, Andriy I.; Cancio, Leopoldo C.; Buchman, Timothy G.
Critical Care Medicine. 38(8):1747-1748, August 2010.

Communication of sedation in the intensive care unit: Is it the real issue? *
Ramelet, Anne-Sylvie
Critical Care Medicine. 38(8):1748-1749, August 2010.

Biomarkers as end points in clinical trials of severe sepsis: A garden of forking paths *
Salluh, Jorge I. F.; Póvoa, Pedro
Critical Care Medicine. 38(8):1749-1751, August 2010.

Once bitten, twice shy: Defective monocyte signaling in acute pancreatitis *
McGregor, Richard J.; Mole, Damian J.
Critical Care Medicine. 38(8):1751-1752, August 2010.

Promising prognostic potentials: Perhaps *
Young, G. Bryan
Critical Care Medicine. 38(8):1753, August 2010.

Letters to the Editor

Vancomycin plus rifampicin for methicillin-resistant Staphylococcus aureus pneumonia benefits only those who have no development of rifampicin resistance during treatment
Tan, Che-Kim; Lai, Chih-Cheng; Lin, Sheng-Hsiang; Hsueh, Po-Ren
Critical Care Medicine. 38(8):1754, August 2010.

Vancomycin plus rifampicin for methicillin-resistant Staphylococcus aureus pneumonia benefits only those who have no development of rifampicin resistance during treatment
Lim, Chae-Man; Jung, Young Ju
Critical Care Medicine. 38(8):1754-1755, August 2010.

Financial disclosures in clinical practice guidelines
Kahn, Jeremy M.; Rubenfeld, Gordon D.
Critical Care Medicine. 38(8):1755-1756, August 2010.

Response from the Editor-in-Chief of Critical Care Medicine
Parrillo, Joseph E.
Critical Care Medicine. 38(8):1756-1757, August 2010.

Predicting dead space ventilation in critically ill patients using clinically available data
Sue, Darryl Y.
Critical Care Medicine. 38(8):1757, August 2010.

Lazarus phenomenon, autoresuscitation, and nonheart-beating organ donation
Rady, Mohamed Y.; Verheijde, Joseph L.
Critical Care Medicine. 38(8):1757-1758, August 2010.
doi: 10.1097/CCM.0b013e3181defd10
+ Favorites
PDF (365 KB)

Lazarus phenomenon, autoresuscitation, and nonheart-beating organ donation
Shemie, Sam D.; Hornby, Karen; Hornby, Laura
Critical Care Medicine. 38(8):1758-1759, August 2010.

Is passive leg raising safe in mechanically ventilated patients receiving enteral nutrition?
Nseir, Saad; Lubret, Rémy
Critical Care Medicine. 38(8):1759, August 2010.

Mechanical ventilation can cause changes in pulmonary circulation
Ñamendys-Silva, Silvio A.; Domínguez-Cherit, Guillermo
Critical Care Medicine. 38(8):1759-1760, August 2010.

Breathing requirement and metabolic rate during cardiopulmonary resuscitation: Cardiac arrest during exercise
Tiangco, Dexter; Haouzi, Philippe
Critical Care Medicine. 38(8):1760-1761, August 2010.

Defining death in donation after circulatory determination of death protocols: A bluish shade of violet
Zamperetti, Nereo
Critical Care Medicine. 38(8):1761, August 2010.

Defining death in donation after circulatory determination of death protocols: A bluish shade of violet
Bernat, James L.; Capron, Alexander M.
Critical Care Medicine. 38(8):1761-1762, August 2010.
doi: 10.1097/CCM.0b013e3181e285cb


martes, 13 de julio de 2010

Pancreatic Cancer 2008 Edition


Since the previous M.D. Anderson Solid Tumor Oncology Series publication on pancreatic cancer, there have been major advances in our understanding of molecular events which underlie pancreatic cancer development, both in the sporadic and inherited forms. We have seen the development of the first mouse models that accurately recapitulate features of the human disease. Several landmark clinical trials in both resectable and metastatic pancreatic cancer have been completed, raising new questions about the standard of care in this disease. Finally, the era of targeted biologic therapies has engendered new excitement about the prospects of more rapid progress in understanding and successfully treating this dreadful disease. Therefore, it is an appropriate time to review these important advances and outline areas of controversy and question in pancreatic cancer biology and treatment.


lunes, 12 de julio de 2010



Publicado por Claudio Mori Gonzales para Casimiro Ulloa el 7/12/2010 11:24:00 PM


Estimados Colegas:
La Presidenta de la Sociedad Peruana de Medicina Interna tiene el agrado de invitar a usted al XVI Congreso Peruano y XXXII Curso Internacional de Medicina Interna que se llevará a cabo del 28 al 31 de octubre en Los Delfines Hotel & Casino.

Se desarrollarán 7 Simposios, 14 Conferencias Magistrales y 6 Cursos Internacionales, participarán como ponentes connotados Profesores de la
American College of Physicians, American College of Cardiology, Clínica Mayo y la Universidad de Miami.

Se está recepcionando los Abstracts siendo la fecha límite el 31 de Agosto, los mejores trabajos serán premiados.

Adjuntamos el formulario de presentación de Abstracts y el Formulario de Inscripción con el detalle de las cuotas de inscripción y el número de
nuestra cuenta, el mismo que puede completarlo con sus datos y enviarlo por esta vía junto con su pago respectivo.

Su inscripción temprana le permitirá beneficiarse de interesantes descuentos.

Los esperamos.

Dra. Rosa Cotrina
Presidenta SPMI

__________ Información de ESET NOD32 Antivirus, versión de la base de firmas de virus 5272 (20100712) __________

ESET NOD32 Antivirus ha comprobado este mensaje.

domingo, 11 de julio de 2010


[Más abajo se incluyen archivos adjuntos de Edwin Villacorta]

VARIOS ARTICULOS sobre ASMA y bronquiolitis en especial

En este link 4 folletos sobre asma



Edwin Villacorta V.
Mi galeria de FOTOS

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


Archivos adjuntos de Edwin Villacorta



ojala que contenga los 4 archivos adjuntos este reenvio

----- Mensaje reenviado ----
De: Edwin Villacorta <>
Para: Salud Loreto <>
CC: Grupo William <>
Enviado: dom,11 julio, 2010 18:09


VARIOS ARTICULOS sobre ASMA y bronquiolitis en especial

En este link 4 folletos sobre asma
http://www.gemasma. com/presentacion /historico. asp



Edwin Villacorta V.
Mi galeria de FOTOS http://evillitaz.

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


sábado, 10 de julio de 2010

Diabetes e hipotiroidismo [Archivo adjunto 1]

[Más abajo se incluyen archivos adjuntos de Carlos Manuel Del Aguila Villar]

Ahi va un articulo relacionado al tema....

Dr. Carlos Manuel Del Aguila Villar

Servicio de Endocrinología del Instituto Nacional de Salud del Niño-Lima Perú

Magister en Nutrición





Diagnostico de hipotiroidismo subclinico en el paciente diabetico, alguien puede ayudarme.

Gracia por su atencion. Gengis Mendez Guatemala


Archivos adjuntos de Carlos Manuel Del Aguila Villar

Archivo 1 de 1

] Emergencies in Urology

Emergencies in Urology

Publisher: Springer
Number Of Pages: 687
Publication Date: 2007-07-11
Sales Rank: 2506695
ISBN / ASIN: 3540486038

welcome to   a good password forum, and medcine forum,  we provider special resoucres (some passwords)  for donators who donate >100 usd,  open

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jueves, 8 de julio de 2010

Cambiando conceptos sobre Hipertension

Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension

Prof Peter M Rothwell FMedSci a Corresponding AuthorEmail Address


Although hypertension is the most prevalent treatable vascular risk factor, how it causes end-organ damage and vascular events is poorly understood. Yet, a widespread belief exists that underlying usual blood pressure can alone account for all blood-pressure-related risk of vascular events and for the benefits of antihypertensive drugs, and this notion has come to underpin all major clinical guidelines on diagnosis and treatment of hypertension. Other potentially informative measures, such as variability in clinic blood pressure or maximum blood pressure reached, have been neglected, and effects of antihypertensive drugs on such measures are largely unknown. Clinical guidelines recommend that episodic hypertension is not treated, and the potential risks of residual variability in blood pressure in treated hypertensive patients have been ignored. This Review discusses shortcomings of the usual blood-pressure hypothesis, provides background to accompanying reports on the importance of blood-pressure variability in prediction of risk of vascular events and in accounting for benefits of antihypertensive drugs, and draws attention to clinical implications and directions for future research.

BLOGS para medicos

BLOGS para medicos

Urticaria and Angioedema

Urticaria and Angioedema
Publisher:Informa Healthcare | Pages:528 | 2004-04-23 | ISBN:0824753151 | PDF | 59 MB

Exploring current treatment options for skin conditions affecting more than 20% of the population, this reference examines every type of urticaria and angioedema, reviews the mechanisms common to all types of these disorders, and discusses the uses and limitations of existing and emerging treatment regimens for urticaria and angioedema, including alternative therapeutic approaches.

Best regards

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Have you heard?

Have you heard?

The Lancet's Impact Factor has recently gone up to 30.76 - just one more reason why you should read the independent and authoritative voice in global medicine.
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Stay informed with the independent and authoritative voice in global medicine. For more information visit:
Most read articles via*

Below are the Top 10 most read articles from The Lancet in 2010 to date.

1. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5

2. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial

3. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension

4. Worldwide mortality in men and women aged 15-59 years from 1970 to 2010: a systematic analysis

5. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials

6. Postexposure protection of non-human primates against a lethal Ebola virus challenge with RNA interference: a proof-of-concept study

7. Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970-2010: a systematic analysis of progress towards Millennium Development Goal 4

8. Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension

9. Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis

10. Survival as a function of HbA1c in people with type 2 diabetes: a retrospective cohort study

* In 2010. Articles are available to purchase individually or can be accessed via a full Online Only subscription with a 25% discount available until 30 July.
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domingo, 4 de julio de 2010

Manejo de las GECAs en Menores de 5 años. Un enfoque basado en la evidencia [Archivo adjunto 1]

[Más abajo se incluyen archivos adjuntos de William Arellano Santillan]

Manejo de la gastroenteritis aguda en menores de 5años: Guía de práctica clínica Ibero-Latinoamericana.
Un enfoque basado en la evidencia
          RPM: #893353
         Cel: 964 713855


Archivos adjuntos de William Arellano Santillan

Archivo 1 de 1

Sindrome de West SOLICITADO [Archivo adjunto 1]

[Más abajo se incluyen archivos adjuntos de genaro julca villarreal]


De: Juan Rojas <> Enviado: vie,2 julio, 2010 03:34
Asunto: [SALUD_LORETO] Sindrome de West :Ayuda por favor !!


Necesito con urgencia preparar una puesta al dia del Sindrome de West y su etiología.

Por ejemplo, este articulo

Epilepsy Res. 2006 Aug;70 Suppl 1:S87-95.
A new paradigm for West syndrome based on molecular and cell biology.
Kato M.

Muy agradecido de antemano
Juan Rojas


Archivos adjuntos de genaro julca villarreal

Archivo 1 de 1

Superando barreras para los nuevos tratamientos


Buenos días
La vida está llena de ventajas y desventajas. Nadie entiende esto mejor que una persona con una enfermedad crónica o discapacidad.
¿Debería existir el esfuerzo para disminuir los costos de tratamiento?¿O el énfasis debería ser puesto en el desarrollo de nuevos y mejores tratamientos?
Más información en el siguiente enlace:

Saludos cordiales
Q.F. Aldo Alvarez Risco
Red Sudamericana de Atención Farmacéutica
Síguenos en Twitter



Procalcitonina e Infecciones [Archivo adjunto 1]

[Más abajo se incluyen archivos adjuntos de Manuel Mayorga]

La procalcitonina (PCT) es sintetizada por un amplio numero de tejidos y organos en respuesta a la invasion por bacterias, pero tambien por algunos parasitos (malaria) y hongos. Los examenes actuales de PCT son rapidos, especificos  y lo suficientemente sensibles para detectar incrementos en los niveles sericos de PCT dentro de las 4 a 6 horas de inicio de la infeccion. Desde el punto de vista de nuestra practica clinica los niveles de PCT pueden ayudarnos a tomar decisiones respecto a la necesidad de iniciar tratamiento antibiotico empirico (diferenciar entre infeccion viral vs bacteriana), evaluar el adecuado control del foco primario en las infecciones quirurgicas y la duracion del tratamiento antimicrobiano. El dosaje de PCT junto con los cultivos tambien nos permitiria discernir entre colonizacion vs infeccion por bacterias patogenicas.

Este examen ya se encuentra en el Peru desde hace buen tiempo pero creo que aun no hemos podido sacarle el debido provecho. Dado su alto valor predictivo negativo me parece que es una valiosa herramienta para un uso mas racional y prudente de los antibioticos en el ambito hospitalario, permitiendo tambien el desescalamiento o descontinuacion precoz de antibioticos, especialmente en la UCI. ¿A lo mejor tambien podria ser agregado dentro de la pregunta 4 del checklist en UCI?

Adjunto les envio un minireview publicado en el ultimo numero del Journal of Clinical Microbiology sobre este tema que debemos retomar.



Saludos cordiales



Médico Intensivista - Maestría en Enfermedades Infecciosas

Jefe de la Unidad de Terapia Intensiva del Hospital Central de la FAP

Past-Presidente de la Sociedad Peruana de Medicina Intensiva

Presidente del Comité de Eventos Científicos e Informes Técnicos (CECIT)

Consejo Nacional del Colegio Médico del Perú

Director Ejecutivo de Red Intensiva Perú

Address:   Avenida Aramburú S/N Cuadra 2 Piso 8 Miraflores Lima 18-Perú

Office:   +511  422-1277

Hospital:   +511  513-5300  Ext 2655

Site:   +511  5135-300  Ext 2765

Fax :  +511  422-1277

Mobile Nextel:  +511  (99) 819*6526


P Please consider the environment before printing this e-mail


This email message is confidential, intended only for the recipient(s) named above and may contain information that is privileged, exempt from disclosure under applicable law.  If you are not the intended recipient, do not disclose or disseminate the message to anyone except the intended recipient.  If you have received this message in error, or are not the named recipient(s), please immediately notify the sender by return email, and delete all copies of this message. Thank you for your cooperation






Archivos adjuntos de Manuel Mayorga

Archivo 1 de 1





Infecciones por retrovirus. Infección por el VIH (I). Epidemiología, aspectos patogénicos y formas clínicas
pulse sobre visualizar documento.
Complicaciones infecciosas en la infección por el VIH
pulse sobre visualizar documento
Complicaciones no infecciosas en la infección por el VIH
pulse sobre visualizar documento
Tratamiento de la infección por el VIH. Fármacos antirretrovirales
pulse sobre visualizar documento
Atención general y extrahospitalaria del paciente con infección por el VIH
pulse sobre visualizar documento


Protocolo diagnóstico del cuadro febril sin foco aparente en pacientes con infección por el VIH
pulse sobre visualizar documento
Protocolo diagnóstico de rash cutáneo en paciente con infección por el VIH
sobre visualizar documento
Protocolo diagnóstico de las infiltraciones pulmonares en pacientes con infección por el VIH
pulse sobre visualizar documento
Protocolo diagnóstico de la afectación del sistema nervioso central en pacientes con infección por el VIH
pulse sobre visualizar documento
Protocolo diagnóstico y terapéutico de la diarrea en pacientes con infección por el VIH
pulse sobre visualizar documento
Protocolo diagnóstico de la pérdida de peso en el paciente con infección por el VIH


sábado, 3 de julio de 2010

] pediatric nephrology shu

2010/7/3 moderadosb <>
Please, need this very urgent.
Cardiomyopathy: a late complication of hemolytic uremic syndrome.
A M Walker, L N Benson, G J Wilson, G S Arbus
Pediatr Nephrol
April 1997 (Vol. 11, Issue 2, Pages 221-2)

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For more options, visit this group at


jueves, 1 de julio de 2010

date rape:betahidroxibutirato

1.        Gamma-hydroxybutyrate. An endogenous short-chain fatty acid that occurs naturally in the body, this illegal substance is not detected by standard toxicology screens. It has emerged as an important intoxicant. It is often sold to participants at large dance parties ("raves") and has been responsible for mass intoxications (Prehosp Emerg Care 3:357, 1999 ). It has also been used as a "date rape" drug. Synonyms include "liquid Ecstasy," "liquid E," "grievous bodily harm," "Georgia home boy," "soap," "salty water," and "organic Quaaludes."

a.        Symptoms include ataxia, nystagmus, somnolence progressing to coma, vomiting, and random clonic movements of the face and extremities. EEG recording supports the belief that these represent myoclonus and not true seizures. Respiratory depression may progress to apnea.

b.        Treatment. Absorption is very rapid, and lavage and activated charcoal administration are of little use. Do not induce emesis. The drug is not antagonized by naloxone or flumazenil. Experimental but no clinical evidence has been found for the use of physostigmine, and its use is not recommended. Administer oxygen and protect the airway; monitor oxygenation. Obtain electrolytes and glucose and establish an IV line. Stimulation, including endotracheal intubation, may stimulate violently aggressive behavior. Give atropine for persistent symptomatic bradycardia. Treat hypotension with IV fluids; pressors are rarely necessary. Obtain an ECG and monitor the cardiac rhythm continuously. Intoxication is usually short lived; coma typically lasts for 1-2 hours, and full recovery often occurs within 8 hours. Stable asymptomatic patients can be discharged after 6 hours of observation. Admit any patient who is still clinically intoxicated after 6 hours (Ann Emerg Med 31:729, 1998 ).

Date rape

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"Date rape", often referred to as "acquaintance rape", is an assault or attempted assault usually commited by a new acquaintance involving sexual intercourse without mutual consent.[1][2]

  • The term "date rape" is widely used. But most experts prefer the term "drug-facilitated sexual assault." However, this term evidently has a more limited scope as it does not include non-drug-assisted rapes. These drugs also are used to help people commit other crimes, like robbery and physical assault. They are used on both men and women. The term "date rape" also can be misleading because the person who commits the crime might not be dating the victim. Rather, it could be an acquaintance or stranger.[3]



[edit] Drug-facilitated date rape

Drug-facilitated date rape is the use of drugs to assist the attacker in a rape. The drug can be any substance that is physical or mind altering.

Drug facilitated sexual assault (DFSA), which is considered an umbrella term for crimes such as drug-facilitated date rape, differs from many rapes in that it is not typically a crime of physical violence but rather of sexual hedonism and entitlement.

Instances of drug facilitated sexual assault have been found in the Bible.[4]

While the phenomenon is not new DFSA emerged as public concern that mostly occurred in social settings. Alcohol was the original date rape agent.

Rohypnol[5] (trade name for Flunitrazepam), is commonly known as a "club drug" because it is usually used in dance clubs and raves. Street names include: Circles, Forget Pill, LA Rochas, Lunch Money, Mexican Valium, Mind Erasers, Roach, Roopies, Roofies, R-2, Roches Dos, Rope, Rophies, Stupifi, Shays, Groundies, etc.[1][3]

Ketamine[6] is commonly known as: Black Hole, Bump, Cat Valium, Green, Jet, K, Kit Kat, Psychedelic heroin, Purple, Special K, Super Acid, Keller, Super C, etc.[3][7]

In 2001, Dr. Michael Welner published pioneering research on the typology of drug-facilitated rapists. The typology has since been cited and used by law enforcement and mental health professionals for distinguishing different perpetrators, their personalities, and their psychological makeup.[8]

The Typology of Drug facilitated sexual assault Includes

•Setting: Typology is best distinguished by the setting in which the attack takes place (e.g. Workplace Setting, Healthcare Setting or Social Setting).

•Accomplices and Conspiracies: There may be multiple perpetrators who conspire to commit the crime. Particularly in social settings, confirmed cases have involved male and female couple collaborators, siblings and friends.

•Intrafamilial DFSA: Many intrafamilial DFSA's often go unreported. Typically there is a power differential that prevent victims from speaking out.

•Male-on-male Offenses: Such cases occur nearly exclusively in social or school settings. Often the crime reflects the perpetrators conflicted feelings about private same-sex thought and desires.

•Sexual Deviance or Sexual Hunters: This group often includes those who are incompetent at finding sexual partners and those who have sexual fantasies of dominance.

[edit] Laws

[edit] United States

In 1996, President Clinton signed the Drug-Induced Rape Prevention and Punishment Act. This act punishes for the use of the drug called Rohypnol. Four years later, the president signed another legislation banning GHB.

People who use date rape drugs have a risk of up to an additional 20 years in prison. Any possession of Rohypnol, even if there is no intent of using it, has a sentence of up to three years in prison. Every state has laws pertaining to rape.[9][10][11]

Indiana has a statute which makes the offense a Class A felony if "the commission of the offense is facilitated by furnishing the victim, without the victim's knowledge, with a drug ... or a controlled substance ... or knowing that the victim was furnished with the drug or controlled substance without the victim's knowledge."[12] (see drink spiking)