The web 2.0 close to doctors and patients

30 05 2011

Pass query and care for patients is, without a doubt, a vocational profession. But, as science progresses and expands the bureaucracy, communicate with people standing is becoming increasingly more complicated for physicians. Something as simple as delay time of the query, or as sensitive as prevent panic before an epidemic, represents a sometimes insurmountable administrative complication: patients waiting hours unnecessarily and do not know if it's flu is serious or not.

Although it may seem paradoxical, new technologies of the web call 2.0, such as blogs or social networks, they could help bring back to patients and physicians. Some, personal, already used some of these media to inform their patients of the progress of the consultation or recommend them healthy habits. For the moment, the majority of the population is not ready to receive these communications. But, for the youngest, It is as natural as talking on the phone, and much more than the printed paper.

It is also more comfortable for the doctor: only with type “today I'm going with an hour late” It could report to the 20 o 30 people have mentioned that they reorganize the morning or, simply, dominate your imapaciencia. Of course, It is not yet possible, because not everyone has access to social networks on the mobile (In fact, many, but do not use). But already there are experiences of this type, and its progress is inevitable.

Delay in Spain

“This is going to be making progress, We want it or not; We plan and get an idea of where we are going”, the doctor argues ‘ Julio Mayol’ , very active surgeon on the network. “Professionals [medical] We cannot wait for others to do so and then say that it is wrong”. All the experts agree, in any case, in that Spain is behind schedule in the medical implantation of these technologies.

An exception is Fernando Casado , family doctor that has in ‘ twitter’ an extension of your query. “It is a normal query”, clarifies, “use a only has to communicate with the 1.700 patients of my quota”. Indicates there are better or worse day for appointment, When he goes on vacation or blogs or trusted web pages recommended. Also, Why not, discuss their views on the pharmaceutical industry, like this: “You have to be up to date and prescribe the penultimate”.

The doctor Married you have the address of your account on the door of the query. Most goes ahead without knowing what. “But the segment which I reached, people of middle age or youth and training, that tells me that you suit them”, the doctor says. “Allows me to maintain contact with patients outside the limits of the query, but is not in any case of a way to resolve specific cases”, Adds.

However, and there may be the key for introduction of these technologies at the official level in the future, Yes avoid many unnecessary queries, It is not due to health problems but to purely bureaucratic procedures. Many people appointment, It looked the tail and lost the morning only to see, for example, that the family doctor can not vaccinate you against malaria, or to dispense a certificate to be able to use weapons.

Filter queries

Time saving, as the own contact with the patient, It may be a double-edged weapon. Now a doctor sees dozens of patients a day, but not all are serious; There are cases, how the above mentioned, they are quickly resolved or derive elsewhere. What would happen if the web filter and all who arrive are serious?, Perhaps 30 in a morning? “This is something that should be taken into account, so doctors do not reject new technologies”, the doctor argues Rafael Bravo , primary care physician that already commonly used web 2.0 to communicate with their patients.

When you share query with a colleague, for example, This doctor uses Google Calendars to indicate what day it is up to each, and so patients can make appointment for your. It seems simple. In fact, It is. But “moving this to the Administration was problematic”, points.

One of the advantages of the web tools 2.0 is precisely this: administrative support is not required. They are free and free. As blogs. Bravo, in fact, maintains one of the most popular, ‘ Albeit non nocere ’. “I'm not using any tool of the institution, We can not censor”, says. What is?, then, the role of institutions in the implementation of these tools? The doctor Mayol argues that “the Administration should facilitate the relationship, but it cannot be the leader of that movement”.

One of the functions of public authorities would be “ensure the security and rights”, According to Mayol, that points to a risk: “We need city because we can create castes [of patients]. Those who have more access to doctors are those who have more access to technology”. In any case, It seems that the public debate will have to wait to reach us: “Administration not learned the web one point and now not is aware of web 2.0″, remacha Bravo. [en línea] Madrid (Spain): elelMundo.es30 in May of 2011, [REF. 27 septiembre de 2010] Available on Internet:

Elliot Krane: The mystery of chronic pain

26 05 2011

We think of pain as a symptom, but there are cases in which the nervous system develops pain feedback cycles that become a terrible disease by itself. Based on the story of a young woman whose sprained wrist became a nightmare, Elliot Krane talk about the complex mystery of chronic pain and analyzes the facts that we are just learning about its operation and treatment.

Elliot Krane, Director of Lucile Packard Children's Hospital

As Director of Lucile Packard Children's Hospital at Stanford, Elliot Krane He works in the study and treatment of children who are subjected to surgical procedures, suffering from complications of diabetes and suffering “neuropathic pain” because of his own nervous system.

[Ted id = 1148 lang = spa] [en línea] New York (USA):, 26 in May of 2011, [REF. may of 2011] Available on Internet:

When can we read the human brain?

23 05 2011

The advances in neuroimaging technology allow to find traces of a piece of information stored in the brain, especially when it comes to guess between a small number of variables; Although the possibility of reading the mind like an open book is still very far away. “We cannot expect to understand how the brain works, but our ability to read the brain of an individual at a given time is very limited”, ensures Stanislas Dehaene, Director of the Of the Neurospin Center cognitive neuroimaging laboratory, located near Paris (France).

In the diagnostic imaging “needs the cooperation of subjects”, Dehaene explains, which requires that “It is very easy that the review does not work”. For example, just make some movements, be carried away by a distraction or, simply, tighten the teeth for “ruin an electroencephalogram (EEG)”.

Then, can you I guess if a person is thinking of the number? 2 or the number 4? Diagnostic Imaging tests Gets “overcoming random”, as it clarifies Dehaene. “If take two numbers, for example the 2 and the 4, There is a 50% possibilities of hit: We arrived right at 60 %”, What can be considered according to the researcher “a feat”. The specialist stresses, However, the limits of these statistical results.

In 2008, the team led by Jack Gallant, of the University of California (USA), He obtained surprising results. He invited two volunteers To watch 120 undergoing a magnetic resonance images, It enables to locate the areas of the brain activity into. With the help of a computer program and the data obtained when those same volunteers watched others 1.750 images, team tried to “guess” what they saw. The percentage of success was of the 92% with a volunteer and the 72% with another, According to a study published in the scientific journal Nature. [en línea] Madrid (Spain):, 23 May 2011[REF. 23 in May of 2011] Available on Internet:

They identified a new gene associated with the risk of breast cancer

20 05 2011

An international study led by researchers at the Institute of biomedical research of Bellvitge (IDIBELL) It has identified a new gene involved in susceptibility for breast cancer. The work coordinated by Miquel Angel Pujana, Head of the research group on Breast Cancer, by Eva Gonzalez-Suarez and head of transformation and metastasis research group, He has published in the magazine Breast Cancer Research and Treatment.

Two genes are known from years ago, the BRCA1 and BRCA2 that, When are mutated, much increase the risk of breast cancer. On the other hand, recent studies have identified mutations penetrance modifiers ofBRCA1/2that you also influence the risk of developing cancer in the general population.

In this context, the study analyzed genetic variants of the gene TNFRSF11A, encodes for the protein RANK and plays an essential role in the process of development and differentiation of the cells of the epithelium of the breast and the initiation of breast tumors. Researchers have seen less of the rs7226991 genetic variant allele carriers to have a reduced risk of breast cancer.

It should be noted that this Association has been found both in sporadic patients, in the general population, in family cases of mutations in the BRCA2 gene carriers.

THE aim of the research group is to include this new genetic information between the algorithms of decision that are used in the units of genetic counseling to improve the follow-up of patients with a high predisposition for cancer.

The Catalan Institute of Oncology have been involved in the study (ICO), the National Center of Oncology Research (CNIO), the Institute of Oncology of the Hospital Vall D'hebron (VHIO), the Hospital de Sant Pau, the Hospital Universitario Miguel Servet de Zaragoza, the Hospital Clinico San Carlos in Madrid and other centres of Israel and Italy.

A sensor could detect early Alzheimer's and Parkinson's

16 05 2011

A team of Spanish and American researchers developed an optical sensor based on a crystal structure of AU nanoparticles capable of detecting the presence of certain infectious proteins until den early symptoms of diseases such as Creutzfeldt-Jakob in humans(mad cow) o, in the future, Alzheimer's and Parkinson's disease. This innovation represents a breakthrough in early detection of such diseases.

The basis of the new method is created supercristal, able to function as a microscopic antenna that identifies the pathogenic molecules. As explained in his study the scientists, the sensor detects up 10 prions (infectious proteins with altered secondary structure) per liter of blood. I.e., the new developed glass is able to find a needle in a haystack.

As explained the lead author of the study, Ramon Alvarez, After immersing the supercristal created with the optical sensor in one sample of plasma or blood centrifuged, “the sensor, It generates an extremely high electric field at the surface of the glass, It makes the signal that bounces off the prions (a type of pathogenic protein) We get it amplified form”. In this way can more easily observe the amount of infectious proteins that exist in the blood.

Applications of the supercristal

The most interesting part of this development is your application. After years of research it has been discovered that diseases such as Parkinson's or Alzheimer's disease have a prionico origin, so, as Alvarez, “systems of early diagnosis for these diseases could be designed“, long before the first symptoms occur. In addition, they could also be detected way “efficient and regular”, outstanding researchers, some diseases with a source prionico, as the mad cows.

The work carried out by Spanish researchers of the CSIC along with American scientists has been published in the magazine Proceedings of the National Academy of United States (PNAS, for its acronym in English). [en línea] Madrid (Spain): mumuyInteresante.es16 May 2011[REF. 3 in May of 2011] Available on Internet:


Europe calls for health care use more new technologies

12 05 2011

The European Commission It has urged States members to accelerate the penetration of electronic health services to ensure a more efficient and safer health care. Also help to reduce costs and, in the long term, the sustainability of health systems in Europe.

“Aside from budget cuts,in the coming 20 years the number of older Europeans of 65 years will increase a 45%. According to forecasts, from the 85 millones en 2008 up the 123 milmillion in30 and this will have a huge social impact, Economic and health”, exposes the Commissioner of Digital Agenda, Neelie Kroes during the opening of the Conference on eHealth held in Budapest.

Only the 8% of patients in Europe you can agree on an appointment via the Internet and can be supervised from his home by the hospital using monitors and integrated systems, as shown by a recent survey by the EU Executive.

This survey also reveals thatonly the 30% of the patientsreceives the prescription in electronic format and just a 4% European hospitals you agree to provide the medical history of the patient over the network, While in the 81% cases these hospitals have their personal records computer systems.


The Commissioner of Digital Agenda have you considered “unacceptable” that Governments are not compromised to provide such services to patients, “even if it involves investing in structural changes in health systems”.

Kroes has ensured that with the introduction of telematic systems in private households to track patients in countries as United Kingdom, Netherlands and Germany have been reduced in a 26% the duration of hospital admissions andincrease in a 15% the expectation of survivalthe patient's, at the same time they have succeeded reduce in a 10% the costs of hospital incorporating the telephone service of nursing.

The Commissioner has urged States members to promote the new technologies of information and communication (ICT ’ s) to boost the diagnostic services, Prevention and treatment and innovative technological solutions based on thetelemedicine and systems of monitoring Remote. In this way, the reduction would be achieved in the 10% hospital admissions due to chronic heart failure. According to the experts, This could be achieved with the generalization of telemedicine. [en línea] Madrid (Spain):, 12 May 2011[REF. 10 in May of 2011] Available on Internet:

PatientsLikeMe: the ePaciente as a source of information for research

9 05 2011

It is common that both suppliers and doctors are left guided by own experience when it comes to medications for purposes other than indicated, to evaluate new it is a slow and expensive process, and very often there are no clinical trials protected by researchers. Now there are platforms on the Internet that they collect data on patients and can complement other methods to draw conclusions in this regard.


The prescription of drugs to treat diseases other than those indicated is a common practice in United States. Although the Center for research and evaluation of medicines from the US Food and Drug Administration verifies the effectiveness and usefulness of a drug for a particular indication, This can end up using to cure other types of conditions. It's a positive circumstance for innovation, Since it can lead to discover new uses for the drug, but this could also be a prescription without sufficient scientific basis.

Carrying out a clinical trial for each new possible indication of a medication is extremely expensive. A new proposal is to evaluate these possibilities through data published by patients in virtual communities, How PatientsLikeMe, where are shared details on treatments, symptoms and side effects.


Discusses treatment information patients published with, for example, amitriptyline and Modafinil, since they are two drugs commonly prescribed for purposes other than those indicated. The platform allows to introduce all sorts of data on the processing.


Between the 1.755 patients of PatientsLikeMe are you medicate with Modafinil, only 34, less than the 1%, they do this to the disease for which it is intended (narcolepsy and sleep disorders different).Some patients claim to have suffered side effects.
In terms of users taking amitriptyline, 104 of the 1.197, a 9%, use it for its intended purpose (narcolepsy).Other side effects are also recorded.


To evaluate these data must be borne in mind that they do not constitute a repository collected systematically, but the platform user answer as and when you want to, so the information can appear very fragmented, and the degree of confidence of the patient is different if he submits to a trial. However, Internet allows you to collect data at very low cost and very different profiles.


This type of platforms are a valuable tool to create new methods of study that can be effective in combination with other techniques.

FlashTicSalut [en línea] Barcelona (Spain):, 9 May 2011[REF. 5 in May of 2011] Available on Internet:

While you're visiting, the world is moving online

5 05 2011

Tener Internet in the query is no longer only necessary, but much more. It is access to a multitude of technologies with great potential and utility, to know the point of view of the world and be connected with this.

Click here, Please enter the address of the site to which you want to travel and enjoy the technology HTML5 (HyperTExt Markup Language, version 5). It is the fifth major revision of the core language of the World Wide Web, HTML.

You will discover which means see different screens in parallel and can interact with them. How could you use is the potential of this language in the field of e-health?

You can do the same trip by watching the following video:

Dr BRUGADA: In times of crisis: thinking about the future

2 05 2011

Prof. Josep Brugada

Medical Director, Hospital Clínic, Barcelona

Our welfare state is not at its best. The economic reality we are placing at the level that is us as a modern State, democratic but less rich than we thought. We have consumed beyond our means and we now have to return what was spent. Many of the investments have been made without strategic planning and thinking more in the territorial or electoral immediacy that needs as a country.

Now we have to accept that we spend what we have and that many of the infrastructure will be underused resigned. Some because they had never built since its usefulness was more than doubtful, and other because does not have the means to implement them at full capacity. This includes, as not, health infrastructures. We have an enviable health care system in many respects. Universal coverage, free benefits, very limited co-payments (Pharmacy) and generosity with all social sectors, even those newcomers not involved of the financing of the same so far.

A system that has an expenditure ceiling. It is unthinkable to keep this situation indefinitely, especially if spending increases exponentially and income are reduced significantly by the decrease in the collection of the State. And this is the situation that we have experienced in recent years. Now have to rethink the entire system. Adapt our expenses to revenues. Do what have to argue why sustainable works and as argues the Prof. Guillem López-Casasnovas, making solvent, changing it, What is not now.

We cannot play as a country to this uncertainty in basic social benefits, and health certainly is one of them. The crisis should be the fuse that fired the necessary evolution towards a health smoothly and continue running regardless of political changes, Economic and social.