Assistive devices for people with spinal cord injuries

29 09 2011

A team of the Universitat Politècnica de Catalunya, directed by Josep María Font, It has developed an active orthosis of knee and ankle to help people with incomplete spinal cord injuries walk. The project is carried out in collaboration with the universities of Coruña and Extremadura.

The aim of the project is the custom design of assistive devices for each specific case of spinal cord injury, A team of the Department of mechanical engineering and of the Biomedical Engineering Research Center (CREB) of the Universitat Politècnica de Catalunya. BarcelonaTech (UPC) It has developed an active orthosis of knee and ankle to help people with incomplete spinal cord injuries walk. The project is carried out in collaboration with the universities of La Coruna and Extremadura. The aim of the project is the custom design of assistive devices for each specific case of spinal cord injury. This customization will allow to improve the patient's autonomy and its process of adaptation to the device. In short, aims to improve the quality of life of the user, and at the same time save time and money in the obtaining of the final product.

The first device developed in the framework of the project is an active knee and ankle orthosis. Orthosis prototype has been designed and built in the Biomechanics laboratory of the Escuela Técnica Superior de Ingeniería Industrial Barcelona (ETSEIB), a space where discusses the dynamics of human walking, and the results are used for the development of personal devices that assist in the movement of incomplete spinal cord injured. "Patients that target this type of device have limited control of the movement of the knee and ankle joints", explains the researcher of the UPC Josep María Font, responsible for the design of the first prototype.

The laboratory is equipped with an optical system of 12 cameras that measure and capture the movement of the human body while walking. At the same time, the force of contact between the foot and the ground is measured using force plates, it contain 4 tri-axial force sensor. Also, using electromyography equipment (EMG) registers muscle activity. The team that is part of this project, consisting of engineers, physicians and orthopedists - is also developing a program of simulation by computer, based on gait analysis and modeling of the body human, allow you to predict what would be the movement of the injured person if you take the orthosis. With this information, You may design assistive devices customized to each patient. "The simulation allows", on the one hand, that the orthosis, made once, conform to the maximum to the end user, and, On the other hand, cost savings, "since it prevents the process of trial and error with real components".

Active orthosis

One of the novelties of this model of active orthosis is the mechanical design of the knee joint that has been developed at the UPC, Since it incorporates two independent systems for performance and blocking of the joint. In this way, the device supports best suited to the different phases of progress than systems that are marketed.

Currently, the most commonly used are the passive orthesis, that do not attend the knee movement externally, either the exosqueletos entire leg, It incorporates six actuators for joints of hips, knees and ankles, which makes the system more expensive and heavier. These exosqueletos systems, In addition, generally designed for people paraplegicas, they are not completely suitable for people affected by an incomplete spinal cord injury, that is to say, they are a total paralysis.

The system developed by the UPC incorporates a technology halfway between Robotics and orthopaedics, It gives lightness to the orthosis and makes it more economical. Another novelty is the low energy consumption, It promotes the autonomy of the device. Is achieved with the addition of a system of mechanical locking of the knee, and non-electric as that used by other types of orthosis and current exosqueletos.

Built after the prototype of orthosis active by the UPC team, a group of the Department of mechanical engineering, Energy and the materials of the University of Extremadura will continue the project with the design and installation of electronic control of the movement of the device. The engine, It is located on the lateral side of the knee, It is activated or deactivated from sensors Plantar, that indicate when the foot touches the ground, and as others that measure angle joints to know at which moment of the March is the user. "The device allows to supply muscles that spinal cord injury has affected", says Josep María Font.

For its part, the laboratory of engineering mechanics at the University of La Coruña, Coordinator of the project, It is responsible for developing the dynamic simulation program that is will predict the movement of the injured person to wear the brace. The device shall be tested in patients of the hospital Juan Canalejo of La Coruña, linked to the University, that will serve to validate the Simulator and the widespread use of the orthosis.

Laboratory of biomechanics

The Biomechanics laboratory, attached to the Centre for research in biomedical engineering and the Department of mechanical engineering of the UPC, It focuses on the dynamic analysis of human walking. It is an area located in Hall D of the higher technical school of Engineering Industrial de Barcelona that supports the teaching and research of the University, and that it also gives service to the orthopaedics industry, footwear and sport sector.

Is equipped with an optical system of the OptiTrack motion capture of 12 infrared cameras, to measure the movement of the relevant segments of the human body in gear. You have a hallway that incorporates two force plates, which measures the force of the foot contact with the ground. Recently, It is equipped with a team of electromyography (EMG) without threads of 8 channels to record the user's muscle activity during movement.
What is a spinal cord injury??
A spinal cord injury, as it is the case of myelopathy, It is a disorder of the spinal cord that may result in loss of sensitivity and/or mobility. It can be caused by trauma due to car accidents or breakages of intervertebral disc, or by some diseases such as poliomyelitis, the spine bifiida, Metastatic or primary tumos, Friedreich's ataxia or hypertrophic osteitis of the column.

The effects of a spinal cord injury can be fully qualified type, in which the motor functionality below the level of the lesion is lost, or incomplete, in which the affected person may have some sensitivity below the level of injury. People with this type of injury may be able to move more than other Member, they can feel parts of the body that cannot move or may perhaps have more functionality in some parts of the body than in other.

Currently, in Spain there are approximately 40.000 people affected by this type of lesion. Each year a 1.200 people suffer from it, the majority because of accidents of
transit.
Source: Universitat Politècnica de Catalunya



When your therapist is only a click away

26 09 2011

The event reminder on Melissa Weinblatt’s iPhone buzzed: 15 minutes till her shrink appointment.

She mixed herself a mojito, added a sprig of mint, put on her sunglasses and headed outside to her friend’s pool. Settling into a lounge chair, she tapped the Skype app on her phone. Hundreds of miles away, her face popped up on her therapist’s computer monitor; he smiled back on her phone’s screen.

She took a sip of her cocktail. The session began.

Ms. Weinblatt, a 30-year-old high school teacher in Oregon, used to be in treatment the conventional way — with face-to-face office appointments. Now, with her new doctor, she said: “I can have a Skype therapy session with my morning coffee or before a night on the town with the girls. I can take a break from shopping for a session. I took my doctor with me through three states this summer!”

And, she added, “I even e-mailed him that I was panicked about a first date, and he wrote back and said we could do a 20-minute mini-session.”

Since telepsychiatry was introduced decades ago, video conferencing has been an increasingly accepted way to reach patients in hospitals, prisons, veterans’ health care facilities and rural clinics — all supervised sites.

But today Skype, and encrypted digital software through third-party sites like CaliforniaLiveVisit.com, have made online private practice accessible for a broader swath of patients, including those who shun office treatment or who simply like the convenience of therapy on the fly.

One third-party online therapy site, Breakthrough.com, said it has signed up 900 psychiatrists, psychologists, counselors and coaches in just two years. Another indication that online treatment is migrating into mainstream sensibility: “Web Therapy,” the Lisa Kudrow comedy that started online and pokes fun at three-minute webcam therapy sessions, moved to cable (Showtime) this summer.

“In three years, this will take off like a rocket,” said Eric A. Harris, a lawyer and psychologist who consults with the American Psychological Association Insurance Trust. “Everyone will have real-time audiovisual availability. There will be a group of true believers who will think that being in a room with a client is special and you can’t replicate that by remote involvement. But a lot of people, especially younger clinicians, will feel there is no basis for thinking this. Still, appropriate professional standards will have to be followed.”

The pragmatic benefits are obvious. “No parking necessary!” touts one online therapist. Some therapists charge less for sessions since they, too, can do it from home, saving on gas and office rent. Blizzards, broken legs and business trips no longer cancel appointments. The anxiety of shrink-less August could be, dare one say … curable?

Ms. Weinblatt came to the approach through geographical necessity. When her therapist moved, she was apprehensive about transferring to the other psychologist in her small town, who would certainly know her prominent ex-boyfriend. So her therapist referred her to another doctor, whose practice was a day’s drive away. But he was willing to use Skype with long-distance patients. She was game.

Now she prefers these sessions to the old-fashioned kind.

But does knowing that your therapist is just a phone tap or mouse click away create a 21st-century version of shrink-neediness?

“There’s that comfort of carrying your doctor around with you like a security blanket,” Ms. Weinblatt acknowledged. “But,” she added, “because he’s more accessible, I feel like I need him less.”

The technology does have its speed bumps. Online treatment upends a basic element of therapeutic connection: eye contact.

Patient and therapist typically look at each other’s faces on a computer screen. But in many setups, the camera is perched atop a monitor. Their gazes are then off-kilter.

“So patients can think you’re not looking them in the eye,” said Lynn Bufka, a staff psychologist with the American Psychological Association. “You need to acknowledge that upfront to the patient, or the provider has to be trained to look at the camera instead of the screen.”

The quirkiness of Internet connections can also be an impediment. “You have to prepare vulnerable people for the possibility that just when they are saying something that’s difficult, the screen can go blank,” said DeeAnna Merz Nagel, a psychotherapist licensed in New Jersey and New York. “So I always say, ‘I will never disconnect from you online on purpose.’ You make arrangements ahead of time to call each other if that happens.”

Still, opportunities for exploitation, especially by those with sketchy credentials, are rife. Solo providers who hang out virtual shingles are a growing phenomenon. In the Wild Web West, one site sponsored a contest asking readers to post why they would seek therapy; the person with the most popular answer would receive six months of free treatment. When the blogosphere erupted with outrage from patients and professionals alike, the site quickly made the applications private.

Other questions abound. How should insurance reimburse online therapy? Is the therapist complying with licensing laws that govern practice in different states? Are videoconferencing sessions recorded? Hack-proof?

Another draw and danger of online therapy: anonymity. Many people avoid treatment for reasons of shame or privacy. Some online therapists do not require patients to fully identify themselves. What if those patients have breakdowns? How can the therapist get emergency help to an anonymous patient? “A lot of patients start therapy and feel worse before they feel better,” noted Marlene M. Maheu, founder of the TeleMental Health Institute, which trains providers and who has served on task forces to address these questions. “It’s more complex than people imagine. A provider’s Web site may say, ‘I won’t deal with patients who are feeling suicidal.’ But it’s our job to assess patients, not to ask them to self-diagnose.” She practices online therapy, but advocates consumer protections and rigorous training of therapists.

Psychologists say certain conditions might be well-suited for treatment online, including agoraphobia, anxiety, depression and obsessive-compulsive disorder. Some doctors suggest that Internet addiction or other addictive behaviors could be treated through videoconferencing.

Others disagree. As one doctor said, “If I’m treating an alcoholic, I can’t smell his breath over Skype.”

Cognitive behavioral therapy, which can require homework rather than tunneling into the patient’s past, seems another candidate. Tech-savvy teenagers resistant to office visits might brighten at seeing a therapist through a computer monitor in their bedroom. Home court advantage.

Therapists who have tried online therapy range from evangelizing standard-bearers, planting their stake in the new future, to those who, after a few sessions, have backed away. Elaine Ducharme, a psychologist in Glastonbury, Conn., uses Skype with patients from her former Florida practice, but finds it disconcerting when a patient’s face becomes pixilated. Dr. Ducharme, who is licensed in both states, will not videoconference with a patient she has not met in person. She flies to Florida every three months for office visits with her Skype patients.

“There is definitely something important about bearing witness,” she said. “There is so much that happens in a room that I can’t see on Skype.”

Dr. Heath Canfield, a psychiatrist in Colorado Springs, also uses Skype to continue therapy with some patients from his former West Coast practice. He is licensed in both locations. “If you’re doing therapy, pauses are important and telling, and Skype isn’t fast enough to keep up in real time,” Dr. Canfield said. He wears a headset. “I want patients to know that their sound isn’t going through walls but into my ears. I speak into a microphone so they don’t feel like I’m shouting at the computer. It’s not the same as being there, but it’s better than nothing. And I wouldn’t treat people this way who are severely mentally ill.”

Indeed, the pitfalls of videoconferencing with the severely mentally ill became apparent to Michael Terry, a psychiatric nurse practitioner, when he did psychological evaluations for patients throughout Alaska’s Eastern Aleutian Islands. “Once I was wearing a white jacket and the wall behind me was white,” recalled Dr. Terry, an associate clinical professor at the University of San Diego. “My face looked very dark because of the contrast, and the patient thought he was talking to the devil.”

Another time, lighting caused a halo effect. “An adolescent thought he was talking to the Holy Spirit, that he had God on the line. It fit right into his delusions.”

Johanna Herwitz, a Manhattan psychologist, tried Skype to augment face-to-face therapy. “It creates this perverse lower version of intimacy,” she said. “Skype doesn’t therapeutically disinhibit patients so that they let down their guard and take emotional risks. I’ve decided not to do it anymore.”

Several studies have concluded that patient satisfaction with face-to-face interaction and online therapy (often preceded by in-person contact) was statistically similar. Lynn, a patient who prefers not to reveal her full identity, had been seeing her therapist for years. Their work deepened into psychoanalysis. Then her psychotherapist retired, moving out of state.

Now, four times a week, Lynn carries her laptop to an analyst’s unoccupied office (her insurance requires that a local provider have some oversight). She logs on to an encrypted program at Breakthrough.com and clicks through until she reads an alert: “Talk now!”

Hundreds of miles away, so does her analyst. Their faces loom, side by side on each other’s monitors. They say hello. Then Lynn puts her laptop on a chair and lies down on the couch. Just the top of her head is visible to her analyst.

Fifty minutes later the session ends. “The screen is asleep so I wake it up and see her face,” Lynn said. “I say goodbye and she says goodbye. Then we lean in to press a button and exit.”

As attenuated as this all may seem, Lynn said, “I’m just grateful we can continue to do this.”

Nytimes.com [en línea] New York (USA): nytimes.com, 26 de septiembre de 2011 [REF. 23 de septiembre de 2011] Available on Internet:

http://www.nytimes.com/2011/09/25/fashion/therapists-are-seeing-patients-online.html?ref=health



A little deception helps push athletes to the limit

22 09 2011

The trained bicyclists thought they had ridden as fast as they possibly could. But Kevin Thompson, head of sport and exercise science at Northumbrian University in England, wondered if they go could even faster.

So, in an unusual experiment, he tricked them.

In their laboratory, Dr. Thompson and his assistant Mark Stone had had the cyclists pedal as hard as they could on a stationary bicycle for the equivalent of 4,000 meters, about 2.5 miles. After they had done this on several occasions, the cyclists thought they knew what their limits were.

Then Dr. Thompson asked the cyclists to race against an avatar, a figure of a cyclist on a computer screen in front them. Each rider was shown two avatars. One was himself, moving along a virtual course at the rate he was actually pedaling the stationary bicycle. The other figure was moving at the pace of the cyclist’s own best effort — or so the cyclists were told.

In fact, the second avatar was programmed to ride faster than the cyclist ever had — using 2 percent more power, which translates into a 1 percent increase in speed.

Told to race against what they thought was their own best time, the cyclists ended up matching their avatars on their virtual rides, going significantly faster than they ever had gone before.

While a 2 percent increase in power might seem small, it is enough to make a big difference in a competitive event that lasts four to five minutes, like cycling for 4,000 meters. At the elite level in sports, a 1 percent increase in speed can determine whether an athlete places in a race or comes in somewhere farther back in the pack.

The improved times observed in his experiment, said Dr. Thompson, are “not just day-to-day variability, but a true change in performance.” And they give rise to some perplexing questions.

What limits how fast a person can run or swim or cycle or row? Is it just the body — do fatigued muscles just give out at a certain point? Or is the limit set by a mysterious “central governor” in the brain, as Timothy Noakes, professor of exercise and sports science at the University of Cape Town in South Africa, has called it, that determines pacing and effort and, ultimately, performance?

Until recently, exercise physiologists have mostly focused on the muscles, hearts and lungs of athletes, asking whether fatigue comes because the body has reached its limit.

But athletes themselves have long insisted that mental factors are paramount. Roger Bannister, the first runner to break the four-minute mile, once said: “It is the brain, not the heart or lungs that is the critical organ. It’s the brain.”

Now researchers like Dr. Thompson are designing studies to learn more about the brain’s influence over athletic performance.

For example, Jo Corbett, a senior lecturer in applied exercise physiology at the University of Portsmouth in England, wondered how much competition can affect an athlete’s speed. To find out, he asked cyclists to ride as hard and as fast as they could on a stationary bicycle for the equivalent of 2,000 meters. As he rode, each rider was shown an on-screen figure representing the cyclist riding the course.

Then Dr. Corbett and his colleagues told each athlete that he would be racing against another rider hidden behind a screen. The researchers projected two figures on the screen, one the outline of the rider and the other the outline of the competitor.

In fact, the competitor on the screen was a computer-generated image of the athlete himself in his own best attempt to ride those 2,000 meters.

The cyclists rode furiously through the on-screen race. And, as happened in Dr. Thompson’s experiments, the cyclists beat their best times, finishing with a burst of speed that carried them to virtual victory by a significant length.

Dr. Corbett said the extra effort, above and beyond what the athletes had previously demonstrated, seems to come from the anaerobic energy system, one that is limited by the amount of fuel stored in muscle. The brain appears to conserve the body’s limited fuel to a certain degree, not allowing athletes to work too hard.

Nytimes.com [en línea] New York (USA): nytimes.com, 22 de septiembre de 2011 [REF. 19 de septiembre de 2011] Available on Internet:

http://www.nytimes.com/2011/09/20/health/nutrition/20best.html?_r=1&ref=health



Propósito del nuevo curso: salir a correr

19 09 2011

At this beginning of year, time of good intentions, from DOCTOPOLIS We want to make a very healthy proposal: Go to run and enjoy nature.

To encourage those that still have not tried and delight to those who are already defined as runners, today I leave you with a video of Kilian Jornet, a fascinating mixture of love for the sport and nature, physical, sacrifice and overcoming.

If after watching this video shoes someone goes and goes out, We will give you satisfied. And if you want to tell your experience, even better.



They discover a treatment against a serious childhood cancer

15 09 2011

A study of the Bellvitge Biomedical Research Institute (IDIBELL) demonstrates that inhibition of metabolism of glucose with the molecule 2-deoxyglucose (2-DG) it induces cell in a type of sarcoma child death: alveolar Rhabdomyosarcoma. This molecule is very similar to that used in tomography positron emission (PET), an imaging technique used to diagnose various tumours according to their rate of consumption of glucose. This suggests that it could be used immediately as this child aggressive tumor treatment. The results have been published in the journal Cancer Research.

Rhabdomyosarcoma is the tumor of soft tissue that are most common in children and adolescents, and represents between the 4 and the 5% of Pediatric tumors. It occurs in two forms: embryonic Rhabdomyosarcoma, the more frequent and less aggressive type, and alveolar Rhabdomyosarcoma, worse forecast. Surgery is the treatment most used for this last type of sarcoma. Chemotherapy treatments are not effective, and currently the rate of survival five years after diagnosis is of the 70%, which indicates that it is necessary to the development of more effective treatments.

New therapeutic strategies

In this sense, in recent years has increased the interest in studying tumor metabolism as a possible therapeutic target. Several metabolic pathways have different functions in tumor cells and healthy cells. In particular, Glycolysis (oxidation of glucose for energy) increases in some tumor cells. This makes them particularly sensitive to inhibitors of Glycolysis as a 2-deoxyglucose.

The study, coordinated by the head of the Group's regulation of cell death, Cristina Muñoz, and the Chief of Group of Sarcomas, Oscar Martinez-Tirado demonstrates that this molecule "in vitro" inhibits the metabolism of glucose needed by tumor cell, causing his death. According to researcher Cristina Muñoz this molecule "slows the growth of tumor cells", his death causes and a percentage of them suffer from a terminal differentiation, "so that they have the appearance of healthy muscle cells".

The image on the left shows tumor cells in an environment without 2-DG.

To the right, in the presence of 2-DG, the tumor cells die.

This molecule is also very similar to that used in the techniques of PET image that serves to diagnose tumors that have a high metabolism of glucose. This, and the fact that are already conducting clinical trials with other tumors, demonstrates that, at high doses, This molecule is little toxic and would be relatively easy to be used in the treatment of alveolar Rhabdomyosarcoma.

Muñoz has added that "the fact of knowing the cellular mechanism that causes the death of these tumor cells allowed", in the future, "refine treatments and make them more personalized".

The article reference

Ramirez-Peinado S., Alcazar-limones F., Lagares-Tena L., Mjiyad b., Expensive-Maldonado to., Pulled O.M. and Munoz-pinedo C. Cancer Research doi:10.1158/0008-5472.CAN-11-0759



AND WHY DOCTOPOLIS??

12 09 2011

(C). Rovira Bassols.

Médico Especialista en Medicina Familiar y Comunitaria

When just a few months ago, in a dispatch from Barcelona, I met two young entrepreneurs to make an exchange of ideas about our respective projects, I was fascinated by the enthusiasm and the desire conveyed to express how, from a personal experience of one of them (Alba), was conceived the idea of creating a company that solved a real problem detected almost casually; and how through ingenuity, work and creativity, they were able to transform that idea into something real call DOCTOPOLIS.

Alba explained to me that after an injury in the pIE practicing athletics, He struggled to find the right specialist and arrange an appointment with the. Just identify two loopholes in the current system: How valid information about the professional who could better serve its specific pathology and the difficulty that sometimes it is get a quotation with this professional using current options provided for this purpose. Today, patients tend to find out who is the best specialist to hear its case through two-way. The first is the traditional "mouth to ear", based on personal experiences from a friend or acquaintance, experiences that rarely coincide with the problem of self and that are usually subjective perceptions about the treatment received at a given time. This method does not usually be based almost never on criteria strictly professionals. The second, It consists of the cold reading of a list of surnames alphabetically ordered that identify professionals with a common generic specialty and places them geographically, but it is devoid of concrete and practical information about the activity of each one of them.

At the same time, in the course of the last 12 years of professional practice, basically care, I have been able to objectify a series of gaps or deficiencies that supports the current system. Among them, the difficulty by doctors of adequate and accurate information about a patient, in an era in which, a considerable percentage of the population, It is served simultaneously by two medical models, the public and the private, that should be complementary, they often work in parallel among themselves. In addition, many centres have own management models that are incompatible with the rest, making even more difficult the obtaining of such information. This fact, attached to the limited involvement of the professionals in the Organization of the centres, causes, in an indirect way, a deterioration of the doctor-patient relationship, to be depleted the inter-relationship of health professionals, both level intercentros as within a same Center and thus, with the patient, just becoming one spectator more of their own health care process, encouraging a passive attitude made their own care.

The concerns that generated me all these circumstances, they did that you raised me the possibility of starting a shared history and telemedicine project, to contribute to minimize the current deficit. At a time of economic crisis, resource capping, that has made evident the need for a change of model that adapts to the current reality, and access more universal daily to the technology applied to the more everyday aspects of people's lives, They seem to be served the right ingredients to transform an idea into a reality. If in addition the possibility of working together to someone with initiative and a complementary vision, the user of the health, dissipates any question that may arise when considering the possibility of bringing the adventure to be part of an innovative and feasible project.

DOCTOPOLIS is born, because, clear and well structured objectives, having bi-directional character, to be directed both to health professionals and users of health. these objectives are:  optimize the management of consultations, facilitate the professional relationship with their patients and offer users the access to rigorous information and detailed on professionals who are going to attend, the activities which they carry and the fields that they are experts. And this is carried out in a transparent manner, Since is the same professional who prepares and publishes all the information of your own profile, in this way bypassing the possibility of generating cross interests, to not intervene DOCTOPOLIS directly in the preparation of the information contained in each profile you just created.

It should be noted that the services DOCTOPOLIS currently offers health professionals contribute directly to minimize high costs arising from the management of a private consultation, in special, If the professional visit in several centres, Since homogenizes and simplifies the entire process through a online agenda only and the digital history, among others. It is also a priority of DOCTOPOLIS offer health professionals the ability to create web portals with own, self-managed domain, include or not, According to the will of each professional, other available services (online agenda, Clinical online stories, automatic sending of SMS, virtual telephone Secretary), for the purpose of increase visibility in the network and to facilitate the access users to specific services.

DOCTOPOLIS He is already working on future projects, projects as diverse such as telemedicine and online billing, that will further help make that DOCTOPOLIS becomes a comprehensive solution for health professionals as well as for its users.



Freezing athletes to speed recovery

8 09 2011

Last week, the American sprinter Justin Gatlin showed up at the World Outdoor Track and Field Championships in Daegu, South Korea, with frostbite on his feet. This condition was painful — he told reporters that he had blisters on both heels — but it was also improbable, given that he’d developed the frostbite in Florida in August. But Mr. Gatlin had been sampling one of the newest, trendiest innovations in elite athlete training. He’d gone into a whole-body cryotherapy chamber, and his feet had frozen there.


The American sprinter Justin Gatlin after competing in the men’s 100-meter race
at the International Association of Athletics Federations’ world championships in Daegu, South Korea.

Whole-body cryotherapy is, essentially, ice baths taken to a new and otherworldly level, and it is drawing considerable attention among athletes, both elite and recreational. In the cryotherapy chambers, the ambient temperature is lowered to a numbing  minus 110 Celsius or minus 166 Fahrenheit. The chambers were originally intended to treat certain medical conditions, but athletes soon adopted the technology in hopes that supra-subzero temperatures would help them to recover from strenuous workouts more rapidly.

That they would place faith in cold therapy is surprising, given that studies examining the effects of simple ice baths have been, at best, “inconclusive,” said Joseph Costello, a doctoral student in the physical education and sports sciences department at the University of Limerick in Ireland, who is studying the effects of whole-body cryotherapy.

A 2007 study of ice baths found that young men who completed a punishing 90-minute shuttle run and then eased themselves into a frigid bathtub (with the water cooled to 50 degrees Fahrenheit) for 10 minutes reported feeling markedly less sore a few days later than a control group who did not soak. But ice baths did not lower the runners’ levels of creatine kinase, often considered a hallmark of muscle damage. They felt better, but their muscles were almost as damaged as if they hadn’t soaked.

Despite such findings, a growing number of elite soccer players, rugby teams, professional cyclists and track and field athletes in the United States and Europe have eagerly turned to whole-body cryotherapy. Because no agency in the United States or Europe regulates it, it’s impossible to say with any precision how many athletes are currently using the treatment, but researchers like Mr. Costello say the numbers are growing rapidly.

Before entering a cryochamber, users must strip to shorts or a bathing suit, remove all jewelry and don several pairs of gloves, a face mask, a woolly headband and dry socks. Mr. Gatlin neglected that last precaution; his socks were sweaty from a previous workout and froze instantly to his feet. The athletes then move through an acclimatization chamber set to about  minus 76 Fahrenheit and from there into the surface-of-the-moon-chilly cryotherapy chamber.

At minus 110 degrees Celsius, whole-body cryotherapy is “colder than any temperature ever experienced or recorded on earth,” Mr. Costello said.

The athletes remain in the chamber for no more than two or three minutes, stamping their feet and waving their arms to retain circulation. A Welsh rugby player described the experience as being in an “evil” sauna, but told British reporters that he believed that the sessions were helping him to recover more quickly from rigorous practices.

The science to support that optimistic appraisal is slim, though. A study by Mr. Costello, published earlier this year in the Scandinavian Journal of Medicine and Science in Sports, found that whole-body cryotherapy did not lessen muscle damage among a group of volunteers who’d completed grueling resistance exercises with their legs before entering the chamber.

Another study, however, published in July in the Public Library of Science One, produced more encouraging results. For it, French researchers recruited a group of trained runners and put them through a simulated 48-minute trail run on a treadmill. The workout was designed to elicit muscle damage and soreness. Afterward, half of the runners entered a whole-body cryotherapy chamber once a day for five days. The rest sat quietly for 30 minutes a day for those five days. Blood was drawn from both groups throughout the experiment.

From the first day onward, the runners who’d entered the chamber showed fewer blood markers of inflammation than the group who had recovered by sitting quietly.

These results suggest that athletes could potentially “save two to three days” of training time compared with forgoing whole-body cryotherapy, François Bieuzen, a professor at the National Institute of Sport, Expertise and Performance in Paris and lead author of the study, wrote in an e-mail. By using the therapy, tired athletes could return to hard training sooner.

But Alan Donnelly, a professor at the University of Limerick and Mr. Costello’s adviser and co-author, is unconvinced. Reducing inflammation, he points out, does not ensure that muscles have recovered. The French researchers did not directly test muscle strength and function after the cryotherapy sessions. So it’s possible that the athletes’ muscles, although less inflamed, were still weak and damaged.

“I just don’t feel that the evidence base for WBC effectiveness is there yet,” Dr. Donnelly said. “If WBC were a clinical treatment or a nutritional aid being put forward for F.D.A. approval, my view is that it would not be approved.”

Such skepticism is not cooling enthusiasm among athletes, however. A cryotherapy chamber that caters to recreational athletes opened in Northern California last month. Its instructional materials caution users to check that all body parts and clothing, including socks, are completely dry before entering the chamber. Frostbite, as Mr. Gatlin discovered, will impede athletic performance. In his signature event, the 100-meter dash, he did not make the finals.

Nytimes.com [en línea] New York (USA): nytimes.com, 8 de septiembre de 2011 [REF. 7 de septiembre de 2011] Available on Internet:

http://well.blogs.nytimes.com/2011/09/07/freezing-athletes-to-speed-recovery/?ref=health



Dr MONGUET: Asymmetry in innovation in the health sector

5 09 2011

Josep M. Monguet Fierro

Dr. Industrial engineer and Professor of the UPC

While innovation has always been closely linked to the success and the failure of the companies, is in recent times that it has become the key word in all, or almost all professional areas. Innovation is the object of systematic study years in more advanced enterprises, serve as an example the famous NEC research laboratory, where is observed in the "Big brother" style employees to discover that situations, behaviors and environments the spark of innovation. Without such extremes, There is a long for innovation in health

Why in some areas of health?, it innovates and researches so dynamic and so consistently and in other innovative advances seem to be a titanic work? Scientific and professional excellence in the development of new treatments, devices and drugs, are as unconnected lakes in a context of inefficiencies that represent limitations to the service that receives the user's health (grade and quality) and a higher cost to the economy that we support all (2/3 the cost of health in Spain they are financed with taxes). According to studies, in the USA the inefficiencies in the health services, due to errors or unnecessary treatments, they would be equivalent to the 30% activity, that is like saying a 5% of GDP. In safe Spain that at least we have a similar ratio.

You can find a multitude of anecdotes, together you configured a showcase of barriers and constraints to innovation in the processes of health. In a first approximation we can differentiate three types of barriers, the human factor-related, with the economic model and method. All of them are the most important, because they are at the origin of the others in the background, they are without doubt from the human factor. We briefly illustrate them below.

People failed to defend our positions and interests, without overview and ability to see future scenarios. We are little educated here and only learn with the, sometimes painful, experiences. This is true for the usuarios-pacientes, for health authorities and health professionals. Whats the underlying problem?? We have a model which makes very difficult if not impossible to create an architecture of motivations. Only by way of example, Internet 2.0 It allows an infinite number of applications based on the concept of "collective intelligence", but without a real change of attitude we will find unprepared to take advantage that deserves. Creativity is not enough to innovate, a favourable environment is required as the who have managed to create for example Sant Joan of Barcelona or the Parc Taulí in Sabadell.

The economic system of health model, He now proclaims unsustainable, He has had failures of a comparable magnitude to "subprime". Already is that not are you can pin the blame on the accounting officer, but one might ask if someone was really doing the accounts. Despite the bad economic times, the truth is that the improvement of the processes in the health system is the only way to reduce costs, and the benefits that can be obtained with the improvement of the services requiring investment. These investments are essential not only to improve the health service, but for the creation of qualified and sustainable jobs in a strategic sector.

The last barrier is related to the method. If we assume that people are for the work and there are financial resources in one way or other, then we also have to develop a method of viable innovation, and as there is to innovate in the field of health is something that does not come in books. They have design, test and implement methodologies in which people work collaboratively managing uncertainty in an atmosphere of generosity.

The most important thing is not to give up.



Humanos y prótesis tecnológicas

1 09 2011

A video to start the course with a reflection on the possibilities of technological prostheses:

VALIDADO POR LA SRA. ALBA CALLS.

Youtube.com [en línea] Montreal (Canada): youtube.com, 1 de septiembre de 2011 [REF. 26 in August of 2011] Available on Internet:

http://www.youtube.com/watch?v=FxiCI8l4qhI