Surgery gives you jetlag

29 12 2011

Surgery gives people jetlag – and the more serious the operation, the worse it gets, a new study shows.

“Our research shows that surgery resets the body’s inner clock so that it no longer follows the rhythm of the day. As a consequence, people get jetlag in the same way as when they’re flying four or five time zones eastwards,” explains registrar Dr Ismail Gögenur of the Department of Gastroenterology at Herlev Hospital in Copenhagen.

He has written a dissertation about the study which has been published as an article in the Danish medical journal Ugeskrift for Læger.

Jetlag on top of surgery can be life-threatening

Healthy people with jetlag suffer a little discomfort in the shape of tiredness and diarrhoea, which are perfectly harmless. Sick or newly-operated people, on the other hand, are much harder hit by jetlag because it is an additional burden on their weak bodies.

“Jetlag constitutes an extra physical stress factor for patients,” says Professor Jacob Rosenberg of Copenhagen University, a specialist at the Institute of Surgery and Internal Medicine at Herlev Hospital, who was also involved in the implementation of the study. “A person suffering a thrombus, for example, is under such pressure that having to cope with jetlag as well is extremely taxing. The overall burden may lead to atrial fibrillation and new blood clot, which could make the situation life-threatening.”

Surgery interferes with the circadian rhythm

The body’s circadian rhythm is controlled by melatonin, a sleep hormone. When it gets dark in the evening, the brain starts producing melatonin, which rapidly increases to the maximum level and then remains constant for the rest of the night. This causes a small reduction in body temperature. The person becomes drowsy and falls asleep, remaining in that state until the next morning when the melatonin levels fall drastically to a minimum.

In the new study, researchers measured how surgery impacts on the body’s circadian rhythm, and the obvious way to do this is to measure the melatonin content of the blood or the urine in patients undergoing major or minor surgery.

The researchers took a blood or urine sample from various groups of patients every hour over the 24-hour period prior to the operation. The procedure was repeated for several days after the surgery.

The more complex the surgery, the worse the jetlag

The samples revealed that surgery caused the melatonin curve to flatten out in all patient groups.

After their operations, the patients found themselves in precisely the same physical condition as people who have interrupted their circadian rhythm after a journey – a condition which wreaks havoc with the melatonin curve, rendering the body unable to receive a clear signal about whether to wake up or fall asleep.

“The greater the extent of the surgery and the longer it takes, the harder the patient is hit,” explains Gögenur. “Jetlag impacts on the person’s feeling of well-being and their ability to think. The patients’ melatonin curves did not return to normal until after several days, when fluctuations began to return.”

Risk of death greatest at night

The researchers still lack adequate documentation of just how harmful this is for newly-operated patients; however, preliminary studies indicate that the interruption of the circadian rhythm by surgery constitutes a considerable risk to the patient. There is clear evidence of increased mortality among newly-operated patients.

Experience shows that the risk of dying from surgery is greatest at night, when melatonin levels are normally high, but are now low because of the operation, explains Rosenberg. There are indications that the cause of death may be an imbalance in the patient’s circadian rhythm.

“The researchers know that jetlag is due not to the anaesthetic but to the surgery itself. Earlier examinations of intensive care patients have shown that these patients got jetlag and that the jetlag was due to the operation,” explains Gögenur. Facts Melatonin tablets should be taken in the evening because they make you sleepy. The hormone causes body temperature to fall, automatically making you feel tired.

Intensive-care patients are an especially vulnerable patient group, so further research was needed to determine whether other patient groups also experience jetlag – and this new study shows that this is actually the case. Melatonin may be a wonder cure Although jetlag is a serious threat to patients who have undergone surgery, the researchers believe it can be easily prevented.

Long-distance travellers can suppress their jetlag by taking melatonin tablets, which are available on prescription, and it may well be possible to prevent jetlag in newly-operated patients in the same way.

“We’re hoping to normalise melatonin levels by giving patients melatonin after surgery,” says Gögenur, referring to experiments that reveal how cancer patients sleep better when they take melatonin, which also has numerous other beneficial effects.

“Melatonin completo potentially healing effect on jetlag and other imbalances or other illnesses is still in need of final verification, Although the results so far look very promising,” says Gögenur.

Sciencenordic.com[en línea]Copenhagen (Denmark): sciencenordic.com, 28 de diciembre de 2011 [REF. 25 in December of 2011] Available on Internet:

http://sciencenordic.com/surgery-gives-you-jetlag



Pura vida for the holidays

22 12 2011

DOCTOPOLIS gives you 3 minutes of pure life for the holidays.

If you are able to watch the following video to the end, you will go to sleep with a new lesson in the Pocket.

Happy holidays!

The DOCTOPOLIS team



“Without computer, the medical revolution is impossible”

20 12 2011

Tromsø, sometimes called the ‘ door of the Arctic ’, is a small town, of around 66.000 inhabitants, in the North of Norway. It is also one of the main focal points of development of telemedicine and medical informatics or ‘ e ’, which is why Luis Fernández Luque, Huelva birth and career software engineer, He decided to settle in this icy but suggestive population.

Was Germany, in a course of Erasmus in 2004, to the 21 years, When it came into contact with e-health, specialty in which has been involved since then. “I have seven years and I do not regret the least“, ensures. “The e-health sector is huge. In fact, in the U.S. moves nearly the same as the information and communication technologies (ICT)”, explains.

Nor will it has heavy have to emigrate to the cold lands of the North, where science, According to this Spanish, enjoy a privileged place in society: “Wages here are some 3.000 euros net per month for PhD students”. Once the thesis has been submitted, the number rises to between 4.000 and 5.000 EUR, Although Fernández Luque already got his contract shortly before completing this stage.

That is something Spain can not compete. “When I left, a bricklayer with the same experience earned much more than I”. A situation that, If it has changed since then, It has been against the bricklayer, never in favour of the researcher. Even so, This expert recalls that “Spain has a lot of experience in e-health: ago almost 20 years the Blue Helmets in the country were treated by specialists at a distance”. In fact, his intention is to return, Although it was aware that this would be a “reduce two or three times my salary and move from fixed to fellow”.

But it is not just a matter of money, also of “resources to make quality projects”, Adds. In Norway, says, “There are fewer hierarchies and everyone has the freedom to apply for grants and projects. Have left me here as a doctoral student fellows participate in many more things that would normally be vetoed”.

The reason for the great development of e-health in the North of Norway is obvious, If one thinks of the harsh climate and the sparsely populated Arctic regions. “It can not be otherwise”, Luque Fernández says. “If attack you a polar bear in the remote Svalbard Islands - to 2.000 kilometres from Tromsø- specialists in the hospital from here guide professionals there. In regions heydays, telemedicine saves lives and saves money“, concludes.

Luque Fernández - who has gone through the universities of Seville, Politécnica de Valencia, of Applied Sciences Stralsund (Germany), Minnesota and Harvard Medical- highlights, like many of his fellow researchers who have left abroad, the need to internationalize and acquire scientific experiments in different environments. In this sense, recognizes that the Norwegian to other countries aid “they are usually very well funded”.

Mobility aids

“There are many facilities to increase mobility, scholarships to go outside that duplicate you the salary, sabbatical years, leaves of absence…”, lists. One final thing: “Aid doubled if you are travelling with the family“. “Here everyone, even in private companies, You benefit from the welfare State and the family conciliation”, explains. And not only when travelling, but also in day to day: “Here you'll never see a later meeting of the three”, ensures.

As for your specialty, He is convinced that we will still see technological revolutions that will change our lives and the way in which the medicine is exercised. “The Internet and social networks are an excellent tool for education and prevention”, relates. “They are now fashion”, grants”, “but we still see how to apply them effectively to improve the health of citizens”.

“Also there is a huge potential in clinical research, especially for rare diseases. Patients increasingly participate more in all areas, from r & d to prevention”, Adds. “Is more, in the age of genetics, There is more data that must be analyzed to personalized medicine”. A goal for which see that the science of computers - his first passion- is essential: “Without computer, la revolución de la medicina personalizada es imposible”, concludes.

Elmundo.es [en línea] Madrid (Spain): elElmundo.es19 de diciembre de 2011 [REF. 19 in December of 2011] Available on Internet:

http://www.elmundo.es/elmundosalud/2011/12/15/biociencia/1323960958.html



Rebuilding the Brain’s Circuitry

15 12 2011

Neuron transplants have repaired brain circuitry and substantially normalized function in mice with a brain disorder, an advance indicating that key areas of the mammalian brain are more reparable than was widely believed.

Collaborators from Harvard University, Massachusetts General Hospital, Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School (HMS) transplanted normally functioning embryonic neurons at a carefully selected stage of their development into the hypothalamus of mice unable to respond to leptin, a hormone that regulates metabolism and controls body weight. These mutant mice usually become morbidly obese, but the neuron transplants repaired defective brain circuits, enabling them to respond to leptin and thus experience substantially less weight gain.

Repair at the cellular-level of the hypothalamus—a critical and complex region of the brain that regulates phenomena such as hunger, metabolism, body temperature, and basic behaviors such as sex and aggression—indicates the possibility of new therapeutic approaches to even higher level conditions such as spinal cord injury, autism, epilepsy, ALS (Lou Gehrig’s disease), Parkinson’s disease, and Huntington’s disease.

“The next step for us is to ask parallel questions of other parts of the brain and spinal cord, those involved in ALS and with spinal cord injuries. In these cases, can we rebuild circuitry in the mammalian brain? I suspect that we can,” said Jeffrey Macklis. Photo by Matt Craig, Harvard Staff Photographer

“There are only two areas of the brain that are known to normally undergo ongoing large-scale neuronal replacement during adulthood on a cellular level—so-called ‘neurogenesis,’ or the birth of new neurons—the olfactory bulb and the subregion of the hippocampus called the dentate gyrus, with emerging evidence of lower level ongoing neurogenesis in the hypothalamus,” said Jeffrey Macklis, Harvard University professor of stem cell and regenerative biology and HMS professor of neurology at Massachusetts General Hospital, and one of three corresponding authors on the paper. “The neurons that are added during adulthood in both regions are generally smallish and are thought to act a bit like volume controls over specific signaling. Here we’ve rewired a high-level system of brain circuitry that does not naturally experience neurogenesis, and this restored substantially normal function.”

The two other senior authors on the paper are Jeffrey Flier, dean of Harvard Medical School, and Matthew Anderson, HMS professor of pathology at BIDMC.

The findings are to appear Nov. 25 in Science.

In 2005, Jeffrey Flier, then the George C. Reisman professor of medicine at BIDMC, published a landmark study, also in Science, showing that an experimental drug spurred the addition of new neurons in the hypothalamus and offered a potential treatment for obesity. But while the finding was striking, the researchers were unsure whether the new cells functioned like natural neurons.

Macklis’s laboratory had for several years developed approaches to successfully transplanting developing neurons into circuitry of the cerebral cortex of mice with neurodegeneration or neuronal injury. In a landmark 2000 Nature study, the researchers demonstrated induction of neurogenesis in the cerebral cortex of adult mice, where it does not normally occur. While these and follow-up experiments appeared to rebuild brain circuitry anatomically, the new neurons’ level of function remained uncertain.

To learn more, Flier, an expert in the biology of obesity, teamed up with Macklis, an expert in central nervous system development and repair, and Anderson, an expert in neuronal circuitries and mouse neurological disease models.

The groups used a mouse model in which the brain lacks the ability to respond to leptin. Flier and his lab have long studied this hormone, which is mediated by the hypothalamus. Deaf to leptin’s signaling, these mice become dangerously overweight.

Prior research had suggested that four main classes of neurons enabled the brain to process leptin signaling. Postdocs Artur Czupryn and Maggie Chen, from Macklis’s and Flier’s labs, respectively, transplanted and studied the cellular development and integration of progenitor cells and very immature neurons from normal embryos into the hypothalamus of the mutant mice using multiple types of cellular and molecular analysis. To place the transplanted cells in exactly the correct and microscopic region of the recipient hypothalamus, they used a technique called high-resolution ultrasound microscopy, creating what Macklis called a “chimeric hypothalamus”—like the animals with mixed features from Greek mythology.

Postdoc Yu-Dong Zhou, from Anderson’s lab, performed in-depth electrophysiological analysis of the transplanted neurons and their function in the recipient circuitry, taking advantage of the neurons’ glowing green from a fluorescent jellyfish protein carried as a marker.

These nascent neurons survived the transplantation process and developed structurally, molecularly, and electrophysiologically into the four cardinal types of neurons central to leptin signaling. The new neurons integrated functionally into the circuitry, responding to leptin, insulin, and glucose. Treated mice matured and weighed approximately 30 percent less than their untreated siblings or siblings treated in multiple alternate ways.

The researchers then investigated the precise extent to which these new neurons had become wired into the brain’s circuitry using molecular assays, electron microscopy for visualizing the finest details of circuits, and patch-clamp electrophysiology, a technique in which researchers use small electrodes to investigate the characteristics of individual neurons and pairs of neurons in fine detail. Because the new cells were labeled with fluorescent tags, postdocs Czupryn, Zhou, and Chen could easily locate them.

The Zhou and Anderson team found that the newly developed neurons communicated to recipient neurons through normal synaptic contacts, and that the brain, in turn, signaled back. Responding to leptin, insulin and glucose, these neurons had effectively joined the brain’s network and rewired the damaged circuitry.

“It’s interesting to note that these embryonic neurons were wired in with less precision than one might think,” Flier said. “But that didn’t seem to matter. In a sense, these neurons are like antennas that were immediately able to pick up the leptin signal. From an energy-balance perspective, I’m struck that a relatively small number of genetically normal neurons can so efficiently repair the circuitry.”

“The finding that these embryonic cells are so efficient at integrating with the native neuronal circuitry makes us quite excited about the possibility of applying similar techniques to other neurological and psychiatric diseases of particular interest to our laboratory,” said Anderson.

The researchers call their findings a proof of concept for the broader idea that new neurons can integrate specifically to modify complex circuits that are defective in a mammalian brain.

The researchers are interested in further investigating controlled neurogenesis—directing growth of new neurons in the brain from within—the subject of much of Macklis’s research as well as Flier’s 2005 paper, and a potential route to new therapies.

“The next step for us is to ask parallel questions of other parts of the brain and spinal cord, those involved in ALS and with spinal cord injuries,” Macklis said. “In these cases, can we rebuild circuitry in the mammalian brain? I suspect that we can.”

This study was funded by the National Institutes of Health, the Jane and Lee Seidman Fund for Central Nervous System Research, the Emily and Robert Pearlstein Fund for Nervous System Repair, the Picower Foundation, the National Institute of Neurological Disorders and Stroke, Autism Speaks, and the Nancy Lurie Marks Family Foundation.

Hms.harvard.edu [en línea] Boston (USA): hms.harvard.edu, 15 in December of 2011 [REF. 28 November of 2011] Available on Internet:

http://www.focushms.com/features/rebuilding-the-brain%E2%80%99s-circuitry/

 



'Teleapoyo' for athletes

12 12 2011

Teskal (www.teskal.com) It is a computer application that comes to mitigate the so-called 'solitude of the athlete'. How much better is a, more time passes away, and few people can afford the luxury of traveling with an Entourage of psychologists, coaches and others. This tool helps them receive sports advice and psychological online wherever they are. María Palacios has detailed its development and validation in a thesis presented at the UPV/EHU, entitled “Psychosocial aspects applied to training in young athletes through new technologies”. Validation of the, also, ECHO will soon be the International Journal of medicine and science of physical activity and sport. Research of palaces is an encounter between the psychology of sport, education and information and communication technologies (ICT). It has its origin in the workplace of the author: "Working in a sports consulting firm" (Iceberg). Until I went, they worked with Sifolito, a program of sports and psychological counselling in which, through questionnaires on paper, they had interviews with athletes, collecting data from your state... We realized that as athletes travel a lot, was necessary to computerize all this; "develop Sifolito through new technologies". Something had apparently never before done in Sport Psychology: "We have not found anything so".

From Sifolito to Teskal

Teskal has been developed on the basis of the same objectives and methodology that Sifolito, the original program. I.e., It is to optimize the performance of the athlete, response capabilities psychosocial aspects, such as motivation, mood, anxiety, emotional control, decision-making processes, the display, self-efficacy, the concentration and psychological tolerance. Palacios was asked what could offer ICT in this area, and it has detected and covering the needs of athletes, coaches and psychologists, up to Teskal, the final application. Explains the researcher that this web application has had a high degree of acceptance, irrespective of the sex of the athlete or the type of sport that practices (both individual and collective). Part of this success could be that it is very easy to use, Since Palacios has used the model of the engineered the usability and accessibility (MPIu a). "Software that is developed is not centered in the computer itself", but that gives more importance to users, "so that the application is easy to understand and remember its use in simple way", explains.

Reliable

Also, the researcher has validated two computerized questionnaires. They are used to study the mood and anxiety, respectively; issues with an impact on athletic performance. The variables of these two questionnaires have yielded consistent results throughout the validity study, carried out on a sample of more of 200 athletes in each case. It is therefore, the computerised version (Teskal) the questionnaires from the original program (Sifolito) shows be reliable. The validation phase has served, at the same time, to verify that there is a close relationship between mood and anxiety: "We have seen that anxiety variables correlated positively with the dimensions of mood" (the voltage, depression, the hostility and fatigue), "and in a negative way with the force". Anyway, It emphasizes that more thorough investigation is required in that regard. Given the positive results thrown by Teskal, Palacios said that coaches be offers a rigorous tool to identify strengths and weaknesses of athletes, and, based on them, propose personal training plans. In addition, You can track the custom, at the same time it allows to be applied to large samples of athletes, overcoming the barriers of space and time. In fact, Teskal already applies in practice. "Not just here", "it continues improving", says Palacios.

About the author

Maria E. Palacios Moreno (Arnedo, La Rioja, 1980) He is a computer engineer by the UPV/EHU. He has written the thesis under the direction of Silvia Arribas Galarraga and José Antonio Arruza Gabilondo, Director and Professor, respectively, of the Department of Didactics of Musical expression, Plastic and body of the UPV/EHU. Also, the thesis has been defended in the same Department, in the College of teachers in San Sebastián. Today, Palacios is a computer engineer in Iceberg S.L sports Advisory Group., company r & d dedicated to counseling of athletes. In fact, It has carried out the thesis in collaboration with the company and with the Ikerki research group 05/30 University of the BASQUE country, orientado a la investigación en el área de la actividad física y el deporte.

Basqueresearch.com [en línea] Basque country (Spain): basqueresearch.com, 12 in December of 2011 [REF. 12 November of 2011] Available on Internet:

http://www.basqueresearch.com/berria_irakurri.asp?Berri_Kod=3641&hizk=G



Alexander Tsiaras: from conception to birth

8 12 2011

Alexander Tsiaras He is an artist and an engineer whose job is to explore the unseen body. It has developed a capable scientific visualization software of “Paint” Human Anatomy based on three-dimensional data. He is the author ofBody Voyage and co-author of Information Architects. More recently, He is the author of From Conception to Birth: To Life Unfolds and The Architecture and Design of Man and Woman: The Marvel of the Human Body, Revealed.

His latest project is The Visual MD, a compendium in displays of health line.

[Ted id = 1270]

Ted.com [en línea] New York (USA): ted.com, 08 in December of 2011 [REF. November of 2011] Available on Internet:

http://www.ted.com/talks/alexander_tsiaras_conception_to_birth_visualized.html



How bioprinting works

5 12 2011

Bioprinting, or making living tissue with a three-dimensional printer, is a relatively new field. Because no one has come up with a perfect process, every group of scientists uses a slightly different method. Jonathan Butcher’s lab at Cornell University focuses on aortic valves, hoping to someday print replacement valves for children with heart disease.

Take an image

An MRI or CT scan or other 3-D image provides the exact dimensions of the tissue that is being replaced. Ideally the tissue will fit so well that the surgeon who implants the tissue will need to do very little, if any, modification.

Generate a blueprint

Computer design software uses the image to generate a detailed, layer-by-layer file that tells the printer where to place each type of cell material. To avoid reproducing defects, an expert may need to tweak the file before printing.

Make the “ink”

Living cells — ideally the patient’s own — are mixed into cell-friendly material, such as collagen, that will make a scaffolding for cells to grow on. The type of cells depends on what they need to do (muscle cells, blood vessel cells, etc.). Scientists can include environmental cues that encourage the cells to do certain things, such as prompting fibrous tissue to attach to muscle.

The first bioprinters were jury-rigged desktop inkjet printers. Now, some labs use machines, made specifically for bioprinting, that cost up to $300,000. Cornell labs make multipurpose 3-D printers, which cost about $2,000, and modify them for bioprinting.

How bioprinting works

Bioprinting, or making living tissue with a three-dimensional printer, is a relatively new field. Because no one has come up with a perfect process, every group of scientists uses a slightly different method. Jonathan Butcher’s lab at Cornell University focuses on aortic valves, hoping to someday print replacement valves for children with heart disease.

How bioprinting works in his lab:

Print

The printer deposits the living cell material in thin layers of usually 1/2 mm or less, although different nozzles can deposit larger or smaller amounts depending on the tissue being printed. The material comes out of the nozzles as viscous liquid, about the consistency of gel toothpaste.

Solidify each layer with UV light

Each layer starts as a liquid, but the tissue needs to firm up and hold its shape before more layers land on top. This blending and solidifying is called crosslinking. Butcher’s lab uses ultraviolet light to promote crosslinking because it works almost instantly. Other labs use heat or chemicals, which require more time between layers.

Incubate the new tissue

Scientists hope to be able one day to print some types of replacement parts directly into patients’ bodies. For now, tissues must spend a few weeks maturing in a type of incubator called a bioreactor. It does a sort of test drive, pushing blood through a heart valve, for example, or stretching muscle fibers, or sending fluid through a liver.

When will humans get bioprinted parts?

No bioprinted products have been put into human trials yet, but some are much closer than others. Several experts in the field helped compile this very loose timetable:

Washingtonpost.com [en línea] Washington (USA): washingtonpost.com, 05 in December of 2011 [REF. 10 in May of 2011] Available on Internet:


Experto anima a científicos y médicos a usar las redes sociales “en beneficio de sus pacientes”

1 12 2011

The director of the Centre for Global eHealth Innovation of the University of Toronto in Canada, Alejandro Jadad, encourages physicians and researchers to use social networks in their daily practice and, Although it considers that they are “the source of most important knowledge that may face, regrets so far “them are not knowing leverage for the benefit of patients”.

Dr. Jadad advocates by “redefine the role of physicians and researchers” in a society where technology changes so “frightening but exciting”, says.

In addition, It has encouraged his colleagues to use some platforms like ‘ Facebook ’, where warns that “There are more than 600 groups that discuss breast cancer”. “People go there because you have symptoms, they want to share experiences, but no one gives answers”, complains.

In the same way, recognizes that “If you share the information from studies on the network, ‘ Wikipedia’ It could be the place where to find the best available information on cancer”.

Dr. Jadad was a pioneer in responding to a medical consultation via e-mail at 1991 “and at the request of the patient”. Since then, asegura “prescribe” videos, make queries by ‘ Skype ’, and “animate” their patients to use e-mail to communicate with, something that “they have never abused”, asegura.ensures

Despite all, It recognizes that these changes in the doctor-patient relationship pose an ethical dilemma for practitioners by the institutions themselves both on a personal level. “When a patient asks me friendship in ‘ Facebook ’, my hospital says it will not accept, my insurer also, but at the end I just accepting, because my mission as a physician is to relieve their suffering”, Express.

Dr. Jadad has concluded his presentation by recalling those doctors who have paid close attention to the battle against the disease, the diagnostico-cura model, but they have forgotten to learn patient. “There is to do things with patients, not for patients”, asserts.

Telecinco.es [en línea] Madrid (Spain): teTelecinco.es01 in December of 2011 [REF. 29 November of 2011] Available on Internet:

http://www.telecinco.es/informativos/sociedad/Experto-cientificos-sociales-beneficio-pacientes_0_1513649290.html