Do you already not discovered new medicines?

31 05 2012

A few decades ago the industry pharmaceutical developed countless tablets to reduce blood pressure, controlling glucose and cholesterol in the blood and prevent infections.

 

Today, very few medicines seem to go to market.

And it is that produce and take a new drug to the clinic might cost $1 billion and is a process which can take more than 15 years.

The industry is facing multiple crises, budgets increasingly reduced and huge scientific challenges.

Is this the end of the new pharmaceutical discoveries?

Margaret Chan, Director of the World Health Organization, He recently warned that the world is leading to a “was post-antibioticos” and that you will come the moment that many of the most common infections already not may be cured.

This is due to the growing resistance to antibiotics currently available.

And as the population ages, scientists struggle to find forms — and drugs- to combat the growing epidemic of nerve diseases such as Alzheimer's and Parkinson's.

Apparently, the old model of drug development is already not working.

This method, in which industry committed huge amounts of money to try to find a drug that could treat to enormous proportions of the population - and generate “mountains” cash to cover other losses- You can no longer sustain the industry.

 

Huge vacuum

The model is inefficient. In nine of each 10 sometimes, molecules that show promise in the early stages fail in more advanced trials.

Another great pressure for pharmaceutical is when the patents on some of their most lucrative drugs expire.

And is becoming more difficult for scientists to find the white suitable for a chemical compound.

As explained by Professor Chas Bountra, expert in translational medicine at the University of Oxford, “We have failed to understand enough about human diseases or enough above how Act existing compounds”.

“If we don't understand that, We can not design molecules superior and better”.

Another problem, Adds, It is the process of duplication in the development of a drug.

“We tend not to publish our failures, or if we publish them, do it too late”, expresses the Professor Bountra.

“As a result, other academics and other companies that are working on the same goal, continue wasting resources and careers and exposing patients to molecules that have the possibility of failure”.

El proceso para producir un nuevo fármaco puede demorar hasta 15 años.

The process to produce a new drug may take up to 15 years.

Open industry

Professor Patrick Vallance, President of pharmaceutical research and development by GlaxoSmithKline (GSK) He believes that the industry is every more open.

“One of the things we have done is to be very open about compounds that they go to the clinic”.

“We publish our results and make available our protocols for scientific review when we deliver our studies”.

“Such things help to a better visibility of what is being” Adds.

But at the same time, argues, “We have to be realistic”.

“There will always be some degree of duplication because this is part of the competition”.

For its part, Professor Paul Workman of the Institute of Cancer Research says that there is another important issue.

“With the problems of the financial crisis has developed a kind of vacuum that many describe as 'Valley of death'” says.

“It is the Valley between basic research and innovation, on the one hand, and the benefit of the patients and commercial success, on the other hand”.

“With a huge division in the middle which shows a lack of investment and many failures”.

 

Collaboration

A possible solution, experts believe, is that charitable foundations, as the Wellcome Trust, investment offered to fill the division.

The Workman Professor believes that the most successful model is the one where many processes for the discovery and development of a drug takes place under one roof.

This should work with the Association of small and large companies, mainly in the later stages of development.

And scientific advances, Adds the expert, they are also allowing for the possibility of new pharmaceutical discoveries.

“Science is moving away from the old model of pharmaceutical production: toward personalized medicine”.

“With this you can identify the patient that will benefit from compound determined by subjecting it to a genetic test”.

“It will thus benefit a small number of patients but will benefit extremely well” Adds.

The collaboration, experts say, It is the key to future success in the pharmaceutical field.

In particular the cooperation in the early stages of the development of a drug.

As Professor Vallance, the largest competition will be in the final stages of a drug.

“There will be a fierce competition to be the first to get the best medicine, to make sure that we are doing a proper trial and that we can prove that we we get the best medication” expresses the Professor Vallance.

Bbc.co.uk [en línea] London (UK): bBBC.co.UK 31 de mayo de 2012 [REF. 27 in May of 2012] Available on Internet: http://www.bbc.co.uk/mundo/noticias/2012/05/120523_descubrimiento_nuevos_medicamentos_men.shtml



E-health and development

28 05 2012

Maria Cristina Rosas

Professor and researcher at the Faculty of political science and social of the UNAM. mcrosas@tutopia.com

Advances in medical science have helped to improve the quality of life of millions of people around the world. A quick look at the evolution of the longevity of persons corroborating: in 1900, the hope of life on the planet was only 31 years and even, among the inhabitants of the more developed countries not lasted beyond the 50 años; in the mid-20th century had already raised, in promediomientras than in, a 48 años, While in 2005 came to the 65.6 años, and to the 80 in some nations such as Japan. It is estimated that in 2030 the life expectancy of women in countries such as United States wilyearse to 85 años.

Other accomplishments that exemplify the benefits of scientific research applied to medicine include the eradication of smallpox; the virtual elimination of leprosy; the reduction of polio cases with a view to its complete abolition in the coming years and the possibility of reducing in 40% the death of children under the age of 5 years in the following five years.

With everything, much remains to be done. This year will die 10 millions of children before their fifth birthday because of any infectious disease that could be prevented. Of the 136 millions of babies that are born each year, 4 million die before the first month of life. Also, a few 70 millions of moms and babies are excluded from the health systems in the world. Another daunting figure is that 530 thousand women die during pregnancy, When dan light or shortly after childbirth, year after year. To make the scenario more complicated should be noted that as the world population increases their life expectancy, one of the greatest challenges for the health systems of countries is dealing with more cases of non-infectious and chronic diseases of adulthood and aging. It is known that a 24 millions of people suffer from dementia now and every year joined 4.6 millions of individuals with this disease, being in developing countries which have with the 60% of all cases.

To meet these challenges is required, In addition to material resources, qualified personnel in this category there is unfortunately a significant shortage of doctors, enfermeras (os) and support staff. The World Health Organization (WHO) points out that missing a few 4.3 millions of doctors, enfermeranurses others in order to provide health services to all people. Also, prevailing unequal distribution of global health professionals, given that the 30% of the 59 existing million are concentrated in United States and Canada, While in sub-Saharan Africa is only the 4% the doctors and nurses (os) available on the planet, Despite being the region that concentratesI 25% of all existing diseases.

Given the magnitude of the challenges described, needed to improve societies access to health services and it is here where the technologies of information lie in option that could contribute to the strengthening of the well-being and quality of life of human beings.

Telemedicine at the e-health

The e-health has its roots in telemedicine, This is, the practice of health care based on the use of audio communications, video and data, for the purposes of diagnosis, query, treatment, education, and transfer of medical information, among other servicios.1 here the interactions occur doctor doctor, either, from doctor to patient.

The practice of telemedicine is part of telehealth, concept covering all uses of telecommunications, with the help of computer, and that goes beyond the clinical aspects of health care. The concept of telehealth was promoted by who in 1997 (e) involving doctors, Administrators, patients and family and the population in general. As program, Telehealth typically includes remote diagnosis, the teleadministracion, the tele-education, and the General. One of the great advantages that telemedicine and tele-health is its contribution to overcome the distance, so promoting equality of access to services that are not available in remote communities, rural, and even urban, either where the physical coverage, for various reasons, It is not feasible. In this sense, through telemedicine and tele-health seeks to transmit data, voice, images and information rather than physically move patients, health personnel and educators, What would improve, in principle, access, the timeliness and convenience, decreasing, also, travel costs. Is considered that through telemedicine and telehealth, users of health services could become active participants monitor their own well-being with greater ease, Amen that would be able to access educational programmes to foster their knowledge about various health aspects in their daily lives from the comfort, convenience and safety of their own homes or very near. Another aspect to consider is the use of telecommunication among health professionals when they provide health care, or even for purposes of training or other.

As a result of the development of telemedicine and telehealth is the e-health, also known as digital health, concept referred to the use of new technologies applied to the management of health systems. WHO refers to the e-health is defined by the use efficiency and security of the information and communication technologies (ICT) in favour of health and related fields, with a view to contribute to strengthening and improving systems and health outcomes.

WHO also explains that "the e-health can contribute to the strengthening of the health systems of several modes": improving availability, the quality and the use of information and data through the strengthening of health information systems and public health surveillance systems; perfecting health workers and improving their performance, because the obstacles that create distance and time thanks to telemedicine and medical training shall be deleted; improving access to existing global and local information and knowledge; "and promote positive changes in the way of life to prevent and control common diseases."2 It should be noted that the concept of e-health was driven in the World Summit of the of the information society held in Geneva, Switzerland, in 2003.

Priorities and realities

For who, then, the e-health is a priority and therefore from 2005 instituted the Global e-Health Observatory (Global Observatory for eHealth) It seeks to provide the States members of information and guidelines on practices, policies and standards in this area. Whereas at present who has with 194 Members, the scope of this initiative are promising. However, so the cibsersalud fulfill its fundamental purpose, requires, among other things, infrastructure. In this respect, in a survey in 2006, the who found that since he began this century, the e-health has experienced considerable expansion, situation that contrasts with the previous decade, When was its development very slow. With everything, Despite its rapid growth in the new century, There is a correlation between the level of income of the countries and the development of the sector, so the e-health is much more evolved in the richest countries, status alert with respect to another digital divide, This time around a crucial aspect for human life as it is the salud.3

A daily occurrence, When commitments it comes, the great distance between what is promised and what is being done and in the case of the e-health there is a lag both in policy formulation and its management by Governments. A closely related to the above point is the role of Governments as guarantors of the equity and the protection of citizens, the promotion of multilingualism, and aspects such as competitiveness and standardization. This is a relevant issue given that various actors are involved in the e-health, In addition to Governments and societies, for example, the private sector - highlighting the pharmaceutical companies-, whose interests do not share the assumption that health is - or should be - a global public good.

To this must be added because the e-health resting in the information technologies, It should not lose sight that unequal access to the same is, not only globally, but within the same country, for economic reasons, ethnic, education, age, corruption, and so on. This digital gap tends to widen since in many countries has been more emphasis on access to technologies than on competencies that an average person should have to use. Also, the awareness of the need to use new technologies is not developed equally among the members of society, which limits the spectrum of the benefits of the cibsersalud. Suffice it to mention that in the "civilized" and "technologized" European Union, the 30% its population has never used Internet.4

The challenges

Input, the e-health, in its simplest meaning, are you confronted with the - traditional - notion of the relationship between doctor and patient. Therefore it is important for the doctor to explain clearly to the patient during the contact that is set within the framework of the e-health, who has the responsibility to monitor their health and medical care. Supervision of the physician in protocols is necessary, conferences and review of medical history at all times. Also, your doctor should be able to immediately contact technicians who are not physicians and providers and patients. It is equally important that your doctor clarify responsibility for the patient with any other health workers involved in the patient's care. In addition, the legal responsibility of health professionals providing assistance through e-health schemes must be clearly defined by the appropriate jurisdiction and regulations.

The above must be hand of privacy and respect for human rights as fundamental criteria for the exchange of data and electronic medical records within countries and among them. WHO says that effect use increasingly e-health services need a legal and ethical regime that guarantees the protection of data and its private and confidential character. This is a very delicate issue, especially in the light of several actions included in the concept of cyber crime, that you may have, in the field of the e-health, a vein to act with tremendous impunity in the absence of standards and mechanisms that guarantee the security and privacy in the handling of this type of information. Already in the film network warned about the deliberate manipulation of medical studies that led to the Secretary of Defense United States committed suicide.

Another scourge that at least for now exists around the e-health, It is the prevailing lack of coordination among the participating entities. In the European Union, for example, which Brussels has very few powers in health, There is a misuse of human and material resources, every time the tests are repeated, health professionals do not share information, and there is also an evaluation to measure the performance of the sistema.5

The next challenge, already referred, It has to do with the fact that e-health services depend on, to a large extent, collaboration between various actors, including the private sector. It is therefore, partnerships are required to safeguard the rights of persons, serve to provide safe and high-quality assistance and benefit both sides. The who has warned these actors to elaborate principles and frameworks for the management of e-Health Alliance, that facilitate both national cooperation and the international exchange of e-health services, promote research and development in information technologies applied to public health and to encourage the donation of material and programs 6.

As well as there is a deficit in the global health professionals, There is also a lack of skilled human resources in the information in the service of health technologies. As suggested above, information technologies can be used to significantly improve not only the methods of training of professionals of the sector health through specific programmes for e-learning, but also the effectiveness of the services of, especially in areas where there are not enough health workers. Part of the solution to this problem is to incorporate training in the information technology in health education programs, which would ensure at least, that new generations of professionals are aware of, benefit and apply the criteria of e-health in their jurisdictions and areas of action.

In the case of Mexico, where it is necessary to improve the coverage of health services, the e-health already has a biting way that, However, You can improve. Suffice it mention that the Institute of security and social services for State employees (ISSSTE) It already has pilot programs and successful experiences in the field and the usefulness of the e-health is out of the question.

Now well, consider the following: According to the Mexican Institute of Social Security (IMSS), of each 10 consultations of the first level of care provided, seven correspond to the elderly, what refers to the aging of the population and the challenges that this entails for the health system. It is well known, older persons have a decline in their abilities, among them, the lack of memory and reduce their self-sufficiency. In United States, for example, It is known that from the 65 años, una de cada cinco personas desarrolla el llamado mal de Alzheimer, and that after the 85 años, the figure includes one of every two people. This situation makes them dependent, causing strong pressure for relatives. Often the dependant loses his job, is isolated socially, waive recreational activities, you get sick of stress and in extreme cases could die before the person who cares for. This situation can be solved through technological support, so that people who suffer from various conditions that limit their mobility or other capabilities, they could tell, they and their caregivers, medical support at a distance, What would improve their quality of life.

At last, with regard to the issue of infrastructure, It should not lose sight that the e-health requires, among other things, a satellite network, which, in the case of Mexico, is at the limit of their service life - theme addressed in this space makes some months-,7 which greatly reduces expectations for development of this sector - and others, relevant all national life.

Notes

1 Diagnostic and clinical purposes only.

2 World Health Organization (30 in August of 2010), Africa has to adopt and use the e-health, Brazzaville, Organization World of the health/Regional Office for Africa, p. 1.

3 World Health Organization (August of 2006), Establishment of infrastructure for the e-health. Progress made by the Member States, Geneva, WHO Global Observatory for e-health, p. 2.

4 The country (11 in June of 2010), "The digital divide and the coordination", "challenges for the future of the e-health", available at http://elpais.com/diario/2010/06/11/sociedad/1276207206_850215.html

5 Ibid.

6 World Health Organization (1 in December of 2005), E-health: instruments and services offered, Geneva, WHO, p.

4, available in https://apps.who.int/gb/ebwha/pdf_files/EB117/B117_15-sp.pdf

7 Maria Cristina Rosas (26 October of 2010), "México": out of orbit??"in etc", available at http://www.etcetera.com.mx/articulo.php?Article = 5404

Etcetera.com.MX [en línea] Mexico (MEX): etcetera.com.MX, 28 de mayo de 2012 [REF. 21 in May of 2012] Available on Internet: http://www.etcetera.com.mx/articulo.php?Article = 12702



Surgery pioneer restore movement to paralyzed man

24 05 2012

Innovative carried out in United States bypass surgery managed to restore the damage in the spinal cord of an individual with paralysis and allowed them to recover the use of one hand.

The injury that the patient had suffered prevented his brain to send signals of movement to your hand.

Surgical operation, the details of which are published in Journal of Neurosurgery, (Journal of neurosurgery), It involved reconnecting the nerves of the hand so that they could return to communicate with the brain.

Surgeons at the University of Washington School of medicine, that he carried out the procedure, “built” a new communication path of nerve impulses between the hand and the brain.

The patient can now use the hand to feed only and is trying to rewrite.

The individual's 71 years suffered a car accident in June of 2008 that caused an injury to the spinal cord injury at the base of the neck.

The man could no longer walk and although with some movement in his arms, He had lost the ability to pinch in both hands and grip.

Specific injury

As explain the scientists, the nerves of the hand were not damaged, they had just lost the ability to communicate with the brain, which you must give instructions of movement.

Despite the fact that the hand was not receiving signals, the brain was still sending instructions to arm.

The operation, the study says, It reconnected the nerves of the arm to set a new path of communication from the brain to the hand.

To do this, Surgeons extracted one of the nerves that leads to a muscle and grafted to the anterior interosseous nerve, that goes to the hand.

“The circuit (in the hand) It was intact but he was no longer connected to the brain”, the BBC explains Professor Ida Fox, specialist in plastic and reconstructive surgery at the University of Washington.

“What we did was take that circuit and restore the connection to the brain”.

According to researcher, the operation is “truly innovative” and a way “ingenious and stimulating” restore the movement.

But he warns that this procedure cannot never be used to restore the normal functions of movement.

“It will never happen”, says Professor Fox.

The limited movement which was achieved did not occur “overnight overnight”, says researcher.

An intensive training of the patient is required to reacquire the hand control.

And now, the nerves that are used to bend the elbow can perform movements of pinch.

After eight months of operation, the patient could return to move fingers thumb, index and Middle.

Now you already can operate alone and makes use of a write “rudimentary”.

Doctors expect that their movements continue improving with more physiotherapy.

But they stress that the procedure will work only with patients who have very specific lesions of the spinal cord at the base of the neck.

If the lesion is located on a high the person shall have no nerve function in the arms and a lower part still will have movement in your hands.

“One of the problems with this type of techniques is the permanence of the results”, the BBC says the doctor Mark Bacon, Director of research at the Organization Spinal Research.

“Once done it is very difficult to reverse it”.

“And inevitably be must sacrifice some healthy functions on top of the injury in order to obtain more useful movements at the bottom”.

“This may be completely acceptable when we're talking about restoring functions that lead to a better quality of life”.

“And for the limited number of patients who could benefit from this technique seems to be a small price to be paid” says the expert.

Bbc.co.uk/ [en línea] London (UK): bbc.co.uk/ 24 de mayo de 2012 [REF. 16 in May of 2012] Available on Internet: http://www.bbc.co.uk/mundo/noticias/2012/05/120516_cirugia_paralisis_mano_men.shtml



Applications to care for the health of patients

21 05 2012

The Colombian website Enterco recommended five useful apps to help in the diagnosis and measurement of various indicators.

By Hugo Luis Sanchez Gonzalez

General medical

As said Steve Jobs when he introduced the iPhone for the first time, in 2007,"the magic is in the software."Applications are those that allow these devices to be useful for almost everything and for different types and user profiles, and doctors are no strangers to this.

Mobile applications can be useful for practitioners and medical students to streamline processes, provide information in real time, reduce data entry errors and much more.

But remember, any applications or technology is above the medical concepts, These applications should be viewed only as tools that assist them in their work and their concepts are much more accurate and efficient.

ABG.

This application interpret arterial blood gas, one of the elements which are analysed in a blood test. It is useful when you have doubts about the States of acid-base of the human body. It is available in English, is free toiOSandAndroid, and hasa version pays for Androidwhich costs 1,99 $.

APGAR SCORE.

In ancient times, the Apgar score table placed it in thermal cradles for the rapid assessment of the newborn. With this single application is click on the known variables and gives quick value of the score. It is available in English, is free toAndroidand foriOSCuesta 0,99 $.

Glasgow Coma Scale.

This scale is often the headache of some students and emergency physicians. There is always a table attached to the wall in the trauma centers. This application is useful for assessing neurological status of a patient after a trauma, It has an intelligent interface and allows selected as patient to a child or an adult. There are many applications with this scale. The ofAndroidcomes in different languages, including the Spanish, and is free of charge.

Sanford Guide to Antimicrobial Therapy 2011-2012.

Those who know this book will know that having this guide on antibiotics on the smartphone is very useful, because it will bring doubt to any interested party. With multiple search options, always up-to-date with what any of these medicines can be found. ForAndroid, is only available in English, and costs 29,99 $, and foriOSCuesta 360 $.

VisualDx.

Many doctors have trouble recognizing what you see in an image. To exit doubt, VisualDx is a database of images in full color on a large number of disease along with a brief description, so it will be easier to make a diagnosis. It has versions foriOSandAndroid, is in English and is free of charge.

Ehealthreporter.com [en línea] Buenos Aires (ARG): ehealthreporter.com, 21 de mayo de 2012 [REF. 08 in May of 2012] Available on Internet: http://www.ehealthreporter.com/es/Noticia/verNoticia/1115



Spanish researchers tested a therapy to prolong the life

17 05 2012

Researchers at the National Cancer Center (CNIO) they have successfully tested the first gene therapy against the decay of the body associated with aging. For the moment, the ‘ anti-aging therapy’ It has achieved, with a single treatment, prolong the life of mice up in a 24 per cent.

The work, published tomorrow in the journal ‘ EMBO Molecular Medicine ’, It develops a strategy never before used to fight aging, It is a safe and effective treatment - in the animal model-, It acts directly on the genes, but that applies to adult animals, and only once.

Led by the Director of the CNIO, Maria A.. Blasco, and Bruno M. Jesus Bernardes, co-author of the work, in collaboration with Eduard Ayuso and Fatima Bosch, Centre for Animal biotechnology and gene therapy from the Autonomous University of Barcelona (UAB), they tried to adult mice, one year of age; and old, two-year. In both cases the gene therapy had an effect “rejuvenating”, write the authors.

The mice that were treated at the end of the year lived, Media, un 24 por ciento más; of two years, un 1apor per centke this, the therapy would be to achieve the cells express telomerase, the enzyme that ‘ slows down’ the ‘ biological clock ’.

In general, therapy significantly improved the health of animals, delaying the onset of diseases associated with age - such as osteoporosis and insulin resistance- and improving the values of indicators of ageing, such as neuromuscular coordination.

This work “It shows that it is possible to develop anti-aging gene telomerase therapy without increasing the incidence of cancer”, write the authors. “Adult organisms accumulated result of shortening of Telomere DNA damage, This work shows that a gene therapy based on the production of telomerase is capable of repair or delay this type of damage”, added.

TELOMERASE: TREATED AS A VIRUS

The therapy is based on treating the animal with a virus whose DNA has been altered, specifically it has been replaced by the enzyme telomerase, one of the most important genes for the aging. Telomerase repairs the ends of chromosomes, called Telomeres, and in doing so slows the biological clock of the cell and thus the body. The virus, to infect the animal, It acts as a vehicle for that deposited the gene for telomerase in the cells.

Telomeres are structures that protect the ends of chromosomes, but on a limited time basis: with each cell division, the Telomeres are shortened, until they reduce too and already can not play its role. As a result, the cell is no longer divided and aging, or die. This prevents with telomerase, shortening of Telomeres slows or even rebuild them again.

The telomerase gene, However, is only active in most cells before birth; the cells of the adult organism, exceptions, they do not have telomerase. The exception are adult stem cells and the cancer, that they divide without limit and are therefore immortal. Precisely, risk of the development of tumors always had been an obstacle to consider anti-aging therapies based on telomerase.

For this reason, the researchers emphasize that animals of this essay have not developed cancer. Researchers attribute this to the therapy begins when the animals are already adults, and therefore do not have time to accumulate the number of aberrant multiplications necessary for the occurrence of tumors.

The viruses used to carry the telomerase gene to cells derived from other non-pathogens in humans and have no ability to replicate. Therefore are “very safe, widely used in gene therapy with great success in the treatment of Hemophilia and eye diseases”.

VIA THE TREATMENT OF DISEASES

The Monza Virginia researchers, of the second University of Naples, and Utz Herbig, of the New Jersey Medical School-University Hospital Cancer Centre, they have pointed out that this work is first and foremost a “proof of concept that gene therapy with telomerase gene is a strategy that is feasible and generally safe to prolong life in good health and diseases related to the presence of short Telomeres”.

Like this, emphasize that although in the short term its application in humans against aging is not possible, Yes it could open a new avenue to the treatment of diseases related to the presence in the tissues of abnormally short Telomeres, as some cases of human pulmonary fibrosis.

Work through highlights that, Although “ageing today is not considered a disease, more and more researchers tend to see it as the cause of diseases such as cardiovascular disease or insulin resistance, whose incidence increases with age”, Therefore, If it is the ageing of cells is could also treat diseases.

For its part, Bosch said that the discovery “It might be essential for anti-aging therapy, Since any other strategy would require a constant administration of the drug for the lifetime of the patient, increasing the risk of adverse effects”.

 

Nuevatribuna.es [en línea] Madrid (ESP): nuevatribuna.es 17 de mayo de 2012 [REF. 16 in May of 2012] Available on Internet: http://articulo/sociedad/2012-05-16/investigadores-espanoles-prueban-una-terapia-para-prolongar-la-vida/2012051610420700860.html www.nuevatribuna.es/



An electronic retina Returns part of the vision to two patients

14 05 2012

Two blind patients were able to see the light and distinguish shapes thanks to the first trial of a “electronic eye” -a microchip that is implanted in the retina- It was in the United Kingdom.

Both subjects had lost the vision from retinitis pigmentosa, a genetic eye disorder that causes permanent blindness, but weeks after surgery, they were light and forms.

As researchers indicate, both are now beginning to experience “the restoration of a useful vision”.

The scientists of the eye Hospital of the University of Oxford and King ’ s College London claim that these results “they exceed all expectations”.

In the past, other retinal implants also have managed to reverse blindness, But unlike this chip - that allows the patient to detect objects with their eyes- those using an external camera.

Lugar del implante.

Location of the implant.

The new technology, developed by the German company Retina Implant, It works by making the light that enters the eye into electrical impulses that are fed to the optic nerve at the back of the eye.

The aim is to replace the cells of the retina that lost individuals who suffer from diseases such as retinitis pigmentosa.

The small microchip, It is implanted under the retina, contains 1500 microscopic electronic light detectors.

The optic nerve is able to pick up electrical signals in the microchip and send them to the brain so that patients can return to experience something of the lost vision.

It works with external power connected to a cable that comes out through the skin behind the ear to connect to a battery.

The implant already has been tested successfully with patients in Germany and this is the first clinical trial in United Kingdom, in which the researchers made some improvements over the previous test.

Vista por rayos X de la poisición del chip y el cable que conecta a la unidad de control.

View x-ray of the poisicion of the chip and the cable that connects to the control unit.

“What makes it unique to this technology is that all the functions of the retina are integrated into the chip”, Explains Professor Robert MacLaren, who directs the study.

“You have 1500 small diodes and electrodes light sensors that stimulate the nerves overlying to create a pixelated image”.

“Apart from a device similar to a hearing that is placed behind the ear, Nothing would indicate that the patient has a retina implant”, Adds the researcher.

Impact “deep”

One of the patients, Chris James of 54 years, He began losing night vision when he was little more than 20 years and was diagnosed with retinitis pigmentosa.

After the operation, described as a “magic moment” When the implant was lit for the first time and he could see light.

“When I was a Flash of light in the eye I confirmed my optic nerves were working properly, This is a very promising sign”, says Chris.

“It was as if someone took a picture with flash, a pulsating light, I recognize instantly”, Adds.

“I can now see a curved or straight line near, far away things are more difficult to. But it is too early and I have yet to learn to interpret the signals which sends the chip to my brain”.

The chip does not work as the conventional view. Signals sent to the brain are flashes of light and not is a vision in colour but in black and white.

As pointed out Professor MacLaren, for a person with normal vision these results may not seem extraordinary.

But for someone who has completely lost his sight, to be able to orient in a room or know where are the doors and Windows is something “extremely useful and practical”.

“We are very excited about these initial results. The vision is different than usual and requires a different type of brain processing”, says researcher.

“We hope, However, electronic chips can provide independence to people who are blind from retinitis pigmentosa”, Adds.

Professor Timothy Jackson, Ophthalmic surgeon of the King ’ of College, who also directs research, says that “This pioneering treatment is still in its early stages of development”.

“But it is an important and exciting step and can eventually lead to a great improvement in the quality of life of people who have lost the view by retinitis pigmentosa”.

“Most of these patients have lost vision by years or decades. The impact to see again, even if it is not a normal view, It can be deep and very moving”, Adds the scientist.

Now researchers hope to carry out a broader test with a 12 British patients who will be subject to the implant. (BBC)

A7.com.mx [en línea] Merida (MEX): aA7.com.MX 14 de mayo de 2012 [REF. 09 in May of 2012] Available on Internet: http://a7.com.mx/vida/salud/11903-ciegos-vuelven-a-ver-gracias-a-retina-electronica.html



UK trial for portable brain-cooling device

10 05 2012

A trial has begun of a portable brain-cooling device which could enhance the survival prospects of cardiac patients.

The Rhinochill machine is a portable device which cools the brain via tubes placed up the nose

The Rhinochill machine is a portable device which cools the brain via tubes placed up the nose

Ground-based cars in the service of the charity London’s Air Ambulance are the first in the UK to carry the Rhinochill machine.

Larger brain-cooling devices are already used in UK hospitals on cardiac and stroke patients to aid recovery.

But cooling the body earlier in the field, during resuscitation, could save more lives, early research suggests.

“We know quite well that if you’re cooled after your heart attack, it can not only mean that your chances of surviving are greatly increased, but your chances of surviving without brain damage are too,” Dr Richard Lyon, a registrar with London’s Air Ambulance, told BBC News.

“For the last 10 years or so, the big thrust has been to cool you as quickly as possible, but usually after you get delivered to hospital, after your heart has been restarted.

“What we’re doing is bringing everything much further forward – starting this brain-cooling process while CPR is still being carried out in the field.”

So far, the team have used the machine five times, with funding for 20 patients over the next year. The money for the trial has been awarded by the College of Emergency Medicine.

The device, made by California-based company Benechill, works by delivering a cold current of air up the nostrils via tubes, cooling the brain and body.

Animal research suggests cooling the brain earlier could have a major impact on survival and recovery prospects for patients.

The machine is being carried by the Physician Response Unit, a vehicle dubbed the “cool car”, which operates during daytime hours and responds to trauma and cardiac emergencies across the capital.

“Essentially, it’s a very small unit which contains a fluorocarbon liquid. You plug the thing into an oxygen cylinder which then vaporises this liquid and the vapour comes out of the end of two nasal cannulai,” explained Dr Lyon.

“We put two tubes into the back of the nose, about half an inch from the brain, and this cold spray which comes out at about four degrees cools the inside of your nasal cavity very rapidly and that cools the brain.”

The brain-cooling unit will be used by the paramedics and doctors in conjunction with defibrillation and cardiopulmonary resuscitation (CPR).

“Someone’s got to be doing CPR – and we often use a mechanical device to do that – someone’s got to be putting a tube into the lungs and someone’s got to work the defibrillator, and then there’s the cooling nasal spay,” he said.

Commenting on the study, Dr Gareth Davies, medical director and chairman of the trustees of London’s Air Ambulance, said: “London’s Air Ambulance prides itself on delivering medical innovation to increase the survival and recovery of its patients.”

 

Bbc.co.uk [en línea] London (UK): BBC.co.UK, 10 de mayo de 2012 [REF. 02 in May of 2012] Available on Internet: http://www.bbc.co.uk/news/health-17869134



Dr. MONTEAGUDO: Prospects for innovation in telemedicine

7 05 2012

José Luis Monteagudo Peña

jlm@ISCIII.es

Head of the unit for telemedicine and e-health

Instituto de Salud Carlos III

In recent years an intense r & d activity has occurred in the area of telemedicine, directed to the development of applications to support innovative models of care for people with chronic health conditions such as hypertension, heart failure, chronic obstructive pulmonary, asthma, Diabetes, cancer, dementia and other ailments [1]. The aim is to implement new models of care most appropriate and effective for the maintenance of health in everyday living conditions, avoiding serious complications and the need for hospital admissions and emergency services. Prevent or delay as much as possible the situation of dependence with attention to pluripatologicas situations that are the most frequent is a growing priority.

The efforts have resulted in a long collection of pilots and demonstrators of telecare and telehealth solutions. Deserve attention because of their relevance in the U.S. Veterans Administration case with 51.000 patients [2] and the "Whole System Demonstrator" of the British Department of health [3] with 6.200 patients is being planned for the future with the program of "3 million lives" [4].

Fig. 1.- The Airmed system (Instituto de Salud Carlos III.y Hospital.U. Puerta de Hierro) He was a pioneer in the development and evaluation clinic systems of mHealth for support of new models of care for people with chronic conditions .

In this context, technological advances are fueling today a new generation of systems of personal and ubiquitous telemedicine based on the convergence of the fourth generation mobile technologies (4G);the terminals of the tablets and smartphones;social networks and personal biomedical devices.  You can talk of telemedicine in the post-PC era already announced Steve Jobs with the birth of the tablets. In fact the proposals of health mobile (mHealth) they are now in full swing.  At the beginning of 2012 are they accounted for more than 33.000 applications for smartphones covering a wide range of proposals [5]. Some developments may seem simple innovations such as calorie meters, Pulse meters, etc. . However there are pre examples of a profound change in the health of the future. Serve as an example of a portable system analysis of tumor cell markers from tissue samples obtained by puncture, you using a sensor that is actually a device connected to a smartphone miniature nuclear magnetic resonance, It is able to determine the chemical structure of organic molecules by radio frequency. [6] This type of evidence currently require tissue samples obtained by biopsy needles 2 mm. diameter in specialized environments and must wait several days for the results of pathological anatomy. The new scanner can detect standard tumor markers with much smaller specimens with fine needles of 0,5 mm in diameter. In addition, results are available in just 30 minutes. According to its developers, the system serves, for example, check the evolution of a treatment of chemotherapy and adjust treatment as cancer progresses. A key aspect is that you can use in a doctor's Office or at home instead of the hospital patients. The "smartphone" facilitates a user-friendly interface with the doctor and the possibility of communication with a specialist for teleconsultation. This type of innovation in telemedicine are spreading to many other diseases and processes, paving the way to a deep transformation of health care as we know it today.

Certainly much of the attention is planning today to smartphones and tablets terminals and biomedical devices that connect them. However, in our opinion the most innovative potential for the future lies in social networks, particularly the mobile social networking with the application of methodologies of dynamical cognitive systems. It is to respond to the need for systems increasingly more complex capable of supporting a large number of users who require more personalized services that are provided on the basis of the context information obtained from the users themselves.

[1] (C). H. Salvador (Coord.) Innovation ICT for older people. Situation, Requirements and solutions for the Integral care of the chronicity and dependency.Edit. Vodafone Foundation. 2011 ISBN: 84-934740-6-1.

[2] http://www.va.gov/health/NewsFeatures/20110816a.asp

[3]http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_100946

[4] http://www.3millionlives.co.uk/

[5]http://www.iphonehealthapps.net

[6] P. Patel IEEE Spectrum. March 2011



Medical technology with human touch

3 05 2012

Computers, smart phones and tablets are more frequent among U.S. physicians. The balance between looking at the screen and the patient requires training.

 

Un actor se hace pasar por paciente para los médicos de la Universidad Georgetown

An actor pretends to be patient for the Georgetown University doctors

Gregory Shumer medicine student analyzes the health history of the patient on the screen of a laptop, and closer to the old man sitting in the examination sheet. "There you go", said pointing to the screen. The weight, the blood sugar and cholesterol were too high.

Although the patient confessed not being too short-sighted to see figures, He acknowledged that he neglected his health after the death of his wife. Schumer set aside the computer view to have a friendly conversation, exactly the objective of the new programme of training of Georgetown University, of United States.

As the country moves towards a medicine without papers, doctors are dealing with a rare challenge: How to use computers?, smart phones or tablets in the Office without losing the human contact with patients? Are electronic devices a help or a distraction??

"This is the tension that I have every day", says Vincent WinklerPrins, doctor in Georgetown. The Faculty of medicine is developing a program to train new doctors in this balancing act and actors like patients used to point out the pitfalls.

An iPad by doctor

Georgetown University, medical students take a full instruction iPad: "Looking in the eyes of the patient", excuse you to check the screen and use it only when need it, They point out the guidelines of Stanford. AND, of course, "nothing of use the internet for personal issues against a patient".

"The potential of these devices to improve clinical care is tremendous", says Dr. Clarence Braddock, Stanford. The doctor uses a secure application on your iPad to get tables of patients to call at any time, No matter wherever you are.

Braddock helped develop standards of Stanford, understanding that there are different obstacles. Middle-aged doctors perhaps are less comfortable with technology and take more time with them. But young people who grew up by sending text messages while making other tasks, perhaps not realize the intrusive patients can be considered devices.

But it is not only a matter of manners. If the doctors spend too much time typing or looking at a screen, one will wonder if there will be a symptom that overlooked.

"If the screen is far from the patient", they don't know if you're watching your electronic health record, "playing solo or looking for investment", says Dr. Glen Stream of family physicians American Academy. As a long time user of computerized records, sure their patients show what you are doing, especially when can the images on the screen help you better understand your health status.

Electronic health records, or HES, they are considered the future of health care for a good reason: they can help prevent medical errors. For example, systems can alert if doctors are about to prescribe a drug that interacts badly with another patient already take.

And while these computerized tables become more sophisticated, They also have the potential to encourage a more efficient care: It will not be necessary to remove new x rays because he forgot to bring his latest resonance, the doctor will be able to see digitally.

A third of doctors in United States using the HES, almost double compared with 2008, According to a report this month in the journal Health Affairs.

Sick actors

A group of actors met recently in Georgetown to play the role of an elderly diabetic seeking to meet for the first time after the death of his wife.

WinklerPrins I saw everything from an external monitor while the students carried out a medical visit of 15 minutes. They used electronic records while they gave to each actor-paciente test results, they taught them a treatment and sent an electronic prescriptions to the Pharmacy.

Then, the "patients" offered valuable feedback. One was upset because your prospective doctor is distracted by the electronic prescription and continued to do the same question instead of ask a minute. Students recognize the value of electronic records, but also how easy that can be distracted with the clicks and movements on screen.

"When you have the machine", I can be less staff, "but my notes are more meticulous", Schumer told his teacher. "It is easier to have a relationship when the computer is not". Luckily, the systems will be less estorbosos, said WinklerPrins. "While", "we do not lose focus on the patient".

Elobservador.com.uy [en línea] Montevideo (UY): elobservador.com.uy, 03 in May of 2012 [REF. 28 April of 2012] Available on Internet: http://www.elobservador.com.uy/noticia/223088/tecnologia-medica-con-toque-humano/