Chequeos de Salud: ¿reducen la morbimortalidad ligada a enfermedades?

31 12 2012

BMJ has published a systematic review and meta-analysis Cochrane on checkups (reviews) General in healthy adults that you intend to reduce morbidity and mortality linked to diseases.

The authors, of the Nordic Cochrane Centre in Copenhagen, were raised as aim to quantify the benefits and risks of these checkups, especially attending relevant outcomes for patients, morbidity and mortality, instead of being limited to the results in variables subrogated as the learn or blood pressure.

Were reviewed 16 randomized clinical trials. The results of the review: No beneficial effects of general health checkups on morbidity were found, hospitalization, disability, concern, additional medical visits or work absenteeism, but not all studies reported on these results. One trial found that these checkups resulted in an increase of the 20% in the total number of new diagnoses per participant for six years, in comparison with control group, as well as a greater number of people who regard themselves as affected by chronic diseases; one trial found a higher prevalence of hypertension and hypercholesterolemia. Two of four studies found a greater use of antihypertensive drugs. Two of four trials found small beneficial health effects autopercibida which could be due to a bias.

The authors conclude that General checkups of health in adults did not reduce the morbidity or mortality, neither general nor for cardiovascular causes or cancer, While it increased the number of new diagnoses. With frequency, important adverse outcomes for patients who undergo these checks or are not studied or not reporting them in the published results.

This type of General checkups can discover alterations such as blood pressure or cholesterol figures high, What are risk factors for diseases, but in themselves do not produce symptoms and go unnoticed by the affected. Hence it is deduced that the regular health checkups, to disclose risk factors and early diagnose treatable diseases, they would be in a decrease in morbidity and mortality. The results of this review, with a high level of evidence for overall mortality and cancer, and with a level of evidence moderate to mortality due to cardiovascular causes, they reveal that such benefits do not occur in reality.

There is evidence that produced those checkups iatrogenesis. People who do not suffer from symptoms or some signs, they spend after the discoveries of these reviews to be considered sick, often chronic, with the psychological impact and in their quality of life that this implies. Many have treatments that are subject, and some very serious and even fatal, adverse effects. Both treatments and the cascade of new diagnostic tests and control that is subjected to these people represent an expense and a very important resource consumption. Resources whose consumption, in the light of the results of this review, It does not produce health benefits but problems, and that could have been used in other well-known benefits activities.

Krogsboll LT, Jørgensen KJ, Gronhoj C Larsen, PC problems. General healthchecks in adults for reducing morbidity and mortality from disease: Cochranesystematic review and meta-analysis.

BMJ. 2012 Nov 20;345:e7191. DOI: 10.1136/bmj.e7191.

Publicado por Jesús Palacio

Sano-y-salvo.blogspot.com.es [en línea]  (ESP): sano-y-salvo.blogspot.com.es, 19 de diciembre de 2012 [REF. 19 in December of 2012] Available on Internet: http://sano-y-salvo.blogspot.com.es/2012/12/chequeos-generales-de-salud-en-adultos.html



Woman with Quadriplegia Feeds Herself Using Mind-Controlled Robot Arm

27 12 2012

PITTSBURGH, Dec. 16, 2012 – Reaching out to “high five” someone, grasping and moving objects of different shapes and sizes, feeding herself dark chocolate. For Jan Scheuermann and a team of researchers from the University of Pittsburgh School of Medicine and UPMC, accomplishing these seemingly ordinary tasks demonstrated for the first time that a person with longstanding quadriplegia can maneuver a mind-controlled, human-like robot arm in seven dimensions (7(D)) to consistently perform many of the natural and complex motions of everyday life.

In a study published in the online version of The Lancet, the researchers described the brain-computer interface (BCI) technology and training programs that allowed Ms. Scheuermann, 53, of Whitehall Borough in Pittsburgh, Pa. to intentionally move an arm, turn and bend a wrist, and close a hand for the first time in nine years.

Less than a year after she told the research team, “I’m going to feed myself chocolate before this is over,” Ms. Scheuermann savored its taste and announced as they applauded her feat, “One small nibble for a woman, one giant bite for BCI.”

Jan Scheuermann, who has quadriplegia, brings a chocolate bar to her mouth using a robot arm she is guiding with her thoughts. Researcher Elke Brown, M.D., watches in the background. Click the photo to download it in high resolution. Photo credit: "UPMC"

“This is a spectacular leap toward greater function and independence for people who are unable to move their own arms,” agreed senior investigator Andrew B. Schwartz, Ph.D., professor, Department of Neurobiology, Pitt School of Medicine. “This technology, which interprets brain signals to guide a robot arm, has enormous potential that we are continuing to explore. Our study has shown us that it is technically feasible to restore ability; the participants have told us that BCI gives them hope for the future.”

In 1996, Ms. Scheuermann was a 36-year-old mother of two young children, running a successful business planning parties with murder-mystery themes and living in California when one day she noticed her legs seemed to drag behind her. Within two years, her legs and arms progressively weakened to the point that she required a wheelchair, as well as an attendant to assist her with dressing, eating, bathing and other day-to-day activities. After returning home to Pittsburgh in 1998 for support from her extended family, she was diagnosed with spinocerebellar degeneration, in which the connections between the brain and muscles slowly, and inexplicably, deteriorate.

“Now I can’t move my arms and legs at all. I can’t even shrug my shoulders,” she said. “But I have come to the conclusion that worrying about something is experiencing it twice. I try to dwell on the good things that I have.”

A friend pointed out an October 2011 video about another Pitt/UPMC BCI research study in which Tim Hemmes, a Butler, Pa., man who sustained a spinal cord injury that left him with quadriplegia, moved objects on a computer screen and ultimately reached out with a robot arm to touch his girlfriend.

“Wow, it’s so neat that he can do that,” Ms. Scheuermann thought as she watched him. “I wish I could do something like that.” She had her attendant call the trial coordinator immediately, and said, “I’m a quadriplegic. Hook me up, sign me up! I want to do that!”

On Feb. 10, 2012, after screening tests to confirm that she was eligible for the study, co-investigator and UPMC neurosurgeon Elizabeth Tyler-Kabara, M.D., Ph.D., assistant professor, Department of Neurological Surgery, Pitt School of Medicine, placed two quarter-inch square electrode grids with 96 tiny contact points each in the regions of Ms. Scheuermann’s brain that would normally control right arm and hand movement.

“Prior to surgery, we conducted functional imaging tests of the brain to determine exactly where to put the two grids,” she said. “Then we used imaging technology in the operating room to guide placement of the grids, which have points that penetrate the brain’s surface by about one-sixteenth of an inch.”

The electrode points pick up signals from individual neurons and computer algorithms are used to identify the firing patterns associated with particular observed or imagined movements, such as raising or lowering the arm, or turning the wrist, explained lead investigator Jennifer Collinger, Ph.D., assistant professor, Department of Physical Medicine and Rehabilitation (PM&R), and research scientist for the VA Pittsburgh Healthcare System. That intent to move is then translated into actual movement of the robot arm, which was developed by Johns Hopkins University’s Applied Physics Lab.

Two days after the operation, the team hooked up the two terminals that protrude from Ms. Scheuermann’s skull to the computer. “We could actually see the neurons fire on the computer screen when she thought about closing her hand,” Dr. Collinger said. “When she stopped, they stopped firing. So we thought, ‘This is really going to work.’”

Within a week, Ms. Scheuermann could reach in and out, left and right, and up and down with the arm, which she named Hector, giving her 3-dimensional control that had her high-fiving with the researchers. “What we did in the first week they thought we’d be stuck on for a month,” she noted.

Before three months had passed, she also could flex the wrist back and forth, move it from side to side and rotate it clockwise and counter-clockwise, as well as grip objects, adding up to what scientists call 7D control. In a study task called the Action Research Arm Test, Ms. Scheuermann guided the arm from a position four inches above a table to pick up blocks and tubes of different sizes, a ball and a stone and put them down on a nearby tray. She also picked up cones from one base to restack them on another a foot away, another task requiring grasping, transporting and positioning of objects with precision.

“Our findings indicate that by a variety of measures, she was able to improve her performance consistently over many days,” Dr. Schwartz explained. “The training methods and algorithms that we used in monkey models of this technology also worked for Jan, suggesting that it’s possible for people with long-term paralysis to recover natural, intuitive command signals to orient a prosthetic hand and arm to allow meaningful interaction with the environment.”

In a separate study, researchers also continue to study BCI technology that uses an electrocortigraphy (ECoG) grid, which sits on the surface of the brain rather than slightly penetrates the tissue as in the case of the grids used for Ms. Scheuermann.

In both studies, “we’re recording electrical activity in the brain, and the goal is to try to decode what that activity means and then use that code to control an arm,” said senior investigator Michael Boninger, M.D., professor and chair, PM&R, and director of UPMC Rehabilitation Institute. “We are learning so much about how the brain controls motor activity, thanks to the hard work and dedication of our trial participants. Perhaps in five to 10 years, we will have a device that can be used in the day-to-day lives of people who are not able to use their own arms.”

The next step for BCI technology will likely use a two-way electrode system that can not only capture the intention to move, but in addition, will stimulate the brain to generate sensation, potentially allowing a user to adjust grip strength to firmly grasp a doorknob or gently cradle an egg.

After that, “we’re hoping this can become a fully implanted, wireless system that people can actually use in their homes without our supervision,” Dr. Collinger said. “It might even be possible to combine brain control with a device that directly stimulates muscles to restore movement of the individual’s own limb.”

For now, Ms. Scheuermann is expected to continue to put the BCI technology through its paces for two more months, and then the implants will be removed in another operation.

“This is the ride of my life,” she said. “This is the rollercoaster. This is skydiving. It’s just fabulous, and I’m enjoying every second of it.”

In addition to Drs. Collinger, Tyler-Kabara, Boninger and Schwartz, study co-authors include Brian Wodlinger, Ph.D., John E. Downey, Wei Wang, Ph.D., and Doug Weber, Ph.D., all of PM&R; and Angus J. McMorland, Ph.D., and Meel Velliste, Ph.D., of the Department of Neurobiology, Pitt School of Medicine.

One Giant Bite:Woman with Quadriplegia Feeds Herself Using Mind-Controlled Robot Arm VIDEO

The BCI projects are funded by the Defense Advanced Research Projects Agency, National Institutes of Health grant 8KL2TR000146-07, the U.S. Department of Veteran’s Affairs, the UPMC Rehabilitation Institute and the University of Pittsburgh Clinical and Translational Science Institute.

For more information about participating in the trials, call 412-383-1355.

 

Upmc.com [en línea] Pittsburgh (USA): upmc.com, 27 de diciembre de 2012 [REF. 16 in December of 2012] Available on Internet: http://www.upmc.com/media/NewsReleases/2012/Pages/bci-press-release-chocolate.aspx



Diabetes mellitus. La crónica de la historia

24 12 2012

Throughout the 20th century non-communicable chronic diseases have passed progressively to occupy the top spots in terms of health and social importance. Diabetes Mellitus, which attaches his name to the Greeks Apolunio and Demetrius of the II century b.c. a.d.. (1) It is the endocrine disorder most commonly found in these moments between the first 10 causes of death in the country with a tendency to the increase in its prevalence, proportion to the aging of the population. (2)

 

Is considered that even we have not really reached the expected prevalence of diabetics who according to previous studies could reach between a 30 a 40 by 100 inhabitants when the active pursuit of the disease reaches its maximum efficiency. (3)

 

Recognition of diabetes as a chronic disease that affects millions of people worldwide has motivated the search for various areas of health care, mainly in relation to the knowledge, perceptions, attitudes and fears of patients in the family and community context. (4)

 

It is important to place emphasis on education to the patient in the doctor's Office, implying teach basic aspects of diabetes, promote the modification of knowledge and solve immediate problems with changes in the psychological frame of reference to help the patient to accept his illness. (5)

 

The influence of the doctor on the behaviour of the patient against the disease is a cardinal point, many health professionals are therefore limited to the diagnosis and the prescription, leaving aside the valuable education tool (6) which must be stressed in the doctor's family, implying teach basic aspects of diabetes, promote the modification of knowledge and solve immediate problems with changes in the psychological frame of reference to help the patient to accept his illness. (5)

 

Because it is as old as humanity suffering diabetes, the educational aspect often has been relegated. The treatment of diabetic must include in order of importance: education, power, exercises and medication. Commonly inverted order. The primary objective is to improve the control, avoid or reduce acute or chronic complications and improve quality of life. (7)

 

Guide of health personnel is needed for these, changing attitudes in patients and relatives family, before the disease (8) educate will allow addressing therapeutic demands with autonomy and responsibility but without undermining the general welfare .(9)

 

The dynamics of relationship to be established between the individual and family is one of the determining factors in the metabolic control as she will report Karisson (10) When writes that diabetic with a favorable family model, It significantly increases its control before the disease. Within the role of the family physician, extendable to all members of the health care system, is as an essential work recognize the influence of family factors on health and take them into account for the same care, also recognizing the influence of the patient in his family's problems. People with diabetes have symptoms and also have families. The road between diabetic patients and their families runs in both directions. (11)

 

Some of the essential functions of the family is providing support to its members. In the case of occurrence of a chronic disease this feature acquired singular importance, both from the physical point of view as emotional and thanks to her can resolve conflict situations which include to turn in the proper disease control. On the other hand allows you to protect the family of dysfunctional situations that may be triggered by the emergence of the disease or its complications. (12)

 

Previous programs on educational principles for diabetic patients as conclusions highlights the enormous importance of having family collaboration to achieve favorable results. (13)

 

The World Health Organization, says: education is a vital and angular in the treatment of diabetic stone for the integration of the diabetic society. (14)

 

Is also known that the cost of a diabetic patient in the treatment of both acute and chronic complications is high worldwide. In addition to the deterioration of his mental and organic State, his relationship with society is impoverished to the extent that this deterioration increases. Knowing the advantages offered by this educational method have been motivated to make our work to promote the educational work both as relatives of the diabetic patients. In these moments it is known that the prevalence of the disease in the country, is up to the year 2001 of a 25,3 by each 1000 inhabitants. (15)

 

In our province the prevalence during the year 2001 was of a 22.7 por cada 1000 population figure that has been on the rise until the value in the 2004 of 30.5 por cada 1000 habitantes. In our municipality, the prevalence of diabetes in the year 2002, behaved, para una población total de 55 280 in 1370, para un índice de 24,78 by 1000/ h; in the 2003 the population was of 55 282, the prevalence increased up to 14for an index of de 26,39; and in the 20for a total population of de 55 569 the prevalence has increased up to 1540, with an index of 27,71 porby each00 hinhabitants According to previous studies of the 50 to the 80% acute complications can be prevented through proper education, so the diabetes education is of vital importance in the current treatment of diabetes. (16).

 

Currently few jobs about the influence of the education of the family are collected jointly with the diabetic patient in disease control. In our opinion, primary health care in function by the improvement of the health status of the population in this group of patients, debe crear estrategias encaminadas a la educación no solo del enfermo sino de la familia y la comunidad, siempre marcando un destino final en el diabético; prevenir o retrasar los daños ya establecidos propios de la enfermedad.

 

Referencias Bibliográficas:

 

Montoro P. La diabetes y su control. Murcia: University of Murcia; 1991. 
Declaration of the Americas on Diabetes. PanAm Health Org Bull. 1996; 30 (3):261-5. 
Harrison IM, Foster DW. Diabetes mellitus. In: Issel Bacher KJ ed. Harrison´s main completo of Internal Medicine. 13 Ed. New York: MC Graww Hill; 2000. 
Arauz AG, G Sanchez, Padilla G, Fernandez M, Rosillo M, Gosman S. Community educational intervention on diabetes, in the field of primary health care. Rev. PanAm health Pub. 2001; 9(3):30-4. 
Garito LL, Wheel a.. Course of diabetes educators. USA: Lilly laboratories diabetes unit. S.A; 1999. 
Lennon GM, Taylor KG, Debney, C J barley. Knowledge, attitudes, technical competence and blood glucose control of type I diabetic patients during an education program after. Diabetic Med. 1997;7:825-32. 
Zuniga S, S Islands. Education of the diabetic patient. Rev Med IMSS. 2000; (3):187-191. 
Hiss R. The activates patients: a foce for change in diabetes health care and education. Diabetes Educ 1986; 12 (suppl): 225–23. 
García R. A dibetes education programme based on and interventive patients centred aproach: the cuban experience. West Indian Med. 1999;4(Bsupplpl 1):1. 
Karlsson J.A. Psycosocial aspect of diseases duration and control in young adults with type I diabetes. Clin Epidemiol. 1988;41(5):435–40. 
Rodriguez Moran M, Gerrero J.F. Importance of family support in the control of glicemia. Salud Pública Méx. 1997;39:44–7. 
De la Revilla L. Conceptos, instrucciones e instrumentos de la atención familiar. Barcelona: DOYMA; 2000. 
Junta de Andalucía. Guía de atención a la salud del anciano. Andalusia: Consejería de salud; 1997. 
Moncada E. Educar en Diabetes. BBarcelona Editorial Científico Médica; 1998. 
Programa Nacional de Prevención y control de la Diabetes Mellitus. La Habana: [s.l.]; May 2002. 
Tame L. A community survey of diabetes in the elderly. Diabetes Med. 1992 Nov;9 (9):860-5.

 

Authors:

 

DRA. Mayelin Fundora Gallardo, 1

DRA. Madelyn Jimenez Garcia 2

DRA. Isdeky Milian Espinosa 3

DRA. Mabel Quintana Sosa. 4

 

¹ Dra. in medicine. Specialist in 1st grade in General comprehensive medicine. Work center polyclinic Juan Martí Pi Area Jicotea.

Dra m². in medicine. Specialist in 1st grade in General comprehensive medicine. Work center: Polic. Juan Martí Pi Jicotea Area.

3 DRA. in medicine. Specialist in 1st grade in General comprehensive medicine. Work center polyclinic Juan Martí Pi Area Jicotea.

4 DRA. in medicine. Specialist in 1st grade in General comprehensive medicine. Specialist in 1st grade in internal medicine. Professor Instructor ISCM VC. Work center polyclinic Juan Martí Pi Area Jicotea.

 

 

Portalesmedicos.com [en línea]Cadiz (ESP): portalesmedicos.com, 24 in December of 2012 [REF. 12 in June of 2007] Available on Internet: http://www.portalesmedicos.com/publicaciones/articles/553/1/Diabetes-mellitus-La-cronica-de-la-historia.html



More than a Machine

20 12 2012

Ribosome regulates viral protein synthesis, revealing potential therapeutic target

 

Some viruses depend on ribosomal protein L40 (rpL40), highlighted within the large (60S) subunit, for protein synthesis. Image courtesy of the Whelan Lab.

Some viruses depend on ribosomal protein L40 (rpL40), highlighted within the large (60S) subunit, for protein synthesis. Image courtesy of the Whelan Lab.

By ELIZABETH COONEY Viruses can be elusive quarry. RNA viruses are particularly adept at defeating antiviral drugs because they are so inaccurate in making copies of themselves. With at least one error in every genome they copy, viral genomes are moving targets for antiviral drugs, creating resistant mutants as they multiply. In the best-known example of success against retroviruses, it takes multiple-drug cocktails to corner HIV and narrow its escape route.

Rather than target RNA viruses themselves, aiming at the host cells they invade could hold promise, but any such strategy would have to be harmless to the host.  Now, a surprising discovery made in ribosomes may point the way to fighting fatal viral infections such as rabies.

Results were published online November 19 in Proceedings of the National Academy of Sciences.

The ribosome has traditionally been viewed as the cell’s molecular machine, automatically chugging along, synthesizing proteins the cell needs to carry out the functions of life. But Amy Lee, a former graduate student in the program of virology, and Sean Whelan, HMS professor of microbiology and immunobiology, now say the ribosome appears to take a more active role, regulating the translation of specific proteins and ultimately how some viruses replicate.

The researchers were studying differences between how viruses and the host cells they infect carry out the process of translating messenger RNAs (mRNAs) into proteins. Focusing on protein components found on the surface of the ribosome, they discovered a protein that some viruses depend on to make other proteins, but that the vast majority of cellular mRNAs do not need.

Called rpL40, this ribosomal protein could represent a target for potential treatments; blocking it would disable certain viruses while leaving normal cells largely unaffected.

“Because certain viruses are very sensitive to the presence and absence of these ribosomal proteins, it might be a useful way for us to think about targeting ribosomes for therapeutic purposes from an antiviral standpoint,” said Whelan. “This is a way to think about interfering with rabies virus infection. There are no therapeutics for rabies infection.”

The team screened protein constituents of the ribosome to see which ones might be involved in specialized protein synthesis. Studying the vesicular stomatitis virus, a rhabdovirus in the same family as the rabies virus, they found that its mRNAs depended on rpL40 but only 7 percent of host-cellular mRNAs did. Some of the cellular mRNAs that depend upon rpL40 were stress response genes.

Experiments in yeast and human cells revealed that a class of viruses, which includes rabies and measles, depended on rpL40 for replication.

“This work reveals that the ribosome is not just an automatic molecular machine but instead also acts as a translational regulator,” said first author Amy Lee, who is now a post-doctoral researcher at the University of California, Berkeley.

The concept of targeting cellular functions such as protein synthesis for antiviral therapies is being explored by a number of research groups, but there are no drugs based on this.

“We think the principle is bigger than just this single protein,” Whelan said.  “Viruses have an uncanny way of teaching us new biology all the time.”

Maria Barna, assistant professor of developmental biology and genetics at Stanford University, called the work part of an exciting area of exploration. Her own recently published findings showed that a single ribosomal protein belonging to the large ribosome subunit rpL38 is critically required for formation of the mammalian body plan and specialized translational control.
 
“It is extremely fascinating that one single ribosomal protein is required for translational control of so many viruses, while its loss does not appear to have a major consequence on general protein synthesis or for cell viability. Any means to down-regulate rpL40 may be a novel therapeutic approach for viral infections,” she said about work led by Whelan. Barna was not involved in the research. “However, a deeper understanding is critically needed to determine whether the few ribosomal proteins, such as rpL40, shown to exert ribosome-mediated translational specificity reflects a harbinger of a new layer of gene regulation.”

This work was supported by NIH grants AI059371 and AI057159. Whelan is a recipient of a Burroughs Wellcome Investigators in the Pathogenesis of Infectious Disease Award. Lee is supported by the Department of Defense through the National Defense Science & Engineering Graduate Fellowship Program and the National Science Foundation through the Graduate Research Fellowship Program.

 

Hms.harvard.edu [en línea] Cambridge, MA (USA): hms.harvard.edu, 20 in December of 2012 [REF. 26 November of 2012] Available on Internet: http://hms.harvard.edu/content/more-machine

 



Weight Loss Surgery May Not Combat Diabetes long-term

17 12 2012

Weight loss surgery, which in recent years has been seen as an increasingly attractive option for treating Type 2 Diabetes, may not be as effective against the disease as it was initially thought to be, according to a new report. The study found that many obese Type 2 diabetics who undergo gastric bypass surgery do not experience a remission of their disease, and of those that do, about a third redevelop diabetes within five years of their operation.

Stuart Bradford

Stuart Bradford

The findings contrast with the growing perception that surgery is essentially a cure for Type II diabetes. Earlier this year, two widely publicized studies reported that surgery worked better than drugs, diet and exercise in causing a remission of Type 2 diabetes in overweight people whose blood sugar was out of control, leading some experts to call for greater use of surgery in treating the disease. But the studies were small and relatively short, lasting under two years.

The latest study, published in the journal Obesity Surgery, tracked thousands of diabetics who had gastric bypass surgery for more than a decade. It found that many people whose diabetes at first went away were likely to have it return. While weight regain is a common problem among those who undergo bariatric surgery, regaining lost weight did not appear to be the cause of diabetes relapse. Instead, the study found that people whose diabetes was most severe or in its later stages when they had surgery were more likely to have a relapse, regardless of whether they regained weight.

“Some people are under the impression that you have surgery and you’re cured,” said Dr. Vivian Fonseca, the president for medicine and science for the American Diabetes Association, who was not involved in the study. “There have been a lot of claims about how wonderful surgery is for diabetes, and I think this offers a more realistic picture.”

The findings suggest that weight loss surgery may be most effective for treating diabetes in those whose disease is not very advanced. “What we’re learning is that not all diabetic patients do as well as others,” said Dr. David E. Arterburn, the lead author of the study and an associate investigator at the Group Health Research Institute in Seattle. “Those who are early in diabetes seem to do the best, which makes a case for potentially earlier intervention.”

One of the strengths of the new study was that it involved thousands of patients enrolled in three large health plans in California and Minnesota, allowing detailed tracking over many years. All told, 4,434 adult diabetics were followed between 1995 and 2008. All were obese, and all underwent Roux-en-Y operations, the most popular type of gastric bypass procedure.

After surgery, about 68 percent of patients experienced a complete remission of their diabetes. But within five years, 35 percent of those patients had it return. Taken together, that means that most of the subjects in the study, about 56 percent — a figure that includes those whose disease never remitted — had no long-lasting remission of diabetes after surgery.

The researchers found that three factors were particularly good predictors of who was likely to have a relapse of diabetes. If patients, before surgery, had a relatively long duration of diabetes, had poor control of their blood sugar, or were taking insulin, then they were least likely to benefit from gastric bypass. A patient’s weight, either before or after surgery, was not correlated with their likelihood of remission or relapse.

In Type 2 Diabetes, the beta cells that produce insulin in the pancreas tend to wear out as the disease progresses, which may explain why some people benefit less from surgery. “If someone is too far advanced in their diabetes, where their pancreas is frankly toward the latter stages of being able to produce insulin, then even after losing a bunch of weight their body may not be able to produce enough insulin to control their blood sugar,” Dr. Arterburn said.

Nonetheless, he said it might be the case that obese diabetics, even those whose disease is advanced, can still benefit from gastric surgery, at least as far as their quality of life and their risk factors for heart disease and other complications are concerned.

“It’s not a surefire cure for everyone,” he said. “But almost universally, patients lose weight after weight loss surgery, and that in and of itself may have so many health benefits.”

 

Well.blogs.nytimes.com [en línea]New York (USA): well.blogs.nytimes.com, 17 in December of 2012 [REF. 28 November of 2012] Available on Internet: http://well.blogs.nytimes.com/2012/11/28/weight-loss-surgery-may-not-combat-diabetes-long-term/?ref=health



They patented a method to reduce the side effects of chemotherapy

13 12 2012

 

Researchers from the Research Centre Príncipe Felipe and Foundation research and innovation for Social development have developed and patented a process for the removal of heavy metals in solution. Will now apply this method in an experimental project for the Elimination of cisplatin surplus in blood. This metal, used in chemotherapy treatments, It is responsible for side effects such as kidney toxicity, nausea, vomiting and blood disorders in patients with cancer.

 

El método se aplicará en la eliminación del cisplatino excedente en sangre, causante de graves efectos secundarios. Imagen: Wicked

The method is applied in the Elimination of cisplatin surplus in blood, that caused serious side effects. Image: Wicked

Centro de Investigación Príncipe Felipe (CIPF) Foundation research and innovation for Social development (FIIDS) they have initiated a joint project to reduce side-effects in chemotherapy treatments to cancer patients.

In particular, researchers at the laboratory of structural biochemistry of CIPF and the area of the FIIDS biomedicine have developed and patented a process for the removal of heavy metals in dissolution, and they have discovered that this process would be also valid for the reduction of metals dissolved in fluids of living beings, They point out both institutions.

According to those responsible for the project, the first intended application of this method is the Elimination of cisplatin surplus in blood after intravenous administration in cancer patients.

“Cisplatin is the medication most often prescribed in the treatment of chemotherapy and is regarded as the cancer more effective and wider spectrum of action. However, It is a metal, the presence of this drug in blood carries a large number of side effects of gravity such as kidney toxicity, nausea, vomiting and blood disorders”, indicate.

 

The therapeutic effectiveness

The process developed for the removal of heavy metals in solution will adapt to the reduction of Platinum through exchange with other non-toxic metals. The Elimination of platinum in the blood shall be carried out by an extracorporeal method similar to hemodialysis.

The application of the process would contribute to reduce these side effects of cisplatin to eliminate this substance in the blood. In addition, the project has among its objectives to increase the efficacy of the drug by allowing your dosage increase, According to the institutions.

 

Agenciasinc.es [en línea]Madrid (ESP): agenciasinc.es, 13 in December of 2012 [REF. 13 November of 2012] Available on Internet: http://www.agenciasinc.es/Noticias/Patentan-un-metodo-para-reducir-los-efectos-secundarios-de-la-quimioterapia



They are placed for the first time an implant hearing of bone conduction with local anesthesia

10 12 2012

Specialists of the Department of Otolaryngology of the clínica Universidad de Navarra have been placed for the first time in the world an implant hearing of bone conduction with local anesthesia.

Foto: EP/CUN

Photo: EP/CUN

It's indicated surgery to implant a device specific to remedy injuries of the outer ear and Middle. The implant, called Bonebridge (commercial name, MED House - the), Unlike other devices of bone conduction, It presents the particularity of stay completely hidden under the skin, without any kind of percutaneous connection that passes through it, According to the clinic in a statement explained.

Like this, the external audioprocesador of the implant is subject by magnets and sends the sound information implanted in the interior part, using frequency modulated waves, without specifying the use of a direct connection, as in the Group of osseointegrated implants.

Team of otolaryngologists of the clínica Universidad de Navarra has already successfully completed the procedure in six patients, “without any kind of surgical complications”.

The surgeries have been led by Dr. Manuel Manrique, next to who have spoken the doctors Raquel Manrique and Jorge de Abajo. The procedure has a duration of between 30 and 60 minutes and, later, does not require hospital admission.

The implant Bonebridge consists of two components. The first is a subcutaneous device (placed under the skin) located behind the ear and the second, an audio processor external charge capture sound waves. These signals are transmitted, through the skin, to the inner you get in turn lead them to the bone implant and, through him, to the inner ear of the patient.

BENEFITS OF LOCAL ANESTHESIA

The importance of the use of local anesthesia in these interventions, with the fully conscious patient, lies, First of all, in a reduction of the risks that anaesthesia general it entails for the involved.

In addition, it becomes a procedure for outpatient surgery, without the need for hospital admission, what contributes to decrease the costs of the procedure. After the intervention, It is necessary to wait three weeks to activate the implant, time required for healing of the surgical wound and remission of edema (swelling).

In this procedure, the anesthetic is infiltrated in the posterior region of the ear, location where will be placed the implant.

The realization of this surgery with local anesthesia has been possible, allegedly doctor Manrique, Thanks to that the team of specialists from the University Clinic of Navarra has experience of 20 years in surgeries of the middle ear with this anesthetic modality. “Due to this background, We know that this type of intervention with this form of anesthesia is perfectly executable, which allows to perform surgeries that require even greater precision than this type of implant BoneBridge“, claims specialist.

 

 

europapress.es [en línea]Madrid (ESP): eueuropapress.es10 in December of 2012 [REF. 28 November of 2012] Available on Internet: http://www.europapress.es/navarra/noticia-colocan-primera-vez-mundo-implante-auditivo-conduccion-osea-anestesia-local-20121128111935.html



Dioxins in pregnancy may affect the reproductive system of children

6 12 2012

Barcelona, 20 November of 2012.- The distances found, they are normally longer in boys than in girls, are reduced among newborn boys whose mothers had greater exposure to dioxins. As revealed in a study, directed by the Centre for research in environmental epidemiology (CREAL) Barcelona, you have participated 700 pregnant women and their newborns in Greece and Spain.

The researchers conclude that the anogenital distance, that is the distance between the anus and penis, was reduced by approximately half mm per each 10 picograms (1 picogram equals one trillionth part of a gram) of dioxin per gram of lipid measures. The Dra. Marina Vafeiadi, first author of the article, explains that “the distance anogenital is a sensitive marker to endocrine disruption and these small distances have been associated with hypospadias (a congenital defect of the urethra and penis), Cryptorchidism (Undescended Testicles) and also with a lower quality of semen and infertility in young men”. In fact, This study confirms human experimental evidence of the effects of dioxins in animals that already used the Organization United Nations food and agriculture (FAO) and the World Organization of the Bless you (WHO) to establish recommendations for Human intake of food dioxin.

Dioxin and similar compounds are persistent chemicals of by-products of industrial processes. The main sources of human exposure are foods rich in fat, mainly of animal origin such as meat, dairy products and fish. Dioxins are transmitted from mother to child through the placenta during pregnancy and after birth through breastfeeding.

The use of advanced biomedical techniques enabled the measurement of dioxin and similar compounds in the mother's blood using a test that provided an overall estimate of exposure to these compounds and the levels thereof during pregnancy.

According to the Coordinator of the study and joint scientific director of the CREAL, the Prof. Manolis Boada, “exposure to dioxins and related compounds has been significantly reduced in the industrialized countries in recent decades Thanks to the control measures. Our results indicate, However, efficient control of persistent compounds requires long periods of time to be effective. The study was conducted along with researchers from the University of Crete (Greece) and the Institute Hospital del Mar research medical-IMIM (Barcelona).

Reference article: In Utero Exposure to Dioxins and overwhelming-like Compounds and Anogenital Distance in Newborns and Infants. Environmental Health Perspectives.Marina Vafeiadi, Silvia Agramunt, Eleni Papadopoulou, Harrie Besselink, Kleopatra Mathianaki, Polyxeni Karakosta, Ariana Spanaki, Antonis Koutis, Leda Chatzi, Martine Vrijheid, Manolis Boada. http://dx.doi.org/10.1289/ehp.1205221.

For more information or arrange interviews, contact with: – Gisela Sanmartin, Head of communications at the CREAL: gsanmartin@creal.cat – View.: 93 214 73 33 – 696 912 841. www.creal.cat.

 

Creal.cat [en línea]Barcelona (ESP): creal.cat, 06 in December of 2012 [REF. 20 November of 2012] Available on Internet: http://www.creal.cat/noticies/view.php?ID = 229



SRA scale. GAMIFICATION: Play to live longer and better.

3 12 2012

Elena scale Sáenz

Diariomedico.com Chief Editor

 

 

The gamification is, along with the social networks and the mobile health, one of the biggest bets in the health sector for the next 5 years. It is incorporated into the scope of health own videogames fun factor in order to promote healthy lifestyles, achieving prevention objectives or improve control of chronically ill.

According to a report from the U.S. consulting firm Gartner, in 2015 more than the 50 per cent of companies have incorporated the gamification your customer loyalty strategy and in 2014 the 70 percent will have at least one application based on the gamification.

The truth is that the gamification is not something new. Use games to motivate people and help them to achieve or even improve your goals is a very old strategy; However, It was not until the advent of video games and other technological advances that the gamification has achieved a deserved support for validation.

Today it is common to use applications that make us objectives, compare them with other users and present us challenges that we must overcome, thus improving our own brands with an extra point of fun. The social factor in the network is essential to make sense of the competition and has already been applied successfully in marketing, personnel selection, management, productivity and loyalty of users, and more and more sectors are committed to the gamification.

The toilet is not far behind, and today we have several examples of the use of the gamification, beyond the typical games that seek to modify parameters related to food and physical activity. Specialists of the Faculty of Sciences of the health of the Universidad Rey Juan Carlos, Madrid, they are working on the validation of a protocol of rehabilitation exercises based on already existing games, and the NISA hospital Aguas Vivas, in Valencia, designing computer games ad hoc for cognitive rehabilitation.

Beyond our borders, working groups of the University of California, in San Francisco, they have already demonstrated that the gamification applied to intensive cognitive training has positive effects on schizophrenia, and the Diabetes Hands Foundation, directed by Manny Hernández, It has garnered one of their biggest hits thanks to HealthSeeker, an application for diabetics that each day poses a few challenges of health. Achieved once a few points are received and the score is reported through social networks (Facebook and Twitter). In addition, the positive reinforcement a person can exercise on other participants is also rewarded with points, which enhances the interaction between all members of the community.

Also, one of the sectors most concerned in the development of the gamification is the insurers. Basically private health systems, as the North American, the gamification can save much money both insurers and employers. Hence, large business groups that employ hundreds of workers in supermarkets have introduced "games" through which they monitored the health of its employees and raise them challenges or objectives that, achieved once, is translated into a reduction in the cost of the policy or economic and social benefits.

It is therefore, the gamification should be seen as something more than a social marketing and advertising tool; the gamification perhaps is the best ally of the future public health policies.