NETWORKS: Instead of diseases, health care

21 07 2011

The lack of plasticity of salu systemsd will soon face the challenge of technologies inWired and genomics.
Eric Topol

Eduard Punset:
On one occasion I heard something that made my imagination. Once said something like that, in the future, medicine will not deal with disease, health and welfare. And you add must be to the great revolution that is coming, Thanks to wireless medicine and genomics. Do we explain you to our audience really approaching something extraordinary??

Eric Topol:
Of course, Let's see. We now think it would be fabulous to be able to prevent diseases before they appear. Unfortunately, medicine has focused primarily on the control of diseases and has not been able to prevent them. Is mainly due to the fact that lacked technology to do so. But it is changing, It is very quickly changing our ability to understand each individual at the biological level, anatomical, physiological, whichever is, a complete discovery of each person.

Eduard Punset:
You also speak of genomics, of knowledge derived from genomics and, under this agenda item, I think, I feel that the man in the foot is deranged, You know, When you compare what people see with what Clinton said, for example, on the radical changes, revolutionaries even, Genomics could be in everyone's life; There is a sense that things have not gone as we thought.

Eric Topol:
Well, I think that to some extent it is true. More or less a decade has passed since the first human genome was sequenced.

Eduard Punset:
It is true.

Eric Topol:
And at the bottom it is not long. During that time envisaged, We are talking about when Clinton was in the White House, in June of 2000, with Collins and Venter, was anticipated that we would have a total renovation of the medicine. We have not yet seen, but there are the first signs in genomics. For example, many of the medications we use regularly, the medical prescriptions, medication, We can adapt them to the patient and so make sure that it will work, We cannot guarantee that they will not have serious side effects, We can make sure that they are given the appropriate dose of the appropriate drug and avoid wasting so these medicines as well as serious side effects. The other big change that find me exciting is that, in December of 2010, was the first case of a child suffering from a rare disease, that I have never seen before here, in Milwaukee, Wisconsin, in the United States. For years, He developed a fistula from the intestine to the skin. He was suffering from terrible infections. They had to operate over a hundred times and it was going to die. They had their genome sequenced.

Eduard Punset:
Its genome...

Eric Topol:
Yes, which revealed the cause, the root cause of your illness. He underwent a specific treatment for the disease, If a bone marrow transplant. It is now a healthy six-year-old boy, He leads a normal life and it saved my life thanks to the genetic sequencing. So we needed all these years but the current progress are huge. It has been possible thanks to the sequencing of the genome and not just some parts as we had done so far. And it's a big step in the right direction. Still we can not cure, for example, the cancer but now know some of the causative genes. It is to analyze the root cause. This is what the genome allows us to analyse, What is the root cause of the cancer that affects a person, which is fabulous.

Eduard Punset:
It's amazing because I'm thinking, the work, your research center is called Scripps Translational Science Institute and I remember having spoken many times with a friend my oncologist, and have you said: “Mira, that period of time between that you discover something about genomics and you can apply it is too long, really...”. They did take ten years or even...

Eric Topol:
Seventeen, Media.

Eduard Punset:
Seventeen years??

Eric Topol:
It's horrible.

Eduard Punset:
It's horrible. The word? “transferring” It has something to do with the desire to reduce..., to work together, say, the scientist, the patient, the doctor in order to reduce the time?

Eric Topol:
You hit the nail on the head. “Transferring” It means to turn basic science into something which mark the difference in terms of health and makes it quickly, as fast as possible. And that's what it means “transferring”. It used to be called “the Valley of death”, that is to say, These two containers which are the basic science and the world of medicine did not speak, so the big ideas that arose from one side just died. It's combining ideas, build bridges, but it must be done quickly to catalyze and accelerate the findings, to change the future of health and medicine.

Eduard Punset:
Listen to me, I'd love my audience know something about wireless devices... Let's talk about some of these devices.

Eric Topol:
Course, of course. I'll show a couple of things… Well, It all began in the world of fitness. Put a sensor in a sports shoe and so people could use this sensor to transfer data to their phones and know the distance that had covered, at what speed, This kind of thing. The next step were the accelerometers, It allowed to know few steps gave the day. A wireless accelerometer, much better than the pedometer, very accurate, up to ten thousand steps. After this, a device found, very interesting, It allowed to measure brain waves. All the time, At home, While we try to sleep, While we sleep. It is a very interesting technology because...

Eduard Punset:
Do you want to know your brain waves??

Eric Topol:
Well, because it can help you sleep better. Or if you have a sleep disorder. For example, These are my brain waves in every minute of sleep. I know at what stage of sleep I am carrying a tape head at night. It is a very interesting device for quantifying the dream. Wireless objects are changing... You know, the person is like a black box. Do you know when an aircraft has an accident and is looking for the black box??

Eduard Punset:
Yes, that's.

Eric Topol:
In fact, the black box is orange but, well, gives equal. Show me, you are looking for to be able to register any event, now everything is logged. If you would like to attend to a patient who is hospitalized, I look at my phone and see how it evolves in this very moment, at this very moment, a specific patient that is entered. So I'm looking for and check it in my phone and see how is now: the electrocardiogram, blood pressure, the temperature, the oxygen in blood at this moment. And soon we will be able apply us it to ourselves because it's the same technology as the mobile, We know all our vital constants.
And instead of having the black box for someone that has crashed, We have the black box for someone who is alive and well...

Eduard Punset:
Until you crash.

Eric Topol:
Until you crash. It is the key, is the key. And we have this other device here. It's a heart ultrasound, VES, You can.... The heart is collapsed.

Eduard Punset:
Is this the heart??

Eric Topol:
Yes. And I put this ultrasound probe - is the same size as any mobile- I can place it where you want to, in the arteries, in the neck, in the heart, in the abdomen...

Eduard Punset:
Can you put it in my heart and...??

Eric Topol:
You could do. You could...

Eduard Punset:
Do it!! Because I have an arrhythmia...

Eric Topol:
Do you have an arrhythmia??

Eduard Punset:
I have paroxysmal atrial fibrillation.

Eric Topol:
Would I like you to do a scan??

Eduard Punset:
Yes, would be wonderful.

Eric Topol:
You have atrial fibrillation all the time or only to times??

Eduard Punset:
No, not, all the time now. It is permanent. Cuando eres joven, you know very well as a cardiologist, cuWhen you are younghave paroxysmal fibrillation crisis, but as you get older or adult, say, becomes something permanent. And notes it all the time. But it is much more mild and not already hurts.

Eric Topol:
De acuerdo, We are going to make you the cardiac examination, then. We need cold gel. I'll have to ask you to desabroches you with the shirt...Ah, is already,I agreeo. Agreement here is, There is your heart. This image is really good. Beautiful girl. It shows the very strong heart muscle. The valves are precious. The left atrium is great, Hence the fibrillation, but your heart rate is very controlled. Your muscles are very strong, see?? The contraction is very good and the mitral valve is normal. But you have a very large left atrial. Do you suffer from high blood pressure??

Eduard Punset:
Sometimes.

Eric Topol:
Because your muscles are very thick, so you probably have high blood pressure. Not have check you it well all these years?, nervous tension? It has been low, or it has been rather uncontrolled??

Eduard Punset:
Well, I've had high.

Eric Topol:
Yes, is what I see.

Eduard Punset:
And took some pills to take very short.

Eric Topol:
Yes. VES, probably your Genetics is conducive to hypertension and possibly to atrial fibrillation, but you have a very strong heart. The contraction is fantastic.
Not only I could do you a heart scan. I don't have to listen to you heart because I see, see it all. But, Why is it important in the world of the wireless era?? Because I can send this... Let's say that if it wasn't cardiologist... I can send this to the expert via wireless and I can answer immediately, in the room of emergency or on the ground. This is what the wireless medicine, is a completely new technological world.

Eduard Punset:
A program like this is already something, But what else can we do really to accelerate these changes towards this new medicine based on wireless technology?

Eric Topol:
Well, We have much to do because the current medicine is practiced at a different level, It is taking as a reference the general population. All women should have a mammogram. Everyone has to do a colonoscopy. Men have to do an analysis for the prostate. That is not the medicine which we want to exercise. We want an individualized medical practice. It's a change that has not been. We have to change this, This whole process: When these tests are ordered with so many people, trials with hundreds, hundreds of thousands of patients for many years... It is something that has prevented many people progress. We need to change this philosophy and it is possible to change. It is only a different approach because there are new capabilities to do so. Let's go back to your case. You have hypertension, but you had no way of measuring your high blood pressure all the time with the phone. Now you can do, so you know how is your blood pressure because it will beep, beep and, then, you know that you have high blood pressure and you can control it better. This will cause the heart muscles walls thin and you will have less chance of ever an abnormality of heart rhythm. So we are talking about preventing disease in persons through sensors, to know your genomics... It is a life change but we will need time until it is accepted universally.

Eduard Punset:
AND, In addition, of course, all the news that you are discovering they are. I have read that you to avoid cholesterol, There is a medicine called a concrete “Statin” that uses people. What the Statin??

Eric Topol:
Well, Statins, This is how we call them, they are drugs with names as Lipitor, CRESTOR, Zocor... Well, gives equal, are those drugs which are more prescribed worldwide. Take them tens of millions of people to reduce your blood cholesterol. However, If there is no heart disease, the proportion of people who can benefit from them and avoid a heart attack is very small, or a stroke, or death. If treat 100 people who do not have heart disease with Statins, all will get better results in laboratory tests, but only a, two or three will have less propensity to suffer a heart attack. So we are medication one hundred people throughout his life, When only one or two leave benefit, and we should not forget that it is drugs that are expensive. So, with luck, We can do things better. It is not that statins are bad but it recetár them to who need them. We still don't know how to do it, but things are going to change.

Eduard Punset:
There is a..., I think..., I don't remember the exact figure, Perhaps Fourteen million or 20 million Americans who suffer from diabetes. I do not remember exactly how many millions are...

Eric Topol:
Well, in the United States, thirty million. And 300 million worldwide. And this which have only been diagnosed. It is an epidemic.

Eduard Punset:
It is an epidemic, the truth.

Eric Topol:
Sí, Yes.

Eduard Punset:
Something new in this field?? Any novelty in wireless medicine and genomics as possible...??

Eric Topol:
Sí, Yes. Wireless medicine and genomics are fantastic in the cases of diabetes. First of all, If you are a diabetic, You can make a genomic classification that say why have you developed diabetes. Why?? There are many reasons that can lead to the development of diabetes. Discover what fault the person: If the pancreas that has failed or the transport of insulin has been… Además, We can insert them a subcutaneous sensor, a small needle under the skin, record levels of glucose and send the results to a terminal such as a mobile phone constantly, so you can see blood glucose levels every five minutes. Is important this?? Well because to control diabetes, you have to know glucose levels 24 hours a day. We can not know simply by clicking a fingertip. And so you know while you sleep or if you're disgusted, in any circumstances of the day, you know if the glucose you tripped, If something you've eaten and which has today you gone bad, Why have a rise or fall of glucose. It is really important to control diabetes each patient individually. Además, is trying to avoid that it reappears diabetes. All we can do is the most important thing.In addition

Eduard Punset:
You know, My father was a country doctor and remembrance, as a child, the first thing you ask any patient was that you take the language , Like this... It would be fantastic, wonderful that he could hear what you say now.

Eric Topol:
It is fabulous, I mean, the perfect time has come to do things in a different way in medicine because, from an economic point of view, We are in a desperate situation but, from the technological point of view, It is the most extraordinary time that we have ever lived.

Rtve.es [en línea] Barcelona (Spain): rtRTVE.es21 of July 2011[REF. 6 March of 2011] Available on Internet:

http://www.rtve.es/television/20110304/redes-lugar-enfermedades-cuidar-salud/413509.shtml

ARTÍCULO VALIDADO POR LA SRA. ALBA CALLS.


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