Una prótesis de brazo solo controlada con el poder de la mente

Christian Kandlbauer, quien perdió ambos brazos en un accidente por alto voltaje, utiliza un sistema innovador que hasta hace poco parecía prácticamente de ciencia ficción: una prótesis de brazo, la primera de su clase en el mundo que él controla sólo con el poder de la mente.

En 2008, la compañía Otto Bock presentó un prototipo de la primera extremidad protética controlada por la mente. Ahora, la empresa presenta la primera prótesis controlada por la mente para el uso diario. Esta invención innovadora, la cual Christian Kandlbauer utiliza en el costado izquierdo, mejoró su independencia y le ayudó a recuperar la confianza en sí mismo, permitiéndole tanto volver a su profesión original como también volver a conducir su propio vehículo.

En cooperación con especialistas en investigación de EEUU, Otto Bock se valió del conocimiento actual sobre la Reinervación de Músculos Objetivos (Targeted Muscle Reinnervation - TMR) del Doctor Todd Kuiken, PhD, del Rehabilitation Institute de Chicago, junto con especialistas del Hospital General de Viena que emplean la TMR en pacientes. Ello consiste en la transferencia de nervios residuales al músculo pectoral para que las señales del cerebro sean utilizadas para controlar la prótesis.

Según resaltó el Doctor Hubert Egger, director del proyecto, una reducción del peso hasta 2,5 kg y la apariencia de un brazo natural son elementos esenciales para su uso en la vida cotidiana.

--Perspectivas para el futuro
Bajo ensayos en laboratorio y con la asistencia de microsensores que se integran en el dedo índice, Christian Kandlbauer podría además percibir sensaciones de contacto igual que antes del accidente. Un sistema que se encuentra todavía en desarrollo y requerirá un periodo de tiempo para perfeccionarse. El Doctor Hans Dietl, CEO de Otto Bock HealthCare Products de Viena, espera poder comercializar la prótesis de brazo sensorial dentro de aproximadamente cuatro años.

Jerónimo Saiz: “la depresión postvacacional no existe”

Síntomas como irritabilidad, insomnio o ansiedad que se manifiestan tras la vuelta al trabajo después del periodo estival de descanso corresponden a un estado de ánimo pasajero y breve, más o menos negativo, que depende en gran medida de la satisfacción que se obtiene del trabajo, del regreso a horarios estrictos o del retorno a la rutina, entre otras circunstancias.
No se trata, por tanto, de ninguna enfermedad o síndrome, sino de un proceso emocional normal. Jerónimo Saiz, Presidente de la Sociedad Española de Psiquiatría (SEP) y Jefe del Servicio de Psiquiatría del Hospital Universitario Ramón y Cajal de Madrid, es tajante, "la depresión postvacacional no existe porque no tiene entidad clínica".
En su opinión, la vuelta al trabajo después de las vacaciones es simplemente una dificultad más de la vida que requiere adaptarse a una realidad que no siempre concuerda con las expectativas. "Si la depresión se asocia al regreso de las vacaciones es puramente una coincidencia. Aquéllos que la sufren estaban enfermos previamente".
Esta situación -incorrectamente denominada "depresión postvacacional"- responde a un estado de ánimo más bien negativo entre los trabajadores que vuelven a sus puestos y que tiene que ver con el nivel de insatisfacción. Sería un sentimiento comparable al que se produce los lunes para muchos trabajadores, tras dos días de descanso y que, ahora, después de un mayor periodo de descanso, se produce de modo más acentuado.
Es, por tanto, un malestar transitorio y breve que no requiere de atención médica ni de un tratamiento farmacológico, sino de un enfrentamiento a la realidad y de aceptación de la nueva situación.
Actualmente estamos asistiendo a una creciente medicalización de la vida cotidiana porque la sociedad busca el placer y trata de evitar el sufrimiento a toda costa. Los especialistas coinciden al afirmar que vivimos en la sociedad del bienestar, físico y psicológico, donde cada vez se tolera menos el estrés, y esta situación de regreso al mundo laboral no es más que producto de este tipo de sociedad, altamente medicalizada, en la que el individuo acude a la consulta en busca de una solución rápida ante el más mínimo sufrimiento.

***Algunos consejos para disfrutar mejor las vacaciones y facilitar su final feliz:

-Mantener una actitud positiva.
-Ser realista.
-Dedicar tiempo para el ocio a diario.
-Tomar las riendas de la propia vida.
-No considerar las vacaciones como la solución a los problemas.
-No buscar denodadamente la felicidad como obligación durante ese periodo.
-Gozar del tiempo improductivo y aprovecharlo.
-Descansar lo suficiente, pero no estar todo el día durmiendo.
-Cultivar aficiones.
-Dedicar un tiempo a mejorar y profundizar en las relaciones con la familia y amigos.
-Planificar el ocio.
-Dedicar un tiempo al desarrollo como personas.
-Tomar las cosas con naturalidad, tanto en vacaciones como fuera de ellas.
-Mentalizarse de que también se puede ser feliz tras la vuelta al trabajo.
-Tratar de incorporarse a la rutina laboral de forma paulatina.
-Pensar que el malestar del regreso es algo pasajero y normal, que se debe afrontar adecuadamente.
-Hacer explícitos, reales y realizables nuestros objetivos.
-Admitir las deficiencias propias.
-Pedir apoyo a los demás.

En palabras de Jerónimo Saiz "como no existe la depresión postvacacional no precisa tratamiento, ni psiquiátrico ni psicológico. Que piensen en todos los que no han podido tomar vacaciones porque no tienen un puesto de trabajo al que reincorporarse. Por otra parte, si las vacaciones no tuvieran límite en el tiempo, dejarían de serlo para convertirse en una situación habitual, que no se percibiría con el aliciente que suscitan los periodos vacacionales breves".

--La depresión, una enfermedad psiquiátrica bien definida
La depresión es una enfermedad psiquiátrica bien definida que nada tiene que ver con el fin del disfrute del periodo estival de cualquier trabajador.
Se trata de un trastorno del estado del ánimo en el que éste se encuentra anormalmente bajo, existe una pérdida de interés o placer en casi todas las cosas, tristeza e irritabilidad.
Tristeza o abatimiento no son sinónimos de depresión. Los períodos de tristeza o melancolía son inherentes a la experiencia humana. La tristeza es un sentimiento normal, pero puede llegar a ser patológica en función de su duración, intensidad y grado de interferencia en la conducta y la vida cotidiana de la persona.
Según estimaciones de la OMS, 154 millones de personas en todo el mundo sufren depresión. Además, las personas con depresión suelen ser objeto de aislamiento social, tienen una mala calidad de vida y presentan tasas de mortalidad más elevadas. Más de 20 millones de europeos padecen depresión y se calcula que en España puede haber seis millones de personas con esta enfermedad (10-15% de la población), la mitad de ellas sin diagnosticar. Constituye la segunda causa de baja laboral en nuestro país y la OMS estima que será la segunda causa de incapacidad en 2020 en todas las edades y sexos.

New Global Campaign Aims to Prevent As Many As 1 Million Atrial Fibrillation-Related Strokes

– 1 Mission 1 Million – Getting to the Heart of Stroke launches today announcing a worldwide effort to help prevent as many as 1 million atrial fibrillation (AF)-related strokes through increased awareness and understanding. This first-of-its kind initiative calls for the submission of project ideas which can help educate and raise awareness of the increased risk of stroke with atrial fibrillation and improve management of the disease. The projects will be reviewed by experts in AF and then voted upon by the public – up to 32 projects will be selected to receive funding from the €1 million in awards that will be made available. Healthcare professionals can register on the 1 Mission 1 Million website ( https://www.heartofstroke.com/) to receive educational materials to support their efforts to inform patients about AF and the risk of stroke.
As many as three million people worldwide have an atrial fibrillation-related stroke every year; equivalent to one person every 12 seconds. One in four people aged 40 years or older develop atrial fibrillation during their lifetime, making it the most common heart rhythm abnormality. Atrial fibrillation causes the heart to beat irregularly and often at a too fast or too slow heart rate. People with atrial fibrillation are five times more likely to have a stroke than people without AF. In addition AF -related strokes are more severe and associated with more disability than non-atrial fibrillation strokes. Three out of four AF-related strokes can be prevented, but many patients are not aware of their risk and do not take action to prevent stroke.
“Many people are unaware of their increased risk and potential life changing consequences of having an atrial fibrillation-related stroke,” said Professor Roberto Ferrari, Professor of Cardiology at the University of Ferrara, Italy and expert panel member. “Through a commitment to education and funding community based projects, 1 Mission 1 Million has the potential to make a significant and meaningful difference for those affected by atrial fibrillation.”
1 Mission 1 Million – Getting to the Heart of Stroke is supported by leading health experts and patient organisations including the World Heart Federation (WHF), Atrial Fibrillation Association (AFA), AntiCoagulation Europe (ACE), and Stroke Alliance For Europe (SAFE) and is sponsored by Boehringer Ingelheim.
“Increasing awareness can lead to earlier diagnosis of atrial fibrillation and to more patients receiving appropriate care - resulting in the potential prevention of more avoidable strokes,” said Professor Günter Breithardt, from the World Heart Federation and Expert Panel member. “Initiatives that work to prevent AF-related stroke will improve the quality of life for patients and have the potential to reduce health-related costs worldwide.”
Healthcare professionals and professional and patient groups can request educational materials on atrial fibrillation and the risk of stroke on http://www.heartofstroke.com/. The materials will be available at no cost.
Projects can be submitted online until 31 December, 2010. The applications will then be reviewed against the campaign’s entry criteria by an Expert Panel whose members include cardiologists and patient group leaders in the area of atrial fibrillation, all of whom have expertise in supporting people with the condition. In February 2011, selected projects will be featured on http://www.heartofstroke.com/ and healthcare professionals, professional and patient groups and the public will be invited to vote on which projects they believe will be most impactful. Voting will close in June 2011, and the projects with the most votes will be awarded funding for implementation. The Expert Panel members will also select 7 ‘Expert Picks’ - projects that are deemed to be deserving of special recognition. There are a total of 32 awards available, ranging from €10,000 to €100,000, totalling 1 million Euros.
For more information about atrial fibrillation-related stroke

Más riesgo en desarrollar diabetes tipo 2 en las madres que no dan el peco a sus bebés

Las madres que no amamantan a sus hijos presentan tasas significativamente más altas de diabetes tipo 2 a lo largo de su vida que las madres que si dieron el pecho, según un estudio de la Universidad de Pittsburgh (Estados Unidos) cuyos resultados se publican en la edición de septiembre del 'American Journal of Medicine'.
"Hemos visto aumentos dramáticos en la prevalencia de la diabetes tipo 2 en el último siglo", asegura Eleanor Bimla Schwarz, autora de dicha investigación, que está convencida de que "además de la influencia ya conocida de la dieta y el ejercicio", la lactancia materna también reduce el riesgo de las mujeres de desarrollar esta enfermedad "al disminuir la grasa del vientre materno".
El presente estudio incluyó a 2.233 mujeres de entre 40 y 78 años, de quienes el 56 por ciento aseguró que habían amamantado a sus bebés durante al menos un mes. El 27 por ciento del resto de mujeres, que no amamantaron a sus hijos, desarrollaron diabetes 2, con casi el doble de probabilidades de tener la enfermedad que las mujeres que si lo hicieron o no tuvieron hijos.
Por el contrario, las madres que amamantaron a todos sus hijos no tenían más probabilidades de desarrollar diabetes que las mujeres que nunca dieron a luz. Además, los investigadores no encontraron diferencias en función de la edad, la raza, la actividad física y el consumo de tabaco o alcohol.

"Nuestro estudio proporciona otra buena razón para alentar a las mujeres a amamantar a sus ebés, al menos durante el primer mes de vida", reconoce Schwarz, que propone también a los médicos que adviertan del riesgo de desarrollar diabetes tipo 2 si no lo hacen.

Assessing the risks of bleeding from antithrombotic therapy

Antithrombotic therapy using antiplatelet and anticoagulant agents is the cornerstone of treatment for acute and chronic coronary artery disease (CAD), yet it is also associated with an increased risk of bleeding. It is paradoxical that elderly patients, the most likely population to develop CAD, are those that suffer most from bleeding complications. Research has been carried out at OLVG Hospital in the Netherlands into the stratification of risk for all patients requiring this type of therapy.
Professor Freek Verheugt led the research. “Until relatively recently, aspirin used to be the only effective antiplatelet drug, but now CAD patients can get increased protection from ADP receptor antagonists added to aspirin,” he said. “Previous studies showed us that, compared to younger patients, the elderly seemed to benefit more from single antiplatelet therapy with aspirin that from dual antiplatelet therapy. This data, however, should be treated with caution since it is derived from post-hoc analysis of randomised control trials.”
The TRITON and PLATO clinical trials demonstrated that newer ADP blockers such as prasugrel and ticagrelor are more effective that clopidogrel. But in both trials, the benefits seemed to reduce in patients over 75 years, although this observation comes from post-hoc analyses of the mega-trials. Other research has also shown that the elderly do not get the full benefit from platelet glycoprotein IIb/IIIa receptors, include abciximab, eptifibatide and tirofiban.
For anticoagulants, there is less data available on the risk of bleeding in relation to age. In elderly patients with fibrinolysis, low molecular weight heparin increases the bleeding risk in the elderly significantly over un-fractionated heparin. So, if chosen as the most effective treatment, low molecular weight heparin should be administered in lower doses for older patients. Bleeding associated with the newer anticoagulant bivalirudin also increased in the elderly, when compared to younger patients.
The research concludes that the risk of bleeding is increased by antiplatelet and anticoagulant therapy when applied to the treatment of acute and chronic CAD. Professor Verheugt explained the findings, “For aspirin, it was clearly shown that the risk reduction of ischemic endpoints applies equally to the elderly, but for clopidogrel this benefit is less apparent. Neither was it clearly seen from use of newer ADP receptor blockers such as prasugrel and ticagrelor. Additionally, no clear benefit was observed for elderly patients treated with glycoprotein receptor blockers for acute coronary syndromes.”
Antiplatelet therapies carry an increased risk of bleeding, especially in the elderly. This is probably also true for anticoagulant drugs, but data that specifically covers the elderly is relatively scarce.

Should antiplatelet response be tested?

The effectiveness of dual antiplatelet therapy (DAT) with clopidogrel in cardiovascular (CV) patients is highly variable, and the degree of residual platelet aggregation can significantly influence the prognosis. A number of clinical and genetic risk factors contribute to this observation, and the contribution of genetic polymorphisms has been addressed. To date, however, common genetic clusters have not been identified that reliably predict a patient’s response to antiplatelet therapy. The challenge faced by researchers at University Hospital, Tuebingen in Germany is to determine ways of balancing the thrombotic risk, with the risk of bleeding when using DAT. The outcomes of the research includes a conclusion that platelet function testing (PFT), while an important component in risk evaluation, should not be relied on to adjust antiplatelet therapy regimes.
New antiplatelet agents have been developed – and will continue to be developed – that overcome low responsiveness to clopidogrel. These agents have a higher antiplatelet effect and are less susceptible to genetic inheritance. But, according to Professor Meinrad Gawaz of the University Hospital in Tuebingen, Germany, there are important factors to consider before prescribing them. “These new agents offering higher platelet inhibition come with an increased risk of bleeding,” he says. “So far, these drugs have mostly been studied in patients with acute coronary syndromes, but their role in stable CV patients has yet to be fully characterised.”

It is therefore essential to identify sub-groups of patients who could benefit from novel treatment regimes. Platelet function testing (PFT) can help to monitor and guide antiplatelet therapy for patients in at-risk groups more likely to respond to additional antiplatelet therapy. These groups include diabetics and patients suffering from stent thrombosis. Major concerns have been expressed, however, about the transferability of results obtained by different PFT methodologies. Near-patient testing methods have been evaluated in the clinical setting and show reproducible results, but consensus has to be reached upon the appropriate cut-off values to differentiate between thrombotic and bleeding risk.
The results of ongoing trials will show whether adjustment on behalf of routine PFT will lead to improved outcomes. Until then, PFT represents an important component to evaluate the thrombotic risk but adjustment of antiplatelet therapy based on PFT cannot be recommended in a routine fashion but can only be considered as an off-label indication in individual cases bearing in mind the bleeding risk.

Study links male Y chromosome variants with the risk of coronary heart disease

Scientists in the UK have shown that genetic variations in the Y chromosome affect a male’s risk of coronary heart disease. It is well known that males have a higher incidence of coronary heart disease than females due, in part, to the Y chromosome they inherit from their fathers. To investigate the role of the Y chromosome further, a team from the University of Leicester carried out research to determine whether genetic variations in the Y-chromosome affect risk for males.
Not all Y chromosomes are the same. There are variants within the male gender called “Y-haplogroups”, which are usually associated with specific geographic regions and tend to indicate the origin of the ancestral line. Professor Nilesh Samani explains the background to the project that was funded by the British Heart Foundation, “We set out to determine if men with differing types of Y chromosome were at differing risk of heart disease. We tested nearly 3,000 British males, and found that those carrying the I-haplogroup variant had a 55 percent higher risk of coronary heart disease.”
Of the 3,000 men tested, 1,295 were the cohort group of those with coronary heart disease and the rest were the control group. The Y-haplogroup was identified in all men, and the results showed that those in the I-haplogroup had an approximately 55 percent higher risk of coronary heart disease compared to the others. The association of the I-haplogroup with coronary heart disease was independent of, and not explained by, traditional heart risk factors such as cholesterol, high blood pressure and smoking.
Commonly found in central, eastern and northern Europe, the I-haplogroup is carried by about 13 percent of British men. Its origin is thought to be of the Gravettian culture, which arrived in Europe from the Middle East about 25,000 years ago. Since the I-haplogroup is not so prevalent in southern parts of Europe, an interesting speculation is whether it contributes to the higher levels of coronary heart disease in the north compared to the south – however, this requires further research and testing.
What is clear from this study though, is that men carrying the I-haplogroup are more likely to suffer from coronary heart disease than men with other Y-haplogroups.