Una hernia en las cervicales podría dar marcha atrás en las primeras medidas ahorrativas que se aplican desde el lunes en hospitales como Vall d’Hebron. Habían suprimido a partir de las 21 horas la guardia presencial del médico adjunto del servicio de rehabilitación de Vall d'Hebron, donde se atienden, entre otros, a lesionados medulares de Catalunya, Baleares, Andorra y sur de Francia. Pero a las 21.30 del primer día de medidas especiales –para estas dos semanas– llegó un paciente con una hernia cervical con pérdida de fuerza en todo el brazo. Y no había adjunto.
“Se armó un follón tremendo”, relatan especialistas del centro que participaban en una protesta ante la conselleria. Tuvieron que ingresar al paciente, “que en condiciones normales no hubiera requerido ingreso”, y este les comunicó que de allí no se movía hasta que le operaran. La medida se ha revertido, según los médicos, y está en revisión según el hospital. Otro de los imprevistos que surgen con estas primeras medidas es el triunfo de las quejas. Una madre mostró su indignación a la dirección del hospital ante el segundo retraso de la operación de rótula de su hija. Y consiguió nueva fecha, aseguran los médicos. “El triunfo del pollo”.
En la hoja de guardias de Bellvitge crece el número de las divididas: allí, hasta las 10 de la noche, y después, localizable. Anteanoche contaban en el gran hospital con un cirujano general, un anestesista y un equipo de instrumentistas, la mitad de lo habitual. “Por la mañana quedaban pendientes una vesícula biliar infectada, una apendicitis y un absceso perineal, que no sabes cómo duele”, explican los médicos. “Y si llega a entrar un accidentado con riesgo vital, ¿esperamos a que llegue el cirujano de guardia localizable o dejamos en el quirófano la apendicitis?”, pregunta una anestesista.
También en cirugía cardiaca de Vall d’Hebron se habían tomado medidas que ahora están en revisión. Hasta ahora había un adjunto en guardia presencial y a partir de ahora se había ordenado que un adjunto estuviera localizable en casa a partir de las 5 de la tarde. A menudo atienden postoperatorios sangrantes y con problemas agudos.
Las garantías tranquilizadoras mostradas por el conseller de Salut no parecen haber surtido efecto. Trabajadores de varios hospitales cortaron el tráfico al mediodía y unos doscientos delegados de Metges de Catalunya pitaron ante su departament, pidieron la dimisión del conseller y entregaron un manifiesto contra los recortes, que “ponen en peligro la sanidad pública”. El conseller Boi Ruiz dijo en el Parlament que algunos agentes del sector sanitario han demostrado un “comportamiento irresponsable”.
**Publicado en "LA VANGUARDIA"
14 April 2011
Stanford research casts sober light on Russia's mortality crisis
With the collapse of the Soviet Union, Russians were faced with more than the demise of a political system. Working-age men began dying in droves, and the country saw a 40 percent surge in deaths between 1990 and 1994. The killer was often alcohol – that much was clear. And for years, many economists and political scientists have blamed Russia's lurch toward democracy and capitalism for driving those men to drink. They reasoned that privatization left many people unskilled and unemployable, ushering in a sense of listlessness and depression that mixed too easily with cheap vodka.
But Stanford researchers have dug up evidence that helps get democracy and capitalism off the hook and points to a new culprit: the end of an anti-alcohol campaign that contributed to a plunge in mortality rates during its short life in the Gorbachev era.
"Most things that kill people disproportionately kill babies and the elderly," said Grant Miller, an assistant professor of medicine and faculty member of the Center for Health Policy. "But working-age men accounted for the largest spike in deaths in the early 1990s. Many people suspect that's somehow entwined with political and economic transition, but there's a lot more to it than that."
Most of the deaths during Russia's mortality crisis were from alcohol poisoning, drunken violence or slower killers like heart attacks and strokes, he said.
Miller has outlined the findings – based on newly compiled and digitized archival data – in a working paper written in collaboration with associate professor of medicine Jay Bhattacharya and Christina Gathmann, an assistant professor of economics at the University of Mannheim in Germany. Their research was supported in part by the National Institutes of Health through Stanford's Center on the Demography and Economics of Health and Aging.
Their study shows a steady rise in the number of deaths between the early 1960s and 1984 in one of the world's heaviest drinking countries. Recognizing that alcoholism was a major cause of death and low work productivity, Mikhail Gorbachev instituted an aggressive anti-alcohol campaign in 1985, shortly after he became the Soviet Union's secretary general.
New regulations slashed official alcohol sales by two-thirds, drove up prices by as much as 50 percent and prohibited stores from selling booze before 2 p.m. on business days. Showing up drunk at work or on the streets could cost Russians a hefty fine or land them in prison.
"It was common practice for workers to take their breaks, go to a liquor store and come back to work drunk," said Bhattacharya, who is also a Stanford Center for Health Policy faculty member. "So the people behind the campaign thought closing the stores during the day could lead to more productivity and fewer work-related deaths and injuries."
But the campaign also emphasized alternatives to drinking. A national temperance society was formed, propaganda promoted sobriety and administrators in all Soviet districts – called oblasts – were required to build more parks and sports clubs to encourage family-friendly fun.
The campaign worked. The number of deaths plummeted in 1985 and remained below the pre-campaign trend throughout the late 1980s. That translated to a 12 percent decline in mortality rates: about 665,000 fewer deaths. But by the early 1990s, shortly after the campaign was dropped – and at the same time that the Soviet Union crumbled – the number of deaths began to climb.
The temperance campaign officially folded in 1988 for two main reasons: It was wildly unpopular and the government realized it was losing too much money from low alcohol sales. By 1991, consumption was back to pre-campaign levels.
And Russia's heaviest drinkers – working-age men – fell off the wagon and got back to dying at alarming rates. The end of the campaign accounts for as much as half of Russia's four-year mortality crisis, Miller and Bhattacharya said.
"Welfare and health are not exactly the same thing," Miller said. "You can restrict people's choices in a way that improves health, but that doesn't unambiguously mean that people are better off. "
**Source: Stanford University
But Stanford researchers have dug up evidence that helps get democracy and capitalism off the hook and points to a new culprit: the end of an anti-alcohol campaign that contributed to a plunge in mortality rates during its short life in the Gorbachev era.
"Most things that kill people disproportionately kill babies and the elderly," said Grant Miller, an assistant professor of medicine and faculty member of the Center for Health Policy. "But working-age men accounted for the largest spike in deaths in the early 1990s. Many people suspect that's somehow entwined with political and economic transition, but there's a lot more to it than that."
Most of the deaths during Russia's mortality crisis were from alcohol poisoning, drunken violence or slower killers like heart attacks and strokes, he said.
Miller has outlined the findings – based on newly compiled and digitized archival data – in a working paper written in collaboration with associate professor of medicine Jay Bhattacharya and Christina Gathmann, an assistant professor of economics at the University of Mannheim in Germany. Their research was supported in part by the National Institutes of Health through Stanford's Center on the Demography and Economics of Health and Aging.
Their study shows a steady rise in the number of deaths between the early 1960s and 1984 in one of the world's heaviest drinking countries. Recognizing that alcoholism was a major cause of death and low work productivity, Mikhail Gorbachev instituted an aggressive anti-alcohol campaign in 1985, shortly after he became the Soviet Union's secretary general.
New regulations slashed official alcohol sales by two-thirds, drove up prices by as much as 50 percent and prohibited stores from selling booze before 2 p.m. on business days. Showing up drunk at work or on the streets could cost Russians a hefty fine or land them in prison.
"It was common practice for workers to take their breaks, go to a liquor store and come back to work drunk," said Bhattacharya, who is also a Stanford Center for Health Policy faculty member. "So the people behind the campaign thought closing the stores during the day could lead to more productivity and fewer work-related deaths and injuries."
But the campaign also emphasized alternatives to drinking. A national temperance society was formed, propaganda promoted sobriety and administrators in all Soviet districts – called oblasts – were required to build more parks and sports clubs to encourage family-friendly fun.
The campaign worked. The number of deaths plummeted in 1985 and remained below the pre-campaign trend throughout the late 1980s. That translated to a 12 percent decline in mortality rates: about 665,000 fewer deaths. But by the early 1990s, shortly after the campaign was dropped – and at the same time that the Soviet Union crumbled – the number of deaths began to climb.
The temperance campaign officially folded in 1988 for two main reasons: It was wildly unpopular and the government realized it was losing too much money from low alcohol sales. By 1991, consumption was back to pre-campaign levels.
And Russia's heaviest drinkers – working-age men – fell off the wagon and got back to dying at alarming rates. The end of the campaign accounts for as much as half of Russia's four-year mortality crisis, Miller and Bhattacharya said.
"Welfare and health are not exactly the same thing," Miller said. "You can restrict people's choices in a way that improves health, but that doesn't unambiguously mean that people are better off. "
**Source: Stanford University
Differences in brain structure indicate risk for developing Alzheimer's disease
Subtle differences in brain anatomy among older individuals with normal cognitive skills may be able to predict both the risk of developing Alzheimer's disease in the following decade and how quickly symptoms of dementia would develop. In their analysis of magnetic resonance (MR) images from two separate study groups, researchers from Rush University Medical Center and Massachusetts General Hospital (MGH) found that, among individuals in whom specific brain structures were thinnest, the risk of developing Alzheimer's was three times greater than in those with above-average thickness. The study appears in April 13 issue of Neurology. "We know, primarily from postmortem studies, that changes characteristic of Alzheimer's disease can be present in the brains of cognitively normal people," says Dr. Brad Dickerson, of the MGH department of neurology, lead author of the paper. "But since it takes a long time to follow people through initial symptom development to eventual diagnosis, how that process occurs has received very little study. We used what we know about the signature brain changes seen in patients with Alzheimer's dementia, measured those areas in individuals with no symptoms and eventually determined that those who ultimately developed dementia showed subtle shrinking long before they had any symptoms."
"The MR measurements could be very important indicators to help identify who may be at risk of developing Alzheimer's dementia. If a drug therapy or treatment is developed in the future, those who are still without symptoms but at great risk would benefit the most from treatment," said Leyla deToledo-Morrell, PhD, senior author of the paper and professor in the department of neurological sciences at Rush University Medical Center.
Participants in this study, men and women in their 70s with similar levels of education, were enrolled in two long-term research investigations of brain changes in older individuals, one based at Rush and the other at MGH. Upon entering the studies, participants had a comprehensive clinical examination, neuropsychological evaluation including memory testing, and brain MR imaging. At annual follow-up visits, each was reassessed to determine whether they were cognitively normal or if they had mild cognitive impairment or probable Alzheimer's dementia.
The Neurology study analyzed data from participants who were cognitively normal at the outset and had at least four follow-up visits – a group that totaled 50 participants who remained cognitively normal at the end of the study period, and 15 who had developed Alzheimer's over an average time span of about nine years. In both study groups, the baseline MR images revealed that areas of the cerebral cortex associated with Alzheimer's in previous studies tended to be thinner in participants who went on to develop dementia.
Among those in whom these signature brain areas were the thinnest, 55 percent developed dementia during the study period, compared with 20 percent of those with average cortical thickness and none of those in whom cortical thickness was above average. Participants with the thinnest cortical areas also developed Alzheimer's significantly faster than those with average thickness.
"Comparing the data from the Chicago and Boston sites showed very similar results," said deToledo-Morrell. "Pulling together the data from both sites makes the findings that much stronger."
Adds Dickerson, who is an associate professor of Neurology at Harvard Medical School, "We believe these MR measurements can be powerful markers of the pattern of brain atrophy in Alzheimer's disease and are investigating their use in several ways, including assessing dementia risk in asymptomatic individuals. Our current results are preliminary and are not ready to be applied outside of research studies, but we are optimistic that this marker will be useful in guiding clinical care in the future."
**Source: Rush University Medical Center
"The MR measurements could be very important indicators to help identify who may be at risk of developing Alzheimer's dementia. If a drug therapy or treatment is developed in the future, those who are still without symptoms but at great risk would benefit the most from treatment," said Leyla deToledo-Morrell, PhD, senior author of the paper and professor in the department of neurological sciences at Rush University Medical Center.
Participants in this study, men and women in their 70s with similar levels of education, were enrolled in two long-term research investigations of brain changes in older individuals, one based at Rush and the other at MGH. Upon entering the studies, participants had a comprehensive clinical examination, neuropsychological evaluation including memory testing, and brain MR imaging. At annual follow-up visits, each was reassessed to determine whether they were cognitively normal or if they had mild cognitive impairment or probable Alzheimer's dementia.
The Neurology study analyzed data from participants who were cognitively normal at the outset and had at least four follow-up visits – a group that totaled 50 participants who remained cognitively normal at the end of the study period, and 15 who had developed Alzheimer's over an average time span of about nine years. In both study groups, the baseline MR images revealed that areas of the cerebral cortex associated with Alzheimer's in previous studies tended to be thinner in participants who went on to develop dementia.
Among those in whom these signature brain areas were the thinnest, 55 percent developed dementia during the study period, compared with 20 percent of those with average cortical thickness and none of those in whom cortical thickness was above average. Participants with the thinnest cortical areas also developed Alzheimer's significantly faster than those with average thickness.
"Comparing the data from the Chicago and Boston sites showed very similar results," said deToledo-Morrell. "Pulling together the data from both sites makes the findings that much stronger."
Adds Dickerson, who is an associate professor of Neurology at Harvard Medical School, "We believe these MR measurements can be powerful markers of the pattern of brain atrophy in Alzheimer's disease and are investigating their use in several ways, including assessing dementia risk in asymptomatic individuals. Our current results are preliminary and are not ready to be applied outside of research studies, but we are optimistic that this marker will be useful in guiding clinical care in the future."
**Source: Rush University Medical Center
La Psiquiatría infantil, nueva especialidad médica en España
Psiquiatría infantil, enfermedades infecciosas, emergencias y urgencias y medicina del deporte serán especialidades médicas al mismo nivel que cardiología o pediatría, por ejemplo, antes de final de año. Lo anunció ayer la ministra de Sanidad, Leire Pajín. Con ello se pone fin a años de reivindicaciones de los profesionales y los pacientes, en busca de una respuesta más eficaz a estas dolencias. Hasta ahora, la tuberculosis o el sida lo trataban internistas o microbiólogos. Y la mayoría de los profesionales que tratan a niños con problemas mentales se han formado para atender pacientes adultos o han tenido que ir al extranjero a especializarse.
La ministra también dijo que estaba en estudio la reglamentación de medicina legal y forense y de educación física y del deporte. Pajín anunció la creación de un registro de médicos que trabajan como especialistas sin tener el título oficial.
**Publicado en "EL PAIS"
La ministra también dijo que estaba en estudio la reglamentación de medicina legal y forense y de educación física y del deporte. Pajín anunció la creación de un registro de médicos que trabajan como especialistas sin tener el título oficial.
**Publicado en "EL PAIS"
40 millones de euros para financiar investigaciones de excelencia en España
El programa Severo Ochoa, que se anunció hace cuatro años, ya está listo para ver la luz. Se trata de subvencionar a los mejores centros de investigación con una convocatoria restrictiva, tanto, que la ministra de Ciencia, Cristina Garmendia, admite que es posible que no haya suficientes centros que cumplan los requisitos.
Para optar a la ayuda (cuatro millones en cuatro años, compatible con todas las demás subvenciones o créditos), los centros de investigación deberán contar con "un director científico de prestigio internacional de experiencia contrastada" y con al menos "10 investigadores principales que en los últimos cinco años hayan tenido publicaciones de impacto". Además, se trata de primar a centros concretos, no a redes o unidades virtuales.
Aparte del dinero, esta acreditación servirá para acceder en mejores condiciones a otras ayudas, a instalaciones, y se espera que sea un marchamo de garantía para conseguir mecenazgos.
Jurados internacionales decidirán quiénes son merecedores de la ayuda.
**Publicado en "EL PAIS"
Para optar a la ayuda (cuatro millones en cuatro años, compatible con todas las demás subvenciones o créditos), los centros de investigación deberán contar con "un director científico de prestigio internacional de experiencia contrastada" y con al menos "10 investigadores principales que en los últimos cinco años hayan tenido publicaciones de impacto". Además, se trata de primar a centros concretos, no a redes o unidades virtuales.
Aparte del dinero, esta acreditación servirá para acceder en mejores condiciones a otras ayudas, a instalaciones, y se espera que sea un marchamo de garantía para conseguir mecenazgos.
Jurados internacionales decidirán quiénes son merecedores de la ayuda.
**Publicado en "EL PAIS"
Reino Unido: Semana de concienciación sobre los cánceres de próstata, testículos y pene
Fue una estrella del rugby y ganó la Copa del Mundo con la selección inglesa en 2003. Ahora, ya retirado del deporte que le dio la fama, Phil Vickery juega en otra liga y con otras 'pelotas' distintas. Ha prestado su imagen y su marca de ropa -Raging Bull- a la organización benéfica Orchid para concienciar a los hombres de la importancia de que vigilen sus propios 'balones' y prevenir así los tres tumores que sólo les pueden afectar a ellos: el de próstata, el de testículos y el de pene. "Cada año, sólo en el Reino Unido, 37.000 varones son diagnosticados con uno de estos tumores. Aumentar la conciencia sobre estas enfermedades es vital para que puedan diagnosticarlas a tiempo", explica Rebecca Porta, directora ejecutiva de Orchid, la asociación que se encarga de luchar contra el cáncer masculino. Pese a la cifra, "el 68% de los hombres no sabe cuáles son los signos que pueden denotar que sufren un cáncer de este tipo", añade Porta, para quien "aumentar el conocimiento sobre el tema, para favorecer el diagnóstico precoz, puede marcar la diferencia y mejorar las tasas de supervivencia de los afectados".
Para llegar más lejos con su mensaje y, sobre todo, para que los jóvenes también tomen conciencia del problema, Orchid propuso un concurso al London College of Fashion para que sus estudiantes diseñaran una camiseta sobre el tema. La ganadora ha sido Elise Pellican, cuya ilustración de hombres haciendo malabares ha sido recreada por los jugadores de rugby Dominic Waldouck, Guy Armitage y Joe Simpson. "Estoy muy orgullosa de poder ayudar a una causa que no siempre tiene la publicidad que merece", ha expresado la diseñadora. La prenda, que cuesta 25 libras (unos 28 euros), está disponible en comercios del Reino Unido y, esta semana, también a través de Internet. El dinero recaudado va íntegramente al organismo benéfico.
-El papel de la mujeres es clave
No se trata sólo de informar a los hombres. De hecho, el lema elegido para este año es 'Su salud en tus manos' y con él se pretende hacer un llamamiento a las mujeres para que se involucren en el cuidado de la salud de sus chicos y que si notan algo raro les convenzan para ir al médico. Ése fue el caso de Will y Lucy, que han contado su historia a Orchid. Cuando Will tenía sólo 17 años, su novia Lucy le notó un bulto en un testículo. Pero como él se encontraba bien, pensó que siempre había estado ahí y que no merecía la pena ir al médico "por nada". Sin embargo, ella insistió y, gracias a eso, le detectaron el cáncer en una fase temprana, antes de que se hubiera extendido al sistema linfático. "Sin ella, igual no lo hubiera contado", reconoce. De estos tres tipos de tumores masculinos, el cáncer de próstata es el más común, especialmente entre los mayores de 65 años. El de testículos es más frecuente en los varones de entre 15 y 45 años. Si se detecta a tiempo, la tasa de curación supera el 95%. El cáncer de pene es menos común y tiene mal pronóstico. Uno de cada cuatro afectados muere. "Vigilarse esa zona y acudir al médico ante cualquier cosa rara que noten es básico para prevenir males mayores", admite Porta.
**Publicado en "EL MUNDO"
Trabajan sobre el Atlas del cerebro en EEUU
Genes, estructuras, conexiones nerviosas, anatomía... Más de 100 millones de datos (que a partir de ahora estarán accesibles libremente a través de internet) componen el nuevo atlas del cerebro presentado en Seattle (EEUU) por el Instituto Allen de Ciencias Cerebrales. Un ambicioso proyecto que permitirá a científicos de todo el mundo indagar en los secretos de uno de los órganos que aún esconde más secretos del cuerpo humano. Con una financiación de 55 millones de dólares (salidos del bolsillo de uno de los fundadores de Microsoft, Paul Allen), el proyecto es el fruto de cuatro años de trabajo y estará disponible a partir de ahora de manera gratuita a través de la web brain-map.org. Este exahustivo trabajo, un mapa con este nivel de detalle, "simplemente no existía", reconoce Allan Jones, director ejecutivo de este organismo sin ánimo de lucro dedicado al estudio del cerebro y las patologías neurológicas. Para llevarlo a cabo, sus autores han contado con la donación de cerebros realizada por dos varones al instituto estadounidense (por lo que los investigadores reconocen que en el futuro será necesario contar con más órganos femeninospara ratificar sus conclusiones en el género opuesto), que han permitido analizar qué genes están 'encendidos' en cada región. Con la ayuda de técnicas de imagen, genética y potentes ordenadores para el procesamiento de datos, el nuevo atlas on line ofrece tanto imágenes en tres dimensiones del órgano, como de la estructura de los nervios que lo componen, las características de sus células o su actividad genética en las distintas localizaciones. "La identificación de los genes que están o no activos es crucial para comprender el mecanismo de ciertas enfermedades", ha señalado al diario 'The New York Times' otro de los participantes en el proyecto, el doctor Jeffrey Noebels, del Baylor College de Houston (también en EEUU). Desentrañando todos los misterios posibles de los dos cerebros de los voluntarios, el atlas ha localizado por ejemplo 1.000 regiones anatómicas que posteriormente se cruzaron con la información sobre los miles de genes que deberían estar normalmente activos. Para su sorpresa, explican, descubrieron que la similitud entre ambos era del 94%. **Publicado en "EL MUNDO"
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