Citalopram Mylan 30 mg/56 comprimidos EFG, nuevo lanzamiento en el área de SNC

Con la responsabilidad de acercar la salud a todos los colectivos y ampliar su vademécum para ofrecer una gama de productos genéricos de calidad en el área de SNC, Mylan lanza Citalopram Mylan 30 mg 56 comprimidos recubiertos con película EFG.

Citalopram Mylan 30 mg está indicado para episodios depresivos mayores, tratamiento preventivo de las recaídas/recurrencias de la depresión, trastorno de angustia con o sin agorafobia y trastorno obsesivo compulsivo.

Mylan, con presencia en más de 150 países y territorios, es una de las compañías líderes mundiales en medicamentos genéricos y especializados. Posee uno de los portafolios más amplios y de la más alta calidad, además de una de las carteras más importantes de productos en desarrollo. Asimismo, dirige una de las mayores compañías de principios activos farmacéuticos del mundo. En nuestro país, Mylan suministra medicamentos especiales y libres de patente, con una fuerte especialización en las áreas de cardiología, osteoporosis, antiinfecciosos, digestivo y sistema nervioso

Xanit Hospital Internacional organiza un curso para profundizar en el tratamiento de las urgencias de Otorrinolaringología

Xanit Hospital Internacional ha organizado, a través del Servicio ORL, el I Curso de Actualización en Urgencias ORL, una jornada que comenzará mañana a las 16.00 horas y que tiene como objetivo actualizar los conocimientos de los tratamientos de las urgencias de Otorrinolaringología a los Médicos de Atención Primaria y Residentes en el Diagnóstico.

“Las urgencias del área de Otorrinolaringología (ORL) representan un importante volumen del total de urgencias atendidas tanto a nivel hospitalario, como en centros de salud y éste ha sido el motivo principal por el que hemos organizado esta jornada, donde los asistentes podrán recibir un resumen actualizado del diagnóstico y tratamiento de este tipo de urgencias, mediante prestaciones temáticas eminentemente prácticas”, asegura el Dr. Robin Reyes, otorrino de Xanit Hospital Internacional y coordinador del curso.

En estas jornadas se ofrecerá una visión práctica del tema mediante imágenes, vídeos y casos clínicos. Además, se incluirá un taller dedicado a la Epíxtasis por parte del Dr. Robin Reyes Eldblom con el objetivo de aportar al médico de Urgencias conocimientos sobre los diferentes taponamientos que existen y su modo de proceder, en cada caso.

El I Curso de Actualización en Urgencias ORL incluirá un total de 4 ponencias en la que se abordarán las urgencias más comunes: “Recuerdo anatómico/exploración ORL en Urgencias”, impartida por el Dr. Robin Reyes Eldblom; “Oído externo, medio e interno”, por la Dra. Elena Monje Vega (Servicio ORL de Xanit Hospital Internacional); “Fosas y senos paranasales”, Dr. Robin Reyes Eldblom y “Faringe, tráquea y cuello”, por el Dr. David Piedrola Maroto (Servicio ORL Xanit Hospital Internacional).

Vitamin D deficiency in pneumonia patients associated with increased mortality

A new study published in the journal Respirology reveals that adult patients admitted to the hospital with pneumonia are more likely to die if they have Vitamin D deficiency. Vitamin D is known to be involved in the innate immune response to infection.
The team of researchers at Waikato Hospital and the Universities of Waikato and Otago, measured vitamin D in the blood samples of 112 adult patients admitted with community acquired pneumonia during the winter at the only acute-care hospital in Hamilton, New Zealand.
The researchers found that Vitamin D deficiency was associated with higher mortality within the first 30 days after hospital admission for pneumonia. The association between vitamin D deficiency was not explained by patient age, sex, comorbidities, the severity of the systemic inflammatory response, or other known prognostic factors.
The authors conclude that "improved understanding of Vitamin D and its role in immunity may lead to better ways to prevent and/or treat pneumonia. We now need to investigate whether Vitamin D supplements could be a useful addition to pneumonia treatment and whether using supplements could help to prevent or reduce the severity of pneumonia among high-risk populations."

**Source: Wiley-Blackwell

Genetic defects hold clues to risk for sudden cardiac death

Sudden cardiac death is always a shocking, tragic event, especially when it occurs at a young age. But, for the first time, scientists are unraveling how genetic defects can help predict the risk of dying suddenly in individuals with one of the leading causes of this unfortunate phenomenon. This knowledge could guide treatment and potentially lessen the occurrence of sudden cardiac death in patients with Long QT syndrome, a rare, inherited heart rhythm disorder. It could also provide insight into the assessment and treatment of the millions of people who experience cardiac arrhythmias – irregular heart rhythms that cause the heart to beat too fast or too slow and can lead to sudden death if not corrected.
The new study, published recently in the journal Science Translational Medicine, shows that the function of specific genetic mutations – namely, the defects these mutations cause – are strong predictors of risk of sudden death and other cardiac events in patients with Long QT.
The finding is especially relevant for individuals who have the condition but don't have particularly pronounced clinical risk factors, such as a very prolonged QT interval – the time it takes for the heart's electrical system to recharge after each heartbeat and get ready for the next (hence, the name "Long QT" syndrome). When the QT interval is prolonged, the heart is more susceptible to arrhythmias.
These tricky, in-between patients, who make up about 70 percent of the Long QT syndrome population, often fall into a treatment gray area. In the future, lead study author Coeli Lopes, Ph.D., hopes that physicians may be able to use mutation-specific information to better identify high-risk individuals in this group who should be followed more carefully and treated more aggressively.
"To our knowledge, this is the first time anyone's linked the activity of specific mutations to actual risk in patients," said Lopes, assistant professor at the Aab Cardiovascular Research Institute at the University of Rochester Medical Center. "We're literally going from studying mutant proteins in cells in the lab to risk assessment in the clinic, which is an exciting and very promising concept."
Long QT occurs most visibly in teens with otherwise healthy hearts and may go unnoticed until a stressful event, like swimming, jumping into cold water or hearing a particularly loud noise jolts the heart out of rhythm, leading to fainting, cardiac arrest or sudden death.
"Before we had such robust genetic information, we based risk solely on clinical measurements, such as the length of the QT interval and if patients had passed out in the past," said Arthur J. Moss, M.D., professor of Cardiology at the Medical Center and the world's foremost authority on the diagnosis and treatment of Long QT syndrome. "These results mean we can be much more specific in prescribing preventive therapy, which is terrific news for patients and their families."
Current treatment options for patients with Long QT include beta blockers, which relieve stress on the heart by slowing the heart rate, and implantable cardioverter defibrillators or ICDs, which detect irregular and potentially fatal heartbeats and shock the heart back into a normal rhythm. Better knowledge of risk will help physicians decide if patients need treatment with a beta blocker, an ICD or both.
In the study, researchers looked at the most frequent mutations found in patients with Long QT syndrome type 1, one of the most common forms of the disease, and analyzed their influence on ion channels – small pores or holes on the surface of each heart muscle cell. These channels open and close to let electrically charged particles flow into and out of the cell, generating the signal the heart needs to stop contracting and relax after pumping blood throughout the body.
When they compared the results with patient outcomes, they discovered that mutations that cause ion channels to open more slowly than they should were strongly associated with increased risk for cardiac events. Patients with these slow activating channels were twice as likely as patients with other mutations to die before the age of 30 or experience serious symptoms.
Even for patients who lacked telltale clinical symptoms, the presence of mutations linked with slow-to-open ion channels was still associated with an increased risk of cardiac events.
"This study creates a paradigm that we not only have to take into account the presence of mutations, but the potential consequences of mutations as well," noted Wojciech Zareba, M.D., Ph.D., director of the Heart Research Follow-up Program and an expert on Long QT. "Some mutations may be more benign and others less so and more research is needed to understand why this is the case."

**Source: University of Rochester Medical Center

UCLA scientists discover way to amp up power of killer T cells

Researchers with UCLA's Jonsson Comprehensive Cancer Center have discovered a way to amp up the power of killer T-cells, called CD8 cells, making them more functional for longer periods of time and boosting their ability to multiply and expand within the body to fight melanoma, a new study has found. The study, done in mouse models of metastatic melanoma that had spread to the brain, has important clinical implications, as the method could boost the cancer-killing power of experimental immunotherapies being tested now in various cancers, including deadly glioblastoma and metastatic melanoma, both of which are very difficult to treat successfully.
Study senior author Dr. Robert Prins, an associate professor of neurosurgery and a Jonsson Cancer Center scientist, said the killer T cells also were better able to recognize and traffic to the cancer, which is crucial as the immune system often fails to identify malignant cells as invading enemies.
The study is published in the May issue of the peer-reviewed the Journal of Immunology.
The process Prins and his team used sought to mimic the way the T cells in the immune system recognize and fight viruses in the body, stimulating what is called the innate immune system. The innate immune system is comprised of cells that immediately defend the body from infection and frequently is not stimulated in the presence of cancer, Prins said. However, the innate immune cells can be tricked into thinking a virus is present by treating with compounds that activate Toll-like receptors (TLR).
Prins' group had previously demonstrated that TLR agonists, such as imiquimod, could synergize with dendritic cell vaccines, both in mouse models and patient clinical trials. Interleukin 12 (IL-12) is one of the predominant cytokines released when TLR are activated. In this study, they wanted to see how IL-12 would affect the CD8 T cells.
Graduate student Dominique Lisiero, first author of the study, said CD8 T cells come in a large variety of "flavors" and can be stimulated in differing ways. However, what signals and which stimuli work best to prime the cells to fight cancer was unclear. Lisiero added IL-12 to the CD8 T cells in culture, before the cells were transferred into mice with established brain tumors.
"We wanted to see if we could make these cells become better at either recognizing the tumor or killing tumor cells," she said. "We didn't know what expect, but what we found was that when we programmed these cells in the presence of IL-12, we saw that the tumors decreased in size and the mice with brain metastases survived longer. In fact, Prins said that the mice treated with killer T cells primed in the presence of IL-12 lived about 2.5 times longer than those not receiving the IL-12.
To better understand the mechanisms by which priming killer T cells in the presence of IL-12 really enhanced their function, the team focused on how these T cells responded to a different cytokine, Interleukin 2 (IL-2). IL-2, which is instrumental for the body's natural response to infection and recognition of foreign invaders, often is included in adoptive transfer immunotherapies to help the T cells survive, but it has to be given in high doses that frequently cause significant toxicity to patients. Prins and Lisiero wanted to know if adding IL-12 would enhance the sensitivity of IL-2 signaling inside the T cells.
"T cells that were primed in the presence of IL-12 had a higher expression of the IL-2 receptor, meaning the T cells had an enhanced ability to respond to the IL-2. This, we believe, allowed the killer T cells to expand and survive after being transferred into mice with brain tumors. " Lisiero said. "Because the IL-12 stimulates the IL-2 receptor, we can give much lower doses of IL-2 and still get the same anti-tumor function from the killer T cells. In patients, this may translate to reduced toxicity. Clinical trials, however, would be required to prove that this priming with IL-12 would have similar effects."
Lisiero also tested the new process on human T cells, culturing them in either IL-2 or IL-12, and studying their function in the lab. The function of the cells programmed in IL-12 was dramatically increased, Prins said, validating the work in the mouse models. Their findings are already influencing how T cells are grown in the lab, he said.
The findings also are translational to the clinic, since metastatic melanoma patients in clinical trials often are removed from the protocol when the cancer appears in their brain. Many oncologists and scientists still believe that T cells can't access the brain because of its immune privilege. This study, however, has proven in a pre-clinical model that these tumors in the brain can in fact be effectively targeted.
"The in vitro priming of mouse tumor-specific CD8 T cells in the presence of IL-12 induced a diverse and rapid anti-tumor effector activity while still promoting the generation of memory cells," the study states. "Importantly, the IL-12-primed effector T cells dramatically reduced the growth of well-established tumors and significantly increased survival to highly immune resistant, established intracranial tumors."

**Source: University of California - Los Angeles Health Sciences

Depression associated with poor medication adherence in patients with chronic illnesses

People who are depressed are less likely to adhere to medications for their chronic health problems than patients who are not depressed, putting them at increased risk of poor health, according to a new RAND Corporation study. Researchers found that depressed patients across a wide array of chronic illnesses such as diabetes and heart disease had 76 percent greater odds of being non-adherent with their medications compared to patients who were not depressed. The findings were published online by the Journal of General Internal Medicine.
The study is the largest systematic review to date to look at the role that depression plays in medication adherence among patients in the United States.
"These findings provide the best evidence to date that depression is an important risk factor that may influence whether patients adhere to their medications," said Dr. Walid F. Gellad, the study's senior author and a natural scientist at RAND, a nonprofit research organization. "There are important implications for both patient health and for health care costs.
"Doctors and other providers should periodically ask patients with depression about medication adherence. Also, when treating a patient who is not taking their medication correctly, they should consider the possibility that depression is contributing to the problem."
Poor adherence to prescribed medication is a well-known problem that is associated with higher death rates among people with chronic illnesses. It is also blamed for increasing U.S. health care costs.
Researchers from RAND and the Claremont Graduate School conducted the study by examining past studies that have measured medication adherence. They combined information from 31 studies involving more than 18,000 people -- significantly more than past reviews –to examine the link between medication adherence and depression.
The study is the first to review the association between depression and medication adherence for patients with high blood pressure and high cholesterol. Other conditions examined in the study include coronary heart disease, diabetes and asthma. The link between depression and medication adherence did not vary significantly between the different chronic illnesses, said Gellad, who is also a physician with the VA Pittsburgh Healthcare System.
"The consistent link between depression and nonadherence across all these illnesses underscores the seriousness of the role that depression plays in keeping people from properly managing chronic conditions," said Jerry L. Grenard, the study's lead author and an assistant professor at the Claremont Graduate School. "That consistency also suggests that lessons learned about how to improve medication adherence among depressed patients with one disease may be applied to other chronic conditions."
Researchers say that depression is just one barrier to getting patients to follow medication recommendations. Additional well-documented barriers to medication adherence are dose complexity and patient cost-sharing. Other barriers that may play a role include beliefs about medications, social support, side effects and provider factors.

**Source: RAND Corporation

Un estudio considera que con 15 óvulos el éxito de una FIV sería máximo

Sabemos que ser menor de 35 años aumenta las posibilidades de éxito de la fecundación 'in vitro' (FIV) igual que el sobrepeso las reduce. Los factores predictivos de los tratamientos de fertilidad son una valiosa información para médicos y pacientes. Ahora, un estudio revela que el número ideal de óvulos extraídos a una mujer para maximizar las opciones de tener un recién nacido es 15.
"Con un mayor número de ovocitos, tendremos más embriones entre los que elegir para transferirlos y podremos seleccionar aquéllos con mejores características, lo que nos dará más oportunidades de lograr un embarazo", explica a ELMUNDO.es Arri Coomarasamy, del Brimingham Women's Hospital (Reino Unido), que ha dirigido el estudio.
En él se han analizado los datos de más de 400.000 tratamientos de FIV practicados en el Reino Unido entre 1991 y 2008. El objetivo era determinar el valor pronóstico (acerca de las posibilidades de tener un hijo) del número de óvulos que se extraen a la mujer para llevar a cabo la 'in vitro'.
Esta relación se suponía importante pero los estudios realizados hasta la fecha arrojaban conclusiones contradictorias. Ahora, los hallazgos de Coomarasamy y sus colegas, publicados en la revista 'Human Reproduction' ofrecen una cifra ideal de ovocitos.
"Alrededor de 15 óvulos sería el número óptimo para una FIV en fresco [sin congelarlos] con el propósito de maximizar su éxito y minimizar el riesgo de hiperestimulación ovárica", explican los autores.
El número de ovocitos que se obtiene en cada ciclo depende del grado de estimulación ovárica que se aplica a la paciente. Con la mínima, se pueden extraer entre seis y ocho, la media da 10-15 y la máxima supera los 20. Pero con esta última, aumenta el riesgo de hiperestimulación y, además, no aumentan las opciones de tener un hijo.
"Es difícil explicar por qué las tasas de embarazo caen cuando el número de óvulos es elevado -señala Coomarasamy-. Debe estar relacionado con una menor calidad de los mismos". Por eso, "nuestros resultados apoyan los protocolos de estimulación moderada", añade.

**Publicado en "EL MUNDO"