Durante la presentación de una guía sobre catéteres venosos centrales, destinada a enfermería, los responsables de Salud de Asturias han confirmado que la región ha conseguido disminuir, desde 2009, un 45 por ciento la incidencia de infecciones por catéteres en las Unidades de Cuidados Intensivos (UCI).
El consejero de Salud y Servicios Sanitarios, Ramón Quirós, y la directora gerente del Servicio de Salud del Principado de Asturias (SESPA), Elena Arias, participaron en dicha presentación, con el objetivo de aumentar la seguridad en los hospitales, a través de la protocolización en el cuidado de estos catéteres, en cuanto al manejo de los mismos y la prevención de las complicaciones. La edición de esta guía se enmarca en las estrategias de mejora de la seguridad de los pacientes, como elemento clave de la calidad asistencial, lo que fue una de las prioridades de la Salud de Asturias a lo largo de esta legislatura.
La citada reducción de infecciones supuso, para la Consejería de Salud Asturiana en los últimos años, una mejora de los indicadores de seguridad en cuanto a incidencia de bacteriemias contraídas en los hospitales, cumpliendo ampliamente las recomendaciones de la OMS y con unos índices que mejoran también la media del Sistema Nacional de Salud. Asturias está actualmente por debajo del estándar máximo de bacteriemias que recomienda la OMS y también por debajo de los datos nacionales. El estándar establecido por la OMS es de menos de cuatro episodios de bacteriemia por 1.000 días de colocación de catéter venoso central; la tasa nacional es de 2,94 y en Asturias de 2,60.La edición de esta guía se enmarca en la mejora de la seguridad de los pacientes, lo que fue una estrategia prioritaria de la Consejería de Salud a lo largo de esta legislatura, con actuaciones en materia de higiene de manos, prevención de úlceras por presión, identificación de pacientes y prevención de caídas en los centros sanitarios, entre otros programas.
30 May 2011
New study about lipids (fatty molecules) in the blood plasma
Studying the genetic make-up of different varieties of lipids (fatty molecules) in the blood plasma of an individual can lead to a better and earlier prediction of diseases such as diabetes, atherosclerosis, and heart disease, two researchers will tell the annual conference of the European Society of Human Genetics today (Monday 30 May). In the first study, Dr. Joanne Curran from the Texas Biomedical Research Institute, San Antonio, USA, will tell the conference that lipidomic profiling will become a more reliable early indicator of individuals likely to develop diabetes than the more commonly used predictors such as blood glucose and insulin levels.
Dr. Curran and colleagues from the US and Australia measured 356 different lipid varieties from about 1100 Mexican American members of large extended families who were part of the San Antonio Family Heart Study. The Mexican American population is at high risk of diabetes with about 25% of this population ultimately becoming diabetic. At the start of the research, 861 of the individuals studied did not have diabetes. However, over the 10 year follow-up examined in the study, 110 individuals did develop the disease.
The scientists were able to isolate 128 different varieties of lipids that predicted the progression to diabetes by measuring the the lipidomic profiles of each individual at multiple timepoints during the follow-up period. "The single best predictor we found was a novel component called dihydroceramide (dhCer). This was substantially increased in people with diabetes. It is also heritable, and appears to be an independent risk factor unconnected to blood sugar and insulin levels," says Dr. Curran.
After uncovering the link between dhCer and diabetes, the team searched the genome to find locations that harboured genes that influence dhCer levels. They identified a region on chromosome 3 that appeared to contain a gene with substantial importance for the production of dhCer. "Through whole genome sequencing, we are now attempting to identify this causal gene in the hope that it will be informative in the understanding of the pathogenesis of diabetes, and also suggest new avenues for treatment," Dr. Curran says.
In the future, the researchers say, measurement of dhCer levels could become routine in the prediction of individuals likely to become diabetic. One of the difficulties of the current predictive methods is that they do not function until a patient is near to developing the disease. Being able to identify those at risk at the earliest stage would mean that individuals have plenty of time to make the lifestyle changes that could help them avoid the disease – through a change in diet, or increasing physical activity, for example.
"Currently one in ten US adults suffers from diabetes and recently the Centers for Disease Control has predicted that this will increase to one in three by 2050", says Dr. Curran. "We are optimistic that our discovery will lead to new treatments, but in the short-term the importance of finding out at an early stage whether any individual is likely to develop it cannot be overstated. A test based on dhCer levels will help to avoid the serious health effects that diabetes has in its own right, such as kidney failure, amputations, and blindness. It is, of course, also a risk for cardiovascular disease, so the health burden of this condition is enormous", she concludes.
In the second study, Dr. Sara Willems, from the Erasmus Medical Centre, Rotterdam, The Netherlands, will describe to the conference research carried out on the influence of common genetic lipid variants on atherosclerosis and related heart disease. "A recent genome-wide meta-analysis of more than 100,000 individuals identified a large number of genetic variants associated with levels of LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. These molecules are, at increased levels of LDL and triglycerides and decreased levels of HDL, important risk factors for cardiovascular disease", says Dr. Willems.
The researchers used risk scores from these genetic variants to test the hypothesis that their cumulative effects were associated with cardiovascular disease. For this purpose they used genetic data from more than 8000 individuals from the population-based Rotterdam Study and more than 2000 individuals participating in the Dutch family-based Erasmus Rucphen Family study.
They found an association between the LDL risk score and arterial wall thickness, and a strong association of this risk score with carotid plaque. These conditions can cause arterial blockage which leads to stroke. The same risk score was also associated with coronary heart disease.
"Our findings show that an accumulation of common genetic variants with small effects on lipid levels can have a significant effect on clinical and sub-clinical outcomes", says Dr. Aaron Isaacs, who led the project. "In the future, as our knowledge of genetic variation increases, effective pre-clinical genetic screening tools may be able to enhance the prediction and prevention of diseases such as cardiovascular disease."
New genetic variants influencing lipid levels are being identified all the time, the researchers say. "As new variants are discovered, we would like to be able to continue to test them, both singly and combined, for association with cardiovascular disease. The cost of these diseases to individuals, families, society and healthcare systems is immense", says Dr. Willems.
"Cardiovascular disease is the main cause of death in Europe, killing over 4 million people per year. It also represents 23% of the total disease burden (illness and death) across the continent. Managing cholesterol levels is important for prevention. This can be done early in life by effective treatment. We hope that our study, showing that common genetic variants play an important role in the occurrence of cardiovascular disease, marks a starting point for early prediction and prevention and may thus reduce the burden of disease," she concludes.
Dr. Curran and colleagues from the US and Australia measured 356 different lipid varieties from about 1100 Mexican American members of large extended families who were part of the San Antonio Family Heart Study. The Mexican American population is at high risk of diabetes with about 25% of this population ultimately becoming diabetic. At the start of the research, 861 of the individuals studied did not have diabetes. However, over the 10 year follow-up examined in the study, 110 individuals did develop the disease.
The scientists were able to isolate 128 different varieties of lipids that predicted the progression to diabetes by measuring the the lipidomic profiles of each individual at multiple timepoints during the follow-up period. "The single best predictor we found was a novel component called dihydroceramide (dhCer). This was substantially increased in people with diabetes. It is also heritable, and appears to be an independent risk factor unconnected to blood sugar and insulin levels," says Dr. Curran.
After uncovering the link between dhCer and diabetes, the team searched the genome to find locations that harboured genes that influence dhCer levels. They identified a region on chromosome 3 that appeared to contain a gene with substantial importance for the production of dhCer. "Through whole genome sequencing, we are now attempting to identify this causal gene in the hope that it will be informative in the understanding of the pathogenesis of diabetes, and also suggest new avenues for treatment," Dr. Curran says.
In the future, the researchers say, measurement of dhCer levels could become routine in the prediction of individuals likely to become diabetic. One of the difficulties of the current predictive methods is that they do not function until a patient is near to developing the disease. Being able to identify those at risk at the earliest stage would mean that individuals have plenty of time to make the lifestyle changes that could help them avoid the disease – through a change in diet, or increasing physical activity, for example.
"Currently one in ten US adults suffers from diabetes and recently the Centers for Disease Control has predicted that this will increase to one in three by 2050", says Dr. Curran. "We are optimistic that our discovery will lead to new treatments, but in the short-term the importance of finding out at an early stage whether any individual is likely to develop it cannot be overstated. A test based on dhCer levels will help to avoid the serious health effects that diabetes has in its own right, such as kidney failure, amputations, and blindness. It is, of course, also a risk for cardiovascular disease, so the health burden of this condition is enormous", she concludes.
In the second study, Dr. Sara Willems, from the Erasmus Medical Centre, Rotterdam, The Netherlands, will describe to the conference research carried out on the influence of common genetic lipid variants on atherosclerosis and related heart disease. "A recent genome-wide meta-analysis of more than 100,000 individuals identified a large number of genetic variants associated with levels of LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. These molecules are, at increased levels of LDL and triglycerides and decreased levels of HDL, important risk factors for cardiovascular disease", says Dr. Willems.
The researchers used risk scores from these genetic variants to test the hypothesis that their cumulative effects were associated with cardiovascular disease. For this purpose they used genetic data from more than 8000 individuals from the population-based Rotterdam Study and more than 2000 individuals participating in the Dutch family-based Erasmus Rucphen Family study.
They found an association between the LDL risk score and arterial wall thickness, and a strong association of this risk score with carotid plaque. These conditions can cause arterial blockage which leads to stroke. The same risk score was also associated with coronary heart disease.
"Our findings show that an accumulation of common genetic variants with small effects on lipid levels can have a significant effect on clinical and sub-clinical outcomes", says Dr. Aaron Isaacs, who led the project. "In the future, as our knowledge of genetic variation increases, effective pre-clinical genetic screening tools may be able to enhance the prediction and prevention of diseases such as cardiovascular disease."
New genetic variants influencing lipid levels are being identified all the time, the researchers say. "As new variants are discovered, we would like to be able to continue to test them, both singly and combined, for association with cardiovascular disease. The cost of these diseases to individuals, families, society and healthcare systems is immense", says Dr. Willems.
"Cardiovascular disease is the main cause of death in Europe, killing over 4 million people per year. It also represents 23% of the total disease burden (illness and death) across the continent. Managing cholesterol levels is important for prevention. This can be done early in life by effective treatment. We hope that our study, showing that common genetic variants play an important role in the occurrence of cardiovascular disease, marks a starting point for early prediction and prevention and may thus reduce the burden of disease," she concludes.
29 May 2011
New treatment dissolves blood clots in brain tissue
A new treatment that treats a subset of stroke patients by combining minimally invasive surgery, an imaging technique likened to "GPS for the brain," and the clot-busting drug t-PA appears to be safe and effective, according to a multicenter clinical trial led by Johns Hopkins researchers. The novel treatment, detailed for the first time at this week's European Stroke Conference in Hamburg, Germany, was developed for patients with intracerebral hemorrhage (ICH), a bleed in the brain that causes a clot to form within brain tissue. This clot builds up pressure and leaches inflammatory chemicals that can cause irreversible brain damage, often leading to death or extreme disability. The usual treatments for ICH—either general supportive care such as blood pressure control and ventilation, which is considered the current standard of care, or invasive surgeries that involve taking off portions of the skull to remove the clot—have similar mortality rates, ranging from 30 to 80 percent depending on the size of the clot.
Seeking to improve these mortality rates and surviving ICH patients' quality of life, Daniel Hanley, M.D., professor of neurology at the Johns Hopkins University School of Medicine, and his colleagues developed and tested the new treatment on 60 patients at 12 hospitals in the United States, Canada, the United Kingdom and Germany. They compared their results to those of 11 patients who received only supportive care.
After neurologists diagnosed patients in the treatment group with ICH at these hospitals, surgeons drilled dime-sized holes in patients' skulls close to the clot location. Using high-tech neuro-navigational software that provides detailed brain images, the physicians threaded catheters through the holes and directly into the clots. They used these catheters to drip t-PA into the clot for up to three days at one of two doses, either 0.3 mg or 1 mg, every eight hours.
The researchers found that clot size in patients treated with either dose shrunk by more than half, compared to only 1 percent in patients who received only supportive care. Comparison of daily CT scans showed that patients in the treatment group whose catheters were most accurately placed through the longest part of the clot had the most effective clot size reduction.
Those in the treatment group and the supportive care group had about a 10 percent mortality rate at 30 days after treatment, lower than the typically high mortality rates expected for this condition. After following the patients out for six months, the researchers found that the treated patients scored significantly higher on a test that measures the ability to function in daily life compared to those who received supportive care.
Overall, Hanley says, the new treatment appears to be a viable and promising alternative to the current standard treatments of supportive care or invasive surgery.
"We're confirming that patients do recover better if we remove as much of the clot as we can, but gentle removal appears to be key," he says. "Reducing the clot's size with a minimally invasive method seems to be pivotal for optimizing patient recovery."
Hanley and his colleagues plan to continue investigating the treatment in a larger multicenter trial.
**Source: Johns Hopkins Medical Institutions
Seeking to improve these mortality rates and surviving ICH patients' quality of life, Daniel Hanley, M.D., professor of neurology at the Johns Hopkins University School of Medicine, and his colleagues developed and tested the new treatment on 60 patients at 12 hospitals in the United States, Canada, the United Kingdom and Germany. They compared their results to those of 11 patients who received only supportive care.
After neurologists diagnosed patients in the treatment group with ICH at these hospitals, surgeons drilled dime-sized holes in patients' skulls close to the clot location. Using high-tech neuro-navigational software that provides detailed brain images, the physicians threaded catheters through the holes and directly into the clots. They used these catheters to drip t-PA into the clot for up to three days at one of two doses, either 0.3 mg or 1 mg, every eight hours.
The researchers found that clot size in patients treated with either dose shrunk by more than half, compared to only 1 percent in patients who received only supportive care. Comparison of daily CT scans showed that patients in the treatment group whose catheters were most accurately placed through the longest part of the clot had the most effective clot size reduction.
Those in the treatment group and the supportive care group had about a 10 percent mortality rate at 30 days after treatment, lower than the typically high mortality rates expected for this condition. After following the patients out for six months, the researchers found that the treated patients scored significantly higher on a test that measures the ability to function in daily life compared to those who received supportive care.
Overall, Hanley says, the new treatment appears to be a viable and promising alternative to the current standard treatments of supportive care or invasive surgery.
"We're confirming that patients do recover better if we remove as much of the clot as we can, but gentle removal appears to be key," he says. "Reducing the clot's size with a minimally invasive method seems to be pivotal for optimizing patient recovery."
Hanley and his colleagues plan to continue investigating the treatment in a larger multicenter trial.
**Source: Johns Hopkins Medical Institutions
Las mujeres son tres veces más propensas que los hombres a desarrollar el síndrome del túnel carpiano
El síndrome del túnel carpiano afecta al nervio medio de la muñeca y puede originarse debido a actividades repetitivas, como usar herramientas o manejar el ratón del ordenador. La extensión de este problema varía enormemente de unos países a otros, y también de unas generaciones a otras, lo que sugiere que se trata de una dolencia cultural, asociada a las costumbres de cada época y lugar.
Las diferentes actividades laborales, junto a otros condicionantes como el sobrepeso, provocan que la prevalencia del síndrome difiera de un país a otro, pero también que aumente en un mismo lugar, entre las generaciones más jóvenes, a medida que las costumbres se transforman. Así lo ha puesto de manifiesto un nuevo estudio que ha analizado la incidencia de este síndrome en Suecia y la ha comparado con la de EEUU.
En el país norteamericano, la presencia de este problema es mucho mayor a la de Suecia entre personas mayores, pero las diferencias se acortan o desaparecen entre las generaciones más jóvenes. "La incidencia en mujeres de menos de 50 años era mayor en Suecia, pero, en mujeres de 50 o mayores, la incidencia era mayor en EEUU", revela el estudio, publicado en 'Achives of Internal Medicine'.
Los resultados en hombres fueron distintos, ya que las mujeres son tres veces más propensas que los hombres a desarrollar este síndrome. Sin embargo, los datos son igualmente compatibles con la interpretación cultural del síndrome: entre varones menores de esa edad, la incidencia era similar en EEUU y Suecia; pero en los mayores, las cifras del país americano doblaban a las del nórdico.
Isam Atroshi, principal firmante del estudio desde el Hospital Hassleholm de Suecia, y sus colegas consideran que hasta un 15% de la población podría sufrir este síndrome, aunque muchos pacientes no son conscientes de ello. El problema se produce por compresión, habitualmente crónica, del nervio mediano, que abarca desde el antebrazo hasta la mano.
Varios estudios mostraron durante la pasada década la relación entre el uso prolongado del ratón del ordenador y el síndrome del túnel carpiano. La Unión Europea, por su parte, ha reconocido este trastorno como una enfermedad laboral, aunque depende de cada país incorporar esta condición a su legislación o no.
Las diferentes actividades laborales, junto a otros condicionantes como el sobrepeso, provocan que la prevalencia del síndrome difiera de un país a otro, pero también que aumente en un mismo lugar, entre las generaciones más jóvenes, a medida que las costumbres se transforman. Así lo ha puesto de manifiesto un nuevo estudio que ha analizado la incidencia de este síndrome en Suecia y la ha comparado con la de EEUU.
En el país norteamericano, la presencia de este problema es mucho mayor a la de Suecia entre personas mayores, pero las diferencias se acortan o desaparecen entre las generaciones más jóvenes. "La incidencia en mujeres de menos de 50 años era mayor en Suecia, pero, en mujeres de 50 o mayores, la incidencia era mayor en EEUU", revela el estudio, publicado en 'Achives of Internal Medicine'.
Los resultados en hombres fueron distintos, ya que las mujeres son tres veces más propensas que los hombres a desarrollar este síndrome. Sin embargo, los datos son igualmente compatibles con la interpretación cultural del síndrome: entre varones menores de esa edad, la incidencia era similar en EEUU y Suecia; pero en los mayores, las cifras del país americano doblaban a las del nórdico.
Isam Atroshi, principal firmante del estudio desde el Hospital Hassleholm de Suecia, y sus colegas consideran que hasta un 15% de la población podría sufrir este síndrome, aunque muchos pacientes no son conscientes de ello. El problema se produce por compresión, habitualmente crónica, del nervio mediano, que abarca desde el antebrazo hasta la mano.
Varios estudios mostraron durante la pasada década la relación entre el uso prolongado del ratón del ordenador y el síndrome del túnel carpiano. La Unión Europea, por su parte, ha reconocido este trastorno como una enfermedad laboral, aunque depende de cada país incorporar esta condición a su legislación o no.
**Publicado en "EL MUNDO"
More money, better health?
A new study from George Mason University and the Urban Institute reveals that greater spending on medical services means better overall health for Medicare participants. Health Administration and Policy Professor Jack Hadley and his co-authors, Urban Institute researchers Timothy Waidmann, Stephen Zuckerman, and Robert Berenson, analyzed data from more than 17,000 Medicare beneficiaries to draw this conclusion. Previous reports showed that Medicare spending varies greatly by geographic area, but with little to show for it-the health outcomes for people who live in expensive geographic areas are not necessarily better than those who live in less expensive geographic areas. As a result, policymakers have considered limiting Medicare payments in high-cost areas.
But, as described in their recent study, "Medical Spending and the Health of the Elderly," the research team found that spending more on Medicare medical expenses actually resulted in greater survival and a better overall health score, using an index that measures perceived health and activity limitations.
"The motivation for the study was a large body of research that's been done over the past ten years that typically has found that there is little or no relationship between how much Medicare spends and the health outcomes of elderly people," Hadley says.
But these studies looked at large swathes of populations, typically by geographic location, and used averages to draw their conclusions. "The implication was that higher spending was not contributing to better health," Hadley says.
He explains, "While that finding is very persuasive, it doesn't look at individuals and the amount of medical care that they each receive." So in this study, the research team used data from the Medicare Current Beneficiary Survey, which collects extensive information from Medicare participants over a three-year span, to determine whether a relationship existed between medical spending and better health.
"The surveys provide much richer information about the person's health condition than one can typically get from insurance claims data," Hadley says.
The full results of the study will appear in an upcoming edition of the journal Health Services Research, which is published by the Health Research and Educational Trust and is an official journal of AcademyHealth.
"Over this three-year period-controlling for people's health when they first come into the survey and new diagnoses they may have had over the course of the three years-what was their health like at the end of the observation period? And did that vary with how much medical care they received as individuals?" Hadley asks.
The statistical analysis indicates that the individuals' health did vary with their medical care spending. Over a three-year span, for a 10 percent increase in medical spending, there was 1.9 percent increase in the patient's health score, called the Health and Activity Limitations Index and a 1.5 percent greater survival probability.
The researchers classify this finding as a "modest effect" but stress that "the key thing is that we did find a positive relationship as opposed to other studies which have suggested that there's no relationship between how much care a person receives and what their health outcomes are."
"This suggests that policymakers need to understand that across-the-board reductions in Medicare spending in a geographic area or on a national level could have harmful effects on beneficiaries' health," The Urban Institute's Timothy Waidmann explains. "To look for inefficiencies, you need to look more closely at specific conditions and diseases and how those are treated. Analysis from 40,000 feet just doesn't do that for you."
**Source: George Mason University
But, as described in their recent study, "Medical Spending and the Health of the Elderly," the research team found that spending more on Medicare medical expenses actually resulted in greater survival and a better overall health score, using an index that measures perceived health and activity limitations.
"The motivation for the study was a large body of research that's been done over the past ten years that typically has found that there is little or no relationship between how much Medicare spends and the health outcomes of elderly people," Hadley says.
But these studies looked at large swathes of populations, typically by geographic location, and used averages to draw their conclusions. "The implication was that higher spending was not contributing to better health," Hadley says.
He explains, "While that finding is very persuasive, it doesn't look at individuals and the amount of medical care that they each receive." So in this study, the research team used data from the Medicare Current Beneficiary Survey, which collects extensive information from Medicare participants over a three-year span, to determine whether a relationship existed between medical spending and better health.
"The surveys provide much richer information about the person's health condition than one can typically get from insurance claims data," Hadley says.
The full results of the study will appear in an upcoming edition of the journal Health Services Research, which is published by the Health Research and Educational Trust and is an official journal of AcademyHealth.
"Over this three-year period-controlling for people's health when they first come into the survey and new diagnoses they may have had over the course of the three years-what was their health like at the end of the observation period? And did that vary with how much medical care they received as individuals?" Hadley asks.
The statistical analysis indicates that the individuals' health did vary with their medical care spending. Over a three-year span, for a 10 percent increase in medical spending, there was 1.9 percent increase in the patient's health score, called the Health and Activity Limitations Index and a 1.5 percent greater survival probability.
The researchers classify this finding as a "modest effect" but stress that "the key thing is that we did find a positive relationship as opposed to other studies which have suggested that there's no relationship between how much care a person receives and what their health outcomes are."
"This suggests that policymakers need to understand that across-the-board reductions in Medicare spending in a geographic area or on a national level could have harmful effects on beneficiaries' health," The Urban Institute's Timothy Waidmann explains. "To look for inefficiencies, you need to look more closely at specific conditions and diseases and how those are treated. Analysis from 40,000 feet just doesn't do that for you."
**Source: George Mason University
El ensayo clínico, un experimiento científico con esperanza vital
El doctor Javier Salvador, coordinador del Servicio de Oncología Médica del Complejo Hospitalario Nuestra Señora de Valme( Sevilla) y miembro de la junta directiva de la SEOM( Sociedad Española de Oncología Médica), afirmó "que un ensayo clínico es la investigación programada con fines terapeúticos. Se trata de un experimento científico para valorar la acción, eficacia, tolerancia y las características farmacocinéticas de un medicamento, a través de un tratamiento administrado a un ser humano diagnosticado de cáncer".
En su intervención en Cuenca, durante un Seminario de Prensa organizado por la SEOM y MSD, incidió que entre sus objetivos destaca incrementar el porcentaje de curaciones globales del cáncer, y en especial de cada tumor, incrementar el porcentaje de respuestas y de supervivencia en el grupo de tumores que no exista posibilidad de curación. E hizo un llamamiento a los medios de comunicación: "Es diferente la noticia que llega de un ensayo fase I que otro de la fase III para no despertar falsas expectativas"
--A este respecto, la doctora Pilar Moreno( vicepresidenta de la Federación Española de Cáncer de Mama, FECMA) afirmó "que los ensayos clínicos suponen para los pacientes oncológicos una fuente de esperanza vital donde el producto final de la investigación, el medicamento, es un bien valioso y apreciado por su potencial curativo". En su ponencia sobre "La perspectiva de los pacientes" aseguró que "cuando el abordaje de los resultados tenga el punto de vista técnico, es decir, mida años de supervivencia ganados, retraso en las recaidas, % de las mismas, reducción del tamaño del tumor, etc, estarán ocupándose relamente de nuestra curación y de nuestro cuidado". Para Moreno "curar y cuidar son elementos indisolubles en el tratamiento del enfermo".
En su intervención en Cuenca, durante un Seminario de Prensa organizado por la SEOM y MSD, incidió que entre sus objetivos destaca incrementar el porcentaje de curaciones globales del cáncer, y en especial de cada tumor, incrementar el porcentaje de respuestas y de supervivencia en el grupo de tumores que no exista posibilidad de curación. E hizo un llamamiento a los medios de comunicación: "Es diferente la noticia que llega de un ensayo fase I que otro de la fase III para no despertar falsas expectativas"
--A este respecto, la doctora Pilar Moreno( vicepresidenta de la Federación Española de Cáncer de Mama, FECMA) afirmó "que los ensayos clínicos suponen para los pacientes oncológicos una fuente de esperanza vital donde el producto final de la investigación, el medicamento, es un bien valioso y apreciado por su potencial curativo". En su ponencia sobre "La perspectiva de los pacientes" aseguró que "cuando el abordaje de los resultados tenga el punto de vista técnico, es decir, mida años de supervivencia ganados, retraso en las recaidas, % de las mismas, reducción del tamaño del tumor, etc, estarán ocupándose relamente de nuestra curación y de nuestro cuidado". Para Moreno "curar y cuidar son elementos indisolubles en el tratamiento del enfermo".
El papel de los grupos cooperativos de investigación sobre el cáncer en España
En España existen 17 Grupos cooperativos de investigación sobre el cáncer en España, abordando tumores como pulmón, mama, sarcomas, melanoma, digestivo, etc. Sus aportaciones a la investigación clínica fue el núcleo de la intervención del doctor Emilio Alba( presidente de la SEOM y especialista del Hospital Clínico de Málaga) en Cuenca durante un Seminario de Prensa titulado "Curar y cuidar en Oncología" bajo la organización de la misma Sociedad y de MSD. Hoy en día el cáncer es la segunda causa de muerte en los pacientes industrializados y la primera en edades inferiores a los 65 años. "El 50% de los pacientes no pueden ser curados pese a los avances médicos. Por ello es clave la investigación y en la Oncología española hay muy buenos mimbres" afirmó el doctor Alba.
La investigación clínica es necesaria para establecer nuevos tratamientos diagnósticos "por lo que los ensayos clínicos pretenden evaluar estrategias terapéuticas para avanzar en la prevención y especialmente en tumores poco frecuentes". Desde hace casi veinte años en España existe una red estable de investigación clínica en cáncer a través de los Grupos Cooperativos( unas organizaciones sin ánimo de lucro con carácter multidisciplinar para desarrollar investigación y que cuentan con el apoyo de la SEOM). Casi todos los Hospitales públicos están involucrados en esta iniciativa autorganizada sin ayuda de la Administración. A lo largo de este tiempo han desarrollado 283 estudios, la mayoría en la fase I, y se han publicado 258 artículos en revistas científicas internacionales de prestigio.
Según el doctor Alba, casi 38.000 pacientes han participado en estos estudios. Los Grupos con más investigaciones se centran en cáncer de pulmón y mama,
así como tumores digestivos. Pero existen posibilidades de mejora como obtener financiación pública, establecer sinergias con el CAIBER, reclutar pacientes, apoyos al investigador y reducir la excesivamente larga burocracia. Para ello es importante establecer acuerdos con grupos cooperativos internacionales, incidir en la formación continuada y colaborar con las Asociaciones de Pacientes en distintas iniciativas. Para el presidente de la SEOM "ésto permitirá a la larga una reducción de costes al Sistema Nacional de Salud".
La investigación clínica es necesaria para establecer nuevos tratamientos diagnósticos "por lo que los ensayos clínicos pretenden evaluar estrategias terapéuticas para avanzar en la prevención y especialmente en tumores poco frecuentes". Desde hace casi veinte años en España existe una red estable de investigación clínica en cáncer a través de los Grupos Cooperativos( unas organizaciones sin ánimo de lucro con carácter multidisciplinar para desarrollar investigación y que cuentan con el apoyo de la SEOM). Casi todos los Hospitales públicos están involucrados en esta iniciativa autorganizada sin ayuda de la Administración. A lo largo de este tiempo han desarrollado 283 estudios, la mayoría en la fase I, y se han publicado 258 artículos en revistas científicas internacionales de prestigio.
Según el doctor Alba, casi 38.000 pacientes han participado en estos estudios. Los Grupos con más investigaciones se centran en cáncer de pulmón y mama,
así como tumores digestivos. Pero existen posibilidades de mejora como obtener financiación pública, establecer sinergias con el CAIBER, reclutar pacientes, apoyos al investigador y reducir la excesivamente larga burocracia. Para ello es importante establecer acuerdos con grupos cooperativos internacionales, incidir en la formación continuada y colaborar con las Asociaciones de Pacientes en distintas iniciativas. Para el presidente de la SEOM "ésto permitirá a la larga una reducción de costes al Sistema Nacional de Salud".
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