A paper published online on June 13 in the Journal of Experimental Medicine (www.jem.org) identifies new gene mutations in patients with chronic lymphocytic leukemia (CLL)—a disease often associated with lack of response to chemotherapy and poor overall survival. CLL is the most common leukemia in the Western world, but the disease varies greatly from patient to patient with regard to prognosis, survival, and disease course. In attempt to understand the genetic basis for this heterogeneity, a group led by Riccardo Dalla-Favera at Columbia University and Gianluca Gaidano at Amedeo Avogadro University of Eastern Piedmont, Novara, Italy surveyed the landscape of mutations in the genes of CLL patients. They found several mutations not previously linked with CLL, but most patients had relatively few genetic mutations compared to some other types of cancer.
The team then turned their attention to NOTCH1, a gene that controls cell division and survival and is often activated by mutation in other types of leukemia. CLL patients harboring NOTCH1 mutations at the time of diagnosis had a significantly poorer prognosis and shorter survival than patients without NOTCH1 mutations. And NOTCH1 mutations were much more common in samples from patients whose disease progressed to more high-risk forms or who failed chemotherapy treatment.
These findings point to the NOTCH1 pathway as potentially useful for diagnostic and therapeutic purposes in human CLL.
**Source: Rockefeller University Press
14 June 2011
Cooling the brain during sleep may be a natural and effective treatment for insomnia
People with primary insomnia may be able to find relief by wearing a cap that cools the brain during sleep, suggests a research abstract that will be presented Monday, June 13, in Minneapolis, Minn., at SLEEP 2011, the 25th Anniversary Meeting of the Associated Professional Sleep Societies LLC (APSS). According to the authors, a reduction in metabolism in the brain's frontal cortex occurs while falling asleep and is associated with restorative sleep. However, insomnia is associated with increased metabolism in this same brain region. One way to reduce cerebral metabolic activity is to use frontal cerebral thermal transfer to cool the brain, a process known as "cerebral hypothermia."
Results show that there were linear effects of all-night thermal transfer intensities on sleep latency and sleep efficiency. The time that it took subjects with primary insomnia to fall asleep (13 minutes) and the percentage of time in bed that they slept (89 percent) during treatment at the maximal cooling intensity were similar to healthy controls (16 minutes and 89 percent).
"The most significant finding from this study is that we can have a beneficial impact on the sleep of insomnia patients via a safe, non-pharmaceutical mechanism that can be made widely available for home use by insomnia sufferers," said principal investigator and lead author Dr. Eric Nofzinger, professor and director of the Sleep Neuroimaging Research Program at the University of Pittsburgh School of Medicine. "The finding of a linear dose response effect of the treatment implies a direct beneficial impact on the neurobiology of insomnia that can improve the sleep of insomnia patients. We believe this has far-ranging implications for how insomnia can be managed in the future."
In this crossover study, Nofzinger and co-investigator Dr. Daniel Buysse screened 110 people, enrolling 12 people with primary insomnia and 12 healthy, age-and gender-matched controls. Participants with insomnia had an average age of about 45 years, and nine of the 12 subjects were women.
Participants received all-night frontal cerebral thermal transfer by wearing a soft plastic cap on their head. The cap contained tubes that were filled with circulating water. The effectiveness of varying thermal transfer intensities was investigated by implementing multiple conditions: no cooling cap, and cooling cap with either neutral, moderate or maximal cooling intensity.
According to Nofzinger, the simplicity and effectiveness of this natural treatment could be a long-awaited breakthrough for insomnia sufferers.
"The primary medical treatment for insomnia has long been the prescription of hypnotics, or sleeping pills, yet only about 25 percent of patients using these treatments are satisfied, citing concerns regarding side effects and the possibility of dependence on a pill to help them sleep at night," he said. "There exists a large gap between what patients with insomnia are looking for to help them and what is currently available. Patients have long sought a more natural, non-pharmaceutical means to help them with their sleep at night. The identification of a dose-dependent improvement by the device used in this study opens the door to a novel, safe and more natural way to achieve restorative sleep in insomnia care."
The American Academy of Sleep Medicine reports that chronic insomnia, or symptoms that last for at least a month, affects about 10 percent of adults. Most often insomnia is a "comorbid" disorder, occurring with another medical illness, mental disorder or sleep disorder, or associated with certain medications or substances. Fewer people suffering from insomnia are considered to have primary insomnia, which is defined as a difficulty falling asleep or maintaining sleep in the absence of coexisting conditions.
In a study published in 2006 in the Journal of Clinical Sleep Medicine, Nofzinger and Buysse reported that increased relative metabolism in several brain regions during non-REM sleep in patients with insomnia is associated with increased wakefulness after sleep onset. They speculated that these effects may result from increased activity in arousal systems during sleep or heightened cognitive activity related to processes such as conflict, anxiety, and fear.
**Source: American Academy of Sleep Medicine
Results show that there were linear effects of all-night thermal transfer intensities on sleep latency and sleep efficiency. The time that it took subjects with primary insomnia to fall asleep (13 minutes) and the percentage of time in bed that they slept (89 percent) during treatment at the maximal cooling intensity were similar to healthy controls (16 minutes and 89 percent).
"The most significant finding from this study is that we can have a beneficial impact on the sleep of insomnia patients via a safe, non-pharmaceutical mechanism that can be made widely available for home use by insomnia sufferers," said principal investigator and lead author Dr. Eric Nofzinger, professor and director of the Sleep Neuroimaging Research Program at the University of Pittsburgh School of Medicine. "The finding of a linear dose response effect of the treatment implies a direct beneficial impact on the neurobiology of insomnia that can improve the sleep of insomnia patients. We believe this has far-ranging implications for how insomnia can be managed in the future."
In this crossover study, Nofzinger and co-investigator Dr. Daniel Buysse screened 110 people, enrolling 12 people with primary insomnia and 12 healthy, age-and gender-matched controls. Participants with insomnia had an average age of about 45 years, and nine of the 12 subjects were women.
Participants received all-night frontal cerebral thermal transfer by wearing a soft plastic cap on their head. The cap contained tubes that were filled with circulating water. The effectiveness of varying thermal transfer intensities was investigated by implementing multiple conditions: no cooling cap, and cooling cap with either neutral, moderate or maximal cooling intensity.
According to Nofzinger, the simplicity and effectiveness of this natural treatment could be a long-awaited breakthrough for insomnia sufferers.
"The primary medical treatment for insomnia has long been the prescription of hypnotics, or sleeping pills, yet only about 25 percent of patients using these treatments are satisfied, citing concerns regarding side effects and the possibility of dependence on a pill to help them sleep at night," he said. "There exists a large gap between what patients with insomnia are looking for to help them and what is currently available. Patients have long sought a more natural, non-pharmaceutical means to help them with their sleep at night. The identification of a dose-dependent improvement by the device used in this study opens the door to a novel, safe and more natural way to achieve restorative sleep in insomnia care."
The American Academy of Sleep Medicine reports that chronic insomnia, or symptoms that last for at least a month, affects about 10 percent of adults. Most often insomnia is a "comorbid" disorder, occurring with another medical illness, mental disorder or sleep disorder, or associated with certain medications or substances. Fewer people suffering from insomnia are considered to have primary insomnia, which is defined as a difficulty falling asleep or maintaining sleep in the absence of coexisting conditions.
In a study published in 2006 in the Journal of Clinical Sleep Medicine, Nofzinger and Buysse reported that increased relative metabolism in several brain regions during non-REM sleep in patients with insomnia is associated with increased wakefulness after sleep onset. They speculated that these effects may result from increased activity in arousal systems during sleep or heightened cognitive activity related to processes such as conflict, anxiety, and fear.
**Source: American Academy of Sleep Medicine
Oral appliance therapy improves craniofacial growth direction and snoring
According to new research that will be presented Saturday, June 11, at the 20th Anniversary Meeting of the American Academy of Dental Sleep Medicine (AADSM), children with enlarged tonsils and adenoids who wore an oral appliance for six months experienced more favorable craniofacial growth, enlargement of pharyngeal dimensions, and improved breathing and snoring during sleep. Enlarged tonsils and dental malocclusion have a strong relation with sleep disturbance in children. Its consequences can include abnormalities of craniofacial growth and facial morphology more suitable to the development of obstructive sleep apnea (OSA).
Forty children from the waiting list for adenotonsillectomy at the ENT Department of the University of São Paulo Medical School were included in the study. The children ranged from 6 to 9 years of age. All of them presented snoring, tonsil and adenoid enlargement grades III and IV, and dental malocclusion (constricted maxilla and/or jaw deficiency). Patients were divided into two randomized groups: 24 patients were treated with the Bioajusta X dental appliance and 16 were controls.
The researchers evaluated the craniofacial growth in children with enlarged tonsils and adenoids, after dental appliance (Bioajusta X) treatment. They also compared the prevalence of snoring before and after treatment.
"The primary finding of the study was the positive influence of this treatment on snoring in children with enlarged tonsils and adenoids and narrow maxillary arch," said principal investigator Walter R. Nunes Jr., DDS, MS, who is affiliated with the Otolaryngology Department of the University of São Paulo Medical School in Brazil.
"This method of treatment acted on the normalization of the respiratory function and sleep, which reflected positively on the quality of life of those children and their families, and also resulted in a better pattern of craniofacial growth," said Nunes. "This normalization on the growth pattern may possibly reduce the incidence of obstructive sleep apnea in the future."
Cephalometric analysis was used to access the growth direction comparing the vertical jaw relationship according to the angle of the palatal plane with the mandibular plane (ANS-PNS / ML). The parents filled out a questionnaire about respiratory symptoms. They were re-evaluated and compared after six months.
Cephalometry showed in the treated group a reduction on the palatal x mandibular angle of - 2,75 º : Media at T1 = 30.08 º (sd 3.8) ; Media at T2 = 27.33 º (sd 3.4) and an increase of this measurement in the untreated group of +1,25 º : Media at T1 = 28.38 º (sd 3.8) ; Media at T2 = 29.60 º (sd 3.5) at the untreated (p<0.001).
This abstract will receive the Graduate Student Research Award at the AADSM 20th Anniversary Meeting.
**Source: American Academy of Sleep Medicine
Forty children from the waiting list for adenotonsillectomy at the ENT Department of the University of São Paulo Medical School were included in the study. The children ranged from 6 to 9 years of age. All of them presented snoring, tonsil and adenoid enlargement grades III and IV, and dental malocclusion (constricted maxilla and/or jaw deficiency). Patients were divided into two randomized groups: 24 patients were treated with the Bioajusta X dental appliance and 16 were controls.
The researchers evaluated the craniofacial growth in children with enlarged tonsils and adenoids, after dental appliance (Bioajusta X) treatment. They also compared the prevalence of snoring before and after treatment.
"The primary finding of the study was the positive influence of this treatment on snoring in children with enlarged tonsils and adenoids and narrow maxillary arch," said principal investigator Walter R. Nunes Jr., DDS, MS, who is affiliated with the Otolaryngology Department of the University of São Paulo Medical School in Brazil.
"This method of treatment acted on the normalization of the respiratory function and sleep, which reflected positively on the quality of life of those children and their families, and also resulted in a better pattern of craniofacial growth," said Nunes. "This normalization on the growth pattern may possibly reduce the incidence of obstructive sleep apnea in the future."
Cephalometric analysis was used to access the growth direction comparing the vertical jaw relationship according to the angle of the palatal plane with the mandibular plane (ANS-PNS / ML). The parents filled out a questionnaire about respiratory symptoms. They were re-evaluated and compared after six months.
Cephalometry showed in the treated group a reduction on the palatal x mandibular angle of - 2,75 º : Media at T1 = 30.08 º (sd 3.8) ; Media at T2 = 27.33 º (sd 3.4) and an increase of this measurement in the untreated group of +1,25 º : Media at T1 = 28.38 º (sd 3.8) ; Media at T2 = 29.60 º (sd 3.5) at the untreated (p<0.001).
This abstract will receive the Graduate Student Research Award at the AADSM 20th Anniversary Meeting.
**Source: American Academy of Sleep Medicine
Simple analysis of breathing sounds while awake can detect obstructive sleep apnea
The analysis of breathing sounds while awake may be a fast, simple and accurate screening tool for obstructive sleep apnea, suggests a research abstract that will be presented Monday, June 13, in Minneapolis, Minn., at SLEEP 2011, the 25th Anniversary Meeting of the Associated Professional Sleep Societies LLC (APSS). Results show that several sound features of breathing were statistically significant between participants with obstructive sleep apnea and healthy controls. In an analysis that combined the two most significant sound features, the presence or absence of OSA was predicted with more than 84-percent accuracy. Sound analysis also allowed for the stratification of OSA severity.
According to the authors, people with OSA tend to have a narrower and more collapsible pharynx with more negative pharyngeal pressure, which creates greater resistance when breathing through the nose. Breathing sounds are directly related to pharyngeal pressure, making sound analysis a viable diagnostic option for OSA.
"Despite being able to breathe at the same high flow rate, the pharyngeal pressure in people with OSA during wakefulness is usually more negative than that in the non-OSA group," said principal investigator and lead author Zahra Moussavi, PhD, professor and Canada Research Chair on Biomedical Engineering at the University of Manitoba in Winnipeg, Canada.
Moussavi and co-investigator Aman Montazeri studied 35 patients with varying severity levels of OSA and 17 age-matched controls. The presence or absence of OSA was validated by full-night polysomnography.
The subjects were instructed to breathe through their nose at their normal breathing level for at least five breaths and then breathe at their maximum flow level for another five breaths. Then the process was repeated as they breathed through their mouth with a nose clip in place. The breathing sounds were picked up by a microphone placed over the neck, and the recordings were repeated in two body positions: sitting upright and lying on the back. Data were digitized and then analyzed using spectral and waveform fractal dimension techniques.
Moussavi added that detecting OSA through sound analysis could become an attractive alternative to the more costly and labor-intensive method of performing overnight polysomnography.
"If we can predict the likelihood of apnea and its severity with the same accuracy as in our pilot study, it will have a significant impact on health-care costs as it can reduce the need for full-night sleep assessment significantly," she said.
The study was supported by the National Sciences and Engineering Research Council of Canada and TRLabs Winnipeg, where Moussavi is an adjunct scientist.
According to the American Academy of Sleep Medicine, OSA is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing that can produce abrupt reductions in blood oxygen saturation and reduce blood flow to the brain. Most people with OSA snore loudly and frequently, and they often experience excessive daytime sleepiness.
The treatment of choice for OSA is CPAP therapy, which provides a steady stream of air through a mask that is worn during sleep. This airflow keeps the airway open to prevent pauses in breathing and restore normal oxygen levels. Help for OSA is available at more than 2,200 AASM-accredited sleep disorders centers across the U.S.
*Source: American Academy of Sleep Medicine
According to the authors, people with OSA tend to have a narrower and more collapsible pharynx with more negative pharyngeal pressure, which creates greater resistance when breathing through the nose. Breathing sounds are directly related to pharyngeal pressure, making sound analysis a viable diagnostic option for OSA.
"Despite being able to breathe at the same high flow rate, the pharyngeal pressure in people with OSA during wakefulness is usually more negative than that in the non-OSA group," said principal investigator and lead author Zahra Moussavi, PhD, professor and Canada Research Chair on Biomedical Engineering at the University of Manitoba in Winnipeg, Canada.
Moussavi and co-investigator Aman Montazeri studied 35 patients with varying severity levels of OSA and 17 age-matched controls. The presence or absence of OSA was validated by full-night polysomnography.
The subjects were instructed to breathe through their nose at their normal breathing level for at least five breaths and then breathe at their maximum flow level for another five breaths. Then the process was repeated as they breathed through their mouth with a nose clip in place. The breathing sounds were picked up by a microphone placed over the neck, and the recordings were repeated in two body positions: sitting upright and lying on the back. Data were digitized and then analyzed using spectral and waveform fractal dimension techniques.
Moussavi added that detecting OSA through sound analysis could become an attractive alternative to the more costly and labor-intensive method of performing overnight polysomnography.
"If we can predict the likelihood of apnea and its severity with the same accuracy as in our pilot study, it will have a significant impact on health-care costs as it can reduce the need for full-night sleep assessment significantly," she said.
The study was supported by the National Sciences and Engineering Research Council of Canada and TRLabs Winnipeg, where Moussavi is an adjunct scientist.
According to the American Academy of Sleep Medicine, OSA is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing that can produce abrupt reductions in blood oxygen saturation and reduce blood flow to the brain. Most people with OSA snore loudly and frequently, and they often experience excessive daytime sleepiness.
The treatment of choice for OSA is CPAP therapy, which provides a steady stream of air through a mask that is worn during sleep. This airflow keeps the airway open to prevent pauses in breathing and restore normal oxygen levels. Help for OSA is available at more than 2,200 AASM-accredited sleep disorders centers across the U.S.
*Source: American Academy of Sleep Medicine
El peligro de la obsesión por el bronceado
Cada año, sobre todo cuando se acerca el verano, Gobierno y otros organismos y autoridades hacen campañas de prevención. "Desde un punto de vista conceptual, esas campañas son buenas, pero después, los datos del impacto que tienen en la modificación de nuestros hábitos saludables y en la disminución de la incidencia de cáncer de piel no son tan buenos", dice el dermatólogo Miguel Sánchez Viera.
El especialista cree que es necesario cambiar ese tipo de iniciativas para que den resultados: "Una opción muy buena es la educación desde la infancia, en el hogar y en el colegio, ya que es clave a la hora de introducir hábitos saludables duraderos".
La tanorexia -obsesión extrema por el bronceado- es un problema cada vez mayor. "Como cualquier adicción, las personas que la sufren están obsesionadas, en este caso, con ponerse morenos a cualquier precio. Y se convierte en el centro de su vida", asegura María Ángeles García, psicóloga clínica. "Esta adicción, sea solar o por cabinas de rayos UVA, es la base del aumento del cáncer de piel", explica el dermatólogo. Sánchez Viera añade que "si además su tipo de piel es claro y se pone morena con dificultad y sufre quemaduras solares, está poniendo en un serio riesgo su salud".
A la hora de tomar el sol, "sea mucho o poco", aclara el doctor, lo fundamental es tomar precauciones. "Hay pautas muy simples como buscar la sombra, especialmente entre las once de la mañana y las cuatro de la tarde, usar una crema solar con factor de protección (FPS) 30 o mayor y aplicar unos 30 gramos de producto por todas las partes expuestas de su cuerpo media hora antes de ponerse al sol", añade el doctor. "No hagamos de tomar el sol una desagracia", concluye.
El especialista cree que es necesario cambiar ese tipo de iniciativas para que den resultados: "Una opción muy buena es la educación desde la infancia, en el hogar y en el colegio, ya que es clave a la hora de introducir hábitos saludables duraderos".
La tanorexia -obsesión extrema por el bronceado- es un problema cada vez mayor. "Como cualquier adicción, las personas que la sufren están obsesionadas, en este caso, con ponerse morenos a cualquier precio. Y se convierte en el centro de su vida", asegura María Ángeles García, psicóloga clínica. "Esta adicción, sea solar o por cabinas de rayos UVA, es la base del aumento del cáncer de piel", explica el dermatólogo. Sánchez Viera añade que "si además su tipo de piel es claro y se pone morena con dificultad y sufre quemaduras solares, está poniendo en un serio riesgo su salud".
A la hora de tomar el sol, "sea mucho o poco", aclara el doctor, lo fundamental es tomar precauciones. "Hay pautas muy simples como buscar la sombra, especialmente entre las once de la mañana y las cuatro de la tarde, usar una crema solar con factor de protección (FPS) 30 o mayor y aplicar unos 30 gramos de producto por todas las partes expuestas de su cuerpo media hora antes de ponerse al sol", añade el doctor. "No hagamos de tomar el sol una desagracia", concluye.
La incidencia del melanoma crece un 7% cada año en España
Las medidas de prevención para evitar el melanoma -cáncer de piel- siguen siendo insuficientes. A pesar de las campañas de información y del incremento de las ventas de cremas fotoprotectoras, su incidencia ha aumentado de forma alarmante desde los años setenta (en torno al 300%). La media de incidencia en España es de dos por cada 100.000 habitantes, y crece un 7% cada año. Si no se detecta a tiempo, tiene muy mal pronóstico. La aparición de metástasis hace que la supervivencia a los cinco años sea casi nula.
El melanoma es un tumor maligno de la piel, muy agresivo y con "una sorprendente capacidad para crear metástasis con rapidez", explica explica Miguel Sánchez Viera, jefe de la Unidad de Cáncer de Piel del hospital USP San Camilo en Madrid. Los primeros signos más frecuentes son manchas marrones o negras y "un cambio de color, forma o tamaño en un lunar previo y en un corto periodo de tiempo", asegura el doctor. En el día europeo contra la enfermedad, que se conmemoró ayer, se pretende prevenir e informar de la aparición de esta enfermedad, que cada vez se ceba más con los jóvenes.
El factor de riesgo conocido más importante es la radiación ultravioleta, es decir, la radiación solar o la de cabinas de rayos UVA. Las partes más expuestas a lo largo de la vida son la cabeza, el cuello, el tronco y las piernas. "La probabilidad de padecer un melanoma se duplica si hemos padecido alguna quemadura solar en la infancia o la adolescencia", dice. Los expertos aseguran que en la actualidad "son capaces de diagnosticar, cada vez más precozmente, melanomas que de otro modo pasarían desapercibidos durante una serie de años". Una vez diagnosticado, la extirpación quirúrgica en fases tempranas "resuelve más del 90% de los casos, sin la necesidad de tratamientos de radio y quimioterapia adicionales", señala el doctor.
Los datos de mortalidad son mayores en personas de más de 50 años, aunque su incidencia es muy alta en menores de 30. Es el cáncer más frecuente en el grupo de edad entre los 25 y 29 años. "La razón del mayor número de muertes en personas mayores es que los jóvenes prestan más atención a la piel, aunque sea por motivos estéticos", aclara el especialista.. Los médicos advierten de la necesidad de acudir a una revisión anual y "hacerlo con más frecuencia si se tienen antecedentes o factores de riesgo especiales". Algunos médicos, incluso, aconsejan examinar la piel al menos una vez al mes "desde la cabeza hasta los pies".
El melanoma es un tumor maligno de la piel, muy agresivo y con "una sorprendente capacidad para crear metástasis con rapidez", explica explica Miguel Sánchez Viera, jefe de la Unidad de Cáncer de Piel del hospital USP San Camilo en Madrid. Los primeros signos más frecuentes son manchas marrones o negras y "un cambio de color, forma o tamaño en un lunar previo y en un corto periodo de tiempo", asegura el doctor. En el día europeo contra la enfermedad, que se conmemoró ayer, se pretende prevenir e informar de la aparición de esta enfermedad, que cada vez se ceba más con los jóvenes.
El factor de riesgo conocido más importante es la radiación ultravioleta, es decir, la radiación solar o la de cabinas de rayos UVA. Las partes más expuestas a lo largo de la vida son la cabeza, el cuello, el tronco y las piernas. "La probabilidad de padecer un melanoma se duplica si hemos padecido alguna quemadura solar en la infancia o la adolescencia", dice. Los expertos aseguran que en la actualidad "son capaces de diagnosticar, cada vez más precozmente, melanomas que de otro modo pasarían desapercibidos durante una serie de años". Una vez diagnosticado, la extirpación quirúrgica en fases tempranas "resuelve más del 90% de los casos, sin la necesidad de tratamientos de radio y quimioterapia adicionales", señala el doctor.
Los datos de mortalidad son mayores en personas de más de 50 años, aunque su incidencia es muy alta en menores de 30. Es el cáncer más frecuente en el grupo de edad entre los 25 y 29 años. "La razón del mayor número de muertes en personas mayores es que los jóvenes prestan más atención a la piel, aunque sea por motivos estéticos", aclara el especialista.. Los médicos advierten de la necesidad de acudir a una revisión anual y "hacerlo con más frecuencia si se tienen antecedentes o factores de riesgo especiales". Algunos médicos, incluso, aconsejan examinar la piel al menos una vez al mes "desde la cabeza hasta los pies".
**publicado en "EL PAIS"
La BBC emitió "Eligiendo morir" y reabre el debate sobre la eutanasia
"Eligiendo morir" La cadena británica BBC emitió la pasada noche un documental sobre la muerte asistida. Cuenta con el testimonio de Terry Pratchett, diagnosticado hace tres años con Alzheimer. La historia http://cort.as/1-2r y el anuncio del programa
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