El Colegio de Médicos de Vizcaya ha mostrado su preocupación por la judicialización de los actos profesionales del médico en una jornada celebrada en Bilbao que reunió médicos colegiados en Vizcaya y jueces sobre la judicialización de la medicina y la responsabilidad civil de los médicos
“El Colegio de Médicos ha organizado esta reunión, porque los médicos estamos preocupados por la judicialización de nuestros actos diarios. Además, como a la mayoría de los ciudadanos nos impone acudir a un juzgado: ya sea como peritos o testigos, y ni qué decir tiene, como imputados” aseguró el doctor Cosme Naveda, presidente del Colegio de Médicos de Vizcaya. “La tendencia de la sociedad a interponer cada día más demandas y las cuantías de las indemnizaciones que las últimas sentencias llevaban aparejadas, hacen que estemos preocupados por cometer cualquier error en nuestro día a día en la consulta. Nuestros pacientes se merecen una medicina de calidad y unos profesionales médicos comprometidos con su salud. Para ello, los médicos debemos trabajar sin la presión de la inseguridad jurídica, tanto en la praxis médica como en una hipotética futura condena”
En la reunión, los ponentes dejaron constancia de los distintos aspectos de índole jurídica y de praxis médica que atañen a la responsabilidad profesional, y tras ellos se entabló un coloquio en el que se abordaron cuestiones prácticas de la responsabilidad profesional, con intervenciones tanto de médicos como de juristas, magistrados y abogados.
En su intervención, los magistrados enviaron un mensaje de tranquilidad a los médicos sobre la situación actual de la judicialización de la profesión médica. Amaia Ortiz, Viceconsejera de Régimen Jurídico del Gobierno Vasco traslado que: “nuestros médicos son muy buenos. No hay casi problemas sanitarios en Vizcaya y los datos lo corroboran, en los últimos 10 años no han aumentado las demandas a los médicos en Vizcaya”. La Comisión Jurídica Asesora de Euskadi, que preside la Viceconsejera Amaia Ortiz, lleva todas las reclamaciones médico sanitarias de la Sanidad Pública del País Vasco. “En el año 2011, la comisión, ha recibido 100 demandas para aproximadamente 7.000 médicos colegiados en Bizkaia que durante el año han realizado millones de actos médicos” transmitió la Viceconsejera.
Para el doctor Cosme Naveda “ha sido una jornada fructífera y todos los participantes han manifestado su deseo de mantener este canal de diálogo abierto”. Así mismo, y en referencia a la labor del Colegio de Médicos de Vizcaya, Naveda aseguró que “nuestra labor como Colegio de Médicos es fomentar que nuestros médicos se sientan cómodos en su labor de cuidado del ciudadano. Nuestra labor pasa por cuidar a nuestros médicos para que ellos sólo se preocupen de cuidar la salud de sus pacientes. Por eso, creemos firmemente que el Colegio de Médicos debe esforzarse por fomentar una sanidad de calidad en la que los principales beneficiados sean los ciudadanos y para ello trabajamos; para que nuestros médicos estén cualificados y permanentemente formados e informados. Jornadas de divulgación como la de hoy son un reflejo del camino que prosigue el Colegio de Médicos de Vizcaya”.
La jornada estuvo organizada por el Colegio de Médicos de Vizcaya, con la colaboración del Departamento de Justicia y Administración Pública del Gobierno Vasco, el Tribunal Superior de Justicia del País Vasco, y la Asociación de Médicos del Igualatorio Médico Quirúrgico. La mesa inaugural de la jornada estuvo compuesta por el doctor Cosme Naveda, presidente del Colegio de Médicos de Vizcaya; qué cedió la presidencia de la misma a D. Juan Luis Ibarra, presidente del Tribunal Superior de Justicia del País Vasco; y Dña. Amaia Ortiz Cabezas, Viceconsejera de Régimen Jurídico del Departamento de Justicia y Administración Pública del Gobierno Vasco.
La mesa de ponentes moderada por el doctor Cosme Naveda, estuvo a su vez formada por el juez decano de Bilbao, Alfonso González Guija; por el magistrado del Tribunal Superior de Justicia del País Vasco, Luis Garrido Bengoetxea; por el médico vizcaíno José Sainz Arregui, especialista en cirugía plástica, estética y reparadora; y por Alfonso Atela, asesor jurídico del Colegio de Médicos de Vizcaya.
**Publicado en "MEDICOS Y PACIENTES"
02 March 2012
La gripe obliga a reabrir 800 camas hospitalarias cerradas en Catalunya
La gripe obliga a reabrir 800 camas hospitalarias cerradas en Catalunya
La incidencia gripal empieza a disminuir gracias a la recuperación de las temperaturas
La gripe ha obliga al departamento de Salud a reaccionar y abrir un total de 800 camas que se habían cerrado de las plantas hospitalarias para poder hacer frente a los pacientes afectados. La incidencia gripal empieza a disminuir gracias a la recuperación de las temperaturas, tras alcanzar el pico del invierno la semana pasada, aunque la actividad del virus continua siendo alta y afecta especialmente a los niños.
El director del CatSalut, Joseph Maria Pedrosa, ha explicado que se trata de un tema "puntual" y que la incidencia llegó a su punto máximo la semana pasada.
"Durante la semana pasada se registraron un total de 460 casos por cada 100.000 ciudadanos y se atendieron hasta 68.000 urgencias; pero esta semana ya ha bajado hasta los 350", ha indicado. Según ha expuesto el director del CatSalut, estas cifras son "comparables con las registradas con la Gripe A durante el 2009. Pedrosa, que ha expuesto estas cifras durante la presentación del Plan de Salud de Cataluña 2011-2015 en la Región Sanitaria de Girona, ha indicado que la gripe ha tenido una influencia mayor en la provincia de Girona, concretamente en la zona de Figueres y en la la costa de Blanes.
**AGENCIAS
La incidencia gripal empieza a disminuir gracias a la recuperación de las temperaturas
La gripe ha obliga al departamento de Salud a reaccionar y abrir un total de 800 camas que se habían cerrado de las plantas hospitalarias para poder hacer frente a los pacientes afectados. La incidencia gripal empieza a disminuir gracias a la recuperación de las temperaturas, tras alcanzar el pico del invierno la semana pasada, aunque la actividad del virus continua siendo alta y afecta especialmente a los niños.
El director del CatSalut, Joseph Maria Pedrosa, ha explicado que se trata de un tema "puntual" y que la incidencia llegó a su punto máximo la semana pasada.
"Durante la semana pasada se registraron un total de 460 casos por cada 100.000 ciudadanos y se atendieron hasta 68.000 urgencias; pero esta semana ya ha bajado hasta los 350", ha indicado. Según ha expuesto el director del CatSalut, estas cifras son "comparables con las registradas con la Gripe A durante el 2009. Pedrosa, que ha expuesto estas cifras durante la presentación del Plan de Salud de Cataluña 2011-2015 en la Región Sanitaria de Girona, ha indicado que la gripe ha tenido una influencia mayor en la provincia de Girona, concretamente en la zona de Figueres y en la la costa de Blanes.
**AGENCIAS
Vitamin D Shrinks Fibroid Tumors in Rats
Treatment with vitamin D reduced the size of uterine fibroids in laboratory rats predisposed to developing the benign tumors, reported researchers funded by the National Institutes of Health.
Uterine fibroids are the most common noncancerous tumors in women of childbearing age. Fibroids grow within and around the wall of the uterus. Thirty percent of women 25 to 44 years of age report fibroid-related symptoms, such as lower back pain, heavy vaginal bleeding or painful menstrual periods. Uterine fibroids also are associated with infertility and such pregnancy complications as miscarriage or preterm labor. Other than surgical removal of the uterus, there are few treatment options for women experiencing severe fibroid-related symptoms and about 200,000 U.S. women undergo the procedure each year. A recent analysis by NIH scientists estimated that the economic cost of fibroids to the United States, in terms of health care expenses and lost productivity, may exceed $34 billion a year.
Fibroids are three to four times more common in African-American women than in white women. Moreover, African-American women are roughly 10 times more likely to be deficient in vitamin D than are white women. In previous research, the study authors found that vitamin D inhibited the growth of human fibroid cells in laboratory cultures.
"The study results provide a promising new lead in the search for a non-surgical treatment for fibroids that doesn't affect fertility," said Louis De Paolo, Ph.D., chief of the Reproductive Sciences Branch of the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development, which funded the study.
First author Sunil K. Halder, Ph.D., of Meharry Medical College in Nashville conducted the research with Meharry colleagues Chakradhari Sharan, Ph.D., and Ayman Al-Hendy, M.D., Ph.D., and with Kevin G. Osteen, Ph.D., of Vanderbilt University Medical Center, also in Nashville. The findings appeared online in the journal Biology of Reproduction.
For the current study, the researchers tested the vitamin D treatment on a strain of rats genetically predisposed to developing fibroid tumors. After examining the animals and confirming the presence of fibroids in 12 of them, the researchers divided the rats into two groups of six each: those that would receive vitamin D and those that would not.
In the first group, small pumps implanted under the skin delivered a continuous dose of vitamin D for three weeks. The researchers then examined the animals in both groups. Fibroids increased in size in the untreated rats, but, in the rats receiving vitamin D, the tumors had shrunk dramatically. On average, uterine fibroids in the group receiving vitamin D were 75 percent smaller than those in the untreated group.
The amount of vitamin D the rats received each day was equivalent to a human dose of roughly 1,400 international units. The recommended amount of vitamin D for teens and adults age 70 and under is 600 units daily, although up to 4,000 units is considered safe for children over age 9, adults, and for pregnant and breastfeeding females.
"Additional research is needed to confirm vitamin D as a potential treatment for women with uterine fibroids," said Dr. Al-Hendy. "But it is also an essential nutrient for the health of muscle, bone and the immune system, and it is important for everyone to receive an adequate amount of the vitamin."
Fatty fish such as salmon, mackerel and tuna are the best natural sources of the vitamin. Very few foods naturally contain vitamin D. Fortified milk and other fortified foods provide an additional source of the vitamin. Vitamin D is also produced when ultraviolet rays from sunlight strike the skin.
**Published in "SCIENCE DAILY"
Vitamin D Shrinks Fibroid Tumors in Rats
Treatment with vitamin D reduced the size of uterine fibroids in laboratory rats predisposed to developing the benign tumors, reported researchers funded by the National Institutes of Health.
Uterine fibroids are the most common noncancerous tumors in women of childbearing age. Fibroids grow within and around the wall of the uterus. Thirty percent of women 25 to 44 years of age report fibroid-related symptoms, such as lower back pain, heavy vaginal bleeding or painful menstrual periods. Uterine fibroids also are associated with infertility and such pregnancy complications as miscarriage or preterm labor. Other than surgical removal of the uterus, there are few treatment options for women experiencing severe fibroid-related symptoms and about 200,000 U.S. women undergo the procedure each year. A recent analysis by NIH scientists estimated that the economic cost of fibroids to the United States, in terms of health care expenses and lost productivity, may exceed $34 billion a year.
Fibroids are three to four times more common in African-American women than in white women. Moreover, African-American women are roughly 10 times more likely to be deficient in vitamin D than are white women. In previous research, the study authors found that vitamin D inhibited the growth of human fibroid cells in laboratory cultures.
"The study results provide a promising new lead in the search for a non-surgical treatment for fibroids that doesn't affect fertility," said Louis De Paolo, Ph.D., chief of the Reproductive Sciences Branch of the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development, which funded the study.
First author Sunil K. Halder, Ph.D., of Meharry Medical College in Nashville conducted the research with Meharry colleagues Chakradhari Sharan, Ph.D., and Ayman Al-Hendy, M.D., Ph.D., and with Kevin G. Osteen, Ph.D., of Vanderbilt University Medical Center, also in Nashville. The findings appeared online in the journal Biology of Reproduction.
For the current study, the researchers tested the vitamin D treatment on a strain of rats genetically predisposed to developing fibroid tumors. After examining the animals and confirming the presence of fibroids in 12 of them, the researchers divided the rats into two groups of six each: those that would receive vitamin D and those that would not.
In the first group, small pumps implanted under the skin delivered a continuous dose of vitamin D for three weeks. The researchers then examined the animals in both groups. Fibroids increased in size in the untreated rats, but, in the rats receiving vitamin D, the tumors had shrunk dramatically. On average, uterine fibroids in the group receiving vitamin D were 75 percent smaller than those in the untreated group.
The amount of vitamin D the rats received each day was equivalent to a human dose of roughly 1,400 international units. The recommended amount of vitamin D for teens and adults age 70 and under is 600 units daily, although up to 4,000 units is considered safe for children over age 9, adults, and for pregnant and breastfeeding females.
"Additional research is needed to confirm vitamin D as a potential treatment for women with uterine fibroids," said Dr. Al-Hendy. "But it is also an essential nutrient for the health of muscle, bone and the immune system, and it is important for everyone to receive an adequate amount of the vitamin."
Fatty fish such as salmon, mackerel and tuna are the best natural sources of the vitamin. Very few foods naturally contain vitamin D. Fortified milk and other fortified foods provide an additional source of the vitamin. Vitamin D is also produced when ultraviolet rays from sunlight strike the skin.
**Published in "SCIENCE DAILY"
How Marijuana Impairs Memory
A major downside of the medical use of marijuana is the drug's ill effects on working memory, the ability to transiently hold and process information for reasoning, comprehension and learning. Researchers reporting in the March 2 print issue of the Cell Press journal Cell provide new insight into the source of those memory lapses. The answer comes as quite a surprise: Marijuana's major psychoactive ingredient (THC) impairs memory independently of its direct effects on neurons. The side effects stem instead from the drug's action on astroglia, passive support cells long believed to play second fiddle to active neurons.
The findings offer important new insight into the brain and raise the possibility that marijuana's benefits for the treatment of pain, seizures and other ailments might some day be attained without hurting memory, the researchers say.
With these experiments in mice, "we have found that the starting point for this phenomenon -- the effect of marijuana on working memory -- is the astroglial cells," said Giovanni Marsicano of INSERM in France.
"This is the first direct evidence that astrocytes modulate working memory," added Xia Zhang of the University of Ottawa in Canada.
The new findings aren't the first to suggest astroglia had been given short shrift. Astroglial cells (also known as astrocytes) have been viewed as cells that support, protect and feed neurons for the last 100 to 150 years, Marsicano explained. Over the last decade, evidence has accumulated that these cells play a more active role in forging the connections from one neuron to another.
The researchers didn't set out to discover how marijuana causes its cognitive side effects. Rather, they wanted to learn why receptors that respond to both THC and signals naturally produced in the brain are found on astroglial cells. These cannabinoid type-1 (CB1R) receptors are very abundant in the brain, primarily on neurons of various types.
Zhang and Marsicano now show that mice lacking CB1Rs only on astroglial cells of the brain are protected from the impairments to spatial working memory that usually follow a dose of THC. In contrast, animals lacking CB1Rs in neurons still suffer the usual lapses. Given that different cell types express different variants of CB1Rs, there might be a way to therapeutically activate the receptors on neurons while leaving the astroglial cells out, Marsicano said.
"The study shows that one of the most common effects of cannabinoid intoxication is due to activation of astroglial CB1Rs," the researchers wrote.
The findings further suggest that astrocytes might be playing unexpected roles in other forms of memory in addition to spatial working memory, Zhang said.
The researchers hope to explore the activities of endogenous endocannabinoids, which naturally trigger CB1Rs, on astroglial and other cells. The endocannabinoid system is involved in appetite, pain, mood, memory and many other functions. "Just about any physiological function you can think of in the body, it's likely at some point endocannabinoids are involved," Marsicano said.
And that means an understanding of how those natural signaling molecules act on astroglial and other cells could have a real impact. For instance, Zhang said, "we may find a way to deal with working memory problems in Alzheimer's."
The findings offer important new insight into the brain and raise the possibility that marijuana's benefits for the treatment of pain, seizures and other ailments might some day be attained without hurting memory, the researchers say.
With these experiments in mice, "we have found that the starting point for this phenomenon -- the effect of marijuana on working memory -- is the astroglial cells," said Giovanni Marsicano of INSERM in France.
"This is the first direct evidence that astrocytes modulate working memory," added Xia Zhang of the University of Ottawa in Canada.
The new findings aren't the first to suggest astroglia had been given short shrift. Astroglial cells (also known as astrocytes) have been viewed as cells that support, protect and feed neurons for the last 100 to 150 years, Marsicano explained. Over the last decade, evidence has accumulated that these cells play a more active role in forging the connections from one neuron to another.
The researchers didn't set out to discover how marijuana causes its cognitive side effects. Rather, they wanted to learn why receptors that respond to both THC and signals naturally produced in the brain are found on astroglial cells. These cannabinoid type-1 (CB1R) receptors are very abundant in the brain, primarily on neurons of various types.
Zhang and Marsicano now show that mice lacking CB1Rs only on astroglial cells of the brain are protected from the impairments to spatial working memory that usually follow a dose of THC. In contrast, animals lacking CB1Rs in neurons still suffer the usual lapses. Given that different cell types express different variants of CB1Rs, there might be a way to therapeutically activate the receptors on neurons while leaving the astroglial cells out, Marsicano said.
"The study shows that one of the most common effects of cannabinoid intoxication is due to activation of astroglial CB1Rs," the researchers wrote.
The findings further suggest that astrocytes might be playing unexpected roles in other forms of memory in addition to spatial working memory, Zhang said.
The researchers hope to explore the activities of endogenous endocannabinoids, which naturally trigger CB1Rs, on astroglial and other cells. The endocannabinoid system is involved in appetite, pain, mood, memory and many other functions. "Just about any physiological function you can think of in the body, it's likely at some point endocannabinoids are involved," Marsicano said.
And that means an understanding of how those natural signaling molecules act on astroglial and other cells could have a real impact. For instance, Zhang said, "we may find a way to deal with working memory problems in Alzheimer's."
**Source: "SCIENCE DAILY"
Clearer Picture of How Protein Machine Systems Tweak Gene Expression
Indiana University biologists have found that specific types of RNA polymerase enzymes, the molecular machines that convert DNA into RNA, can differ in function based on variation in the parts -- in this case protein subunits -- used to assemble those machines.
The new findings on the synthesis and function of different RNA polymerases (Pols), including two RNA polymerases that lead author Craig Pikaard discovered over a decade ago -- the plant-specific enzymes Pol IV and Pol V -- indicate that subunit composition of the polymerases plays a role in selecting how some genes are silenced while others are not.
All eukaryotes -- a group that includes plants, animals, fungi and all other organisms with nuclei -- contain life-essential Pols I, II and III that are each built from different combinations of 12 to 17 protein subunits, with each of the three enzymes assigned specific, unique tasks in the cell. In 1999 while analyzing the newly sequenced genome of Arabidopsis thaliana, a member of the mustard family considered a model organism for experimentation in plant biology, Pikaard identified Pol IV and Pol V.
Pikaard's work has since shown that while the Pol IV and Pol V enzymes are not essential to life and are actually specialized forms of Pol II (the RNA polymerase responsible for generating RNAs that encode proteins), they play important roles in RNA-directed DNA methylation, a process that silences mobile genetic elements known as retrotransposons that can cause trouble if allowed to spread.
"In fact, most of the 12 protein subunits present in Pols II, IV and V are encoded by the same genes," Pikaard said. "Interestingly, among these common subunits are alternative forms of the ninth subunit, and the two forms of the ninth subunit (9a and 9b) are extremely similar, differing in only 8 of their 114 amino acids."
This high degree of similarity suggested 9a and 9b proteins might be redundant, but the Pikaard lab's new research found this to be only partially true.
"When you remove both proteins, the plants die as embryos; but if they lack just one of the proteins, they still survive, which is evidence that the two alternative forms of the protein are redundant for survival," he said. "But despite this, plants missing either 9a or 9b have different physical characteristics, such as leaf shape, suggesting that Pol II built using 9a does not function exactly the same as Pol II assembled using 9b."
Another unique feature found between the two protein subunits involves the functionality of Pol V and its ability to conduct RNA-directed DNA methylation: The Pol V polymerase built using 9b facilitates methylation, while the 9a-built Pol V does not.
"This is the first evidence showing that different functional subtypes of nuclear RNA polymerases are generated using alternative subunits, and there are multiple subunits for which more than one variant is produced," Pikaard said. "The results also show for the first time that the ninth subunit has a role in RNA-directed DNA methylation."
With new evidence from other research that RNA-directed DNA methylation and transposon silencing also takes place in the sperm-forming cell lineage in mammals, and not just in plants, Pol II transcription is implicated in methylation in both plants and animals.
"Alterations in DNA methylation and gene silencing are involved in multiple genetic disorders and diseases, including cancer," Pikaard said. "Our studies of RNA Pol IV and Pol V may tell us important things about their cousin, Pol II, that may not be possible to know otherwise, including how RNA synthesis can help specify sites of DNA methylation."
Pikaard is the Carlos O. Miller Professor of Plant Growth and Development in the IU Bloomington College of Arts and Sciences' Department of Biology and Department of Molecular and Cellular Biochemistry. Last year he was also named as an investigator of the Howard Hughes Medical Institute and the Gordon and Betty Moore Foundation along with 14 other scientists as part of a $75 million plant science initiative.
The new findings on the synthesis and function of different RNA polymerases (Pols), including two RNA polymerases that lead author Craig Pikaard discovered over a decade ago -- the plant-specific enzymes Pol IV and Pol V -- indicate that subunit composition of the polymerases plays a role in selecting how some genes are silenced while others are not.
All eukaryotes -- a group that includes plants, animals, fungi and all other organisms with nuclei -- contain life-essential Pols I, II and III that are each built from different combinations of 12 to 17 protein subunits, with each of the three enzymes assigned specific, unique tasks in the cell. In 1999 while analyzing the newly sequenced genome of Arabidopsis thaliana, a member of the mustard family considered a model organism for experimentation in plant biology, Pikaard identified Pol IV and Pol V.
Pikaard's work has since shown that while the Pol IV and Pol V enzymes are not essential to life and are actually specialized forms of Pol II (the RNA polymerase responsible for generating RNAs that encode proteins), they play important roles in RNA-directed DNA methylation, a process that silences mobile genetic elements known as retrotransposons that can cause trouble if allowed to spread.
"In fact, most of the 12 protein subunits present in Pols II, IV and V are encoded by the same genes," Pikaard said. "Interestingly, among these common subunits are alternative forms of the ninth subunit, and the two forms of the ninth subunit (9a and 9b) are extremely similar, differing in only 8 of their 114 amino acids."
This high degree of similarity suggested 9a and 9b proteins might be redundant, but the Pikaard lab's new research found this to be only partially true.
"When you remove both proteins, the plants die as embryos; but if they lack just one of the proteins, they still survive, which is evidence that the two alternative forms of the protein are redundant for survival," he said. "But despite this, plants missing either 9a or 9b have different physical characteristics, such as leaf shape, suggesting that Pol II built using 9a does not function exactly the same as Pol II assembled using 9b."
Another unique feature found between the two protein subunits involves the functionality of Pol V and its ability to conduct RNA-directed DNA methylation: The Pol V polymerase built using 9b facilitates methylation, while the 9a-built Pol V does not.
"This is the first evidence showing that different functional subtypes of nuclear RNA polymerases are generated using alternative subunits, and there are multiple subunits for which more than one variant is produced," Pikaard said. "The results also show for the first time that the ninth subunit has a role in RNA-directed DNA methylation."
With new evidence from other research that RNA-directed DNA methylation and transposon silencing also takes place in the sperm-forming cell lineage in mammals, and not just in plants, Pol II transcription is implicated in methylation in both plants and animals.
"Alterations in DNA methylation and gene silencing are involved in multiple genetic disorders and diseases, including cancer," Pikaard said. "Our studies of RNA Pol IV and Pol V may tell us important things about their cousin, Pol II, that may not be possible to know otherwise, including how RNA synthesis can help specify sites of DNA methylation."
Pikaard is the Carlos O. Miller Professor of Plant Growth and Development in the IU Bloomington College of Arts and Sciences' Department of Biology and Department of Molecular and Cellular Biochemistry. Last year he was also named as an investigator of the Howard Hughes Medical Institute and the Gordon and Betty Moore Foundation along with 14 other scientists as part of a $75 million plant science initiative.
**Published by "SCIENCE DAILY"
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