¿Cómo mejorar la evacuación?

Aunque la frecuencia idónea varía en función de cada persona, existen hábitos que contribuyen a que sea la adecuada:

**Trate de no contener de forma habitual las ganas de defecar. Esperar a estar en casa por costumbre supone una inhibición muy desaconsejable del reflejo de de evacuación

**La fibra que aportan las frutas, las verduras y hortalizas, las legumbres y los cereales integrales acelerar el tránsito intestinal y reduce la incidencia del problema. Además, beber suficientes líquidos ayuda a ablandar el bolo fecal y facilita la deposición de las heces

**El sedentarismo puede acusar el estreñimiento. La actividad física moderada, un buen paseo todos los días sin ir más lejos, puede bastar para mejorar nuestra regularidad

**Procure adoptar costumbres horarias que fomenten la regularidad. Pero, en cualquier caso, vaya al baño solo cuando tenga ganas. Sentarse y esperar puede ser contraproducente

New statistical model lets patient's past forecast future ailments

Analyzing medical records from thousands of patients, statisticians have devised a statistical model for predicting what other medical problems a patient might encounter. Like how Netflix recommends movies and TV shows or how Amazon.com suggests products to buy, the algorithm makes predictions based on what a patient has already experienced as well as the experiences of other patients showing a similar medical history.

"This provides physicians with insights on what might be coming next for a patient, based on experiences of other patients. It also gives a predication that is interpretable by patients," said Tyler McCormick, an assistant professor of statistics and sociology at the University of Washington.

The algorithm will be published in an upcoming issue of the journal Annals of Applied Statistics. McCormick's co-authors are Cynthia Rudin, Massachusetts Institute of Technology, and David Madigan, Columbia University.

McCormick said that this is one of the first times that this type of predictive algorithm has been used in a medical setting. What differentiates his model from others, he said, is that it shares information across patients who have similar health problems. This allows for better predictions when details of a patient's medical history are sparse.

For example, new patients might lack a lengthy file listing ailments and drug prescriptions compiled from previous doctor visits. The algorithm can compare the patient's current health complaints with other patients who have a more extensive medical record that includes similar symptoms and the timing of when they arise. Then the algorithm can point to what medical conditions might come next for the new patient.

"We're looking at each sequence of symptoms to try to predict the rest of the sequence for a different patient," McCormick said. If a patient has already had dyspepsia and epigastric pain, for instance, heartburn might be next.

The algorithm can also accommodate situations where it's statistically difficult to predict a less common condition. For instance, most patients do not experience strokes, and accordingly most models could not predict one because they only factor in an individual patient's medical history with a stroke. But McCormick's model mines medical histories of patients who went on to have a stroke and uses that analysis to make a stroke prediction.

The statisticians used medical records obtained from a multiyear clinical drug trial involving tens of thousands of patients aged 40 and older. The records included other demographic details, such as gender and ethnicity, as well as patients' histories of medical complaints and prescription medications.

They found that of the 1,800 medical conditions in the dataset, most of them -- 1,400 -- occurred fewer than 10 times. McCormick and his co-authors had to come up with a statistical way to not overlook those 1,400 conditions, while alerting patients who might actually experience those rarer conditions.

They came up with a statistical modeling technique that is grounded in Bayesian methods, the backbone of many predictive algorithms. McCormick and his co-authors call their approach the Hierarchical Association Rule Model and are working toward making it available to patients and doctors.

"We hope that this model will provide a more patient-centered approach to medical care and to improve patient experiences," McCormick said.

The work was funded by a Google Ph.D. fellowship awarded to McCormick and by the National Science Foundation.

**Source: University of Washington

New breast cancer drug halts tumor growth better than standard therapy

A new cancer treatment that links chemotherapy with an agent that homes in on specific breast cancer cells was significantly better than the current drug regimen at keeping patients' advanced tumors from progressing, according to results from a Phase III clinical trial led by Kimberly Blackwell, M.D., of the Duke Cancer Institute. Participants with invasive breast cancer who took the investigational drug, called trastuzumab emtansine, or T-DM1, also had fewer and less harsh side effects than study participants who received a standard treatment.

The findings were reported June 3 at the American Society of Clinical Oncology annual meeting in Chicago, and will form the basis for Genentech, the drug's manufacturer, to seek marketing approval from the U.S. Food and Drug Administration. Genentech and its parent company, Roche funded the clinical trial.

"This drug is significantly better than the current approved combination in keeping the cancer under control," said Blackwell, director of the Breast Cancer Clinical Program at Duke and principal investigator of the international study. "This is a drug that brings us another step closer to treating cancer without the side effects of chemotherapy. It's going to be a good option for patients faced with HER-2 positive tumors."

Nearly 1,000 people with advanced breast cancer were enrolled during the three-year study. All the participants had a form of aggressive breast cancer distinguished by elevated levels of a protein known as human epidermal growth factor receptor 2, or HER-2. The protein promotes the growth of cancer cells, and plays a role in about 20 percent of invasive breast cancers.

For many people with HER-2 positive breast cancers, an antibody called trastuzumab has been an effective treatment, binding to the HER-2 protein on the surface of cancer cells and interfering with its ability to fuel tumor growth. Trastuzumab is prescribed alone or as an added treatment along with chemotherapy drugs.

T-DM1 represents one of the first in a new class of cancer-fighting agents called antibody drug conjugates. Linking the antibody trastuzumab directly with chemotherapy, the conjugate works like a sort of smart bomb, homing in on the HER-2 targets in the tumor cells and delivering the added payload of chemotherapy.

Blackwell and colleagues report that the median amount of time people on T-DM1 had no cancer growth was 9.6 months, compared to a median 6.4 months for people receiving the current standard drug regimen of capecitabine and lapatinib.

"These are significant and clinically meaningful improvements against comparative drugs that are highly effective for this group of patients," Blackwell said.

After two years, 65.4 percent of the T-DM1 patients were alive, compared to 47.5 percent of participants on standard treatment. The difference, while a notable trend, failed to meet a statistical benchmark set by its predetermined study design. A later analysis of overall survival is planned.

The new drug also caused fewer side effects. Blackwell said trastuzumab emtansine caused liver injury and a drop in blood platelets in some study participants, but most did not suffer the hair loss, rashes, nausea and diarrhea common to traditional chemotherapies.

"This is a more targeted way of delivering chemotherapy to HER-2 overexpressed cells," Blackwell said. "It delivers the drug directly to the cancer cells, while avoiding cells that don't really need to receive chemotherapy, which keeps patients from getting sick."

As a result, more people were able to stay on the drug without dose reductions, with 16.3 percent of participants on T-DM1 needing to adjust the dosage, compared to 53.4 percent of participants on capecitabine and 27.3 percent for lapatinib.

"As a clinician who takes care of breast cancer patients, it's important to have a treatment that is both effective and well tolerated," Blackwell said. "This drug has very little dose-limiting toxicity. That is in stark contrast to so many of the treatments we have available today. This drug works."

**Source: Duke University Medical Center

¿Cómo usar bien los antisépticos?

**Para heridas leves no es necesario el uso de antisépticos. Si utiliza alguno, los más recomendables son la povidona yodada y la clorhexidina

**No utilice nunca dos antisépticos a la vez porque pueden interaccionar y dificultar la curación o, incluso, producir algún efecto adverso como alergia o irritación de la piel

**Revise el botiquín y lleve los medicamentos y los antisépticos caducados a los puntos de recogida SIGRE

**Vaya al médico si la herida tiene objetos incrustados, si no puede controlar la hemorragia producida o si le ha mordido algún animal, ya que puede requerir algún tipo de medicación o tratamientop

La Sociedad Española de Neurociencia

Este año 2012 es el Año de la Neurociencia. La organizadora de todos los eventos relacionados en España con esta efemérides es la Sociedad Española de Neurociencia, fundada en 1985. Sus principales objetivos se concentran en la difusión y divulgación  del conocimiento del sistema nervioso.
Nació como respuesta al reto de aunar esfuerzos para avanzar en el conocimiento entre los investigadores y actúa como canal de información hacia la opinión pública sobre los resultados y las implicaciones de las Neurociencia.

Asistencia sanitaria: viaje tranquilo este verano gracias a su teléfono inteligente

 A tiempo para las vacaciones de verano, la Eurocopa de fútbol y los Juegos Olímpicos de Londres de este año, la Comisión Europea ha lanzado una aplicación para teléfonos inteligentes en la que explica cómo se utiliza la tarjeta sanitaria europea.    

    La tarjeta permite recibir asistencia sanitaria pública si se cae enfermo o se sufre un accidente durante un viaje o una estancia temporal en treinta y un países europeos. Los proveedores nacionales del seguro de enfermedad expiden gratuitamente la tarjeta, que garantiza el acceso a tratamiento urgente en las mismas condiciones y al mismo coste (en algunos países, gratis) que las personas aseguradas en el país en cuestión.  

    Las diferencias entre los sistemas sanitarios pueden hacer que resulte difícil entender cómo se utiliza la tarjeta en ciertos países y cuáles son las normas en cada uno de ellos. Esta guía práctica sobre cómo utilizar la tarjeta en los veintisiete países de la UE, más Islandia, Liechtenstein, Noruega y Suiza, está disponible como aplicación para teléfonos inteligentes en tres sistemas operativos: iOS, Android y Windows 7 mobile. Contiene información general sobre la tarjeta, los números de teléfono de emergencias, los tratamientos cubiertos y sus costes, además de información sobre la solicitud de reembolso y a quién contactar en caso de perderla. La aplicación está disponible en veinticuatro lenguas e incluye la opción de cambiar de lengua.  

    La tarjeta sanitaria europea no puede ser generada ni descargada por la aplicación sino que ha de solicitarse a los proveedores nacionales del seguro de enfermedad.  

    Descargue la aplicación "tarjeta sanitaria europea" en su teléfono inteligente: http://ec.europa.eu/social/main.jsp?catId=559&langId=es  

    Contexto  

    http://europa.eu/rapid/pressReleasesAction.do?reference=IP/12/563&format=HTML&aged=0&language=ES&guiLanguage=en  

    Más información  

    Sitio web sobre la tarjeta sanitaria europea:http://ehic.europa.eu/  [http://ehic.europa.eu/social/main.jsp?langId=en&catId=509 ]  

ORENCIA® ▼ (abatacept) Demonstrates Comparable Efficacy to Humira® (adalimumab) in Patients with Moderate to Severe Rheuma

 Bristol-Myers Squibb Company [http://www.bms.com ]  today announced the results of AMPLE (Abatacept Versus Adalimumab Comparison in Biologic-Naïve rheumatoid arthritis (RA) Subjects With Background Methotrexate), a head-to-head clinical trial of 646 patients comparing the subcutaneous (SC) formulation of ORENCIA(R) (abatacept)vs. HUMIRA(R) (adalimumab), each on a background of methotrexate (MTX), in biologic naïve patients with moderate to severe RA. AMPLE met its primary endpoint (as measured by non-inferiority) and demonstrated that abatacept plus MTX achieved comparable rates of efficacy for the American College of Rheumatology criteria of 20 percent (ACR20) response at 1 year of 64.8% vs. 63.4% adalimumab plus MTX.  

    ACR50, 70 and major clinical response (ACR70 for 6 consecutive months), considered to be more stringent measures of efficacy, as well as DAS-28-CRP, were also assessed at 1 year and found to be generally comparable for the two arms. Kinetics of response and inhibition of radiographic progression were generally comparable for the two groups over a 12-month period. Injection-site reactions (a key secondary endpoint) were statistically significantly fewer in the abatacept plus MTX group. Discontinuations due to adverse events were 3.5% for abatacept plus MTX compared to 6.1% for adalimumab plus MTX while discontinuations due to serious adverse events were 1.3% for abatacept plus MTX compared to 3% for adalimumab plus MTX. Autoimmune events (mild to moderate in severity) reported in the abatacept SC plus MTX group was 3.1% and 1.2% in the adalimumab plus MTX group. Other safety outcomes were similar at 12 months. The results of AMPLE were presented today at the European League Against Rheumatism (EULAR) Annual European Congress of Rheumatology.  

    "Results from AMPLE provide important information comparing the efficacy of abatacept SC to adalimumab, including kinetics of response," said Michael Schiff, M.D., M.A.C.R., University of Colorado, and principal AMPLE study investigator. "The results demonstrate comparability between two agents for the primary endpoint of ACR20 and provides relevant data on ACR50 and 70."  

    "AMPLE is the first head-to-head study between two biologics which incorporates radiographic progression endpoints and provides important data on erosions and joint space narrowing in patients using abatacept SC and adalimumab, both on a background of methotrexate," said Désirée van der Heijde, M.D. Ph.D., Professor of Rheumatology, Leiden University Medical Center