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Strict Standards: Non-static method SimplePie_Misc::parse_url() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 8583

Strict Standards: Non-static method SimplePie_Misc::parse_url() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 1532

Strict Standards: call_user_func() expects parameter 1 to be a valid callback, non-static method SimplePie_Cache::create() should not be called statically in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 1536

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Strict Standards: Non-static method SimplePie_Misc::get_curl_version() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 7609

Strict Standards: Non-static method SimplePie_Misc::get_curl_version() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 7621

Strict Standards: Non-static method SimplePie_Misc::xml_encoding() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 1711

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Strict Standards: Non-static method SimplePie_Misc::encoding() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 8737

Strict Standards: Non-static method SimplePie_Misc::encoding() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 8738
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Descubren un blanco de ataque com√ļn a todas las variedades de virus del √Čbola 22 Oct 2014


Strict Standards: Non-static method SimplePie_Misc::get_element() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 13264

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Strict Standards: Non-static method SimplePie_Misc::normalize_url() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 8401

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Strict Standards: Non-static method SimplePie_Misc::get_element() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 13264

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Unos bioqu√≠micos han presentado oficialmente un descubrimiento que podr√≠a resultar muy √ļtil para combatir al virus del √Čbola, cuya infecci√≥n se ha propagado por varios pa√≠ses en √Āfrica y cuenta ya con un caso de contagio en Espa√Īa. Los autores de la nueva investigaci√≥n han producido una mol√©cula, del tipo conocido como p√©ptidos imitadores, la cual indica la existencia de una regi√≥n funcionalmente cr√≠tica del virus que est√° conservada en todas las especies de virus del √Čbola. Esta nueva herramienta puede ser utilizada para identificar de manera m√°s f√°cil un blanco farmacol√≥gico atacable mediante alg√ļn nuevo medicamento, una v√≠a de tratamiento que resultar√≠a eficaz para combatir a cualquier cepa actual conocida y probablemente cualquier otra futura.

ebola_dmEl hallazgo es obra de un extenso equipo de varias instituciones, encabezado por los bioquímicos Debra Eckert y Michael S. Kay, de la Universidad de Utah en Salt Lake City, Estados Unidos.

Por regla general, los actuales f√°rmacos experimentales para combatir al virus del √Čbola explotan blancos de ataque que son espec√≠ficos de solo una de las cinco especies del virus. La actual y creciente epidemia demuestra la necesidad de disponer de terapias efectivas y de amplio espectro para el virus, tal como subraya la Dra. Tracy R. Clinton, del equipo de investigaci√≥n. La informaci√≥n de la secuencia viral de las cepas implicadas en la epidemia, y esto es muy importante, revela cambios r√°pidos en el genoma viral, mientras que la secuencia gen√©tica identificada como un blanco estable, y com√ļn a todas las variedades del virus, no experimenta cambios. Por tanto, trabajar en el desarrollo de f√°rmacos que ataquen a esa regi√≥n gen√©tica espec√≠fica es una estrategia muy atractiva, pues si se alcanza el √©xito, todo apunta a que este ser√° duradero.

El virus del √Čbola causa una fiebre hemorr√°gica grave, con una tasa de mortalidad del 50 al 90 %. Existen cinco especies conocidas del virus. Las epidemias por infecci√≥n de este virus han estado ocurriendo con frecuencia creciente en a√Īos recientes, y la actual es la m√°s importante.
octubre 9/2014 (NCYT)

Tracy R. Clinton,Matthew T. Weinstock, Michael T. Jacobsen,Nicolas Szabo-Fresnais,Maya J. Pandya,Frank G. Whitby.Design and characterization of ebolavirus GP prehairpin intermediate mimics as drug targets.Protein Sci. 2014 Oct 6. doi: 10.1002/pro.2578

Una hormona que nos mantiene alerta también suprime la diseminación del cáncer 22 Oct 2014


Strict Standards: Non-static method SimplePie_Misc::get_element() should not be called statically, assuming $this from incompatible context in /home/cubaheal/public_html/classes/simplepie/simplepie.inc on line 13264

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En un hallazgo sorprendente que fue recientemente dado a conocer en Nature Communications (doi: 10.1038/ncomms6073.), investigadores del Instituto Weizmann de Ciencias demostraron que la noche es el momento correcto para que el cáncer crezca y se disemine por el cuerpo. Sus hallazgos indican que la administración de determinados tratamientos en coincidencia con el ciclo diurno-nocturno del cuerpo podría mejorar su eficacia.

imagesEste hallazgo surgi√≥ de una investigaci√≥n sobre las relaciones entre diferentes receptores en la c√©lula ‚ÄĒuna red compleja que todav√≠a no comprendemos del todo‚ÄĒ. Los receptores ‚ÄĒmol√©culas de prote√≠na en la superficie celular o dentro de las c√©lulas‚ÄĒ reciben mensajes bioqu√≠micos secretados por otras c√©lulas y los pasan hacia el interior de la c√©lula.

Los científicos, dirigidos por la Dra. Mattia Lauriola, investigadora posdoctoral del grupo de investigación del Profesor Yosef Yarden del Departamento de Regulación Biológica del Instituto Weizmann, en colaboración con el Profesor Eytan Domany del Departamento de Física de Sistemas Complejos, se enfocaron en dos receptores específicos.

El primero, el receptor de factor de crecimiento epid√©rmico, EGFR, favorece el crecimiento y la migraci√≥n de las c√©lulas, incluidas las cancerosas. El segundo se une a una hormona esteroide llamada glucocorticoide (GC). Los glucocorticoides desempe√Īan un papel en mantener los niveles de energ√≠a del cuerpo durante el d√≠a, as√≠ como el intercambio metab√≥lico de sustancias. A menudo se denomina la hormona del estr√©s, porque sus concentraciones aumentan en situaciones estresantes, que llevan r√°pidamente al organismo a un estado de alerta plena.

La c√©lula, con receptores m√ļltiples, recibe todo clase de mensajes a la vez y algunos de estos mensajes adoptan prioridad con respecto a otros. En el experimento, Lauriola y Yarden descubrieron que la migraci√≥n de las c√©lulas ‚ÄĒla actividad favorecida por el receptor de EGF‚ÄĒ se suprime cuando el receptor de GC se une a su mensajero esteroide.

Puesto que las concentraciones de esteroide alcanzan su m√°ximo durante las horas de vigilia y descienden durante el sue√Īo, los cient√≠ficos se preguntaron c√≥mo esto podr√≠a afectar al segundo receptor: EGFR. Verificando los grados de esta actividad en los ratones, descubrieron que hay una diferencia importante. Este receptor es mucho m√°s activo durante el sue√Īo y quiescente en las horas de vigilia.

¬ŅCu√°n relevantes son estos hallazgos para el c√°ncer, sobre todo para los tipos que utilizan los receptores de EGF para crecer y diseminarse? Con el prop√≥sito de descubrirlo, los cient√≠ficos administraron lapatinib ‚ÄĒuno de los f√°rmacos antineopl√°sicos de nueva generaci√≥n‚ÄĒ- a¬† modelos de c√°ncer en el rat√≥n. Este f√°rmaco, utilizado para tratar el c√°ncer de mama, est√° concebido para inhibir al EGFR, y por consiguiente evitar el crecimiento y la migraci√≥n de las c√©lulas cancerosas. En el experimento, administraron el f√°rmaco a los ratones a diferentes horas del d√≠a. Los resultados revelaron diferencias significativas entre los tama√Īos de los tumores de los diferentes grupos de ratones, lo que dependi√≥ de si hab√≠an recibido el f√°rmaco durante las horas de sue√Īo o de vigilia. Los hallazgos experimentales indican que es en realidad el aumento y el descenso de las concentraciones de los esteroides GC en el curso de 24 horas lo que dificulta o posibilita el crecimiento del c√°ncer.

La conclusión, dicen los científicos, es que podría ser más eficiente administrar algunos fármacos antineoplásicos por la noche.

“Parece un problema de sincronizaci√≥n”, dice Jord√°n. “Los f√°rmacos para tratar el c√°ncer se suelen administrar durante el d√≠a, justamente cuando el cuerpo del paciente est√° suprimiendo la diseminaci√≥n del c√°ncer por s√≠ mismo. Lo que proponemos no es un nuevo tratamiento, sino m√°s bien un nuevo horario de tratamiento para algunos de los f√°rmacos actuales”
octubre 13/10/2014

Lauriola M, Enuka Y, Zeisel A, D’Uva G, Roth L, Sharon-Sevilla M.Diurnal suppression of EGFR signalling by glucocorticoids and implications for tumour progression and treatment.Nat Commun. 2014 Oct 3;5:5073.

La inmunoterapia induce la remisión en muchas personas con un cáncer de sangre difícil de tratar 22 Oct 2014


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Una terapia experimental del sistema inmunitario puede llevar a menudo a la remisi√≥n completa en los pacientes de leucemia que se han quedado sin opciones, seg√ļn confirma un nuevo estudio.

girliv_40290Los investigadores hallaron que 27 de 30 ni√Īos y adultos con leucemia linfobl√°stica aguda (LLA) avanzada consiguieron la remisi√≥n total tras recibir las versiones modificadas gen√©ticamente de c√©lulas de su propio sistema inmunitario.

“El 90 % de los pacientes que ya no ten√≠an opciones llegaron a la remisi√≥n total. Es sorprendente”, dijo el investigador principal, el Dr. Stephan Grupp, del Hospital Pedi√°trico de Filadelfia y la Universidad de Pensilvania.

Sin embargo, siete pacientes que llegaron a la remisi√≥n finalmente sufrieron una reca√≠da, seg√ļn el estudio.

Los hallazgos, publicados en la revista New England Journal of Medicine (doi: 10.1056/NEJMoa1407222), confirman lo que estudios m√°s peque√Īos hab√≠an sugerido: La terapia ofrece esperanza a las personas con LLA que no han mejorado con los tratamientos est√°ndares.

Pero aunque los estudios anteriores se han centrado en los adultos, en este estudio se incluy√≥ mayoritariamente a ni√Īos.

“Muestra que la terapia puede funcionar igual de bien en los ni√Īos con LLA, y ver esto es fant√°stico”, dijo el Dr. Michel Sadelain, investigador del Centro Oncol√≥gico Memorial Sloan-Kettering de la ciudad de Nueva York, que trabaj√≥ en uno de los estudios anteriores.

Pero tanto Grupp como Sadelain dijeron que hay estudios en marcha que clarificar√°n el papel de la terapia en el tratamiento de la LLA.

La LLA es un c√°ncer de la sangre y de la m√©dula √≥sea que avanza con rapidez. Es m√°s com√ļn en los ni√Īos que en los adultos, pero aunque los ni√Īos a menudo se curan con la quimioterapia, los adultos tienen unas peores perspectivas, indic√≥ Sadelain.

Seg√ļn la Sociedad Americana Contra El C√°ncer (American Cancer Society, ACS), este a√Īo en EE. UU. se diagnosticar√°n unos 6000 casos de LLA, y algo m√°s de 1400 de esos pacientes morir√°n. Los adultos conformar√°n el 80 % de esas muertes, seg√ļn la ACS.

El primer tratamiento est√°ndar de la LLA consiste en tres rondas distintas de f√°rmacos de quimioterapia, y en muchos pacientes esto les hace superar el c√°ncer. Por desgracia, la enfermedad a menudo regresa. En ese momento, explic√≥ Sadelain, la √ļnica esperanza para la supervivencia a largo plazo es someterse a otra ronda de quimioterapia que acabe con el c√°ncer, seguido de un trasplante de c√©lulas madre.

Pero cuando el c√°ncer recurre, es probable que sea resistente a muchos medicamentos de quimioterapia. La nueva terapia plantea un enfoque completamente distinto: se usa el sistema inmunitario para dirigirse a prote√≠nas espec√≠ficas de las c√©lulas con LLA, seg√ļn los investigadores.

Los m√©dicos recogen c√©lulas T del sistema inmunitario de la sangre de un paciente. Entonces, las modifican gen√©ticamente para expresar los llamados receptores de ant√≠genos quim√©ricos, lo que permite a las c√©lulas T reconocer y destruir las c√©lulas con LLA. Las c√©lulas modificadas se vuelven a insertar en la sangre del paciente, donde se reproducen. Los investigadores apodaron a las c√©lulas modificadas las c√©lulas “cazadoras”.

De los 30 pacientes tratados en el presente estudio, 27 llegaron r√°pidamente a la remisi√≥n completa, lo que significa que ya no se les detectaba ning√ļn c√°ncer. A la mayor√≠a de las personas del grupo se les dio seguimiento durante al menos 6 meses, y durante hasta 2 a√Īos, dijeron los investigadores. Durante ese tiempo, 19 permanecieron en el estado de remisi√≥n, aunque 7 fallecieron despu√©s de que el c√°ncer regresara o progresara.

Una pregunta importante ahora, dijo Grupp, es si la terapia celular, por sí misma, puede mantener a los pacientes de LLA en el estado de remisión.

Sadelain se mostró de acuerdo. Ahora mismo, dijo, si la terapia celular lleva a la remisión total, normalmente se ofrece a los pacientes un trasplante de células madre, porque se sabe que los trasplantes aumentan las probabilidades de supervivencia de las personas a largo plazo.

Pero algunos pacientes no desean un trasplante o no se les puede realizar, debido, por ejemplo, a otras afecciones m√©dicas. De modo que, seg√ļn Sadelain, ser√° crucial que se haga un seguimiento a los pacientes a lo largo del tiempo, para ver si la terapia celular es suficiente para evitar una reca√≠da.

En el presente estudio, 15 de los pacientes que consiguieron mantener la remisión no recibieron más tratamiento.

Grupp calific√≥ eso como una se√Īal “esperanzadora” de que la terapia celular podr√≠a ser un tratamiento por s√≠ misma. “Pero todav√≠a no hemos llegado a eso”, enfatiz√≥.

En cuanto a la seguridad, Grupp afirm√≥ que el riesgo principal a corto plazo es el s√≠ndrome de liberaci√≥n de citoquinas, que causa s√≠ntomas como la fiebre persistente, un aumento de la presi√≥n arterial y la dificultad para respirar. Todos los pacientes del ensayo actual contrajeron el s√≠ndrome de liberaci√≥n de citoquinas poco despu√©s del tratamiento, seg√ļn el estudio. Pero nadie fallece como resultado de esta terapia.

“Los pacientes pueden ponerse bastante enfermos”, dijo Grupp, “pero se trata de un efecto secundario que se puede manejar”.

En julio, la Administraci√≥n de Alimentos y Medicamentos (FDA) de EE. UU. concedi√≥ a la terapia celular la designaci√≥n de “avance terap√©utico” para la LLA avanzada, lo que podr√≠a acelerar el tratamiento mediante el proceso de revisi√≥n reguladora est√°ndar, seg√ļn los investigadores.

Novartis, la compa√Ī√≠a farmac√©utica, que parcialmente financi√≥ este estudio, ha autorizado el uso de la tecnolog√≠a particular empleada en el presente estudio y va a realizar un ensayo de mayor tama√Īo en varios hospitales estadounidenses; Grupp y algunos de sus colegas investigadores han inventado la tecnolog√≠a y obtendr√°n beneficios econ√≥micos.

Sadelain es un fundador de Juno Therapeutics, que tambi√©n va a hacer ensayos de mayor tama√Īo de la terapia celular.

Este tratamiento sigue restringido al ámbito de la investigación, pero Grupp afirmó que los pacientes con una recaída de la LLA pueden preguntar a su médico sobre la posibilidad de inscribirse en un ensayo.
octubre 16/2014 (Medlineplus)

Maude SL, Frey N, Shaw PA, Aplenc R, Barrett DM, Bunin NJ.Chimeric antigen receptor T cells for sustained remissions in leukemia.N Engl J Med. 2014 Oct 16;371(16):1507-17.

La gesti√≥n del dolor postquir√ļrgico mejor√≥ en la d√©cada anterior 22 Oct 2014


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El porcentaje de pacientes estadounidenses que experimentan dolor postquir√ļrgico severo parece haberse reducido de forma significativa en la √ļltima d√©cada, revela una encuesta reciente.

surgery_18062¬ŅQu√© tan significativamente? En 2003, el 63 % de los encuestados dijeron que se hab√≠an enfrentado a alg√ļn tipo de dolor notable dos semanas tras una cirug√≠a en el hospital, pero en 2014, apenas el 39 % tuvieron experiencias similares, seg√ļn la encuesta.

“En primer lugar, debo decir que, en general, los pacientes quir√ļrgicos s√≠ experimentan algo de dolor tras la cirug√≠a”, anot√≥ el autor del estudio, el Dr. Asokumar Buvanendran, director de anestesia ortop√©dica del Centro M√©dico de la Universidad de Rush, en Chicago. “Pero en los √ļltimos 20 a√Īos, nuestra comprensi√≥n sobre la forma en que las distintas clases de medicamentos para el dolor funcionan ha mejorado, permitiendo a m√©dicos y anestesi√≥logos combinar distintos f√°rmacos para tratar mejor las necesidades espec√≠ficas de cada paciente. Y esto ha conducido a una reducci√≥n en la incidencia del dolor postquir√ļrgico severo”.

Buvanendran y sus colaboradores reportaron sus hallazgos en la reunión anual de la Sociedad Americana de Anestesiólogos (American Society of Anesthesiologists), en Nueva Orleáns.

Los autores apuntaron que actualmente los hospitales estadounidenses realizan alrededor de 45 millones de cirug√≠as en pacientes internos cada a√Īo. Una encuesta llevada a cabo en 1998 y en 2002 hall√≥ que casi dos terceras partes (el 63 %) de los 129 pacientes encuestados hab√≠an experimentado dolor de moderado a severo durante el primer par de semanas tras su alta del hospital.

Para ver si la experiencia de los pacientes hab√≠a mejorado desde entonces, el equipo condujo una nueva encuesta sobre el dolor postquir√ļrgico en aproximadamente 400 pacientes internos en el hospital.

Se pidi√≥ a todos los participantes que describieran qu√© tan satisfechos estaban con el tratamiento que recibieron para el dolor. Tambi√©n se les pidi√≥ calificar la severidad de cualquier dolor postquir√ļrgico que experimentaran, desde ning√ļn dolor hasta un dolor extremo. Ambas preguntas se plantearon antes del alta hospitalaria, y de nuevo una, dos y tres semanas tras la cirug√≠a.

En algunas medidas, el equipo halló poco cambio en los resultados.

Por ejemplo, al comparar el periodo de dos semanas en ambas encuestas, el equipo no halló un cambio significativo en el porcentaje de pacientes, apenas poco más de una quinta parte en ambas encuestas, que dijeron que no habían experimentado dolor tras la cirugía.

Adem√°s, la satisfacci√≥n de los pacientes con los analg√©sicos que les ofrecieron sigui√≥ siendo bastante comparable en las distintas encuestas: el 83 %¬† dijeron estar “satisfechos” o “muy satisfechos” en 2003, frente al 87 % en 2014.

Pero el cambio fue dramático respecto al dolor de moderado a extremo dos semanas tras la cirugía: la proporción de pacientes que experimentaron ese tipo de dolor se redujo de aproximadamente seis de cada 10 en 2003 a cuatro de cada 10 en 2014.

“No se debe a ning√ļn f√°rmaco en particular que estemos usando”, explic√≥ Buvanendran. “En lugar de ello, refleja la comprensi√≥n m√°s sofisticada que estamos adquiriendo sobre la forma en que los analg√©sicos funcionan mejor”.

“Por ejemplo, si se somet√≠a a una apendectom√≠a, antes recib√≠a 10 mgs de morfina para la gesti√≥n del dolor. Pero ahora sabemos que podemos administrar un f√°rmaco como Motrin, en combinaci√≥n con Tylenol, y en combinaci√≥n con, por ejemplo, solo cinco miligramos de morfina. Y la ventaja es que se pueden administrar varios f√°rmacos que funcionan en distintos puntos. Y eso en realidad reduce la cantidad de narc√≥ticos utilizados al mismo tiempo que se controla mejor el dolor”, afirm√≥.

“Dir√≠a que estos resultados reflejan una amplia tendencia nacional”, a√Īadi√≥. “Y es una tendencia que creo que seguir√° mejorando con el tiempo”.

El Dr. Richard Rosenquist, presidente del departamento de gestión del dolor de la Clínica Cleveland y presidente del comité sobre la medicina del dolor de la Sociedad Americana de Anestesiólogos, se mostró de acuerdo.

“Durante muchos a√Īos, hubo un tratamiento relativamente insuficiente para el dolor”, coment√≥. “A todos se les pon√≠a una inyecci√≥n de Demerol (un narc√≥tico) en el trasero, y eso era todo. Todos recib√≠an la misma dosis, frecuencia y cantidad. Y eso en realidad no funciona porque todos llegamos con necesidades distintas, y los mensajes de dolor se transmiten por muchas v√≠as distintas”.

“As√≠ que ahora no solo es m√°s espec√≠fico seg√ļn el procedimiento quir√ļrgico”, a√Īadi√≥, “sino que tambi√©n se personaliza para los pacientes en s√≠. Si llega un hombre de 25 a√Īos, ser√° distinto que uno de 85, y lo trataremos de forma diferente. Y un paciente que se hace una cirug√≠a del t√≥rax recibir√° un control del dolor distinto que alguien que se somete a una cirug√≠a abdominal”.
octubre 14/2014 (MedlinePlus)

 

La preeclampsia puede ser causada por el feto, no por la placenta 22 Oct 2014


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La preeclampsia, el trastorno potencialmente mortal que afecta a las mujeres embarazadas, puede deberse a problemas para satisfacer las necesidades de ox√≠geno del feto en crecimiento, seg√ļn un editorial publicado en Anaesthesia ( DOI: 10.1111/anae.12832), la revista de la Asociaci√≥n de Anestesi√≥logos de Gran Breta√Īa e Irlanda (AAGBI).

fetoEl hallazgo ha inducido a la coautora del editorial, Profesora Asociada Alicia Dennis, Anestesióloga Consultora y Directora de Investigación de Anestesia en el Royal Women Hospital en Melbourne, Australia, a recomendar que se modifique el nombre del trastorno para que las mujeres tomen más conciencia de los riesgos.

“El llamarla hipertensi√≥n causada por el embarazo, en vez del nombre hist√≥ricamente obsoleto de preeclampsia significar√≠a que las mujeres en todo el mundo podr√≠an estar mejor informadas y asesoradas en torno al trastorno”, dice.

La Profesora Asociada Dennis fue coautora del editorial, publicado en la revista Anaesthesia, junto con el Dr. Julian Castro, un cardiólogo interconsultante del St. Vincent Hospital Melbourne.

“La causa de la preeclampsia y el identificar cu√°les mujeres presentar√°n hipertensi√≥n durante el embarazo, ha desconcertado a los m√©dicos durante d√©cadas, de manera que estamos muy interesados por presentar las teor√≠as planteadas por Dennis y Castro”, dice el Dr. Steve Yentis, Editor en Jefe de Anaesthesia, que es publicada por Wiley-Blackwell por parte de la AAGBI.

Dennis y Castro consideran que el embarazo no tiene contratiempos en mujeres que pueden mantener un aporte de oxígeno sostenido y equilibrado para satisfacer las necesidades metabólicas cambiantes del feto. Es cuando una mujer tiene una menor capacidad para proporcionar oxígeno al feto que se vuelve letal para la madre y el producto.

Su nueva teor√≠a unificada de la preeclampsia cuestiona el punto de vista actual de que esta es causada espec√≠ficamente por un problema de la placenta. As√≠ mismo, cuestiona el punto de vista ampliamente aceptado de que la preeclampsia sea causada por una sustancia a√ļn no identificada que produce la placenta. Proponen que hay muchos trastornos diferentes, sea en la madre, en la placenta o en el feto, que conducen a un aporte insuficiente de ox√≠geno para el feto. La respuesta de la madre es tratar de aportar m√°s ox√≠geno al feto para ayudar a su crecimiento, pero esto aumenta su presi√≥n arterial y da√Īa su cuerpo.

“La hipertensi√≥n en las mujeres embarazadas sigue siendo un problema global grave que afecta a cerca de 13 millones de personas al a√Īo”, dice el editorial de Anaesthesia, el cual fue redactado despu√©s que los autores analizaron estudios de investigaci√≥n de todo el mundo.

La Profesora Asociada Dennis explica: “No ha habido una disminuci√≥n de la prevalencia de la preeclampsia en los √ļltimos 50 a√Īos. Estamos tratando de establecer una teor√≠a unificada para explicar por qu√© tantas mujeres embarazadas presentan este trastorno”.

Dennis y Castro dicen que a fin de reducir el n√ļmero de muertes consecutivas a preeclampsia, los m√©dicos deben comenzar a desmitificar esta consecuencia cardiovascular frecuente del embarazo.

El editorial en Anaesthesia dice que si los efectos del trastorno, y su tratamiento, se comprendiesen mejor en el ámbito clínico, habría menos fallecimientos por el trastorno.

La preeclampsia puede ser mortal en las madres y lactantes o causar complicaciones graves para la salud, entre ellas, convulsiones, insuficiencia renal, insuficiencia cardíaca y hemorragia.

Una de cada cuatro mujeres con hipertensión no complicada durante el embarazo presentará preeclampsia y es más frecuente en mujeres portadoras de gemelos o trillizos, mujeres que son obesas o que tienen diabetes.

No se dispone de una prueba exacta para determinar cu√°les mujeres embarazadas presentar√°n el trastorno. Los autores se√Īalan que hay una necesidad urgente de aplicar las mismas normas de tratamiento en las mujeres embarazadas que las que se aplican en adultas no embarazadas con cardiopat√≠as potencialmente letales, sobre todo el empleo de ecograf√≠a card√≠aca.
octubre 17/2014 (Medcenter.com)

A. T. Dennis, J. M. Castro.Hypertension and haemodynamics in pregnant women ‚Äď is a unified theory for pre-eclampsia possible?.Anaesthesia.Volume 69, Issue 11.Pages 1183‚Äď1189 .Nov 2014

Lanzamientos repetitivos podrían provocar problemas graves en hombros de los adolescentes 22 Oct 2014


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Los deportistas j√≥venes que lanzan m√°s de 100 pelotas por semana se arriesgan a una dolorosa lesi√≥n por uso excesivo que puede da√Īar el desarrollo normal del hombro, advierte una investigaci√≥n reciente.

Young boy baseball pitcherLa lesión se conoce como apofisiolisis acromial, y los investigadores dijeron que puede conducir a problemas adicionales, como desgarros en el manguito rotatorio.

“No hay problema con que los adolescentes realicen lanzamientos en el b√©isbol. El problema es exagerar”, se√Īal√≥ el Dr. Johannes Roedl, radi√≥logo de la divisi√≥n musculoesquel√©tica del Hospital de la Universidad de Thomas Jefferson, en Filadelfia.

“Animo a los padres a hacer que sus hijos jueguen deportes, pero no hagan que sus hijos realicen repetitivamente los mismos movimientos, uno de los cuales es el lanzamiento”, aconsej√≥ Roedl.

El acromion, que forma el hueso en la parte superior del hombro, se desarrolla de la fusi√≥n de cuatro huesos individuales en la adolescencia. Pero Roedl encontr√≥ que las lesiones por uso excesivo del acromion antes de los 25 a√Īos se vinculaban con una fusi√≥n incompleta posteriormente.

Para el estudio, que aparece en la revista Radiology (doi.org/10.1148/radiol.14140587), los investigadores observaron los expedientes de m√°s de 2300 pacientes de ambos sexos que ten√≠an entre 15 y 25 a√Īos de edad. Todos se hab√≠an sometido a IRM entre 1998 y 2012 tras quejarse de dolor de hombro. La mayor√≠a eran lanzadores de b√©isbol o softbol.

Cerca del tres por ciento sufrían de dolor en la parte superior del hombro, y una fusión incompleta del acromion. Roedl comparó a esos pacientes con un grupo similar de la afección, y estudió sus antecedentes de lanzamientos.

Lanzar más de 100 lanzamientos por encima de la cabeza por semana fue un factor de riesgo sustancial para contraer la afección, advirtió.

De los que tenían una lesión por uso excesivo, el 40 % dijeron que habían realizado más de cien lanzamientos de pelotas a la semana. En el grupo de comparación, apenas el 8 % habían lanzado tanto.

Todos los jugadores lesionados dejaron de lanzar durante tres meses. Uno se sometió a cirugía, y los demás recibieron antiinflamatorios no esteroides.

Se realizaron IRM o radiograf√≠as al menos dos a√Īos despu√©s, cuando los jugadores hab√≠an cumplido los 25 a√Īos. Mientras que el 86 % de los jugadores con una lesi√≥n por uso excesivo ten√≠an una fusi√≥n incompleta del acromion, lo mismo sucedi√≥ en apenas un 4 % de los jugadores sanos.

Más de dos terceras partes del grupo de uso excesivo también habían sufrido de desgarros del manguito rotatorio, frente al 29 % de los demás, y los desgarros eran más graves en el grupo de uso excesivo, halló el estudio.

Aunque este inconveniente no es com√ļn, puede ser un problema, advirti√≥ el Dr. Michael Shepard, cirujano ortop√©dico del Instituto Ortop√©dico del Hospital de Hoag en Newport, California, y m√©dico de equipo de los Angels of Anaheim de Los √Āngeles.

El mensaje final es claro: evitar lanzar en exceso, planteó Shepard, que no participó en el estudio.

Las lesiones por uso excesivo son comunes en los estados c√°lidos, donde muchos ni√Īos juegan b√©isbol y otros deportes durante todo el a√Īo, coment√≥.

“No deje que su hijo juegue pelota todo el a√Īo, y tampoco que lance todo el a√Īo”, aconsej√≥. “Haga que jueguen en general menos de nueve meses. Y que lancen menos de seis meses”.

Generalmente, los profesionales tienen tres meses de descanso, anotó.

El Dr. Craig Spurdle, cirujano ortop√©dico del Hospital Pedi√°trico de Miami, en Florida, se mostr√≥ de acuerdo en que jugar todo el a√Īo no es buena idea.

Que 100 lanzamientos se consideren como pocos o demasiados “depende de la edad”, dijo Spurdle, que no particip√≥ en el estudio.

El Instituto Americano de Medicina Deportiva (American Sports Medicine Institute) dice que los lanzadores de 15 a 18 a√Īos no deben jugar m√°s de dos partidos por semana, y que deben limitar los lanzamientos a 50 por partido.
octubre 15/2014 (Medlineplus)

Roedl JB, Morrison WB, Ciccotti MG, Zoga AC.Acromial Apophysiolysis: Superior Shoulder Pain and Acromial Nonfusion in the Young Throwing Athlete.Radiology. 2014 Oct 14

 
 
 
Clínica Central Cira García
IPK (Instituto de Medicina Tropical)
IPK (Instituto de Medicina Tropical)
INOR
Instituto Nacional de Oncológica y Radiobiologia
Ciren
CIREN(Centro Internacional de Restauración Neurológica).
Centro de Salud La Pradera
Centro Internacional de Salud La Pradera
 
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