miércoles, 13 de diciembre de 2017

¨Big data¨ para evitar el dolor.

Si eres capaz de predecir algo 
quiere decir que conoces sus causas

Se conoce como 'big data' el análisis de grandes cantidades de datos para extraer información útil. Sus aplicaciones más conocidas pasan por el campo de la informática o la banca, pero la medicina también se puede beneficiar de estas aplicaciones. Lo han demostrado un grupo de investigadores de la Universidad de Oviedo, que han desarrollado un sistema que predice los efectos secundarios en el tratamiento del cáncer de mama, principalmente en aquellas mujeres que ya han pasado la menopausia, a través del estudio matemático de cientos de miles de variaciones genéticas.

Ver también:

Matemáticas terapéuticas

El grupo de Problemas Inversos, Optimización y Aprendizaje Automático de la Universidad de Oviedo, dirigido por el profesor Juan Luis Fernández-Martínez y en el que participan los también profesores Enrique J. de Andrés y Ana Cernea, ha probado la relación entre las mutaciones genéticas y patologías como los dolores articulares que padecen algunas mujeres cuando están a tratamiento por un cáncer de mama. «Esperamos que nuestras investigaciones sirvan para proporcionar hipótesis en la búsqueda de nuevos fármacos y dianas terapéuticas», sostiene Juan Luis Fernández-Martínez.

El otro gran logro de su estudio es haber conseguido interpretar una mutación en la leucemia linfocítica crónica, la más común en los países occidentales. Con este descurimiento han conseguido establecer una relación entre la mutación y su efecto en el progreso de la enfermedad. «Si eres capaz de predecir algo quiere decir que conoces sus causas», explica el profesor. 
Las modelizaciones realizadas en la Universidad de Oviedo están siendo utilizadas ya para el diseño de nuevos tratamientos de inmunoterapia.

Ver también:

La Universidad de Oviedo abre la puerta a nuevos tratamientos contra la leucemia

Social Justice in the EU – INDEX REPORT 2017 / Healthy life expectancy

 Greece still has the sixth-best score on healthy life expectancy. People in Greece can expect an average of 64 healthy life (or disability-free) years. Only Sweden, Malta, Ireland, Belgium, Spain and Germany perform equal or better in this respect. The Netherlands and Denmark, each with a value of just below 60 years, fall – somewhat surprisingly – into the lower half with respect to this indicator. While their overall health scores are still high, this suggests that for the number of expected healthy life years, it is not only the quality of and conditions of access to health care that are relevant, but also individual behavior in the sense of healthy or unhealthy lifestyles. In the case of Denmark, which has one of the most inclusive health care systems in the European Union, the country experts point out that “there has been a marked decline in smoking in Denmark in recent years, but obesity rates have increased. The social gradient in health remains strong.”

Italy numbers among those countries to have deteriorated relatively significantly in recent years. Strong regional differences have had an effect on this outcome, but the SGI country experts highlight initially promising efforts to address the regional heterogeneity of health care quality and inclusiveness: “On average, the services provided achieve medium to high standards of quality (a recent Bloomberg analysis ranked the Italian system among the most efficient in the world), but, due to significant differences in local infrastructures, cultural factors, and the political and managerial proficiency of local administrations, the quality of public health care is not nationally uniform. In spite of similar levels of per capita expenditure, services are generally better in northern and central Italy than in southern Italy. In some areas of the south, corruption, clientelism and administrative inefficiency have driven up health care costs. In these regions, lower quality levels and typically longer waiting lists mean that wealthier individuals will often turn to private sector medical care. Regional disparities also lead to a significant amount of health tourism heading north. Early moves in the direction of fiscal federalism are now stimulating efforts to change this situation through the introduction of a system of national quality standards (correlated with resources), which should be implemented across regions.” (Más)

Ver anterior:
Social Justice in the EU – INDEX REPORT 2017 / Health & Access

martes, 12 de diciembre de 2017

Abilify MyCite, ethical questions...


  • ABILIFY MYCITE (aripiprazole tablets with sensor) is a drug-device combination product comprised of Otsuka’s oral aripiprazole tablets embedded with an Ingestible Event Marker (IEM) sensor. The ABILIFY MYCITE System includes: ABILIFY MYCITE, the MYCITE® Patch (wearable sensor); the MYCITE APP (a smartphone application); and web-based portals for healthcare providers and caregivers
  • The system records medication ingestion and communicates it to the patient and healthcare provider. In addition, it can collect data on activity level, as well as self-reported rest and mood which, with patient consent, can be shared with the healthcare provider and selected members of the family and care team
  • The system provides an objective summary of drug ingestion over time, to help enhance collaboration with healthcare providers who treat patients with certain serious mental illnesses (Más)

The ‘smart pill’ for schizophrenia and bipolar disorder raises tricky ethical questions

Smart pills” that can track whether or when you’ve taken your medication might be helpful for some people. 

Unfortunately, the first smart pill approved by the Food and Drug Administration, Abilify MyCite, is a drug used to treat schizophrenia and bipolar disorder. That raises tricky ethical issues.

Decades of research and clinical experience support the fact that not taking medicines as prescribed is a significant problem across all domains of medicine. Smart pills might help people with memory problems, or those with diabetes, heart failure, or other medication-dependent conditions who want to do a better job of sticking with their prescribed regimens.

There’s no question that mental illness kills people and shortens lives, and that medications can be helpful. The World Health Organization identifies mental illness as a major contributor to the global burden of disease. Episodes of psychosis, which are common among individuals who do not take appropriate psychiatric medications, put them in additional danger by actually damaging the brain and increasing the risk of their harming themselves or others.

Sticking to a medication regimen is as important for people with mental illness as it is for those with physical illness. But what makes Abilify MyCite, a high-tech version of aripiprazole, problematic is that it could easily be incorporated into forced treatment, which ignores the values and preferences of people with mental illness. 
Involuntary treatment has a long and painful history in mental health. Without their consent, people with mental illness can be committed to inpatient or outpatient treatment, and sometimes forced to take medications. Only in the 1970s did the U.S. Supreme Court first address the lack of rights for people hospitalized against their will.

We need to take a hard look at the risks and benefits of Abilify MyCite
It may help some people take their medications as prescribed, but it could also serve as a high-tech form of coercion in psychiatric care. If this new drug is to improve the treatment of people with schizophrenia and bipolar disorder, there needs to be a careful consideration of exactly who will benefit and who could suffer.

Abilify MyCite was approved without any directions for its ethical use. I believe that a panel of clinicians and consumers should be convened to create such ethical guidelines. That panel must include those for whom this drug might be appropriate — people diagnosed with schizophrenia and/or bipolar disorder.

True progress in psychiatric care includes real respect for those who struggle with mental illness, not just a new way to force treatment upon them. (Más)

Tia P. Powell, M.D., is director of the Montefiore Einstein Center for Bioethics and professor of epidemiology and psychiatry at the Albert Einstein College of Medicine. 

About the Author

Social Justice in the EU – INDEX REPORT 2017 / Health & Access


In the area of health, Sweden, Germany and Luxembourg hold the top three places. The Netherlands, Malta, Belgium, the Czech Republic and France also belong to the expanded top group. 
By contrast, conditions have deteriorated the most since 2008 in Greece, which is second from the bottom in the 2017 cross-EU comparison and is closely followed by Latvia.

In most EU countries, the quality of health care is high. However, with regard to both quality and inclusiveness in health care systems (equality of access), there are quite significant variations within the European Union. The greatest deficits are still to be found in Latvia, Greece and Romania. (Más)

lunes, 11 de diciembre de 2017

Humor...es lunes: De senos y bigotes...

Creatividad: ‘Keep Media Good’ / UER, Unión Europea de Radiodifusión

La UER, Unión Europea de Radiodifusión, asociación que reúne a los medios de comunicación de servicio público, lanzó la campaña ‘Keep Media Good’, que tiene como objetivo defender el papel que cumplen esos medios frente a la proliferación de noticias falsas, las disputas sobre su financiación o la aparición de “gigantes de la transmisión ‘online’”, se indica en un comunicado de la organización.

Es la primera vez, se indica en el comunicado difundido por la UER, que las organizaciones de medios de servicio público (MCSP) de Europa se unen “con una sola voz”.

A través de una selección de relatos e historias personales, se narra cómo determinados programas ayudaron o inspiraron a personas de distintos países a modificar sus vidas cotidianas o a impulsar una vocación y posterior desarrollo profesional. 
Los Juegos Paralímpicos, en el caso de un joven español inválido tras un accidente de tráfico, le convencieron para practicar baloncesto; la serie de animación Érase una vez el hombre, despertaron en otra joven española su inquietud por la Historia, lo que acabó convirtiéndose en su vocación, o la visión de los refugiados llevó a otra mujer a dedicar parte de su tiempo a tareas de ayuda humanitaria. Estos son algunos de los ejemplos que se muestran en la campaña. (Más)

domingo, 10 de diciembre de 2017

Citario/El dijo que...: Emilio de Benito / El Pais La salida del armario del VIH


Hace 25 años un diagnóstico de Sida suponía una "condena" para el afectado. Hoy las cosas son muy distintas. 
Al periodista de EL PAÍS Emilio de Benito le dieron como mucho tres años de vida. Ahora con 56, repasa en este vídeo cómo ha convivido con la enfermedad y cómo fue su "salida del armario del VIH". 
Una salida que es continúa, confiesa, como cualquier otra salida: "A la familia tardé muchísimo [en decírselo], más que nada por no darles el disgusto, y en el trabajo que tenía entonces nunca lo dije. Luego, al empezar a trabajar en el periódico tuve un altavoz".(Más)

viernes, 8 de diciembre de 2017

Cinema Paradiso: Morir


Un septiembre lluvioso en la costa cantábrica. Luis (Andrés Gertrudix) le confiesa a Marta (Marian Álvarez) que le ha mentido, que las pruebas médicas que se hizo antes de salir de vacaciones no habían salido bien. Ella estaba planeando las vacaciones del año siguiente y él es consciente de que no durará tanto, de que no tiene futuro. ¿Y si no hay verano que viene? Las vidas de Luis y Marta se ven abruptamente paralizadas. Las mentiras, la culpa y el miedo ponen a prueba la estabilidad y el amor de la pareja. 

Fernando Franco (La herida) dirige este drama que ha co-escrito junto a Coral Cruz (Incerta glòria). Sus protagonistas son Marian Álvarez (La niebla y la doncella), Andrés Gertrúdix (Que dios nos perdone) e Iñigo Aranburu (El guardián invisible). (Ver)

Visita médica: Sex, Drugs and Quarterly Goals, (VI) "No Illegal Drugs"

The world of pharmaceutical sales provides the backdrop for R/X, a soap-opera style webseries combining elements of comedy and drama. The tagline promises sex, drugs, and quarterly goals. While the latter may not inspire anyone to tune in, the former two certainly will!
It seems this series was made in 2007, so it's unclear why it's been sitting on the shelf for so long. The good news for fans though is that we're never left waiting too long for new episodes.

Ep. 6 "No Illegal Drugs"

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jueves, 7 de diciembre de 2017

USA: Novartis "suelta lastre"...Sandoz genéricos


The market for generic pills has gotten so bad in the U.S. that Novartis is thinking about selling off its oral solids business there, outgoing CEO Joseph Jimenez has told analysts.

The question of whether the Swiss drugmaker would ever spin off its Sandoz generics business came up during a conversation that Bernstein analysts had last week with Jimenez and drug development chief Vas Narasimhan, who will take over as CEO Feb. 1.

The CEO said that Novartis still likes the generics business outside the U.S., where he said biosimilars have given Sandoz a leading position, but it is thinking about exiting the oral solids portion of this business in the U.S. as that market continues to deteriorate, Bernstein analyst Tim Anderson recounted for clients in a note today.

So we are examining our options, inclusive of a spin,” Jimenez told the analyst.(...)

For Novartis, the price competition translated into a 13% generic sales decline in the U.S. in the third quarter. Sandoz reported sales of $2.6 billion, up up 1% in constant currencies, which were salvaged by 9% growth in the rest of the world.

Novartis hinted it was looking at such a move a couple of months ago when it said it would close a 450-employee generics API plant in Broomfield, Colorado.

"Novartis is currently experiencing above-average pricing pressure in our U.S. portfolio. With several products no longer competitive in saturated markets, we have made the decision to discontinue or divest these limited growth products to optimize our product portfolio," the spokesman said at the time.(Más)

Fake news: Consejos para identificar noticias falsas