sábado, 28 de noviembre de 2009

Éstos están peor que en Guate !!!


viernes, 27 de noviembre de 2009

¿Un aerosol para prevenir la eyaculación precoz?

Pruebas en más de 500 hombres que padecen ese mal revelaron que un aerosol que adormece el pene puede ayudar a prevenir el trastorno, que afecta hasta a un tercio de los norteamericanos de 18 a 59 años
El laboratorio que desarrolló el fármaco, la división Sciele Pharma Inc de la firma japonesa Shionogi, planea buscar la aprobación del spray en Estados Unidos el año próximo. Pruebas sobre más de 500 hombres con eyaculación precoz mostraron que estaban más satisfechos y menos angustiados cuando empleaban el aerosol, indicaron los investigadores en un encuentro de la Sociedad de Medicina Sexual de Norteamérica, en San Diego. "La eyaculación precoz (EP) puede tener un impacto poderosamente negativo sobre la vida emocional y sexual de los hombres y sus parejas", dijo Stanley Althof, del Centro de Salud Marital y Sexual del Sur de Florida. No existe tratamiento de venta bajo receta aprobado por la Administración de Alimentos y Medicamentos de Estados Unidos (FDA por su sigla en inglés) para este trastorno. Sciele estima que la condición afecta hasta a un tercio de los hombres estadounidenses de 18 a 59 años. "Recientemente, la comunidad de expertos en salud sexual coincidió en que la EP debería definirse como la eyaculación que se produce aproximadamente dentro del primer minuto de la penetración, que causa angustia en el paciente", indicó Althof en un comunicado. El medicamento, llamado por su nombre experimental PSD502, es una combinación de los agentes anestésicos lidocaína y prilocaína. El equipo del doctor Ira Sharlip, de la University of California en San Francisco, evaluó a 300 hombres con eyaculación precoz y les pidió que se aplicaran el aerosol cinco minutos antes de la relación sexual. Los hombres, en promedio, experimentaban el clímax antes del minuto de iniciada la penetración antes del uso del spray. Luego de la aplicación del aerosol durante tres meses, el 60 por ciento de los participantes logró que la eyaculación se produjera más de tres minutos después de la penetración, informó el equipo de Sharlip. Un segundo estudio observó a 256 hombres estadounidenses, polacos y canadienses y halló que el medicamento "producía un aumento clínico y estadísticamente significativo" de menos de un minuto a un promedio de 2,6 minutos en el tiempo de eyaculación, dijeron los expertos durante la reunión.

Fuente: Reuters

L-Arginina, un nuevo viagra femenino que potencia el placer

Se trata de un aminoácido que interviene en la primera fase de la respuesta erectiva del clítoris. Un sexólogo explicó a Infobae.com que se recomienda para "mujeres con dificultad para excitarse, deseo sexual disminuido o anaorgasmia"
Si la aparición en el mercado del sildenafilo o sildenafil -más conocido como Viagra- utilizado para tratar algunos tipos de impotencia masculina representó toda una revolución, la reciente existencia de una sustancia que aumenta el deseo sexual femenino no será menos.
L-Arginina es un aminoácido que interviene en la primera fase de la respuesta erectiva tanto del pene como del clítoris y, por acción de la enzima óxido-sintetasa, se convierte en óxido nítrico (es un gas vasodilatador que producirá el comienzo del proceso de vasodilatación en los cuerpos cavernosos de las estructuras clitoridianas), lo que resulta en un aumento de la capacidad eréctil del órgano erótico por excelencia en las mujeres.El médico sexólogo Adrián Sapetti detalló a Infobae.com que el aminoácido "se puede tomar diariamente en forma de comprimidos y también, combinado con otras sustancias, viene en gel para aplicar en la zona del clítoris"."En su modalidad de aplicación clitoridiana bastan dos o tres para sentir el efecto al momento de las relaciones sexuales", aseguró el profesional, y agregó que "por la vía oral, el resultado se advierte tras la primera toma, pero lo ideal es después de la tercera".Asimismo, Sapetti aclaró que, si bien en los hombres no funciona en su versión "local", la L- Arginina por vía oral "produce mejoras en las erecciones". Así, en mujeres con dificultad para excitarse, deseo sexual disminuido o anaorgasmia, el aminoácido en su uso tópico (gel) podría "aumentar la excitación, turgencia y erección clitoridianas favoreciendo el orgasmo". Aunque también incrementa el goce en mujeres que no tienen ninguna disfunción y simplemente desean sentir y gozar más.El producto es de venta libre y, pese a que –según Sapetti- "no es necesaria la prescripción médica", no se recomienda su uso en mujeres embarazadas o alérgicas a alguna de las sustancias.El también llamado "viagra natural" (pese a que nada tiene que ver con ese medicamento que sí requiere prescripción e indicaciones médicas) "aumenta la sensibilidad en el clítoris, principal responsable del orgasmo femenino. La mujer experimenta un aumento de la excitación y llega a orgasmos más rápidos e intensos, lo que realza la experiencia sexual de la pareja".Sapetti, quien acaba de presentar su libro Confesiones íntimas, historias reales de sexo y pasión, en el que relata historias que cuentan los pacientes al sexólogo, destacó que el aminoácido "también daría mayor capacidad y poder a nivel de los músculos del cuerpo".

2009-2010 Influenza Season Triage Algorithm for Adults (older than 18 years of age) With Influenza-Like Illness


domingo, 22 de noviembre de 2009

Felicitaciones a Uruguay !!!

Espero sigan con éstas tendencias sociales..., por este tipo de acciones, están con solo algunos otros (en América) en la cima de los indicadores mundiales de buena calidad de vida, etc..

URUGUAY DOTA DE COMPUTADORAS A TODOS LOS ESCOLARES DEL PAIS

Fuente: EFE noticias

Nada como un artista !!!


viernes, 20 de noviembre de 2009

Debería ser LEY tener acceso a éste VITAL líquido en toda oficina !!!


Euda Carías, maravillosa deportista Guatemalteca !!!


Y además muy guapa !!!
La guatemalteca Euda Carías, bronce en el pasado campeonato mundial de taekwondo de Copenhagen, demostró que pasa por un buen momento y el fin de semana consiguió la medalla de plata en el World Tour México 2009.

Steroids beneficial, but antiviral agents are of uncertain value for Bell palsy

Clinical Question: Are both corticosteroids and antiviral agents beneficial for the treatment of Bell palsy?
Bottom Line: Corticosteroids alone are beneficial in the treatment of Bell palsy, but antiviral agents alone are not. The value of combined treatment with corticosteroids and antiviral agents compared with corticosteroids alone remains uncertain. Total corticosteroid treatment doses greater than an equivalent dose of 450 mg of prednisone are superior to lower doses.
Reference: de Almeida JR, Al Khabori M, Guyatt GH, et al. Combined corticosteroid and antiviral treatment for Bell palsy. A systematic review and meta-analysis. JAMA 2009;302(9):985-993.
Study Design: Meta-analysis (randomized controlled trials)
Synopsis: The value of both corticosteroids and antiviral agents in the treatment of Bell palsy remains uncertain. These investigators thoroughly searched multiple databases including MEDLINE, EMBASE, Web of Science, conference proceedings and abstracts, bibliographies of relevant articles, clinical trial registries, and noted experts for randomized controlled trials evaluating either corticosteroids or antiviral agents in the management of Bell palsy. No language restrictions were applied. Two individuals independently critiqued all studies for inclusion criteria and methodologic quality using standard criteria. Differences were resolved by consensus agreement. A total of 18 studies (N = 2786 patients) -- 8 evaluating corticosteroids, 7 evaluating antiviral agents, and 3 evaluating both corticosteroids and antiviral agents -- met all criteria. Follow-up occurred for a median of 6 months. Evidence quality was graded as moderate to high for the individual studies. Corticosteroids alone significantly reduced the risk of unsatisfactory facial recovery (number needed to treat [NNT] = 11; 95% CI, 8-25) and synkinesis and autonomic dysfunction (NNT = 7; 6-10). Higher doses (greater than the equivalent of 450 mg prednisone) produced a significantly greater benefit than lower doses. Antiviral agents alone were not significantly beneficial, but antiviral agents combined with corticosteroids were borderline significantly superior to corticosteroids alone (relative risk = 0.75; 0.56 - 1.00). The authors found no evidence for publication bias or significant heterogeneity in the results.

lunes, 16 de noviembre de 2009

Felicitaciones a Chile y Uruguay !!!

Todos los años, Transparencia Internacional prepara el Índice de Corrupción, donde se estudia y mide la corrupción presente en los gobiernos del mundo en una escala del 0 (más corrupto) al 10 (menos corrupto).
Este índice, que con el reporte del 2008 cumple 11 años de existencia “madura”, confirma año a año que la corrupción y el subdesarrollo van de la mano.
Mientras los países desarrollados difícilmente obtienen puntajes menores a 7, los subdesarrollados difícilmente obtienen puntajes mayores a 4.
En América del Sur, este índice, que salvo las honrosas excepciones de Chile y Uruguay podría denominarse el Índice de la Vengüenza.
Mientras Guatemala cae puestos y ahora está en el 96 con 3.1 puntos, Chile y Ecuador comparten el mismo puesto, con 6.9 puntos y están a la par de la élite mundial pero por encima de muchos países del primer mundo como Francia, España, Portugal, Italia entre otros.

Fuente: http://www.transparency.org/policy_research/surveys_indices/cpi/2008/cpi_2008_table

Soluble or insoluble fiber in irritable bowel syndrome in primary care? Randomised placebo controlled trial

C J Bijkerk, general practitioner1, N J de Wit, associate professor of general practice1, J W M Muris, associate professor of general practice2, P J Whorwell, professor of medicine and gastroenterology3, J A Knottnerus, professor of general practice2, A W Hoes, professor of clinical epidemiology and general practice11 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, Netherlands, 2 Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, 6200 MD Maastricht, Netherlands, 3 Department of Medicine and Gastroenterology, University of Manchester, Manchester, M23 9LT Correspondence to: C J Bijkerk c.j.bijkerk-2@umcutrecht.nl
Objective To determine the effectiveness of increasing the dietary content of soluble fibre (psyllium) or insoluble fibre (bran) in patients with irritable bowel syndrome.
Design Randomised controlled trial.
Setting General practice.
Participants 275 patients aged 18-65 years with irritable bowel syndrome. Interventions 12 weeks of treatment with 10 g psyllium (n=85), 10 g bran (n=97), or 10 g placebo (rice flour) (n=93).
Main outcome measures The primary end point was adequate symptom relief during at least two weeks in the previous month, analysed after one, two, and three months of treatment to assess both short term and sustained effectiveness. Secondary end points included irritable bowel syndrome symptom severity score, severity of abdominal pain, and irritable bowel syndrome quality of life scale.
Results The proportion of responders was significantly greater in the psyllium group than in the placebo group during the first month (57% v 35%; relative risk 1.60, 95% confidence interval 1.13 to 2.26) and the second month of treatment (59% v 41%; 1.44, 1.02 to 2.06). Bran was more effective than placebo during the third month of treatment only (57% v 32%; 1.70, 1.12 to 2.57), but this was not statistically significant in the worst case analysis (1.45, 0.97 to 2.16). After three months of treatment, symptom severity in the psyllium group was reduced by 90 points, compared with 49 points in the placebo group (P=0.03) and 58 points in the bran group (P=0.61 versus placebo). No differences were found with respect to quality of life. Fifty four (64%) of the patients allocated to psyllium, 54 (56%) in the bran group, and 56 (60%) in the placebo group completed the three month treatment period. Early dropout was most common in the bran group; the main reason was that the symptoms of irritable bowel syndrome worsened.
Conclusions Psyllium offers benefits in patients with irritable bowel syndrome in primary care.

domingo, 8 de noviembre de 2009

Usemos nuestro mejor raciocinio y pensemos en TODA Guatemala...

ALEPH
http://www.prensalibre.com/pl/2009/noviembre/07/353474.html
Guatemala, 7 de noviembre de 2009
Carolina Escobar Sarti
¿Desobediencia civil y obediencia religiosa?

Más de la mitad de las mujeres jóvenes indígenas del área rural ha tenido un parto antes de los 20 años, y siete de cada 10 sin educación primaria tuvieron un parto antes de los 20 años. Al menos eso dice la Encuesta Nacional de Salud Materno Infantil. Romanticismos y dogmatismos aparte, eso perpetúa el ciclo de la miseria en que vive sumida buena parte de la población de nuestro país, y significa la reducción de la autonomía social y económica de muchas mujeres jóvenes, además de poner en riesgo sus vidas y las de sus hijos o hijas.
Sin saber escribir siquiera su nombre y sin entender qué es eso tan rebuscado de los valores y principios en una sociedad que las tiene viviendo al margen de todas las orillas, las adolescentes difícilmente estarán interesadas en la controversia que ha desatado la Ley de Planificación Familiar. No saben que una historia de siglos y la perpetuación de esta desde la Iglesia, la política, la academia y demás instituciones que sostienen el statu quo son lo que no permite que salgan de ese estrecho círculo del “creced y multiplicaos”. A ellas, hablémosles de abstinencia, contratémoslas para el trabajo doméstico como su máxima aspiración en la vida y digámosles que Santa Claus existe.
Guatemala es el país con las más altas cifras de embarazos adolescentes de toda la región centroamericana y también ostenta con orgullo una de las cifras más altas de toda Latinoamérica de mortalidad materna e infantil. En este contexto de muerte e hipocresía, en una ocasión anterior y en medio de un debate sobre anticonceptivos, el jerarca de la Iglesia Católica guatemalteca apareció en la primera plana de un diario con una bala en la mano; hoy se aparece con un aspirador manual endouterino. Toda esta caricatura para justificar la postura medieval de la Iglesia en contra de iniciativas de planificación familiar. Indudablemente, en actitudes como esa encontramos el símbolo más contundente de nuestro subdesarrollo; ojalá los liderazgos se sostuvieran sobre principios de conciencia y no sobre los prejuicios de una moral timorata.
El cardenal sugirió a los padres y madres practicar la desobediencia civil para hacer valer su derecho de decidir qué tipo de educación sexual y reproductiva darán a sus hijos e hijas. Solo le faltó decir, aprovechándose del dogma de fe: desobedezcan al Estado y obedezcan a la Iglesia. Si de verdad respetara el derecho a decidir, no les estaría pidiendo que hicieran caso a la Iglesia o al Estado o a la televisión o a la tradición, sino a convicciones más profundas de conciencia que tienen que ver con una realidad innegable de extremos, de complejidades y de abandonos sostenidos en contra de la niñez, adolescencia y juventud de este país.
Es perverso ese manejo de la fe sin sustancia. Seguro no han entendido que la sexualidad no significa solo tener relaciones sexuales ni reducirlo todo a la genitalidad, sino que constituye una dimensión vital para el desarrollo integral de cualquiera, hasta el de los célibes y castos. Es indolente e inútil querer esconder información en un mundo globalizado y tecnificado, donde hasta los bebés son estimulados y bombardeados con cientos de mensajes de todo tipo. Y, señores de las iglesias, negar información a personas en formación en una sociedad donde muchas niñas y mujeres mueren por dar a luz es, como dirían ustedes, un pecado.
Tenemos la responsabilidad de formar a niñas, niños, adolescentes y jóvenes hablándoles abiertamente de salud sexual y reproductiva. Y esta va mucho más allá de los métodos anticonceptivos; hay que contarles que la sexualidad en la vida de cada una y cada uno de ellos puede basarse en el amor y en la comprensión, más que en el miedo y el pecado. Y no se preocupen, jerarcas de todas las iglesias, que con o sin su permiso, con o sin su distorsión, la humanidad seguirá caminando.
cescobarsarti@gmail.com

sábado, 7 de noviembre de 2009

Diuretics Best for Prevention of Congestive Heart Failure in Hypertension

Diuretics are the most effective antihypertensive drugs for prevention of heart failure, closely followed by ARBs and ACE inhibitors, according to the results of a large network meta-analysis presented at ESC 2009.[13] Presenting the data in Barcelona, Sebastiano Sciarretta, MD (University of Rome "La Sapienza," Italy), said that their network meta-analysis, the largest ever performed in essential hypertension, showed that all antihypertensive strategies, with the exception of those based on alpha-blockers, were more effective than placebo in preventing heart failure. CCBs were significantly less effective than diuretics as first-line agents and they also tended to be inferior to RAS blockers and beta-blockers, with the differences being very close to statistical significance, Dr. Sciarretta reported.

Hypertension is a major risk factor for the development of heart failure. Estimates from the Framingham Heart Study indicate that persistent hypertension is the predominant contributory factor in 40% of men and 60% of women in whom heart failure develops. Despite all the evidence, however, heart failure is usually considered a "soft" endpoint in hypertension clinical trials and greater attention has been given to MI and stroke, Dr. Sciarretta noted. He and his colleagues recently showed in another meta-analysis of hypertension trials that the overall incidence of heart failure was comparable with other measured cardiovascular events, and not significantly different from that for stroke.[14]

"Since there was no conclusive evidence about the optimal antihypertensive therapy among different classes of drugs in heart failure prevention in hypertensive subjects," Dr. Sciarretta said, he and his colleagues carried out a network meta-analysis of recent trials in hypertension to investigate the most effective antihypertensive strategies in heart failure prevention. They used computerized searches of PubMed and Embase databases to find clinical studies published in peer-reviewed English-language journals between 1997 and December 2008. The investigators identified 25 trials involving patients with hypertension or at high cardiovascular risk with a predominant presence of hypertensive patients (> 65%), involving ≥ 200 subjects, with a duration of follow-up of ≥ 2 years that reported the absolute incidence of heart failure and other major cardiovascular events. Dr. Sciarretta explained that the Bayesian network meta-analysis that they performed is a more powerful meta-analytic technique that combines direct evidence provided by clinical trials with indirect evidence constructed from studies that have treatments in common.

The 25 trials identified involved a total of 217,387 subjects. Among these individuals, 40.3% were randomized to receive "traditional" antihypertensive therapy, including mostly diuretics and anti-adrenergic agents; 18.6% of patients were assigned to diuretic-based therapy, 4.1% patients to alpha-blockers, and 2.2% to beta-blockers. The remaining patients were treated with the "newer" antihypertensive drug classes, including CCBs, ACE-inhibitors, and ARBs. In addition, 7.1% of patients were randomized to receive placebo or the best standard treatment for their condition. The trials used different definitions of heart failure, which was most often a secondary endpoint.

A total of 8291 new heart failure cases occurred in the trials. All the antihypertensive therapies with the exception of those based on alpha-blockers were more effective in preventing heart failure onset compared with placebo. Diuretics were the most effective class of drugs (OR, 0.56; 95% CI, 0.44-0.69), followed by ARBs (OR, 0.67; 95% CI, 0.52-0.80) and ACE-inhibitors (OR, 0.67; 95% CI, 0.56-0.79). CCBs appeared to have the smallest effect (0.78; 0.62-0.92). From direct comparisons in trials, diuretics appeared to be significantly more effective than ACE inhibitors, CCBs, and beta-blockers; although more effective than ARBs, this difference was not significant.

Because the trials used different definitions of heart failure, the investigators performed 3 subanalyses. The first included only studies that did not enroll patients with heart failure at baseline; the second excluded the Antihypertensive and Lipid-Lowering treatment to prevent Heart Attack Trial (ALLHAT) studies (because of criticism about the diagnosis of heart failure in this study); and the third excluded the ALLHAT studies and other trials that also included an endpoint of non-hospitalized heart failure. However, the results of these subanalyses did not differ from those of the main analysis, in that diuretics still appeared to be the most effective compared with the other drug classes and CCBs appeared to be less effective than the others.

Comment
Dr. Sciarretta noted that this meta-analysis was unable to reveal any information about the influence of differences in blood pressure, but he noted that previous landmark meta-analyses showed that heart failure prevention was independent of blood pressure reduction.
[15,16] He suggested that the most effective first-line therapy for prevention of heart failure in hypertensive patients is a combination of a low-dose diuretic and a RAS inhibitor.
Commenting on the results of the analysis, ESC session co-chair, Prof. Schmieder pointed out that diuretics differ substantially with respect to the duration of effect on blood pressure and dosage. "We know well from hypertension trials like ALLHAT
[17] that chlorthalidone has a long-lasting effect at low dose, and it has been said that we will never see that result with hydrochlorothiazide (HCTZ)," he said. He noted that chlorthalidone is not used as much in Europe as it is in the United States, and not at doses > 25 mg because of potential adverse metabolic effects.

Fuente: Medscape-Internal Medicine http://www.medscape.com/viewarticle/710877_3

Physicians Are Talking About: Is It Worth Getting the H1N1 Vaccine?

As the H1N1 vaccine arrives in local healthcare centers, the public debate still rages whether to risk the vaccine or the flu. Not even physicians are immune to the controversy.

An internist posting on Medscape's Physician Connect (MPC), an all-physician discussion board, asked his colleagues whether they plan to get vaccinated against H1N1. Some have responded with a decided "yes."

"I will take the swine flu vaccine as soon as it's available," says a clinical immunologist. "Ditto for wife and son."

"I am anxiously awaiting the vaccine," says a pregnant family medicine physician. "Pregnant women especially are having serious complications from H1N1, and I will take any and all immunity I can get."

"I have an acquaintance whose otherwise healthy 13-year-old died from H1N1 this summer," says a pediatrician, "so that'd be a great big yes."

"Immunizations have saved millions of lives, and counting," says a family medicine physician. "Why wouldn't I get the vaccine?"

However, other physicians are equally adamant about not getting the H1N1 vaccine.

"I don't want to be a lab rat," says an internist.

"No way I or my family will receive the vaccine. Not a chance!" comments another internist.

"Emphatically no to both vaccines," says a family medicine physician. "I agree with Dr. Joseph Mercola's take on the swine flu and this and the prior round of vaccinations for it. I believe, based on all I've read to date, that vaccinations cause a body more harm than good."
"I remember the last vaccine rushed to production. People died and some developed paralysis," says another family medicine physician. "I prefer to take my chances."
Several physicians wonder about the advisability of vaccinating segments of the population already exposed to influenza. An emergency medicine physician, who saw H1N1 cases throughout September, comments, "If the epidemiology here mirrors the Southern Hemisphere flu season, by the time H1N1 vaccine is available the virus probably will be done circulating through my community."
An anesthesiologist in the Dallas/Fort Worth, Texas, area commented that his community experienced a flu outbreak in September: "I'm not very enthused about giving my son the swine flu shot considering [that] he's likely had the disease already."

MPC contributors who have been treating H1N1 in their communities say that the illness, in the majority of cases, is mild. However, data on the spread and severity of the H1N1 virus are only now emerging. Two studies recently published in JAMA reported that the outbreaks in Mexico and Canada lasted about 3 months, but the peak lasted just a few weeks.[1] The Mexican cohort incurred a mortality of 27%,[2] twice as high as the Canadian cohort (14%).[3] The studies reported that the H1N1 influenza can produce a rapidly progressive respiratory failure that is refractory to conventional mechanical ventilation and that frequently targets young and healthy patients.

"This ain't your grandma's seasonal flu virus," says a pediatrician. "It's a quadruple-reassortant swine/avian hybrid that's never been seen before, significantly different from its predecessors, even if relatively wimpy." For this reason, he suggests that caution is warranted with regard to the infection and the vaccine. He adds, "It's not inconceivable that this vaccine could cause side effects not seen with seasonal vaccine, although it seems safe in trials, so far." A family medicine physician agrees: "Any vaccine made at the last minute and made only by a few manufacturers with huge government contracts at stake cannot help but be higher risk for untoward side effects."
Some of the reluctance to take the vaccine revolves around the accounts of increased risk for Guillain-Barré syndrome (GBS) associated with the 1976 H1N1 vaccine. The US Centers for Disease Control and Prevention (CDC) maintains that in 1976 there was a small risk for GBS after H1N1 vaccination (approximately 1 additional case per 100,000 people receiving vaccine),[4] which was slightly higher than the risk found in the general population. The potential risks for GBS associated with the current vaccine are unknown.
"GBS isn't directly attributable to the vaccine," says a pediatrician, "and the risk is miniscule. Definitely less than the risk of getting the flu and possibly having secondary problems develop." An internist concurs, "It doesn't make sense to risk getting an illness that is a known cause of GBS because of fear that the vaccine for the disease might carry a risk for it."
One family medicine physician considers the greatest benefit of the vaccine may be the immunity that it yields to future, more deadly influenza strains: "If H1N1 recombines with H5N1 picking up a gene or mutating so it binds deeper in the respiratory tract and hence becomes more likely to cause more serious illness, more pneumonia, we're in for a world of hurt. If the current vaccine develops even scant partial immunity to developing lethal forms, then it's worth the risk. For me and my children."
The scant amount of data available on the H1N1 vaccine leaves the risk-benefit ratio unclear for some physicians and their patients. A 60-year-old pediatrician who takes steroids and hydroxychloroquine (Plaquenil®) comments, "I am still not sure if I will take the shots." He adds that he does not know what to do about his patients who have autoimmune diseases, noting that there is no consensus among their rheumatologists. A family medicine physician comments, "I'm not sure I can justify recommending this vaccine to all children until safety is better ascertained when, so far, cases on the whole seem to be mild."
A pulmonologist says, "If you are in a high-risk group of flu complication, you should receive the vaccine. If you are in a high-exposure profession, you roll the dice and take your chances -- the chances of bad happening to you without the vaccine are likely to be higher than bad happening to you with the vaccine."
An internist considers the vaccine especially indicated in healthcare providers: "Influenza is highly contagious. Healthcare workers get exposed to it even more than members of the general population, and people infected with it can shed virus before they are symptomatic. Given these facts, the only ethical course for most healthcare workers is to be vaccinated."
One advocate for the vaccine speaks to the irony of the situation: "Those of us who take the risk and get the vaccine protect those who are unwilling to take the risk themselves."

viernes, 6 de noviembre de 2009

Inhalador para el asma !!!

video

Can a single question effectively rule-out unhealthy alcohol use in adults ?

Participants were asked, "How many times in the past year have you had X or more drinks in a day?", where X is 5 for men and 4 for women, and a response of 1 or more times is considered positive. This single question is fairly good at ruling out unhealthy use of alcohol in a high prevalence population, with a sensitivity of 81.8%. It is better for excluding patients with alcohol use disorder (sensitivity = 87.9%).
Synopsis:
To conduct this study, researchers approached 286 patients being seen for various reasons in a general internal medicine clinic of an urban safety net hospital. Approximately half the patients were men, 72% had graduated from high school, and 63% were Black or African American. Almost half (46.5%) had a current or past history of a drug use disorder. The prevalence of unhealthy alcohol use -- risky alcohol consumption or an alcohol use disorder -- was 30.8%, and only 6.3% of patients were totally free of alcohol-related problems in their lifetimes. All patients were asked a prescreening question about any alcohol use and 10 were asked the single screening question regardless of the answer to the first question. Alcohol use was defined as risky alcohol consumption, using a 30-day recall of alcohol use. Alcohol use disorder was assessed by using the Composite International Diagnostic Interview Substance Abuse Module to identify abuse and dependence. The single question was 81.8% sensitive and 79.3% specific for identifying any unhealthy use of alcohol. Sensitivity was higher (87.9%) for detecting alcohol use disorder but less specific (66.8%). These results were similar to the 3-question Alcohol Use Disorders Identification-Consumption (AUDIT-C) screening test also administered to the same patients. This study was administered by a research associate and not the patients' individual physicians, and results in clinical practice may be different.
Reference:
Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. Primary care validation of a single-question alcohol screening test. J Gen Intern Med 2009;24(7):783-788.

Poner atención a la foto !!!


CITAS DEL DIA

1. Es fácil tener principios cuando eres rico, lo más importante es tener principios cuando eres pobre. Ray Croc, Presidente de McDonald´s

2. El trabajo es de los más divertido, podría pasarme horas observándolo. Anónimo.

miércoles, 4 de noviembre de 2009

Un polémico concurso premió en Hungría a Miss Cirugía Estética.

El ideal de belleza cambia junto con las épocas y, acorde al paso del tiempo, también se modifican los concursos que premian a las mujeres más bonitas. En Hungría, se realizó el certamen Miss Plastic Hungary, donde se eligió a la reina de las cirugías estéticas.Las 18 postulantes desfilaron en Budapest ante la atenta mirada de un jurado compuesto por cirujanos, que evaluaron el trabajo que sus colegas realizaron en los cuerpos de las jóvenes. El objetivo que perseguían los organizadores del concurso es mostrar a la sociedad que una mujer operada también puede lucir una belleza natural, y no necesariamente artificial como dicta el prejuicio.De la competencia sólo podían participar mujeres que hayan pasado por el bisturí. Aquellas que sólo se hubieran animado a las inyecciones de bótox o colágeno, debían abstenerse. La mayoría de las candidatas tenían operadas la nariz o los pechos, pero también había algunas que, pese a su juventud, ostentaban algún que otro lifting en el rostro.Las chicas además tuvieron que presentar su historial médico, donde constara que las intervenciones se habían realizado bajo las normas adecuadas y sin poner en riesgo la salud del paciente, según informó el sitio 20minutos.es.El premio que se llevó la ganadora, Reka Urban, de 22 años, no es nada despreciable: la joven se convirtió en propietaria de un departamento y el pasaje para competir en Miss Plastic World, donde se medirá con mujeres operadas de todo el mundo. Las otras dos finalistas, en tanto, Edina Kulcsar y Alexandra Horvath se hicieron acreedoras de un auto 0 KM y de un viaje, respectivamente.

Fuente original: nutrar.com

Type 2 diabetes: tight control does not affect mortality

Clinical Question: In patients with type 2 diabetes, what is the effect on cardiovascular outcomes of aiming for intensive blood glucose control?

Bottom Line: Tight control of blood glucose does not protect patients from dying prematurely, whether by any cause or by cardiovascular disease. Tight control might confer some protection against the development of cardiovascular disease, but even this likelihood is tenuous. Aiming for tight control doubles the likelihood a patient will experience hypoglycemia severe enough to require medical intervention.

Reference: Kelly TN, Bazzano LA, Fonseca VA, Thethi TK, Reynolds K, He J. Systematic review: Glucose control and cardiovascular disease in type 2 diabetes. Ann Intern Med 2009;151(6):394-403.

Study Design: Meta-analysis (randomized controlled trials)
Funding: Foundation Setting:Various (meta-analysis)

Synopsis: To conduct this study, the researchers searched only one database to find randomized controlled trials of treatment of type 2 diabetes in adults. Two reviewers independently selected studies for inclusion and abstracted the data. The identified the 5 large trials (N = 27,802) that evaluated the role of tight blood glucose control. One problem: They excluded the University Group Diabetes Project study, which found increased cardiovascular mortality associated with treatment with sulfonylureas. The tight control of type 2 diabetes does not decrease the risk of mortality or cardiovascular-related mortality, though it may have an effect on slightly reducing the risk of cardiovascular disease (relative risk = 0.90; 95% CI 0.83 - 0.98). Including only the 3 newer studies, which enrolled older patients who had longstanding diabetes, found no benefit to tight control. Aiming for tight control doubled the likelihood that patients would experience severe hypoglycemia requiring medical attention. This analysis included enough patients to demonstrate even small benefits in intense blood glucose control, if they exist.

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Cuidado a los usuarios frecuentes de facebook, ya que según noticia de Prensa Libre del 02/11/09 el "Rey del Spam", Sanford Wallace, fué condenado en California x utilización ilegal de las cuentas de usuarios y deberá pagar US 711 millones.

La importancia de los retrovisores laterales !!!


Excelentes deportistas guatemaltecos !!!




Nery Velásquez, a principios del 2009 x un estúpido camionetero sufrió una aparatoso accidente con saldo de severo trauma cerrado de tórax y por lo menos estuvo inconsciente en cuidados intensivos 48 h, y tan solo en éste octubre 2009 se coronó campeón de la 50 vuelta ciclística de Guatemala !!!

Francisco Arredondo va de maravilla en el Rally de Marruecos, en el puesto 12 de la general en motos mayores a 450 cc !!!

Kevin Cordón y Rodolfo Ramírez arrasaron en el Abierto de Santo Domingo de badminton, llevándose dos oros y una plata, y tan solo hace una semana Kevin se coronó campeón Panamericano en México !!!

SON UN RESPIRO Y EJEMPLO EN ESTE TAN CONFLICTIVO PAIS...

domingo, 1 de noviembre de 2009

Extaño marsupial !!!




Soy apasionado de la fauna, pero no conocía éste marsupial. Dasyurus es un género de marsupiales dasiuromorfos de la familia Dasyuridae conocidos vulgarmente como cuoles, quoles, gatos marsupiales, gatos nativos o satanelos. Son un grupo de carnívoros de mediano tamaño que habitan en Australia, Tasmania, Nueva Guinea, Islas Aru, y otras cercanas a éstas.

Bellezas de Guatemala !


1 de noviembre en Guatemala, un día muy importante...

El 1 de noviembre o Día de los Santos, es una celebración muy pero muy importante en Guatemala, se recuerda a quienes ya no están con nosotros, se degustan comidas muy especiales y deliciosas (fiambre, jocotes en dulce, ayote en dulce, garbanzos en dulce) se vuelan maravillosos barriletes de todos tamaños, aunque los famosos son los gigantescos se Sumpango Sacatepequez y lo más importante para mí, NOS une a las familias.