viernes, 28 de febrero de 2014

APLICACION URINE MICROSCOPY PARA SMARTHPHONE






"Urine Micoscopy App" es una aplicacion para la identificación de elementos que encontramso en el sedimento urinario. Basada en la Guia Europea de urianalisis cuentas con imágenes representativas del sedimento encontrados en patologias frecuentes e importantes.

URINE MICROSCOPY APP

PARA iTunes



PARA ANDROID

Low-Dose Statins Good Option for Some Heart Patients: Study

A new analysis suggests that people at high risk for heart disease who can't take high-dose statin drugs to lower their cholesterol might benefit from a treatment combination that includes taking a low-dose statin.
Scientists at Johns Hopkins reviewed published research to compare the benefits and harms of a lower-intensity statin when combined with one of several other cholesterol-lowering treatments in adults at high risk for heart disease.
Study author Dr. Kimberly Gudzune said combining a low-dose statin with either a so-called bile acid sequestrant or Zetia (ezetimibe) -- both of which are medications that also work to lower cholesterol levels -- lowered "bad" (LDL) cholesterol. Taking a high-dose statin by itself also lowered LDL levels.
"At least in the short term, this strategy seems to be as effective as the high-dose statin alone, although there were two major caveats: We don't know much about side effects and we don't know about long-term effectiveness," said Gudzune, an assistant professor of medicine at Johns Hopkins.
She also said the researchers were not able to draw conclusions about mortality or heart problems such as heart attacks.
There was not enough evidence regarding LDL cholesterol reduction when it came to using a low-dose statin with fibrates, niacin or omega-3 fatty acids, Gudzune said. Fibrates can lower levels of blood fats known as triglycerides and can sometimes raise levels of "good" (HDL) cholesterol.
The review was published online Feb. 10 in the journal Annals of Internal Medicine.
The American College of Cardiology and the American Heart Association cholesterol guidelines recommend moderate- or high-intensity statin therapy for people whose medical conditions or cholesterol levels put them at risk for heart disease -- the leading cause of death for both men and women in the United States.
But some patients don't respond to high doses of statins and some suffer from side effects, including muscle pain, Gudzune said.
"It doesn't happen infrequently that patients come in and say, 'I'm having muscle pains on this statin,'" she said. "So we wanted to review the literature and help shed a little bit of light on it for those patients."
Gudzune said they aren't yet sure of the long-term benefits of combining low-dose statins and other medications.
"Unfortunately, we weren't really able to examine the risk for [heart] events like heart attacks or strokes," she said. "We aren't sure if it translates into decreased [heart] risk."
Dr. Chip Lavie is medical director of cardiac rehabilitation and preventive cardiology at the John Ochsner Heart and Vascular Institute in New Orleans.
"This is a nice paper," Lavie said. "But I suspect that many clinicians ... already know that a lower-dose statin combined with a second lipid agent -- most know this best with ezetimibe -- produced at least similar but probably slightly better [results] ... compared with lower-dose statins alone."
Based on the most recent guidelines, Lavie said, doctors should try to get patients to tolerate the proven therapies before resorting to other less proven "but potentially very effective treatment approaches."
Tomado de: HealthDay News. SOURCES: Kimberly Gudzune, M.D., M.P.H., assistant professor, medicine, Johns Hopkins University School of Medicine, Baltimore; Carl Lavie, M.D., professor, medicine, and medical director, cardiac rehabilitation and preventive cardiology, John Ochsner Heart and Vascular Institute, New Orleans, and Ochsner Clinical School, University of Queensland School of Medicine, Brisbane, Australia; Feb. 10, 2014, Annals of Internal Medicine, online

jueves, 27 de febrero de 2014

Biomarked for Death—Four Blood Proteins Can Predict Early Demise

While you may appear to be healthy, you may be frailer than you know. You may even be at risk of death—from one disease or another—within the next five years. Would you want to know? You may now have the choice, thanks to researchers at the Estonian Genome Center and the Institute for Molecular Medicine, Finland.
These researchers have developed a screening technology. It looks for four biomarkers that have been associated with a risk of dying from any disease in the near future. Ordinarily, biomarkers are used to assess an individual’s risk of developing a specific condition. The new screening technology, however, is used to reveal general frailty, even in apparently healthy people. It reflects the risk for dying, whatever the ultimate cause—heart disease, cancer, or any other condition.
The biomarkers identified by the researchers are albumin, alpha-1-acid glycoprotein, citrate, and the size of very-low-density lipoprotein particles. Of these, albumin was the only one previously linked with mortality. All these molecules are normally present in everyone's blood—the amounts of these molecules are what matter. To assess the degree to which an individual’s biomarkers are imbalanced, the researchers found a way to compile a biomarker score.
The researchers found that individuals with a biomarker score in the top 20% had a risk of dying within five years that was 19 times greater than that of individuals with a score in the bottom 20% (288 versus 15 deaths). In addition, biomarker scores were still predictive of early death—that is, a death within the next five years—independent of well-known risk factors such as age, smoking, drinking, obesity, blood pressure, and cholesterol.
The researchers detailed their results February 25 in PLOS Medicine, in an article entitled “Biomarker Profiling by Nuclear Magnetic Resonance Spectroscopy for the Prediction of All-Cause Mortality: An Observational Study of 17,345 Persons.” To carry out their study, the researchers relied on technology that allowed them to screen blood samples for a wide range of blood biomarkers.
This technology, nuclear magnetic resonance (NMR) spectroscopy, screened for over 100 potential biomarkers in two cohorts of healthy people. The first cohort, investigated by Estonian members of the research team, consisted of 9,842 people. So astonished by what they found, the Estonian scientists asked their Finnish colleagues to repeat the experiment. The Finnish cohort, consisting of 7,503 people, produced the same result: Just four biomarkers are predictive of cardiovascular mortality, as well as death from cancer and other nonvascular diseases.
While the researchers emphasized that more studies would be needed before their findings could be implemented in clinical practice, they expressed optimism that their work could alert seemingly healthy people to the need for medical intervention. One of the study’s Finnish authors, Johnannes Kettunen, said, “We believe that in the future these measures can be used to identify people who appear healthy but in fact have serious underlying illnesses and guide them to proper treatment.”
In discussing their results, the authors of the PLOS Medicine story wrote, “In spite of [this study’s] limitations, the fact that the same four biomarkers are associated with a short-term risk of death from a variety of diseases does suggest that similar underlying mechanisms are taking place. This observation points to some potentially valuable areas of research to understand precisely what's contributing to the increased risk.”

Tomado de genengnews.com

martes, 25 de febrero de 2014

MIT Team Develops Urine Test for Cancer


Scientists at MIT say they have developed a simple, cheap paper test that could be used to improve cancer diagnosis rates and help people get treated earlier. The diagnostic, which works much like a pregnancy test, reportedly could reveal within minutes, based on a urine sample, whether a person has cancer. This approach has helped detect infectious diseases, and the new technology allows noncommunicable diseases to be detected using the same strategy.
The technique, developed by MIT professor and Howard Hughes Medical Institute investigator Sangeeta Bhatia, Ph.D., relies on nanoparticles that interact with tumor proteases, each of which can trigger release of hundreds of biomarkers that are then detectable in a patient's urine.
“When we invented this new class of synthetic biomarker, we used a highly specialized instrument to do the analysis,” said Dr. Bhatia. “For the developing world, we thought it would be exciting to adapt it instead to a paper test that could be performed on unprocessed samples in a rural setting, without the need for any specialized equipment. The simple readout could even be transmitted to a remote caregiver by a picture on a mobile phone.”
Dr. Bhatia, who is also a member of MIT's Koch Institute for Integrative Cancer Research and Institute for Medical Engineering and Science, is the senior author of a paper (“Point-of-care diagnostics for noncommunicable diseases using synthetic urinary biomarkers and paper microfluidics”) describing the particles in Proceedings of the National Academy of Sciences.
In 2012, Dr. Bhatia and colleagues introduced the concept of a synthetic biomarker technology to amplify signals from tumor proteins that would be hard to detect on their own. These proteins, known as matrix metalloproteinases (MMPs), help cancer cells escape their original locations by cutting through proteins of the extracellular matrix, which normally holds cells in place.
The MIT nanoparticles are coated with peptides targeted by different MMPs. These particles congregate at tumor sites, where MMPs cleave hundreds of peptides, which accumulate in the kidneys and are excreted in the urine.
In the original version of the technology, these peptides were detected using a mass spectrometer. However, these instruments are not readily available in the developing world, so the researchers adapted the particles so they could be analyzed on paper, using a lateral flow assay.
“We describe the design of exogenous agents that serve as synthetic biomarkers for NCDs [noncommunicable diseases] by producing urinary signals that can be quantified by a companion paper test. These synthetic biomarkers are composed of nanoparticles conjugated to ligand-encoded reporters via protease-sensitive peptide substrates,” wrote the investigators. “Upon delivery, the nanoparticles passively target diseased sites…where up-regulated proteases cleave the peptide substrates and release reporters that are cleared into urine. The reporters are engineered for detection by sandwich immunoassays, and we demonstrate their quantification directly from unmodified urine.”
In tests in mice, the researchers were able to accurately identify colon tumors as well as blood clots. Dr. Bhatia says these tests represent the first step toward a diagnostic device that could someday be useful in human patients.
  • Tomado de genengnews.com

Marijuana may protect the immune system against SIV and slow disease progression

New evidence that chronic intake of THC, the primary psychoactive ingredient in marijuana, can protect critical immune tissue in the gut from the damaging effects of HIVinfection is reported in AIDS Research and Human Retroviruses, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available on the AIDS Research and Human Retroviruses website.
Patricia Molina and coauthors from Louisiana State University Health Sciences Center, New Orleans, report that chronic THC administration was associated with greater survival of T cell populations and reduced overall cell death in the gut in monkeys, which is known to be a key target for simian immunodeficiency virus (HIV) replication and infection-related inflammation. The researchers present their findings in the article "Modulation of Gut-Specific Mechanisms by Chronic-9-Tetrahydrocannabinol Administration in Male Rhesus Macaques Infected with Simian Immunodeficiency Virus: A Systems Biology Analysis." This report provides mechanistic insights into their previous observation that THC administration attenuates disease progression in SIV infected macaques (AIDS Research and Human Retroviruses 2011; 27: 585-592).
"To better treat HIV infection, we need a better understanding of how it causes the disease we call AIDS. We also need alternative approaches to treatment," says Thomas Hope, PhD, Editor-in-Chief of AIDS Research and Human Retroviruses and Professor of Cell and Molecular Biology at the Feinberg School of Medicine, Northwestern University, Chicago, IL. "This study is important because it begins to explain how THC can influence disease progression in SIV-infected macaques. It also reveals a new way to slow disease progression."
Referencia:Modulation of Gut-Specific Mechanisms by Chronic Δ9-Tetrahydrocannabinol Administration in Male Rhesus Macaques Infected with Simian Immunodeficiency Virus: A Systems Biology Analysis, Authors: Molina, Patricia E., Amedee, Angela M., Le Capitaine, Nicole J., Zabaleta, Jovanny, Mohan, Mahesh, Winsauer, Peter J., Vande Stouwe, Curtis, McGoey, Robin R., Auten, Matthew W., LaMotte, Lynn, Chandra, Lawrance C., and Birke, Leslie L., AIDS Research and Human Retroviruses. doi:10.1089/aid.2013.0182
Tomado de:medicalnewstoday.com

viernes, 7 de febrero de 2014

TOMA DE MUESTRA : SANGRE ARTERIAL

VIDEO SOBRE LA TOMA DE MUESTRA DE
 SANGRE  ARTERIAL





Tomado de MedicineUpToDate

Zinc for colds

Zinc was recognized as an element in 1509 and as an essential mineral much later. In 1961, zinc deficiency was linked with hypogonadism. Zinc is included in almost all over-the-counter daily vitamins and mineral supplements, typically in the form of zinc oxide, zinc acetate, and zinc gluconate. Zinc is absorbed through the small bowel with an efficiency of 20%-40%. It is the second most important metal in the body after iron and is present in virtually 100% of proteins.
Zinc inhibits viral replication. Because of this, it has been investigated as a way to decrease the duration of symptoms from the common cold. With some evidence suggesting that it works, we know little about the right dose for zinc to exert its magical effects.
In a recently published systematic review, Singh and Das updated a previous Cochrane systematic review and, once again, evaluated the efficacy of zinc in reducing the incidence, severity, and duration of common cold symptoms (Cochrane Database Syst. Rev. 2013;6:CD001364). Studies were included if they were randomized, double-blind, placebo-controlled trials using zinc for at least 5 days for treatment or 5 months for prevention of the common cold.
Sixteen therapeutic trails involving a total of 1,387 people, and two preventive trials with 394 participants were included in the meta-analysis. Zinc came in the form of syrup, lozenges, or tablets. Zinc was associated with statistically significant reductions in theduration but not the severity of symptoms. The mean difference in reduction duration was 1 day (95% confidence interval, –1.72 to –0.34). After 7 days of treatment, significantly fewer subjects had symptoms. Zinc was associated with a reduced incidence of colds, absences from school, and receipt of antibiotics. Bad taste and nausea were significantly higher in patients treated with zinc. The authors suggested that there is a significant reduction in the duration of cold symptoms at a dose of at least 75 mg/day in the lozenge form.
Inhaled zinc can cause permanent anosmia, and so this delivery route was not investigated. Lozenges may be the best bet, since we know the daily dose should be at least 75 mg for treatment. For patients interested in using zinc for prevention, no clear dosage recommendations can be made. Megadose supplementation or high zinc intake has been associated with abdominal pain, diarrhea, nausea, and vomiting. Zinc may interfere with copper absorption, and high zinc intake (greater than 150 mg/day) can lead to copper deficiency and should be avoided.

Tomado: internalmedicinenews.com
By: JON O. EBBERT, 

TU CEREBRO Y EL ALCOHOL

VIDEO ANIMADO SOBRE LA INTERACCION DEL ALCOHOL Y TU CEREBRO




TOMADO DE AsapSCIENCE·

miércoles, 5 de febrero de 2014

HPV vaccine doesn't promote risky sex

Young women who get the human papillomavirus (HPV) vaccine don't see it as a license to have more sexual partners or forgo condoms, a new study confirms.
The US Centers for Disease Control and Prevention calls for both girls and boys to be vaccinated against HPV, the sexually transmitted virus that causes cervical cancer.
Some parents and community groups have been concerned that the vaccine might promote risky sex.
But in the new study, even the small group of girls who misunderstood their risk of sexually transmitted infections (STIs) after getting vaccinated didn't change their behaviour as a result, researchers found.
"There are so many contributing factors to whether an adolescent decides to have sex or not, and whether they decide to limit their number of partners or use condoms," says Dr Jessica Kahn. "Getting a vaccine probably just plays a very, very small role in their decisions."
Kahn worked on the study at Cincinnati Children's Hospital Medical Center in Ohio.
Her team's findings are in line with another report that showed girls who had been vaccinated weren't more likely to get other STIs or become pregnant.
"To me, the issue is laid to rest," says Kahn. "As clinicians and researchers, we have no concerns that vaccination will lead to riskier sexual behaviours."

Maintaining their behaviour

She and her colleagues studied 339 young women between 13 and 21 years old who were getting their first of three HPV shots. Most of the women were black and came from low-income families.
The researchers surveyed participants about how important they considered safe sex to be, and how concerned they were about STIs. Then they asked the participants about changes in their sexual behaviour when the young women came back two and six months later for their next shots.
After getting the first vaccine, most young women agreed it was still necessary to use condoms and generally practice safe sex. On a scale from zero to 10, where lower scores indicate a better understanding of risks, participants scored a 1.6, on average.
Most study participants also understood that the HPV vaccine doesn't protect against other STIs, and they scored a 3.9 on their perceptions of STI risks, according to findings published in the journal Pediatrics.
"The vast majority of girls thought that safer sexual behaviours were still important after vaccination," says Kahn. But even those who didn't accurately perceive their risks weren't any more likely to start having sex or stop using condoms, her study shows.
Among women who say they had never had sex when they got their first vaccine, 20 per cent had become sexually active by the time the researchers checked in with them six months later.
Of those who were already having sex when the study started, close to two thirds said at their six-month visit that they used a condom the last time they had sex. About one third reported two or more sexual partners since their last visit.
"The findings strengthen a growing body of literature that indicates that getting HPV vaccination is very unlikely to change an adolescent's perception about risk and also their actual sexual behaviour," says Dr Amanda Dempsey.
Dempsey is a paediatrician and vaccine researcher at the University of Colorado, Denver and wasn't involved in the new research. She tells parents that young people's attitudes on sex are based on years of discussions about family values — so a shot shouldn't have a major effect.
Kahn says she is worried that parents' concerns about changes in sexual behaviour might still be keeping them from getting their children vaccinated.
HPV vaccination rates in the United States are relatively low. One in three girls between 13 and 17 years old had gotten all three shots in 2012, the researchers note.

Significant impact in Australia

In Australia, the HPV vaccine is given to girls and boys aged 12 and 13 years at school.
According to Dr Julia Brotherton of the Victorian Cytology Service in Melbourne, the rate of coverage in Australia is around 70 per cent.
"Vaccine uptake is fairly evenly spread across the socio-economic spectrum because of the school-based system," says Brotherton. "In the United States, it relies on parents to make an appointment, then a doctor has to administer it and it is then claimed from the insurer."
She says there has also been more of a focus on the benefits of the HPV vaccine in Australia.
Brotherton adds that since the vaccine was released on the market in 2007, the rate of HPV infections has declined.
"We've already seen rates of infection go down by 77 per cent, while genital warts have almost disappeared in young women and men," she says.
Two of the study's seven authors have received grants from the two companies that sell HPV vaccines, Merck and GlaxoSmithKline. The current study was funded by the US National Institutes of Health.
Tomado de: abc.net.au
Genevra Pittman and staff

Fecal immunochemical tests detect most colorectal cancers

Fecal immunochemical tests have an overall diagnostic accuracy of 95% for the detection of colorectal cancer, according to the results of a meta-analysis just published in the Annals of Internal Medicine.
The tests, which have already begun to replace the fecal occult blood test (FOBT) in national screening programs in the United States, Europe, and Asia, were found to be 79% sensitive and 94% specific for CRC.
"This systematic review and meta-analysis suggests that FITs [fecal immunochemical tests] have high accuracy, high specificity, and moderately high sensitivity for detection of CRC," Dr. Douglas Corley of the Kaiser Permanente division of research in Oakland, Calif., and his associates wrote (Ann. Intern. Med. 2014;160:171-81).
FITs are more sensitive at detecting both CRC and adenomas than the FOBT, they maintained, and are also more practical for people to perform at home, requiring only one or two stool samples and no special dietary or medication restrictions.
Despite a greater potential ease of use for mass screening, reports on the diagnostic performance of FITs have been inconsistent, the investigators explained. They therefore performed the meta-analysis to determine the overall diagnostic accuracy and factors affecting the tests’ performance. Nineteen trials were included that involved more than 113,000 individuals and provided data on eight different FITs available for use in the United States.
In addition to the sensitivities and specificities of FITs, positive and negative likelihood ratios (LR) were calculated to assess the ability of the tests to respectively "rule in" or "rule out" a diagnosis of CRC. The threshold set for a positive LR was a value above 5 and for a negative LR was 0.2. Pooled data from the trials showed a positive LR of 13.10 and a negative LR of 0.23.
Increasing the number of FIT samples did not affect the pooled sensitivities, specificities, positive LRs, or negative LRs of FITs for CRC. There also was no great difference in performance between the FIT brands evaluated in the studies. Dr. Corley and his associates pointed out, however, that head-to-head comparisons were not included in most studies so this finding should be interpreted with caution.
Diagnostic performance was affected by the cutoff values used to define a positive test, which might influence which test health systems decide to use, the researchers said.
"Health systems wishing to optimize use of a quantitative FIT should consider the tradeoff between increasing sensitivity (by lowering the cutoff threshold for a positive test) and the resulting increase in the number of positive results," they wrote. The latter could significantly impact colonoscopy resources if more procedures were indicated by a positive test.
The researchers recommended that health systems also look at individual studies comparing single or repeat testing, as the current data do not provide a definitive answer on the effect of sample number on the performance of FITs.
The National Institute of Diabetes and Digestive and Kidney Diseases and the National Cancer Institute funded the research.

By: SARA FREEMAN, Family Practice News Digital Network