dimarts, 11 d’agost de 2009

dilluns, 10 d’agost de 2009

Grip nova, grip A, grip del porc, en definitiva; Grip.

El meu pacient va venir l’altre dia, va entrar tot esverat preguntant per la grip que vindrà o que ja està, i això es el que li vaig explicar.

Que això es una grip, que no es més, febre, dolors per tot el cos, sense ganes de fer res, sol d’estar al llit o al sofà, que la clínica dura de tres a cinc dies i res més. Que la gent amb malalties de base –com poden ser els bronquitics crònics, els que pateixen insuficiència renal o hepàtica (no carbura molt el ronyó o el fetge), els HIV, els que pateixen malalties cròniques i fotudes-, son els que tenen risc de morir o de passar-ho malament.

Per què es dona tanta publicitat a la malaltia? Perquè la primera notícia que va aparèixer, dos-cents morts a Mèxic va alarmar a tothom, encara que després es va veure que no eren tants, per no dir que no eren més de dos o tres, sempre amb patologies anteriors. Aquest virus té d’especial que es una nova família del virus de la grip, però de moment no s’ha vist que sigui més letal que la resta de virus de la grip, no es sap si mutarà i serà més nociu, però la resta de virus de la grip coneguts des de fa anys no s’han tornat molt més agressius, així que en teoria no hi ha que patir per això.

Tema vacuna. No està feta, la que volen treure es vol saltar o s’ha saltat dues de les quatre fases que es necessita per aprovar un medicament. Normalment per treure un fàrmac es pot tardar de cinc a deu anys, per aquesta vacuna es vol fer amb mesos. La pregunta, cal tan temps per treure un fàrmac? O, surt aquest massa aviat? La OMS –Organització Mundial de la Salut-, no te gaire clar el tema vacuna, així que no crec que aquest any hi hagi la vacuna de la grip A, de la resta de grips ja està feta.

“Ve una gran pandèmia de grip”, això es el que sentim aquest any, però també es va sentir l’any passat, i fa dos, i tres, i quatre..., i al final res de res. També cada any te que haver-hi més al·lèrgies, més bronquitis... I uns anys si i altres no.

Per finalitzar, la mortalitat. El número de morts per la grip de tota la vida –de la que tenim vacuna-, es d’uns cent pacients al dia durant els mesos d’hivern, la d’aquesta grip es la de sis en dos mesos, tres al mes, fins ara, com es pot veure una mitja molt menor i sempre amb pacients que ja tenien malalties importants anteriors. Diuen que si s’ajunten els dos virus pot anar a pitjor, a Argentina –on es hivern-, el pic ha durat un mes, sense augment de la mortalitat habitual.

divendres, 7 d’agost de 2009

La química que viene

He estado leyendo un artículo publicado en The New Yorker, nos habla de la química del futuro, de los medicamentos que utilizan muchos estudiantes y trabajadores norteamericanos para mejorar su rendimiento, permaneces más horas despierto y aumenta tu capacidad de retención. Cuando estás en la Universidad debes ser el que mejores notas sacas, el que más sale por la noche, el que más liga... y para eso necesitas TIEMPO, y ¿cómo vencer al tiempo? Parece que los fármacos son la respuesta, utilizar anfetaminas y derivados de estos. Para conseguirlo acudir al médico simulando ser una persona hiperactiva, comprarlos por internet o a cualquiera que tenga de “sobras”. Los problemas vienen después, cuando aparecen los efectos secundarios, cuando necesitas elevada cantidad de dopamina para mantener tu actividad y esta sólo viene de la química, cada día más. Por eso en inglés fármaco es drug.

Os dejo el principio del artículo y después si lo queréis todo sólo hace falta pinchar en este enlace.

BRAIN GAIN
The underground world of “neuroenhancing” drugs.
by Margaret Talbot

A young man I’ll call Alex recently graduated from Harvard. As a history major, Alex wrote about a dozen papers a semester. He also ran a student organization, for which he often worked more than forty hours a week; when he wasn’t on the job, he had classes. Weeknights were devoted to all the schoolwork that he couldn’t finish during the day, and weekend nights were spent drinking with friends and going to dance parties. “Trite as it sounds,” he told me, it seemed important to “maybe appreciate my own youth.” Since, in essence, this life was impossible, Alex began taking Adderall to make it possible.
Adderall, a stimulant composed of mixed amphetamine salts, is commonly prescribed for children and adults who have been given a diagnosis of attention-deficit hyperactivity disorder. But in recent years Adderall and Ritalin, another stimulant, have been adopted as cognitive enhancers: drugs that high-functioning, overcommitted people take to become higher-functioning and more overcommitted. (Such use is “off label,” meaning that it does not have the approval of either the drug’s manufacturer or the Food and Drug Administration.) College campuses have become laboratories for experimentation with neuroenhancement, and Alex was an ingenious experimenter. His brother had received a diagnosis of A.D.H.D., and in his freshman year Alex obtained an Adderall prescription for himself by describing to a doctor symptoms that he knew were typical of the disorder. During his college years, Alex took fifteen milligrams of Adderall most evenings, usually after dinner, guaranteeing that he would maintain intense focus while losing “any ability to sleep for approximately eight to ten hours.” In his sophomore year, he persuaded the doctor to add a thirty-milligram “extended release” capsule to his daily regimen.
Alex recalled one week during his junior year when he had four term papers due. Minutes after waking on Monday morning, around seven-thirty, he swallowed some “immediate release” Adderall. The drug, along with a steady stream of caffeine, helped him to concentrate during classes and meetings, but he noticed some odd effects; at a morning tutorial, he explained to me in an e-mail, “I alternated between speaking too quickly and thoroughly on some subjects and feeling awkwardly quiet during other points of the discussion.” Lunch was a blur: “It’s always hard to eat much when on Adderall.” That afternoon, he went to the library, where he spent “too much time researching a paper rather than actually writing it—a problem, I can assure you, that is common to all intellectually curious students on stimulants.” At eight, he attended a two-hour meeting “with a group focussed on student mental-health issues.” Alex then “took an extended-release Adderall” and worked productively on the paper all night. At eight the next morning, he attended a meeting of his organization; he felt like “a zombie,” but “was there to insure that the semester’s work didn’t go to waste.” After that, Alex explained, “I went back to my room to take advantage of my tired body.” He fell asleep until noon, waking “in time to polish my first paper and hand it in.”
I met Alex one evening last summer, at an appealingly scruffy bar in the New England city where he lives. Skinny and bearded, and wearing faded hipster jeans, he looked like the lead singer in an indie band. He was ingratiating and articulate, and smoked cigarettes with an ironic air of defiance. Alex was happy enough to talk about his frequent use of Adderall at Harvard, but he didn’t want to see his name in print; he’s involved with an Internet start-up, and worried that potential investors might disapprove of his habit...

Continua AQUÍ

dimarts, 4 d’agost de 2009

Nueva derrota de los All Blacks ante Sudáfrica

Os dejo la crónica de este partido que he publicado en GLOBEDIA.

Si sólo queréis imágenes aquí os dejo el resumen del partido