Salud Pública (Continuación)

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Mexico City is one of the greatest urban agglomerations in the world, a dense and teeming mountain valley with a population of more than 20 million. Wealthy enclaves have the sleekness of Manhattan or Beverly Hills, but much of the metropolitan area is gritty and anonymous. It must be an easy place in which to disappear.

Yet somehow, amid all the chaos and bustle, Mexican health authorities noticed an unusual cluster of deaths -- first just a handful, then a few dozen. That observation led to the identification of a new, potentially dangerous strain of influenza, and now governments worldwide are issuing travel advisories, readying stockpiles of medicine, canvassing hospitals for possible cases of "swine flu" and, of course, telling citizens not to panic.…  Seguir leyendo »

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As the swine flu threatens to become the next pandemic, the biggest questions are whether its transmission from human to human will be sustained and, if so, how virulent it might become. But even if this virus were to peter out soon, there is a strong possibility it would only go underground, quietly continuing to infect some people while becoming better adapted to humans, and then explode around the world.

What happens next is chiefly up to the virus. But it is up to us to create a vaccine as quickly as possible.

Influenza viruses are unpredictable because they are able to mutate so rapidly.…  Seguir leyendo »

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Durante las últimas décadas se han producido brotes de enfermedades infecciosas previamente desconocidas que, en función de su virulencia y modo de transmisión, han disparado las alarmas de los sistemas de salud públicos. En el año 1981, se identificaron los primeros casos de sida, en 1987 el virus ébola fue el causante de repetidos brotes de fiebres hemorrágicas de alta mortalidad, en 1995 fueron los priones del mal de las vacas locas, el 2003 apareció el síndrome agudo respiratorio severo (SARS) y el 2004 la gripe de las aves en humanos. El escenario confirma que, a pesar de todos los avances biomédicos, las enfermedades infecciosas siguen dando sorpresas y siendo una amenaza para la raza humana.…  Seguir leyendo »

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For the first time since 1976, a strain of influenza virus - apparently related to the 1918-19 pandemic - has infected the public. More than 1,000 cases have been reported in Mexico, with over 80 deaths. And the disease has now spread to several areas within the United States and to New Zealand. The virus has been identified by the American Centres for Disease Control and Prevention (CDC) as type H1N1, containing a mixture of swine, avian and human genetic material.

This outbreak of influenza is viewed with alarm by public health workers. First, because the earlier pandemic was so deadly; second, because this is the first clear demonstration of human-to-human spread of the infection; and third, because it apparently started its spread after the normal "flu season" in the northern hemisphere.…  Seguir leyendo »

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The first question on people's lips when the spectre of pandemic flu looms large is often: “Is there a vaccine and where can I get it?” That question is no doubt being asked again now with the outbreak of swine flu in Mexico.

Flu is an awesome foe because it is so slippery, constantly changing its colours. Every year the World Health Organisation decides which strains are likely to be most prevalent in the following year and bases the annual flu vaccinations on this combination.

Many assume that H5N1 will be the pandemic flu sub-type and that it will emerge from the Far East.…  Seguir leyendo »

MundoAméricaInternacionalSalud Pública,

Nearly 30 years after the first cases were recognized in the United States, HIV/AIDS remains an incurable disease that is devastating large swaths of our country and the rest of the world. To understand the magnitude of the destruction, look around our nation's capital. Last month, D.C. health officials announced that 3 percent of city residents had full-blown AIDS or were infected with HIV. Not only is that infection rate on a par with rates in some African countries, but the D.C. data were based only on those who have been tested for HIV; the actual rate is probably much higher.…  Seguir leyendo »

InternacionalSalud Pública

The news last week that prenatal testing for autism might be on the cards was rather spun out of shape: we are not on the verge of a test — not right now, anyway – but work by the Autism Research Centre at Cambridge University shows we are heading that way.

The team found that babies exposed to high levels of testosterone in the womb had a higher risk of developing autistic traits. Previous research had shown that high levels of testosterone were associated with less eye contact by a child’s first birthday, slower language development by their second birthday, more peer difficulties by their fourth birthday and more difficulties with empathy by their sixth birthday.…  Seguir leyendo »

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To most people the very mention of Alzheimer's induces a state of hopelessness. We make nervous jokes about "senior moments", or express don't-know-how-you-manage sympathy to carers. Those with Alzheimer's themselves, meanwhile, are often talked of as if they've already slipped the bonds of humanity: they're ex-persons.

So if I told you that I'd spent an evening at the Wellcome Collection in London a few weeks ago discussing dementia and emerged feeling excited, you might wonder about the soundness of my mind. Yet the pioneering work described there is profoundly improving the experiences of both people with dementia and their carers. Later this month the government launches a national dementia strategy.…  Seguir leyendo »

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China's food supply appears to be awash in the industrial chemical melamine. Dangerous levels have been detected not only in milk and eggs, but also in chicken feed and wheat gluten, meaning that melamine is almost impossible to avoid in processed foods. Melamine in baby formula has killed at least four infants in China and sickened tens of thousands more.

In response, the United States has blasted lax Chinese regulations, while the Food and Drug Administration, in a rare move, announced last week that Chinese food products containing milk would be detained at the border until they were proved safe.

For all the outrage about Chinese melamine, what American consumers and government agencies have studiously failed to scrutinize is how much melamine has pervaded our own food system.…  Seguir leyendo »

InternacionalSalud Pública

In late September, the authorities in Belgium seized more than two million counterfeit painkillers and antimalarial drugs that had been manufactured in India and were en route to Africa. It was the largest seizure ever of fake pharmaceuticals in Europe.

The incident shines a light on one of the most pressing problems in delivering life-saving medicines to the world’s poorest patients: the proliferation of low-quality and counterfeit products, many of which are dangerous. If aid organizations are serious about combating the spread of deadly diseases in the developing world, they must do more to ensure the safety and quality of drugs.…  Seguir leyendo »

InternacionalSalud Pública

Children aged 5 to 18 suffer at least 96,000 sports-related concussions every year in the United States, the Centers for Disease Control and Prevention estimates. Even more troubling, as many as 20 percent of all high school football players sustain concussions annually, studies show. Because teenage brain tissue is still developing, injuries at this age can be especially damaging. Yet most high schools and colleges fail to provide athletes the kind of neuropsychological testing that’s needed to help them recover.

It’s true that coaches have become better educated about concussions. The days of patting the athlete who’s had his “bell rung” on the backside and sending him back into the game are diminishing.…  Seguir leyendo »

InternacionalSalud Pública

Many people have asked me how I first realized I was suffering from a brain tumor and what I have done about it.

The first sign that I was in trouble came July 23, when my 2004 black Corvette struck a pedestrian on 18th Street while I was on my way to my office downtown.

I did not realize I had hit anyone until a young man on a bicycle, who I thought was a bicycle messenger, jumped in front of my car to block the way. In fact, he was David A. Bono, a partner in the high-end law firm Harkins Cunningham.…  Seguir leyendo »

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Numerous media reports followed a federal task force's announcement this month that there is insufficient medical evidence to assess the risks and benefits of prostate cancer screening in men younger than 75 and that doctors should stop testing men over age 75 [" U.S. Panel Questions Prostate Screening; 'Dramatic' Risks for Older Men Cited," front page, Aug. 5].

It's important to note that consideration was not given to the overwhelming body of emerging evidence that screening with PSA tests and digital rectal exams saves lives. Rates of death from prostate cancer and rates of diagnosis at advanced stages have decreased markedly since testing became widespread.…  Seguir leyendo »

InternacionalSalud Pública

Se ha clausurado en México la 17ª Conferencia Internacional del Sida (CIS), que ha tenido el mérito de ser la primera realizada en un país de América Latina, de haber contado con traducción al castellano y de haber dado la oportunidad de participar a las comunidades de esta región. Pero, como en las últimas ediciones, la reunión no ha estado exenta de polémica.

Por un lado, la falta de novedades científicas y la creciente presencia mediática han convertido las CIS en una plataforma para que gobiernos y agencias internacionales compitan por hacer visibles su contribución a la lucha contra la enfermedad, y en la que las oenegés reivindican la inclusión de sus opiniones en las agendas técnicas y políticas.…  Seguir leyendo »

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Here's a concept you've probably never heard of: "viral sovereignty." This extremely dangerous idea comes to us courtesy of Indonesia's minister of health, Siti Fadilah Supari, who asserts that deadly viruses are the sovereign property of individual nations -- even though they cross borders and could pose a pandemic threat to all the peoples of the world. So far "viral sovereignty" has been noted almost exclusively by health experts. Political leaders around the world should take note -- and take very strong action.

The vast majority of repeated avian flu outbreaks the past four years, in both humans and poultry, have occurred in Indonesia.…  Seguir leyendo »

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The Justice Department and the Food and Drug Administration are looking into whether Ranbaxy Laboratories, one of the world's biggest makers of generic drugs, manufactured substandard HIV drugs that were administered to thousands of poor Africans under a contract with the President's Emergency Plan for AIDS Relief, the Wall Street Journal reported this week. But this type of tragedy has already affected American consumers.

Between November and February, 95 Americans died after experiencing an allergic reaction to heparin, the FDA has reported. The blood-thinning medication contained an active pharmaceutical ingredient from China that the FDA suggests was likely to have been "intentionally contaminated."…  Seguir leyendo »

InternacionalSalud Pública

Last week, I stood in the blinding sunshine outside the United Nations building in New York, watching cars disgorge eunuchs, activists and bureaucrats - all the usual suspects for another “UN high-level meeting on Aids”. Besides swelling profits of the New York hotel trade with money that could have been used to buy condoms and clean needles, what did this meeting achieve? Not a lot, I was prepared to report, but in fact the UN has managed to take a step backwards.

For all the talk of a “global pandemic”, there are two completely separate HIV epidemics in the world. One is in parts of Africa, where HIV is spread by unprotected sex between men and women who have more than one steady partner.…  Seguir leyendo »

InternacionalSalud Pública

¿Doctor, una vez más nos va a decir que se trata de un enfermo?
Más que nunca mi respuesta es:
-Rotundamente sí. Sólo un enfermo con una patología grave puede tener una conducta así.

Los hechos que nos llegan de la prensa son sobrecogedores. Josef Fritzl, un ingeniero electrónico jubilado de 73 años que vive en un pueblo del oeste de Viena de unos 20.000 habitantes, se ve obligado por circunstancia de un hijo enfermo a contar una historia atroz, terrible, macabra, demoledora, ante la que uno se queda sin palabras, al saber que este sujeto ha tenido secuestrada a su hija Elisabeth durante 24 años en el sótano acorazado de su casa, en un espacio de unos 60 metros cuadrados y del que ella no ha salido.…  Seguir leyendo »

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The revelation of the medical trial in which dummy pills worked as well as famous drugs for all but the most severely depressed has understandably made both pharmaceutical companies and patients miserable. But for the individuals who placed their hopes on these drugs, there is nothing to be down about.

The depressed who felt better after taking medicine may feel like the purchasers of a medieval elixir that proved to be piss. But, apart from unstoppable calamities such as cancer and cardiac arrest, there is strong evidence that a positive outlook can improve outcome. In a television documentary last year, Professor Richard Dawkins proved that homeopathic medicine is scientific idiocy and yet that it improves the condition of numerous patients.…  Seguir leyendo »

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Yesterday the journal PLoS Medicine published a study which combined the results of 47 trials on some anti-depressant drugs, including Prozac, and found only minimal benefits over placebo, except for the most depressed patients. It has been misreported as a definitive nail in the coffin: this is not true. It was a restricted analysis but, more important, on the question of antidepressants, it added very little. We already knew SSRIs give only a modest benefit in mild and moderate depression and, indeed, the Nice guidelines themselves have actively advised against using them in milder cases.

But the real story goes way beyond the question of Prozac.…  Seguir leyendo »