lunes, 27 de diciembre de 2010

An American Child May Hold Secrets to Aging


Brooke Greenberg is almost 18, but she has remained mentally and physically at the level of a toddler. An American physician is trying to uncover the child's secret, because he wants to give mankind the gift of eternal life.


It is possible that the key to immortality is hidden in this delicate girl, who is only about 76 centimeters (2 feet, 6 inches) tall and weighs seven kilograms (15.4 pounds). Her arms and legs are as fragile as the branches of a young tree. Her laugh sounds like the whimper of a puppy; she has hazel eyes. And when Brooke Greenberg wants her mother she stretches out her tiny arms, shakes her head slowly, and twists her face into a lopsided moue.


"Come here, Brooke, yes, you are a pretty girl." Melanie Greenberg, 49, picks up the fragile looking child and gently strokes her back. "She loves being held," says Greenberg, a mother of four. Brooke's sisters are named Emily, Caitlin and Carly. Brooke is the second youngest. She will be 18 in January.


Other girls her age are driving, going out dancing and sleeping with their first boyfriends. But for Brooke it's as if time had stood still. Mentally and physically, the girl remains at the level of an 11-month-old baby.
"Brooke is a miracle," says her father, Howard Greenberg. "Brooke is a mystery," says Lawrence Pakula, her pediatrician. "Brooke is an opportunity," says Richard Walker, a geneticist with the University of South Florida College of Medicine. They all mean the girl from Reisterstown, a small town in the US state of Maryland, who may hold the answer to a human mystery. At issue is nothing less than immortality: Brooke Greenberg apparently isn't aging.


She has no hormonal problems, and her chromosomes seem normal. But her development is proceeding "extremely slowly," says Walker. If scientists can figure out what is causing the disorder, it might be possible to unlock the mysteries of aging itself. "Then we've got the golden ring," says Walker.

He hopes to simply eliminate age-related diseases like cancer, dementia and diabetes. People who no longer age will no longer get sick, he reasons. But he also thinks eternal life is conceivable. "Biological immortality is possible," says Walker. "If you don't get hit by a car or by lightning, you could live at least 1,000 years."


An Unprecedented Case

Brooke Greenberg was born prematurely on Jan. 8, 1993 at Sinai Hospital in Baltimore, Maryland. She weighed only 1,800 grams (about four pounds) at birth. It soon became clear that she wasn't normal. Almost all of her organ systems were altered. Her hips were dislocated, so that her legs pointed awkwardly toward her shoulders. She'd hardly been born before she was placed in a cast.

The first six years were torture for Brooke and her parents. On one occasion, seven holes in the child's abdominal wall had to be repaired. Because food kept entering her windpipe instead of her stomach, a gastric feeding tube had to be inserted. She fell into a 14-day coma when she was four. Then doctors diagnosed a brain tumor (the diagnosis later proved to be incorrect). "The Greenbergs had gone out already and made the preparations, buying a coffin and talking to the rabbi," pediatrician Pakula recalls.

Pakula practices in a medical building near the Greenbergs' house. He wears a tie adorned with cartoonish hippopotamuses. A tall stack of paper -- Brooke's file -- sits on his desk. "This can't be lost," says the doctor, placing his hand on the documents. He knows what a treasure the file represents.

The most surprising thing about Brooke is that she hardly ages at all. Her body stopped growing when she was two years old. She hasn't grown a centimeter or gained a pound. Pakula injected the girl with growth hormones, but nothing happened. He studied the medical literature and consulted specialists worldwide. "She was presented to everybody who was anybody in the medical world at the time," says the 77-year-old pediatrician, "but she didn't match anything any physician had seen before."

The Greenbergs waited and hoped -- one year, two years, 10 years -- but nothing happened. Their daughter's facial features have remained unchanged. There are no signs of puberty. "Brooke's nurses, her teachers, even her father can't consistently sort photos of her chronologically," says Pakula. Only the girl's hair and fingernails are growing normally.


'She's a Miracle'

At the family's house in Reisterstown, Howard Greenberg points to photos on the walls: Brooke at three, next to her one-year-old sister Carly, who was already bigger than she was at the time; Brooke in a playsuit on her 12th birthday; Brooke at 14, at her Bat Mitzvah, the Jewish rite of initiation.

Greenberg hurries from picture to picture. Brooke looks the same in all the photos. Her mouth is always slightly lopsided and her eyes just a tough too far apart. "She's a miracle." It's something that has to be said, again and again. "What's she missing in life? Nothing. She hasn't got a worry in the world. She isn't broken. We're the ones who are broken." This is the father's way of explaining away his daughter's condition. "If you look at it that way, it makes it much more bearable," he says later on.

At first Melanie Greenberg took care of Brooke on her own, but now she has help. Feeding Brooke through the tube takes 10 hours a day. She goes to a school for disabled children from 7:30 a.m. to 3:30 p.m. Much of the rest of the time she spends in her room, sitting in her bed and watching television, or bobbing back and forth in her light-blue baby swing.
"She can do this all day," says Melanie Greenberg, lifting her daughter into the air and carefully placing her on her thin little legs, with her feet twisted inward. "It was not easy, it was very hard," she says, "but I'm sure there is a reason for Brooke to be here. Something is in her, something that could help millions of people."

lunes, 6 de diciembre de 2010

Ospitale birtuala, etorkizuneko medikuak trebatzeko

     UPV-k ere badu ospitale birtuala. Ospitale Birtuala ikasleak eta mediku-gaiak trebatzeko sortu da.

     Aurrerapen teknologikoei esker manikiak sortu dira medikuntza-simulazioak egiteko. Manikiek bizi-konstanteak dituzte (arnasketa, auskultazioa, esplorazioa...), eta teknikak lantzeko erabil daitezke era askotako egoeratan. Horrela, hainbat egoera simulatzen dira, sinpleak nahiz konplexuak, teknikak landu, egoera kritikoei aurre egin eta algoritmoak eta beste trebetasun batzuk garatzeko, egiazko paziente batekin egingo litzatekeen moduan. Ondoren, bideoz ikusten da eginiko lana, akatsak zuzendu eta talde-lanean sakontzeko. Era horretan, ikasleak edo mediku-gaiak maniki batekin lantzen ditu gerora egiazko paziente batean aurkituko dituen egoerak, eta trebatzeko eta akatsak zuzentzeko balio dio horrek. Gainera, simulazioari esker, koordinazioa, komunikazioa, talde-lana, lidergoa eta gaurdaino kontuan hartu ez diren beste alderdi batzuk lantzen dira.








BIDEOA: "Asma krisi batek jotako gizon bat eraman zuen Bilboko larrialdi zerbitzuetako anbulantzia batek Basurtoko ospitale birtualera. Zain zituen Victor Bustamante eta Iñaki Arriagamedikuak eta Usune eta Leire Gonzalez mediku egoiliarrak. Mediku egoiliarren lan ari esker, ospitalera iritsi eta mintu gutxira, pazientearen egoerak hobera egin zuen nabarmen. 
          Euskal Herriko Unibertsitateko ospitale birtualaren helburua ikasitakoa praktikan jartzea izango da. Honi esker, etorkizunean trebatuta egingo diete ikaslek aurre benetako kasuei."

viernes, 26 de noviembre de 2010

GALENO: erromatarren medikua

Como aquellos que describen la naturaleza de un país mostrando en primer lugar sus fronteras y después continúa enumerando sus partes, de la misma forma, yo también quiero comenzar describiendo y delimitando la fronteras del tórax



 Galeno (Pergamum, 131-201) mediku greziarra izan zen, Erromatarren inperioaren garaian bizi izan zena.

 Eragin handia eduki du medikuntzaren historian zehar. Gaur egun, oraindik erabiltzen da "galeno" hitza medikuaren sinonimo moduan.

- Gladiadoreak osatuz traumatologia arloan esperientzia handia hartu zuen. Garai hartan ere, begi lausoak operatzen jardun zuen.
- Anatomia inguruan jakintza zabala erakutsi zuen. Animalien bibisekzioen bidez giltzurrunen eta bizkarrezur-muina aztertu zituen.

Galenoren ekarpenak medikuntzara:

§                     Demostró cómo diversos musculos son controlados por la medula espinal.
§                     Identificó siete pares de nervios craneales
§                     Demostró que es el cerebro el órgano encargado de controlar la voz.
§                     Demostró las funciones del riñon y de la vejiga.
§                     Demostró que por las arterias circula sangre, y no aire (como pensaban Erasístrato y Herófilo).
§                     Descubrió diferencias estructurales entre venas y arterias.
§                     Describió las válvulas del corazon.
§                     Describió diversas enfermedades infecciosas (como la peste de los años 165-170) y su propagación.
§                     Dio gran importancia a los métodos de conservación y preparación de fármacos, base de la actual farmacia galenica.
§                     Su tratado Sobre el diagnóstico de los sueños (De Dignotione ex Insomnis Libellis, en latín) describe los sueños (es decir, las ensoñaciones) y afirma que éstos pueden ser un reflejo de los padecimientos del cuerpo.

Ume batek lehen aldiz amaren ahotsa entzuten du.


Un video que muestra la reacción de un bebé al que le realizaron un implante coclear.En la filmación se puede ver cómo Jonathan ríe y se sorprende con la voz de su madre. El chico, de ocho meses, recibió un implante coclear para aquellos pacientes que padecen de sordera de ambos oídos.

Este tipo de implantes se convirtió en una intervención clave en los últimos años.


miércoles, 24 de noviembre de 2010

Odol artifiziala nahi baino urrunago

     
        Preziatua eta bizitzeko ezinbestekoa. Horixe da odola. Gure gorputzak behar-beharrezkoa du egoki funtzionatzeko. Oxigenoaren, elikagaien eta hondakinen garraiatzaile eraginkorra da. Eta beste hamaika funtzio ere betetzen ditu: besteak beste, gorputza infekzioetatik babesten du, eta tenperaturaren erregulazioaren arduraduna da.
       Horretaz guztiaz jabetu bezain pronto hasi zen, nolabait, odolaren ordezkoa aurkitzeko lasterketa. Transfusioetarako nahi beste odol garbi izatea da helburua. 
      Mundu osoko ikertzaileek hainbat hamarkada daramatzate ordezko bideragarri baten bila, baina odolaren osagai gutxi batzuen ordezko sintetikoak baino ez dira lortu bidean. Aurrerapen ugari egin bada ere, hornikuntza odol-emaile boluntarioen esku dago oraindik ere. Benetako odol artifiziala urrun da oraindik.

Farmakogenetika, medikuntza pertsonalizatuaren bidean...

   Guztiak desberdinak gara, eta horregatik era desberdinean erantzun dezakegu farmakoen aurrean. Gaur egun medikura jaotean garenean ordea, gaixotasun berdinaren aurrean botika berdina hartzeko agintzen digu medikuak: "3 sobre egunean, jatordu bakoitzaren ondoren", adibidez . Baina botika horrek batzuengan eraginkortasun handia eduki dezake, besteengan txikia eta gutxi batzuentzat albo efektuak. Terapia orokorretan oinarritzen da gaur egungo medikuntza. 

      Farmakogenetikak berriz, tratamendu orokorrak alde batera utzi eta terapia pertsonalagoetaruntz abiatzea du helburu. Pertsona bakoitzaren herentzia genetiko eta geneetan oinarrituz, norberak farmakoekiko izan dezakeen erantzuna aztertzen duen zientzia da farmakogenetika. Hau da, farmakoak eta genetika erlazionatzen dituen zientzia da.

      Adibidez, ikusi da leuzemiaren aurkako farmako baten aurrean pazienteak erantzun ezberdinak dituztela. Batzuk, horien artean umeak, oso azkar metabolizatzen dute farmako hau, eta dosi handiagoa behar dute. Beste batzuk ordea, oso motel metabolizatzen dutenez, dosi askoz ere txikiagoa behar dute. Farmako honen metabolismoarekin erlazionatutako geneak aztertuz, determina daiteke zein den paziente bakoitzarentzako dosi egokiena eta horrela farmakoaren eraginkortasuna handituko da kasu bakoitzean.

       Farmakogenetikari buruz ikerketa asko ari dira egiten, eta etorkizunerako medikuntzaren oinarri izan daiteke seguraski: terapia pertsonalizatu eta eraginkorretako etorkizuneko medikuntza.




 

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