China Medical Center

guide for insight into the treatment of asthma

2009-09-08T11:14:00.001-07:00

Editorial Eduforma MAD presents a practical guide for insight into the treatment of asthma, the most common chronic disease in childhood.

• The book includes hundreds of questions and answers about a respiratory condition with an incidence of between 5.5% and 14.6% in the Spanish population and addresses the issues that typically arise in families living with childhood asthma

• The Editorial Andalusian reinforces this release with the creation of the web www.mad.es / asmainfantil, with information on the work and its authors, the prestigious American specialists Claudia S. Plottle and B. Robert Feldman

Editorial Eduforma MAD presents a practical manual for parents and carers of children with asthma in children, backed by prestigious U.S. doctors specializing in treating this disease that affects millions of people around the world.

With the publication in Spain the book 100 Questions and answers about asthma in children, Editorial Eduforma MAD provides a useful tool for those who live daily with the respiratory condition with an incidence in the Spanish population of between 5.5% and 14.6%, according to each area.

Through questions from clinical practice, anyone interested in knowing about this disease will find this book accessible and international real information on aspects such as the causes, symptoms of this disease and its treatment.

What doctor diagnosed asthma? Can it be cured? What is the difference between allergy and asthma? What medications are useful to treat it? or Why is it important to include environmental monitoring my child's asthma? are some questions to find a practical answer in this book MAD Eduforma Editorial, that reveals how far medicine has advanced the understanding of this disease and how much progress has been made to confront and control in children and adolescents.

In this practical manual is recognized that in clinical practice have been introduced new and more effective medicines along with the oldest remedies and proven, although the modern treatment of asthma, the most common chronic disease in childhood, not limited to prescription drugs. In fact, now there is more emphasis than ever to study what role environmental factors in asthma.

Also shown in this book MAD Eduforma Editorial another key component of effective care of the child with asthma is to recognize the importance of collaboration between patient treatment, parents and the physician.

It also stresses the importance of individualized programs of self-control asthma, which are a useful frame of reference for parents and children learn about the disease in general and to decide the best way to treat asthma in particular small.

About the Authors

The authors of this book are Claudia S. Plottle, medical specialist in Pneumology of New York University Medical Center and B. Robert Feldman, a doctor specializing in Pediatrics, Allergology and Immunology at Morgan Stanley Children's Hospital of New York Presbyterian. Since the endorsement of a joint experience of over 60 years, New Yorkers these professionals specializing in the care of children, adolescents and adults with asthma reveal scientific progress in understanding this disease and cope.

New tool in Internet Publishing Eduforma MAD

To contribute to the dissemination of the contents of this book and practical information for people interested in this disease, Editorial MAD Eduforma enabled web address www.mad.es / asmainfantil, where you will find more information on this manual, its authors and the Collection of the Family Health and Editorial.

Editorial MAD Eduforma has an experience of over 26 years in publishing books with a mainly practical. Little by little has been enriching its extensive catalog with the creation of different collections such as the Health and Family Services, which owns the book 100 Questions and answers about asthma in children, including titles like 100 questions and answers about the epilepsy or 100 questions and answers about psoriasis.

Hospiten is 40 years since opening its first hospital.

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It was in January 1969 when it opened the first hospital Hospiten Group, Hospiten Bellevue in Puerto de la Cruz on the island of Tenerife. The first center was the response to existing health claim on the northern island of Tenerife and is now a modern hospital with 183 beds and modern diagnostic and therapeutic technologies.

The philosophy of Hospiten Group since its inception has always been the dedication to patient care with dedication of all those attending any of the twelve centers Hospiten distributed in Spain, Dominican Republic and Mexico.

This has allowed Hospiten established and the demand for medical care in places as far apart as the Canaries, Costa del Sol, Dominican Republic and Mexico as one of the largest international hospital groups in Spain and Latin sound. And all this based on a high quality of services both medical professionals as of latest technologies applied to medicine, which is combined with individualized treatment and close to all patients in our hospitals.

The growth of the Group focused on its beginnings on the island of Tenerife has two centers in Puerto de la Cruz Hospiten Tamaragua Hospiten Bellevue, a center in the south of the island, Hospiten South, and finally opened in 1995 Hospiten Rambla in the capital of Tenerife, which has Hospiten four centers on the island. Later in 1999 opened Hospiten Lanzarote and to complete the service network in the Canary Islands we introduced the hand we Clinic Rock on the island of Gran Canaria with two centers Hospiten San Augustine Clinic Hospiten Roca Roca Clinic Puerto Rico.

Out of the Canary Islands, the Group Hospiten has five centers, one located in the Iberian Peninsula, more particularly on the Costa del Sol, Estepona Hospiten called, both located in Dominican Republic, Bavaro and Hospiten Hospiten Santo Domingo, and two centers in Mexico, Cancun Hospiten and the last to open its doors in 2006 Hospiten Riviera Maya.
Besides these twelve medical centers and hospital of high complexity Hospiten Group has more than 100 outpatient clinics under the brand Clinic Assist to complete a health care network with the highest international quality standards.
These twelve centers located in thirteen countries and over a hundred clinics Clinic Assist Hospiten enable the Panel to expand its area of influence to expand their new countries, as is the case of Jamaica, where the Group already has Hospiten different facilities Clinic Assist and is under study and implementation of a new hospital to meet the health demands of the northern coast of the island.

Hospiten Group is an international hospitality network committed to providing service of high quality health care. With an experience of 40 years, the Group has twelve Hospiten private hospitals in Spain, Dominican Republic and Mexico, annually serves more than 600,000 patients around the world and has over 3,000 employees.

Extending the manifestations of eating disorders.

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Whenever there are more specific disorders in which patients have trouble eating. This applies to the vigorexia, sadorexia or diabulimia, among others.

The eating disorders (ED) is a health problem that has a strong impact on our society. The major changes both social, economic and cultural relate directly to changes in eating behavior. And that beauty, physical attractiveness and body are rising values in the twenty-first century society.

The problem of these disorders is as varied and multifactorial requiring attention and action that includes the clinical, familial, but also cultural, social and educational. As noted by the Eating Disorders Institute (ITA) increasingly extending the various manifestations of these disorders, which implies a greater diversity for treatment.

The specific diagnostic criteria of mental disorders (DSM-IV-TR) defines three types of eating disorders: anorexia nervosa (refusal to maintain body weight at or above the minimum value), bulimia nervosa (eating food in a short space of time in excess of what most people would eat during a similar time in short, a feeling of loss of control over eating) and eating disorder not otherwise specified (all those disorders not meet the criteria of the previous two categories).

The same classification also describes various disorders linked to eating disorders: pica disorder (persistent ingestion of nonnutritive substances) Rumination disorder (repeated regurgitation and new chews food) and the Feeding disorder of childhood or childhood (difficulty persistent inability to eat adequately with significant weight gain or significant weight loss).

New manifestations of TCA
The most recognizable manifestations of TCA are anorexia and bulimia nervosa to binge eating together. As of today appear more strongly as new manifestations vigorexia, orthorexia, sadorexia, night eating syndrome and diabulimia. These specific disorders are less known and yet increasingly common.

The vigorexia is a disorder that affects between 1 and 10% of regular users of gyms. It is characterized by obsessive preoccupation with physical and distortion of body schema affects mostly men between 15 and 35 years, but also women. This entails an addiction to physical activity (especially in body building) along with obsessive thoughts and continuing on how to improve the appearance (concern about being weak or poorly muscled). Often leads to substance use for muscle development and excessive dietary control, imbalanced where the amount of protein and carbohydrate consumed is excessive.

Another manifestation of the TCA is called orthorexia, appetite literally correct, ie, the obsession with healthy eating. It manifests itself through excessive worry about the quality of the food, feeling guilty and corrupt when not met their own dietary beliefs. Thus, the subjects, mostly young women, develop their own rules food and, unlike anorexia or bulimia nervosa, which focuses on the amount of food, orthorexic become obsessed with the quality of it reaching socially isolated because his way of eating. In short, everyday life is affected, because what started as a dietary habit, derives almost a religion where the slightest transgression is tantamount to sin.

Together with the two conditions above are the sadorexia (sadomasochism and anorexia) seen an evolution or second generation of the traditional TCA. Behavior is characterized by an anorexic, bulimic or orthorexic where traditional symptomatology is absent giving way to the use of unconventional techniques such as thinning severe masochism to achieve extreme thinness. In these cases the physical abuse and external control of behavior may lead to rapid weight loss and permanent. These actions do not arouse suspicion in even family or friends and family cause social isolation.

Other disorders diagnosed shortly but no less important are: night eating syndrome, the diabulimia and certain phobic disorders that involve eating.

We like that night eating syndrome comprising both eating disorder and a sleep disorder. It affects between 1 and 2% of the population and focuses on overeating at night being able to reach between 3 and repeat 5 times. People who suffer from eating half asleep so do not fully realize or remember what they do.

For its part, diabulimia is a disorder in which people with type 1 diabetes skip their insulin injections in order to lose weight. Often, these individuals are diagnosed with an eating disorder like anorexia or bulimia nervosa rather than diabetes. He frequently appears in adolescence and is more common in women than in men.

In phobic disorders can find certain behaviors such as avoiding eating in public, swallow food and selection, developing avoidant behavior due to the unpleasant sensations that brings on the presence of certain foods, fear of choking, etc..

The use of psychotropic drugs to treat mental health problems do not always respond to rational standards.

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Section of Psychiatry of the Academy of Medical Sciences of Bilbao organizes the conference, which will focus on the rational use of medicines in mental health.

A simplistic concept of mental illness and human behavior has contributed to extending treatment with psychotropic drugs that conditions can hardly be considered psychiatric disorders, and should be addressed differently.

The popularization and trivialization of some use of some psychiatric medications has contributed to widespread use of a poorly justified. Drugs like Prozac are now part of the culture of XX and XXI century, said Dr. Uriarte Uriarte.

In recent years it has been called into question the efficacy and safety of many of these drugs, especially when used indiscriminately, with little control, and regardless of other therapeutic alternatives.

Reflect on the different aspects that condition the assistance to mental health problems today, and more specifically, which determine the use of psychotropic medication. This will be the main focus of Dr. Jose Juan Uriarte Uriarte, department head of the Psychiatric Rehabilitation Unit, Hospital de Zamudio. The workshop organized by the Academy of Medical Sciences of Bilbao, to be titled The Use and Abuse of prescription psychoactive drugs. Towards a rational use will take place on Wednesday 28 January at 19.00 in the hall of the Medical Association of Bizkaia (Lersundi, 9 to 5 degrees).

The rapporteur will delve into the idea that the current use of medications in mental health does not always have a rational basis and in the various aspects that determine the use of psychoactive drugs. This will begin by reviewing the various interpretations of the concept of rationality applied to the field of health and social changes that influence current medical practice, with particular reference to the extension of the concept of health. Then, before entering fully into the factors influencing the current spread of psychoactive drugs, the expert will analyze the impacts of low awareness of the causes and pathogenesis of mental illness.

Causes of the spread of psychoactive drugs
The huge spread and success of psychoactive drugs in the last decade has various causes among which are: technical progress and the excessive reliance on technology, the relative effectiveness of other intervention methods (such as psychotherapy), dissemination of assessment models of interventions (clinical trials), social changes, changes in psychiatric nosology and the influence of the pharmaceutical industry, says Dr. Uriarte. To all this must be added that the extension of the idea that symptoms of mental illness depend on brain function regulated by chemical substances, and can be modified in a controlled and socially acceptable has contributed to the incredible diffusion of drugs like Prozac, as part of the culture of XX and XXI century.

A simplistic concept of mental illness and human behavior has also helped reduce the stigma attached to treatment with psychotropic drugs, especially antidepressants, which have gone in a few years of being rejected or consumed in secret, to be sued directly by patients, says expert psychiatrist. The extension of the mental health field has certainly been exploited by the pharmaceutical industry, which has stretched to the utmost traditional diseases like depression, and has contributed to an explosion and expansion of mental health problems likely treatment, including adjoining normal situations, such as shyness or hyperactive behavior in children, he adds.

Treatments questioned
However in recent years has challenged the efficacy and safety of many drugs. Moreover, the lack of progress in the knowledge of the causes of mental illnesses just to temper enthusiasm and unrealistic statements indicate JJ Uriarte. Note that psychotropic drugs have traditionally had a competitor in the market for human psychiatric disorders and discomforts. It is psychological and psychotherapeutic treatments that have even greater initial sympathy, suffer from the same or even larger gaps that the speaker says psychoactive drugs. It is necessary to move towards a greater understanding of the factors that are associated with greater efficacy and safety of our interventions, efficacy and safety, which often is achieved with a comprehensive approach that cleverly combines the best of each type of approach, psychopharmacological and psychotherapeutic .

It should also be noted that the marketing of new drugs is based on controlled clinical trials. But the information they provide is often difficult to extrapolate to routine clinical practice, so research is needed to reflect more reliably what happens in real life and help us making decisions. Recent studies such as CATIE, have had a major impact in the psychiatric community and have led to deeply held beliefs are shaken.

The Foundation awards the trajectory Balmis Doctor vacunólogo prestigious José Antonio Navarro.

2009-09-08T11:11:00.001-07:00

First edition of the awards dedicated to Vaccinology, Epidemiology and Preventive Medicine

Doctor Balmis Foundation, created under the auspices of the Rotary Club Alicante, sponsored by Esteve, created the prizes that bear his name to distinguish the most important personalities in the field of Vaccinology, Epidemiology and Preventive Medicine Spanish. In this first edition, which has an annual continuity, has recognized the professional work of Dr. Jose Antonio Navarro Alonso, currently Chief of Vaccinology, Health Promotion and Protection of the Regional Government of Murcia.

Member of the Spanish Association of Vaccinology, Navarro Alonso also part of the Vaccine Safety Project of the World Health Organization and the European Advisory Group on Vaccines and Immunizations, among many other agencies. Collected the award yesterday Friday, January 23 in Alicante, from the hands of Health Minister, Bernat Soria, and in the presence of leading authorities from the health and social, that in this way support the philosophy of service delivery and community Award promotes.

It is noteworthy that Dr. Balmis Foundation aims to disseminate the values they embody the figure of this great figure of the eighteenth century, which enjoys great recognition in the Latin American countries and in the Philippines but is widely unknown in Spain and their homeland, Alicante.

Francisco Javier Balmis dedicated his life to medicine and pioneered the study of the applications of the vaccine, especially smallpox, considered a pest that has caused more deaths in the human species. He starred in one of the most impressive feats of Medicine, by spreading the vaccine in a philanthropic expedition that sailed around the world. It was inspired by Rotary International in the achievement of Dr. Balmis to develop the Polio Plus campaign, through which virtually eradicated polio in the world, through the vaccination of hundreds of thousands of children.

The Award ceremony was held yesterday, January 23 at 21.30 at Hotel Sidi San Juan (Alicante), usual venue of the Rotary Club of Alicante, currently chaired by Dr. Jorge Alió, who also chairs the Foundation Doctor Balmis.

Bet on vaccines Esteve
Esteve, sponsor of the Doctor Balmis Foundation Award, is a chemical-pharmaceutical group leader in Spain and with a strong international presence. Currently the Group provides a comprehensive solution within the health sector with a variety of segments in which it is active. The presence in the field of vaccines Esteve has materialized on the one hand, through the market (since 2000) of a broad portfolio of vaccines within the fields of influenza and meningitis, and more recently through incorporation into a project with the Catalan Center for Research and AIDS Vaccine Development (HIVACAT), a public-private initiative that has focused on developing a vaccine for HIV.

Esteve has expanded its scope of action towards preventive medicine, in particular vaccines. More and more diseases preventable through vaccines, and Balmis Awards initiative responds to the social commitment of Esteve.

7. Evaluation of Health Services:

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In 1973 an American physician who reviewed China, the impression of şöye explains: "Less developed countries immediately noticeable, happy life with the poverty of minorities in the luxury and guarantee people's lives in China, the difference between no. The houses are simple, but the Chinese could sit niteliktedir housing. All have water and electricity. Large and small cities and villages everyone was dressed in the appropriate manner. At first glance, for no one outstanding issue that is not a hunger problem. Author self-question with an attitude is questionable, "But I've seen this only in places like that did you?". China wants to go anywhere author, other authors' observations and open-hearted response to the Chinese to have the following results are based on: "Every place I've seen in my life may not be. However, the real situation is usually the way I see and the former was compared with the much improved. Today, life in China, compared to western countries, the standard is very simple. But people's standard of living, average income per capita of 120 dollars (1,300 USD) compared to the other less developed countries is very high level. "

In China since the liberation of health to determine how the objective is increased, indicating the status of all of China is not about death and birth rates. China Ministry of Health does not collect statistical data for all China, or at least yayınlamamaktadır. However, travel to foreign researchers in the cities and villages to find demographic data for that location. This data, especially in cities in China, death, birth, infant mortality and the mortality is low to be compared to less developed countries, even developed countries can be compared with measurements. For example, in 1971 the birth rate in urban Shanghai in the bin 12, the death rate of 5.2 per mil, infant mortality rate is 8.7 per mil. The other objective criteria to improve the health level of infectious diseases has been wholly under control.

Mother and child health services and health services in the achievement is a metric to reflect the success. Publications in this area can be summarized as follows: Home health as negatively affecting a problem for China is not excessive fertility. 32-33 years old 23 years old and younger who multiparlar young primiparlar is very sparse. Nutrition for pregnant women, mother and fetus in terms of health is adequate. All pregnant women, antenatal care and education are. Her birth, education, carried out by midwives or doctors are peasants. Between 4 and 9 percent of Premature rate varies. Periodic examinations of children of peasant workers by physicians and health is red. BCG at birth to children, two months and three months when I was polio type II and III polio vaccine is made. Diphtheria-tetanus-pertussis vaccine begins third month. Flowers vaccine seventh, eighth month of the measles vaccine is applied. Meningitis and encephalitis B vaccine immunization in Kindergarten also maintained. Full implementation of the immunization program, even the most remote rural areas do not fall below 80 percent. Treatment of acute diseases of children even in the most remote rural areas are made by physicians without delay villagers. Estimated infant mortality rate in China in a thousand 17-20.

Development of school children, compared with the United States an author of children's development, "pre-school children of average height and weight compared to children in the United States is low in the normal limits", especially. Evaluation of health services, health management in China, the World Health Organization experts have reviewed the end result will be in place. This expert report on "China's life a generation open it in time, worn by disease, ignorant, semi-feudal and humane life, just happy to belong to a minority as a country to be free, dynamic, healthy, producers, and community informed all her work to people's participation has become a country "he is.

China's health program can be applied in other less developed countries, did you? Question of the World Health Organization General Assembly in 1973, the Chinese delegation participating in the meeting that the response is: "Our program, is a program that meets our requirements and opportunities. Our program, not other countries, just as we do our own conditions and development opportunities appropriate program can succeed. "

This rule, details of a health program in the right direction, but the principle is not true. Principles of health management in China, health and community development professionals and managers of the less developed countries in the last ten years, the principles are recommended. So what success in the implementation of China managers have demonstrated these principles? must search for an answer to the question. Chinese health authorities have information about a Canadian expert in the broad success of reasons to gather in two groups. The first point, the population of China is top quality. Chinese people are very disciplined. To accomplish the job to them to spend every effort and often members of their social group, other members will serve without expecting any money. This continued for ages in China is a part of culture. Second point, Chinese managers of health services to all socio-economic revolution to address as part of this revolution to be in power really want and are able to do so.

As a result, other less developed countries, China miracle, but this coming together of the two conditions may occur at the rate of blood should be noted.

5. Health Organization:

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The basic unit in health organizations, and commune in rural areas are neighborhoods in cities. (Table: 2 and 3)

Table: 2-China People's Republic Health Organization in the Rural Area

Organization of Layer

Population covered

Health Institutions and Personnel

State or province (all 27 in China)

1-50 Million

n Provincial Hospitals

the Public Health Office

n Sub-Branch Professionals

n the Western and Chinese Medicine Doctor of Public

County (all in China, 2000)

Up to 1 Million

n District hospitals

n Specialist doctors

n the Western and Chinese Medicine Doctor of Public

Commune (in Greater China 27,000)

Up to 60 thousand

Hospital and Health Center or the commune

n the Western and Chinese Medicine Doctor of Public

the nurses, midwives

Production Team (All communard 5-20)

500-3.000

n Health station

n villagers Doctor

n Health Assistant

Production team (Each team in 10-30)

50-300

n villagers Doctor

n Health Assistant

Commune, a social unit in rural areas is self-sufficient. Communard agriculture, industry, trade, land-water protection, education, health, social and economic functions of all kinds, such as the organization is run. As collective property commune members, the government is not. The manufactured goods are the property komünün. Commune, identify and sell goods over the price earnings, at a rate of contribution is distributed among the members. Products outside of the income distribution than is collected in two fonda. These are investment funds and social prosperity. Culture, education, health assistance, job benefits, such as senile and can not see spending, social prosperity of the fund are met.

Table: 3 - in the city in the People's Republic of China Health Management

Organization of Layer

Population covered

Health institutions and personnel

Municipality

Up to 11 Million

the Special Branch and Education Hospital

the Public Health Office

n Sub-Branch Professionals

Region

Up to 900 thousand

n Area Hospitals

with the epidemic of War Central

n Specialist Doctors

Neighborhood

40.000-70.000

Neighborhood Health Center or the hospital

n the Western and Chinese Medicine Doctor of Public

n Assist Doctors

the nurses, midwives

Neighborhood Association

1.000-8.000

n Health Station

Health Workers in the Red

certain hours of the incoming physician

Public Groups

50-100

Communard population is very different. Population of 60,000 is up to the communard. Advanced communard a hospital, a health center is located in less developed communard. These hospitals and health centers in western medicine doctors studied medical and public works. These hospitals, laboratories and x-ray parts to maintain the level of a patient is satisfactory. Each production team and production team communard 5-20 in the production team is 10-30. A production team is usually mapped to a village and includes a population of 50-300. Assist physicians and health workers in these units to the villagers. Services, the station if necessary, and villagers are being carried out at home.

As for the city, district hospitals or health centers in each district are available. The other factory workers in the stations and duties of doctors sub-organization of the district, which covers a population of 1000-8000 in the neighboring units at particular times of day red health workers and health stations are the work of physicians. Health education and public services such as environmental health aspects of conducted in the district covering a population of 50-100 people, the bottom unit of the group. Each group responsible for their health will choose a medical assistant. This will help you organize the business in society.

At higher levels in rural areas, district hospitals and provincial hospitals communard vardır. These are much more advanced and specialized doctors working in sub-branch of the hospital. Cities and regions in the neighborhood over the region after the council has. Hospitals and public health at all levels are flat. Rural areas and upper levels of each hospital in the city will work with lower levels and that levels are responsible for in-service training of employees.

One of the characteristics of Chinese rule, a single organization for a service to society is not found. A service conducted by many organizations will cooperate. For example, health services and health organizations as well as women's federation to be conducted, workers unions, party organizations such as the organizations are also mission. The main task of the Party organizations of various organizations to coordinate services and to bring out misbehaviors. China is an important element of management "service leaders" (Cadre Personnel) dir. China manager, service team leaders to be trained to give great importance. These people are carefully selected and well trained technicians. These technical issues or how to do what can be done very well knows, are very resourceful and dynamic individuals.

Health services to develop the Soviet Union is the example of the health organizations were taken in 1949-1965 typically urban and industrial workers, especially on health services development, outbreaks of the disease to war, in every county west of the hospital-type samples by opening the services to spread to the environment, rural region, with mobile teams to bring services that are . Number of beds in hospitals 90,000 from 700,000 'e was increased.

In this period, the control of health problems for a short time with trained personnel was carried out campaigns of the population participated. One of them, and most importantly, is the campaign to improve environmental health conditions. Other captivity of opium, venereal diseases, prostitution and war campaigns şistozomyazis. China to review written by a Western doctor, the Chinese people won the great success of this campaign. All life allows women to earn their living by working is provided. Result of this campaign to end prostitution in China is over. Venereal (genital) diseases are the root of the starving. New born baby does not stay in Bel frostiness silver nitrate drops in the eyes of the applications have been abandoned.

As environmental health campaigns, the remaining three weeks in China during that time an author sees horn 3 and the other 4 clubs you see in 6 weeks, a third did not see no horn to me. And also a huge narcotics war Şistozomyazis was successful. Narcotics use, and one root Şistozomların kalmamıştır shaven.

In this period, significant achievements gained in the field of health at the beginning of 1960s but has been criticized as a serious health organizations. Criticism is collected in the following points:

a-The priority given to the city but the village could not be taken until the service.

Preventive medicine will be given to the importance of b-to said that in this area and to make some successful applications, the treatment in the field of medical research, training and implementation are given more importance. The merger of Western and Chinese folk medicine and folk medicine the important need to achieve is not important.

c-other countries, the application of the techniques can be adapted to Chinese conditions apply.

d-in management education and persuasion rather than to collective leadership and command must be applied to the way in the classical hierarchical order was established and the road has been doing business with the order.

e-drive instead of the standard to all services that are to be increased.

f-executives serve to establish a close relationship with the person. Opinion studies are considered more valuable body of work.

1965 Chairman Mao, the first movement as a cultural revolution in the health ministry was severely criticized in a way. Give importance to service in rural areas, the training is unnecessarily long, theoretical weight is given to education, preventive medicine, and research on diseases common to the Chairman Mao's criticism is not important. Ministry of Health was distributed during this period, as mentioned above also closed faculties, research published in journals has not been published. During this period, 20,000 doctors working in the city a few years or permanently to work in rural areas is the way. 1600 Number of mobile teams working in rural areas to be removed, one million peasants doctors, three million have been trained medical assistant. Both rural and urban areas in the medical care system, improved coordination and organization of this article described the health organizations have been established.

Finance 6.Sağlık Services:

Necessary for the health spending money in China come from three sources. One of them is to pay the public directly. 2 slots for all of health care (12 lira) gives. Also pays for each service a little. This payment will not prevent use of services is less. The second source, commune and factory are social security funds. This chocolate is usually a hospital for the hospital expenses. The third source, the government's budget is separate from the appropriations for health services. These payments, when required, or special programs to support local organizations, for example, family planning program, to be financed.

Health services costs and the high growth for each country and especially the chops for less developed countries, is a big problem. About the cost of health services in China to specify a number is not possible. However, according to Chinese health management in China the impression of viewing health care spending compared to other countries, and especially as a less than the government is not installed. The reason for this can be collected at three points:

Serving as a focus for services to medical workers and peasants will not make a special payment. They will receive their share of production, such as other friends. A peasant in the medical benefit of the 300 slots (1,800 lira) is. The fees paid to other health personnel to other countries is very low.

b-home and outpatient services and preventive medicine in the treatment is actually given priority.

c-acupuncture and herbs, made from extensive use of folk medicine, the pharmaceutical industry because drug spending is for profit also be running is very low compared to other countries.

4. Health manpower:

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Health services staff in China Table: 1 shows:

Table: 1 - Health Personnel in the People's Republic of China

Full Day Staff Personnel

Employees as Additional Services

In his spare time to voluntary work

Top Layer

Peasants Physicians

Health assistants

Doctor of Western medicine

Workers Physicians

Stomatologlar

Red health workers

Farmakolog the

Doctor of Chinese folk medicine

Middle layer

Medical Assistant

Nurses

Midwives

Pharmacists

Technicians

Missionaries in China, the western type of medicine was founded by training and has been developed. 1950, the number of doctors trained in western-type was in the neighborhood of 20,000. "Liberation" after the definition of health personnel trained in the Soviet model was applied. For adults to educate faculty physicians, child health and illness for the medical faculty and public health physician is trained to educate faculty was established. Besides, helping the school was founded to educate physicians. Over the period 1949-1960, these examples are too many doctors trying to educate. Number of physicians in this period 20,000 of 150,000 e, 170,000 Number of physician assistant 'e, 185,000 Number of nurses' e, the number of midwives 40.000' e was increased. Despite this increase is very important, the number of health staff to meet China's needs were so far away.

In 1957-1959 "Great Forward roll" movement is the start of a new personnel policy, needs to be resolved at local level is seen arandığı way. "The villagers Doctor" or "barefoot doctors" and begin to educate physicians, called the people to be doctors and mobile teams of health organizations to increase the occurrence of this period.

With the start of the 1965 cultural revolution, culture and health personnel working in the policy change has been great. Between the years 1965-1971 have been closed and faculty members of medical schools within the framework of a specific program in rural areas are 1-2 years. The goal is, to many people's needs, occupational problem for China's realities of the faculty members and students to enable them to see that China's health problems has been to decode grow. In 1971 with emphasis on practical training in medical school and 3-4 years in re-education has begun a program to educate physicians. This recovery of the profession of medicine (deprofessionalization) action is called. Three-year medical school in the first 4 months of basic medical sciences are taught, then rural areas in the health center to students master-apprentice method clinical and preventive medicine training is done in the second year training conducted in hospitals, the third year in the rural areas, health centers continues.

Selection method has been changed to medical school students. Each end of secondary education for at least three years younger in rural areas must work in production was adopted. Want to be the end of this period, and a young doctor working in the production team or a team of farmers, their higher education they choose for this young, doctors are able to enter medical school. Chance to enter medical school, doctors in villages and factories and working as a peasant or worker who is higher. Administrators, according to a person's physician to be intelligent and knowledgeable is not a student, loved by the people and believe that the one is important.

Against doctors in China needs to the most original and successful approach in the application peasants, workers and housewives from the selected service to the people who grow medicine. "The villagers Doctor" or "barefoot doctors," he called it, people say they are farmers or workers, health services need to work out when to make health services. A separate charge for this service they do not, they have worked in the fields or the payment is made at the factory. 8-10 years, more than a million villagers have been trained doctors. Today, the doctors have been the backbone of China Health Management.

In 1973 the World Health Organization General Assembly, a peasant doctor participate in technical discussions, Meng Ching-yu, tasks are summarized as follows:

(1) Most of the thirty-disease treatment,

(2) First aid and minor surgery,

(3) Birth assistance,

(4) Physician's recommendation in accordance with the treatment of chronic patients at home,

(5) to carry out immunization services,

(6) Environmental health services to educate people and to carry out initial checks for these services to

(7) Herbs for medicines and folk medicine to prepare

(8) Acupuncture,

(9) Ring to teach the rules of personal hygiene,

(10) to make family planning education and practice,

(11) Ana-child health services to conduct,

(12) Doctors and hospitals require treatment by selecting the facts, health centers and hospitals to send.

The villagers are not standard medical education programs. Every place and every person or even a specific application is made. The issues are common, villagers trained in health services to be selected from amongst the villagers of the winter production done when the commune hospitals, health centers or for mobile team up 3-6 months after training back to the village and learn how and what can do it in the village of application. While working in the village hospital and health center serving the region in cooperation with physicians and continuing education services are at the very beginning. Knowledge and skills of doctors a few years, villagers in the winter months the hospital, health center or execution by the mobile teams is increasing.

These physicians to learn about what is taught them in the handbook topics Supplement: 1, and the use of drugs and supplies Supplement: 2 is presented. Of this list of books and the need for China is not standard, as mentioned above, in each place where it should be noted that applications are different from each other.

Such a training program will be directed to the first criticism, 3-4 month short-term education of a peasant, peasants, and doctors said Meng Ching-yu'nun how to do things mentioned above expected. This is the response: "3-4 months in the field of health education, all of a peasant can not do this job. Most times you can also make mistakes. However, the village will do something useful and accurate. Before that, he made nothing in the field of health is not in the village must not be forgotten. So this barefoot doctors, to develop health services in the village, would be more useful in 3-4 years. To understand the philosophy of health managers in China, think about this answer, and it must be evaluated. Çin'li desired for administrators, not the best to do a useful thing to do.

Peasants in villages where work of physicians in cities "Workers doctors" or "Health Workers for the Red" is. These factory workers, or are selected from among housewives. Peasants in rural areas than doctors in the health personnel are available. These are health and assist in the supervision of doctor services will see the villagers. These people are volunteers who work outside of business hours.

Chinese managers, the number of 500,000 'i find that people always have to take advantage of the doctor and ask them to teach techniques of western medicine have. In the period 1949-1965 have been working in this direction is the achievement after the start of the 1965 cultural revolution has been made. Currently, schools in China teach western medicine among the public schools are taught medicine. Public access to physicians in solo off from the direction of medical personnel is not clear, especially in rural areas, increasing public trust in health services has been effective. Because people trust doctors and the people know is that the villagers.

In the People's Republic of China Health Management *

2009-03-27T18:41:00.000-07:00

1.Introduction:

Less developed countries can not solve the problems of the health level of the country and everyone take health services. The reason for this failure of the health manpower and the inadequacy of economic power with nutrition, positive environment and relationship education with strict conditions, such as health there is also be changed. People's Republic of China, the least developed countries, such as between 10-15 years in a short time the country's health level is the only country that can bring services to everyone. This is the review of maintenance management and success of China health reasons saptanması is very useful for other less developed countries.

2.Eski China:

Republic of China in the field of health development to evaluate, "Independence" tan (Chinese in China, feudal and capitalist order to put an end to the "Salvation" is also. Western authors found that the incident with the same term to define.) Previous to the recall and to develop general socio - -economic framework to examine the benefits and there is no obligation. China is viewing the authors explained the old China "in China are often drought, floods and disasters such as typhoon, people will starve to death was convicted. Murder for a handful of rice in this period, not to die of hunger, eating human flesh was normal. "Natural disasters in the period to buy food for families sell their children or die. Scarcity periods often seen outside the big epidemic, and as long hiperandemik infection and parasitic diseases in the community would continue to erode. "Opium habit and prostitution in big cities, China's largest of the social and medical problems. In old China, especially the urban mess is indicated by a word: terrible. "Immediately after the liberation in China, in 1950, health services, but in cities and had a very limited extent. Population of 600 million are on the medical service in China including the number of trained health personnel was 32,000. Physician / population ratio was one to 25,000. "

Levels Affecting Health of China to 3.Çağdaş Development Management Policy:

Related to health management and health in China, the important principles of general management are:

a-The first priority should be given to the public the services. This principle is the philosophy of Mao Tse-Tung'un basis. As with all services in the health services is an important principle.

b-discuss and criticize the people in their own services should develop. This policy of the 1920s Mao Tse-Tung and friends have established China's northern province of management Kiangsi'de has not changed since. Chairman Mao, workers and farmers are required to solve their own problems, but to the government's own guidance, and some may make the necessary help.

China Administrators, the role of people in development countries are mentioned in the following way: Information from lethargic to win half of the people must awaken, their power to use them for upgrades and recovery encouraged. If the people in decision-making process takes place, new things to gain the courage to do, be an interest in government affairs, criticized the attempt to find the truth and doing superstitious side at a revolution of society and if the potential leap forward like a volcano explodes.

c-immediately after China's establishment, in 1950, collected the National Health Committee, health management has been identified the following principles:

(1) Workers, peasants and soldiers in the service should be given priority,

(2) should be given priority to the protection,

(3) Western medicine and Chinese medicine for the people must be united,

(4) Public health services should be applied to mass movement.

Implementation services to the mass movement implied, that all the people all the different ways people affect the right of management support and the problem is resolved with the administration of the public. These campaigns "for home health movement" name is given. First of this campaign, to bring the environment into a positive situation in 1952 has launched the campaign. Objectives, cities and villages and drinking water to prevent mixing with the faeces, housefly, mosquitoes, and rats destroy the wood to dry.

d-for each service by itself should be sufficient in China. These principles, particularly in 1966 when the Soviet Union to help China cut and often repeated after withdrawal of technical personnel and a policy has been given much importance.

e-as in all social policy, health policy to achieve success in the implementation of the following three conditions are:

(1) Government organization, applicable policies to understand the people in the unit to the point of contact with the same understanding and knowledge that can spread in nature, should be

(2) Policy for the implementation of the necessary facilities should be provided,

(3) Implementation of the policy community or cultural values should not be contrary to the very values of society in the direction of changing this policy must be provided through training.

f-with people who serve the public should minimize the social distance. These principles, the principles of Chinese managers are very important. People, especially the peasants and the urban-social distance between the two to minimize the application has started "" From down here, "and" Nagorno and rural area to the task to Go "campaign. "From below" campaign, administration officials at high levels for some time further down there are being assigned to jobs away from people trying to prevent managers are derived. Another application of this campaign, while the body shape everyone is making craftsmanship. "" Dağlık and rural area to the task to Go "campaign to finish primary and secondary education of young people who go to rural areas as required and there are at least three years work. At the end of this period, they work with high school students to see the villagers they deem suitable to return to the city and sees higher education. 40 million young people between the years 1955-1965 went to rural areas. The purpose of this campaign, these young people to teach literacy to peasants, agriculture and other services to assist in the development of peasant and urban youth with Chairman Mao's words, by re-educating villagers.

g-city to be the front. China's social policies to facilitate the city is one of prevention. This application is the application of measures for each household over the exact placement saptanması anyone without permission from the government replaced the. Furthermore, those who have migrated to urban villages to return to the rural areas "where he was born and returned to join the production" campaign is being carried out.

h-management should be desantralize. Management is one of the most important principles Desantralizasyon China. 800 million population is 200 people in the work of the Ministry of Health in China, gives a good idea of desantralizasyonun width. How a business being conducted, what will be the standard, including the smallest administrative unit is determined by. Therefore, except for general principles applied in China is impossible to make generalizations about.

i-Bürokratizm should fight. Especially during the 1965 revolution, the culture war against bürokratizme opened. Command to (comandism) to remove and replace "Kollektif Leadership" and "Education and the Order Trust" has been given the importance of the establishment. Collective leadership, a service workers of all persons involved in decisions execution means.

j-priority should be given to rural Bölgeninin the resolution of health problems. Chairman Mao's Cultural Revolution in 1965 in this policy assert that is a policy.

k-Population growth must be controlled. According to China's population policy, terms of population growth are identified as acceleration or deceleration. However, the general policy to stabilize China's population has been directed to. Acceleration of population growth and population policy for ethnic minorities in areas where very little is being implemented. Pronatalist population policy is applied, very small proportion compared to antinatalist policy is applied. Reducing population growth policies among the countries of the profit to be China's most successful countries must be specified. Chinese population policies "Late, Seyrek and small as to indicate. "Late" to delay the age of marriage, "Rarely", birth spacing and the extension of the "small", not more than two means have children. The control of fertility on the family has a heavy social pressure. Late marriage has become a fashion. Neighborhood children have more than two women who are dispraise and find it embarrassing. Married women who are going to do and how many children they will bear when they are already designed and discussed with women in the same place when the unit is determined to deliver. Remaining outside of the time pregnant women identify the children are decreasing.

"To save women's" movement also plays an important role in fertility control: women's rescue, the People's Republic of China and a large fastidiousness implementation managers believe is a revolution. Married a girl in the old Chinese culture, and the brother of the father, married woman, her husband and a woman or widow, her son is also used to overpower. A married woman, her husband and the husband or the good of the family do have to accept everything that was bad. Had no right to ask for divorce. First important step in the recognition of women's rights adopted in 1950 the age of marriage. However, the Chinese managers of production and work of women as men participate in housework and taking the equality of the extent of the right to reduce the time to know and you are trying to provide.

Mesothelioma: Questions and Answers

2009-02-17T10:54:00.001-08:00

Mesothelioma is a rare form of cancer in which malignant (cancerous) cells are found in the mesothelium, a protective sac that covers most of the body's internal organs. Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles.

What is the mesothelium?

The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.

The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart. The mesothelial tissue surrounding the male internal reproductive organs is called the tunica vaginalis testis. The tunica serosa uteri covers the internal reproductive organs in women.

What is mesothelioma?

Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.

How common is mesothelioma?

Although reported incidence rates have increased in the past 20 years, mesothelioma is still a relatively rare cancer. About 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age.

What are the risk factors for mesothelioma?

Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in about 70 percent to 80 percent of all cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos.

Asbestos is the name of a group of minerals that occur naturally as masses of strong, flexible fibers that can be separated into thin threads and woven. Asbestos has been widely used in many industrial products, including cement, brake linings, roof shingles, flooring products, textiles, and insulation. If tiny asbestos particles float in the air, especially during the manufacturing process, they may be inhaled or swallowed, and can cause serious health problems. In addition to mesothelioma, exposure to asbestos increases the risk of lung cancer, asbestosis (a noncancerous, chronic lung ailment), and other cancers, such as those of the larynx and kidney.

Smoking does not appear to increase the risk of mesothelioma. However, the combination of smoking and asbestos exposure significantly increases a person's risk of developing cancer of the air passageways in the lung.

Who is at increased risk for developing mesothelioma?

Asbestos has been mined and used commercially since the late 1800s. Its use greatly increased during World War II. Since the early 1940s, millions of American workers have been exposed to asbestos dust. Initially, the risks associated with asbestos exposure were not known. However, an increased risk of developing mesothelioma was later found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other tradespeople. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.

The risk of asbestos-related disease increases with heavier exposure to asbestos and longer exposure time. However, some individuals with only brief exposures have developed mesothelioma. On the other hand, not all workers who are heavily exposed develop asbestos-related diseases.

There is some evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers. To reduce the chance of exposing family members to asbestos fibers, asbestos workers are usually required to shower and change their clothing before leaving the workplace.

What are the symptoms of mesothelioma?

Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face.

These symptoms may be caused by mesothelioma or by other, less serious conditions. It is important to see a doctor about any of these symptoms. Only a doctor can make a diagnosis.

How is mesothelioma diagnosed?

Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine. In an MRI, a powerful magnet linked to a computer is used to make detailed pictures of areas inside the body. These pictures are viewed on a monitor and can also be printed.

A biopsy is needed to confirm a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist (a doctor who specializes in diagnosing and treating cancer) removes a sample of tissue for examination under a microscope by a pathologist. A biopsy may be done in different ways, depending on where the abnormal area is located. If the cancer is in the chest, the doctor may perform a thoracoscopy. In this procedure, the doctor makes a small cut through the chest wall and puts a thin, lighted tube called a thoracoscope into the chest between two ribs. Thoracoscopy allows the doctor to look inside the chest and obtain tissue samples. If the cancer is in the abdomen, the doctor may perform a peritoneoscopy. To obtain tissue for examination, the doctor makes a small opening in the abdomen and inserts a special instrument called a peritoneoscope into the abdominal cavity. If these procedures do not yield enough tissue, more extensive diagnostic surgery may be necessary.

If the diagnosis is mesothelioma, the doctor will want to learn the stage (or extent) of the disease. Staging involves more tests in a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Knowing the stage of the disease helps the doctor plan treatment.

Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.

How is mesothelioma treated?

Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined.

Surgery is a common treatment for mesothelioma. The doctor may remove part of the lining of the chest or abdomen and some of the tissue around it. For cancer of the pleura (pleural mesothelioma), a lung may be removed in an operation called a pneumonectomy. Sometimes part of the diaphragm, the muscle below the lungs that helps with breathing, is also removed.

Radiation therapy, also called radiotherapy, involves the use of high-energy rays to kill cancer cells and shrink tumors. Radiation therapy affects the cancer cells only in the treated area. The radiation may come from a machine (external radiation) or from putting materials that produce radiation through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy).

Chemotherapy is the use of anticancer drugs to kill cancer cells throughout the body. Most drugs used to treat mesothelioma are given by injection into a vein (intravenous, or IV). Doctors are also studying the effectiveness of putting chemotherapy directly into the chest or abdomen (intracavitary chemotherapy).

To relieve symptoms and control pain, the doctor may use a needle or a thin tube to drain fluid that has built up in the chest or abdomen. The procedure for removing fluid from the chest is called thoracentesis. Removal of fluid from the abdomen is called paracentesis. Drugs may be given through a tube in the chest to prevent more fluid from accumulating. Radiation therapy and surgery may also be helpful in relieving symptoms.

Are new treatments for mesothelioma being studied?

Yes. Because mesothelioma is very hard to control, the National Cancer Institute (NCI) is sponsoring clinical trials (research studies with people) that are designed to find new treatments and better ways to use current treatments. Before any new treatment can be recommended for general use, doctors conduct clinical trials to find out whether the treatment is safe for patients and effective against the disease. Participation in clinical trials is an important treatment option for many patients with mesothelioma.

People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from the Cancer Information Service (CIS) (see below) at 1–800–4–CANCER. Information specialists at the CIS use PDQ®, NCI's cancer information database, to identify and provide detailed information about specific ongoing clinical trials. Patients also have the option of searching for clinical trials on their own. The clinical trials page on the NCI's Cancer.gov Web site, located at http://www.cancer.gov/clinicaltrials on the Internet, provides general information about clinical trials and links to PDQ.

People considering clinical trials may be interested in the NCI booklet Taking Part in Cancer Treatment Research Studies. This booklet describes how research studies are carried out and explains their possible benefits and risks. The booklet is available by calling the CIS, or from the NCI Publications Locator Web site at http://www.cancer.gov/publications on the Internet.

# # #

Related NCI materials and Web pages:

For more help, contact:

NCI's Cancer Information Service
Telephone (toll-free): 1–800–4–CANCER (1–800–422–6237)
TTY (toll-free): 1–800–332–8615
LiveHelp^® online chat: https://cissecure.nci.nih.gov/livehelp/welcome.asp

Benign cystic mesothelioma

2009-02-17T10:51:00.001-08:00

Benign cystic mesotheliomalar (BCM) nadir
It is a common lesion. Patients in the history of
patogenez and prognosis differ mostly in
thesis is defended. BCM first time in 1979
And is defined by Smith Mennemeyer.
Multikistik peritoneal mesothelioma, peritoneum of the cystic
mesothelioması, multiokuler cysts of the peritoneum,
multikistik mesothelioma and peritoneal multiokuler
inklüzyon kisti
Other names used are
forms olmuştur. Multible, thin-walled, frajil a
structure of the large mass of the abdomen
oluşturabilmektedir.
Preoperative diagnosis is often difficult. Separator
In recognition sarcomas, lymphoma and Non Hodgkin's lymphoma
Just as surgery düşünülmelidir.Tedavi method
at a rate of recurrence has been reported, but there is 50%.
Sıklıklayerleştiğiyerler; over, falloptüpleri, column,
cul de sac and pelvis is the base. Dimensions 0.3 cm and 15
cmarasındadeğişebilmektedir.
Both are very rare in men with
can be seen in the breed. Usually fertile
are seen in women and 1998 since
Total 130 cases have been reported in English literature.
These are only 19 male patients. Literature
reviewed by the rare, mature men
Besides that, the placement of peritoneal malignant and selim tümöral audience to distinguish the importance
nedeniylesunulmuştur
15-year-old male patient with abdominal pain and right lower
was admitted to our clinic because of the sensitivity dial.
Stories, the two-day loss of appetite and nausea vomiting
was available. Physical examination in the right lower quadrant
sensitivity of patients with bowel sounds present
routine, had no defense and rebound. Acute appendicitis front
the patients were diagnosed pancakes. Configuration of examinations
The white sphere is 76% 8800/mm ³ and granulocyte
other routine examinations were normal except for. Configuration
ultrasonography (USG) 'de; ilia vascular structures
The reshuffle of the medial area of the iliopsoas muscle
In the neighborhood of about 57x22x16 mm
In the septasyonları and thin ekojeniteleri
complicated in view of the fluid collection was identified.
And bladder in the neighborhood also trasede ilia
multible lenfadenopatiler (lap) seen. "Perforated
appendicitis? "has been reported as (Figure 1.2). A
In the next report "hydatid cyst?" de
were normal, but multiple appendiks lap.
Observation of the patient, except in the right lower quadrant pain
USG findings and reports be determined because of different patient diagnostic information
has been scheduled for laparaskopi. General anesthesia
six 1 cm below the belly of the camera insizyondan
was entered. Looked at in the right neighborhood pelviste bladder
The cystic structures were observed on multible peritoneum. And other Western bodies Appendiks salim
as was observed. Then right-va left 5mm'lik trokar
After entering the cystic lesions of the lower quadrant
to complete by being perforated with peritoneal
been removed (Picture3). Be done to identify pathological
reported as a result of benign cystic mesothelioma
edildi. Smooth as the first postoperative day the patient
taburcuedildi.3aysonrakontroleçağrıldı.
BCM mezotelyumdan from peritoneal
tumoral is a rare occurrence. Etiology of
There is no definite information. Often, early or
the age of fertility is higher for women
seen in male patients but also has been reported.
Connected with malignant Asbestozise a clear mesothelioma
relationship-although, even if it has been reported 2 patients
has not been shown. In the stories of patients often
not the surgical operations, or endometriozis
is an inflammatory event. BCM a reactive
is considered as events and malignant transformation
expected. Metastasis is reported so far
is not.
Abdominal distension and masses in the form of
Discharge is the most common findings. Rare as
karınağrısıilekarşımızaçıkar. Bizimolgumuzdasağ
lower quadrant pain with the present findings, such as a rare
olmuştur. However Tangjitgamol et al. 'T say
not a specific finding as preoperative diagnosis
nedeniylemümkünolmamaktadır.
Anekoik with imaging techniques, low
reported as mass density or cystic hipointense
are. We also as a result USG cystic
characters are defined by the audience. The specific
view of the findings; invasion without mass
Depending on the size of the distortion around the structure
is doing. Abdominal into us, the grapes
as a bunch of thin-walled, fluid-filled interior of the serous
out as the formation of various sizes. Our
Although it is small, white grape olgumuzda
salkımıgörüntüsümevcuttu.
Diagnostic imaging techniques, except in the thin
needle aspiration biopsy has been applied, but non
Except mezotelyal cells specific findings
as a useful means to identify preoperative
It is not.
In the differential diagnosis of cystic Hygroma, endometriozis,
retroperitonu tutan müllerian cyst, cystic adenomatoid
tumors, cystic mezonefrik duktus residues and
formation of benign cystic form endosalpingiozisin
should be considered as pathological in bakılan. As malignant
ise; mesothelioma and peritoneal malignant serous and kicking
tümörlerdüşünülmelidir.
Surgical resection is the most effective treatment methods.
Not be removed if the recurrence is often OK.
For this aggressive surgical approach kistoredüktif
with peritonektomi is recommended. We
Because of the small mass limit clean surgery to remove the entire laparaskopik way we did it.
If a second surgical attempt to detect the recurrence
yerineantiöstrojenlerveyagonadotropinanaloglarıile
hormonal therapy, intraperitoneal hipertermik
chemotherapy and tetrasiklinle sikleroterapi
is recommended. However, success is variable. Benign
after surgery due to be in natur Adjuvan
olarakkemoterapiveradyoterapiönerilmemektedir.
As a result, good-natured with a tümöral structure
BCM, preoperative diagnosis is difficult, despite
treatment is possible with resection method.
Cystic appearance must occur in the presence
mutlakatümüyleçıkarılmalıdır.

Bibliography

1. Mennemeyer R, Smith M. Multicystic peritoneal

mesothelioma: A report with electron microscopy of a

case mimicking intraabdominal cystic hygroma

(lymphangioma).Cancer1979;44:692.

2. Akata D, Arat A, Ozdogan M. Benign cystic

mesothelioma of the peritoneum. Abdom Imaging

1999;24:188.

3. Tangjitgamol S, Erlichman J, Northrup H, Malpica A,

Wang X, Lee E, et al. Benign multicystic peritoneal

mesothelioma: cases reports in the family with

diverticulosis and literature review. Int J Gynecol

Cancer2005;15:1101-7.

4. O'Neil JD, Ros PR, Storm BL, Buck JL, Wilkinson EJ.

Cystic mesothelioma of the peritoneum. Radiology

1989;170:333-7.

5. Samson P, Cacala S. Rare case of benign multicystic

peritoneal mesothelioma. A letter. ANZ J Surg 2005;

75(7):619-20.

6. Safioleas MC, Kontzoglou C, Stamakos M,

Glaslakiotis K, Safioleas C, Kostakis A. Benign

multicystic peritoneal mesothelioma:Acase report and

review of the literature.World J Gastroenterol 2006;

12(35):5739-42

What is mesothelioma?

2009-02-17T10:48:00.000-08:00

Is a natural silicate mineral asbestos with people because of the combination does not transmit heat started in the old ages. On the ninth hundred years in the second half of the next industrial revolution, heat, electricity, friction, and is resistant to acid because many businesses are using the "magic mineral" as is the twentieth in the face of the second half after being karsinojenik emerged, the name "deadly dust" has been.

Asbestos as a solid physical structure (amphibol) and curve-fiber (chrysotile) has two types. Amphibol of asbestos, according to chemical structure, crocidolite (blue asbestos), amosite (brown asbestos), tremolit to anthophollite and actinolite varieties are available. Industries most frequently used in chrysotile, crocidolite and amosite were denominated. These are the most dangerous for health and crocidolite were banned in many countries using amosite'nin. 90% of the asbestos industry in many countries, including chrysotile, but is prohibited in some countries is less controversial karsinojenisitesi are used under strict control.

Asbestos disease can only enters the body through breathing. Caused diseases, may be benign or malignant. In the first group, plevrada fibrosis, calcification, effüzyon; parankima in lung fibrosis (asbestosis) is located. In the second group, the malignant mezotelyomaları pleura and peritoneum, lung cancer and even if less is available larenks and cancer of the digestive organs. No non-smoker and non-industrial relations risk of lung cancer in people 1 is approved, this rate 45'e who smokes 20 a day, and smoking, but also the 92 times out who is breathing asbestos dust. With smoking and asbestos are carcinogenic for human health when minerals can be very dangerous. In Turkey, smoking rates of men in rural areas and find the% 70'lerin however breathing asbestos fibers that have the higher our people would say the chances of cancer, you'll catch.

To make a benign or beneficial owner of the asbestos diseases, has been left to take a period of 20-40. People asbestos, work environment (vocational or occupational) or environmental (environmental or Domestic) way to breathe. Az da olsa, asbestos workers who have stuck to the powder of the clothes at home that relatives can breathe it in as indirek directly or to the left is called asbestos paraoccupational way.

In Central Anatolia in Turkey approximately 16 million people living in the rural areas are considered to have. These are approximately 25% of asbestos depends on over the age of twenty Plevral disease are benign. This ratio as a linear increase as the years progress, and can reach the 80's%. Asbestos is also mezotelyoma it is aklamMaliğn. In the Western world mezotelyoma incidence of malignant 1-2.2 / 1,000,000 / year in Turkey, while at least 500 persons per year are seen in this disease. Western countries have retired asbestos worker malignant disease mezotelyoma, our country is in middle age disease. We the people of our rural areas, environmental asbestos-Domestic way to breathe. Reported above, the most number of years it could happen by the left vocational asbestos. That is, vocational disease of the western world, our environment is our disease. Central Anatolian origin is actually working in Europe to receive compensation for their workers per mezotelyomaya shot was caught when the asbestos that accept and lungs were found in the Anatolian territories show that the request can not be accepted as tremolit. Asbestos-related diseases in workers in Europe, "Imported asbestos" and running a shameful situation, it is funny.

Turkey is working in the same confusion that is. Asbestos is processed in a factory work related illness occurs employer-worker is the problem. Asbestos workers to patients has come from his village, or did you work?

In Turkey to the left of asbestos fibers, asbestos in the white ground, "Ak soil," the heavens earth "," Ceren earth "" Çelpek "with various names, lime, plaster, roof and ground floor is used as is. Used for this purpose in the villages of Anatolia, most of the land in the industrial value of any non-asbestos tremolit have to. This type of asbestos fiber, just like blue and brown asbestos thin or thick can be long.

Asbestos, environmental way our country is connected to the left peak of disease in the region: Mihallıççik districts and villages of Eskişehir and Konya Ereğli'sinin Ayrancı Halkapınar and villages, of Çankırı Ilgaz and Şabanözü Sorgun village and district of Yozgat and villages, and Yıldızeli of Sivas Şarkışla villages, west of Diyarbakir in South Eastern Anatolia region Ergani and villages, Polu Mine and villages of Elazığ, Malatya, Adiyaman and Urfa district includes the Siverek. Coast of the Black Sea and Eastern Anatolia regions in residential areas do not have asbestos-related diseases. Connected to the asbestos left several villages in Thrace Plevral benign changes are found. Only in the villages in the Aegean region Denizli'in Tavas County, Burdur's Yeşilova region, and the Gediz Aslanapa district of Kütahya, Afyon district's Elmadag about asbestos disease was found sporadically in the villages. Mediterranean region, the slope of the Taurus Mountains in the villages and some villages of Hatay Kirikhan and Reyhanlı soil drink the above mentioned tremolit way asbestos is used by the left end of the air within the environment to develop diseases related asbesle.

The 30 species of natural zeolit'lerin a aluminosilikat crystallize only in erionite and mordenite lifsel structure. The crystal structure alone is erionite'in epidemiological lifsel, in vivo and in vitro has been shown to be as karsinojenik and fibrojenik. So far, the most potent carcinogen known Erionite'nin a mineral that is connected to the World Health Organization, the International Cancer Research Agency (International Agency for Research on Cancer) has been adopted by.

Thousands of years ago, Erciyes, Hasandağı and the volcanic lava of nearby mountains covered Melendiz that foreigners Cappadocia, Goreme said we are in the unique natural wonders of the geological structure has emerged. The region's only three-place, water and salt into the reaction of volcanic lava chabazite, clinopitololite create and crystallize as lifsel structure where erionite'nin Karain, Sarıhıdır villages and is located Tuzköy. To all of the diseases of asbestos Erionite'nin caused Göreme region has to face the day with work. This area is separate from the three villages in the other villages is infrequent, and peritoneal malignant Plevral has been shown by us to be mezotelyoma endemisi. The average age of patients from the region mezotelyomalı most people 50 and 26, were the oldest is 75. In both men and women and Disease was seen. Interesting side of the business, the disease was seen in a way more intense in some families. A family with the lymphoma mezotelyoma Plevral and peritoneal, liver cancer, bone sarcoma, tumors such as non-mezotelyoma were seen. On these observations formed the basis of cancer, although genetic predisposition factors erionite also suggests additional factors may be as effective.

Göremenin Karain, Tuzköy and the proportional mortality studies Sarıhıdır villages, the first of two who died in a village in the fact that 70% died from malignant disease has been revealed. However Kızırmağın the oldest settlements in the south of the river flooding and falling rocks in the back of people and animals by causing loss of time due to the government in 1958 villages of the north side of the river in the brick, briquette made with materials such as new home has to be moved. Be below 50% of Sarıhıdır'daki mortality rate is probably related. All patients except one in this village was born in the old villages were individuals. This event Göreme'deki the problem of cancer, but show the villages can be solved through a change of location.

Cancer Göreme'deki people in villages, houses and garden walls of the building blocks that slide into the water to breathe in erionit'ten. Bronchi of the patient and provide sekresyonunda, breathing the air in the house and in the lungs is similar to the erionite fibers and asbestos cisimcik shows zeolite cisimcik. Today only 35 digits of a village that has become a large part Karainliler'ın, for various reasons, domestic and foreign locations to maintain life. After finishing elementary school, even separated from the village who goes to the world, wherever you are mezotelyoma risk.

Mesothelioma Treatment Methods
1. İmmünoterapi and / or combination chemotherapy
Ex: + IFN-a combination of cisplatin,
cisplatin + mitomisin - C + IFN-a combination,
IL-2 or IFN-g intrakaviter,
intralezyoner GM-CSF infusion,

2. Photodynamic therapy

3. Gene therapy

4. Selective receptors for growth or antagonistic treatment faktöıü

5. Plörektomi / intrakaviter chemotherapy / postoperative chemotherapy / radiotherapy preventif

Median 4-12 months after diagnosis MPM'de between sağkalım are reported.

At the moment not possible to talk about curing the disease is below 5% in five years of life.

Treatment cases are reported with long-lived.

Prognostic factors in the life time is effective.

Can not be used in response to PA lung graph treatment.

For phase MPM'de "International mesothelioma Interest Group" (IMIG) prepared by the phase recommended for use (Table 4).

For less than the number of Olgu treatment is difficult to comment about. Studies suggest that at least 15 patients are. This case centered on the work should come into question.

The multidisciplinary treatment of liver diseases can change the natural history of disease.

2009-02-15T09:37:00.000-08:00

I Multidisciplinar Open Classroom in Viral and Bacterial Infections of the Liver.

• Sponsored by Gilead Sciences Laboratory, the reunion is accredited by the Menendez Pelayo International University and sponsored by the Spanish Association for the Study of the Liver.

• One hundred hepatologists Spaniards have gathered in this first Open Classroom Cross is drawn into a discussion forum on infectious diseases of the liver.

• The ideal drug is one that achieves a potent viral suppression (effectiveness) as long as possible (no resistance).

• Around 400 million people worldwide are infected with Hepatitis B, and 200 million for hepatitis C. Most do not know.

• In Spain there are between 300,000 and 400,000 people with hepatitis B, and between 800,000 and one million with hepatitis C.

El Palacio de la Magdalena Santander I just host the Open Classroom in Cross Viral and Bacterial Infections of the liver that has brought over one hundred nationally hepatologists.

The objective of this class has been updated knowledge related to bacterial and viral infectious diseases of the liver, especially hepatitis B and C, so that specialists may be transferred to everyday clinical practice, it has been established what should be the action protocols in many cases. It also has a special focus on the most controversial points of the treatment of these diseases. This classroom has led Dr. Fernando Pons Romero, Professor of Medicine and Chief of Digestive Medicine of the Hospital Universitario Marqués de Valdecilla, Dr. José Luis Calleja, Deputy Medical Service of Gastroenterology Hospital Universitario Puerta de Hierro, and Dr. Javier Garcia Crespo, Physician Assistant Digestive Medicine Department of Hospital Universitario Marqués de Valdecilla. Sponsored by Gilead Sciences Laboratory, the reunion had the accreditation of the Menéndez Pelayo International University and sponsored by the Spanish Association for the Study of the Liver.

This meeting, held for the first time in Spain, intends to become a forum for discussion of liver disease in the coming years. It has highlighted the importance of multidisciplinary treatment of viral and bacterial diseases of the liver, focusing on the need to work together in addressing them to ensure that treatment is successful.

Thus, Dr. Fernando Pons explains that for this first class multidisciplinary "have been selected infectious diseases for several reasons, firstly by its frequency, because of its high morbidity and have at present a very effective therapeutic arsenal can control. " We therefore have analyzed the liver related to hepatitis B and C which are responsible for a significant number of hepatitis, which if not treated properly can lead to the development of liver cirrhosis and even liver cancer.
Similarly, we have studied the bacterial diseases that can present and cirrhotic patients whose diagnosis and treatment is essential because they are a very important cause of mortality.

Here I Cross Open Classroom in viral and bacterial diseases of the liver has been spoken of spontaneous bacterial peritonitis, bacterial infections in cirrhotic patients in hepatic disease or infectious diseases. About C virus has affected the clinical extrahepatic manifestations of this virus in the predictors of non-modifiable and modifiable treatment response and treatment of hepatitis C after liver transplantation. As for the B virus, in this meeting have been presented the epidemiological changes of infection by this virus in Spain, explaining the diagnosis of infection and evolving forms of B virus infection highlighting the therapeutic options currently available.

Specialist Hospital Universitario Marqués de Valdecilla stresses the importance of these meetings as a forum for exchange of knowledge between hepatologists and other specialists who treat diseases that are related to these infections and to alter its natural history, hence the importance the multidisciplinary approach. "

Hepatitis B and C. Treatment

Among other points, in this classroom were addressed novel aspects in epidemiology, natural history, diagnosis and treatment of chronic infection by hepatitis B. Dr. José Luis Calleja, Deputy Medical Service of Gastroenterology Hospital Universitario Puerta de Hierro, emphasizes that the majority of treatments are prescribed for long term is essential to choose appropriate candidates for the treatment. At present, most of the international consensus to recommend treating only those patients who present with histologic and analytical data relevant to active disease. " In this sense, it emphasized the importance of team-resistant effectiveness when planning appropriate treatment. The ideal drug is one that achieves a potent viral suppression (effectiveness) as long as possible (no resistance). In this sense, the new generation of antiviral drugs such as tenofovir, a major breakthrough for the treatment of these patients and are regarded as drugs of choice, "clarifies Dr. Calleja.

Regarding hepatitis C, this reunion was discussed the possibility of improving the antiviral response by modifying factors: treatment of docility, the host and virus. It also emphasized the individualization of treatment, ie the adaptation of treatment to each patient and each type of virus to achieve optimal viral response in the shortest possible time and with fewer side effects. Thus, Dr. Javier Crespo, Associate Medical Digestive Medicine Department of Hospital Universitario Marqués de Valdecilla, explains that "it is important impact on reducing the treatment time in patients infected with genotype I with low viral load and that they possible treatment of 6 months instead of 12 without loss of efficiency. " On the other hand, in the Open Classroom I Cross in viral and bacterial diseases of the liver, is said to increase the treatment in some cases of infection with genotype 3 and high viral loads do not exhibit an early virological response.

Hepatitis B and C. Prevalence

One in 12 people worldwide are living with hepatitis B or C, and most have known the disease. According to estimates by the World Health Organization estimated that there are approximately 400 million people globally affected by hepatitis B and between 170 and 200 million cases of hepatitis C. One in three people worldwide have ever been exposed to hepatitis B or C.

The prevalence of these diseases is highest in China, Southeast Asia and tropical Africa, and in turn the lowest in North America, Western Europe and Australia.

5% of the world population are carriers of hepatitis B virus and produces two million deaths annually caused by this virus. In Southeast Asia and in sub-Saharan Africa 10% of the population are chronic carriers. The level of prevalence of hepatitis B is such that the number of infected is 10 times higher than those infected with the AIDS virus and its transmission is 100 times easier than that of HIV.

In Spain, there are 12,000 cases of hepatitis B each year. Between 5 and 10% become chronic hepatitis B and approximately 250 cases developed hepatocarcinoma (liver cancer). In total, there are between 300,000 and 400,000 Spaniards infected by this virus, approximately 1% of the population. For its part, the prevalence of hepatitis C infection is relatively high, with between 800,000 and one million infected people in our country. It is estimated that nearly a million Spaniards are unaware that they carry some hepatitis viruses.

Complications commonly associated with hepatitis B and C are cirrhosis, liver failure and liver cancer, disorders that may affect 20 percent of these patients. The existence of such factors as alcohol consumption, being male, having been infected in late age and being infected by human immunodeficiency virus negative impact on prognosis and disease progression.

About Gilead Sciences

Gilead Sciences, sponsor of the Open Classroom I Cross in viral and bacterial infections of the liver, is a biopharmaceutical company that discovers, develops and markets innovative treatments in areas with unresolved medical needs. The company's mission is to advance the care of patients suffering from life-threatening diseases worldwide. Gilead Sciences now sells Viread ® (tenofovir), a single administration of antiviral daily for the treatment of chronic hepatitis B and Hepsera ®, widely used in Europe. In addition, the company is developing small molecule compounds for the treatment of hepatitis C and a hepatoprotective liver fibrosis due to hepatitis.

Pill and wife celebrate 30 years to grow together.

2009-02-15T09:34:00.000-08:00

• Yesterday was inaugurated in Madrid the exhibition "Pill and women 30 years of evolution" that will tour major cities in Spain.

• According to experts, the pill has undergone in recent years a radical transformation and now have fewer side effects and many health benefits.

Yesterday, October 7, 2008 was held in Spain on 30th anniversary of the decriminalization of the contraceptive pill. A date which marked a milestone in the history of women and society of our country, and that somehow symbolized the arrival of a new era of openness and freedom.

Since then, many things have changed for women and society itself, but so has the pill. Now, three decades later, the pill is no longer used only as a contraceptive method, but developments in recent years have focused on meeting additional health needs and welfare of women.

This has been reflected in the "Pill and women: 30 years of evolution" which was presented yesterday at the hands of the Spanish Society of Gynecology and Obstetrics, the Spanish Society of Contraception and in collaboration with Bayer Schering Pharma. The sample includes the testimonies of 30 women on the pill and its evolution over these 30 years.

According to sociologist Jose M Bleda, "it is striking to see how women have changed in so little time. Its more professional, its growing integration into working life and other facets of development has marked his career in 30 years and has led him to be more demanding and have greater concern for their health, wellbeing and physical appearance .

In these years there has been a substantial change in relation to the pill. Once the efficacy and safety of contraceptives, recent developments have been designed to meet the changing needs of health and welfare of women. In this sense, as the widow of Dr. Esther, Chairman of the SEC and Gynecologist Hospital of Guadalajara, "Reducing the dose of hormone and the incorporation of new progestins increasingly similar to natural progesterone in women has been key to achieving other benefits to health and welfare of women. " Now, the contraceptive pill also has a therapeutic use to reduce symptoms associated with menstruation such as menorrhagia (abundant bleeding) or dysmenorrhea (menstrual pain), treatment of acne and seborrhea, or alleviation of symptoms associated andalusia Premenstrual syndrome. Sometimes, these signs have become characteristic of oral contraception or treatment specialists recommend that outside purely contraceptive. This means that over 1,700,000 women choose this method in Spain.

Along with all of them in this presentation has been Mr. Theo van der Loo, Managing Director of Bayer Healthcare in Spain, which now incorporates the company that once was responsible for the introduction of the pill in our country, and which now represents 30 years after the breakthrough and development in this method since, and wanted to support with their presence Sponsored by: In collaboration with: the initiative and show the company's commitment to continue working on improving the health and quality of life of women.

On exposure

The exhibition is based on the personal testimony of 30 Spanish women, of varying age and condition, we have personal experience with the contraceptive pill. Among them we find housewives, students, journalists or gynecologists.

Some of the familiar faces that have given their testimony are actresses Monica Estarreado, or Powdery Ana Carla Hidalgo. The show also has collected the testimony of political or professional recognition by the President of the Spanish Federation of Women Entrepreneurs, Business & Professional (FEMENP), Carmen Sanz Chacon or writer Mariana Jara.

Also the exhibition runs through the development of oral contraception in the last 30 years, so informative and entertaining.

Pill and Women: 30 years of evolution starts today in Madrid, but your first stop for the general public will be in Santiago de Compostela from October 28 to November 1. Other cities that will traverse Bilbao, Sevilla, Valencia and Barcelona. In February revert back to Madrid where he will be a week before its closure. During his trip, the exhibition provides informative host various activities around the oral contraceptive. For the itinerary or further information: http://www.pildoraymujer.com.

30 years of decriminalization

On October 7, 1978 the courts gave the green light by the Law 45/1978 which approved the decriminalization of the use of the contraceptive pill. Today, 30 years later, the Spanish Association of Gynecology and Obstetrics (SEGO) and the Society of Contraception Esañola (SEC), supported by Bayer Shering Pharma, the company which marketed the first pill in our country, and we have held in Madrid with the opening of an exhibition that will tour the Spanish in the coming months.

Although oral contraceptives were being recent past as menstrual regulation, legalization of contraceptive use as the beginning of a new era for millions of Spanish, since that time, had the opportunity to choose when and how to conceive.

The stigma of mental illness results in a lack of resources.

2009-02-15T09:33:00.000-08:00

• On Friday, October 10 is World Day of Mental Health.

• The prevalence of psychiatric disorders in Spain is high at around 20-25% of the population.

• The health care effort, both as a means of adequately trained personnel, which is below it as a "pro" to load.

• For every 100,000 inhabitants, in Spain there are 5.5 psychiatrists, while in another EU country there are 15 professionals.

• The rate of suicide mortality adjusted for age and sex of persons suffering from a schizophrenic disorder, is 9 times that of the general population.

• An important factor that affects the use of mental health services is the stigma and discrimination associated.

In Spain, about half a million people suffer from some form of serious mental disorder, however, mental illness is still not well known socially. The prevalence of psychiatric disorders in Spain is high at around 20-25% of the population.

At present there is widespread concern among patients, families and professionals regarding the need to ensure access to quality care to reduce the heavy burden of suffering and disability associated with mental disorders, therefore, the Spanish Foundation Psychiatric and Mental Health (FEPSM) joins the voices on the occasion of World Day of Mental Health, calling for a sustained and coherent effort to achieve that goal.

Mental disorders as a whole, in Europe are responsible for the greatest burden of disease pathology groups, ahead of cardiovascular disease or cancer. However, the effort of care, both as a means of adequately trained personnel, which is below it as a "pro" to load.

The reasons for this situation which is repeated in many countries, are manifold, ranging from stigma / discrimination associated with this group of disorders until the late introduction of psychiatric care to National Health System as has happened in our country, through suffering cuts on social protection in times of economic crisis.

There is a big difference between the number of professionals for the Mental Health in Spain and one of the most advanced countries of the European Union. Per 100,000 inhabitants, in Spain there are 5.5 psychiatrists, while in another EU country there are 15 professionals. If we attend to the number of nurses, found that in our country there are about 6 compared to 50 other European countries. On the other hand, if we refer to the number of occupational therapists, we find that in Spain with 0.5 per 100,000 population compared to 20 other countries. And finally, if we stop at the number of social workers, we see that while the figures in any of European countries is around 10 in our country we are close to 1.3. (Fuente. - Studio 2001 J. Luis Váquez, a professor at the University of Cantabria)

Interesting Facts

According to the Mental Health Strategy, Ministry of Health and Consumption, 2006, produced in collaboration with andalusia FEPSM, the prevalence of psychiatric disorders is high, 20-25% of the general population as the most rigorously designed epidemiological studies . In Spain it is estimated that half a million people suffer from some form of serious mental disorder. The distribution of prevalence by regional governments is relatively uniform, varying according to the present data between Andalusia and Catalonia 15.71 with 23.68.

Mental disorders are the cause of 10.5% of days lost for temporary disability and about 6.8% of the years of life lost due to permanent disability. The suicide mortality rate adjusted for age and sex of persons suffering from a schizophrenic disorder, is 9 times that of the general population. In major depression, the suicide risk is multiplied by 21, on eating disorders by 33 and 86 for drug addiction.

Spanish Foundation of Psychiatry and Mental Health (FEPSM)

One of the most important in recent years in the health world, has been the growth of mental illness. So all national health systems considered as a mental health emergency needs. In the immediate future, these problems will require greater attention in the planning and provision of social services and health.

In Spain, about half a million people suffer from some form of serious mental disorder, however, mental illness is still not well known socially. In this sense, the Spanish Foundation of Psychiatry and Mental Health (FEPSM) aims to contribute to knowledge development and refinement of Psychiatry and Mental Health, as well as their related disciplines, through meetings, publications, scientific events, developing research and other scientific and cultural activity.

This Foundation was created as an initiative of the Spanish Society of Psychiatry (SEP) and Spanish Society of Biological Psychiatry (SEPB) to give the general public of an instrument of service to the scientific advancement of Psychiatry and Mental Health in Spain.

Conclusions of the XXIII Annual Meeting of the Spanish Group of Photobiology.

2009-02-14T07:19:00.001-08:00

*

Are we protected from the sun an umbrella? What is therapeutic light?
*

More than 40 experts in dermatology, physics, chemistry, meteorology, biology and pharmacy, have presented this weekend in Barcelona the latest research that reveals the keys to these questions.

More than 40 recognized experts in the fields of dermatology, physics, chemistry, meteorology, biology and pharmacy, have participated in the XXIII Annual Meeting of the Spanish Group of Photobiology (GEF) held this weekend in Barcelona. During the meeting, there have been recent developments and research on the effects of sunlight and other sources of artificial light on health in general and in particular the skin, and its possible practical application in the prevention damage.

"Mindful of the effects of solar radiation on the immune system of humans, a large group of professionals decided to create this group and pool our efforts to prevent its negative consequences and exploit the positive towards the health of humans , "said Dr. José Manuel Carrascosa, coordinator of the GEF and dermatologist Service of Dermatology Hospital Universitari Germans Trias i Pujol" Can Ruti.

This year, in terms of diagnosis and treatment of diseases, mainly skin, experts presented the latest developments related to the treatment of skin cancer, psoriasis and vitiligo with phototherapy, fotoquimioterapia (PUVA) and photodynamic therapy.

This block has been reinforced by the launch of the first theoretical-practical course of phototherapy to dermatologists and dermatology residents, organized by the GEF and held at the Hospital de Sant Pau and Santa Creu of Barcelona, whose aim was to updating and deepening of the methodological aspects of some of the variants of phototherapy and studying the most common photosensitivity. The increasing number of patients with these diseases and the limited number of Photobiology and phototherapy limit access of many users of public health to these treatments. Both the course and in the reunion of the GEF, have prestigious dermatologists like Dr. José Manuel Carrascosa, coordinator of the GEF and dermatologist Service of Dermatology Hospital Universitari Germans Trias i Pujol "Can Ruti" Dr. Agustín Alomar, Chief of Dermatology of the Hospital de la Santa Creu i Sant Pau and Dr. Mario Lecha, dermatologist Dermatology Service, Hospital Clínic i Provincial and founding member of the GEF.

As for the latest research on the adverse effects of sunlight on human health include the presentation of the study by Joseph A. Martínez and M. Lozano Utrillas Pilar, professors in the Department of Thermodynamics, Faculty of Physics, University of Valencia, which shows that, far from much of the population believes the umbrella is not enough to protect us from the negative effects of the sun . The study concludes that the diffuse radiation under the umbrella is 35% which equates to an ICU for 3 or 4, so we can burn it too low. In case you are putting the risk is lower, but if you are sitting or standing under it must also add radiation by reflection from the sand (25%) or grass (33%).
Josep Montero, pharmaceutical ISDIN and founding member of the GEF, said that "these findings is essential to remind people that, despite that we will be under the umbrella on the beach, pool or field, it is very important to apply photoprotective one suited to the needs of each type of skin that protect us and help prevent skin cancer. "

About the GEF
The GEF is a multidisciplinary group, attached to the Spanish Academy of Dermatology and Venerology, born in 1988 to promote the exchange of scientific knowledge about the effects of radiation of light in the earth and man, studying the effects of artificial light sources and assess the risks from exposure to light sources.

Throughout his more than 20 years of work, the GEF has undertaken projects relating to the fields of Photobiology (science that studies the interaction between electromagnetic radiation and life), fotodiagnóstico, phototherapy and photoprotection, activity sun and the ozone layer. Moreover, it has worked on many skin diseases and drug reactions, batteries fotoparches, skin diseases and cancer, regulation of the tanning booth ....

Since its inception, ISDIN, leading dermatology pharmaceutical company in the Spanish market, has supported and publicized the work of the GEF, as well as holding its annual reunion in several Spanish cities.

http://www.aedv.es/grupos_trabajo/fotobiologia/

The Hepatitis B vaccination of health professionals is required to perform their work.

2009-02-14T07:18:00.001-08:00

• About 95 percent of the health care of our environment is vaccinated against Hepatitis B.

• Failure of the immunization schedule for this group of legal and industrial implications

• Working in a sensitive habitat, the risk of occupational health is above average and the consequences of transmission of Hepatitis A and B are most relevant.

• The philosophy behind this concept is to protect oneself and others by vaccination.

• Ignorance of the working calendar of the immigrant population increases the risks of contagion and sobrevacunación.

• The scientific community is working on a protocol for action in the event of an influenza pandemic.

• The policy approach of Public Health means that, thanks to the immunization schedule for children, young people entering the labor market are better protected than the older population.

Health professionals should be vaccinated for the performance of their work. The rotundity of the sentence, the core of the conference organized by the Center for Immunization in the workplace (OVAL) today, Thursday, February 5, 2009, from 11:00 in the Company Bilbaina is based on a goals: minimizing the risk to others. As John says Goiri, president of the Academy of Medical Sciences of Bilbao and coordinator of the observatory, "Vaccination is a medical fitness test, especially as a means of preventing infection, both to themselves and colleagues to patients.

OVAL coordinator understands that "health professionals, and other labor groups at risk, must exercise extreme vigilance when it comes to health care. Not surprisingly, working in an environment where the risk is above average and the consequences of transmission of hepatitis B are more relevant. Andalusia handled in many cases, people with immune deficiencies are more serious sequelae.

The conference organized by the vaccinations OVAL seen as a test of capacity to work, both from a legal perspective and from the standpoint of occupational medicine. The judge of the administrative division of the Tribunal Superior de Justicia del País Vasco, Luis Garrido, explain what are the legal requirements for the performance of the health profession, with special emphasis on the criterion of medical and fitness of the worker to his job, along with preventive measures that work proceed in its case. " He recalled what the legal consequences are brought about by a breach of infection immunization schedule.

The president of the National Commission of Occupational Medicine, Mary Castilian, also recommended "an appropriate vaccination reduces rates of infection and the risk to others. Health professionals face a greater responsibility than other professionals and have to monitor this issue as a clear measure of job protection. " Both voices have been moderated by Dr. Juan José Díaz Franco.

It is, however, has already warned that a deep draft. Juan Goiri that "about 95 percent of the health care of our environment is vaccinated against Hepatitis B. The philosophy behind this concept is to protect oneself and others by vaccination. "To this we must add another fact that underscores the president of the Academy of Medical Sciences of Bilbao. "The policy approach of Public Health means that, thanks to the immunization schedule for children, young people entering the labor market are better protected than the older population."

Also, the time of updating the knowledge organized by the OVAL has reviewed the three most common types of vaccines in adults: influenza vaccine, tetanus vaccine and vaccines against hepatitis B. The head of vaccines and monitoring of management of Public Health of the Basque government, José María Arteagoitia has reviewed the current status of vaccine, and future prospects. This field is particularly important with the analysis of a virtual scene: how to act in the event of an influenza pandemic? The expert says that "has established a protocol on who to vaccinate first vaccination and what criteria should be followed."

In the field of tetanus vaccine, José Antonio Navarro-Alonso, a member of the European Commission on Prevention, revised criteria such as the risk of hipervacunación-economic carries a surcharge, the more discomfort and possible side-effects and lack of timing vaccine followed by the immigrant population. Following these reflections, Juan Goiri advocates the creation of a universal vaccination record, which reduces the margin of error. "

In any of the aforementioned types of vaccines, their administration is voluntary within the healthcare workplace. Unlike in the case of the vaccine for Hepatitis B. Luis Urbiztondo, section chief of infectious disease prevention for the general direction of Public Health of Catalonia, increased the possibility of reducing the number of doses required for a proper prophylaxis. Scientific research towards a vaccine for life ", a concept that, in the words of John Goiri," would significantly advance the health workforce of health professionals.

Some innovative practices workshops instruct medical residents about the physical examination of the locomotor system.

2009-02-14T07:17:00.002-08:00

● Residents of Orthopedic Surgery and Traumatology have had the opportunity to train in the physical form of current, complete and practical.
● The conference took place within the Congress of the Spanish Society of osteoporotic fractures

Under the Second Congress of the Spanish Society of osteoporotic fracture (SEFRAOS), which is taking place these days in Madrid, there have been some innovative practices Exploration Workshop Physics Locomotive. The purpose of these meetings has been to offer a comprehensive and detailed knowledge of the specific exercises necessary to address the problems of locomotion. As commented by Dr. Antonio Rios, Orthopedic Surgery Service, Hospital Virgen del Mar de Almería, who has been a teacher "It is essential for proper diagnosis of any problem locomotor conducting a thorough physical examination it. This is a test of a very high reliability and great tradition, to which is added a series of radiological tests in order to obtain an accurate diagnosis. "

At the conference, sponsored by Bayer Schering Pharma, residents have orthopedic surgery and traumatology in Spain. Professor Francisco Gomar has been in charge of coordinating the practices taught by specialists who have carried out spot tests for structured exploration location: shoulder, knee, spine, hip, hand, ankle-foot.

According to Dr. Rios' One day as we have given are of great importance for the learning of medical residents as it is rare to receive such training. " It added that "practices, in the framework of a national congress, are quite novel in Spain. But in the American Congress is very common and make small workshops, several hours' duration, which focus on a specific part of the locomotor system, and study from beginning to end everything associated with it. I trust that these meetings will be repeated next year in the Congress of the SEFRAOS to become a tradition. "

Roundtable on thromboembolic disease

Bayer Schering Pharma also sponsors of this Congress in a Roundtable on thromboembolic disease tomorrow.

During the meeting, national experts will address various aspects of thromboprophylaxis: the role of primary care, the use of catheters, new drugs, etc..

Referring to the issue of new drugs for the treatment of thromboembolic disease, the European Commission in September 2008 authorized the sale of Xarelto ® (rivaroxaban), a new anticoagulant, and fixed-dose oral administration once daily for preventing the formation of venous blood clots in patients undergoing elective surgery for total hip replacement and knee. Bayer Schering Pharma will market Xarelto ® in Spain shortly, a drug that has been launched in over 15 countries worldwide.

The marketing authorization by the European Union (EU), was received after the evaluation of data from the RECORD clinical program that included three Phase III studies conducted with rivaroxaban, involving nearly 10,000 patients undergoing elective surgery of replacing hip or knee (RECORD1, RECORD2 and RECORD3). The results of this program demonstrate the superior efficacy of rivaroxaban compared with enoxaparin in both tests (RECORD1 and RECORD3) as compared to the long pattern of rivaroxaban (5 weeks) compared to the standard short (2 weeks) enoxaparin (RECORD2). In all three studies, rivaroxaban showed a comparable safety profile, including a low incidence of bleeding similar.

Xarelto ® provides the comfort of administration in the hospital and home, as it does not require monitoring or dose adjustment. As an oral treatment, unlike conventional heparins are administered by injection, and low risk of interactions with other drugs, it makes has all the characteristics the ideal anticoagulant. Rivaroxaban offers superior performance, without an increased risk of bleeding.
The extensive program of clinical trials of the drug make it an oral anticoagulant, direct Factor Xa inhibitor, the world's most studied so far. It is expected that over 60,000 patients are included in the clinical development program for rivaroxaban, which will investigate the product for the prevention and treatment of a wide range of diseases, both acute and chronic, related to blood clotting. For example the treatment of venous thromboembolism (VTE), prevention of stroke in patients with atrial fibrillation, the prevention of VTE in medical patients in hospitals and secondary prevention of acute coronary syndrome.

The number of men affected by eating disorders.

2009-02-14T07:17:00.001-08:00

Currently 8-10% of patients are men, especially youth sports

The Eating Disorders (ED) are increasingly affecting a wide profile of patients. Currently ranging from 10 years young, older people who have symptoms of the disease swept over much of his life and is at maturity when manifested more clearly.

Anorexia, bulimia and other eating disorders are not exclusive to women. Although the ratio is still there and 9 out of 10 affected women, plus the ever increasing number of men. According to the experience of the Eating Disorders Institute (ITA) the number of men affected by these diseases has increased in recent years, reaching around 8-10% of the total. These figures may vary depending on the clinical picture and age, but in the case of the men remained in anorexia and bulimia this data is even more frequent.

In regard to age, number of patients is higher with fewer years. Thus, between groups of prepubertal between 11-13 years reach a 25-30% incidence of the disease, and 15-20% decrease in 13-14 years.

Eating disorders are also more frequently in certain groups who practice sports of effort such as gymnasts, jockeys, dancers, or skaters.

Changing profile of patients with TCA

In the 10 years history of ITA, 101 boys have passed constituting 5% of the total admitted to the hospital. Has been basically since 2005 that has begun to raise the incidence of these disorders in males and in the last year has led to double the number of patients treated at the Institute.

Eating Disorders in the male

In practice, the symptoms of eating disorders in males is very similar to that of women, but you can highlight the following aspects:
• Men with anorexia are more obsessed than women, with a tendency to intellectualise, perfectionism and rigidity.
• In men allegedly stealing more and more compulsive emotional stress.
• It is more often a history of overweight, both in patient and family, more somatic complaints, more and more psychiatric comorbidity disorders among family members of men
• An important aspect is related to hyperactivity. Has established the presence of hyper-inflated until exhaustion as a mechanism of weight control much more common in men.
• The environment of the ED is related to the cultures, the unbridled passion for fitness, concern for the body to develop muscles and shape the figure.
• love cooking for others, love to make huge and unnecessary purchases of food, collecting cookbooks, the composition of food, calories, forcing others to eat even without wishing to do so, because many hours in the kitchen, etc.
• It has linked the ED in men with sexual identity. Greater proportion of homosexuals. They were more dissatisfied with their shape and weight than heterosexuals and more concerned with the physical layout and appearance.
• "sexual alexithymia: difficulty to feel and express emotions or communicate their feelings on everything that relates to the sexual area.
• Regarding the precipitating stress is at a higher intensity and more.

About ITA

The Eating Disorders Institute (ITA) is a health care network founded in 1998 for treatment, training and investigation of disturbances in eating behavior. This is the main institution at the state level in private care for Eating Disorders (ED). The institution understands that the care of such disorders must encompass not only preventing disease and restoring health, but also the rehabilitation and reintegration into their environment.

ITA offers a variety of healthcare resources to achieve its objectives: inpatient facilities, day hospitals, outpatient and medical floors. This is the first center in Spain in terms of number of beds and patients.

In phase III studies have shown that raltegravir in combination achieved significant reductions in viral load during 96 weeks ..

2009-02-14T07:15:00.000-08:00

In phase III studies have shown that raltegravir in combination achieved significant reductions in viral load during 96 weeks in previously treated patients whose HIV was resistant to three classes of drugs.

In the phase III studies, BENCHMRK-1 and 2, the integrase inhibitor from Merck Sharp & Dohme (MSD) raltegravir in combination with an optimized base treatment (TBO) produced greater reductions in viral load compared to placebo for 96 more TBO weeks in previously treated patients whose HIV was resistant to three classes of drugs that were not responding to antiretroviral treatment. (Poster 571b).
These results together with data from other studies were presented Monday at the XVI Conference on Retroviruses and Opportunistic Infections (CROI) held in Montreal, Canada.
"As doctors continue using raltegravir in patients treated previously, data from longer term studies BENCHMRK-1 and 2 continues to inspire confidence among physicians when treating patients whose treatment cycle is more advanced," said Dr. Daniel S. Berger, assistant clinical professor, College of Medicine, University of Illinois at Chicago and medical director of Northstar Medical Center.
Raltegravir is indicated in combination with other antiretroviral agents for the treatment of infection with human immunodeficiency virus (HIV-1) in adult patients previously treated and who show signs of HIV-1 replication despite receiving antiretroviral therapy.
This indication is based on data on safety and efficacy trials of two double-blind, placebo-controlled 48 weeks' duration in patients treated previously.

Important safety information about raltegravir.
We need to warn patients that antiretroviral treatment can not cure HIV infection and that has not been shown to prevent HIV transmission to others through blood or sexual contact. Should continue to take appropriate precautions.

In HIV-infected patients with severe immunodeficiency at the time of the introduction of antiretroviral combination therapy (TARC) may be an inflammatory reaction to asymptomatic or residual opportunistic pathogens, which can cause severe clinical disorders or exacerbate symptoms. Usually, such reactions are observed in the first weeks or months after the start of the TARC. Some relevant examples are cytomegalovirus retinitis, mycobacterial infections, and generalized or focal pneumonia caused by Pneumocystis jiroveci (formerly known as Pneumocystis carinii). All symptoms should be evaluated inflammatory treatment should be initiated when necessary.

Demonstrated the persistence length and tolerability of raltegravir to week 96 in previously treated patients (BENCHMRK-1 and-2)
The results of the studies BENCHMRK 1 and 2 after 96 weeks showed that in 96 weeks, 57% of patients (262 of 460) treated with raltegravir achieved a more TBO undetectable viral load (less than 50 copies / ml ), compared with 26% of patients (62 of 237) treated with placebo plus TBO, p <0001. In addition, patients treated with the pattern with raltegravir experienced significantly higher increases of CD4 counts (123 células/mm3) than those treated with placebo and TBO (49 células/mm3) at week 96, p <0001.
In BENCHMRK studies, patients received 400 mg of raltegravir orally twice daily in combination with TBO (n = 462) of placebo or 400 mg orally in combination with TBO (n = 237). The data demonstrate that raltegravir plus TBO has an antiretroviral and immunological efficacy powerful and superior to that obtained with placebo over TBO. The reductions in viral load and immunological efficacy was maintained through week 96: 57% of patients treated with raltegravir more TBO had viral load below 50 copies / ml, up to 79% of patients treated with enfuvirtide darunavir and raltegravir with TBO in the viral load remained below 50 copies / ml. There were few withdrawals for adverse events: 4% of patients receiving raltegravir and TBO and 5% of those treated with placebo and TBO. The risk of malignancy was equivalent in the raltegravir groups and control.
Rates adjusted for exposure (per 100) of clinical adverse events related to the medication most common (frequency ≥ 2.0%, of any intensity) observed in patients treated with raltegravir and TBO and in patients treated with placebo and TBO were: headache (2.7 per 100 and 4.5 per 100), nausea (2.3 per 100 and 4.1 per 100), diarrhea (1.8 per 100 and 4.5 per 100) fatigue (1.8 per 100 and 0.7 per 100), abdominal distension (1.5 and 1.2 per 100 for 100), vomiting (0.8 per 100 and 1.9 per 100) and fever (0, 5 per 100 and 2.2 per 100), respectively.
The cancer rate in patients treated with raltegravir and TBO in studies BENCHMRK 1 and 2 was 3.0 per 100 and 2.6 per 100 in those treated with placebo and TBO, which represents a relative risk of 1 , 1 (0.5, 3.1). The rate of new AIDS-defining illnesses or recurring was 2.2 per 100 in the raltegravir group and 4.1 per 100 in the placebo group, representing a relative risk of 0.5 (0.2, 1 , 3).
Raltegravir is indicated in combination with other antiretroviral agents for the treatment of infection with human immunodeficiency virus (HIV 1) in adult patients previously treated and who show signs of HIV-1 replication despite receiving antiretroviral therapy.
This indication is based on data on safety and efficacy trials of two double-blind, placebo-controlled 48 weeks' duration in patients previously treated
The marketing of raltegravir was approved in Spain by the Spanish Ministry of Health in February 2008.

More important safety information about raltegravir.
Raltegravir should be used with caution when given concurrently with potent inducers of uridine diphosphate glucuronosiltransferasa (UGT) 1A1 (eg., Rifampin). Rifampicin reduces plasma concentrations of raltegravir; unknown impact on the efficacy of raltegravir. However, if coadministration with rifampin is inevitable, we can consider doubling the dose of raltegravir.
The safety assessment of raltegravir in patients previously treated is based on the pooled safety data from three randomized clinical trials. These studies used the recommended dose of 400 mg twice daily in combination with an optimized base treatment (TBO) in 507 patients, compared with those obtained in 282 patients who received placebo in combination with TBO. During the double blind treatment, the total period of follow-up was 504.1 patient-years in the group of raltegravir 400 mg twice a day and 202.5 patient-years in the placebo group.
In group 400 mg of raltegravir twice daily + TBO and the comparison group of TBO + placebo, adverse reactions reported most frequently (> 10% of patients in each group) of any degree of intensity and independently of causality were: diarrhea in 17.6% and 20.6%, nausea in 11.2% and 15.2% and headache in 10.1% and 12.4%, pyrexia in 6.3% and 11.0% of patients, respectively. In this pooled analysis, the rates of discontinuation for adverse events were 2.4% in patients receiving raltegravir TBO + and 2.8% in patients receiving placebo + TBO.
There have been reports of myopathy and rhabdomyolysis, but it ignores the relationship of raltegravir to these events. Use with caution in patients who have had in the past myopathy or rhabdomyolysis, or having any factor, including other pharmaceutical products associated with these diseases.

Other posters on raltegravir presented at the CROI
In addition to studies BENCHMRK 1 and 2 previously treated patients, were presented at CROI two other posters in that also evaluates the safety and efficacy of raltegravir. They are:
• A review of cancer incidence in clinical trials of raltegravir in patients previously treated and untreated, which until now have not observed differences in risk among HIV-infected patients treated with raltegravir and treaties with other antiretroviral (Poster 859) and
• A review of preliminary data from a prospective, open, non-randomized and dose determination currently on raltegravir TBO more in children and adolescents aged 6 to 18 years previously treated (IMPAACT P1066). These results will be presented by the National Institutes of Health.

Review of cancer incidence in clinical trials of raltegravir.
We reviewed the incidence of cancer, a well known complication of HIV infection, in five randomized clinical trials and double blind study of raltegravir in patients previously treated and untreated, and in an expanded access program in the open. In an analysis of pooled data from two Phase II studies (protocols 004 and 005) and three phase III studies (BENCHMRK-1, BENCHMRK-2 and STARTMRK) to monitor at least 48 weeks and 120 at most ( exposure to raltegravir than 1700) showed that during double-blind cancer rates were slightly lower in patients treated with raltegravir (rate 1.7 per 100, is a broad definition of cancer, including recurrences, cancers other than melanoma and carcinoma in situ) without reaching statistical significance compared to patients receiving antiretroviral comparison (rate 2.2 per 100, definition of cancer). This was a relative risk of 0.75 with a confidence interval of 0.40 to 1.46.
With an additional exposure to raltegravir approximately 600 double-blind phases, cancer rates remained similar (rate 2.1 per 100) to those observed in the double blind phase. In a context of expanded access, after a median follow up of 24 weeks in more than 5,400 patients (raltegravir exposure to more than 2,200), cancer rates were similar to those observed in clinical trials with raltegravir.
In protocol 004, raltegravir was administered at doses of 100 to 600 mg twice daily for 48 weeks and a maximum of 400 mg thereafter. In protocol 005, raltegravir was administered at doses of 200 to 600 mg twice daily for 24 weeks at least in part double-blind study, all patients received a dose of 400 mg in the open part of the test. In the analysis of the combination of studies in phases II and III involved 1039 patients who received raltegravir, was assigned a treatment compared to 605 patients, 173 of whom went on to receive raltegravir at the open stage. In all cases, raltegravir is used in combination with other antiretrovirals. Made public the details of at least 48 weeks in the phase III trial STARTMRK of 96 weeks in trials BENCHMRK 1 and BENCHMRK 2 and at least 120 weeks in Phase II (protocols 004 and 005). We included double-blind and open data.

About raltegravir
Raltegravir is the first drug approved for a new class of antiretrovirals called integrase inhibitors,. Raltegravir works by inhibiting the insertion of HIV-1 DNA into human DNA by the integrase enzyme. By preventing the integrase to perform its function, limiting the ability of the virus to multiply and infect other cells. It is currently used drugs that inhibit two other enzymes critical to the replication process of HIV protease and reverse transcriptase, but raltegravir is the only drug approved that inhibits integrase.
Raltegravir is in a single tablet of 400 mg administered twice daily, regardless of meals. Raltegravir does not require reinforcement with ritonavir.

Global approval of raltegravir
Since 2007, raltegravir was approved in over 50 countries worldwide for use in combination with other antiretroviral agents for the treatment of adult patients infected by HIV-1 and previously treated who show signs of HIV-1 replication despite receiving antiretroviral treatment. MSD continues to submit applications for approval in other countries.

Merck's research on HIV
MSD is committed to developing innovative treatments that involve advances in the treatment of infectious diseases, including HIV infection. MSD's efforts to develop experimental treatments for HIV and AIDS reach over 20 years and continues today.
Merck began its research on the integrase inhibitor for HIV in 1993 and was the first to demonstrate inhibition of HIV integrase in vitro and in vivo.
Raltegravir is part of MSD in the history of research on HIV, including the development of indinavir sulfate, a protease inhibitor and efavirenz, a reverse transcriptase inhibitor non-nucleoside, and ongoing research into other options treatment.

Worldwide prevalence of HIV infection and AIDS
It is estimated that in the world 33 million people infected with HIV and AIDS, 1 and that in 2007 there were approximately 2.7 million cases of AIDS contagio.1 is a major cause of mortality from infectious diseases All mundo1 in 2007 and was responsible for approximately two million deaths.

About MSD
Merck & Co. Inc., Whitehouse Station, NJ, USA, which operates in many countries as MSD (Merck Sharp & Dohme) is an international pharmaceutical company based on research whose primary concern are the patients. Founded in 1891, Merck currently discovers, develops, manufactures and markets vaccines and medicines to meet unmet medical needs. The company also devotes great efforts to improve access to medicines through far-reaching programs that not only donate Merck medicines but help to distribute them to people who need them. Furthermore, MSD publishes objective information on health nonprofit. For more information, visit www.merck.com. / Www.msd.es

Bibliography:
1. UNAIDS. 2008 Report on the global AIDS epidemic. Available at: http://www.unaids.org/en/KnowledgeCentre/HIVData/ GlobalReport/2008/2008_Global_report.asp. Accessed on January 30, 2009.

World giant merger in the pharmaceutical sector

2009-02-11T14:24:00.002-08:00

As one of the world's largest company and the New York Stock Exchange are registered to Pfizer, a leading pharmaceutical manufacturer, agreed to purchase Wyeth'i was 68 billion dollars. Board of Directors of both companies approved the agreement by Pfizer, Wyeth will pay for the dollar 50.19 per share.
This merger results in the health sector in the Pfizer world product diversity will become one of the highest company.
The owner of the new company will be based on calculations produced by the year 2012 came thanks to the diversity of drugs of any drug in the company's total revenue is expected to be over 10 per cent of the share.
In the statement on the subject, will gain power in the global scale thanks to the changing needs of the health sector Pfizer'ın in faster and more effective for the specified action will be.
The merger agreement through the consortium of banks, cash, stock exchange and debt financing for the purchase occurred in 22.5 billion dollars in commitments are made.

EU DRUG SECTOR RESEARCH REPORT Published COMPETITION-2008: FRONT drug is

2009-02-11T14:24:00.001-08:00

Preliminary report on competition in the sector araşitırması European Komisyonuilaç published. Not according to the report, such as competition in the sector. Especially for large companies to market drugs jenrik to avoid or to delay. Examples in the report between the years 2000-2007 in the 17 member countries over protection panet received the drugs. If the original company before tarafınadn generic 3 billion pound savings were not, or if geciktilmemiş can be calculated. Report on the patent strategy of firms conducting aggressive efforts to prevent the first describes the generic.
One of the most widely used method in the treacherous beam receiving patent (patent clustering). 1300 for a drug that a company can receive a separate patent. Other methods with the generic drug companies on every pretext to prosecute. Though 60% of cases for generic drug manufacturers to earn more than the average of the 3-year isede each case is considered better for the size of the emerging business.
We hope that at least the members of the national drug sanayiimizin valuable time to read the attached report and develop strategies accordingly. Em, as so far at this time that you "manually from the wedding feast" philosophy will wait until the egg comes to the door and then as always, will ağlaş ..

DRUG biggest rebellion

Revolt of the European Commission. Issues related to "drug report" issued the Commission, a big drug companies, cheap drugs to prevent entry into the European Union said. Therefore, loss of 3 billion euro tasaruf health sector. Rebellion of the European Commission, the EU countries access to cheap medicines to kolaylaştırısa, it is expected to make use of Turkey.

The report from the Commission, the big companies between the years 2000-2007 of this attitude of the community health services that can be done to save a loss of 3 billion that has explained why.

Commission to market the drug companies to prevent competitors in the legal initiatives that were added.

Pharmaceutical companies take measures in accordance with law, emphasized the development and research objectives is to protect the investment says.

European market entry of generic drug must

After the patent expired drugs for pharmaceutical companies producing cheaper versions of products into the European market are having trouble for a long time was expressed.

European Commission, the pharmaceutical manufacturers to enter the European market sometimes drugs cheaper to prevent a lot of overlap, have made application.

Commission at a time for a single drug, a full application for a patent in 1300 was done to this example.

700 cases

The European Commission's report, indicated that similar problems are experienced at the national level.

Approximately 700 patents related to open cases in the report that more than 200 brand name pharmaceutical companies in the main drug producing company to reach agreement was announced between.

More than 10 per cent of this agreement, the drug blocked the entrance to the market.

Global ilç printing sector

Unfair practices of the European Commission found that large penalties if drug companies could not be saved.

The Commission's report, has increased the pressure on the global pharmaceutical industry.

January 20 in the U.S. is prepared to take over the tasks of the new president Barack Obama'nın, the country is expected to work to reduce drug costs.

Patient medication, industry is waiting for blood

2009-02-11T14:20:00.000-08:00

Importing drugs into the black thoughts of immunoglobulin prices skyrocket to U.S. $ 1000 was U.S. $ 5 thousand. Pharmacists Room 'is working hard to overcome the problem takip'le

ISTANBUL - Turkey's large number of cancer patients for vital İmmunglobulin (blood product) containing drugs to the black after falling Trying to find an emergency solution. Istanbul Chamber of Pharmacists,
drug stores and importers with the protocol by making the company is trying to prevent black market.
'İmmunglobulin' group of drugs to Turkey's agenda for 21 months with down syndrome Khan's death came Demirci. The governing body's immune system Kağan serum immunoglobulin was supposed to take 21 days. However, the Ministry of Health's pharmaceutical companies and importers to reduce prices of medicines due to the Khan, and the medication had lost their lives in the month of June.
Premature babies, cancer patients, and neurological and immune system of patients given that vital for these patients' immunoglobulin 'difficulties are still. This type of drugs, is produced from human blood. Large amount of blood in small amounts can be removed and thus is valuable. Ministry of Health to reduce drug prices in Turkey 'immunoglobulin' trouble came to the agenda.

A global crisis of blood!
Produced in Turkey, but immunoglobulin and importance, the price of drugs has been reduced. Manufacturers, are more expensive when sold to Turkey for a while the country did not sell.
Error returned from, the price was held back. This time around the world
'immunoglobulin' had difficulties.
Drug production in many countries of the Red Cross for blood collector organization closed. In China have stopped production. Also in the collection of blood all over the world in recent years was in trouble. Price of drugs, due to increased scarcity. As a result in Turkey 'immunoglobulin' seven the number of imports from the three pharmaceutical companies fell. Thousands of people remained without medication.
These drugs for many years of sales expertise that Berk Pharmaceuticals consultant with Ozan Şener, "production difficulties have forced the first cause. Timing of blood and blood which is produced from drugs is running low. This way all over the world. How will the solution I do not know. Moreover, China's production does not make the market was shaken. This drugs being imported Hıfzıssıhha first samples will be reviewed by. This action on the long. sometimes for months waiting for answers. This brought the drugs to be delayed. We last 2 thousand units have brought drugs. all been exhausted. Right now we do not. new drugs to bring in Hıfzıssıhha We are waiting for samples to be given is, "he said.
In the meantime, a large number of patients waiting, some pharmacies drug, the drug stock is sold to five times more expensive. Name you want to open a drug store officer, "immunoglobulin medication, some pharmacies by more than five-fold under-the prices are sold. United Pharmacies near hospitals, before the stock and 1000 YTL olan
sell drugs to U.S. $ 5 thousand. Anchor and to do this work in Aksaray have too many pharmacies, "he spoke.

Come to the office, learning
Pharmacists Istanbul Chamber Chairman Zafer Kaplan some pharmacies, drug shortage in the abuse has been noted, "Drug store relations using will sell more than receive. These medicines stockpile, the difficulty begins to wait. Ilac does not exist, the secret to high prices they are sold. We that prohibit For drug stores and importing companies are working in cooperation. computer system how much medication is coming and where is not being saved. This medicine doctor with a prescription are sold. Prescription the field hospital in the office came to where the medication can learn. Eczacılar room signature without prescription medication is not. After that, drug stores, prescribing by seeing and controlling the use of the pharmacy will make the delivery. Also urgent is the need to take priority. Because these drugs, for a small disturbance can be given. There are currently few drugs we have. But I will run again and to experience difficulties, "he is talking.
Turkey with a population of 8 million in Austria are importing drugs. Turkey's why these drugs produce question Zafer Kaplan gives the following answer: "70 million people live in a country where we are. But we do not have tradition of giving blood. Actually, we generated from the blood of this drug can do and many people can save our lives."

"Cancer of the China Miracle" attention

2009-02-11T14:19:00.000-08:00

Swedish Karolinska Institute of Cell and Gene Therapy Center Coordinator Prof. Dr. Dilber Sirac, "Cancer of the China Miracle" is identified as a large number of drugs for treatment in Turkey and Europe are going to China by the patient, the patient was alert.

Dilber, based on the p53 gene in European and American pharmaceutical drugs to be sold in the market currently is not authorized by the agency said.

Dilber Sirac, "cancer miracle in China" launched as a drug, the body guards of the gene known as p53'u based and healthy cells in the p53 gene by adding a simple virus, the cancer cells are made by injection. This method has not been discovered in China and known for years that the phrase Dilber, drugs produced by this method, with many parts of the world created in laboratory conditions was point.

Almost identical to that shown as miracle drugs in the United States since 1994 by a company is subject to various research and clinical studies on head-neck cancer using language which has been begun Dilber, şöyle devam etti:

"This continues to be the company's Phase 3 clinical studies. The results of this clinical study full does not occur, and the head-neck cancer has an impact not conclude whether the European Medicines Agency (EMEA) and the U.S. Drug Agency (FDA) to be sold in the market is currently not allowed. "

CHINA MEDICINE CORPORATION PERMISSION of

America and Europe and in the ethics of drug control is very strict because of the many companies in the Far East countries, said the lead Dilber that in 2003, a researcher is a partner of the firm's China in Drug Authority (SFDA) of the drug only top-neck tumors to be used in the clinical record is used in the permit that was saved. Dilber, SFDA'nın also in 2004 that drug use in the head-neck tumors decided to sell the record in the market said.
Creation science circles that decision SFDA'nın söyleyen astonishment Dilber, especially in the case of commercial concerns about the medication has made many problematical. SFDA'nın decision after the company's drug of first gene therapy medicine as "that indicates market Dilber, then things are even more off the rails, Europe and America, many institutions and associations, companies like be on the scientific data has been announced. The company's international success of any therapeutic yayınlayamadığını on the magazine said the Dilber, thus further increasing their doubts about the drugs you are defending.

Dilber, 2005 are included in some statistical results, the Chinese researchers in an article that said information is not held each other and are determined some distortion of information, is published in a magazine reported.

WARNING in China for treatment

Chinese patients' treatment by the government to meet the demand for "drug effect is not certain" that has been rejected highlight Dilber, Turkey and Europe, some companies and people who abuse this business in China by various health organizations who want to understand every cancer patient for treatment was taken to China was recorded.

Head-neck in China, only licensed for tumors of the drug for a patient of the total price of 3 thousand 360 dollars that emphasize Dilber, but going to China, the cost of treatment for patients is about 50 thousand - 60 thousand dollars has been mentioned as a defense of the patient was alert.

Dilber, not yet completed studies of medicine, resulting in children with growth disorders may cause added words.

Traditional Chinese pharmaceuticals

2009-02-11T14:16:00.000-08:00

Traditional Chinese medications, traditional Chinese medicine to prevent the disease, the medications used to treatment and examination. Medications resources, materials obtained from nature are being processed. Between plant, animal, mineral, chemical and biological agents are available. In China using traditional Chinese ilâçlarının found and has a history of thousands of years.
China on "the doctor one day taste the more than 100 plants, 70 kinds are poisonous," he is popular. The nature of this question and the disease of old people to fight, medications and experience to find the means to win the arduous effort.

Xia, Shang and Zhou dynasties (on 256 years before Christ until the end of the 22nd century), were made in China ilâçlı drinks and douche. Hanedan Xizhou (approx. B.C-771 in the 11th century), published in the period of "Shijing" a poetry collection named until now, the recipes are the oldest medicines. There are currently the oldest known book of Chinese medicine theory, the "Neijing", the traditional theories put forward a series, the basic theory of traditional Chinese pharmaceutical creates.

So far, the most ancient pharmaceutical book, the "Shennong Bencaojing" a book about herbal ilâçlarla, Qin and Han dynasties between the period (220 years before Christ and 221-MS) by several medical experts in response to a summary of the information collected was written. This book is still in use today are 365 kinds of medicines.

In Tang dynasty (618-1644) to develop the economy, has enabled the development of the traditional Chinese pharmacy. Tang management, first world, "Tang Bencao" recognized under the name of a book on herbal ilâçlara editing work was completed. All books and pictures were collected in 850 varieties of herbal medicines has been described.

The Ming dynasty (1368-1644) until the Chinese pharmacist Li Shizhen, the 27-year study, the work of famous traditional Chinese pharmacy "Bencao Gangmu" he completed yu. Entire book to describe the thousand and 892 kinds of herbal medicines that, in the history of China's pharmaceutical plant was the largest collection of herbal medicines.

After the establishment of the People's Republic of China in 1961 "in terms of Traditional Chinese Medicines" was released on his work. Was released in 1977 in "Encyclopedia of Traditional Chinese Medicines" section 5 thousand 767 registered varieties of traditional Chinese ilâçlarının number reached. Traditional Chinese ilâçlarını researching, producing and teaches the traditional Chinese pharmaceutical companies were founded after ardı.

Herbal medicines item collection, production of traditional Chinese ilâçlarının is a very important public. Chinese pharmacists, various medications should hammaddesinin collected in different seasons to highlight. The elements contained in various stages produce herbal medications and the amounts are different, the treatment results and side effects of medications is not the same. Therefore, timely collection of herbal medications, drugs to increase the positive results in treatment and may help reduce side effects. Generally, plants, branches and leaves and flowers profusely that is collected at the time of the first open. Flowers in drug substance, should be collected before the flowers open. Fruit and vegetable seed materials used in medicines, usually collected after the fruit is the mature. Of plant roots and used gövdesininin drug substances, generally at the end of autumn or spring is collected. Collected material is used after it is processed. Processing methods to choose between, slice, boil, bake, to cook in steam, water to cook, to yeast, germinate, is to purge and distillation.

Theory and practical experience of traditional Chinese pharmacy, shows the characteristics of traditional Chinese culture. Majority taken from nature and side effects of traditional Chinese ilâçlarının poison is very small. Has many elements in a kind of drug for the treatment of many diseases is. Usually, a few traditional Chinese medicine combined with different rates are used. The appropriate rate is mixed according to the traditional Chinese medications, and treatment of complex diseases, and medications to increase impact and ensure zehirinin reduced.

The use of traditional Chinese medicine, traditional Chinese medicine theory, the drugs created in the human body is carried out based on the treatment results. Traditional Chinese ilâçlarının treatment effect, are caused by the properties of drugs.