Rheumatoid arthritis is a disease almost unknown despite more than 200,000 people have it in Spain.

According to the study psychosocial Living with Rheumatoid Arthritis promoted by ConArtritis


● A large percentage of society does not know what the main symptoms of Rheumatoid Arthritis (RA). In fact, 83% of patients interviewed did not know what the AR at the time of diagnosis

● Over the past years has reduced the time between the onset of symptoms and definitive diagnosis of RA. Still, it remains vital to conduct an early diagnosis to begin treatment as soon as possible with the right drug.

● RA is a highly disabling disease, pain, fatigue and loss of functionality aspects are more negatively affect the quality of life of patients with rheumatoid arthritis.

● RA affects significantly to the personal and family life and work of the patient

● Thanks to the biological drugs, and better ways of monitoring a large number of patients could have better control of symptoms and even these treatments have succeeded in stopping the progression, leading to a large increase in the quality of life people with RA.


A modified release and a cross and patients living with Rheumatoid Arthritis (RA) the time at which it transmits the rheumatologist diagnosis of disease sufferers. A release because finally know the cause of the symptoms have been gradually limiting his daily activities and a cross because they face a chronic, disabling disease, which erode substantially undermined their welfare and quality of life.

This is one of the results of Living with Rheumatoid Arthritis study sponsored by the National Coordinator of Arthritis (ConArtritis), which launched this morning and approached from a psychological point of view how patients live their different stages of disease and how they deal with an ailment that, in 77% of cases considered unknown to society. In fact, 83% of patients interviewed did not know what the AR at the time of diagnosis.

And is that although a high percentage of society ignores the implications of this disease exist in Spain more than 200,000 people affected by RA, which represents a prevalence of 0.5% (1). This disease has become also the most common cause of potentially reversible disability in the Western world.


The study, which has enjoyed the cooperation of Roche and has been found useful for rheumatic patients by the Spanish Society of Rheumatology (SER), which usually reveals the diagnosis of RA is a long time, starting normally the primary care physician, and is sometimes associated with a pilgrimage to various medical specialties until finally the patient arrives at the reference specialist, rheumatologist, who is establishing the accurate diagnosis of RA.

But fortunately there is a positive development: The delay to diagnosis was shorter in patients who participated in the study with a newly diagnosed RA than in those diagnosed over 10 years.

Quite contrary to widespread belief that RA is a disease of older people, the first symptoms of RA may manifest after age 25, when the person is fully productive age. So 62% of patients in the study are aged between 26 and 55. I began to suffer the first symptoms before the age of 30 years. My youth and the little information that had caused disease which never thought of it could be Rheumatoid Arthritis, says Laly Warden, executive secretary of ConArtritis.


Assuming the disease

Once the diagnosis, there are two words that resonate in the minds of patients: chronic and limiting. Both words ultimately translate into one: disabling.

Receiving the news of getting this type of disease, with which we must live our entire lives and we have to go tailoring is a great emotional impact, explains Antonio Torralba, ConArtritis president.
The patient initiates a process of internalization of the disease, although 88% of respondents acknowledged having accepted, 67% of them said that his character changed as a result of RA, and 32% which was diagnosed following considered a more serious person or sad.

However, over time, as the patient manages more information, the situation usually improves.

The attitude of a person against disease is vital. Face life with optimism and confidence in the future is undoubtedly what makes the difference between these patients and others, Laly says Warden.


The work and personal impact of RA in daily

After diagnosis and acceptance of the disease, the patient must face the hardest part: the day to day. Dressing, grooming, household tasks or hold certain jobs may become an insurmountable obstacle for people affected by AR, since the joint deterioration makes even the simplest tasks become milestones with considerable complications.

According to Antonio Torralba, quality of life of RA patients is severely impaired. In 65% of cases pain is the most affecting aspect of the study participants, followed by fatigue reported by 62%, and loss of function in 60% of cases.

For this reason, many people are forced to abandon or redefine countless small tasks before illness smoothly. This affects the working environment very obvious where the patient faces a total inability to 35% of cases, frequent medial and sometimes impossibility to continue performing the same functions.

At impact on the working environment would add, moreover, those that occur on a personal level. Thus, according incorporates the study, RA patients are subjected to psychological disturbances, major changes in family function-they go from being caregivers to be cared for, and major adjustments in terms of their partnership. And is that 35% of patients have a degree of disability above 65%.


The hope of new treatments

Treatment with biologic agents has led to many patients a major step in increasing their quality of life. These new drugs may have gotten a better control of symptoms of the disease, and in many cases have managed to halt its progression, leading to the possibility of recovering part of normal daily activities.

However, according to data published in Rheumatoid Arthritis Study: burden of disease and patient access to treatment (2), in 2000 only 8% of patients with RA in our country was treated with biologic agents.

In this regard, Dr. Rosario García de Vicuña, president of the Spanish Society of Rheumatology (SER), states that the diagnosis and early treatment slow the progression of the disease and slow down deterioration of the joint, and thereby achieves a decrease in its impact on the patient, as well as days lost due to disability.

He adds, biological treatments and new patterns of onset and follow our expectations have changed because we have shown that it can have an activity of the disease from zero, while previously we were satisfied with the patient often be maintained at 3 or 5, in a hypothetical scale of zero to ten.

With regard to patients' trust in their doctor reference, the rheumatologist, the chair of the SER highlights the results of the study, which states that a patient's basic needs is to feel heard, and 86.4 % of participants said that it succeeds. Moreover, according to this research, patients believe that the rheumatologist, who knows the disease as a resource and not as patient or family concerned is that which can tell you about their situation, both in relation to disease progression, as the treatment to follow.

Antonio Torralba, ConArtritis president, notes, meanwhile, that patients who belong to associations are more informed about the disease and possible treatments. These people have a clearer perception of the progress occurring in research, particularly in the area of biological therapies, he says.

While I believe that every patient should be treated with medication that best fits your needs, personally I must say that the possibility of resorting to new and different therapies is something that calms me, Laly says Warden.

Overall, the relationship between the RA patient and rheumatologist is usually very small, establishing between them a close and trusting relationship.


About RA

Rheumatoid arthritis is an autoimmune disease, chronic and deforming characterized by inflammation of the membrane around the joints. This inflammation causes pain, stiffness and swelling, which can lead to irreversible destruction of the joints.

The condition is highly disabling and affects young adults aged 25 to 55 years.

In our country there are 200,000 people suffering from this disease and its prevalence is 0.5 percent.


About ConArtritis

The National Coordinator of Arthritis (ConArtritis) is a non-profit association which brings together 15 associations of RA patients in Spain.

Since its founding in 2004, ConArtritis focuses its efforts on providing both information and support to people suffering from this disease as well as in disseminating their ideas, needs and opinions.

Electronic commerce in health institutions Bionexo

Electronic commerce in health institutions grew by 28% during 2008, reaching 318 million in transactions through the platform Bionexo.

In Spain, Bionexo has become the e-commerce platform for the healthcare industry leader with over 420 suppliers nationwide.

Between Brazil, Argentina and Spain, last year 96 new hospitals were added to generate the largest online community of the healthcare industry with over 350 healthcare institutions.

According to data taken from the latest report from the Telecommunications Market Commission (CMT), Spain ranks 15th worldwide in Internet usage as a means of purchase, thanks to the growth of electronic commerce 40% compared to 2007.

E-commerce in the health sector

According to Dr. Julio Villalobos Hidalgo, academic director of the Health Area of the UOC, "The Spanish health sector because of their complexity, idiosyncrasy and perhaps by its inertia, it took longer than other sectors to incorporate more enterprising technologies information.

Although the volume of business e-commerce in the health sector still lags behind other sectors of the economy, the introduction of electronic procurement systems is an irreversible fact. In the current environment of economic slowdown is essential for health institutions to seek strategies to control costs without losing the quality of their services.

More than 318 million transactions on Medical Devices

With regard to electronic transactions carried out in 2008 via platform Bionexo moved 318 million in the purchase of health products (consumables and drugs) and non-health (cleaning materials, catering, office and textiles), surpassing 28% of 248 million last year.

Bionexo, the largest online community

Juan Pablo Villalobos, director of operations Bionexo Iberian states that "The number of hospitals and other health agencies that have joined the platform Bionexo during 2008 was of 96 institutions, creating the biggest virtual community of institutions and healthcare providers with a network of 362 hospitals, clinics and health operators in Brazil, Argentina and Spain. "

The operation of this tool offers a better health institutions and greater access to providers of medical devices. "Electronic purchasing through Bionexo hospital would open new business opportunities as they break geographical barriers and allows healthcare facilities to interact with a wide network of suppliers in the process of supply and demand, thus promoting an optimization management of purchases.

Expanding and opening soon in Mexico

Bionexo continue its international expansion project this coming to Colombia and Mexico in April, hoping to land in July 2009. For this exercise also plans to begin operations in Portugal.

Juan Pablo Villalobos, Director of Operations Bionexo Iberian

Juan Pablo Villalobos is Director of Operations in Spain and Bionexo member of the International Implementation Bionexo.

Degree in Marketing from the Universidad Panamericana and having led projects to market research and consulting in marketing and communication in Latin America with special emphasis on the health sector and new technologies, Juan Pablo Villalobos joins Bionexo expansion project, directing its presence in Spain.

BIONEXO

Bionexo is the largest e-commerce platform for the healthcare industry in Latin America is now venturing into the European market.
It offers a solution for rapid implementation of electronic procurement for the healthcare industry, becoming fully transparent and dynamic tool for suppliers and buyers of medical devices.
Bionexo born in 2000 as an initiative of Banco Santander in Latin America. In 2002 the company was acquired by a group of private investors.

New call for Jesus Galan prizes for best academic.

The Colleges of Physicians should propose their candidates among those orphans who have completed medical best academic or engineering bachelor's degree or higher studies in Medicine.

The Orphan Foundation Medical Board Prince of Asturias has called a new edition of the awards Jesus Galan. The awards, which were established in memory of the doctor acting as Vice Chairman of Board of Orphan Medical, are endowed with 5,000 euros for the orphan doctor who has completed his engineering degree or higher in 2007-2008 and have justified obtained the highest scores among all applicants.



Second prize is granted equally endowed with 3,500 euros, the best record in the studies of orphan medicine doctor who has also finished his career in 2007-2008. Both awards will be given to who in the opinion of the Board of Trustees deserve it, unable to lie both in the same person.



The candidate must be nominated by the College of Physicians and corresponding applications should be directed to the Foundation (Plaza de las Cortes, 11, Madrid) include appropriate official certification of studies by 31 July.



The Orphan Foundation Medical Board Prince of Asturias is an organ of collective solidarity with medical folks in need, as well as collegiate children of deceased who need help. Currently assists over 3,000 people: orphans of medical student age or older orphans, medical patients or pensioners, and widows of the Association.

Sports Traumatology.

Trauma and experts involved in the sport in all of Spain will meet in Valencia to celebrate the 22 Days of Sports Traumatology, which will take place on 15 and 16 May at the Port Authority of Valencia.


This meeting, which will involve around 200 professionals, is led by Dr. Carlos Sanchez Marchori, president of the Spanish Society of Sports Traumatology (SETRADE), Dr. Francisco Gomar Sancho, professor at the University of Valencia, organized by the Valencia Port Authority.


The days will consist of workshops and panel-discussion, so that they become a suitable framework for discussion to share methodologies of work between professionals and learn the most advanced treatments in relation to injuries from the sport.


The theme chosen this year is the Trauma Practice in the sport because some days are eminently practical, as explained Dr. Sanchez Marchori, is oriented toward a different course and novel in its entirety, because it consists only internship and round tables, so we change the format of the workshop according to market demand.
The workshops are intended for residents of different specialties and physiotherapists, will be held in three rooms simultaneously, and will deal with external fixators, arthroscopic knee and shoulder periarticular infiltration and other application techniques, functional bandages neuromsuculares, musculoskeletal ultrasound, local anesthesia ultrasound-guided exploration and functional anatomy and palpation.


The workshops are also open to participation so that attendees can present their work and research in oral form until May 4.

A surgical simulator for learning to operate.

Like the pilots, surgeons now have simulators to learn surgical practices.

To err is not synonymous with experience, says a popular proverb, and it becomes particularly important when learning to surgery. Historically, surgeons looking acquired skills, copying and operated patients, but this technique begins to be replaced with the virtual simulation. There is a tendency in the world to complement the tutored learning of residents with tools and technology to simulate real situations, so as to reduce the learning curve. There is already talk of a new paradigm in medical education, says Dr. Fernando Iudica, deputy chief of General Surgery Department, Hospital Universitario Austral.

The Service is testing a simulator donated by Johnson & Johnson Medical to teach laparoscopic procedures. With it you can practice from basic maneuvers to complete surgical practices such as cholecystectomies, colectomies, eventroplastias, gastric bypass, among others.

It's amazing, says Dr. Peter Valdez, a resident of surgery. On the screen in front of the machine which has seen an image of the gallbladder is very similar to that obtained during laparoscopic surgery in the operating room, and a variety of instruments that the resident moves and changes. Is playing with a sensor parts you want to remove the gallbladder as if it were a real body: The simulator reproduces a tactile feel, creates a resistance as if the same tissue. Feel when grasp the needle, when you pass the point badly.

One of the advantages of learning virtually, according to Dr. Valdez, is that it gives the possibility to see how situations would be resolved in the operating room during surgery, implement solutions and evaluate results, and do it as often as you like. Moreover, simulation training has the benefits of improving patient safety, decrease medical education costs and optimize the use of operating rooms.

Each physician that uses the simulator has a user and the computer stores all the actions it performs. It tells you how long it takes, voluntary and involuntary movements that did, the successes, risk situations, allowing the evaluation of the resident instructor and suggesting improvements. Then the system shows a ranking of all persons who entered the simulator to compare the data with other residents the same service, other specialties or other hospitals, says Dr. Gabriel Menaldi, chief resident of Surgery.

The Austral is directed toward developing an educational simulated in Medicine, which opens the door to one of the ways to acquire more advanced technical skills, says Dr. Iudica, who was at the Simulation Center Hospital University of Washington, one of the pioneers in the United States in developing this new form of medical education, with its director, Prof. Carlos Pellegrini.

He added that the simulation is applied not only surgery but also in other situations of everyday medical practice, with other instruments, inanimate models or dolls that are used, for example, in nursing education placement of roads, intubation of the airway auscultation and probes. In obstetrics, these same dolls obstetric maneuvers used to learn in childbirth, and caring for the baby and mother.

The sweat test is the key to detecting a genetic disease prevalent.

The salty kiss of the disease


Fibrocystic disease of the pancreas may go unnoticed and cause havoc in the body. The test that diagnosed in time.

Salt in the sweat, the skin and salt right out of the sea, may indicate one of the most common genetic problems and serious white: fibrocystic disease of the pancreas.

"It's the genetic disease, inherited autosomal recessive most frequent in whites," says Dr. Omar Pivetta, medical geneticist, adding that the cause is a mutation of the CFTR gene, which is involved in the production of sweat, gastric juice and mucus. In general, results in the formation and accumulation of a thick, sticky mucus in the lungs, intestines, pancreas and liver in particular. Difficulty breathing is the most common symptom, "by causing chronic lung infection in most cases," says the specialist.

The incidence in Argentina is higher than the average in Latin America: 1 in 30 healthy people are carriers of genetic mutation. This is because "the constitution of our population, predominantly Caucasian," says Dr. Pivetta. Its early diagnosis is crucial, as "70% of children who receive no care die before reaching the year while, with treatment that exist today, 50% live more than 46 years," according geneticist.

In the detection plays a central role of the typical symptoms of the disease fibroquísitca: large concentrations of salt in sweat and through the skin, which is why it is known as the "kissing disease salty." From this observation was invented sweat proof, as indispensable as absent.

Measure the excess salt

There are several methods for detecting fibrocystic disease, the first of which is binding for some years is the examination of newborn screening. It draws a drop of blood from newborn heel at all levels and there is a pancreatic enzyme, trypsin immuno-reactive. But this test is not sufficient to confirm the diagnosis, and here comes in the "sweat test".

The test takes about 40 minutes and shows the concentration of salt that removes abnormal body sweating. Is prescribed for children who had a positive neonatal screening, or for any child or adult with suspected symptoms.

Despite the effectiveness of this study, Dr. Pivetta laments that "in few places is done correctly." "In Buenos Aires, for example, no more than three sites do so reliably, and the country's total is less than 10 sites. The key is to be done, and we do well here, "he says.

How is after a diagnosis of fibrocystic disease? The doctor explained that treatment was "symptomatic and life": "In summer it is more water and more salt to the patient, because it has more risk of heat stroke and dehydration. And to address pulmonary infection, apply sprays and kinesitherapy to release the mucus.

Emphasizes the importance of identifying the problem in time to avoid "medical errors, lost time and increased lung damage."

Symptoms

Excessively salty sweat.
Retardation in growth.
Difficulty gaining weight.
Abundant and oily diarrhea.
Persistent respiratory infections.
Chronic cough.
Male sterility.


* Source: FIPAN (Asociación Argentina de Combat fibrocystic disease of the pancreas)

300,000 Bizkaian will benefit from the new service appointment reminders by SMS Hospital Galdakao-using it.

- The mechanism to remind patients, with 72 hours in advance of the appointment

- The new program not only andalusia Hospital Galdakao - Usansolo but extends to the five outpatient Durango, Llodio, Gernika, Basauri Galdakao and operating in its area of influence

- The user can cancel your appointment to receive the message

- Nearly 300,000 people will benefit from this new service.

What day, what time and where I have quoted. The three most common uncertainties quoted are for a patient response to the new service appointment reminders by SMS activated at the Hospital of Galdakao - Usansolo starting next Monday, December 15, 2009. Three days prior to referral to the specialist, the hospital sent the patient a message to your mobile phone which shows the date, time and expertise for which he is quoted.

The service, which during the first quarter of 2009 also put the warning voice messages through the phone, aims to improve care in the hospital, speeding up the procedures for managing schedules and reduce failure rates to the event that some services may reach fourteen percent, says Begoña Segurola, deputy director of Organization and Systems Hospital Galdakao - Usansolo.

The service has a significant field. Not for nothing is not limited exclusively to the health center said, but extends to the five outpatient Durango, Llodio, Gernika, Basauri Galdakao and operating in its area of influence. The content of the message will specify the name of the center that the patient has to go.

It is a capital case, given that the catchment area of Hospital Galdakao includes a population of 300,000, a figure similar to the number of annual appointments made by the Hospital Galdakao - Usansolo and five clinics in addition to this initiative . The system aims to provide an interactive way, the user can cancel the appointment, which will allow another patient to use that quote, by a reply message (the estimated price of 0.15 euros) and the system itself has a safety mechanism that repeats the sending of SMS, 48 hours before the appointment, if it detects that the first consignment has not been opened on the mobile phone receiver.

In the event that a user wants to dispense with this service must apply via the Patient Care Hospital.