hiperglicemia

---------- Mensaje reenviado ----------
De: Máximo Cuadros <maximocuadros@yahoo.es>
Fecha: 20 de marzo de 2010 03:55
Asunto: [interno_residente_medico_PERU] hiperglicemia
Para: interno_residente_medico_PERU@yahoogroups.com

 

Tratamiento de la hiperglucemia en el hospital

Med Clin (Barc). 2009;132:465-75
pulse sobre visualizar documento 

 

Atte.
MÁXIMO CUADROS

http://es.groups.yahoo.com/group/interno_residente_medico_PERU/

UNYK: 245 HRP

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medicamentos caros

Los medicamentos más caros del mundo aparecen en Forbes
Costo. La lista incluye precios de hasta $us 409.500 para cada paciente

El universal. México
Cuando la gente se refiere a medicinas caras, normalmente se refiere a aquéllas como Lipitor, que controla el colesterol ($us 1.500 al año), Zyprexa, para esquizofrenia ($us 7.000 al año) o Avastin, para combatir el cáncer ($us 50.000 al año).
Pero ninguna de estas medicinas supera las consideradas más caras, de acuerdo con un artículo de "Forbes".
Los medicamentos de la lista estiman costos cercanos a los $us 200.000 al año, en promedio, por cada paciente que se somete a un tratamiento con ellos.

La mayoría de los pacientes se trata con estos fármacos por enfermedades genéticas raras, las que afectan a menos de 10.000 personas. Así que prácticamente, las compañías puede cobrarlas al precio que ellas deseen.

La farmacéutica Alexion, con su medicamento Soliris, proporciona el medicamento más caro del mundo, que cuesta $us 409.500 al año. Este anticuerpo monoclonal trata un trastorno en el cual el sistema inmune destruye los glóbulos rojos por la noche.

El trastorno, hemoglobinuria paroxysymal nocturna (PNH por sus siglas en inglés), afecta a 8.000 estadounidenses. El año pasado, las ventas de Soliris fueron de $us 295 millones. Desde que Alexion comenzó a vender Soliris, hace dos años, el precio de sus acciones en bolsa subieron un 130%.

En el mundo actual, con los precios de estos medicamentos, entre menos pacientes, más altos serán los costos.
Otro caso lo brinda la Farmacéutica Shire con su medicamento Elaprase, que cuesta $us 375.000 al año y trata un raro trastorno metabólico que se llama Síndrome de Hunter.

Apenas 500 estadounidenses sufren esta enfermedad, la cual causa infecciones, problemas de respiración y daño cerebral. El año pasado, las ventas nacionales de Elaprase se ubicaron en $us 353 millones.

El medicamento Naglazyme, de la Farmacéutica BioMarin, se emplea en tratamientos de otro raro padecimiento metabólico y cuesta $us 365.000 al año, de acuerdo con el banco de inversiones Robert W. Baird.

ViroPharma, por su parte, predijo que las ventas de su producto Cinryze, un tratamiento para evitar una peligrosa hinchazón de la cara, aumentará de $us 95 millones del año pasado a $us 350 millones durante varios años a partir de ahora. El medicamento cuesta cerca de $us 350.000 al año.
 
  La receta  
- Soliris. Producido por Alexion, cuesta $us 409.500. Es un anticuerpo que trata un trastorno nocturno en el que los glóbulos rojos mueren. En EEUU Sólo 8.000 personas padecen la enfermedad.

- Elaprase. Producido por Shire, su valor asciende a $us 375.000. Se produce para 500 pacientes en EEUU que sufren del Síndrome de Hunter.

- Naglazyme. Surge del laboratorio BioMarin, cuesta $us 365.000 para combatir trastornos del metabolismo.

- Cinryze. Es elaborado por ViroPharma y llega a costar $us 350.000 en un tratamiento de un año completo.
Otros. Avastin (de Roche), Zyprexa (de Eli Lilly) y Lipitor (de Pzifer) forman parte del grupo de medicamentos caros pero que no superan los $us 50.000 al año
 
ESTE LINK
El COF de Madrid quiere fuera de la farmacia los medicamentos ...

 
 
MÚSICOTERAPIA
DUEÑO DE NADA

acido urico factor de riesgo

El  acido urico es un factor de riesgo coronario y vascular

Un estudio de cohortes m uestra que m jeres con GOTA tienen un riesgo del 40% de tener un infarto de miocardio en los ss 7 anos. La magnitud de la asociacion es mas fuerte que en hombres. Esto es importante desde varios puntos de vista. Por ejemplo he notado que muchos medicos usan coxis 2 para manejar crisis de gota y sabemos que los coxis 2 aumentan tambien el riesgo de infarto en personas de alto riesgo aun usados por pocos dias. Hace poco tuve la oportunidad de observar un hombre de 38 anos que tuvo un infarto y habia sido medicado con un coxis2  en dosis mas altas que las recomendadas por pocos dias. El acido urico suele ser mas alto en hombres que en mujeres pero en estas suele elevarse despues de la menopausia. El acido urico que se deposita en articulaciones y tejidos periarticulares. El acido urico tiene efectos sobre la proliferacion de celulas musculares vasculares y sobre la infalamacion y asi como sobre la agregacion y adhesividad plaquetaria.

Fwd: [interno_residente_medico_PERU] Necesito Articulos "miocardiopatia diabetica" - actualizados [Archivo adjunto 1]

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2413069&tool=pmcen
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2413069&blobtype=pdf&tool=pmcentreztrez
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2782307&tool=pmcentrez

---------- Mensaje reenviado ----------
De: Carlos Manuel Del Aguila Villar <caguilav@hotmail.com>
Fecha: 7 de febrero de 2010 20:45
Asunto: RE: [interno_residente_medico_PERU] Necesito Articulos "miocardiopatia diabetica" - actualizados [Archivo adjunto 1]
Para: Interno-residente-medico <interno_residente_medico_peru@yahoogroups.com>

 

[Más abajo se incluyen archivos adjuntos de Carlos Manuel Del Aguila Villar]

Ojala sea de utilidad....saludos

Dr. Carlos Manuel Del Aguila Villar

Servicio de Endocrinología del Instituto Nacional de Salud del Niño-Lima Perú

Magister en Nutrición

http://profesordelaguila.blogspot.com/

 

 

 

 

---

To: maximocuadros@yahoo.es; interno_residente_medico_peru@yahoogroups.com
From: melvin_ma67@hotmail.com
Date: Sun, 7 Feb 2010 21:36:43 +0000
Subject: [interno_residente_medico_PERU] Necesito Articulos "miocardiopatia diabetica" - actualizados

 

Hola buenas tardes grupo, soy interno de medicina, jeje un favor necesito articulos acerca de miocardiopatia diabetica, las mas actualizadas posibles, se lo agradecere bastante pues. miles de gracias anticipadamente.
 
Melvin Frank Girón Cornelio 

---

Sobre autismo, mas

http://peru21.pe/noticia/408607/estudian-pildora-que-ayudaria-atender-problemas-aprendizaje

la no costosa Niacina es mejor que Ezetimibe(zetia)

estimado CEAI SVARONUS

no hemos analizado nuestra data todavia sin embargo hemos hecho todo lo que aconsejas e igual la tolerabilidad es pobre asi como la aceptacion.

Hablo de peruvians

2009/11/23 C.E.A.I. <svaronus2008@yahoo.com>

 

SEGUN QUE ESTUDIO?   En general este medicamento tiene unos efectos adversos un tanto singulares pero NO matan a nadie. la mayoria y los mas frequentes si los administras correctamente son benignos. si le das aspirina o ibuprofeno media hora antes de que las tomen el picor o el flushing en la cara disminuyen ( es mas esos duran que 15 a 30 minutos no mas). y se recomienda que lso des con leche o alimentos tambien en la noche.   the best thing. INEXPENSIVE and it works!. if you choose the extended release formulations youll pay more.   You will remember a little of what you hear, some of what you read, considerably more of what you see but almost all of what you understand --- On Mon, 11/23/09, Claudio Mori gonzales <clagui57@gmail.com> wrote: From: Claudio Mori gonzales <clagui57@gmail.com> Subject: Re: [SALUD_LORETO] la no costosa Niacina es mejor que Ezetimibe(zetia) To: "interno_residente_medico_PERU" <interno_residente_medico_PERU@yahoogroups.com> Date: Monday, November 23, 2009, 12:48 PM   niacina mejor que ezetimibe sin embargo los peruanos no la toleran bien   This copy is for your personal, noncommercial use only. You can order presentation- ready copies for distribution to your colleagues, clients or customers here or use the "Reprints" tool that appears next to any article. Visit www.nytreprints. com for samples and additional information. Order a reprint of this article now. November 16, 2009 Study Raises Questions About Cholesterol Drug's Benefit By NATASHA SINGER ORLANDO, Fla. — For patients taking a statin to control high cholesterol, adding an old standby drug, niacin, was superior in reducing buildup in the carotid artery to adding Zetia, a newer drug that reduces bad cholesterol, according to a new study. The results of the study, published in The New England Journal of Medicine, were presented here Sunday night at an annual meeting of the American Heart Association. The study has been a polarizing topic here and has also attracted the attention of a powerful senator who has been investigating the conduct of two drug makers, Merck and Schering-Plough, in relation to their sales and marketing of Zetia and a combination cholesterol drug, Vytorin, which includes Zetia. The drug makers merged this month. The small study, with only 208 patients, has attracted outsize attention because the researchers did a head-to-head comparison of niacin and Zetia, which has been heavily marketed. The Food and Drug Administration approved Zetia in 2002 to lower bad cholesterol, a risk factor for heart disease. But the drug has not yet proved to have a longer-term clinical benefit in reducing heart attacks and deaths. Merck, the maker of the drug, is conducting a clinical trial on that issue involving up to 18,000 patients. Statins like Lipitor have proved in studies to significantly lower the risk of heart attack. Some cardiologists here hailed the study as an indication that the popularity of Zetia and Vytorin, which had combined sales last year of about $4.6 billion, has far outstripped their evidence of a concrete benefit on heart health. Other doctors here dismissed the study because it did not directly measure the drugs' effects on reducing heart attacks. Nevertheless, this study has the potential to make big waves in the use of cholesterol drugs. "It will certainly strengthen the idea that, after you give a statin, the weight of the evidence is that, as a second agent, you should give niacin," said Dr. Roger S. Blumenthal, a professor of medicine at the Johns Hopkins University Medical School. "That is the implication of the study." But Dr. Peter S. Kim, the president of Merck Research Laboratories, said Sunday in an interview that the study was limited because it did not compare the groups of patients taking a statin and a second drug to a placebo group. Furthermore, he said, a drug's ability to improve artery-wall thickness has not been proved to automatically correlate with a reduction in heart attacks. Zetia, he said, lowers bad cholesterol and lowering bad cholesterol is a known good. The study results "should be compared to the overwhelming body of evidence that lowering LDL cholesterol is an important thing to do to improve cardiovascular health," Dr. Kim said. The study randomly assigned patients who were taking a statin and who had heart disease or a risk of heart disease to additionally take either Zetia or Niaspan. Statins are a class of drug which lowers LDL, known as bad cholesterol because it can cause arterial thickening and lead to heart problems. The drugs work by inhibiting the production of cholesterol in the liver. Zetia, which inhibits the absorption of cholesterol in the intestines, lowers bad cholesterol. Niaspan is a prescription extended-release form of niacin, not the over-the-counter vitamin. Niacin increases HDL, known as "good cholesterol." Niaspan is made by Abbott Laboratories, which financed the study. Over the course of the 14-month study, the bad cholesterol of the patients on Zetia decreased by 19.2 percent, but the patients' arterial wall thickness stayed the same, the study said. In the niacin group, good cholesterol increased by 18.4 percent and the carotid wall thickness decreased. By itself, the study does not have major significance, said Dr. James H. Stein, a professor at the University of Wisconsin medical school. But taken in the context of more than 30 years of research on and use of niacin, he said, the study adds to the weight of evidence that it can a great benefit to patients with heart disease, he said. "Compare that to Zetia where there is not a shred of evidence that it does anything good for blood vessels or heart disease," Dr. Stein said. On Friday, Senator Charles E. Grassley, Republican of Iowa, wrote to the Department of Health and Human Services, asking its director, Kathleen Sebelius, what action she intended to take in light of the study results. Mr. Grassley sits on the Senate Finance Committee which has jurisdiction over Medicare and its drug spending. In 2006 and 2007, the drug makers made more than $300 million through Medicare Part D in sales of Vytorin, a drug that combines Zetia and a statin, Mr. Grassley wrote. In response to a query from a reporter, a Merck spokesman said the small trial did not change the company's belief in the demonstrated ability of Zetia and Vytorin to reduce bad cholesterol. You will remember a little of what you hear, some of what you read, considerably more of what you see but almost all of what you understand

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Niacina es mejor que Ezetimibe(zetia) pero

niacina mejor que ezetimibe sin embargo los peruanos no la toleran bien

 

This copy is for your personal, noncommercial use only. You can order presentation-ready copies for distribution to your colleagues, clients or customers here or use the "Reprints" tool that appears next to any article. Visit www.nytreprints.com for samples and additional information. Order a reprint of this article now. November 16, 2009 Study Raises Questions About Cholesterol Drug's Benefit By NATASHA SINGER ORLANDO, Fla. — For patients taking a statin to control high cholesterol, adding an old standby drug, niacin, was superior in reducing buildup in the carotid artery to adding Zetia, a newer drug that reduces bad cholesterol, according to a new study. The results of the study, published in The New England Journal of Medicine, were presented here Sunday night at an annual meeting of the American Heart Association. The study has been a polarizing topic here and has also attracted the attention of a powerful senator who has been investigating the conduct of two drug makers, Merck and Schering-Plough, in relation to their sales and marketing of Zetia and a combination cholesterol drug, Vytorin, which includes Zetia. The drug makers merged this month. The small study, with only 208 patients, has attracted outsize attention because the researchers did a head-to-head comparison of niacin and Zetia, which has been heavily marketed. The Food and Drug Administration approved Zetia in 2002 to lower bad cholesterol, a risk factor for heart disease. But the drug has not yet proved to have a longer-term clinical benefit in reducing heart attacks and deaths. Merck, the maker of the drug, is conducting a clinical trial on that issue involving up to 18,000 patients. Statins like Lipitor have proved in studies to significantly lower the risk of heart attack. Some cardiologists here hailed the study as an indication that the popularity of Zetia and Vytorin, which had combined sales last year of about $4.6 billion, has far outstripped their evidence of a concrete benefit on heart health. Other doctors here dismissed the study because it did not directly measure the drugs' effects on reducing heart attacks. Nevertheless, this study has the potential to make big waves in the use of cholesterol drugs. "It will certainly strengthen the idea that, after you give a statin, the weight of the evidence is that, as a second agent, you should give niacin," said Dr. Roger S. Blumenthal, a professor of medicine at the Johns Hopkins University Medical School. "That is the implication of the study." But Dr. Peter S. Kim, the president of Merck Research Laboratories, said Sunday in an interview that the study was limited because it did not compare the groups of patients taking a statin and a second drug to a placebo group. Furthermore, he said, a drug's ability to improve artery-wall thickness has not been proved to automatically correlate with a reduction in heart attacks. Zetia, he said, lowers bad cholesterol and lowering bad cholesterol is a known good. The study results "should be compared to the overwhelming body of evidence that lowering LDL cholesterol is an important thing to do to improve cardiovascular health," Dr. Kim said. The study randomly assigned patients who were taking a statin and who had heart disease or a risk of heart disease to additionally take either Zetia or Niaspan. Statins are a class of drug which lowers LDL, known as bad cholesterol because it can cause arterial thickening and lead to heart problems. The drugs work by inhibiting the production of cholesterol in the liver. Zetia, which inhibits the absorption of cholesterol in the intestines, lowers bad cholesterol. Niaspan is a prescription extended-release form of niacin, not the over-the-counter vitamin. Niacin increases HDL, known as "good cholesterol." Niaspan is made by Abbott Laboratories, which financed the study. Over the course of the 14-month study, the bad cholesterol of the patients on Zetia decreased by 19.2 percent, but the patients' arterial wall thickness stayed the same, the study said. In the niacin group, good cholesterol increased by 18.4 percent and the carotid wall thickness decreased. By itself, the study does not have major significance, said Dr. James H. Stein, a professor at the University of Wisconsin medical school. But taken in the context of more than 30 years of research on and use of niacin, he said, the study adds to the weight of evidence that it can a great benefit to patients with heart disease, he said. "Compare that to Zetia where there is not a shred of evidence that it does anything good for blood vessels or heart disease," Dr. Stein said. On Friday, Senator Charles E. Grassley, Republican of Iowa, wrote to the Department of Health and Human Services, asking its director, Kathleen Sebelius, what action she intended to take in light of the study results. Mr. Grassley sits on the Senate Finance Committee which has jurisdiction over Medicare and its drug spending. In 2006 and 2007, the drug makers made more than $300 million through Medicare Part D in sales of Vytorin, a drug that combines Zetia and a statin, Mr. Grassley wrote. In response to a query from a reporter, a Merck spokesman said the small trial did not change the company's belief in the demonstrated ability of Zetia and Vytorin to reduce bad cholesterol. You will remember a little of what you hear, some of what you read, considerably more of what you see but almost all of what you understand

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