Clinica San Felipe

01/02/2019

Sending electronic pulses through a brain that is being damaged by Alzheimer’s disease might become a new method of early treatment.

A study headed by Dr. Andres Lozano at Toronto Western Hospital’s Krembil Neuroscience Centre in Canada, has concluded that patients over the age of 65 with mild Alzheimer’s disease can benefit from deep brain stimulation.

Deep brain stimulation is nothing new but using it as a more targeted therapy could yield dividends.
“Deep brain stimulation (DBS) implants have been used for over 30 years, mostly to treat the tremors of Parkinson’s disease patients,” Dr. Doug Scharre, director of the Division of Cognitive Neurology at The Ohio State University Wexner Medical Center, told Healthline.
Scharre notes that while DBS treatment is approved by the Food and Drug Administration (FDA) for Parkinson’s disease, it’s still an experimental therapy when it comes to Alzheimer’s.
Lozano’s phase II trial directed stimulation at the fornix, a bundle of nerve fibers in the brain.

Researchers found that participants aged 65 or older appeared to experience a slower progression of the disease than younger participants.

Encouraged by these findings, Lozano and his team will launch phase III trials soon.
“I think it’s an interesting paper and it’s important to expand the types of therapies that we’re exploring,” James Hendrix, PhD, director of global science initiatives at the Alzheimer’s Association, told Healthline.
Hendrix did note this latest research involved a relatively small study group.
“The main aim was to look at safety in people with mild Alzheimer’s disease, and it does appear to be safe,” Hendrix said. “We just need more research to be done in this area before we can say for sure if this is going to be an effective treatment.”
Various areas of research
There are no expectations of finding a cure for Alzheimer’s disease in the near future.

However, that doesn’t mean that researchers aren’t making breakthroughs.
“One of the most promising areas of research that’s ongoing right now is the research into biomarkers,” said Hendrix.

The reason that biomarkers are so important, particularly when it comes to developing drugs for Alzheimer’s patients, is that it gives doctors and researchers more definitive ways to diagnose the disease, particularly early in its progression when symptoms might be mild.
“Until a few years ago, the only way you could tell if someone had Alzheimer’s disease was through an autopsy,” explains Hendrix. “We had to find people to be in clinical trials just based on their targeted symptoms. These new technologies allow us to look inside of a living brain to see what’s going on.”
Hendrix also notes that lifestyle changes may help patients stay healthy and ward off disease.

The Alzheimer’s Association is supporting a U.S. POINTER study, a two-year clinical trial that looks into whether lifestyle interventions can protect brain health.
Many hurdles remain
The most obvious issue with treating Alzheimer’s disease is that the best-case scenario isn’t a cure but rather slowing the rate of decline.
But there’s a host of less-obvious issues that stand in the way of finding effective therapies for Alzheimer’s disease.
Scharre notes that DBS therapy has its limitations.
“It requires brain surgery to place the stimulator wires into the brain,” he explains. “While this is now a standard procedure and frequently used for Parkinson’s disease, brain surgery with anesthesia is required. Battery packs have to be changed or recharged regularly. Adjustments for the stimulator settings are required at the beginning to find the optimal settings for each individual patient, requiring ambulatory visits after surgery.
Hendrix says there are two significant hurdles when it comes to the big picture of researching potential therapies: money and finding appropriate study participants.
“It’s very expensive — there are estimates that the cost of drug therapy development is upward of $2 billion,” he said. “That’s certainly something that very few organizations can bear the cost of, especially considering the high risk. The reason it’s so expensive is that Alzheimer’s is a slowly progressive disease, so the trials tend to be longer.”
In order to prove that a therapy is effective, researchers need to show that the group receiving the therapy is doing better than the group receiving the placebo. With a slowly progressing disease like Alzheimer’s, Hendrix says this can take a long time.
There’s also the fact that some of the new diagnostic technologies are expensive.
“There’s the cost of biomarkers in clinical research,” said Hendrix. “Amyloid and PET (positron emission tomography) imaging is anywhere between 3,000 and 5,000 dollars per scan. So if you’ve got 3,000 people in your phase 3 trial, and everybody needs to get a PET scan, or maybe two or three, you can see how quickly the costs go up.”
Despite the fact that Alzheimer’s disease is widespread in the United States, it’s actually difficult for researchers to find appropriate study participants for clinical trials.
“It’s very challenging because many trials have inclusion and exclusion criteria,” said Hendrix. “Many people don’t know they have Alzheimer’s disease in the early stages and so therefore they might not seek a clinical trial, and once they progress further in the disease they may then become ineligible for the trial.”
This hurdle is significant enough that the Alzheimer’s Association offers a free clinical studies matching service called TrialMatch. This service generates customized lists of studies based on user-provided information, allowing potential study participants to see what studies they might qualify for.
While the challenges loom large, technologies like biomarker analysis and deep brain stimulation show that progress is being made, even if a cure isn’t yet in sight.
“I think that deep brain stimulation is an example of expanding the types of therapies that we’re interested in,” said Hendrix. “At the Alzheimer’s Association, we’re interested in all types. We want to treat this disease effectively. We’re interested in device approaches like DBS, we’re interested in drug approaches, and we’re also interested in lifestyle as a way of lowering risk.”

31/01/2019

EL SUICIDIO:

El suicidio, ponerle fin a tu propia vida, es una reacción trágica a situaciones de vida estresantes; más trágica aún porque el suicidio puede prevenirse. Si estás pensando en suicidarte o conoces a alguien que esté teniendo sentimientos suicidas, aprende a identificar los signos de advertencia del suicidio y a comunicarte para buscar ayuda y tratamiento profesional de inmediato. Puedes salvar una vida; la tuya o la de otro.

Puede parecer que tus problemas no tienen solución y que el suicidio es la única forma de poner fin al dolor. Pero hay algunas medidas que puedes tomar para mantenerte a salvo y volver a disfrutar de la vida.
Para ayuda inmediata
Si piensas que puedes intentar suicidarte, obtén ayuda ahora:
Llama de inmediato al 112 o al número de emergencia local.

Síntomas
Los signos que advierten sobre el suicidio o los pensamientos suicidas incluyen lo siguiente:
Hablar acerca del suicidio, por ejemplo, con dichos como “me voy a suicidar”, “desearía estar muerto” o “desearía no haber nacido”
Obtener los medios para quitarse la vida, por ejemplo, al comprar un arma o almacenar pastillas
Aislarse de la sociedad y querer estar solo
Tener cambios de humor, como euforia un día y desazón profunda el siguiente
Preocuparse por la muerte, por morir o por la violencia
Sentirse atrapado o sin esperanzas a causa de alguna situación
Aumentar el consumo de dr**as o bebidas alcohólicas
Cambiar la rutina normal, incluidos los patrones de alimentación y sueño
Hacer actividades arriesgadas o autodestructivas, como consumir dr**as o manejar de manera negligente
Regalar las pertenencias o poner los asuntos personales en orden cuando no hay otra explicación lógica para hacerlo
Despedirse de las personas como si no se las fuera a ver de nuevo
Manifestar cambios de personalidad o sentirse extremadamente ansioso o agitado, en especial cuando se tienen algunos de los signos de advertencia que se mencionaron con anterioridad
Los signos de advertencia no siempre son obvios y pueden cambiar de persona a persona. Algunos dejan en claro sus intenciones mientras que otros guardan en secreto sus pensamientos y sentimientos suicidas.
Cuándo debes consultar con un médico
Si tienes pensamientos suicidas, pero no estás pensando en hacerte daño a ti mismo en lo inmediato:
Acércate a un amigo cercano o un ser querido, aunque sea difícil hablar sobre tus sentimientos
Comunícate con un pastor, un líder espiritual u otra persona de tu comunidad religiosa
Llama a la línea directa de asistencia al suicida
Programa una consulta con tu médico, un profesional de salud mental u otro profesional de atención médica
Los pensamientos suicidas no desaparecen por sí solos, así que busca ayuda.
Causas
Los pensamientos suicidas pueden tener distintas causas. Con mayor frecuencia, los pensamientos suicidas pueden ser el resultado de sentimientos que no puedes afrontar cuando se presenta una situación abrumadora en tu vida. Si crees que no hay esperanzas en el futuro, puede que pienses, equivocadamente, que el suicidio es una solución. Es posible que experimentes una especie de estrechez de criterio donde, en medio de una crisis, sientas que el suicidio es la única salida.
También puede existir una propensión genética al suicidio. Las personas que cometen suicidio o que tienen pensamientos o conductas suicidas suelen tener antecedentes familiares de suicidio.
Factores de riesgo
Aunque los intentos de suicidio son más frecuentes entre las mujeres, los hombres son más propensos a completar el suicidio ya que tienden a usar métodos más letales, como las armas de fuego.
Tal vez corras más riesgos de suicidarte en los siguientes casos:
Si ya has intentado suicidarte antes
Si te sientes desesperanzado, inútil, agitado, aislado de la sociedad o solo
Si te sucede una situación estresante, como la pérdida de un ser querido, el servicio militar, una separación o problemas financieros o legales
Si tienes un problema de consumo de sustancias; el abuso del alcohol y las dr**as puede empeorar los pensamientos suicidas y hacerte sentir lo suficientemente temerario o impulsivo como para actuar en función de tus pensamientos
Si tienes pensamientos suicidas y tienes acceso a armas de fuego en tu hogar
Si tienes un trastorno psiquiátrico no diagnosticado, como depresión grave, trastorno de estrés postraumático o trastorno bipolar
Si tienes antecedentes familiares de trastornos mentales, abuso de sustancias, suicidio o violencia (que incluye abuso s*xual o físico)
Si tienes una enfermedad que se puede asociar con la depresión y los pensamientos suicidas, como una enfermedad crónica, dolor crónico o una enfermedad terminal
Si eres lesbiana, gay, bis*xual o transgénero y no encuentras apoyo en la familia o estás expuesto a un entorno hostil
Niños y adolescentes
El suicidio en niños y adolescentes se produce como consecuencia de acontecimientos estresantes de la vida. Lo que una persona joven percibe como algo grave e insuperable, a un adulto puede parecerle leve, por ejemplo, los problemas en la escuela o la pérdida de una amistad. En algunos casos, un niño o un adolescente puede tener pensamientos suicidas debido a determinadas circunstancias de la vida sobre las que no quiere hablar, entre ellas:
Tener un trastorno psiquiátrico, como depresión
La pérdida o un conflicto que involucre a amigos o a familiares cercanos
Antecedentes de maltrato físico o abuso s*xual
Problemas de alcoholismo o drogadicción
Problemas físicos o médicos, por ejemplo, quedar embarazada o tener una infección de transmisión s*xual
Ser víctima de hostigamiento
Sentir incertidumbre acerca de la orientación s*xual
Leer o escuchar la historia de un suicidio o haber conocido a un compañero que se haya suicidado
Si estás preocupado por un amigo o un familiar, preguntarle sobre sus pensamientos e intenciones suicidas es la mejor manera de identificar el riesgo.
As*****to y suicidio
En casos poco frecuentes, existe el riesgo de que la persona con intención suicida mate a otros y después atente contra su propia vida. Esto se conoce como “homicidio-suicidio” o “asesinato-suicidio”, y algunos de los factores de riesgo son los siguientes:
Antecedentes de conflictos con el cónyuge o con la pareja
Problemas familiares de naturaleza legal o financiera por los que se esté pasando
Antecedentes de problemas de salud mental, en particular la depresión
Abuso de alcohol y dr**as
Acceso a armas de fuego
Consumo de antidepresivos y mayor riesgo de suicidio
En general, la mayoría de los antidepresivos son seguros, pero la Administración de Alimentos y Medicamentos exige que todos los antidepresivos tengan advertencias de recuadro negro, la advertencia más estricta para los medicamentos recetados. En algunos casos, niños, adolescentes y adultos menores a 25 años pueden presentar un incremento de comportamientos y pensamientos suicidas si consumen antidepresivos, especialmente durante las primeras semanas o cuando se modifica la dosis.
Sin embargo, recuerda que es más probable que los antidepresivos reduzcan los pensamientos suicidas a largo plazo, ya que mejoran el estado

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02/04/2018

Autism spectrum disorder (ASD) is the name for a range of similar conditions, including Asperger syndrome, that affect a person's social interaction, communication, interests and behaviour. In children with ASD, the symptoms are present before three years of age, although a diagnosis can sometimes be made after the age of three. It's estimated that about 1 in every 100 people in the UK has ASD. [ 1,189 more word ]

Autism spectrum disorder (ASD) is the name for a range of similar conditions, including Asperger syndrome, that affect a person’s social interaction, communication, interests and behaviour. In children with ASD, the symptoms are present before three years of age, although a diagnosis can sometimes...

16/03/2018

16/03/2018

En Clínica San Felipe disponemos de todos los recursos para un tratamiento integral de cualquier tipo de paciente. Somos especialistas en Salud Mental y clínica de referencia en la Región de Murcia y zonas limítrofes, desde hace más de 15 años. Compruébalo en el siguiente vídeo.

21/02/2018

El trastorno bipolar es una enfermedad que puede afectar aproximadamente a 2 de cada 100 personas, y que tiene la misma incidencia en ambos s*xos. El trastorno bipolar es una enfermedad cerebral en la que se produce una alteración de los mecanismos bioquímicos que regulan las emociones y el humor. Las personas que lo padecen experimentan cambios inusuales en el estado de ánimo, en la percepción de la energía y en la conducta. [ 1,173 more word ]

El trastorno bipolar es una enfermedad que puede afectar aproximadamente a 2 de cada 100 personas, y que tiene la misma incidencia en ambos s*xos. El trastorno bipolar es una enfermedad cerebral en la que se produce una alteración de los mecanismos bioquímicos que regulan las emociones y el humor....

19/02/2018

Con la inauguración de nuestras nuevas instalaciones (Nueva Unidad de Clínica San Felipe), se amplía la cartera de servicios que ofrecemos para nuestros pacientes. Ya no es necesario ingresar todo el día. Contamos con doce camas y unas instalaciones completamente nuevas que proporcionan un lugar donde nuestros pacientes pueden disfrutar de toda clase de servicios como si de su propia casa se tratara (TV, internet, taller de lectura, práctica deportiva con elíptica y bicicleta estática, talleres múltiples con nuestras terapeutas ocupacionales...), contando, además, con supervisión sanitaria las 24 horas del día. [ 148 more words ]

Con la inauguración de nuestras nuevas instalaciones (Nueva Unidad de Clínica San Felipe), se amplía la cartera de servicios que ofrecemos para nuestros pacientes. Ya no es necesario ingresar todo el día. Contamos con doce camas y unas instalaciones completamente nuevas que proporcionan un lugar...

19/02/2018

El autismo es un trastorno neurológico complejo que generalmente dura toda la vida. Es parte de un grupo de trastornos conocidos como trastornos del espectro autista (ASD por sus siglas en inglés). Actualmente se diagnostica con autismo a 1 de cada 68 individuos y a 1 de cada 42 niños varones, haciéndolo más común que los casos de cáncer, diabetes y SIDA pediátricos combinados. [ 824 more words ]

El autismo es un trastorno neurológico complejo que generalmente dura toda la vida. Es parte de un grupo de trastornos conocidos como trastornos del espectro autista (ASD por sus siglas en inglés). Actualmente se diagnostica con autismo a 1 de cada 68 individuos y a 1 de cada 42 niños varones, ha...

02/12/2017

Inauguración de la Nueva Unidad de Clínica San Felipe junto al Consejeronde Sanidad, D. Manuel Villegas y otras autoridades políticas y médicas, públicas y privadas, de la Región de Murcia.

https://www.carm.es/web/pagina?IDCONTENIDO=94730&IDTIPO=10&RASTRO=c$m122,70

10/11/2017

Nuevas Instalaciones y Servicios en Clínica San Felipe.

Clinica de Salud Mental San Felipe

10/11/2017

Hemos creado una Nueva Unidad de Hospitalización con 12 camas para brindar el mejor de los servicios posibles en Salud Mental.

17/06/2017

Even Moderate Alcohol Consumption May Harm the Brain

Moderate drinking is associated with pathologic findings in the brain, including hippocampal atrophy, vs no drinking, new research shows.
Higher alcohol intake also predicted faster decline in cognitive measures of lexical fluency, although not semantic fluency or word recall, researchers found.
"In this study, we found that moderate drinking, within US safe limits, was associated with multiple adverse structural brain outcomes and faster cognitive decline, rather than being protective," lead author, Anya Topiwala, MD, Department of Psychiatry, University of Oxford, Warneford Hospital, United Kingdom, told Medscape Medical News. No protective effect was seen with light alcohol intake.
The findings are published online June 6 in BMJ.
The results support the recent reduction in alcohol guidance in the United Kingdom and call into question the limits currently recommended in the United States, the researchers write.
"Alcohol might represent a modifiable risk factor for cognitive impairment, and primary prevention interventions targeted to later life could be too late," the researchers conclude.
Guidelines from the American Heart Association advise one drink per day for women and one to two drinks per day for men. (A drink is defined as 12 ounces of beer, 4 ounces of wine, 1.5 ounces of 80-proof spirits, or 1 ounce of 100-proof spirits.)
In the United Kingdom, the chief medical officer recently changed the guidelines for low-risk drinking from 21 units to no more than 14 units per week for both men and women because of accumulating evidence that even light drinking increases risk for cancer. The guidelines define 1 unit as 10 mL or 8 g of pure alcohol.
The question of whether moderate alcohol consumption is harmful or protective to the brain "was a really interesting and important one, particularly because so many people drink this amount," Dr Topiwala said.
"There were a few studies reporting that a little alcohol staves off dementia, but the few brain imaging studies were conflicting in their results. The Whitehall II cohort, with its 30 years of rich data on drinking, and many other things, seemed like a perfect group to investigate this important question," she said.
The Whitehall II study was established in 1985 at University College London to investigate the relation between socioeconomic status, stress, and cardiovascular health in over 10,000 nonindustrial civil servants.
Dr Topiwala and her group randomly selected 550 people from this study for the current Whitehall II imaging substudy to determine whether self-reported alcohol consumption over a 30-year period was associated with brain imaging and memory decline.
The mean age of the study participants was 43 years at baseline (standard deviation, 5.4 years), none were alcohol dependent, and all were safe to undergo multimodal MRI of the brain at follow-up.
The participants completed questionnaires and had clinical examinations approximately every 5 years over the study period and had detailed brain scans with MRI at the end.
After adjusting for possible confounding factors, such as age, s*x, education, social class, physical and social activity, smoking, stroke risk, and medical history, the researchers found that the people who drank more than the 30 years had higher odds of hippocampal atrophy — shrinkage in the part of the brain that is important for memory and commonly found in Alzheimer's disease — compared with those who did not drink.
The risk was dose dependent, with those who consumed more than 30 units of alcohol per week having the highest risk compared with abstainers (odds ratio [OR], 5.8; 95% confidence interval [CI], 1.8 - 18.6; P ≥ .001).
The risk was also higher among people who drank moderately (14 to 21 units per week). These individuals had 3 times the odds of right-sided hippocampal atrophy (OR, 3.4; 95% CI, 1.4 to 8.1; P = .007).
There was no protective effect in reducing the odds of atrophy of light drinking, defined as 1 to 7 units per week, over abstinence.
Higher alcohol use was also associated with differences in corpus callosum microstructure and faster decline in lexical fluency, or the number of words starting with the same letter that people can generate in 1 minute.
"The corpus callosum is the large white matter tract, or cabled set of wires, that connects the 2 halves of the brain. One of the brain images we did enabled us to estimate the quality of those fibers, or in other words, how good their insulation was. As people get older, or have problems with their brain blood vessels, this insulation quality reduces. This means nerve impulses are transmitted less efficiently, and this has been linked to reduced memory performance," Dr Topiwala said.
Specifically, higher average alcohol consumption across the study "was inversely associated with white matter integrity…reflected by lower corpus callosum fractional anisotropy and higher radial, axial and mean diffusivity," the authors write. "These associations were focused on the anterior corpus callosum (genu and anterior body)."
Dr Topiwala said she hopes their study spotlights the popular conception that moderate drinking protects against cognitive decline.
"Clearly, ideally guidelines are written on the basis of a wealth of evidence, but this is one piece of evidence that suggests current US drinking guidelines, particularly for men, may need modification. We also need further research in the area to see if similar findings are found in different groups of people."
Doctors should probably avoid suggesting moderate drinking to their patients, Dr Topiwala added.
"On the basis of this study, I would suggest they do not advocate moderate drinking as a strategy to protect against memory decline. In my personal clinical practice, I will be advising my patients drinking over 14 units weekly this may not be safe for their brain health," she said.
In an accompanying editorial, Killian A. Welch, Royal Edinburgh Hospital, Scotland, writes that the current study's report of adverse effects even at lower levels of alcohol consumption, as well as the finding that drinking more than 14 units per week was associated with both brain pathology and cognitive decline, "provides further support for the chief medical officer's recent decision" to lower recommended levels of alcohol consumption.
"As intake increases, so does the risk to health, probably in a dose dependent manner. Heavy consumption is associated with potentially severe impairments in memory and executive function, even when other obvious risk factors are absent," Dr Welch writes.
"Topiwala and colleagues' findings strengthen the argument that drinking habits many regard as normal have adverse consequences for health. This is important. We all use rationalisations to justify persistence with behaviours not in our long term interest. With publication of this paper, justification of 'moderate' drinking on the grounds of brain health becomes a little harder," he concludes.

The study was funded by UK Medical Research Council, the Gordon Edward Small's Charitable Trust, and the HDH Wills 1965 Charitable Trust. Dr Topiwala and Dr Welch have disclosed no relevant financial relationships.
BMJ. Alcohol Consumption May Harm the Brain - Medscape - Jun 07, 2017.