Month: October 2011

30% Of children presents sleep disturbances.

30% Of children presents alterations of sleep

during the 25th National Congress of the society of Pediatrics Extrahospitalaria and primary care (SEPEAP).

-the role of primary care pediatrician is essential in the early diagnosis and treatment of these disorders

-parents or caregivers should know the characteristics of the dream of children in each age of development

– to avoid sleep disorders recommended bed the child in bed, that the atmosphere is quiet and with Dim light

– may be cause of school delays

-the rejection of the child at bedtime, Nighttime Awakenings, excessive daytime drowsiness, nightmares and sleepwalking are some of the causes that may indicate that there was some disorder

-communication skills workshop aims to increase knowledge about communication so pediatrician those applied in the query

-looks, gestures, facial expression and smile are key elements that must be taken into account in establishing a two-way doctor-patient communication

Santiago de Compostela, 2011-October training and debate have been some of the key factors in the celebration of the 25th National Congress of the society of Pediatrics Extrahospitalaria and primary care (SEPEAP). For this reason, these days have taken place several workshops for pediatricians in which were discussed among other topics, children sleep problems and the necessary communication skills in Pediatrics.

Sleep and its disorders

The role of primary care pediatrician is essential in the early diagnosis and treatment of major disorders of sleep. Within the framework of this Congress reviewed the most important aspects which the pediatrician should take into account to make a correct diagnosis of normal and physiological events related to the dream.

30% Of children presents sleep disturbances. About this incidence, the SEPEAP has promoted the Organization of a working group dedicated to the study of the sleep disorders and more specialist training courses promoted in different Spanish cities.

Causes and solutions

Although the child sleep disorders can manifest from birth, should be borne in mind that “ in the case of the newborns feeding brand sleep ”, explains Dr. Manuel Sampedro, Member of SEPEAP and the Centre for health Novoa Santos paediatrician, Ourense.

However, pediatricians attached great importance to the fact that parents or caregivers are aware of the characteristics of the dream of children in each age of development. This is vital because “ in the case of the newborn there is active sleep, in which the child sleeps making grimaces and emitting sounds, something that parents sometimes confused with cramps and raise the child in the cradle breaking your sleep cycle ”, points out Dr. Sampedro.

To prevent sleep disorders pediatricians emphasize the importance of lay the child on the bed, that the atmosphere is quiet and with Dim light. “ To follow a daily routines for sleeping children and try to be always at the same time, read a story, etc. ”, qualifies the specialist.

Warning signs and side effects

Sleep little and not rest may be affected the physical and intellectual development of the child. Furthermore, “ sleep disorders may be cause of delay school, making that the child not rendering at school. But when these cases are investigated in depth, is often a lack of sleep ”, emphasizes Dr. Sampedro.

In this sense, pediatricians confirm that night sleep must be 8 or 9 hours, but when this is not the case, your pediatrician advises on the possibility that “ maybe can see certain warning signs that may indicate the existence of a disorder such as the rejection of the child at bedtime, Nighttime Awakenings, excessive daytime drowsiness, nightmares and sleepwalking ”.

Communication in Pediatrics skills

Although initially may seem very simple, sometimes it is not easy to communicate with other people. This fact can complicate more when involving children in conversation. For these reasons, one of the workshops promoted by the SEPEAP in this Congress focuses on the communication.

It’s a dynamic workshop that seeks the participation of attendees. Says Dr. Matilde Riquelme, Member of SEPEAP and pediatrician at the Centre of health La Chopera, Madrid, “ this workshop aims to increase knowledge about communication so pediatrician those applied in the query ”.

Many factors, such as expressions, gestures and phrases come into play when communicating. “ We need parents or caregivers of children to understand what we want to transmit and to this end, we have to serve both the non-verbal and verbal communication ”, qualifies the expert.

In this sense, looks, gestures, facial expression and smile are key elements that must be taken into account when establishing a physician-patient two-way communication that promotes understanding on both sides.

Spanish society of community-based Pediatrics and primary care (SEPEAP)

The Spanish society of Pediatric Extrahospitalaria and primary care (SEPEAP) emerged to accommodate a group of Pediatricians with a few needs upgrading, training and professional problems differentiated and minusvaloradas pediatric practice 25 years ago. Scientific and professional and non-profit it currently has more than 2,200 members.

The structure of the SEPEAP consists of societies and sections provincial and/or regional paediatric Extrahospitalaria and primary care, without losing its own character, linked to it and to the societies of Pediatric regional of the Spanish Association of Paediatrics (AEP).

Since the beginning of the SEPEAP were clear its purpose, as indicated in its statutes: promoting the study of Pediatrics Extrahospitalaria, the problems of children and adolescents within the lash (outpatient health centers, public and private clinics, external consultations in hospitals, etc.). In addition, is intended to cover the three fundamental missions of Pediatrics Extrahospitalaria: care (preventive, curative and rehabilitative), teacher (collaboration in the formation of undergraduate student of medicine in Pediatrics Extrahospitalaria, in the formation of the residents of the specialty of Pediatrics in pediatric Extrahospitalaria)(, in the continuing education of the lash pediatrician in exercise and health education for the population at all levels) and researcher, to promote the correlation of paediatric Extrahospitalaria and services primary care with other health services and social resources of the community within the A.E.P.

Read More

The prevalence of gout increases in relation to inadequate dietary habits and the increase of associated diseases.

the prevalence of gout increases in relation to inadequate dietary habits and the increase in diseases associated.

XLI Congress national of the society Spanish of Nephrology.

-the disease affects 1% of the adult population. Dietary habits, obesity and the presence of other diseases increase the risk.

– has just been adopted in Spain a new treatment for gout, which was not the case for 40 years.

Seville, 2011-October The prevalence of gout is growing in the surrounding countries, due to factors such as unhealthy eating habits and the emergence of other diseases associated with greater longevity of the population. It is one of the conclusions of the General Committee advances in the treatment of gout in patients with renal failure within the XLI National Congress of the Spanish society of Nephrology. This rheumatic disease, which is attending with pain and swelling in the joints, affects about 1% of the adult population, and may reach 6% in men older than 70 years, according to a recent study carried out in United States and published in the journal Arthritis and Rheumatism (1).

Gout is one of the most ancient diseases of which record and its prevalence has grown over the last decade (2), due to “ lack of exercise, poor diet, the growth of obesity and a sedentary lifestyle, as well as the excessive intake of alcohol ”, according to Dr. José Luño, head of the service of Nephrology the Hospital Gregorio Marañón in Madrid, moderator of the General Committee. Gout usually appears after 35 years, but “ bad dietary habits observed in young people, as it is happening in Western countries, increase the risk of infected ”, adds Dr. Fernando Pérez of the Rheumatology service of the Hospital de Cruces, in Barakaldo. Also influence its increase in the ageing of the population and the use of diuretic medications that raise the levels of uric acid.

Gout is an inflammatory reaction sudden and intense in the toe of the foot, although it can also occur in the rest of the foot, ankle, knee and less frequently the upper limbs, explains Dr. Pérez. It is caused by a high concentration of urato, which originates in the body to decompose purine, a compound of the nucleoproteins. “ Foods that can increase uric acid are, in general, all rich in proteins, “ especially red meat and viscera, but also vegetables such as asparagus, peas, tomatoes, spinach; and legumes such as lentils, for its high content in purine ”, explains Dr. Marian Goicoechea, of the service of Nephrology of Hospital Gregorio Marañón in Madrid.

The urato is dissolved in the blood and is eliminated through the urine and feces. When very high are uric acid levels (hyperuricemia) for so long in time, either by an increase in their production or decreased in the excrección, it settles in the form of crystals of monosodium urato joints and gout attacks occur. After the first crisis of gout, the majority of patients shall suffer other crises within a year (3).

Gout long-term complications include injury to the bones and joints and the appearance of lumps in the skin and joints, called tophi. Hyperuricemia is also associated with increased risk of kidney stones.

first step in 40 years

during the Congress the results of the first treatment occur in 40 years (4) for chronic hyperuricemia in gout, which has just been adopted in Spain, febuxostat. This drug is indicated for the treatment of chronic hyperuricemia in situations in which has already occurred urato Depot, including symptoms, or the presence of tophi or gouty arthritis (5). Also demonstrated in various studies that it is capable of reducing and maintaining levels of uricemia below 6.0 mg/dl in a high percentage of patients (6.7), which is the target set by the EULAR (European League against rheumatism) (8). The sustained reduction of the levels of serum urato is associated to an almost complete elimination of gotosas crises, as well as a high rate of reduction of tophi (9).

Other contributions of this treatment is their safety, according to Dr. Luño: “ “ is a very effective, well tolerated drug that in addition to reducing the levels of uric acid may have positive effects on patients with kidney failure. In fact in a recent study that we led with Dr. Goicoechea and recently published in the journal of the American Society of Nephrology, intervention to reduce levels of uric acid in patients with chronic renal is associated with less progression of renal disease ”.

Referencia:

(1) Zhu, and Pandya BJ, Choi HK: Prevalence of gout and hyperuricemia in the U.S. general population. Arthritis Rheum. 2011 Jul 28. DOI: 10.1002/art.30520

(2) Richette p., Bardin T. Gout.Lancet 2010; 375: 318-328

(3) McGill NW.Gout and other crystal-associated arthropathies. Baillieres Best Pract Res Clin Rheumatol. 2000 Sep; 14 (3): 445-60

(4) M. Hu, Tomlinson B. Febuxostat in the management of chronic gout and hyperuricemia: a review. Therapeutics and Clinical Risk Management 2008; 4 (6): 1209-1220

(5) technical specifications of Adenuric ®

(6) MA, Schumacher HR Jr, Wortmann RL, et Becker to the. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med. 2005 Dec 8; 353 (23): 2450-61.

(7) Schumacher HR Jr, Becker MA, Wortmann RL, et to the. Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial. Arthritis Rheum. 2008 Nov 15; 59 (11): 1540-8.

(8) Zhang W, Doherty M, Bardin T, et to the. EULAR evidence based recommendations for gout. Part II: Management. Report of task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006 Oct; 65 (10): 1312-24

(9) Schumacher HR Jr, Becker MA, Lloyd E., et to the. Febuxostat in the treatment of gout: 5-yr findings of FOCUS the efficacy and safety study. Rheumatology (Oxford). 2009 Feb; 48 (2): 188-94.

Read More

The CECOVA recommends preventing osteoporosis through a proper diet rich in calcium and the practice of moderate exercise.

El CECOVA recommended to prevent osteoporosis through a proper diet rich in calcium and exercise practice moderate.

ávila stressed “ the importance of lead an active life, with the practice of regular exercise, as one of the most important elements to build a good bone density ”.

Spain, 2011-October The Valencia Council of nursing (CECOVA) and the colleges of nursing in Valencia, Castellón and Alicante offered yesterday, on the eve of the World Osteoporosis Day, a series of recommendations to prevent or at least slow down the emergence of this disease which consists of an excessive loss of calcium and other components of the bonewhich leads to a decrease in their strength.

The President of the CECOVA, José Antonio Avila Olivares, recalled that this situation can be prevented with a number of measures which include adequate food through a diet rich in calcium-containing foods (milk, cheese, dairy, fish derivatives …). Avila Olivares also advised the realization of moderate exercise with daily walks more or less long in relation to the possibilities of each individual, until the completion of a program established by a specialist in the field (swimming, tennis, bicycle …). In any case, recommended to avoid a sedentary lifestyle and the immobilization.

Leave toxic habits

In addition, the President of the CECOVA insisted on the need to leave toxic habits like alcohol or tobacco use, especially in excess, and nor should abuse coffee. In the same way, he warned about the need to prevent fractures trying to prevent falls and injuries, so it must respond to the creation of an environment in which elimination or minimize the risks of accident, especially in the home.

Finally, he stressed the importance of lead an active life, with regular exercise, it is one of the most important elements to build a good bone density. It is important to walk to most places, instead of using vehicles and up or down stairs, instead of using the elevator, to develop the musculoskeletal system.

It should be recalled that osteoporosis is the most common metabolic bone disease and affects three and a half million Spaniards, of which one million are male. In the Valencian Community, it is estimated that this ailment affects around 350,000 people, i.e. almost 7% of the population of Valencia suffered osteoporosis.

Osteoporosis is a nutritional disorder by inappropriate contribution of calcium and vitamin D; the deterioration of physical mobility related to pain and Musculoskeletal changes; the pain associated with fractures and Musculoskeletal spasm; and the high risk of injury from fractures at the lack of activity, falls, neuromuscular disorders.

Read More

In patients with kidney transplant is essential to improve the cardiovascular risk profile.

In patients with kidney transplant is essential to improve the risk profile cardiovascular.

within the framework of the XLI National Congress of the society Spanish of Nephrology (SEN) which took place between 15 and 18 October in the capital andaluza.

-cardiovascular disease, more specifically the coronary heart disease is the leading cause of death of patients

-the classical cardiovascular risk factors (hypertension)(, Hyperlipidemia, diabetes, and obesity), boosted by some aspects specific to kidney transplantation (the status of renal failure and the use of immunosuppressive drugs), are the real culprits that kidney transplanted patients suffering cardiovascular events that threaten his life

– early intervention (before transplantation) and comprehensive management of transplanted patients, they are the best weapons to improve the quality of life and reduce the mortality of cardiovascular origin in these patients

Seville, October of 2011- renal diseases are directly related to cardiovascular diseases. Thus, the classical cardiovascular risk factors (diabetes, hypertension, obesity, cholesterol, tobacco, etc.) are also risk factors for kidney patients

the relationship between the kidney and heart is essential, because kidney disease is part of the cardiovascular and vice versa. Chronic kidney disease (ERC) is a risk factor for the cardiac patients with heart failure, coronary artery disease, heart attack, etc. Similarly, it is proven that the kidney patient has 95% of hypertension cases, 85% Cardiac involvement and 53 per cent die with ERC.

According to Dr. José María Morales, nephrologist of the 12 of October in Madrid Hospital, “ cardiovascular disease, more specifically the coronary heart disease is the leading cause of death of our patients. Therefore, in patients with kidney transplant is essential to improve the cardiovascular risk profile ”.

While there has been optimizing Kidney Graft short-term survival, improving the surgical technique with the emergence of new immunosuppressive drugs, transplanted kidney’s long-term survival has not improved substantially, due, among other factors, the rate of cardiovascular mortality in renal transplanted patients.

“ Classical cardiovascular risk factors (hypertension, hiperlemia, diabetes and obesity), powered by some specific aspects of kidney transplantation (the status of renal failure and the use of immunosuppressive drugs), are the real culprits that kidney transplanted patients suffering cardiovascular events that threaten his life ”, points out Dr. Morales.

In addition, “ kidney transplantation outcomes have improved in recent years in Spain chronic nephropathy of graft and the death of the patient with a functioning transplant to be the two main causes of loss of graft ”.

Therefore, “ the early intervention (before transplantation) and a comprehensive medical approach of transplanted patients are suitable weapons to improve the quality of life and reduce the mortality of cardiovascular origin in this patient ”, stresses.

Immunosuppressive Protocol

The fundamental objective of the currently used immunosuppressive therapy is to prevent the rejection of the graft trying to avoid, at the same time, the infectious and neoplastic morbidity associated with the on immunosuppression.

The most widely used immunosuppressant Protocol consists of triple therapy with steroids, tacrolimus (delayed release tacrolimus) and mycophenolate mofetil / acid micofenolico. According to Dr. Morales, “ the effectiveness of this combination is excellent although patients may have greater or lesser extent diabetes of novo, Hyperlipidemia and hypertension (hypertension) ”.

The withdrawal of steroid and adjustment of tacrolimus levels improve these complications. The inhibitors m-TOR improve renal function but induce hypocaloric, although is not proved conducive to the development of coronary heart disease.

In this sense, in heart transplant patients used successfully since it decreases the graft vascular disease. “ Belatacept is a new immunosuppressant, inhibitor drug of the coestimuladora track, which has shown similar efficacy to CyA-based regimes. In addition, it has no effect nefrotoxico or influences the development of hypertension, diabetes or hypocaloric. Therefore, the possible combinations with Belatacept can improve cardiovascular profile post-transplant and perhaps reduce serious cardiovascular complications and mortality post-transplant ”, concludes Dr. Morales.

The Spanish society of Nephrology

The Spanish society of Nephrology is a scientific society whose objectives are to promote and disseminate scientific and advances clinical in the field of specialty, covering fields as diverse as high blood pressure, kidney disease, the progression of renal insufficiency, or renal dialysis (hemodialysis or peritoneal dialysis) or kidney transplant replacement therapy when the renal function does not allow the survival of the patient. It also promotes research on extra kidney complications of kidney disease (anemia, bone disorders, cardiovascular complications, etc.). It currently has 1,700 members between researchers and clinical Nephrologists on topics related to the specialty. This company organizes a Conference, as well as several refresher courses throughout the year, both for specialists and resident doctors.

Read More

Surah Al-Rehman – The Ultimate Free Remedy for Incurable Diseases

(By Listening Only- 20 Minutes Only)

Kindly download the Surah “AL-REHMAN” (recited by Qari Abdul Basit without translation) from here.


Treatment Plan

Just Listen to it three times a day (morning, afternoon, evening) for seven consecutive days using following procedure:-


    Before listening:

  • Close your eyes
  • Feel your self in front of ALLAH Almighty/ God
  • Then listen to it with greater concentration and closed eyes

    When the recitation/ AUDIO is finished:

  • Open your eyes and take half glass of water
  • Close your eyes again and say “ALLAH” three times in your heart with deep affection/ love
  • Then drink the water with closed eyes in three sips

Surah Al-Rehman – The Ultimate Free Remedy for Incurable Diseases

(By Listening Only- 20 Minutes Only)

Kindly download the Surah “AL-REHMAN” (recited by Qari Abdul Basit without translation) from here.


Treatment Plan

Just Listen to it three times a day (morning, afternoon, evening) for seven consecutive days using following procedure:-


    Before listening:

  • Close your eyes
  • Feel your self in front of ALLAH Almighty/ God
  • Then listen to it with greater concentration and closed eyes

    When the recitation/ AUDIO is finished:

  • Open your eyes and take half glass of water
  • Close your eyes again and say “ALLAH” three times in your heart with deep affection/ love
  • Then drink the water with closed eyes in three sips