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| 2.4 trillion dollars it wore out in health in 2008, according to National Coalition on Health Care |
| How to lower his costs in health |
Writing / agency
Washington Hispanic
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| The severity of the allergies they change from person person and can go from a small annoyance of the skin to an anafilaxis, that is to say, a potentially mortal emergency. |
In these times of economic crisis, everything what means saving must be made use, and the expense in health is not an exception. For the same, continue these advices prepared by the University of Harvard.
Economists, doctors and patients are in accordance with indicating the reform to the system of health of the United States it will fail if it is that the constant increase is not controlled in the expense of this sector.
Even persons with a good medical insurance are paying an important part of his accounts of health, be already in the form of copayments, deductible and other expenses that are not included in the coverage.
For the same, investigators of the University of Harvard, as a whole with doctors of the same house of studies, analyzed the situation and created the following recommendations that will allow him to lower his medical costs, you allowing him not only to save, but to the society in general.
Have a good relation with his doctor. A primary doctor who knows his situation, that of his family and his circumstances have more probabilities of delivering good advices (be already doctors or of life styles) that will allow him to support his health, compared with a specialist who does not know his case. A doctor who meets him will be able to practise in accordance with his specific condition and the circumstances that surround him.
Do not resort to the emergency room unless it is definitely necessary. Often the persons go to emergency rooms for conditions that have a less drastic solution. This raises the health expenses both of the country and of the persons. To avoid this situation, call his doctor and explain to him that the situation, in order to which this one should deliver to him advices should be already in person or by phone.
Continue the treatment. Be already that you are taking a chronic condition medicines, must do his control panel to him or have to change his life style, it is the most important that it continues the recommendations of his doctor exactly. Of not doing it, it is possible that his chronic illness, already diabetes or cardiovascular disease is two of the most common in the Hispanic community — descontrolen, forcing it to surrender to treatments not only more invasive, but costlier.
Eye in spite of going directly to a specialist. Even if his medical insurance should allow you to be able to visit a specialist without having to pass for his family doctor, it is advised the first consultation to be with his primary doctor, whenever it is possible. If his family doctor does not know what happens with his health, it is possible that this leads to a resources squandering, like doing more tests of the necessary ones or double treatments, which also can be dangerous.
Prefer the generic thing. The generic medicines cost less than those of mark and there are practically the same. Also, most of the insurances must cancel major copayments for the mark medicines. For the same, it is useful that it consults with his doctor on the possibility of choosing for the generic thing when this one prescribes some medicine.
One does not allow to be. In the case that is taking a medicine some time, the period discusses with his doctor that low treatment has been, if it is that this one works or not and, in the case that already not of the awaited result, there sees the possibility of discontinuing his use.
Discuss the need for costly tests. Do not press for doing to him new tests that can be expensive only because you believe that you will be better. If his doctor orders him to do to himself a costly test as a magnetic nuclear resonance or a scanner ask him that porqué it is necessary and how it will do a difference.
Stay healthy. Stop smoking, eat I recover, do exercise and sleep the sufficient thing. If it continues these advices, it will be able to reduce the possibilities of developing an illness that needs medical care.
| Interview |
| Why to take part in scientific studies |
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| Margarita Hurtado. Photo: Felipe Lagos/WH. |
For Felipe Lagos
Washington Hispanic
The Hispanic community must approach the investigators so that they take them into consideration
For years, there was a tendency in investigation in which the results of the studies were applied to most of the population. For example, if these investigations were realized mostly in the white population, of that time the conclusions understood to the totality of the individuals, without considering his ethnic group or race.
That has changed. Now, the distinction is done between minorities under the premise that diverse conditions affect in a way different from community diverse.
The Latin Americans we fall down in this category, says Margarita Hurtado, principal scientific researcher in services and communication of health of the American Institutes of Investigation (AIR, for his acronym in English).
“ There has been recognized the importance of different communities, like the Hispanic one, in health investigation. With that it is possible to see that the genetic aspects and of living conditions they affect the development of certain conditions, between other things. For the same, we must inform him the community that porqué there is important the investigation and his participation in the studies and of what way he them is going to benefit straight”, says the expert.
— How to do a better scope to the community so that it takes part in studies?
“ What has been seen in many areas is that the level of confidence that exists between the community in general and the scientific community is not what should be for bad experiences, but in the Latin population it is because there has not been many history. This achieves across a relation that it is constructed when one has already worked with a population and this one trusts in the scientists. It is necessary to work jointly with community organizations, which are already giving services to these community and know his needs and how to come to them”.
— What is the responsibility of the scientists of doing community scope and what is the responsibility of the community of saying “here we are”?
“ Of the point of view of the scientists, the porqué has not communicated in an adapted way the investigation is important, what is asked the person who informs, his rights, what is going to happen during the study. I am sure that a sufficient effort has not been done in reaching our community in his language. It is supremely important for the Latin Americans understanding porqué they must take part, and the reason is in that there are certain illnesses that affect us in disproportionate form, like the obesity, especially in the children. When we speak about immigrants, this problem does not exist in his fatherlands, but it happens here for the change in the living conditions, feeding, physical activity and many other aspects. This in the end provokes illnesses the heart or diabetes. Only across our participation in studies we are going to be able to know better about what way can treat and to develop medicines to solve these problems”.
| To his health |
| My god, I have a bundle in the bosom |
For the Doctor Elmer Huerta
THE DIRECTOR PREVENTORIUM OF THE CANCER
One of the things of that more he is afraid a woman is to be or that the doctor finds a bundle in the bosom.
The ideal thing is that the careful and polite woman finds it she itself, when the bultito newly is developing, or perhaps when it is of the size of a frejolito; and not to give him the surprise of finding it enormous, of the size of a lemon or a tangerine.
First of all, the woman of any age that a bultito finds in the bosom must consult immediately with a doctor, of preference with a surgeon specializing in the illnesses of the bosoms (up to this moment it is not obligatory that this professional is a specialist in cancer of the bosoms).
You do not imagine how this one, which looks like such a basic and elementary recommendation, is not continued by many women, who before the find of a bultito, dead of fear, prefer to ignore it and to think “that it is not at all” and that “it is already going to disappear”.
That thing about the age is very important because the principal factor of risk (characteristic) that it is going to determine if this bundle is or is not a cancer is the age of the woman. It is anticipated (and this changes region to region), that 85 % of the cases of cancer of the bosom happens in a woman older than 40 years. In such a way that at major age of the woman, major risk that the bultito that has been in the bosom is bad.
How does the doctor face this bundle in the bosom of his patient?
The first thing that the professional does is to rise many questions. Some of them are: from when does it have it, if it hurts or does not hurt, if it takes secretion as the nipple, if it is the first time that goes out for him a bundle, if it has already had biopsies earlier, if it has familiar cancer history, etc.
The second thing, and the most important action that the doctor takes, is to examine carefully the bosoms of his patient. Here it is fixed in the hardness of the bundle, if this one moves freely or is given how to the deep textiles, if the skin that it covers to the tumor is given to this one, if it hurts or does not hurt, if the nipple is like "shove", if there is bultitos in the armpit of the side in which the tumor went out, if another bosom has also bultitos, etc. The most dangerous bundles are those that are hard and do not hurt (let's remember that the cancer hardly ever hurts) and that they are given to the skin or to the deep textiles.
The third thing, and after having completed the two previous steps (to ask and to examine), is that the doctor must decide if he needs or not to arrange the auxiliary examinations: the sonografía and the mamografía. If you believe that these examinations are always obligatory, I tell him that not in all the cases of bundles in the bosom one needs a sonografia or a mamografía. That depends on the evaluation of the professional.
For example, and in this the experience of the professional takes root, if the woman is young (less than 30 years), the bultito is very mobile, he is given neither to the textiles nor to the skin and it is a bit painful, the doctor can diagnose a fibroadenoma of the breast, the most frequent benign tumor of the breast in the young woman and only he decides to examine the patient again in 6 months without doing any auxiliary examination.
But if the woman has more than 35 years, the bundle is hard and almost it does not move for being given to the textiles, the doctor arranges immediately a sonografía and a mamografía.
Only 5 to 10 % of the cases of cancer of the bosom happen in a woman with familiar history. That's why the woman who believes that why there is no case of cancer in the family it is protected, is completely wrong.
More than 80 % of the cases of cancer of the bosom happens in women older than 40 years, happening the majority of them after the 50. Surely the cancer of the bosom happens also in young women, (and they are those who more attract public's attention, especially if they are famous women) but they are much less frequent.
In the United States, between 80 and 90 % of the cases of cancer of the bosom are found very early, when they are still curable. In Peru and other countries of Latin America, the opposite happens exactly, 80 % of the cases is detected in the very advanced and incurable state.
| More than 50 illnesses can provoke serious cases of itching |
| They discover mechanics of the itch |
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| While the medicines can relieve some types of itching, other cases are resistant to the treatments. |
Agencies
When one has an itching and scratches an agreeable mitigation sensation takes place... Now the scientists have managed to observe the behavior of the back nerves that transmit signs of mitigation to the brain of the monkeys, a possible step towards new treatments for the persistent itch in the persons.
More than 50 illnesses can provoke serious cases of itching, between them the AIDS, the evil of Hodgkin and the side effects of the treatment the chronic pain, stood out Glenn J. Giesler, Jr., a neurocientífico of the University of Minnesota, with head office in Mineápolis.
In case of some types of enclosed terminal cancer the use of medicines limits itself for the pain only in order to reduce the itch, it indicated.
When one scratches, can provoke injuries the skin and infections in case of the people with itch chronicle, he added.
Therefore the scientists want to find means so that these persons have mitigation “and the skin does not tear”, he added.
While the medicines can relieve some types of itching, other cases are resistant to the treatments.
He has not gone so far as to know with accuracy why to to scratch the itch gets better. But a study in simians that Giesler and his companions realized, with federal financing, passes to reveal the mystery in an article published in the cybernetic place of the magazine Nature Neuroscience.
The scientists cite as an example a type of nerve of the spine that transmits the sign of the "itching" to the brain. These nerves come to the brain at a height of the base of the rib cage.
The investigators sedated to the macaques of long hair to realize the experiment and placed electrodes in his back nerves. They injected a chemical substance into the skin of a leg in order to produce itch. The nerves provoked electronic signs as reaction.
Next the investigators scratched the leg with a manoeuvrable metallic piece that simulates to be three fingers of the monkey. The level of the reaction descended, like an apparent sign of “mitigation“.
In contrast, when the investigators scratched the leg and the sign of answer did not provoke the itch previously it went off. Which means that the nerves "can" react in a way different from the need for mitigation from one itch, which when it is not.
“ It is as if there was a small brain” in the spine, stood out Giesler.
It is probable that the scientists could identify the signs that they indicate them to these nerves that should provide the mitigation answer, and next try to imitate the action with medicines or some type of stimulant, it added.
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