sábado, 15 de enero de 2011

Nigeria’s Promise, Africa’s Hope

OP-ED CONTRIBUTOR

Nigeria’s Promise, Africa’s Hope

AFRICA has endured a tortured history of political instability and religious, racial and ethnic strife. In order to understand this bewildering, beautiful continent — and to grasp the complexity that is my home country, Nigeria, Africa’s most populous nation — I think it is absolutely important that we examine the story of African people.

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In my mind, there are two parts to the story of the African peoples ... the rain beating us obviously goes back at least half a millennium. And what is happening in Africa today is a result of what has been going on for 400 or 500 years, from the “discovery” of Africa by Europe, through the period of darkness that engulfed the continent during the trans-Atlantic slave trade and through the Berlin Conference of 1885. That controversial gathering of the leading European powers, which precipitated the “scramble for Africa,” we all know took place without African consultation or representation. It created new boundaries in ancient kingdoms, and nation-states resulting in disjointed, inexplicable, tension-prone countries today.
During the colonial period, struggles were fought, exhaustingly, on so many fronts — for equality, for justice, for freedom — by politicians, intellectuals and common folk alike. At the end of the day, when the liberty was won, we found that we had not sufficiently reckoned with one incredibly important fact: If you take someone who has not really been in charge of himself for 300 years and tell him, “O.K., you are now free,” he will not know where to begin.
This is how I see the chaos in Africa today and the absence of logic in what we’re doing. Africa’s postcolonial disposition is the result of a people who have lost the habit of ruling themselves, forgotten their traditional way of thinking, embracing and engaging the world without sufficient preparation. We have also had difficulty running the systems foisted upon us at the dawn of independence by our colonial masters. We are like the man in the Igbo proverb who does not know where the rain began to beat him and so cannot say where he dried his body.
People don’t like this particular analysis, because it looks as if we want to place the blame on someone else. Let me be clear, because I have inadvertently developed a reputation (some of my friends say one I relish) as a provocateur: because the West has had a long but uneven engagement with Africa, it is imperative that it also play an important role in forging solutions to Africa’s myriad problems. This will require good will and concerted effort on the part of all those who share the weight of Africa’s historical albatross.
In Nigeria, in the years before we finally gained independence in 1960, we had no doubt about where we were going: we were going to inherit freedom; that was all that mattered. The possibilities for us were endless, or so it seemed. Nigeria was enveloped by a certain assurance of an unbridled destiny, by an overwhelming excitement about life’s promise, without any knowledge of providence’s intended destination.
While the much-vaunted day of independence arrived to much fanfare, it rapidly became a faded memory. The years flew past. By 1966, Nigeria was called a cesspool of corruption and misrule. Public servants helped themselves freely to the nation’s wealth. Elections were blatantly rigged. The national census was outrageously stage-managed to give certain ethnic groups more power; judges and magistrates were manipulated by the politicians in power. The politicians themselves were corrupted by foreign business interests.
The political situation deteriorated rapidly and Nigeria was quickly consumed by civil war. The belligerents were an aggrieved people in the southeast of the nation, the Biafrans, who found themselves fleeing pogroms and persecution at the hands of the determined government of the Federal Republic of Nigeria, which had been armed to the teeth by some of the major international powers. My fellow Biafrans spent nearly three years fighting for a cause, fighting for freedom. But all that collapsed and Biafra stood defeated.
It had been a very bitter experience that led to the hostilities in the first place. And the big powers got involved in prolonging it. You see, we, the little people of the world, are constantly expendable. The big powers can play their games, even if millions perish in the process. And perish they did. In the end, more than a million people (and possibly as many as three million), mainly children, died either in the fighting or from starvation because of the Nigerian government’s economic blockade.

After the civil war, we saw a “unified” Nigeria saddled with an even more insidious reality. We were plagued by a home-grown enemy: the political ineptitude, mediocrity, indiscipline, ethnic bigotry and corruption of the ruling class. Compounding the situation was the fact that Nigeria was now awash in oil boom petrodollars. The country’s young, affable head of state, Gen. Yakubu Gowon, ever so cocksure following his civil war victory, was proclaiming to the entire planet that Nigeria had more money than it knew what to do with. A new era of great decadence and decline was born. It continues to this day.
What can Nigeria do to live up the promise of its postcolonial dream? First, we will have to find a way to do away with the present system of political godfatherism. This archaic practice allows a relative handful of wealthy men — many of them half-baked, poorly educated thugs — to sponsor their chosen candidates and push them right through to the desired political position, bribing, threatening and, on occasion, murdering any opposition in the process. We will have to make sure that the electoral body overseeing elections is run by widely respected and competent officials, chosen by a nonpartisan group free of governmental influence or interference.
And we have to find a way to open up the political process to every Nigerian. Today, we have a system where only those individuals who can pay an exorbitant application fee and finance a political campaign can vie for the presidency. It would not surprise any close observer to discover that in this inane system, the same unsavory characters who have destroyed the country and looted the treasury are the ones able to run for the presidency.
But we must also remember that restoring democratic systems alone will not, overnight, make the country a success. Let me borrow from the history of the Igbo ethnic group. The Igbo have long been a very democratic people. They express a strong anti-monarchy sentiment with the common name Ezebuilo, which translates to “a king is an enemy.”
There is no doubt that they experienced the highhandedness of kings, so they decided that a king cannot be a trusted friend of the people without checks and balances. And they tried all kinds of arrangements to whittle down the menace of those with the will to power, because such people exist in large numbers in every society. So the Igbo created all kinds of titles which cost very much to acquire. In the end, the aspirant to titles becomes impoverished in the process and ends up with very little. So that individual begins again, and by the time his life is over, he has a lot of prestige, but very little power.
This is not a time to bemoan all the challenges ahead. It is a time to work at developing, nurturing and sustaining democracy. But we also must realize that we need patience and cannot expect instant miracles. Building a nation is not something a people do in one regime, in a few years, even. The Chinese had their chance to emerge as the leading nation in the world in the Middle Ages, but were consumed by interethnic political posturing and wars, and had to wait another 500 years for another chance. America did not arrive at its much admired democracy overnight. When President Abraham Lincoln famously defined democracy as “the government of the people, by the people, for the people” he was drawing upon classical thought and at least 100 years of American rigorous intellectual reflection on the matter.
Sustaining democracy in Nigeria will require more than just free elections. It will also mean ending a system in which corruption is not just tolerated, but widely encouraged and hugely profitable. It is estimated that about $400 billion has been pilfered from Nigeria’s treasury since independence. One needs to stop for a moment to wrap one’s mind around that incredible figure. It is larger than the annual gross domestic products of Norway and Sweden. This theft of national funds is one of the factors essentially making it impossible for Nigeria to succeed. Nigerians alone are not responsible. We all know that the corrupt cabal of Nigerians has friends abroad who not only help it move the billions abroad but also shield the perpetrators from persecution.

Many analysts see a direct link between crude oil and the corruption in Nigeria, that creating a system to prevent politicians from having access to petrodollars is needed to reduce large-scale corruption. For most people, the solution is straightforward: if you commit a crime, you should be brought to book. But in a country like Nigeria, where there are no easy fixes, one must examine the issue of accountability, which has to be a strong component of the fight against corruption.
Some feel that a strong executive should be the one to hold people accountable. But if the president has all the power and resources of the country in his control, and he is also the one who selects who should be probed or not, clearly we will have an uneven system where those who are favored by the emperor have free rein to loot the treasury.
Nigeria’s story has not been, entirely, one long, unrelieved history of despair. At the midcentury mark of the state’s existence, Nigerians have begun to ask themselves the hard questions. How does the state of anarchy become reversed? What measures can be taken to prevent corrupt candidates from recycling themselves into positions of leadership? Young Nigerians have often come to me desperately seeking solutions to several conundrums: How do we begin to solve these problems in Nigeria where the structures are present but there is no accountability?
ONE initial step is to change the nation’s Official Secrets Act. Incredible as it may seem, it is illegal in Nigeria to publish official government data and statistics — including accounts spent by or accruing to the government. This, simply, is inconsistent with the spirit and practice of democracy. There is now a freedom of information bill before the National Assembly that would end this unacceptable state of affairs. It should be passed, free from any modifications that would render it ineffectual, and assented to by President Goodluck Jonathan. This can and should be achieved before the presidential election in April.
In the end, I foresee that the Nigerian solution will come in stages. First we have to nurture and strengthen our democratic institutions — and strive for the freest and fairest elections possible. That will place the true candidates of the people in office. Within the fabric of a democracy, a free press can thrive and a strong justice system can flourish. The checks and balances we have spoken about and the laws needed to curb corruption will then naturally find a footing.
And there has to be the development of a new patriotic consciousness, not one simply based on the well-worn notions of the “Unity of Nigeria” or “Faith in Nigeria” often touted by our corrupt leaders; but one based on an awareness of the responsibility of leaders to the led and disseminated by civil society, schools and intellectuals. It is from this kind of environment that a leader, humbled by the trust placed upon him by the people, will emerge, willing to use the power given to him for the good of the people.
Chinua Achebe, a professor at Brown University, is the author of “Things Fall Apart.

Detección, evaluación y manejo de la anemia preoperatoria en los pacientes ortopédicos quirúrgicos electivos: Guía NATA

Detección, evaluación y manejo de la anemia preoperatoria en los pacientes ortopédicos quirúrgicos electivos: Guía NATA
Detection, evaluation, and management of preoperative anaemia in the elective orthopaedic surgical patient: NATA guidelines.
Goodnough LT, Maniatis A, Earnshaw P, Benoni G, Beris P, Bisbe E, Fergusson DA, Gombotz H, Habler O, Monk TG, Ozier Y, Slappendel R, Szpalski M.
Department of Pathology and Medicine, Stanford University School of Medicine, Pasteur Dr., Stanford, CA 94305, USA. ltgoodno@stanford.edu
Br J Anaesth. 2011 Jan;106(1):13-22.
 

Abstract
Previously undiagnosed anaemia is common in elective orthopaedic surgical patients and is associated with increased likelihood of blood transfusion and increased perioperative morbidity and mortality. A standardized approach for the detection, evaluation, and management of anaemia in this setting has been identified as an unmet medical need. A multidisciplinary panel of physicians was convened by the Network for Advancement of Transfusion Alternatives (NATA) with the aim of developing practice guidelines for the detection, evaluation, and management of preoperative anaemia in elective orthopaedic surgery. A systematic literature review and critical evaluation of the evidence was performed, and recommendations were formulated according to the method proposed by the Grades of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. We recommend that elective orthopaedic surgical patients have a haemoglobin (Hb) level determination 28 days before the scheduled surgical procedure if possible (Grade 1C). We suggest that the patient's target Hb before elective surgery be within the normal range, according to the World Health Organization criteria (Grade 2C). We recommend further laboratory testing to evaluate anaemia for nutritional deficiencies, chronic renal insufficiency, and/or chronic inflammatory disease (Grade 1C). We recommend that nutritional deficiencies be treated (Grade 1C). We suggest that erythropoiesis-stimulating agents be used for anaemic patients in whom nutritional deficiencies have been ruled out, corrected, or both (Grade 2A). Anaemia should be viewed as a serious and treatable medical condition, rather than simply an abnormal laboratory value. Implementation of anaemia management in the elective orthopaedic surgery setting will improve patient outcomes
Enlace para leer el artículo en PDF

 

Atentamente
Anestesiología y Medicina del Dolor

Colocación de sonda nasoyeyunal por método endoscópico frente a método electromagnético


REMI envía todos sus contenidos gratuitamente por correo electrónico a más de 8.800 suscriptores. [Suscripción]
Artículo nº 1590. Vol 11 nº 1, enero 2011.
Autor: Vicente Gómez Tello

Colocación de sonda nasoyeyunal por método endoscópico frente a método electromagnético

Artículo original
: Jejunal tube placement in critically ill patients: A prospective, randomized trial comparing the endoscopic technique with the electromagnetically visualized method. Holzinger U, Brunner R, Miehsler W, Herkner H, Kitzberger R, Fuhrmann V, Metnitz PG, Kamolz LP, Madl C. Crit Care Med 2011; 39(1): 73-77. [Resumen] [Artículos relacionados]

Introducción: La nutrición enteral en el paciente crítico suele verse impedida por un alto residuo gástrico. Para solventar esta incidencia, las guías de nutrición proponen la inserción de una sonda naso-yeyunal (SNY), aunque es posible que estudios recientes, que elevan el residuo tolerable a 500 ml, la hagan menos necesaria [3]. No obstante, si se precisa, su colocación no siempre es logísticamente sencilla. El objetivo de este estudio fue comparar dos métodos de inserción de SNY, el endoscópico, considerado el más fiable, frente a una nueva técnica de guía electromagnética [1, 2] de la punta de la sonda que permite la visualizaciación de su trayecto en un monitor externo.

Resumen: Se trata de un estudio prospectivo y aleatorizado realizado en dos UCI universitarias austriacas. Se incluyeron 66 pacientes críticos que no toleraron nutrición por sonda nasogástrica. Se excluyeron pacientes no candidatos a nutrición enteral o que presentaban anomalías morfológicas en nasofaringe. Se aleatorizaron estos pacientes en una razón 2:1 a un método de inserción endoscópica (n=22) o al método electromagnético (n=44). La colocación correcta, resultado principal, se consiguió en 21 de 22 pacientes con endoscopia, frente a 40 de 44 con método magnético (MM) (95% y 91%; RR 0,95; IC 95% 0,80-1,13; P = 0,57). En los cuatro pacientes restantes se colocó la sonda por vía endoscópica. Los tiempos de colocación (15 minutos frente a 11 minutos en el MM) e inicio de nutrición, permanencia en correcta posición, y sangrado fueron similares. El MM consiguió una inserción más frecuente al primer intento.

Comentario: La inserción de una SNY por este nuevo método (no disponible en España) es tan rápida, segura y efectiva como el método endoscópico en pacientes críticos, y podría ser de inestimable ayuda para facilitar una técnica a veces engorrosa. Existen publicaciones que favorecen este nuevo método [4]. El aprendizaje era corto (3 pruebas antes del estudio) y al alcance de cualquier personal, incluso no médico [5]. Sin embargo debemos advertir que no se detalla el método de aleatorización, no se especifica si se realizó algún tipo de cegamiento en el análisis de datos, y no se realiza una descripción de costes de ambos métodos. Además la sonda sólo es yeyunal, precisando después la inserción de una sonda gástrica. Es posible que este prometedor método ahorre tiempo, intentos, radiografías y terceros especialistas, con su coste asociado, haciendo la técnica más sencilla a pie de cama. Pero estas ineludibles ventajas tienen que probarse como coste/efectivas en análisis rigurosos de evaluación de tecnología.
Vicente Gómez Tello
Hospital Moncloa, Madrid
©REMI, http://remi.uninet.edu. Enero 2011.

Enlaces:
  1. Sistema de nutrición yeyunal Cortrak. [Página Web]
  2. Ventajas y descripción del método por el fabricante. [PDF]
  3. Gastric residual volume during enteral nutrition in ICU patients: the REGANE study. Montejo JC, Minambres E, Bordeje L, Mesejo A, Acosta J, Heras A, Ferre M, Fernandez-Ortega F, Vaquerizo CI, Manzanedo R. Intensive Care Med 2010; 36(8): 1386-1393. [PubMed]
  4. Treating delayed gastric emptying in critical illness: metoclopramide, erythromycin, and bedside (cortrak) nasointestinal tube placement. Taylor SJ, Manara AR, Brown J. JPEN J Parenter Enteral Nutr 2010; 34(3): 289-294. [PubMed]
  5. Nasoenteral feeding tube placement by nurses using an electromagnetic guidance system (with video). Mathus-Vliegen EM, Duflou A, Spanier MB, Fockens P.Gastrointest Endosc 2010; 71(4): 728-736. [PubMed]
Búsqueda en PubMed:
  • Enunciado: Alimentación yeyunal, métodos, resultados, complicaciones.
  • Sintaxis: Jejunal feeding AND critical illness AND method
  • [Resultados]
Palabras clave: Sonda nasoyeyunal, Alimentación yeyunal, Nutrición enteral, Pacientes críticos.

Sintomas depressivos maternos, nível sérico de folato e desfecho da gestação: resultados do estudo de Crianças Nascidas em Amsterdã e do Desenvolvimento delas


Sintomas depressivos maternos, nível sérico de folato e desfecho da gestação: resultados do estudo de Crianças Nascidas em Amsterdã e do Desenvolvimento delas

 
 
São Paulo, 17 de Dezembro de 2010
Pesquisadores holandeses publicaram, recentemente, no American Journal of Obstetrics & Gynecology, um estudo em que procuraram explorar se os diferentes níveis de sintomas depressivos em gestantes, combinados aos seus níveis séricos de folato, estão associados à idade gestacional e ao peso ao nascimento de seus descendentes.

Dados foram derivados de gestantes de Amsterdã que completaram um questionário sobre sintomas depressivos (Escala de Depressão do Centro para Estudos Epidemiológicos) e de quem amostras sangüíneas foram obtidas para determinação do nível sérico de folato. Apenas recém-nascidos vivos e de gestações únicas foram incluídos (n = 4044) na análise de regressão multivariada.

Após ajustamento para variáveis de confusão, apenas a associação entre sintomas depressivos maiores e idade gestacional permaneceu significativa (–0,2 semanas; IC95% = –0,4 a –0,1). Mulheres com sintomas depressivos e baixos níveis séricos de folato (7,6%) apresentaram a menor idade gestacional (38,6 semanas) e o menor peso ao nascimento (3270 g; não houve interação significativa).

Os pesquisadores concluíram que os sintomas depressivos se associam à menor idade gestacional e menor peso ao nascimento relatado. Os resultados do estudo destacam a importância da reposição de ácido fólico, principalmente em mulheres que sofrem de sintomas depressivos.

Uma resenha de Maternal depressive symptoms, serum folate status, and pregnancy outcome: results of the Amsterdam Born Children and their Development study
 - American Journal of Obstetrics & Gynecology; 2010;203:563.e1-563.e7

Alteração da incapacidade após internação ou atividade restrita em pacientes idosos

Alteração da incapacidade após internação ou atividade restrita em pacientes idosos
 
 
São Paulo, 09 de Dezembro de 2010
Incapacidade em pacientes idosos é um processo dinâmico altamente dinâmico e complexo, com elevadas taxas de recuperação e transições freqüentes entre os estados de incapacidade. O papel das doenças interpostas e lesões (isto é, eventos) nestas transições é incerto. Pesquisadores ligados à Faculdade de Medicina da Universidade de Yalepublicaram, recentemente, no Journal of the American Medical Association, um estudo em que avaliaram a relação entre os eventos interpostos e as transições entre estados de não incapacidade, incapacidade leve, incapacidade grave e óbito e para determinar a associação da fragilidade física a estas transições.

Foi realizado um estudo de coorte prospectivo, conduzido na grande New Haven, em Connecticut, entre Março de 1998 a Dezembro de 2008 com 754 pessoas comunitárias com idade igual ou superior a 70 anos, não portadores de incapacidades em momento basal nas quatro atividades essenciais da vida diária: tomar banho, vestir-se, caminhar e mudar de lugar. Entrevistas telefônicas foram realizadas mensalmente por mais de dez anos para avaliar incapacidade e certificar-se da exposição a eventos interpostos, que incluiu doenças e lesões que levam à internação ou à restrição da atividade. Fragilidade física (definida como velocidade da marcha > 10 segundos ao teste de caminhada rápida) foi avaliada a cada 18 meses, por 108 meses. Os principais desfechos avaliados foram as transições entre “sem incapacidade”, “incapacidade leve” e “incapacidade grave” e três transições de cada um destes estados para “óbito”, avaliados mensalmente.

Internação associou-se fortemente a oito das nove transições possíveis, com aumento das razões de risco (HR) multivariadas até 168 (IC95% = 118 – 239) para a transição de “sem incapacidade” à “incapacidade grave” e HRs diminuídas até 0,41 (IC95% = 0,30 – 0,54) para a transição de “incapacidade leve” a “sem incapacidade”. Atividade restrita também aumentou a tendência de transição de “sem incapacidade” para “incapacidade leve” ou “incapacidade grave” (HR = 2,59; IC95% = 2,23 – 3,02 e HR = 8,03; IC95% = 5,28 – 12,21), respectivamente, e de “incapacidade leve” para “incapacidade grave” (HR = 1,45; IC95% = 1,14 – 1,84), porém não se associou à recuperação de incapacidade leve ou grave. Para todas as nove transições, a presença de fragilidade física acentuou as associações dos eventos sobrepostos. Por exemplo, o risco absoluto de transição de “sem incapacidade” para “incapacidade leve” um mês após a internação para indivíduos frágeis foi igual a 34,9% (IC95% = 34,5 – 35,3%) versus 4,9% (IC95% = 4,7 – 5,1%) para indivíduos não frágeis. Entre as possíveis razões de internação, lesão relacionada a quedas conferiu a maior tendência de desenvolvimento de incapacidade nova ou piorada.

Os pesquisadores concluíram que, entre pacientes idosos, principalmente os fisicamente frágeis, doenças interpostas e lesões aumentam grandemente a tendência de desenvolvimento de incapacidade nova ou piora da incapacidade pré-existente. Apenas os eventos mais potentes, isto é, aqueles que levam à internação, reduzem a tendência de recuperação da incapacidade.

Uma resenha de Change in disability after hospitalization or restricted activity in older persons - JAMA; 2010;304(17):1919-1928

La mochila que evita el dolor de espalda


La mochila que evita el dolor de espalda
Cada vez son más los niños en edad escolar que presentan problemas en la espalda por el mal uso que hacen de las mochilas. Posturas incorrectas y excesivo peso encabezan la lista de los errores más frecuentes que se cometen.
FUENTE | La Razón digit@l15/01/2011
Para corregir este problema surge la mochila Aironback que, en palabras de su creador, Juan Demetrio Chillarón, «gracias a su novedoso sistema patentado de respaldo ergonómico, el usuario, ya sea deportista o escolar, puede transportar la carga diaria sin sufrir lesiones de espalda o fatiga muscular y caminar totalmente erguido, favoreciendo así la corrección postural, muy importante en las edades del crecimiento».

Este sistema resulta más beneficioso que los convencionales debido a que «las mochilas actuales están poco adaptadas para el uso del transporte de cargas», añade. Para obtener estos beneficios, las mochilas Aironback tienen como objeto «la distribución óptima de las cargas a soportar, mediante unas cámaras de aire graduadas por unas válvulas de hinchado y un regulador de presión incorporados en el cinturón del abdomen de la mochila. Las cámaras hinchables están situadas una en la zona lumbar y otra en la zona dorsal, que son puntos de localización en la distribución del peso a transportar en la mochila con respecto a los puntos de carga de nuestro cuerpo. Una vez hinchada la cámara de la parte lumbar, el centro de gravedad de la mochila se aproxima a la vertical del usuario distribuyendo mejor la carga a soportar. Por su parte, la cámara de la parte dorsal, una vez hinchada, provoca un esfuerzo de flexión sobre la línea de hombros e hiperextensiona la columna vertebral alcanzando una postura totalmente erguida, potenciando la musculatura erectora del tronco y pectoral», explica Chillarón.

GRAN ACEPTACIÓN
Aunque el producto no estará disponible hasta mayo de este año, su creador sostiene que «ya ha sido presentada en ferias, tanto a nivel nacional como internacional, de Madrid o Hong Kong, donde ha tenido una gran aceptación por parte de los usuarios». Además, su uso «está avalado y aprobado por especialistas en traumatología y pediatría y, actualmente, se encuentra en manos del Instituto de Biomecánica para profundizar en el desarrollo del producto». A medio-largo plazo, «nos planteamos presentar un proyecto al Ministerio de Defensa y facilitar este sistema a los militares que están expuestos a cargar una gran cantidad de peso durante sus maniobras y marchas. También lo propondremos al Ministerio de Educación para contribuir a la mejora en el transporte de peso de los escolares», matiza Chillarón.

Autor:   B. Muñoz

La circuncisión protege del virus del papiloma


La circuncisión protege del virus del papiloma
La circuncisión rutinaria a varones sanos es uno de los pocos métodos que han demostrado científicamente reducir el riesgo de infección por VIH. Un estudio realizado en Uganda y publicado en The Lancet hizo que la OMS recomendara su empleo en países con tasas elevadas de sida, como en el África subsahariana.
FUENTE | Público15/01/2011
La revista británica vuelve ahora a recoger la demostración de una nueva ventaja de la circuncisión. Según dos ensayos clínicos paralelos de la Universidad Johns Hopkins (EEUU) y del Programa de Ciencias de la Salud Rakai (Uganda), realizados ambos en este país africano, los hombres circuncidados trasmiten un 23% menos el virus del papiloma humano (VPH) a sus parejas que los que mantienen la piel que protege el prepucio. El VPH es el único causante del cáncer de cuello de útero, una de las principales causas de mortalidad femenina en los países en vías de desarrollo. Aunque existen dos vacunas frente a este virus, su precio sigue siendo elevado.

OBSERVADO DESDE ANTIGUO
Ya en 1901 un investigador observó que había muy poca incidencia de cáncer de cuello de útero en las mujeres judías, que siempre contraían matrimonio con hombres circuncidados. Sin embargo, aunque otros estudios ya habían demostrado el posible papel protector de la circuncisión, ninguno se había diseñado como el actual, que compara directamente la presencia del virus en parejas de hombres que se someten o no a la intervención, a lo largo de dos años.

El editorial que acompaña al estudio valora positivamente los resultados de la investigación, pero recalca que la circuncisión no debe ser vista como un único método de prevención ya que, tal y como sucede con el VIH, la reducción en la transmisión es solo parcial y, además, pequeña, del 23% (en el caso del VIH oscila entre el 38% y el 66%). Así, los editorialistas reclaman la implantación masiva de programas de vacunación frente al VPH.

Autor:   A. I.

Los nuevos trucos de Google Goggles


Los nuevos trucos de Google Goggles
Google Goggles, la fantástica aplicación móvil que permite buscar en la Web simplemente con tomar una fotografía, ha aprendido un par de nuevos trucos. Además de acelerar la lectura de códigos de barra, Google Goggles ahora reconoce anuncios impresos e incluso resuelve Sudokus.
FUENTE | ABC Periódico Electrónico S.A.15/01/2011
El pasado noviembre, Google anunció un experimento con Google Goggles para ofrecer más contenido a los usuarios cuando escanearan algunos anuncios. A diferencia del experimento de noviembre, que llevaba a los usuarios a un enlace específico, la nueva característica lleva a una lista de resultados relacionados. La aplicación reconocerá anuncios que hayan sido publicados en revistas estadounidenses desde agosto del 2010.

En cuanto al Sudoku, Google Goggles será capaz de resolverlos. Según Google, "si alguna vez te atoras, toma una fotografía clara del Sudoku entero con Goggles y te diremos la solución correcta".

EL FUTURO INTERNET MÓVIL

Estas nuevas posibilidades de Google Goggles son accesorios para hacer la aplicación más divertida para los usuarios y más atractiva para los anunciantes. Sin embargo, el interés que tiene Google en las búsquedas visuales nos da una idea de cómo será el Internet móvil en los próximos años.

En octubre se lanzó Google Goggles para iPhone, y a la espera de que llegue el Nexus S a España, nos gustaría conocer las experiencias concretas de nuestros lectores utilizando esta popular aplicación con los diferentes smartphones. 

Bargain Skiing? Yes, It’s Possible.

January 11, 2011, 11:00 PM

Bargain Skiing? Yes, It’s Possible.

A skier prepares to head down the slopes at Whiteface near Lake Placid.Seth Kugel for The New York TimesA skier prepares to head down the slopes at Whiteface near Lake Placid, N.Y.
I don’t own skis and I haven’t been on a chairlift this millennium. My winter clothing is so woefully insufficient after spending the last two years in balmy Brazil that the warmest jacket in my possession is a black leather number with a broken zipper. I didn’t even own a hat and gloves until a recent knuckle-numbing emergency led me to drop $10 on a Chinatown street corner.
That would explain how perplexed I was at the tiny little skis the man was trying to rent me at Whiteface ski resort during my bargain overnight escape in December.
“Why are these things so short?” I said.
“I guess it’s been a long time since you’ve been skiing,” he said.
Moments later I was bemoaning my long absence from the slopes with the teenage girl who was checking lift tickets as I got ready for my first ascent of the mountain that claims to have the biggest vertical drop of any ski resort in the East.
“It doesn’t matter,” she said as she held her scanner up to my lift ticket bar code. “It’s like riding a bicycle.”

Understood, but how long have they been scanning lift tickets every time you go up the mountain? What was next, magnetized ski poles that would magically pop back up from the ground if a skier stupidly drops one from the chairlift 30 seconds into the ride?
A skier disobeys advice at Whiteface.Seth Kugel for The New York TimesA skier disobeys advice at Whiteface.
Um, no, as I found out shortly. But no matter, thanks either to parabolic technology or to my being in decent shape because of my recent dedication to Bikram yoga, I was soon barreling down the slopes like a teenager myself, remembering just how great it feels to zoom past snow-covered pines, with wind whipping harmlessly past goggles, and smooth turns fueled by a flapjack and bacon breakfast just moments earlier.
So why hadn’t I been skiing in so long? I guess because I thought it was simply too expensive for anyone without the dedication to have his own equipment or some kind of season pass. But it turns out that even if you’re a rusty or unprepared skier like me — with no equipment, no car, no one to share hotel costs — you can plan a trip to the Lake Placid area with a budget of less than $300.
Whiteface seemed the obvious choice. It is in Wilmington, N.Y., right near Lake Placid, and at 300 miles from New York City was just barely within tolerable driving range. I went midweek in December, when hotels were empty and presumably desperate for customers. Not everyone can do that, of course, but on the other hand, I was traveling alone and just about all the bargain packages are based on double occupancy, so I had to wrangle up my own deals. (Let’s call it even.)
A room at Gauthier’s Saranac Lake Inn: $199, three nights, with lift tickets for two.Seth Kugel for The New York TimesA room at Gauthier’s Saranac Lake Inn: $199, three nights, with lift tickets for two.
A slew of calls to hotels that I found on Lake Placid’s tourism office Web site led to the very friendly staff at Gauthier’s Saranac Lake Inn. Stating my (fictitious) case – that I was looking to play hooky from work as long as I could keep costs down – they agreed to give me a $109 special for one night, single-occupancy, significantly less than reserving the room at a $79 rack rate and paying $57 for an early-season lift ticket. (Their best rate for couples is even better: a three-night stay for $199, including lift tickets.)
Equipment rental at the mountain would cost $40, and a plea I put out on my personal Facebook page landed me a cozy, several-layered ski outfit that only cost me a post-midnight trek to my friend’s Greenwich Village apartment to make the pick-up. (He was working long hours and could only meet me that late.)
Though it is possible to get up to Lake Placid by public transportation  —  taking Amtrak to Westport and a shuttle the rest of the way  —  the staff at Gauthier’s said it was very tough (though not impossible) to get around town without a car. So I drummed up the best rental I could find, $38 a day for a Chevy Aveo from Enterprise’s office in the Doubletree Suites Hotel in Jersey City —  shocked when that beat out every online trick I could think of, including bidding on Priceline.
That Jersey City location also has a few other advantages to renting in the city: the PATH train from Manhattan to right near the office costs less than a subway ride ($1.75 vs. $2.25) and you skip tunnel or bridge tolls ($8) when you return to the city.
When I got to Enterprise, I found out that I had been upgraded to a Jeep Cherokee S.U.V. I was temporarily elated. But that was before I realized my gas budget would have to be more than doubled to $105, putting me past $300 and not doing any favors to the environment, either.
A house near Lake Placid.Seth Kugel for The New York TimesA house near Lake Placid.
Though it hadn’t snowed yet downstate, five hours later I was entering a Lake Placid region in the throes of a full-on lake-effect snowstorm. I realized that it had been three winters since I’d seen snow, and this was the real thing: big flakes whooshing sideways by the windshield and clinging onto pines and picturesque shingled roofs decked out with Christmas lights. Feeling every bit the tourist, I pulled over the car and started snapping pictures of the Norman Rockwell panorama.
I arrived at Gauthier’s to find an old-school motel retrofitted with comfy beds and organic Tima linens  —  turns out the owners, two 30-something brothers named Doug and Dan Brownell, along with Doug’s wife, Nicole,  have wonFour-Leaf Audubon eco-status for their place, and are in the midst of redoing all the bathrooms in terra-cotta style as well. At the recommendation of Cory, a part-timer who must be the nicest hotel clerk around, I went to the Lake Placid Pub & Brewery, where I had a pint of 46’er pale ale ($4 – her husband’s favorite, I believe she said) and the chicken pot pie ($10 – recommended by the bartender on a break from gossiping with the local crowd).
Breakfast at Saranac Sourdough.Seth Kugel for The New York TimesBreakfast at Saranac Sourdough.
I turned in early, eager to get to the slopes and be the first in line when the lifts opened at 8:30 a.m. Two obstacles, however, stood in my way: my general laziness, and the pancake, egg and bacon breakfast at a local bakery and deli called Saranac Sourdough. So I got up at 8, got to Sourdough by 9, and to the slopes by 10.
Local retirees, workers who had the morning off, and college students were out in full force. Conversation in the gondola  —  I had forgotten about that part of skiing  —  ranged from what classes the students were skipping to a chef talking about the Korean ribs he was going to make that afternoon to talk of someone who had crashed on the first run of the day and broken his leg.
Though the regulars told me that I was only seeing a fraction of the mountain — fewer than a quarter of the trails were open — it looked just great to me. The lake-effect snow had largely blown into the woods, but snow-making equipment made up for it, and a few icy patches just made things more exciting. The scenery was spectacular (on an East Coast scale, I admit), and there were no lines at all for the lifts, meaning I could get in about 10 good runs.
I took my last run at around 3  —  not that long before darkness began to fall  —  and headed to Big Mountain Deli and Creperie for one of their 46 luscious-sounding sandwiches on my way out of town. I suppose that, having already cracked my $300 limit with gas still to be bought, I should have just hit the road and starved myself. But sandwich No. 1, the Marcy  —  roast turkey, cranberry horseradish sauce, Cheddar, apples and cracked pepper mayo on asiago peppercorn bread  —  was too good to pass up for $7. Plus, five and a half hours of the NPR-Fox-Elvis-Caliente rotation on the S.U.V.’s satellite radio was more than I could bear on an empty stomach.