De vueltas con el futuro
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1 DE VUELTAS CON EL FUTURO Dr. Josep Morera
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Transcript of De vueltas con el futuro
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DE VUELTAS CON EL FUTURO
Dr. Josep Morera
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“Nunca hago predicciones y nunca las haré” Paul Gascoigne
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Eriksen M. Judith Mackay Hana Ross EL ATLAS DEL TABACO cuarta edición. http://www.tobaccoatlas.org/uploads/Images/PDFs/TA4Spanish.pdf !
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The art of medicine The cigareDe catastrophe conEnues
The lancet Vol 385 March14,2015 Robert N Proctor
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Manila (Filipinas) 31 octubre 2011 Nace Danica May Manila Camacho. la ciudadana número 7mil millones del planeta
Sarajevo(Bosnia) 13 octubre, 1999 Nace Adnan Nevic, el ciudadano número 6 mil millones
De vueltas con el futuro ¡Que es la demograUa!
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! !El mundo en 2050.Todas las tendencias que cambiaran el planeta (The Economist).ed Franklin D. y Andrews J. 2012
¡Que es la demograUa! De vueltas con el futuro
7 Noncommunicable Diseases David J. Hunter, M.B., B.S., M.P.H., Sc.D., and K. Srinath Reddy, M.D., D.M.N New Engl J Med 2013; 369:1336-‐1343 October 3, 2013
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8 N Engl J Med. 2013 Jan 24;368(4):351-‐64
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9 N Engl J Med. 2013 Jan 24;368(4):341-‐50
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Smoking and Mortality — Beyond Established Causes Brian D. Carter, ChrisXan C. Abnet, Diane Feskanich, Neal D. Freedman., Patricia Hartge, Sc.D., Cora E. Lewis, M.D., Judith K. Ockene, Ross L. PrenXce., Frank E. Speizer,, Michael J. Thun, and Eric J. Jacobs. N Engl J Med 2015; 372: February 12,
In conclusion, this comprehensive examinaXon of cause-‐specific mortality in a large contemporary populaXon idenXfied associaXons between smoking and increased mortality from several diseases that are not currently established as caused by smoking. Although these associaXons should be invesXgated further, our results suggest that the number of persons in the United States who die each year as a result of smoking cigareaes may be substanXally greater than currently esXmated.
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Kiley J, Mockrin S, Lauer M, Mensah GA, Hoots K, Patel Y, Cook NL, Paaerson AP, Gibbons GH. Am J Respir Crit Care Med 2015;191:489–491.
The NHLBI in 2025: What If . . . Imagine a world where we are able to prevent and preempt the burden of cardiovascular, lung, and blood diseases; a world where we are able to capture the promise of personalized precision medicine, where each person receives the right treatment, tailored to their needs, at the right Xme. In this new world, what if we were able to realize a stroke-‐free generaXon of individuals living with sickle cell disease (SCD), what if we were able to eliminate health inequiXes (both domesXc and global) with effecXve and rapid uptake of evidence-‐based pracXces and tools, and what if we could expand the fronXers of scienXfic knowledge and revoluXonize how we diagnose, prevent, and treat disease by leveraging the power of big scienXfic data systems? This vision is not merely a collecXon of idle dreams; the boundless possibiliXes of this bold new world are well within our reach.
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To the Editor: In their nice editorial in the March issue of the Journal, Kiley and colleagues (1) list the strategic prioriXes and procedures of the NaXonal Heart, Lung, and Blood InsXtute (NHLBI) to streamline human health research up to 2025. From a historical perspecXve, we all recognize the significant achievements of the U.S. NaXonal InsXtutes of Health and the NHLBI, with decades of success, that have facilitated breakthroughs in promoXng health and fighXng disease by funding key research both internally and extramurally, including internaXonally. However, we were surprised that the (magical) keyword “tobacco” was not menEoned at all within this short document, so anyone might wonder, what if . . . the NHLBI considers tobacco? Likely, beyond your pages, some readers in the sister, simultaneous publicaXons in the American Journal of Public Health, Blood, CirculaXon, or the Journal of the American College of Cardiology might consider that tobacco affects paXents in most (all?) respiratory and nonrespiratory condiXons. We must keep reminding ourselves that tobacco is the first and foremost causal, avoidable risk factor for human disease. Perhaps it has been neglected too ojen in the past in many medical venues (2, 3). Therefore, the NHLBI should welcome iniXaXves on key tobacco-‐related translaXonal issues as well as on the efficacy and the effecXveness of any smoking reducXon and/or avoidance intervenXons, in addiXon to iniXaXves on any other risk factors to help define smoking issues at the populaXon and individual levels. Well past the so-‐called cigareae century (4), tobacco is sXll causally linked to an increasing number of diseases (5). Although there have been some recent successes in the West, there are more smokers nowadays than ever before in human history, causing far too many premature deaths and disabiliXes (6). We strongly believe that research drives all health advocacy and that the final soluXon to the tobacco problem will be through legislaXon (7). Rephrasing the introductory paragraphs of the editorial, “Imagine a world with no tobacco, and later, perhaps only one generaXon ajer, a no-‐tobacco-‐related-‐disease world.” Wouldn’t it be nice? We can set this objecXve within our lifeXme, and certainly we will parXcipate in this process (8). Volume 191, Issue 1(June 15, 2015) Soriano and Morera
What if . . . the NaEonal Heart, Lung, and Blood InsEtute Considers Tobacco? Joan B. Soriano M.D. and Josep Morera M.D.
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FluEcasone furoate and vilanterol and survival in chronic obstrucEve pulmonary disease with heightened cardiovascular risk (SUMMIT): a double-‐blind randomised controlled trial Jorgen Vestbo, Julie A Anderson, Robert D Brook,Peter M A Calverley, B.Celli, Courtney Crim, Fernando MarXnez, Julie Yates, David E Newby, on behalf of the SUMMIT InvesXgators.
The lancet. April 2016
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Indacaterol-‐Glycopyrronium versus Salmeterol-‐FluEcasone for COPD. Wedzicha JA1, Banerji D1, Chapman KR1, Vestbo J1, Roche N1, Ayers RT1, Thach C1, Fogel R1, Patalano F1, Vogelmeier CF1; FLAME InvesXgators. N Engl J Med. 2016 May 15
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Vestbo J et al. N Engl J Med 2016;375:1253-‐1260.
Treatment Effect on Moderate or Severe Exacerba
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Chest. 2012 Nov;142(5):1300-‐7.
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Emerging IndicaEons for Extracorporeal Membrane OxygenaEon in Adults with Respiratory Failure Darryl Abrams1 and Daniel Brodie1Annals of the American Thoracic Society, Vol. 10, No. 4 (2013), pp. 371-‐377.
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Butler JP et al. N Engl J Med 2012;367:244-‐247.
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Nanotechnology in respiratory medicine Omlor et al. Respiratory Research (2015)
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The Asthma–COPD Overlap Syndrome Postma DS, Rabe KF. N Engl J Med 2015;373:1241-‐1249.
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De vueltas con el futuro
CONCLUSIONES 1.-‐ La mortalidad por tabaquismo seguirá aumentando en todo el siglo XXI 2.-‐ Se priorizan las medidas terapéuXcas sobre las medidas prevenXvas 3.-‐ El tabaquismo, la obesidad y el asma, y sus patologías relacionadas, serán nuestros máximos retos en el futuro 4.-‐ Los grandes avances en bioingeniería, biotecnología, y genéXca prometen grandes espectaXvas en un futuro próximo
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