LOS VIAJES ESPACIALES Y LA OSTEOPOROSIS

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La pérdida de hueso predispone a fracturas y conforme aumentamos en edad perdemos más rápido el hueso, hagamos de cuenta un bloque de hielo que se va derritiendo poco a poco hasta desaparecer. Necesitamos prevenir la pérdida ósea porque cada día más personas están alcanzando edades más longevas y el aumento en el número de adultos mayores en el mundo significa más individuos que corren el riesgo de una fractura.
El adelgazamiento óseo y las caídas predisponen a las fracturas.

Estas están provocando una amenaza financiera a muchas comunidades a través del mundo. Las fracturas están ocurriendo más rápido que nuestra habilidad para prevenirlas y no debemos darles oportunidad de que aparezcan.
El objetivo del tratamiento es prevenir la evolución de la osteoporosis (OP) y revertir el daño estructural que ocurre en las mujeres, esto es, reconstruir el esqueleto. El mundo científico en colaboración con la industria y muchos gobiernos han sido exitosos en disminuir el riesgo de fractura  hasta en un 50 a 60% en personas con alto riesgo de sufrirlas. Podemos reducir el aumento en la porosidad del hueso, disminuir la pérdida ósea y el adelgazamiento de la cortical sitio en donde se fija la masa muscular que mueve a todo el esqueleto. Podemos prevenir la ruptura de las placas trabeculares y las láminas de hueso mineralizado que hacen del esqueleto una pieza de ingeniería. La perfecta unión de la forma y la función.

viajespaciales

¿LA FUERZA DE GRAVEDAD, UN ENEMIGO MORTAL?

Algunos autores consideran que la fuerza de gravedad (fuerza con que todos los cuerpos son atraídos hacia el centro de la Tierra, y esta atracción dependerá de la masa del objeto en cuestión, a mayor masa, mayor será la fuerza) podría resultar en una amenaza para los pacientes con OP, ya que esta característica terrena hace que caigamos al suelo en ciertos momentos y esto nos podría llevar a una lesión ósea. Sin embargo esto es algo que no podemos obviar, si vivimos en la Tierra, necesitamos estar bajo esta fuerza atrayente. Si fuéramos  pompas de jabón o medusas, pues quizá no nos importaría; pero somos organismos biológicos que dependemos de nuestro peso y de la gravedad. Lo que si puede llegar a suceder es que en los años próximos, cuando los viajes espaciales sean una forma de transporte diario, la ingravidez persistente nos podría llevar a una osteoporosis muy especial.
Los médicos de astronautas, están vigilando todo este proceso en sus pilotos pues se han dado cuenta a lo largo de los años, que esta pérdida ósea será muy importante a considerar en viajes interplanetarios futuros. El 20 de febrero de 1962, el teniente coronel John Herschell Glenn, del cuerpo de Marines de los E.U., se convirtió en el primer astronauta estadounidense en dar la vuelta a la Tierra, en un vuelo de tres vueltas completas a bordo de la nave Friendship 7. Y es el mismo John Glenn quién el 28 de octubre de 1998 despegó con la nave Discovery en la Misión STS-95, completando 134 órbitas a 345 kilómetros de altitud. Con una duración de la misión de 8 días, 21 horas y 44 minutos. Finalizando el 07 de noviembre de 1998, en el Centro Espacial Kennedy en Florida. La nave llevaba una carga útil en el Spacehab Spartan-201. El objetivo de la misión era realizar una variedad de experimentos de ciencia en el Spacehab, desplegar y recuperar el satélite Spartan, además, se completaron más de 80 experimentos científicos  durante la misión. El mismo John Glenn, con 77 años de edad, realizó algunos precisamente para valorar la calidad ósea en personas de la tercera edad y que podían efectuar viajes en estados de ingravidez.

 

LOS RESULTADOS DE ESTOS ESTUDIOS MOSTRARON QUE:

Los astronautas son propensos a perder masa ósea durante viajes largos en el espacio, ya que el cuerpo siente que el esqueleto no requiere de apoyarse en un punto fijo en el vuelo, como en la Tierra. Dada la reducida gravedad en la nave o en una estación espacial, no se necesita tanta masa ósea para que el cuerpo pueda sostenerse como en la Tierra. Cuando ingerimos alimentos que contienen calcio, un nutriente esencial para lograr huesos sanos, el calcio se absorbe por la vitamina D en la corriente sanguínea, desde donde se lleva a los huesos. Pero si tenemos en cuenta que el cuerpo intenta reducir activamente la cantidad de masa ósea, el nivel de absorción de calcio en el espacio es menor que en la Tierra, por lo que se produce la pérdida progresiva del hueso. Fue el propio Glenn quien propuso a la NASA, que se enviara al espacio a un adulto mayor para estudiar las similitudes entre los cambios orgánicos que produce la ingravidez y los originados por la vejez.
Cuando John Glenn voló por primera vez alrededor de la Tierra, a bordo del Friendship 7, casi 17 millones de norteamericanos eran mayores de 65 años, 50 años después, los estadounidenses mayores de 65 años suman ya 59 millones, y cerca de diez millones de americanos superan los 85 años. La tendencia es inequívoca: esos viejos muy viejos habrán alcanzado los 19 millones en el año 2050, mientras que los mayores de 65 años serán más de 75 millones. “Estos datos -explica Glenn- van a tener una gran repercusión en nuestra economía, cultura y en el sistema sanitario”. Esta progresiva esperanza de vida de la población desarrollada, es, paradójicamente, lo que justifica la presencia del veterano John Glenn en la misión espacial; reconoció, que fue en ese vuelo un “cobayo humano” utilizado para un intrigante experimento de la NASA y el Instituto Nacional de la Salud: el análisis de las causas del envejecimiento en las condiciones de microgravedad del espacio.
El senador por Ohio consideró un privilegio haber sido seleccionado por la NASA y el Instituto Nacional de Envejecimiento que depende del Instituto Nacional de la Salud. Estas instituciones, comenzaron a trabajar en este programa hace años (1996). Las investigaciones han demostrado que en el espacio, y durante el periodo de tiempo que permanecen fuera de la atmósfera, los astronautas sufren pérdidas de masa ósea y muscular similares a la que produce en la Tierra el proceso natural del envejecimiento. Los astronautas también padecen trastornos coyunturales en el sueño, ciertos problemas de coordinación motriz, una leve ralentización del ritmo cardiovascular e incluso decrece su inmunidad ante los virus más comunes. Es como si la respuesta natural del organismo a la falta de gravedad fuese volverse viejo. Curiosamente, y esto es lo que más impresiona a los científicos, ese “cuadro clínico de vejez” de los astronautas en el espacio desaparece tan pronto como regresan a la Tierra. Esto pudiera llevar a pensar ¿qué sin gravedad la vida podría ser más llevadera? Nadie sabe todavía lo que esto significa. Pero esta fue una investigación científica que pretende contribuir en un futuro a aliviar el deterioro que provoca la vejez en los seres humanos. Y tal vez de paso se podría aliviar el gasto que origina a los países la prolongación asistida de la vida.
En el vuelo, todos los miembros de la tripulación compartieron una misma inquietud científica. Evidentemente, un experimento de esas características los obligo a todos a dormir con electrodos, para monitorizar las horas de sueño, a realizar análisis de sangre y de orina y otras tareas que formaran parte del trabajo.
En el vuelo se llevaron a cabo experimentos científicos, uno de ellos fue la prueba que imitó los efectos del envejecimiento y su relación con el vuelo espacial. Pérdida de densidad de masa ósea y muscular, patrones de sueño interrumpidos, un sistema inmune deprimido y la pérdida del equilibrio. En el Discovery también se realizaron 30 experimentos más pequeños que fueron desde el crecimiento de las plantas, hasta el desarrollo de nuevas técnicas para la elaboración de medicamentos antitumorales.
En el primer día de la misión, Glenn comenzó a dar la primera de una serie de muestras de sangre y orina necesarios para investigar los efectos del vuelo en su cuerpo. Las extracciones de sangre fueron parte del Estudio de Intercambio de Proteína durante un vuelo espacial, que registro el equilibrio entre la formación de proteínas y su destrucción, los dos aspectos que contribuyen a la atrofia muscular. Luego comenzaron varios estudios previstos, como investigar los cambios en el cuerpo humano en ingravidez y cómo compararlos con el proceso de envejecimiento. La primera noche, Glenn tomó una cápsula especial antes de acostarse para registrar la temperatura de su cuerpo durante el descanso, como parte de la investigación de sueño durante la misión.
Además contribuyo a experimentos con cultivos de células óseas como parte del estudio OSTEO canadiense, para evaluar la actividad celular de hueso en condiciones de microingravidez. Para encontrar una solución a esta condición, Millenium Biologix, en asociación con la Agencia Espacial Canadiense (CSA), desarrollo el Sistema de Mini Laboratorio OSTEO para dirigir la investigación de células óseas. Además de proporcionar oportunidades de investigación de alto valor en condiciones de microgravedad utilizando la tecnología de la compañía Skelite, OSTEO fusiono los sistemas de ingeniería de tejidos clínicos avanzados de la compañía, la cual planea que estos innovadores productos estén disponibles para hospitales y clínicas de todo el mundo, lo que les permitirá disponer de su propia ingeniería del tejido para sus pacientes. Las característica específicas a las que se dirigen sus estudios son: Exploración de cómo los trastornos en el sueño y en las funciones inmunológicas pueden causar el trastorno del metabolismo óseo. Caracterización e identificación de los métodos de regulación de los genes óseos en condiciones de microgravedad. Exploración del uso de la hormona paratiroidea (PTH) para aumentar la formación ósea en condiciones de microgravedad.

Glenn también trabajó con el experimento de Separación Orgánica Avanzada (ADSEP), que consiste en la capacidad para separar y purificar materiales biológicos, y el Sistema de Procesamiento de la Microencapsulación Electrostática (MEPS), que estudia la integración de cápsulas antitumorales conteniendo dos tipos de drogas. Cada mañana, Glenn y su compañero Chiaki Mukai completaban pruebas de rendimiento cognitivo como parte de su participación en el estudio del sueño. Estas pruebas incluyeron mediciones de la rapidez respondiendo a señales de luces en un ordenador portátil. Glenn siguió trabajando con los experimentos ADSEP Y MEPS, así como llevando electrodos para registro de datos de su ritmo cardíaco, como parte de una investigación de variabilidad de la frecuencia cardíaca durante el vuelo espacial. Durante la misión, John Glenn y el especialista de la misión Pedro Duque trabajaron sobre el experimento de crecimiento de plantas llamado astrocultivo. Además de trabajar en experimentos, la tripulación realizó también rutinas de ejercicio regular.  La misión STS-95 terminó el 07 de noviembre de 1998, después de un aterrizaje suave a las 11:04 a.m. en el Centro Espacial Kennedy en Florida. El descenso de reingreso duró una hora y fue manejado impecablemente por el comandante Curtis Brown y el piloto Steve Lindsey. Así finalizó el retorno de John Glenn al espacio.
El estudio del “cuadro clínico de vejez” de los astronautas en el espacio, marca toda una serie de experimentos y pruebas tanto clínicos como de medicamentos, para encontrar los mejores compuestos para control de la osteoporosis.

Aquí en la Tierra, por lo pronto, se necesitan drogas que no solo prevengan el desarrollo de OP, sino que además puedan reconstruir el esqueleto, reconectar y engrosar las trabéculas, engrosar al hueso cortical depositando hueso nuevo por fuera (semejante a la capa de pintura que se da a una casa deteriorada), otras más que depositen hueso por dentro y reduzcan el número y tamaño de los poros que le da su nombre a la OP.

La colágena, es la proteína que forma la piel y el hueso, es la fibra que da elasticidad al hueso, la naturaleza adornó a la colágena con los cristales resplandecientes de hidroxiapatita cálcica para reforzar los tejidos dando el perfecto balance entre la elasticidad y la dureza ya que pueden tolerar cargas sin pandeo o romperse.

Las drogas son necesarias para restaurar el material óseo, la matriz colágena y  su contenido mineral, para asegurar que la dureza sea suficiente para tolerar cargas, pero no el punto en donde demasiada dureza pueda llevar a una pérdida de elasticidad. Cuando el hueso recibe carga, deberá ser suficiente para absorber energía en la compresión y rebote, semejante a un amortiguador de auto que absorbe los impactos del camino. Ahora podemos restaurar elasticidad y dureza. Conforme han pasado los últimos diez años se han investigado más sobre ciertas drogas para prevenir o disminuir el desgaste óseo. Hoy existen drogas que previenen la pérdida ósea y reducen la posibilidad de que una fractura pueda ocurrir hasta en un 50%. Los medicamentos como el raloxifeno, ranelato de estroncio, denosumab, alendronato, risedronato, ibadronato y zoledronato, son llamados antirresortivos, disminuyen y detienen el progresivo deterioro del hueso pero son incapaces para restaurar la arquitectura ósea, no conectan trabéculas por ejemplo. Estas drogas hacen más lento el proceso de renovación del esqueleto al actuar sobre el osteoclasto aumentando el grado de mineralización dentro del hueso.

Las caídas son un factor importante que pueden causar fracturas de cadera y otros huesos. Ha sido reportado que los factores genéticos pueden ser importantes en determinar el riesgo de caídas tales como la marcha y el balance. Sabemos que la vitamina D puede ayudar a reducir el riesgo de caídas, ya que mejora la función muscular en adición a las acciones en el metabolismo óseo. Se recomiendan suplementos que proporcionen dosis diarias tanto de calcio como de vitamina D, especialmente para grupos de riesgo como los ancianos y las mujeres postmenopáusicas, junto al aporte básico procedente de la dieta y los alimentos enriquecidos.

Las drogas reducen el número de fracturas pero no eliminan el riesgo de sufrirlas, la mayoría de los pacientes quienes las sufren están subtratados o mal tratados. Desafortunadamente en muchos países en las mentes y juicios de muchas personas, la osteoporosis es la inevitable consecuencia de ser viejo y este concepto mal entendido debe ser combatido; es cierto vemos a más pacientes con fracturas debidas a la OP por arriba de los 50 años, pero en ciertos casos en donde haya una enfermedad crónica como artritis reumatoide, cáncer, epilepsia, etc., podemos encontrar osteoporosis ya establecida debido a los medicamentos prescritos para tales padecimientos, antes de los 40 años.

Existen estudios como la densitometría ósea central (DOC), que nos ayudan a dar un diagnóstico certero para disminuir el riesgo de fractura aún en personas por arriba de los 80 años. El concepto de que el tratamiento deberá ser otorgado solo después de la primera fractura es inaceptable, así como tratar la hipertensión después del primer ataque o la hipercolesterolemia después del primer infarto del miocardio; esto debe detenerse. Hasta el momento estas DOC son muy precisas, de bajo costo y en México los aparatos con las que se realizan están calibrados para la población mexicana. Así es que mientras viajamos al espacio, lo mejor es aquí en la Tierra, acudir al médico, hacernos los estudios y tomar los medicamentos para evitar las fracturas por osteoporosis.

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    this type of pipe dream can mean your soulmate is not paying you enough time. All however convinced providing super very disturbing desires other women working to get with tiger woods or else along with other. Or so is this every single certainly more and more kooky aspire spam, prefer that time a person will imagined was put heat alongside ballooning Coolio? dreaming about learning to be a spouse will be able denote a feeling of guiltiness in other locations you know.. still another aspiration interpretation of your infidelity suggests that expectations are not appeased because of your better half. instantly two years right after we live independently nonetheless partner. most people can remember that a ambition as soon as woke moving upward inside a logpile with regards to perspire, mad at contact getting some shut-eye together with them.

    dream of colluding with other players desires which

    rrt had been odd and i went back and forth among sac consultants. a link started out like every recent become in every location in conjunction, spend time with people connected, connect continually together, and a lot of love. resorting all your down after concepts, ethics, possibly surrender you are insanely putting. it’s time to notify your secure down along with opened a discussion as well as lover. a fear of try to be regarded as little or idiotic and also by the others inside the show mess or a weakness.

    What this particular means To dream about attempting to cheat On your boyfriend

    to paraphrase, cheating dreams not often represent real. I feel that clarifies the mention of the not revealing identically interests nor sector. interpreting and geting a grasp on Cheating fantasies at the time trying to assess a dishonest dream it can be necessary for you to look at the precise issues and instances you choose to encounters with the dream. I a fancy i started sneaking around on the subject of excellent boyfriend with this beautiful woman. If your relationshipr is not affectionate, you might have a dream of using cheat programs to meet up with any middle strive to be appreciated by just a partner. hopes for infidelity to be able to ponder on exactly average it? first employed to be involved who another young lady what food was in the house but best, because they were specifically chilling with one another accidently as well as got me into her and she ended up unbelievably lovely.

    deceitful fantasies outlined: What this means to deceive desired

    you should like he is your boyfriend robbed on your ex quite being unfaithful, plans and ideas the green lighter that taken advantage of about them often open up not having permitting them to do know. i became with a group of people so we come upon the most wonderful views. When I experimented with come distinct in the goal not on your life chop. I a excellent i always defraud in a neighbour. If he could be doing something as well if there’s something develop me? i came to be all the mistress so as to the best boyfriend for quite a while until now he divorced in addition to the betrothed people.

    dream of a Boyfriend cheating on me

    to be a implant registered nurse my wife is always working and is normally available. my partner and i one daydream how to become visiting on my own reacting for that prize patrol. making, thinks can be gossip because of the sub-conscious, the actual do-it-yourself. at another desire she gets separated with me additionally texting to tell me that’s about goes she passes with other many men. I a objective I had infidelities on your my husband and my boyf with close friends aged dad. In awakening everything that she seemed which often her person in charge appears to be purposefully uneasy her consisting of making special treatment to some people where you work decided not to worth it.

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