domingo, 25 de diciembre de 2011

Can caffeine make us healthy?

We're always being told to cut down on caffeine for our wellbeing – yet new studies suggest it could protect against a range of diseases. Kate Hilpern filters fact from froth

For years we have been told to beware of caffeine. Now we seem to have swung in the opposite direction, with studies claiming that moderate amounts of coffee may reduce headaches and protect against diabetes, Alzheimer's and heart disease, among others. So where does the truth lie?

We don't all have the same reactions to caffeine, Mehul Dhinoja, a consultant cardiologist at BMI London Independent Hospital, says.

"Each of us has an enzyme in the liver that breaks down and metabolises caffeine. It's that process that enables caffeine to have its effect around the body," he says. "Some people are born with an enzyme that works extremely efficiently and others have quite the opposite. Because this isn't controlled in studies about caffeine, it's not surprising to find statistical contradictions."

Peter Rogers, head of experimental psychology, says some people are more sensitive to the effects of caffeine, while others develop a tolerance. "One of the things caffeine has been found to do is increase blood pressure and make your hands shake a little," he says. "But actually this depends if you're a person who regularly consumes caffeine."

You can even develop a dependence of caffeine so that without it, you can feel fatigued and headachey, he says. "That's why if coffee drinkers haven't had caffeine for a while – for example, overnight – the coffee they have in the morning is likely to make them feel more energetic and alert, while for a non-regular drinker, it will make them jittery."

So while some studies say coffee stimulates the brain and makes drinkers feel more awake, Rogers and his team have found the "caffeine high" may just be a reaction to the body craving the drug. Caffeine may even have radically different effects on the sexes. Studies from Bristol University have found that drinking caffeinated coffee boosted a woman's performance in stressful situations, but had the opposite effect on men, who became less confident and took longer to complete tasks once they had several coffees.

What caffeine is good for

Forget hair of the dog. If you want to cure a hangover, a good old cup of coffee and aspirin really is best, according to a new study from Thomas Jefferson University in Philadelphia. Confirming what many have suspected for years, the research found that the caffeine in coffee and the anti-inflammatory ingredients of aspirin reacted against the chemical compounds of ethanol, or pure alcohol, which – even in small doses – can bring on headaches.

Tim Grattan, who developed the technology for the new paracetamol and caffeine product, Panado Extra Advance, isn't surprised: "There's plenty of clinical evidence that shows caffeine actually speeds up the painkilling properties of various painkillers. In fact, caffeine has played a role in making our new product 37 per cent more tough on pain than ordinary paracetamol tablets."

Drinking lots of coffee can also boost sports performance by as much as 6 per cent – but, critically, only in any activity where muscles are not being worked to the limit, meaning coffee or tea could benefit a long-distance runner but not a sprinter.

Rob James, from the University of Coventry's department of Biomolecular and Sports Science, believes caffeine in the bloodstream may influence receptors on skeletal muscle, making a person temporarily more powerful. If you overdo it, fear not – caffeine can help here, too. A study from the University of Georgia found that caffeine can help reduce the soreness that discourages some people from keeping up their workouts.

What it's bad for

Contrary to popular opinion, one thing coffee doesn't do is sober you up – it may even further impair your judgement, scientists at Temple University in Philadelphia have found. Combining alcohol and caffeine at the same time produces a potentially lethal mix that makes it harder to realise you are drunk, according to the study published in Behavioural Neuroscience. Perhaps less of a surprise is the discovery that energy drinks – some of them, at least – are bad for our health. "There have been increasing instances of atrial fibrillation (AF), a heart-rhythm problem, among young people who consume large amounts of energy drinks," Dhinoja says. It's not just drinks that can cause this problem. In 2009, a 13-year-old boy needed hospital treatment after ingesting "energy" chewing gum that contained 320mg of caffeine – more than in three cups of coffee.

Large amounts of caffeine in pregnancy also appear to be risky. Back in 2008, the Food Standards Agency warned women to have no more than two cups of coffee a day after a study linked caffeine to low birth weight. Caffeine may affect your chances of getting pregnant in the first place, too, according to a Netherlands study that found that women who drank four cups of coffee a day were 26 per cent less likely than average to have conceived naturally.

Caffeine could even shrink some women's breasts. Swedish research found that too much of it can affect hormones, playing havoc with their bust size.

Cancer and heart disease

An analysis of 59 studies just published on the BioMed Central Cancer website suggests that coffee consumption may reduce your overall risk of getting cancer and that it may be inversely associated with the risk of bladder, breast, pharynx, pancreas and prostate cancers and leukaemia, among others. One study even discovered that caffeine can cut the risk of skin cancer by more than a third.

But women who drink more than four cups of coffee a day increase their risk of developing breast cancer by a third, according to Harvard University. A high caffeine intake can also increase the chance of developing larger tumours, which are harder to treat.

The jury is still out on caffeine's relationship with the heart, too. Arthur Klatsky, a cardiologist, and his team at the Kaiser Permanente Division of Research in California discovered that regular coffee drinkers were less likely to be treated in hospital for irregular heartbeats or rhythms. The more cups of coffee they drank each day, the less likely they were to suffer from the condition. Spanish research has even shown that women who drink three cups a day could reduce their risk of dying from heart disease by a quarter, whilst another study found that men who drank five or more cups a day were 44 per cent less likely to die from the disease.

Other factors

Women who drink tea were recently found by American researchers to be at greater risk of developing rheumatoid arthritis. Other studies have shown tea drinkers can halve their risk of dementia and cut their risk of a stroke. Yet the same cannot be said about coffee drinkers. "This highlights a really important point – that the other constituents in tea and coffee may have their very own impact on health and well-being," Rogers says.

Australian scientists found that drinking three to four cups of coffee a day can lower the risk of type 2 diabetes by 25 per cent, but those who drank decaffeinated coffee showed similar results. And a study of almost 50,000 men found that those who drank the most coffee were 60 per cent less likely to develop the most aggressive form of prostate cancer.

Should we give it up?

Doctors often tell patients to quit caffeine, but that may not be necessary, Rogers says. "It seems to me odd to be telling someone to give up something they enjoy and when there's no real evidence."

Rogers followed a group of people with tinnitus – a condition for which caffeine has traditionally been deemed by doctors as a big no-no. "We found that those who did give up caffeine didn't improve their condition in any way." He adds: "Not to undermine the importance of my own research, but tea and coffee are things to worry about so much less than if you're a smoker, overweight or have a poor diet."

Fuente: The Independent
Fuente de la imagen:

Can caffeine make us healthy?

Navarra Quartet, Wigmore Hall

Beethoven’s deafness was a noisy affair, with his dying hearing-sensors sending dreadfully garbled messages to his brain, but you’d never know it from the magisterial poise of the music he went on writing.

Bedrich Smetana, on the other hand, made a deliberate choice to translate the tinnitus which heralded his deafness into an explicitly musical form.

The movement with which he concludes his String Quartet No 1 is marked ‘vivace’, and it really is vivacious until a sudden high E comes in like a dentist’s drill, bringing everything to a juddering halt, after which the instruments sound as if they are tiptoeing away.

The young Navarra Quartet presented this moment with fine panache, after delivering a convincing account of this autobiographical work. ‘I wanted to paint in sounds the course of my life,’ wrote this Czech composer, and though the Prague chamber music society dismissed it as impossible to play, it is now deservedly one of the best-loved works in the chamber repertoire.
The Navarras didn’t quite catch the heel-clicking precision needed for the first of the country dances, but in every other respect they did it proud, bringing burning intensity to the ‘in memoriam’ for the composer’s dead wife, and a generous warmth to its evocations of village life.

They had begun their concert with Haydn’s Quartet Opus 54 No 2, and whoever penned the unsigned programme-note – one of the players? – deserves praise for a singular piece of illumination. It pointed out that in Haydn’s day quartets were mostly played by amateurs at home, where there would at best be just one skilled violinist: this work’s Adagio – one of the most sublime Haydn ever wrote – calls for extreme expressiveness from the first violin, while the other instruments provide the simplest of backdrops.

In point of fact, though the rest of the work was ably played, we didn’t get that sublimity from the Navarras: they had bags of vitality, but not that subtle synergy which distinguishes the most seasoned quartets. And by ending with an underwhelming account of Beethoven’s late A minor Quartet, with its transcendent Adagio, they demonstrated how far they have yet to go. This is holy ground, and only those able to penetrate its chiaroscuro mysteries should tread it.

Fuente: The Independent

Being Ernest: John Walsh unravels the mystery behind Hemingway's suicide

America's most celebrated writer, Ernest Hemingway, ended his life 50 years ago – in a manner his biographers have struggled to explain

Fifty years ago, in the early hours of Sunday 2 July, 1961, Ernest Hemingway, America's most celebrated writer and a titan of 20th-century letters, awoke in his house in the Sawtooth Mountains of Idaho, rose from his bed, taking care not to wake his wife Mary, unlocked the door of the storage room where he kept his firearms, and selected a double-barrelled shotgun with which he liked to shoot pigeons.

He took it to the front of the house and, in the foyer, put the twin barrels against his forehead, reached down, pushed his thumb against the trigger and blew his brains out.

His death was timed at 7am.

Witnesses who saw the body remarked that he had chosen from his wardrobe a favourite dressing gown that he called his "emperor's robe".

They might have been reminded of the words of Shakespeare's Cleopatra, just before she applied the asp to her flesh: "Give me my robe. Put on my crown; I have immortal longings in me".

His widow Mary told the media that it was an unfortunate accident, that Ernest had been cleaning one of his guns when it accidentally went off. The story was splashed on the front page of all American newspapers.

It took Mary Welsh Hemingway several months to admit that her husband's death was suicide; and it's taken nearly 50 years to piece together the reasons why this giant personality, this rumbustious man of action, this bullfighter, deep-sea fisherman, great white hunter, war hero, gunslinger and four-times-married, all-round tough guy, whom every red-blooded American male hero-worshipped, should do himself in.

How could he? Why would he? Successive biographers – AE Hochtner, Carlos Baker, KS Lynn, AJ Monnier, Anthony Burgess – have chewed over the available facts, his restless travelling, his many amours, the peaks and troughs of his writing career.

But eventually it took a psychiatrist from Houston, Texas, to hold up all the evidence to the light and announce his disturbing conclusions.

The idealised life of Ernest Hemingway, the one the writer himself wanted the world to buy, was simple: he was the perfect man, the perfect synthesis of brain and brawn.

Driven by a thirst for adventure, he was a swashbuckling, hard-drinking pugilist who loved being in the thick of the action, whether in the front line of battle or within charging distance of a water buffalo.

He also happened to be the finest writer around, disdaining the grandiose wordiness of Victorian prose for a clean, stripped-back simplicity, conveying emotion by what was not said as much as by what was.

Wounded on the Italian front in the First World War, he was a handsome convalescent who fell in love with a pretty nurse and wrote A Farewell to Arms as a result.

In the 1920s, he was at the forefront of American writers and artists who hung out in Paris, "being geniuses together". They included F Scott Fitzgerald, who (according to A Moveable Feast) once showed Hemingway his penis and confessed his worry that it was too small to satisfy his wife Zelda; Hemingway kindly reassured him it was OK.

In the 1930s, he went to Spain to fight for the republic against Franco and wrote For Whom the Bell Tolls, in which a brave American hero falls in love with a peasant guerrilla called Maria.

In the Second World War, he was at the Normandy landings and the liberation of Paris. After the war he retired with his fourth wife to Cuba, where he fished for marlins and wrote The Old Man and the Sea, won the Nobel Prize, was lionised wherever he went – but was killed in an unfortunate firearm accident.

That's the official story. In the years after his death, however, the jigsaw pieces of a counter-life gradually began to emerge. His war record, for instance. Hemingway was only 18 when he signed up for the First World War – but it was as a non-combatant. He had a defective left eye, inherited from his mother, which kept him out of battle. He went to Italy to man the Red Cross canteens and evacuate the wounded. Helping a wounded man to safety one evening, he was shot in the leg and hospitalised in Milan, with three other patients and 18 nurses. Though his dalliance with Sister Agnew von Kurovsky was unconsummated, he fell in love with European culture and manners, swanned about in an Italian cloak, drank wine and affected a clipped delivery borrowed from a British officer, Eric Dorman-Smith.

In Paris, where he enjoyed a temporary idyll with his first wife Hadley and their baby John (or "Bumby"), Hemingway started to make his name as a writer – but also to display dangerous mood swings, irascibility, spite and a compulsion to turn against those who helped him.

He dumped Hadley and the baby and took up with Pauline Pfeiffer, a decision for which he was racked with nightmares of guilt, and moved to Key West, Florida.

For some reason, he became obsessed with bullfighting: the glorification of blood, the spilt horse-guts, the matador's passes with the cape and sword, the art of killing.

In Death in the Afternoon, Hemingway seemed to be working out some personal philosophy about death, but it was hard to follow.

The critic Max Eastman complained that his prose style had become the equivalent of "false hair on the chest".

Unable to participate directly in killing bulls, Hemingway decamped to Mombasa where he could legitimately blaze away at lions and kudu.

Not content with land-based mayhem, he bought a 38-foot cruiser called the Pilar to fish, in Key West and Havana, for marlin and other aquatic creatures twice the size of himself.

Between 1928 and 1936, he seemed to spend months posing beside up-ended fish trophies, the self-burnished image of the muscular man of action, handsome, tanned, drinking with the sailors in Sloppy Joe's bar.

He went to Spain during the civil war, not to fight, like George Orwell, but because he was commissioned to report on it for the North American Newspaper Alliance – and because his new love, Martha Gellhorn, was going there.

He stressed many times that he wasn't taking sides, and didn't want to see the USA embroiled in a foreign war.

In Madrid, despite the bombardment, he had the time of his life – enjoying caviar and vodka at the Gaylord Hotel, the Russian HQ, making a movie called The Spanish Earth and supplying its gravelly commentary, writing his broadly fictional dispatches for newspapers that criticised them as "very inefficient".

He looked the part of a hunky warrior, but he was a lucky dilettante, who could have left Spain any time he liked.

He wrote a play about Madrid in 1936 called The Fifth Column, about Dorothy, a plucky female journalist, who falls for Philip, a tough, intrepid, hard-drinking spy masquerading as a war correspondent. Self-projection turned into self-parody.

When America entered the Second World War in 1944, Hemingway got himself to England on "priority war business" – writing pieces about the RAF for Collier's magazine. It was a tough assignment.

He took a room at the Dorchester, where he held court as the Great American Writer and went to parties, receiving compliments on his beardy, macho wonderfulness.

When he was concussed in a car accident that followed a drunken party with Robert Capa the photographer, Martha Gellhorn – who'd travelled to England in a ship packed with high explosives – visited him in hospital and laughed at his footling mock-heroics.

As though stung into action, he headed for the war, joining the invasion fleet to Normandy and, later, General Patton's armoured divisions.

He was a so-so war correspondent who was simultaneously a sort-of-warrior. At the liberation of Paris, he was found in a hotel with a small private army.

When asked to leave by a French general, he liberated the Traveller's Club and the Ritz, taking a room at the latter to entertain his new love, Mary Welsh...

It's easy to be spiteful about Hemingway.

All his posturing, his editing of the truth, his vainglorious fibbing can obscure his undoubted bravery.

He loved being in the thick of the war – the tank advance through the Ardennes, the Battle of the Bulge – dodging bullets, watching men being shot to hell all around him.

But it's hard to shake off the feeling that what he was doing wasn't bravery, but psychotic self-dramatisation.

And when you inspect the image of Hemingway-as-hero, you uncover an extraordinary sub-stratum of self-harming.

You discover that, for just over half of his life, Hemingway seemed hell-bent on destroying himself.

It was about the time he was finishing A Farewell to Arms, in 1928, when he learnt that his father Clarence had shot himself in the head with a Civil War revolver, that Hemingway's life first began to crack apart.

The most obvious external evidence was a succession of bizarre physical accidents, many of which were bashes on the head.

One, in Paris, left him with a split head needing nine stitches, after he yanked the chain in the bathroom, thinking it was the lavatory flush, and pulled the skylight down on top of him.

He became weirdly accident-prone. His car accident that occasioned his row with Martha saw him hurled through the windscreen, lacerating his scalp and requiring 57 stitches.

Three months later, he came flying off a motorbike evading German fire in Normandy. He suffered headaches, tinnitus, diplopia, showed speech and memory problems for months.

Back in Cuba after the war, he tore open his forehead on the rear-view mirror when his car skidded. Five years later, while drinking, he slipped on the deck of the Pilar, and concussed himself. Why, you'd almost think he was trying to emulate his late father, and his self-imposed head wound.

The most egregious injury, however, occurred in January 1954. He and Mary took off from Nairobi in a small plane, heading for the Belgian Congo.

Near Victoria Falls it crash-landed in a thorn thicket and Ernest sprained his shoulder. As rumours of his death spread, he and his companions were rescued and put in a 12-seater De Havilland Rapide which – incredibly – burst into flames on the runway.

Finding the door jammed, Hemingway volunteered to use his head as a battering ram, butted the door twice and got out.

He liked to present it as a classic example of superman pragmatism, but it nearly killed him.

He fractured his skull and lacerated his scalp; cerebrospinal fluid seeped from his ear.

In Nairobi he was diagnosed with grave overall concussion, temporary vision-loss in the right eye, deafness in left ear, paralysis of sphincter muscle, first degree burns on face, arms and head, sprained arm, shoulder and leg, crushed vertebra and ruptured liver, spleen and kidney.

Astonishingly, he was at it again only a month later: helping to extinguish a small fire, he fell into the flames and suffered second degree burns on legs, belly, chest, lips, left hand and right forearm.

Hemingway's taste for chronic self-immolation was matched by his prodigious feats of drinking: "The manager of the Gritti Palace in Venice tells me," wrote Anthony Burgess later, "that three bottles of Valpolicella first thing in the day were nothing to him, then there were the daquiris, Scotch, tequila, bourbon, vermouthless martinis.

The physical punishment he took from alcohol was ... actively courted; the other punishments were gratuitous – kidney trouble from fishing in chill Spanish waters, a torn, groin muscle from something unspecified when he was visiting Palencia, a finger gashed to the bone in a mishap with a punchbag..."

The drinking got worse after his father shot himself.

Ernest went to a doctor in 1937, complaining of stomach pains; liver damage was diagnosed and he was told to give up alcohol.

He refused. Seven years later, in 1944, when Martha Gellhorn visited him in hospital, she found empty liquor bottles under his bed.

In 1957, his doctor friend AJ Monnier wrote urgently, "My dear Ernie, you must stop drinking alcohol. This is definitely of the utmost importance." But even then, he couldn't stop.

What was bugging Hemingway? Why all the drinking, the macho excess, the manic displays of swaggering? Why was he so drawn to war, shooting, boxing and conflict? Why did he want to kill so many creatures? Was he trying to prove something? Or blot something out of his life?

Some answers were offered in 2006 by a long article in the American Psychiatry magazine, called "Ernest Hemingway: A Psychological Autopsy of a Suicide".

It was by Christopher D Martin, whose official title is Instructor and Staff Psychiatrist at the Menninger Department of Psychiatry and Behavioural Sciences at Baylor College of Medicine in Houston Texas.

Martin had read widely in the 15 or so biographies and memoirs of Hemingway and offered his expert analysis – based, inevitably, at second hand, but still a convincing evaluation.

He had no trouble in diagnosing the author as suffering from "bipolar disorder, alcohol dependence, traumatic brain injury, and probably borderline and narcissistic personality traits".

He notes that many in the Hemingway family – his father and mother, their siblings, his own son and his grand-daughter Margaux – were prone to manic-depression (Margaux's was the fifth, or possibly sixth, suicide in four generations) and suggests that it was Ernest's manic episodes that drove him to his astonishing feats of creativity. But he locates the writer's trauma in two childhood experiences.

It seems that it was his mother Grace's habit to dress him, as a child, in long white frocks and fashion his hair like a little girl's.

It was a 19th-century custom to dress infants alike, but she took it to extremes. She referred to him, in his cute lacy dress, as "Dutch dolly".

She said she was his Sweetie, or, as he pronounced it, "Fweetee". Once, when Ernest was two, Grace called him a doll once too often.

He replied, "I not a Dutch dolly... Bang, I shoot Fweetee".

But she also praised him for being good at hunting in the woods and fishing in the stream in boys' clothes.

It was too confusing for a sensitive kid. He always hated her, and her controlling ways. He always referred to her as "that bitch". He'd spend the rest of his life in a galloping parody of masculinity.

Dutch dolly indeed. He'd show the bitch there was no confusion in his head.

"I shoot Fweetee." The trouble was, he also wanted to shoot his father. Clarence Hemingway was a barrel-chested, six-foot bully, a disciplinarian who beat his son with a razor strop.

Ernest didn't retaliate directly. He bottled it up and subsumed it into a ritual, in which he'd hide in a shed in the family backyard with a loaded shotgun and take aim at his father's head.

Martin speculates that, when Clarence shot himself, Hemingway, aged 29, felt terrible guilt that he'd fantasised about killing him.

Unable to handle this, he took to blaming his mother for his father's death. "I hate her guts and she hates mine," he wrote in 1949. "She forced my father to suicide."

After Clarence's death, Hemingway told a friend, "My life was more or less shot out from under me, and I was drinking much too much entirely through my own fault".

He suffered a chronic identity crisis.

Henceforth he could be warm and generous or ruthless and overbearing. His friendships were often unstable (he could turn vicious or cruel, even with supposedly close pals) and his relations with women were full of conflict. He sulked like a child when, on his first safari, his wife Pauline shot a lion before he did.

And he was pursued, for the rest of his life, by a colossal death wish – either to join his late father, or to expatiate his guilt at his father's death by mirroring it.

Death took up residence at the heart of Hemingway's life, a constant spur to his creative imagination, a constant companion, a dark, secret lover.

Themes of violence and suicide informed his stories from the start.

His letters are full of references to his future suicide.

And when not contemplating his own death, he was putting himself into danger and combat as though to hasten it.

Wars, rebellion, bull-running in Pamplona, big-game hunting in Africa, fishing in Havana – they were all his way of throwing himself before the Grim Reaper. "I spend a hell of a lot of time killing animals and fish," he told Ava Gardner, "so I won't kill myself."

And of course writing was his way of evading the need to die.

He could polish his real-life experiences at war, in Italy, Spain, the Ardennes, and burnish his life in hindsight.

Being awarded the Nobel Prize in 1954 must have been a triumphant affirmation of his genius, but he worried that, after receiving the prize, most laureates never wrote anything worthwhile again.

Luckily, after finding two trunks of notes from the 1920s in a Paris hotel, he was able to manage one more book: A Moveable Feast, his touching memoir of being young, poor and happy in the French capital, with his first wife and baby, before everything started going to hell.

After 1960, however, he found he could no longer write.

The words wouldn't come. Depression came instead, and with it (as we learn from AE Hotchner's memoir, Papa Hemingway), paranoid delusions.

He thought that the two men he saw working late in a bank were "Feds", checking his bank account for irregularities.

He thought his friends were trying to kill him.

When his car slightly grazed another vehicle, he fretted that he'd be thrown in jail. It was a sorry thing, to see the epitome of "grace under pressure" succumbing to dementia.

He was given medication and, horribly, a course of electroconvulsive shock treatments.

In the spring of 1961, he was asked to contribute a single sentence to a presentation volume for John F Kennedy's inauguration.

Hemingway couldn't oblige. "It just won't come any more," he told Hotchner, and wept.

In April, his wife Mary found him sitting with a shotgun and two shells. He was sent to hospital in Ketchum, Idaho, his birthplace, but he tried twice more to end his life, once by walking into the path of a plane taxiing on the runaway.

There was a two-month period of hospitalisation and comparative peace and quiet, when he appeared sane to his doctor and deranged to his wife.

He seemed to be acting, right to the end.

He was released home one more time, had a picnic lunch with wine (he saw some state troopers and was sure they'd arrest him for possess of alcohol) and, the next morning, shot himself.

"The accumulating factors contributing to his burden of illness at the end of his life are staggering," writes Martin, listing Hemingway's bipolar mood disorder, depression, chronic alcoholism, repetitive traumatic brain injuries, the onset of psychosis.

But it seems clear that the defining problem of his life was his experience of childhood.

His confusion over gender, his Oedipal desire to kill his father for beating him, together led to what Martin calls "a retreat into a defensive façade of hyper-masculinity and self-sufficiency".

Building and sustaining the myth of Hemingway the Man's Man took courage and determination, but it was something he needed to do – and when it dwindled, along with the all-important capacity to write, he had no answer except to go the same way as his father.

The image of his father, a moody, bullying, depressive man, but a role model none the less, haunted his life.

He wanted to revivify him, in order to release himself from the responsibility for his death. He wanted to be the big, strong, heroic man that the world could call "Papa".

Fighter, writer, lover: a life in brief

1898 Ernest Hemingway is born in Oak Park, Illinois

1918 Wounded in Italy while working for the Red Cross during the First World War

1921 Marries first wife Hadley Richardson; they move to Paris

1923 First son John is born

1927 Divorced by Hadley, he marries Pauline Pfeiffer

1928 His father Clarence shoots himself in the head

1937 Works as a war correspondent during the Spanish Civil War

1940 For Whom the Bell Tolls is published; Hemingway marries Martha Gellhorn

1944 Reports on the liberation of Paris; begins relationship with Mary Welsh who he will marry in 1946

1952 The novella The Old Man and the Sea is published

1954 Awarded the Nobel Prize for Literature

1961 Shoots himself in the head in Ketchum, Idaho


Of mice and medicine: In defence of animal experiments

Animal experiments in the UK are on the rise.
Though controversial, these tests are transforming human lives, discovers Paul Vallely

Professor David McAlpine, Director of the UCL Ear Institute, where mice are used to investigate tinnitus

A sad-eyed, mournful-mouthed beagle stares out from a poster on a bus shelter by the front door of the Ear Institute of University College London. Below the melancholy dog blares the legend 'Boycott Vivisection'. It is clearly intended to be a reprimand to the scientists passing through the door into one of the world's leading research centres on hearing and deafness.

Not that there are any experiments on dogs going on in the Institute, but then facts are not always the first currency when it comes to the emotive subject of experiments on animals.

The number of research procedures on animals carried out in the UK rose by 3 per cent last year. The figure has risen steadily over the past decade to just over 3.7 million in 2010. 'Procedures' is the term used by the Home Office, which is looking at ways to meet a commitment in the Government's coalition agreement to reduce the use of animals in scientific research. And it is a significant word, for behind it lies a major shift in animal experimentation.

The headline figure disguises considerable changes. Experiments on many of the kind of animals which most inspire protest among animal rights activists were down: dogs by 2 per cent, rabbits by 10 per cent and cats by 32 per cent. Even the eponymous guinea pigs were down 29 per cent. There was also a fall of 11 per cent in the number of animals used in toxicity trials, as thanks to rule changes one test can now be used to satisfy several requirements.

Where there was an increase was in mice and fish – the latter up a whopping 23 per cent. What that reveals is a switch to animals whose genes can be easily modified. An extraordinary 44 per cent of those 'procedures' turn out not to be what most members of the public imagine as an 'animal experiment' but merely the act of breeding transgenic creatures, mostly done by allowing mice to do what male and female mice do naturally anyway. But the nature of the experiments has undergone a notable change.

For decades now, the terms of the debate on this subject have been set by the emotive, sentimental or absolutist intolerance of animal rights activists. We rarely hear the other side of the story, from the scientists who have for years kept themselves in the shadows, for fear of attacks from animal rights extremists, the most violent of whom are now in jail.

Inside the Ear Institute, research is being done by Professor David McAlpine and his colleagues into the problem of tinnitus – that odd buzzing sound in the ears which afflicts most of us when we leave a noisy rock concert. For more than five million people in the UK, however, that noise never goes away.

"People with tinnitus hear a constant noise in their ears, a buzzing, beeping or whining. It can get very distressing," says a senior researcher, Dr Roland Schaette. "Around 10 per cent of the population are chronic sufferers. And for 1 to 2 per cent, their quality of life is badly affected. They lose silence. Some can't relax or sleep. Social isolation and depression can follow. It can drive some people to suicide."

Dr Schaette uses mice in his research, to fill the gap between theoretical models and his experiments on human subjects. "We do behavioural training with the mice," he explains. "Obviously you can't ask them what they are experiencing so you have to train them to behave. We play a loud noise, and they jump. Next we play a low noise before the loud one and they learn not to jump when the big noise comes. Then you induce tinnitus in them and play a low constant noise at the same pitch as the first low noise. Mice with tinnitus don't hear [this] so they jump when the big noise comes; mice without, don't."

What happens then is that Dr Schaette and his research assistant use electro-physiological recording techniques to see how nerve activities are affected. "We place a tiny wire into the brain of a mouse that has been sedated with anaesthetic, and given a pain killer," he says. "Then we can record the reaction of a tiny area of the brain, even down to a single neurone, to see how nerve activities are affected, how it alters and what mechanisms alter it." At the end of the experiment the scientists increase the sedative to a fatal dose so that the mouse dies.

So couldn't they achieve the same ends without using an animal? "There are lots of ways of finding things out," interjects Prof McAlpine. "For some tasks you can use a dish of cells. For others you can used brain imaging like magneto-encephalography", which maps activity by the brain's natural electrical currents by recording the magnetic fields they generate.

"But that is a very limited technique. It is great for telling how the human brain lights up when the body is doing particular activities. But it won't tell you how neural pathways change in tinnitus. You can't tell without an animal model to investigate the neurones. There are more synapses – connections between neurones in the brain – than there are stars in the universe. We can look at which connections grow when a mouse learns a task."

But it is not research like this which accounts for the rise in animal experiments. Across the river at King's College London, in the school of biomedical sciences, research is being done manipulating mice genes in a search for a cure for Parkinson's Disease, the progressive disorder that causes problems with movement, including tremor and muscle rigidity.

This debilitating disease is caused by the death of nerve cells in the brain. It gets worse as more nerve cells die. Doctors don't know why. But through experiments on animals they have discovered drugs which dramatically alleviate the terrible shaking which characterises the disease. The problem is these only work for five years. So further experiments are underway as Roger Morris, Professor of Molecular Neurobiology and Head of the School of Biomedical Sciences at King's College explains.

"The primary cause of Parkinson's is the death of neurons that deliver an essential chemical called dopamine to the forebrain," he says. "The primary treatment is to provide a substitute chemical, L-DOPA. But in the healthy brain, dopamine is released only in very specific regions. L-DOPA, however, penetrates the whole brain, in a way that the body is not used to. Abnormal changes start to happen, resulting in continuous uncontrolled limb and body movements."

Scientists at King's – which has 22,000 experimental animals, 21,000 of them mice – have, over the past couple of decades, used marmosets – small, primitive New World monkeys – to discover the dose of L-DOPA which brings the fewest unwanted side effects. Work with such non-human primates is not quite so controversial as experiments with African monkeys. But this is the kind of work which most incenses animal rights activists.

Professor Morris is unapologetic. "There is a lot you can do without animals. Most scientists who use animals do so as part of a whole portfolio of techniques, which will include work with isolated molecules and genes, building up to whole cells growing on plastic dishes in tissue culture to study the more complex integration of cells to work together as a single tissue," he says. Some 90 per cent of his staff's work is done with individual molecules and cells in culture.

"At all these stages, extensive use is made of computational modelling, and analyses of databases, to bring together all the information available on how the particular aspect we work on functions in a living body," he continues. "And there are now non-invasive brain imaging techniques that tell us a lot. But real diseases are diseases of the whole body, and can only be studied in the whole body."

Dopamine deficiency is a key component of Parkinson's but the underlying cause is a complex set of interactions triggered by inflammation in the autoimmune system. "So we need to understand the interaction between two complex bodily systems – the brain, and the immune system – to understand this multi-tissue, multi-step disease. The body's controls on how those two systems interact are lost the moment both are cultured in a plastic dish. We need to look at living brain."

britain has the strictest rules in the world on such experiments, a House of Lords select committee has found. The Animals (Scientific Procedures) Act 1986 says they can only be performed where there is a clear potential benefit to either people, animals or the environment, and when there is no means of obtaining these benefits without using animals. The act also builds in a cost-benefit analysis which insists, in a very English test of reasonableness, that the good to humans must clearly outweigh the harm to animals.

Experiments must use the minimum number of animals, involve animals with the lowest degree of sensitivity, and cause the least suffering consistent with arriving at a clear scientific conclusion. Institutions, projects and scientists need three sets of licences. Home Office inspectors visit their labs around 12 times a year.

Evidence of proportionality is not hard to find. More than 120,000 people suffer from Parkinson's today in the UK. That seems a grievous problem set against the discomfort of a relatively small colony of marmosets – numbering just a few hundred over the past decade – whose suffering has dramatically improved the treatment of the disease. Moreover, when Parkinson's is induced in marmosets the disease does not progress as it does in human beings "and the animals live into old age, housed in pairs throughout their lives in an enriched environment," Prof Morris says.

All this is a big change from the bad old days. "I was appalled at some of what was allowed when I started my PhD in the United States in 1972," he recalls. "The kind of science done in living experiments with animals has completely changed." Thirty years ago a lot of experiments were with cats and dogs or primates.

Today there are more experiments recorded, but the animals used are mostly mice and fish and the procedures are considerably less severe. Before 1984, scientists could do anything with an animal that the Home Office had not specifically disallowed. Today the default is reversed; nothing is allowed that has not been specifically sanctioned.

In the old days the first line of experiment was often with the living animal, and the tests used were not very sophisticated. Now, before they get to an animal, scientists have refined the question they want to ask by extensive work with cells and computer modelling.

Previously, scientists had to breed a large number of animals just to get the type they needed – mice of the same age with the same parents. Now, thanks to genetic modification, they can generate precisely the number and kind they need for a particular experiment.

"We increase the number of animals used," says Professor Dominic Wells, of the neuromuscular disease group at the Royal Veterinary College, "but we decrease the overall severity of what we're doing." The technology allows a gene to be deleted so that an adult mouse appears to be normal until asked to remember something, which it cannot then do.

A scientist working elsewhere on spinal cord injuries, who asked to remain unnamed for fear of animal rights reprisals, elaborated on this. He is working on trying to stimulate the human body to regenerate nerves in the spinal cords of the 400,000 people in Europe who are paralysed after back or neck injuries from car accidents, violent falls or sports injuries.

"Human suffering is far more protracted and severe than anything we would allow in animals," he told me. "Procedures are done to reduce discomfort to a minimum. Our work is about understanding the early stages of the development of diseases, before irreversible brain damage has commenced, and understanding the subsequent disease mechanism so we can prevent it at an early stage. So we don't need to take animals to extremes. We can study the effects of that in humans."

What that means in practice is that, in his case, rats are partially paralysed – in one paw or to impair the tail. "You wouldn't enter a rat with a partial lesion of its spinal cord in a rat race," he told me, "but it can get around the cage well enough. What we are studying is mechanisms, so a 10 per cent paralysis will suffice to study what prevents a paraplegic human from recovering – and being condemned to 30 years in a wheelchair." Researchers have already discovered an enzyme which allows previously disabled rats to walk again almost normally.

There are both scientific and moral reasons that impel scientists to choose the simplest animal system that will give them the result they seek. "We do have a moral perspective about an animal's suffering," says David McAlpine. "There is a hierarchy. I'm unashamedly modernist about that. You take the animal that's the lowest in the hierarchy that will answer your question."

So basic studies on cell-division could be done to Nobel Prize level, as they were by Sir Paul Nurse, studying something as primitive as yeast, Prof Morris says. "It's very fast, very simple and you get clear answers quickly. But as you ask more detailed or complicated questions you need to go up the chain – to fish, mice, rats, bigger mammals and sometimes primates."

Prof McAlpine concurs. "Fruit flies go deaf for the same reasons you and I do," he says. "So you can do some basic work with them and do it much more quickly because they have simpler nervous systems. A mouse has a different hearing range from a human – it hears much higher sounds – but mice are close enough to us for use to study the range of hearing loss problems we have. For some things people use guinea pigs because they have a very similar hearing range to humans; you can do a cochlear implant in a guinea pig but not in mouse.

Despite the focus on dogs, cats and monkeys in the campaign posters of animal rights activists, those creatures were used in less than half of 1 per cent of all procedures in last year's official figures. A report by Professor Sir Patrick Bateson, president of the Zoological Society, in July found that 91 per cent of research on non-human primates between 1997 and 2007 was of high quality and scientifically and ethically justified. It is being conducted by 72 researchers working mainly on Alzheimer's and Parkinson's. Some animals were used in more than one procedure since the experiments had only minimal effect on the animals. Since then, The National Centre for the Replacement, Refinement and Reduction of Animals in Research has been brought into tighten up conditions to avoid even that 9 per cent failure rate. They vet each application for experiments involving primates.

But monkeys are not the area of innovative work in animal research. Fish are. Or to be more precise, zebrafish. In the Randall Division of Cell and Molecular Biophysics at King's College in London, Dr Claudia Linker is at her computer looking at a video made through a microscope of a small tear made in the tail of a zebrafish.

Zebrafish are those tiny, iridescent, black-striped creatures, originally natives of the Ganges River in India but popular now in Britain's home aquariums. But they are perfect creatures for the study of the early development of embryos. Not only do they grow up and reproduce in just three months, going through the same development stages as a human embryo, but their tiny eggs have clear shells that develop rapidly into translucent embryos so they can be studied using just an optical microscope.

They are easy to keep in a laboratory, lay around 200 eggs at a time which can be harvested without the need to kill the mother (as happens with lab mice). They develop from egg to fish within 18 hours. Scientists can not only look at a fish's heart beating under a microscope, they can mark individual cells with a fluorescent marker gene which they transfer from jellyfish. They can use different coloured markers for different cells and watch different cells participating in the embryo's development and multi-tag all the tissues. And their genes can be modified more easily than those of mice.

Dr Linker is enthralled by what she can see. The movement of blood cells towards the wound is clearly evident. "Can you see them moving?" she asks and shows me different examples of migratory cells. "My work is to find out how cells know when to start migrating, where to go, what to do when they arrive at their destination. I am not working on curing a particular disease but on understanding how the basic mechanism directing cell migration works. Once we understand it we might learn how to intervene to promote cells to do what we want, for example, stop the migration of cancer cells. It's very exciting, but it is open-ended."

Down the corridor, her colleague Professor Simon Hughes is doing something similar on skeletal muscle development. "We need to understand what is the signal mechanism within an embryo that says make a muscle here, a heart there, a liver over there – and you can't find that out from a test-tube."

Research on zebrafish published earlier in the year found that the fish are able to repair muscle within their hearts. "That's not something that happens in us, or mice. By experimenting with that it may well be possible to gain some insight that will enable human hearts to be regenerated," says Prof Hughes, who once researched with mice but switched to zebrafish. He is attempting to lay the groundwork for treatments for muscular dystrophy.

Wandering through a laboratory like this can be an exciting journey. By the stairs I meet Dr QueeLim Ch'ng who decided to study C elegans, a little worm almost too small to see with the naked eye, and discovered proteins which turn out to be involved in premature ageing, and which in man are critically involved in Alzheimer's.

Another King's scientist has discovered that coral produces a chemical which enables it to adapt to living in UV light – and that fish which eat the coral transfer that chemical to their eyes, so they don't get UV damage from light. The next step will be to see how the chemical moves from the fish's digestive system into its eyes by implanting the chemical in mice; the hope is that the research will lead to a treatment to prevent macular degeneration, which causes blindness in humans.

In another lab, a PhD student has identified the world's first therapy to partially reverse arm disabilities in strokes – and he did it by injecting a human molecule which naturally occurs in muscle into the upper arm muscles of rats. It even works 24 hours after a stroke.

Several of the range of drugs which have changed the lives of people with Aids have been based on animal experiments studying the mechanism of which cells it infects, how it gets into those cells, why it binds to particular receptors, and which drugs block that interaction. "Now," says Professor Morris, "we are working on something similar with Alzheimer's, trying to make a mouse model by altering three mouse genes to reproduce in mice some of the behaviour found in people with Alzheimer's."

For a nation of pet-lovers, we Britons take a surprisingly pragmatic attitude to all this. Most of us are aware of the ambiguity of our relationship with animals. Over 90 per cent of the population eats meat. As we are happy to breed animals for food, so we are content, too, to see them bred for experiments which improve human health. Polls consistently show that 60 per cent of the population are happy for any experiments to be done on animals. The proportion of Brits who accept animal experiments, subject to the kind of conditions now in place, is over 90 per cent. When you spend a little time with the scientists involved, you understand why.


Language Impairment Associated With Arachnoid Cysts: Recovery After Surgical Treatment

Case Report

Nicole Laporte BSca, Anne De Volder MD, PhDa, Christine Bonnier MD, PhDa, Christian Raftopoulos MD, PhDb, Guillaume Sébire MD, PhDc, Corresponding Author Contact Information, E-mail The Corresponding Author

a Service de Neuropédiatrie, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
b Service de Neurochirurgie, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
c Service de Neurologie Pédiatrique, Centre Hospitalier Universitaire de Sherbrooke, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada

Available online 22 December 2011.

Supporting data from the literature, we observe that large arachnoid cysts may affect cognitive function.

Neuropsychologic assessment plus magnetic resonance imaging allowed for documentation of associations between left temporal arachnoid cysts, language impairment, and other cognitive dysfunctions.

Significant cognitive improvements were evident soon after cysto-peritoneal shunting.

These observations reinforce the rationale for neuropsychologic assessments of patients with developmental delay and arachnoid cysts, and support the potential benefit of surgical decompression for arachnoid cysts associated with neurologic deficits, even if surgery is performed well after the occurrence of neurologic deficits.

Corresponding Author Contact InformationCommunications should be addressed to: Dr. Sébire; Service de Neurologie Pédiatrique; Centre Hospitalier Universitaire de Sherbrooke; Faculté de Médecine; Université de Sherbrooke; 3001 12ème Avenue Nord; Sherbrooke, Quebec J1H5N4, Canada.

FUENTE: Pediatric Neurology
Volume 46, Issue 1, January 2012, Pages 44-47


22 de diciembre de 2011 • 11:15

El uso incorrecto de los artefactos de pirotecnia que se utilizan en la actualidad puede provocar traumas acústicos que derivan en pérdida auditiva permanente e irreversible, explicaron especialistas de la comisión de Ecología del Colegio de Fonoaudiólogos de la regional La Plata.

La pirotecnia en general, que se vende en el mercado produce sonidos de muy alta intensidad que al explotar pueden llegar hasta los 120 ó 140 decibeles, equivalente al producido por un arma de fuego o despegue de avión", explicó la entidad.

Los expertos señalaron que "está científicamente comprobado que toda intensidad sonora que supere los 90 decibeles resulta dañina para el oído.

De acuerdo con las últimas estadísticas oficiales, correspondientes a la atención de pacientes en la última Navidad, casi el 20% de los accidentados que ingresaron a las guardias presentaban alguna lesión auditiva.

De los 85 jóvenes y adultos atendidos en esa fecha, 15 tuvieron que recibir, además, atención en los servicios de audiología.

La secretaria del Colegio de Fonoaudiólogos, Noemí Díaz, explicó que al estallar un petardo por ejemplo, se produce un ruido corto, muy intenso e imprevisto, por lo tanto el oído de quien está cerca o lo manipula, pierde su capacidad de defensa".

"De esta manera es que puede producirse un `trauma acústico´ lo que provoca una pérdida auditiva permanente e irreversible y también resultan frecuentes las apariciones de zumbidos, en los momentos posteriores a la detonación", advirtió.

Díaz remarcó que "la pérdida súbita de la audición es una verdadera urgencia otorrinolaringológica que debe tratarse sin la menor dilación, en menos de 24 horas si es posible, para tener las mayores posibilidades de recuperación".

A partir de los resultados de estos estudios, el Colegio de Fonoaudiólogos de La Plata recomendó una manipulación responsable de este tipo de artefactos.

La presidenta del Colegio de Fonoaudiólogos de La Plata, Alejandra Morchón, expresó que "en esta época del año se intensifica el uso de pirotecnia y a veces los adultos no asumen los recaudos necesarios".

"Promovemos el uso responsable para preservar la salud de la población, aseguró.

Díaz explicó que los primeros síntomas de una afección en el aparato auditivo son el aturdimiento, molestia auditiva y en ocasiones, pérdida de equilibrio y zumbidos agudos.

Las autoridades explicaron que el riesgo es mayor aún si la explosión ocurre en lugares cerrados, como puede ser un balcón, un patio cubierto, un galpón ya que el sonido reverbera.

"Estamos hablando de que en algunos casos se duplica el ruido que se acepta como tolerable para un ser humano" dijeron los especialistas.

Silvia Bermúdez, responsable de la Comisión de Ecología del Colegio, explicó que "el oído está provisto en forma natural de un mecanismo protector que reduce la transmisión de los sonidos más intensos hacia las delicadas células del oído interno, pero actúa recién después de unos diez centésimos de segundo, por lo cual es ineficaz frente al ruido de los petardos".

"En general las personas asisten a consulta de guardias médicas, por otro tipo de consecuencias como quemaduras o heridas en ojos, y recién advierten el daño auditivo posteriormente, aseguró Díaz.



¿Cuánto tiempo duran los audífonos ?

fuente de la imagen:

Martes, 20 de diciembre 2011

Los audífonos normalmente duran de tres a cinco años, aunque en algunos casos pueden durar mucho más.

Los componentes en miniatura en los audífonos tienden a desgastarse con el tiempo, e incluso cuando son reparados, no tienen la misma integridad que los nuevos componentes.

Aunque los audífonos son frágiles aparatos electrónicos en miniatura, que están expuestos a la humedad, la transpiración,la cera de los oídos ya veces la lluvia, o la laca y otros factores - que no son ideales para los dispositivos médicos minúsculos.

Se ha demostrado que el uso de deshumidificadores especiales de audífonos , que ayudan a eliminar la humedad de los audífonos cuando no se utilizan, prolonga la vida de los audífonos.

Estos dispositivos pueden ser obtenidos a partir en su centro de ventade audífonos local . Además, la limpieza de sus audífonos con regularidad le ayudará a asegurarse que tengan una larga vida.

En muchos casos, la pérdida de la audición tiende a empeorar con el tiempo.

Por lo tanto, puede ser necesario usar audífonos nuevos para adaptarse a su pérdida de audición a medida que cambia.

Mientras que en muchos casos, los audifonos digitales modernos puede ser re-programados,para adaptarlos a cambios en la audición, algunas personas optan por comprar audífonos nuevos con el fin de beneficiarse de nuevas características que vienen con los avances en la tecnología de los audífonos.


sábado, 24 de diciembre de 2011

Chronic intracranial hypotension.General Information

Intracranial Hypotension

Intracranial hypotension is a condition in which there is negative pressure within the brain cavity.
There are several possible causes:
Cerebrospinal fluid (CSF) leak from the spinal canal:
A leak following a lumbar puncture (spinal tap).
A defect in the dura (the covering the spinal tube).
Spontaneous, sometimes following exertion such as swinging a golf club.
A congenital weakness.
Following spinal surgery.
Following spinal trauma.
Following a shunt procedure for hydrocephalus.
Lumboperitoneal shunt.
Ventriculoperitoneal shunt with a low pressure valve.
In some cases, spinal CSF leaks can lead to a descent of the cerebellar tonsils into the spinal canal, similar to a Chiari malformation.
Large spinal dural defects can lead to herniation of the spinal cord into the defect.


The classic symptom is severe headache when upright, which is relieved when lying flat.
Other symptoms can include nausea, vomiting, double vision and difficulty with concentration.


Diagnosis is usually suspected based on the postural dependency of the headache, although in many cases the diagnosis of intracranial hypotension is not considered for some time.
A contrast-enhanced brain magnetic response imaging (MRI) scan typically shows thickened and brightly enhancing meninges (pachymeningeal enhancement). Other findings include descent of the thalamus and cerebellar tonsils.
Continuous intracranial pressure monitoring is definitive for documenting abnormally negative intracranial pressures.
The identification of the site of CSF leak in the spinal canal can be very challenging. In some cases, the site cannot be identified. Methods include:
Dynamic myelography with fluoroscopy and computed tomography (CT).
Radioisotope cisternography.
Spinal MRI.


If the site of the spinal CSF leak can be identified, then options include:
Epidural blood patch, performed by an anesthesiologist pain management specialist.
Surgical repair of the defect.
Over-draining CSF shunts are managed by replacing the valve with one that drains less.
Lumboperitoneal shunts may have to be removed or ligated.


If the cause of the intracranial hypotension can be identified, the outcome following treatment is typically excellent.

fuente: UCLA

Chronic intracranial hypotension.

Mackenzie RA, Lethlean AK, Shnier R, Blum PW

Acute intracranial hypotension can occur following lumbar puncture or a fall, and sometimes spontaneously.

Most cases resolve within weeks or months but some require surgical repair of the defect causing leakage of cerebrospinal fluid (CSF).

It is conceivable that such leaks could become chronic if the defect is incompletely sealed.

We report the case of a 49-year-old male who presented with a 10-month history of headache associated with a leaking thoracic extradural arachnoid cyst.

After this was repaired he reported relief not only of his recent headaches but also of chronic alcohol-related headaches.

A long-standing anaemia resolved and tinnitus hyperacusis improved.

It is suggested that an injury 30 years before may have initiated the leak of CSF resulting in chronic intracranial hypotension.

Fuente: J Clin Neurosci 1998 Oct; 5(4):457-60.

Alteraciones otorrinolaringológicas en el anciano

Aunque la afección más popular es la presbiacusia, debido a las alteraciones psicológicas y sociales que origina, el anciano puede presentar las mismas enfermedades del adulto, incluso algunas con mucha mayor frecuencia
En todo caso, estas enfermedades presentan en la persona mayor unas características especiales que hay que tener en cuenta a la hora de valorar al paciente

La sordera tiene un efecto adverso sobre las funciones cognitivas, conducta emocional y bienestar social, y puede ser un factor con peso específico considerable
para llevar una vida independiente.

Cerca de un 25% de las personas de 65-74 años y hasta el 50% de los mayores de 75 años sufren una pérdida de audición.

Valoración de la discapacidad auditiva del anciano

Prueba de la voz susurrada

Se explica al paciente que se le pedirá que repita tres números. El examinador se coloca detrás del paciente para evitar que le lea los labios.
Se tapa el oído contralateral. A continuación el examinador espira completamente (lo que reduce el volumen de la voz) y, desde una distancia de unos 60 centímetros
de la oreja, le susurra tres números.
Si el paciente no puede repetir el 50% (tres números o más) en dos ensayos,
se considera que no ha superado la prueba.

Clasificación de la patología

Oído externo
1. Tapón de cerumen.
2. Otitis externa.
3. Otitis externa maligna.
4. Tumores benignos.
5. Lesiones precancerosas.
6. Tumores malignos.

Oído medio
1. Otosclerosis.
2. Otitis media aguda.
3. Otitis media crónica.
4. Tumores.

Oído interno
1. Presbiacusia.
2. Acúfenos.

1. Faringitis crónica.

Oído externo

Tapón de cerumen

Motivo de consulta. Paciente que refiere hipoacusia (de transmisión) y/o inestabilidad y mareos, así como sensación de ocupación y autofonía.
Exploración y diagnóstico. Por otoscopia se visualizará el tapón de cerumen obstruyendo el conducto auditivo externo (CAE).
Actitud terapéutica. Extracción:
1. Reblandecimiento del tapón mediante gotas
tópicas disolventes.
2. Extracción con agua templada mediante jeringa
3. Nunca usar pinzas para su extracción.
Complicaciones de la extracción: breve crisis vertiginosa
por la introducción de agua muy caliente o fría.

Perforación timpánica
Motivo de consulta. Paciente que consulta por hipoacusia (de transmisión), otalgia, drenaje por el oído y acúfenos.
Entre sus antecedentes personales destaca otitis media o traumatismo mecánico o barotrauma.
Exploración y diagnóstico. En otoscopia se visualiza la perforación timpánica.
Actitud terapéutica. El tímpano roto o perforado tiende a recuperarse por sí solo en dos meses. Los objetivos del tratamiento son aliviar el dolor y prevenir
la infección.
La reparación quirúrgica está indicada cuando:
— Hipoacusia de conducción significativa.
— Infección crónica y otorrea.
— Presenta riesgo de aparición de colesteatoma.

La edad avanzada no es una contraindicación para la reparación en un paciente que esté por lo demás sano.

Otitis externa

Motivo de consulta. Paciente que consulta por OTALGIA (al presionar el trago), hipoacusia (de transmisión) y en ocasiones prurito (cuando la etiología es
Exploración y diagnóstico. En la otoscopia se aprecia el oído enrojecido e inflamado, incluyendo el canal auditivo, el cual puede aparecer similar a un eccema
con descamación de la piel.
La palpación o manipulación del oído externo aumenta el dolor. El cultivo del drenaje del oído puede revelar la presencia de bacterias u hongos.
Tratamiento. Generalmente, la aplicación tópica de gotas que contienen antibióticos para combatir lainfección y corticoides para reducir el prurito y la inflamación
es efectiva. Ocasionalmente, los medicamentos tópicos se complementan con pastillas.
En casos en que el dolor sea muy severo, se pueden usar analgésicos, y también resulta útil la aplicación de calor sobre el área afectada para reducir dicho dolor.

Otitis externa maligna o necrotizante

Motivo de consulta. Anciano diabético o inmunodeprimido que consulta por otitis externa pertinaz y progresiva.

El cuadro se puede acompañar de focalidad neurológica (parálisis facial periférica).
Diagnóstico. El cuadro es producido por pseudomona aeruginosa.
En la otoscopia llama la atención la presencia de tejido de granulación con formación de pólipos y esfacelos en las paredes del conducto. Posteriormente
necrosis de tejidos adyacentes.

Realización de tac craneal.
Tratamiento. Es un cuadro poco frecuente, pero muy grave (mortalidad 50%).
Tratamiento con ciprofloxacino 400 mg/12 h iv o ceftacidima iv 2 g/8 h.
Cuidados locales con desbridamiento quirúrgico.

Tumores benignos

Queratosis seborreica

Motivo de consulta. Consulta por lesión elevada, irregular, untuosa al tacto, con formación de quistes y surcos que pueden sangrar.
Tratamiento. Extirpación quirúrgica.

Lesiones precancerosas

Cuerno cutáneo

Motivo de consulta. El paciente consulta por neoformación verrugosa claramente delimitada de la epidermis con superficie ligeramente rugosa, que, localizada en el pabellón auricular, no afecta al cartílago.
Tratamiento. Extirpación quirúrgica.

Queratosis senil

Motivo de consulta. Aparición de elevación de la piel sobre el pabellón auricular y el conducto auditivo externo mal delimitada y superficie áspera, intacta y
parcialmente cubierta con costras que no infiltra el cartílago. Carecen de fositas y surcos característicos de la queratosis seborreica.
Es la lesión precancerosa más frecuente en el anciano.
Tratamiento. Extirpación quirúrgica.

Tumores malignos

Carcinoma espinocelular

Motivo de consulta. El paciente presenta tumor exofítico mal delimitado, superficie ulcerada, localizado en el borde del pabellón, infiltra el cartílago. Crece lentamente y produce metástasis en ganglios linfáticos.

Tratamiento. Extirpación quirúrgica amplia y vaciamiento cervical ganglionar si hay extensión regional.

Pronóstico. Lesiones pequeñas del hélix o antehélix tienen una tasa de curación a los cinco años del 95%, mientras que las lesiones próximas al meato auditivo
tienen peor pronóstico.

Oído medio
Otitis media aguda

Motivo de consulta. El paciente presenta hipoacusia,
autofonía, acúfenos y otalgia.
Diagnóstico. Otoscopia: tímpano hundido y/o congestivo.
Ante todo anciano que presenta una otitis aguda o serosa, especialmente si es unilateral, se debe explorar el cavum para descartar patología tumoral.
Tratamiento. Tratamiento de la infección si existe.

Otitis media crónica

Motivo de consulta. Se caracteriza por la aparición de procesos infecciosos que se prolongan durante más de seis semanas o bien cuando los episodios se
presentan tres o más veces al año. Ausencia de dolor e hipoacusia.
Diagnóstico. Otoscopia: perforación del tímpano y supuración fétida.
Cultivo del exudado.
Tratamiento. Antibioterapia y plantear cirugía.

Oído interno

Motivo de consulta. El paciente presenta hipoacusia de percepción pura (3), es decir, no hay separación entre la conducción ósea y aérea. Es bilateral y
aproximadamente simétrica.
Comienzo insidioso, nunca bruscamente; precozmente aparecen dificultades para la audición de sonidos agudos (timbre del teléfono, pájaros...).
Alteraciones de discriminación en ambientes ruidosos o en conversaciones cruzadas. Oyen pero no entienden.

Diagnóstico. Audiometría tonal y verbal:
La curva total desciende gradualmente y bilateral de las frecuencias agudas con conservación de las graves.
Hay discordancia entre la inteligibilidad, la discriminación y la curva tonal.
Tratamiento. Médico: carece de terapia eficaz.
Refuerzo psicológico o pautas de comunicación:

1. Mire de frente a la persona que tiene pérdida de audición para que ella pueda ver su cara cuando usted hable. Esto le permite a una persona con deficiencia de la capacidad auditiva observar las expresiones faciales, los gestos y movimientos
corporales y de labios, todas claves que facilitan la comunicación.
2. Hable lentamente y pronunciando.
3. Durante las conversaciones, apague la radio o televisión. Ambiente silencioso.
4. Hable levemente más fuerte que lo normal, pero no grite. El grito puede distorsionar su habla.
5. Reformule las afirmaciones con oraciones más cortas y sencillas si cree que no están entendiendo lo que dice.
Rehabilitador: prótesis acústica.
Una persona con hipoacusia bilateral debería usar audífonos bilaterales, ya que permiten mejorar la discriminación, la localización del sonido y percibir mejor
las conversaciones en lugares con ruido. Sin embargo, muchas personas no pueden permitirse comprar dos aparatos. El coste normal de un audífono es de
1.000-2.500 euros.
Si la única opción es colocar un audífono, debe colocarse en el que tenga menor hipoacusia.


Motivo de consulta. Los acúfenos, tinnitus o ruidos de oído, tan frecuentes en el anciano, representan uno de los problemas más difíciles de resolver.
Tratamiento. Pueden mejorar con medicación vasorreguladora.

Patología vestibular

Motivo de consulta. Cualquier alteración de estas estructuras origina un desequilibrio que se va a expresar en forma de crisis vertiginosa (sensación errónea
de giro de objetos), desequilibrio (pérdida del balance corporal en la bipedestación), mareo (sensaciones vagas o inespecíficas o vista nublada).
Muchos procesos pueden producir este cuadro.

Enfermedad de Meniére

Motivo de consulta. Crisis vertiginosas intensas,
cortejo vegetativo, hipoacusia brusca, acúfenos.
Sensación de plenitud auricular. Intercrisis libres de síntomas.

Tratamiento. Restricción de sal y el uso de diuréticos El uso episódico de antivertiginosos es útil para el tratamiento de los episodios de vértigos.


Faringitis seca
Motivo de consulta. El paciente con procesos urémicos, diabéticos, con falta de hidratación o en fase terminal que presenta: sensación de sequedad, picazón, carraspeo y/o sensación de cuerpo extraño en faringe.
Diagnóstico. Mucosa atrófica, seca, brillante.
Secreciones costrosas.
Tratamiento. Hidratación e intensa humidificación.

Fuente: parte del articulo
Isabel Ródenas Iruela
Mercedes García Moreno
Javier Bordas Guijarro
M.ª Ángeles Flores Carmona
Carlos Martínez Manzanares

Better Ways to Wire Your Ears for Music

Published: December 21, 2011

Dollar for dollar, headphones are the best way to listen to music. They pack more sonic wallop than even the most face-meltingly amazing loudspeaker system, and they do it for a lot less money. Think about it: a truly magnificent home-speaker system can cost well into the tens of thousands of dollars. A screaming set of headphones? A few hundred bucks, tops — and those in the Really Quite Good category can cost less than $100.
The basic Apple earbuds are among a selection of listening options that range from simple to sophisticated.
Tony Cenicola/The New York Times
The AKG K 390 noise-canceling headphones.

And yet most people go along and listen to music on whatever headphones or earbuds came with their audio player. For not a lot of money (or, if you’d prefer, kind of a lot of money) you can make a real and lasting improvement to the music you hear when you’re on your own. What follows is not an exhaustive test of headphones, because what sounds good to one person may be just plain terrible to another. Instead, use the information below to find your own sonic bliss.

THE GOOD BRANDS There are dozens of headphone makers. If you’re beginning a search, consider models from these manufacturers: AKG, Audio-Technica, Beyerdynamic, Etymotic, Grado, Klipsch and Sennheiser. Are there other makers of good headphones? Sure, but even though furious debates rage on in audiophile circles, these are the names that keep coming up. As to which brand is best, it depends on your needs.

REGARDING BEATS BY DR. DRE It seems necessary to mention here why Beats by Dr. Dre, a popular and groundbreaking headphone brand, is not included in the above group. Some people love Beats, which are known for their (overly?) strong bass. Some people think they are overpriced and not that good. There’s too much disagreement out there to include them in the “universally liked/respected” camp. They sure do look nice, though, so by all means check out the shiny red or white Beats models and come to your own conclusion.

KNOW YOUR HEADPHONE TYPES “Earbuds” are those earphones that likely came with your phone or music player. Replacement pairs can be bought for as little as $5 and often top out at around $30. Earbuds sit somewhat in your ear, but not all the way in. They are usually a single piece of plastic. maybe with some softer rubber permanently attached. These are the coach class of headphones; they’ll get you there, but nobody raves about them.

“In-ear earphones” are a step up. These models consist of a hard part, which contains the mechanics and electronics, and a very soft, pliable earpiece that goes well into your ear, plugging up the canal and forming a seal. In-ear earphones can be amazing — and also costly. For example, some models, like Klipsch’s Lou Reed X10i Signature Edition headphones, cost $400. But other well-regarded models, like Klipsch’s comparatively downmarket headphones, the S3s, cost $50.

Just remember two things about in-ear earphones. They do form a nearly soundproof seal, so you won’t hear much, like, say, a fire truck rapidly approaching a crosswalk, and that seal is entirely dependent on little rubber or polyurethane earpieces, which have an annoying tendency to pop off and roll down a storm drain when you pull the earphones out of your pocket.

“On-the-ear” headphones start to get you into more serious territory. These models don’t fully enclose the ear, but sit on top of the outer ear; if you think of foam-covered, Walkman-era headphones, you’ve got a correct, if outdated, image in mind.

On-the-ear headphones strike a middle ground between superportable in-ear models and bulkier over-the-ear headphones. Since they neither plug up your ear canal nor encapsulate your entire ear, they do let external sounds creep in, but in a home setting or even in many portable situations, you may not want to be fully closed off from the world around you. Prices run from $50 to $200.

On-ear headphones can either have an open or closed back. Open-backed headphones allow air to circulate, which is more comfortable. They also can help give the impression that sound is coming from around you, as opposed to emanating from your corpus callosum, which is a characteristic of closed-back and in-ear headphones. Closed-back models are better at sealing off the outside world, but your ears may get hot from the lack of air circulation.

“Over-the-ear” headphones are the Nimitz-class of the category. These are large domes that fully sit around and over your ear. They are bulky, often expensive (you can spend $40, or nearly $2,000), hard to travel with, primarily meant for listening at home and — when they are good — completely amazing. Over-the-ear models can also be closed- or open-backed. Since they are generally designed for home use, they sometimes come with a larger plug (0.25 inches, or 6.35 mm) instead of the miniplug (3.5 mm) connections common to digital music players.
The Beyerdynamic T-1 headphones.
The AKG K 450 headphones.

UNDERSTAND NOISE CANCELING A subcategory of headphones provides noise-canceling (N.C.) features. Noise-canceling headphones can be active or passive, but wearing them won’t turn the world into a silent movie: some noise will get through. What will be eliminated is lower-frequency ambient noise, like the constant thrum in an airplane’s cabin. This means you can listen to your selected audio at a lower volume, saving your ears.

Passive noise cancellation isn’t very sophisticated — sealing off your ear canal or covering your whole ear are the most common methods — but it is fairly effective. What’s fancier is active N.C., in which the headphones detect ambient noise and emit a sound wave that cancels out the humming/buzzing you would otherwise hear.

Noise-canceling headphones are good for certain situations, but they aren’t necessary for everyday use and most people can do without them. They can also run from about $70 to a few hundred dollars. Bose is a big name in the active-N.C. world, but also consider the brands mentioned above, many of which offer active N.C. headphones in earbud, on-the-ear and over-the-ear models.

FIND YOUR PAIR (THE RIGHT WAY) Determining which kind of headphones to get is something only you can figure out. Some people, for example, prefer the portability that a pair of earbuds provide — just roll them up and stick them in your pocket. Other people can’t stand the idea of little rubber plugs sticking in their ears.

You won’t know your own preference until you try headphones out in person. Go to a store and try out a few different models. Bring your iPhone, iPod, Zune, whatever, and connect it to a pair and play a song you know really well. It may be more revealing if you’re listening to some obsessively engineered track that creates an unparalleled soundscape (I’m talking to you, Steely Dan fans), but even if your favorite song is “Jump” by Kriss Kross, it’s better to judge equipment with a song you know than something provided by the store.

Using your reference song, you can then determine which style and model of headphone sounds best. Pay no attention to the specs. It doesn’t matter what it says on the side of the box; if it sounds good to you, then it sounds good.

Fuente: The New York times, Personal Tech.

Who Made That Sound?


For the past week, I actually haven’t set foot on the sixth floor, as I’ve been serving my civic duty as a juror in the State of New York. Between each case that’s called, though, I can’t help hearing that sound. If you’ve ever watched an episode of “Law and Order,” you know exactly what I mean. It has been called, among other variations, the “doink doink,” the “dun dun” and the “chung chung.”

No, the courts of New York do not actually blast those two, distinctive notes through the speaker system (although that would be amazing), but I can’t get them out of my head. According to IMDb, “The distinctive thunk-thunk sound effect used in between scenes was created by combining close to a dozen sounds, including that of a group of monks stamping on a floor. The sound is intended to be reminiscent of both a jurist’s gavel and a jail-cell door slamming.” When the original “Law and Order” was canceled last year, Brandon Kim of I.F.C. referred it as the “sound that’s got to be the current title holder for Most Recognizable Sound on TV.”

That audible brand was created by Mike Post, who also wrote the theme to the show. He’s a Grammy and Emmy award-winning composer who has scored the themes of television shows like “The A-Team,” “Doogie Howser, M.D.,” “MacGyver,” “Magnum, P.I.,” “N.Y.P.D. Blue” and “The Greatest American Hero.” Multiple albums are available of Post’s work, including “Inventions from the Blue Line” and “The Essential Mike Post TV Theme Collection.”

Fuente: The New York times

To Sleep on the Subway, Maybe, but to Dream? Poor Chance

Dr. Brandon Foreman, a neurology fellow, was able to fall asleep on the A train to help a researcher study the quality of sleep obtained on the subway.
image: Marcus Yam for The New York Times

Published: December 7, 2011

A ride on the New York subway can be a sensory overload: musicians perform for change; conductors plead to those who hold open train doors to relent; and passengers, often in unimaginably close proximity, subject one another to all sorts of sights, sounds, smells and touches, preferably inadvertent.

Milagro Benitez wired Dr. Foreman's head with electrodes to capture brain-wave data while he slept. He was asleep for 10 minutes on a 23.5-minute ride.

Amid all of that, some New Yorkers nevertheless manage to fall asleep. Seats are found, trains begin their rhythmic rattles of movement, and eyelids flutter closed. Gritted jaws loosen, furrowed brows release and heads nod.

People outside of New York may wonder how in a city that never sleeps, so many New Yorkers manage to doze on the subway.

There is no law against it, but those who take subway catnaps do so at their own risk; a recent Metropolitan Transportation Authority committee meeting featured a presentation on how criminals seeking iPhones slice open the pockets of dozing passengers.

So are these naps really worth the trouble?

Dr. Carl Bazil, director of the Epilepsy and Sleep Division at New York-Presbyterian Hospital/Columbia University Medical Center, offered to try to find out.

After Dr. Bazil stepped into an uptown A train on a recent morning, he tried to guess what stage of sleep the nappers onboard were in. He said that to reach Stage 1 sleep, the least restorative of the five stages, riders must be able to slow down their eye movements. To get Stage 2 sleep, riders must relax their muscles and stop moving their eyes entirely.

As Dr. Bazil watched the riders sitting across from him, the nappers’ eyelids fluttered when train doors opened. The riders also seemed to clench their messenger bags and backpacks with death grips.

“I suspect all you get is Stage 1 sleep; it’s not going to be restorative,” he said. “It’s kind of wasted sleep.”

At a reporter’s request, Dr. Bazil wired up a sleepy subway rider to study his brain waves as he tried to nap. He enlisted Dr. Brandon Foreman, a 30-year-old neurology fellow, whose 2-year-old son, Jude, still does not sleep through the night. Neither does Dr. Foreman.

But he has observed how the subway lulls his son to sleep, so he tries to replicate the train’s stops and jerks when he puts his son to bed. Dr. Foreman is no stranger to subway napping: He began doing so when commuting from Brooklyn during his residency, and said he coveted any sleep he could get.

“Lectures, classes, I can pretty much sleep anywhere,” Dr. Foreman said. “But it’s not usually a great sleep. It’s more the nodding off.”

Both doctors met at the end of a long workweek after Dr. Foreman had been up every night dealing with his son’s cold. As Dr. Foreman yawned, Dr. Bazil had a technician attach 25 multicolored plastic wires to Dr. Foreman’s head, connecting them to a monitor slightly larger than an iPod to track his brain waves. Then Dr. Foreman covered the wires with a long sock and a winter hat.

The pair got onto a southbound A train at 207th Street. After Dr. Foreman chose a corner seat, Dr. Bazil sat across from him to take notes. When the train left the station at 6:09 p.m., it seemed unlikely that Dr. Foreman would get any sleep. The train’s operator screeched the cars along as if she were training for Formula One. She shouted into the loudspeakers that her train was late, and peeled from stop to stop.

Dr. Foreman yawned, folded his arms, crossed his legs and shut his eyes. He opened his eyes when the train stopped. His eyes fluttered when several neurologists boarded and chatted over his shoulder. The train jostled. He opened his eyes and yawned deeply.

By 6:18 p.m., two minutes after Dr. Foreman left the 168th Street station, he looked as if he was falling asleep. He first held his head up and kept his arms crossed. But he let his head nod back and forth slightly. Then his head fell, and he dozed until 59th Street — no doubt aided by the uninterrupted run from 125th Street. As the doors opened at 59th Street, Dr. Foreman jumped up and hopped off the train.

After they briefly celebrated what looked like a successful subway nap, the doctors boarded an uptown train to see if Dr. Foreman could fall asleep again. Dr. Foreman found a seat lodged between two passengers. He put on his jacket hood, crossed his legs, folded his arms and let his head fall. While the conductor was quieter on this train, Dr. Foreman could not get back to sleep. At 145th Street, when a vendor stood before him and shouted that he was selling four DVDs for $10, Dr. Foreman opened his eyes widely.

“No luck,” he said.

Dr. Bazil was more pleased with the results. After downloading the data about Dr. Foreman’s brain waves, Dr. Bazil found that Dr. Foreman had slept for 10 minutes out of a 23.5-minute ride. For three and a half minutes, Dr. Foreman reached a Stage 2 level of sleep.

“It looks like it is definitely possible to get small amounts of restorative sleep on the subway, but only very small amounts,” Dr. Bazil said. He added that some studies show “even a brief nap that includes Stage 2 sleep can improve performance.”

But Dr. Foreman was less persuaded that he got any productive sleep.

“I don’t feel rested,” he said. “It’s not like I took a nap in bed.”
Fuente: The New York Times

viernes, 23 de diciembre de 2011

LEY Nº 1.540 de Contaminacion Sonora

La Legislatura de la Ciudad Autónoma de Buenos Aires

sanciona con fuerza de Ley

Control de la Contaminación Acústica en la Ciudad Autónoma de Buenos Aires

Título I

Disposiciones generales

Artículo 1º.- Objeto. El objeto de esta Ley es prevenir, controlar y corregir, la contaminación acústica que afecta tanto a la salud de las personas como al ambiente, protegiéndolos contra ruidos y vibraciones provenientes de fuentes fijas y móviles, así como regular las actuaciones específicas en materia de ruido y vibraciones en el ámbito de competencia de la Ciudad Autónoma de Buenos Aires.

Artículo 2º.- Consideración. A los efectos de esta Ley se considera a los ruidos y a las vibraciones como una forma de energía contaminante del ambiente. Se entiende por contaminación acústica a la introducción de ruidos o vibraciones en el ambiente habitado o en el ambiente externo, generados por la actividad humana, en niveles que produzcan alteraciones, molestias, o que resulten perjudiciales para la salud de las personas y sus bienes, para los seres vivos, o produzcan deterioros de los ecosistemas naturales.

Artículo 3º.- Ámbito de aplicación y alcance. Queda sometida a las disposiciones de esta Ley, cualquier actividad pública o privada y, en general, cualquier emisor acústico sujeto a control por parte del Gobierno de la Ciudad de Buenos Aires que origine contaminación por ruidos y vibraciones que afecten a la población o al ambiente y esté emplazado o se ejerza en el territorio de la Ciudad Autónoma de Buenos Aires, sin perjuicio de lo establecido por la legislación vigente en materia de seguridad e higiene en el trabajo y otras normativas de aplicación.

Artículo 4º.- Definiciones. A los efectos de esta Ley, los conceptos y términos básicos referentes a ruido y vibraciones quedan definidos en el Anexo I.

Artículo 5º.- Autoridad de Aplicación. Es Autoridad de Aplicación de la presente Ley, la dependencia con competencia ambiental del Poder Ejecutivo, la que debe actuar en forma coordinada con otros organismos o dependencias cuyas competencias tengan vinculación con el objeto de la presente Ley.

Artículo 6º.- Competencias de la Autoridad de Aplicación. Compete a la Autoridad de Aplicación:

La reglamentación de la presente Ley.
El control, inspección y vigilancia de las actividades reguladas en esta Ley.
El ejercicio, de conformidad con lo previsto en la legislación aplicable, de la potestad sancionadora, en las materias que regula esta Ley.
Establecer el Plan de Actuación.
La delimitación de las áreas de sensibilidad acústica.
Fijar los límites de emisión e inmisión y los límites de vibraciones.
Propender mecanismos de coordinación interjurisdiccional con relación a los estándares y límites de emisión e inmisión, tecnología, capacitación y equipamiento a tener en cuenta en la revisión técnica periódica y en el control técnico aleatorio de fuentes móviles libradas al tránsito, o su equivalente, a los fines de homologar la normativa vigente.

Artículo 7º.- Información al público. Toda persona física o jurídica tiene derecho, sin obligación de acreditar un interés determinado, a acceder a la información sobre el ambiente en el ámbito de la Ciudad de Buenos Aires, conforme lo establecido en la Leyes Nros. 104, B.O.C.B.A. Nº 1041 del 4/10/00 y 303, B.O.C.B.A. Nº 858 del 13/1/00. La Autoridad de Aplicación desarrollará mecanismos de información a la población sobre la incidencia de la contaminación acústica en la Ciudad Autónoma de Buenos Aires.

Artículo 8º.- Plan de actuación. La Autoridad de Aplicación, en el plazo de trescientos sesenta y cinco (365) días, establecerá un plan permanente en materia de ruido y vibraciones, el que será revisado y actualizado en períodos no superiores a cinco (5) años a partir del establecimiento de los ECAs. Dicho plan concretará las líneas de actuación a poner en práctica y que harán referencia, entre otros, a los siguientes aspectos:

La elaboración de programas para la prevención, el control y la corrección de la contaminación acústica.
Información y concientización del público.
Elaboración de mapas de ruido y vibraciones como primera herramienta de diagnóstico.
Establecimiento de un catálogo de actividades potencialmente contaminantes por ruido y vibraciones.
Procedimiento de revisión.
Mecanismos de financiamiento.
Determinación de los Estándares de Calidad Acústica (ECAs) asociados a los límites de emisión e inmisión de ruidos y vibraciones, a alcanzar gradualmente en períodos verificables de dos (2) años a partir de la vigencia de la presente Ley.
Definición de planes de conservación para áreas de protección.

Artículo 9º.- Delimitación de las áreas de sensibilidad acústica. La delimitación de las áreas de sensibilidad acústica a las que se refiere el art. 6º inc. 5 de la presente Ley, requerirá la emisión de un informe documentado por parte de la Autoridad de Aplicación.

Título II

Inmisiones y emisiones acústicas

Artículo 10.- Valoración. La valoración de los niveles de inmisión y emisión de ruidos y vibraciones producidas por los emisores acústicos, se realizará conforme a los procedimientos establecidos en la reglamentación de la presente Ley, la cual podrá tomar como referencia las normas IRAM correspondientes.

Artículo 11.- Áreas de sensibilidad acústica. A los efectos de la aplicación de esta Ley, la clasificación de las áreas de sensibilidad acústica será la siguiente:

Ambiente exterior:
Tipo I: área de silencio zona de alta sensibilidad acústica, que comprende aquellos sectores que requieren una especial protección contra el ruido tendiente a proteger y preservar zonas de tipo:
a) Hospitalario.
b) Educativo.
c) Áreas naturales protegidas.
d) Áreas que requieran protección especial.
Tipo II: área levemente ruidosa.
Zona de considerable sensibilidad acústica, que comprende aquellos sectores que requieren una protección alta contra el ruido con predominio de uso residencial.
Tipo III: área tolerablemente ruidosa.
Zona de moderada sensibilidad acústica, que comprende aquellos sectores que requieren una protección media contra el ruido con predominio de uso comercial.
Tipo IV: área ruidosa.
Zona de baja sensibilidad acústica, que comprende aquellos sectores que requieren menor protección contra el ruido con predominio de uso industrial.
Tipo V: área especialmente ruidosa.
Zona de muy baja sensibilidad acústica, que comprende aquellos sectores afectados por infraestructuras de transporte (público automotor de pasajeros, automotor, autopistas, ferroviario, subterráneo, fluvial y aéreo) y espectáculos al aire libre.
A fin de evitar que colinden áreas de muy diferentes sensibilidad se deben establecer zonas de transición.
Ambiente interior
Tipo VI: área de trabajo.
Zona del interior de los ambientes de trabajo que comprende las siguientes actividades: sanidad, docente, cultural, oficinas, comercios e industrias, sin perjuicio de la normativa específica en materia de seguridad e higiene en el trabajo.
Tipo VII: área de vivienda.
Zona del interior de las viviendas y usos equivalentes, en la que se diferenciará entre la zona habitable, que incluye dormitorios, salones, despachos y sus equivalentes funcionales y la zona de servicios, que incluye cocinas, baños, pasillos, aseos, patios, centros libre de manzana, terrazas y sus equivalentes funcionales.

Artículo 12.- Niveles de evaluación sonora. A los efectos de esta Ley se establecen los siguientes niveles de evaluación sonora:

Nivel de emisión de ruido de fuentes fijas al ambiente exterior.
Nivel de inmisión de ruido de fuentes fijas en ambiente interior.
Nivel de emisión de ruido de las fuentes móviles.
Nivel de inmisión de transmisión de vibraciones en ambiente interior.

Artículo 13.- Valores Límite Máximos Permisibles (LMP).
La Autoridad de Aplicación, en el plazo de trescientos sesenta y cinco (365) días, debe establecer los valores máximos permisibles a alcanzar como metas u objetivos de calidad acústica. Hasta tanto se determinen dichos valores se utilizarán como referencia las tablas contempladas en el art. 47 de la presente Ley.

Artículo 14.- Períodos de referencia para la evaluación. A efectos de la aplicación de esta Ley, se considerarán los siguientes períodos horarios:

Como período diurno el comprendido entre las 7.01 y las 22 horas.
Como período nocturno el comprendido entre las 22.01 y las 7 horas.

La Autoridad de Aplicación reglamentará las zonas y horarios de fines de semana y feriados.

Título III

Prevención de la contaminación acústica

Artículo 15.- Evaluación de la incidencia acústica sobre el medio ambiente.
Las disposiciones de la presente Ley serán de aplicación para la determinación de la incidencia acústica sobre el ambiente, de las actividades catalogadas como potencialmente contaminantes por ruidos y vibraciones sin perjuicio de lo normado por la Ley Nº 123 B.O.C.B.A. Nº 622 del 1º/2/99 y sus modificatorias.

Artículo 16.- Registro de actividades catalogadas como potencialmente contaminantes por ruido y vibraciones.
La Autoridad de Aplicación, en el plazo de trescientos sesenta y cinco (365) días, creará un registro de actividades catalogadas como potencialmente contaminantes por ruidos y vibraciones en el que deberán inscribirse los titulares de las actividades involucradas habilitadas o por habilitarse.

Artículo 17.- Inscripción. Para la inscripción en dicho registro será necesaria la presentación, con carácter de Declaración Jurada, de un Informe de Evaluación de Impacto Acústico de la actividad sobre el ambiente firmado por un profesional inscripto en el Registro de Consultores y Profesionales en Auditorias y Estudios Ambientales de la Ley Nº 123.
Para las actividades catalogadas y categorizadas como Sin Relevante Efecto según la Ley Nº 123, modificada por la Ley Nº 452, B.O.C.B.A. Nº 1025 del 12/9/00, y la reglamentación vigente, y que no requieran de la presentación de un Estudio de Impacto Ambiental, deberán presentar el Informe de Impacto Acústico mencionado con carácter previo a su habilitación ante la Autoridad de Aplicación de la presente Ley.

Artículo 18.- Informe. En el Informe de Evaluación de Impacto Acústico se analizarán como mínimo los siguientes aspectos:

Nivel de ruido en el estado preoperacional, mediante la elaboración de mapas de los niveles acústicos en el ambiente exterior durante los períodos diurno y nocturno.
Nivel de ruido en el estado operacional, mediante la elaboración de mapas de los niveles acústicos en el ambiente exterior durante los períodos diurno y nocturno.
Evaluación del impacto acústico previsible de la nueva actividad, mediante comparación del nivel acústico en los estados operacional y preoperacional.
Comparación de los niveles acústicos en los estados preoperacional y operacional con los valores límite definidos en la reglamentación de la presente Ley.
Definición de las medidas correctoras del impacto acústico a implantar en la nueva actividad, en caso de resultar necesarias como consecuencia de la evaluación efectuada.
Presentación de una Memoria Técnica que contendrá como mínimo lo siguiente:
6.1. Descripción del tipo de actividad y horario previsto de funcionamiento.
6.2. Descripción de los locales en los que se va a desarrollar la actividad, así como (en su caso) los usos de los adyacentes y su situación respecto a viviendas u otros usos sensibles.
6.3. Características de las fuentes de contaminación acústica de la actividad.
6.4. Declaración que, una vez puesta en marcha, la actividad no producirá niveles de inmisión que incumplan los objetivos de calidad establecidos para las áreas de sensibilidad acústica aplicables.
6.5. Planos de situación.
6.6. Descripción detallada de medidas correctoras.

Artículo 19.- Medición. Las mediciones de los niveles acústicos en el estado preoperacional se realizarán de acuerdo con las prescripciones contenidas al respecto en esta Ley. La evaluación de los niveles de ruido en el estado operacional se realizará con la ayuda de modelos de predicción (u otros sistemas técnicamente adecuados) a los diferentes emisores implicados.
La Autoridad de Aplicación determinará los modelos o sistemas válidos en cada caso.

Artículo 20.- Criterios generales para la determinación de medidas correctoras de las actividades catalogadas.
Con carácter general, será preciso incorporar medidas correctoras de la contaminación acústica a aquellas actividades catalogadas cuyos niveles acústicos estimados para el estado operacional superen los valores límites establecidos en esta Ley y en su reglamentación.
Las medidas correctoras necesarias se establecerán otorgando prioridad al control de ruido en la fuente o en su propagación, frente a la adopción de medidas correctoras en los receptores. Las medidas correctoras en los receptores habrán de garantizar que los niveles de inmisión de ruido en ambiente interior no superarán lo establecido en la Reglamentación y en las Cláusulas Transitorias hasta tanto la Autoridad de Aplicación determine dichos valores.
Los costos asociados al estudio, proyecto e implantación de medidas correctoras de la contaminación acústica en los receptores correrán a cargo del promotor de la actividad una vez sean aprobadas.

Artículo 21.- Áreas de protección de sonidos de origen natural. La Autoridad de Aplicación deberá delimitar áreas de protección de sonidos de origen natural, las cuales serán identificadas como Lugares Vulnerables al Ruido, entendiendo por tales aquellos en que la contaminación acústica producida por la actividad humana sea imperceptible o pueda ser reducida hasta tales niveles.
En estas áreas, la Autoridad de Aplicación establecerá planes de conservación que incluyan la definición de las condiciones acústicas de tales zonas y adoptar medidas dirigidas a posibilitar la percepción de sonidos de origen natural.

Artículo 22.- Transporte. Todos los proyectos o modificaciones de los recorridos actuales de transporte, público y privado, y vías de circulación entre las que se incluyen las autopistas, autovías, carreteras, líneas férreas, aeropuertos, subterráneos y puertos incluirán un estudio específico de impacto acústico, medidas para la prevención y reducción de la contaminación acústica mediante la investigación e incorporación de mejoras tecnológicas en las cuestiones de instalaciones, en el desarrollo de actividades, en los procesos de producción y productos formales, constitutivos de fuentes sonoras.

Artículo 23.- Mapas de ruido. A fin de conocer la situación acústica dentro del Ámbito de la Ciudad Autónoma de Buenos Aires y poder actuar consecuentemente, la Autoridad de Aplicación, establecerá un programa permanente de medición de los niveles de ruido en el ambiente exterior en las zonas de mayor concentración urbana consideradas como los más afectados por la contaminación acústica. Los resultados de tales mediciones se presentarán en forma de mapas de ruido, los que se confeccionarán de acuerdo con métodos normalizados establecidos en la reglamentación de esta Ley, y deberán actualizarse cada cinco (5) años a partir de la aprobación de la presente Ley.
Los mapas de ruido deberán contener, como mínimo, la representación de los datos relativos a los siguientes aspectos,

Situación acústica existente, anterior o prevista expresada en función de un indicador de ruido.
Superación de un valor límite ("mapa de conflicto").
Número de viviendas en una zona dada que están expuestas a una serie de valores de un indicador de ruido.
Número de personas afectadas (molestias sonoras, alteración del sueño, etc.) en una zona dada.
Relaciones costos-beneficios u otros datos económicos sobre las medidas correctoras o los modelos de lucha contra el ruido.

Los mapas de ruido podrán presentarse en forma de:

Datos numéricos en cuadros.
Datos numéricos en formato electrónico.

Los mapas de ruido servirán de:

Base para los datos.
Fuente de información destinada a los ciudadanos con arreglo al art. 7º de la presente Ley.
Fundamento de los planes de acción del Gobierno de la Ciudad Autónoma de Buenos Aires.

Título IV

Criterios sobre actividades específicas potencialmente contaminantes por ruido y vibraciones

Artículo 24.- Ruido de vehículos. Todo vehículo de tracción mecánica deberá tener en buenas condiciones de funcionamiento los elementos capaces de producir ruidos, con la finalidad de que el nivel sonoro emitido por el vehículo en su situación más desfavorable de marcha no exceda los valores límite de emisiones establecidos en la Reglamentación, o en las Cláusulas Transitorias de la presente Ley hasta tanto la Autoridad de Aplicación determine los mismos.

Artículo 25.- Revisión técnica periódica. A efectos de dar cumplimiento al artículo precedente se establece que las fuentes móviles libradas al tránsito deben estar sujetas a la revisión técnica periódica a fin del control de emisión de ruido y vibraciones propias del vehículo.

Artículo 26.- Revisión técnica aleatoria. La Autoridad de Aplicación debe realizar controles técnicos aleatorios sobre las fuentes móviles libradas al tránsito, en cualquier punto de su recorrido, sobre emisión de ruidos.

Artículo 27.- Trabajos en la vía pública. A los fines de no producir contaminación acústica, los trabajos realizados en la vía pública, actividades de carga y descarga de mercadería, las obras públicas y privadas, se ajustarán a las siguientes prescripciones:

El horario de trabajo de dichas actividades será dentro del período diurno, según se define tal período en esta Ley.
Se deben adoptar las medidas oportunas para evitar que se superen los valores límites de emisión. Las actividades contempladas en este artículo que justifiquen técnicamente la imposibilidad de respetar dichos valores necesitarán una autorización expresa por parte de la Autoridad de Aplicación.
Se exceptúan de la obligación establecida en el punto a):
I. Las obras de reconocida urgencia.
II. Las obras y trabajos que se realicen por razones de seguridad o peligro.
III. Las obras y trabajos que por sus inconvenientes o por razones operativas no puedan realizarse durante el período diurno.

El servicio público de higiene urbana debe adoptar las medidas y precauciones necesarias para cumplir con los límites establecidos en esta Ley.

Artículo 28.- Dispositivos acústicos. Los vehículos en servicio de los cuerpos y fuerzas de seguridad y policía, servicio de extinción de incendios y salvamentos y otros vehículos destinados a servicios de urgencia dispondrán de un mecanismo de regulación automática de la potencia sonora de sus dispositivos acústicos que permita, en función de la velocidad del vehículo, reducir los niveles de presión sonora de 90 dB(A) a 70 dB(A), medidos a 3 m de distancia.
Sus conductores limitarán el uso de los dispositivos de señalización acústica de emergencia a los casos de necesidad y cuando no sea suficiente la señalización luminosa.

Artículo 29.- Sistemas de alarma. El nivel sonoro máximo autorizado para cualquier sistema de aviso acústico instalado no podrá superar los 70 dBA, medido a 3 metros de distancia y en la dirección de máxima emisión.
Las alarmas instaladas deberán cumplir con las especificaciones técnicas en cuanto a niveles de emisión máxima, en cada una de las posibilidades de funcionamiento, tiempo máximo de emisión por ciclo de funcionamiento y secuencia de repetición que indique la certificación del fabricante.
La Autoridad de Aplicación reglamentará las condiciones a las que se deben ajustar los sistemas de aviso acústico.

Artículo 30.- Sistemas de propalación de sonido. Los sistemas de reproducción de sonido de que estén dotados los vehículos no podrán transmitir al ambiente exterior niveles sonoros superiores a los máximos autorizados en la reglamentación.
Se prohíbe la colocación de sistemas electroacústicos de propalación de sonido en la vía pública de carácter fijo o sobre instalaciones móviles, ya sea para difusión de música como de anuncios publicitarios y propaganda.
Se exceptúan las actividades culturales y de espectáculos en el espacio público, las que deben contar con su aprobación por la autoridad competente, de acuerdo con la normativa vigente.

Artículo 31.- Dispositivo de señalización acústica. Los vehículos deberán estar provistos de un dispositivo de señalización acústica, símil bocina, de no más de dos tonos que suene simultáneamente, cuyo sonido, sin ser estridente ni prolongado, se oiga en condiciones de campo libre a cien (100) metros de distancia, debiendo cumplir en cuanto a sus límites y procedimientos de ensayo según lo establecido por la Norma CETIA 13 D 1 para cada una de las siguientes categorías de vehículos:

En los automóviles, vehículos de carga y de transporte público de pasajeros;
En las motocicletas, motonetas y bicicletas a motor;
Las ambulancias, vehículos policiales, de bomberos y los de brigadas de servicios públicos de apuntalamiento y derrumbe.

(Conforme texto Art. 1º de la Ley Nº 3013, BOCBA 3158 del 21/04/2009)

Artículo 32.- Condiciones acústicas particulares en actividades y edificaciones donde se generan niveles elevados de ruido.
En los establecimientos donde se ubiquen actividades o instalaciones que generen niveles sonoros interiores superiores a 70 dBA, se exigirán aislamientos acústicos más restrictivos, en función de los niveles de ruido producidos en el interior de las mismas y horario de funcionamiento. La Autoridad de Aplicación reglamentará las especificaciones técnicas que deben cumplir dichos aislamientos.
En establecimientos de espectáculos públicos, locales bailables y de actividades recreativas donde se superen los 80 dBA se debe colocar en lugar visible el siguiente aviso: "Los niveles sonoros en este lugar pueden provocarle lesiones permanentes en el oído".
Artículo 33.- Medidas preventivas y actuaciones sobre la circulación. Cuando en determinadas zonas o vías urbanas en las que, de forma permanente o a determinadas horas de la noche se aprecie una degradación notoria del medio por exceso de ruido y vibración imputables al tránsito, la Autoridad de Aplicación podrá restringir o limitar dicho tránsito.

Título V

Corrección de la contaminación acústica

Artículo 34.- Declaración de Zonas de Situación Acústica Especial

Las áreas en que se incumplan los objetivos de los ECAs que les sean de aplicación, aun observándose los valores límite de emisión de cada uno de los emisores acústicos, podrán ser declaradas por el Gobierno de la Ciudad Autónoma de Buenos Aires como Zonas de Situación Acústica Especial.
El procedimiento para la declaración de Zona de Situación Acústica Especial se iniciará de oficio.
Una vez comprobada la desaparición de las causas que provocaron la declaración de Zona de Situación Acústica Especial, la Autoridad de Aplicación levantará tal declaración.

Artículo 35.- Régimen de actuaciones en Zonas de Situación Acústica Especial.
En las Zonas declaradas de Situación Acústica Especial se perseguirá la progresiva reducción de los niveles de inmisión hasta alcanzar los objetivos de calidad sonora que les sean de aplicación.
En esta situación, se podrán adoptar, a tenor de las circunstancias, todas o algunas de las siguientes medidas:

No podrá autorizarse en la zona la puesta en marcha o modificación de un emisor sonoro que incremente los niveles de ruido existentes en tanto permanezcan las condiciones acústicas que originaron la declaración.
Se elaborarán programas zonales específicos para la progresiva mejora del medio ambiente sonoro, que garanticen el descenso de los niveles de inmisión. Estos programas contendrán las medidas correctoras a aplicar, tanto a los emisores acústicos como a las vías de propagación, los responsables implicados en la adopción de las medidas, la cuantificación económica de las mismas y, en su caso, un proyecto de financiación.
Para las edificaciones destinadas a usos hospitalarios o educativos, localizadas en Zonas de Situación Acústica Especial en las que se incumplan los objetivos de calidad acústica correspondientes a su ambiente interior, se establecerán ayudas dirigidas a fomentar programas específicos de reducción del nivel de inmisión de ruido en el ambiente interior, de acuerdo con lo establecido en el Título VI de la presente Ley.

Título VI

Instrumentos económicos

Artículo 36.- Medidas económicas, financieras y fiscales. El Gobierno de la Ciudad Autónoma de Buenos Aires, en el ámbito de sus respectivas competencias, podrá establecer las medidas económicas, financieras y fiscales adecuadas para la prevención de la contaminación acústica, así como para promover programas, procedimientos y tecnologías de reducción de la contaminación acústica. Asimismo, podrán establecer incentivos a la investigación y desarrollo en materia de sistemas, métodos y técnicas de medida, análisis y evaluación de la contaminación acústica.
El Gobierno de la Ciudad Autónoma de Buenos Aires promoverá, el uso de maquinaria y equipos de baja emisión acústica, en particular en el marco de la contratación pública.

Título VII

Poder de Policía

Artículo 37.- Inspección, vigilancia y control. Corresponde a la Autoridad de Aplicación, ejercer el control del cumplimiento de esta Ley, exigir la adopción de medidas correctoras, señalar limitaciones, realizar inspecciones e imponer las sanciones correspondientes en caso de incumplimiento, de conformidad con lo previsto en la legislación aplicable y conforme al reglamento de la presente Ley.

Artículo 38.- Inspección de los vehículos a motor. Los cuerpos de vigilancia e inspección, en el caso de verificar que una fuente móvil sobrepasa los valores límite de emisión permitidos, labrarán el acta de comprobación correspondiente, e intimarán al titular o al conductor a presentar el vehículo en el lugar y hora determinados para su reconocimiento e inspección. Este reconocimiento e inspección podrá referirse tanto al método de vehículo en movimiento como al del vehículo estático.

Artículo 39.- Procedimiento sancionador. La imposición de sanciones se realizará mediante la apertura de expediente sancionador, que se tramitará conforme a lo establecido en la legislación aplicable por razón de la materia.

Artículo 40.- Competencia. El ejercicio de la potestad sancionadora por incumplimiento de las obligaciones previstas en esta Ley corresponderá al Gobierno de la Ciudad Autónoma de Buenos Aires, en ejercicio de sus respectivas competencias, de conformidad con lo previsto en la legislación aplicable.

Artículo 41.- Responsables. Serán sancionados por hechos constitutivos de infracciones administrativas por el incumplimiento de las obligaciones reguladas en esta Ley las personas físicas o jurídicas que resulten responsables de los mismos, aun a título de mera inobservancia.
Cuando en la infracción hubieren participado varias personas y no sea posible determinar el grado de intervención de las mismas en la infracción, la responsabilidad de todas ellas será solidaria.
Los titulares o promotores de las actividades o establecimientos serán responsables solidarios del incumplimiento de las obligaciones previstas en esta Ley, por quienes estén bajo su dependencia.

Artículo 42.- Infracciones y sanciones. El incumplimiento de las obligaciones establecidas en esta Ley sancionará, cuando proceda, de conformidad con lo dispuesto en la legislación aplicable por razón de la materia.
Modifícase el punto 1.3.3. del Capítulo III, Sección 1º, Libro II del Anexo I, de la Ley Nº 451, el que quedará redactado de la siguiente manera:
1.3.3.- El/la titular o responsable del establecimiento o inmueble desde el que se produzcan ruidos y vibraciones, por encima de los niveles permitidos, es sancionado/a con multa de $ 200 a $ 5.000.
Cuando se trate de un edificio afectado al régimen de propiedad horizontal, y no pueda identificarse al responsable de la falta, la multa se aplica contra el consorcio de propietarios, o en forma solidaria contra todos los propietarios de los departamentos que conforman el edificio.
Cuando se trate de un establecimiento industrial o comercial o recreativo el titular o responsable es sancionado con multa de $ 2.000 a $ 30.000.
Cuando no se facilite el acceso a los agentes de la autoridad para realizar los controles pertinentes establecidos en la Ley de Control de la Contaminación Acústica, será sancionado con multa de $ 6.000 a $ 15.000.
Quien manipule los dispositivos del mecanismo de regulación automática de la potencia sonora de modo que altere sus funciones será sancionado con multa de $ 6.000 a $ 15.000.
El/la titular del establecimiento que ponga en funcionamiento actividades, equipos con orden de cese o clausura en vigor, será sancionado con multa de $ 6.000 a $ 15.000.
El/la titular del establecimiento que ponga en funcionamiento actividades, instalaciones o equipos permanentes productores de ruidos, que no cuentan con habilitación correspondiente, y exceden los niveles permitidos de emisión e inmisión y vibración será sancionado con multa de $ 6.000 a $ 15.000.
Quien incumpla con las condiciones de aislamiento acústico o vibratorio establecidas en la habilitación correspondiente será sancionado con multa de $ 6.000 a $ 15.000.
Quien falsee los datos de los proyectos, certificados o estudios acústicos establecidos para la concesión de la habilitación será sancionado con multa de $ 6.000 a $ 15.000.
En todos los casos, además de la multa puede procederse al decomiso de los elementos que produzcan la emisión contaminante, y/o clausura del establecimiento y/o inhabilitación de hasta diez (10) días.

Artículo 43.- Graduación de las multas. Las multas correspondientes a cada clase de infracción se graduarán teniendo en cuenta, como circunstancias agravantes, la valoración de los siguientes criterios:

El riesgo de daño a la salud de las personas.
La alteración social a causa de la actividad infractora.
El beneficio derivado de la actividad infractora.
Las circunstancias dolosas o culposas del causante de la infracción.
Infracciones en zonas acústicamente saturadas.
La reiteración de dos o más infracciones leves de grado máximo en el período de un (1) año.

Tendrá la consideración de circunstancia atenuante de la responsabilidad, la adopción espontánea, por parte del autor de la infracción, de medidas correctoras con anterioridad a la incoación del expediente sancionador.

Cláusulas Transitorias

Artículo 44.- En el plazo de ciento ochenta (180) días de puesta en vigencia de la presente Ley, el Poder Ejecutivo realizará las modificaciones requeridas por la reglamentación de la Ley Nº 123 de Evaluación de Impacto Ambiental, para llevar a cabo la correcta aplicación de la Evaluación de Impacto Ambiental Acústico, para prevenir y reducir la contaminación acústica por ruido y vibraciones en los futuros emprendimientos, o los sujetos a dicha evaluación que se encuentran en funcionamiento.

Artículo 45.- El Poder Ejecutivo debe reglamentar la presente en el término de ciento ochenta (180) días a partir de su publicación, salvo aquellos puntos para los que la presente Ley establezca plazos determinados.

Artículo 46.- La Autoridad de Aplicación hasta cumplimentar lo establecido en el art. 13 de la presente Ley, referido a los Límites Máximos Permisibles de Ruido y los Valores Límites de Transmisión de Vibraciones, utilizará los parámetros indicados en las siguientes tablas:

Ambiente exterior
En el ambiente exterior ningún emisor acústico podrá producir niveles de inmisión sonoros que excedan los LMP’s establecidos en la tabla siguiente:

Área de sensibilidad acústica

Período diurno (15 hs.)

Período nocturno (9 hs.)
Tipo I (Área de silencio)


Tipo II (Área levemente ruidosa)


Tipo III (Área tolerablemente ruidosa)


Tipo IV (Área ruidosa)


Tipo V (Área especialmente ruidosa)



Ambiente interior
En el ambiente interior ningún emisor acústico podrá producir niveles de inmisión sonoros que excedan los LMP’s establecidos en la tabla siguiente:
Área de sensibilidad acústica

Uso predominante del recinto

Período diurno (15 hs.)

Período nocturno (9 hs.)
Tipo VI (Área de trabajo)


Tipo VI (Área de trabajo)


Tipo VI (Área de trabajo)


Tipo VI (Área de trabajo)


Tipo VI (Área de trabajo)


Tipo VI (Área de trabajo)


Tipo VII (Área de vivienda)
Zona habitable


Tipo VII (Área de vivienda)
Zona de servicios



* De acuerdo con el Área de Sensibilidad Acústica donde se encuentre localizada la vivienda. Los primeros valores corresponden a áreas con predominio de uso residencial. Los segundos valores, a áreas con predominio de usos no residenciales, comerciales e industriales.
Para actividades no mencionadas en las tablas anteriores, los límites de aplicación serán los establecidos por usos similares regulados.
Valores límite de emisión de ruido de fuentes móviles.
Nivel sonoro de ruido emitido según método dinámico (Norma IRAM AITA 9 C).

Vehículos destinados al transporte de personas con capacidad de hasta 8 plazas sentadas como máximo, además del asiento del conductor 77 dBA.
Vehículos destinados al transporte de personas con capacidad para más de 8 plazas sentadas como máximo, además del asiento del conductor con un peso máximo no mayor de 3.5 toneladas 79 dBA.
Vehículos destinados al transporte de personas con capacidad para más de 8 plazas sentadas como máximo, además del asiento del conductor, con un peso máximo que exceda de 3.5 toneladas 80 dBA.
Vehículos destinados al transporte de personas con capacidad para más de 8 plazas sentadas, además del asiento del conductor, cuyo motor tenga una potencia igual o superior a 150 Kw 83 dBA.
Vehículos destinados al transporte de mercancías que tengan un peso máximo que no exceda las 12 Tn. 84dBA
Vehículos destinados al transporte de mercancías que tengan un peso máximo que exceda las 12 Tn. 86 dBA.
Motocicletas y ciclomotores con cilindrada menor o igual a 80 cm3 78 dBA.
Motocicletas y ciclomotores con cilindrada entre 81 y 125 cm3 80 dBA.
Motocicletas y ciclomotores con cilindrada entre 126 y 350 cm3 83 dBA.
Motocicletas y ciclomotores con cilindrada entre 350 y 500 cm3 85 dBA.
Motocicletas y ciclomotores con cilindrada mayor a 500 cm3 86 dBA.

Ningún vehículo en circulación podrá emitir un nivel sonoro de ruido que sea mayor al valor de referencia homologado, según el método estático, para cada configuración de vehículo, con una tolerancia de tres decibeles A (3 dBA) para los incisos a., b.,c.,d.,e. y f. y de dos decibeles A (2 dBA) para los incisos g.,h.,i.,j. y k., con la finalidad de cubrir la dispersión de producción, la influencia del ruido ambiente en la medición de verificación y la degradación admisible en la vida del sistema de escape. Para toda configuración de vehículo en el que el valor no sea homologado por el fabricante o importador por haber cesado en su producción, regirá el valor máximo declarado por el fabricante o importador en la respectiva categoría.
La medición del nivel sonoro de ruido emitido, según el método estático, se efectuará aplicando la norma IRAM-AITA 9 C-1.

Artículo 47.- De los ruidos provenientes de fuentes fijas transitorias.
Toda fuente de ruidos molestos de carácter transitorio, originados en la actividad personal o de máquinas, instalaciones, vehículos, herramientas, artefactos de naturaleza industrial de servicio, para poder operar deben bloquear los ruidos que originan con medios idóneos y adecuados a sus características para que no trasciendan con carácter de molestos, siendo su nivel máximo permitido el que corresponde a un ámbito de percepción predominantemente industrial.

Artículo 48.- Valores límite de transmisión de vibraciones al ambiente interior.
Ninguna fuente vibrante podrá transmitir vibraciones al ambiente interior cuyo índice de percepción de vibraciones K supere los valores establecidos en la siguiente tabla:
Área de sensibilidad acústica

Uso predominante del recinto

Período diurno (15 hs.)

Período nocturno (9 hs.)
Tipo VI (Área de trabajo)



Tipo VI (Área de trabajo)



Tipo VI (Área de trabajo)



Tipo VI (Área de trabajo)



Tipo VI (Área de trabajo)



Tipo VI (Área de trabajo)



Tipo VII (Área de vivienda)

Zona habitable


Tipo VII (Área de vivienda)

Zona de servicios



Artículo 49.- Derógase la Sección 5 de la Ordenanza Nº 39.025 A.D. 500.46, a excepción de los parágrafos (Procedimiento de Medición para Fuentes Fijas), (Instrumento de Medición), (Procedimiento de Medición para Vibraciones) y el (Instrumentos de Medición de Vibraciones), los que quedarán vigentes hasta la reglamentación de la presente Ley.

Artículo 50.- Los gastos que demande la presente Ley serán imputados en la jurisdicción 65 (Secretaría de Producción, Turismo y Desarrollo Sustentable) en el Programa 41, del Presupuesto para el Ejercicio del 2005.

Artículo 51.- Comuníquese, etc.



LEY Nº 1.540

Sanción: 02/12/2004

Promulgación: Decreto Nº 24/005 del 05/01/2005

Publicación: BOCBA Nº 2111 del 18/01/2005

Reglamentación: Decreto Nº 740/007 del 23/05/2007

Publicación: BOCBA Nº 2694 del 30/05/2007