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Friday, January 19, 2018

16th century epidemics

Salmonella Could Have Caused 16th-Century Epidemic

Flu Vaccine

Scientists Move Closer to a Universal Flu Vaccine
Researchers hope their new approach, which works well in lab animals, may save more lives
Credit: Roger Harris Getty Images


The flu takes a formidable toll each year. Researchers and health workers save lives by routinely rolling out seasonal vaccines and deploying drugs to fight the virus and its secondary infections. But in the U.S. alone the flu still kills tens of thousands of people and hospitalizes hundreds of thousands more.
A big part of the problem has been correctly predicting what strains of the influenza virus health officials should try to combat in a given season. A team of scientists from the U.S. and China now say they have designed a vaccine that could take the guesswork out of seasonal flu protection by boosting the immune system’s capacity to combat many viral strains./.../

Longevity and Diet

Longevity and DietGo to the profile of Dr. Jason Fung
However, much of this data results from animal data as it is difficult to experiment on live humans. The table below illustrates the results from dietary, exercise, genetic and drug interventions and their main mechanism of action. Pay particular attention to the column ‘Main Mechanism of Action’. This is the best guess as to how all these different interventions may increase lifespan.

Baby's microbioma



Baby’s first bacteria may take root before birth

A baby gestures minutes after he was bornThe fetus, placenta and womb were thought to be sterile, but some scientists argue that a baby’s microbiome begins to develop long before birth.

New Cancer blood test

Ovarian cancer cell
Ovarian cancer is one of eight cancers detected by a new blood test. (Eye of Science/SPL)

One blood test detects eight different kinds of cancer

An experimental blood test can detect ovarian, liver, stomach, pancreatic, esophageal, colorectal, lung or breast cancer. Researchers hope it will lead to faster and cheaper diagnoses. The CancerSEEK test looks for DNA mutations and aberrant levels of certain proteins associated with tumours, but the assay’s sensitivity varies widely depending on the cancer.

repeated head injury


Repeated Hits to the Head — Not Concussion — May Cause CTE
By SEAN GREGORY 
January 18, 2018
TIME Health
For more, visit TIME Health.
When a football player stumbles off the field, woozy, there’s a good chance the player suffered a concussion. Often, medical professionals will converge on him, offering an assessment as to whether he can safely return to the game. These procedures are wise: Concussions are dangerous, and a brain should never be put at further risk.
But concussive episodes alone may not be responsible for the potential long-term damage to a football player’s brain. New studies from Boston University in humans and mice suggest that repeated head injury can trigger the onset of chronic traumatic encephalopathy (CTE) — a neurodegenerative disease associated with head trauma — independent of concussion./.../

Complexity Science

Recomendado pelo AMICOR Reginaldo Hollanda Albuquerque.

Science

Thursday, January 18, 2018

Hospitals their own drug company

US hospitals to start their own drug company


About 300 hospitals in the US plan to create a non-profit generic drug company to battle shortages and high prices. Physician Marc Harrison says the move is “a shot across the bow of the bad guys”, who buy the rights to old, off-patent drugs and then jack up the prices.


Teladoc

Recomendado pelo AMICOR Reginaldo Hollanda Albuquerque (Brasília)
Teladoc Virtual Healthcare 2018 Predictions white paper_Final.pdf

AD autosomal dominant

Summary

Background

Tests sensitive to presymptomatic changes in Alzheimer's disease could be valuable for clinical trials. Accelerated long-term forgetting—during which memory impairment becomes apparent over longer periods than usually assessed, despite normal performance on standard cognitive testing—has been identified in other temporal lobe disorders. We assessed whether accelerated long-term forgetting is a feature of presymptomatic autosomal dominant (familial) Alzheimer's disease, and whether there is an association between accelerated long-term forgetting and early subjective memory changes.

Methods

This was a cross-sectional study at the Dementia Research Centre, University College London (London, UK). Participants were recruited from a cohort of autosomal dominant Alzheimer's disease families already involved in research at University College London, and had to have a parent known to be affected by an autosomal dominant Alzheimer's disease mutation, and not report any current symptoms of cognitive decline. Accelerated long-term forgetting of three tasks (list, story, and figure recall) was assessed by comparing 7-day recall with initial learning and 30-min recall. 7-day recognition was also assessed. Subjective memory was assessed using the Everyday Memory Questionnaire. The primary outcome measure for each task was the proportion of material retained at 30 min that was recalled 7 days later (ie, 7-day recall divided by 30-min recall). We used linear regression to compare accelerated long-term forgetting scores between mutation carriers and non-carriers (adjusting for age, IQ, and test set) and, for mutation carriers, to assess whether there was an association between accelerated long-term forgetting and estimated years to symptom onset (EYO). Spearman's correlation was used to examine the association between accelerated long-term forgetting and subjective memory scores.

Findings

Between Feb 17, 2015 and March 30, 2016, we recruited 35 people. 21 participants were mutation carriers (mean EYO 7·2 years, SD 4·5). Across the three tasks, we detected no differences between carriers and non-carriers for initial learning or 30-min recall. The proportion of material recalled at 7 days was lower in carriers than non-carriers for list (estimated difference in mean for list recall −30·94 percentage points, 95% CI −45·16 to −16·73; p=0·0002), story (–20·10, −33·28 to −6·91; p=0·0048), and figure (–15·41, −26·88 to −3·93; p=0·012) recall. Accelerated long-term forgetting was greater in carriers nearer to their estimated age at onset (p≤0·01 for all three tests). Mutation carriers' 7-day recognition memory was also lower across all tasks (list [mean difference −5·80, 95% CI −9·96 to −2·47; p<0 14="" 1="" 7="" 95="" a="" accelerated="" adjusted="" and="" asymptomatic="" between="" carriers.="" carriers="" ci="" compared="" correlation="" difference="" figure="" forgetting="" found="" in="" long-term="" means="" memory="" mutation="" non-carriers="" p="" poorer="" recognition="" scores="" story="" subjective="" to="" we="" were="" with="">

Interpretation/.../

Wednesday, January 17, 2018

Ecocardiografia

Para eventuais interessados:
Victor Herrera
 victor.herrera@sermo.com

14:22 (Há 12 minutos)





Apreciável Doctor,

Meu nome é Victor Herrera e em nome da SERMO, tenho o honor de convidar-lhe a participar do estudo que estamos realizando sobre Ecocardiogramas e gostariamos de saber se podemos contar com a sua valiosa participação.

O objetivo do estudo é analizar as tendências e os volumens dos procedimentos com os Ecocardiogramas. Nenhum tipo de informação pessoal de pacientes será requerido, unicamente é o volume.

Percutaneous CoronaryInterventions

Recomendado pelo AMICOR Enrique Barros
Overuse of Percutaneous Coronary Interventions
JAMA Intern Med. Published online January 16, 2018. doi:10.1001/jamainternmed.2017.7828
Since Gruentzig first used a balloon to inflate the left anterior descending of a young man with angina in 1977, there have been hundreds of millions of percutaneous coronary interventions (PCI) done worldwide. Most PCI are performed on patients who are asymptomatic or who have not had a trial of optimal medical therapy,1 which is equally effective in preventing myocardial infarction or death. Furthermore, in symptomatic patients there is no benefit to PCI in reducing symptoms or improving quality of life compared with a placebo procedure.2 This carefully performed analysis3 from the China PEACE study adds to the concern of overuse of PCI. It documents yet another commonly known but little discussed contributor to inappropriate PCI—the inaccuracy of angiographic readings. Visual assessments tend to systematically overestimate the magnitude of the stenosis, meaning that patients will get an intervention on a lesion that is not hemodynamically significant. In a painstaking analysis of 1295 patients who underwent PCI in China, Zhang et al3 compared physician visual assessment with quantitative coronary angiography (QCA). They found systematic overestimation of angiographic stenosis by 10% for patients with acute myocardial infarction (AMI), and 16% for patients without AMI./.../

Antibiotics

WHO/Europe launches online course for clinicians on prescribing and using antibiotics wisely


WHO/A. Kristensen
Testing for antimicrobial susceptibility provides vital information to clinicians and guides decisions about patient treatment.
WHO/Europe has launched a newly developed online course that aims to equip clinicians with the information they need to prescribe antibiotics appropriately and wisely. This free course, titled “Antimicrobial stewardship: A competency-based approach”, is available via the OpenWHO platform.
While enrolment is open to anyone, the course is particularly relevant for clinicians who frequently prescribe antibiotics. The discovery of these life-saving drugs is among the most important advances of medicine in the 20th century. However, data increasingly shows widespread misuse of antimicrobials across all health-care settings. This misuse contributes to the emergence of multidrug-resistant organisms, which threaten to undermine the effectiveness of antibiotics./.../

Saúde Urbana

Recomendado pela AMICOR Maria Inês Reinert Azambuja

Acta paul. enferm. vol.30 no.3 São Paulo May/Jun. 2017

http://dx.doi.org/10.1590/1982-0194201700033 

Editorial
Arlindo Philippi Jr.1  2  3 
1Engenheiro Civil (UFSC)
2Engenheiro Sanitarista (USP), Mestre em Saúde Ambiental, Doutor em Saúde Pública (USP),
3Pós-Doutor em Estudos Urbanos e Regionais (MIT), Livre-Docência em Política e Gestão Ambiental (USP), e Professor Titular (Faculdade de Saúde Pública da USP)
Fiquei honrado com o convite da Acta Paulista de Enfermagem para abordar o tema Ambiente, Saúde e Sustentabilidade. A relação deste editorial com o Dia Internacional da Enfermagem (comemorado em maio) tem um significado especial para mim, devido às atuações mais abrangentes que estes profissionais vêm assumindo e desenvolvendo.
Tanto os quadros conceituais globais de referência como o campo prático indicam que as mudanças sociais atuais estão pressionando os pesquisadores a considerar outras formas para desenvolver pesquisas, as quais envolvem a relação ambiente, saúde e sustentabilidade em contextos urbanos. Os pesquisadores precisam se concentrar nos seres humanos e sua relação intrínseca com o ambiente e a saúde para melhor entender os novos contextos sociais. Isto permitirá contribuir com respostas efetivas às necessidades concretas das pessoas no seu cotidiano e no ambiente urbano em transformação, considerando tanto os princípios da sustentabilidade como as necessidades de articulação e os conceitos interdisciplinares de produção do conhecimento. Portanto, é preciso ampliar os espaços de reflexão e discussão no âmbito acadêmico para possibilitar que novas categorias de análise e intervenção de ambiente e saúde no âmbito urbano sejam aprofundadas./.../