Thursday, March 31, 2005

Prorrogação prazo taxa reduzida 6th ICPC para latinos

-----Mensagem original-----
De: Mario F. de Camargo Maranhão [mailto:mariomaranhao@uol.com.br]
Enviada em: quinta-feira, 31 de março de 2005 13:33
Para: aloyzio.achutti
Assunto: - 31 de março - PRORROGADO! prazo para inscrições com taxa reduzida para Latino-americanos
Achutti: o valor REDUZIDO da inscrição para brasileiros e latino americanos está prolongado indefinidamente.
Gratos,
MM
Endereço para inscrições:
https://www.ics-online.com/ei/getdemo.ei?id=125&s=_1G80YNLJ0

Cardiologia Baseada em Evidência

cardiologia.pdf (application/pdf Object)
: Robespierre ... [mailto:dr.robespierre@gmail.com]
Enviada em: quinta-feira, 31 de março de 2005 14:13
Para: aloyzio.achutti@terra.com.br
Assunto: Artigo ATS - Robespierre


Já se encontra disponível no site da Sociedade Mineira de Cardiologia o artigo sobre Medicina Baseada em Evidências,

Atenciosamente,

Robespierre

Wednesday, March 30, 2005

6th ICPC 31 de março - Prazo Inscrições US$110 para Latino-Americanos

Aproxima-se a 6a. Conferência Internaciconal de Cardiologia Preventiva em Foz do Iguaçu. Dia 31 de março termina o prazo para as inscrições com taxa reduzida para Latino-americanos.
Aproveitem clicando no hyperlink ou pelo endereço abaixo:
https://www.ics-online.com/ei/getdemo.ei?id=125&s=_1G80YNLJ0
ou em caso de algum problema comunicando-se com
Paula Buczak
Project Manager
ICS Congresos Internacionales S.A.
P.O. BOX 73
C1084ZAA - Buenos Aires, Argentina
Tel +54-11-4382-5772
Fax +54-11-4382-5730
www.congresosint.com.ar
INCON Partner

ICS - The Netherlands
www.lgce.nl
ICS - Denmark
www.ics.dk
CMC Ltda - Chile
www.cmcevent.com

WEBSIMPOSIO

Foi feita ontem, dia 29 de março, a primeira transmissão ao vivo do WebSimpósio, com o tema Atualização do Congresso American College of Cardiology e participação ativa da platéia de 201 colegas de todo o Brasil.

Mesmo não tendo participado do programa ao vivo, você poderá agora assistir ao conteúdo, no momento em que desejar, rigorosamente com a mesma qualidade da transmissão ao vivo. Você poderá, inclusive, assistir como os palestrantes responderam às perguntas formuladas pelos colegas de todo o Brasil.

Estamos empenhados em fazer um excelente programa e agradecemos seu apoio, esperando contar com você, nos futuros eventos.

Equipe WebSimpósio
congressos@websimposio.com.br
www.websimposio.com.br

Becoming the Framingham Study 1947-1950 -- Oppenheimer 95 (4): 602 -- American Journal of Public Health

Becoming the Framingham Study 1947-1950 -- Oppenheimer 95 (4): 602 -- American Journal of Public Health: "Becoming the Framingham Study 1947�1950
Gerald M. Oppenheimer, PhD, MPH
In the epidemiological imagination, the Framingham Heart Study has attained iconic status, both as the prototype of the cohort study and as a result of its scientific success.
When the Public Health Service launched the study in 1947, epidemiological knowledge of coronary heart disease was poor, and epidemiology primarily involved the study of infectious disease. In constructing their investigation, Framingham�s initiators had to invent new approaches to epidemiological research. These scientific goals were heavily influenced by the contending institutional and personal interests buffeting the study.
The study passed through vicissitudes and stages during its earliest years as its organizers grappled to define its relationship to medicine, epidemiology, and the local community. "

Tuesday, March 29, 2005

Inflammation and Endothelial Function: Direct Vascular Effects of Human C-Reactive Protein on Nitric Oxide Bioavailability

Inflammation and Endothelial Function: Direct Vascular Effects of Human C-Reactive Protein on Nitric Oxide Bioavailability -- Clapp et al. 111 (12): 1530 -- Circulation

Endothelial Dysfunction in Childhood Infection

Marietta Charakida MD*, et al.
Background--Atherosclerosis begins in early life, and endothelial dysfunction is recognized as a key initiating event in the development of atherosclerosis. Although infection has been implicated in endothelial dysfunction and atherogenesis, the impact of acute common childhood infections on the vascular endothelium is unknown.
Methods and Results--We studied 600 children aged 10 years drawn from the Avon Longitudinal Study of Parents and Children. The children were divided into 3 groups: those with current acute infection (AI; n=135; 73 boys and 62 girls); a convalescent group with infection in the past 2 weeks (n=166; 78 boys and 88 girls), and a healthy control group (n=299; 131 boys and 168 girls). Endothelial function was determined in all subjects by high-resolution ultrasound to measure brachial artery flow-mediated dilation (FMD) and was expressed as the percentage change in diameter from baseline after reactive hyperemia. FMD was repeated in 40 children in the AI group and 50 in the control group after a mean interval of 1 year. FMD was lower in both the AI group (6.3±2.7%, mean±SD) and the convalescent group (8.1±3.1%) than in the control group (9.7±2.5%; P<0.001 for both). The observed differences in FMD remained after adjustment for potential confounding variables. At the repeat visit, FMD was unchanged in controls (P=0.85) but improved in the AI group (P<0.001).
Conclusions--Acute infection in childhood is associated with impaired endothelium-dependent vasodilation. These findings support a potential role for previously unsuspected extrinsic inflammatory stimuli in the pathogenesis of early atherosclerosis.

Uric Acid and the Heart

PLoS Medicine: Uric Acid and the Heart
Wheeler JG, Juzwishin KDM, Eiriksdottir G, Gudnason V, Danesh J (2005) Serum uric acid and coronary heart disease in 9,458 incident cases and 155,084 controls: Prospective study and meta-analysis.
What is the level of medical evidence that should be used to inform medical practice? At the bottom of the hierarchy of evidence are anecdotes, expert opinion, case reports, and case series, and at the top is the systematic review of published (and sometimes unpublished) evidence. By necessity, systematic reviews come many years after hypotheses are first raised, and in the interim recommendations for practice may sway back and forth. One example of this is the debate over the role of uric acid in heart disease, which has been going on for more than 50 years. It started with a paper published in 1951 in the Annals of Internal Medicine that found higher serum uric acid concentrations in patients with coronary heart disease (CHD) compared with controls. Since then, measurement of serum uric acid has been suggested as a predictor of CHD. But many of the studies on serum uric acid are epidemiologic studies—somewhere in the middle of the hierarchy of evidence—and have come to different conclusions about how useful measurement of uric acid is.

Sunday, March 27, 2005

Prevalence of Risk Factors for Cardiovascular Disease in Employees of the Research Center at Petrobras


Maria de Fátima Duarte Matos, Nelson Albuquerque Souza e Silva,Armando Jorge Marques Pimenta, Antonio José Ledo Alves da Cunha
Results - Of 1,911 employees, 970 were studied, 75.4% were men and 24.6% were women with a mean age of 42.2 years old. The risk factors were lack of exercise (67.3%), cholesterol > 200 mg/dL (56.6%), overweight (42%), obesity (17%), blood hypertension (18.2%), smoking (12.4%), and diabetes mellitus (2.5%).
Conclusion - The high prevalence of risk factors for cardiovascular disease in young individuals draws attention to the need for the adoption of workplace programs to encourage healthy lifestyles and to prevent diseases.

Variability Among Cardiologists in the Management of Patients Under Secondary Prevention of Ischemic Heart Disease


Variability Among Cardiologists in the Management of Patients Under Secondary Prevention of Ischemic Heart Disease
Ricardo Stein, Caroline Alboim, Candice Campos, Renato Bandeira de Mello, Guido Aranha Rosito, Carisi Anne Polanczyk
disease, prevalence of previous myocardial infarction, and previous revascularization procedures showed no significant differences between the patients in groups I and II. In group I, 98% of the patients received aspirin, while, in group II, 83% of the patients received that drug (p=0.02). In regard to the use of lipid-lowering drugs, the prevalences were 60% in group I and 19% in group II (p=0.001). The lipid profile examination was
requested for 98% of group I individuals and 79% of group II individuals (p=0.003).
Conclusion
In regard to new medical evidence, mainly prescription of aspirin and lipid-lowering drugs, the management was more reliable in the outpatient clinic specifically aimed at treating ischemic heart disease.

Indicadores de Doença Cardiovascular no Estado do Rio de Janeiro com Relevo para a Insuficiência Cardíaca


Indicadores de Doença Cardiovascular no Estado do Rio de Janeiro com Relevo para a Insuficiência Cardíaca
Francisco Manes Albanesi Filho
As doenças cardiovasculares (DCV) constituem a segunda causa de hospitalização pelo Sistema Único de Saúde (SUS) no Estado do Rio de Janeiro. Entre elas, a síndrome de insuficiência cardíaca (IC) é a mais freqüente. Os dados apresentados neste artigo revelam a incidência das internações e óbitos, a taxa de mortalidade e os recursos financeiros empregados no país e no Estado do Rio de Janeiro para o atendimento desses pacientes. A IC constitui atualmente o maior desafio clínico na área da saúde pública, sendo considerado um problema epidêmico em progressão.

Reflexões sobre o Relacionamento entre o Médico Acadêmico, a Sociedade em Geral e Empresas Produtoras de Medicamentos e Equipamentos


Reflexões sobre o Relacionamento entre o Médico Acadêmico, a Sociedade em Geral e Empresas Produtoras de Medicamentos e Equipamentos
em Particular
José Antonio Marin-Neto e Benedito Carlos Maciel

Clinical and Demographic Characteristics of 99 Episodes of Rheumatic Fever in Acre, the Brazilian Amazon


Clinical and Demographic Characteristics of 99 Episodes of Rheumatic Fever in Acre, the Brazilian Amazon
Fátima Borges, Maria Luiza A. Barbosa, Renata Beyruth Borges, Olívia C. Pinheiro, Carlos Cardoso, Claudilson Bastos, Roque Aras Rio Branco, AC / Salvador, BA
From July 2003 to February 2004, 99 patients with rheumatic fever were assessed (mean age, 11 years, SD= ± 10.18) with a predominance of females (59.6%), and a racial phenotype of a mixture of Caucasian and Indian (60.6%). Three individuals were excluded because they did not meet the diagnostic criteria. Mean age was 9.1 years old, and in 30.4% of the patients, the disease was diagnosed at the first episode of rheumatic fever.
The most frequent clinical manifestations were carditis (69.7%), arthritis (21.4%), and chorea (6.1%). Mitral regurgitation was the most common lesion (36.4%) followed by the association of mitral regurgitation and aortic regurgitation (9.1%).
Conclusion
Rheumatic carditis was the most common manifestation of rheumatic fever, predominant in the group with a racial mixture of Caucasian and Indian (60.6%). Low compliance with antibiotic therapy contributed to the recurrence of the disease and to cardiac sequelae.

Saturday, March 26, 2005

4o.Congresso Internacional de Cardiologia pela INTERNET

De: Silvia Nanfara [mailto:nanfara@fac.org.ar]
Enviada em: sábado, 26 de março de 2005 18:34
Assunto: Cuarto Congreso Virtual de Cardiologia

Cuarto Congreso Virtual de Cardiologia, organizado por la Region Patagonica de la Federacion Argentina de Cardiologia a realizarse entre el 01 de setiembre y el 30 de noviembre de 2005.
Como en las ediciones anteriores la inscripcion es gratuita.
Aprovecho la oportunidad para invitarlo aparticipar activamante del mismo.
Le agradezco su atencion y lo saludo atentamente.
Dra. Silvisa Nanfara

4to Congreso Internacional de Cardiología por Internet
4to Congreso Virtual de Cardiología - CCVC

Esta cuarta edición de la mayor actividad cardiológica en Internet se desarrollará entre el 1 de septiembre y el 30 de noviembre de 2005 en www.fac.org.ar/ccvc

Desde el 1ero de marzo hasta el 30 de mayo de 2005, se reciben abstracts de temas libres para ser presentados en el CCVC. Se accede a las instrucciones para la preparacion y el envio desde www.fac.org.ar/ccvc/gralesp/instrtl.htm

La asistencia y la participación en el CCVC son gratuitas. La inscripción se realiza llenando un formulario en www.fac.org.ar/ccvc/gralesp/inscesp.php3

Encontrarán mayores informaciones sobre el congreso en www.fac.org.ar/ccvc

Prof. Dra. Silvia Fedchteyn de Eskenazi
CETIFAC
sidemi@terra.com.pe
Cuarto Congreso Virtual de Cardiologia
Federacion Argentina de Cardiologia

Epidemiology and reporting of randomised trials published in PubMed Journals.

The Journal : Current Issue
An-Wen Chan, Douglas G Altman
Although randomised trials are important for evidence-based medicine, little is known about their overall characteristics. We assessed the epidemiology and reporting of methodological details for all 519 PubMed-indexed randomised trials published in December, 2000 (383 [74%] parallel-group, 116 [22%] crossover). 482 (93%) were published in specialty journals. A median of 80 participants (10th-90th percentile 25-369) were recruited for parallel-group trials. 309 (60%) were blinded. Power calculation, primary outcomes, random sequence generation, allocation concealment, and handling of attrition were each adequately described in less than half of publications. The small sample sizes are worrying, and poor reporting of methodological characteristics will prevent reliable quality assessment of many published trials.

Friday, March 25, 2005

EPIDEMIOLOGY: How Dirty Air Hurts the Heart -- Kaiser 307 (5717): 1858b -- Science

EPIDEMIOLOGY: How Dirty Air Hurts the Heart -- Kaiser 307 (5717): 1858b -- Science
. Citing the body of evidence, an American Heart Association scientific panel in last June labeled fine particles a "serious public health problem" and urged the Environmental Protection Agency to consider "even more stringent standards."

Leucocyte count may predict heart disease in women -- Kermode-Scott 330 (7493): 690 -- BMJ

Leucocyte count may predict heart disease in women -- Kermode-Scott 330 (7493): 690 -- BMJ
“The white blood cell count comes out at least as strong a predictor of coronary heart disease as the C reactive protein,” said Dr Margolis. “In any situation in which you might consider testing C reactive protein to further evaluate cardiovascular risk, then the white blood cell count could be considered as an alternative.”

New standards for cardiopulmonary resuscitation -- Deakin 330 (7493): 685 -- BMJ

New standards for cardiopulmonary resuscitation -- Deakin 330 (7493): 685 -- BMJ: "Charles D Deakin, consultant anaesthetist "

New standards for cardiopulmonary resuscitation

New standards for cardiopulmonary resuscitation -- Deakin 330 (7493): 685 -- BMJ
Represent a milestone in resuscitation practice and training
Charles D Deakin, consultant anaesthetist


A joint statement, Cardiopulmonary Resuscitation—Standards for Clinical Practice and Training, has been issued by the Royal College of Anaesthetists, Royal College of Physicians of London, the Intensive Care Society, and the Resuscitation Council (UK).1 This was endorsed by a further nine healthcare organisations including the National Patient Safety Agency and defines minimum standards for the delivery of resuscitation related services in healthcare institutions. Perhaps the only major omissions from this list are the Royal College of General Practitioners and the Royal College of Obstetricians.

Wednesday, March 23, 2005

II Encontro de Boas Práticas do Programa Agita São Paulo

O Centro de Estudos do Laboratório de Aptidão Física de São Caetano do Sul - CELAFISCS e a Secretaria de Estado da Saúde, coordenadores do Programa Agita São Paulo convidam para participar da solenidade de abertura do II Encontro de Boas Práticas do Programa Agita São Paulo e a II Mostra de Programas de Promoção da Atividade Física. O evento realizar-se-á no próximo dia 6 de Abril de 2005, das 8:00 às 14:00 horas na Associação Paulista de Medicina, sito à Avenida Brigadeiro Luís Antonio, 278, 9º andar - Auditório Nobre - São Paulo - SP.
Na ocasião será feita a apresentação oficial do PROGRAMA AGITA SAMPA o lançamento do novo livro de "Boas Práticas em Agita São Paulo 2005".
Contando com tão insigne presença, solicitamos que envie confirmação de sua participação.

Cordialmente,


Dr. Victor K. R. Matsudo
Coordenador Geral do Programa
Programa Agita São Paulo

“Culture of Life” Politics at the Bedside — The Case of Terri Schiavo


George J. Annas, J.D., M.P.H.
For the first time in the history of the United States, Congress met in a special emergency session on Sunday, March 20, to pass legislation aimed at the medical care of one patient — Terri Schiavo. President George W. Bush encouraged the legislation and flew back to Washington, D.C., from his vacation in Crawford, Texas, so that he could be on hand to sign it immediately. In a statement issued three days earlier, he said: “The case of Terri Schiavo raises complex issues. . . .

Terri Schiavo — A Tragedy Compounded


Timothy E. Quill, M.D.The story of Terri Schiavo should be disturbing to all of us. How can it be that medicine, ethics, law, and family can work so poorly together in meeting the needs of this woman who was left in a persistent vegetative state after having a cardiac arrest?
Ms. Schiavo has been sustained by artificial hydration and nutrition through a feeding tube for 15 years, and her husband, Michael Schiavo, has
been locked in a very public legal struggle with her parents and siblings about whether such treatment should be continued or stopped.

Tuesday, March 22, 2005

Racial/Ethnic and Socioeconomic Disparities in Multiple Risk Factors for Heart Disease and Stroke --- United States, 2003

Racial/Ethnic and Socioeconomic Disparities in Multiple Risk Factors for Heart Disease and Stroke --- United States, 2003
Heart disease and stroke are the first and third leading causes of death, respectively, in the United States (1). Certain modifiable risk factors, including high blood pressure, high cholesterol, diabetes, tobacco use, obesity, and lack of exercise, are the main targets for primary and secondary prevention of heart disease and stroke. A substantial proportion of the population has multiple risk factors, increasing their likelihood of cardiovascular disease (2,3). To assess the prevalence of multiple risk factors for heart disease and stroke and to identify disparities in risk status among population subgroups, CDC analyzed data from the 2003 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report summarizes the results of that analysis, which indicated that approximately 37% of the survey population had two or more risk factors for heart disease and stroke and that considerable disparities in risk factors existed among socioeconomic groups and racial/ethnic populations. To decrease morbidity and mortality from heart disease and stroke, public health programs should improve identification of persons with multiple risk factors and focus interventions on those populations disproportionately affected.

Gastric Invasion by Trypanosoma cruzi and Induction of Protective Mucosal Immune Responses

De: Maria Inês Reinert Azambuja [mailto:miazambuja@terra.com.br]
Enviada em: terça-feira, 22 de março de 2005 13:11
Para: aloyzio.achutti@terra.com.br
Assunto: trypanosoma invasion

http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=174296&blobtype=pdf
Gastric Invasion by Trypanosoma cruzi and Induction of
Protective Mucosal Immune Responses
DANIEL F. HOFT,1* PATRICIA L. FARRAR,2 KATHERINE KRATZ-OWENS,1 AND DAWN SHAFFER2
Departments of Internal Medicine1 and Comparative Medicine,2 Saint Louis University Health Sciences Center,
St. Louis, Missouri 63110
Received 6 February 1996/Returned for modification 27 March 1996/Accepted 13 May 1996
Trypanosoma cruzi is an intracellular parasite transmitted from a reduviid insect vector to humans by exposure of mucosal surfaces to infected insect excreta. We have used an oral challenge murine model that mimics vector-borne transmission to study T. cruzi mucosal infection. Although gastric secretions have microbicidal activity against most infectious pathogens, we demonstrate that T. cruzi can invade and replicate in the gastric mucosal epithelium. In addition, gastric mucosal invasion appears to be the unique portal of entry for systemic T. cruzi infection after oral challenge. The mucosal immune responses stimulated by T. cruzi gastric infection are protective against a secondary mucosal parasite challenge. This protective mucosal
immunity is associated with increased numbers of lymphocytes that secrete parasite-specific immunoglobulin A. Our results document the first example of systemic microbial invasion through gastric mucosa and suggest the feasibility of a mucosal vaccine designed to prevent infection with this important human pathogen

Saturday, March 19, 2005

Provocative Study Says Obesity May Reduce U.S. Life Expectancy


In the 1980s and 1990s, the late maverick economist Julian Simon infuriated environmentalists by arguing that free markets and scientific progress were constantly improving human life rather than pushing the world toward ecological ruin, social collapse, and famine. A key example was life expectancy at birth, which Simon showed had been steadily rising for centuries. Using that as a metric, he repeatedly claimed that in the 21st entury, “humanity’s condition will improve in just about every material way.”....

Friday, March 18, 2005

Number of overweight women in developing countries is increasing

Number of overweight women in developing countries is increasing -- Dobson 330 (7492): 620 -- BMJ

Most developing countries now have more overweight than underweight women. Numbers of overweight women are increasing at an alarming rate, a new report based on data for women younger than 50 in 36 developing countries has found (American Journal of Clinical Nutrition 2005;81:714-21).
In 10 countries, more than half of the women living in urban areas are overweight (body mass index of 25 or more), according to the report. In 18 of the countries, more than a fifth of rural women were also overweight.....
(referred by Marcelo Gustavo Colominas [mgcolominas@hotmail.com])

Thursday, March 17, 2005

Study: Obesity to cut 2 to 5 years off live span

Study: Obesity to cut 2 to 5 years off live span
CHICAGO - New and disputed research adds a twist to the Social Security dilemma, suggesting that a nation gorging itself on bacon double-cheeseburgers will one day dramatically shorten the average U.S. life span.

Obesity - especially its alarming rise among children - is the culprit, fueling a startling reversal in life expectancy, which likely will drop by two to five years or more within 50 years, according to a report in Thursday's New England Journal of Medicine.

Obesity to cut 2 to 5 years off live span

Study: Obesity to cut 2 to 5 years off live span
CHICAGO - New and disputed research adds a twist to the Social Security dilemma, suggesting that a nation gorging itself on bacon double-cheeseburgers will one day dramatically shorten the average U.S. life span.

Obesity - especially its alarming rise among children - is the culprit, fueling a startling reversal in life expectancy, which likely will drop by two to five years or more within 50 years, according to a report in Thursday's New England Journal of Medicine.

This would reverse the mostly steady increase in American life expectancy that has occurred in the past two centuries. It could even inadvertently "save" Social Security, but the tremendous price would be higher death rates and escalating health care costs, said lead author S. Jay Olshansky, a longevity researcher at the University of Illinois at Chicago.

Tuesday, March 15, 2005

Discovering the Full Spectrum of Cardiovascular Disease: Minority Health Summit 2003: Executive Summary

Discovering the Full Spectrum of Cardiovascular Disease: Minority Health Summit 2003: Executive Summary -- Yancy et al. 111 (10): 1339 -- Circulation
Of all the forms of inequality, injustice in health is the
most shocking and inhumane. —Martin Luther King, Jr

The American Heart Association (AHA) has a stated goal
of achieving a 25% reduction in coronary heart disease,
stroke, and the risk for these diseases by 2010, with a specific
emphasis on people who are at highest risk. To meet this goal,
best practices in prevention, diagnosis, and treatment need to
be applied broadly to the US population. That population is
now described by a remarkably changing demographic profile.
During the past several decades, the US population has
become much more ethnically diverse than it once was. The
current representation of non-Hispanic whites in this country
has declined to 67% and is expected to be at 60% in another
decade, and perhaps as low as 50% by the middle of the
twenty-first century.1 According to the US Census Bureau,
the most populous state, California, no longer has a single
majority population. Hispanics now represent 14% to 15% of
the US population. The Hispanic segment is not only the
largest minority population but also the fastest growing
segment of the US population. People of predominantly
African descent represent another 12% of the US population,
and people of Asian descent and Native Americans constitute
the remainder of the population.2 If there is to be a meaningful
impact on death and disability resulting from heart disease
and stroke in the United States, then the diversity of the US
demographic must be considered.

Minority Health Summit 2003: Report of the Advocacy Writing Group

Discovering the Full Spectrum of Cardiovascular Disease: Minority Health Summit 2003: Report of the Advocacy Writing Group -- Yancey et al. 111 (10): e140 -- Circulation
The US population is exceptionally rich in cultural diversity,
and that diversity is increasing rapidly. Nearly 33%
of the US population self-identifies as a member of a racial or
an ethnic minority.1 Trends in US Census data for the past 30
years point to the continual increase in the number of diverse
groups. Roughly 1 million immigrants enter the United States
each year; by 2000, there were 32 million immigrants.
Some regions are extraordinarily diverse: For example, in Los
Angeles County, Calif, 140 nationalities have been documented.
2 In terms of future population trends, Latinos,
Asians, and their subgroups will at least double, if not triple,
in population size by the year 2050.2 Likewise, people of
predominantly African descent and Native Americans will show
marginal increases in population size. The number of individuals
who claim membership in at least 2 ethnic groups will increase
10% by 2050, and racial/ethnic minorities will constitute 50%
of the US population.2

Minority Health Summit 2003: Report of the Obesity, Metabolic Syndrome, and Hypertension Writing Group

Discovering the Full Spectrum of Cardiovascular Disease: Minority Health Summit 2003: Report of the Obesity, Metabolic Syndrome, and Hypertension Writing Group -- Smith et al. 111 (10): e134 -- Circulation
This article provides an overview of our current understanding
of the epidemiology of obesity, the metabolic
syndrome, and hypertension among racial/ethnic groups.
Three presentations made at the conference by the present
writing group are summarized and updated with other information
on ethnic groups, and recommendations developed by
the writing group for programs, public policy, and research
are put forward.

Minority Health Summit 2003: Report of the Outcomes Writing Group

Discovering the Full Spectrum of Cardiovascular Disease: Minority Health Summit 2003: Report of the Outcomes Writing Group -- Benjamin et al. 111 (10): e124 -- Circulation
Despite the steady decline in cardiovascular disease
(CVD) mortality during the past 30 years,1 CVD remains
the No. 1 killer of adults across all racial/ethnic groups
in the United States.2 Observational studies have been central
to understanding the epidemiology of CVD, including its
incidence, prevalence, predictors, and prognosis. Until recently,
the majority of epidemiological studies have been
based predominantly, or even exclusively, on middle-class,
white, non-Hispanic cohorts. Hence, the generalizability of
the findings to all populations has been uncertain. The lack of
information on the epidemiology of CVD in racial/ethnic
minority groups and people of lower socioeconomic status
(SES) is particularly problematic in light of data that underscore
the undue burden of CVD and its risk factors in
racial/ethnic minorities and poor people.3

Discovering the Full Spectrum of Cardiovascular Disease: Minority Health Summit 2003: Report of the Basic Science Writing Group

Discovering the Full Spectrum of Cardiovascular Disease: Minority Health Summit 2003: Report of the Basic Science Writing Group -- Benjamin et al. 111 (10): e120 -- Circulation
Despite considerable overall improvement in the clinical
prevalence and outcome of cardiovascular disease in the
US population during the past 50 years, striking disparities in
disease burden plague specific racial/ethnic subgroups. Black
patients with cardiovascular disease (CVD) in particular have
increased morbidity and mortality as compared with white
patients. For example, a black man between 45 and 65 years
old is 4 times more likely to have a stroke than his white
counterpart. Even when accounting for access to high-quality
health care, ethnic minorities bear a higher burden of obesity,
type 2 diabetes mellitus, and hypertension as compared with
whites. The mechanisms for these disparities remain incompletely
understood but likely include a combination of genetic,
environmental, and socioeconomic factors. If recent
advances in basic science are to be exploited to reduce
disparities in cardiovascular health care, then the emerging
disciplines in human genetics, biological sciences, and molecular
medicine are likely to afford us unprecedented opportunities
for deciphering the complex mechanisms involving
race/ethnicity, genetic differentiation, allele frequency disparities,
and gene– environment interactions.

Clinical Trial Registration: A Statement From the International Committee of Medical Journal Editors -- De Angelis et al. 111 (10): 1337 -- Circulation

Clinical Trial Registration: A Statement From the International Committee of Medical Journal Editors -- De Angelis et al. 111 (10): 1337 -- Circulation
Altruism and trust lie at the heart of research on human
subjects. Altruistic individuals volunteer for research
because they trust that their participation will contribute to
improved health for others and that researchers will minimize
risks to participants. In return for the altruism and trust that
make clinical research possible, the research enterprise has an
obligation to conduct research ethically and to report it
honestly. Honest reporting begins with revealing the existence
of all clinical studies, even those that reflect unfavorably
on a research sponsor’s product.

Eliminating Disparities in Cardiovascular Health

Six Strategic Imperatives and a Framework for Action
George A. Mensah, MD

Disparities in cardiovascular health are among the most serious public health problems in the United States today. Despite the remarkable declines in cardiovascular mortality observed nationally over the last 3 decades, many population subgroups defined by race, ethnicity, gender, socioeconomic status, educational level, or geography show striking, and often widening, disparities in cardiovascular health. The pervasive nature of these disparities and compelling evidence of the adverse impact they have on clinical outcomes and quality of life have been well documented. The elimination of these disparities is 1 of the 2 overarching goals of the Healthy People 2010 national public health agenda; however, few publications provide guidance on what actions to take. In this review, 6 strategic imperatives within a framework for action are presented. Other key elements of the framework include 10 focal areas and 6 major settings within which the framework calls for accelerated interventions to eliminate disparities in cardiovascular health. Success in this endeavor will require innovative and comprehensive interventions built on a foundation of sound clinical and public health science. Strategic partnerships with communities, community-based organizations, state and local governments, and public and private partners from both health and nonhealth sectors are essential. Additionally, investment in local-level disparities surveillance, community-based participatory research, and development of a diverse clinical and public health workforce will be invaluable.

Ethnic Differences in Coronary Calcification: The Multi-Ethnic Study of Atherosclerosis (MESA)

Ethnic Differences in Coronary Calcification: The Multi-Ethnic Study of Atherosclerosis (MESA) -- Bild et al. 111 (10): 1313 -- Circulation:
"Background: There is substantial evidence that coronary calcification, a marker for the presence and quantity of coronary atherosclerosis, is higher in US whites than blacks; however, there have been no large population-based studies comparing coronary calcification among US ethnic groups.
Methods and Results: Using computed tomography, we measured coronary calcification in 6814 white, black, Hispanic, and Chinese men and women aged 45 to 84 years with no clinical cardiovascular disease who participated in the Multi-Ethnic Study of Atherosclerosis (MESA). The prevalence of coronary calcification (Agatston score >0) in these 4 ethnic groups was 70.4%, 52.1%, 56.5%, and 59.2%, respectively, in men (P<0.001) and 44.6%, 36.5%, 34.9%, and 41.9%, respectively, (P<0.001) in women. After adjustment for age, education, lipids, body mass index, smoking, diabetes, hypertension, treatment for hypercholesterolemia, gender, and scanning center, compared with whites, the relative risks for having coronary calcification were 0.78 (95% CI 0.74 to 0.82) in blacks, 0.85 (95% CI 0.79 to 0.91) in Hispanics, and 0.92 (95% CI 0.85 to 0.99) in Chinese. After similar adjustments, the amount of coronary calcification among those with an Agatston score >0 was greatest among whites, followed by Chinese (77% that of whites; 95% CI 62% to 96%), Hispanics (74%; 95% CI 61% to 90%), and blacks (69%; 95% CI 59% to 80%).
Conclusions: We observed ethnic differences in the presence and quantity of coronary calcification that were not explained by coronary risk factors. Identification of the mechan"

Ischemic Stroke Subtype Incidence Among Whites, Blacks, and Hispanics: The Northern Manhattan Study

Ischemic Stroke Subtype Incidence Among Whites, Blacks, and Hispanics: The Northern Manhattan Study -- White et al. 111 (10): 1327 -- Circulation:
"Background: Stroke incidence is greater in blacks than in whites; data on Hispanics are limited. Comparing subtype-specific ischemic stroke incidence rates may help to explain race-ethnic differences in stroke risk. The aim of this population-based study was to determine ischemic stroke subtype incidence rates for whites, blacks, and Hispanics living in one community.
Methods and Results: A comprehensive stroke surveillance system incorporating multiple overlapping strategies was used to identify all cases of first ischemic stroke occurring between July 1, 1993, and June 30, 1997, in northern Manhattan. Ischemic stroke subtypes were determined according to a modified NINDS scheme, and age-adjusted, race-specific incidence rates calculated. The annual age-adjusted incidence of first ischemic stroke per 100 000 was 88 (95% CI, 75 to 101) in whites, 149 (95% CI, 132 to 165) in Hispanics, and 191 (95% CI, 160 to 221) in blacks. Among blacks compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.85 (95% CI, 1.82 to 18.73); extracranial atherosclerotic stroke, 3.18 (95% CI, 1.42 to 7.13); lacunar stroke, 3.09 (95% CI, 1.86 to 5.11); and cardioembolic stroke, 1.58 (95% CI, 0.99 to 2.52). Among Hispanics compared with whites, the relative rate of intracranial atherosclerotic stroke was 5.00 (95% CI, 1.69 to 14.76); extracranial atherosclerotic stroke, 1.71 (95% CI, 0.80 to 3.63); lacunar stroke, 2.32 (95% CI, 1.48 to 3.63); and cardioembolic stroke, 1.42 (95% CI, 0.97 to 2.09).
Conclusions: The high ischemic stroke incidence among blacks and Hispanics compared with"

US-National Survey of Stroke Risk Awareness Among Women

American Heart Association and American Stroke Association National Survey of Stroke Risk Awareness Among Women -- Ferris et al. 111 (10): 1321 -- Circulation
Conclusions— Results of this national survey document that awareness and knowledge about stroke is suboptimal among women, especially among racial/ethnic minorities, who are at highest risk. These data support the need for targeted educational programs about stroke risk and symptoms and underscore the importance of public health programs to improve awareness of stroke among women.

Monday, March 14, 2005

The New York Times > Health > Tracking the Uncertain Science of Growing Heart Cells

The New York Times > Health > Tracking the Uncertain Science of Growing Heart Cells
Muito interessante...
As motivações dos cientistas e dos médicos são diferentes "indeed"... inclusiva as de ordem $$$$... onde e para quem vai o dinheiro da inovação, se para os laboratórios ou para os médicos que realizam o procedimento (transplante de medula), também é um ponto em disputa aqui?
Acho que eu torço para o transplante de medula.
Maria Inês

n April 2001, researchers from the New York Medical College and the National Institutes of Health announced electrifying news for heart surgeons and their patients: stem cells from bone marrow, injected into the damaged hearts of mice, had morphed into the special cardiac muscle cells that the body cannot replace after a heart attack.

The researchers held out the hope that the procedure could be applied to people, too. The findings underlined a basic premise of stem cell therapy, that it will work before the cells and their elaborate control systems are fully understood - just put stem cells in the right place in the body, and they will do the rest.

But four years later, the treatment has yet to demonstrate whether it will fulfill its promise. And it has touched off a sharp difference of views among clinical doctors as to whether the therapy is ready to be taken to people.

Sunday, March 13, 2005

PSYCHOCARDIOLOGY: THE INTERTWINNING OF HEART AND MIND

Dr. Schvinger, Amaryllis
PsycoCardiology is a field of Clinical Psychology . Clinical Psychology had been from its beginning a part of Mental Health research and practice, but nowadays it became enrolled in the wider sphere of the Health Sciences.
From this point of reference, our view of PsychoCardiology intends to go further and affirm a radical rupture with the Cartesian epistemological model which has dualism as its core – ground of modern science – and is present in the distinction between the material (body) and the imaterial (mind or spirit) of the human being constitution. PsychoCardiology has its philosophical ground mainly in Edmund Husserl’s notion of the lived body (Leib), later developed by the French philosopher Maurice Merleau-Ponty and, the North American psychiatrist Drew Leder.
Scientific researches developed around the Body/Mind unity and interelationships, and specifically around the relations of psychological processes with cardiovascular diseases give the scientific support to the PsychoCardiology proposal.
The present work is supplemented by data from a phenomenological research conducted by the author at the Instituto Nacional de Cardiologia Laranjeiras, in Rio de Janeiro, Brazil. Clinical interviews were made with 53 inpatients that either were submitted to revascularization surgery ,1 to 8 days before the interview, or were going to be submitted to the surgery on the following 1 to 20 days after the interview.
Results point to two kinds of conexions between physical and mental or psychological processes:
1. By simultaneity: refers to conexions presented by experimental studies that search for causal relations among psychosocial factors and cardiac pathology, e.g. the Type A Behavior Pattern as an independent risk factor to MI;
2. By repercussion: refers to the acknowledgement, via phenomenological-hermeneutical reasoning, that what is experienced in the body affects the mind and vice-versa. “Psychological reactions to heart disease can be more astonishing and dramatic than those of the cardiovascular system itself” (Cassem & Hackett, 1977).
Existence, a heideggerian expression, best conveys the body/mind unity and says even more: this unity exists in intrinsic relation with the people and the world around.

Dr. Schvinger, Amaryllis
International Affiliation: American Psychological Association
Address: Estrada do Mataporcos, 2101
Corrêas Petrópolis, RJ Brazil
Postcode: 25730-070
Phone: (5521) 2521 7840 Fax: (5521)2521 7840
Email: aletheia@serraon.com.br

Saturday, March 12, 2005

Warning signs often occur hours or days before a stroke -- Mayor 330 (7491): 556 -- BMJ

Warning signs often occur hours or days before a stroke -- Mayor 330 (7491): 556 -- BMJ

Nearly one in eight patients who have an ischaemic stroke have a transient ischaemic attack (TIA) at some point in the previous seven days, according to a study published this week, indicating the need to treat TIA as a medical emergency to improve the prevention of subsequent stroke.

The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community -- Milne et al. 330 (7491): 576 -- BMJ

The pre-eclampsia community guideline (PRECOG): how to screen for and detect onset of pre-eclampsia in the community -- Milne et al. 330 (7491): 576 -- BMJ
Many maternal and fetal deaths from pre-eclampsia are associated with substandard care

Poor management includes failure to assess or act on risk at booking or to act on signs and symptoms after 20 weeks' gestation

Our community guideline provides an evidence based risk assessment, a list of factors suitable for early referral, and a two tiered schedule of assessment and step-up referral for signs and symptoms of pre-eclampsia

This is a practical extension of NICE's antenatal guideline

Wednesday, March 09, 2005

Nikolai Sergeievichj Korotkov (www.whonamedit.com)

Nikolai Sergeievichj Korotkov (www.whonamedit.com)
In November 05, 1905 Korotkov presentd during a scientific meeting at the Military Hospital of the Imperial Military Academy a short communication : "Concerning the problem of the methods for investigating blood pressure"

laugh is good for the heart

A good laugh is good for the heart, according to a study by researchers at the University of Maryland School of Medicine.

Researchers presented their findings at the Scientific Session of the American College of Cardiology in Orlando, Florida.

For their findings, the team showed two movies to 20 healthy non-smoking, volunteers and tested the function of their blood vessels.

They found that laughter-provoking movies, such as "King Pin" increased blood flow by an average of 22 percent compared with a decrease of 35 percent for stressful movies such as "Saving Private Ryan."

The team reported laughter appears to cause the tissue that forms the inner lining of blood vessels called the endothelium, to dilate or expand in order to increase blood flow.

Tuesday, March 08, 2005

STEM CELLS: Which ones and why?

(Referência do Reginaldo H. Albuquerque, do Cardiosource.)
The Challenge
Among survivors of myocardial infarction (MI), heart failure frequently ensues as a consequence of cell loss and scar formation in myocardium within the distribution area of the infarct-related artery. In theory, late revascularization might enable hibernating myocardium to recover contractility.1

Cell transplantation may be one means of achieving late myocardial recovery and restoration. Various delivery methods are being evaluated using a variety of cell types (Slide 1), including skeletal myoblasts, endothelial progenitor cells from peripheral blood, and hematopoietic or mesenchymal stem cells derived from fatty tissue or bone marrow.2

Dia Internacional da Mulher

HOMENAGEM TAMBÉM A TODAS NOSSAS MULHERES AMICOR!....
Dia Internacional da Mulher: SIMERS rende homenagem à primeira médica do Brasil
Porto Alegre, 4 de fevereiro de 2005.

A Prefeitura de Rio Pardo e o Sindicato Médico do Rio Grande do Sul (SIMERS) vão reverenciar na terça-feira, dia 8, a memória de uma das mulheres pioneiras no Brasil. Para marcar o Dia Internacional da Mulher no Estado, o município, por meio do Arquivo Histórico e Câmara de Vereadores, e o SIMERS farão ato no Museu Municipal lembrando os feitos da gaúcha Rita Lobato, a primeira médica formada no Brasil. Rita, que morreu em 1954 aos 87 anos, rompeu a fronteira da Medicina e foi também a primeira vereadora eleita no país. Ela foi ainda a segunda médica formada na América Latina.
...........

Thursday, March 03, 2005

[2236 - AMICOR - 03/Março/2005] AMICOR; AMICOR SMOKE; AMICOR PRESERVE

[2236 - AMICOR - 03/Março/2005] AMICOR; AMICOR SMOKE; AMICOR PRESERVE

Caros AMICOR,
A menor frequência das mensagens de alerta se devem às férias e às reformulações no estilo da comunicação AMICOR. Novas referências estarão sendo acrescentadas na medida em que forem sendo encontradas. Assim quando tiverem oportunidade, podem visitar os endereços de seu interesse, independentemente de mensagem de alerta.

Dear AMICOR,
Our alert messages are now less frequent due to the vacation period and to the addaptation to the new AMICOR style. New references will be added as they will be found. So, when you have an opportunity you are invited to visit the addresses of you interest, independently of the alert message.


http://amicor.blogspot.com
Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress
Minding the gender gap: The divergence between men's and women's health research
Plaque Instability Frequently Occurs Days or Weeks Before Occlusive Coronary Thrombosis
Lack of women cardiologists might lower standards -- Dobson 330 (7488): 379 -- BMJ
COX-2 Inhibitors — Lessons in Drug Safety
Association of weight change with ethnicity and life course socioeconomic position among Brazilian civil servants

http://amicorsmoke.blogspot.comAusência Previsível
Fumicultores querem garantias do governo; indústria ataca tratado
El Convenio Marco para el Control del Tabaco entra en vigor

http://amicor_preserve.blogspot.com
A nova Philips Gigante holandesa de eletrônicos agora mira em hospitais e clnicas e transformasetor de saúde na prioridade mundial
Amartya Sen and the capability approach

Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress

Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress
artigo científico discutido hoje no serviço de cardiologia do HMV.
Apresentador: Luis Beck SIlva Neto.


Ilan S. Wittstein, et al.
Conclusions Emotional stress can precipitate severe, reversible left ventricular dysfunction in patients without coronary disease. Exaggerated sympathetic stimulation is probably central to the cause of this syndrome.