Tuesday, May 31, 2005
Comparing On-Pump and Off-Pump Coronary Artery Bypass Grafting: Numerous Studies but Few Conclusions: A Scientific Statement From the American Heart A
Numerous Studies but Few Conclusions: A Scientific Statement From the American Heart Association Council on Cardiovascular Surgery and Anesthesia in Collaboration With the Interdisciplinary Working Group on Quality of Care and Outcomes Research
Frank W. Sellke"
Informativos da Sociedade Brasileira de Diabetes
Indice de matérias
A Biotecnologia avança e surgem duas novas técnicas
Reginaldo Albuquerque (AMICOR com grande sucesso na WEB. Grato e Parabéns!) - Comissão científica do site
Nestas últimas semanas, duas novas técnicas de manipulação do genoma, visando à cura de doenças vieram a público.
A primeira, que mereceu maior divulgação nas capas dos principais jornais, revistas e TVs do mundo - denominada de “obtenção de células-tronco personalizadas” -, foi desenvolvida pelo grupo do cientista sul coreano Woo Suk Hwang.
Monday, May 30, 2005
Global Burden of Cardiovascular Diseases: Part I: General Considerations, the Epidemiologic Transition, Risk Factors, and Impact of Urbanization -- Yu
Global Burden of Cardiovascular Diseases: Part II: Variations in Cardiovascular Disease by Specific Ethnic Groups and Geographic Regions and Preventio
This two-part article provides an overview of the global burden of atherothrombotic cardiovascular disease. Part I initially discusses the epidemiological transition which has resulted in a decrease in deaths in childhood due to infections, with a concomitant increase in cardiovascular and other chronic diseases; and then provides estimates of the burden of cardiovascular (CV) diseases with specific focus on the developing countries. Next, we summarize key information on risk factors for cardiovascular disease (CVD) and indicate that their importance may have been underestimated. Then, we describe overarching factors influencing variations in CVD by ethnicity and region and the influence of urbanization. Part II of this article describes the burden of CV disease by specific region or ethnic group, the risk factors of importance, and possible strategies for prevention.
Sunday, May 29, 2005
Andy Wielgosz MSc MD PhD FRCPC Corresponding Author Contact Information, E-mail The Corresponding Author
501 Smyth Road, Ottawa, Ont., Canada K1H 8L6
This first issue of the official journal of the World Heart Federation contains all abstracts of the 6th ICPC presentations.
The Editor welcomes contributions for the next issues.
Available online 23 April 2005.
With this issue, the Editorial Board and I wish to welcome you to a new and exciting publishing venture. We believe the timing is right, the need is there and we will occupy an important niche. Prevention and Control, as the official journal of The World Heart Federation, is aimed in particular at those who are concerned about the epidemic of cardiovascular diseases that is reaching the farthest corners of the globe, and also at those who seek to make a difference. The character that this journal develops will depend in large part on the response that we elicit; it is still early.
There are admittedly a few preconceived ideas that I am committed to foster. The focus of the journal will be primarily though not exclusively on issues, which are important to developing countries. Such a focus should not be a surprise given that more than half of the world’s burden of cardiovascular diseases is placed in low and middle income countries and all forecasts indicate an exponential increase over the next two decades. This focus is also aligned with the mission of the World Heart Federation.
There are several key factors that require attention in order to be able to publish excellent articles from and about low and middle income countries. While English is the international language of science, it is not the working language for most in the developing world. We are committed to assisting authors who generate excellent science but have difficulties expressing themselves in English. Particularly for young, emerging scientists we plan to organize a workshop on scientific writing at the upcoming World Congress of Cardiology in Barcelona. Hopefully such workshops will take place at other large meetings as well.
Our reviewers will be encouraged to provide constructive feedback particularly where methodological shortcomings prevent acceptance of manuscripts for publication.
Although the journal will include materials pertaining to both prevention and control of cardiovascular diseases, as its name states, it is my hope that there will be an ever-increasing number of publications addressing prevention. To encourage this will require some innovative approaches to linking research and publishing, perhaps even by creating a forum for dialogue in the planning phase of preventive programmes. I want to be flexible and responsive to suggestions and above all I want the journal to be a valuable resource of knowledge and ideas. This can be achieved by providing a variety of materials including articles reporting the results of experimental research, review articles, informative news and reports particularly of successes in policies and actions in communities, relevant guidelines and others.
Along with the publisher Elsevier and the World Heart Federation, we are committed to the success of this journal. The response of the scientific community and the readership will help guide us and we look forward to your involvement and feedback, which we will survey periodically. Prevention and Control is being launched aptly at the 6th International Conference on Preventive Cardiology in Iguassu Falls, Brazil. The Editorial Board members and I look forward to meeting many potential authors and readers there.
Corresponding Author Contact InformationFax: +613 737 8918
De: Marcelo Gustavo Colominas [mailto:email@example.com]
Enviada em: domingo, 29 de maio de 2005 09:57
Para: firstname.lastname@example.org; email@example.com
Assunto: The Euro Cardio-QoL Project
Oldridge, N.; Saner, H.; McGee, H.M.
Vol: 12, Nro: 2, Págs. 87 - 94. Fecha: 1/4/2005
Obesity and the Risk of New-Onset Atrial Fibrillation, November 24, 2004, Wang et al. 292 (20): 2471
Conclusions Obesity is an important, potentially modifiable risk factor for AF. The excess risk of AF associated with obesity appears to be mediated by left atrial dilatation. These prospective data raise the possibility that interventions to promote normal weight may reduce the population burden of AF.
Can niacin slow the development of atherosclerosis in coronary artery disease patients already taking statins?
B Greg Brown
In coronary artery disease patients, carotid atherosclerosis progresses significantly in 1 year despite statin therapy to lower LDL cholesterol, but progression is almost halted if extended-release niacin is added to statin"
Ageing cells may lead to clogged arteries - US team helps explain why even healthy eaters get heart disease.
Saturday, May 28, 2005
Páginas com muito material sobre Obesidade e Síndrome Metabólico. Neste endereço deverá ser colocado um slideshow apresentado por Philip James no último dia da 6a. Conferência de Cardioloogia Preventiva em Foz do Iguaçu.
Pages with a great quantity of material on Obesity and Metabolic Syndrome. In this site must be posted next week a conference from Philip James during the last day of the 6th ICPC.
World Heart Federation and sanofi-aventis Join Forces to Encourage Prevention of Cardiovascular Disease
The World Heart Federation and sanofi-aventis have today announced a three-year partnership agreement to address prevention and control of cardiovascular disease. The announcement was made at the World Heart Federation's Sixth International Congress of Preventive Cardiology (ICPC) in Brazil and confirms both organisations' commitment to the prevention of cardiovascular disease across the world.
Tuesday, May 17, 2005
Methods and Results--Homeless persons were randomly selected at shelters for single adults in Toronto. Response rate was 79%. Participants (n=202) underwent interviews, physical measurements, and blood sampling. The mean age of participants was 42 years, and 89% were men. The prevalence of smoking among homeless subjects (78%; 95% confidence interval [CI], 72% to 84%) was significantly higher than in the general population (standardized morbidity ratio [SMR], 254; 95% CI, 216 to 297). Hypertension, high cholesterol, and diabetes were not more prevalent than in the general population but were often poorly controlled. Homeless men were significantly less likely to be overweight or obese than men in the general population (SMR, 79; 95% CI, 63 to 98). Cocaine use in the last year was reported by 29% of subjects (95% CI, 23% to 36%). CVD was reported by 15% of subjects, fewer than one third of whom reported taking aspirin or cholesterol-lowering medication. According to multiple-risk-factor equations, the median estimated 10-year absolute risk of myocardial infarction or coronary death among homeless men aged 30 to 74 years was 5% (interquartile range, 3% to 9%).
Conclusions--Cardiovascular risk factor modification is suboptimal among homeless adults in Toronto, despite universal health insurance. Multiple risk factor equations may underestimate true risk in this population because of inadequate accounting for factors such as cocaine use and heavy smoking.
Monday, May 16, 2005
"Strokes different in men vs. women. Researchers are investigating factors that could cause significant gender disparities in the impact and care received when stroke occurs.
By Victoria Stagg Elliott, AMNews staff. May 23/30, 2005.
The woman had been at a financial planning conference when she suddenly had double vision. It eventually returned to normal. Still, over the next few days, she realized she was having a hard time reading. The problem ultimately led her to the office of Barbara Kostick, MD, a family physician in Freemont, Calif.
This scenario is not usually considered a stroke, but that's exactly what it was -- a small stroke."
Saturday, May 14, 2005
Epidemiological studies have largely contributed to our understanding of the natural history of coronary heart disease. Although clinical manifestations of the disease usually become evident in adult life, early signs are recognisable in childhood. The discovery that individuals who develop coronary heart disease grow differently during early life has led to the recognition of new developmental models for the disease. In 1995 David Barker wrote: "The fetal origins hypothesis states that fetal undernutrition in middle to late gestation, which leads to disproportionate fetal growth, programmes later coronary heart disease."1 Now, 10 years later, the importance of events before birth for lifetime health has been confirmed in many populations.2-4 In humans, birth size serves as a marker of the intrauterine environment. Considering that birth size is just one snapshot of the trajectory of fetal growth it is fascinating that long term health outcomes are predicted by the body size of the newborn.
'The clinical trial by Hakonarson et al provides an exciting attempt to translate genetic findings to clinical applications. How close clinicians and researchers are to the promised destination of a genome-based diagnostics and therapeutics for MI and stroke remains uncertain. This phase 2 pharmacogenetic trial and its implications must be interpreted with the same degree of caution as with any newly proposed risk factor. Continued research is warranted to replicate the original ALOX5AP association. Careful attention to proper study design will be essential to make future trials credible. … As with nongenetic risk factors, the emerging evidence will need to be carefully and continuously examined to ensure that the benefits outweigh the risks as genomics-based strategies are tested in clinical trials,' concludes Dr. O'Donnell. "
Wednesday, May 11, 2005
By Katrina Woznicki, MedPage Today Staff Writer. Reviewed by Ethan A. Halm, MD, MPH; Associate Professor in the Departments of Medicine and Health Policy at the Mount Sinai School of Medicine in New York.
# Encourage patients to include low-fat dairy, such as skim milk, into their daily diets. Low fat dairy intake has been found to be associated with a reduced risk for type 2 diabetes.
# Research from the Health Professional Follow-Up study suggests low fat dairy may have favorable effects on body weight, hypertension, and abnormal glucose homeostasis, through which it might help lower type 2 diabetes risk.
# Skim milk appeared to be the most protective. High-fat dairy did not significantly reduce the risk of diabetes."
Tuesday, May 10, 2005
TEL AVIV, May 9-Halting low-dose aspirin a week before coronary-artery bypass surgery may be counterproductive, suggests a small Israeli study.
Patients who took low-dose aspirin until the day before surgery had shorter ICU stays and quicker recovery times, reported Rabin Gerrah, M.D., and colleagues in the May issue of Chest."
Monday, May 09, 2005
Impaired Vascular Growth in Late Adolescence After Intrauterine Growth Restriction -- Brodszki et al., 10.1161/CIRCULATIONAHA.104.490326 -- Circulatio
Methods and Results--In a prospective study, vascular mechanical properties of the common carotid artery (CCA), abdominal aorta , and popliteal artery (PA) were assessed by echo-tracking sonography in 21 adolescents with IUGR and abnormal fetal aortic blood flow and in 23 adolescents with normal fetal growth and normal fetal aortic blood flow. Endothelium-dependent and -independent vasodilatation of the brachial artery was measured by high-resolution ultrasound. After adjustment for body surface area and sex, the IUGR group had significantly smaller end-diastolic vessel diameters than the referents in the abdominal aorta and PA (mean difference, 1.7 mm [95% CI, 0.62 to 2.74] and 0.6 mm [95% CI, 0.25 to 1.02], respectively) (P=0.003 and P=0.002, respectively), with a similar trend in the CCA (P=0.09). A higher resting heart rate was observed in the IUGR group (P=0.01). No differences were found in stiffness or in endothelium-dependent and -independent vasodilatation between the 2 groups.
Conclusions--IUGR caused by placental insufficiency appears to be associated with impaired vascular growth persisting into young adulthood in both men and women. The smaller aortic dimensions and the higher resting heart rate seen in adolescents with previous IUGR may be of importance for future cardiovascular health."
Obesity has a high and rising prevalence and represents a major public health problem. Obstructive sleep apnea (OSA) is also common, affecting an estimated 15 million Americans, with a prevalence that is probably also rising as a consequence of increasing obesity. Epidemiologic data support a link between obesity and hypertension as well as between OSA and hypertension. For example, untreated OSA predisposes to an increased risk of new hypertension, and treatment of OSA lowers blood pressure, even during the daytime. Possible mechanisms whereby OSA may contribute to hypertension in obese individuals include sympathetic activation, hyperleptinemia, insulin resistance, elevated angiotensin II and aldosterone levels, oxidative and inflammatory stress, endothelial dysfunction, impaired baroreflex function, and perhaps by effects on renal function. The coexistence of OSA and obesity may have more widespread implications for cardiovascular control and dysfunction in obese individuals and may contribute to some of the clustering of abnormalities broadly defined as the metabolic syndrome. From the clinical and therapeutic perspectives, the presence of resistant hypertension and the absence of a nocturnal decrease in blood pressure in obese individuals should prompt the clinician to consider the diagnosis of OSA, especially if clinical symptoms suggestive of OSA (such as poor sleep quality, witnessed apnea, excessive daytime somnolence, and so forth) are also present.
Commission to End Health Care Disparities
In April, 2004 the second meeting of the Federation Task Force on Disparities in Health Care was convened. With representation from over 35 state and specialty medical societies and other health professional organizations, the task force, chaired by the American Medical Association, in conjunction with the National Medical Association, reaffirmed its commitment to eliminating disparities in health care. The group elected to call themselves the Commission to End Health Care Disparities, focusing on physician leadership, quality, and system approaches to the elimination of disparities.
At a subsequent meeting as the Commission, the group formalized its mission and vision statements and agreed to focus on the following four strategies:
* Increasing awareness of disparities
* Promoting better data gathering
* Promoting workforce diversity
* Increasing education and training
The Commission to End Health Care Disparities, inspired by the Institute of Medicine Report, “Unequal Treatment,” recognizes that health care disparities exist due to multiple factors, including race and ethnicity. We will collaborate proactively to increase awareness among physicians and health professionals; use evidence-based and other strategies; and advocate for action, including governmental, to eliminate disparities in health care and strengthen the health care system.
Aided by the work of the Commission and its member organizations, physicians, health professionals, and health systems will provide quality care to all people.
Learn more about the timeline of events leading to development of the Commission. For additional information contact McKenzie Smith."
Doctors are talking with colleagues and reading journal articles for advice on how to ensure that all patients get equal care.
By Susan J. Landers, AMNews staff. May 16, 2005.
Washington -- Physicians are getting the message that they have a major role to play in eliminating disparities in health care, and many are already looking to their own practices to address this concern.
A national survey conducted by the AMA Institute for Ethics found that 55% of physicians believe that minority patients generally receive a lower quality of care than non-minority patients, and 75% said they are in a good position to improve that care."
"The topic dominated the American College of Physicians annual meeting as physicians wrestle with ways to prevent, control and treat this increasingly occurring disease.
By Victoria Stagg Elliott, AMNews staff. May 16, 2005.
When it comes to diabetes care, primary care physicians no longer are being asked to shoulder the burden alone.
In recognition of both the fact that the disease's incidence continues to increase and its management is becoming more complicated, the American College of Physicians launched a $10 million, three-year diabetes project. The initiative aims to improve care by advancing a team-approach model and providing educational tools for physicians, allied health care practitioners and patients."
Saturday, May 07, 2005
ATMOSPHERE: Enhanced: Air Pollution-Related Illness: Effects of Particles -- Nel 308 (5723): 804 -- Science
Worldwide epidemiological studies show a consistent increase in cardiac and respiratory morbidity and mortality from exposure to particulate matter [HN1] (PM) (1-3). PM is a key ingredient of polluted air and is estimated to kill more than 500,000 people each year (4). To prevent this staggering loss of life we must understand the characteristics of the toxic particles and gain insight into how these characteristics are related to adverse health effects [HN2] (5). As our understanding increases, we can use this knowledge to develop biomarkers in the hope of identifying susceptible individuals and reducing their exposure to PM."
Improving Medical Statistics and the Interpretation of Medical Studies
There is considerable variability in the information that the public and physicians receive regarding the results of medical trials. One contributing factor is the incorrect application of statistics in the medical literature. A more common source of error is that the conclusions of a study are not always a reasonable reflection of the data presented.
The following includes examples of the misuse of statistics and inappropriate conclusions in the medical literature. Some suggestions for improvement are included.
New York Janice Hopkins Tanne
Americans hear four good health rules: don�t smoke, maintain a normal weight, eat fruit and vegetables, and get some exercise. But almost nobody follows them.
A study of national data has shown that only 3% of Americans followed all four of the recommended rules. Women, older people, white people, better educated people, people in good health, and wealthier people did a little bit better in following the rules. Younger people were slightly better at maintaining a body mass index of 25 or less (Archives of Internal Medicine 2005;165:854-7).
�The effect of a healthy lifestyle is huge. We could eliminate the vast majority of chronic disease by following a healthy lifestyle,� said Matthew Reeves, lead author of the study and an epidemiologist at Michigan State University. Dr Reeves said that doctors could use his study to help patients change their habits by asking, �Are you one of the 3%?� Then doctors could guide patients in simple ways to incorporate 10 more minutes of exercise three times a day into their schedule or to include a few more fruits and vegetables in their meals.
Dr Reeves used data collected annually from the behavioural risk factor surveillance system sponsored by the Centers for Disease Control and Prevention, which, for many years, has surveyed people annually in all US states. His study was based on information collected from more than 153
People were asked and graded yes or no on four counts: whether they smoked, maintained a healthy weight (body mass index of 25 or less), ate five servings of fruit and vegetables a day, and took regular exercise (30 minutes "
Trends in rates of different forms of diagnosed coronary heart disease, 1978 to 2000: prospective, population based study of British men -- Lampe et a
"Results Over the 20 year period, 1561 major coronary events occurred; 1087 and 1816 men had new diagnoses of angina and coronary heart disease, respectively. The age adjusted annual relative changes were -3.6% (95% confidence interval -4.8% to -2.4%, P < 0.001) for all major coronary events, 2.6% (1.1% to 4.0%, P < 0.001) for first diagnosed angina and -0.8% (-1.8% to 0.3%, P = 0.18) for first diagnosed coronary heart disease. The fall in major coronary events occurred across all categories of event (fatal and non-fatal, first and recurrent). Similarly, first diagnosed angina increased for both uncomplicated angina and angina after myocardial infarction. The age adjusted annual relative change in case fatality at 28 days of first major coronary events was -1.4% (-3.1% to 0.4%, P = 0.12).
Conclusions Among British middle aged men, a substantial decline in the rate of major coronary events over the past two decades seems to have been largely offset by an increase in the incidence of diagnosed angina. Overall there was little change in the incidence of first diagnosed coronary heart disease. A continuing need exists for resources and services for coronary heart disease in general, and for new angina in particular."
Friday, May 06, 2005
# Consider the use of combination therapy comprising statins, aspirin, and beta-blockers as secondary prevention for patients who have been diagnosed with cardiovascular disease.
# Recognize that further studies are needed to support the notion that combination therapy would be useful in the primary prevention of ischemic heart disease.
Enviada em: sexta-feira, 6 de maio de 2005 13:00
Assunto: 4º Congresso Internacional de Cardiologia na Internet
4º Congresso Internacional de Cardiologia na Internet
Esta quarta edição da maior atividade cardiológica na Internet, acontecerá
no período de 1º de setembro a 30 de novembro de 2005 em www.fac.org.ar/ccvc
Desde 1º de março até 30 de maio de 2005, serão recebidos abstracts de temas livres, para serem apresentados no Congresso. As instruções para a
preparação e envio dos temas livres, podem ser acessadas em
Para assistir ou participar ativamente do Congresso, a inscrição é gratuita
e pode ser feita através do preenchimento de um formulário em
Informações mais detalhadas sobre o Congresso, poderão ser encontradas em
4th International Congress of Cardiology through the Internet 4th Virtual Congress of Cardiology - FVCC
This fourth edition of the main cardiological activity on the Internet will be held from September 1st, to November 30th 2005, at: www.fac.org.ar/ccvc
Since March 1st until May 30th, 2005, you can send abstracts of brief communications to be presented in the FVCC. You can access the instructions to prepare them and send them from:
Participating in the FVCC is free of charge. You can fulfill your registration by filling in a form at:
You will find important information about the congress at:
Prof. Dra. Silvia Fedchteyn de Eskenazi
Fourth Virtual Congress of Cardiology
ARGENTINE FEDERATION OF CARDIOLOGY
Eis o programa certo de 2005
IVo CURSO de EXTENSÃO UNIVERSITÁRIA em CARDIOLOGIA do EXERCÍCIO e do ESPORTE
do INST. DANTE PAZZANESE de Cardiologia
Responsável geral : Dr NABIL GHORAYEB
Coordenação: Dr GIUSEPPE S. DIOGUARDI
sábado, 18 de junho de 2005
7:00 hs inscrições
8:00 – 8:30 hs Conferência: O Enigma da Morte Súbita no Atleta: Prof Dr Michel Batlouni
8:30 – 10:00 hs Colóquio “ Avaliar e orientar na Academia, no Lazer e Provas de rua
Prof Mauro Guiselini
Coordenador Dr. Daniel Daher Dr. Carlos Alberto Cyrillo Sellera
Dr. Antonio Tebexreni
10:00 -10:15 hs visita aos expositores
10:15 -12:00 hs Mesa Redonda – Papel da Atividade Física
10:15 -10:40 hs -Síndrome Metabólica – Dr Daniel J.Daher
10:40 -11:05 hs -Prevenção secundária – Dr Romeu S.Meneghelo
11:05- 11:30 hs -Arritmias em atletas.O que há de novo – Dr Dalmo Moreira
11:30 -12:00 hs -discussão
12:00 -13:00 hs Almoço-satélite MSD: Dislipidemia-
Dr Jairo Borges e Dr Giuseppe Dioguardi
13:00 -13:15 hs visita aos expositores
13:15 -14:15 hs Mesa Redonda: aspectos em Medicina do Esporte
-Rehidratação – Prof Dr Turíbio L.Barros
-Suplementos para esportistas e atletas – Dr Ronaldo L. Abud
-Erros alimentares no esporte – nutricionista Alyne Stefanutto
14:30 -15:30 hs Discussão de casos: Cardiopatias e atividade física/esportiva
Coordenação: Dr Giuseppe Dioguardi
Apresentação do 10 caso Dra Mariana Romanello
Apresentação do 20caso Dr Julio César A. Medeiros
Debatedores: Dr Giuseppe Dioguardi, Dr Hélio Schwartz , Dr Carlos Sierra Reyes
15:30 - 15:45 hs visita aos expositores
15:45 - 17:00 hs Mesa Redonda – Problemas médicos
15:45 - 16:10 hs -Dopping no esporte e na academia – Dr Cláudio A. Baptista
16:10 - 16:35 hs -Morte Súbita de atletas, paradoxo possível de prevenir – Nabil Ghorayeb
16:35 - 17:00 hs -Síndrome do Excesso de Treinamento (overtraining) – Dra Ana Lucia Pinto
17:00 - 17:25 hs -Bioética no esporte – Prof Dr Max Gimberg
17:25 - 17:45 hs -Debates
17:45 - 19:15 hs Colóquio “Tire suas dívidas”
Coordenação Nabil Ghorayeb:
Medicina e Fisiologia do esporte: Dr Paulo Zogaib
Medicina do Esporte – Dr Samir Daher
Psicologia do esporte – Cristina Akel/Samuel Andrade
Cardiologia do Esporte – Giuseppe Dioguardi
SOMA EVENTOS 30621722 /// 30621710 fax firstname.lastname@example.org
SEÇÃO MÉDICA DE CARDIOESPORTE 11-50854228 / 50854239 email@example.com
Wednesday, May 04, 2005
PIRÂMIDE ALIMENTAR TEM NOVA FORMA DE DISTRIBUIÇÃO DOS ALIMENTOS
(Recomendado pelo Reginaldo Hollanda Albuquerque)
Durante muitos anos a conhecida pirâmide alimentar foi apresentada na forma de níveis ou andares, cada um deles dizendo respeito a um dos princípios alimentares.
Recentemente os órgãos de saúde do governo americano mudaram a maneira de distribuição doas alimentos, que agora passam a ser mostrados em faixas longitudinais de cores diferentes que descem do alto até a base da pirâmide. Veja a figura em anexo.
Este novo formato permite uma melhor visualização e compreensão sobre os princípios básicos para uma alimentação saudável.
No site www.mypyramid.gov podem ser encontrados diversas ferramentas para a aplicação imediata. As principais são:
• Inside mypyramid
• Mini-poster que pode ser baixado e utilizado imediatamente.
• Tips and sources
• My pyramid tracker
EAST LANSING, Mich., April 27-Only 3% of Americans follow the four basic healthy lifestyle habits that public health experts consider the cornerstones to a longer and better life.
That conclusion comes from a study published in the Archives of Internal Medicine. It found that just a tiny fraction of 153,000 Americans surveyed in 50 states abided by all four -- engaging in regular exercise, refraining from smoking, eating five or more fruits and vegetables daily, and maintaining a healthy weight.
Responsável geral: Prof Dr NABIL GHORAYEB
Coordenaço: Dr GIUSEPPE S. DIOGUARDI
Local: Instituto Dante Pazzanese de Cardiologia - auditório A Dia: em 19 de junho 2004
SBC – 3554 TEC 3,6 pontos"
Tuesday, May 03, 2005
Thomas E. Novotny
Most people believe that as societies advance economically they have higher levels of cardiovascular disease (CVD) and other noncommunicable disease (NCD) risks. However, a more detailed analysis of how parameters of economic development are associated with health outcomes as well as NCD risk factors is needed to inform local and global health policies. Such an analysis might dispel prejudices about the “diseases of affluence” and stimulate policy approaches and research that appropriately target emerging risk groups across the globe, regardless of socioeconomic status.
Rethinking the ‘‘Diseases of Affluence’’ Paradigm: Global Patterns of Nutritional Risks in Relation to Economic Development
Rethinking the ‘‘Diseases of Affluence’’ Paradigm: Global Patterns of Nutritional Risks in Relation to Economic Development
Majid Ezzati1*, Stephen Vander Hoorn2, Carlene M. M. Lawes2, Rachel Leach3, W. Philip T. James3, Alan D. Lopez4,
Anthony Rodgers2, Christopher J. L. Murray
Cardiovascular diseases and their nutritional risk factors—including overweight and obesity, elevated blood pressure, and cholesterol—are among the leading causes of global mortality and morbidity, and have been predicted to rise with economic development.
Methods and Findings
We examined age-standardized mean population levels of body mass index (BMI), systolic blood pressure, and total cholesterol in relation to national income, food share of household expenditure, and urbanization in a cross-country analysis. Data were from a total of over 100 countries and were obtained from systematic reviews of published literature, and from national and international health agencies.
BMI and cholesterol increased rapidly in relation to national income, then flattened, and eventually declined. BMI increased most rapidly until an income of about I$5,000 (international dollars) and peaked at about I$12,500 for females and I$17,000 for males. Cholesterol’s point of inflection and peak were at higher income levels than those of BMI (about I$8,000 and I$18,000, respectively). There was an inverse relationship between BMI/cholesterol and the food share of household expenditure, and a positive relationship with proportion of population in urban areas. Mean population blood pressure was not correlated or only weakly correlated with the economic factors considered, or with cholesterol and BMI.
When considered together with evidence on shifts in income–risk relationships within developed countries, the results indicate that cardiovascular disease risks are expected to systematically shift to low-income and middle-income countries and, together with the persistent burden of infectious diseases, further increase global health inequalities. Preventing obesity should be a priority from early stages of economic development, accompanied by
population-level and personal interventions for blood pressure and cholesterol.
Based on the ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (STEMI)"
* As the World health report 2006 (WHR2006) will open World Health Day 2006, which is also expected to launch the Health Workforce Decade (2006–2015), the Report will offer scientific and policy support for the Day and the Decade. The Day will energize relevant constituencies to celebrate health workers around the world. The follow-up activities of the Decade will focus on implementing and evaluating policies and strategies for workforce development. Both the Day and the Decade will emphasize global responsibility for health workforce issues.
* As WHR2006 is the premier report of WHO, it should be evidence-based, of superior technical quality, and foundational for the field. WHR2006 should aim to achieve excellence and a durable shelf-life.
* As WHR2006 aims to mobilize broad constituencies, WHR2006 should adopt an expansive, inclusive, and participatory approach – drawing from, engaging with and inviting contributions from diverse communities within and beyond the WHO – including NGOs and the private sector – even as authority for the Report remains with WHO.
* As WHR2006 is intended to attract key audiences, especially national health leaders, the Report should not be afraid of tackling complexity or controversy, and setting out policy and strategic frameworks for change across the spectrum of health workforce development.
* WHR2006 is set in an ongoing framework of initiatives in health workforce development that have taken place in the past (e.g. primary health care), the present (JLI, HLF) and will take place in the future. While it is the future that we wish to highlight, it is important to learn the lessons of history and of research.
Title: Working for health
The title should convey the core messages; preliminary titles will change over time; subthemes may be interwoven into the major storyline."
DIRETRIZES PARA HABILITAÇÃO DE CENTROS DE TREINAMENTO E PARA OBTENÇÃO DE CERTIFICAÇÃO HEMODINÂMICA E CARDIOLOGIA INTERVENCIONISTA
Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista Sociedade Brasileira de Cardiologia
Por Luis Bruschtein - Recomendado por Marcelo Gustavo Colominas [mailto:firstname.lastname@example.org]
“JoséAlvarez ha cumplido once años, tiene cuatro hermanos y todos viven en El Pescado, una de las comunidades más inaccesibles y pobres del departamento de Tarija. Para que un equipo sanitario llegue allí, hay que caminar más de cuatro horas desde el río, al que se llega tras cinco horas en coche desde la ciudad. Como a sus otros hermanos, a José le han diagnosticado Chagas este año, algo que le hace parecerse a otros pequeños de su comunidad. Sin embargo, él no es igual, es el único que no puede jugar ni levantarse ni asistir a la escuela. José es un minusválido desde que nació y, para diagnosticarlo y poder tratarlo, su padre tuvo que llevarlo en brazos durante horas y él mismo llegó gateando hasta la casa donde se hacen los controles de tratamiento.”
Es un párrafo del libro Chagas, una tragedia silenciosa, que acaba de editar Losada con el trabajo de la agrupación Médicos Sin Fronteras sobre esta enfermedad latinoamericana. “No estalla como las bombas, ni suena como los tiros –escribió Eduardo Galeano en la contratapa–. Como el hambre, mata callando. Como el hambre, mata a los callados; a los que viven condenados al silencio y mueren condenados al olvido. Tragedia que no suena, enfermos que no pagan, enfermedad que no vende.”
En América latina hay 18 millones de enfermos de Chagas. El país más golpeado es Bolivia, donde se realizó el trabajo de Médicos sin Fronteras. Y dentro de Bolivia, el foco está en el departamento de Tarija, que también es de los más ricos por su cuenca gasífera. Pero en Argentina se calcula que hay dos millones y medio de infectados en el norte del país.
El Chagas es una enfermedad de los pobres. Los pobres no tienen plata para pagar remedios. Y por lo tanto no tiene demasiado atractivo para la industria farmacêutica. El proceso de diagnóstico y tratamiento es complicado y por lo tanto los gobiernos tampoco hacen demasiadas inversiones ni tienen políticas prioritarias.
En el libro de MSF hay muchos datos y hay historias como las de JoséAlvarez. “Cómo puede ser que en una zona tan rica en hidrocarburos como es Tarija la gente viva en esas condiciones?”, preguntó un señor del público durante la presentación que se hizo el domingo en la Feria del Libro. “Adonde va esa plata?” “Cómo puede ser que en Argentina haya todavía tanta gente con Chagas?”, preguntó una señora. “Cómo puede ser que con tantos enfermos haya escasez de remedios específicos?”, fue otra pregunta. “Cómo puede ser que con tantas personas enfermas el Chagas nunca aparece entre los programas prioritarios de ningún gobierno?”
Cuando la medicina se concibe como negocio y a los enfermos como mercado, todos esos “cómo pueden ser”, pueden ser. La diferencia con el sida es que en el mapamundi el Chagas sólo afecta a los países del Sur. En cambio, el sida, además de hacer estragos en el Sur, afecta también a los países del Norte, entonces hay un mercado de enfermos con más capacidad adquisitiva. El Chagas, en cambio, funciona como “limitante del crecimiento poblacional” entre los pobres. Hay zonas en Estados Unidos que también tienen vinchucas, pero allí no hay Chagas porque la gente no vive en las condiciones ínfimas como tiene que hacerlo en el Sur.
El Chagas no deja en pie ni un solo paradigma de la economía de mercado, no hay derrame, no hay interés, no hay inversión, solamente hay silencio y millones de enfermos que muchas veces asumen ese padecimiento como algo natural. El que muere de Chagas muere de muerte natural, pero es una naturalidad que no tienen otras personas. Es una muerte natural para el pobre, para el campesino o el indígena que vive en zonas riquísimas en condiciones infrahumanas.
“Las personas que padecen la enfermedad de Chagas –dice en el epílogo Emilia Herranz Montes, presidenta de MSF– están atrapadas en el círculo de falta de interés y voluntad política: no búsqueda activa de los enfermos, no diagnóstico, no tratamiento, no demanda, no investigación.”
Eduardo Galeano lo ratifica: “No es negocio que atraiga a la industria farmacêutica, ni es tema que interese a los políticos ni a los periodistas. Elige a sus víctimas en el pobrerío. Las muerde lentamente, poquito a poco va acabando con ellas. Sus víctimas no tienen derechos, ni dinero para comprar los derechos que no tienen. Ni siquiera tienen el derecho de saber de qué mueren”. "
Risk Factors Associated With Acute Myocardial Infarction in the São Paulo Metropolitan Region. A Developed Region in a Developing Country
Álvaro Avezum, Leopoldo Soares Piegas, Júlio César R. Pereira
São Paulo, SP
The following risk factors showed and independent association with AMI: smoking [odds ratio (OR)=5.86; 95% confidence interval (CI) 3.25-10.57; P < 0.00001); waist-hip ratio (first vs. third tertile) (OR=4.27; 95% CI 2.28-8.00; P<0.00001); antecedents of arterial hypertension (OR=3.26; 95% CI 1.95-5.46; P<0.00001); waist-hip ratio (first vs second tertile) (OR=3.07; 95% CI 1.66-5.66; P=0.0003); LDL-cholesterol level (OR=2.75; 95%
CI 1.45-5.19; P=0.0018); antecedents of diabetes mellitus (OR= 2.51; 95% CI 1.45-5.19; P=0.023); family history of coronary artery disease (OR=2.33; 95% CI 1.44-3.75; P=0.0005); and HDL-cholesterol level (OR=0.53; 95% CI 0.32-0.87; P=0.011).
Smoking, waist-hip ratio, antecedents of arterial hypertension and of diabetes mellitus, family history of coronary artery disease, and LDL-cholesterol and HDL-cholesterol levels showed to be independently associated with AMI within the São Paulo metropolitan region.
os Próximos 50 Anos!
Cardiovascular Risk Factors in Brazil: The Next 50 Years!
Carisi Anne Polanczyk
Hámais de 55 anos, uma cidade dos Estados Unidos, Framingham em Massachusetts, foi selecionada pelo governo americano para ser o local de um estudo cardiovascular. Foram inicialmente recrutados 5.209 residentes saudáveis entre 30-60 anos de idade para uma avaliação clínica e laboratorial extensiva. Desde então a cada 2-4 anos, esta população e, atualmente as gerações descendentes, é reavaliada cuidadosamente e acompanhado
em relação ao desenvolvimento de doença cardíaca. O consagrado estudo de Framingham foi uma das primeiras coortes onde foi demonstrando a importância de alguns fatores de risco para o desenvolvimento de doença cardíaca e cerebrovascular 1. Parece inconcebível, mas antes do Framingham, a maioria dos médicos acreditava que aterosclerose era um processo de envelhecimento inevitável, a hipertensão arterial um resultante fisiológico deste
processo que auxiliava o coração a bombear o sangue pelas artérias com lúmen reduzido. Foram mais de 1.000 publicaçãoes somente nesta coorte de paciente e milhares de outras que nos levaram, ao longo das últimas décadas, para um entendimento detalhado e aprofundado das características individuais e ambientais relacionadas com maior probabilidade de doença cardíaca 2. Estudos estes que confirmaram a importância do tabagismo, níveis elevados de colesterol LDL, baixos de HDL, diabete melito, hipertensão arterial sistêmica, história familiar, obesidade, sedentarismo, obesidade central, síndrome plurimetabólica e ingesta de álcool como fatores fortemente relacionados com aterosclerose e suas manifestações clínicas.
Monday, May 02, 2005
Contributions of Depressive Mood and Circulating Inflammatory Markers to Coronary Heart Disease in Healthy European Men. The Prospective Epidemiologic
Background--Data on the possible association between depressive disorders and inflammatory markers are scarce and inconsistent. We investigated whether subjects with depressive mood had higher levels of a wide range of inflammatory markers involved in coronary heart disease (CHD) incidence and examined the contribution of these inflammatory markers and depressive mood to CHD outcome.
Methods and Results--We built a nested case-referent study within the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study of healthy middle-aged men from Belfast and France. We considered the baseline plasma sample from 335 future cases (angina pectoris, nonfatal myocardial infarction, coronary death) and 670 matched controls (2 controls per case). Depressive mood characterized men whose baseline depression score (13-item modification of the Welsh depression subscale) was in the fourth quartile (mean score, 5.75; range, 4 to 12). On average, men with depressive mood had 46%, 16%, and 10% higher C-reactive protein, interleukin-6, and intercellular adhesion molecule-1 levels, respectively, independently of case-control status, social characteristics, and classic cardiovascular risk factors; no statistical difference was found for fibrinogen. The odds ratios of depressive mood for CHD were 1.35 (95% CI, 1.05 to 1.73) in univariate analysis and 1.50 (95% CI, 1.04 to 2.15) after adjustment for social characteristics and classic cardiovascular risk factors. The latter odds ratio remained unchanged when each inflammatory marker was added separately, and in this analysis, each inflammatory marker contributed significantly to CHD event risk.
Conclusions--These data support an association of depressive mood with inflammatory markers and suggest that depressive mood is related to CHD even after adjustment for these inflammatory markers.
Sunday, May 01, 2005
(Este comentário do Luciano poderá ser aberto clicando na próprio texto original, onde diz Comments 1.
Como poucos comentários tem vindo e os AMICOR não estão acostumados a procurar por eles, vou colocar este no Blog. Certamente comentários serão benvindos.
Especificamente sobre o comentário, entendi que a notícia chama atenção de que existem mais problemas do que os que são relatados, mas não que a droga está matando mais do que tratando...
É incrivel como noticias desse tipo ganham a midia.
sou um cardiologista clinico sem interesse em defender ou atacar a industria.
Me lembro q no final de 2003 houve um congresso com repercussao mundial em alusâo aos 10 anos de uso clinico das estatinas, no qual foram destacadas a eficácia e a segurança delas além de ressalterem os efeitos pleotróficos adicionais. Na mesma ocasiao, tais achados justificaram seu uso em criança.
Como é que agora aparecem dados isolados dizendo q tais drogas estão 'matando' mais do que tratando?
Décio Mion Jr.(estava também na reunião de Brasília), pesquisador de renome internacional, médico e professor da USP, disponibiliza aos colegas médicos e a pacientes de todo o Brasil valiosas informações sobre a Hipertensão. Doença que, pela sua ação insidiosa, sem sintomas aparentes, é conhecida como "Inimiga Silenciosa".