Friday, September 30, 2005

How Do I Start My Exercise Program/ Prescribing Fitness in Your Office Practice

Cardiosource: "Abstract

The Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel or ATP III) estimates that the direct medical costs to diagnose and manage cardiovascular disease (CVD) exceeds $100 billion each year in the United States; indirect costs, such as reduced productivity, accounts for a similar amount./.../

The most cost-effective methods to prevent coronary heart disease, according to ATP III, remain lifestyle modifications such as changes in diet, weight control, smoking avoidance/cessation, and exercise (Slide 1) (Click here for ATP III Moreover, new data suggest that one of the most effective prescriptions a clinician can write is an exercise prescription. "

Therapeutic angiogenesis

E-Journal - Volume 4 - vol4n3:
"Prof. S. Nikol
Munich, Germany
Member of the Nucleus of the ESC Working Group on Interventional Cardiology

Recommended by Marcelo Gustavo Colominas []

Therapeutic angiogenesis : Definition
Therapeutic angiogenesis describes an emerging field of cardiovascular medicine whereby new blood vessels are induced to grow to supply oxygen and nutrients to cardiac muscle tha has mostly been rendered ischaemic as a result of progressive atherosclerosis.
Myocardial ischemia is one of the most promising targets of gene therapy, particularly, in the case of refractory angina.
As life expectancy is increasing, patients with angina pectoris refractory to conventional antianginal therapeutics are a challenging problem. Therapeutic angiogenesis may be one way to approach this problem. "/.../

Wednesday, September 28, 2005

Hygiene Hypothesis May Explain Rise in Coronary Heart Disease

Hygiene Hypothesis May Explain Rise in Coronary Heart Disease: "Hygiene Hypothesis May Explain Rise in Coronary Heart Disease

By Matias A. Loewy

BUENOS AIRES (Reuters Health) Sept 23 - Early childhood viral infections might reduce the risk of later ischemic heart disease by as much as 90%, researchers from Sweden and Finland reported here on Wednesday at the IV World Congress of Pediatric Cardiology and Cardiac Surgery.

According to the investigators, 'improved hygiene in early childhood might partially explain the greatest epidemic of the 20th century, coronary heart disease'.

It is the first time that the so-called 'hygiene hypothesis', which postulates that reduced microbial exposure because of improved sanitation and cleaner lifestyles has facilitated the rise in asthma, allergic disease and multiple sclerosis in the Western world, is linked to the development of heart disease.

Researchers led by Dr. Erkki Pesonen, from the University Hospital in Lund, Sweden, compared 350 patients with unstable angina pectoris or myocardial infarction with paired controls without coronary disease. They all answered a questionnaire about their childhood experience of contagious diseases, specifically whether they had ever had varicella, scarlet fever, measles, German measles, mononucleosis or parotitis.

Childhood contagious diseases were more frequent in the controls, researchers noted. Furthermore, they found a consistent linear trend between the number of childhood infections and the reduction in coronary risk. For instance, two viral infections reduced the coronary risk by 40%, four infections was associated with a 60% decreased risk, and six infections with a 90% reduction in risk.

Dr. Horacio Faella, a pediatric cardiologist at the Garrahan Hospital, Buenos Aires, and member of the Organizing Committee of the meeting, considered the finding to be interesting but preliminary. 'We need to do more studies about the influence of the immune system on the cardiovascular system', he said.


Monday, September 26, 2005

Dietary Recommendations for Children and Adolescents: A Guide for Practitioners:

Dietary Recommendations for Children and Adolescents: A Guide for Practitioners: Consensus Statement From the American Heart Association: Endorsed by the American Academy of Pediatrics -- Gidding et al. 112 (13): 2061 -- Circulation:
"Since the American Heart Association last presented nutrition guidelines for children, significant changes have occurred in the prevalence of cardiovascular risk factors and nutrition behaviors in children. Overweight has increased, whereas saturated fat and cholesterol intake have decreased, at least as percentage of total caloric intake. Better understanding of children’s cardiovascular risk status and current diet is available from national survey data. New research on the efficacy of diet intervention in children has been published. Also, increasing attention has been paid to the importance of nutrition early in life, including the fetal milieu. This scientific statement summarizes current available information on cardiovascular nutrition in children and makes recommendations for both primordial and primary prevention of cardiovascular disease beginning at a young age."/.../

Colchicine in Addition to Conventional Therapy for Acute Pericarditis: Results of the COlchicine for acute PEricarditis (COPE) Trial -- Imazio et al.

Colchicine in Addition to Conventional Therapy for Acute Pericarditis: Results of the COlchicine for acute PEricarditis (COPE) Trial -- Imazio et al. 112 (13): 2012 -- Circulation
Conclusions— Colchicine plus conventional therapy led to a clinically important and statistically significant benefit over conventional treatment, decreasing the recurrence rate in patients with a first episode of acute pericarditis. Corticosteroid therapy given in the index attack can favor the occurrence of recurrences.

Saturday, September 24, 2005

Dia Mundial do Coração: 25 de Setembro 2005. Caminhada do Centro de Qualidade de Vida

Comemorando o Dia Mundial do Coração, unindo-se ao que acontece ao redor de todo o mundo neste dia 25 de setembro, o Centro de Qualidade de Vida do Hospital Moinhos de Vento convida a todos, profissionais da saúde e população em geral, para uma caminhada que deverá sair do Shopping Center Iguatemy, até o Parcão.
O lema deste ano é “Healthy weight, healthy shape” ou Peso Saudável, mantenha-se em Forma
O endereço internacional na INTERNET é:
Em Porto Alegre, o credenicamento será às 09:00 em frente ao Iguatemi e saída às 09:30.
Em caso de chuva será cancelada a atividade. A distância é de carca de 3 Km, seremos recepcionados pela equipe do Parcão com relaxamento e alongamento na chegada além de dicas de nutrição. A indumentária recomendada é tênis e uma roupa confortável, tipo abrigo/ bermuda, roupa de ginástica, etc... aqui será dado camisetas no cadastro com a arte do convite: os dois saltando e formando um coração.
No Boulevard – PARCÃO , recepcionaremos o público que chegar da caminhada.
Lá teremos:
- Medição dos números da Saúde com os profissionais do ESBE (peso, altura, circunferência abdominal, medição de pressão)
- quiosque da Sanofi com distribuição de folders
- mesa de apoio para o hospital divulgar material educativo.
- distribuição de água
- Profissionais para alongamentos
- Apoio do pessoal do Núcleo da Mama de Porto Alegre

The metabolic syndrome—a new worldwide definition Vol 366 September 24, 2005
(Full text available on request)
The metabolic syndrome (visceral obesity, dyslipidaemia, hyperglycaemia, and hypertension), has become one of the major public-health challenges worldwide.1 There has been growing interest in this constellation of closely
related cardiovascular risk factors. Although the association of several of these risk factors has been known for more than 80 years,2 the clustering received scant attention until 1988 when Reaven described syndrome X:
insulin resistance, hyperglycaemia, hypertension, low HDL-cholesterol, and raised VLDL-triglycerides. Surprisingly, he omitted obesity, now seen by many as an essential component, especially visceral obesity. Various names were subsequently proposed, the most popular being metabolic syndrome.
The cause of the syndrome remains obscure. Reaven proposed that insulin resistance played a causative role, but this remains uncertain. Lemieux et al suggested visceral obesity and the hypertriglyceridaemic waist phenotype as a central component,4 but this too has been contested. Several different factors are probably involved, many related to changes in lifestyle.
The ultimate importance of metabolic syndrome is that it helps identify individuals at high risk of both type 2 diabetes and cardiovascular disease (CVD). Several expert groups have therefore attempted to produce diagnostic criteria. The first attempt was by a WHO diabetes group in 1999, which proposed a definition that could be modified as more information became available.5 The criteria had insulin resistance or its surrogates, impaired glucose tolerance or diabetes, as essential components, together with at least two of: raised blood pressure, hypertriglyceridaemia and/or low HDL-cholesterol, obesity (as measured by waist/hip ratio or body-mass index), and microalbuminuria. The European Group for the Study of Insulin Resistance6 then produced a modification of the WHO criteria excluding people with diabetes and requiring hyperinsulinaemia to be present. Waist circumference was the measure of obesity, with different cutoffs for the other variables./.../

Monday, September 19, 2005

Aplicación del pensamiento complejo e introducción de la Epistemología Crítica en las Insuficiencias Cardíacas
Artigos discutindo aspectos filosóficos da Medicina e Saúde são frequentemente postados no endereço Crítica Medicina constante na lista de referências colocados na coluna ao lado. Recomendamos aos interessados que visitem periodicamente o endereço. Na medida do possível chamaremos atenção para novas publicações.
Aplicación del pensamiento complejo en las insuficiencias cardíacas Dr. Alejandro Wajner
Aplicación del pensamiento complejo e introducción de la Epistemología Crítica en las Insuficiencias Cardíacas (ICCs)

" Atreverse sigue siendo la mejor manera de lograr algo en la vida"
tomado prestado del Consultorio pedagógico de Emilia Digistani.

¿ Cómo pasar del Corazón como máquina biológica a un “Ser con el Corazón en queja” ?

Una Respuesta:
“ perseguir una pregunta difícil de contestar”( Nicolás Casullo: Revista Confines, N° 16, 2005)

Tal vez atravesar los cuerpos y conocimientos con relaciones y Otros saberes, para abrirlos a la complejidad./.../

Risk Factor Modification of Coronary Artery Disease, Vol. 5, No. 1, SEMJ

Risk Factor Modification of Coronary Artery Disease, Vol. 5, No. 1, SEMJ:
"Risk Factor Modification of Coronary Artery Disease
A. R. Moarreaf , M.D."
Cerebrovascular accident (CVA) is the third most common cause of death and has two main types: Ischemic (subdivided to thrombotic and embolic) and hemorrhagic (including intracranial hemorrhage and subarachnoid hemorrhage). Administration of thrombolytic, anticoagulant and antiplatelet agents are the main treatments of ischemic stroke; while surgical procedures, brain structure decompression, and closure of aneurysm are essential in the management of hemorrhagic ones./.../

Sunday, September 18, 2005

60o. Congreso da SBC em Porto Alegre. Começa hoje.

COMEÇA EM PORTO ALEGRE O MAIOR EVENTO DE CARDIOLOGIA DO BRASILComeça nesse domingo, dia 18, no Centro de Eventos FIERGS, em Porto Alegre, o 60º Congresso da Sociedade Brasileira de Cardiologia, o maior evento do setor, que traz ao Rio Grande do Sul mais de 4.000 especialistas do Brasil e de outros países, com destaque para 31 conferencistas dos Estados Unidos, Itália, França, Canadá, Venezuela, Portugal e Argentina, todos eles mundialmente famosos por suas pesquisas e conhecimento sobre as moléstias que afetam o coração. O presidente do Congresso, Iran Castro, explica que o coração mata a cada ano 300 mil brasileiros e que a maior parte dessas mortes é evitável, à luz dos modernos avanços da Cardiologia e da prevenção dos fatores de risco. Por isso mesmo o Congresso deste ano não é um evento fechado e exclusivo para médicos, mas inclui um importante fórum de Nutrição em Cardiologia, outro de Fisioterapia em Cardiologia, pois ao contrário do que ocorria há alguns anos, o exercício físico, supervisionado, é essencial até para o infartado. Haverá também um fórum de Psicologia em cardiologia e outro de Enfermagem. O médico destaca ainda duas características especiais deste Congresso: os "highlights", sessões especiais onde será resumido o "estado da arte" de cada setor da Cardiologia, isto é, onde o médico poderá receber numa única sessão todos os dados sobre pesquisas e evoluções recentes de temas como Cirurgia Cardíaca, Hipertensão ou Cardiologia Pediátrica, setor muito desenvolvido nos últimos anos especialmente no Rio Grande do Sul, onde cirurgias cardíacas tem sido realizadas em fetos que ainda não nasceram, durante a gestação. A segunda característica do Congresso é a valorização da Cardiologia brasileira pois, "apesar da presença de muitos especialistas internacionais, que valorizam o evento, uma grande parte da evolução recente da Cardiologia se deve a pesquisas brasileiras, que tornam a especialidade uma das mais evoluídas em nosso País", garante Iran Castro. Para ele, o Brasil nada fica a dever no setor no que respeita à capacitação de seus profissionais. "O que falta ainda, é garantir o acesso de maior parcela da população aos benefícios da Cardiologia". É justamente por isso que a SBC insiste tanto na divulgação dos fatores de risco para o coração, colesterol elevado, sedentarismo, fumo, estresse, hipertensão, etc. O médico alerta que justamente por causa disso a entidade maior da Cardiologia acaba de preparar o "Atlas Corações do Brasil", que será distribuído à mídia durante o Congresso e que, com base numa pesquisa de dois anos, realizada em 72 cidades brasileiras, mostra em detalhes os fatores de risco mais presentes, em cada região.

Thursday, September 15, 2005

"Happy Hour" dia 17 setembro (sábado) 19 horas

Professor Jorge Pinto Ribeiro (Diretor) e demais membros do Centro de Cardiologia do Hospital Moinhos de Vento, convidam, e terão um grande prazer em receber, os colegas que vêm para o 60o.Congresso da SBC, numa "Happy Hour" a partir das 19 horas no próximo sábado dia 17, dia de atividades pré-congresso.
O endereço é na Rua Tiradentes 333, 3o andar, no próprio Centro de Cardiologia, situado no Bairro Moinhos de Vento, entrada preferencial pelo prédio novo do Hospital, em rua transversal à Ramiro Barcellos, onde se situa o antigo acesso.
Para qualquer dificuldade ou informação adicional podem ser usados os telefones 3314-3434 ou 3233-3579.
Esperamos todos lá para confraternizar e conhecer o serviço.

Sunday, September 11, 2005

World Heart Day: healthy weight, healthy shape

World Heart Day: "
The World Heart Day motto 'A Heart for Life'. Healthy Weight, Healthy Shape is the theme of WHD 2005.
Go through a plenty of material on prevention and celebrate de World Heart Day 2005, next September 25.

Governments ignore the world’s leading cause of death

press.releases.esc.4sept.pdf (application/pdf Object)
4th September 2005, Stockholm, Sweden - Cardiovascular disease is the world’s leading cause of death and a major cost burden for healthcare administrators. 17 million people die from cardiovascular disease (CVD) each year, with 80 per cent of all deaths occurring in low and middle income countries. While simple and costeffective preventative measures can reduce CVD death and disability by 50 per cent, CVD is being excluded from the global health agenda. At the European Society of Cardiology (ESC) Congress 2005, the World Heart Federation, an NGO dedicated to the global prevention of heart disease and stroke, will call for an expansion of the global health agenda, particularly the Millennium Development Goals, a week before the 2005 World Summit where Heads of State and Government will meet at the United Nations, in New York, for the first comprehensive review of the goals set in 2000.
“Many developing countries are now affected by a double burden of disease; the combination of infectious diseases, with a rapidly growing new epidemic of chronic, noncommunicable diseases, such as heart disease, stroke, diabetes, chronic lung disease and some cancers. While it is important to remain focused on HIV/AIDS, Malaria and TB, it is imperative to begin to reduce the burden of cardiovascular disease, the leading chronic disease,” said Dr Valentin Fuster, President, World Heart Federation.
“Governments simply cannot afford to wait any longer. The lack of global recognition will limit investment into research, programmes and policies to help prevent cardiovascular disease from overwhelming already overstretched health budgets, negatively impacting developing economies and resulting in millions of unnecessary premature deaths. Governments need to acknowledge the global threat of cardiovascular disease, to extend the health objectives of the Millennium Development Goals by including chronic disease such as cardiovascular disease and to take action now./.../

Thursday, September 08, 2005

ACC/AHA Key Data Elements and Definitions for Measuring the Clinical Management of Chronic Heart Failure

1124918429571HFDataStndsFinal.pdf (application/pdf Object)
The American College of Cardiology (ACC) and the American Heart Association (AHA) recognize the importance of refining the lexicon used to describe the process and outcomes of clinical care, whether in randomized trials, observational studies, registries, or quality improvement initiatives. Broad professional agreement on a common vocabulary with common definitions will facilitate cross-study comparisons or, when advantageous, combining of data across studies and improving the assessment of any project’s generalizability to clinical practice. To further efforts aimed at standardizing such a
lexicon, the ACC and AHA have undertaken to develop and publish clinical data standards—sets of standardized data elements and corresponding definitions that can be used in a variety of data collection efforts for a range of cardiovascular conditions.
It is hoped that these clinical data standards will:
1. Improve cross-comparison of results and clinical outcomes between different trials and registries.
2. Facilitate the development and conduct of future registries, at both hospital and national levels, by providing a list of major variables, outcomes, and definitions.
3. Facilitate measurement for quality improvement programs.
4. Become the basis for a standardized medical documentation process with the anticipation that the medical record will progress to an electronic format.

Wednesday, September 07, 2005

How New Heart-Scanning Technology Could Save Your Life -- Sep. 05, 2005 -- Page 1 How New Heart-Scanning Technology Could Save Your Life -- Sep. 05, 2005 -- Page 1
(Recommended by Paulo Schvartzman [])
More and more, doctors are diagnosing coronary disease without any invasive tests whatever

improvements in CT (for computed tomography) scanning, which uses highly specialized X-ray machines to take multiple, finely layered pictures of the heart and surrounding blood vessels. Sophisticated computer programs sort the data to generate amazingly detailed, three-dimensional images like the ones that alerted Fackelmann's doctors to his hidden heart problem. Advances in other techniques like MRI (magnetic resonance imaging) have astonished physicians with the clarity of details now available to them on the inner workings of the heart.

Tuesday, September 06, 2005

IV Congreso Virtual de Cardiologia.

Estimado Dr. Achutti, el 1º de setiembre se inicio con todo exito el Cuarto Congreso Virtual de Cardiologia.
Hasta la fecha contamos con 17.364 inscriptos de 126 paises del mundo.
Durante los proximos tres meses, trataremos de ofrecer a nuestros lectores, un variado y ambicioso programa cientifico, dentro del cual se destaca la realizaciòn del LinuxMed 1er Congreso Mundial Virtual sobre Software Libre en el Area Salud y
ISHNE Atrial Fibrillation World-Wide Internet Symposium
Tambien se realizara un curso basico de Bioestadisticas para medicos.
La incripcion al Congreso es libre y gratuita y puede realizarse en:
Seria un honor para nosotros contar en nuestra audiencia con Usted y los prestigiosos miembros de AmiCor.
Dra. Silvia Nanfara
Co-Presidente Cuarto Congreso Virtual de Cardiologia
Federacion Argentina de Cardiologia

comparing contributions from primary prevention and secondary prevention

Modelling the decline in coronary heart disease deaths in England and Wales, 1981-2000: comparing contributions from primary prevention and secondary prevention

Belgin Unal, Julia Alison Critchley , Simon Capewell
(Recommended by Mario de Camargo Maranhão[])

* Correspondence to:

Objective To investigate whether population based primary prevention (risk factor reduction in apparently healthy people) might be more powerful than current government initiatives favouring risk factor reduction in patients with coronary heart disease (CHD) (secondary prevention).

Design, setting, and participants The IMPACT model was used to synthesise data for England and Wales describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in healthy people and in CHD patients.

Results Between 1981 and 2000, CHD mortality rates fell by 54%, resulting in 68 230 fewer deaths in 2000. Overall smoking prevalence declined by 35% between 1981 and 2000, resulting in approximately 29 715 (minimum estimate 20 035, maximum estimate 44 675) fewer deaths attributable to smoking cessation: approximately 5035 in known CHD patients and approximately 24 680 in healthy people. Population total cholesterol concentrations fell by 4.2%, resulting in approximately 5770 fewer deaths attributable to dietary changes (1205 in CHD patients and 4565 in healthy people) plus 2135 fewer deaths attributable to statin treatment (1990 in CHD patients, 145 in people without CHD). Mean population blood pressure fell by 7.7%, resulting in approximately 5870 fewer deaths attributable to secular falls in blood pressure (520 in CHD patients and 5345 in healthy people) plus approximately 1890 fewer deaths attributable to antihypertensive treatments in people without CHD. Approximately 45 370 fewer deaths were thus attributable to reductions in the three major risk factors in the population: some 36 625 (81%) in people without recognised CHD and 8745 (19%) in CHD patients.

Conclusions Compared with secondary prevention, primary prevention achieved a fourfold larger reduction in deaths. Future CHD policies should prioritise population-wide tobacco control and healthier diets.

(Accepted 26 July 2005)

Monday, September 05, 2005

IEA World Congress of Epidemiology 2008: Porto Alegre

De: Bruce B. Duncan []
Enviada em: segunda-feira, 5 de setembro de 2005
Para: Aloyzio Achutti
Cc: Maria Ines Azambuja

Assunto: IAE World Congress of Epidemiologia 2008 Porto Alegre

Prezado Achutti,
É com imensa alegria que informamos que Porto Alegre foi a cidade vencedora para receber o XVIII Congresso Mundial de Epidemiologia para o ano de 2008.

Com esforços conjuntos da ABRASCO (Associação Brasileira de Saúde Coletiva), EMBRATUR e o Porto Alegre Convention & Visitors Bureau, a defesa da candidatura aconteceu nesta quarta-feira, dia 24 de agosto, em Bangkok, Tailândia.

Porto Alegre recebeu 75 votos, contra os 11 votos recebidos por Agra (Índia) e os 36 votos recebidos por Edinburgh (Escócia).

Dra. Maria Inês Schmidt (PPG-Epidemiologia, UFRGS) fez a apresentação vencedora. Participaram também, no esforço, Maurício Barreto, Glória Teixeira, César Víctora e Bruce Duncan. O congresso será feito em paralelo com o Epi-Tche, o VII Congresso Brasileira de Epidemiologia.
Um abraço,
P.S. Foto da equipe atachado.

Parabens aos promotores e para todos nós!.
Como no ano anterior ao Congresso Mundial (2007) estaremos completando 10 anos do Seminário Nacional de Epidemiologia e Prevenção Cardiovascular de Gramado, sugiro que se organize um segundo comemorativo, de atualização da Declaração de Gramado e de Preparação de última hora para o Mundial.