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Saturday, June 30, 2007

Public policy & the challenge of chronic noncommunicable diseases

De: Ruggiero, Mrs. Ana Lucia (WDC)
Enviada em: quinta-feira, 28 de junho de 2007 12:25

Public policy & the challenge of chronic noncommunicable diseases

Olusoji Adeyi, OwenSmith, Sylvia Robles
The International Bank for Reconstruction and Development / The World Bank, June 2007


"....A new World Bank report launched June 27 warns that poor countries are catching up with wealthier nations in terms of cancer, diabetes, obesity, and heart disease, and that by 2015, these chronic illnesses will be the leading cause of death in developing countries. The report calls for actions to slow down the trend, and to prepare for subsequent heavy demand on health care budgets.

According to the new report, life expectancy for all age groups, lower fertility rates, better control of infectious diseases, and changing lifestyles with more smoking, bad diets and lack of exercise, mean that poor countries face a future where non-communicable diseases (NCDs) become a major problem. The report says that countries need to promote healthy aging and avoid premature deaths. They will also need to adapt their health systems to cope with the growing numbers of elderly people who will require long-term care and request expensive treatment.
The report says that in Indonesia, for example, private healthcare spending is projected to more than double by 2020, compared to 2005, as its elderly population grows in size, and needs treatment for chronic diseases...."

Saturday, June 23, 2007

[2358 - AMICOR10 - 23/06/2007]

[2358 - AMICOR10 - 23/06/2007]
Do grupo antigo de mais de 300, manifestaram interesse em continuar na AMICOR10 os 121 abaixo listados:
From the more then 300 members, the following 121expressed interest in to follow in the AMICOR10:

Airton Stein, Albertino Damasceno, Alberto C. Duque, Alberto José Niituma Ogata, Alberto Stein, Alejandro Wajner, Alexander Daudt, Aloyzio Achutti, Amanda Sousa, Ana Lúcia Robinson Achutti, Ana Menezes, Andréa Silveira Gomes, André Steffens, Antônio Pedro Mirra, Ari Timerman, Aristóteles Comte de Alencar Fo.,Beatriz Amaral, Blau Souza, Bruce B. Duncan, Bruno Caramelli, Carisi Polanczyk, Carlos Alberto Machado, Carlos H. Klein, Carlos Marcílio de Souza, Catia Teixeira, Cesar G Victora, Claudia Caminha Escosteguy, Claudio A. Bandeira Medina, Catherine Coleman, Dalfran Maciel, Darcy Lima, Denis Martinez, Edi e Ponciano Vieira, Eduardo A Costa, Éffrem Maranhão, Elisabeth Nader, Emilio Moriguchi, Eney Fernandes, Fernando Lucchese, Flavio Danni Fuchs, Flávio Kanter, Geniberto Paiva Campos, Gilberto Barcellos, Gilberto Brodt, Gilson Feitosa, Giuseppe Repetto, Gláucia M. Oliveira, Helder Reis, Henrique Barata, Ines Lessa, Isaac Roitman, Isabela Giuliano, Iseu Gus, Izabella Rohlfs, Jaqueline Scholz Issa, Jefferson Fernandes, João Carlos F. Braga, João Giongo, Joel Barcellos, Jorge Dable, Jorge Ilha Guimarães, Jorge Ossanai, José Miguel Chatkin, José Roberto Goldim, José da Silva Moreira; Juliana Nunes, Kleber Gaspar, Leo A. e Clara Trombka, Leopoldo Soares Piegas, Lucélia Magalhães, Lucia Pellanda, Luciana Fornari, Luciano Loos, Lucio Bakos, Luis Paulo Melione, Luis Soares Halty, Luiz Carlos Corrêa da Silva, Luiz Scala, Manoel A. P. P. Albuquerque, Marcelo Gustavo Colominas, Margarita Diaz, Maria Inês Azambuja, Mariana Lourenço de Lima Carneiro, Mario Becker, Mario F. C. Maranhão, Mario Wiehe, Marta Filippi, Maura Malcon, Mendel Rabin, Moacyr Saffer, Montezuma Ferreira, Murilo Foppa, Nelson Souza e Silva, Nilton Brandão da Silva, Orlando C. B. Wender, Patrícia Pereira Ruschel, Paulo Cesar Jardim, Paulo Henkin, Paulo Opitz, Paulo Roberto Prates, Pedro Albuquerque, Pedro van Zeller, Reginaldo Albuquerque, Romero Bezerra, Romildo Andrade, Rosa Maria Sampaio Vilanova de Carvalho, Salvador Serra, Sandra C. Fuchs, Sérgio Haussen, Sérgio Luiz Bassanesi, Sérgio V. Perrone, Silvia Maria Cury Ismael, Silvia Nanfara y Crespin César, Tânia Braga, Tänia Maria Cavalcante ,Telmo Bonamigo, Timóteo Leandro de Araújo, Ueli Grüninger, Ulisses Coelho, Valderês Robinson Achutti, Waldir Castro,

This week Highlights
Entre vários assuntos publicados desde a última postagem chamo atenção para:
About The Literature, Arts & Medicine Database
http://amicor.blogspot.com ,
Custo da violência no Brasil 2004 e
Escalas do Universo: Nikon no
http://amicor_preserve.blogspot.com

É possível assinar gratuitamente para receber informação automática dos Blogs AMICOR ou de outros através de programas como Bloglines ou FeedBlitz, basta acessar o endereço e fazer sua inscrição dando os endereços desejados;

http://www.bloglines.com/public/achutti

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About The Literature, Arts & Medicine Database

About The Literature, Arts & Medicine Database

This site is to be visited many times. It contains material we are needing nowadays while we use to limit medicine to the realm of sciences.

The Literature, Arts, & Medicine Database is an annotated multimedia listing of prose, poetry, film, video and art that was developed to be a dynamic, accessible, comprehensive resource for teaching and research in MEDICAL HUMANITIES, and for use in health/pre-health, graduate and undergraduate liberal arts and social science settings. It is a multi-institutional project (see Editorial Board) that was initiated by faculty of the New York University School of Medicine, Felice Aull, Martin Nachbar, Karen Brewer; programming specialist Roy Smith; and then-medical student Irene Chen, '96. The on-line database began in Gopher Internet format in the summer of 1993 and was converted to Web format in 1994 by Martin Nachbar and Roy Smith. In 2006 Yoo Kyung Chang, Eunbong Sohn and William Holloway re-designed the database to a dynamic Web format. This Web site is produced and maintained by Division of Educational Informatics (DEI), formerly the Hippocrates Project-- the multi-disciplinary development laboratory for application of information technologies to medical education at New York University School of Medicine.

Wednesday, June 20, 2007

ezetimibe/simvastatin versus simvastatin versus atorvastatin

1: Am J Cardiol. 2007 Jun 15;99(12):1706-1713. Epub 2007 May 2. Related Articles, Links


Comparison of effects of ezetimibe/simvastatin versus simvastatin versus atorvastatin in reducing C-reactive protein and low-density lipoprotein cholesterol levels.

Pearson T, Ballantyne C, Sisk C, Shah A, Veltri E, Maccubbin D.

University of Rochester School of Medicine and Dentistry, Rochester, New York.

The lowering effects of ezetimibe/simvastatin combination therapy on low-density lipoprotein (LDL) cholesterol and high-sensitivity C-reactive protein (CRP) were compared with those of simvastatin or atorvastatin monotherapy in a large cohort of patients with primary hypercholesterolemia. To compare ezetimibe/simvastatin with simvastatin, data were combined from 3 identical, prospective 12-week trials in which patients were randomized to receive placebo; ezetimibe 10 mg; ezetimibe 10 mg added to simvastatin 10, 20, 40, or 80 mg; or simvastatin 10, 20, 40, or 80 mg. To compare ezetimibe/simvastatin with atorvastatin, data were analyzed from a phase III double-blind, active-controlled study in which patients were randomized equally to receive ezetimibe/simvastatin 10/10, 10/20, 10/40, or 10/80 mg or atorvastatin 10, 20, 40, or 80 mg for 6 weeks. When averaged across doses, ezetimibe/simvastatin produced significantly greater reductions compared with simvastatin alone in LDL cholesterol (52.5% vs 38.0%, respectively) and CRP levels (31.0% vs 14.3%, respectively). At each individual simvastatin dose, co-administration with ezetimibe produced significant further CRP reductions versus simvastatin alone. Ezetimibe/simvastatin was significantly more effective at lowering LDL cholesterol than atorvastatin when pooled across doses (53.4% vs 45.3%, respectively) and in each milligram-equivalent dose comparison. Reductions in CRP of similar magnitude were observed with ezetimibe/simvastatin and atorvastatin when averaged across doses and at each milligram-equivalent statin dose comparison. In conclusion, the lipid-modulating and anti-inflammatory effects of ezetimibe/simvastatin provide additional benefits not realized by statin monotherapy alone.

PMID: 17560879 [PubMed - in process]

Calcified plaque x estrogens

JoAnn E. Manson, M.D., et al NEJM
Background Calcified plaque in the coronary arteries is a marker for atheromatous-plaque burden and is predictive of future risk of cardiovascular events. We examined the relationship between estrogen therapy and coronary-artery calcium in the context of a randomized clinical trial.

Methods In our ancillary substudy of the Women's Health Initiative trial of conjugated equine estrogens (0.625 mg per day) as compared with placebo in women who had undergone hysterectomy, we performed computed tomography of the heart in 1064 women aged 50 to 59 years at randomization. Imaging was conducted at 28 of 40 centers after a mean of 7.4 years of treatment and 1.3 years after the trial was completed (8.7 years after randomization). Coronary-artery calcium (or Agatston) scores were measured at a central reading center without knowledge of randomization status.

Results The mean coronary-artery calcium score after trial completion was lower among women receiving estrogen (83.1) than among those receiving placebo (123.1) (P=0.02 by rank test). After adjustment for coronary risk factors, the multivariate odds ratios for coronary-artery calcium scores of more than 0, 10 or more, and 100 or more in the group receiving estrogen as compared with placebo were 0.78 (95% confidence interval, 0.58 to 1.04), 0.74 (0.55 to 0.99), and 0.69 (0.48 to 0.98), respectively. The corresponding odds ratios among women with at least 80% adherence to the study estrogen or placebo were 0.64 (P=0.01), 0.55 (P<0.001), and 0.46 (P=0.001). For coronary-artery calcium scores of more than 300 (vs. <10), the multivariate odds ratio was 0.58 (P=0.03) in an intention-to-treat analysis and 0.39 (P=0.004) among women with at least 80% adherence.

Conclusions Among women 50 to 59 years old at enrollment, the calcified-plaque burden in the coronary arteries after trial completion was lower in women assigned to estrogen than in those assigned to placebo. However, estrogen has complex biologic effects and may influence the risk of cardiovascular events and other outcomes through multiple pathways. (ClinicalTrials.gov number, NCT00000611 [ClinicalTrials.gov] .)

Razão Apo B/Apo A-I e Predição de Risco

Apo B/Apo A-I Ratio and Cardiovascular Risk Prediction
Luciana Moreira Lima, Maria das Graças Carvalho, Marinez Oliveira Sousa
Universidade Federal de Minas Gerais - Belo Horizonte, MG - Brasil

ConclusãoCom base nas recentes evidências das vantagens do uso das apolipoproteínas A-I e B como marcadores de risco cardiovascular, o índice apo B/apo A-I emerge como importante parâmetro complementar para avaliação desse risco, especialmente em indivíduos normolipêmicos, com
potencial importância para aplicação na monitoração de pacientes de alto risco em terapia com agentes hipolipemiantes no futuro.

Sunday, June 17, 2007

[2357 - AMICOR10 - 17/06/2007]

[2357 - AMICOR10 - 17/06/2007]
Manifestaram interesse em continuar na lista AMICOR10:
(Se seu nome não consta desta lista mande uma mensagem)
(If your name is not in this list, please send a message)

Airton Stein, Albertino Damasceno, Alberto C. Duque, Alberto José Niituma Ogata, Alberto Stein, Alejandro Wajner, Alexander Daudt, Aloyzio Achutti, Ana Lúcia Robinson Achutti, Ana Menezes, Andréa Silveira Gomes, André Steffens, Antônio Pedro Mirra, Ari Timerman, Aristóteles Comte de Alencar Fo.,Beatriz Amaral, Blau Souza, Bruce B. Duncan, Bruno Caramelli, Carisi Polanczyk, Carlos Alberto Machado, Carlos H. Klein, Catia Teixeira, Cesar G Victora, Claudia Caminha Escosteguy, Claudio A. Bandeira Medina, Catherine Coleman, Darcy Lima, Denis Martinez, Edi e Ponciano Vieira, Eduardo A Costa, Éffrem Maranhão, Emilio Moriguchi, Eney Fernandes, Fernando Lucchese, Flavio Danni Fuchs, Flávio Kanter, Geniberto Paiva Campos, Gilberto Barcellos, Gilberto Brodt, Gilson Feitosa, Giuseppe Repetto, Gláucia M. Oliveira, Helder Reis, Henrique Barata, Ines Lessa, Isaac Roitman, Isabela Giuliano, Iseu Gus, Izabella Rohlfs, Jaqueline Scholz Issa, Jefferson Fernandes, João Carlos F. Braga, João Giongo, Joel Barcellos, Jorge Dable, Jorge Ilha Guimarães, Jorge Ossanai, José Miguel Chatkin, José Roberto Goldim, José da Silva Moreira; Juliana Nunes, Kleber Gaspar, Leopoldo Soares Piegas, Lucélia Magalhães, Luis Paulo Melione, Lucia Pellanda, Luciano Loos, Lucio Bakos, Luiz Carlos Corrêa da Silva, Luiz Scala, Manoel A. P. P. Albuquerque, Marcelo Gustavo Colominas, Margarita Diaz, Maria Inês Azambuja, Mario Becker, Mario F. C. Maranhão, Marta Filippi, Maura Malcon, Mendel Rabin, Moacyr Saffer, Montezuma Ferreira, Murilo Foppa, Nelson Souza e Silva, Nilton Brandão da Silva, Orlando C. B. Wender, Patrícia Pereira Ruschel, Paulo Cesar Jardim, Paulo Henkin, Paulo Opitz, Paulo Roberto Prates, Pedro Albuquerque, Pedro van Zeller, Reginaldo Albuquerque, Romero Bezerra, Romildo Andrade, Rosa Maria Sampaio Vilanova de Carvalho, Salvador Serra, Sandra C. Fuchs, Sérgio Haussen, Sérgio Luiz Bassanesi, Sérgio V. Perrone, Silvia Maria Cury Ismael, Tânia Braga, Telmo Bonamigo, Timóteo Leandro de Araújo, Ueli Grüninger, Ulisses Coelho, Valderês Robinson Achutti, Waldir Castro,

This week Highlights
Entre vários assuntos publicados desde a última postagem chamo atenção para O artigo sobre hipertensão e peso ao nascer reafirmando a hipótese de Barker da revista Circulation com abstract no http://amicor.blogspot.com , bem como os artigos sobre corrupção e desvio de dinheiro da saúde do http://amicor_preserve.blogspot.com e por fim um endereço para publicar via WEB.

Saturday, June 16, 2007

Birth Weight and Hypertension:Do Not Confound withGenetic and Shared Environmental Factors

Genetic and Shared Environmental Factors Do Not Confound the Association Between Birth Weight and Hypertension
A Study Among Swedish Twins
Niklas Bergvall, MSc; Anastasia Iliadou, PhD; Stefan Johansson, MD; Ulf de Faire, MD, PhD; Michael S. Kramer, MD; Yudi Pawitan, PhD; Nancy L. Pedersen, PhD; Paul Lichtenstein, PhD; Sven Cnattingius, MD, PhD
From the Department of Medical Epidemiology and Biostatistics (N.B., A.I., S.J., Y.P., N.L.P., P.L., S.C.), Division of Cardiovascular Epidemiology, Institute of Environmental Medicine and Department of Cardiology, Karolinska University Hospital (U.d.F.), Karolinska Institutet, Stockholm, Sweden, and Departments of Pediatrics and of Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Canada (M.S.K.).

Correspondence to Niklas Bergvall, MSc, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, SE–171 77 Stockholm, Sweden. E-mail niklas.bergvall@ki.se

Received November 7, 2006; accepted March 30, 2007.

Background— Studies have found associations between low birth weight and increased risks of cardiovascular diseases in adulthood. However, these associations could be due to confounding by genetic or socioeconomic factors.

Methods and Results— We performed a study on Swedish like-sexed twins with known zygosity who were born from 1926 to 1958. First, to obtain an overall effect of birth weight on risk of hypertension, we performed cohort analyses on all twins (n=16 265). Second, to address genetic and shared environmental confounding, we performed a nested co-twin control analysis within 594 dizygotic and 250 monozygotic twin pairs discordant for hypertension. Birth characteristics, including birth weight, were obtained from original birth records. Information from adulthood was collected from a postal questionnaire in 1973 (body mass index, height, smoking, and alcohol use) and from a telephone interview conducted from 1998 to 2002 (hypertension and socioeconomic status). Hypertension was defined as reporting both high blood pressure and treatment with antihypertensive medication. In the cohort analysis, the adjusted odds ratio for hypertension in relation to a 500-g decrease in birth weight was 1.42 (95% confidence interval, 1.25 to 1.61). In the co-twin control analyses, the corresponding odds ratios were 1.34 (95% confidence interval, 1.07 to 1.69) for dizygotic and 1.74 (95% confidence interval, 1.13 to 2.70) for monozygotic twins.

Conclusions— In the largest twin study on the fetal origins of hypertension, we found that decreased birth weight is associated with increased risk of hypertension independently of genetic factors, shared familial environment, and risk factors for hypertension in adulthood, including body mass index.

Desfibriladores en las playas gallegas para los problemas cardiacos - Videos - Sociedad

ELPAIS.com - Video: Desfibriladores en las playas gallegas para los problemas cardiacos - Videos - Sociedad: "Desfibriladores en las playas gallegas para los problemas cardiacos
Se trata de un aparato inteligente, del tamaño de un reproductor portátil de DVD
ATLAS - 15-06-2007"

De: Saul Drajer [mailto:sdrajer@fibertel.com.ar]
Enviada em: sábado, 16 de junho de 2007 19:20
No es un chiste gallego:
http://www.elpais.com/videos/sociedad/Desfibriladores/
playas/gallega/problemas/cardiacos/elpvidsoc/
20070615elpepusoc_5/Ves/
Clicken esta dirección (o péguenla en la ventana correspondiente) y verán un video que muestra que ¡¡¡HASTA LOS GALLEGOS ENTIENDEN LA IMPORTANCIA DEL DESFIBRILADOR EXTERNO AUTOMÁTICO!!!
¿Y NOSOTROS?...

Saludos
Saúl Drajer

Saturday, June 09, 2007

[2356 - AMICOR10 - 09/06/2007]

[2356 - AMICOR10 - 09/06/2007] http://www.bloglines.com/public/Achutti

Manifestaram interesse em continuar na lista AMICOR10:
(Se seu nome não consta desta lista mande uma mensagem)
(If your name is not in this list, please send a message)

Airton Stein, Albertino Damasceno, Alberto C. Duque, Alberto José Niituma Ogata, Alejandro Wajner, Alexander Daudt, Aloyzio Achutti, Ana Lúcia Robinson Achutti, Ana Menezes, Antônio Pedro Mirra, Ari Timerman, Aristóteles Comte de Alencar Fo.,Beatriz Amaral, Blau Souza, Bruce B. Duncan, Bruno Caramelli, Carisi Polanczyk, Carlos Alberto Machado, Carlos H. Klein, Cesar G Victora, Claudia Caminha Escosteguy, Claudio A. Bandeira Medina, Catherine Coleman, Darcy Lima, Denis Martinez, Eduardo A Costa, Éffrem Maranhão, Emilio Moriguchi, Eney Fernandes, Fernando Lucchese, Flavio Danni Fuchs, Flávio Kanter, Geniberto Paiva Campos, Gilberto Barcellos, Gilberto Brodt, Gilson Feitosa, Giuseppe Repetto, Gláucia M. Oliveira, Helder Reis, Ines Lessa, Isaac Roitman, Isabela Giuliano, Iseu Gus, Izabella Rohlfs, Jaqueline Scholz Issa, Jefferson Fernandes, João Carlos F. Braga, João Giongo, Joel Barcellos, Jorge Dable, Jorge Ilha Guimarães, Jorge Ossanai, José Miguel Chatkin, José Roberto Goldim, Juliana Nunes, Kleber Gaspar, Leopoldo Soares Piegas, Lucélia Magalhães, Luis Paulo Melione, Lucia Pellanda, Luciano Loos, Luiz Carlos Corrêa da Silva, Luiz Scala, Manoel A. P. P. Albuquerque, Marcelo Gustavo Colominas, Margarita Diaz, Maria Inês Azambuja, Mario Becker, Mario F. C. Maranhão, Marta Filippi, Maura Malcon, Mendel Rabin, Moacyr Saffer, Montezuma Ferreira, Murilo Foppa, Nelson Souza e Silva, Nilton Brandão da Silva, Orlando C. B. Wender, Patrícia Pereira Ruschel, Paulo Cesar Jardim, Paulo Henkin, Paulo Opitz, Paulo Roberto Prates, Pedro Albuquerque, Pedro van Zeller, Reginaldo Albuquerque, Romero Bezerra, Romildo Andrade, Rosa Maria Sampaio Vilanova de Carvalho, Salvador Serra, Sandra C. Fuchs, Sérgio Haussen, Sérgio Luiz Bassanesi, Sérgio V. Perrone, Silvia Maria Cury Ismael, Tânia Braga, Telmo Bonamigo, Timóteo Leandro de Araújo, Ueli Grüninger, Valderês Robinson Achutti, Waldir Castro,

Caríssimos AMICOR,
O Blog AMICOR básico HTTP://AMICOR.BLOGSPOT.COM ) deverá continuar ativo, e poderá ser visitado sempre e a qualquer momento, bem como as demais páginas especializadas e tudo o que foi publicado desde agosto de 2005. Para buscar por assunto é só utilizar a caixa de diálogo situada no topo do lado esquerdo e digitar palavras chave.
This week Highlights
Entre vários assuntos publicados desde a última postagem chamo atenção para as eleições para a SBC e a carta da futura Presidente do GEECABE; sobre o artigo de Ford ES et al. "Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980-2000." N Engl J Med 2007;356:2388-98 que certamente suscita controvérisas sobre a causas da redução da epidemia de doença isquêmica; sobre os estudos comparando o efeito entre drogas (Findings of Published Trials of Drug–Drug Comparisons: Why Some Statins Appear More Efficacious than Others Lisa Bero, Fieke Oostvogel, Peter Bacchetti3, Kirby Lee); bem como para o forum proposto por ProCOR sobre o artigo da Maria Inês R. Azambuja “Coronary Heart Disease: One or Several Diseases? “; Por último a referência às idéias de Patrik Dixon que fez uma conferência em Porto Alegre na última semana no Curso Fronteiras do Pensamento: http://www.globalchange.com/

Eleições SBC - GEECABE

Mensagem da Futura Presidente do Grupo de Estudos sobre Epidemiologia e Cardiologia Baseada em Evidências

EXERÇA SEU DIREITO DE VOTAR!
É época de votar para presidente da SBC e para os Departamentos e seus respectivos grupos de estudo.
O GEECABE é um grupo de estudos voltado, como o próprio nome menciona, para o desenvolvimento da Epidemiologia e da Cardiologia Baseada em Evidências dentro da Sociedade Brasileira de Cardiologia.
Dado a pertinência e necessidade de alargamento dos domínios dos conhecimentos que norteiam a relação complementar entre a ciência com base populacional e os cuidados dos pacientes baseados em princípios sólidos nasce a importância de expandir este grupo de estudos para um Departamento com maior autonomia, passo que poderemos almejar em um futuro próximo.
Nosso grupo, juntamente com muitos outros colegas com os quais temos compartilhado informações e experiências, está disposto a buscar junto à nossa sociedade o desenvolvimento destes novos caminhos.
A determinação social da saúde e da doença, entretanto, tem nos demonstrado que o domínio dos fenômenos populacionais e sua aplicação em saúde pública têm outras dimensões igualmente essenciais para que possamos alcançar o sucesso em nossa missão. Pretendemos desse modo, contribuir objetivamente no campo da Saúde Pública buscando efetivamente colaborar com a diminuição dos fatores de risco, da morbidade, da mortalidade, do impacto econômico e do sofrimento por doenças cardiovasculares no Brasil. Por isso criamos um Sub-Comitê de Saúde Pública.
Apresentamos nosso chapa e nossa proposta de caminharmos rumo a uma efetiva participação na Sociedade Brasileira de Cardiologia com vistas a nos transformarmos o mais breve possível em um novo Departamento da SBC.

Chapa da Diretoria GEECABE (Biênio 2008-2009)


Presidente: Gláucia Maria Moraes Oliveira (RJ)
(21) 2267-2445 (21) 2513-2482 glauciam@cardiol.br

Vice-Presidente: Lília Nigro Maia (SP)
(17) 3201-5054 (17) 3201-5154 lnigro@cardiol.br

Diretor Científico: Álvaro Avezum Jr. (SP)
(11) 5085-6204 (11) 9624-9979 aavezum@cardiol.br

Diretor Administrativo: Luís Cláudio Lemos Correia (BA)
(71) 3359-1032 (71) 9971-1032 lccorreia@cardiol.br

Diretora Financeira: Carisi Anne Polanczik (RS)
(51) 3222-2183 (51) 3330-7558 sianne@cardiol.br

Diretor de Comunicação: Anis Rassi Jr. (GO)
(62) 3227-9000 (62) 3227-9311 arassijr@cardiol.br

Subcomitê de Saúde Pública :

Aloyzio Achutti (RS)
(51) 3233-3579 (51) 9966-1625 achutti@cardiol.br

Ines Lessa (BA)
(71) 3334-3232 (71) 3334-7784 ines@lessa.org

Aristóteles Comte de Alencar Fo (AM)
(92) 3635-2944 (92) 8114-9279 aristoteles.al@uol.com.br

Geniberto Paiva Campos (DF)
(61) 3346 4988 (61) 9553-0830 genibertocampos@gmail.com

Thursday, June 07, 2007

Cardiac Mortality Drop Attributed to Therapies and Risk Factor Reductions - CME Teaching Brief® - MedPage Today

Cardiac Mortality Drop Attributed to Therapies and Risk Factor Reductions - CME Teaching Brief® - MedPage Today: "Cardiac Mortality Drop Attributed to Therapies and Risk Factor Reductions

By Neil Osterweil, Senior Associate Editor, MedPage Today
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
June 06, 2007

ATLANTA, June 6 -- Credit for the near halving of the rate of coronary disease deaths in the U.S, from 1980 to 2000, belongs equally to reductions in risk factors and to the rise of evidence-based therapies, found CDC and British researchers."

Ford ES et al. "Explaining the Decrease in U.S. Deaths from Coronary Disease, 1980-2000." N Engl J Med 2007;356:2388-98.

Tuesday, June 05, 2007

Trials of Drug–Drug Comparisons: Why Some Statins Appear More Efficacious than Others

Associated with Findings of Published Trials of Drug–Drug Comparisons: Why Some Statins Appear More Efficacious than Others
Lisa Bero1*, Fieke Oostvogel2, Peter Bacchetti3, Kirby Lee4
1 Clinical Pharmacy and Health Policy, University of California, San Francisco, California, United States of America, 2 Department of Mathematics, University of Leiden, The Netherlands, 3 Department of Epidemiology and Biostatistics, University of California, San Francisco, California, United States of America, 4 Department of Clinical Pharmacy, University of California, San Francisco, California, United States of America
Background
Published pharmaceutical industry–sponsored trials are more likely than non-industry-sponsored trials to report results and conclusions that favor drug over placebo. Little is known about potential biases in drug–drug comparisons. This study examined associations between research funding source, study design characteristics aimed at reducing bias, and other factors that potentially influence results and conclusions in randomized controlled trials (RCTs) of statin–drug comparisons.
Methods and Findings
This is a cross-sectional study of 192 published RCTs comparing a statin drug to another statin drug or non-statin drug. Data on concealment of allocation, selection bias, blinding, sample size, disclosed funding source, financial ties of authors, results for primary outcomes, and author conclusions were extracted by two coders (weighted kappa 0.80 to 0.97). Univariate and multivariate logistic regression identified associations between independent variables and favorable results and conclusions. Of the RCTs, 50% (95/192) were funded by industry, and 37% (70/192) did not disclose any funding source. Looking at the totality of available evidence, we found that almost all studies (98%, 189/192) used only surrogate outcome measures. Moreover, study design weaknesses common to published statin–drug comparisons included inadequate blinding, lack of concealment of allocation, poor follow-up, and lack of intention-to-treat analyses. In multivariate analysis of the full sample, trials with adequate blinding were less likely to report results favoring the test drug, and sample size was associated with favorable conclusions when controlling for other factors. In multivariate analysis of industry-funded RCTs, funding from the test drug company was associated with results (odds ratio = 20.16 [95% confidence interval 4.37–92.98], p < 0.001) and conclusions (odds ratio = 34.55 [95% confidence interval 7.09–168.4], p < 0.001) that favor the test drug when controlling for other factors. Studies with adequate blinding were less likely to report statistically significant results favoring the test drug.
Conclusions
RCTs of head-to-head comparisons of statins with other drugs are more likely to report results and conclusions favoring the sponsor's product compared to the comparator drug. This bias in drug–drug comparison trials should be considered when making decisions regarding drug choice.
Funding: This research was supported by the California Tobacco-Related Disease Research Program Grant 13RT-0108 (principal investigator, L. A. Bero). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Academic Editor: Alessandro Liberati, Italian Cochrane Centre, Italy
Citation: Bero L, Oostvogel F, Bacchetti P, Lee K (2007) Factors Associated with Findings of Published Trials of Drug–Drug Comparisons: Why Some Statins Appear More Efficacious than Others. PLoS Med 4(6): e184 doi:10.1371/journal.pmed.0040184
Received: September 4, 2006; Accepted: April 2, 2007; Published: June 5, 2007
Copyright: © 2007 Bero et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abbreviations: CI, confidence interval; OR, odds ratio; RCT, randomized controlled trial
* To whom correspondence should be addressed. E-mail: berol@pharmacy.ucsf.edu

Coronary Heart Disease: One or Several Diseases?

ProCOR-Discussion Forum: "
5 June 2007

[This article proposes an alternative causation for the emergence and decline of the coronary heart disease 'epidemic' experienced by many developed countries. A consistent explanation by the authors addressing the emergence of CHD in developing countries would be that many populations of developing countries have had high prevalence of infectious diseases and malnutrition which has created a vulnerability to CHD when these people later in their lives are exposed to tobacco smoking and other risky behaviors.]

Title: Coronary Heart Disease (CHD)--One or Several Diseases?

Author: MI Azambuja, R Levins

Reference: Perspectives in Biology and Medicine 2007; 50(2): 228,
http://muse.jhu.edu/journals/perspectives_in_biology_and_medicine/toc/pbm50.2.html

Reviewer: Carlos Mendoza Montano, PhD, APRECOR, Guatemala, ProCOR contributing editor, e-mail: projhouse@intelnet.net.gt


Purpose of study: The current article presents an interesting perspective about the causation of CHD. It revisits evidence that may have been overlooked or misinterpreted during the heights of the CHD epidemic in the United States and other developed countries due to the prevalent framework of multicausality, and the hegemony of the lipid over alternative hypotheses to CHD causation. The authors of the article propose a fresh look at some old evidence which leads to new ways of thinking about CHD, its trends and its causes, and new ways of thinking about chronic disease occurrence in general."/.../

8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke

Abstracts
8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke
May 9–11, 2007 Omni Shoreham Hotel, Washington, DC
Sponsored by the American Heart Association’s Quality of Care and Outcomes. Research Interdisciplinary Working Group. Cosponsored by the Councils on Cardiovascular Nursing, Clinical Cardiology, and Stroke
Conference Program Committee
John A. Spertus, MD, MPH, Conference Chair; John S. Rumsfeld, MD, PhD, Conference
Vice-chair Ralph G. Brindis, MD, MPH, FACC; Kim C. Coley, PharmD; Elizabeth R. DeLong, PhD; T. Bruce Ferguson, Jr, MD; Matthew E. Fitzgerald, DrPH; William A. Ghali, MD; David C. Goff, Jr, MD, PhD, FAHA; Edward P. Havranek, MD; Kathy A. Hebert, MD, MMM, MPH; Harlan M. Krumholz, MD, SM; Frederick A. Masoudi, MD, MSPH; Rita F. Redberg, MD, MSc, FACC; Anne Sales, MSN, PhD; Lee H. Schwamm, MD, FAHA; Richard E. Shaw, MA, PhD, FACC, FACA; Henry H. Ting, MD, MBA
Increasingly there is interest in efforts to assess and improve clinical and health care delivery
performance. This has been the focus of the Forum on Quality of Care and Outcomes Research. The meeting is held annually in Washington, DC and includes workshops, plenary sessions, concurrent sessions, and both oral and poster abstract presentations. This year, abstracts were accepted from more than 15 countries covering broad topics in outcomes research.

Long-Term Progression and Outcomes With Aging in Patients With Lone Atrial Fibrillation.

Long-Term Progression and Outcomes With Aging in Patients With Lone Atrial Fibrillation. A 30-Year Follow-Up Study -- Jahangir et al., 10.1161/CIRCULATIONAHA.106.644484 -- Circulation
Long-Term Progression and Outcomes With Aging in Patients With Lone Atrial Fibrillation. A 30-Year Follow-Up Study Arshad Jahangir MD, Victor Lee MBBS, Paul A. Friedman MD*, Jane M. Trusty RN, David O. Hodge MS, Stephen L. Kopecky MD, Douglas L. Packer MD, Stephen C. Hammill MD, Win-Kuang Shen MD, and Bernard J. Gersh MBChB, DPhil
From the Divisions of Cardiovascular Diseases (A.J., V.L., P.A.F., J.M.T., S.L.K., D.L.P., S.C.H., W.-K.S., B.J.G.) and Biostatistics (D.O.H.), Mayo Clinic, Rochester, Minn.
* To whom correspondence should be addressed. E-mail:
friedman.paul@mayo.edu
.
Background--The long-term natural history of lone atrial fibrillation is unknown. Our objective was to determine the rate and predictors of progression from paroxysmal to permanent atrial fibrillation over 30 years and the long-term risk of heart failure, thromboembolism, and death compared with a control population.
Methods and Results--A previously characterized Olmsted County, Minnesota, population with first episode of documented atrial fibrillation between 1950 and 1980 and no concomitant heart disease or hypertension was followed up long term. Of this unique cohort, 76 patients with paroxysmal (n=34), persistent (n=37), or permanent (n=5) lone atrial fibrillation at initial diagnosis met inclusion criteria (mean age at diagnosis, 44.2±11.7 years; male, 78%). Mean duration of follow-up was 25.2±9.5 years. Of 71 patients with paroxysmal or persistent atrial fibrillation, 22 had progression to permanent atrial fibrillation. Overall survival of the 76 patients with lone atrial fibrillation was 92% and 68% at 15 and 30 years, respectively, similar to 86% and 57% survival for the age- and sex-matched Minnesota population. Observed survival free of heart failure was slightly worse than expected (P=0.051). Risk for stroke or transient ischemic attack was similar to the expected population risk during the initial 25 years of follow-up but increased thereafter (P=0.004), although CIs were wide. All patients who had a cerebrovascular event had developed 1 risk factor for thromboembolism.
Conclusions--Comorbidities significantly modulate progression and complications of atrial fibrillation. Age or development of hypertension increases thromboembolic risk.

Monday, June 04, 2007

Genetics and Genomics for Prevention and Treatment of

Relevance of Genetics and Genomics for Prevention and Treatment of
Cardiovascular Disease: A Scientific Statement From the American Heart
Association Council on Epidemiology and Prevention, the Stroke Council, and
the Functional Genomics and Translational Biology Interdisciplinary Working
Group
Donna K. Arnett, Alison E. Baird, Ruth A. Barkley, Craig T. Basson,
Eric Boerwinkle, Santhi K. Ganesh, David M. Herrington, Yuling Hong,
Cashell Jaquish, Deborah A. McDermott, and Christopher J. O'Donnell
Circulation 2007;115 2878-2901
http://circ.ahajournals.org/cgi/content/abstract/115/22/2878?etoc

Clinical Trial Registration

Clinical Trial Registration
Looking Back and Moving Ahead
Christine Laine, MD, MPH; Richard Horton, FMedSci; Catherine D. DeAngelis, MD, MPH; Jeffrey M. Drazen, MD; Frank A. Frizelle, MBChB, MMedSci; Fiona Godlee, MBBChir, BSc; Charlotte Haug, MD, PhD, MSc; Paul C. Hébert, MD, MHSc; Sheldon Kotzin, MLS; Ana Marusic, MD, PhD; Peush Sahni, MS, PhD; Torben V. Schroeder, MD, DMSc; Harold C. Sox, MD; Martin B. Van Der Weyden, MD; Freek W.A. Verheugt, MD
JAMA. 2007;298:(doi:10.1001/jama.298.1.jed70037).
In 2005, the International Committee of Medical Journal Editors (ICMJE) initiated a policy requiring investigators to deposit information about trial design into an accepted clinical trials registry before the onset of patient enrollment.1 This policy aimed to ensure that information about the existence and design of clinically directive trials was publicly available, an ideal that leaders in evidence-based medicine have advocated for decades.2 The policy precipitated much angst among research investigators and sponsors, who feared that registration would be burdensome and would stifle competition. Yet, the response to this policy has been overwhelming. The ICMJE promised to reevaluate the policy in 2 years after implementation. Here, we summarize that reevaluation, specifically commenting on registries that meet the policy requirements, the types of studies that require registration, and the registration of trial results. As is always the case, the ICMJE establishes policy only for the 12 member journals (a detailed description of the ICMJE and its purpose is available at http://www.icmje.org/), but many other journals have adopted our initial trial registration recommendations, and we hope that they will also adopt the modifications discussed in this update.

Friday, June 01, 2007

CVD CALENDAR -ProCOR

The full calendar can be accessed online at www.procor.org. ProCOR's CVD Calendar is a collection of global events and conferences relevant to cardiovascular health promotion. To submit an event or to receive the full calendar in an e-mail, please e-mail Juan Ramos, ProCOR Program Coordinator, at jramos3@partners.org.]

[2355 - AMICOR10 - 01/06/2007]

[2355 - AMICOR10 - 01/06/2007] http://www.bloglines.com/public/Achutti
Caríssimos AMICOR,
Verifique se seu nome consta da lista dos que manifestaram interesse em continuar recebendo as mensagens semanais de alerta. Agradeço pela manifestação pois a partir do fim deste mês passarei a utilizar somente esta nova lista, na presunção de que os demais não continuam interessados em permanecer.
O Blog AMICOR básico (http://amicor.blogspot.com) deverá continuar ativo, com a lista de outros especializados no menu da direita que poderão ser visitados a qualquer momento, bem como tudo o que foi publicado desde agosto de 2005. Para buscar por assunto é só utilizar a caixa de diálogo situada no topo do lado esquerdo e digitar palavras chave, maneira de buscar tudo o que está nos arquivos.
Entre vários assuntos publicados desde a última postagem chamo atenção para os artigos sobre Fumo Passivo (second hand smoking) no blog básico e no AMICOR SMOKE a propósito do dia mundial sem tabaco comemorado mundialmente ontem. Também sobre o estudo Câncer Risk Screening http://www.cancer.org/docroot/RES/RES_6_6.asp que pretende examinar meio milhão de pessoas.

Manifestaram interesse em continuar na lista AMICOR10:

Airton Stein, Alberto C. Duque, Alberto José Niituma Ogata, Alejandro Wajner, Aloyzio Achutti, Ana Menezes, Aristóteles Comte de Alencar Fo.,Beatriz Amaral, Blau Souza, Bruce B. Duncan, Carisi Polanczyk, Carlos Alberto Machado, Carlos H. Klein, Cesar G Victora, Claudia Caminha Escosteguy, Claudio A. Bandeira Medina, Catherine Coleman, Darcy Lima, Denis Martinez, Eduardo A Costa, Éffrem Maranhão, Emilio Moriguchi, Eney Fernandes, Fernando Lucchese, Flavio Danni Fuchs, Flávio Kanter, Geniberto Paiva Campos, Gilberto Barcellos, Gilberto Brodt, Gilson Feitosa, Giuseppe Repetto, Gláucia M. Oliveira, Helder Reis, Ines Lessa, Isaac Roitman, Isabela Giuliano, Iseu Gus, Izabella Rohlfs, Jaqueline Scholz Issa, Jefferson Fernandes, João Carlos F. Braga, João Giongo, Jorge Dable, Jorge Ilha Guimarães, Jorge Ossanai, José Miguel Chatkin, Juliana Nunes, Kleber Gaspar, Leopoldo Soares Piegas, Lucélia Magalhães, Luis Paulo Melione, Lucia Pellanda, Luciano Loos, Luiz Carlos Corrêa da Silva, Luiz Scala, Manoel A. P. P. Albuquerque, Marcelo Gustavo Colominas, Margarita Diaz, Maria Inês Azambuja, Mario Becker, Mario F. C. Maranhão, Moacyr Saffer, Montezuma Ferreira, Murilo Foppa, Nelson Souza e Silva, Nilton Brandão da Silva, Orlando C. B. Wender, Patrícia Pereira Ruschel, Paulo Cesar Jardim, Paulo Henkin, Paulo Opitz, Paulo Roberto Prates, Reginaldo Albuquerque, Romero Bezerra, Romildo Andrade, Rosa Maria Sampaio Vilanova de Carvalho, Salvador Serra, Sandra C. Fuchs, Sérgio Haussen, Sérgio Luiz Bassanesi, Sérgio V. Perrone, Silvia Maria Cury Ismael, Telmo Bonamigo, Timóteo Leandro de Araújo, Ueli Grüninger, Valderês Robinson Achutti.