DIABETES ATLAS – 3rd Edition

De: Grégory Ghyoot [mailto:Gregory.Ghyoot@idf.org]
Enviada em: quinta-feira, 31 de janeiro de 2008 12:08
Para: undisclosed-recipients:
Assunto: Diabetes Atlas 3rd edition promotion

 

Grégory Ghyoot
| Project Coordinator
tel +32-2-5431633 | Gregory.Ghyoot@idf.org

International Diabetes Federation
Avenue Emile De Mot 19, B-1000 Brussels, Belgium
tel +32-2-5385511 | fax +32-2-5385114
info@idf.org | www.idf.org | VAT BE 433.674.528

IDF | Promoting diabetes care, prevention and a cure worldwide

 

The State of the World’s Children 2008 – Child Survival

De: Equity, Health & Human Development [mailto:EQUIDAD@LISTSERV.PAHO.ORG]
Em nome de Ruggiero, Mrs. Ana Lucia (WDC)
Assunto: [EQ] The State of the World's Children 2008 - Child Survival

 

The State of the World's Children 2008 – Child Survival

 

United Nations Children's Fund (UNICEF)

December 2007

 

Available online as PDF file [164p.] at:

http://www.unicef.org/sowc08/docs/sowc08.pdf

 

"…..The State of the World's Children 2008 assesses the state of child survival and primary health care for mothers, newborns and children today. These issues serve as sensitive barometers of a country's development and wellbeing and as evidence of its priorities and values. Investing in the health of children and their mothers is a human rights imperative and one of the surest ways for a country to set its course towards a better future…."

 

"…..What is a life worth? Most of us would sacrifice a great deal to save a single child. Yet somehow on a global scale, our priorities have become blurred.
Every day, on average more than 26,000 children under the age of five die around the world, mostly from preventable causes. Nearly all of them live in the developing world or, more precisely, in 60 developing countries. More than one third of these children die during the first month of life, usually at home and without access to essential health services and basic commodities that might save their lives. Some children succumb to respiratory or diarrhoeal infections that are no longer threats in industrialized countries or to early childhood diseases that are easily prevented through vaccines, such as measles. In up to half of under-five

deaths an underlying cause is undernutrition, which deprives a young child's body and mind of the nutrients needed for growth and development.

Unsafe water, poor sanitation and inadequate hygiene also contribute to child mortality and morbidity…."

 

Download the executive summary [PDF, 618 KB]

 

Content:
- 1Child survival: Where we stand
- 2 Lessons learned from evolving health-care systems and practices
- 3 Community partnerships in primary health care for mothers, newborns and children
- 4 Strengthening community partnerships, the continuum of care, and health systems
- 5 Uniting for child survival

 

What works in Health Care

Knowing what works in health care: A roadmapfor the nation.

US Institute of Medicine (IOM).January 2008.

Washington, DC: The National Academies Press

Available online at: http://www.nap.edu/catalog.php?record_id=12038

“…..Solutions to some of the nation’s most pressing health policy problems hinge on the ability to identify which diagnostic, treatment, and prevention services work best for various patients and circumstances. Spending on ineffective care contributes to rising health costs and insurance premiums. Variations in how health care providers treat the same conditions reflect uncertainty and disagreement about what clinical practice standards should be. Patients and insurers cannot always be confident that health professionals are delivering the most effective care.

A new Institute of Medicine report, Knowing What Works in Health Care: A Roadmap for the Nation, provides a blueprint for a national program to assess the effectiveness of clinical services and to provide credible, unbiased information about what really works in health care. The report recommends that Congress direct the U.S. Department of Health and Human Services to establish a program with the authority, expertise and resources necessary to set priorities for evaluating clinical services and to conduct systematic reviews of the evidence. The program would also develop and promote rigorous standards for creating clinical practice guidelines, which could help minimize use of questionable services and target services to the patients most likely to benefit. …/.../

Longevidade: novos indicadores

Novos padrões de envelhecimento
Pesquisadores criam indicadores para melhor avaliar a longevidade da população

Os indicadores demográficos usados atualmente para medir a longevidade da população mundial incomodam alguns pesquisadores dessa área. Esses índices refletem o envelhecimento verificado atualmente, mas são incapazes de apontar novos padrões nesse fenômeno. Uma pessoa que atingiu os 60 anos em 2000, por exemplo, embora já seja considerada idosa, tem uma expectativa de vida maior do que alguém que tivesse a mesma idade em 1900. Para contornar discrepâncias como essa, uma equipe de especialistas desenvolveu três novos indicadores para avaliar a longevidade da população.

Os índices foram apresentados em artigo publicado eletronicamente esta semana na revista Nature pela equipe do pesquisador Wolfang Lutz, do Instituto Internacional para a Análise de Sistemas Aplicados (Laxenburg, Áustria). Lutz esclarece que o objetivo dos novos indicadores é capturar de diferentes maneiras a expectativa de vida a partir do momento em que o indivíduo atinge a idade média máxima até sua morte, e não apenas partindo-se do seu nascimento, como acontece ao se utilizar como parâmetro a idade cronológica.

“Esses indicadores projetam algumas novas perspectivas a respeito da forma como o envelhecimento é percebido”, explica ele em entrevista à CH On-line. “Eles acabam também por fornecer outros dados que nos dão uma visão um pouco mais otimista da situação do envelhecimento populacional, conforme o que foi analisado em relação às tendências demográficas mundiais.”

A PRÓXIMA GUERRA

Recebi uma mensagem com o documento que segue, do José Azambuja, esposo da Dra. Maria Inês. Como há definitivamente determinação sócio-econômica na saúde/doença, se isto tudo for verdade - e ao menos é plausível – está dentro dos objetivos deste Blog AMICOR.

Segue abaixo o relato de uma pessoa conhecida e séria, que passou recentemente em um concurso público federal e foi trabalhar em Roraima. Trata-se de um Brasil que a gente não conhece.

As duas semanas em Manaus foram interessantes para conhecer um Brasil um pouco diferente, mas chegando em Boa Vista (RR) não pude resistir a fazer um relato das coisas que tenho visto e escutado por aqui.

Conversei com algumas pessoas nesses três dias, desde engenheiros até pessoas com um mínimo de instrução.

Para começar o mais difícil de encontrar por aqui é roraimense, pra falar a verdade, acho que a proporção é de um roraimense para cada 10 pessoas é bem razoável, tem gaúcho, carioca, cearense, amazonense, piauiense, maranhense e por aí vai. Portanto falta uma identidade com a terra. Aqui não existem muitos meios de sobrevivência, ou a pessoa é funcionária pública, e aqui quase todo mundo é, pois em Boa Vista se concentram todos os órgãos federais e estaduais de Roraima, além da prefeitura é claro. Se não for funcionário público a pessoa trabalha no comércio local ou recebe ajuda de Programas do governo. Não existe indústria de qualquer tipo. Pouco mais de 70% do Território roraimense é demarcado como reserva indígena, portanto restam apenas 30%, descontando-se os rios e as terras improdutivas que são muitas, para se cultivar a terra ou para a localização das próprias cidades. (Na única rodovia que existe em direção ao Brasil (liga Boa Vista a Manaus, cerca de 800 km) existe um trecho de aproximadamente 200 km reserva indígena Waimiri Atroari) por onde você só passa entre 6:00 da manhã e 6:00 da tarde, nas outras 12 horas a rodovia é fechada pelos índios (com autorização da FUNAI e dos americanos) para que os mesmos não sejam incomodados.

Detalhe: Você não passa se for brasileiro, o acesso é livre aos americanos, europeus e japoneses. Desses 70% de território indígena, diria que em 90% dele ninguém entra sem uma grande burocracia e autorização da FUNAI.

Detalhe: Americanos entram na hora que quiserem, se você não tem uma autorização da FUNAI mas tem dos americanos então você pode entrar. A maioria dos índios fala a língua nativa além do inglês ou francês, mas a maioria não sabe falar português. Dizem que é comum na entrada de algumas reservas encontrarem-se hasteadas bandeiras americanas ou inglesas. É comum se encontrar por aqui americano tipo nerds com cara de quem não quer nada, que veio caçar borboleta e joaninha e catalogá-las, mas no final das contas pasme, se você quiser montar um empresa para exportar plantas e frutas típicas como cupuaçu, açaí camu-camu etc., medicinais, ou componentes naturais para fabricação de remédios, pode se preparar para pagar 'royalties' para empresas japonesas e americanas que já patentearam a maioria dos produtos típicos da Amazônia...

Por três vezes repeti a seguinte frase após ouvir tais relatos: É os americanos vão acabar tomando a Amazônia e em todas elas ouvi a mesma resposta em palavras diferentes. Vou reproduzir a resposta de uma senhora simples que vendia suco e água na rodovia próximo de Mucajaí:

'Irão não minha filha, tu não sabe, mas tudo aqui já é deles, eles comandam tudo, você não entra em lugar nenhum porque eles não deixam. Quando acabar essa guerra aí eles virão pra cá, e vão fazer o que fizeram no Iraque quando determinaram uma faixa para os curdos onde iraquiano não entra, aqui vai ser a mesma coisa'.

A dona é bem informada não? O pior é que segundo a ONU o conceito de nação é um conceito de soberania e as áreas demarcadas têm o nome de nação indígena. O que pode levar os americanos a alegarem que estarão libertando os povos indígenas. Fiquei sabendo que os americanos já estão construindo uma grande base militar na Colômbia, bem próximo da fronteira com o Brasil numa parceria com o governo colombiano com o pseudo objetivos de combater o narcotráfico. Por falar em narcotráfico, aqui é rota de distribuição, pois essa mãe chamada Brasil mantém suas fronteiras abertas e aqui tem Estrada para as Guianas e Venezuela. Nenhuma bagagem de estrangeiro é fiscalizada, principalmente se for americano, europeu ou japonês, (isso pode causar um incidente diplomático)... Dizem que tem muito colombiano traficante virando venezuelano, pois na Venezuela é muito fácil comprar a cidadania venezuelana por cerca de 200 dólares.
Pergunto inocentemente às pessoas; porque os americanos querem tanto proteger os índios. A resposta é absolutamente a mesma, porque as terras indígenas além das riquezas animais e vegetais, da abundância de água são extremamente ricas em ouro (encontram-se pepitas que chegam a ser pesadas em quilos), diamante, outras pedras preciosas, minério e nas reservas norte de Roraima e Amazonas, ricas em PETRÓLEO.
Parece que as pessoas contam essas coisas como que num grito de Socorro a alguém que é do sul, como se eu pudesse dizer isso ao presidente ou a alguma autoridade do sul que vá fazer alguma coisa. É pessoal, saio daqui com a quase certeza de que em breve o Brasil irá diminuir de tamanho.. Um grande abraço a todos. Será que podemos fazer alguma coisa???
Acho que sim.

Repasse esse e-mail para que um maior número de brasileiros fique sabendo desses absurdos.

Mara Silvia Alexandre Costa Depto de Biologia Cel. Mol. Bioag.
Patog. FMRP - USP

Opinião pessoal:

Gostaria que você, especialmente que recebeu este e-mail, o repasse para o maior número possível de pessoas. Do meu ponto de vista seria interessante que o país inteiro ficasse sabendo desta situação através dos telejornais antes que isso venha a acontecer.

Afinal foi um momento de fraqueza dos Estados Unidos que os europeus lançaram o Euro, assim poderá se aproveitar esta situação de fraqueza norte-americana (perdas na guerra do Iraque) para revelar isto ao mundo a fim de antecipar a próxima guerra. Conto com sua participação, no envio deste e-mail..

Celso Luiz Borges de Oliveira Doutorando em Água e Solo FEAGRI/UNICAMP

Tel: (19) 3233-1840 Celular: (19) 9136-6472 e-mail´s:
Celso@ufba.br; celso@agr.unicamp.br ; celsoborges@gmail.com

La Critica Medicina

http://lacriticamedicina.blogspot.com/
Dr. Alejandro H. Wajner y Dr. Ernesto Augusto Guidos
Visitem e colaborem.

Staying active...

Staying active and drinking moderately is the key to a long life
Authors:
Emma Mason Tel: +44 (0)1376 563090 Mobile: +44(0)7711 296 986 Email: wordmason@mac.comESC Press OfficeTel: +33 (0)4 92 94 86 27Fax: +33 (0)4 92 94 77 51E-mail: press@escardio.org

People who drink moderate amounts of alcohol and are physically active have a lower risk of death from heart disease and other causes than people who don’t drink at all, according to new research. People who neither drink alcohol nor exercise have a 30-49 per cent higher risk of heart disease than those who either drink, exercise or both.
The research, which was published in the European Heart Journal [1] today (Wednesday 9 January), is the first to look at the combined influence of leisure-time physical activity and weekly alcohol intake on the risk of fatal ischaemic heart disease (a form of heart disease characterised by a reduced blood supply to the heart) and deaths from all causes.
Between 1981-1983 Danish researchers obtained information on various health-related issues (including exercise and alcohol intake) from 11,914 Danish men and women aged 20 or older, who were taking part in the larger, Copenhagen City Heart Study.

Investment for Health: Integrating Health in All Policies

Investment for Health: Integrating Health in All PoliciesVenice, 9th-14th, March 2008
General Information
There is a growing awareness today that many key health issues at the local, regional and national level cannot be solved by traditional approaches in medicine and public health alone. New research and innovative approaches to policy clearly show us that a person’s health is influenced by the conditions in which she or he lives and that a community’s health is influenced by programs and policies that often extend far beyond the health care sector. Social and economic conditions - such as poverty, social exclusion, unemployment, and poor housing - strongly influence health. They contribute to inequities in health, explaining why people living in poverty die sooner and get sick more often than those living in more privileged conditions. Addressing health’s social and economic determinants means reorienting efforts within the health sector, and working with other sectors including finance and education. To do this, health professionals require specialised knowledge, new skills and innovative tools. This course is organized by the University of Padua Medical School in collaboration with the Veneto Region, Yale/WHO Collaborating Centre (US), Bradford University (UK), the Medical University of Graz (Austria) and the WHO European Office for Investment for Health and Development (Venice) and aims to provide an evidence-based, systematic and accountable approach to the full integration of social and economic determinants of health into development strategies of countries in the WHO European Region. In particular, the three main objectives of the Course are:
1. To strengthen knowledge and understanding of social determinants of health;
2. To provide a solid grounding in the emerging field of investment for health;
3. To identify policies and strategies to reduce health inequities and reorient the efforts within the health sector.
TARGET AUDIENCE:
The course is intended for 20 professionals already working in public health and relevant public policy sectors. Applications will be accepted until all places have been filled. Five additional places are reserved for post-graduate students; a limited number of bursaries may be available.
VENUE:
SS. Giovanni e Paolo Hospital, Castello 6777 - Venice
FACULTY:
International experts from the Universities of Padua (Italy), Yale (US), Bradford (UK) and Graz (Austria), WHO Regional Office for Europe, WHO Headquarters Geneva, WHO Eastern Mediterranean Regional Office, Veneto Region.
WORKING LANGUAGE:
English
TEACHING METHOD:
The course will consist of lectures, workshops and group work. All participants will be asked to review material circulated in advance in preparation for the course take part in seminars, workshops, and interactive panel discussions.
COURSE FEE:
1.300 Euros (including: tuition, accommodation at the Domus Ciliota, situated in the heart of Venice's historical center, breakfast, coffee breaks, lunches, welcome reception, farewell reception, a resource pack including key readings).
CERTIFICATE:A certificate will be awarded to all participants who successfully complete the Course and participate fully in all seminars. CME Information on the credits will be provided as soon as available.

Hereditary Hemochromatosis Linked to Iron Overload Mainly in Men - in Public Health & Policy, Genetics from MedPage Today

Medical News: Hereditary Hemochromatosis Linked to Iron Overload Mainly in Men - in Public Health & Policy, Genetics from MedPage Today: "MELBOURNE, Australia, Jan 17 -- In hereditary hemochromatosis with HFE mutations, iron overload developed in a substantial proportion of men but in only a small number of women, according to researchers here. Action Points


Explain to interested patients that individuals, especially men, with mutations on the genes that control iron absorption have a greater risk of developing iron overload and, as a result, liver disease.
In a prospective study of 31,192 persons, iron-overload-related liver disease developed in 28% of men and 1% of women who were homozygous for C282Y, the HFE allele most commonly associated with hereditary hemochromatosis, found Katrina J. Allen, M.D., Ph.D., of the University of Melbourne, and colleagues.
Most persons who are homozygous for C282Y have elevated levels of serum ferritin and transferrin saturation reported, the researchers noted in the Jan. 17 issue of the New England Journal of Medicine. Diseases related to iron overload develop in some C282Y homozygotes, but the extent of the risk is debated."

U.S. Mortality Rate Hits Record Low in 2005 - in Infectious Disease, Public Health from MedPage Today

Medical News: U.S. Mortality Rate Hits Record Low in 2005 - in Infectious Disease, Public Health from MedPage Today: "HYATTSVILLE, Md., Jan. 17 -- The age-adjusted death rate in the U.S. reached an all-time low in 2005, according to the CDC's National Center for Health Statistics.
The rate dropped 0.2% to 798.8 per 100,000 population, the agency found. In 2004, the rate was 800.8 per 100,000, which had been the previous record low.
Life expectancy held steady at 77.8 years for the entire population, the report said. It increased by 0.1 year for the black population as a whole and by 0.2 years for black females."

2377 - AMICOR10 - 18/01/2008

2377 – AMICOR10 – 18/01/2008

Friday, January 18, 2008
Primary Health for All (Extended version): Scientific American
Thursday, January 17, 2008
Income inequality and mortality: a multilevel prospective study of 521 248 individuals in 50 US states
Labels: inequality, mortality
Management of Type 2 Diabetes
NEJM -- Management of Type 2 Diabetes: "Case Vignette
The Moral Instinct - New York Times

Drug Approved. Is Disease Real? - New York Times
By ALEX BERENSON
Calcium Supplements May Increase MI Risk in Healthy Older Women
Labels: Calcium, Myocardial Infarction
Tuesday, January 15, 2008
Happiness and Health
Labels: Population Health
ABEAD

The Global Challenge of Health Systems

Health, development, and equity—call for papers
Health, development, and equity—call for papers
Richard Horton, The Lancet, London, UKTikki Pang, WHO Geneva, SwitzerlandThe Lancet, Volume 371, Number 9607, 12 January 2008Website: http://www.thelancet.com/journals/lancet/article/PIIS0140673608600860/fulltext
2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction
Labels: CAD
2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention
Labels: PCI
Implementation of Bystander-Initiated Cardiopulmonary Resuscitation
Labels: cardiopulmonary resuscitation
Thursday, January 10, 2008
Outcomes in Athletes with Marked ECG Repolarization Abnormalities
Labels: ECG, exercise
Tuesday, January 08, 2008
Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study
Labels: mortality, risk factors
Low Vitamin D Plus Hypertension May Worsen Cardiovascular Risks - in Cardiovascular, Myocardial Infarction from
Saturday, January 05, 2008
Edge http://www.edge.org/3rd_culture/bios/norretranders.html

Primary Health for All (Extended version): Scientific American

Primary Health for All (Extended version): Scientific American: "Primary Health for All (Extended version)
Ten key actions could globally ensure a basic human right at almost unnoticeable cost
By Jeffrey D. Sachs

recent UNICEF report on child mortality provides some harrowing data combined with some startling hope. The shock is that 9.7 million children under the age of five years died in 2006. The good news in this bleak statistic is that it is actually down from 12.7 million in 1990, out of populations of roughly 630 million children under age five in both years. The even better news is that the remaining nearly 10 million deaths are themselves almost totally avoidable, at low cost, and in a way which will ease rather than exacerbate the population pressures of poor countries.
Almost all of the deaths (roughly 98 percent) occur in the developing countries. These are deaths, in effect, of extreme poverty and the under-provisioning of health systems in poor countries. The causes of death reflect the unsafe living conditions of the poor (such as vulnerability to tropical diseases, unsafe drinking water, and indoor air pollution) and the lack of access to preventative and curative health services. The main contributors to the high death rates are deaths that occur in the first 28 days after birth, caused by diarrhea (from unsafe drinking water), respiratory infection (often caused by wood-burning stoves), malaria, and vaccine-preventable diseases. It is estimated that around half of all deaths have chronic under-nourishment as a co-factor."/.../

Income inequality and mortality: a multilevel prospective study of 521 248 individuals in 50 US states

Background Some of the most consistent evidence in favour of an association between income inequality and health has been among US states. However, in multilevel studies of mortality, only two out of five studies have reported a positive relationship with income inequality after adjustment for the compositional characteristics of the state's inhabitants. In this study, we attempt to clarify these mixed results by analysing the relationship within age–sex groups and by applying a previously unused analytical method to a database that contains more deaths than any multilevel study to date.
Methods The US National Longitudinal Mortality Study (NLMS) was used to model the relationship between income inequality in US states and mortality using both a novel and previously used methodologies that fall into the general framework of multilevel regression. We adjust age–sex specific models for nine socioeconomic and demographic variables at the individual level and percentage black and region at the state level.
Results The preponderance of evidence from this study suggests that 1990 state-level income inequality is associated with a 40% differential in state level mortality rates (95% CI = 26–56%) for men 25–64 years and a 14% (95% CI = 3–27%) differential for women 25–64 years after adjustment for compositional factors. No such relationship was found for men or women over 65.
Conlcusions The relationship between income inequality and mortality is only robust to adjustment for compositional factors in men and women under 65. This explains why income inequality is not a major driver of mortality trends in the United States because most deaths occur at ages 65 and over. This analysis does suggest, however, the certain causes of death that occur primarily in the population under 65 may be associated with income inequality. Comparison of analytical techniques also suggests coefficients for income inequality in previous multilevel mortality studies may be biased, but further research is needed to provide a definitive answer. /.../

Management of Type 2 Diabetes

NEJM -- Management of Type 2 Diabetes: "Case Vignette
A 55-year-old woman with type 2 diabetes, obesity, and hypertension has been under your care for the past 2 years. She has no history of microalbuminuria, retinopathy, or neuropathy. She has never had a cardiovascular event and reports no cardiac symptoms.
In the past, she has successfully lost weight (from 5 to 12 kg) on various diets but each time has regained all of the weight she lost. She tries to walk 30 minutes each day. She monitors her fasting glucose levels three times weekly using a personal glucometer, and her morning fasting glucose levels have ranged between 110 and 140 mg per deciliter (6.1 and 7.8 mmol liter). She has been receiving metformin (1000 mg twice a day) and glipizide (10 mg twice daily).
She has hypertension that is treated with hydrochlorothiazide (25 mg daily) and lisinopril (20 mg daily). She takes aspirin (81 mg daily) and simvastatin (20 mg daily). She notes that she consistently takes her medications."/.../

The Moral Instinct - New York Times

The Moral Instinct - New York Times: "Which of the following people would you say is the most admirable: Mother Teresa, Bill Gates or Norman Borlaug? And which do you think is the least admirable? For most people, it’s an easy question. Mother Teresa, famous for ministering to the poor in Calcutta, has been beatified by the Vatican, awarded the Nobel Peace Prize and ranked in an American poll as the most admired person of the 20th century. Bill Gates, infamous for giving us the Microsoft dancing paper clip and the blue screen of death, has been decapitated in effigy in “I Hate Gates” Web sites and hit with a pie in the face. As for Norman Borlaug . . . who the heck is Norman Borlaug?"/.../

Drug Approved. Is Disease Real? - New York Times

Drug Approved. Is Disease Real? - New York Times: "Drug Approved. Is Disease Real?
By ALEX BERENSON
Fibromyalgia is a real disease. Or so says Pfizer in a new television advertising campaign for Lyrica, the first medicine approved to treat the pain condition, whose very existence is questioned by some doctors.
For patient advocacy groups and doctors who specialize in fibromyalgia, the Lyrica approval is a milestone. They say they hope Lyrica and two other drugs that may be approved this year will legitimize fibromyalgia, just as Prozac brought depression into the mainstream.
But other doctors — including the one who wrote the 1990 paper that defined fibromyalgia but who has since changed his mind — say that the disease does not exist and that Lyrica and the other drugs will be taken by millions of people who do not need them.
As diagnosed, fibromyalgia primarily affects middle-aged women and is characterized by chronic, widespread pain of unknown origin. Many of its sufferers are afflicted by other similarly nebulous conditions, like irritable bowel syndrome."/.../

Calcium Supplements May Increase MI Risk in Healthy Older Women

Auckland, New Zealand, Jan 16 -- Healthy older women taking high-dose calcium supplements had a significantly increased risk of myocardial infarction, investigators here found.
Action Points --->
Explain that the findings of MI risk for older women taking high doses of calcium (one gram a day) are not definitive and should be balanced against the benefits for bone health.
MI was twice as common in women taking one gram of elemental calcium daily than in those taking a placebo, Ian R. Reid, M.D., of the University of Auckland, and colleagues reported online in BMJ.
However, the researchers cautioned, this potentially detrimental effect should be balanced against the likely benefits of calcium on bone.
These findings do not permit definitive conclusions but do flag cardiac health as an area of concern in relation to calcium use, the investigators wrote.
Evidence has suggested that high calcium intake might protect against vascular disease by increasing the ratio of HDL to LDL cholesterol. However, the researchers said, evidence from controlled trials supporting this theory is lacking.

Happiness and Health

Happiness And Health: Lessons—And Questions—For Public PolicyCarol Graham
PROLOGUE: Throughout the centuries, human happiness and its causes have been a central concern to clerics, philosophers, psychologists, and therapists of various kinds. Given the subject matter, some might be surprised to see economists dipping their toes into these waters, viewing them as Johnny-come-latelys or even as gatecrashers—economics, after all, is sometimes known as the "dismal science." But economists have their own rich tradition in this area, and their discipline is, in fact, rooted in "moral science," in which happiness plays a central role. Moreover, as "queen of the social sciences," economics brings with it insights from myriad aspects of social life and a vast array of mathematical tools for exploring relationships between self-reported happiness and just about anything else one can think of.
By bringing economic and psychological principles to bear, "happiness economists" have produced a substantial body of evidence that health is a consistent determinant of self-reported happiness—one that transcends national boundaries, belief systems, and the highly subjective nature of happiness. The fruits of their labors include "happiness equations," in which health is among the handful of measurable variables that account for observed variability in human happiness. Even more compelling, Carol Graham informs us, is the observation that health correlates more strongly with happiness than any other variable included—even income—in countries throughout the world. Happiness surveys, Graham shows us, are powerful tools that members of the health policy community can use to gain fresh perspectives on the public’s health behavior and to develop policy worldwide.
Graham (mailto:cgraham@brookings.edu is a senior fellow in the Economic Studies Program at the Brookings Institution, in Washington, D.C., and a professor of public policy at the University of Maryland in College Park. Her book (coauthored with Stefano Pettinato) Happiness and Hardship: Opportunity and Insecurity in New Market Economies was published by Brookings in 2002.

ABEAD

ABEAD

:: Editorial
Caros Associados,
Começamos mais um ano de atividades, estudos e, principalmente, ações em prol da redução do consumo do álcool, tabaco e outras drogas. Sempre com o intuito de se aproximar cada vez mais de seus associados, seguimos com o envio dos boletins regulares, um importante meio de conhecimento e atualização.
O ano de 2008 é muito importante para nós. Em virtude dos 30 anos desta Associação, realizaremos em setembro próximo uma edição especial do já conceituado congresso anual da Abead, com direito a festejos diversos para comemorar o aniversário. Para o evento alcançar o sucesso almejado, a participação de todos é fundamental. Também destacamos a atualização do cadastro do nosso quadro associativo. É muito importante que todos os associados informem seus dados e contatos para o recebimento de correspondências (jornais, suplementos, malas diretas de congressos, etc). Como sempre, disponibilizaremos apenas as informações que você permitir.
Um ótimo ano para todos e boa leitura!
Analice Gigliotti
Para associar-se clique aquiSe você já é sócio e deseja atualizar seu cadastro, clique aqui
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The Global Challenge of Health Systems

De: Ruggiero, Mrs. Ana Lucia (WDC) Para: EQUIDAD@LISTSERV.PAHO.ORG The Global Challenge of Health Systems - Summary of Pocantico Discussions Pocantico II - New York, USA - September 20–21, 2007 The Rockefeller Foundation Available online as PDF file [50p.] at: http://www.rockfound.org/library/0907pocantico_brochure.pdf

Health, development, and equity—call for papers

Health, development, and equity—call for papers

Richard Horton, The Lancet, London, UK
Tikki Pang, WHO Geneva, Switzerland
The Lancet, Volume 371, Number 9607, 12 January 2008

Website: http://www.thelancet.com/journals/lancet/article/PIIS0140673608600860/fulltext

“……..Research can lead to more cost-effective interventions, better delivery strategies, improved management practices, rational health-system policies, and optimum ways to increase health-seeking behaviour. Research is essential to ensure that new strategies are adapted to fit local political, cultural, and economic contexts. Ultimately, the only truly sustainable way to improve health outcomes is to build local research and innovation capacity so that developing countries can continually improve the effectiveness, equity, and efficiency of their own health systems.4

To address these issues, a Global Ministerial Forum on Research for Health will be held in Bamako, Mali, Nov 17–19, 2008, that will convene ministers of health, science, and technology, to discuss research and innovation with leading experts and stakeholders in the research process from around the world.

The theme “research for health” reflects a desire to link discussions on health research with the broader science and technology community, especially research on education, water, the environment, food, and agriculture sectors. Health goals cannot be seen in isolation: reducing poverty and increasing education and gender equity are tied to good health, better nutrition, and clean water.

Research on social determinants of health, new directions in e-health, implementation research and participatory research will be explored through panel discussions and debates, round-tables for in-depth participation, and networking to catalyse more effective national, regional, and global efforts in research for health.

Six partners have come together to organise the Bamako 2008 Forum: the Council on Health Research for Development, Global Forum for Health Research, Government of Mali, UNESCO, World Bank, and WHO.

The Lancet plans to produce a theme issue on research for health, development, and equity, and is inviting papers that address the core themes of the conference, which include:

Strengthening of leadership for health, development, and equity—empowering governments to develop structured and prioritised policies for research for health as part of their broader research strategies and to improve systems capacities for the implementation of those policies; and enhancing international collaboration to address global and national health-research challenges

Engagement of all relevant constituencies in research and innovation for health—ensuring inclusion of public and private actors, different sectors and disciplines, civil society, and local, national, and international organisations in both the content and process of such research in a coherent and coordinated manner to improve the governance of global health research

Increased accountability of research systems—measure outcomes and assess the impact of research for health, monitor initiatives and partnerships involved in research for health, and earn public confidence by setting standards for fair, transparent, and equitable research processes

Manuscripts should be submitted online: http://ees.elsevier.com/thelancet to The Lancet by June 2, 2008. In your covering note, please state that your submission is in response to this call for papers. The bulk of manuscripts should follow the usual journal format for original research papers, but can also include case studies and other less research-oriented submissions.

We will serve as co-editors of this themed issue in collaboration with the Steering Committee for the Bamako 2008 Global Ministerial Forum on Research for Health…..”

2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction

2007 Focused Update of the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction

A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the Canadian Cardiovascular Society Endorsed by the American Academy of Family Physicians: 2007 Writing Group to Review New Evidence and Update the ACC/AHA 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, Writing on Behalf of the 2004 Writing Committee

Elliott M. Antman, MD, FACC, FAHA, Co-Chair

A primary challenge in the development of clinical practice guidelines is keeping pace with the stream of new data upon which recommendations are based. In an effort to respond more quickly to new evidence, the American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines has created a new "focused update" process to revise the existing guideline recommendations that are affected by evolving data or opinion. Before the initiation of this focused approach, periodic updates and revisions of existing guidelines required up to 3 years to complete. Now, however, new evidence will be reviewed in an ongoing fashion to more efficiently respond to important science and treatment trends that could have a major impact on patient outcomes and quality of care. Evidence will be reviewed at least twice a year, and updates will be initiated on an as needed basis as quickly as possible, while maintaining the rigorous methodology that the ACC and AHA have developed during their more than 20 years of partnership.

These updated guideline recommendations reflect a consensus of expert opinion following a thorough review that consisted primarily of late-breaking clinical trials identified through a broad-based vetting process as important to the relevant patient population and of other new data deemed to have an impact on patient care (see Section 1.1 for details on this focused update). It is important to note that this focused update is not intended to represent an update based on a full literature review from the date of the previous guideline publication. Specific criteria/considerations for inclusion of new data include:

2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention

2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention

A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 Writing Group to Review New Evidence and Update the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention, Writing on Behalf of the 2005 Writing Committee

Spencer B. King, III, MD, MACC, FAHA, FSCAI, Co-Chair^{* et al.}

A primary challenge in the development of clinical practice guidelines is keeping pace with the stream of new data upon which recommendations are based. In an effort to respond more quickly to new evidence, the American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Practice Guidelines has created a new "focused update" process to revise the existing guideline recommendations that are affected by evolving data or opinion. Before the initiation of this focused approach, periodic updates and revisions of existing guidelines required up to 3 years to complete. Now, however, new evidence will be reviewed in an ongoing fashion to more efficiently respond to important science and treatment trends that could have a major impact on patient outcomes and quality of care. Evidence will be reviewed at least twice a year, and updates will be initiated on an as needed basis as quickly as possible while maintaining the rigorous methodology that the ACC and AHA have developed during their more than 20 years of partnership.

Implementation of Bystander-Initiated Cardiopulmonary Resuscitation

Reducing Barriers for Implementation of Bystander-Initiated Cardiopulmonary Resuscitation. A Scientific Statement From the American Heart Association for Healthcare Providers, Policymakers, and Community Leaders Regarding the Effectiveness of Cardiopulmonary Resuscitation

Benjamin S. Abella MD, MPhil, Tom P. Aufderheide MD, FAHA, Brian Eigel PhD, Robert W. Hickey MD, FAHA, W. T. Longstreth Jr MD, FAHA, Vinay Nadkarni MD, FAHA, Graham Nichol MD, FAHA, Michael R. Sayre MD, Claire E. Sommargren RN, PhD, FAHA, and Mary Fran Hazinski RN, MSN, FAHA

Key words: AHA Scientific Statement • cardiopulmonary resuscitation • resuscitation • heart arrest • defibrillation

Outcomes in Athletes with Marked ECG Repolarization Abnormalities

Antonio Pelliccia, M.D., Fernando M. Di Paolo, M.D., Filippo M. Quattrini, M.D., Cristina Basso, M.D., Franco Culasso, Ph.D., Gloria Popoli, M.D., Rosanna De Luca, M.D., Antonio Spataro, M.D., Alessandro Biffi, M.D., Gaetano Thiene, M.D., and Barry J. Maron, M.D.
Background Young, trained athletes may have abnormal 12-lead electrocardiograms (ECGs) without evidence of structural cardiac disease. Whether such ECG patterns represent the initial expression of underlying cardiac disease with potential long-term adverse consequences remains unresolved. We assessed long-term clinical outcomes in athletes with ECGs characterized by marked repolarization abnormalities.
Methods From a database of 12,550 trained athletes, we identified 81 with diffusely distributed and deeply inverted T waves (2 mm in at least three leads) who had no apparent cardiac disease and who had undergone serial clinical, ECG, and echocardiographic studies for a mean (±SD) of 9±7 years (range, 1 to 27). Comparisons were made with 229 matched control athletes with normal ECGs from the same database.
Results Of the 81 athletes with abnormal ECGs, 5 (6%) ultimately proved to have cardiomyopathies, including one who died suddenly at the age of 24 years from clinically undetected arrhythmogenic right ventricular cardiomyopathy. Of the 80 surviving athletes, clinical and phenotypic features of hypertrophic cardiomyopathy developed in 3 after 12±5 years (at the ages of 27, 32, and 50 years), including 1 who had an aborted cardiac arrest. The fifth athlete demonstrated dilated cardiomyopathy after 9 years of follow-up. In contrast, none of the 229 athletes with normal ECGs had a cardiac event or received a diagnosis of cardiomyopathy 9±3 years after initial evaluation (P=0.001).
Conclusions Markedly abnormal ECGs in young and apparently healthy athletes may represent the initial expression of underlying cardiomyopathies that may not be evident until many years later and that may ultimately be associated with adverse outcomes. Athletes with such ECG patterns merit continued clinical surveillance.

Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study

Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study
Kay-Tee Khaw, Nicholas Wareham, Sheila Bingham, Ailsa Welch, Robert Luben, Nicholas Day
1 Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom, 2 Medical Research Council, Epidemiology Unit, Cambridge, United Kingdom, 3 Medical Research Council, Dunn Nutrition Unit, Cambridge, United Kingdom
Background
There is overwhelming evidence that behavioural factors influence health, but their combined impact on the general population is less well documented. We aimed to quantify the potential combined impact of four health behaviours on mortality in men and women living in the general community.

Low Vitamin D Plus Hypertension May Worsen Cardiovascular Risks - in Cardiovascular, Myocardial Infarction from MedPage Today

Medical News: Low Vitamin D Plus Hypertension May Worsen Cardiovascular Risks - in Cardiovascular, Myocardial Infarction from MedPage Today:
"By John Gever, Staff Writer, MedPage Today
Published: January 07, 2008
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
Thomas J. Wang, M.D., Massachusetts General Hospital

BOSTON, Jan. 7 -- Moderate vitamin D deficiency nearly doubles the risk of myocardial infarction, stroke, and heart failure over a mean of 5.4 years in patients with high blood pressure, researchers here said.
The finding emerged from the Framingham Heart Study, which now includes the adult offspring of the study's original participants."/.../

Edge

Referência descoberta pela Dra. Maria Inês Reinert Azambuja
http://www.edge.org/3rd_culture/bios/norretranders.html
Edge: "The Edge Annual Question — 2008
When thinking changes your mind, that's philosophy.
When God changes your mind, that's faith.
When facts change your mind, that's science.
WHAT HAVE YOU CHANGED YOUR MIND ABOUT? WHY?
Science is based on evidence. What happens when the data change? How have scientific findings or arguments changed your mind?'
164 contributors; 111,530 words"

2376 – AMICOR10 – 04/01/2008 – FELIZ ANO NOVO/HAPPY NEW YEAR.

Friday, January 04, 2008

Doctor's Guide Weekly News - Cardiology.

e-newsletter designed to help you quickly and easily stay abreast of the latest Cardiology news

 

Mayo Clinic Risk Score for Percutaneous Coronary Intervention

Mayo Clinic Risk Score for Percutaneous Coronary Intervention Predicts In-Hospital Mortality in Patients Undergoing Coronary Artery Bypass Graft Surgery

Labels: CAD, Risk score

Perinatal Risk Factors for Ischemic Heart Disease. Disentangling the Roles of Birth Weight and Preterm Birth

Labels: CAD, Perinatal risk

GLOBALink - The International Tobacco Control Community

GLOBALink - The International Tobacco Control Community: "This is the Public site of GLOBALink,

Top Tobacco News
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CVD Calendar - ProCOR

ProCOR - Home Page: "ProCOR's CVD Calendar compiles events taking place globally that are relevant to the prevention of cardiovascular disease in developing countries.
To submit information about an event to the calendar, email details to info@procor.org.

CVD Calendar
• 2008
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Physicians Commonly Use Placebos to Placate Patients

By Michael Smith, North American Correspondent, MedPage Today

Labels: Placebo

Tuesday, January 01, 2008

AMEDEO, The Medical Literature Guide - Scientific Information in Medicine

AMEDEO, The Medical Literature Guide - Scientific Information in Medicine:

Monday, December 31, 2007

CT scans implicated in 2% of cancers ... American Medical News

AMNews: Jan. 7, 2008. CT scans implicated in 2% of cancers ... American Medical News:

 

Health Promotion

What makes us healthy?
Good health includes our physical, mental and social well-being.
In this section, you can explore:
What determines health (such as health habits, income, environment)
Health promotion strategies and tools to help improve health.
By understanding what influences our health, we can take action for ourselves and for our communities.
Throughout CHN, you will find information on health promotion and the determinants of health for specific groups, topics or diseases.

Labels: Health Promotion

Doctor's Guide Weekly News - Cardiology.

Dear Doctor:
Welcome to Doctor's Guide Weekly Cardiology edition, the e-newsletter designed to help you quickly and easily stay abreast of the latest Cardiology news! Doctor's Guide Weekly delivers the top news most read by your colleagues including:
The most relevant clinical papers from 2,000+ peer-reviewed journals
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Key scientific developments from over 120 medical conferences annually Please accept this free subscription with our compliments. We are confident that you will find Doctor's Guide Weekly to be an invaluable tool in "Keeping you up to date...Always".
Best regards, Doctor's Guide Weekly Publishing Team
TOP READ in the past 7 daysNew oral anticoagulants in atrial fibrillationThis paper reviews the mechanism of platelet inhibition and vitamin K antagonism in the prevention of stroke among patients with atrial fibrillation, the possible adverse pharmacological effects of these agents, the targets for novel anticoagulants, and the new agents in various stages of clinical development...Full Story

Most read Cardiology news in the past 7 daysPapers and articles, pertaining to Cardiology, most read by your colleagues in the past 7 days
The clinical reality of guidelines for primary prevention of cardiovascular disease in type 2 diabetes in Italy (Atherosclerosis)
N-acetylcysteine for prevention of acute renal failure in patients with chronic renal insufficiency undergoing cardiac surgery: A prospective, randomized, clinical trial* (Crit Care Med)
Curing atrial fibrillation: Two decades of progress (J Interv Card Electrophysiol)
Management of ST-segment elevation myocardial infarction in EDs (Am J Emerg Med)
Less increase of BNP and NT-proBNP levels in obese patient with decompensated heart failure Interpretation of natriuretic peptides in obesity (Int J Cardiol)
Endovenous 980-nm laser treatment of saphenous veins in a series of 500 patients (J Vasc Surg)
From 'optimal' to 'borderline' blood pressure in subjects under chronic antihypertensive therapy (J Hypertens)
Paraoxonase (PON1) is associated with familial combined hyperlipidemia (Atherosclerosis)
Effectiveness and tolerability of administration of granulocyte colony-stimulating factor on left ventricular function in patients with myocardial infarction: A meta-analysis of randomized controlled trials (Clin Ther)
Long-term survival in patients older than 80 years hospitalised for heart failure. A 5-year prospective study (Eur J Heart Failure)

Mayo Clinic Risk Score for Percutaneous Coronary Intervention

Mayo Clinic Risk Score for Percutaneous Coronary Intervention Predicts In-Hospital Mortality in Patients Undergoing Coronary Artery Bypass Graft Surgery Mandeep Singh MD, MPH*, Bernard J. Gersh MB, ChB, Shuang Li MS, John S. Rumsfeld MD, John A. Spertus MD, MPH, Sean M. O’Brien PhD, Rakesh M. Suri MD, DPhil, and Eric D. Peterson MD, MPH
From the Division of Cardiovascular Diseases (M.S., B.J.G., R.M.S.), Mayo Clinic, Rochester, Minn; Duke Clinical Research Institute (S.L., S.M.O., E.D.P.), Durham, NC; Mid America Heart Institute/UMKC (J.A.S.), Kansas City, Mo; and Denver V A Medical Center (J.S.R.), Denver, Colo.
Background—Current risk models predict in-hospital mortality after either coronary artery bypass graft surgery or percutaneous coronary interventions separately, yet the overlap suggests that the same variables can define the risks of alternative coronary reperfusion therapies. Our goal was to seek a preprocedure risk model that can predict in-hospital mortality after either percutaneous coronary intervention or coronary artery bypass graft surgery.
Methods and Results—We tested the ability of the recently validated, integer-based Mayo Clinic Risk Score (MCRS) for percutaneous coronary intervention, which is based solely on preprocedure variables (age, creatinine, ejection fraction, myocardial infarction 24 hours, shock, congestive heart failure, and peripheral vascular disease), to predict in-hospital mortality among 370 793 patients in the Society of Thoracic Surgeons database undergoing isolated coronary artery bypass graft surgery from 2004 to 2006. For the Society of Thoracic Surgeons coronary artery bypass graft surgery population studied, the median age was 66 years (quartiles 1 to 3, 57 to 74 years), with 37.2% of patients 70 years old. A high prevalence of comorbid conditions, including diabetes mellitus (37.1%), hypertension (80.5%), peripheral vascular disease (15.3%), and renal disease (creatinine 1.4 mg/dL; 11.8%), was present. A strong association existed between the MCRS and the observed mortality in the Society of Thoracic Surgeons database. The in-hospital mortality ranged between 0.3% (95% confidence interval 0.3% to 0.4%) with a score of 0 on the MCRS and 33.8% (95% confidence interval 27.3% to 40.3%) with an MCRS score of 20 to 24. The discriminatory ability of the MCRS was moderate, as measured by the area under the receiver operating characteristic curve (C-statistic=0.715 to 0.784 among various subgroups); performance was inferior to the Society of Thoracic Surgeons model for most categories tested.
Conclusions—This model, which is based on 7 preprocedure risk variables, may be useful for providing patients with individualized, evidence-based estimates of procedural risk as part of the informed consent process before percutaneous or surgical revascularization.

Perinatal Risk Factors for Ischemic Heart Disease. Disentangling the Roles of Birth Weight and Preterm Birth

Perinatal Risk Factors for Ischemic Heart Disease. Disentangling the Roles of Birth Weight and Preterm Birth Magnus Kaijser MD, PhD*, Anna-Karin Edstedt Bonamy MD, Olof Akre MD, PhD, Sven Cnattingius MD, PhD, Fredrik Granath PhD, Mikael Norman MD, PhD, and Anders Ekbom MD, PhD
From the Clinical Epidemiology Unit, Department of Medicine (M.K., O.A., F.G., A.E.), Department of Woman and Child Health (A.-K.E.B.), Department of Medical Epidemiology and Biostatistics (S.C.), and Department of Clinical Science, Intervention, and Technology (M.N.), and Department of Clinical Sciences at Danderyds Hospital (M.K.), Karolinska Institutet, Stockholm, Sweden.
* To whom correspondence should be addressed. E-mail: magnus.kaijser@ki.se
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.
Background—Several studies have reported an association between low birth weight and ischemic heart disease, but it remains unclear whether the association is mediated through poor fetal growth or short gestational duration.
Methods and Results—In a cohort study, we have identified all subjects born preterm or with a low birth weight at 4 major delivery units in Sweden from 1925 through 1949. For comparison, an equal number of subjects with none of these criteria were identified within the same source population. The study population consists of 6425 subjects, of whom 2931 were born before 37 weeks of gestation and 2176 had a birth weight <2500 g. Fetal growth was estimated through birth weight for gestational age. The cohort was followed up for occurrence of ischemic heart disease through the nationwide Hospital Discharge and Cause of Death Registries during the period of 1987 through 2002. In the cohort, 617 cases of ischemic heart disease occurred. Compared with subjects with a normal fetal growth, those born small for gestational age (birth weight -2 SD below the mean) were at increased risk of ischemic heart disease (adjusted hazard ratio, 1.64; 95% confidence interval, 1.23 to 2.18). The negative association between fetal growth and risk of ischemic heart disease was independent of gestational duration.
Conclusions—The association between low birth weight and adult risk of ischemic heart disease appears to be mediated entirely by poor fetal growth.

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CVD Calendar - ProCOR

ProCOR - Home Page: "ProCOR's CVD Calendar compiles events taking place globally that are relevant to the prevention of cardiovascular disease in developing countries.
To submit information about an event to the calendar, email details to info@procor.org.


CVD Calendar
• 2008
• 2009
• 2010
• Additional Event Resources

Physicians Commonly Use Placebos to Placate Patients

By Michael Smith, North American Correspondent, MedPage Today
Published: January 03, 2008
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.
Key findings:

45% reported they had used a placebo in clinical practice.
Among those, the most common practice -- at 33% -- was prescribing antibiotics for viral or other nonbacterial diagnoses.
20% had prescribed vitamins, 7% subtherapeutic doses of medication, and 5% herbal supplements, while only 2% had actually given prepared placebo tablets and only 1% had prescribed sugar or artificial sweetener pills.
The most common reasons given were to calm the patient and as supplemental treatment, at 18% each.
95% of respondents believed that placebos can have therapeutic effects, although 21% said it was rare, 58% said it happened sometimes, and 16% thought it occurred often.
68% agreed and 27% strongly agreed that "the placebo effect is real."
40% said placebos could benefit patients physiologically for certain health problems.
12% said that placebo use in routine medical care should be categorically prohibited.

AMEDEO, The Medical Literature Guide - Scientific Information in Medicine

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