Sunday, May 31, 2009

World No Tobacco Day 2009: Call to action

Today, 31 May 2009, is World No Tobacco Day. This year’s theme is “Tobacco health warnings.” Learn more at www.who.int/tobacco/wntd/2009.

Health warnings on tobacco packages that combine text and pictures are one of the most cost-effective ways to increase public awareness of the serious health risks of tobacco use and to reduce tobacco consumption.

A call to action
AMICOR joins ProCor and the World Health Organization in a call to action./.../

Thursday, May 28, 2009

US Tobacco Control

Policy Coherence in US Tobacco Control: Beyond FDA Regulation

Joshua S. Yang1, Thomas E. Novotny2*

1 Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California , United States of America, 2 Graduate School of Public Health, San Diego State University, San Diego, California, United States of America

Introduction Top

As the Obama administration moves to enact meaningful and comprehensive health care reform in the United States, tobacco control must be elevated as a public health priority [1]. Though tobacco control efforts have been recognized as a top public health achievement of the 20th century [2], tobacco use continues to be the leading preventable cause of death in the US [3]. As Box 1 shows, the US bears a heavy burden from the health and fiscal effects of smoking. Thus, continued progress in preventing tobacco use and promoting smoking cessation must be a leading priority for health care reform under the new administration. This policy paper gives the current status of tobacco control policies, initiatives, and legislative action at the time of going to press./.../

Wednesday, May 27, 2009

Ear Problem Common in Older Adults

Ear Problem Common in Older Adults

By Nancy Walsh, Contributing Writer, MedPage Today
Published: May 26, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine and
Dorothy Caputo, ,

RIDGEWOOD, N.J., May 26 -- Vestibular function is impaired in 35 percent of U.S. adults over 40 and can contribute to catastrophic outcomes such as falls, a new study found.
Action Points  
  • Explain to interested patients that their balance is affected by the correct functioning of their inner ear structures, and that this functioning declines as they age.


  • Also explain that this contributes significantly to their risk of falling and being seriously injured.

The condition affects approximately 69 million Americans, according Yuri Agrawal, M.D., and colleagues at Johns Hopkins, reporting in the May 25 Archives of Internal Medicine.

The odds of having vestibular dysfunction increased significantly with age, with an adjusted odds ratio of 22.7 for individuals age 80 and over (95% CI 16.8 to 30.7), compared with those ages 40 to 49, the researchers found. /.../

Tuesday, May 26, 2009

Percutaneous Closure of PFO for Secondary Stroke Prevention

(Circulation. 2009;119:2743-2747.)
© 2009 American Heart Association, Inc.


AHA/ASA/ACCF Science Advisory

Percutaneous Device Closure of Patent Foramen Ovale for Secondary Stroke Prevention

A Call for Completion of Randomized Clinical Trials: A Science Advisory From the American Heart Association/American Stroke Association and the American College of Cardiology Foundation The American Academy of Neurology affirms the value of this science advisory.

Patrick T. O'Gara, MD, FAHA, FACC, Chair; Steven R. Messe, MD, FAHA; E. Murat Tuzcu, MD, FAHA, FACC; Gloria Catha, BA; John C. Ring, MD, FACC

The optimal therapy for prevention of recurrent stroke or transient ischemic attack in patients with cryptogenic stroke and patent foramen ovale has not been defined. Although numerous observational studies have suggested a strong association between patent foramen ovale and cryptogenic stroke, a causal relationship has not been convincingly established for the majority of affected patients. Treatment choices include medical therapy with antiplatelet agents or vitamin K antagonists, percutaneous device closure, or open surgical repair. Whereas suture closure of an incidental patent foramen ovale is performed routinely during the course of an operation undertaken for another indication, primary surgical repair is rarely advocated in the current era. The choice between medical therapy and percutaneous device closure has been the subject of intense debate over the past several years, albeit one that has not been adequately informed by randomized, prospective clinical trial data to permit an objective comparison of the relative safety and efficacy of these respective approaches. Enrollment in clinical trials has lagged considerably despite frequent calls for participation from the US Food and Drug Administration and major professional societies. Completion and peer review of ongoing trials are critical steps to establish an evidence base from which clinicians can make informed decisions regarding the best therapy for individual patients. The present advisory strongly encourages all clinicians involved in the care of appropriate patients with cryptogenic stroke and patent foramen ovale—cardiologists, neurologists, internists, radiologists, and surgeons—to consider referral for enrollment in these landmark trials to expedite their completion and help resolve the uncertainty regarding optimal care for this condition.

Risk Factors for Heart Disease

Where are the psycho-social RF and the social determination of Health Disease??
Figure 1

The May 27, 2009, issue of JAMA includes an article about cardiovascular disease risk factors among National Football League players.

RISK FACTORS


  • Smoking
  • High blood pressure
  • A high level of low-density lipoprotein (LDL; bad cholesterol) especially when associated with a low level of high-density lipoprotein (HDL; good cholesterol)
  • High levels of triglycerides (another form of fat found in the bloodstream that can contribute to heart disease)
  • Diabetes
  • Overweight (body mass index [BMI] greater than 25) or obesity (BMI greater than 30)
  • Excessive alcohol use
  • Family history of premature death (before age 65) from heart disease 

World Health Statistics 2009

World Health Statistics 2009 report

World Health Statistics 2009


World Health Statistics 2009 contains WHO's annual compilation of data from its 193 Member States, and includes a summary of progress towards the health-related Millennium Development Goals and targets.

This edition also contains a new section on reported cases of selected infectious diseases.

:: Progress on the health-related Millennium Development Goals (MDGs)
Fact sheet N°290

DOWNLOAD THE FULL REPORT

Available in 6 languages

Arabic [pdf 9.35Mb] | Chinese [pdf 6.85Mb] | English [pdf 6.05Mb] | French | Russian [pdf 7.85Mb] | Spanish

Friday, May 22, 2009

Diabetes—a global threat

Editorial
The Lancet, Volume 373, Issue 9677, Page 1735, 23 May 2009  doi:10.1016/S0140-6736(09)60954-5

Diabetes—a global threat

This week The Lancet is publishing a special issue dedicated to diabetes—one of the greatest contributors to the global burden of disease. This themed issue, published in advance of the American Diabetes Association's scientific sessions in New Orleans on June 5—9, focuses on some of the major causes and most devastating complications of diabetes./.../
http://www.procor.org/globaldialogue/globaldialogue_show.htm?doc_id=921751

Wednesday, May 20, 2009

Digital Disease Detection


Volume 360:2153-2157 May 21, 2009 Number 21
The New England Journal of Medicine



Harnessing the Web for Public Health Surveillance
John S. Brownstein, Ph.D., Clark C. Freifeld, B.S., and Lawrence C. Madoff, M.D.

The Internet has become a critical medium for clinicians, public health practitioners, and laypeople seeking health information. Data about diseases and outbreaks are disseminated not only through online announcements by government agencies but also through informal channels, ranging from press reports to blogs to chat rooms to analyses of Web searches (see Digital Resources for Disease Detection). Collectively, these sources provide a view of global health that is fundamentally different from that yielded by the disease reporting of the traditional public health infrastructure.1

Over the past 15 years, Internet technology has become integral to public health surveillance. Systems using informal electronicinformation have been credited with reducing the time to recognition of an outbreak, preventing governments from suppressing outbreak information, and facilitating public health responses to outbreaks and emerging diseases. Because Web-based sources frequently contain data not captured through traditional government communication channels, they are useful to public health agencies, including the Global Outbreak Alert and Response Network of the World Health Organization (WHO), which relies on such sources for daily surveillance activities./.../

VIDEOS IN CLINICAL MEDICINE

Videos in Clinical Medicine have been published on this Web site since April 13, 2006. For more information, see the editorial, Videos in Clinical Medicine — A New Journal Feature.

Este e muitos outros Videos úteis para o treinamento e/ou atualização de conceitos e técnicas.

Rotating Graphic

Blood-Pressure Measurement

Evaluation of blood pressure is used in assessing cardiovascular health, in screening for hypertension, and in monitoring the effectiveness of treatment. This video demonstrates the appropriate technique for the indirect measurement of blood pressure in adults.

Williams JS, Brown SM, Conlin PR. N Engl J Med 2009;360:e6, January 29, 2009.

Tuesday, May 19, 2009

"Declare Global economic downturn a health emergency!”

“Declare Global economic downturn a health emergency!”


Economic Recession“Economic Recession is a threat to the World’s Health”

The People’s Health Movement urges the World Health Organization and member governments to “declare the economic recession currently gripping the globe as a health emergency”.

Health activists gathered here in Geneva for the World Health Assembly (18-22 May) are expected to lobby the UN health body and governments to declare global downturn a health emergency./.../

Primary Care

“Passionate for Primary Health Care”, Dr. Mirta Roses Periago, PAHO


Dr. Mirta Roses Periago, Director, PAHO

Dr. Mirta Roses Periago, Director, PAHO

Dr. Mirta Roses Periago, Director of PAHO, the Pan American Health Organisation told us: I am passionately in favor of Primary Health Care because I believe we need to have in place well-functioning health systems!”

 

Q: Commenting on two opposite vision of PHC, a session moderator commented that Alma Ata's definition of PHC was that of ESSENTIAL health care for all, but many have redefined PHC as "PRIMITIVE health care". Would you care to comment?

Dr Mirta Roses Periago: I am passionately in favor of Primary Health Care because I believe we need to have in place well-functioning health systems that are:

  • Able to protect the population under any circumstances;
  • Resistant and resilient in the face of crises;
  • Capable of reacting rapidly and developing urgent strategies;
  • Skilled at rebuilding themselves as necessary to respond to current and future challenges arising from demographic and epidemiological changes./.../
  • Learning Device on Social Determinants

     
     
     

    Appropriate Use Criteria for Cardiac Radionuclide Imaging

    ACCF/ASNC/ACR/AHA/ASE/SCCT/SCMR/SNM 2009 Appropriate Use Criteria for
    Cardiac Radionuclide Imaging. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the American Society of Nuclear Cardiology, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the Society of Cardiovascular Computed Tomography, the Society for Cardiovascular Magnetic Resonance, and the Society of Nuclear Medicine
    Robert C. Hendel, Daniel S. Berman, Marcelo F. Di Carli, Paul A.
    Heidenreich, Robert E. Henkin, Patricia A. Pellikka, Gerald M. Pohost, and
    Kim A. Williams
    Circulation published 18 May 2009, 10.1161/CIRCULATIONAHA.109.192519
    http://circ.ahajournals.org/cgi/content/abstract/CIRCULATIONAHA.109.192519v1?papetoc

    Investigational Drug Offers Gentler Afib Remedy

    HRS: Investigational Drug Offers Gentler Afib Remedy

    By Peggy Peck, Executive Editor, MedPage Today
    Published: May 18, 2009
    Reviewed by Zalman S. Agus, MD; Emeritus Professor
    University of Pennsylvania School of Medicine.

    BOSTON, May 18 -- An investigational antiarrhythmic drug may be as effective as amiodarone for treatment of paroxymal atrial fibrillation, but less toxic, researchers here reported.
    Action Points  

    Patients who took 600 mg of budiodarone twice a day in a Phase II trial reduced atrial fibrillation burden by a median of 75.5% compared with placebo, according to Michael Ezekowitz, M.B. Ch.B., D.Phil., of Lankenau Institute for Medical Research in Wynnewood, Pa.

    Budiodarone is a chemical analogue of amiodarone with two important differences -- a shorter half-life and improved clearance mechanism, both of which appear to make the drug a softer, gentler amiodarone.

    Dr. Ezekowitz reported results of the trial, called PASCAL, at a late-breaking clinical trials plenary session at the annual meeting of the Heart Rhythm Society. /.../

    Sunday, May 17, 2009

    We have launched a new website:

    Nature, Emerging Infectious Diseases, WHO, Scientific American, New England Journal of Medicine, Science, FDA Drug Safety, CDC, Neurology, British Journal of Medicine (BMJ), Lancet, JAMA, Annals of Internal Medicine, ICU Rounds, Lancet Oncology, Johns Hopkins Medicines, American Heart Association, Lancet Infectious Diseases, Lancet Neurology, Nature Neuropod

    Best regards,
    Bernd Sebastian Kamps
    __________________________________________________________

    Senior Editor



    2419 - AMICOR 12

    Caríssimos AMICOR,
    Hoje dia 17 de maio, completamos os 12 anos de existência desta lista de comunicação via INTERNET.
    Mais uma vez desejo agradecer a companhia, o incentivo e o afeto de todos, em particular daqueles que se manifestaram: Ueli Gruenninger, Mário Becker, Luiz Maria Yordi e Alberto Ogata.
    A comunicação muito evoluiu nestes doze anos. Nos tentamos nos adaptar e manter o propósito inicial: o de expor aos colegas as referências e fontes mais relevantes pelas quais tenho navegado.
    Embora minha escolha de assuntos por sí pode já representar uma seleção de valores, sua discussão nunca foi uma característica manifestamente apreciada pelos AMICOR. Como fontes adicionais de referência e oportunidade para discussão recomendo dois outros endereços: ProCOR (inicitiva do Prof. Bernard Lown) e Doc2doc (do grupo British Medical Journal). Os links estão na coluna da direita, na entrada do Blog.
    Pretendo abrir uma página com as referências que mais frequentemente tenho utilizado para quem quiser visitar diretamente as fontes. Gostaria também de colocar numa página as linhas de pesquisa e a produção científica nas quais os AMICOR estão trabalhando, mas isto dependerá da informação que me for enviada.
    Estarei sempre a disposição para sugestões.
    Um abraço a todos.

    Dear AMICOR,
    Today, May 17, we are completing 12 years of this list of communication through INTERNET.
    Once more I wish to thank your company, suport and affection, in particular from those that sent me a message: Ueli Gruenninger, Mário Becker, Luiz Maria Yordi and Alberto Ogata.
    Communication have had a great evolution during these twelve years. Was our intention to be updated, mantaining the initial purpose to tell to colleagues the references and more relevant and reliable sources we found surfing in the INTERNET.
    Although my sellections per se may represent a definition of values, the discussion of these themes never was a characteristic appreciated by the AMICOR.
    As additional sources of reference and opportunity to exercise discussion I recomend two other addresses: ProCOR (Professor Bernard Lown initiatve) and Doc2doc (from the BMJ group). Both links are in the right column at the entrance of the Blog.
    Is my intention to open another page with the most commoun utilized references to whom like to go directly to the sources. I should like to opoen also another page with the research lines and scientific producion of the AMICOR, but this wil depend on the provided information.
    All king of suggestioons will be welcome.
    Sincerely
    AA

    World Hypertension Day 2009: from ProCOR

    [procor] World Hypertension Day 2009
    From: ProCor to Global
    12:58 AM (8 hours ago)

    Today, 17 May 2009, is World Hypertension Day. This year's theme is "Salt and high blood pressure: two silent killers."

    A modest reduction in population salt intake worldwide would result in a major improvement in public health. The World Health Organization and several countries around the world currently recommend reducing salt intake to six grams a day, which is equivalent to one teaspoon.

    A reduction in salt intake can be achieved by a gradual and sustained reduction in the amount of salt added to food by the food industry. World Action on Salt and Health (WASH, www.worldactiononsalt.com) is a global group working to reduce salt in the diet worldwide by exerting pressure on multi-national food companies to reduce the salt content of their products and by advocating for government policies on salt reduction. WASH membership has grown to 368 individuals from 80 countries./../
    Publications developed by the World Hypertension League to support local World Hypertension Day activities around the world can be downloaded at no charge at www.worldhypertensionleague.org/pages/WHD.aspx.
    Juan Ramos
    Program Coordinator, ProCor

    ASH: Birth Weight Link to Blood Pressure Grows Throughout Life

    ASH: Birth Weight Link to Blood Pressure Grows Throughout Life
    By Crystal Phend, Staff Writer, MedPage Today
    Published: May 08, 2009
    Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

    SAN FRANCISCO, May 8 -- The cardiovascular impact of low birth weight increases over a lifetime, according to a long-running, detailed observational study. Action Points
    --------------------------------------------------------------------------------

    The strength of the association between systolic blood pressure and birth weight increased from childhood to adolescence to adulthood (P<0.0001 for age-related trend), Gerald Berenson, M.D., of Tulane University in New Orleans, and colleagues reported here at the American Society of Hypertension meeting.

    These findings add to evidence linking low birth weight to higher blood pressure later in life and emphasize the importance of good maternal nutrition and not smoking during pregnancy -- factors linked to birth size -- they said.

    The results also suggest synergism between these intrauterine effects and environmental factors children are exposed to as they grow into adulthood, the researchers said.

    Although "you can't change your birth weight," there are things that can be done to interrupt the progression to high blood pressure, Dr. Berenson said.

    "We recommend low dose medication for young individuals tracking above the 90th percentile, exercise, and a nutritional diet for at-risk children, especially when obese," he said in a statement. /.../

    ASH: Common Genes Contribute to Blood Pressure Regulation

    • ASH: Hypertension: American Society of Hypertension Meeting
     

    ASH: Common Genes Contribute to Blood Pressure Regulation

    By Crystal Phend, Staff Writer, MedPage Today
    Published: May 10, 2009
    Reviewed by Zalman S. Agus, MD; Emeritus Professor
    University of Pennsylvania School of Medicine.


    Copy the code below to embed video on your website or blog:
    " name="embed_code">
    SAN FRANCISCO, May 10 -- Common genetic variants that help determine risk of hypertension and blood pressure levels in the population have been discovered.
    For the first time, genome-wide analyses revealed variants -- in 13 regions, nearly all previously unsuspected -- linked with systolic and diastolic blood pressure as well as hypertension.

    Odds ratios for hypertension associated with each of these variants ranged up to 1.16. But the researchers leading these studies cautioned that the findings would not be immediately useful for screening purposes.

    These findings from the combined efforts of two genetic research consortia were presented here at the American Society of Hypertension meeting and released online in two papers in Nature Genetics.

    Each study found eight significant gene regions, of which three overlapped, between meta-analysis and confirmatory genotyping analyses./.../

    ..............................

    He also noted that screening patients for a hypertension-risk genetic profile is unlikely to reach clinical practice any time soon. "Frankly, it may actually just be simpler to use a blood pressure cuff . . . since high-normal blood pressure is a risk factor for hypertension."

    Drs. Levy and Newton-Cheh reported no relevant conflicts of interest.

    Major funding for the consortia's work came from a large number of public and private organizations.
    *******************************
    Primary source: Nature Genetics
    Source reference:
    Newton-Cheh C, et al "Genome-wide association study identifies eight loci associated with blood pressure" Nat Genet 2009; DOI: 10.1038/ng.361.

    Additional source: Nature Genetics
    Source reference:
    Levy D, et al "Genome-wide association study of blood pressure and hypertension" Nat Genet 2009; DOI: 10.1038/ng.384. /.../

    Friday, May 15, 2009

    Fumo de terceira mão

    Todos nós conhecemos os inúmeros malefícios relacionados ao tabagismo ativo e passivo. Mais recentemente, foi criado um novo conceito relacionado ao tabagismo: o "fumo de terceira mão" (thirdhand smoke).

    Este termo refere-se à contaminação da fumaça dos derivados do tabaco que se prolonga nos ambientes, muito depois de alguém parar de fumar, permanecendo em nossas roupas depois que deixamos um restaurante, bar ou boate frequentados por fumantes.

    Joining Forces in Mortality and Longevity Conference


    Plenary Speakers
    Maria Azambuja
    Universidade Federal do Rio Grande do Sul, Brazil
    Proponent, in 1994, of an association between the 1918 Influenza and the 20th Century CHD pandemics. Studying cohort effects of influenza priming upon longevity

    A AMICOR Maria Inês foi convidada para participar da Conferência em Edinburgo.

    Mortalidade Precoce por Doenças Cardiovasculares e Desigualdades Sociais em Porto Alegre: da Evidência à Ação

    observapoa@observapoa.com.br

     



           Está disponível, entre v´rios outros estudos, no site do Observatório da Cidade de Porto Alegre, na seção Estudos e Pesquisas, o artigo “Mortalidade Precoce por Doenças Cardiovasculares e Desigualdades Sociais em Porto Alegre: da Evidência à Ação” de Sérgio Luiz Bassanesi, Maria Inês Azambuja, Aloyzio Achutti da Universidade Federal do Rio Grande do Sul, Academia Sul-Riograndense de Medicina. Para acessar diretamente o artigo, clique no link: http://www2.portoalegre.rs.gov.br/observatorio/default.php?p_secao=10

                   Equipe técnica
                   Observatório da Cidade de Porto Alebre
                   www.observapoa.com.br

    Wednesday, May 13, 2009

    Novel Agent Lowers BP Two Ways

     Novel Agent Lowers BP Two Ways

    By Crystal Phend, Staff Writer, MedPage Today
    Published: May 12, 2009
    Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

    SAN FRANCISCO, May 12 -- A novel agent that blocks both angiotensin and endothelin receptors may lower blood pressure with a single pill that works the way two antihypertensives do now, researchers found.
    Action Points  
    • Explain to interested patients that the dual-acting agent is not FDA approved for any indication.

    • Note that this study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

    At the highest, 800-mg dose, the single molecule compound reduced systolic pressure by 23.4 mm Hg over 12 weeks compared with a 10.7 mm Hg reduction by the angiotensin receptor blocker irbesartan (Avapro, P<0.003).>

    Monday, May 11, 2009

    Return of the J-curve: TNT analysis shows that BP can be too low in CAD patients

    Return of the J-curve: TNT analysis shows that BP can be too low in CAD patients
    May 8, 2009 | Michael O'Riordan

    San Francisco, CA - An analysis of one of the major "lower-is-better" cholesterol trials has shown that lower might not be best when it comes to blood pressure. In fact, in this group of patients with coronary artery disease, despite substantial lowering of LDL-cholesterol levels, a J-curve relationship exists between systolic and diastolic blood pressure and cardiovascular events.

    "It stands to reason that when you lower blood pressure too much, you can do harm," said study investigator Dr Franz Messerli (St Luke's-Roosevelt Hospital, New York). "After all, if blood pressure is zero, mortality is 100%. So somewhere there must be a nadir, below which the lowering of blood pressure becomes counterproductive."

    The findings, from an analysis of the Treating to New Targets (TNT) study, were presented here yesterday at the American Society of Hypertension 2009 Scientific Meeting in San Francisco, CA./.../

    African tribe colonized world 70,000 yrs ago

    A single tribe of around 200 people which crossed the Red Sea 70,000 years ago is responsible for the existence of the entire human race outside Africa, a new study has found. 

    Research by geneticists and archaeologists has allowed them to trace the origins of modern homo sapiens back to a single group of people who managed to cross from the Horn of Africa and into Arabia. From there they went on to colonise the rest of the world.

    While there are 14 ancestral populations in Africa itself, just one seems to have survived outside of the continent, the Daily Telegraph reported.

    The latest genetic research has shown that it was not until around 70,000 years ago that humans were able to take advantage of falling sea levels to cross into Arabia at the mouth of the Red Sea, which is now known as the Gate of Grief.

    At the time the 18 mile gap between the continents would have dropped to just 8 miles. It is not clear how they might have made such a journey but once a cross, the humans were able to spread along the Arabian coast where fresh water springs helped support them.

    It has long been assumed that humans success in spreading around the world was due to their adaptability and hunting skills. The latest research, however, suggests that the very early human pioneers who ventured out of Africa owe far more of their success to luck and favourable changes in climate change than had previously been realised.

    Stephen Oppenheimer, a geneticist at Oxford University, said: “What you can see from the DNA of all non-Africans is that they all belong to one tiny African branch that came across the Red Sea. If it was easy to get out of Africa we would have seen multiple African lineages in the DNA of non-Africans but that there was only one successful exit suggests it must have been very tough to get out”. 

    What Do You Give the Developing World for Mother’s Day?

    What Do You Give the Developing World for Mother’s Day?
    NY Times: Published: May 9, 2009
    The Op-Ed page asked experts on women's health to suggest simple measures to improve the wellbeing of mothers around the world.
    A Birth Pill By AMY GROSSMANAn inexpensive medicine could save lives.
    A Dose of Care By HELEN EPSTEINCounseling should be an important part of food aid programs.
    An Education By ESTHER DUFLOMake going to school affordable.
    A Safer Labor By L. LEWIS WALLProvide clinics with the basics to perform Caesarean deliveries.
    A Custom Drug By RUTH FADEN, ANNE DRAPKIN LYERLY and MAGGIE LITTLEResearch to better medicate mothers-to-be. /.../

    Sunday, May 10, 2009

    Feliz Dia das Mães!
           HAPPY MOTHER'S DAY!
             FELIZ DIA DAS MÃES!

    Saturday, May 09, 2009

    Urban Health

    Urban Health means putting the needs of people and communities at the heart of the urban planning process to ensure better accessto urbanservices which improve human health for all. Except in a few instances, urban health problems are not markedly different from those in rural areas, but their solutions are quite different. The key difference revolves in accommodating the higher density of people spread over large areas. Thus, urban health goes well beyond improved access to health services./.../

    Friday, May 08, 2009

    A Economia do Tráfico na Cidade do Rio de Janeiro

    A Economia do Tráfico na Cidade do Rio de Janeiro: uma tentativa de calcular o valor do negócio
    Sergio Guimarães Ferreira e Luciana Velloso Sub-Secretaria de Estudos Econômicos Secretaria da Fazenda - Governo do Estado do RJ

    Este trabalho procura dimensionar o negócio de entorpecentes na cidade do Rio de Janeiro. Esta estimativa é feita a partir de informações das pesquisas de consumo de drogas - especificamente maconha, cocaína e crack, e de pesquisas de preços da droga no atacado e no varejo, permitindo-se inferir o valor da demanda por esses produtos. Dimensiona-se também o custo operacional do tráfico de drogas a partir de pesquisas sobre a força de trabalho empregada nesse comércio, e de dados oficiais de apreensão de armas, para se chegar a uma estimativa do excedente operacional compatível com a demanda (faturamento) estimada. Obviamente, o mercado de drogas não é o único ilegal em nenhuma grande cidade, mas ele é tipicamente mais associado à violência urbana. Além disso, ao contrário de outros mercados ilegais, há algumas pesquisas p&u acute;blicas rigorosas sobre o consumo das mercadorias que o movimentam, as quais permitem que se calculem valores de faturamento minimamente consistentes./.../
     [+] Leia na íntegra aqui

    Tabagismo na coorte de nascimentos de 1982: da adolescência à vida adulta, Pelotas, RS.

    Tabagismo na coorte de nascimentos de 1982: da adolescência à vida adulta, Pelotas, RS.
    MENEZES, Ana M B et al.
    Rev. Saúde Pública [online]. 2008, vol.42, suppl.2, pp. 78-85. ISSN 0034-8910. doi: 10.1590/S0034-89102008000900011.
    OBJETIVO: Avaliar a prevalência de tabagismo em adolescentes e adultos jovens pertencentes a uma coorte de nascimentos de base populacional.
    MÉTODOS: Estudo prospectivo de coorte dos nascidos em 1982 na cidade de Pelotas, RS, entrevistados em 1997, 2000-1 e 2005. O desfecho estudado foi o tabagismo, definido como consumo de pelo menos um cigarro na última semana nos acompanhamentos de 1997 e 2000-1. No acompanhamento de 2005, a variável dependente foi tabagismo atual. A análise ajustada foi realizada por meio de regressão de Poisson.
    RESULTADOS: As prevalências de tabagismo entre homens foram de 5,9%, 20,2% e 27,6% nos acompanhamentos de 1997, 2000-1 e 2005, respectivamente. Os respectivos valores para as mulheres foram 9,3%, 27,5% e 23,6%. A idade média de início do fumo foi de 15,1 anos (dp=2,5). Na análise multivariável, menor escolaridade materna, baixa renda familiar em 1982, ter sido pobre durante todo o período acompanhado e fumo materno na gravidez estiveram significativamente associados com maiores prevalências de fumo em ambos os sexos. A cor da pele não branca associou-se com maior risco de fumo apenas entre as mulheres. A amamentação não mostrou associação com tabagismo. Nas mulheres, o fumo esteve inversamente associado com o peso ao nascer na análise bruta, mas perdeu a significância na ajustada.
    CONCLUSÕES: A maior concentração de tabagismo nos grupos mais pobres sugere que condutas como o combate ao fumo na gestação e o aumento do preço do cigarro poderiam ter importante impacto populacional. Leia o artigo na íntegra aqui
    http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102008000900011&lng=pt&nrm=iso

    Obesity, inflammation, and atherosclerosis

    Nature Reviews Cardiology, advance online publication, Published online 28 April 2009 |doi:10.1038/nrcardio.2009.55

    Subject Category: Vascular disease

    Obesity, inflammation, and atherosclerosis

    Viviane Z. Rocha1 & Peter Libby1  About the authors

    top

    Understanding of the pathophysiology of atherogenesis has evolved substantially during the last few decades. Atherosclerosis was once identified as a lipid-storage disease, but is now recognized as a subacute inflammatory condition of the vessel wall, characterized by infiltration of macrophages and T cells, which interact with one another and with cells of the arterial wall. The pathological mechanisms of obesity recapitulate many features of the inflammatory processes at work in atherosclerosis. Our current appreciation of the similarities between obesity and atherosclerosis has already fostered innovations for the diagnosis, prognosis, and prevention of these two conditions./.../

    Império do medo

    Zero Hora: 08 de maio de 2009 | N° 15963

    ARTIGOS

    Império do medo, por Aloyzio Achutti*

    O susto, a surpresa, a insegurança e o medo atrapalham qualquer um, dificultando as reações de defesa e a tomada de decisões racionais e as mais adequadas. Quando incidem sobre uma multidão, ou atingem a população, seus efeitos se potencializam e podem assumir proporções catastróficas.

    A julgar pelas manchetes, parece que se está vivendo no império do medo: gripe suína, febre amarela, dengue, crise financeira, quebra da bolsa, sequestro da poupança, desemprego, despejos, falência das instituições, chantagem, propaganda enganosa, cascata de corrupção, difamação, ruína da família, descrédito na Justiça, deportações, atentados, terrorismo, pânico, homens-bomba, sequestro relâmpago, rapto, estupro, assaltos, invasões, arrastão, assassinatos, bala perdida, genocídio, guerra, armas de destruição em massa, bomba atômica, aquecimento global, poluição ambiental, espécies em extinção, agrotóxicos, inundações, seca, raios, tornados, ciclones, queda de meteorito, desmatamento, desertificação, contaminação dos mananciais, racionamento de energia e de água, fome, obesidade, câncer, infarto do miocárdio, aids, tuberculose, hepatite, Alzheimer, loucura, morte súbita, acidentes de trânsito, tráfico de drogas, e outras tantas barbaridades...

    Tem para todos os gostos e sensibilidades, e contemplando globalmente é um terror.

    O medo deveria ser um mecanismo de proteção, mas exagerado estraga com a vida e pode provocar respostas piores do que o mal que o gerou. Terá valido a pena todo o aparato contra o terrorismo internacional?

    Se não for o império, é ao menos a cultura do medo que se observa. É possível que o volume de informação circulante e o nível progressivo de estímulo a todos os sentidos tenham propiciado este fenômeno.

    Existe uma tese que tenta explicar a necessidade crescente de se expor a situações de risco (que causam medo e liberam “adrenalina”) como uma reação inconsciente contra a depressão difusamente presente em todo a sociedade, consequente ao aumento populacional e às frustrações pelo homem mesmo fabricadas. Nossos mecanismos de reação ao perigo (que causa medo) se acompanham de concentração da atenção e certa euforia e disponibilidade transitória de mais força para facilitar a superação. Estes mecanismos fisiológicos podem ser comparados ao efeito da nicotina e o de outras drogas sobre o organismo. Isto tem a ver não somente com a disseminação do uso de substâncias psicoativas como também com a busca de situações apavorantes reais ou imaginárias. Até a prevalência maior de hipertensão em populações urbanas poderia ter aí uma de suas explicações.

    Certamente, há também os que se aproveitam da situação para tirar ganhos econômicos, exercício de dominação/dependência, discriminação e xenofobia. A cultura do medo oportuniza manipulação social e gera progressiva insensibilidade, que pode desmoralizar os sinais de alarme e retardar a resposta quando ela realmente se fizer necessária.

    Pode-se ter esperança em ganhos secundários: alguns simples como hábitos de higiene e de civilidade (lavar as mãos e evitar o contágio pela tosse e pelo espirro sem proteção). Quem sabe, também, se ficar evidente que quase tudo que causa medo não acontece por acaso ou por obra de demônios, mas sim do próprio homem, invista-se mais em educação e na cultura da racionalidade e do diálogo, já que violência somente leva à destruição e à infelicidade.

    *MÉDICO

    Thursday, May 07, 2009

    Preventing Sudden Cardiac Death

    Release date: March 10, 2009
    Expiration date: March 10, 2010

    Sudden cardiac arrest (SCA) accounts for approximately 325,000 deaths per year in the United States, representing an incidence of 0.1% to 0.2% per year in the adult population. The incidence of SCA in other countries though, appear to be lower and may be attributed to inadequate methods for identifying high-risk candidates as well as the prevalence of coronary artery disease prevalence in those populations. Revascularization, pacemaker, and implantation of an implantable cardioverter defibrillator (ICD) have been found to be highest in North America and Western Europe and lowest in South America and Eastern Europe, demonstrating that the incidence, etiology, and management of SCA may vary by region. Ongoing studies and discussions will be needed to address these continental and regional differences, including reimbursement issues and the need for additional education surrounding emerging clinical trial data and clinical guidelines, to ensure clinician awareness and facilitate appropriate patient analysis and management. Join Drs. Prystowsky, Lau, and Oseroff as they provide an international perspective on various prevention strategies of SCA including challenges faced in the Pacific Rim and South America.
    To participate in this internet activity: (1) review the target audience, learning objectives, and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation; (4) view/print certificate. 

    Wednesday, May 06, 2009

    Produção científica cresce no Brasil

    Produção científica cresce 56% no Brasil
       O Brasil alcançou na 13ª posição na classificação mundial em produção científica em 2008 e ultrapassou a Rússia (15ª) e a Holanda (14ª). De 19.436 artigos em 2007, essa produção subiu para 30.451 publicações no ano passado, crescimento de 56%. Os dados são do National Science Indicators, base de dados estatísticos sobre pesquisa e ciência que reúne dados atualizados de mais de 180 países./.../

    Doc2doc.bmj.com

    Welcome to doc2doc

    Connecting doctors worldwide - doc2doc registration is free and connects you to colleagues around the world.

    • Get answers to your clinical questions from a community you can trust.
    • Start a discussion about anything from the latest research to careers advice.
    • Find colleagues you used to work with.
    • Create your own online meeting place for your friends, colleagues, hospital or society. 

    Tuesday, May 05, 2009

    A seat of wisdom in the brain?

    A seat of wisdom in the brain?

    April 24, 2009
    Courtesy University of California - San Diego
    and World Science staff

    Two re­search­ers have com­piled what they say is the first schol­arly re­view of the ba­sis in the brain of wis­dom—once the sole prov­ince of re­li­gion and phi­los­o­phy. 

    The study by Dilip V. Jeste and Thom­as W. Meeks of the Uni­ver­s­ity of Ca­li­for­nia, San Die­go, was pub­lished in the re­search jour­nal Ar­chives of Gen­er­al Psy­chi­a­try on April 6./.../

    Mortality risk one in 1000 for patients undergoing catheter ablation of AF

    Mortality risk one in 1000 for patients undergoing catheter ablation of AF
    May 4, 2009 | Michael O'Riordan

    Milan, Italy - Roughly one patient in 1000 will die from complications caused by the catheter ablation of atrial fibrillation (AF), with the most common cause of death being tamponade, followed by stroke and atrioesophageal fistula [1].

    These are the findings of a large retrospective analysis of 45 000 ablation procedures in 32 000 patients performed worldwide between 1995 and 2006. Investigators report that center experience did not appear to influence the risk of death, nor did different ablation techniques.

    "The present study provides an unprecedented view of the causes and incidence of death in patients undergoing catheter ablation of AF, which may be of help in designing more appropriate and efficient [electrophysiology] EP settings for increasing current standards of procedural safety, planning start programs in EP centers with limited facilities or experience, delivering recommendations by regulatory authorities, and developing safer technologies," write Dr Riccardo Cappato (Policlinico San Donato, Milan, Italy) and colleagues in the May 12, 2009 issue of the Journal of the American College of Cardiology.

    In an editorial accompanying the published report [2], Dr Bernard Belhassen (Tel-Aviv Sourasky Medical Center, Israel) asks whether a mortality rate of approximately one in 1000 can be considered an "acceptable risk" for patients with AF, particularly since the main expectation from the procedure is an improvement in the quality of life. Until recently, clinicians had little they could tell their patients about the procedure, except to say that it was associated with a relatively low complication rate, he notes.

    Global variability in fruit and vegetable consumption

    Authors: JN Hall, S Moore, SB Harper, JW Lynch

    Reference: Am J Prev Med 2009; 36(5): 402-409, http://www.ajpm-online.net/article/S0749-3797(09)00097-X/abstract

    Summarized by: Juan Ramos, Program Coordinator, ProCor

    More than three-quarters of 196,300 adults from 52 mostly low- and middle-income countries consume less than the minimum recommended five daily servings of fruits and vegetables, according to data from the 2002-2003 World Health Survey analyzed in 2008. Countries participating in the survey represented all WHO regions, with 14 countries from Europe, 18 from Africa, six from the Americas, four from the Eastern Mediterranean, five from South-East Asia, and five from the Western Pacific.

    Nearly three million deaths and more than 26 million disability adjusted life years were attributable to low fruit and vegetable intake globally, according to previous data from 2000. Further, 31% of ischemic heart disease, 19% of ischemic stroke, 19% of gastric cancer, and 12% of lung cancer worldwide could be prevented by increasing dietary intake of fruits and vegetables to the minimum recommended five daily servings./.../

    Monday, May 04, 2009

    Albert Einstein e Sobral, 29 de maio de 1919

    Há 90 anos, ocorria no Brasil o registro do eclipse solar que deu fama a Einstein
    Pesquisa FAPESP -  
    © Acervo do Observatório Nacional do Rio de Janeiro
    Sobral em 1919: local onde foi observado o eclipse em frente da Igreja Nossa Senhora do Patrocínio  

    Neste mês de maio celebramos os 90 anos da prova da deflexão da luz pela gravidade, prevista pela Relatividade Geral. As fotografias obtidas em Sobral, no Ceará, foram fundamentais para isso, mas o fato é ignorado por grande parte da comunidade científica. Ele é particularmente importante por ter tornado Einstein conhecido mundialmente e se tornado um dos maiores ícones de nossa era. É relevante recuperar essa memória, não só para o público brasileiro, mas mundialmente, aproveitando a grande visibilidade do Brasil na Assembleia Geral da União Astronômica Interrnacional (IAU, na sigla em inglês) que se realizará no Rio de Janeiro de 3 a 14 de agosto de 2009. /.../