Tuesday, November 30, 2010
Exposure to second-hand smoke is common in many countries but the magnitude of the problem worldwide is poorly described. We aimed to estimate the worldwide exposure to second-hand smoke and its burden of disease in children and adult non-smokers in 2004.
The burden of disease from second-hand smoke was estimated as deaths and disability-adjusted life-years (DALYs) for children and adult non-smokers. The calculations were based on disease-specifi c relative risk estimates and area-specifi c estimates of the proportion of people exposed to second-hand smoke, by comparative risk assessment methods, with data from 192 countries during 2004.
Findings Worldwide, 40% of children, 33% of male non-smokers, and 35% of female non-smokers were exposed to second-hand smoke in 2004. This exposure was estimated to have caused 379 000 deaths from ischaemic heart disease, 165 000 from lower respiratory infections, 36 900 from asthma, and 21 400 from lung cancer. 603 000 deaths were attributable to second-hand smoke in 2004, which was about 1·0% of worldwide mortality. 47% of deaths from second-hand smoke occurred in women, 28% in children, and 26% in men. DALYs lost because of exposure to secondhand smoke amounted to 10·9 million, which was about 0·7% of total worldwide burden of diseases in DALYs in 2004. 61% of DALYs were in children. The largest disease burdens were from lower respiratory infections in children younger than 5 years (5 939 000), ischaemic heart disease in adults (2 836 000), and asthma in adults (1 246 000) and children (651 000).
These estimates of worldwide burden of disease attributable to second-hand smoke suggest that substantial health gains could be made by extending eff ective public health and clinical interventions to reduce passive smoking worldwide.
Published Online: 11 October 2010
Revising the definition of Alzheimer's disease: a new lexicon
Prof Bruno Dubois MD a , Prof Howard H Feldman MD b c d, Claudia Jacova PhD b, Jeffrey L Cummings MD e, Prof Steven T DeKosky MD f, Pascale Barberger-Gateau MD g, André Delacourte PhD h, Prof Giovanni Frisoni MD i, Prof Nick C Fox MD j*, ProfDouglas Galasko MD k, Prof Serge Gauthier MD l, Prof Harald Hampel MD m, Gregory A Jicha MD n, Kenichi Meguro MD o, John O'Brien DM p, Prof Florence Pasquier MD q, Prof Philippe Robert MD r, Prof Martin Rossor MD j, Prof Steven Salloway MD s, Marie Sarazin MD a, Leonardo C de Souza MD a, Prof Yaakov Stern PhD t, Pieter J Visser MD u v, Prof Philip Scheltens MD v
Alzheimer's disease (AD) is classically defined as a dual clinicopathological entity. The recent advances in use of reliable biomarkers of AD that provide in-vivo evidence of the disease has stimulated the development of new research criteria that reconceptualise the diagnosis around both a specific pattern of cognitive changes and structural/biological evidence of Alzheimer's pathology. This new diagnostic framework has stimulated debate about the definition of AD and related conditions. The potential for drugs to intercede in the pathogenic cascade of the disease adds some urgency to this debate. This paper by the International Working Group for New Research Criteria for the Diagnosis of AD aims to advance the scientific discussion by providing broader diagnostic coverage of the AD clinical spectrum and by proposing a common lexicon as a point of reference for the clinical and research communities. The cornerstone of this lexicon is to consider AD solely as a clinical and symptomatic entity that encompasses both predementia and dementia phases./.../
Citation: The PLoS Medicine Editors (2010) Can We Count on Global Health Estimates? PLoS Med 7(11): e1001002. doi:10.1371/journal.pmed.1001002
Published: November 30, 2010
Copyright: © 2010 PLoS Medicine Editors. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors are each paid a salary by the Public Library of Science, and they wrote this editorial during their salaried time.
Competing interests: The authors' individual competing interests are athttp://www.plosmedicine.org/static/editorsInterests.action. PLoS is funded partly through manuscript publication charges, but the PLoS Medicine Editors are paid a fixed salary (their salary is not linked to the number of papers published in the journal).
* E-mail: firstname.lastname@example.org
Mortality Resulting From Congenital Heart Disease Among Children and Adults in the United States, 1999 to 2006
Suzanne M. Gilboa, PhD; Jason L. Salemi, MPH; Wendy N. Nembhard, PhD; David E. Fixler, MD; Adolfo Correa, MD, PhD From the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Ga (S.M.G., A.C.); Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa (J.L.S., W.N.N.); and Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas (D.E.F.). Correspondence to Suzanne M. Gilboa, PhD, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mail Stop E-86, 1600 Clifton Rd, Atlanta, GA 30333. E-mail email@example.com
Background— Previous reports suggest that mortality resulting from congenital heart disease (CHD) among infants and young children has been decreasing. There is little population-based information on CHD mortality trends and patterns among older children and adults.
Methods and Results— We used data from death certificates filed in the United Statesfrom 1999 to 2006 to calculate annual CHD mortality by age at death, race-ethnicity, and sex. To calculate mortality rates for individuals 1 year of age, population counts from the US Census were used in the denominator; for infant mortality, live birth counts were used. From 1999 to 2006, there were 41 494 CHD-related deaths and 27 960 deaths resulting from CHD (age-standardized mortality rates, 1.78 and 1.20 per 100 000, respectively). During this period, mortality resulting from CHD declined 24.1% overall. Mortality resulting from CHD significantly declined among all race-ethnicities studied. However, disparities persisted; overall and among infants, mortality resulting from CHD was consistently higher among non-Hispanic blacks compared with non-Hispanic whites. Infant mortality accounted for 48.1% of all mortality resulting from CHD; among those who survived the first year of life, 76.1% of deaths occurred during adulthood (18 years of age).
Conclusions— CHD mortality continued to decline among both children and adults; however, differences between race-ethnicities persisted. A large proportion of CHD-related mortality occurred during infancy, although significant CHD mortality occurred during adulthood, indicating the need for adult CHD specialty management.
Influence of Age on,
The Cardiovascular Risk in Young Finns Study, the Childhood Determinants of Adult Health Study, the Bogalusa Heart Study, and the Muscatine Study for the International Childhood Cardiovascular Cohort (i3C) Consortium.
Markus Juonala, MD, PhD*;
Background— Atherosclerosis has its roots in childhood. Therefore, defining the age when childhood risk exposure begins to relate to adult atherosclerosis may have implications for pediatric cardiovascular disease prevention and provide insights about the early determinants of atherosclerosis development. The aim of this study was to investigate the influence of age on the associations between childhood risk factors and carotid artery intima-media thickness, a marker of subclinical atherosclerosis.
Methods and Results— We used data for 4380 members of 4 prospective cohorts—Cardiovascular Risk in Young Finns Study (Finland), Childhood Determinants of Adult Health study (Australia), Bogalusa Heart Study (United States), and Muscatine Study (United States)—that have collected cardiovascular risk factor data from childhood (age 3 to 18 years) and performed intima-media thickness measurements in adulthood (age 20 to 45 years). The number of childhood risk factors (high [highest quintile] total cholesterol, triglycerides, blood pressure, and body mass index) was predictive of elevated intima-media thickness (highest decile) on the basis of risk factors measured at age 9 years (odds ratio [95% confidence interval] 1.37 [1.16 to 1.61], P=0.0003), 12 years (1.48 [1.28 to 1.72],P<0.0001), 15 years (1.56 [1.36 to 1.78], P<0.0001), and 18 years (1.57 [1.31 to 1.87], P<0.0001). The associations with risk factors measured at age 3 years (1.17 [0.80 to 1.71], P=0.42) and 6 years (1.20 [0.96 to 1.51], P=0.13) were weaker and nonsignificant.
Conclusions— Our analyses from 4 longitudinal cohorts showed that the strength of the associations between childhood risk factors and carotid intima-media thickness is dependent on childhood age. On the basis of these data, risk factor measurements obtained at or after 9 years of age are predictive of subclinical atherosclerosis in adulthood.
Estudos com ratos sugerem que é possível eliminar de modo mais eficaz a memória de um evento desagradável
Edição Online - 29/11/2010
Eliminar um fato da memória não significa apagá-lo, mas aprendê-lo de outra forma, propôs no início do século passado o fisiologista russo Ivan Pavlov, o mesmo que condicionou cães a salivar sempre que ouviam o toque de uma sineta. Quase cem anos mais tarde experimentos com ratos feitos por pesquisadores do Brasil e da Argentina indicam que Pavlov aparentemente estava certo. Ao menos no que se refere ao esquecimento de eventos desagradáveis ou aterrorizantes, como deparar na esquina com um assaltante portando uma arma./.../
Monday, November 29, 2010
Health professionals for a new century: transforming education to strengthen health systems in an interdependent world
Prof Julio Frenk MD a ‡, Dr Lincoln Chen MD b ‡, Prof Zulfiqar A Bhutta PhD c, Prof Jordan Cohen MD d, Nigel Crisp KCB e,Prof Timothy Evans MD f, Harvey Fineberg MD g, Prof Patricia Garcia MD h, Prof Yang Ke MD i, Patrick Kelley MD g, Barry Kistnasamy MD j, Prof Afaf Meleis PhD k, Prof David Naylor MD l, Ariel Pablos-Mendez MD m, Prof Srinath Reddy MD n, Susan Scrimshaw PhD o, Jaime Sepulveda MD p, Prof David Serwadda MD q, Prof Huda Zurayk PhD r
|No inverno, Porto Alegre é a segunda capital brasileira mais poluída por material particulado inalável|
No inverno, depois de São Paulo, Porto Alegre é a capital que tem o ar mais poluído por material particulado inalável. Essa informação foi dada pela professora Cláudia Rohden durante reunião-almoço Saneamento Ambiental em Foco, promovida pela Abes-RS (Associação Brasileira de Engenharia Sanitária e Ambiental – seção Rio Grande do Sul) no salão nobre da Federasul, nesta sexta-feira (26), com o tema “Poluição do ar e efeitos sobre a saúde”.
Depois de um breve relato sobre a situação mundial em relação à poluição atmosférica, a drª Rohden apresentou os resultados dos trabalhos que sua equipe vem realizando em parceria com a equipe do dr. Paulo Saldiva, da USP, a maior autoridade brasileira no setor. Com tecnologia simples – tendo como bioindicador uma planta de jardim chamada Tradescantia pallida – a equipe da professora investigou a qualidade do ar em diferentes pontos de Porto Alegre, identificando no bairro Humaitá uma área crítica no verão, possivelmente por estar sobre um lixão aterrado.
Numa pesquisa que durou um ano e meio, feita também em outras cinco capitais brasileiras, monitorando apenas um poluente (o material particulado inalável, que se instala na parte baixa do pulmão), Porto Alegre se situou no nível de Belo Horizonte e Curitiba, mas durante o inverno a qualidade do ar da capital gaúcha foi considerada a pior do Brasil depois da de São Paulo.
A drª Cláudia Rhoden é professora adjunta da Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), onde coordena o Laboratório de Estresse Oxidativo e Poluição Atmosférica, e é pesquisadora associada ao Departamento de Patologia da Faculdade de Medicina da Universidade de São Paulo (USP).
|Foto: Felipe Gaieski|
Assessoria de Imprensa da ABES-RS
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