The CVD epidemic alert

Em agosto de 2004 a AMICOR Maria Inês Reinert Azambuja enviou para ProCOR o comentário cujos parágrafos inciais estão abaixo mas que pode ser conseguido na íntegra clicando no hyperlink. Pode ser oportuno nesta hora em que se retoma a discussão sobre Doenças Crônicas.

Commentary: 

Author:

Maria Inês Reinert Azambuja, MD, PhD, Department of Social Medicine School of Medicine, Federal University of Rio Grande do Sul, Brazil

Commentaries are personal reflections on topics relevant to cardiovascular disease prevention contributed by members of ProCor's global community.

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Between 2001 and 2004, several papers were published internationally, strongly suggesting an imminent dislocation of the CVD epidemic from developed to developing countries. The quotations below reproduce some of these "epidemic alerts," usually made as an introductory remark to an immediate call for action, aimed to "prevent" that anticipated disaster through widespread public health interventions in our countries./.../

Red Wine in a Stent

By MedPage Today Staff Published: April 29, 2011 The saga of red wine and heart disease has taken a surprising new turn, and a new study suggests that parts of a rat's brain may take short naps even when the animal is awake -- highlights of this week's edition of Lab Notes. Bring Me a Stent of Your Best Bordeaux, Please Modest intake of red wine is good for preventing heart disease. But for those with already diseased coronary arteries, a red wine-eluting stent might do the trick. In a study reported at the American Heart Association's Arteriosclerosis, Thrombosis and Vascular Biology conference, industry and academic researchers described how they combined red wine polyphenols resveratrol and quercetin into a coating for drug-eluting stents. When tested on rats, the plastered stent appeared to dose-dependently block restenosis and local inflammation in the month after stenting compared with a bare metal stent. Equally as impressive, the red wine compounds accelerated endothelial growth by 31% at 10 days post implant. James J. Kleinedler of Louisiana State University presented the study. -- C.P and C.K.

REVELAÇÕES DO CENSO: RS

http://zerohora.clicrbs.com.br/pdf/10913010.pdf 
ZH: 30 de abril de 2011 | N° 16686 

Um Rio Grande ao estilo europeu

juliana.bublitz@zerohora.com.br

JULIANA BUBLITZO Rio Grande do Sul envelheceu, está mais solitário e sua população tende a parar de crescer daqui a, no máximo, 20 anos. Divulgada ontem pelo Instituto Brasileiro de Geografia e Estatística (IBGE), uma nova leva de dados do Censo 2010 indica que o Estado mais austral do Brasil, ponta de lança de uma tendência nacional, é o campeão em idosos, tem cada vez menos crianças e adolescentes e ostenta a menor média de moradores por domicílio do país, semelhante à de países europeus.Pelo menos 9,3% de seus quase 10,7 milhões de habitantes têm 65 anos ou mais. O índice equivale a um contingente de 162,3 mil pessoas – a maioria concentrada em municípios de pequeno e médio portes, como São João do Polêsine, na Região Central, onde os vovôs são 17,9% da população.A título de comparação, em 2000, essa mesma faixa etária não passava de 7,2% do total, deixando o Estado na terceira colocação no país. O mais curioso é que, em 2010, não apenas as cidadezinhas do Interior ficaram mais velhas. O principal conglomerado urbano gaúcho seguiu caminho igual.De acordo com o IBGE, Porto Alegre alcançou o topo do ranking das capitais com mais octogenários, ao lado do Rio. Com seus cabelos brancos e sua experiência, eles passaram a compor 2,46% dos habitantes.– O que chama a atenção é que, apesar de se consolidar como o mais velho do país, o Rio Grande do Sul ainda não tem a melhor expectativa de vida – alerta o supervisor de informações do IBGE e coordenador do censo no Estado, Ademir KoucherIsso porque, segundo o pesquisador, os gaúchos ainda contabilizam muitas mortes na faixa dos 60 aos 69 anos. A explicação, para Koucher, é cultural. Por trás, estariam hábitos nada saudáveis, como o churrasco gordo, o fumo e o consumo das bebidas alcoólicas.– É urgente que se comece a pensar em políticas públicas voltadas para essa população – diz o chefe do IBGE no Estado, José Renato de Almeida.De fato, o censo mostrou que o Rio Grande do Sul está em último lugar em população com até 14 anos e é o que menos cresce em termos populacionais desde 2000. Koucher acredita que, em menos de 20 anos, talvez 15, o crescimento cesse de vez, salvo algum novo fluxo migratório. Também é provável que cada vez menos gente divida a mesma casa, como os dados indicam.

Censo Demográfico 2010

Primeiros resultados definitivos do Censo 2010: população do Brasil é de 190.755.799 pessoas

O Brasil tem 190.755.799 habitantes. É o que constata a Sinopse do Censo Demográfico 2010, que contém os primeiros resultados definitivos do XII Recenseamento Geral do Brasil... 29/04/2011

Technology Advances; Humans Supersize

By PATRICIA COHEN

Published: April 26, 2011

For nearly three decades, the Nobel Prize-winning economist Robert W. Fogel and a small clutch of colleagues have assiduously researched what the size and shape of the human body say about economic and social changes throughout history, and vice versa. Their research has spawned not only a new branch of historical study but also a provocative theory that technology has sped human evolution in an unprecedented way during the past century/.../

Caminhar faz bem

Prezados Parceiros segue mais uma evidência do Celafiscs  e do Programa Agita São Paulo tema do Programa Bem estar da Rede Globo de Televisão 

Segue o link : http://g1.globo.com/videos/bem-estar/v/caminhar-protege-o-coracao/1493975/#/Todososvídeos/20110426/page/1

How Food Explains the World

From China's strategic pork reserve to a future where insects are the new white meat, 10 reasons we really are what we eat.

BY JOSHUA KEATING | MAY/JUNE 2011

They say you are what you eat. And that applies to countries and cultures as much as individuals. The food in our mouths defines us in far more fundamental and visceral terms than the gas in our tanks or the lines on a map. So it's not surprising that the most important questions of global politics often boil down to: What should we eat?

---

The New Geopolitics of Food
By Lester R. Brown

Street Eats
An FP Slide Show

The Strategic Pork Reserve

China is a porcine superpower as well as a human one. The Middle Kingdom boasts more than 446 million pigs -- one for every three Chinese people and more than the next 43 countries combined. So when there's a major disruption in the pork supply it hits the economy hard; the "blue-ear pig" disease that forced Chinese farmers to slaughter millions of pigs in 2008, for example, drove the country's inflation rate to its highest level in a decade.

To prevent further disruptions, the Chinese government established a strategic pork reserve shortly afterward, keeping icy warehouses around the country stocked with frozen pork that can be released during times of shortage. The government was forced to add to the reserve -- taking pigs off the market -- in the spring of 2010 when a glut led to prices collapsing./.../

PETER PARKS/AFP/Getty Images 

Physician Compensation Report 2011

• How much do physicians earn?
• Which practice settings earn the most?
• How much time is spent with patients?

Specialist Compensation

• Anesthesiology
• Cardiology
• Dermatology
• Diabetes & Endocrinology
• Emergency Medicine
• Gastroenterology
• General Surgery

• ID/HIV
• Nephrology
• Neurology
• Ob/Gyn & Women's Health
• Oncology
• Ophthalmology
• Orthopedics
• Pediatrics

• Plastic Surgery
• Primary Care
• Psychiatry & Mental Health
• Pulmonary Medicine
• Radiology
• Rheumatology
• Urology

Perspective

• The Specialist/Primary Care Split Continues -- and Not Just in Compensation
  How do physicians feel about how much they earn, how many hours they work, and whether they are fairly compensated? All is revealed in the first annual Medscape Physician Compensation Report (detailed data results above).
  Medscape Business of Medicine, April 2011

Methodology

• Survey fielded to 455,000 US physicians
• Total respondents*: 15,794 US physicians across 22 specialty areas
• Fieldwork conducted by Medscape from February 2-March 30, 2011
• Data collected via third-party online survey collection site

* Respondents were entered into a sweepstakes to win a $50 American Express gift card - issued to 100 physicians. Demographic/attitudinal weighting not applied to tabulation

Alzheimer's Caregivers Need Care, Too

Expert suggests ways to keep mind and body healthy for the task

By Robert Preidt

Wednesday, April 27, 2011

But caregivers can take various steps to protect their health, says Rebecca Axline, a clinical social worker at the Nantz National Alzheimer Center in Houston.WEDNESDAY, April 27 (HealthDay News) -- The growing number of people with Alzheimer's disease in the United States means that more people are becoming caregivers, a responsibility that health experts warn can pose risks to body and mind.

To keep stress in check, for instance, she emphasizes the need to find time and ways to reenergize, to keep meaningful things in your life and to remain social and participate in your favorite activities.

Axline also offered communication techniques that can help reduce caregivers' stress and frustration:/.../

Tobacco Control

Cover image

Reproduced with the permission of the WHO – Tobacco Free Initiative, Geneva, Switzerland.

Agita São Paulo

WHF: impending disaster

New WHO report reveals an ‘impending disaster’ caused by a rise in deaths from heart disease and other non-communicable diseases The World Heart Federation welcomes report recommendations for a ‘forceful response’ to the potential tragedy posed by non-communicable diseases, particularly in the developing world Geneva, April 27, 2011 – The World Health Organization has today published a report on non-communicable diseases (NCDs), including cardiovascular disease (CVD) which is the number one killer worldwide, and has described them as an ‘impending disaster’ for health, society and national economies. The World Heart Federation, the leading global body dedicated to heart-health, welcomes the publication of the report and today issued the following statement: “The increasing burden of CVD, when cost-effective interventions exist, is unacceptable. Worldwide, CVD claims over 17.1 million lives and is projected to rise to 23.6 million by 2030. Although NCDs cause 63% of all global deaths, 80% of which occur in developing countries, the international community displays no sense of urgency or outrage about NCDs, the silent killer that is threatening development and economic progress. It is critical that NCDs are recognized as a development priority. “Contrary to the public’s perception of NCDs as diseases of affluence, poverty plays a role both as a risk factor and as a consequence of NCDs. One-third of the poorest two quintiles in the developing world die prematurely from preventable NCDs, affecting all aspects of society from children to the elderly. The omission of NCDs from the Millennium Development Goals (MDGs) targets has been a critical barrier to securing donor funding for NCDs, depriving low-and middle-income governments of the financial and technical assistance needed to turn the NCD epidemic around. This must change. “The World Heart Federation calls for a global response that places NCDs and therefore CVD, at the centre of development initiatives. This means giving prominence to disease prevention, recognition of the strong correlations between communicable (infectious) diseases and NCDs, and strengthening existing health systems which encourage early detection and multisectoral government approaches to public health. As the report suggests, a large proportion of people with high cardiovascular risk remain undiagnosed in low- and middle-income countries. Evidence and experience have demonstrated that if appropriate action is taken, countries can cost-effectively reverse negative trends. “We therefore look forward to the United Nations High-Level Summit on Non-Communicable diseases this September where it is essential that world leaders make strong recommendations and commitments to the prevention and control of NCDs. This international commitment must be translated into measurable action that will halt and reverse the impending NCD disaster.” All quotations are attributable to Dr Kathryn Taubert, Senior Science Officer, World Heart Federation. For further information on the burden on non-communicable diseases, please visit www.worldheart.org To access the WHO report, please visit http://www.who.int/nmh/publications/ncd_report_full_en.pdf For media enquiries, please contact: Charanjit K. Jagait, PhD Director of Communications - World Heart Federation Tel: +41 (79) 625 32 96Email: charanjit.jagait@worldheart.org

Global Status Report on NCDs

Nossa querida AMICOR Vera Luiza da Costa e Silva nos envia direto de Moscou:
(são dois documentos um no link abiaxo e o outro no título da postagem)
Para os amigos do coração, fresquinho da Russia! abs, Vera

http://www.who.int/dg/speeches/2011/global_forum_ncd_20110427/en/index.html

Global Status Report on NCDs

The Global Status Report on Noncommunicable Diseases 2010 is the first report on the worldwide epidemic of cardiovascular diseases, cancer, diabetes and chronic respiratory diseases, along with their risk factors and determinants.

Non-communicable diseases killed tens of millions of people in 2008, and a large proportion of these deaths occurred before the age of 60, so during the most productive period of life. The magnitude of these diseases continues to rise, especially in low- and middle-income countries./.../

US: The 10 Most Prescribed Drugs

From WebMD Health News

Daniel J. DeNoon

April 20, 2011 — The 10 most prescribed drugs in the U.S. aren't the drugs on which we spend the most, according to a report from the IMS Institute for Healthcare Informatics.

The institute is the public face of IMS, a pharmaceutical market intelligence firm. Its latest report provides a wealth of data on U.S. prescription drug use.

Continuing a major trend, IMS finds that 78% of the nearly 4 billion U.S. prescriptions written in 2010 were for generic drugs (both unbranded and those still sold under a brand name). In order of number of prescriptions written in 2010, the 10 most-prescribed drugs in the U.S. are:

• Hydrocodone (combined with acetaminophen) -- 131.2 million prescriptions
• Generic Zocor (simvastatin), a cholesterol-lowering statin drug -- 94.1 million prescriptions
• Lisinopril (brand names include Prinivil and Zestril), a blood pressure drug -- 87.4 million prescriptions
• Generic Synthroid (levothyroxine sodium), synthetic thyroid hormone -- 70.5 million prescriptions
• Generic Norvasc (amlodipine besylate), an angina/blood pressure drug -- 57.2 million prescriptions
• Generic Prilosec (omeprazole), an antacid drug -- 53.4 million prescriptions (does not include over-the-counter sales)
• Azithromycin (brand names include Z-Pak and Zithromax), an antibiotic -- 52.6 million prescriptions
• Amoxicillin (various brand names), an antibiotic -- 52.3 million prescriptions
• Generic Glucophage (metformin), a diabetes drug -- 48.3 million prescriptions
• Hydrochlorothiazide (various brand names), a water pill used to lower blood pressure -- 47.8 million prescriptions.

The 10 Best-Selling Drugs

It shouldn't be a surprise that these generic drugs are not the ones bringing in the big bucks for pharmaceutical companies. The drugs on which we spend the most money are those that are still new enough to be protected against generic competition.

The IMS reports that Americans spent $307 billion on prescription drugs in 2010. The 10 drugs on which we spent the most were:

• Lipitor, a cholesterol-lowering statin drug -- $7.2 billion
• Nexium, an antacid drug -- $6.3 billion
• Plavix, a blood thinner -- $6.1 billion
• Advair Diskus, an asthma inhaler -- $4.7 billion
• Abilify, an antipsychotic drug -- $4.6 billion
• Seroquel, an antipsychotic drug -- $4.4 billion
• Singulair, an oral asthma drug -- $4.1 billion
• Crestor, a cholesterol-lowering statin drug -- $3.8 billion
• Actos, a diabetes drug -- $3.5 billion
• Epogen, an injectable anemia drug -- $3.3 billion

U.S. Prescription Drug Use: 2010 Factoids

Who's paying for all these drugs? Commercial insurance helped pay for 63% of prescriptions, down from 66% five years ago. Federal government spending through Medicare Part D covered 22% of prescriptions.

For Americans covered by insurance, Medicare, or Medicaid, the average co-payment for a prescription was $10.73 -- down a bit from 2009 due to increased use of generic drugs. The average co-payment for branded drugs for which generic alternatives were available jumped 6% to $22.73.

Other facts from the 2010 IMS report:

• Doctor visits were down 4.2% since 2009.
• Patients filled more than half of their prescriptions -- 54% -- at chain drugstores, possibly because of discounts on generic drugs.
• Brands that lost their protection from generic competition led to $12.6 billion less spending in 2010 than in 2009.
• The price increase for drugs without generic competition led to $16.6 billion more spending in 2010 than in 2009.
• Drug companies offered $4.5 billion in rebates to assist patients with the high cost of brand name drugs for which there was no generic alternative.

SOURCE:

IMS Institute for Healthcare Informatics: "The Use of Medicines in the United States: Review of 2010," April 2011.

Visiting Chernobyl, 25 Years Later

Apocalypse Today: 

By EBEN HARRELL AND JAMES MARSON / PRYPYAT Tuesday, Apr. 26, 2011

A May 1986 aerial photo of the damaged reactor at the Chernobyl nuclear power plant

Vladimir Repik / AP

The 18.5-mile (30 km) radius around the Chernobyl nuclear power plant is known officially as the "zone of alienation." Abandoned cars, tractors, buildings and homes litter the landscape and are slowly being devoured by trees and shrubs. A classroom bulletin board not far from the central Lenin Street in the town where the plant workers used to live reads, "No return. Farewell, Prypyat, April 28, 1986."

Read more: http://www.time.com/time/health/article/0,8599,2067562,00.html#ixzz1Kde4Kp00/.../

Managing High BP in Seniors

Download Complimentary Source PDF

By Todd Neale, Staff Writer, MedPage Today Published: April 25, 2011 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston. Activate MedPage Today's CME feature and receive free CME credit on medical stories like this one Action Points   Explain that a new document on treating hypertension in those 65 and older was the result of an expert consensus panel because there was not enough evidence available for creating formal guidelines. Note that the document recommended a target blood pressure of <140/90 mm Hg for most older individuals, while acknowledging that there was uncertainty for those 80 and older. A lower target was recommended for those with diabetes, kidney disease, and coronary artery disease. The American College of Cardiology and the American Heart Association have issued the first guidance specifically for the treatment of hypertension in patients 65 and older in the form of an expert consensus document. In general, the target blood pressure should be less than 140/90 mm Hg, although the authors acknowledged that there was some uncertainty about whether patients 80 and older should have a different goal than those ages 65 to 79. A systolic target of 140 to 145 mm Hg would be acceptable for patients who have reached 80, noted the writing committee, co-chaired by Wilbert Aronow, MD, of New York Medical College, Jerome Fleg, MD, of the National Heart, Lung and Blood Institute, and Carl Pepine, MD, of the University of Florida. The new recommendations were developed in collaboration with the American Academy of Neurology, the American Geriatrics Society, the American Society of Hypertension, the American Society of Nephrology, the American Society for Preventive Cardiology, the Association of Black Cardiologists, and the European Society of Hypertension. They were published simultaneously online in the Journal of the American College of Cardiology, the Journal of the American Society of Hypertension, the Journal of Clinical Hypertension, and the Journal of Geriatric Cardiology/.../

Trans Fat in Dairy and Beef Not Benign

By Crystal Phend, Senior Staff Writer, MedPage Today Published: April 19, 2011 Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

GENEVA -- Small amounts of naturally occurring trans fats in milk and beef boost cardiac risk more than expected, according to data from a large Norwegian population study. Higher intake of these ruminant trans-fatty acids was consistently linked to greater risk of death from coronary heart disease and cardiovascular disease (P=0.05 toP=0.002 for trend) in the study of more than 71,000 people followed for around 25 years./.../

The Science of Why We Don't Believe Science

Illustration: Jonathon Rosen

How our brains fool us on climate, creationism, and the vaccine-autism link.

— By Chris Mooney

Mon Apr. 18, 2011 3:00 AM PDT

Read also: Kate Sheppard on the smear campaign behind Climategate.

"A MAN WITH A CONVICTION is a hard man to change. Tell him you disagree and he turns away. Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your point." So wrote the celebrated Stanford University psychologist Leon Festinger(PDF), in a passage that might have been referring to climate change denial—the persistent rejection, on the part of so many Americans today, of what we know about global warming and its human causes. But it was too early for that—this was the 1950s—and Festinger was actually describing a famous case study in psychology./.../