Também no domingo passado faleceu - e lamento ter que comunicar - o pai de um paciente que eu atendera como nenê há mais de 50 anos e que fez questão de mo apresentar com saúde, parece que como prenúncio de sua última oportunidade de nosso encontro.
Relato e foto no endereço AMICOR de 19 de setembro do ano passado:
http://amicor.blogspot.com.br/2015/09/visita-desta-semana.html
Sunday, January 31, 2016
L.P.D.(*22/04/1905 +24/01/2016)
Dona L. paciente com quase 111, anos faleceu no domingo passado.
Ela era única, pois nos meus 57 anos de profissão como médico nunca tive uma cliente que tivesse vivido tanto, e certamente não terei nenhuma chance de repetir a experiência. Também não conheci ninguém tão longevo - mesmo fora da atividade clínica - e acho que pouca gente tem esta chance.
Por estas simples razões, sinto-me compelido, com um misto de pesar, e ao mesmo tempo com a alegria de sua memória, a participar seu falecimento.
Meu primeiro registro de Dona L. data de 02 de setembro de 1963, com quase cinco anos de formado. Por indicação de um colega (Dr. Jol Pereira da Rosa - falecido aos 80 anos em 2007) ela resolveu me procurar (então com 52 anos), logo após o falecimento de seu esposo Domingos Arnaldo Donadio.
Quando ela se aproximava do centenário, eu lhe dizia em tom jocoso: vou lhe colocar em meu currículo, não porque a senhora esteja tão bem por minha causa, mas porque tenho conseguido não lhe atrapalhar ou fazer mal…
Já tivemos várias clientes centenárias, atualmente ela era a única representante do grupo. Sempre foi muito comunicativa e nos dava alegria de atendê-la. Tinha excelente memória que lamento não ter aproveitado para explorá-la mais em nossas conversas.
Esteve lúcida até próximo aos 110 anos e ainda se comunicando até um ano atrás. No início de 2015 esteve hospitalizada por problema respiratório, e desde a internação permaneceu dependente de alimentação por sonda nasoentérica.
Seus exames de laboratório até recentemente sempre foram muito bons. Nunca precisou de muita medicação. Em 2013 foi examinada pela neuropsicóloga Renata Kochhann, com avaliação favorável, em que pese dificuldade de encontrar parâmetros comparativos para o grupo dos centenários. Foi também acompanhada nos últimos tempos pela geriatra Dra. Laura Maria Arieta Barcellos.
Antes da última hospitalização seu problema maior foi uma fratura de colo de fêmur em consequência de uma queda aos 107 anos. Consegui acelerar a fila da internação perguntando ao cirurgião quantos anos tinha a paciente mais idosa que ele havia atendido...
Como seria de se esperar era a Rainha de uma família muito amável, e era irmã do político Armando Temperani Pereira, Deputado Estadual pelo PTB, professor da Faculdade de Economia da UFRGS, e caçado pela ditadura militar.
Para mim e para minha esposa, Dra Valderês, foi uma distinção ter acompanhado sua trajetória e poder comprovar nossa potencialidade de viver vinte a trinta anos a mais do que habitualmente aceitamos como limite razoável.
Nossos cumprimentos à família que lhe deu suporte e motivações para viver tanto.
Friday, January 29, 2016
Elements
Astronomy Picture of the Day
Discover the cosmos! Each day a different image or photograph of our fascinating universe is featured, along with a brief explanation written by a professional astronomer.2016 January 25
Image Credit: Cmglee (Own work) CC BY-SA 3.0 or GFDL, via Wikimedia Commons
Thursday, January 28, 2016
stay-at-home hospitals
How virtual wards will pave the way for stay-at-home hospitals
The topics in this series were developed by New Scientist in conjunction with Philips, which paid for them to be produced
IF YOU have ever had to stay on a hospital ward, you will know how stressful it can be, no
matter how caring and professional the medical staff. Besides the boredom and loneliness,
there’s the noise and lack of privacy.
matter how caring and professional the medical staff. Besides the boredom and loneliness,
there’s the noise and lack of privacy.
Help is at hand, however, as a new type of hospital ward is beginning to open its doors.
The difference is that in this ward, patients stay at home. The idea is to use the home as a
“virtual” ward. Instead of staying in hospital longer than is strictly necessary, people go
home to recover once they are out of danger.
The difference is that in this ward, patients stay at home. The idea is to use the home as a
“virtual” ward. Instead of staying in hospital longer than is strictly necessary, people go
home to recover once they are out of danger.
But out of sight does not mean out of mind: medical teams still visit regularly – perhaps to
re-dress wounds, give injections, provide physiotherapy or check blood pressure. And more
high-tech virtual wards can use advanced telehealth devices, meaning people are issued with
innovative wireless sensors that track their vital signs. These devices can continually feed
data to cloud-based services, where predictive algorithms issue alerts if someone seems to
be at risk of a serious health event, such as a heart attack. In this case, an emergency team
can speed to the person’s home to intervene.
re-dress wounds, give injections, provide physiotherapy or check blood pressure. And more
high-tech virtual wards can use advanced telehealth devices, meaning people are issued with
innovative wireless sensors that track their vital signs. These devices can continually feed
data to cloud-based services, where predictive algorithms issue alerts if someone seems to
be at risk of a serious health event, such as a heart attack. In this case, an emergency team
can speed to the person’s home to intervene.
Virtual wards allow people to monitor the parameters relevant to such conditions using a
variety of wireless vital-sign monitors that communicate with a tablet computer via Bluetooth.
The sensors include blood pressure cuffs, blood glucose level meters, pulse oximeters that
measure blood oxygen levels, heart rate monitors and even wireless weight and body fat scales./.../
variety of wireless vital-sign monitors that communicate with a tablet computer via Bluetooth.
The sensors include blood pressure cuffs, blood glucose level meters, pulse oximeters that
measure blood oxygen levels, heart rate monitors and even wireless weight and body fat scales./.../
BDNF
A protein in the brain may hold a key to slowing progression of Alzheimer's disease, a new study suggests.
And boosting this protein might be as simple as increasing exercise and social activity, experts say.
The protein is encoded by a gene called brain-derived neurotrophic factor, or BDNF.
Researchers found that seniors with the highest levels of BDNF gene function had a 50 percent slower loss of memory and thinking than those with the lowest levels.
"What is cool about this study is that we have shown that BDNF, which is involved in brain cell survival, may protect against dementia," said lead researcher Dr. Aron Buchman. He is a professor in the department of neurological sciences at Rush University Medical Center in Chicago.
BDNF was protective despite the brain having plaques and tangles, hallmarks of Alzheimer's disease, Buchman said. "If you have high levels of BDNF, you might not have the mental decline people with low levels have, even if you have plaques and tangles," he noted.
To study the effect of BDNF on dementia, Buchman's team followed 535 people, average age 81, until death.
Over an average of six years, the researchers tested participants' thinking and memory skills annually. After death, they examined BDNF levels in the brain. They then compared the two sets of results to see how BDNF levels might be associated with a decline in memory and thinking skills.
Even people with the most plaques and tangles but the highest levels of BDNF had slower mental decline compared with those with the lowest amount of BDNF, the researchers found.
The report was published Jan. 27 online in the journal Neurology.
Michal Schnaider Beeri, an associate professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City, viewed the results more cautiously.
Still, this study may be a step in "thinking about how we can change the course of Alzheimer's disease to something milder," Beeri said.
Existing drugs to treat Alzheimer's aren't very effective, Beeri added. "There might be new medications in the future that increase levels of BDNF and may possibly decrease the rate of decline in Alzheimer's disease," she said.
If borne out in additional research, Buchman thinks these findings may usher in a "whole different approach to aging." Traditionally, researchers have been looking for ways to treat plaques and tangles in the brain and other ravages of Alzheimer's disease. "That hasn't gone so well," he said.
Buchman's idea focuses on increasing the amount of the brain's BDNF. "That may be a way of treating and slowing the rate of mental decline even if we can't get rid of the Alzheimer's disease pathology in the brain," he said.
It is not known why one person naturally has high levels of BDNF and another doesn't, Buchman said.
However, studies have found that purpose in life, social interaction, education and exercise may boost levels of BDNF and "could provide some protection against Alzheimer's pathology," he said.
The next step is to find a way to raise BDNF levels, Buchman said. It might be a drug or a change in behavior. But, at what age that lifestyle change must start or what the effects of a drug might be are unknowns, he said.
Beeri pointed out that exercise has been shown to increase levels of BDNF in the blood, but said a relationship between BDNF protein levels in the blood and in the brain hasn't been established.
Exercise and mentally stimulating activities can't hurt, she said. "It's worth giving it a try," she said.
And boosting this protein might be as simple as increasing exercise and social activity, experts say.
The protein is encoded by a gene called brain-derived neurotrophic factor, or BDNF.
Researchers found that seniors with the highest levels of BDNF gene function had a 50 percent slower loss of memory and thinking than those with the lowest levels.
"What is cool about this study is that we have shown that BDNF, which is involved in brain cell survival, may protect against dementia," said lead researcher Dr. Aron Buchman. He is a professor in the department of neurological sciences at Rush University Medical Center in Chicago.
BDNF was protective despite the brain having plaques and tangles, hallmarks of Alzheimer's disease, Buchman said. "If you have high levels of BDNF, you might not have the mental decline people with low levels have, even if you have plaques and tangles," he noted.
To study the effect of BDNF on dementia, Buchman's team followed 535 people, average age 81, until death.
Over an average of six years, the researchers tested participants' thinking and memory skills annually. After death, they examined BDNF levels in the brain. They then compared the two sets of results to see how BDNF levels might be associated with a decline in memory and thinking skills.
Even people with the most plaques and tangles but the highest levels of BDNF had slower mental decline compared with those with the lowest amount of BDNF, the researchers found.
The report was published Jan. 27 online in the journal Neurology.
Michal Schnaider Beeri, an associate professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City, viewed the results more cautiously.
The new study shows an association between BDNF and slower mental decline, not that this protein was the cause of that slowing, said Beeri, who wrote an accompanying journal editorial.
Still, this study may be a step in "thinking about how we can change the course of Alzheimer's disease to something milder," Beeri said.
Existing drugs to treat Alzheimer's aren't very effective, Beeri added. "There might be new medications in the future that increase levels of BDNF and may possibly decrease the rate of decline in Alzheimer's disease," she said.
If borne out in additional research, Buchman thinks these findings may usher in a "whole different approach to aging." Traditionally, researchers have been looking for ways to treat plaques and tangles in the brain and other ravages of Alzheimer's disease. "That hasn't gone so well," he said.
Buchman's idea focuses on increasing the amount of the brain's BDNF. "That may be a way of treating and slowing the rate of mental decline even if we can't get rid of the Alzheimer's disease pathology in the brain," he said.
It is not known why one person naturally has high levels of BDNF and another doesn't, Buchman said.
However, studies have found that purpose in life, social interaction, education and exercise may boost levels of BDNF and "could provide some protection against Alzheimer's pathology," he said.
The next step is to find a way to raise BDNF levels, Buchman said. It might be a drug or a change in behavior. But, at what age that lifestyle change must start or what the effects of a drug might be are unknowns, he said.
Beeri pointed out that exercise has been shown to increase levels of BDNF in the blood, but said a relationship between BDNF protein levels in the blood and in the brain hasn't been established.
Exercise and mentally stimulating activities can't hurt, she said. "It's worth giving it a try," she said.
SOURCES: Aron Buchman, M.D., professor, department of neurological sciences, Rush University Medical Center, Chicago; Michal Schnaider Beeri, Ph.D., associate professor, psychiatry, Icahn School of Medicine, Mount Sinai, New York City; Jan. 27, 2016, Neurology, online
Wednesday, January 27, 2016
Aged Garlic Extract
Aged Garlic Extract Retards Progression of Coronary Artery Calcification1,2
+Author Affiliations
- ↵3To whom correspondence should be addressed: E-mail: budoff@ucla.edu.
Abstract
Prospective epidemiologic studies have identified several risk factors for heart disease, and most can be the target of risk reduction interventions. The most widely recognized risk factors for atherosclerotic cardiovascular disease (ASCVD) include age, gender, cigarette smoking, sedentary lifestyle, elevated LDL, reduced HDL, hypertension, and diabetes. The consistency of associations between these factors and ASCVD risk across populations is substantial. Our understanding of the pathogenesis and etiology of coronary ASCVD, as well as its clinical implications, has grown tremendously over the past 20 y. The role garlic might play in treating ASCVD has been postulated for many years, but until recently no studies on garlic's ability to inhibit the atherosclerotic process have been reported. A pilot study evaluating coronary artery calcification and the effect of garlic therapy in a group of patients who were also on statin therapy suggested incremental benefits. The implications of this study must be put in context of the potential importance of early atherosclerosis detection and prevention./.../
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- ....M, Sarah Smith , G Lowe, Gordon Lowe, K Rahman, Rahman, Khalid, Lowe, Gordon M, Gordon M Lowe ] [Liverpool John Moores University, Liverpool, School of Pharmacy and Biomolecular Sciences, United Kingdom] Aged Garlic Extract Inhibits Human Platelet Aggregation by Altering Intracellular Signaling...
- ...of Florida, Food Science and Human Nutrition Department, FL] Aged Garlic ExtractModifies Human Immunity123 [] [aged garlic extract, flu, human immunity, NK cell, γδ-T cell, colds] Aged Garlic Extract Modifies Human Immunity123 © 2016 American Society for Nutrition Aged Garlic Extract Modifies...
- Abstract
- Full Text (PDF)
- Reprints and Permissions
- Add to Custom Publication
- ...Garlic Extract Suppresses the Development of Atherosclerosis in Apolipoprotein E–Knockout Mice123 [] [T helper cell 1, aged garlic extract, apolipoprotein E–knockout mice, triglyceride, atherosclerosis, CD11b, cholesterol] Aged Garlic Extract Suppresses the Development of Atherosclerosis...
- ...of the whole garlic clove in organic solvents. Although allicin is not contained in the extracted oil fragment, both DADS and DATS are readily available (14). Aged garlicextract. Aged garlic extract (AGE) is prepared by storing raw sliced garlic in 15–20% ethanol for 20mo in a stainless steel tank...
- ...Pharmaceutical Co., Drug Discovery Laboratory, Akitakata, Ltd., Japan] Development of an Analytic Method for Sulfur Compounds in Aged Garlic Extract with the Use of a Postcolumn High Performance Liquid Chromatography Method with Sulfur-Specific Detection123 [] [hexaiodoplatinate reagent, aged garlic extract...
- ...Hirotaka, Kenji Itoh , Kenji Itoh] [Wakunaga Pharmaceutical Co., Drug Discovery Laboratory, Akitakata, Ltd., Japan] Pharmacokinetics of S-Allyl-l-cysteine in Rats Is Characterized by High Oral Absorption and Extensive Renal Reabsorption12 [] [agedgarlic extract, renal reabsorption, oral absorption...
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