fromRuggiero, Mrs. Ana Lucia (WDC) <ruglucia@paho.org>reply-to"Equity, Health & Human Development" <EQUIDAD@listserv.paho.org>
Population Aging and Economic Growth David Bloom, Clarence James Gamble Professor of Economics & Demography and Chair, Department of Global Health & Population, Harvard School of Public Health.David Canning, Professor of Economics and International Health, Department of Global Health and Population, Harvard School of Public Health. Günther Fink, Assistant Professor of International Health Economics, Department of Global Health and Population, Harvard School of Public Health.Commission on Growth and Development, 2008 Available online as PDF file [48p.] at: http://www.growthcommission.org/storage/cgdev/documents/gcwp032web.pdf
Tuesday, August 19, 2008
Monday, August 18, 2008
UNDP Human Development Report 2007 2008 - Encyclopedia of Earth
UNDP Human Development Report 2007 2008 - Encyclopedia of Earth: "Introduction Cover of the UNDP Human Development Report 2007/2008. (Source: UNDP)The United Nations Development Programme Human Development Report 2007/2008 was released on November 27, 2007.
The report's title 'Fighting climate change: Human solidarity in a divided world' reflects the consensus of its authors who conclude that the greatest threat to the future of human development lies in the potential consequences of oncoming climate change.
Findings The Report documents that that climate change is not just a future scenario. Increased exposure to droughts, floods and storms is already destroying opportunity and reinforcing inequality. Meanwhile, there is now overwhelming scientific evidence that the world is moving towards the point at which irreversible ecological catastrophe becomes unavoidable. Business-as-usual climate change points in a clear direction: unprecedented reversal in human development in our lifetime, and acute risks for our children and their grandchildren."/.../
The report's title 'Fighting climate change: Human solidarity in a divided world' reflects the consensus of its authors who conclude that the greatest threat to the future of human development lies in the potential consequences of oncoming climate change.
Findings The Report documents that that climate change is not just a future scenario. Increased exposure to droughts, floods and storms is already destroying opportunity and reinforcing inequality. Meanwhile, there is now overwhelming scientific evidence that the world is moving towards the point at which irreversible ecological catastrophe becomes unavoidable. Business-as-usual climate change points in a clear direction: unprecedented reversal in human development in our lifetime, and acute risks for our children and their grandchildren."/.../
WHO | Volume 86, Number 8, August 2008, 577-656
WHO Volume 86, Number 8, August 2008, 577-656:
"Volume 86, Number 8, August 2008, 577-656
IN THIS MONTH’S BULLETIN
WHO 60th anniversary commemorative volume; Primary health care; Religion and science; Positive policy change; Denaturalizing scarcity; Migrant health; Many barriers to treatment; Ethics versus economics; A human rights approach; Ethics and technology; Ethical oversight needed; A personalist approach; Guidelines for herbal medicine research; Emerging epidemics; Time to revisit surgery; Health sector needs to support abused women
Full article text [HTML] Full article text [pdf 251kb]
EDITORIALS
The contribution of ethics to public health- Carl H Coleman et al.doi: 10.2471/BLT.08.055954Full article text [HTML] Full article text [pdf 131kb]
and more/.../
"Volume 86, Number 8, August 2008, 577-656
IN THIS MONTH’S BULLETIN
WHO 60th anniversary commemorative volume; Primary health care; Religion and science; Positive policy change; Denaturalizing scarcity; Migrant health; Many barriers to treatment; Ethics versus economics; A human rights approach; Ethics and technology; Ethical oversight needed; A personalist approach; Guidelines for herbal medicine research; Emerging epidemics; Time to revisit surgery; Health sector needs to support abused women
Full article text [HTML] Full article text [pdf 251kb]
EDITORIALS
The contribution of ethics to public health- Carl H Coleman et al.doi: 10.2471/BLT.08.055954Full article text [HTML] Full article text [pdf 131kb]
and more/.../
Unexpected connections (book excerpt: The Light Within) ... American Medical News
AMNews: Aug. 25, 2008. Unexpected connections (book excerpt: The Light Within) ... American Medical News: "Unexpected connections (book excerpt: The Light Within)
Texas physician Lois M. Ramondetta, MD, writes about the bond she formed with a cancer patient, the book's co-author.
By AMNews staff. Aug. 25, 2008.
In this excerpt, Dr. Ramondetta, an associate professor of gynecologic oncology at the University of Texas MD Anderson Cancer Center, grapples with Deborah Rose Sill's grim diagnosis.
The results of Deb's biopsy came in within twenty-four hours, and our worst fears were confirmed: The cancer had returned. I knew the results before Deb did, but it wasn't my job to share the findings with her. That was up to her principal physicians, Dr. Bouquet or Dr. Darling. By the time I saw her the following day, they'd already broken the news.
'How long do you think I have?' she asked me."/.../
Texas physician Lois M. Ramondetta, MD, writes about the bond she formed with a cancer patient, the book's co-author.
By AMNews staff. Aug. 25, 2008.
In this excerpt, Dr. Ramondetta, an associate professor of gynecologic oncology at the University of Texas MD Anderson Cancer Center, grapples with Deborah Rose Sill's grim diagnosis.
The results of Deb's biopsy came in within twenty-four hours, and our worst fears were confirmed: The cancer had returned. I knew the results before Deb did, but it wasn't my job to share the findings with her. That was up to her principal physicians, Dr. Bouquet or Dr. Darling. By the time I saw her the following day, they'd already broken the news.
'How long do you think I have?' she asked me."/.../
Survey captures snapshot of nation's health ... American Medical News
AMNews: Aug. 25, 2008. Survey captures snapshot of nation's health ... American Medical News
http://www.cdc.gov/nchs/nhanes.htm
What's NewNHANES Tutorials
Data Sets and Related Documentation
Introduction to NHANES and Mobile Examination Center
Links to Survey Results and Products
Information for Survey Participants or Health Professionals
Spanish Version
Access to Public and Non-Public NHANES Data Sets
Proposal Guidelines for New
Survey Content
http://www.cdc.gov/nchs/nhanes.htm
What's NewNHANES Tutorials
Data Sets and Related Documentation
Introduction to NHANES and Mobile Examination Center
Links to Survey Results and Products
Information for Survey Participants or Health Professionals
Spanish Version
Access to Public and Non-Public NHANES Data Sets
Proposal Guidelines for New
Survey Content
¿Investigadores en obesidad deben pensar como capitalistas?
(Referência enviada pela Dra. Rosa Maria Vilanova)
Para detener el avance de la obesidad, tenemos que estudiar el entramado de intereses y estrategias comerciales que la promueven, plantea Jonathan Wells.
Pelotas es una ciudad del sur brasileño de pronunciados contrastes desde el punto de vista económico: al costado de la vía pública, delgados ponis tiran de carros desvencijados y algunas bicicletas; por la misma calle, motos y elegantes autos modernos pasan a mayor velocidad. Algunas personas viven en chozas construidas con bolsas de plástico; otras, en mansiones con yates amarrados a la vera del jardín. Lejos del centro de la ciudad, pequeños comercios aún venden alimentos de primera necesidad y verduras a bajo precio. Pero en las inmediaciones del centro sobresale un gran supermercado al que se accede desde el estacionamiento mediante una escalera automática.
La ciudad, en la que colaboro realizando investigación epidemiológica sobre obesidad, también vive una pronunciada transición nutricional. En Brasil, entre 1973 y 1996, la obesidad aumentó del 2,4 al 6,9 por ciento en los hombres y del 7 al 12,5 por ciento en las mujeres./.../
Para detener el avance de la obesidad, tenemos que estudiar el entramado de intereses y estrategias comerciales que la promueven, plantea Jonathan Wells.
Pelotas es una ciudad del sur brasileño de pronunciados contrastes desde el punto de vista económico: al costado de la vía pública, delgados ponis tiran de carros desvencijados y algunas bicicletas; por la misma calle, motos y elegantes autos modernos pasan a mayor velocidad. Algunas personas viven en chozas construidas con bolsas de plástico; otras, en mansiones con yates amarrados a la vera del jardín. Lejos del centro de la ciudad, pequeños comercios aún venden alimentos de primera necesidad y verduras a bajo precio. Pero en las inmediaciones del centro sobresale un gran supermercado al que se accede desde el estacionamiento mediante una escalera automática.
La ciudad, en la que colaboro realizando investigación epidemiológica sobre obesidad, también vive una pronunciada transición nutricional. En Brasil, entre 1973 y 1996, la obesidad aumentó del 2,4 al 6,9 por ciento en los hombres y del 7 al 12,5 por ciento en las mujeres./.../
Saturday, August 16, 2008
Data by Geography > Brazil > Summary - Population Reference Bureau
Data by Geography > Brazil > Summary - Population Reference Bureau: "Data by Geography > Brazil > Summary"
PRB 2008 WORLD POPULATION DATA SHEET: Global Demographic Divide Widens The demographic divide—the inequality in the population and health profiles of rich and poor countries—is widening. Two sharply different patterns of population growth are evident: Little growth or even decline in most wealthy countries and continued rapid population growth in the world's poorest countries. The Population Reference Bureau will release its 2008 World Population Data Sheet at a press briefing in Washington, DC. The Data Sheet and its summary report provide up-to-date demographic, health, and environment data for all countries and major world regions. New on the Data Sheet this year are data on maternal mortality and percent of population undernourished. The Data Sheet and related material will be online at www.prb.org, on Aug. 19 at 10 a.m. (EDT).
PRB 2008 WORLD POPULATION DATA SHEET: Global Demographic Divide Widens The demographic divide—the inequality in the population and health profiles of rich and poor countries—is widening. Two sharply different patterns of population growth are evident: Little growth or even decline in most wealthy countries and continued rapid population growth in the world's poorest countries. The Population Reference Bureau will release its 2008 World Population Data Sheet at a press briefing in Washington, DC. The Data Sheet and its summary report provide up-to-date demographic, health, and environment data for all countries and major world regions. New on the Data Sheet this year are data on maternal mortality and percent of population undernourished. The Data Sheet and related material will be online at www.prb.org, on Aug. 19 at 10 a.m. (EDT).
Friday, August 15, 2008
Gmail - [EQ] This is Public Health Toolkit - achutti@gmail.com
From: Ruggiero, Mrs. Ana Lucia (WDC) to EQUIDAD
[ASPH] - 2008Toolkit: http://www.thisispublichealth.org/toolkit/ “….Most people don't understand what public health is, much less how it impacts their daily lives. The “This Is Public Health” campaign was designed to let people know that public health affects them on a daily basis and that we are only as healthy as the world we live in. The campaign utilizes stickers with the slogan “This is Public Health” placed in strategic locations around communities to build awareness of the many ways in which public health impacts our well being. …”“……As part of the “This is Public Health”campaign, ASPH has developed the This is Public Health toolkit to which will serve as a resource for anyone who is interested in educating others about public health issues or the field of public health. The materials in the toolkit are suggestions or templates, which can either be used as is, or tailored to suit your specific audiences. The toolkit also includes links for other sources that can increase knowledge of public health both inside and outside of the classroom. Through the toolkit, we hope to provide a hub containing more information on both the “This is Public Health ” campaign and the field as a whole. Materials will be provided that target a range of individuals, accommodating varying age groups and differing levels of familiarity with the field of public health. …”Website: http://www.whatispublichealth.org/
[ASPH] - 2008Toolkit: http://www.thisispublichealth.org/toolkit/ “….Most people don't understand what public health is, much less how it impacts their daily lives. The “This Is Public Health” campaign was designed to let people know that public health affects them on a daily basis and that we are only as healthy as the world we live in. The campaign utilizes stickers with the slogan “This is Public Health” placed in strategic locations around communities to build awareness of the many ways in which public health impacts our well being. …”“……As part of the “This is Public Health”campaign, ASPH has developed the This is Public Health toolkit to which will serve as a resource for anyone who is interested in educating others about public health issues or the field of public health. The materials in the toolkit are suggestions or templates, which can either be used as is, or tailored to suit your specific audiences. The toolkit also includes links for other sources that can increase knowledge of public health both inside and outside of the classroom. Through the toolkit, we hope to provide a hub containing more information on both the “This is Public Health ” campaign and the field as a whole. Materials will be provided that target a range of individuals, accommodating varying age groups and differing levels of familiarity with the field of public health. …”Website: http://www.whatispublichealth.org/
association between adult socioeconomic status (SES) and adult levels of inflammatory risk marker
Objective: To examine the association between cumulative life course and adult socioeconomic status (SES) and adult levels of inflammatory risk markers (fibrinogen, white blood cell count (WBC), C-reactive protein (CRP), von Willebrand factor (vWF) and an overall inflammatory score).
Design: Retrospective cohort study.
Setting: 12 681 white and African-American participants in the Atherosclerosis Risk in Communities (ARIC) study and two ancillary studies.
Methods: Participants provided information on SES and place of residence in childhood and young (30–40 years) and mature (45+) adulthood. Residences were linked to census data for neighbourhood SES information. Multiple imputation (MI) was used for missing data. Linear regression and adjusted geometric means were used to estimate the effects of SES on inflammatory risk marker levels.
Results: Graded, statistically significant associations were observed between greater cumulative life-course exposure to low education and social class and elevated levels of fibrinogen and WBC among white participants. Stronger graded, statistically significant associations were observed between low adult education, social class and neighbourhood SES and elevated inflammatory levels. Associations were weaker and less consistent in African-Americans. Covariate adjustment attenuated results but many associations remained strong.
Conclusions: Our results suggest that cumulative exposure to adverse SES conditions across the life course and low adult SES are associated with an elevated systemic inflammatory burden in adulthood. Chronic systemic inflammation may be one pathway linking low life-course SES and elevated cardiovascular disease risk./.../
Design: Retrospective cohort study.
Setting: 12 681 white and African-American participants in the Atherosclerosis Risk in Communities (ARIC) study and two ancillary studies.
Methods: Participants provided information on SES and place of residence in childhood and young (30–40 years) and mature (45+) adulthood. Residences were linked to census data for neighbourhood SES information. Multiple imputation (MI) was used for missing data. Linear regression and adjusted geometric means were used to estimate the effects of SES on inflammatory risk marker levels.
Results: Graded, statistically significant associations were observed between greater cumulative life-course exposure to low education and social class and elevated levels of fibrinogen and WBC among white participants. Stronger graded, statistically significant associations were observed between low adult education, social class and neighbourhood SES and elevated inflammatory levels. Associations were weaker and less consistent in African-Americans. Covariate adjustment attenuated results but many associations remained strong.
Conclusions: Our results suggest that cumulative exposure to adverse SES conditions across the life course and low adult SES are associated with an elevated systemic inflammatory burden in adulthood. Chronic systemic inflammation may be one pathway linking low life-course SES and elevated cardiovascular disease risk./.../
Thursday, August 14, 2008
Premiado Dr. Cesar Gomes Victora
(Prêmio para o AMICOR Cesar Victora, notícia apontada por Dra. Maria Inês Reinert Azambuja)
Dr. Cesar Gomes Victora Profesor Emérito, Universidade Federal de Pelotas, Brasil.Premio Carso a la Trayectoria Personal en Investigación en Salud El Dr. Cesar Gomes Victora es médico graduado de la Universidad Federal de Rio Grande do Sul, Brasil y epidemiólogo con Doctorado en Epidemiología del Centro de Evaluación y Planeación de la London School of Hygiene and Tropical Medicine del Reino Unido. El Dr. Victora ha contribuido en forma importante a la salud y nutrición materna e infantil. Destacando sus investigaciones en cuanto a la importancia de la alimentación con leche materna en la epidemiología y control de la diarrea, enfermedades respiratorias agudas y otras causas de mortalidad infantil.Su trabajo en la promoción de la alimentación a pecho materno estableció el rol de “salvador de vidas infantiles” y ha sido un líder en el proceso que llevó a la lactancia materna exclusiva en los primeros seis meses de vida como recomendación mundial.
El Dr. Victora actualmente lidera la colaboración de los cinco mayores y más prolongados estudios de cohortes de países de bajos y medianos recursos. Estos estudios ofrecerán información fundamental de cómo la desnutrición temprana, seguida por la adopción de dietas y estilos de vida occidentales durante la adolescencia y vida adulta pueden constituirse en factores de riesgo extremadamente importantes para el desarrollo de enfermedades crónicas.
Dr. Cesar Gomes Victora Profesor Emérito, Universidade Federal de Pelotas, Brasil.Premio Carso a la Trayectoria Personal en Investigación en Salud El Dr. Cesar Gomes Victora es médico graduado de la Universidad Federal de Rio Grande do Sul, Brasil y epidemiólogo con Doctorado en Epidemiología del Centro de Evaluación y Planeación de la London School of Hygiene and Tropical Medicine del Reino Unido. El Dr. Victora ha contribuido en forma importante a la salud y nutrición materna e infantil. Destacando sus investigaciones en cuanto a la importancia de la alimentación con leche materna en la epidemiología y control de la diarrea, enfermedades respiratorias agudas y otras causas de mortalidad infantil.Su trabajo en la promoción de la alimentación a pecho materno estableció el rol de “salvador de vidas infantiles” y ha sido un líder en el proceso que llevó a la lactancia materna exclusiva en los primeros seis meses de vida como recomendación mundial.
El Dr. Victora actualmente lidera la colaboración de los cinco mayores y más prolongados estudios de cohortes de países de bajos y medianos recursos. Estos estudios ofrecerán información fundamental de cómo la desnutrición temprana, seguida por la adopción de dietas y estilos de vida occidentales durante la adolescencia y vida adulta pueden constituirse en factores de riesgo extremadamente importantes para el desarrollo de enfermedades crónicas.
Sunday, August 10, 2008
Mário Fernando de Camargo Maranhão: Prêmio Mérito SBC – Personalidade da Cardiologia
A Diretoria da Sociedade Brasileira de Cardiologia escolheu o AMICOR Mário de Camargo Maranhão para receber o Prêmio Mérito SBC – Personalidade da Cardiologia – prêmio criado para homenagear um cardiologista, membro da SBC, que tenha contribuído significativamente nas áreas de ciência e/ou docência e/ou assistência.
A premiação será realizada na Cerimônia de Abertura do 63º Congresso Brasileiro de Cardiologia, no dia 7 de setembro de 2008 (domingo). O prêmio será entregue por seu padrinho, Prof. Dr. Ayrton Pires Brandão, Ex-Presidente da SBC.
A premiação será realizada na Cerimônia de Abertura do 63º Congresso Brasileiro de Cardiologia, no dia 7 de setembro de 2008 (domingo). O prêmio será entregue por seu padrinho, Prof. Dr. Ayrton Pires Brandão, Ex-Presidente da SBC.
Epidemiologia e Saúde Pública em Curitiba
- O Grupo de Trabalho sobre Epidemiologia e Cardiologia Baseada em Evidência (GEECAB) do Departamento de Cardiologia Clínica da Sociedade Brasileira de Cardiologia, juntamente com o Ministério da Saúde estão organizando um Painel/Oficina no dia 06 de setembro próximo (sábado, das 14 às 18 horas), em Curitiba, como atividade pré-congresso do 63º. Congresso Brasileiro de Cardiologia.
O encontro - num clima de informalidade - pretende oportunizar uma visão compartilhada (de especialistas em cardiologia e de saúde pública) sobre saúde cardiovascular da população brasileira, seus problemas e possíveis soluções.
Alguns tópicos já delineados compreendem: - 1o. Bloco (14h – 16h)
1.2-Visão de cardiologista: problemas, prioridades e recursos
1.3-Visão de Saúde Pública: DCV no contexto da Saúde Pública e recursos do SUS
1.4-Estimativa de custos globais das DCV no Brasil
1.5-Determinantes Sociais de Saúde e Doença, e Saúde Cardiovascular no Brasil
1.6-Política de medicamentos
1.7-Política de Procedimentos de Alta Complexidade
- 2o. Bloco (16h15min – 18h)
2.2-Linhas prioritárias de investigação e de vigilância epidemiológica
2.3-O que o MS espera da SBC e proporia como linha de colaboração
2.4-Possíveis considerações de observadores externos
2.5-Questionamentos e sugestões da assistência
2.6-Esboço de agenda mínima de colaboração objetiva, de curto e médio prazo
A Presidente do GT (Dra. Gláucia Martins de Oliveira) e eu convidamos a todos que queiram e possam colaborar para comparecer ao encontro e, se não der, podem enviar sugestões ou temas a serem elaborados nesta ocasião ou em ocasiões fruturas. Se souber de alguém que também tenha idéias para apresentar ou discutir, sintam-se a vontade para estender o convite.
Saturday, August 09, 2008
Simvastatin Used With Amiodarone - Risk of rhabdomyolysis when simvastatin is used with amiodarone
http://mail.google.com/mail/#inbox/11ba801b7e9ff163
FDA notified healthcare professionals of the risk of muscle injury, rhabdomyolysis, which can lead to kidney failure or death, when simvastatin is used with amiodarone. This risk is dose-related and increases when a dose of simvastatin greater than 20 mg per day is given with amiodarone. Although a revision of the simvastatin labeling in 2002 described an increased risk of rhabdomyolysis when amiodarone is taken with simvastatin doses greater than 20 mg daily, FDA continues to receive reports of rhabdomyolysis in patients treated concurrently with amiodarone and simvastatin. Prescribers should be aware of the increased risk of rhabdomyolysis when simvastatin is prescribed with amiodarone, and they should avoid doses of simvastatin greater than 20 mg per day in patients taking amiodarone. Read the complete MedWatch safety summary, including links to the FDA Drug Information page, Information for Healthcare Professionals sheet, and labels (Prescribing Information) for simvastatin and amiodarone products, at http://www.fda.gov/medwatch/safety/2008/safety08.htm#Simvastatin
FDA notified healthcare professionals of the risk of muscle injury, rhabdomyolysis, which can lead to kidney failure or death, when simvastatin is used with amiodarone. This risk is dose-related and increases when a dose of simvastatin greater than 20 mg per day is given with amiodarone. Although a revision of the simvastatin labeling in 2002 described an increased risk of rhabdomyolysis when amiodarone is taken with simvastatin doses greater than 20 mg daily, FDA continues to receive reports of rhabdomyolysis in patients treated concurrently with amiodarone and simvastatin. Prescribers should be aware of the increased risk of rhabdomyolysis when simvastatin is prescribed with amiodarone, and they should avoid doses of simvastatin greater than 20 mg per day in patients taking amiodarone. Read the complete MedWatch safety summary, including links to the FDA Drug Information page, Information for Healthcare Professionals sheet, and labels (Prescribing Information) for simvastatin and amiodarone products, at http://www.fda.gov/medwatch/safety/2008/safety08.htm#Simvastatin
Thursday, August 07, 2008
Latin America: old and new challenges -- Ebrahim 37 (4): 689 -- International Journal of Epidemiology
Latin America: old and new challenges -- Ebrahim 37 (4): 689 -- International Journal of Epidemiology: "This issue is devoted to Latin America, and is intended to provide a link with the World Congress of Epidemiology, Porto Alegre, Brazil in September 2008. We expect this congress to exceed attendance at previous International Epidemiology Association world meetings by about 5-fold. A large epidemiology following in Latin America reflects a sense of solidarity among epidemiologists in the region, a willingness to participate and a thirst for knowledge. Perhaps, most importantly, in Latin American countries epidemiology is seen more as an . . ."/.../
IV antihypertensive clevidipine approved in the US
IV antihypertensive clevidipine approved in the US: "Parsippany, NJ - The Medicines Company has announced that the US FDA has approved its intravenous antihypertensive clevidipine (Cleviprex), which is the first new IV drug for high blood pressure in 10 years [1].
Clevidipine is a new calcium-channel blocker, which has shown promise in several studies, including in severe acute hypertension in the emergency department and in the setting of perioperative blood-pressure management. Doctors presenting these trials, as previously reported by heartwire, said the advantages of clevidipine over current drugs used for acute hypertension—such as sodium nitroprusside, labetalol, and nicardipine—are that it is easy to titrate and has an ultrashort half-life of less than one minute."/.../
Clevidipine is a new calcium-channel blocker, which has shown promise in several studies, including in severe acute hypertension in the emergency department and in the setting of perioperative blood-pressure management. Doctors presenting these trials, as previously reported by heartwire, said the advantages of clevidipine over current drugs used for acute hypertension—such as sodium nitroprusside, labetalol, and nicardipine—are that it is easy to titrate and has an ultrashort half-life of less than one minute."/.../
More Americans Seek Medical Care and Most Walk Away with a Prescription
ATLANTA, Aug. 6 -- On average, each American seeks medical care at a doctor's office, a clinic, or a hospital emergency department about four times a year, according to data released by the CDC.
And that number is an increase of 26% over the decade from 1996 to 2006, the latest CDC/National Center for Health Statistics National Health Care Survey showed.
The increase outpaced the growth in population, which rose by 11% during the same decade, wrote Susan M. Schappert, M.A., of the National Center for Health Statistics, and colleagues.
The CDC said the observed increase in medical visits "can be linked to both the aging of the population, as older persons have higher visit rates than younger persons in general, and an increase in utilization by older persons."
The overall visit rate was not significantly different for white and black persons. /.../
And that number is an increase of 26% over the decade from 1996 to 2006, the latest CDC/National Center for Health Statistics National Health Care Survey showed.
The increase outpaced the growth in population, which rose by 11% during the same decade, wrote Susan M. Schappert, M.A., of the National Center for Health Statistics, and colleagues.
The CDC said the observed increase in medical visits "can be linked to both the aging of the population, as older persons have higher visit rates than younger persons in general, and an increase in utilization by older persons."
The overall visit rate was not significantly different for white and black persons. /.../
Wednesday, August 06, 2008
Brain Pathway Yields Clues to Cigarette Addiction
Brain Pathway Yields Clues to Cigarette Addiction - healthfinder.gov:
"TUESDAY, Aug. 5 (HealthDay News) -- New insight into how the brain processes the rewarding and addictive properties of nicotine sheds light on why some people seem to become addicted once they have their first cigarette, say Canadian researchers.
'Nicotine interacts with a variety of neurochemical pathways within the brain to produce its rewarding and addictive effects. However, during the early phase of tobacco exposure, many individuals find nicotine highly unpleasant and aversive, whereas others may become rapidly dependent on nicotine and find it highly rewarding. We wanted to explore that difference,' study leader Steven Laviolette, of the department of anatomy and cell biology at the Schulich School of Medicine & Dentistry, University of Western Ontario, said in a university news release."/.../
"TUESDAY, Aug. 5 (HealthDay News) -- New insight into how the brain processes the rewarding and addictive properties of nicotine sheds light on why some people seem to become addicted once they have their first cigarette, say Canadian researchers.
'Nicotine interacts with a variety of neurochemical pathways within the brain to produce its rewarding and addictive effects. However, during the early phase of tobacco exposure, many individuals find nicotine highly unpleasant and aversive, whereas others may become rapidly dependent on nicotine and find it highly rewarding. We wanted to explore that difference,' study leader Steven Laviolette, of the department of anatomy and cell biology at the Schulich School of Medicine & Dentistry, University of Western Ontario, said in a university news release."/.../
Tuesday, August 05, 2008
2008 State of the Future
Nine of the eleven annual State of the Future reports were selected by Future Survey as among the year’s best books on the future.
This “Report Card on the Future” distills the collective intelligence of over 2,500 leading scientists, futurists, scholars, and policy advisors who work for governments, corporations, non-governmental organizations, universities, and international organizations. The 2008 State of the Future comes in two parts: a 100-page print executive summary and an attached CD containing about 6,000 pages of research behind the print edition and the Millennium Project’s 12 years of cumulative research and methods. Some unique features not available in other global assessments include:
15 Global Challenges – Prospects, Strategies, Insights
State of the Future Index for the world and nations
Government Future Strategy Units and some potentials for international strategic coordination
Global Energy Collective Intelligence – system design options
Environmental Security – overview
Real-Time Delphi technique
700 Annotated Scenario Sets
and much more futures intelligence on technology, environment, governance, and the human condition
It is produced by the Millennium Project, which collects, feeds back, and assesses insights from creative and knowledgeable people on emerging crises, opportunities, strategic priorities, and the feasibility of actions. /.../
This “Report Card on the Future” distills the collective intelligence of over 2,500 leading scientists, futurists, scholars, and policy advisors who work for governments, corporations, non-governmental organizations, universities, and international organizations. The 2008 State of the Future comes in two parts: a 100-page print executive summary and an attached CD containing about 6,000 pages of research behind the print edition and the Millennium Project’s 12 years of cumulative research and methods. Some unique features not available in other global assessments include:
15 Global Challenges – Prospects, Strategies, Insights
State of the Future Index for the world and nations
Government Future Strategy Units and some potentials for international strategic coordination
Global Energy Collective Intelligence – system design options
Environmental Security – overview
Real-Time Delphi technique
700 Annotated Scenario Sets
and much more futures intelligence on technology, environment, governance, and the human condition
It is produced by the Millennium Project, which collects, feeds back, and assesses insights from creative and knowledgeable people on emerging crises, opportunities, strategic priorities, and the feasibility of actions. /.../
Monday, August 04, 2008
Translating Research Into Practice for Healthcare Providers: The American Heart Association's Strategy for Building Healthier Lives, Free of Cardiovascular Diseases and Stroke -- Jones et al. 118 (6): 687 -- Circulation
Translating Research Into Practice for Healthcare Providers: The American Heart Association's Strategy for Building Healthier Lives, Free of Cardiovascular Diseases and Stroke -- Jones et al. 118 (6): 687 -- Circulation
Daniel W. Jones, MD, FAHA; Eric D. Peterson, MD, MPH, FAHA; Robert O. Bonow, MD, FAHA; Frederick A. Masoudi, MD, MSPH; Gregg C. Fonarow, MD, FAHA; Sidney C. Smith, Jr, MD, FAHA; Penelope Solis, JD; Meighan Girgus, MBA; Patricia C. Hinton, MA, MS; Anne Leonard, MPH, RN, FAHA; Raymond J. Gibbons, MD, FAHA
Abstract—The American Heart Association’s (AHA’s) mission is “to build healthier lives, free of cardiovascular diseases and stroke.” This first article in a 2-part series will serve to present an overview of the work the AHA has undertaken to translate evidence into practice for healthcare professionals. It describes the extensive work of the AHA to support and further the delivery of evidence-based medicine, which includes the following: (1) supporting scientific discovery and the next generation of healthcare professionals and researchers; (2) disseminating scientific information; (3) developing evidence-based guidelines and statements; (4) creating and advocating for the implementation of performance indicators/measures; (5) developing clinical decision support and quality improvement tools; and (6) developing directed-cause campaigns, all of which can lead to improved patient care. This article also discusses the need for novel approaches and some of the AHA’s evolving strategies to help address gaps in care. The second article, which will be published shortly after this one, will examine the AHA’s efforts to engage and empower healthcare consumers to become more involved with their own health and health care. (Circulation. 2008;118:687-696.)
Key Words: cardiovascular diseases research stroke
Daniel W. Jones, MD, FAHA; Eric D. Peterson, MD, MPH, FAHA; Robert O. Bonow, MD, FAHA; Frederick A. Masoudi, MD, MSPH; Gregg C. Fonarow, MD, FAHA; Sidney C. Smith, Jr, MD, FAHA; Penelope Solis, JD; Meighan Girgus, MBA; Patricia C. Hinton, MA, MS; Anne Leonard, MPH, RN, FAHA; Raymond J. Gibbons, MD, FAHA
Abstract—The American Heart Association’s (AHA’s) mission is “to build healthier lives, free of cardiovascular diseases and stroke.” This first article in a 2-part series will serve to present an overview of the work the AHA has undertaken to translate evidence into practice for healthcare professionals. It describes the extensive work of the AHA to support and further the delivery of evidence-based medicine, which includes the following: (1) supporting scientific discovery and the next generation of healthcare professionals and researchers; (2) disseminating scientific information; (3) developing evidence-based guidelines and statements; (4) creating and advocating for the implementation of performance indicators/measures; (5) developing clinical decision support and quality improvement tools; and (6) developing directed-cause campaigns, all of which can lead to improved patient care. This article also discusses the need for novel approaches and some of the AHA’s evolving strategies to help address gaps in care. The second article, which will be published shortly after this one, will examine the AHA’s efforts to engage and empower healthcare consumers to become more involved with their own health and health care. (Circulation. 2008;118:687-696.)
Key Words: cardiovascular diseases research stroke
Hospitals shine light on mistakes by publicly saying: 'We're sorry' ... American Medical News
AMNews: Aug. 11, 2008. Hospitals shine light on mistakes by publicly saying: 'We're sorry' ... American Medical News: "These public mea culpas come on the heels of intense pressure on physicians and hospitals to improve patient safety and transparency, admit mistakes to patients and apologize when things go wrong. While apology and disclosure is still far from the norm, experts say, it is becoming more common as a majority of states now protect expressions of empathy, regret and apology from admissibility in court."/.../
Sunday, August 03, 2008
Amedeo Prize 2008
The voters of the Amedeo Medical Literature Service have awarded the 2008 Amedeo Prize to the Wellcome Trust Case Control Consortium (WTCCC), United Kingdom, for its article "Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls", published in Nature on June 6th, 2007 (447:661-78; free full-text).
1.
Wellcome Trust Case Control Consortium - Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature - Free full-text
359
2.
Baker, Jennifer L - Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med - Free full-text
291
3.
Takahashi K - Induction of Pluripotent Stem Cells from Adult Human Fibroblasts by Defined Factors. Cell - Free full-text
282
4.
Yu J - Induced Pluripotent Stem Cell Lines Derived from Human Somatic Cells. Science - Free full-text
245
5.
Zhang, David D - Global climate change, war, and population decline in recent human history. Proc Natl Acad Sci U S A - Free full-text
241
6.
Menzies, Dick - Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann Intern Med - Free full-text
215
7.
Dubois, Bruno - Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurol - Free full-text
213
8.
Amanna, Ian J - Duration of humoral immunity to common viral and vaccine antigens. N Engl J Med - Free full-text
203
9.
Reddy, Madhuri - Oral drug therapy for multiple neglected tropical diseases: a systematic review. JAMA - Free full-text
190
10.
Vernooij, Meike W - Incidental findings on brain MRI in the general population. N Engl J Med - Free full-text
1.
Wellcome Trust Case Control Consortium - Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature - Free full-text
359
2.
Baker, Jennifer L - Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med - Free full-text
291
3.
Takahashi K - Induction of Pluripotent Stem Cells from Adult Human Fibroblasts by Defined Factors. Cell - Free full-text
282
4.
Yu J - Induced Pluripotent Stem Cell Lines Derived from Human Somatic Cells. Science - Free full-text
245
5.
Zhang, David D - Global climate change, war, and population decline in recent human history. Proc Natl Acad Sci U S A - Free full-text
241
6.
Menzies, Dick - Meta-analysis: new tests for the diagnosis of latent tuberculosis infection: areas of uncertainty and recommendations for research. Ann Intern Med - Free full-text
215
7.
Dubois, Bruno - Research criteria for the diagnosis of Alzheimer's disease: revising the NINCDS-ADRDA criteria. Lancet Neurol - Free full-text
213
8.
Amanna, Ian J - Duration of humoral immunity to common viral and vaccine antigens. N Engl J Med - Free full-text
203
9.
Reddy, Madhuri - Oral drug therapy for multiple neglected tropical diseases: a systematic review. JAMA - Free full-text
190
10.
Vernooij, Meike W - Incidental findings on brain MRI in the general population. N Engl J Med - Free full-text
Saturday, August 02, 2008
Smoke-free Legislation and Hospitalizations for Acute Coronary Syndrome
Jill P. Pell, M.D et all
Background Previous studies have suggested a reduction in the total number of hospital admissions for acute coronary syndrome after the enactment of legislation banning smoking in public places. However, it is unknown whether the reduction in admissions involved nonsmokers, smokers, or both.
Methods Since the end of March 2006, smoking has been prohibited by law in all enclosed public places throughout Scotland. We collected information prospectively on smoking status and exposure to secondhand smoke based on questionnaires and biochemical findings from all patients admitted with acute coronary syndrome to nine Scottish hospitals during the 10-month period preceding the passage of the legislation and during the same period the next year. These hospitals accounted for 64% of admissions for acute coronary syndrome in Scotland, which has a population of 5.1 million.
Results Overall, the number of admissions for acute coronary syndrome decreased from 3235 to 2684 — a 17% reduction (95% confidence interval, 16 to 18) — as compared with a 4% reduction in England (which has no such legislation) during the same period and a mean annual decrease of 3% (maximum decrease, 9%) in Scotland during the decade preceding the study. The reduction in the number of admissions was not due to an increase in the number of deaths of patients with acute coronary syndrome who were not admitted to the hospital; this latter number decreased by 6%. There was a 14% reduction in the number of admissions for acute coronary syndrome among smokers, a 19% reduction among former smokers, and a 21% reduction among persons who had never smoked. Persons who had never smoked reported a decrease in the weekly duration of exposure to secondhand smoke (P<0.001 by the chi-square test for trend) that was confirmed by a decrease in their geometric mean concentration of serum cotinine from 0.68 to 0.56 ng per milliliter (P<0.001 by the t-test).
Conclusions The number of admissions for acute coronary syndrome decreased after the implementation of smoke-free legislation. A total of 67% of the decrease involved nonsmokers. However, fewer admissions among smokers also contributed to the overall reduction.
Background Previous studies have suggested a reduction in the total number of hospital admissions for acute coronary syndrome after the enactment of legislation banning smoking in public places. However, it is unknown whether the reduction in admissions involved nonsmokers, smokers, or both.
Methods Since the end of March 2006, smoking has been prohibited by law in all enclosed public places throughout Scotland. We collected information prospectively on smoking status and exposure to secondhand smoke based on questionnaires and biochemical findings from all patients admitted with acute coronary syndrome to nine Scottish hospitals during the 10-month period preceding the passage of the legislation and during the same period the next year. These hospitals accounted for 64% of admissions for acute coronary syndrome in Scotland, which has a population of 5.1 million.
Results Overall, the number of admissions for acute coronary syndrome decreased from 3235 to 2684 — a 17% reduction (95% confidence interval, 16 to 18) — as compared with a 4% reduction in England (which has no such legislation) during the same period and a mean annual decrease of 3% (maximum decrease, 9%) in Scotland during the decade preceding the study. The reduction in the number of admissions was not due to an increase in the number of deaths of patients with acute coronary syndrome who were not admitted to the hospital; this latter number decreased by 6%. There was a 14% reduction in the number of admissions for acute coronary syndrome among smokers, a 19% reduction among former smokers, and a 21% reduction among persons who had never smoked. Persons who had never smoked reported a decrease in the weekly duration of exposure to secondhand smoke (P<0.001 by the chi-square test for trend) that was confirmed by a decrease in their geometric mean concentration of serum cotinine from 0.68 to 0.56 ng per milliliter (P<0.001 by the t-test).
Conclusions The number of admissions for acute coronary syndrome decreased after the implementation of smoke-free legislation. A total of 67% of the decrease involved nonsmokers. However, fewer admissions among smokers also contributed to the overall reduction.
Friday, August 01, 2008
Tobacco Smoking by physicians
Derek R Smith1, and Peter A Leggat
Tobacco smoking by physicians represents a contentious issue in public health, and regardless of what country it originates from, the need for accurate, historical data is paramount. As such, this article provides an international comparison of all modern literature describing the tobacco smoking habits of contemporary physicians.
Methods
A keyword search of appropriate MeSH terms was initially undertaken to identify relevant material, after which the reference lists of manuscripts were also examined to locate further publications.
Results
A total of 81 English-language studies published in the past 30 years met the inclusion criteria. Two distinct trends were evident. Firstly, most developed countries have shown a steady decline in physicians' smoking rates during recent years. On the other hand, physicians in some developed countries and newly-developing regions still appear to be smoking at high rates. The lowest smoking prevalence rates were consistently documented in the United States, Australia and the United Kingdom. Comparison with other health professionals suggests that fewer physicians smoke when compared to nurses, and sometimes less often than dentists.
Tobacco smoking by physicians represents a contentious issue in public health, and regardless of what country it originates from, the need for accurate, historical data is paramount. As such, this article provides an international comparison of all modern literature describing the tobacco smoking habits of contemporary physicians.
Methods
A keyword search of appropriate MeSH terms was initially undertaken to identify relevant material, after which the reference lists of manuscripts were also examined to locate further publications.
Results
A total of 81 English-language studies published in the past 30 years met the inclusion criteria. Two distinct trends were evident. Firstly, most developed countries have shown a steady decline in physicians' smoking rates during recent years. On the other hand, physicians in some developed countries and newly-developing regions still appear to be smoking at high rates. The lowest smoking prevalence rates were consistently documented in the United States, Australia and the United Kingdom. Comparison with other health professionals suggests that fewer physicians smoke when compared to nurses, and sometimes less often than dentists.
Thursday, July 31, 2008
House Votes to Let FDA Regulate Tobacco - NYTimes.com
House Votes to Let FDA Regulate Tobacco - NYTimes.com: "Decades after the surgeon general first warned that cigarettes were a health hazard, the House of Representatives overwhelmingly approved legislation on Wednesday that would for the first time give the Food and Drug Administration the power to regulate tobacco products."/.../
Diretrizes Brasileiras sobre Diagnóstico, Tratamento e Prevenção da Febre Reumática
SBC lidera discussão sobre diretrizes de febre reumática
Nesta sexta-feira e sábado, dias 1º e 2 de agosto, a Sociedade Brasileira de Cardiologia (SBC) lidera reunião que discutirá a elaboração das Diretrizes Brasileiras sobre Diagnóstico, Tratamento e Prevenção da Febre Reumática. O encontro, realizado com o apoio da Secretaria de Saúde do Estado da Bahia, acontecerá em Salvador com a presença do presidente da Câmara dos Deputados, Arlindo Chinaglia, representando o governo federal, dos secretários de Saúde da Bahia e de Salvador e, também, das sociedades de Pediatria e de Reumatologia.
O evento é da maior relevância, na avaliação do vice-presidente da SBC, Paulo José Bastos Barbosa. “A diretriz servirá de pilar básico para posterior construção de um programa de prevenção e controle da febre reumática no país”, declara. Segundo ele, a exemplo do que foi realizado na Austrália e na Índia, por exemplo, no documento constarão recomendações baseadas na realidade nacional particularmente do sus.
Diretrizes Brasileiras sobre Diagnóstico, Tratamento e Prevenção da Febre Reumática
Nesta sexta-feira e sábado, dias 1º e 2 de agosto, a Sociedade Brasileira de Cardiologia (SBC) lidera reunião que discutirá a elaboração das Diretrizes Brasileiras sobre Diagnóstico, Tratamento e Prevenção da Febre Reumática. O encontro, realizado com o apoio da Secretaria de Saúde do Estado da Bahia, acontecerá em Salvador com a presença do presidente da Câmara dos Deputados, Arlindo Chinaglia, representando o governo federal, dos secretários de Saúde da Bahia e de Salvador e, também, das sociedades de Pediatria e de Reumatologia.
O evento é da maior relevância, na avaliação do vice-presidente da SBC, Paulo José Bastos Barbosa. “A diretriz servirá de pilar básico para posterior construção de um programa de prevenção e controle da febre reumática no país”, declara. Segundo ele, a exemplo do que foi realizado na Austrália e na Índia, por exemplo, no documento constarão recomendações baseadas na realidade nacional particularmente do sus.
Diretrizes Brasileiras sobre Diagnóstico, Tratamento e Prevenção da Febre Reumática
GEECAB em CURITIBA NO CONGRESSO da SBC
Auditório 12 (114)
Atividade Pré-Congresso do Grupo de Estudos sobre Epidemiologia
e Cardiologia baseada em Evidências – Geecabe e Ministério da Saúde
Horário das 14h - 18h
As Doenças Cardiovasculares (DCV), compondo o conjunto de Doenças Crônicas (também rotuladas como
Doenças e Agravos Não Transmissíveis – DANT), são mundialmente reconhecidas como responsáveis pelos mais altos índices de morbidade e mortalidade precoce, inclusive no Brasil. Essas doenças causam grande impacto econômico tanto pela demanda de assistência quanto pela repercussão sobre o trabalho e a produção, e têm também forte determinação social e maior expressão em populações menos favorecidas. Além do desafio aos especialistas na assistência aos seus casos clínicos, constituem-se num enorme problema de Saúde Pública somente redutível através de ações preventivas e de promoção da saúde coletiva.
Dirigentes da SBC e do MS já desenvolvem profícuo diálogo, resultando em programas de tratamento e ações de controle. Entretanto ainda há muito que mobilizar e fazer, motivo pelo qual o Grupo de Estudos sobre Epidemiologia e Cardiologia Baseada em Evidências (GEECAB) planejou um painel específico, junto à principal atividade científica da cardiologia nacional, visando aprofundar e estender a colaboração de cardiologistas e sanitaristas.
A desproporção entre a magnitude do problema e o tempo disponível para este primeiro painel, impõe limitações ao número de expositores e às suas apresentações. É desejável, entretanto, que a assistência de dirigentes e interessados de ambas as instituições seja a mais ampla possível, e que as discussões e elaboração de temas tenha continuidade, única forma de se encontrar novos caminhos e garantir os resultados almejados.
Atividades Pré-Congresso
06 de setembro, sábado
Objetivo: Oportunizar uma visão compartilhada (de especialistas e de saúde pública) sobre saúde cardiovascular da população brasileira, seus problemas e possíveis soluções.
Delineamento: Painel/Oficina em dois blocos, composto por membros da SBC e do MS e possíveis observadores da Federação Mundial de Cardiologia (WHF) e Organização Pan-Americana da Saúde (OPAS) e mídia, aberto para assistência e questionamento de congressistas.
Itens: motivação, visões de ambas as partes, determinação social de saúde/doença, recursos existentes, possíveis linhas de investigação e intervenção, esboço de agenda mínima de colaboração.
Coordenação: Drs. Gláucia Morais (SBC), Rosa Maria Sampaio (MS) e Aloyzio Achutti (SBC).
Programa
1o. Bloco (14h – 16h)
(em torno de 15 minutos no máximo para cada tópico/depoimento)
1.1-Motivação: breve apresentação de justificativa e motivação do encontro. (Dra. Gláucia Moraes, GEECAB)
(5 minutos)
1.2-Visão de cardiologista: problemas, prioridades e recursos (Dr. Antonio Carlos Palandri Chagas, Presidente da SBC, e Luiz Antônio de Almeida Campos, Diretor Científico da SBC)
1.3-Visão de Saúde Pública: Doenças CV no contexto da Saúde Pública no Brasil e recursos do SUS (Dr. José Noronha, Secretário de Assistência à Saúde e Dra. Rosa Maria Sampaio, Diretora do HIPERDIA, do MS.)
1.4-Estimativa de custos globais das DCV no Brasil (Dr Aloyzio Achutti)
1.5-Determinantes Sociais de Saúde e Doença, e Saúde Cardiovascular no Brasil (Maria do Carmo Leal - da Comissão de Determinantes Sociais)
1.6-Política de medicamentos (Dr. Reinaldo Guimarães da Secretaria de Ciência e Tecnologia do MS e Dr. Dirceu Barbano, diretor do Departamento de Assistência Farmacêutica DAF do MS)
1.7-Política de Procedimentos de Alta Complexidade (Dr. Beltrame, Diretor do Departamento de Assistência Especializada DAE – MS) e (Rosemary da ANS).
2o. Bloco (16h15min – 18h)
2.1-O que a SBC espera do MS e proporia como linha de colaboração (Dr. Lázaro Fernandes de Miranda Diretor de Relações Governamentais da SBC).
2.2-Linhas prioritárias de investigação e de vigilância epidemiológica (Representantes das Secretarias de
Vigilância à Saúde - SVS e Coordenação de Vigilância de DANTS)
2.3-O que o MS espera da SBC e proporia como linha de colaboração (Participação ampliada, sob coordenação da Dra. Rosa Maria Sampaio).
2.4-Considerações dos observadores (WHF e OPAS)
2.5-Questionamentos e sugestões da assistência
2.6-Esboço de agenda mínima de colaboração objetiva, de curto e médio prazo (coordenação)
(Um esboço de documento será elaborado pela coordenação do evento, contando com contribuições, que serão bem vindas, incorporando-se posteriormente novas idéias, sugestões e recomendações levantadas durante a reunião)
Lista de Documentos básicos para informação e discussão:
http://departamentos.cardiol.br/geecabe/proposta-geecabe.asp
http://hiperdia.datasus.gov.br/
Nota final: os tópicos fundamentais do documento serão apresentados ao final para uma aprovação preliminar e serão colhidos endereços eletrônicos dos componentes da mesa e da assistência para facilitar a circulação do documento até chegar a uma versão mais representativa para a devida divulgação e aplicação em ambas as instituições.
Atividade Pré-Congresso do Grupo de Estudos sobre Epidemiologia
e Cardiologia baseada em Evidências – Geecabe e Ministério da Saúde
Horário das 14h - 18h
As Doenças Cardiovasculares (DCV), compondo o conjunto de Doenças Crônicas (também rotuladas como
Doenças e Agravos Não Transmissíveis – DANT), são mundialmente reconhecidas como responsáveis pelos mais altos índices de morbidade e mortalidade precoce, inclusive no Brasil. Essas doenças causam grande impacto econômico tanto pela demanda de assistência quanto pela repercussão sobre o trabalho e a produção, e têm também forte determinação social e maior expressão em populações menos favorecidas. Além do desafio aos especialistas na assistência aos seus casos clínicos, constituem-se num enorme problema de Saúde Pública somente redutível através de ações preventivas e de promoção da saúde coletiva.
Dirigentes da SBC e do MS já desenvolvem profícuo diálogo, resultando em programas de tratamento e ações de controle. Entretanto ainda há muito que mobilizar e fazer, motivo pelo qual o Grupo de Estudos sobre Epidemiologia e Cardiologia Baseada em Evidências (GEECAB) planejou um painel específico, junto à principal atividade científica da cardiologia nacional, visando aprofundar e estender a colaboração de cardiologistas e sanitaristas.
A desproporção entre a magnitude do problema e o tempo disponível para este primeiro painel, impõe limitações ao número de expositores e às suas apresentações. É desejável, entretanto, que a assistência de dirigentes e interessados de ambas as instituições seja a mais ampla possível, e que as discussões e elaboração de temas tenha continuidade, única forma de se encontrar novos caminhos e garantir os resultados almejados.
Atividades Pré-Congresso
06 de setembro, sábado
Objetivo: Oportunizar uma visão compartilhada (de especialistas e de saúde pública) sobre saúde cardiovascular da população brasileira, seus problemas e possíveis soluções.
Delineamento: Painel/Oficina em dois blocos, composto por membros da SBC e do MS e possíveis observadores da Federação Mundial de Cardiologia (WHF) e Organização Pan-Americana da Saúde (OPAS) e mídia, aberto para assistência e questionamento de congressistas.
Itens: motivação, visões de ambas as partes, determinação social de saúde/doença, recursos existentes, possíveis linhas de investigação e intervenção, esboço de agenda mínima de colaboração.
Coordenação: Drs. Gláucia Morais (SBC), Rosa Maria Sampaio (MS) e Aloyzio Achutti (SBC).
Programa
1o. Bloco (14h – 16h)
(em torno de 15 minutos no máximo para cada tópico/depoimento)
1.1-Motivação: breve apresentação de justificativa e motivação do encontro. (Dra. Gláucia Moraes, GEECAB)
(5 minutos)
1.2-Visão de cardiologista: problemas, prioridades e recursos (Dr. Antonio Carlos Palandri Chagas, Presidente da SBC, e Luiz Antônio de Almeida Campos, Diretor Científico da SBC)
1.3-Visão de Saúde Pública: Doenças CV no contexto da Saúde Pública no Brasil e recursos do SUS (Dr. José Noronha, Secretário de Assistência à Saúde e Dra. Rosa Maria Sampaio, Diretora do HIPERDIA, do MS.)
1.4-Estimativa de custos globais das DCV no Brasil (Dr Aloyzio Achutti)
1.5-Determinantes Sociais de Saúde e Doença, e Saúde Cardiovascular no Brasil (Maria do Carmo Leal - da Comissão de Determinantes Sociais)
1.6-Política de medicamentos (Dr. Reinaldo Guimarães da Secretaria de Ciência e Tecnologia do MS e Dr. Dirceu Barbano, diretor do Departamento de Assistência Farmacêutica DAF do MS)
1.7-Política de Procedimentos de Alta Complexidade (Dr. Beltrame, Diretor do Departamento de Assistência Especializada DAE – MS) e (Rosemary da ANS).
2o. Bloco (16h15min – 18h)
2.1-O que a SBC espera do MS e proporia como linha de colaboração (Dr. Lázaro Fernandes de Miranda Diretor de Relações Governamentais da SBC).
2.2-Linhas prioritárias de investigação e de vigilância epidemiológica (Representantes das Secretarias de
Vigilância à Saúde - SVS e Coordenação de Vigilância de DANTS)
2.3-O que o MS espera da SBC e proporia como linha de colaboração (Participação ampliada, sob coordenação da Dra. Rosa Maria Sampaio).
2.4-Considerações dos observadores (WHF e OPAS)
2.5-Questionamentos e sugestões da assistência
2.6-Esboço de agenda mínima de colaboração objetiva, de curto e médio prazo (coordenação)
(Um esboço de documento será elaborado pela coordenação do evento, contando com contribuições, que serão bem vindas, incorporando-se posteriormente novas idéias, sugestões e recomendações levantadas durante a reunião)
Lista de Documentos básicos para informação e discussão:
http://departamentos.cardiol.br/geecabe/proposta-geecabe.asp
http://hiperdia.datasus.gov.br/
Nota final: os tópicos fundamentais do documento serão apresentados ao final para uma aprovação preliminar e serão colhidos endereços eletrônicos dos componentes da mesa e da assistência para facilitar a circulação do documento até chegar a uma versão mais representativa para a devida divulgação e aplicação em ambas as instituições.
Wednesday, July 30, 2008
Tau-Targeted Therapy Slows Alzheimer's Progression for 19 Months
CHICAGO, July 29 -- An old drug for urinary-tract infections, methylene blue (Urolene Blue), may hold the key to a therapy that can slow the progress of Alzheimer's disease for as long as 19 months, researchers here reported. After 24 months of treatment with 60 mg three times a day of methylthioninum chloride (rember), patients with moderate Alzheimer's disease achieved a treatment effect that "was twice the effect seen with donepezil (Aricept)," said Claude Wischik, Ph.D., of the University of Aberdeen in Scotland. The drug called rember is a formulation of methylene blue made by TauRx Therapeutics, and Dr. Wischik is founder and chairman of TauRx Therapeutics. The drug attacks tau, which promotes tangles, as opposed to amyloid plaques./.../
Tuesday, July 29, 2008
The Impact of Prevention on Reducing the Burden of Cardiovascular Disease -- Kahn et al. 118 (5): 576 -- Circulation
The Impact of Prevention on Reducing the Burden of Cardiovascular Disease -- Kahn et al. 118 (5): 576 -- Circulation: "Objective— Cardiovascular disease (CVD) is prevalent and expensive. While many interventions are recommended to prevent CVD, the potential effects of a comprehensive set of prevention activities on CVD morbidity, mortality, and costs have never been evaluated. We therefore determined the effects of 11 nationally recommended prevention activities on CVD-related morbidity, mortality, and costs in the United States."/.../
Noninvasive Coronary Artery Imaging
Since the early 1960s, selective x-ray coronary angiography has provided the only means of visualizing the coronary arterial system in vivo. However, it has several disadvantages. First, the incidence, albeit relatively low, of so-called major adverse events (death, myocardial infarction, or stroke) during or within 24 hours of selective coronary angiography is reported to be 0.2% to 0.3%, and the incidence of so-called minor complications (most of which are related to problems with the peripheral vessels through which catheters are inserted) is roughly 1% to 2%.1–3 Second, x-ray coronary angiography is accompanied by a modest amount of discomfort, because the placement of catheters is invasive. Third, it is expensive: the required equipment is costly, and the performance of the procedure necessitates considerable time and skill of highly trained physicians and support personnel. Last, the information obtained via catheter-based coronary angiography pertains to the coronary arterial lumen alone. As a result, alternative methods of visualizing the coronary arterial system that would allow one to avoid these disadvantages are desirable.
mobile health (IT)
BELLAGIO, Italy -- The United Nations Foundation and Vodafone Group Foundation’s Technology Partnership (Technology Partnership) announced today the start of a conference session designed to harness the potential of mobile health (mHealth) to unlock access to health data and improve healthcare in the developing world. Co-facilitated by the Technology Partnership and the Telemedicine Society of India, the session is part of the Rockefeller Foundation conference “Making the eHealth Connection: Global Partners, Local Solutions.”
The “mHealth and Mobile Telemedicine” session is gathering 25 private sector and public health leaders to explore the challenges, opportunities and way forward in building mHealth systems that can improve the access, efficiency and quality of health services in the developing world. The overarching goal of the Rockefeller Foundation conference is to develop a roadmap and global partnerships that support the use of emerging digital technologies to improve public health.
The “mHealth and Mobile Telemedicine” session is gathering 25 private sector and public health leaders to explore the challenges, opportunities and way forward in building mHealth systems that can improve the access, efficiency and quality of health services in the developing world. The overarching goal of the Rockefeller Foundation conference is to develop a roadmap and global partnerships that support the use of emerging digital technologies to improve public health.
Population growth and climate change
Population growth and climate change
Universal access to family planning should be the priority
The world’s population now exceeds 6700 million, and humankind’s consumption of fossil fuels, fresh water, crops, fish, and forests exceeds supply.1 These facts are connected. The annual increase in population of about 79 million means that every week an extra 1.5 million people need food and somewhere to live. This amounts to a huge new city each week, somewhere, which destroys wildlife habitats and augments world fossil fuel consumption. Every person born adds to greenhouse gas emissions, and escaping poverty is impossible without these emissions increasing. Resourcing contraception therefore helps to combat climate change, although it is not a substitute for high emitters reducing their per capita emissions. In 1798 Malthus predicted that as the population increased exponentially, shortfalls in food supply would be unavoidable.2 A sevenfold increase in the population has led, 210 years later, to unprecedented food shortages, escalating prices, and riots. Until these events Borlaug’s "green revolution"3 had seemingly proved Malthus wrong. Yet fertilisers, pesticides, tractors, and transport are dependent on fossil fuels, which apart from being in short supply, exacerbate climate change.4 5 /.../
Universal access to family planning should be the priority
The world’s population now exceeds 6700 million, and humankind’s consumption of fossil fuels, fresh water, crops, fish, and forests exceeds supply.1 These facts are connected. The annual increase in population of about 79 million means that every week an extra 1.5 million people need food and somewhere to live. This amounts to a huge new city each week, somewhere, which destroys wildlife habitats and augments world fossil fuel consumption. Every person born adds to greenhouse gas emissions, and escaping poverty is impossible without these emissions increasing. Resourcing contraception therefore helps to combat climate change, although it is not a substitute for high emitters reducing their per capita emissions. In 1798 Malthus predicted that as the population increased exponentially, shortfalls in food supply would be unavoidable.2 A sevenfold increase in the population has led, 210 years later, to unprecedented food shortages, escalating prices, and riots. Until these events Borlaug’s "green revolution"3 had seemingly proved Malthus wrong. Yet fertilisers, pesticides, tractors, and transport are dependent on fossil fuels, which apart from being in short supply, exacerbate climate change.4 5 /.../
Alzheimer's Linked to Thyroid-Related Hormone
"BOSTON, July 28 -- Abnormal levels of the hormone thyrotropin, which controls thyroid function, may be associated with an increased risk of Alzheimer's disease in women, researchers found."
Guideline Update on Valvular Heart Disease: Focused Update on Infective Endocarditis.
ACC/AHA 2008 Guideline Update on Valvular Heart Disease: Focused Update on Infective Endocarditis. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines -- Nishimura et al., 10.1161/CIRCULATI
These updated guideline recommendations reflect a consensus of expert opinion after a thorough review primarily of late-breaking clinical trials identified through a broad-based vetting process as important to the relevant patient population, and of other new data deemed to have an impact on patient care (see Section 1.1 “Evidence Review” for details regarding this focused update). It is important to note that this
focused update is not intended to represent an update based on a full literature review from the date of the previous guideline publication. /.../
These updated guideline recommendations reflect a consensus of expert opinion after a thorough review primarily of late-breaking clinical trials identified through a broad-based vetting process as important to the relevant patient population, and of other new data deemed to have an impact on patient care (see Section 1.1 “Evidence Review” for details regarding this focused update). It is important to note that this
focused update is not intended to represent an update based on a full literature review from the date of the previous guideline publication. /.../
Sleep Apnea and Cardiovascular Disease.
Sleep Apnea and Cardiovascular Disease. An American Heart Association/American College of Cardiology Foundation Scientific Statement
Sleep-related breathing disorders are highly prevalent in patients with established cardiovascular disease. Obstructive sleep apnea (OSA) affects an estimated 15 million adult Americans and is present in a large proportion of patients with hypertension and in those with other cardiovascular disorders, including coronary artery disease, stroke, and atrial fibrillation.1–14 In contrast, central sleep apnea (CSA) occurs mainly in patients with heart failure.15–19 The purpose of this Scientific Statement is to describe the types and prevalence of sleep apnea and its relevance to individuals who either are at
risk for or already have established cardiovascular disease.
Special emphasis is given to recognizing the patient with cardiovascular disease who has coexisting sleep apnea, to understanding the mechanisms by which sleep apnea may contribute to the progression of the cardiovascular condition, and to identifying strategies for treatment./.../
Sleep-related breathing disorders are highly prevalent in patients with established cardiovascular disease. Obstructive sleep apnea (OSA) affects an estimated 15 million adult Americans and is present in a large proportion of patients with hypertension and in those with other cardiovascular disorders, including coronary artery disease, stroke, and atrial fibrillation.1–14 In contrast, central sleep apnea (CSA) occurs mainly in patients with heart failure.15–19 The purpose of this Scientific Statement is to describe the types and prevalence of sleep apnea and its relevance to individuals who either are at
risk for or already have established cardiovascular disease.
Special emphasis is given to recognizing the patient with cardiovascular disease who has coexisting sleep apnea, to understanding the mechanisms by which sleep apnea may contribute to the progression of the cardiovascular condition, and to identifying strategies for treatment./.../
Monday, July 28, 2008
Don't quit on smokers: If at first they don't succeed... ... American Medical News
AMNews: Aug. 4, 2008. Don't quit on smokers: If at first they don't succeed... ... American Medical News: "Physicians and patients have been down this road before -- many times. The physician keeps bringing up the subject of smoking cessation. The patient tries to quit and fails, even though he or she knows that parting ways with those villainous cigarettes is long overdue. Still, the breakup is elusive.
And here the two sit again, confronting the question: Will the next attempt be successful, or is it time for the patient to surrender to the pull of nicotine once and for all?"/.../
www.ahrq.gov/path/tobacco.htm
And here the two sit again, confronting the question: Will the next attempt be successful, or is it time for the patient to surrender to the pull of nicotine once and for all?"/.../
www.ahrq.gov/path/tobacco.htm
Development Outreach: Business and Poverty: Opening markets to the poor
WorldBank: Development Outreach: "In recent years, business has played a significant role in alleviating poverty, especially in sectors such as telecommunications, information technology, and microfinance. Certain initiatives in these sectors, such as microfinance in urban Latin America and wireless telecommunication in Asia, have yielded impressive results, creating unrealistic benchmarks against which other corporate programs are being judged. Although businesses have made significant contributions in some sectors, in many others they have been unable to “move the needle” on poverty.1"/.../
Sunday, July 27, 2008
Managing Prediabetes
Recommended by Catherine Coleman ProCOR
Physician's First Watch: "Consensus Statement Issued for Managing Prediabetes
The American College of Endocrinology has issued its first guidelines for management of patients with prediabetes.
Among the recommendations:
Patients with prediabetes (fasting glucose: 100–125 mg/dL; or 2-hour post-glucose challenge: 140–199 mg/dL) should undergo annual glucose tolerance and microalbuminuria testing.
Fasting plasma glucose, hemoglobin A1c, and lipids should be checked every 6 months.
As first-line treatment, patients should reduce their weight by 5%–10%, exercise for 30 to 60 minutes 5 days a week, and follow a low-fat, high-fiber diet.
For high-risk patients (e.g., those with worsening glycemia or cardiovascular disease), metformin and acarbose may be considered.
Lipid targets are the same as for patients with diabetes (e.g., LDL: 100 mg/dL); statins are recommended.
Blood pressure targets are also the same as for diabetic patients (systolic BP: <130 mm Hg; diastolic: 80 mm Hg), and ACE inhibitors and angiotensin receptor blockers should be considered first-line agents.
LINK(S):
Prediabetes consensus statement (Free PDF)
Published in Physician's First Watch July 24, 2008"
Physician's First Watch: "Consensus Statement Issued for Managing Prediabetes
The American College of Endocrinology has issued its first guidelines for management of patients with prediabetes.
Among the recommendations:
Patients with prediabetes (fasting glucose: 100–125 mg/dL; or 2-hour post-glucose challenge: 140–199 mg/dL) should undergo annual glucose tolerance and microalbuminuria testing.
Fasting plasma glucose, hemoglobin A1c, and lipids should be checked every 6 months.
As first-line treatment, patients should reduce their weight by 5%–10%, exercise for 30 to 60 minutes 5 days a week, and follow a low-fat, high-fiber diet.
For high-risk patients (e.g., those with worsening glycemia or cardiovascular disease), metformin and acarbose may be considered.
Lipid targets are the same as for patients with diabetes (e.g., LDL: 100 mg/dL); statins are recommended.
Blood pressure targets are also the same as for diabetic patients (systolic BP: <130 mm Hg; diastolic: 80 mm Hg), and ACE inhibitors and angiotensin receptor blockers should be considered first-line agents.
LINK(S):
Prediabetes consensus statement (Free PDF)
Published in Physician's First Watch July 24, 2008"
GEECAB: CURITIBA NO CONGRESSO da SBC
Prezados AMICOR,
Estamos planejando um encontro do GEECAB (Grupo de Trabalho em Epidemiologia e Cardiologia Baseada em Evidências) da SBC, para o dia 06 de setembro próximo, na véspera da abertura do Congresso Nacional de Curitiba, para planejar um Seminário Nacional sobre Epidemiologia e Prevenção para o próximo ano.
Deverá ser no estilo do que realizamos em Gramado em 1997.
Eu e Dra. Glaucia M. Oliveira, Presidente do GT estamos interessados em saber quem tem planos de lá estar nesta data, ou está interessado neste Seminário. Mesmo quem não puder ir, poderá opinar ou dar sugestões. Pretendemos manter todos informados.
Estamos planejando um encontro do GEECAB (Grupo de Trabalho em Epidemiologia e Cardiologia Baseada em Evidências) da SBC, para o dia 06 de setembro próximo, na véspera da abertura do Congresso Nacional de Curitiba, para planejar um Seminário Nacional sobre Epidemiologia e Prevenção para o próximo ano.
Deverá ser no estilo do que realizamos em Gramado em 1997.
Eu e Dra. Glaucia M. Oliveira, Presidente do GT estamos interessados em saber quem tem planos de lá estar nesta data, ou está interessado neste Seminário. Mesmo quem não puder ir, poderá opinar ou dar sugestões. Pretendemos manter todos informados.
Saturday, July 26, 2008
Bill Gates & Bloomberg: Tobacco Control
Hola, amigos:
En el enlace que aparece abajo verán 8 segmentos de video en Youtube con la conferencia de prensa donde se anunció en NY el donativo de fondos adicionales para el control del tabaco. ....................................................
http://www.youtube.com/watch?
Saludos / Greetings,
Beatriz
Beatriz Marcet Champagne, PhD
InterAmerican Heart Foundation
www.interamericanheart.org
Dra. María Paz Corvalán
MEDEF-Chile http://www.medef.com.ar
Globalink NIMI-Español
http://newses.globalink.org/
http://join.globalink.org/
INWAT http://www.inwat.org/
MEDEF-Chile http://www.medef.com.ar
Globalink NIMI-Español
http://newses.globalink.org/
http://join.globalink.org/
INWAT http://www.inwat.org/
Friday, July 25, 2008
How have Global Health Initiatives impacted on health equity?
How have Global Health Initiatives impacted on health equity? Johanna Hanefeld Health Policy Unit, London School of Hygiene and Tropical MedicinePromotion & Education, Vol. 15, No. 1, 19-23 (2008) PDF online at: http://ped.sagepub.com/cgi/reprint/15/1/19 Website: http://ped.sagepub.com/cgi/content/refs/15/1/19 “……..This review examines the impact of Global Health Initiatives (GHIs) on health equity, focusing on low- and middle-income countries.
Thursday, July 24, 2008
Global Atlas of the Health Workforce
Global Atlas of the Health Workforce
There is a growing need for high quality information on human resources in health systems to inform decision making for policies and programmes at the national and international levels. The WHO Department of Human Resources for Health has been collecting and compiling cross-nationally comparable data on health workers in all WHO Member States. The data available in the Global Atlas of the Health Workforce is the main outcome of this effort. Estimates of the stock (absolute numbers) and density (per 1000 population) of the health workforce are available here for 193 Member States. National-level data refer to the active health workforce, that is, all persons currently participating in the health labour market. Counting health workers poses challenges, including how to define them. The World Health Report 2006 defines health workers as "all people engaged in actions whose primary intent is to enhance health." Various permutations and combinations of what constitutes the health workforce potentially exist depending of each country's situation and the means of measurement. The information presented here reflects a framework for harmonizing the boundaries and constituency of the health workforce across contexts. Two sets of data are contained in the Global Atlas: a main (aggregated) set and a disaggregated set. The aggregated dataset includes estimates of the stock and density of health workers for up to 9 occupational categories. This includes: (i) physicians; (ii) nursing and midwifery personnel; (iii) dentistry personnel; (iv) pharmaceutical personnel; (v) laboratory health workers; (vi) environmental and public health workers; (vii) community and traditional health workers; (viii) other health service providers; and (ix) health management and support workers, that is, those who do not provide services directly but are critical to the performance of health systems. In the disaggregated dataset, estimates of the stock of health workers are available for some countries for up to 18 occupational categories, reflecting greater distinction of some categories of workers according to assumed differences in skill level and skill specialization. More information on the framework for categorizing health workers can be found in the definition notes. /.../
There is a growing need for high quality information on human resources in health systems to inform decision making for policies and programmes at the national and international levels. The WHO Department of Human Resources for Health has been collecting and compiling cross-nationally comparable data on health workers in all WHO Member States. The data available in the Global Atlas of the Health Workforce is the main outcome of this effort. Estimates of the stock (absolute numbers) and density (per 1000 population) of the health workforce are available here for 193 Member States. National-level data refer to the active health workforce, that is, all persons currently participating in the health labour market. Counting health workers poses challenges, including how to define them. The World Health Report 2006 defines health workers as "all people engaged in actions whose primary intent is to enhance health." Various permutations and combinations of what constitutes the health workforce potentially exist depending of each country's situation and the means of measurement. The information presented here reflects a framework for harmonizing the boundaries and constituency of the health workforce across contexts. Two sets of data are contained in the Global Atlas: a main (aggregated) set and a disaggregated set. The aggregated dataset includes estimates of the stock and density of health workers for up to 9 occupational categories. This includes: (i) physicians; (ii) nursing and midwifery personnel; (iii) dentistry personnel; (iv) pharmaceutical personnel; (v) laboratory health workers; (vi) environmental and public health workers; (vii) community and traditional health workers; (viii) other health service providers; and (ix) health management and support workers, that is, those who do not provide services directly but are critical to the performance of health systems. In the disaggregated dataset, estimates of the stock of health workers are available for some countries for up to 18 occupational categories, reflecting greater distinction of some categories of workers according to assumed differences in skill level and skill specialization. More information on the framework for categorizing health workers can be found in the definition notes. /.../
Tuesday, July 22, 2008
Bernard Lown New Book
Message received from:
Coleman, Catherine
Hello friends,One of the first articles about Dr Lown and his new book appeared on Sunday,here is the link.
http://www.boston.com/news/local/articles/2008/07/20/a_prescription_for_good_deeds/?page=full
For info about readings etc visit www.bernardlown.org.
The book is a GREAT read! It's exciting and inspiring and fascinating. Availablefrom Amazon.
Catherine
Catherine Coleman
Editor in Chief ProCOR
Lown Cardiovascular Research Foundation
21 Longwood Avenue, Brookline, MA 02446 USA
www.procor.orgccoleman5@partners.org
Coleman, Catherine
Hello friends,One of the first articles about Dr Lown and his new book appeared on Sunday,here is the link.
http://www.boston.com/news/local/articles/2008/07/20/a_prescription_for_good_deeds/?page=full
For info about readings etc visit www.bernardlown.org.
The book is a GREAT read! It's exciting and inspiring and fascinating. Availablefrom Amazon.
Catherine
Catherine Coleman
Editor in Chief ProCOR
Lown Cardiovascular Research Foundation
21 Longwood Avenue, Brookline, MA 02446 USA
www.procor.orgccoleman5@partners.org
Monday, July 21, 2008
warnings for fluoroquinolones ... American Medical News
AMNews: July 28, 2008. FDA requires black-box warnings for fluoroquinolones ... American Medical News: "FDA requires black-box warnings for fluoroquinolones
Associated risk of tendon injuries is higher among older patients, those on steroids and transplant recipients.
By Susan J. Landers, AMNews staff. July 28, 2008.
Washington -- The Food and Drug Administration has notified the makers of fluoroquinolone antimicrobials that they need to place boxed warnings on the labels of seven drugs in this class because they pose a risk for tendinitis and tendon rupture.
The FDA said a medication guide to inform patients also is necessary."/.../
Associated risk of tendon injuries is higher among older patients, those on steroids and transplant recipients.
By Susan J. Landers, AMNews staff. July 28, 2008.
Washington -- The Food and Drug Administration has notified the makers of fluoroquinolone antimicrobials that they need to place boxed warnings on the labels of seven drugs in this class because they pose a risk for tendinitis and tendon rupture.
The FDA said a medication guide to inform patients also is necessary."/.../
Drug industry: No more free pens, pads or mugs ... American Medical News
AMNews: July 28, 2008. Drug industry: No more free pens, pads or mugs ... American Medical News: "In 2006, drugmakers spent $6.7 billion, or about $8,000 per physician, on detailing, according to pharmaceutical market research firm IMS Health Inc. Pharmaceutical companies spent $4.8 billion on direct-to-consumer advertising and $463 million on professional journal ads, IMS said."/.../
Sunday, July 20, 2008
Corações Carentes
Matérias do Caderno Vida do Jornal Zero Hora (Jornalista Daniel Cardoso daniel.cardoso@zerohora.com.br) do dia 19 de julho p.p. relacionadas com nosso Estudo sobre Mortalidade Cardiovascular Precoce e Condições Socio-Econômicas em Porto Alegre:
http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055280.xml&template=3898.dwt&edition=10297§ion=86http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055290.xml&template=3916.dwt&edition=10297§ion=85http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055317.xml&template=3898.dwt&edition=10297§ion=86http://zerohora.clicrbs.com.br/pdf/4715701.pdfhttp://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055305.xml&template=3898.dwt&edition=10297§ion=86
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2008000600004&lng=en&nrm=iso&tlng=en
http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055280.xml&template=3898.dwt&edition=10297§ion=86http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055290.xml&template=3916.dwt&edition=10297§ion=85http://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055317.xml&template=3898.dwt&edition=10297§ion=86http://zerohora.clicrbs.com.br/pdf/4715701.pdfhttp://zerohora.clicrbs.com.br/zerohora/jsp/default2.jsp?uf=1&local=1&source=a2055305.xml&template=3898.dwt&edition=10297§ion=86
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2008000600004&lng=en&nrm=iso&tlng=en
Tuesday, July 15, 2008
Policiais, juízes e médicos...
15 de julho de 2008 N° 15663
Artigo meu publicado no jornal ZH de hoje, seguido de comentário da Dra. Maria Inês.
Policiais, juízes e médicos...,
por Aloyzio Achutti*
Ultimamente tem sido possível apreciar a conhecida diferença de postura entre policiais e juízes no exercício de suas profissões: até prova em contrário, o suspeito pode ser culpado ou inocente dependendo de quem o considere.
Doença, freqüentemente, se associa com culpa e castigo, muito embora nem sempre o acometido tenha responsabilidade pelo infortúnio. Nas instâncias de saúde e doença, não existem duas profissões com distintos enfoques. O mesmo médico precisa dosar sua atitude frente a cada caso, agindo como policial ao buscar as provas para ajuizar o diagnóstico e tomar a melhor decisão de tratamento de acordo com seu paciente.
Médicos de serviços de emergência e unidades de tratamento intensivo, pela experiência de lidarem com casos predominantemente graves, tendem a agir como policiais. Já os sanitaristas, pediatras e obstetras costumam ter uma experiência que os inclina para a preservação da saúde, até prova em contrário.Enquanto a medicina se ocupava só de doenças avançadas, não importava que a atitude fosse de policial, mas na medida em que nos preocupamos com prevenção, e agora com promoção da saúde, cada vez mais se faz necessária uma atitude de juiz para evitar que se tratem como doentes as pessoas sadias.
Como todos os remédios são venenos em potencial e se justificam pelo princípio do mal menor, é fundamental um juízo clínico acertado, mais ainda quando se procura agir antecipadamente - com pessoas normais - na presunção de um mal futuro.Hoje está de volta a investida de usar estatinas (medicamentos usados para reduzir o colesterol) em crianças sem nenhuma evidência de doença, e a discussão fica parecida com a que se estabelece entre policiais e juízes.
Não se ignora que a atitude tanto de uns quanto de outros possa sofrer influências políticas e ideológicas. Da mesma forma em medicina, para aumentar a confusão, existem os lobbies da indústria e dos interesses empresariais, que terminam pesando na balança das decisões, por mais isento que o profissional tente ser.
A isenção científica provendo por evidências seria a salvação, mas hoje grande parte da pesquisa médica está sendo financiada, inclusive nas universidades, pela "filantropia" industrial...
Quem sabe, para conseguir o contrabalanço, tenhamos que cindir também os profissionais da saúde em duas categorias, como entre policiais e juízes?
*Médico
Comentário da Dra. Maria Inês Reinert Azambuja (miazambuja@terra.com.br):
Bem provocante (o artigo)... Acho que o início de tudo foi a Medicina Preventiva de Leavell e Clark. Os médicos embarcaram, eu diria até que alguns com bastante resistência, no canto da sereia que prometia a ampliação do mercado de trabalho dos doentes para toda a população. Mas quanto menos doentes os pacientes, menos qualificação é requerida, abrindo-se a possibilidade de formar-se facilmente mais médicos, com cada vez menos qualidade e portanto sem crítica, mais dependentes de normas técnicas e presa fácil dos interesses economicos do complexo médico-industrial. Como na indústria metalmecânica, a nova etapa é substituir trabalho humano por robôs, no caso, a internet, o google, e a venda direta ao consumidor. Para que intermediários? Mas e dá para reverter isto? Eu acho que os médicos deveriam voltar a focar sua atenção nos doentes e na medicina laboratorial/experimental. Com enfase na individualização dos casos. Só não sei se isto é possível.
Maria Inês
Artigo meu publicado no jornal ZH de hoje, seguido de comentário da Dra. Maria Inês.
Policiais, juízes e médicos...,
por Aloyzio Achutti*
Ultimamente tem sido possível apreciar a conhecida diferença de postura entre policiais e juízes no exercício de suas profissões: até prova em contrário, o suspeito pode ser culpado ou inocente dependendo de quem o considere.
Doença, freqüentemente, se associa com culpa e castigo, muito embora nem sempre o acometido tenha responsabilidade pelo infortúnio. Nas instâncias de saúde e doença, não existem duas profissões com distintos enfoques. O mesmo médico precisa dosar sua atitude frente a cada caso, agindo como policial ao buscar as provas para ajuizar o diagnóstico e tomar a melhor decisão de tratamento de acordo com seu paciente.
Médicos de serviços de emergência e unidades de tratamento intensivo, pela experiência de lidarem com casos predominantemente graves, tendem a agir como policiais. Já os sanitaristas, pediatras e obstetras costumam ter uma experiência que os inclina para a preservação da saúde, até prova em contrário.Enquanto a medicina se ocupava só de doenças avançadas, não importava que a atitude fosse de policial, mas na medida em que nos preocupamos com prevenção, e agora com promoção da saúde, cada vez mais se faz necessária uma atitude de juiz para evitar que se tratem como doentes as pessoas sadias.
Como todos os remédios são venenos em potencial e se justificam pelo princípio do mal menor, é fundamental um juízo clínico acertado, mais ainda quando se procura agir antecipadamente - com pessoas normais - na presunção de um mal futuro.Hoje está de volta a investida de usar estatinas (medicamentos usados para reduzir o colesterol) em crianças sem nenhuma evidência de doença, e a discussão fica parecida com a que se estabelece entre policiais e juízes.
Não se ignora que a atitude tanto de uns quanto de outros possa sofrer influências políticas e ideológicas. Da mesma forma em medicina, para aumentar a confusão, existem os lobbies da indústria e dos interesses empresariais, que terminam pesando na balança das decisões, por mais isento que o profissional tente ser.
A isenção científica provendo por evidências seria a salvação, mas hoje grande parte da pesquisa médica está sendo financiada, inclusive nas universidades, pela "filantropia" industrial...
Quem sabe, para conseguir o contrabalanço, tenhamos que cindir também os profissionais da saúde em duas categorias, como entre policiais e juízes?
*Médico
Comentário da Dra. Maria Inês Reinert Azambuja (miazambuja@terra.com.br):
Bem provocante (o artigo)... Acho que o início de tudo foi a Medicina Preventiva de Leavell e Clark. Os médicos embarcaram, eu diria até que alguns com bastante resistência, no canto da sereia que prometia a ampliação do mercado de trabalho dos doentes para toda a população. Mas quanto menos doentes os pacientes, menos qualificação é requerida, abrindo-se a possibilidade de formar-se facilmente mais médicos, com cada vez menos qualidade e portanto sem crítica, mais dependentes de normas técnicas e presa fácil dos interesses economicos do complexo médico-industrial. Como na indústria metalmecânica, a nova etapa é substituir trabalho humano por robôs, no caso, a internet, o google, e a venda direta ao consumidor. Para que intermediários? Mas e dá para reverter isto? Eu acho que os médicos deveriam voltar a focar sua atenção nos doentes e na medicina laboratorial/experimental. Com enfase na individualização dos casos. Só não sei se isto é possível.
Maria Inês
Monday, July 14, 2008
Translating Research Into Practice for Healthcare Providers.
Translating Research Into Practice for Healthcare Providers. The American Heart Association's Strategy for Building Healthier Lives, Free of Cardiovascular Diseases and Stroke Daniel W. Jones MD, FAHA*, Eric D. Peterson MD, MPH, FAHA, Robert O. Bonow MD, FAHA, Frederick A. Masoudi MD, MSPH, Gregg C. Fonarow MD, FAHA, Sidney C. Smith Jr MD, FAHA, Penelope Solis JD, Meighan Girgus MBA, Patricia C. Hinton MA, MS, Anne Leonard MPH, RN, FAHA, and Raymond J. Gibbons MD, FAHA
From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Denver Health Medical Center, Denver, Colo (F.A.M.); University of California at Los Angeles Medical Center (G.C.F.); University of North Carolina at Chapel Hill (S.C.S.); American Heart Association, Dallas, Tex (P.S., M.G., P.C.H., A.L.); and Mayo Clinic, Rochester, Minn (R.J.G.).
* To whom correspondence should be addressed. E-mail: djones@ovc.umsmed.edu
Abstract—The American Heart Association's (AHA's) mission is "to build healthier lives, free of cardiovascular diseases and stroke." This first article in a 2-part series will serve to present an overview of the work the AHA has undertaken to translate evidence into practice for healthcare professionals. It describes the extensive work of the AHA to support and further the delivery of evidence-based medicine, which includes the following: (1) supporting scientific discovery and the next generation of healthcare professionals and researchers; (2) disseminating scientific information; (3) developing evidence-based guidelines and statements; (4) creating and advocating for the implementation of performance indicators/measures; (5) developing clinical decision support and quality improvement tools; and (6) developing directed-cause campaigns, all of which can lead to improved patient care. This article also discusses the need for novel approaches and some of the AHA's evolving strategies to help address gaps in care. The second article, which will be published shortly after this one, will examine the AHA's efforts to engage and empower healthcare consumers to become more involved with their own health and health care.
From the University of Mississippi Medical Center, Jackson (D.W.J.); Duke University, Durham, NC (E.D.P.); Northwestern University Medical Center, Evanston, Ill (R.O.B.); Denver Health Medical Center, Denver, Colo (F.A.M.); University of California at Los Angeles Medical Center (G.C.F.); University of North Carolina at Chapel Hill (S.C.S.); American Heart Association, Dallas, Tex (P.S., M.G., P.C.H., A.L.); and Mayo Clinic, Rochester, Minn (R.J.G.).
* To whom correspondence should be addressed. E-mail: djones@ovc.umsmed.edu
Abstract—The American Heart Association's (AHA's) mission is "to build healthier lives, free of cardiovascular diseases and stroke." This first article in a 2-part series will serve to present an overview of the work the AHA has undertaken to translate evidence into practice for healthcare professionals. It describes the extensive work of the AHA to support and further the delivery of evidence-based medicine, which includes the following: (1) supporting scientific discovery and the next generation of healthcare professionals and researchers; (2) disseminating scientific information; (3) developing evidence-based guidelines and statements; (4) creating and advocating for the implementation of performance indicators/measures; (5) developing clinical decision support and quality improvement tools; and (6) developing directed-cause campaigns, all of which can lead to improved patient care. This article also discusses the need for novel approaches and some of the AHA's evolving strategies to help address gaps in care. The second article, which will be published shortly after this one, will examine the AHA's efforts to engage and empower healthcare consumers to become more involved with their own health and health care.
On the Origin of Species (C.Darwin)
On the Origin of Species (historical e-book)
Author: Charles Darwin
Edition Used: London: John Murray, Albemarle Street. 1959.
First published: 1859
Hardcover: ISBN: 1592242863
Health care access problems surge among insured Americans
One report finds that millions more insured patients are delaying or not getting care, while another shows a spike in "underinsured" Americans.
By Doug Trapp, AMNews staff. July 21, 2008
Washington -- Middle-income insured Americans are increasingly experiencing health care access difficulties that are more commonly associated with their lower-income counterparts and the uninsured, according to two recent reports. These troubles include delayed or unmet needs for medical care, high insurance deductibles and difficulty getting in to see physicians.
One in five Americans -- 59 million people -- reported delaying or not getting needed health care in 2007, up from one in seven in 2003, found a June 26 Center for Studying Health System Change report. "We've been tracking access to care for 10 years, and this is by far the biggest change that we've seen in those 10 years," said Peter Cunningham, PhD, study co-author and senior fellow at the center. Of those reporting an access problem last year, 43.5 million had insurance, compared with 25.9 million in 2003./.../
By Doug Trapp, AMNews staff. July 21, 2008
Washington -- Middle-income insured Americans are increasingly experiencing health care access difficulties that are more commonly associated with their lower-income counterparts and the uninsured, according to two recent reports. These troubles include delayed or unmet needs for medical care, high insurance deductibles and difficulty getting in to see physicians.
One in five Americans -- 59 million people -- reported delaying or not getting needed health care in 2007, up from one in seven in 2003, found a June 26 Center for Studying Health System Change report. "We've been tracking access to care for 10 years, and this is by far the biggest change that we've seen in those 10 years," said Peter Cunningham, PhD, study co-author and senior fellow at the center. Of those reporting an access problem last year, 43.5 million had insurance, compared with 25.9 million in 2003./.../
Saturday, July 12, 2008
On the counter medicines
From:"Maria Inês Reinert Azambuja"
To: ProCOR
Dear Catherine
This is the culmination of a long-term process of reducing the medical power through what was sold as a strategy to enhance it: trading more "science" for the art of care. The evidence-based strategy did to medicine the same that industrialization, in a process later perfectionate through the application of the so called scientific management (Taylorism), did to artisans: turned them into de-skilled workers. The objectives - mass production - and the methods - standardizing the ways of performing a task, training the workers on it, disregarding individual differences - are the same, all focused on increasing the productivity at the cost of de-humanizating the work.
We are trapped. We were used to give credibility to the evidence-based strategy. Now that the strategy is validated, the pharmaceutical and equipment industries may sell their products direcly to consumers, bypassing the doctors...
The good thing is that this would also be a good moment to re-think medicine.
Maria Inês Azambuja, MD - Brazil.
To: ProCOR
Dear Catherine
This is the culmination of a long-term process of reducing the medical power through what was sold as a strategy to enhance it: trading more "science" for the art of care. The evidence-based strategy did to medicine the same that industrialization, in a process later perfectionate through the application of the so called scientific management (Taylorism), did to artisans: turned them into de-skilled workers. The objectives - mass production - and the methods - standardizing the ways of performing a task, training the workers on it, disregarding individual differences - are the same, all focused on increasing the productivity at the cost of de-humanizating the work.
We are trapped. We were used to give credibility to the evidence-based strategy. Now that the strategy is validated, the pharmaceutical and equipment industries may sell their products direcly to consumers, bypassing the doctors...
The good thing is that this would also be a good moment to re-think medicine.
Maria Inês Azambuja, MD - Brazil.
Health Promotion
CAMH:Health Promotion: "Health Promotion
The World Health Organization defines health promotion as 'the process of enabling people to increase control over, and to improve, their health.' (WHO, 1986) This section is designed to help people in the fields of mental health and addiction access health promotion information and resources that will enhance their work toward improving the health of individuals and communities. Health Promotion
The World Health Organization defines health promotion as 'the process of enabling people to increase control over, and to improve, their health.' (WHO, 1986) This section is designed to help people in the fields of mental health and addiction access health promotion information and resources that will enhance their work toward improving the health of individuals and communities."/.../
The World Health Organization defines health promotion as 'the process of enabling people to increase control over, and to improve, their health.' (WHO, 1986) This section is designed to help people in the fields of mental health and addiction access health promotion information and resources that will enhance their work toward improving the health of individuals and communities. Health Promotion
The World Health Organization defines health promotion as 'the process of enabling people to increase control over, and to improve, their health.' (WHO, 1986) This section is designed to help people in the fields of mental health and addiction access health promotion information and resources that will enhance their work toward improving the health of individuals and communities."/.../
Wednesday, July 09, 2008
Liver Protein: Diabetes Risk in older adults
SAN DIEGO, July 8 -- The hepatic protein fetuin-A may predict diabetes onset in older adults independently of recognized risk factors, researchers found.
Action Points --->
Explain to interested patients that the study suggested a protein made in the liver may be involved in development of diabetes.
Note that the findings need to be confirmed, particularly for adults in middle age, who are at the highest risk for new onset diabetes.
The highest serum levels of fetuin-A were associated with a 2.41 times higher risk of incident diabetes compared with the lowest protein levels (P=0.007), reported Joachim H. Ix, M.D., of the University of California San Diego, and colleagues in the July 9 issue of the Journal of the American Medical Association.
This association in the longitudinal Health, Aging, and Body Composition (Health ABC) Study was independent of physical activity, weight, blood pressure, fasting glucose, lipid levels, C-reactive protein level, and other factors.
The results strengthen the link between fetuin-A and insulin resistance found in prior cross-sectional studies, the researchers said.
Fetuin-A is secreted by the liver and is thought to cause insulin resistance in muscle and fat by binding to the insulin receptor tyrosine kinase.
"If confirmed in future studies, fetuin-A may ultimately prove useful as a target for therapeutics, and its study may provide novel insights to glucose metabolism in humans," the researchers said.
They conducted a case-control study within the larger Health ABC study of well-functioning Medicare beneficiaries ages 70 to 79. /.../
Action Points --->
Explain to interested patients that the study suggested a protein made in the liver may be involved in development of diabetes.
Note that the findings need to be confirmed, particularly for adults in middle age, who are at the highest risk for new onset diabetes.
The highest serum levels of fetuin-A were associated with a 2.41 times higher risk of incident diabetes compared with the lowest protein levels (P=0.007), reported Joachim H. Ix, M.D., of the University of California San Diego, and colleagues in the July 9 issue of the Journal of the American Medical Association.
This association in the longitudinal Health, Aging, and Body Composition (Health ABC) Study was independent of physical activity, weight, blood pressure, fasting glucose, lipid levels, C-reactive protein level, and other factors.
The results strengthen the link between fetuin-A and insulin resistance found in prior cross-sectional studies, the researchers said.
Fetuin-A is secreted by the liver and is thought to cause insulin resistance in muscle and fat by binding to the insulin receptor tyrosine kinase.
"If confirmed in future studies, fetuin-A may ultimately prove useful as a target for therapeutics, and its study may provide novel insights to glucose metabolism in humans," the researchers said.
They conducted a case-control study within the larger Health ABC study of well-functioning Medicare beneficiaries ages 70 to 79. /.../
Tuesday, July 08, 2008
Chronic Poverty
The Chronic Poverty Report 2008-09 Chronic Poverty Research Centre CPRC - UK's Department for International Development (DFID)July 2008 Available online PDF [164p.] at: http://www.chronicpoverty.org/pubfiles/CPR2_whole_report.pdf '…..Over the last five years, in an era of unprecedented global wealth creation, the number of people living in chronic poverty has increased. Between 320 and 443 million people are now trapped in poverty that lasts for many years, often for their entire lifetime. Their children frequently inherit chronic poverty, if they survive infancy. Many chronically poor people die prematurely from easily preventable health problems. For the chronically poor, poverty is not simply about having a very low income: it is about multidimensional deprivation – hunger, undernutrition, illiteracy, unsafe drinking water, lack of access to basic health services, social discrimination, physical insecurity and political exclusion. Whichever way one frames the problem of chronic poverty – as human suffering, as vulnerability, as a basic needs failure, as the abrogation of human rights, as degraded citizenship – one thing is clear.Widespread chronic poverty occurs in a world that has the knowledge and resources to eradicate it./.../
segurança para equipes cirúrgicas
Organização Mundial de Saúde elabora lista de verificação de segurança para equipes cirúrgicas
Autora: Laurie BarclayPublicado em 24/06/2008
A fim de melhorar a segurança do ato cirúrgico em todo o mundo, a Organização Mundial da Saúde (OMS) lançou uma nova lista de verificação de segurança para equipes cirúrgicas, de acordo com um relatório do Safe Surgery Saves Lives, publicado on line em 25 de junho no site da revista britânica The Lancet, também disponível no site da OMS. Esta é a primeira edição da lista e de orientações da OMS e será finalizada para a divulgação no fim de 2008, após a conclusão da avaliação, em nível mundial, em oito locais onde será aplicado o projeto piloto.
Dra. Margaret Chan, diretora-geral da OMS, declarou em uma coletiva de imprensa que "lesões evitáveis e óbitos ocorridos durante o ato cirúrgico são hoje uma preocupação crescente e seguir a lista de verificação é a melhor forma de reduzir o número de erros cirúrgicos e melhorar a segurança do paciente".
A elevada mortalidade e morbidade associadas aos procedimentos cirúrgicos de grande porte demandam medidas de saúde pública e vigilância global para melhorar a segurança do procedimento, especialmente em áreas de baixa renda com acesso cirúrgico limitado. As estimativas sugerem que cerca de metade das complicações cirúrgicas podem ser prevenidas.
A iniciativa Safe Surgery Saves Lives, uma colaboração de mais de 200 sociedades médicas nacionais e internacionais e de ministérios de saúde liderados pela Harvard School of Public Health, visa reduzir a morbidade e a mortalidade cirúrgicas evitáveis.
A recém-desenvolvida lista de verificação de segurança cirúrgica da OMS fornece um conjunto de normas de segurança aplicáveis em todos os países e contextos de sistema de saúde.
Nos oito locais onde o projeto piloto está sendo aplicado, as conclusões preliminares de 1.000 pacientes submetidos a procedimentos cirúrgicos, nos quais a lista de verificação foi utilizada, sugerem que a probabilidade de que os pacientes receberão um padrão mais elevado de cuidados cirúrgicos foi praticamente duplicada, com aumento no cumprimento destas normas de 36% para 68% e para cerca de 100% em alguns hospitais. Uma melhor adesão tem sido associada a reduções significativas na mortalidade e morbidade cirúrgicas, apesar dos resultados finais não estarem ainda disponíveis.
A lista de verificação abrange três fases de um procedimento cirúrgico: antes da indução anestésica, antes da incisão cutânea e antes da saída do paciente da sala cirúrgica. Para cada fase, um coordenador da lista de verificação confirma que a equipe tenha completado as tarefas designadas antes que a próxima fase da operação ocorra.
Antes da indução anestésica, os principais componentes da lista são os seguintes:
• Confirme a identidade do paciente, o local a ser operado, bem como o procedimento a ser feito e que o paciente tenha fornecido o consentimento informado.• O local a ser operado deve ser marcado, se for o caso.• A verificação da segurança da anestesia deve ser completada.• O oxímetro de pulso deve ser colocado sobre o paciente e deve estar funcionando apropriadamente.• Verifique se o paciente apresenta (1) Uma alergia conhecida. Se assim for, estas devem ser documentadas. (2) Uma via aérea anatomicamente difícil para intubação ou risco de broncoaspiração. Se assim for, equipamento suplementar e de assistência devem estar disponíveis. (3) Risco de perda sangüínea acima de 500 mL em adultos ou 7 ml/kg em crianças. Se assim for, é conveniente providenciar acesso intravenoso adequado e fluidos.
Antes da incisão cutânea, a lista de verificação apresenta os seguintes componentes:
• Todos os membros da equipe devem ser apresentados por seus nomes e por suas funções na equipe cirúrgica.• O cirurgião, o anestesiologista e a enfermeira deverão confirmar, verbalmente, a identidade do paciente, o local a ser operado, e o procedimento a ser realizado.• Antecipação de eventos críticos que devem ser revisados pelo cirurgião: quaisquer etapas críticas ou inesperadas, tempo operatório estimado e perda de sangue prevista.• Antecipação de eventos críticos que devem ser revisados pela equipe de anestesia: verificar se há necessidade de cuidados específicos em cada paciente.• Antecipação de eventos críticos que devem ser revisados pela equipe de enfermagem: confirmação da esterilização do instrumental cirúrgico, suprimentos e campo (incluindo o resultado do indicador de esterilização); documentação e discussão de quaisquer questões de equipamentos ou preocupações; se a profilaxia antibiótica foi realizada nos últimos 60 minutos, se for o caso; e, se a imagem essencial para o procedimento está projetada, se for o caso.
Antes da saída do paciente da sala cirúrgica, a lista de verificação apresenta os seguintes componentes:
• A enfermeira confirma verbalmente com a equipe o nome do procedimento a ser documentado e verifica a contagem de instrumentos, compressas e agulha, se for o caso; identificação da peça cirúrgica, incluindo o nome do paciente e se existe qualquer problema de equipamento a ser abordado.• O cirurgião, o anestesiologista e a enfermeira devem revisar os principais cuidados relativos à recuperação e conduta específica no paciente.
A OMS salienta que a lista de verificação não pretende ser exaustiva, mas incentiva alterações específicas e inclusões adequadas em cada local de prática.
"O tratamento cirúrgico é um componente essencial dos sistemas de saúde a nível mundial há mais de um século", segundo o co-autor da lista Dr. Atul Gawande, MPH, cirurgião e professor da Harvard Medical School, em Boston, Massachusetts. "Embora melhorias significativas tenham ocorrido ao longo das últimas décadas, a qualidade e a segurança dos tratamentos cirúrgicos são preocupantemente variáveis. O Safe Surgery Saves Lives pretende mudar esse fato através da elevação dos padrões que os pacientes podem esperar em qualquer lugar".
Lancet. Publicado on line em 25 de junho de 2008.
Informação sobre a autora: A Dra. Laurie Barclay é revisora e escritora freelancer para o Medscape. Declaração de conflito de interesses: A autora declara não possuir conflito de interesses.
Autora: Laurie BarclayPublicado em 24/06/2008
A fim de melhorar a segurança do ato cirúrgico em todo o mundo, a Organização Mundial da Saúde (OMS) lançou uma nova lista de verificação de segurança para equipes cirúrgicas, de acordo com um relatório do Safe Surgery Saves Lives, publicado on line em 25 de junho no site da revista britânica The Lancet, também disponível no site da OMS. Esta é a primeira edição da lista e de orientações da OMS e será finalizada para a divulgação no fim de 2008, após a conclusão da avaliação, em nível mundial, em oito locais onde será aplicado o projeto piloto.
Dra. Margaret Chan, diretora-geral da OMS, declarou em uma coletiva de imprensa que "lesões evitáveis e óbitos ocorridos durante o ato cirúrgico são hoje uma preocupação crescente e seguir a lista de verificação é a melhor forma de reduzir o número de erros cirúrgicos e melhorar a segurança do paciente".
A elevada mortalidade e morbidade associadas aos procedimentos cirúrgicos de grande porte demandam medidas de saúde pública e vigilância global para melhorar a segurança do procedimento, especialmente em áreas de baixa renda com acesso cirúrgico limitado. As estimativas sugerem que cerca de metade das complicações cirúrgicas podem ser prevenidas.
A iniciativa Safe Surgery Saves Lives, uma colaboração de mais de 200 sociedades médicas nacionais e internacionais e de ministérios de saúde liderados pela Harvard School of Public Health, visa reduzir a morbidade e a mortalidade cirúrgicas evitáveis.
A recém-desenvolvida lista de verificação de segurança cirúrgica da OMS fornece um conjunto de normas de segurança aplicáveis em todos os países e contextos de sistema de saúde.
Nos oito locais onde o projeto piloto está sendo aplicado, as conclusões preliminares de 1.000 pacientes submetidos a procedimentos cirúrgicos, nos quais a lista de verificação foi utilizada, sugerem que a probabilidade de que os pacientes receberão um padrão mais elevado de cuidados cirúrgicos foi praticamente duplicada, com aumento no cumprimento destas normas de 36% para 68% e para cerca de 100% em alguns hospitais. Uma melhor adesão tem sido associada a reduções significativas na mortalidade e morbidade cirúrgicas, apesar dos resultados finais não estarem ainda disponíveis.
A lista de verificação abrange três fases de um procedimento cirúrgico: antes da indução anestésica, antes da incisão cutânea e antes da saída do paciente da sala cirúrgica. Para cada fase, um coordenador da lista de verificação confirma que a equipe tenha completado as tarefas designadas antes que a próxima fase da operação ocorra.
Antes da indução anestésica, os principais componentes da lista são os seguintes:
• Confirme a identidade do paciente, o local a ser operado, bem como o procedimento a ser feito e que o paciente tenha fornecido o consentimento informado.• O local a ser operado deve ser marcado, se for o caso.• A verificação da segurança da anestesia deve ser completada.• O oxímetro de pulso deve ser colocado sobre o paciente e deve estar funcionando apropriadamente.• Verifique se o paciente apresenta (1) Uma alergia conhecida. Se assim for, estas devem ser documentadas. (2) Uma via aérea anatomicamente difícil para intubação ou risco de broncoaspiração. Se assim for, equipamento suplementar e de assistência devem estar disponíveis. (3) Risco de perda sangüínea acima de 500 mL em adultos ou 7 ml/kg em crianças. Se assim for, é conveniente providenciar acesso intravenoso adequado e fluidos.
Antes da incisão cutânea, a lista de verificação apresenta os seguintes componentes:
• Todos os membros da equipe devem ser apresentados por seus nomes e por suas funções na equipe cirúrgica.• O cirurgião, o anestesiologista e a enfermeira deverão confirmar, verbalmente, a identidade do paciente, o local a ser operado, e o procedimento a ser realizado.• Antecipação de eventos críticos que devem ser revisados pelo cirurgião: quaisquer etapas críticas ou inesperadas, tempo operatório estimado e perda de sangue prevista.• Antecipação de eventos críticos que devem ser revisados pela equipe de anestesia: verificar se há necessidade de cuidados específicos em cada paciente.• Antecipação de eventos críticos que devem ser revisados pela equipe de enfermagem: confirmação da esterilização do instrumental cirúrgico, suprimentos e campo (incluindo o resultado do indicador de esterilização); documentação e discussão de quaisquer questões de equipamentos ou preocupações; se a profilaxia antibiótica foi realizada nos últimos 60 minutos, se for o caso; e, se a imagem essencial para o procedimento está projetada, se for o caso.
Antes da saída do paciente da sala cirúrgica, a lista de verificação apresenta os seguintes componentes:
• A enfermeira confirma verbalmente com a equipe o nome do procedimento a ser documentado e verifica a contagem de instrumentos, compressas e agulha, se for o caso; identificação da peça cirúrgica, incluindo o nome do paciente e se existe qualquer problema de equipamento a ser abordado.• O cirurgião, o anestesiologista e a enfermeira devem revisar os principais cuidados relativos à recuperação e conduta específica no paciente.
A OMS salienta que a lista de verificação não pretende ser exaustiva, mas incentiva alterações específicas e inclusões adequadas em cada local de prática.
"O tratamento cirúrgico é um componente essencial dos sistemas de saúde a nível mundial há mais de um século", segundo o co-autor da lista Dr. Atul Gawande, MPH, cirurgião e professor da Harvard Medical School, em Boston, Massachusetts. "Embora melhorias significativas tenham ocorrido ao longo das últimas décadas, a qualidade e a segurança dos tratamentos cirúrgicos são preocupantemente variáveis. O Safe Surgery Saves Lives pretende mudar esse fato através da elevação dos padrões que os pacientes podem esperar em qualquer lugar".
Lancet. Publicado on line em 25 de junho de 2008.
Informação sobre a autora: A Dra. Laurie Barclay é revisora e escritora freelancer para o Medscape. Declaração de conflito de interesses: A autora declara não possuir conflito de interesses.
Monday, July 07, 2008
World Population Approaches 7 Billion
World Population Approaches 7 Billion
World population is projected to reach 7 billion in 2012, according to the U.S. Census Bureau. The world population hit 6 billion in 1999.
These figures come from the updated world population estimates and projections released today through the Census Bureau’s International Data Base (IDB). The IDB provides information on population size and growth, age and sex composition, mortality, fertility and net migration. The data are available for 226 countries and other selected geographies.
This revision to the IDB includes updated projections for 34 countries. Compared to previous estimates, this revision indicates that the world population will be 146 million larger in 2050.
The Census Bureau’s latest projections show world population growing at a slower pace during the first half of the 21st century than the latter half of the 20th century. The world population doubled from 3 billion in 1959 to 6 billion in 1999, but is projected to increase by only 50 percent between 1999 and 2040.
Global population growth, about 1.2 percent per year, is projected to decline to 0.5 percent by 2050. However, this growth will be concentrated in less-developed countries.
About 1.5 percent of the current global population is 80 or older, with more than half living in developed countries. By 2050, about 5 percent of the world’s population is projected to be 80 or older, with about three in four likely to be living in less-developed countries. For developed countries, the percentage of the population 80 or older will grow to about 10 percent in 2050.
World population estimates and projections include the impact of HIV and AIDS. Of the 34 countries updated in this revision, nine are hard hit by this pandemic (Benin, Côte d’Ivoire [Ivory Coast], Eritrea, Ethiopia, Guinea, Nigeria, South Africa, Zimbabwe and the Central African Republic). Data for other countries seriously affected by HIV and AIDS are also available from the International Data Base.
The International Data Base offers online users a choice of ways to retrieve demographic data, including:
Country summary pages showing key population indicators <http://www.census.gov/ipc/www/idb/summaries.html>
Tables of demographic indicators for countries and regions <http://www.census.gov/ipc/www/idb/tables.html>
Population pyramids showing age and sex composition <http://www.census.gov/ipc/www/idb/pyramids.html>
For more information about this update, including the list of updated countries, visit <http://www.census.gov/ipc/www/idb/idbr2008b.html>
World population is projected to reach 7 billion in 2012, according to the U.S. Census Bureau. The world population hit 6 billion in 1999.
These figures come from the updated world population estimates and projections released today through the Census Bureau’s International Data Base (IDB). The IDB provides information on population size and growth, age and sex composition, mortality, fertility and net migration. The data are available for 226 countries and other selected geographies.
This revision to the IDB includes updated projections for 34 countries. Compared to previous estimates, this revision indicates that the world population will be 146 million larger in 2050.
The Census Bureau’s latest projections show world population growing at a slower pace during the first half of the 21st century than the latter half of the 20th century. The world population doubled from 3 billion in 1959 to 6 billion in 1999, but is projected to increase by only 50 percent between 1999 and 2040.
Global population growth, about 1.2 percent per year, is projected to decline to 0.5 percent by 2050. However, this growth will be concentrated in less-developed countries.
About 1.5 percent of the current global population is 80 or older, with more than half living in developed countries. By 2050, about 5 percent of the world’s population is projected to be 80 or older, with about three in four likely to be living in less-developed countries. For developed countries, the percentage of the population 80 or older will grow to about 10 percent in 2050.
World population estimates and projections include the impact of HIV and AIDS. Of the 34 countries updated in this revision, nine are hard hit by this pandemic (Benin, Côte d’Ivoire [Ivory Coast], Eritrea, Ethiopia, Guinea, Nigeria, South Africa, Zimbabwe and the Central African Republic). Data for other countries seriously affected by HIV and AIDS are also available from the International Data Base.
The International Data Base offers online users a choice of ways to retrieve demographic data, including:
Country summary pages showing key population indicators <http://www.census.gov/ipc/www/idb/summaries.html>
Tables of demographic indicators for countries and regions <http://www.census.gov/ipc/www/idb/tables.html>
Population pyramids showing age and sex composition <http://www.census.gov/ipc/www/idb/pyramids.html>
For more information about this update, including the list of updated countries, visit <http://www.census.gov/ipc/www/idb/idbr2008b.html>
Mortalidade Precoce por DCV
Mortalidade Precoce por Doenças Cardiovasculares e Desigualdades Sociais em Porto Alegre: da Evidência à Ação:. Sérgio Luiz Bassanesi, Maria Inês Azambuja, Aloyzio Achutti
Low vitamin D linked to increased risk of heart attack, death ... American Medical News
AMNews: July 14, 2008. Low vitamin D linked to increased risk of heart attack, death ... American Medical News:
"The weight of evidence connecting low vitamin D levels with poor health is getting heavier.
One study published in the June 9 Archives of Internal Medicine linked low levels of this vitamin in men to an increased risk of myocardial infarction. The other, in the June 23 issue of the same journal, found that being deficient in this vitamin more than doubled the risk of death from any cause.
'The evidence is just becoming overwhelming,' said Dr. Harald Dobnig, lead author on the second paper and professor of internal medicine at the Medical University of Graz in Austria.
These are the latest studies to identify low vitamin D as a significant health risk. Additional analyses completed on the cohort studied by Dr. Dobnig and due to be published in the future show that vitamin D status also influences the risk of cancer and stroke."/.../
"The weight of evidence connecting low vitamin D levels with poor health is getting heavier.
One study published in the June 9 Archives of Internal Medicine linked low levels of this vitamin in men to an increased risk of myocardial infarction. The other, in the June 23 issue of the same journal, found that being deficient in this vitamin more than doubled the risk of death from any cause.
'The evidence is just becoming overwhelming,' said Dr. Harald Dobnig, lead author on the second paper and professor of internal medicine at the Medical University of Graz in Austria.
These are the latest studies to identify low vitamin D as a significant health risk. Additional analyses completed on the cohort studied by Dr. Dobnig and due to be published in the future show that vitamin D status also influences the risk of cancer and stroke."/.../
Dementia in Oldest-Old Twice as Likely to Affect Women
By Crystal Phend, Staff Writer, MedPage TodayPublished: July 03, 2008Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.
IRVINE, Calif., July 3 -- The likelihood of women developing dementia as they age into their 90s is significantly greater than it is for men, according to researchers here.
Among women, dementia prevalence nearly doubled every five years after age 90 whereas prevalence reached a plateau among men, reported Maria M. Corrada, Sc.D., of the University of California Irvine, and colleagues online in Neurology.
These findings from one of the largest epidemiological studies in the oldest-old group suggested that the pattern of dementia changes for men late in life. Yet for women the doubling rate was similar to that in previous studies that typically included patients only up through age 85.
Men in Dr. Corrada's study who reached age 90 were about half as likely to have dementia than women in the same age group, which may have been at least partially because of shorter survival both overall and after dementia diagnosis, the researchers said. /.../
IRVINE, Calif., July 3 -- The likelihood of women developing dementia as they age into their 90s is significantly greater than it is for men, according to researchers here.
Among women, dementia prevalence nearly doubled every five years after age 90 whereas prevalence reached a plateau among men, reported Maria M. Corrada, Sc.D., of the University of California Irvine, and colleagues online in Neurology.
These findings from one of the largest epidemiological studies in the oldest-old group suggested that the pattern of dementia changes for men late in life. Yet for women the doubling rate was similar to that in previous studies that typically included patients only up through age 85.
Men in Dr. Corrada's study who reached age 90 were about half as likely to have dementia than women in the same age group, which may have been at least partially because of shorter survival both overall and after dementia diagnosis, the researchers said. /.../
Sunday, July 06, 2008
Tofu 'may raise risk of dementia'
BBC NEWS Have Your Say Tofu 'may raise risk of dementia':
"Eating high levels of some soy products - including tofu - may raise the risk of memory loss, research suggests.
The study focused on 719 elderly Indonesians living in urban and rural regions of Java.
The researchers found high tofu consumption - at least once a day - was associated with worse memory, particularly among the over-68s.
The Loughborough University-led study features in the journal Dementias and Geriatric Cognitive Disorders.
Soy products are a major alternative protein source to meat for many people in the developing world."/...
"Eating high levels of some soy products - including tofu - may raise the risk of memory loss, research suggests.
The study focused on 719 elderly Indonesians living in urban and rural regions of Java.
The researchers found high tofu consumption - at least once a day - was associated with worse memory, particularly among the over-68s.
The Loughborough University-led study features in the journal Dementias and Geriatric Cognitive Disorders.
Soy products are a major alternative protein source to meat for many people in the developing world."/...
Custo de acidentes é de R$ 28 bi
Custo de acidentes é de R$ 28 bi
Vanessa FajardoDo Diário do Grande ABC
Estudo feito pela ANTP (Agência Nacional de Transportes Públicos) aponta que em todo o Brasil são registradas anualmente 40 mil mortes e 360 mil feridos em acidentes de trânsito. Destes, 120 mil ficam com seqüelas permanentes. O custo disso atinge a casa dos R$ 28 bilhões todos os anos.
"Valores pagos tanto pela sociedade quanto pelo governo", explica a especialista em segurança de trânsito Cristina Baddini. Segundo ela, gasta-se R$ 144 mil com cada vítima fatal no trânsito, R$ 17,5 mil com um ferido e R$ 3.000 com os acidentes sem vítimas. Do custo total, 43% representam perda de produtividade do trabalhador com o acidente; 30% são os danos materiais nas vias públicas e nos veículos; 16% são de tratamento médico e resgate da vítima; e 11% representam outros gastos./.../
Vanessa FajardoDo Diário do Grande ABC
Estudo feito pela ANTP (Agência Nacional de Transportes Públicos) aponta que em todo o Brasil são registradas anualmente 40 mil mortes e 360 mil feridos em acidentes de trânsito. Destes, 120 mil ficam com seqüelas permanentes. O custo disso atinge a casa dos R$ 28 bilhões todos os anos.
"Valores pagos tanto pela sociedade quanto pelo governo", explica a especialista em segurança de trânsito Cristina Baddini. Segundo ela, gasta-se R$ 144 mil com cada vítima fatal no trânsito, R$ 17,5 mil com um ferido e R$ 3.000 com os acidentes sem vítimas. Do custo total, 43% representam perda de produtividade do trabalhador com o acidente; 30% são os danos materiais nas vias públicas e nos veículos; 16% são de tratamento médico e resgate da vítima; e 11% representam outros gastos./.../
Friday, July 04, 2008
Tópicos Selecionados de Linguagem Médica e História da Medicina
Artigos, notas e comentários.
Editado por J M Rezende
Linguagem médica
Símbolo da medicina
Caminhos da medicina
Editado por J M Rezende
Linguagem médica
Símbolo da medicina
Caminhos da medicina
Thursday, July 03, 2008
A Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS-2006)
(Por Recomendação da Dra.Rosa Maria Sampaio Vilanova de Carvalho)
A Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS-2006) traça um perfil da população feminina em idade fértil e das crianças menores de cinco anos no Brasil. Financiada pelo Ministério da Saúde, foi coordenada pela equipe da área de População e Sociedade do Centro Brasileiro de Análise e Planejamento (Cebrap).
Em sua terceira edição, a PNDS foi realizada pela primeira vez no Brasil em 1986 e repetida em 1996. Os resultados recentes fornecem subsídios para uma avaliação dos avanços ocorridos na saúde da mulher e da criança no Brasil. Além disso, permitem comparações internacionais e auxiliam na formulação de políticas e estratégias de ação.
A maior parte dos dados foi coletada por meio de entrevistas domiciliares, realizadas com cerca de 15 mil mulheres entre 15 e 49 anos, que vivem em áreas urbanas e rurais nas cinco regiões brasileiras. A metodologia incluiu ainda mensurações como as antropométricas, que medem altura e peso; análises laboratoriais de amostras de sangue, para dosagens de vitamina A e hemoglobina, e do teor de iodo disponível no sal consumido pelas famílias.
Os dados coletados permitem analisar a fecundidade e intenções reprodutivas; a atividade sexual e anticoncepção; a assistência à gestação e ao parto; a morbidade feminina e o estado nutricional das crianças. Permitem ainda estudar três novos temas introduzidos pela primeira vez na PNDS 2006: o acesso a medicamentos, os micronutrientes e a segurança alimentar nos domicílios (acesso à alimentação em quantidade suficiente e qualidade adequada).
Quatro instituições participaram da pesquisa, duas da Universidade de São Paulo (o Núcleo de Pesquisas em Nutrição e Saúde da Faculdade de Saúde Pública e o Laboratório de Nutrição do Departamento de Clínica Médica da Faculdade de Medicina de Ribeirão Preto); duas da Universidade Estadual de Campinas (o Núcleo de Estudos de População (NEPO) e o Departamento de Medicina Preventiva da Faculdade de Ciências Médicas). O Instituto Brasileiro de Opinião Pública e Estatística (IBOPE) executou o trabalho de campo.
O estudo permite estabelecer uma interlocução com o projeto Measure DHS (Demographic and Health Survey), uma investigação realizada em escala global com o apoio da Agência dos Estados Unidos para o Desenvolvimento Internacional (USAID) e parceria de várias outras instituições internacionais, que tem como objetivo prover dados e análises para um amplo conjunto de indicadores de planejamento, monitoramento e avaliação de impacto nas áreas de população, saúde e nutrição de mulheres e crianças de países em desenvolvimento. traça um perfil da população feminina em idade fértil e das crianças menores de cinco anos no Brasil. Financiada pelo Ministério da Saúde, foi coordenada pela equipe da área de População e Sociedade do Centro Brasileiro de Análise e Planejamento (Cebrap).
Em sua terceira edição, a PNDS foi realizada pela primeira vez no Brasil em 1986 e repetida em 1996. Os resultados recentes fornecem subsídios para uma avaliação dos avanços ocorridos na saúde da mulher e da criança no Brasil. Além disso, permitem comparações internacionais e auxiliam na formulação de políticas e estratégias de ação.
A maior parte dos dados foi coletada por meio de entrevistas domiciliares, realizadas com cerca de 15 mil mulheres entre 15 e 49 anos, que vivem em áreas urbanas e rurais nas cinco regiões brasileiras. A metodologia incluiu ainda mensurações como as antropométricas, que medem altura e peso; análises laboratoriais de amostras de sangue, para dosagens de vitamina A e hemoglobina, e do teor de iodo disponível no sal consumido pelas famílias.
Os dados coletados permitem analisar a fecundidade e intenções reprodutivas; a atividade sexual e anticoncepção; a assistência à gestação e ao parto; a morbidade feminina e o estado nutricional das crianças. Permitem ainda estudar três novos temas introduzidos pela primeira vez na PNDS 2006: o acesso a medicamentos, os micronutrientes e a segurança alimentar nos domicílios (acesso à alimentação em quantidade suficiente e qualidade adequada).
Quatro instituições participaram da pesquisa, duas da Universidade de São Paulo (o Núcleo de Pesquisas em Nutrição e Saúde da Faculdade de Saúde Pública e o Laboratório de Nutrição do Departamento de Clínica Médica da Faculdade de Medicina de Ribeirão Preto); duas da Universidade Estadual de Campinas (o Núcleo de Estudos de População (NEPO) e o Departamento de Medicina Preventiva da Faculdade de Ciências Médicas). O Instituto Brasileiro de Opinião Pública e Estatística (IBOPE) executou o trabalho de campo.
O estudo permite estabelecer uma interlocução com o projeto Measure DHS (Demographic and Health Survey), uma investigação realizada em escala global com o apoio da Agência dos Estados Unidos para o Desenvolvimento Internacional (USAID) e parceria de várias outras instituições internacionais, que tem como objetivo prover dados e análises para um amplo conjunto de indicadores de planejamento, monitoramento e avaliação de impacto nas áreas de população, saúde e nutrição de mulheres e crianças de países em desenvolvimento.
A Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS-2006) traça um perfil da população feminina em idade fértil e das crianças menores de cinco anos no Brasil. Financiada pelo Ministério da Saúde, foi coordenada pela equipe da área de População e Sociedade do Centro Brasileiro de Análise e Planejamento (Cebrap).
Em sua terceira edição, a PNDS foi realizada pela primeira vez no Brasil em 1986 e repetida em 1996. Os resultados recentes fornecem subsídios para uma avaliação dos avanços ocorridos na saúde da mulher e da criança no Brasil. Além disso, permitem comparações internacionais e auxiliam na formulação de políticas e estratégias de ação.
A maior parte dos dados foi coletada por meio de entrevistas domiciliares, realizadas com cerca de 15 mil mulheres entre 15 e 49 anos, que vivem em áreas urbanas e rurais nas cinco regiões brasileiras. A metodologia incluiu ainda mensurações como as antropométricas, que medem altura e peso; análises laboratoriais de amostras de sangue, para dosagens de vitamina A e hemoglobina, e do teor de iodo disponível no sal consumido pelas famílias.
Os dados coletados permitem analisar a fecundidade e intenções reprodutivas; a atividade sexual e anticoncepção; a assistência à gestação e ao parto; a morbidade feminina e o estado nutricional das crianças. Permitem ainda estudar três novos temas introduzidos pela primeira vez na PNDS 2006: o acesso a medicamentos, os micronutrientes e a segurança alimentar nos domicílios (acesso à alimentação em quantidade suficiente e qualidade adequada).
Quatro instituições participaram da pesquisa, duas da Universidade de São Paulo (o Núcleo de Pesquisas em Nutrição e Saúde da Faculdade de Saúde Pública e o Laboratório de Nutrição do Departamento de Clínica Médica da Faculdade de Medicina de Ribeirão Preto); duas da Universidade Estadual de Campinas (o Núcleo de Estudos de População (NEPO) e o Departamento de Medicina Preventiva da Faculdade de Ciências Médicas). O Instituto Brasileiro de Opinião Pública e Estatística (IBOPE) executou o trabalho de campo.
O estudo permite estabelecer uma interlocução com o projeto Measure DHS (Demographic and Health Survey), uma investigação realizada em escala global com o apoio da Agência dos Estados Unidos para o Desenvolvimento Internacional (USAID) e parceria de várias outras instituições internacionais, que tem como objetivo prover dados e análises para um amplo conjunto de indicadores de planejamento, monitoramento e avaliação de impacto nas áreas de população, saúde e nutrição de mulheres e crianças de países em desenvolvimento. traça um perfil da população feminina em idade fértil e das crianças menores de cinco anos no Brasil. Financiada pelo Ministério da Saúde, foi coordenada pela equipe da área de População e Sociedade do Centro Brasileiro de Análise e Planejamento (Cebrap).
Em sua terceira edição, a PNDS foi realizada pela primeira vez no Brasil em 1986 e repetida em 1996. Os resultados recentes fornecem subsídios para uma avaliação dos avanços ocorridos na saúde da mulher e da criança no Brasil. Além disso, permitem comparações internacionais e auxiliam na formulação de políticas e estratégias de ação.
A maior parte dos dados foi coletada por meio de entrevistas domiciliares, realizadas com cerca de 15 mil mulheres entre 15 e 49 anos, que vivem em áreas urbanas e rurais nas cinco regiões brasileiras. A metodologia incluiu ainda mensurações como as antropométricas, que medem altura e peso; análises laboratoriais de amostras de sangue, para dosagens de vitamina A e hemoglobina, e do teor de iodo disponível no sal consumido pelas famílias.
Os dados coletados permitem analisar a fecundidade e intenções reprodutivas; a atividade sexual e anticoncepção; a assistência à gestação e ao parto; a morbidade feminina e o estado nutricional das crianças. Permitem ainda estudar três novos temas introduzidos pela primeira vez na PNDS 2006: o acesso a medicamentos, os micronutrientes e a segurança alimentar nos domicílios (acesso à alimentação em quantidade suficiente e qualidade adequada).
Quatro instituições participaram da pesquisa, duas da Universidade de São Paulo (o Núcleo de Pesquisas em Nutrição e Saúde da Faculdade de Saúde Pública e o Laboratório de Nutrição do Departamento de Clínica Médica da Faculdade de Medicina de Ribeirão Preto); duas da Universidade Estadual de Campinas (o Núcleo de Estudos de População (NEPO) e o Departamento de Medicina Preventiva da Faculdade de Ciências Médicas). O Instituto Brasileiro de Opinião Pública e Estatística (IBOPE) executou o trabalho de campo.
O estudo permite estabelecer uma interlocução com o projeto Measure DHS (Demographic and Health Survey), uma investigação realizada em escala global com o apoio da Agência dos Estados Unidos para o Desenvolvimento Internacional (USAID) e parceria de várias outras instituições internacionais, que tem como objetivo prover dados e análises para um amplo conjunto de indicadores de planejamento, monitoramento e avaliação de impacto nas áreas de população, saúde e nutrição de mulheres e crianças de países em desenvolvimento.
Vitamin D reduce CV risk.
(Recommended by Mario Maranhão)
The latter part of 2007 heralded findings from two studies on vitamin D. A meta analysis—titled “Vitamin D Supplementation and Total Mortality”— appeared in the September 10, 2007 issue of the Archives of Internal Medicine and suggested that ordinary doses of vitamin D supplements seem to be associated with decreases in total mortality rates. Other research published in the November 2007 Journal of National Cancer Institute showed a decrease in colorectal mortality with a 72% reduced risk of dying from colorectal cancer when high levels of vitamin D were present.
More recently, a study published in the June 9, 2008 Archives of Internal Medicine says a vitamin D deficiency puts men at an increased risk—2.5 times more likely—for a heart attack.
The research. Epidemiologist Edward Giovannucci, MD, ScD, from Boston’s Harvard School of Public Health, led the prospective study, which was sparked by the hypothesis that a vitamin D deficiency may be involved in atherosclerosis and coronary heart disease development./.../
The latter part of 2007 heralded findings from two studies on vitamin D. A meta analysis—titled “Vitamin D Supplementation and Total Mortality”— appeared in the September 10, 2007 issue of the Archives of Internal Medicine and suggested that ordinary doses of vitamin D supplements seem to be associated with decreases in total mortality rates. Other research published in the November 2007 Journal of National Cancer Institute showed a decrease in colorectal mortality with a 72% reduced risk of dying from colorectal cancer when high levels of vitamin D were present.
More recently, a study published in the June 9, 2008 Archives of Internal Medicine says a vitamin D deficiency puts men at an increased risk—2.5 times more likely—for a heart attack.
The research. Epidemiologist Edward Giovannucci, MD, ScD, from Boston’s Harvard School of Public Health, led the prospective study, which was sparked by the hypothesis that a vitamin D deficiency may be involved in atherosclerosis and coronary heart disease development./.../
Wednesday, July 02, 2008
Chronic Diseases and Health Promotion
WHO Chronic Diseases and Health Promotion: "Chronic diseases, such as heart disease, stroke, cancer, chronic respiratory diseases and diabetes, are by far the leading cause of mortality in the world, representing 60% of all deaths. Out of the 35 million people who died from chronic disease in 2005, half were under 70 and half were women.
This invisible epidemic is an under-appreciated cause of poverty and hinders the economic development of many countries. Contrary to common perception, 80% of chronic disease deaths occur in low and middle income countries.
The global epidemic of chronic disease must, and can, be stopped"/.../
This invisible epidemic is an under-appreciated cause of poverty and hinders the economic development of many countries. Contrary to common perception, 80% of chronic disease deaths occur in low and middle income countries.
The global epidemic of chronic disease must, and can, be stopped"/.../
Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use:
Background
Alcohol, tobacco, and illegal drug use cause considerable morbidity and mortality, but good cross-national epidemiological data are limited. This paper describes such data from the first 17 countries participating in the World Health Organization's (WHO's) World Mental Health (WMH) Survey Initiative.
Methods and Findings
Household surveys with a combined sample size of 85,052 were carried out in the Americas (Colombia, Mexico, United States), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine), Middle East and Africa (Israel, Lebanon, Nigeria, South Africa), Asia (Japan, People's Republic of China), and Oceania (New Zealand). The WHO Composite International Diagnostic Interview (CIDI) was used to assess the prevalence and correlates of a wide variety of mental and substance disorders. This paper focuses on lifetime use and age of initiation of tobacco, alcohol, cannabis, and cocaine. Alcohol had been used by most in the Americas, Europe, Japan, and New Zealand, with smaller proportions in the Middle East, Africa, and China. Cannabis use in the US and New Zealand (both 42%) was far higher than in any other country. The US was also an outlier in cocaine use (16%). Males were more likely than females to have used drugs; and a sex–cohort interaction was observed, whereby not only were younger cohorts more likely to use all drugs, but the male–female gap was closing in more recent cohorts. The period of risk for drug initiation also appears to be lengthening longer into adulthood among more recent cohorts. Associations with sociodemographic variables were consistent across countries, as were the curves of incidence of lifetime use.
Conclusions
Globally, drug use is not distributed evenly and is not simply related to drug policy, since countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones. Sex differences were consistently documented, but are decreasing in more recent cohorts, who also have higher levels of illegal drug use and extensions in the period of risk for initiation./.../
Alcohol, tobacco, and illegal drug use cause considerable morbidity and mortality, but good cross-national epidemiological data are limited. This paper describes such data from the first 17 countries participating in the World Health Organization's (WHO's) World Mental Health (WMH) Survey Initiative.
Methods and Findings
Household surveys with a combined sample size of 85,052 were carried out in the Americas (Colombia, Mexico, United States), Europe (Belgium, France, Germany, Italy, Netherlands, Spain, Ukraine), Middle East and Africa (Israel, Lebanon, Nigeria, South Africa), Asia (Japan, People's Republic of China), and Oceania (New Zealand). The WHO Composite International Diagnostic Interview (CIDI) was used to assess the prevalence and correlates of a wide variety of mental and substance disorders. This paper focuses on lifetime use and age of initiation of tobacco, alcohol, cannabis, and cocaine. Alcohol had been used by most in the Americas, Europe, Japan, and New Zealand, with smaller proportions in the Middle East, Africa, and China. Cannabis use in the US and New Zealand (both 42%) was far higher than in any other country. The US was also an outlier in cocaine use (16%). Males were more likely than females to have used drugs; and a sex–cohort interaction was observed, whereby not only were younger cohorts more likely to use all drugs, but the male–female gap was closing in more recent cohorts. The period of risk for drug initiation also appears to be lengthening longer into adulthood among more recent cohorts. Associations with sociodemographic variables were consistent across countries, as were the curves of incidence of lifetime use.
Conclusions
Globally, drug use is not distributed evenly and is not simply related to drug policy, since countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones. Sex differences were consistently documented, but are decreasing in more recent cohorts, who also have higher levels of illegal drug use and extensions in the period of risk for initiation./.../
Tuesday, July 01, 2008
Should Doctors Be Increasing Their Carbon Footprint By Flying To Medical Conferences?
Should Doctors Be Increasing Their Carbon Footprint By Flying To Medical Conferences?: "Should Doctors Be Increasing Their Carbon Footprint By Flying To Medical Conferences?
ScienceDaily (June 29, 2008) — Every year thousands of doctors and scientists fly to meetings all over the world, but with climate change accelerating, can this type of travel be justified, two doctors debate the issue in the British Medical Journal."/.../
ScienceDaily (June 29, 2008) — Every year thousands of doctors and scientists fly to meetings all over the world, but with climate change accelerating, can this type of travel be justified, two doctors debate the issue in the British Medical Journal."/.../
Associação: tabagismo e perda de memória
Possível associação entre tabagismo e perda de memória na meia idade
Autora: Marlene BuskoPublicado em 06/12/2008
De acordo com uma análise baseada em dados de um estudo amplo, prospectivo de coorte, chamado Whitehall II, o tabagismo foi correlacionado a um aumento de risco para deficiências de memória e cognitiva em indivíduos de meia idade.
Séverine Sabia, MSc, do Institut National de la Santé et de la Recherche Médicale, em Villejuif, França, e colaboradores publicaram seus achados no volume de 9 de junho do Archives of Internal Medicine.
Após ajuste para fatores confundidores, em comparação com indivíduos que nunca fumaram, os participantes fumantes apresentaram um risco aumentado em 37% de apresentar escores no menor quintil de um teste de memória (lembraram menos de 5 de 20 palavras), conforme informou a autora ao Medscape Psychiatry./.../
Autora: Marlene BuskoPublicado em 06/12/2008
De acordo com uma análise baseada em dados de um estudo amplo, prospectivo de coorte, chamado Whitehall II, o tabagismo foi correlacionado a um aumento de risco para deficiências de memória e cognitiva em indivíduos de meia idade.
Séverine Sabia, MSc, do Institut National de la Santé et de la Recherche Médicale, em Villejuif, França, e colaboradores publicaram seus achados no volume de 9 de junho do Archives of Internal Medicine.
Após ajuste para fatores confundidores, em comparação com indivíduos que nunca fumaram, os participantes fumantes apresentaram um risco aumentado em 37% de apresentar escores no menor quintil de um teste de memória (lembraram menos de 5 de 20 palavras), conforme informou a autora ao Medscape Psychiatry./.../
Monday, June 30, 2008
Population-Based Prevention of Obesity
Population-Based Prevention of Obesity. The Need for Comprehensive Promotion of Healthful Eating, Physical Activity, and Energy Balance. A Scientific Statement From American Heart Association Council on Epidemiology and Prevention, Interdisciplinary Committee for Prevention
(Formerly the Expert Panel on Population and Prevention Science) Shiriki K. Kumanyika PhD, RD, MPH, FAHA, Eva Obarzanek PhD, MPH, RD, FAHA, Nicolas Stettler MD, MSCE, FAHA, Ronny Bell PhD, Alison E. Field ScD, Stephen P. Fortmann MD, FAHA, Barry A. Franklin PhD, FAHA, Matthew W. Gillman MD, SM, Cora E. Lewis MD, MSPH, FAHA, Walker Carlos Poston II PhD, MPH, FAHA, June Stevens PhD, and Yuling Hong MD, PhD, FAHA
Abstract—Obesity is a major influence on the development and course of cardiovascular diseases and affects physical and social functioning and quality of life. The importance of effective interventions to reduce obesity and related health risks has increased in recent decades because the number of adults and children who are obese has reached epidemic proportions. To prevent the development of overweight and obesity throughout the life course, population-based strategies that improve social and physical environmental contexts for healthful eating and physical activity are essential. Population-based approaches to obesity prevention are complementary to clinical preventive strategies and also to treatment programs for those who are already obese. This American Heart Association scientific statement aims: 1) to raise awareness of the importance of undertaking population-based initiatives specifically geared to the prevention of excess weight gain in adults and children; 2) to describe considerations for undertaking obesity prevention overall and in key risk subgroups; 3) to differentiate environmental and policy approaches to obesity prevention from those used in clinical prevention and obesity treatment; 4) to identify potential targets of environmental and policy change using an ecological model that includes multiple layers of influences on eating and physical activity across multiple societal sectors; and 5) to highlight the spectrum of potentially relevant interventions and the nature of evidence needed to inform population-based approaches. The evidence-based experience for population-wide approaches to obesity prevention is highlighted./.../
(Formerly the Expert Panel on Population and Prevention Science) Shiriki K. Kumanyika PhD, RD, MPH, FAHA, Eva Obarzanek PhD, MPH, RD, FAHA, Nicolas Stettler MD, MSCE, FAHA, Ronny Bell PhD, Alison E. Field ScD, Stephen P. Fortmann MD, FAHA, Barry A. Franklin PhD, FAHA, Matthew W. Gillman MD, SM, Cora E. Lewis MD, MSPH, FAHA, Walker Carlos Poston II PhD, MPH, FAHA, June Stevens PhD, and Yuling Hong MD, PhD, FAHA
Abstract—Obesity is a major influence on the development and course of cardiovascular diseases and affects physical and social functioning and quality of life. The importance of effective interventions to reduce obesity and related health risks has increased in recent decades because the number of adults and children who are obese has reached epidemic proportions. To prevent the development of overweight and obesity throughout the life course, population-based strategies that improve social and physical environmental contexts for healthful eating and physical activity are essential. Population-based approaches to obesity prevention are complementary to clinical preventive strategies and also to treatment programs for those who are already obese. This American Heart Association scientific statement aims: 1) to raise awareness of the importance of undertaking population-based initiatives specifically geared to the prevention of excess weight gain in adults and children; 2) to describe considerations for undertaking obesity prevention overall and in key risk subgroups; 3) to differentiate environmental and policy approaches to obesity prevention from those used in clinical prevention and obesity treatment; 4) to identify potential targets of environmental and policy change using an ecological model that includes multiple layers of influences on eating and physical activity across multiple societal sectors; and 5) to highlight the spectrum of potentially relevant interventions and the nature of evidence needed to inform population-based approaches. The evidence-based experience for population-wide approaches to obesity prevention is highlighted./.../
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