A não-dieta dos franceses

De: Sergio Metzger 

     PREZADOS AMIGOS

     COM  A PALAVRA NUTRICIONISTAS E  ENDOCRINOLOGISTAS ALGUNS JA DISSERAM QUE FUNCIONA MESMO  MAS VALE CONHECER TODAS AS OPINÕES ABALISADAS DE QUEM ENTENDE DA MATÉRIA TB

 

     ABS SERGIO

 

Mais uma...E funciona mesmo !!! 

(segundo eles)

A dieta dos franceses 

  Dr. Will Clower, autor de "A não-dieta dos  franceses", lançado recentemente pela editora Campus. O médico neurofisiologista desenvolveu, durante sua estada de dois anos no Institute of Cognitive Science, em Lyon, na França, um plano de 10 etapas para nunca mais fazer dieta e, ainda assim, emagrecer com saúde, como os franceses. 

"Descobri que os franceses violam todas as regras alimentares que estipulamos para nós. E, apesar de seus cremes, queijos, manteigas e pães, a taxa de obesidade na França é de apenas 11,3% da população, segundo pesquisa realizada em 2005 pela Internacional Obesity Task Force. O programa de emagrecimento saudável é baseado em quatro grandes princípios básicos: comer alimentos de verdade, aprender a comer, reduzir a quantidade de comida e ser ativo, sem necessariamente se exercitar", explica no livro. 

" Em uma volta pelo supermercado fiquei impressionado com os laticínios. Onde estavam os produtos lights? " 

Segundo o médico, estamos inundados de alimentos artificiais - açúcares sintéticos, gorduras sintéticas e produtos alimentícios artificiais. Falta-nos reaprender o que é comida de verdade, já que é a ingestão dela que proporciona ao corpo a nutrição na forma de que ele necessita. Clower afirma que em vez de estimular a ingestão de novas substâncias químicas para enganar o organismo, o programa mostra porque alimentos de verdade funcionam em favor do corpo. 

"Temos que reaprender o que é comida de verdade. Alimentos de verdade são os produtos naturais, que podem ser encontrados em um texto de biologia e que normalmente fazem parte da cadeia alimentar. Refrigerantes não dão em árvore, margarina é uma invenção, e os corantes, conservantes e estabilizantes que aumentam a vida do produto não foram feitos para o nosso corpo", defende. 

Em sua observação dos costumes alimentares franceses, o médico descobriu que os franceses não comem alimentos processados, não evitam gorduras, chocolates e nem carboidratos, não tomam suplementos alimentares, não se abstêm do vinho no almoço e no jantar e não comem com pressa. Ao adotar os hábitos franceses, ele e a mulher emagreceram onze e cinco quilos, respectivamente. 

- Em uma volta pelo supermercado fiquei impressionado com os laticínios - fileiras e fileiras de queijos, uma geladeira inteira só pra iogurtes e queijos frescos.. 

Onde estavam os produtos lights? 

Entre outras dicas, Clower prescreve uma limpa na despensa e na geladeira, com o auxílio de  que se deve ter em casa , fala sobre os benefícios da cerveja e do vinho, com moderação, é claro, da importância de se passar mais tempo à mesa, usufruindo do sabor da comida e de como isso auxilia a diminuir o tamanho das porções, e da necessidade de se manter ativo. 

 Os resultados, garante ele, surgem em seguida. 

Plano de 10 etapas para nunca mais fazer dieta!!!! 

1 - Comer devagar. Comer muito rápido faz comer mais. O estômago demora cerca de 20 minutos para mandar um sinal para o cérebro. Comendo devagar, o cérebro tem tempo de receber a mensagem de que seu corpo está satisfeito. 

2 - Garfadas menores.. O paladar está na superfície da língua. Se a sua boca está cheia de comida, você nem sente o gosto. 

3 - Concentre-se na comida. Comer em frente à TV ou no carro faz o momento se tornar irrelevante. A falta de atenção faz com que se coma demais. 

4 - Apóie o garfo no prato. Se ainda tem comida na sua boca, coloque o garfo no prato. Não o encha novamente até que tenha engolido. 

5 - Sirva a comida em pratos pequenos. Isso resolve dois problemas de uma só vez: o de lavar a louça e o fato de você comer com os olhos. 

6 - Comida sem gordura engorda. Comidas sem gordura não satisfazem e contêm mais açúcares. 

7 - Se não for comida, não coma. Nosso corpo sabe o que é comida de verdade: carnes, frutas, verduras. Invenções como coca-cola causam problemas de saúde e de sobrepeso. 

8 - Coma em etapas. Coma a salada primeiro. Isso ajuda a ganhar tempo à mesa e previne que você coma rápido e em grande quantidade. 

9 - Gordura é necessária na dieta. Seu corpo e cérebro necessitam de gordura para serem saudáveis. Você come uma quantia normal de gordura quando come alimentos de verdade, como manteiga, azeite, ovos, castanhas e queijos. 

10 - Alta qualidade da comida leva a comer menos quantidade. 

  

 Alimentos que se deve ter em casa 

Peixes (salmão, sardinha, atum) 

Grãos (granola, aveia, arroz) 

Hortaliças (feijões, cebola, batata, abóbora, tomate) 

Óleos e vinagres (azeite de oliva, óleo 100% vegetal, vinagre) 

Produtos de padaria (farinha, ervas, temperos, açúcar branco ou mascavo, pimenta, sal) 

Lanches (frutas desidratadas, biscoitos não-hidrogenados, nozes, azeitona) 

Condimentos (mostarda, maionese de verdade) 

Lacticínios (manteiga, queijo, ovos, leite, iogurte) 

Bebidas (café, cerveja, suco de fruta, chá, água, vinho) 

 

**O QUE ACONTECE QUANDO VOCÊ ACABA DE BEBER UM REFRIGERANTE**

Base 1 lata padrão

 

Primeiros 10 minutos:

10 colheres de chá de açúcar batem no seu corpo, 100% do recomendado diariamente.

Você não vomita imediatamente pelo doce extremo, porque o ácido fosfórico corta o gosto.

 20 minutos:

O nível de açúcar em seu sangue estoura, forçando um jorro de insulina.

O fígado responde transformando todo o açúcar que recebe em gordura.

(É muito para este momento em particular.)

 

40 minutos:

A absorção de cafeína está completa.

Suas pupilas dilatam, a pressão sanguínea sobe, o fígado responde bombeando mais açúcar na corrente.

Os receptores de adenosina no cérebro são bloqueados para evitar tonteiras.

 

45 minutos:

O corpo aumenta a produção de dopamina, estimulando oscentros de prazer do corpo.

(Fisicamente, funciona como com a heroína.)

 

50 minutos:

O ácido fosfórico empurra cálcio, magnésio e zinco para o intestino grosso, aumentando o metabolismo.

As altas doses de açúcar e outros adoçantes aumentam a excreção de cálcio na urina.

60 minutos:

As propriedades diuréticas da cafeína entram em ação. Você urina.

Agora é garantido que porá para fora cálcio, magnésio e zinco, os quais seus ossos precisariam.

 

Conforme a onda abaixa você sofrerá um choque de açúcar.

Ficará irritadiço.

 

Você já terá posto para fora tudo que estava no refrigerante, mas não sem antes ter posto para fora, junto, coisas das quais farão falta ao seu organismo.

 

Pense nisso antes de beber refrigerantes.

 Se não puder evitá-los, modere sua ingestão!

  

Prefira sucos naturais!!!

 

Em sendo possível, dê preferência por aqueles em que se vêem as frutas (de boa procedência) sendo preparadas.

 

Seu corpo agradece!*

 

Esta não é uma campanha para prejudicar a venda deste ou daquele refrigerante, mas sim, uma Campanha pela Saúde; sua e do seu bolso, que deixará de comprar muitos remédios...

 

Chronic Diseases: An economic perspective

This major report, 'Chronic disease: an economic perspective', written by Marc Suhrcke, Rachel A. Nugent, David Stuckler and Lorenzo Rocco for OxHA, demonstrates that chronic diseases – heart and lung disease, cancer and diabetes – are having a negative economic impact on both the developed and developing world and should thus be adequately addressed by domestic and international policy makers.

The Executive Summary is below.

• Click here >> to download the report as a pdf.
• Click here >> for a press release introducing the report.
• Click here >> for the Web-Annex of supplementary graphs and tables.

Deaths of Children and Noncombatants in Iraq, 2003–2008

NEJM: Volume 360:1585-1588 April 16, 2009 Number 16

The Weapons That Kill Civilians — Deaths of Children and Noncombatants in Iraq, 2003–2008

Madelyn Hsiao-Rei Hicks, M.D., M.R.C.Psych., Hamit Dardagan, Gabriela Guerrero Serdán, M.A., Peter M. Bagnall, M.Res., John A. Sloboda, Ph.D., F.B.A., and Michael Spagat, Ph.D.

Armed violence, such as that in the ongoing conflict in Iraq, is a threat to global health.¹ It causes serious injuries and deaths of civilians, makes orphans of children, traumatizespopulations, and undermines the ability of communities to provideadequate medical care even as it dramatically increases health care needs. Moreover, indiscriminate or intentional harm tocivilians violates humanitarian principles and basic human rights.Believing that a careful assessment of the effects of different kinds of weapons on civilians in Iraq was needed, we used the database of the Iraq Body Count (IBC), a nongovernmental organization that documents civilian violent deaths in Iraq,²to determine the nature and effects of various weapons on civilians in Iraq. The patterns we found convince us that documenting the particular causes of violent civilian deaths during armed conflict is essential, both to prevent civilian harm and to monitor compliance withinternational humanitarian law.

Unlike surveys that do not distinguish between Iraqi combatants and noncombatants among the dead,³ the large-scale IBC database attempts to specifically identify civilians, whose deaths are of particular concern from a public health and humanitarian standpoint.^1,4 Recent findings from the Iraq Family Health Survey support the validity of the IBC database by showing similar regional trends and distributions of violent deaths.³ The IBC has monitored direct civilian deaths daily since the Iraq war began on March 20, 2003, with the invasion by U.S.-led coalition forces. IBC sources are primarily reports in the professional media, including reports translated from Arabic, supplemented by reports from hospitals and morgues. Deaths are added to the database when sources report the number of civilians killed, with time and location described adequately to avoid double counting. Also recorded are the perpetrator, the target, the weapons used, the primary sources, and whenever possible, each victim's age, sex, occupation, and name. Although the IBC records injuries as well as deaths, we limited our analysis to deaths, which are more consistently reported by the media.² "Civilian" deaths include those of most women, children under 18 years of age, noncombatants, and police officers killed during regular, but not paramilitary, activities, since police are considered part of normal civil society. Database entries are systematically error-checked by three IBC volunteers before publication on the IBC Web site (www.iraqbodycount.org).²

We based our data set on the number of Iraqi civilian deaths recorded as of June 13, 2008, for the 5-year period of analysis, March 20, 2003, through March 19, 2008. Of the total of 91,358 Iraqi civilian deaths from armed violence recorded for this period, we excluded 10,027 deaths from prolonged violence (e.g., the two sieges of Fallujah and prolonged episodes of violence during the invasion of March 20, 2003, through April 30, 2003), and 20,850 deaths recorded only in aggregate reports from morgues and hospitals, since these deaths were not reliably linked to specific events of a weapon's use. As our table shows, we focused on the remaining 60,481 deaths of Iraqi civilians and the causative weapons in 14,196 armed-violence events considered to be of short duration (lasting up to two calendar dates), occurring in an identifiable location, and directly causing one or more reported civilian deaths. Each death included in the table is of an individual noncombatant and is linked to a type of weapon used in a specific time and place; these are not estimates extrapolated from a sample./.../

Understanding the Past, Transforming the Future

Understanding the Past, Transforming the Future
MD/PhDs in the Social Sciences and Humanities Meet in Philadelphia

By Ippolytos Kalofonos and Seth Holmes
Contributing Writers

Discussions of contemporary medical research are frequently accompanied by proclamations that we are entering a genetic age that will see the rise of personalized medicine based on individual genotyping. Stem cell research is gaining momentum and may lead to dramatic breakthroughs in diseases such as Alzheimer and Parkinson’s that lack effective treatment.

Yet, many of the most vexing challenges in medicine today are decidedly macroscopic in nature. The numbers of uninsured people in the United States grows even as the amount of money spent on health care grows. Health problems across the globe, from infectious disease to obesity to drug abuse, are as related to social, political and economic problems as they are to molecular mechanisms. Are the medical leaders of today and tomorrow prepared to confront these challenges?/.../

VIGITEL

De:

Maria Inês Reinert Azambuja 

Estudo Vigitel completo

VIGITEL BRASIL 2008

VIGILÂNCIA DE FATORES DE RISCO E PROTEÇÃO PARA DOENÇAS

CRÔNICAS POR INQUÉRITO TELEFÔNICO

http://189.28.128.100/portal/arquivos/pdf/VIGITEL2008_web.pdf

Secondhand Smoke Exposure Pervasive in New York

Download Complimentary Source PDF

By Crystal Phend, Staff Writer, MedPage Today Published: April 10, 2009 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.

SAN FRANCISCO, April 10 -- More than half of non-smoking New Yorkers have elevated cotinine levels from secondhand tobacco smoke, Jennifer A. Ellis, Ph.D., of the New York City Department of Health & Mental Hygiene, and colleagues reported online in Nicotine & Tobacco Research.

The New York City rate easily beat the national average (56.7% versus 44.9%, P<0.05),>P<0.05). 

Músicas de sucesso de 1904 a 2003

De:

Anne Schneider

 

Para os que apreciam música, um site para guardar nos Favoritos. Há videoclipes de músicas de sucesso, de 1904 a 2003. http://www.planetarei.com.br/100anos/index.htm

Em busca da felicidade

Ela é possível? Como encontrá-la? O sociólogo Zygmunt Bauman vai atrás das respostas, não garante solução mágica, mas tem ricas definições sobre um dos temas centrais da nossa existência no livro “A Arte da Vida”

Zygmunt Bauman, 83 anos, vive com medo, diferente do nosso, porém com um medo real. Não mora em casa gradeada, mas teme o terrorismo no interior da Inglaterra onde reside. Está relativamente distante da violência urbana, porém a exclusão, estrangeiro em solo que não é o seu, o inquieta. Como nós, talvez tenha sofrido por amor. Como milhões de outros exilados, precisou deixar a sua Polônia natal correndo, quando a ex-URSS anexou o país, e depois peregrinou como professor (de futuro escancarado, mas incerto) por Canadá, Estados Unidos, Austrália e Grã-Bretanha.

Em Medo Líquido (Zahar, 240 páginas, R$ 30), lançado em 2006, ele fez um inventário dos distintos, nada distantes, medos contemporâneos. Classificou o medo como uma das marcas mais visíveis do nosso tempo. No Brasil, o terror nos cerca e nos afoga. Basta pisar fora do primeiro degrau da nossa escada particular na tentativa de chegar ao shopping-center mais próximo. O medo está no ar. Surpreendente como o vôo de uma asa-delta./.../

*********************************

Esta aparente sensação de segurança do indivíduo diante de um mundo sujeito a poucas intempéries do tipo que nossos avós costumavam enfrentar - guerras intercontinentais, epidemias, fascismo - é, no entanto, uma armadilha, segundo o sociólogo polonês Zygmunt Bauman. Em Medo Líquido (Jorge Zahar, R$ 29,90, 240 páginas), publicado este ano, o autor que se tornou um best-seller ao aproximar a sociologia do cotidiano dá seqüência ao estudo do mundo atual à luz de sua teoria líquida.

Depois de escrever Modernidade Líquida, Amor Líquido, Tempos Líquidos e Vida Líquida — sempre tendo como norte a volatilidade e a instabilidade das relações atuais —, o polonês mira agora na insegurança. Para descrever a trajetória deste sentimento e decifrar por que continuamos apavorados, em pleno século 21, Bauman retrocede para além da II Guerra de Desejo e Reparação. Reimagina a experiência de se existir no século 16, que foi definida por Lucien Febvre como "peur toujour, peur partout" (medo sempre e em toda parte). O historiador francês vinculava a ubiqüidade do medo à escuridão do mundo, que começava do lado de fora da casa. A modernidade seria o grande salto à frente: com o avanço das ciências, chegaria o tempo do fim das surpresas, das calamidades, das catástrofes. Mas não foi bem assim: "O que deveria ser uma rota de fuga, contudo, revelou-se, em vez disso, um longo desvio. (...) Esta nossa vida tem se mostrado diferente do tipo de vida que os sábios do Iluminismo e seus herdeiros avistaram e procuraram planejar",constata Bauman./.../

CUTTING SOCIAL PROGRAMS

STATES CUTTING SOCIAL PROGRAMS WHICH WOULD SAVE MONEY OVER TIME

11 April 2009

BY ERIK ECKHOLM

PHOENIX — Battered by the recession and the deepest and most widespread budget deficits in several decades, a large majority of states are slicing into their social safety nets — often crippling preventive efforts that officials say would save money over time.

President Obama’s $787 billion stimulus package is helping to alleviate some of the pain, providing large amounts of money to pay for education and unemployment insurance, bolster food stamp programs and expand tax credits for low earners.

But the money will offset only 40 percent of the losses in state revenues, and programs for vulnerable groups have been cut in at least 34 states, according to the Center for Budget and Policy Priorities, a private research group in Washington

Perhaps nowhere have the cuts been more disruptive than in Arizona, where more than 1,000 frail elderly people are struggling without home-care aides to help with bathing, housekeeping and trips to the doctor. Officials acknowledge that some are apt to become sicker or fall, ending up in nursing homes at a far higher cost.

Tobacco x Mosquitos

From Globalink. org by Mr. James Repace
Go to other forums Rate this article Reply to author Reply to all
For over a hundred years, tobacco products have been manufactured and marketed world-wide on an industrial scale, addicting billions of people, and killing and injuring hundreds of millions of these addicts and innocent by-standers. The multi-national tobacco companies have evolved into a rogue pharmaceutical industry that has engineered cigarettes to be ever more addictive, and has successfully corrupted governments world-wide to preserve itself. Although widespread knowledge about the harm that smoking can do has caused U.S. smoking prevalence to decline by about 50% since 1965, the absolute number of smokers in the U.S. declined by only 7% from a peak of 50.1 million in 1965 to 46.5 million in 2000, and the annual number of cigarettes sold declined by ~17.5%, which has been offset by price increases and lowered costs of production. I haven't seen any tobacco companies going out of business lately. If governments ever get as serious about tobacco as they are about malaria, they would wipe out this industry like they wipe out mosquitos. Since Philip Morris has endorsed the FDA legislation, this is an omen that FDA regulation, while achieving some cosmetic results, will prove to be a Pyrrhic victory for Public Health -- a lot of Strurm und Drang, signifying nothing. Jim Repace

From: 

Sergio Metzger

Sabedoria  Judaica

(Passagem do Talmud o Livro dos Sabios)

 

Preste atenção em teus pensamentos, pois eles se tornarão palavras. 

Preste atenção em tuas palavras, pois elas se tornarão atos. 

Preste atenção em teus atos, pois eles se tornarão hábitos. 

Preste atenção nos hábitos, pois eles se tornarão o teu caráter. 

Preste atenção no teu caráter, pois ele é o teu destino.

A window to arterial ageing

Published Online First: 26 August 2008. doi:10.1136/hrt.2008.151787
Heart 2009;95:611-612

Copyright © 2009 BMJ Publishing Group Ltd & British Cardiovascular Society.

EDITORIALS

Carotid ultrasound in children: a window to arterial ageing

James H Stein

Correspondence to:
Dr James H Stein, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, G7/341 CSC, MC 3248, Madison, WI 53717-1800, USA; jhs@medicine.wisc.edu

Carotid ultrasound is a well-established research tool that can identify the presence of atherosclerosis and quantify the degree of arterial injury in a broad range of populations. A specific application of carotid ultrasound, measurement of intima-media thickness (IMT), precisely quantifies the combined thicknesses of intimal and medial layers of the arterial wall. Carotid IMT values are strongly associated with abnormal levels of risk factors for atherosclerotic vascular disease and prevalent vascular disease, and independently predict future cardiovascular disease events.¹ In well-trained hands, the accuracy and reproducibility of carotid IMT are unsurpassed among non-invasive tests of arterial injury. The strong evidence base associating increased cardiovascular disease risk with increasing carotid IMT has led to this test being recommended, in selected adults, as a clinical tool to assist with cardiovascular disease risk prediction./.../

INTERNAÇÕES HOSPITALARES PELO SUS em POA e determinantes de SUA DISTRIBUIÇÃO ESPACIAL

Ontem foi apresentada uma dissertação de mestrado cujo resumo segue abaixo, pela Dra. Lizia Maria Meirelles Mota, utilizando a mesma matriz da distribuição de indicadores de desenvolvimento humano já utilizada pra Doenças Cardiovasculares, para Doenças respiratórias e para espectativa de vida. Parabéns para Dra. Lisia.

DISSSERTAÇÃO DE MESTRADO PROFISSIONAL
DE EPIDEMIOLOGIA: GESTÃO DE TECNOLOGIAS EM SAÚDE

Por Lizia Maria Meirelles Mota, Orientador: Prof. Dr. Sérgio Luiz Bassanesi. Co-orientador: Prof. Dr. Roger dos Santos Rosa

RESUMO: 

Este dissertação busca investigar a associação entre a distribuição espacial das internações hospitalares e fatores demográficos e socioeconômicos em Porto Alegre. De um número inicial de 102.215 internações hospitalares ocorridas no município entre julho de 2005 a junho de 2006, obtivemos 92.148 com endereços válidos, contendo as variáveis relacionadas à internação (hospital, causa, data e tempo de permanência) e ao paciente (sexo, idade e endereço). Os endereços das internações foram geograficamente distribuídos nos respectivos bairros de Porto Alegre e estratificados por variáveis a fim de analisar o perfil sócio demográficos destes. As taxas de internações hospitalares (excluídos as por partos) por bairros em Porto Alegre apresentaram um padrão espacial de distribuição não aleatório, sendo menores na região central da cidade, provida de condições socioeconômicas melhores. Entretanto, este comportamento não foi observado em taxas de internações por procedimento de alto custo, representado por angioplastias. Mesmo assim, o SUS mostrou-se equitativo em se tratando de internações hospitalares, pois propiciou acesso proporcionalmente maior às mesmas em maior número às regiões mais carentes, representadas por estratos de piores índices socioeconômicos. Encontramos correlações das taxas gerais de internações (excluídos partos) com as variáveis independentes taxa de fecundidade, coeficiente de mortalidade externa e renda, sendo esta última a mais altamente significativa (p=0, 0000002). Isto evidencia a influência de determinantes sociais em internações hospitalares pelo SUS no município. Salientamos que os achados neste estudo podem embasar os gestores públicos municipais de saúde a decidir sobre localização de serviços hospitalares de saúde.

Palavras-chave: Internações. Determinantes Sociais. Distribuição Espacial.

ABSTRACT

 This dissertation seeks to investigate the association between the spatial distribution of hospital admissions, and socioeconomic and demographic factors in Porto Alegre. From an initial number of 102,215 hospitalizations occurred in the city between July 2005 and June 2006, obtained 92,148 valid addresses containing the variables related to hospitalization (hospital, cause, date and length of stay) and patient (sex, age and address). The addresses of the admissions were geographically distributed in the districts of Porto Alegre and stratified by variables to examine the socio demographic profile of these. The rates of hospital admissions (excluding births per) for neighborhoods in Porto Alegre showed a spatial pattern of distribution not random, and lower in the central region of the city, equipped with better socioeconomic conditions. However, this behavior was not observed in rates of hospitalization for high-cost procedure, represented by angioplasty. Even so, the SUS has proved equal in the case of hospitalization thus provided greater access to the same proportion in many poor regions, represented by strata of worse socioeconomic indicators. We found correlations of the general rates of hospitalization (excluding births) with the independent variables in fertility rate, mortality rate and foreign income, the latter being the most highly significant (p = 0, 0000002). This shows the influence of social determinants in the hospitalization by the SUS in the city. We stress that the findings in this study are based the municipal public health managers to decide on location of hospital health services.

Keywords: Admissions. Social Determinants. Spatial Distribution.

Memories of pain beyond the power of healing

Lown RCTs (Random Clinical Thoughts): Memories of pain beyond the power of healing

Author:

Dr. Bernard Lown, ProCor Founder and Chair

Attachments

Lown RCTs (Random Clinical Thoughts): Memories of pain beyond the power of healing (37K) [description] [download]

Whenever I read of an Iraqi war veteran's suicide or of a soldier afflicted with post-traumatic stress disorder, I feel a frisson of anguish. My emotional reaction may be due to the many Holocaust victims whom I have doctored. They have taught me that some remembrances of pain and savagery are so deep and tautly embedded that the passage of time can only dilute, not purge. 

One memory that frequently surfaces and fills me with desolation does not concern a Holocaust victim. This singular memory I wish to extirpate, but it leaves me helpless. My tormentor is a small, elderly housewife who was never a victim of Auschwitz, Buchenwald or the other charnel places of horror that had pockmarked Europe. This event happened so long ago that I have forgotten much else of that time.

The event I am about to relate occurred 61 years ago. The place was the Montefiore Hospital in New York City, where I was a medical resident. The hospital was then the city's leading institution for the treatment of chronic disease, with its mostly elderly patients suffering from multiple intractable problems. Jack K., the intern working at the time on my service, was heavyset, ponderous, uninterested, and invariably complaining of indigestion. More annoying was his contempt for these elderly patients. He was impatient to complete the "stinking" internship and get on with his life's commitment to psychiatry./.../

total ban on smoking indoors, including bars, restaurants and hotels

São Paulo State, under the leadership of Governor José Serra, former Ministry of Health, has passed today on its Assembly a total ban on smoking indoors, including bars, restaurants and hotels. No smoking designated areas, no special ventilations, no ammendments to dilute the law despite a huge opposition of the Hospitality industry supported by some newspapers. Bars, Hotels and Restaurants Associations were crowding the Assembly galeries claiming about jobs and profits losses if the law wa approved. This is a huge victory taking into account the importance, role model and dimension of São Paulo state - 40 million inhabitants, probably one major population in the world  that is about to be protected by a smoke-free law. We are all overjoyed with this accomplishment where both the São Paulo state government and the civil society n amely the Brazil Tobacco Control Alliance - ACTBR, a broad coalition of several organizations, had a crucial role. Ammendments to the law where also approved and demand mandatory educational campaigns, mandatory access to smoking cessation treatment and exempt tobacco stores and religious cerimonies from the smoke -free law. This is the most restrictive smoke-free law in the country with tough fines and will surely influence other similar laws in states and municipalities and influence a federal project of law under  discussion in Brazil's congress that also proposes bans of smoking designated areas. The law goes now for sanction by the Governor, a major tobacco control ally. 

Best wishes, 

Vera Luiza da Costa e Silva, MD PhD

WHO consultant

Here is the link with the news in the Official São Paulo state website in Portuguese, with reference to the WHO FCTC provisions: 

http://www.saopaulo.sp.gov.br/spnoticias/lenoticia.php?id=20... 

Here is the link of a major newspaper in São Paulo

http://www.estadao.com.br/estadaodehoje/20090408/not_imp3517... 

Louise Lown Heart Hero Award

From: Ramos, Juan   ProCOR

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The 30 April 2009 deadline for the Louise Lown Heart Hero Award is fast
approaching! Community-based initiatives from around the world that promote
heart health are encouraged to apply for the US$2000 award.

Information about the award including who can apply, criteria, and the
application are provided below. The information is also available in Word and
PDF at www.procor.org or by emailing Juan Ramos, ProCor program coordinator, at
jramos3@partners.org.

The award is administered by ProCor (www.procor.org), a US-based communication
network that uses email and the web to support knowledge sharing of
cardiovascular health among a global community working in clinical, community,
research, and policy settings.

Past recipients of the award include the Rheumatic Heart Disease Prevention
Program in Tonga (2008), which screens primary school children for rheumatic
heart disease and provides early, effective treatment; and the Heart and Stroke
Foundation South Africa Children's Programme (2007), which teaches heart healthy
practices, such as growing vegetables for their daily meals, to over a million
children in rural and urban impoverished settings throughout South Africa.

Dr. Bernard Lown, Nobel Peace Prize recipient, inventor of the defibrillator,
and founder of ProCor, created the award in 2007 to honor his wife's lifelong
commitment to the rights and wellbeing of others through her work as a social
worker, activist, and writer.

Who can apply
Applications are encouraged from community-based programs (non-profit,
governmental, or private sector) that have successfully worked to promote heart
health in developing countries or other low-resource settings (i.e.,
disadvantaged communities in developed countries) through innovative, preventive
approaches. The Heart Hero Award is not a grant. Applicants should focus on
their past accomplishments that deserve recognition, rather than future
initiatives that need funding. Programs that are accepted for consideration but
that do not receive the award will gain increased visibility through ProCor
among a diverse global community committed to sharing knowledge in order to
prevent cardiovascular disease.

Examples of eligible initiatives include community programs promoting physical
activity, nutrition, or tobacco control; population-based interventions reducing
diabetes, hypertension, and obesity; patient-focused clinical programs
increasing access to screening, identification, and control of risk factors;
advocacy and policy activities; and resource development and dissemination.

Award criteria
Applicants should focus on one specific initiative rather than an organization's
entire scope of work. The initiative must:
- Build awareness or support action that promotes heart health.
- Be community-based and innovatively respond to local health needs.
- Demonstrate success.
- Be cost-effective and potentially sustainable.
- Have the potential to be adapted or replicated in other settings.
- Have been in operation for a minimum of one year.

Application process and timeline
- Applications are accepted year-round.
- Deadline for the 2009 award is 30 April 2009.
- Applications are reviewed on a continuous basis by an award committee.
- Applicants are notified whether their program has been accepted for
consideration.
- Information about programs that are selected for award consideration may be
published in ProCor's email news and discussion forum and website
(www.procor.org).
- Funds are provided directly to the organization or individual with primary
responsibility for the initiative.

For more information
Contact Juan Ramos, ProCor Program Coordinator.
Email: jramos3@partners.org
Telephone: 1 617 732 1318 ext. 3319

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Application

The following required information may be submitted via fax, postal mail, email
attachment, or in the text of a plain text email. Abstracts will not be
considered.
- Program title
- Program location (e.g., country, state/province/region, city/town/village)
- Contact person
- Organization
- Mailing address
- Telephone
- Fax
- Email
- Website

Please describe the initiative in approximately 500-1000 words. Applications
exceeding the word count requirement will be returned for revision or rejected.
The following must be included:
- Program purpose
- Program history
- Local needs that are addressed
- Local partners, resources, sources of support
- Strategies or activities that build awareness of cardiovascular disease and/or
support action to promote heart health
- Evidence of success and accomplishments (e.g., statistical data, anecdotal
stories, etc.)

References
Please provide contact information for three (3) people we can contact to learn
more about your program.

Please read and sign the following
- The information submitted in this application for the Louise Lown Heart Hero
Award is accurate to the best of my knowledge.
- If this application is accepted for award consideration, I understand that the
references provided above may be contacted for more information.
- The information submitted may be published in ProCor's electronic mailing list
and website (www.procor.org), and/or in materials produced by the Lown
Cardiovascular Research Foundation, and may be edited prior to publication. I
understand that the purpose of sharing this information is to promote
cardiovascular health.
- I waive and release all claims for any compensation for such use of this
information, or for damages, and I hold the Lown Cardiovascular Research
Foundation and its funders harmless against any and all claims for damages
rising out of the use of this information.

Signature: __________________________           Date: _________

Send the information requested to Juan Ramos, ProCor Program
Coordinator.
Email: jramos3@partners.org
Fax: 1 617 277 0347
Mail:   Louise Lown Heart Hero Award
Lown Cardiovascular Research Foundation
21 Longwood Avenue
Brookline MA 02446 USA

Rheumatic Fever: Neglected Again

Science 3 April 2009: Vol. 324. no. 5923, p. 37 DOI: 10.1126/science.324.5923.37b

Letters

Rheumatic Fever: Neglected Again

We appreciate M. Enserink's News of the Week story ("Some neglected diseases are more neglected than others," 6 February, p. 700) on the Moran et al. study analyzing the current state of research into so-called "neglected diseases" (1). We would like to highlight one neglected disease that was neglected once again: rheumatic fever (RF).

RF and its sequel, rheumatic heart disease (RHD), are almost exclusively restricted to developing countries, with a mortality comparable to that of rotavirus, and about 50% of that of malaria (2). According to the George Institute report, only 0.07% of global funding is directed toward RF, much less the treatment and prevention of RHD. This limited allocation for RF illustrates the misdirection of global health funding. Although the complications of RF/RHD are potentially lethal, they are entirely preventable with antibiotic prophylaxis, which has been shown to be cost-effective in individuals with prior group A streptococcal infection (3). Despite the limited scientific understanding of RF/RHD, some developing countries have been able to control the disease, simply by investing heavily in existing technologies and programs (4). In Enserink's words, global investment in RF/RHD would "pay off quickly."

Although Moran et al. note a consensus on preventative vaccine development for RF/RHD, they fail to document two other critical areas of research--epidemiologic surveillance and disease control. Although several promising initiatives for RF/RHD surveillance and control have been recently published (5), funding opportunities for such programs are still rather scant. We encourage the international donor community to critically examine their funding priorities regarding RF/RHD. We also suggest that future surveys by the George Institute researchers include epidemiological and treatment programs, which are crucial to the eradication of neglected diseases.

David A. Watkins
Department of Medicine
Groote Schuur Hospital and University of Cape Town
Cape Town 7925, South Africa

Liesl J. Zuhlke
Western Cape Paediatric Cardiac Services
Red Cross War Memorial Children's Hospital
Cape Town 7700, South Africa

Mark E. Engel
Department of Medicine
Groote Schuur Hospital and University of Cape Town
Cape Town 7925, South Africa

Bongani M. Mayosi^*
Department of Medicine
Groote Schuur Hospital and University of Cape Town
Cape Town 7925, South Africa

^*To whom correspondence should be addressed. E-mail: bongani.mayosi@uct.ac.za

References

1. M. Moran et al., PLoS Med. 6, e30 (2009).
2. J. R. Carapetis, A. C. Steer, E. K. Mulholland, M. Weber, Lancet Infect. Dis. 5, 685 (2005).
3. K. A. Robertson, J. A. Volmink, B. M. Mayosi, BMC Cardiovasc. Disord. 5, 11 (2005).
4. P. Nordet, R. Lopez, A. Duenas, L. Sarmiento, Cardiovasc. J. Afr. 19, 135 (2008).
5. B. Mayosi et al., S. Afr. Med. J. 96, 246 (2006).

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The editors suggest the following Related Resources on Science sites:

In Science Magazine

NEWS OF THE WEEK
GLOBAL HEALTH: Some Neglected Diseases Are More Neglected Than Others

Martin Enserink (6 February 2009)
Science 323 (5915), 700. [DOI: 10.1126/science.323.5915.700]
 |  Summary »  |  Full Text »  |  PDF »

World Health Day 2009

Save lives. Make hospitals safe in emergencies

World Health Day 2009 focuses on the safety of health facilities and the readiness of health workers who treat those affected by emergencies. Health centres and staff are critical lifelines for vulnerable people in disasters - treating injuries, preventing illnesses and caring for people's health needs. Often, already fragile health systems are unable to keep functioning through a disaster, with immediate and future public health consequences.

This year, WHO and international partners are underscoring the importance of investing in health infrastructure that can withstand hazards and serve people in immediate need. They are also urging health facilities to implement systems to respond to internal emergencies, such as fires, and ensure the continuity of care.

News

- Event in Beijing: remarks by Dr Margaret Chan, WHO Director-General
- News release: focus on making hospitals safe in emergencies
- Statement by Dr Margaret Chan, WHO Director-General
- News release: Jet Li appointed Goodwill Ambassador

Background

- Emergencies: global and local impact
- How emergencies threaten health facilities and delivery of care
- Why keep health facilities safe?
- How to safeguard health facilities
- What can you do?
- Global efforts to make hospitals safe from disasters
- Making hospitals safe in emergencies: country examples
- More information resources 

World Physical Activity Day

Today, 6 April 2009, is World Physical Activity Day. This year's theme is "Active neighborhoods building health." For more information visit www.agitamundo.com.
From ProCOR:
Every year World Physical Activity Day mobilizes more than one million people in more than 6000 events around the world. The annual campaign is organized by Agita Mundo, a Brazil-based organization that supports research, advocacy, and community education for physical activity and health.

This year Agita Mundo is encouraging "active citizenry" for all people--a commitment to simple lifestyle changes that incorporate physical activity, such as riding a bike to work and walking as a primary mode of transportation whenever possible. The organization recommends at least 150 minutes of physical activity a week, which can be accomplished in 30 minutes a day, five days a week.

Events celebrating World Physical Activity Day are taking place around the world from 1-10 April 2009. More than 20,000 people walked the 3-km Eighth Agita Mundo Walk in São Paulo on Sunday, 5 April 2009.

Information on physical activity from the World Health Organization is available at www.who.int/dietphysicalactivity/pa.

Tips for the general public to become more physically active or to start an exercise program are available from the American College of Sports Medicine at www.acsm.org/physicalactivity.

For more information on Agita Mundo and World Physical Activity Day visit www.agitamundo.orgor send an email to agitamundo@agitamundo.org. Website is available in English, Portuguese, and Spanish; Adobe Flash Player plug-in required to view website.

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Juan Ramos
Program Coordinator, ProCor

Changing history: interview

Changing history: The questions you ask patients keep expanding

The centuries-old interview at the core of medical practice is under pressure to evolve, just as it also becomes more essential.

By Victoria Stagg Elliott, AMNews staff. Posted April 6, 2009.

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[Illustration by Wesley Bedrosian / www.wesleybedrosian.com]

After Martin Duke, MD, retired as director of medical education and chief of cardiology at Connecticut's Manchester Memorial Hospital, he found himself more often the patient than the physician. As a result, he spent more time giving his medical history than taking someone else's, and he noticed significant changes in how the task was accomplished. The time spent on it was shorter. It often was taken by an allied health worker. And, sometimes it didn't even involve a face-to-face conversation. Instead, he simply checked "yes" or "no" boxes on a questionnaire.

In a paper he authored in the November-December 2008 Connecticut Medicine, he bemoaned this shift. "If this trend were to continue, it is conceivable that one day patients and doctors may not even be speaking with each other," he wrote.

"Technology has changed the whole approach, and technology does add something," said Dr. Duke in an interview. "But it cannot stand by itself. It needs the person-to-person interaction for some direction."/.../

ATLAS IDH REGIÃO METROPOLITANA POA

ATLAS DO DESENVOLVIMENTO HUMANO DA REGIÃO METROPOLITANA DE PORTO ALEGRE
O Atlas é uma produção do Observatório da Cidade de Porto Alegre que tem por objetivo disponibilizar um instrumental de análise que possibilite conhecer em profundidade diversos aspectos da realidade socioeconômica em níveis geográficos de município e intramunicípio para a Região Metropolitana de Porto Alegre. O Atlas contém um conjunto de indicadores, para os anos de 1991 e de 2000, obtidos através dos questionários dos censos demográficos do IBGE. São mais de 100 indicadores para os dois anos considerados, agrupados nos seguintes temas: Demografia, Educação, Renda, Habitação, Vulnerabilidade, Trabalho, População e Objetivos de Desenvolvimento do Milênio. O Atlas apresenta também o Índice de Desenvolvimento Humano Municipal - IDHM e os subíndices que o constituem. O IDH sintetiza o nível de sucesso atingido pela sociedade quanto a três necessidades básicas e universais do ser humano: educação, longevidade e renda. /.../

American College of Cardiology Meeting 2009

For the latest news, features, columns, video and audio reports and more,visit our home page at www.medpagetoday.com

HIV in Act of Infection

Videos Capture HIV in Act of Infection

By Michael Smith, North American Correspondent, MedPage Today Published: March 26, 2009 Reviewed by Zalman S. Agus, MD; Emeritus Professor  University of Pennsylvania School of Medicine.

NEW YORK, March 26 -- Remarkable video images show HIV reaching out from an infected T cell to enter an adjacent uninfected cell, researchers here said.  The images, taken using quantitative, high-speed, three-dimensional video microscopy, provide new insight into how HIV propagates from cell to cell, according to Benjamin Chen, M.D., Ph.D., of Mount Sinai School of Medicine here, and colleagues.  In the video images, the virus is seen to reach out through "virological synapses," forming "synaptic buttons" from which genetic material penetrates a target cell, Dr. Chen and colleagues reported in the March 26 issue of Science.

Big Tobacco & Big Food

The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food?

Kelly D. Brownell and Kenneth E. Warner

Context: In 1954 the tobacco industry paid to publish the “Frank Statement to Cigarette Smokers” in hundreds of U.S. newspapers. It stated that the public’s health was the industry’s concern above all others and promised a variety of good-faith changes. What followed were decades of deceit and actions that cost millions of lives. In the hope that the food history will be written differently, this article both highlights important lessons that can be learned from the tobacco experience and recommends actions for the food industry.

Methods: A review and analysis of empirical and historical evidence pertaining to tobacco and food industry practices, messages, and strategies to influence public opinion, legislation and regulation, litigation, and the conduct of science.

Findings: The tobacco industry had a playbook, a script, that emphasized personal responsibility, paying scientists who delivered research that instilled doubt, criticizing the “junk” science that found harms associated with smoking, making self-regulatory pledges, lobbying with massive resources to stifle government action, introducing “safer” products, and simultaneously manipulating and denying both the addictive nature of their products and their marketing to children. The script of the food industry is both similar to and different from the tobacco industry script.

Conclusions: Food is obviously different from tobacco, and the food industry differs from tobacco companies in important ways, but there also are significant similarities in the actions that these industries have taken in response to concern that their products cause harm. Because obesity is now a major global problem, the world cannot afford a repeat of the tobacco history, in which industry talks about the moral high ground but does not occupy it. 

Inovação em ciência no Brasil?

(Recomendado pela Dra. Maria Inês Reinert Azambuja)

Notícias

Quinta-Feira, 02 de abril de 2009

  JC e-mail 3731, de 30 de Março de 2009.  

10. ''É irreal fazer inovação no Brasil'', diz Antonio Carlos Martins de Camargo
Farmacologista explica porque pediu demissão do cargo do cargo de diretor do Centro de Toxinologia Aplicada (CAT) do Instituto Butantã após ocupá-lo por oito anos Herton Escobar escreve para “O Estado de SP”: O farmacologista Antonio Carlos Martins de Camargo, há oito anos diretor do Centro de Toxinologia Aplicada (CAT) do Instituto Butantã, pediu demissão do cargo. Motivo: "É irreal pensar em fazer inovação no Brasil atualmente. Você pode dar dinheiro para o melhor cientista do mundo que ele vai morrer na praia", justificou, em entrevista exclusiva ao Estado. "Comecei a me sentir mal em mistificar uma coisa que não funciona. Não vou mexer mais com isso", desabafa. Inaugurado em 2000, o CAT é um dos 11 Centros de Pesquisa, Inovação e Difusão (Cepids) da Fundação de Amparo à Pesquisa do Estado de São Paulo (Fapesp). Foi criado para trabalhar em uma das áreas supostamente mais promissoras da biotecnologia: a busca de novos princípios ativos para drogas em espécies da biodiversidade brasileira. /.../

Functional Foods

Medical News: Diet & Nutrition   See other related items in the same address

No Clear Definition or Regulation for Functional Foods  4/1/2009 LITTLE FALLS, N.J. -- With the growing popularity of so-called "functional foods" and no official government guidance to help consumers sort them out, the American Dietetic Association has developed its own definition: a food that provides a "beneficial effect on health when consumed as part of a varied diet on a regular basis at effective levels." /.../

ECG in College Athletes

ACC: ECG Reveals Cardiac Problems in A Third of College Athletes

By Crystal Phend, Staff Writer, MedPage Today Published: April 01, 2009 Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco Earn CME/CE credit for reading medical news

ORLANDO, April 1 -- Cardiac screening for college-level athletes that included an electrocardiogram discovered abnormalities in 21% to 37% of students, according to two studies at major U.S. universities. Action Points   Note that these studies were published as abstracts and presented as posters at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. Note that neither study included a control group for comparison of standard history- and physical exam-based preparticipation screening with and without electrocardiograms. But researchers from the two groups reached opposite conclusions about routine EKGs for athletes at the American College of Cardiology (ACC) meeting here this week. Professional athletes in the U.S. commonly get intensive cardiac screening, but its use at lower levels of competition has been debated. The European Cardiology Society supports routine electrocardiograms to reduce risk of sudden cardiac death in competitive collegiate sports. The ACC recommends only a simpler, history- and physical exam-based screening. The leader of one research group, Anthony Magalski, M.D., of St. Luke's Mid America Heart Institute in Kansas City, Mo., spoke to the value of added testing./.../

Novel Thyroid Hormone Agent Cuts Lipids Beyond What Statin Can Do Alone

ACC: Novel Thyroid Hormone Agent Cuts Lipids Beyond What Statin Can Do Alone

By Crystal Phend, Staff Writer, MedPage Today Published: April 01, 2009 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.

ORLANDO, April 1 -- An experimental agent that targets thyroid receptor hormones in the liver may lower lipids substantially as an add-on to statins, researchers said. Action Points   Explain to interested patients that the liver and thyroid play important roles in cholesterol regulation. Note that this study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. Investigational eprotirome reduced LDL cholesterol by 25% on average over 12 weeks in patients already on a statin, Bo Angelin, M.D., Ph.D., of the Karolinska University Hospital in Stockholm, and colleagues reported at the American College of Cardiology meeting here. The dose-ranging study showed no signal for thyroid, liver, or cardiac adverse effects, Dr. Angelin said. However, given the history of these agents, some top cardiologists sounded a note of caution about overinterpreting the short-term safety results. "Big pharma has tried for three decades to make this work," commented Steven Nissen, M.D., of the Cleveland Clinic. "It suggests there will be a challenging road ahead./../