Louise Lown Heart Hero Award
The Louise Lown Heart Hero Award is given annually to celebrate and recognize innovative, preventive approaches to promoting cardiovascular health in developing countries and other low-resource settings.
The annual award amount is US$2000.
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, criteria, and timeline Application
Tuesday, February 16, 2010
Androgen-Deprivation Therapy in Prostate Cancer and Cardiovascular Risk
(Circulation. 2010;121:833-840.)
© 2010 American Heart Association, Inc.
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AHA/ACS/AUA Science Advisory
Androgen-Deprivation Therapy in Prostate Cancer and Cardiovascular Risk
A Science Advisory From the American Heart Association, American Cancer Society, and American Urological Association: Endorsed by the American Society for Radiation Oncology
Glenn N. Levine, MD, FAHA, Chair; Anthony V. D'Amico, MD, PhD; Peter Berger, MD, FAHA; Peter E. Clark, MD; Robert H. Eckel, MD, FAHA; Nancy L. Keating, MD, MPH; Richard V. Milani, MD, FAHA; Arthur I. Sagalowsky, MD; Matthew R. Smith, MD, PhD; Neil Zakai, MD, on behalf of the American Heart Association Council on Clinical Cardiology and Council on Epidemiology and Prevention, the American Cancer Society, and the American Urological Association
Key Words: AHA Scientific Statements • cardiovascular risk • prostate cancer • androgen-deprivation therapy
An extract of the first 250 words of the full text is provided, because this article has no abstract.
Introduction
Androgen-deprivation therapy (ADT) is a widely used treatment for prostate cancer. Recently, several studies have reported an association between ADT and an increased risk of cardiovascular events, including myocardial infarction and cardiovascular mortality.1–5 These reports have led to increased interest and discussion regarding the metabolic effects of ADT and its possible association with increased cardiovascular risk. In addition, likely as a result of these reports, internists, endocrinologists, and cardiologists are now being consulted regarding the evaluation and management of patients in whom ADT is being initiated. Most of these physicians are not aware of the possible effects of ADT on cardiovascular risk factors or the issues regarding ADT and cardiovascular disease. Therefore, this multidisciplinary writing group has been commissioned to review and summarize the metabolic effects of ADT, to evaluate the data regarding a possible relationship between ADT and cardiovascular events in patients with prostate cancer, and to generate suggestions regarding the evaluation and management of patients, both with and without known cardiac disease, in whom ADT is being initiated.
The writing group emphasizes that the purpose of this advisory is strictly informative. This advisory should thus not be construed as dictating clinical practice or superseding the clinical judgment of physicians, and it should not be used for medicolegal purposes./.../
© 2010 American Heart Association, Inc.
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AHA/ACS/AUA Science Advisory
Androgen-Deprivation Therapy in Prostate Cancer and Cardiovascular Risk
A Science Advisory From the American Heart Association, American Cancer Society, and American Urological Association: Endorsed by the American Society for Radiation Oncology
Glenn N. Levine, MD, FAHA, Chair; Anthony V. D'Amico, MD, PhD; Peter Berger, MD, FAHA; Peter E. Clark, MD; Robert H. Eckel, MD, FAHA; Nancy L. Keating, MD, MPH; Richard V. Milani, MD, FAHA; Arthur I. Sagalowsky, MD; Matthew R. Smith, MD, PhD; Neil Zakai, MD, on behalf of the American Heart Association Council on Clinical Cardiology and Council on Epidemiology and Prevention, the American Cancer Society, and the American Urological Association
Key Words: AHA Scientific Statements • cardiovascular risk • prostate cancer • androgen-deprivation therapy
An extract of the first 250 words of the full text is provided, because this article has no abstract.
Introduction
Androgen-deprivation therapy (ADT) is a widely used treatment for prostate cancer. Recently, several studies have reported an association between ADT and an increased risk of cardiovascular events, including myocardial infarction and cardiovascular mortality.1–5 These reports have led to increased interest and discussion regarding the metabolic effects of ADT and its possible association with increased cardiovascular risk. In addition, likely as a result of these reports, internists, endocrinologists, and cardiologists are now being consulted regarding the evaluation and management of patients in whom ADT is being initiated. Most of these physicians are not aware of the possible effects of ADT on cardiovascular risk factors or the issues regarding ADT and cardiovascular disease. Therefore, this multidisciplinary writing group has been commissioned to review and summarize the metabolic effects of ADT, to evaluate the data regarding a possible relationship between ADT and cardiovascular events in patients with prostate cancer, and to generate suggestions regarding the evaluation and management of patients, both with and without known cardiac disease, in whom ADT is being initiated.
The writing group emphasizes that the purpose of this advisory is strictly informative. This advisory should thus not be construed as dictating clinical practice or superseding the clinical judgment of physicians, and it should not be used for medicolegal purposes./.../
Thursday, February 11, 2010
HEALTH INEQUALITIES IN ENGLAND POST 2010 (MARMOT REVIEW)
STRATEGIC REVIEW OF HEALTH INEQUALITIES IN ENGLAND POST 2010 (MARMOT REVIEW)
Download Fair Society, Healthy Lives - The Marmot Review Final Report (25Mb) Download Fair Society, Healthy Lives - The Marmot Review Executive Summary (8Mb) Go to the Documents Section for individual chapters, background documents and press documents. Please visit www.marmot-review.org.uk for information on the Marmot Review Conference. The Review followed the publication of the global Commission on Social Determinants of Health, also chaired by Sir Michael Marmot and published by the WHO. The CSDH advocated that national governments develop and implement strategies and policies suited to their particular national context aimed at improving health equity. The English review is a response to that recommendation and to the government's commitment to reducing health inequalities in England. The aim of the Review was to propose an evidence based strategy for reducing health inequalities from 2010. The strategy includes policies and interventions that address the social determinants of health inequalities. The Review had four tasks: (i) identify, for the health inequalities challenge facing England, the evidence most relevant to underpinning future policy and action (ii) show how this evidence could be translated into practice (iii) advise on possible objectives and measures, building on the experience of the current PSA target on infant mortality and life expectancy (iv) publish a report of the review's work that will contribute to the development of a post-2010 health inequalities strategy It is anticipated that the Review will also have relevance for other countries developing strategies aimed at tackling health inequalities, following the recommendations of the CSDH. You can find further details in the documents section. |
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Tuesday, February 09, 2010
Doutores em humilhação
Indicado pela AMICOR Maria Inês Reinert Azambuja
domingo, 7 de fevereiro de 2010, 07:19 | Versão Impressa
Doutores em humilhação
Agredir e insultar um homem a caminho do trabalho é obviamente inaceitável. Pior quando os agressores estudam medicina
Debora Diniz* - O Estado de S.Paulo
Três Três rapazes agridem um senhor em uma bicicleta com um tapete de carro. A força do impacto leva o homem a se desequilibrar e cair da bicicleta. Excitados pelo impulso sádico, os rapazes teriam gritado "ô, nego". Um grupo de testemunhas denuncia os rapazes à polícia. Eles são presos, o que poderia ser considerado um desfecho justo ao ritual de humilhação racial e de classe. Mas o Centro Universitário Barão de Mauá, no interior de São Paulo, decidiu também expulsá-los do curso. Eles estudavam medicina./.../
Monday, February 08, 2010
Out-of-Hospital Cardiac Arrest
(Circulation. 2010;121:709-729.)
© 2010 American Heart Association, Inc.
Graham Nichol, MD, MPH, FAHA, Chair ; Tom P. Aufderheide, MD, FAHA ; Brian Eigel, PhD ;Robert W. Neumar, MD, PhD ; Keith G. Lurie, MD ; Vincent J. Bufalino, MD, FAHA ; Clifton W. Callaway, MD, PhD ;Venugopal Menon, MD, FAHA ; Robert R. Bass, MD ; Benjamin S. Abella, MD, MPhil ; Michael Sayre, MD ;Cynthia M. Dougherty, PhD, FAHA ; Edward M. Racht, MD ; Monica E. Kleinman, MD ; Robert E. O'Connor, MD ;John P. Reilly, MD ; Eric W. Ossmann, MD ; Eric Peterson, MD, MPH, FAHA , on behalf of the American Heart Association Emergency Cardiovascular Care Committee; Council on Arteriosclerosis, Thrombosis, and Vascular Biology ;Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation ; Council on Cardiovascular Nursing ;Council on Clinical Cardiology ; Advocacy Committee ; Council on Quality of Care and Outcomes Research Out-of-hospital cardiac arrest continues to be an important public health problem, with large and important regional variations in outcomes. Survival rates vary widely among patients treated with out-of-hospital cardiac arrest by emergency medical services and among patients transported to the hospital after return of spontaneous circulation. Most regions lack a well-coordinated approach to post–cardiac arrest care. Effective hospital-based interventions for out-of-hospital cardiac arrest exist but are used infrequently. Barriers to implementation of these interventions include lack of knowledge, experience, personnel, resources, and infrastructure. A well-defined relationship between an increased volume of patients or procedures and better outcomes among individual providers and hospitals has been observed for several other clinical disorders. Regional systems of care have improved provider experience and patient outcomes for those with ST-elevationmyocardial infarction and life-threatening traumatic injury. This statement describes the rationale for regional systems of care for patients resuscitated from cardiac arrest and the preliminary recommended elements of such systems. Many more people could potentially survive out-of-hospital cardiac arrest if regional systems of cardiac resuscitation were established. A national process is necessary to develop and implement evidence-based guidelines for such systems that must include standards for the categorization, verification, and designation of components of such systems. The time to do so is now./.../
© 2010 American Heart Association, Inc.
AHA Policy Statement |
Regional Systems of Care for Out-of-Hospital Cardiac Arrest
A Policy Statement From the American Heart Association
Wednesday, February 03, 2010
MAKE POVERTY HISTORY
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Pressão Arterial
(Artigo enviado para o Jornal Zero Hora que provavelmente não vai mais ser publicado)
A notícia do problema de saúde do Presidente chamou atenção, provocando muitas especulações. É oportunidade para contribuir com alguns esclarecimentos (obviamente não sobre o paciente, mas sobre pressão arterial). O assunto interessa muita gente (de um e meio a três milhões de gaúchos, dependendo do critério adotado como ponto de corte) e sobre o qual devem existir ainda questionamentos, apesar das informações veiculadas pela mídia, muitas focadas na agenda de trabalho.
Em 1978, sob a coordenação geral do Dr. Eduardo de Azeredo Costa, fizemos uma pesquisa cobrindo amostras representativas de toda a população adulta do Estado. Na época a primeira e maior pesquisa do gênero no hemisfério sul. Passados mais de trinta anos, estudos posteriores não mostraram grandes mudanças nas proporções. Encontramos níveis médios de pressão arterial progressivos com a idade, bem como a prevalência de hipertensão arterial; mais mulheres do que homens, mais no cinturão metropolitano do que no interior rural, mais entre iletrados e com baixa escolaridade do que em gente com formação superior; inversamente proporcional ao status social, e tendência à agregação familiar. Somente uma quarta parte daqueles considerados hipertensos tinha níveis controlados, e um bom número de entrevistados, embora com diagnóstico médico no passado e mesmo sem efeito de remédios, tinham pressão normal no momento da pesquisa. Com a idade diminuía a proporção de fumantes e aumentavam as médias de pressão e a prevalência de hipertensão em não fumantes (os hipertensos que simultaneamente fumavam já haviam saído da população...).
Vale insistir em algumas informações já que as pressões, por se expressarem por números, podem dar uma falsa impressão de precisão e segurança. Um diagnóstico de doença hipertensiva não pode se basear exclusivamente neles. O que mais interessa é a permanência dos níveis elevados e não sua elevação transitória. A pressão arterial varia normalmente com o esforço e com as emoções (pode chegar normalmente a momentos de 200 mm Hg); a massa corporal, o sal na alimentação, a temperatura ambiente, certos medicamentos, agitação, ansiedade, e até a técnica utilizada podem influir sobre as medidas. Os exercícios em geral são benéficos, e repouso só se faz necessário frente a complicações ou para esclarecer dúvidas.
Chamou atenção um vídeo feito momentos antes de o Presidente se sentir mal. Ele dizia que estava com uma gripe ou sinusite e com perturbação de voz. Drogas vasoconstritoras e anti-inflamatórias - freqüentemente usadas (ou abusadas) com finalidade meramente sintomática – podem anular o efeito do tratamento, elevam a pressão arterial e podem causar uma “crise hipertensiva”, nesta hipótese, iatrogênica.
Por falar em gripe e em doença crônica, até recentemente esta relação era cientificamente pouco valorizada. As viroses, e o estado inflamatório por elas provocado, podem desencadear ou desestabilizar doenças relacionadas com arterioesclerose (infarto, trombose cerebral) e complicar a doença hipertensiva.
Vem daqui também a valorização das complicações da gripe e de outras doenças inflamatórias no contexto de doenças crônicas (entre elas a hipertensão arterial), anteriormente rotuladas como degenerativas, como se pertencessem a outro “departamento”. Mais uma vez, faz-se jus homenagear a prata da casa pela contribuição de nossa pesquisadora e professora da UFRGS – hoje a reconhecida internacionalmente Dra. Maria Inês Reinert Azambuja, há vários anos defendendo esta tese.
Nesta perspectiva nossa pressão arterial é somente mais uma variável de um conjunto orgânico, socialmente interdependente, em permanente interação com o meio (físico-bio-psico-social) onde se vive.
Aloyzio Achutti. Médico.
Tuesday, February 02, 2010
Iniquidade menor não freia crise no Brasil
Brasília, 29/01/2010'Iniquidade menor não freia crise no Brasil'
Pesquisador do IPEA afirma que, apesar da redução da pobreza e da desigualdade, economia ainda é sustentada por 30% da população
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Apesar da redução da pobreza nos últimos anos, a economia brasileira ainda é sustentada pelo consumo de uma pequena parcela da população, afirma o economista Sergei Dillon Soares, do IPEA (Instituto de Pesquisa Econômica Aplicada). Em entrevistapara um boletim do CIP-CI (Centro Internacional de Políticas para o Crescimento Inclusivo), ele defende que a melhoria da desigualdade de renda aumentou o peso dos mais pobres no mercado, mas não a ponto de blindar o Brasil contra crises econômicas — esse processo ajudou apenas “um pouco” a diminuir os efeitos da recessão de 2009, por exemplo.
“O que podemos dizer é que, para além das muito prudentes políticas macroeconômicas que foram seguidas no passado recente, e todo o resto que foi feito corretamente — e o Brasil fez muitas coisas corretamente — talvez a melhoria na desigualdade ajudou um pouco, foi um fator adicional, mas certamente não o principal”, diz Soares./.../
Remédio para Chagas
Tóquio, 28/01/2010Remédio para Chagas será testado em 2010
Novo medicamento é visto como uma das maiores descobertas contra a doença em 40 anos; teste em humanos poderá ser feito no Brasil
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da PrimaPagina
Um novo medicamento para o tratamento da doença de Chagascomeçará a ser testado em seres humanos a partir deste ano. Chamada Ravuconazol, a droga até agora mostrou bastante eficácia em impedir a multiplicação e invasão das células pelo protozoário Trypanosoma cruzi, causador da enfermidade.
Segundo Tânia Araújo Jorge, pesquisadora e diretora do Instituto Oswaldo Cruz, esta é uma das novidades mais promissoras no tratamento contra a doença, que mata cerca de 11 mil pessoas por ano segundo a OMS, mais do que a malária. No Brasil, foram 5.023 mortes em 2008, de acordo comdados preliminares do Ministério da Saúde — mais que malária e tuberculose, por exemplo. “De todos os medicamentos em fase pré-clinicas, esse é um dos melhores", afirma Tânia.
O motivo do otimismo está no fato de o Ravuconazol ter se mostrado eficaz no segundo estágio da doença, a chamada fase crônica. Os outros dois medicamentos existentes, descobertos há mais de 30 anos, não são muito eficientes nesse estágio, sendo mais aconselhados para a primeira fase da doença. O problema é que apenas 1% das pessoas apresentam sintomas na primeira fase, o que dificulta o tratamento. Além disso, a nova droga mostrou ser efetiva contra todas as cepas do parasita —ao contrário dos outros —, além de ser bem menos invasivo ao organismo humano. Atualmente, só há um medicamento que age na fase crônica, e ele causa muitos efeitos colaterais, como enjoo, alergia e problemas na medula óssea.
National Goals for Cardiovascular Health Promotion and Disease Reduction
The American Heart Association’s Strategic Impact Goal Through 2020 and Beyond
Donald M. Lloyd-Jones, MD, ScM, FAHA, Chair ; et col.
This document details the procedures and recommendations of the Goals and Metrics Committee of the Strategic Planning Task Force of the American Heart Association, which developed the 2020 Impact Goals for the organization. The committee was charged with defining a new concept, cardiovascular health, and determining the metrics needed to monitor it over time. Ideal cardiovascular health, a concept well supported in the literature, is defined by the presence of both ideal health behaviors (nonsmoking, body mass index <25 kg/m2, physical activity at goal levels, and pursuit of a diet consistent with current guideline recommendations) and ideal health factors (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, and fasting blood glucose <100 mg/dL). Appropriate levels for children are also provided. With the use of levels that span the entire range of the same metrics, cardiovascular health status for the whole population is defined as poor, intermediate, or ideal. These metrics will be monitored to determine the changing prevalence of cardiovascular health status and define achievement of the Impact Goal. In addition, the committee recommends goals for further reductions in cardiovascular disease and stroke mortality. Thus, the committee recommends the following Impact Goals: "By 2020, to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%." These goals will require new strategic directions for the American Heart Association in its research, clinical, public health, and advocacy programs for cardiovascular health promotion and disease prevention in the next decade and beyond. (Circulation. 2010;121:586-613.)
Davos 2010
Full List
10 THINGS I LEARNED IN DAVOS
- Emerging Markets: Whoa, Have They Emerged
- Unemployment Is The New Crisis
- Bankers Are Not Repentant — Or Even Embarrassed
- The Obama Administration is Stand Offish
- West Coast Techies Are In Demand
- Canada's Central Banker Is Smart and Sexy
- Cell Phones Solve Social Problems
- Capitalism Is Roughed Up, But Surviving
- Financial Regulatory Fixes Remain a Mystery
- We Should All Learn Chinese
MORE FROM DAVOS
Read more:http://www.time.com/time/specials/packages/completelist/0,29569,1955058,00.html#ixzz0eNtpsJiQ
Chronic Disease Risk
Future Chronic Disease Risk Goes Beyond BMI | ||||||
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Monday, February 01, 2010
potential for reducing coronary heart disease mortality in the USA
Cardiovascular risk factor trends and potential for reducing coronary heart disease mortality in the United States of America
Simon Capewell a, Earl S Ford b, Janet B Croft c, Julia A Critchley d, Kurt J Greenlund c & Darwin R Labarthe c
a. Division of Public Health, University of Liverpool, Liverpool, L69 3GB, England.
b. Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America (USA).
c. Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
d. Institute of Health and Society, Newcastle University, Newcastle, England.
b. Division of Adult and Community Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America (USA).
c. Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.
d. Institute of Health and Society, Newcastle University, Newcastle, England.
Correspondence to Simon Capewell (e-mail: capewell@liverpool.ac.uk).
(Submitted: 18 August 2008 – Revised version received: 30 December 2008 – Accepted: 07 June 2009 – Published online: 08 December 2009.)
Bulletin of the World Health Organization 2010;88:120-130. doi: 10.2471/BLT.08.057885
INTRODUCTION
Coronary heart disease (CHD) accounted for over 450 000 deaths in the United States of America in 2004.1,2 The burden of CHD in the United States is enormous; more than 13 million people are affected, and the costs of direct health care exceed US$ 150 billion annually.1,2
Since the late 1970s, age-adjusted CHD mortality rates have been halved in most industrialized countries, including the United States. However, between 1990 and 2000 this decrease diminished, and in younger age groups it nearly ceased.1,2 Many adults in the United States are still at high risk for cardiovascular disease. Total blood cholesterol levels exceed 200 mg/dl among more than 100 million adults; approximately 70 million have or are being treated for high blood pressure (systolic blood pressure 140 mmHg or diastolic blood pressure 90 mmHg), and over 50 million people still smoke.2–4
The Healthy People 2010 (HP2010) initiative promoted by the government of the United States contains targets for heart disease and stroke that explicitly address risk factor prevention, detection and management, along with prevention of recurrent events. HP2010 objectives include a 20% reduction in age-adjusted CHD mortality rates (from an overall rate of 203 per 100 000 population in 1998 to 162 per 100 000 in 2010).3 They also include specific targets for reducing mean total blood cholesterol (to 199 mg/dl), smoking (to 12% of the population), hypertension (to 16%), diabetes (to 6%), obesity (to 15%) and inactivity (to 20%).3 Inactivity was measured in the Behavioral Risk Factor Surveillance System of the United States Centers for Disease Control and Prevention as the proportion of adults engaging in no physical activity.5 If those targets are achieved, what reduction in CHD mortality might actually result by 2010?/.../
Flexner Report
Flexner Report Linked to Growth of Specialty Medicine | ||||
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