Academia SR Medicina

Academia Sul-Riograndense de Medicina.
2a reunião sobre Literatura e Medicina no dia 22 de novembro 2016
Dr. João Gomes Mariante sobre sua obra Getúlio Vargas, o lado oculto do Presidente

Esquerda para Direita: Germano Bonow, Luiz Fernando Jobim, Ellis Darrigo Busnello, João Gomes Mariante, Um membro da Academia SR de Letras, A. Achutti e Rogério Xavier.

Einstein in a graphic novel

Maria PopovaVerified account‏@brainpicker

Einstein's extraordinary life, in a graphic novel https://www.brainpickings.org/2016/06/13/einstein-maier-simon-nobrow/ …

US Dementia Prevalence 2000-2012

Indicado pela AMICOR Maria Inês Reinert Azambuja

A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012

Kenneth M. Langa, MD, PhD^1,2,3,4; Eric B. Larson, MD, MPH⁵; Eileen M. Crimmins, PhD⁶; et alJessica D. Faul, PhD³; Deborah A. Levine, MD, MPH^1,2,4,7; Mohammed U. Kabeto, MS^1,2; David R. Weir, PhD³

Author Affiliations Article Information

JAMA Intern Med. Published online November 21, 2016. doi:10.1001/jamainternmed.2016.6807

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Prevalence of Dementia in the United States in 2000 and 2012

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Prevalence of Dementia in the United States in 2000 and 2012 (JAMA Internal Medicine)

(1:50)

Prevalence of Dementia in the United States in 2000 and 2012

Key Points

Question  Has the prevalence of dementia among older adults in the United States changed between 2000 and 2012?

Findings  In this observational cohort study of more than 21 000 US adults 65 years or older from the nationally representative Health and Retirement Study, dementia prevalence declined significantly, from 11.6% in 2000 to 8.8% in 2012.

Meaning  Population brain health seemed to improve between 2000 and 2012; increasing educational attainment and better control of cardiovascular risk factors may have contributed to the improvement, but the full set of social, behavioral, and medical factors contributing to the improvement is still uncertain.

Abstract

Importance  The aging of the US population is expected to lead to a large increase in the number of adults with dementia, but some recent studies in the United States and other high-income countries suggest that the age-specific risk of dementia may have declined over the past 25 years. Clarifying current and future population trends in dementia prevalence and risk has important implications for patients, families, and government programs.

Objective  To compare the prevalence of dementia in the United States in 2000 and 2012.

Design, Setting, and Participants  We used data from the Health and Retirement Study (HRS), a nationally representative, population-based longitudinal survey of individuals in the United States 65 years or older from the 2000 (n = 10 546) and 2012 (n = 10 511) waves of the HRS.

Main Outcomes and Measures  Dementia was identified in each year using HRS cognitive measures and validated methods for classifying self-respondents, as well as those represented by a proxy. Logistic regression was used to identify socioeconomic and health variables associated with change in dementia prevalence between 2000 and 2012.

Results  The study cohorts had an average age of 75.0 years (95% CI, 74.8-75.2 years) in 2000 and 74.8 years (95% CI, 74.5-75.1 years) in 2012 (P = .24); 58.4% (95% CI, 57.3%-59.4%) of the 2000 cohort was female compared with 56.3% (95% CI, 55.5%-57.0%) of the 2012 cohort (P < .001). Dementia prevalence among those 65 years or older decreased from 11.6% (95% CI, 10.7%-12.7%) in 2000 to 8.8% (95% CI, 8.2%-9.4%) (8.6% with age- and sex-standardization) in 2012 (P < .001). More years of education was associated with a lower risk for dementia, and average years of education increased significantly (from 11.8 years [95% CI, 11.6-11.9 years] to 12.7 years [95% CI, 12.6-12.9 years]; P < .001) between 2000 and 2012. The decline in dementia prevalence occurred even though there was a significant age- and sex-adjusted increase between years in the cardiovascular risk profile (eg, prevalence of hypertension, diabetes, and obesity) among older US adults.

Conclusions and Relevance  The prevalence of dementia in the United States declined significantly between 2000 and 2012. An increase in educational attainment was associated with some of the decline in dementia prevalence, but the full set of social, behavioral, and medical factors contributing to the decline is still uncertain. Continued monitoring of trends in dementia incidence and prevalence will be important for better gauging the full future societal impact of dementia as the number of older adults increases in the decades ahead.

Fidel Castro: 1926-2016

By THE NEW YORK TIMES NOV. 26, 2016

A master of image and myth, Mr. Castro believed himself to be the messiah of his fatherland, an indispensable force with authority from on high to control Cuba and its people.

Credit: BORIS CHALIAPIN

Fidel Castro on the Jan. 26, 1959, cover of TIME

How Fidel Castro Went From Revolutionary to Ruler

• Lily Rothman @lilyrothman
 

9:01 AM ET

Fidel Castro, the long-time Cuban leader who has died at 90, defined decades for his homeland—and, though he wasn’t always a man of such power, his charisma and drive were obvious from the beginning.

When TIME first mentioned his name, in the Dec. 10, 1956, issue, it was as a “wellborn, well-to-do daredevil of 29.” At that point, he had already been jailed after leading a 1953 uprising against Cuba’s then-leader, Fulgencio Batista; had gone to Mexico to pull together forces; had called their group the July 26 Movement after the date of the earlier failed uprising; and had issued an ultimatum to Batista. “In Havana,” TIME reported. “Castro’s followers painted ‘This is the year’ on walls.”/.../

Polyphenols

Supplementary Facts: Polyphenols' Power Is in Food and Drink, Not in Pill Form

Gayle Nicholas Scott, PharmD

Disclosures | November 21, 2016

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EDITORS' RECOMMENDATIONS

• Supplement Use Stable, Despite Research Questioning Benefit
• Beneficial Effect of a Polyphenol-Rich Diet on CVD Risk
• Resveratrol Stabilizes Amyloid in Alzheimer's

A Refresher on Polyphenols

"Phytochemicals" are widely marketed as dietary supplements. Advertisements for these supplements often contain such terms as "polyphenol," "bioflavonoid," and a myriad of others that may read as vague or mysterious to most. But what do these terms really mean?

Phytochemicals are chemicals from plants (phyto being the Greek word for "plant") and comprise a wide variety of biologically active substances. Humans and animals cannot synthesize phytochemicals. Examples of phytochemicals include the phytosterols (eg, sitosterol), which are chemically related to cholesterol; terpenes (eg, eugenol); and the indoles, which may mediate the proposed anticancer effect of cruciferous vegetables, such as broccoli.

The most studied class of phytochemicals is polyphenols. The aim of this brief pharmacognosy review is to describe the various classes of polyphenols and subclasses of flavonoids, as well as provide some examples of foods in which they can be found.

To refresh organic chemistry-challenged minds, polyphenols are characterized by the presence of multiple phenolic rings (ie, benzene rings with hydroxyl groups). They are produced by plants to defend against ultraviolet radiation or pathogens. Polyphenols are responsible for some of the color, flavor, odor, and bitterness of fruits, vegetables, grains, and such beverages as tea and coffee. They function as antioxidants and have been reported to bestow health benefits, including protection from cardiovascular disease, cancer, infections, and a variety of other conditions./.../

Hippocratic Oath

Is the Hippocratic Oath Still Relevant?

November 22, 2016

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EDITORS' RECOMMENDATIONS

• Oaths for Physicians -- Necessary Protection or Elaborate Hoax?

Nearly all doctors recite the original Hippocratic Oath or an alternative version of it in medical school. Yet it remains controversial, prompting questions about whether it should be retired.

Defenders assert that it has as much relevance today as ever, because it remains a public declaration of the social contract between the profession of medicine, its individual members, and society as a whole. Critics wonder whether the oath is a "necessary protection or an elaborate hoax." This is because the notion that a physician has independent power to behave morally and ethically in the treatment of patients is complex, given the role of the health insurance industry, hospital employers, and the pharmaceutical industry, not to mention the still-pervasive fee-for-service environment.

The oath, written 2400 years ago in and for a simpler time, appears silent on these issues. Thus, the question becomes: is the Hippocratic Oath still relevant?

Ancient Rome Economics

ECONOMICS

What Can Ancient Rome Teach Us About Economics?

They had markets, merchant bankers, poets, and potters. So why didn’t it lead to an industrial revolution?

Adrian Monck in Arc Mag

Smoking: the next 50 years

Lembrei-me que do Report of the Surgeon General de 1992 (Tobacco and Health: Status in the Americas) fui um dos Senior Editors, e Vera Luiza da Costa e Silva responsável pelo relatório do Brasil. 

The Next 50 Years

For more than 50 years, the Surgeon General has reported the dangers of smoking and tobacco use. The findings have inspired us to help smokers quit and keep young people from starting to smoke. We know the strategies that work. Together we can end the tobacco epidemic and save millions of lives.

Addiction in US

Addressing addiction in the USA

The Lancet

Published: 26 November 2016

Summary

• Full Text

• Tables and Figures

The huge toll that substance use and misuse is having on individuals, families, and communities in the USA has culminated in a major public health crisis that shows few signs of abating. Last week, the US Surgeon General released Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health—the Surgeon General's first-ever statement on this topic. This 426-page report addresses the problem of substance use and the wide range of adverse health effects from alcohol and both legal and illegal drugs. It brings together evidence on prevention; treatment; and recovery interventions, policies, and programmes.

There are some alarming statistics. 20·8 million people in the USA have a substance use disorder, equivalent to the number of Americans with diabetes. In 2014, there were 47 055 drug overdose deaths, 28 647 of which involved prescription opioid drugs and heroin. Of the one in seven Americans (14·6% of the population) expected to develop a substance use disorder during their lives, only one in ten will receive treatment. More than 66·7 million people reported binge drinking in the past month. Alcohol misuse contributes to 88 000 deaths in the USA each year. These numbers do not include the millions of people misusing substances who will later develop a substance disorder.

The Surgeon General, Vivek Murthy, emphasises that addiction is a chronic neurological disorder that should be treated like other chronic illnesses. He calls for a cultural shift—from perceiving addiction as a “moral failing” to removing the stigma and shame that prevents addicted people from seeking help. The review of the science of substance abuse is thorough, and the argument for an evidenced-based and equitable public health approach to reducing the harms of both alcohol and drugs is a welcome advance. The report defends harm reduction and policies that reduce the imprisonment of drug users. It also advocates screening and early intervention in primary care and the integration of alcohol and drug use treatment into mainstream medical care. Endorsement of these effective approaches is a radical departure from the preceding US drug policy.

The challenge will be in implementing the report's recommendations. The call for more investment in scientific research should be heeded, but this report could have been more specific about what should be done over the next 5 years in expanding treatment capacity, for example. The report does not go far enough in acknowledging the major harms of past US drug policies of zero tolerance—namely, racial and ethnic discrimination in enforcement, leading to the mass incarceration of Black and Latino men, to the detriment of minority families and communities. The report does not even acknowledge that race has been at the centre of the war of the drugs. Nor does it see drug policy reform as an essential step in reducing the harms of substance use.

Despite the acknowledged severity of the US opioid problem, the report provides few details on how best to address it. It is a pity the report emphasises “brain disease” explanations at the expense of the socioeconomic factors that underlie addiction. For example, the chances of becoming addicted to opioid drugs increases if an individual is young, unemployed, or has co-occurring psychiatric disorders. This situation makes it critically important to have social policies that ensure people have job opportunities and affordable access to effective mental health services, rather than exclusively focusing on eliminating drugs from society.

It is unclear if Murthy's report will have the same impact as the 1964 landmark tobacco report from the Surgeon General, which galvanised several decades of work on the dangers of smoking and helped bring smoking rates down substantially. We already knew that substance use is a public health problem in the US. That fact still needed to be shown conclusively for tobacco in 1964. Also tobacco has been easier to address as a single legal substance that was culturally acceptable in the 1960s, unlike a mix of licit and illicit substances that are not all culturally acceptable. Clearly, different approaches will be required to gain traction. There is also a real danger that the incoming administration will oppose the approaches set out in this report, and return to the failed drug policies of the past. This would be disastrous given the evidence presented here. America's leaders must take a bipartisan stance on this issue. It would be a moral and political failure to allow the premature loss of lives from substance use to continue.

For Facing addiction in America: The Surgeon General's report on Alcohol, Drugs, and Health see https://addiction.surgeongeneral.gov/

Vivek Murthy

Associated Press

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U.S. Surgeon General Vivek H. Murthy on Facing Addiction in America

By Dr. Vivek H. Murthy

Credit: Office of the Surgeon General / Ann S. Kim.

When I became a doctor, I expected that most of my time would be spent seeing patients with chronic conditions like heart disease, diabetes, and cancer. When I became Surgeon General, I was eager to engage our nation in discussions about how to prevent those diseases and how to make sure everyone has a fair shot at living a healthy and productive life./.../

Elements Periodic Table

http://elements.wlonk.com/ElementsTable.htm
Do hidrogênio até...
A tabela periódica tradicional ordena os elementos químicos por número atômico (número de prótons), configuração dos elétrons e propriedades químicas.
Thinkstock Tabela periódica tradicional A tabela periódica tradicional não tem uma aparência atraente para crianças 1
Elementos que têm um comportamento químico semelhante ficam na mesma coluna.
A primeira versão da tabela periódica foi criada pelo químico e físico russo Dmitri Mendeleiev em 1869, e foi revolucionária ao prever as propriedades de elementos que ainda não tinham sido descobertos.
O primeiro elemento é o hidrogênio e o último é o de número 118, o ununóctio, que recentemente passou a ser chamado de oganessono, em homenagem ao físico nuclear russo Yuri Oganessian.
A União Internacional de Química Pura e Aplicada (Iupac, na sigla em inglês) validou os elementos sintetizados mais recentemente em dezembro do ano passado.
'Para mim e meus filhos'
Mas como o americano Enevoldsen teve a ideia de fazer uma tabela com ilustrações modernas?
Keith Enevoldsen Tabela criada por Keith Enevoldsen Além das ilustrações, a tabela interativa abre janelas detalhando cada elemento 1 /.../

Anthropocene

ANTHROPOCENE

The Anthropocene defines Earth's most recent geologic time period as being human-influenced, or anthropogenic, based on overwhelming global evidence that atmospheric, geologic, hydrologic, biospheric and other earth system processes are now altered by humans.

The word combines the root "anthropo", meaning "human" with the root "-cene", the standard suffix for "epoch" in geologic time.

The Anthropocene is distinguished as a new period either after or within the Holocene, the current epoch, which began approximately 10,000 years ago (about 8000 BC) with the end of the last glacial period.

Source: The Encyclopedia of Earth.

Birmingham Health Charter

A New Politics for Health

The Public Health team at Birmingham City University is working with the Politics of Health Group and The Equality Trust  on A New Politics for Health – an exciting project involving organisations and activists from across the political spectrum that aims to reignite a movement for nationwide health equity. It will build upon and strengthen the provisions of the Ottawa Charter for Health Promotion, working to focus attention on the social and political determinants of health inequity. This will lead to the creation and promotion of the Birmingham Health Charter; a charter recognising the challenges to and need for health equity in the 21st century.

We have held a series of regional meetings to identify what the current demands for a healthy and equitable society look like. These ideas will be bought forward to the main event, A New Politics for Health – The Birmingham Health Charter, a national conference in Birmingham on the 23rd of November 2016.

Join us at the main event

Participants from around the country will take part in interactive workshops to develop the ideas that have emerged from the regional meetings, ultimately resulting in a Birmingham Health Charter.

Confirmed speakers, who will be joining us for the day, are Richard Wilkinson and Kate Pickett – authors of The Spirit Level: Why Equality is Better for Everyone, John Middleton – President of The Faculty of Public Health and Anuj Kapilashrami of the Peoples’ Health Movement.

Even if you can’t join us in Birmingham you can contribute to this exciting project by sharing your thoughts with us and completing this online survey here.

Facebook: Politics of Health Group