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Sunday, April 30, 2006

programação científica do congresso Norte-Nordeste de Cardiologia

De: pfalbuquerque [mailto:pfalbuquerque@uol.com.br]
Enviada em: domingo, 30 de abril de 2006 09:53
Para: aloyzio.achutti

Assunto: Programação científica Congresso Norte-Nordeste

Caro Prof. Achutti,

Gentileza comunicar à rede que a programação científica do congresso Norte-Nordeste de Cardiologia, encontra-se no site www.cardiol.br calendário de eventos.

Muito obrigado

Pedro Albuquerque-presidente do evento.

Wednesday, April 26, 2006

ACC: Combination Therapy Useful In Dyslipidemia

ACC: Combination Therapy Useful In Dyslipidemia - CME Teaching Brief - MedPage Today: "ATLANTA, March 12 - Combination therapies in dyslipidemia have two roles -- to lower LDL cholesterol and to achieve non-HDL goals, according to a symposium here.

'In the absence of a lot of data on outcomes, there are some things that are absolute indications for combination therapies,' said Alan Brown, M.D., medical director of the Midwest Heart Disease Prevention Center in Napierville, Ill.

Specifically, he said, some patients won't achieve LDL goals on monotherapy, at least without going to very high doses, which increases the risk of complications, including rhabdomyalysis.

Others, whose LDL cholesterol is controlled, will need combination treatments to control other aspects of their dyslipidemia, he told a satellite symposium held in conjunction with the annual meeting of the American College of Cardiology."

Enbrel Decreases Inflammatory Markers in Metabolic Syndrome -

Enbrel Decreases Inflammatory Markers in Metabolic Syndrome - CME Teaching Brief - MedPage Today: "BOSTON, April 25 — Blocking a key protein with Enbrel (etanercept) improves several inflammatory markers in patients with metabolic syndrome, according to researchers here.

In a small randomized trial, patients treated with the agent had lower levels of C-reactive protein and higher levels of adiponectin—indications of a decrease in the inflammation thought to be a key link between the syndrome and cardiovascular risk, said Steven Grinspoon, M.D., of Massachusetts General Hospital here.

Results of the study, published in the April 25 issue of Archives of Internal Medicine, amount to 'proof of principle,' Dr. Grinspoon said in a statement, and 'sheds light on the physiology of inflammation and its relation to cardiac risk in obese patients.'"

Monday, April 24, 2006

Coffee Consumption and Coronary Heart Disease in Men and Women. A Prospective Cohort Study -- Lopez-Garcia et al., 10.1161/CIRCULATIONAHA.105.598664 -

Coffee Consumption and Coronary Heart Disease in Men and Women. A Prospective Cohort Study -- Lopez-Garcia et al., 10.1161/CIRCULATIONAHA.105.598664 -- Circulation
Esther Lopez-Garcia DrPH, Rob M. van Dam PhD, Walter C. Willett MD, DrPH, Eric B. Rimm ScD, JoAnn E. Manson MD, DrPH, Meir J. Stampfer MD, DrPH, Kathryn M. Rexrode MD, MPH, and Frank B. Hu MD, PhD*

From the Departments of Nutrition (E.L.-G., R.M.v.D., W.C.W., E.B.R., M.J.S., F.B.H.) and Epidemiology (W.C.W., E.B.R., J.E.M., M.J.S., F.B.H.), Harvard School of Public Health; the Channing Laboratory (W.C.W., E.B.R., J.E.M., M.J.S., F.B.H.) and Division of Preventive Medicine (J.E.M., M.J.S., K.M.R.), Harvard Medical School, Boston, Mass.
* To whom correspondence should be addressed. E-mail: nhbfh@channing.harvard.edu.

Background--We examined the association between long-term habitual coffee consumption and risk of coronary heart disease (CHD).

Methods and Results--We performed a prospective cohort study with 44 005 men and 84 488 women without history of cardiovascular disease or cancer. Coffee consumption was first assessed in 1986 for men and in 1980 for women and then repeatedly every 2 to 4 years; the follow-up continued through 2000. We documented 2173 incident cases of coronary heart disease (1449 nonfatal myocardial infarctions and 724 fatal cases of CHD) among men and 2254 cases (1561 nonfatal myocardial infarctions and 693 fatal cases of CHD) among women. Among men, after adjustment for age, smoking, and other CHD risk factors, the relative risks (RRs) of CHD across categories of cumulative coffee consumption (<1> 4 cups/wk, 5 to 7 cups/wk, 2 to 3 cups/d, 4 to 5 cups/d, and ≥6 cups/d) were 1.0, 1.04 (95% confidence interval 0.91 to 1.17), 1.02 (0.91 to 1.15), 0.97 (0.86 to 1.11), 1.07 (0.88 to 1.31), and 0.72 (0.49 to 1.07; P for trend=0.41); among women, the RRs were 1.0, 0.97 (0.83 to 1.14), 1.02 (0.90 to 1.17), 0.84 (0.74 to 0.97), 0.99 (0.83 to 1.17), and 0.87 (0.68 to 1.11; P for trend=0.08). Stratification by smoking status, alcohol consumption, history of type 2 diabetes mellitus, and body mass index gave similar results. Similarly, we found no effect when the most recent coffee consumption was examined. RRs for quintiles of caffeine intake varied from 0.97 (0.84 to 1.10) in the second quintile to 0.97 (0.84 to 1.11) in the highest quintile (P for trend=0.82) in men and from 1.02 (0.90 to 1.16) to 0.97 (0.85 to 1.11; P for trend=0.37) in women.

Conclusions--These data do not provide any evidence that coffee consumption increases the risk of CHD.

Saturday, April 22, 2006

Clinical Stress Testing in the Pediatric Age Group: A Statement From the American Heart Association Council on Cardiovascular Disease in the Young, Co

Clinical Stress Testing in the Pediatric Age Group: A Statement From the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth -- Paridon et al. 113 (15): 1905 -- Circulation: "This statement is an updated report of the American Heart Association’s previous publications on exercise in children. In this statement, exercise laboratory requirements for environment, equipment, staffing, and procedures are presented. Indications and contraindications to stress testing are discussed, as are types of testing protocols and the use of pharmacological stress protocols. Current stress laboratory practices are reviewed on the basis of a survey of pediatric cardiology training programs."

Reciprocal Relationships Between Insulin Resistance and Endothelial Dysfunction: Molecular and Pathophysiological Mechanisms -- Kim et al. 113 (15): 1

Reciprocal Relationships Between Insulin Resistance and Endothelial Dysfunction: Molecular and Pathophysiological Mechanisms -- Kim et al. 113 (15): 1888 -- Circulation: "Endothelial dysfunction contributes to cardiovascular diseases, including hypertension, atherosclerosis, and coronary artery disease, which are also characterized by insulin resistance. Insulin resistance is a hallmark of metabolic disorders, including type 2 diabetes mellitus and obesity, which are also characterized by endothelial dysfunction. Metabolic actions of insulin to promote glucose disposal are augmented by vascular actions of insulin in endothelium to stimulate production of the vasodilator nitric oxide (NO). Indeed, NO-dependent increases in blood flow to skeletal muscle account for 25% to 40% of the increase in glucose uptake in response to insulin stimulation. Phosphatidylinositol 3-kinase–dependent insulin-signaling pathways in endothelium related to production of NO share striking similarities with metabolic pathways in skeletal muscle that promote glucose uptake. Other distinct nonmetabolic branches of insulin-signaling pathways regulate secretion of the vasoconstrictor endothelin-1 in endothelium. Metabolic insulin resistance is characterized by pathway-specific impairment in phosphatidylinositol 3-kinase–dependent signaling, which in endothelium may cause imbalance between production of NO and secretion of endothelin-1, leading to decreased blood flow, which worsens insu"

XXVI Congresso Norte/Nordeste de Cardiologia

XXVI Congresso Norte/Nordeste de Cardiologia
De: pfalbuquerque [mailto:pfalbuquerque@uol.com.br] Enviada em: quarta-feira, 19 de abril de 2006 13:
Gentileza divulgar o XXVICongresso Norte-Nordeste de Cardiologia, o qual estamos presidindo será em Maceió nos dias 8,9 e 10 de junho de 2006.
Site http://congresso.cardiol.br/norte-nordeste.
Muito obrigado.
Pedro Albuquerque

Friday, April 21, 2006

Heart Diseases and Stroke Statistics 2006

(Recomendado por Maria Inês Reinert Azambuja)
The American Heart Association works with the Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC/NCHS), the National Heart, Lung, and Blood Institute (NHLBI), the National Institute of Neurological Disorders and Stroke (NINDS), and other government agencies to derive the annual statistics in this update. This section describes the most important sources we use. For more details and an alphabetical list of abbreviations, see the Glossary and Abbreviation Guide.

All statistics are for the most recent year available. Prevalence, mortality and hospitalizations are computed for 2003 unless otherwise noted. Mortality as an underlying or contributing cause of death is for 2002. Economic cost estimates are for 2006. Due to late release of data, some disease mortality are not updated to 2003. Mortality for 2003 are underlying preliminary data, obtained from the NCHS publication National Vital Statistics Report: Deaths: Preliminary Data for 2003 (NVSR, 2005;53:15) and from unpublished tabulations furnished by Robert Anderson of NCHS. US and state death rates and prevalence rates are age-adjusted per 100 000 population (unless otherwise specified) using the 2000 US standard for age standardization.

Morbidity (illness) and mortality (death) data in the United States use a standard classification system—the International Classification of Diseases (ICD). About every 10–20 years, the ICD codes are revised to reflect changes over time in medical technology, diagnosis or terminology. Effective with mortality data for 1999, we’re using the tenth revision (ICD/10). It will be a few more years before the tenth revision is used for hospital discharge data.

Heart Diseases and Stroke Statistics 2006

(Recomendado por Maria Inês Reinert Azambuja)
The American Heart Association works with the Centers for Disease Control and Prevention’s National Center for Health Statistics (CDC/NCHS), the National Heart, Lung, and Blood Institute (NHLBI), the National Institute of Neurological Disorders and Stroke (NINDS), and other government agencies to derive the annual statistics in this update. This section describes the most important sources we use. For more details and an alphabetical list of abbreviations, see the Glossary and Abbreviation Guide.

All statistics are for the most recent year available. Prevalence, mortality and hospitalizations are computed for 2003 unless otherwise noted. Mortality as an underlying or contributing cause of death is for 2002. Economic cost estimates are for 2006. Due to late release of data, some disease mortality are not updated to 2003. Mortality for 2003 are underlying preliminary data, obtained from the NCHS publication National Vital Statistics Report: Deaths: Preliminary Data for 2003 (NVSR, 2005;53:15) and from unpublished tabulations furnished by Robert Anderson of NCHS. US and state death rates and prevalence rates are age-adjusted per 100 000 population (unless otherwise specified) using the 2000 US standard for age standardization.

Morbidity (illness) and mortality (death) data in the United States use a standard classification system—the International Classification of Diseases (ICD). About every 10–20 years, the ICD codes are revised to reflect changes over time in medical technology, diagnosis or terminology. Effective with mortality data for 1999, we’re using the tenth revision (ICD/10). It will be a few more years before the tenth revision is used for hospital discharge data.

The White Man's Burden

http://download.thelancet.com/pdfs/journals/0140-6736/PIIS0140673606685619.pdf
The White Man’s Burden has one basic motif: that large-scale plans to help the poor through increased foreign aid are bound to go awry.
According to William Easterly, there is too much corruption in recipient countries, unaccountability in delivery mechanisms, and sheer uncertainty about what to do. Rather than aiming big, with comprehensive and well funded strategies, Easterly thinks it is better to aim small and piecemeal, making progress one gradual step at a time—“the right plan is to have no plan”, he asserts. Aid should be as he imagines markets to be: without plans but fi lled with “searchers” looking for piecemeal progress.
Searching is, of course, needed to identify best practices for foreign aid. But so too are plans, at local, national, and international levels, to take those best practices to scale.
Easterly seems to misunderstand the historical record on aid, and, far more unfortunately, to misjudge what’s possible in the future. His main methodological error is a failure to make careful distinctions across countries and types of aid programme.
By neglecting to hone in on what has worked and failed in the past, Easterly conveys a misplaced sense of helplessness in the face of massive but solvable problems.
The critical fact is that much is known about how to help the poor. As The Lancet helped to show in its 2003 series on child mortality, the know-how and technologies exist to save lives each year by the millions, and to improve livelihoods by the tens or hundreds of millions, but only by expanding beyond piecemeal approaches and applying knowledge at scale. The same conclusions were reached in two reports that I helped to direct for WHO and the United Nations in
2001 and 2005, respectively, both of which are roundly criticised by Easterly.

WCC September - Call for papers

The Lancet:
"Coronary heart disease has the dubious distinction of being the leading cause of death worldwide, and rapid containment of this global pandemic seems unlikely. New factors, such as sociodemographic change in lower-income countries, are providing fresh challenges for prevention and treatment. The Lancet will publish a special issue to coincide with the World Congress of Cardiology in September, in Barcelona. We therefore welcome papers on any aspect of cardiology, to be submitted by May 22. We are especially interested in research that will be presented at the Congress but will also consider other articles. Submissions from the developing world are particularly welcome. Papers should be submitted online and the covering letters should state that the submission is in response to this call for papers."

Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women -- Mosca et al. 109 (5): 672 -- Circulation

Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women -- Mosca et al. 109 (5): 672 -- Circulation:
"Significant advances in our knowledge about interventions to prevent cardiovascular disease (CVD) have occurred since publication of the first female-specific recommendations for preventive cardiology in 1999.1 Despite research-based gains in the treatment of CVD, it remains the leading killer of women in the United States and in most developed areas of the world.2�3 In the United States alone, more than one half million women die of CVD each year, exceeding the number of deaths in men and the next 7 causes of death in women combined. This translates into approximately 1 death every minute.2 Coronary heart disease (CHD) accounts for the majority of CVD deaths in women, disproportionately afflicts racial and ethnic minorities, and is a prime target for prevention.1�2 Because CHD is often fatal, and because nearly two thirds of women who die suddenly have no previously recognized symptoms, it is essential to prevent CHD.2 Other forms of atherosclerotic/thrombotic CVD, such as cerebrovascular disease and peripheral arterial disease, are critically important in women. Strategies known to reduce the burden of CHD may have substantial benefits for the prevention of noncoronary atherosclerosis, although they have been studied less extensively in some of these settings.
In the wake of the reports of the Women�s Health Initiative and the Heart and Estrogen/Progestin Replacement Study (HERS), which unexpectedly showed that combination hormone therapy was associated with adverse CVD effects, there is a heightened need to critically review and document strategies to prevent CVD in women.4�7 These studies underscore the importance of evidence-based practice for chronic disease prevention. /.../"

Friday, April 14, 2006

New Cardiac Resuscitation Protocol Improves Survival - CME Teaching Brief - MedPage Today

New Cardiac Resuscitation Protocol Improves Survival - CME Teaching Brief - MedPage Today: "Review
TUSCON, Ariz., April 13 - When performed by EMS personnel, a new approach to cardiopulmonary resuscitation (CPR) substantially improves the survival rate for most patients with out-of-hospital cardiac arrest, according to researchers.
The new approach, dubbed cardiocerebral resuscitation (CCR), emphasizes fast, forceful chest compressions to get blood moving through the body over airway management, said Michael J. Kellum, M.D., of the University of Arizona College of Medicine here.
Compared with standard CPR, the new approach nearly tripled survival rates during a one-year study, Dr. Kellum and colleagues reported online in the American Journal of Medicine.
The Wisconsin Emergency Medical Services Bureau teamed with the University of Arizona researchers to test the new protocol in two Wisconsin counties during 2004 and 2005.
During the previous three-year control period, when standard CPR was used, there were 92 adult patients with witnessed cardiac arrests and an initially 'shockable' rhythm. Eighteen of these patients (20%) survived, and 14 (15%) survived neurologically intact.
After the CCR protocol was initiated, there were 33 such patients. Nineteen (57%) survived, and 16 (48%) survived neurologically intact. The differences in both total survival and neurologically normal survival were statistically significant (P=0.001).
With CCR, first responders skip the first steps of the standard protocol: intubating the patient for ventilation and delivering a shock using a defibrillator. While still attaching the victim to a defibrillator, they do not wait for the device to analyze the patient's heart rhythm, but start fast, forceful chest compressions. /.../"

Trans Fats Judged Major Villain in Cardiovascular Disease - CME Teaching Brief - MedPage Today

Trans Fats Judged Major Villain in Cardiovascular Disease - CME Teaching Brief - MedPage Today:
"When talking with patients about food choices, remind them to read labels looking for trans fatty acids amounts but also to heed the serving amounts stated on the label.
Remind patients that the unhealthy trans fats are found in deep-fried foods, bakery products, packaged snack food, margarines, and crackers, and to try to avoid these foods.

Review
BOSTON, April 13
- Consumption of trans fatty acids raised lipid levels and increases the risk of coronary heart disease, sudden death from cardiac causes, and possibly diabetes, according to a review article.
The risk of coronary heart disease increased 23%, said the review in the April 13 issue of New England Journal of Medicine. Sudden death from a cardiac event was up 47% and tripled when evaluated for certain trans-fat isomers. "/.../

Monday, April 10, 2006

ACP: Garlic, Ginseng, Ginkgo Biloba, and Ginger All Bad Actors with Warfarin - CME Teaching Brief - MedPage Today

ACP: Garlic, Ginseng, Ginkgo Biloba, and Ginger All Bad Actors with Warfarin - CME Teaching Brief - MedPage Today: "

Explain to patients who ask that vitamins as well as so-called natural substances can react with prescription drugs.
Explain to patients, who ask, that periodic review of all prescription and non-prescription drugs that they are using can reduce the risk of adverse events.
Review
PHILADELPHIA, April 9 - When it comes to adverse events associated with Coumadin (warfarin) therapy, beware of herbs and many supplements beginning with the letter G, according to a University of Washington investigator. "/.../

Saturday, April 08, 2006

Ethnic groups and differences in hypertension -- 332 (7545): 0 -- BMJ

Ethnic groups and differences in hypertension -- 332 (7545): 0 -- BMJ:
(Recomendado por Marcelo Gustavo Colominas [mgcolominas@hotmail.com])
"On p 833, Brown discusses the evidence for differences between ethnic groups in terms of pathogenesis, prevalence, complications, and treatment of hypertension. Hypertension in young white people seems to be high renin (type 1) hypertension and best responds to treatment with angiotensin converting enzyme inhibitors and blockers (AB drugs). Hypertension in young black people, however, seems to be low renin (type 2) hypertension and responds better to calcium channel blockers and diuretics (CD drugs). Differences in responses to treatment are yet to be studied in most ethnic groups and are important for our understanding of hypertension, says the author. "

Thursday, April 06, 2006

Statins & Heart Failure

Cardiosource: "Statin therapy may prevent the development of new-onset chronic heart failure (CHF),1 but it�s unclear whether statins are beneficial or harmful in patients who have already developed CHF. Based on autopsy data, up to one-third of the deaths in CHF patients are related to acute coronary syndromes.2 If statin therapy is safe and effective in reducing acute coronary events in patients with CHF, millions of patients who would benefit from such therapy are not currently being treated. Alternatively, if statins have adverse effects in the setting of CHF, a large number of heart failure patients are being exposed unnecessarily. Given the available data, should clinicians recommend or avoid statin therapy for patients with CHF?"

Sunday, April 02, 2006

Physical Activity Cuts Stroke Risk

(Enviado por: Marcelo Gustavo Colominas [mailto:mgcolominas@hotmail.com] )
domingo, 2 de abril de 2006 18:12
(Disponível por solicitação)

Dr. G. Hu, Pr. J. Tuomilehto*
Helsinki, Finland
* Past-Chairman of the Working Group on Epidemiology and Prevention


Stroke remains a leading cause of severe disability and premature death in the United States and other Western countries. Effective therapies for the treatment of acute ischemic stroke only are used in a small number of patients and many stroke survivors require lengthy rehabilitation and chronic care. Thus, the identification of modifiable lifestyle factors remains critical for stroke prevention.
There is good evidence that regular physical activity reduces the risk for cardiovascular disease (1). However, the protective effect of physical activity specifically on stroke risk is less clear, and the results are inconsistent.
Study Results
Some studies (2-7), but not all (8-11) have indicated a significant inverse association between leisure-time physical activity and stroke risk.
Moreover, studies on women are sparse (4-7, 11), and only three of them have found a significant inverse association between leisure-time physical activity and stroke risk (5-7). Small sample sizes and few stroke events, especially among women, may have contributed to the inconsistent observations./.../

Cardiovascular risk factor burden has a stronger association with self-rated poor health

Taylor & Francis Group - Article
Conclusions: The interaction between risk factors, education, and self-rated health suggests a frightening picture, especially for the US. Public health interventions for reducing cardiovascular risk factors need to include both population and individual measures. Taking people's overall evaluation of their health into account when assessing total health risk is important.