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Monday, September 26, 2011

Devemos usar estatinas em diabéticos recém-diagnosticados ?

Do site da SBD e dos AMICOR Reginaldo Albuquerque e Maria Inês Reinert Azambuja

Devemos usar estatinas em diabéticos recém-diagnosticados ?
Reginaldo Albuquerque - editor
O assunto voltou à tona durante o recente Congresso Europeu de Diabetes em Lisboa. No site, o tema já foi abordado, em uma de nossas colunas, pelo Dr. Sérgio Vencio. No link abaixo foi anunciado um webcast para a discussão do assunto, o que levou uma de nossas colegas do Rio Grande Sul, Maria Inês Azambuja, a indagar: "Isto é verdade? Os cardiologistas não deveriam chamar seus pacientes - um "recall", como fazem nas distribuidoras de carros, e pendurar a conta na indústria?”

Bacteria Show Up in Hospital Rooms, Again

By  Friday, September 23, 2011 | 
Silverstock / Getty Images

We get it — hospitals are crawling with germs. If it's not your cell phone, the doctor's coat or even the hands-free water faucet, then it's the privacy curtain around the bed that's tainted 
with unwanted bacteria.
Researchers from the University of Iowa presented data at a scientific conference in 
Chicago this week showing that they had found disease-causing bugs, including 
drug-resistant varieties like MRSA (methicillin-resistant Staphylococcus aureus)
 and VRE (vancomycin-resistant enterococcus), on 95% of hospital room privacy 
curtains tested. Brand new curtains were contaminated within a week, the researchers said.
The team tested 43 curtains in 30 hospital rooms twice a week for three weeks, 
taking 180 swab cultures total. They found:
  • 12 of 13 new curtains were contaminated within 7 days
  • 41 of 43 curtains were contaminated on at least one occasion
  • MRSA was found on 21% of curtains
  • VRE was found on 42% of curtains
One of the authors of the study received consulting fees from PurThread Technologies,
 a company that makes antimicrobial fabrics for hospitals — including, hey, privacy curtains.
Luckily, there's an easier and cheaper way for doctors to prevent the spread of 
disease-causing bacteria from curtains (or anywhere) to patients: by washing their hands.

Five more heart disease genes identified

SEPTEMBER 23, 2011 Sue Hughes
Leicester, Oxford, and Cambridge, UK - An international group of scientists have discovered five new genes that affect the risk of developing coronary artery disease (CAD), which should shed light on new pathways involved in heart disease.

The research, published online on September 22 in PLoS Genetics [1], was led by four British scientists: Professor Nilesh Samani (University of Leicester, UK), Professor Hugh Watkins (University of Oxford, UK), and Professor John Danesh and Dr Adam Butterworth (both from Cambridge University, UK).
Butterworth explained to heartwire that they looked for 50 000 variations in 2000 genes thought to be influential in cardiovascular disease (CVD) in 15 500 patients with heart disease (cases) and 35 000 healthy controls. By comparing the occurrence of each variant between cases and controls, they confirmed the 24 variants already known and identified five new variants that contribute to heart disease risk.
They then validated their results in another 17 000 patients with heart disease and 40 000 healthy controls.
Butterworth said that the most immediate impact of the new gene variants would be the signaling of new pathways involved in heart disease. "They are leading us to investigate new biology that we had not considered before to be involved in heart disease."

First genetic evidence of inflammation in CAD/.../

Sunday, September 25, 2011

Clinical Practice Companion

Clinical Practice Companion

We are pleased to present you with a collection of recent articles relevant to today's practicing physician. NEJM is committed to helping physicians improve patient care by providing the best current information in an understandable and clinically useful format . These regular features, Clinical PracticeClinical Therapeutics, andCurrent Concepts, demonstrate how to diagnose and manage diseases, keep you up to date with the latest in clinical care, and highlight the best treatments and management options. This collection will only be available for a limited time, with free access available by clicking through from this Special Collections tab. You may also download the PDF within the Special Collections tab.
Clinical Practice articles begin with the presentation of a single case and continue to provide a complete description of diagnostic and treatment strategies, therapeutic options, areas of uncertainty, treatment guidelines -- everything you need to know about the current state of knowledge about a common condition. These articles are also available in audio format, so you can listen at your computer or download articles for transfer to any iPod or MP3 player.

Diabetics now number 366 million

SEPTEMBER 13, 2011 Shelley Wood

Lisbon, Portugal - New numbers released here on the opening day of the European Association for the Study of Diabetes (EASD) 2011 Meeting say that the number of people now living with diabetes worldwide has reached 366 million.
Moreover, the annual death rate from diabetes now hovers at 4.6 million, while healthcare costs for the diagnosis and treatment of the disease has reached US $465 billion.
The formal numbers will appear in the upcoming fifth edition of the Diabetes Atlas, to be published in November by theInternational Diabetes Federation (IDF). Topline figures were released early to highlight the scope of the disease one week in advance of the UN Summit on Noncommunicable Diseases, being held next week in New York, NY.
"In 2011, one person is dying from diabetes every seven seconds," IDF president Dr Jean Claude Mbanya observed in a press release with the new statistics. "The clock is ticking for the world's leaders."
The figure of 366 million people with diabetes in 2011 is up almost 30% from the 285 million cited for 2010 in the fourth edition of the atlas./.../

Saturday, September 24, 2011

Chocolate consumption and cardiometabolic disorders:

 systematic review and meta-analysis

Free via Creative Commons: OPEN ACCESS selecionado pelo AMICOR Jorge Ossanai
  1. Adriana Buitrago-Lopez, visiting research assistant123
  2. Jean Sanderson, research associate1
  3. Laura Johnson, research associate1,
  4. Samantha Warnakula, PhD student1
  5. Angela Wood, university lecturer in biostatistics1
  6. Emanuele Di Angelantonio, university lecturer in medical screening1
  7. Oscar H Franco, clinical lecturer in public health1
+Author Affiliations
  1. 1Department of Public Health and Primary Care, Cardiovascular Epidemiology Unit, University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
  2. 2Fundacion Universitaria de Ciencias de la Salud, Hospital de San Jose, Bogota, Colombia
  3. 3Pontificia Universidad Javeriana, Bogota, Colombia
  1. Correspondence to: O H Franco
  • Accepted 23 May 2011


Objective To evaluate the association of chocolate consumption with the risk of developing cardiometabolic disorders.
Design Systematic review and meta-analysis of randomised controlled trials and observational studies.
Data sources Medline, Embase, Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, reference lists of relevant studies to October 2010, and email contact with authors.
Study selection Randomised trials and cohort, case-control, and cross sectional studies carried out in human adults, in which the association between chocolate consumption and the risk of outcomes related to cardiometabolic disorders were reported.
Data extraction Data were extracted by two independent investigators, and a consensus was reached with the involvement of a third. The primary outcome was cardiometabolic disorders, including cardiovascular disease (coronary heart disease and stroke), diabetes, and metabolic syndrome. A meta-analysis assessed the risk of developing cardiometabolic disorders by comparing the highest and lowest level of chocolate consumption.
Results From 4576 references seven studies met the inclusion criteria (including 114 009 participants). None of the studies was a randomised trial, six were cohort studies, and one a cross sectional study. Large variation was observed between these seven studies for measurement of chocolate consumption, methods, and outcomes evaluated. Five of the seven studies reported a beneficial association between higher levels of chocolate consumption and the risk of cardiometabolic disorders. The highest levels of chocolate consumption were associated with a 37% reduction in cardiovascular disease (relative risk 0.63 (95% confidence interval 0.44 to 0.90)) and a 29% reduction in stroke compared with the lowest levels.
Conclusions Based on observational evidence, levels of chocolate consumption seem to be associated with a substantial reduction in the risk of cardiometabolic disorders. Further experimental studies are required to confirm a potentially beneficial effect of chocolate consumption.