Graphic Warnings for Cigarette Labels

Slide Show

Howard K. Koh, M.D., M.P.H.

N Engl J Med 2011; 365:e10August 4, 2011

Article

Slide Show

Graphic Warnings for Cigarette Labels.

Beginning in September 2012, the Food and Drug Administration will require larger, more prominent health warnings on all cigarette packaging and advertisements in the United States. These new labels mark the first change in cigarette warnings in more than 25 years and represent an important advance in communicating the dangers of smoking. The nine different text warnings and accompanying graphic images are designed to increase awareness of the specific health risks associated with smoking, such as addiction, lung disease, cancer, stroke, heart disease, and death.

A decade of experience in more than 30 other countries has demonstrated that such graphic warnings lead to an array of public health benefits. The warnings are more likely to be noticed than text-only labels, are viewed as more effective in communicating health risks to smokers, and are associated with increased motivation on the part of smokers to quit smoking. Integrating this effort with the other measures outlined in the 2010 tobacco-control action plan of the Department of Health and Human Services should maximize the public health benefit for the country.

Disclosure forms provided by the author are available with the full text of this article at NEJM.org.

SOURCE INFORMATION

Dr. Koh is Assistant Secretary for Health, Department of Health and Human Services, Washington, DC.

Int. Conference on Alzheimer's Disease and Related Disorders

Int. Conference on Alzheimer's Disease and Related Disorders Paris • July 16 - 21, 2011

Tesamorelin Boosts Cognition in Elderly    PARIS -- A drug that increases growth hormone release improved several measures of cognitive function in cognitively normal and mildly impaired older individuals, a researcher said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27675

Alzheimer Hopes Pinned on Family Study    PARIS -- Researchers heading a large study of families with genetically determined early-onset Alzheimer’s disease said the program offers some of the best hopes for diagnostic methods and treatments that can benefit patients with the far more common sporadic forms of the disease. http://www.medpagetoday.com/MeetingCoverage/ICAD/27669

Blood Test May Be New Tool to Detect Alzheimer’s    PARIS -- Results with a multi-marker panel of blood proteins and demographic factors corresponded with high accuracy to beta-amyloid plaque burdens seen in PET scans and to clinical diagnoses, a researcher said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27636

Brain Edema More Common With AD Biologic    PARIS -- Cerebral vascular edema occurred much more frequently than previously reported in clinical trial participants treated with bapineuzumab, the investigational biologic drug that scavenges beta-amyloid plaques in the brain, researchers said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27632

Tracer Lights Up Alzheimer’s Hot Spots in Brain    PARIS -- Clinical outcomes in cognitively normal or mildly impaired people were successfully predicted with PET scans using the investigational beta-amyloid tracer florbetapir, a researcher said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27624

Alzheimer’s Drugs Fail to Deliver Survival Benefit  PARIS -- A new, more detailed analysis has essentially erased the survival benefit for dementia patients treated with cholinesterase inhibitor drugs, according to the researcher who reported the initial findings in 2008. http://www.medpagetoday.com/MeetingCoverage/ICAD/27622

Exercise Protects Brain in New Studies    PARIS -- Two new studies presented here add to the mountain of research indicating that physical activity in older people keeps their brains active and healthy as well. http://www.medpagetoday.com/MeetingCoverage/ICAD/27599

Targeting Risk Factors Could Slash AD Numbers  PARIS -- If the known risk factors in Alzheimer’s disease were actually modified to a relatively modest degree, nearly half a million Americans with the condition might have avoided it, according to a study presented here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27595

Vascular Defects Predate Cognitive Decline    PARIS -- Individuals who lose mental abilities with age often show evidence of cerebrovascular defects years before symptoms develop, researchers said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27588

Mental Losses Common in ex-NFL Players    PARIS -- One-third of former National Football League players studied using a spousal survey appeared to have substantial mental deficits similar to those seen in much older people, a researcher said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27581

Brain Atrophy, CSF Proteins Predict Alzheimer’s    PARIS -- Measuring tau and beta-amyloid proteins in cerebrospinal fluid in addition to brain atrophy improves the ability to predict which patients with mild cognitive impairment will progress quickly to Alzheimer’s disease, a researcher said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27579

Alzheimer’s Patients Not Helped by Antidepressants    PARIS -- In patients with dementia, standard antidepressants were no better than placebo at relieving depression symptoms and actually made many of them feel worse, a researcher said here at the Alzheimer’s Association International Conference on Alzheimer’s Disease. http://www.medpagetoday.com/MeetingCoverage/ICAD/27576

TBI History Doubles Dementia Risk in Vets    PARIS -- Older veterans who had suffered a traumatic brain injury in the past -- in combat or not -- were twice as likely to have a subsequent diagnosis of dementia as vets without a history of such injuries, it was reported here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27572

Falls in Elderly Signal Amyloid Buildup    PARIS -- Cognitively normal seniors were substantially more likely to suffer falls when brain scans showed large deposits of beta-amyloid plaques in a small study, a researcher reported here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27565

Eyes Spot Early Alzheimer’s    PARIS -- The eyes are a window into the brain for many disorders, and Alzheimer’s disease may be no exception, a researcher said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27564

’Normal’ Elderly Often Have Large Amyloid Burden    PARIS -- People classed as cognitively normal may still have large beta-amyloid plaque deposits that correlate with diminished mental abilities, a researcher said here. http://www.medpagetoday.com/MeetingCoverage/ICAD/27562

Biomarkers Take Center Stage in Alzheimer’s Field    PARIS -- Although disease-modifying treatments for Alzheimer’s disease are still years away, research on biomarkers and imaging techniques for identifying individuals most likely to benefit from them is making great strides, an association officer says. http://www.medpagetoday.com/MeetingCoverage/ICAD/27548

global tobacco epidemic, 2011

WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco

This report is the third in a series of WHO reports on the status of global tobacco control policy implementation.

All data on the level of countries’ achievement for the six MPOWER measures have been updated through 2010, and additional data have been collected on warning the public about the dangers of tobacco. The report examines in detail the two primary strategies to provide health warnings – labels on tobacco product packaging and anti-tobacco mass media campaigns. It provides a comprehensive overview of the evidence base for warning people about the harms of tobacco use as well as country-specific information on the status of these measures.

To continue the process of improving data analysis, categories of policy achievement have been refined and, where possible, made consistent with new and evolving guidelines for the implementation of the WHO Framework Convention on Tobacco Control. Data from the 2009 report have been re-analyzed to be consistent with these new categories, allowing for more direct comparisons of the data across both reports.

• Download full report (File size: 6.5 MB)
• Executive summary

Estudios Socioespaciales

III Congreso Internacional de Estudios Socioespaciales:
Ciudades, Fronteras y Movilidad Humana

II CIRCULAR – Julio 2011

TERCER CONGRESO INTERNACIONAL DE ESTUDIOS SOCIOESPACIALES: CIUDADES, FRONTERAS Y MOVILIDAD HUMANA.

ORGANIZA: LABORATÓRIO PAN- AMAZÔNICO – LEPAPIS/ DEPARTAMENTO DE ANTROPOLOGIA E PROGRAMA PÓS-GRADUAÇÃO EM ANTROPOLOGIA SOCIAL/ UNIVERSIDADE FEDERAL DO AMAZONAS.

AUSPICIAN: FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DO AMAZONAS – FAPEAM.

PRÓ-REITORIA DE EXTENSÃO E INTERIORIZAÇÃO - PROEXTI, UFAM.

APOYA: RED INTERNACIONAL DE ESTUDIOS SOCIOESPACIALES.

MANAUS, AMAZONAS - BRASIL.

23, 24, 25 DE NOVIEMBRE DE 2011.

1. Presentación:

La consolidación de un “pensamiento espacial”, tal y como lo denominara Edward Soja, ha mostrado ser una necesidad imperiosa en un mundo contemporáneo abigarrado, pletórico de mutaciones, de explosiones e implosiones que revientan las estructuras convencionales de producción de los espacios y provocan la emergencia incesante de nuevas espacialidades en las que las sociabilidades apelan a códigos y anclajes diversos. La dinámica expansiva de la globalización económica, aparejada con la primacía del capitalismo y el ajuste estructural bajo el régimen neoliberal, ha provocado una transformación espacial sin precedentes, tanto en porciones visibles, llámense paisajes, ciudades, pueblos, edificios o infraestructura; como en componentes más intangibles pero esenciales de la organización socioespacial, sean estos memorias, saberes, prácticas y/o conocimientos./.../

noncommunicable diseases

EDITORIALS

Development at risk: addressing noncommunicable diseases at the United Nations high-level meeting
- Ala Din Alwan et al.
doi: 10.2471/BLT.11.091074

• Full article text [HTML]
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Action on noncommunicable diseases: balancing priorities for prevention and care
- Dermot Maher & Nathan Ford
doi: 10.2471/BLT.11.091967

• Full article text [HTML]
• Full article text
  pdf, 511kb

More Exercise Means Better Heart Health

By Charles Bankhead, Staff Writer, MedPage Today Published: August 01, 2011 Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco. Action Points   Explain that people who exercise for the recommended 150 minutes of moderately intense physical activity weekly had a 14% reduction in the risk of coronary heart disease (CHD) compared with individuals who reported no physical activity; benefits were even greater for those who exercise at least 300 min/week. Point out that individuals who did not meet the 150-minute threshold, but did exercise regularly, also had a significantly lower CHD risk compared with sedentary study participants. Some exercise tops none but more exercise trumps both for preventing coronary heart disease, authors of a meta-analysis concluded. People who accumulated 150 minutes of moderately intense physical activity weekly had a 14% reduction in the risk of coronary heart disease (CHD) compared with individuals who reported no physical activity. Increasing the weekly total to 300 minutes reduced CHD risk by 20% compared with sedentary people, according to an article published online in Circulation: Journal of the American Heart Association. Individuals who did not meet the 150-minute threshold, but did exercise regularly, also had a significantly lower CHD risk compared with sedentary study participants. "The present study provides quantitative data supporting the 2008 Physical Activity Guidelines for Americans, which recommend the equivalent of 150 minutes per week of moderate-intensity physical activity for health and 300 minutes per week for additional benefits and encourage any amount of activity for those unable to meet the minimum," Jacob Sattelmair, ScD, of the Harvard School of Public Health, and co-authors wrote./.../

Endoplasmic Stress Protein C/EBP Homologous in Arteriosclerosis

Involvement of Endoplasmic Stress Protein C/EBP Homologous Protein in Arteriosclerosis Acceleration With Augmented Biological Stress Responses

1. Junhong Gao, MD, PhD; et al.

Abstract

Background—The processes of arteriosclerosis, including atherosclerosis and vascular remodeling, are affected by interactions among numerous biological pathways such as responses to inflammation, oxidative stress, and endoplasmic reticulum stress. C/EBP homologous protein (CHOP), which is well known to induce cellular apoptosis in response to severe endoplasmic reticulum stress, is reportedly upregulated in plaque lesions.

Methods and Results—We examined the effects of CHOP deficiency on 2 types of arteriosclerosis: cuff injury–induced neointimal formation and hypercholesterolemia-induced atherosclerosis. Cuff injury–induced neointimal formation was markedly inhibited in CHOP^−/− mice with suppressed aortic expression of inflammatory factors and smooth muscle cell proliferation–related proteins. A CHOP deficiency also inhibited aortic plaque formation in hypercholesterolemic apolipoprotein E^−/− mice with suppressed aortic expression of inflammatory factors and oxidative stress markers. Bone marrow transplantation experiments revealed that recipient CHOP deficiency significantly suppressed both cuff injury–induced neointimal formation and hypercholesterolemia-induced atherosclerotic plaque formation to a greater extent than donor CHOP deficiency, suggesting the importance of CHOP in vascular cells for arteriosclerosis progression. Furthermore, in our in vitro experiments, in not only macrophages but also endothelial and smooth muscle cell lines, endoplasmic reticulum stress inducers upregulated inflammation-, adhesion-, or smooth muscle cell proliferation–related proteins, whereas decreased CHOP expression remarkably suppressed endoplasmic reticulum stress–induced upregulation of these proteins.

Conclusions—In addition to the well-known signaling for apoptosis induction, CHOP may play important roles in augmenting potentially pathological biological stress responses. This noncanonical role of CHOP, especially that expressed in vascular cells, may contribute to the progression of vascular remodeling and atherosclerosis.

New Clinical Profile of Stress Cardiomyopathy CME

Study Identifies 

News Author: Lisa Nainggolan
CME Author: Hien T. Nghiem, MD

Authors and Disclosures

CME Released: 07/25/2011; Valid for credit through 07/25/2012 

Clinical Context

Stress cardiomyopathy is a transient form of acute heart failure triggered by stressful events and is associated with a distinctive left ventricular (LV) contraction pattern, called "apical ballooning." The incidence of stress cardiomyopathy is unknown, and it primarily affects postmenopausal women. Complications are rare, and the prognosis of patients with stress cardiomyopathy is favorable. Various aspects of its clinical profile have been described in small, single-center populations, but larger, multicenter data sets have been lacking so far. Overall, it remains difficult to quickly establish diagnosis on admission and is an important differential diagnosis of acute coronary syndrome.

The aim of this study by Eitel and colleagues was to comprehensively define the clinical spectrum and evolution of stress cardiomyopathy in a large population, including tissue characterization data from cardiovascular magnetic resonance imaging (MRI), and to establish a set of cardiovascular MRI criteria suitable for diagnostic decision making in patients acutely presenting with suspected stress cardiomyopathy.

Milk and Soy Protein Intake Reduce Systolic BP

Será que nosso velho feijão não faz o mesmo?

News Author: Lisa Nainggolan
CME Author: Désirée Lie, MD, MSEd

Authors and Disclosures

CME Released: 07/21/2011; Valid for credit through 07/21/2012

Clinical Context

According to He and colleagues, hypertension is highly prevalent, and a 2-mm Hg reduction in systolic blood pressure (BP) could lead to a 6% reduction in stroke mortality rates, a 4% reduction in coronary artery mortality rates, and a 3% reduction in all-cause mortality rates. A diet rich in dairy products has been shown to reduce BP in clinical trials, perhaps because of the high content of potassium and calcium in these diets.

This randomized, double-blind, crossover trial compares the effect of soy protein, milk protein, and refined carbohydrates on systolic and diastolic BP in adults with prehypertension or stage I hypertension./.../

The chip can be used to test for HIV

31 July 2011 Last updated at 22:40 GMT

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Tiny blood card offers easier tests for remote areas

A cheap and portable blood test could provide a breakthrough for diagnosing infections in remote areas of the world, a scientific study says.

The mChip is about the size of a credit card and can diagnose infections within minutes, according to a study in the journal Nature Medicine.

Prototype tests for diseases such as HIV and syphilis in Rwanda showed almost 100% accuracy, it said.

The US-developed device has a projected cost of $1 (60p).

This would make it much cheaper than the lab-based tests currently used.

The plastic chip contains 10 detection zones, and can test for multiple diseases with only a pinprick of blood./.../

UN Summit on non-communicable diseases

What, no obesity?

Click here for February report on Big Snack and the UN Summit
Click here for March report on WHO and the UN Summit
Click here for April report on DOHaD and the UN Summit 
Click here for May report on NCD Alliance and the UN Summit 
Click here for July report on civil society, industry and the UN Summit

The NCD Summit proposals sideline compelling evidence against fast food and sugared drinks – obesity. They also skate over other forms of malnutrition

The news team reports. This story displays and comments on the draft 'Political Declaration' to be issued from the UN Summit on prevention of and control of non-communicable diseases, being held in New York next month on 19-20 September. This is the key document to be discussed, revised, agreed and issued by UN member states at UN headquarters./.../