Outubro com tudo: blogue em recesso (ou o Red and Green October)

Amigos: como todos sabem, um blogue não fecha, está sempre aberto. Nesse mês de outubro permanecerá em estado de latência, quase sem sinal de vida.

Motivo: o excesso de compromissos acadêmicos e administrativos assumidos que se acumularam quase todos nesse mês.

Nos anos 70, outubro era mês complicado na Faculdade de Medicina: eleições sempre disputadas no CAOC, Mac-Med e Show Medicina.

Agora, décadas depois, a vida continua apertada nesse mês.

Sem contar, claro que o Boston Red Sox estará defendendo seu título e, o Palmeiras caminha para o pentacampeonato. Ambos, o vermelhão e o verdão me obrigarão a plantões televisivos intensos.

Transfat: o novo alvo

Walter Willett esteve essa semana em São Paulo e Porto Alegre. Ele é um dos assim chamados "figurões" da ciência mais acessíveis e de fácil trato. Publiquei em 2004, um trabalho em conjunto com ele. Agora, ele (na esquerda da foto) começa a campanha pra banir os alimentos com gordura trans.

Nutrition Chair Willett Joins Mayor Menino in Reminding Bostonians of Start of Trans Fat Ban
Walter Willett, chair of the HSPH Department of Nutrition, joined Mayor Thomas Menino at a press conference on Friday, September 12, to remind residents that Boston’s ban on artificial trans fat would begin officially the next day. The press conference was held at local Mission Hill bistro The Savant Project, which stopped using trans fat three months ago.
According to a press release from the Boston Public Health Commission, Boston is the first city in Massachusetts to implement a ban on trans fats. Brookline has passed a similar ban, but it will not go into effect until later this year. Approximately 5,600 restaurants and other food service establishments in the city must start eliminating partially hydrogenated oil from food or beverages. Businesses that violate the ban will receive a citation and fine ranging from $100 to $1,000. Trans fatty acids, or trans fats, raise the level of bad (LDL) cholesterol in the body and lower the good (HDL) cholesterol. Consuming trans fat can increase one’s risk of developing heart disease and stroke. It can also put people at higher risk of developing Type 2 diabetes. Willett has been a leading voice in encouraging the removal of trans fats from foods. His research has helped contribute to the public's understanding of the health detriments of consuming the substance and to federal regulations requiring it be listed on food labels. The Public Health Commission board approved the trans fat ban in March and is implementing it in two phases. As of September 13, food service establishments may no longer use oils, shortenings, and margarines containing partially hydrogenated vegetable oil for frying, sautéing, grilling, or as a spread. Six months later, the ban will apply to baked goods, mixes, partially fried items, and all other foods containing artificial trans fat. The ban affects all food service establishments that are required to hold a permit from Boston’s Inspectional Services Department. These include restaurants, grocery stores, delis, cafeterias in schools and businesses, caterers, senior-center meal programs, children’s institutions, mobile food-vending units and commissaries that supply them, bakeries, park concessions, street-fair food booths, and other establishments. The ban does not apply to food or beverages served in the manufacturer’s original sealed package, such as a package of cookies or a bag of potato chips. It also does not apply to food or beverage items that contain less than 0.5 grams of trans fat per serving.

dicas dos amigos (1): Gapminder

Dica de Vitor Kawabata. O site é o Gapminder.
http://www.gapminder.com/

Consegue atrapalhar um pouca a vida de demógrafos e epidemiologistas, não porque traz pronto uma sériede informações, mas porque permite cruzá-las. Vejam ao lado a relação entre infecção pelo HIV e renda per capital: façam o triângulo Brasil, África do Sul e Estados Unidos e, comparem a capacidade de manusear a epidemia de cada um dos três países.

Bem, o GapMinder é muito interessante. Aguardo comentários dos meus amigos demógrafos plugados na rede do Taquinho.

Um cordão sanitário ao redor da China não será nada mal.

Brinquedos, rações de animais, heparina e agora o leite. Alguém precisa contabilizar o fator chinês na redução de seres humanos e animais somente no último ano. Como a Organização Mundial do Comércio não fará nada para conter a China, e a Organização Mundial da Saúde é dirigida por uma chinesa, resta aos governos de países democráticos e que defendem a saúde dos seus cidadãos tomar a atitude necessária para evitar mais danos. Abaixo, reproduzo a situação na África, descrito em despacho da agência Reuters, onde mostra o comércio entre países africanos e China.
DAKAR (Reuters) - Bans on imports of Chinese milk products by African states fearing contamination have highlighted the growing presence of Chinese goods in Africa's markets and raised worries over depending on them too heavily.
From Ivory Coast in the west to Tanzania in the east, governments have joined the list of countries blocking Chinese milk imports over concerns they could be contaminated with deadly melamine.
Since the start of the decade, African leaders have been keen to strike often controversial deals with China which guarantee supply of oil or metals from Africa in return for billions of dollars in loans and infrastructure projects. These deals have opened the door to imports of cheap Chinese goods, including food, which African consumers have come to rely on as they struggle with high prices. Chinese exports to Africa rose 40 percent to $23 billion year-on-year in the first half of 2008.
Chinese powdered milk laced with industrial chemical melamine has been blamed for causing four deaths in China so far and making thousands more ill.
The health scare means African authorities and shoppers are now also worried about what's in Chinese dairy products. Togo became the latest African country to ban them on Wednesday. Burundi, Gabon and Ghana also have bans.
"Chinese products are all over the place and the prices are very attractive, so we must be careful," said Maame Abdallah, a grandmother in Ghana's capital Accra.
"Chinese milks are the most affordable and they help a lot," said Ghanaian mother Jane Morkeh. "There are a lot of others in the market, but I use the new ones, including those made in China, because I can afford to buy in bulk," she added.

Taquicardia postural ortostática e fadiga crônica

Postural orthostatic tachycardia syndrome is an under-recognized condition in chronic fatigue syndrome
A. Hoad1, G. Spickett1, J. Elliott2 and J. Newton3
Background: It has been suggested that postural orthostatic tachycardia syndrome (POTS) be considered in the differential diagnosis of those with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). Currently, measurement of haemodynamic response to standing is not recommended in the UK NICE CFS/ME guidelines.
Objectives: To determine prevalence of POTS in patients with CFS/ME.
Design: Observational cohort study.
Methods: Fifty-nine patients with CFS/ME (Fukuda criteria) and 52 age- and sex-matched controls underwent formal autonomic assessment in the cardiovascular laboratory with continuous heart rate and beat-to-beat blood pressure measurement (Task Force, CNSystems, Graz Austria). Haemodynamic responses to standing over 2 min were measured. POTS was defined as symptoms of orthostatic intolerance associated with an increase in heart rate from the supine to upright position of >30 beats per minute or to a heart rate of >120 beats per minute on standing.
Results: Maximum heart rate on standing was significantly higher in the CFS/ME group compared with controls (106 ± 20 vs. 98 ± 13; P = 0.02). Of the CFS/ME group, 27% (16/59) had POTS compared with 9% (5) in the control population (P = 0.006). This difference was predominantly related to the increased proportion of those in the CFS/ME group whose heart rate increased to >120 beats per minute on standing (P = 0.0002). Increasing fatigue was associated with increase in heart rate (P = 0.04; r2 = 0.1).
Conclusions: POTS is a frequent finding in patients with CFS/ME. We suggest that clinical evaluation of patients with CFS/ME should include response to standing. Studies are needed to determine the optimum intervention strategy to manage POTS in those with CFS/ME.

vitamina D e depressão

Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial
R. Jorde 1,2 , M. Sneve 2 , Y. Figenschau 3,4 , J. Svartberg 1,2 & K. Waterloo 5,6
From the 1Institute of Clinical Medicine, University of Tromsø ; Departments of 2Internal Medicine and 3 Medical Biochemistry, University Hospital of North Norway ; 4 Institute of Medical Biology, University of Tromsø ; 5 Department of Neurology, University Hospital of North Norway ; and 6 Department of Psychology, University of Tromsø, Tromsø, Norway
Correspondence to Rolf Jorde, Medical Department, University Hospital of North Norway, Tromsø 9038, Norway.(fax: + 47 776 26863; e-mail: rolf.jorde@unn.no). J Intern Med 2008;
Objectives. The objective of the present study was to examine the cross-sectional relation between serum 25-hydoxyvitamin D [25-(OH) D] levels and depression in overweight and obese subjects and to assess the effect of vitamin D supplementation on depressive symptoms.
Design. Cross-sectional study and randomized double blind controlled trial of 20.000 or 40.000 IU vitamin D per week versus placebo for 1 year.
Setting. A total of 441 subjects (body mass index 28–47 kg m−2, 159 men and 282 women, aged 21–70 years) recruited by advertisements or from the out-patient clinic at the University Hospital of North Norway.
Main outcome measures. Beck Depression Inventory (BDI) score with subscales 1–13 and 14–21.
Results. Subjects with serum 25(OH)D levels <40 nmol L−1 scored significantly higher (more depressive traits) than those with serum 25(OH)D levels ≥40 nmol L−1 on the BDI total [6.0 (0–23) versus 4.5 (0–28) (median and range)] and the BDI subscale 1–13 [2.0 (0–15) versus 1.0 (0–29.5)] (P < 0.05). In the two groups given vitamin D, but not in the placebo group, there was a significant improvement in BDI scores after 1 year. There was a significant decrease in serum parathyroid hormone in the two vitamin D groups without a concomitant increase in serum calcium.
Conclusions. It appears to be a relation between serum levels of 25(OH)D and symptoms of depression. Supplementation with high doses of vitamin D seems to ameliorate these symptoms indicating a possible causal relationship.

Situação marital e mortalidade

Marital and cohabitation status as predictors of mortality: A 10-year follow-up of an Italian elderly cohort
Emanuele Scafatoa, Lucia Galluzzoa, , , Claudia Gandina, Silvia Ghirinia, Marzia Baldereschib, Antonio Capursoc, Stefania Maggid, Gino Farchia and for the ILSA Working Group1
aPopulation Health and Health Determinants Unit, National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Via Giano della Bella 34, 00161 Roma, Italy bInstitute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy cDepartment of Geriatrics, University of Bari, Italy dItalian National Research Council (CNR), Aging Section, Padova, Italy . Available online 31 July 2008.
Abstract
The relationship between mortality and marital status has long been recognized, but only a small number of investigations consider also the association with cohabitation status. Moreover, age and gender differences have not been sufficiently clarified. In addition, little is known on this matter about the Italian elderly population. The aim of this study is to examine differentials in survival with respect to marital status and cohabitation status in order to evaluate their possible predictive value on mortality of an Italian elderly cohort. This paper employs data from the Italian Longitudinal Study on Aging (ILSA), an extensive epidemiologic project on subjects aged 65–84 years. Of the 5376 individuals followed-up from 1992 to 2002, 1977 died, and 1492 were lost during follow-up period. The baseline interview was administered to 84% of the 5376 individuals and 65% of them underwent biological and instrumental examination. Relative risks of mortality for marital (married vs. non-married) and cohabitation (not living alone vs. living alone) categories are estimated through hazard ratios (HR), obtained by means of the Cox proportional hazards regression model, adjusting for age and several other potentially confounding variables. Non-married men (HR = 1.25; 95% CI: 1.03–1.52) and those living alone (HR = 1.42; 95% CI: 1.05–1.92) show a statistically significant increased mortality risk compared to their married or cohabiting counterparts. After age-adjustment, women's survival is influenced neither by marital status nor by cohabitation status. None of the other covariates significantly alters the observed differences in mortality, in either gender. Neither marital nor cohabitation status are independent predictors of mortality among Italian women 65+, while among men living alone is a predictor of mortality even stronger than not being married. These results suggest that Italian men benefit more than women from the protective effect of living with someone.