sábado, 17 de maio de 2008

Há quase 40 anos em uma garagem no Ipiranga

ONGs, o braço ativista da Big Pharma

Esse blogue sempre afirmou que as ONGs que afirmam defender os direitos dos doentes são extensão dos departamentos de marketing da Big Pharma. Nesse domingo, a Folha de S. Paulo traz reportagem mostrando que 11 ONGs brasileiras endossam qualquer tipo de proposta que não quebre patentes da Big Pharma. Quem quiser ver a lista, consulte a Folha de S. Paulo. Uma das ONGs é lobista não somente de medicamentos como também de equipamentos diagnósticos e, possui forte influência no legislativo. Outra tem a mesma assessoria de imprensa da empresa que ela defende o uso de medicamentos. Mais detalhes no site do Essential Action.

sexta-feira, 16 de maio de 2008

Qual a cotação do rim em Karachi ? e, em Manila?

A bolsa de órgãos de Karachi ou de Manila irão regular o mercado de órgãos e haverá também o mercado futuro. O sarcasmo é a única resposta aos fatos relatos nesse post do WSJ.
Cash, Not Goodwill, Can Solve Organ Shortage. Posted by Scott Hensley Gavin Carney, an Australian nephrologist, has a solution for the perennial shortage of kidneys for transplant: let people sell theirs for $50,000. “We’ve tried everything to drum up support” for organ donation, Carney told the Sydney Morning Herald, but “people just don’t seem willing to give their organs away for free.” Plus, let’s be realistic, the advocates of the new approach argue. There already is a market for organs; it just happens to be a shady one. Some Australians, unable to get kidneys at home, travel to Pakistan and India to buy organs on the black market. Forget about ethics or even good clinical practices in that sort of transaction. Sally Satel, an American psychiatrist and the recipient of a kidney from a friend, thinks Carney’s on the right track, she writes on the opinion pages of the WSJ. She points to World Health Organization estimates that 5% to 10% of transplants performed each year occur in “clinical netherworlds” in China, Colombia, Egypt Pakistan and the Philippines. “The way to stop illicit transactions – and the depredations of underground markets – is to sanction legal exchanges,” she argues. There are worries, of course, that monetary incentives for organs in Australia or America would simply shift exploitation of the desperately poor onshore from less developed countries. To minimize that risk, Satel and Carney suggest careful screening of donors and longer-term rewards rather than lump sums for donations. Those might include a down payment on a house, money for a retirement fund, or even lifetime health insurance. How much money would it take? A couple of years ago, economists Gary Becker and Julio Elias of put the “going price” at about $15,000 for kidneys and about $35,000 for livers, though they acknowledged the data for those figures were limited. Even if those guesstimates were too low, payment for organs wouldn’t dramatically affect the total cost of transplants, which run about $100,0000 for kidneys and $175,000 for livers.

quinta-feira, 15 de maio de 2008

A nova pirâmide da dieta saudável

A Harvard School of Public Health lançou nova pirâmide para indicar quais os alimentos mais saudáveis. Quem quiser acesse o programa Healthy Eating Program onde a proposta é apresentada. A pirâmide da Harvard é baseada em um série imensa de estudos que justificam as prioridades apresentadas. No entanto, para quem verificar os cinco steps reproduzidos abaixo, há um ponto bastante controverso, o de número 5. O uso de multivitamínicos tem pouca base, embora a recomendação é para suplementar com vitamina D. Mas, o pior é sugerir a ingestão de bebida alcóolica, apesar da precaução adotada no texto. Eu gosto muito das sugestões apresentadas, mas ficaria com 4 etapas, somente. Uma adaptação ao Brasil da proposta pode ser lido no How Stuff Works, Alimentação saudável no Brasil escrito pela Professora da Faculdade de Medicina, Isabela Bensenor (isabensenor@hu.usp.br) ou no livro "Orientação Nutricional: perda de peso e saúde cardiovascular" da mesma autora.
1. Start with exercise. A healthy diet is built on a base of regular exercise, which keeps calories in balance and weight in check. 2. Focus on food, not grams. The Healthy Eating Pyramid doesn’t worry about specific servings or grams of food, so neither should you. It’s a simple, general guide to how you should eat when you eat. 3. Go with plants. Eating a plant-based diet is healthiest. Choose plenty of vegetables, fruits, whole grains, and healthy fats, like olive and canola oil. 4. Cut way back on American staples. Red meat, refined grains, potatoes, sugary drinks, and salty snacks are part of American culture, but they’re also really unhealthy. Go for a plant-based diet rich in non-starchy vegetables, fruits, and whole grains. And if you eat meat, fish and poultry are the best choices. 5. Take a multivitamin, and maybe have a drink. Taking a multivitamin can be a good nutrition insurance policy. Moderate drinking for many people can have real health benefits, but it's not for everyone. Those who don’t drink shouldn’t feel that they need to start. For more information, read "Alcohol: Balancing Risks and Benefits."

quarta-feira, 14 de maio de 2008

A noite da manipulação no complexo médico-industrial-midiático.

Todo ano é a mesma coisa, a reunião da ASCO provoca asco. Trata-se maior manipulação da informação no complexo médico-industrial-midiático. Há dez anos houve um caso exemplar: um mero abstract alavancou muito as ações de uma empresa farmacêutica devido ao potencial efeito do medicamento envolvido. Quando o paper foi publicado, o resultado era desapontador. Mas, quem já tinha ganho na alta .....Abaixo, post do blogueiro do The Wall Street Journal.
Wall Street Drug Analysts to Pull All-Nighter Tomorrow Posted by Jacob Goldstein Tomorrow night, at 9 p.m. Eastern, American Society of Clinical Oncology is going to release the results of thousands of cancer studies that will be presented at the group’s big annual meeting. At least a few of those are likely to be market-moving, especially the ones that involve small biotechs whose future rests on a single cancer drug. But the trick is finding the market-moving needles in a haystack of data — and doing it before the markets open Friday morning. Michael King, a biotech analyst at Rodman & Renshaw, figures he’ll stay up all night looking through the data, trying to see what it will mean for companies such as Regeneron and Onyx, Bloomberg reports. And he figures scores of his rival analysts are likely to do the same. In the past, ASCO sent out abstract books to member doctors a few weeks before the conference, but the data were supposed to remain secret until they were presented at the conference. This led to some allegations that people were trading on data that were supposedly still under wraps. So ASCO decided this year to eliminate the embargo problem altogether. King told Bloomberg he prefers the new system. “Although it’s a pain, putting it out on the Web for everyone to see is the best way to do it,” he said. Of course, some analysts aren’t waiting for the abstracts to make bets about what the data will hold. Morgan Stanley analyst Steven Harr on Monday lowered his rating on ImClone, which makes the cancer drug Erbitux. The company’s stock fell more than 7% Monday, before recovering a bit yesterday.

terça-feira, 13 de maio de 2008

Mais um argumento para controle da propaganda de cervejas: o dono do bêbado é o bandido

Por pudor, não declamarei o ditado popular sobre o que acontece com bêbados. Mas, pesquisadores canadenses mostraram com um estudo muito elegante que há risco aumentado em ser vítima de assalto ou briga, aquele que consome álcool. Superior, mesmo ao risco de acidente de trânsito. Uma resenha do artigo pode ser lido no Plos Medicine com acesso livre.
Não podemos esquecer a grande contribuição dos nossos legisladores pró-violência do lobby das cervejeiras. , os mesmos que denunciarão nas campanhas eleitorais, a "leniência da justiça" e "ineficiência da polícia" em conter a violência. Ou, então dos publicitários dândis que faturam os tubos com publicidade de cerveja e, depois inventam "movimentos pela paz" para conter a violência. A hipocrisia sobre o uso de drogas e violência muito bem apresentada em "Tropa de Elite" é a mesma dos nossos legisladores e publicitários do lobby cervejeiro.

DST em Vitória, ES e, a prevalência da prostituição.

Um artigo com resultados esperados, outros supreendentes sobre a prevalência de doenças sexualmente transmissíveis em mulheres jovens de Vitória, ES. A autora Angélica Espinosa poderá fornecer o artigo completo em espinosa@ndi.ufes.br. Esses dados merecem ser repetidos em outros locais. Confesso que por ignorância ou por falta de dados, descobri a prevalência da prostituição:1,4%. Population-based Survey of the Prevalence of HIV, Syphilis, Hepatitis B and Hepatitis C Infections, and Associated Risk Factors Among Young Women in Vitória, Brazil AIDS and Behavior, 05/13/08
Objective To estimate the prevalence of HIV, hepatitis B (HBV) and C (HCV), and syphilis infections and associated risk exposures in a population-based sample of young women in Vitória, Brazil. Methods From March to December 2006, a cross-sectional sample of women aged 18–29 years was recruited into a single stage, population-based study. Serological markers of HIV, HBV, HCV, and syphilis infections and associated risk exposures were assessed. Results Of 1,200 eligible women, 1,029 (85.8%) enrolled. Median age was 23 (interquartile range 20–26) years; 32.2% had ≤8 years of education. The survey weighted prevalence estimates were: HIV, 0.6% [(95% CI), 0.1%, 1.1%]; anti-HBc, 4.2% (3.0%, 5.4%); HBsAg, 0.9% (0.4%, 1.6%); anti-HCV, 0.6% (0.1%, 1.1%), and syphilis 1.2% (0.5%, 1.9%). Overall, 6.1% had at least one positive serological marker for any of the tested infections. A majority (87.9%) was sexually active, of whom 12.1% reported a previously diagnosed sexually transmitted infection (STI) and 1.4% a history of commercial sex work. Variables independently associated with any positive serological test included: older age (≥25 vs. <25>4× minimum wage), previously diagnosed STI, ≥1 sexual partner, and any illicit drug use. Conclusions These are the first population-based estimates of the prevalence of exposure to these infectious diseases and related risks in young women, a population for whom there is a scarcity of data in Brazil.

segunda-feira, 12 de maio de 2008

Mais uma epidemia com mortes na China

Ok, faz de conta que aceitamos as explicações da OMS segundo divulgado hoje na imprensa mundial. Quem quiser saber mais sobre a doença, clique aqui, para ver a síntese do CDC.
Para quem não estava atento, reproduzo resumo de artigo da Folha de S.Paulo, retirado de "OFiltro" em 04 de maio: Uma epidemia de um vírus intestinal já matou 22 crianças e infectou 4.529 numa província do leste da China. As primeiras 12 vítimas do EV71, que causa a doença de febre aftosa humana – sem relação com a bovina-, morreram entre março e abril, mas o governo chinês só divulgou agora. O vírus causa febre, aftas e bolhas nas mãos e nos pés. Nos casos mais graves, causa paralisia e edema pulmonar. Atinge especialmente crianças com menos de 6 anos. Há 978 crianças internadas, 48 em estado grave. Foram registrados 500 novos casos apenas entre sexta-feira e sábado. A demora na divulgação da epidemia, repete o episódio da gripe aviária, em que o governo chinês foi muito criticado por autoridades de saúde do mundo todo
WHO Backs China's Reporting of Fatal Virus. By Jason Leow BEIJING -- The World Health Organization's China representative said he doesn't believe China covered up initial cases of the hand, foot and mouth disease that has infected almost 16,000 people and led to 28 deaths. Hans Troedsson, the WHO's China representative, said at a news conference Wednesday that there was a delay in releasing information about the outbreak because initial cases brought to Chinese clinicians' showed atypical symptoms. He said authorities hadn't thought to test the cases for a virus that causes hand, foot and mouth disease and instead focused on testing for severe acute respiratory syndrome and avian flu