Quebra de patentes: decisão técnica, sem patriotismos.

A decisão da quebra da patente do efavirenz é um decisão técnica. ponto final. Se for manifestação patrioteira - com assessores do Presidente cantando o Hino Nacional - será uma besteira tremenda, sem qualquer ganho. Minha opinião é que a Merck Sharp & Dhome "piscou", na certeza de seria mais um caso Kaletra com a Abbott, quando o Ministério rugiu, mas depois voltou atrás. Importante notar que foi José Serra e o PSDB que impuseram uma forma nova de relacionamento com a Big Pharma. Ela foi melhor para o programa de aids, mas não foi melhor para a indústria farmacêutica local (capital estrangeiro e brasileiro, mas criando conhecimento e empregos no país) e, também para os interesses estratégicos da Big Pharma. Aliás, brigar com a Merck para conseguir 30 milhões de desconto com empresas de genérico indianas não compensa em nada ao país.

A atitude mais consequente será conseguir que a Big Pharma traga tecnologia para cá, ao invés de vender produto pronto. Quem aplica essa política é o governo americano. De leve, avisou que a Roche suíca deveria abrir uma fábrica nos Estados Unidos para produzir o tamiflú, indicado para a gripe aviária. A empresa cedeu.

Estarei essa semana participando do Congresso Interamericano de Hipertensão em Miami, onde amanhã participarei de mesa redonda sobre obesidade.

Uma data histórica esquecida: 04 de maio de 1977

Hoje, 04 de maio de 2007 completam-se 30 anos de uma virada histórica no país. No entanto, a data não será destaque em nenhum jornal para lembrar a primeira passeata estudantil nos anos 70. As palavras de ordem, liberdades democráticas, anistia ( e, depois constituinte) se tornariam vitoriosas inaugurando o período mais livre do nosso país. Esse ano foi fundamental começou antes com manifestação exclusiva da USP para aumento de verbas em março que saiu do Butantã até o Largo dos Pinheiros. Em maio, a concentração no Largo de São Francisco foi até o meio do viaduto do Chá e, retornou para o Largo do Patriarca. Depois de São Paulo, as manifestações se espalhariam por todos os campi do país, culminando com o confronto da Universidade de Brasília que foi ocupada em agosto. Em setembro haveria a invasão da Faculdade de Medicina da USP (cuja história um dia será contada), sem vítimas e, um dia depos da PUC com várias vítimas. A luta democrática avançaria depois de maio de 77 em todos os setores da sociedade. Historiadores obreiristas somente reconhecem as greves salariais do ABC em 78 como o ponto da virada, mas elas nada tinham de políticas, como o seu líder fazia questão de deixar bem claro. Jornalistas somente lembram de 1968 e, com certeza daqui a um ano haverá várias reportagens com a famosa foto da Maria Antonia e carros pegando fogo.

Escrevo sem ressentimento, para lembrar um grande momento que vários leitores também compartilharam. Infelizmente, Paulo Mendes de Carvalho, Marcelo Garcia e Celso Máximo de Figueiredo que estiveram comigo em todos os momentos acima, não lerão essa mensagem (0u lerão??) . Aos demais amigos, os parabéns pela vitória.

Lembro que o pior sujeito não é o que não sabe perder, mas sim aquele que não sabe ganhar!

Genética da doença cardíaca: overrated!

Li, somente o resumo que pode ser visto clicando o título feito pela Reuters sobre artigos a serem publicados amanhã no Science. Na famosa disputa "nature versus nurture", não nego minha preferência pela explicação social e ambiental para as doenças cardiovasculares e diabetes. As variações temporais rápidas e os estudos de migrantes que "adotam" a incidência do novo local são exemplos que que as explicações genéticas da etiologia das doenças cardíacas são sempre overrated como gostam de afirmar os americanos para pessoas e instituições cujo valor real é inferior ao propagado. Por outro lado, as perspectivas de novos fármacos a partir desses novos conhecimentos são muito grandes.

DNA mutation causes heart disease in whites By Maggie Fox, Health and Science Editor WASHINGTON (Reuters) - A treasure hunt for genes has found that up to three-quarters of people of European descent have DNA that raises their risk for heart disease -- and these genes are close to a stretch of DNA linked to diabetes. The findings, made by two independent groups of researchers, may help explain why so many people have heart disease even if they do not have clear risk factors such as smoking, high cholesterol or high blood pressure. And they could lead to a test to predict the risk of heart disease, the biggest cause of death across the globe. "I think this is a stunner," Dr. Francis Collins, director of the National Human Genome Research Institute, told reporters. "It seems like this one place carries all of that weight for two very common and very dangerous diseases." Both teams used a new method of combing the genome for disease genes called a genome-wide association study, which was not possible until the full human genome was published in 2003. Now scientists can map the DNA of people with a disease, compare them to this template genome or to people without a disease, and find what is different. The two studies, using 40,000 people, found the same thing -- a stretch of DNA called 9q21 carried certain mutations in people with heart disease. It is an area that had not previously been identified as a gene, which may make it more difficult to determine how it causes disease, scientists said.

JAMA: editorial contra a obrigatoriedade da vacina para o HPV

Finalmente, alguém de bom senso e juízo com visibilidade e respeitabilidade para se contrapor ao absurdo de se vacinar meninas de 11-12 anos para um vírus que talvez nunca se infectem e, caso infectadas não tenha nenhum significado maior. Catherine DeAngelis, editora do JAMA critica a proposta (clique no título) que está sendo votada em vários estados americanos. Aqui, clínicas particulares já estão oferecendo para quem não tem risco de câncer de colo uterino, mas quem se beneficiaria ...

Abaixo, trecho do editorial

Public health authorities, pediatricians, and infectious disease specialists, rather than political bodies, should drive mandatory vaccination decisions and policies. The Centers for Disease Control and Prevention recommend routine use of HPV vaccinations, but that is not equivalent to mandatory use. Merck, the manufacturer of the HPV quadrivalent vaccine, lobbied legislatures to make the vaccine mandatory before withdrawing its campaign when it became controversial. Since the manufacturer stands to profit from widespread vaccine administration, it is inappropriate for the company to finance efforts to persuade states and public officials to make HPV vaccinations mandatory, particularly so soon after the product was licensed. Private wealth should never trump public health. Human papillomavirus is not a highly infectious airborne disease, which is the paradigm for the exercise of compulsory vaccination. There is no immediate risk of rapid transmission of HPV in schools, as is the case, for example, with measles. The HPV vaccine does not create herd immunity, although it would probably reduce the prevalence of HPV infections. The primary justification for HPV vaccination is to protect women from long-term risks, rather than to prevent immediate harm to others. This may not be a definitive argument against universal use of HPV vaccine because states already mandate vaccination against another disease (hepatitis B) that can be transmitted sexually (among other routes of exposure). But because the HPV vaccine is not immediately necessary to prevent harm to others, it does suggest that compulsory measures need to be more carefully thought through.

China: mudança na assistência à aids e ao portador do HIV.

Depois de negar a existência da aids no país, permitir transfusões sem controles e de perseguir ativistas hemofílicos e pesquisadores da área, o governo chinês assumiu a responsabilidade pelo diagnóstico e tratamento da aids. Em seis anos houve aumento de verbas e política própria de prevenção e tratamento. A distribuição geográfica é bem diferenciada como mostrado na figura. Abaixo, extrato do texto do The New England Journal of Medicine que pode ser acessado na íntegra clicando o título desse post. A prevalência da aids/HIV no Brasil é de aproximadamente 0,7%, ou seja quase 15 vezes o identificado na China.

Although China's first AIDS cases were discovered in 1989, the government did not publicly acknowledge the existence of a major epidemic until 2001. Two years later, as international attention mounted after the outbreak of severe acute respiratory syndrome (SARS), the government abruptly changed course, launching aggressive measures against AIDS. An interagency committee was created to coordinate a government-wide response, and a national AIDS treatment program was established. The national budget for HIV–AIDS grew from approximately $12.5 million in 2002 to about $100 million in 2005 and about $185 million in 2006.1 In January 2006, the Chinese Cabinet issued regulations for HIV–AIDS prevention and control, outlining the responsibilities of the central and local governments and stipulating the rights and responsibilities of infected persons. The government estimates that 650,000 Chinese people are infected with HIV and hopes to limit the total to 1.5 million by 2010. The current estimate represents an HIV prevalence of approximately 0.05%.

A cardiologia avança no tratamento do infarto do miocárdio

JAMA dessa semana divulga o artigo "Decline in Rates of Death and Heart Failure in Acute Coronary Syndromes, 1999-2006" dos investigadores do Global Registry of Acute Coronary Events (GRACE) cujo resumo pode ser visto clicando o título do post. Trata-se de demonstração da ação dos tratamentos preconizados no tratamento da insuficiência coronariana aguda com melhoras impressionantes com redução da mortalidade e aparecimento de insuficiência cardíaca. O estudo foi realizado em 113 hospitais em 14 países, incluindo Brasil. Abaixo, um excelente resumo feito pela Associated Press. Antes, um comentário: trata-se de estudo mostrando o mundo real e do poder transformador da medicina e da...Big Pharma. O uso de medicamentos baratos como aspirina e beta-bloqueadores e, outros agora também baratos como inibidores da enzima de conversão ( o nosso captopril) ao lado de procedimentos mais custosos como angioplastia (utilizado em excesso, segundo o próprio estudo) e trombólise propiciaram redução na letalidade e na principal complicação, a insuficiência cardíaca. No Brasil, temos todas as condições para aplicar a maioria dessas propostas, mas como na maioria dos países ainda temos sérios problemas no atendimento pré-hospitalar e de emergência. Nunca é tarde lembrar que esse blogueiro participou e participa de ensaios clínicos com agentes antiplaquetários.

Heart-Attack Death Rates DropAs Treatment Options Improve Associated PressMay 1, 2007 4:00 p.m. CHICAGO -- In just six years, death rates and heart failure in hospitalized heart attack patients have fallen sharply, most likely because of better treatment, the largest international study of its kind suggests. The promising trend parallels the growing use of cholesterol-lowering drugs, powerful blood thinners, and angioplasty, the procedure that opens clogged arteries, the researchers said. "These results are really dramatic, because, in fact, they're the first time anybody has demonstrated a reduction in the development of new heart failure," said lead author Keith Fox, a cardiology professor at the University of Edinburgh. The six-year study involved nearly 45,000 patients in 14 countries who had major heart attacks or dangerous partial artery blockages. The percentage of patients who died in the hospital or who developed heart failure was nearly cut in half from 1999 to 2005. And the heart-attack patients treated most recently were far less likely to have another attack within six months of being hospitalized when compared to the patients treated six years earlier -- a sign that the more aggressive efforts of doctors in the last few years are working. There have been other signs that better treatment of heart patients has been saving lives, but not on a scale as large as this international study, the researchers said. "It's much more dramatic than we expected, in the course of six years," Dr. Fox said. The new study follows landmark research results in March that showed angioplasty is being overused on people who have chest pain but are not in immediate danger of a heart attack. But this popular procedure, which typically uses stents to keep an unclogged vessel open, is still a powerful tool for saving those who are having a heart attack or are at high risk of one. Patients for the study enrolled between July 1999 through December 2005 and were followed for up to six months after hospitalization. Besides the U.S., they were in hospitals in Argentina, Australia, Austria, Belgium, Brazil, Canada, France, Germany, Italy, New Zealand, Poland, Spain and the United Kingdom. The research showed that in 2005, 4.6% of the heart attack patients died in the hospital, compared with 8.4% in 1999. Heart failure developed in 11% of heart attack patients in 2005, versus nearly 20% in 1999. And just 2% had subsequent heart attacks in 2005, compared to 4.8% previously. Improved outcomes also were found in those with partial blockages, which include less-severe heart attacks. The researchers said these marked improvements are probably a "direct consequence" of new practices that followed updated guidelines from key organizations of heart doctors in the U.S. and Europe. The study "is the first report of what's actually going on in the real world," said Joel Gore, a co-author and cardiologist at the University of Massachusetts Medical Center. Recommendations in those guidelines include quick use of aspirin or more potent blood thinners; beta blockers to reduce the damaged heart's oxygen needs, statins to lower cholesterol; ACE inhibitors to relax blood vessels; and angioplasty to open blocked vessels soon after hospital arrival. Use of each of these treatments climbed during the study and in some cases more than doubled. For example, 85% of heart patients studied got holesterol drugs in 2005 versus just 37% in 1999; 78% got potent blood thinners including Bristol-Myers Squibb Co. and Sanofi-Aventis's Plavix versus 30% in 1999; and 53% had quick angioplasty, compared to just 16% six years earlier. The study appears in Wednesday's Journal of the American Medical Association. It was funded by a grant from Sanofi, which makes several other heart drugs as well as ACE inhibitors. Dr. Fox and several other authors reported getting fees and grants from Sanofi and other drug makers. Steven Nissen, former president of the American College of Cardiology and a Cleveland Clinic heart specialist, said the study doesn't prove the recommended treatments were saving lives but he suspects that is the case. "I really am encouraged that those things that appear in our guidelines are being used by physicians around the world," Dr. Nissen said. American Heart Association spokesman Sidney Smith said the results are "exactly what we would hope would happen from the major efforts in this area over the past decade. "The tragedy is that too many patients delay before coming to the hospital," Dr. Smith sai

Sal, risco cardiovascular e a cultura brasileira.

Nessa edição do British Medical Journal há artigo original e editorial reproduzido abaixo sobre o efeito da redução do sal a longo prazo: redução em 25% de eventos cardiovasculares. O artigo é de Nancy Cook e equipe com quem trabalhei no Brigham and Women´s Hospital. Para nós, brasileiros, essa é uma questão séria, visto que o consumo de sal é muito elevado, assim como a prevalência de hipertensão arterial e a incidência e mortalidade por doença cerebrovascular. Chegou o momento de pesquisa séria e dirigida ao tema. O artigo original pode ser acessado clicando no título.

BMJ 2007;334 (28 April), doi:10.1136/bmj.39196.679537.47 Fiona Godlee, editor fgodlee@bmj.com Just over a decade ago, the BMJ found itself in the eye of the storm about dietary salt (BMJ 1996;312:1239-40). We had published the Intersalt study some years previously; it concluded that populations with high average intakes of salt were likely to have higher average blood pressures. But the salt producers' trade organisation, the Salt Institute, had criticised the study's methods and asked the investigators to hand over their raw data for reanalysis. A reanalysis was done—by the original investigators—and published in the BMJ (BMJ 1996;312:1249-53). The findings were the same. It's worth remembering this skirmish in the war on dietary salt, now that the battle around the evidence linking salt and heart disease has largely been won. At the time we knew that dietary salt was linked to increased blood pressure, and over the next decade the link to actual cardiovascular disease grew stronger. So did the evidence from randomised trials that reducing salt in the diet reduced blood pressure. But still the food industry's fight against restrictions continued. At the time they could argue that the long term benefits of reducing salt on cardiovascular disease had not been shown in randomised trials—but not any longer. This week the BMJ publishes what may be the final bugle call in the battle of the evidence. Nancy Cook and colleagues followed up people who took part in two randomised trials of dietary salt reduction to see whether reductions in blood pressure converted into reductions in cardiovascular events (doi: 10.1136/bmj.39147.604896.55). They gathered data on three quarters of the original participants and found that, after 10-15 years, the risk of cardiovascular events was more than 25% lower in people who had cut their salt intake for at least 18 months. Such hard evidence is at last bringing the food industry to the negotiating table. Voluntary limits and food labelling, as adopted by the UK's Food Standards Agency and the European Union, have brought some progress from the industry, as has the "carrot" of growing markets for healthy foods, but they are unlikely to bring enough muscle to bear on a powerful industry practiced in the arts of mitigation and delay. As Francesco Cappuccio says in his editorial (doi: 10.1136/bmj.39175.364954.BE), real progress will need the additional "stick" of legislation. Most salt in developed countries is consumed in bread and processed foods, and much of it is consumed outside the home in canteens and sandwich bars, so a population-wide policy of salt reduction will come only through pressure on the food and catering industries. The current policy—encouraging consumers to make sensible choices—effectively abandons the poor and uninformed, increasing social inequities. While we wait for mandatory food labelling and firm limits on salt in processed foods across Europe, what can health professionals do to reduce the impact of dietary salt on people's health? Cappuccio suggests that baseline assessment of salt intake should be part of the UK's National Service Framework. A 24 hour urinary collection is cheaper than testing cholesterol. You might try talking salt in your next consultation

Big Pharma abre o armário.

A Big Pharma está com séria intenção de reduzir o seu papel de vilã no roteiro da assistência médica. The Wall Street Journal divulga a decisão da Lilly e de outras empresas em divulgar todos os financiamentos realizados a instituições e ONGs. A atitude é fruto de pressão do Senado americano e, também da crítica cada vez maior da intereferência da indústria em questões educacionais. Não há nenhum problema em receber recursos de indústrias, mas universidades e ONGs deveriam mostrar isso na porta de entrada da instituição e nas páginas eletrônicas. Under Criticism,Drug Maker LillyDiscloses Funding By AVERY JOHNSONMay 1, 2007; Page B1 Amid criticism that money from drug companies is overly influential in the practice of medicine, Eli Lilly & Co. for the first time plans to release a detailed report today on its grants to nonprofit groups and educational institutions. Recipients of the $11.8 million that the Indianapolis-based drug maker gave out in the first quarter of 2007 include some of the best-known medical institutions in the country, a range of foundations devoted to disease research and education and some for-profit companies specializing in continuing medical education for doctors. The largest single grant was $825,000 to Massachusetts General Hospital's psychiatry department for a year-long educational program with more than 150,000 registrants. The National Alliance for the Mentally Ill, an advocacy group for patients, received $544,500. Of that, $450,000 went to fund a project called "Campaign for the Mind of America." Some grants went to for-profit education companies. Optima Educational Solutions, based in Arlington Heights, Ill., received nearly $75,000 for a project called "Current Strategies and Needs for Managing the Critically Ill Patient with Diabetes." Lilly's best-selling drug is Zyprexa, a schizophrenia medicine that has come under scrutiny for serious side effects, including obesity and diabetes, in long-term users. It also makes insulins like Humulin and Humalog and sells the diabetes drug Byetta with Amylin Pharmaceuticals Inc. But Lilly says there is no connection between its grants and efforts to market its drugs. "These grants are first and foremost designed to improve patient care, and they are unsolicited," says Alan Breier, Lilly's chief medical officer, whose division oversees the grant office. "We desire to be a reliable and trusted partner and transparency is a critical aspect of trust." Lilly plans to list its grants on its grant-office Web site quarterly. Lilly's move reflects how, amid increasing criticism, some drug companies have begun to lift the veil on their funding. Drug makers' grants help cover the costs of nonprofit groups that raise awareness about diseases and treatment options for patients. The money also goes to educational institutions that provide doctors with courses to keep their licenses up-to-date. But critics argue grants curry favor with physicians and influential organizations, and allow companies to defend newer, more expensive medications against generic remedies and expand use of medicines for unapproved purposes. The companies, including Lilly, say these funds help assure that patients and doctors have up-to-date information on treatment options. Only a handful of drug companies have begun revealing funding details, and it's not clear how many others will follow. Lilly's decision to disclose its grants was prompted in part by an investigation into drug company donations by the Senate Finance Committee. The committee's report last week said while there is separation between grants and sales and marketing, potential for abuse remains. Some Eli Lilly executives had worried revealing the company's grants could expose recipients to criticism and bring more scrutiny. But ultimately, Lilly decided to disclose the details after an internal analysis showed the marketing department wasn't influencing the grant office's decisions, says Michael Bigelow, Lilly's assistant general counsel. Lilly shouldn't have to feel "apologetic" about the grants, he adds. Sen. Charles Grassley of Iowa, ranking Republican on the Senate Finance Committee, says "Eli Lilly's action is a positive step, and I hope other drug companies will do the same thing." A Lilly spokesman says the company funds about a third of the grant proposals received. The majority of grants are awarded in categories in which the company markets medicines. The spokesman says that's because grant seekers are aware of Lilly's expertise and because the company's reviewers are more knowledgeable in those areas. In deciding on a particular grant, Lilly considers the potential clinical value of the projects and whether they would improve patient care. The Wellness Community, a nonprofit focused on cancer, got a $37,500 Lilly grant last quarter for a program called "Frankly Speaking about Lung Cancer." Lilly makes Alimta, a drug to treat lung cancer. The Wellness Community's president and chief executive, Kim Thiboldeaux, says it shouldn't necessarily be a "bad thing" when nonprofit and drug company interests align: "They want to get information to patients and so do we," she said, adding that her organization presents information without any influence from the funding companies. Asked about the Eli Lilly grant, Jerrold Rosenbaum, psychiatrist-in-chief at Massachusetts General Hospital, says, "We issued a challenge to the pharmaceutical industry: You say you believe in [continuing medical education], then give to academic institutions without any direct knowledge of what the curriculum will be." He says his program receives funding from a number of drug companies and that their support doesn't influence its content. "We have strict guidelines that govern corporate relationships and protect against conflicts of interest," says Bob Carolla, NAMI's director of media relations. "We do not endorse any specific treatment, medication, service or product." Other drug makers have begun taking steps toward fuller disclosure. Earlier this year, GlaxoSmithKline PLC started posting online its payments to European groups that work as advocates for patients. The posts show that Glaxo, based in London, gave about $12.2 million to 424 groups last year. Glaxo was spurred by new rules from the Association of the British Pharmaceutical Industry. Pfizer Inc. yesterday began posting an online status report on follow-up studies the Food and Drug Administration has required for company drugs already on the market. Critics have hammered the drug industry for not living up to these commitments and the FDA for not enforcing them adequately. But some critics say disclosure does little to make up for the fact that drug companies have become such important benefactors of education, especially continuing education for physicians. "Drug companies are not educational institutions," says Eric Campbell, assistant professor of medicine at Massachusetts General Hospital and Harvard Medical School. "They're beholden to stockholders and exist to develop and sell drugs," he says.

Aumenta a desnutrição na India.

A India foi aquele paraíso para onde iam os hippies nos anos 60 e, agora dizem ser o exemplo a ser seguido pelo Brasil devido ao aspas vigor da sua economia aspas. Abaixo, relato do The Lancet sobre o aumento da desnutrição em crianças na India, mesmo no locais mais afluentes. De forma simplificada, a India passa por um período de crescimento ao período 1966-79 quando os indicadores sociais - mortalidade infantil, p.ex - não estavam em paralelo com aqueles da economia. O acesso ao The Lancet necessita inscrição, mas esse texto é de acesso livre em http://www.thelancet.com. O texto chega afirmar que a situação é pior do que na Etiópia.

The growth of India's economy during the past decade has had little effect on the nutritional status of its youngest citizens. Even in affluent states, the percentage of underweight children younger than 3 years has risen over the past 10 years. Chandigarh, the joint capital of Haryana and Punjab—two of India's richest states—is an elegant city, with the highest yearly per head income in the country. The signs of affluence are everywhere: glitzy malls, luxury cars, and a high-spending middle class. But on the outskirts of this town, the underbelly of India's booming economy is clearly visible. Despite having an economy growing at nearly 10% a year, widespread malnutrition, and its associated health problems, such as anaemia, remain one of India's formidable challenges. In February this year, UNICEF officials created a stir by telling a gathering of national and international journalists in Delhi that an Indian child is more likely to be malnourished than a child in Ethiopia, the Horn of Africa nation known for its periodic droughts, famines, and long civil conflict and border war with Eritrea. The comment stemmed from India's 2005-06 National Family Health Survey (NFHS), which reveals that almost half of Indian children younger than 3 years are underweight. The results show that the malnutrition crisis is not confined to migrants huddled in urban shanties.. Anaemia and undernutrition in small children and pregnant women in their prime is growing, even in India's prosperous states like Haryana. Life in Dundahera village in the Gurgaon district of Haryana, offers a glimpse of perhaps why economic boom is not translating into better maternal and child health in India. In recent years, Gurgaon has emerged as one of India's hottest outsourcing hubs. Shopping centres, multinational companies, and industrial complexes dot the cityscape. Eager to tap the emerging commercial opportunities, Dunadhera's farmers are selling their land to builders. New houses have been built to accommodate the growing number of migrant families streaming into the area to fuel the economic boom. Many families who have sold their land have suddenly become rich. But within the family and this highly patriarchal society, the status of women has scarcely improved.

Recuperando a virgindade na França

Despacho da Reuters informa que há aumento de himenoplastia entre as muçulmanas francesas para não desapontar o noivo. Pois é, a medicina faz de tudo. Reportagem completa, clicando no título do post.

Muslim women in France regain virginity in clinics Sun Apr 29, 2007 9:49pm ET By Alexandra Steigrad PARIS (Reuters) -- Sitting in a cafe near the Champs Elysees, the 26-year-old French-born woman of Algerian descent looks like any other arisian. But two months ago, she did something none of her friends have done. She had her hymen re-sewn, technically making her a rgin again. "I'm glad I had it done," said the woman, who spoke to Reuters on condition of anonymity. "I wanted to reconstruct part of my life, to reconstruct myself so that I could feel better about myself." This 30-minute outpatient procedure, called "hymenoplasty" and costing etween 1,500 and 3,000 euros ($2,000-$4,000), is increasingly popular among young women of North African descent in France. No exact figures exist to say how many such operations are done, but the woman's surgeon says he gets three to five queries and performs one to three hymenoplasties each week. Demand has been rising for the past three or four years. Doctor Marc Abecassis, whose office is near the chic Champs Elysees, sees the rise in religion among France's five million Muslims fuelling this trend. His patients are between 18 and 45 years old, Muslim, born both in France and in North Africa. "Many of my patients are caught between two worlds," said Abecassis. They have had sex already but are expected to be virgins at marriage according to a custom that he called "cultural and traditional, with enormous family pressure

KFC elimina frituras com ácidos graxos poli-insaturados na forma trans

Abaixo, despacho da Associated Press. Ao que constar, a rede Starbuck´s já tomou posição idêntica. Faltam ainda McDonald´s e Burguer King que possuem filiais no Brasil.KFC Eliminates Trans Fat From Its Chicken ASSOCIATED PRESSApril 30, 2007; Page B6 KFC's fried-chicken buckets soon will proclaim that its chicken has zero grams of trans fat. The KFC chain, a subsidiary of Yum Brands Inc., Louisville, Ky., is announcing that all 5,500 of its U.S. restaurants have stopped frying chicken in trans fat. The company said in October it was switching to a new soybean oil believed to be less likely to cause heart disease. Sister brand Taco Bell also is expected to announce that its U.S. restaurants have switched to an oil with zero grams of trans fat. All 4,200 single-brand Taco Bells were converted to a canola oil, and all 1,400 multibrand locations switched to a soybean oil, it said. Other companies, including Wendy's International Inc., Starbucks Corp., McDonald's Corp. and Burger King Holdings Inc. have also said they will phase out trans fat from their products

Influenza e Doença Coronariana: uma hipótese

Maria Inês Azambuja, professora da Universidade Federal do Rio Grande do Sul, persegue há vários anos a hipótese de que a epidemial de influenza determinou o pico de doença coronariana quatro décadas depois. Na figura, dados de Massachusetts, Estados Unidos. Abaixo, o resumo do seu artigo que poderá ser requisitado na íntegra para miazambuja@terra.com.br.

ABSTRACT In retrospect, mortality from coronary heart disease (CHD) in the 20th century followed an epidemic pattern: mortality rates increased dramatically from 1920 until about 1960, remained roughly constant for almost a decade, and have been decreasing since the late 1960s. CHD has traditionally been conceived of as a single disease with multifactorial causality.We suggest instead that CHD cases may comprise at least two distinct populations: those associated with hypercholesterolemia, and those associated with insulin resistance.The epidemic of CHD was due primarily to changes in the incidence of the hypercholesterolemia subgroup.We propose that young adults who survived the 1918 influenza pandemic were rendered vulnerable to lipid-associated CHD and coronary thrombosis upon reinfection with influenza later in life.This vulnerability may be due to autoimmune disruption of low-density lipoprotein-receptor interactions. Historical events may affect the health of populations by affecting the susceptibility of populations to chronic diseases such as CHD. The life experiences of individuals are known to influence their susceptibility to infectious diseases;we suggest that life experiences may also influence individual susceptibility to chronic diseases. *Perspectives in Biology and Medicine, volume 50, number 2 (spring 2007):228–42