The Lancet: editorial sobre dengue no Rio de Janeiro

The Lancet aborda tema já aqui apresentado: a importância climática no aumento de casos de dengue (clique aqui) e, em editorial condena os governos brasileiros na três esferas pela epidemia no Rio de Janeiro. Leia abaixo.

International action needed on dengue The statistics on dengue have been getting increasingly alarming over the past few years with 2·5 billion people now living in areas that put them at risk of becoming infected with the virus. Yet the world seems unprepared to tackle this growing global epidemic, as the citizens of Rio De Janeiro know only too well. This year, almost 50000 people in this Brazilian State have been infected with the dengue virus and over 60 people have died. But the death toll is rising and the situation is causing public panic. Treatment of dengue with precise fluid and colloid correction can reduce the mortality rate from 5% to 1%. Such treatment needs to be given swiftly to prevent the devastating clinical consequences of dengue haemorrhagic fever and dengue shock. Yet local hospitals have been unprepared and three military field clinics have been opened to help ease the pressure on overcrowded emergency departments. The outbreak has also triggered an ugly display of finger pointing with President Lula de Silva, the State Governor, the State Minister of Health, and the city's Mayor all blaming each other for mishandling the crisis and for being ill-prepared. The doctors' union in Rio de Janeiro has also announced that it would press charges against the city, state, and federal governments for negligence in the prevention of, and fight against, dengue fever. Such accusations are unhelpful and detract from the effort to control dengue. Environmental experts and infectious disease specialists disagree over the role of climate change in the rise of dengue but everyone seems to agree that urbanisation is a contributing factor. And since 77% of the population of Latin America now lives in urban areas, and over half of the world's population will live in cities by 2050, an increasing number of dengue outbreaks is inevitable unless the international community takes urgent action. There is a pressing need for a comprehensive, coordinated, and cohesive international action plan to help affected countries tackle disease prevention and also to assist in the scale-up of immediate treatment to affected populations when outbreaks occur. The Lancet

Situação da saúde no Chile: bom exemplo?

Recebi do Karl e, recomendo o seu site " Ecce Medicus": http://eccemedicus.blogspot.com

Copiei a mensagem sobre o sistema de saúde chileno.

Quarta-feira, 9 de Abril de 2008 Solo Epistemológico A Reforma Neoliberal da Saúde no Chile vem sendo elogiada, em especial, pelo Banco Mundial, que se refere a ela como exemplo para outros países. Entretanto, há uma série de críticas quanto a forma como ela vem sendo realizada desde seu início, no governo Pinochet (1973–1989).Este artigo da PlosMedicine analisa as mudanças realizadas e chama atenção para o aumento dos gastos e o financiamento público do sistema privado:

Vai mal o "sistema" de saúde americano: todos no pronto-socorro

A reportagem do The Wall Street Journal exagera a chamar de ricos aqueles com renda quatro vezes acima do nível de pobreza nos Estados Unidos. Mas, mostra o quão complicado é a situação da assistência médica naquele país. O acesso a consulta não é simples. A marcação de consulta em consultório é tão complicada quanto no nosso serviço público. A hora marcada não é bem na hora marcada e, por aí vai uma série de problemas no relacionamento médico-paciente que desemboca na procura do pronto-socorro para atendimentos de problemas sem risco de morte. April 8, 2008, 2:52 pmRich,

Not Poor, Are Crowding Emergency Rooms Posted by Jacob Goldstein

This is the conventional wisdom: Priced out of health insurance, ever more Americans are crowding into emergency rooms because they can’t afford a trip to the doctor.Yes, ERs are getting busier. But it’s not because of poor people or the uninsured, according to this analysis in the Annals of Emergency Medicine.The study is based on national surveys conducted between 1996 and 2004. During that time, overall visits to the ER increased by 26% — but a disproportionate share of the growth came from those whose incomes put them at more than four times the poverty level, and who typically get their care at a doctor’s office. The percentage of uninsured ER patients remained flat, at roughly 15%.The researchers did the study because the conventional wisdom didn’t seem to match the on-the-ground experience of ER docs. Instead, they saw a rise in ER traffic across the demographic spectrum, said Jonathan A. Showstack a study author based UCSF’s Institute for Health Policy Studies.“Focusing the political debate and the health-care debate about the overuse and sometimes the ‘abuse’ of emergency departments by the poor and the uninsured is really missing the point,” he told the Health Blog. “It’s based on the wrong assumptions and an incorrect interpretation of what’s really going on.”While expanding health insurance coverage may sound like a big enough issue to tackle, the findings of the study suggest that it wouldn’t do much to slow the influx of patients to emergency departments.Instead, the the authors conclude, “increase in ED use may be attributable to lack of ready access to primary care and other structural problems in the health care system.” Trying to fix those will make the insurance issue look easy.

Ne sutor supra crepidam

Leitores, amigos e jornalistas pedem que opine sobre uma variedade de assuntos, os quais tenho com essses interlocutores o mesmo interesse e conhecimento. Talvez, possa somente indicar alguém com mais lustro e experiência.

Se, comento alguns desses temas é porque compartilho como os leitores, textos esclarecedores. Não sou Caetano Veloso, nem Glauber Rocha e outros da blogosfera que falam sobre tudo. Há muito tempo, um herdeiro de Plínio orientou-me a não ir além das sandálias.

Ensaios Clínicos em Cardiologia: 2008

A reunião anual do American College of Cardiology em março, juntamente com a da American Heart Association em novembro é local privilegiado de divulgação de novos ensais clínicos. Criei uma seção "Ensaios Clínicos em Cardiologia" onde há onze artigos originais com acesso livre ou em alguns casos utilizando o acesso CAPES.

Advertência do Mestre: usina do Rio Madeira

De Luiz Hildebrando Pereira da Silva, médico, parasitologista, professor cassado da Faculdade de Medicina da USP em 1969, pesquisador do Instituto Pasteur no Estadão, hoje:

" Que digam alto por aí o nós daqui estamos anunciando baixinho, preventivamente, em Rondônia sobre epidemias a evitar, nas áreas de impacto das usinas hidrelétricas do Rio Madeira....Trata-se de possíveis epidemias de malária, febre amarela, febre tifóide, hepatites A e gastroenterites, repetindo o drama que aconteceu muitas décadas atrás na construção da Ferrovia Madeira-Mamoré.