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Friday, December 31, 2004

Fast Food Linked To Obesity And Diabetes

Fast Food Linked To Obesity And Diabetes
Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis
Clear link between increased fast-food consumption and obesity Fast-food consumption has strong positive associations with weight gain and insulin resistance, suggesting that fast-food increases the risk of obesity and type 2 diabetes, concludes a US study by David Ludwig and colleagues. In an accompanying Comment, Arne Astrup says: "Fast-food restaurants may argue that the evidence that customers are being super-sized by their meals is too weak. But should customers not be given the benefit of the doubt? ? Recently, some major fast-food companies have taken positive steps by launching new healthier choices, such as porridge for breakfast, and fruit and vegetables for desert."

Para ser coerente com nossa preocupação com obesidade e diabete, deveríamos de cobrar um imposto maior para as empresas de fastfood (a começar pela MD)!

[2216 - AMICOR - 31/12/2004] New fashion for AMICOR; Conflict of Interest.

We will try a new experimental style for the AMICOR presentation. During an initial period we will keep both: the traditional presentation in the AMICOR SERVER and this new one as a blog,
If you know any member of the list no more receiving the alert messages, please ask them to send again a message to reactivate participation in the list. I will cancel from the list all addresses with difficult delivery.

You may also visit other three blogs I will maintain:
* related with the Health Priorities consultation
* where I use to keep of my interest but with doubtful general interest.
* related with medical education issues.

Direct to consumer advertising -- Mansfield et al. 330 (7481): 5 -- BMJ

Direct to consumer advertising -- Mansfield et al. 330 (7481): 5 -- BMJ
This article deals with a new industry strategy, bypassing professionals, as they are progressively aware of the conflict of interest, and pressed by scientific societies and ethical committees to control manipulation of physicians.

FDA to review "missing" drug company documents -- Lenzer 330 (7481): 7 -- BMJ
Eli Lilly & Prozac affaire.
The additional question is not just scientific, but moral: is it right to hidden documents and lack of transparency for secondary interest?

SCIELO list of scientific publication references

Subject list of serials

Tuesday, December 28, 2004

Consulta sobre prioridades em Saúde.

Com vistas num estudo sobre impacto econômico das doenças cardiovasculares em países em desenvolvimento foi apresentado junto com a mensagem AMICOR 2191, um questionário respondido por vários especialistas (lista anexa aos resultados). O que foi colhido até o presente momento pode também ser visto através de um hiperlink (

O questionário continua aberto a quem quiser colaborar respondendo ou comentando os resultados. Os respectivos créditos serão respeitados.

Há planos de expor estes resultados a uma amostra mais extensa da população, para colher também sua percepção, porém através de um questionário mais fechado.

[2214-AMICOR - 27/12/2004] Ethics & Professionalism

ACCF/AHA Consensus Conference Report on Professionalism and Ethics
(Full article available on request. Artigo completo deve ser pedido por e-mail:

Richard J. Popp, Conference Co-Chair Sidney C. Smith, Jr, Conference Co-Chair

The recommendations set forth in this report are those of the conference participants and do not necessarily reflect the official position of the American College of Cardiology Foundation and the American Heart Association, Inc.
When citing this document, the American College of Cardiology Foundation and the American Heart Association would appreciate the following citation format: ACCF/AHA consensus conference report on professionalism and ethics. Presented in Bethesda, Maryland, June 2–3, 2004. Circulation. 2004;110:2506 –2549.

The health care professions have always enjoyed special trust and position in our society. Patients trust health care professionals (HCPs) to guard their health, inform them, and put a patient’s interests above any other consideration.
This is one definition of “professionalism.” When HCPs deal with human subjects in research there are basic ethical principles, articulated in the classic Belmont Report of 1979, that have been accepted by all (1).
We believe from our experience that the members and staff of the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) strive to do “good” for society in general and for patients specifically.
They put patients’ interests first, above their own, in an overwhelming majority of situations. There are virtually hundreds of thousands of patient-HCP encounters daily in the U.S. It is assumed that HCPs are trying their utmost to benefit their patients even when the outcome is not optimal or when disease progression cannot be effectively treated. Complications of therapy occur despite the best of intentions. Clinician-scientists and the medical industry develop new therapies to improve the lives of patients living with cardiovascular disease, and society has seen the benefits of this effort over the past several years. Everything in this system works well until or unless a conflict between the HCP’s interests and those of the patient results in actions that harm the patient. Then it is assumed that there has been a breach of that respected patient-HCP trust. Many modern situations exist in which the personal interest of the HCP may not be aligned with that of the patient. Ethical choices must be made by the HCP in these situations. Examples include:

● A physician is awakened and gets out of bed in the middle of the night to assess a patient with chest pain.

● A procedure is done or an antibiotic is given with marginal indication by the HCP to satisfy the patient’s wishes rather than the HCP providing a long or detailed explanation of why the action need not be taken.

● Procedures produce income for HCPs and provide experience and prestige that are valuable for the HCP in ways beyond those only for the individual patient’s direct benefit.

● Medical scientists have a deep interest in developing new methods or therapies requiring testing in humans despite the initial imperfection of the agents being tested.

● HCPs continue to devote precious time to help patients make important behavioral changes (smoking and substance abuse cessation, dietary counseling, and so on), despite a lack of reimbursement or support from health care delivery systems and payers.

● An HCP advocates for a product or procedure because of his or her role as an adviser or consultant to a company profiting from the product or procedure while trying to differentiate this role from that of an impartial physician or other HCP educator.

● The HCPs are chosen for their opinions to serve as paid experts in legal actions, de facto taking “sides” in cases related to patient care or product liability issues.

● A physician prescribes a new statin drug for secondary prevention because he or she heard about it at a recent meeting hosted by a drug representative, although this drug is less proven to prevent subsequent events than older medications.

Sunday, June 13, 2004

Why use AMICOR.blogspot as Pre-Confernece 6th ICPC

Dear Friends of the Heart,
Until now we didn't have the expected participation in our proposal, but I am sure we have at hands a great instrument, it depends on our will to make it productive.
In the Time Magazine today issue (June 13) you may read an article on the blogs potentialities:
time magazine Sunday, Jun. 13, 2004
Meet Joe Blog
Why are more and more people getting their news from amateur websites called blogs? Because they're fast, funny and totally biased
A few years ago, Mathew Gross, 32, was a free-lance writer living in tiny Moab, Utah. Rob Malda, 28, was an underperforming undergraduate at a small Christian college in Michigan. Denis Dutton, 60, was a professor of philosophy in faraway Christchurch, New Zealand. Today they are some of the most influential media personalities in the world. You can be one too.

I hope you will progressively react, when you discover what is possible to do with communication and networking.

Wednesday, June 09, 2004

The Milan Declaration

The Milan Declaration (Draft for the 5th IHHC)
The 5th International Heart Health Conference, which is taking place June 13-16, 2004 in Milan, Italy, will culminate in the creation of the Milan Declaration 2004. This key document will guide global efforts to prevention cardiovascular disease over the coming years. Through ProCOR, the Declaration’s authors are making a draft of the Declaration available for global review and comment prior to its finalization.

There is time enough to participate, with your comment and suggestion.
This is also a good opportunity to start thinking in our 6th ICPC that should be another step in continuation to these efforts aiming the health promotion and prevention of cardiovascular diseases.
Please, you may use a form that is available in the ProCOR address, or use this blog for matters related with the next year meeting.

Wednesday, June 02, 2004

Global Burden of Chronic Diseases

Dear friends,
In the last AMICOR message [2079] I sent hyperlinks to the last issue of JAMA with rich material on the Global Burden of Chronic Diseases, with emphasis to the Developing Countries.
This is an important issue desserving serious discussion. I suggest to pick up one of your interest and bring topics to discussion, what may be an opportunity to feed speakers invited for the 6th ICPC, at less than one year of the formal opening.
You may post comments below, or new messages directly clicking in the spot or sending me a message
We will be waiting for your reaction.

Thursday, May 27, 2004


Dear friends,
Following in our purpose of stimulate inputs from a broader audience before the meeting of the 6th ICPC,
Im posting today the titles scheduled for the Morning Plenary Sections, as it is for while, without the name of the speakers, quite all confirmed. I need a final word from the chairman of the Scientific Committee, to identify them.
The titles meanwhile may be already a stimulus for thinking and to receive contributions: questions, suggestions of emphasis or priorities.
You are welcome to add a comment to this blog (see at bottom) or to send a message to my address AAchutti on any of these topics.
MORNING PLENARY (0900-1030 Hours)
*Mapping the menace: Global burden of CVD and risk factors (Mortality; Disability estimates; Projections)
*Dynamics of Health Transition: How accurate are the models for predicting the course of cardiovascular disease epidemics?
*Upstream determinants of the global CVD epidemics (Social and economic factors influencing health behaviours and health systems)
*Macro-economic effects of cardiovascular diseases (With special emphasis on developing economies and economies in transition)
*What have we learnt from Community interventions?
*Policy interventions as instruments of change: What kind of evidence is available and needed?
*Helping communities to change: What can be the contributions of NGOs?
*Influencing the dynamics of epidemiological transition in developing countries: What can work?
*Understanding ‘risk’ in individuals: What should guide the management approach?
*Clinical Guidelines: How relevant? How generalizable? How effective?
*How should ‘cost-effectiveness’ and ‘affordability’ guide cardiovascular risk reduction strategies?
*Polypill: What will be its impact on CVD prevention?

Wednesday, May 26, 2004

Expandindo a Comunidade Virtual e suas Opções # Extending our Virtual Community and its Options

Caros amigos, Dear friends (below there is a translation of this text)
Conforme já nos referimos em comunicação anterior, pretendemos manter o SERVIDOR AMICOR, por enquanto com as caracterí­sticas atuais, mas explorar a potencialidade desta nova forma de comunicação chamada BLOG, expandindo ainda mais nossa comunidade virtual, estabelecendo uma ponte contí­nua também com outras iniciativas semelhantes.
Assim, este nosso endereço é:
Continuamos com o outro Servidor:
No endereço BLOG, por enquanto vamos tentar desenvolver uma discusso em cima dos temas da 6a. Conferência Internacional de Cardiologia Preventiva que se iniciará¡ fí­sicamente no dia 21 de maio do próximo ano, em Foz do Iguaçu, sob a Presidência do AMICOR Mário de Camargo Maranhão e com a coordenação Científica do K. Srinath Reddy e minha cooperação.
Para tanto vamos procurar estimular a revisão dos temas programados e a possibilidade de levantar contribuições ou contestações dentro dos temas previstos, de forma que possam de alguma forma alimentar o que vai acontecer durante o Congresso.
Não esqueçam de que este formato Blog, permite que qualquer um dos amigos possa dar diretamente sua contribuição on line, sem maiores interferências burocráticas.
No endereço do SERVIDOR AMICOR, pretendemos continuar apresentando as referências mais importantes colhidas por mim e julgadas com potencial interesse para ao menos alguns dos membros da lista.
Lembramos tambémm o endereço do ProCOR:
que continuará, sob a direção de Catherine Coleman dentro de sua programação tradicional, trazendo atualizações e sucitando contrivesias.
O Blog do AMICOR Reginaldo Hollanda Albuquerque, seguirá também com sua linha de discussão, principalmente voltada no momento para os aspectos da nutrição e diabete. O endereço dele é
Hoje a AMICOR Maria Inês Reinert Azambuja acrescentou um texto com sua opinião sobre a discussão polí­tica-industrial-agrícola-nutricional-saúde relacionada com o recente protocolo aprovado na OMS, basta que este endereço seja portanto buscado.
Pretendemos convidar, visando consolidar laçoos já existentes, de forma ordenada e mais definida, outras iniciativas semelhantes, respeitando suas peculiaridades que a semelhanças da biodiversidade, poderão nos reaproximar de formas naturais, enriquecendo as oportunidades e as opções de quem quizer se juntar a esta grande comunidade virtual.
Nem sempre será possível traduzir todas as idéias em todos os idiomas, mas certamente, todos estarão dispostos a fazê-lo sempre que alguém solicitar neste sentido.
Ainda a oportunidade dos BLOGS, transcrevo uma informação enviada pelo Reginaldo no dia de ontem:
No Caderno de Informática do Correio Brasiliense saiu hoje esta nota


Para Bill Gates, personalidade mais influente do mundo da informática, os blogs funionarão em breve como ferramentas de negócios. Os blogs e as mensagens acrescentadas a essas páginas tornam a comunicação muito mais fácil, disse o presidente da Microsoft no encontro anual de executivos do setor realizado anualmente pela empresa. O tema foi o que teve mais destaque na apresentação de Gates. Isso significa que agora, os blogs considerados até hoje como meros "diários virtuais, serão vistos com outros olhos pelos empresários do ramo.

As we already mentioned in a previous communication, is our intention to maintain the AMICOR SERVER, for while with its present characteristics, while exploring the potentialities of this new format of communication named BLOG, expanding even more our virtual communicty, building a bridge also with other similar initiatives.
So, our address here is:
We will follow with the other Server:
In the BLOG address, for while, we will try to develope a discussion on the thems of the 6th. International Conference on Preventive Cardiology that will open physically in May 21 of the next year, in Iguazu Falls, under the chairmanship of the AMICOR Mário de Camargo Maranhão and with the Scientific Coordination of K.Srinath Reddy and my cooperation.
In this way we will stimulate a review of the programmed themes, trying to rise contributions and controversies among the proposals to feed in some form what will happen during the Congress.
Don't forget that this Blog format, allow write directly on line your contribution, without major bureocratic interference.
In the AMICOR SERVER address, we will follow presenting the most relevant references I find (assumed as of potential interest at least for some members of the list.
I wish to recall also the ProCOR address:
that will follow, under direction of Catherine Coleman with its current programation, dispensing scientific opinions and rising also controversial themes.
The Blog from the AMICOR Reginaldo Hollanda Albuquerque, will follow also with its discussion line, particularly directed, in this moment, to aspects of nutrition and diabetes. Its address is:
Today the AMICOR Maria Inês Reinert Azambuja posted a new contribution with her opinion on the political-industrial-agri­cultural-nutritional-helath discussion related with the recent protocol approved by WHO.
Is our intention to invite, aiming to consolidate ties already existents, in a more ordered and defined format, other similar iniciatives, respecting their peculiarities. In some form similar to the biodiversity, we may approach nature, increasing opportunities and options to whom could desire to join us in this wide virtual community.
Not allways will be possible to translate all the ideas in all the specific idiom of each partner, but certainly all of us will be ready to do it.
Even, on the opportunity of the BLOGS, below is an information sent yesterday by Reginaldo:

From the Informatic Section of the newspaper "Correio Brasiliense"

The New Era of the BLOGS
For Bill Gates, the most influent personality in the informatics world, the blogs will function soon as business instruments. The BLOGS and messages added to these pages will turn communication much more easy, said the Microsoft president, during the annual meeting of executives of his corporation. The theme was the most highlighted during the Gates speach. This now means that the BLOGS, until now considered "virtual diaries", will be viewed differently by the enterpreneurers of the field.

Tuesday, May 25, 2004


Por sugestão do AMICOR Reginaldo Hollanda Albuquerque que nos acompanha há vários anos, vamos tentar utilizar este recurso atualmente disponível como veículo de nosso experiência em INFORMAÇÃO & COMUNICAÇÃO agora já em seu sétimo ano de existência.
Inicialmente pretendo manter o SERVIDOR AMICOR ativo, utilizando esta nova experiência como um veículo para as discussões pré-Conferência da 6a. Conferência Internacional sobre Cardiologia Preventiva que se realizará no próximo ano em 25 de maio de 2005, em Foz do Iguaçu, sob a presidência do AMICOR e ex-presidente da Federação Mundial de Cardiologia, Dr. Mário de Camargo Maranhão.
Deverei colocar em seguida a disposição o programa preliminar, assim como está esboçado, tentando provocar e estimular contribuições dos amigos da lista AMICOR, bem como de outros colegas que queiram participar desta reunião que será a primeira a se realizar no hemisfério sul.