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Friday, December 15, 2017


Dementia prevention, intervention, and care Gill Livingston, Andrew Sommerlad, Vasiliki Orgeta, Sergi G Costafreda, Jonathan Huntley, David Ames, Clive Ballard, Sube Banerjee, Alistair Burns, Jiska Cohen-Mansfield, Claudia Cooper, Nick Fox, Laura N Gitlin, Robert Howard, Helen C Kales, Eric B Larson, Karen Ritchie, Kenneth Rockwood, Elizabeth L Sampson, Quincy Samus, Lon S Schneider, Geir Selbæk, Linda Teri, Naaheed Mukadam
 Executive summary Acting now on dementia prevention, intervention, and care will vastly improve living and dying for individuals with dementia and their families, and in doing so, will transform the future for society. Dementia is the greatest global challenge for health and social care in the 21st century. It occurs mainly in people older than 65 years, so increases in numbers and costs are driven, worldwide, by increased longevity resulting from the welcome reduction in people dying prematurely. The Lancet Commission on Dementia Prevention, Intervention, and Care met to consolidate the huge strides that have been made and the emerging knowledge as to what we should do to prevent and manage dementia. Globally, about 47 million people were living with dementia in 2015, and this number is projected to triple by 2050. Dementia affects the individuals with the condition, who gradually lose their abilities, as well as their relatives and other supporters, who have to cope with seeing a family member or friend become ill and decline, while responding to their needs, such as increasing dependency and changes in behaviour. Additionally, it affects the wider society because people with dementia also require health and social care. The 2015 global cost of dementia was estimated to be US$818 billion, and this figure will continue to increase as the number of people with dementia rises. Nearly 85% of costs are related to family and social, rather than medical, care. It might be that new medical care in the future, including public health measures, could replace and possibly reduce some of this cost. Dementia is by no means an inevitable consequence of reaching retirement age, or even of entering the ninth
Lancet 2017; 390: 2673–734 Published Online July 20, 2017 S0140-6736(17)31363-6 See Comment pages 2614 and e51 Division of Psychiatry, University College London, London, UK (Prof G Livingston MD, A Sommerlad MSc, V Orgeta PhD, S G Costafreda PhD, J Huntley PhD, C Cooper PhD, Prof R Howard MD, N Mukadam MSc); Camden and Islington NHS Foundation Trust, London, UK (Prof Gill Livingston, S G Costafreda, C Cooper, Prof R Howard); Department of Old Age Psychiatry, King’s College London, London, UK (J Huntley); National Ageing Research Institute, Parkville, VIC, Australia (Prof D Ames MD); Academic Unit for Psychiatry of Old Age, University of Melbourne, Kew, VIC, Australia (Prof D Ames); Medical School, University of Exeter, Exeter, UK (Prof C Ballard MD); Centre for Dementia Studies, Brighton and Sussex Medical School, University of Sussex, Brighton, UK (Prof S Banerjee MD); Centre for Dementia Studies, University of Manchester, Manchester, UK (Prof A Burns MD); Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine (Prof J Cohen-Mansfield PhD), Heczeg Institute on Aging (Prof J Cohen-Mansfield), and Minerva Center for Interdisciplinary Study of End of Life (Prof J Cohen-Mansfield), Tel Aviv University, Tel Aviv, Israel; Dementia Research Centre, University College London, Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK (Prof N Fox MD); Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD, USA (L N Gitlin PhD); Department of Psychiatry, University of Michigan,
Key messages
1 The number of people with dementia is increasing globally Although incidence in some countries has decreased.
2 Be ambitious about prevention We recommend active treatment of hypertension in middle aged (45–65 years) and older people (aged older than 65 years) without dementia to reduce dementia incidence. Interventions for other risk factors including more childhood education, exercise, maintaining social engagement, reducing smoking, and management of hearing loss, depression, diabetes, and obesity might have the potential to delay or prevent a third of dementia cases.
3 Treat cognitive symptoms To maximise cognition, people with Alzheimer’s disease or dementia with Lewy bodies should be offered cholinesterase inhibitors at all stages, or memantine for severe dementia. Cholinesterase inhibitors are not effective in mild cognitive impairment.
4 Individualise dementia care Good dementia care spans medical, social, and supportive care; it should be tailored to unique individual and cultural needs, preferences, and priorities and should incorporate support for family carers.
5 Care for family carers Family carers are at high risk of depression. Effective interventions, including STrAtegies for RelaTives (START) or Resources for Enhancing Alzheimer’s Caregiver Health intervention (REACH), reduce the risk of depression, treat the symptoms, and should be made available.
6 Plan for the future People with dementia and their families value discussions about the future and decisions about possible attorneys to make decisions. Clinicians should consider capacity to make different types of decisions at diagnosis.
7 Protect people with dementia People with dementia and society require protection from possible risks of the condition, including self-neglect, vulnerability (including to exploitation), managing money, driving, or using weapons. Risk assessment and management at all stages of the disease is essential, but it should be balanced against the person’s right to autonomy.
8 Manage neuropsychiatric symptoms Management of the neuropsychiatric symptoms of dementia including agitation, low mood, or psychosis is usually psychological, social, and environmental, with pharmacological management reserved for individuals with more severe symptoms.
9 Consider end of life A third of older people die with dementia, so it is essential that professionals working in end-of-life care consider whether a patient has dementia, because they might be unable to make decisions about their care and treatment or express their needs and wishes.
10 Technology Technological interventions have the potential to improve care delivery but should not replace social contact.

Jornal Mente Corpo

Agora foi minha vez: n o início da semana passada foi minha irmã Lia Maria  reinaugurando seu atelier de artes, no Diário de Santa Maria. Nesta Semana, foi a vez da outra irmã Maria Helena no mesmo jornal. Ontem recebi exemplar de novembro (152) do Jornal Mente Corpo, com matéria que segue abaixo.

Thursday, December 14, 2017

Maria Helena Cechella Achutti

Diário de Santa Maria, no dia 11/12 p.p. publicou uma entrevista com minha outra irmã.
Tratando-se de uma página inteira de jornal, para facilitar a leitura pode usar Zoom.

NEJM 2017 Notable

Free Exclusive Collection
Notable Articles of 2017
Selected by NEJM editors
Dear Reader,
2017 was the year of big data. One study took data from 61 million Americans and looked at the association between air pollution and mortality. The trial found that for every increase of 10 μg per cubic meter in fine particulate matter (PM2.5), there was an associated 7.3% increase in all-cause mortality. These findings stress the need for tighter regulation of air-pollutant levels, and make the point that we still have time to make a difference.
Another study analyzed data from 68.5 million people from 195 countries to find the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. This study found that the global obesity epidemic is worsening in most parts of the world, but — as with the air pollution study — our future is not immutable.
As the medical information published in NEJM is regularly used in daily practice, we ensure each paper published meets exacting standards for editorial quality, clinical relevance, and impact on patient outcomes. Among all papers published in 2017, this “most notable” collection was selected by the editors as being the most meaningful in improving medical practice and patient care. We hope that you will take valuable insights from these articles.
Jeffrey M. Drazen, M.D.
Editor-In-Chief, The New England Journal of Medicine
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PRB 2017

We wish you a happy and healthy 2018.
Enjoy a quick look back at what we did in 2017.

Science 2017 Top Stories

Colliding neutron stars, gene editing, human origins and more top stories of 2017
DEC 13, 2017 07:12 AM
A gravitational wave discovery is the year's biggest science story - again. Read More

Scientific Understanding

Artist's impression of a supermassive black hole

Is There a Limit to Scientific Understanding?Artist's impression of a supermassive black hole

Albert Einstein said that the “most incomprehensible thing about the universe is that it is comprehensible.” He was right to be astonished. Human brains evolved to be adaptable, but our underlying neural architecture has barely changed since our ancestors roamed the savannah and coped with the challenges that life on it presented. It’s surely remarkable that these brains have allowed us to make sense of the quantum and the cosmos, notions far removed from the “commonsense,” everyday world in which we evolved.
But I think science will hit the buffers at some point. There are two reasons why this might happen. The optimistic one is that we clean up and codify certain areas (such as atomic physics) to the point that there’s no more to say. A second, more worrying possibility is that we’ll reach the limits of what our brains can grasp. There might be concepts, crucial to a full understanding of physical reality, that we aren’t aware of, any more than a monkey comprehends Darwinism or meteorology. Some insights might have to await a post-human intelligence.

Promoção e Proteção da Saúde do Aduilto e Idoso - UFRGS

Anteontem, no dia 12, fomos convidados pela gentil coordenadora - Professora Roberta Rigo Dalla Corte para mais um jantar de fim de ano da Disciplina PPSIII ou PPSAI. Estavam presentes também os Professores Sérgio Goldani e João José Oliveira Bianchini que deram sustentação à disciplina depois de minha aposentadoria, em anos difíceis nos quais ficaram sozinhos mantendo as atividades e as idéias que orientaram sua criação.  A trinta anos em 30 de junho de 1987 eu recebera a incumbência de coordenar a Disciplina Acompanhamento de Família III (MED 703) que estava fadada a desaparecer, momento em que surgiu a proposição de substituir as três disciplinas por novas com designação e objetivos diferentes. A nossa passou a se chamar Promoção e Proteção da Saúde com ênfase no Adulto, incluíndo o Idoso ou PPSIII (MED 114).
Presentes também coordenadores anteriores Professores. Sérgio Haussen e Emílio H Moriguchi (atual chefe do Departamento de Medicina Interna do Hospital de Clínicas). Também Professor Luciano Goldani (atual vice-diretor da Faculdade de Medicina). Como atuais membros da Disciplina Professores Andréa Carla Bauer Abauer, Rafael Mendonça Chakr e  Jonas Alex Morales Saute.
A propósito pretendo resgatar mais algumas histórias da Disciplina e colocar à disposição de quem possa interessar.

Timelapse - Google Earth

Por , em 13.12.2017

Você provavelmente conhece o Google Earth, mas não uma das funções mais incríveis da ferramenta: a aba “Timelapse”, que nos permite visualizar décadas de mudanças ambientais e populacionais em apenas alguns segundos.

Wednesday, December 13, 2017

Losing Control

The Fear of Losing Control and its Role in Anxiety Disorders

by Neuroscience News
The fear of losing control over thoughts and actions can impact OCD behaviors and other anxiety disorders, researchers report.
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Hearing loss and dementia


New and Expanded Risk Factors for Cognitive Decline and Alzheimer's Disease

– Verbal and sensory skills, hospitalization may predict future cognitive function –

LONDON, July 17, 2017 — Detection of dementia at the earliest stages has become a worldwide scientific priority because drug treatments, prevention strategies and other interventions will likely be more effective very early in the disease process, before extensive brain damage has occurred. Research results reported at the Alzheimer's Association International Conference (AAIC) 2017 provide clues about associations between cognitive status in older people and several behavior and lifestyle factors, including verbal skill, hearing, and hospitalization.

"It is essential that we learn more about factors that indicate or impact risk for Alzheimer's disease and other dementias, especially lifestyle factors that we can change or treat," said Maria C. Carrillo, PhD, Alzheimer's Association Chief Science Officer. "The Alzheimer's Association is committed to advancing scientific research to identify simple and accessible ways to spot the signs of cognitive decline."

Tuesday, December 12, 2017

Censo Nacional sobre Diabete (30 anos)

Parabéns ao AMICOR Reginaldo Hollanda Albuquerque e aos demais Diabetólogos.
Reginaldo escreveu o que segue e eu posso repassar os arquivos a quem estiver interessado.
Prezados(as) colegas: ao realizar hoje uma faxina no meu computador encontrei os docs básicos dos belíssimos  e importantes trabalhos que realizamos entre 1986-1988.  

Me emocionei ao reler os dois projetos básicos: o do Censo que foi um sucesso e a proposta do Plano Nacional de Atendimento ao diabético que não saiu do papel. Desejo-lhes e um feliz 2018 e que possamos nos encontrar no decorrer do ano para uma comemoração desta data. Quem sabe possamos continuar batendo nas mesmas teclas. Permanecem  atuais e fundamentais.
Reginaldo Albuquerque

Os docs estão anexados, tal e qual os encontrei.

MW word of the year

And Merriam Webster’s Word of the Year for 2017 Is...

Parkinson's D. PINK1

Tapeworm Drug May Help in Fight Against Parkinson’s

by Neuroscience News
Cardiff University researchers report a molecule in a common medication used to treat tapeworm has shown to be effective in enhancing the PINK1 protein and slowing the progression of Parkinson's disease.Read more of this post
Neuroscience News | December 12, 2017 at 10:49 am | Tags: Niclosamide | URL:
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Proton Pump

Recomendado pelo AMICOR Reginaldo Hollanda Albuquerque (Brasília)
Ainda não li tudo, mas  o primeiro questionamento que me surgiu foi: quanto de pré-seleção nas amostras, separando gente estressada ou não, cofator para hiperacidez, gastrite e úlcera e motivo para usar antiácido? Estou curioso para saber se isso foi analisado...

Published in Primary Care
Expert Opinion / Commentary · November 17, 2017

2017 Top Stories in Primary Care: Proton Pump Inhibitors and Risk of Death

Written by
 David Rakel MD, FAAFP

Monday, December 11, 2017

Breast Cancer Risk and contraceptives

All Hormonal Birth Control Is Linked to Increased Breast Cancer Risk, Study Shows

Here's what you need to know.
8 DEC 2017
New research has added to the growing pile of evidence that taking hormonal contraceptives increases your relative risk of developing breast cancer.
While these findings fall in line with what we already know, the study focussed mostly on formulations and delivery methods that have been developed since the mid-1990s - meaning that even newer contraceptives on the market are still adding to the problem./.../

Genes and Behavior

Do Genes Direct Our Behavior? [Video]

Studying the acute sense of smell may provide some answers
What do we do when we’re hungry? How do we react when people gather around us? Where do we go when we want to be alone? Humans have so many complex behaviors, yet researchers think many of them have developed directly from the ways animals act and react. Whether that is true can be revealed by studying how genes direct biological functions, and how those functions result in action.
Cori Bargmann, a neurobiologist at Rockefeller University, is hot on this trail. 

Industrial Revolution sequelae

Industrial Revolution Left a Damaging Psychological Imprint on Today’s Populations

by Neuroscience News
Image shows an old photo of factories.
The team controlled for an extensive range of other possible influences – from competing economic factors in the 19th century and earlier, through to modern considerations of education, wealth and even climate. image is adapted from the University of Cambridge news release.
People who are historically more reliant on the coal industry tend to have more negative personality traits, University of Cambridge researchers report. The researchers believe this could be a lasting effect of the Industrial Revolution.
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Cardiologista BR

SBC Revela o Perfil do Cardiologista Brasileiro
A Diretoria da Sociedade Brasileira de Cardiologia 2016-2017 apresenta os resultados da pesquisa Perfil do Cardiologista Brasileiro, coordenada por sua Diretoria de Pesquisa, com o apoio da Diretoria de Tecnologia de Informação e o envolvimento todos os demais diretores. O dados foram coletados por respostas enviadas por 2.101 sócios, 33% na faixa etária dos 30-39 anos, 27% entre 40 e 49 anos e 30% de 50 a 59 anos. A pesquisa contempla dados sobre trabalho, saúde, estresse, remuneração, uso da tecnologia, previdência privada, aposentadoria, satisfação e insatisfação profissionais e até espiritualidade, entre muitas informações de grande relevância. Os dados coletados proporcionam um conhecimento atualizado do universo dos cardiologistas brasileiros, sócios da SBC, além de subsidiarem elementos concretos para ações diversas, como de defesa profissional e desenvolvimento associativo.

Em um questionário anexo, foram também pesquisados os anseios dos sócios da SBC em relação aos benefícios ofertados pela entidade. Tais respostas objetivaram avaliar as ações já realizadas e orientar ações futuras do SBC Clube, rede de benefícios criada na atual gestão.

Uma outra importante pesquisa, sobre a Saúde Cardiovascular e Fatores de Risco do Cardiologista Brasileiro, está em fase de consolidação de dados, sob a coordenação da Diretoria de Promoção da Saúde Cardiovascular/FUNCOR e da Diretoria de Comunicação, com a participação das representações estaduais do FUNCOR, contemplando a coleta de dados clínicos e amostras sanguíneas.

Os dados completos do Perfil do Cardiologista Brasileiro, assim como os da outra pesquisa, Saúde Cardiovascular e Fatores de Risco do Cardiologista Brasileiro, realizados pela Diretoria da SBC 2016-2017, estarão em breve disponíveis em publicações científicas.

Clique aqui e conheça o Perfil do Cardiologista Brasileiro.

Marcus Vinícius Bolívar Malachias
Leandro Ioschpe Zimerman
Osni Moreira Filho

Sunday, December 10, 2017

AD & Education

Genetics Study Adds Further Evidence That Education Reduces Alzheimer’s Risk

by Neuroscience News
A new study adds further weight to the theory that being educated may help to stave off Alzheimer's disease.
Neuroscience News | December 9, 2017 at 9:24 am | Tags: cognitive reserve | URL:
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primordial ‘soup’

Straining a strange soup for lessons on our Universe

© Science Photo Library - MEHAU KULYK/Getty Images
© Science Photo Library - MEHAU KULYK/Getty Images
Scientists have used collisions between protons to investigate strange hadrons, whose formation may provide deeper insights into the origins of our Universe, according to a study published in Nature Physics.
A few billionths of a second after the Big Bang, an extremely hot and dense primordial ‘soup’ formed from freely roaming quarks and gluons, the fundamental building blocks of the Universe. By studying the properties of this soup, known as a quark-gluon plasma, scientists can gain a better understanding into the origins of our Universe.
Using data from the ALICE detector at the Large Hadron Collider, an international team of physicists, including researchers from the Moscow Engineering Physics Institute, have observed for the first time the enhanced formation of strange hadrons, particles that contain at least one strange quark, which are indicative of the formation of the quark-gluon plasma, opening up a new way to study the origins of our Universe.
  1. Nature Physics 13, 535–539 (2017). doi: 10.1038/nphys4111

The new record-holder for faraway quasars comes from a period of rapid change in the universe. Read More
supermassive black hole