Homenaje a las victimas del 11 M

DRUGS

  DRUGS 2007, Volume 67, Issue 3

Journal en PDF

DRUGS 2008, Volume 68, Issue 4

Journal en rar

Gracias JS, pases medicos

Placebo

Hace unos dias publicamos un link de un estudio donde se hacia referencia a la preferencia de las personas a placebos mas caros que placebos mas baratos. Desde Medicine Wars surgio un excelente comentario que vale el tiempo de leer. Un tema descuidado por la medicina tradicional, al igual que el efecto nocebo, y que suele adjudicarse su eficacia a efectos “psicologicos”, cual si la mente misma estuviera separada del resto de nuestro cuerpo. Pues bien, el articulo puede leerse en http://medicinewars.wordpress.com/2008/03/10/placebo/

Que lo disfruten, como yo.

New US National Hypertension Guidelines — JNC 8 — To Be Announced?

From Medscape Cardiology

Hypertension Highlights

Linda Brookes, MSc
Author Information

Information from Industry

The Institute for Advances in Point-of-Care Testing
Keep up with emerging trends in glycemic control, anticoagulation management, and other areas of point-of-care testing, to help reduce costs, enhance the efficacy of healthcare management, and improve patient outcomes.

Abstract

The National Heart, Lung, and Blood Institute of the US National Institutes of Health has now reversed its previous position and announced that it will promulgate an updated version of the current national hypertension guidelines (JNC 7), for publication in 2009, along with updates of other key cardiology guidelines, to result in an overall cardiovascular knowledge network. The role of the American Society of Hypertension in this endeavor has also been clarified. In other news this month, several new analysis of key NHANES data or well-known clinical trial data provide insights into the prevalence of hypertension, its control or failure to persist in therapy to control, and its attendant comorbidities in important population subsets.

New US National Hypertension Guidelines (JNC Scheduled for 2009

The National Heart, Lung, and Blood Institute (NHLBI)^[1] announced that it is in the process of appointing an expert panel to review and update the US national hypertension guidelines. Since the first Report of the Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure was published in 1976, the guidelines have been updated every 4-5 years. The latest, the Seventh Report (JNC 7), was published in 2003;^[2] however, since 2003, other hypertension management guidelines have appeared in the United States, including those published by the American Heart Association for patients at high cardiovascular risk,^[3] and other national guidelines published the same year, such as those in Europe, have already been updated.^[4,5] Some other national guidelines, such as those in Canada, are updated annually. The NHLBI has said that it expects to release the Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC in 2009.

JNC 8 will be one of 3 new updated guidelines scheduled for release by the NHLBI in 2009.^[6] Separate expert panels are being convened to update and develop new guidelines for the prevention, detection, evaluation, and treatment of high blood cholesterol/dyslipidemia — Adult Treatment Panel (ATP) IV, an update of ATP III published in 2002^[7] and updated in 2004,^[8] — and guidelines on overweight/obesity in adults, originally published in 1998.^[9] The NHLBI does not expect that the previous guidelines will require a complete overhaul; instead the panels will be able to focus on updating the most pertinent issues that could improve important health outcomes. As part of the update process, the panels will also propose strategies for improving the dissemination and implementation of the updated guidelines.

As part of the NHLBI’s longer term plan, all 3 updated guidelines will eventually be integrated into an evidence-based, comprehensive set of clinical guidelines for overall reduction of cardiovascular disease in adult patients directed mainly at primary care practitioners. These guidelines are scheduled to be released in 2010. An additional expert panel is being set up to review and update scientific evidence related to the assessment and management of cardiovascular risk factors for the integrated guidelines.

The NHLBI says the review “will be based on an evidence model that will give rise to a set of critical questions to be answered by the scientific evidence.” The panel will focus on developing a comprehensive integrated guideline across all cardiovascular risk factors to more closely mimic “real world” clinical scenarios faced by individuals and clinicians. In addition to reviewing and updating the scientific content and integrating multiple cardiovascular risk factors into one comprehensive guideline, the expert panel will also focus on implementation, developing more user-friendly guidelines that will be easier for clinicians and patients to put into practice. This includes the development and use of “innovative tools to facilitate guideline adoption and adherence to recommendations in order to improve the current state of suboptimal risk factor assessment and management.” This new effort will be the first of its kind to address overall cardiovascular risk factor identification and treatment in adults within 1 guideline, the NHLBI says. The update panels will function as subpanels of the integrated guidelines panel.

The Cardiovascular Knowledge Network

As part of its “longer term vision,” the guideline development effort will feed into development of a cardiovascular knowledge network (CKN). The CKN is intended:

“to facilitate interaction among the domains of knowledge generation, knowledge translation and dissemination, knowledge utilization, and knowledge technology to bridge the gap between discovery and delivery, identify knowledge gaps that should be addressed by future research, bring user communities together to better meet their needs, and speed translation of research into practice through use of more effective approaches for synthesizing and organizing evidence.”

The Role of the American Society of Hypertension

In the January issue of The Journal of Clinical Hypertension^[10] Daniel Levy, MD, director of the NHLBI’s Center for Population Studies and Framingham Heart Study and a director-at-large of the American Society of Hypertension (ASH), emphasizes the future role of ASH in the development of the new hypertension guidelines. “ASH will participate in a leadership capacity as a key stakeholder throughout this guideline development process,” he says. He reports that Suzanne Oparil, MD (University of Alabama at Birmingham), current President of ASH, will represent ASH as a member of the newly formed NHLBI Clinical Guidelines Leadership Group for Cardiovascular Disease Risk Reduction. The Clinical Guidelines Leadership Group, which will meet annually, consists of representatives of major professional and patient stakeholder communities. Dr. Levy reassures ASH members that “As ASH’s President, Dr. Oparil’s membership in the guidelines leadership group means that the perspectives of ASH — its membership and leadership — will be heard throughout the guidelines development process.” In 2005 ASH leaders proposed a new definition of hypertension and proposed expanding the definition and classification by incorporating the presence of absence of risk factors, early disease markers, and target organ damage in addition to blood pressure levels.^[11] At that time, with no update of JNC 7 scheduled, the Society was discussing other ways in which new hypertension guidelines for the United States could be produced.

Section 1 of 7

Next Page: Hypertension Prevalence in the United States Remains Unchanged Since 1999

AP al dia: revistas de interes – Marzo 1 al 9 de 2008 –

British Medical Journal. Vol. 336. Núm. 7643

Originales

Biddle L, Brock A, Brookes ST, Gunnell D. Suicide rates in young men in England and Wales in the 21st century: time trend study. Págs. 539-542 R TC PDF

Wheeler BM, Gunnell D, Metcalfe C, Stephens P, Martin RM. The population impact on incidence of suicide and non-fatal self harm of regulatory action against the use of selective serotonin reuptake inhibitors in under 18s in the United Kingdom: ecological study. Págs. 542-545 R TC PDF

Editoriales

Simon G. Antidepressants and suicide. Págs. 515-516 TC (s) PDF (s)

Turner EH, Rosenthal R. Efficacy of antidepressants. Págs. 516-517 TC (s) PDF (s)

Verbeek J, van Dijk F. Assessing the ability to work. Págs. 519-520 TC (s) PDF (s)

Revisiones

Ramaraj R, Sorrell VL. Degenerative aortic stenosis. Págs. 550-555 TC (s) PDF (s)

Comentario

Lenzer J, Brownlee S. Antidepressants: An untold story?. Págs. 532-534 TC (s) PDF (s)

Talley NJ. Controversies in NICE guidance on irritable bowel syndrome. Págs. 558-559 TC (s) PDF (s)

Análisis

Gillam S. Is the declaration of Alma Ata still relevant to primary health care?. Págs. 536-538 TC (s) PDF (s)

Guías de práctica clínica

Dalrymple J, Bullock I. Guidelines: Diagnosis and management of irritable bowel syndrome in adults in primary care: summary of NICE guidance. Págs. 556-558 TC (s) PDF (s)

New England Journal of Medicine. Vol. 358. Núm. 10

Originales

Schwarz UI, Ritchie MD, Bradford Y, Li C, Dudek SM, Frye-Anderson A et al. Genetic Determinants of Response to Warfarin during Initial Anticoagulation. Págs. 999-1008 R TC (s) PDF (s)

Revisiones

Tapson VF. Medical Progress: Acute Pulmonary Embolism. Págs. 1037-1052 TC (s) PDF (s)

Práctica clínica

Rogers RG. Urinary Stress Incontinence in Women. Págs. 1029-1036 TC (s) PDF (s)

JAMA. The Journal of the American Medical Association. Vol. 299. Núm. 9

Originales

Soetikno RM, Kaltenbach T, Rouse RV, Park W, Maheshwari A, Sato T et al. Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults. Págs. 1027-1035 R TC (s) PDF (s)

Heiss G, Wallace R, Anderson GL, Aragaki A, Beresford SAA, Brzyski R et al. Health Risks and Benefits 3 Years After Stopping Randomized Treatment With Estrogen and Progestin. Págs. 1036-1045 R TC (s) PDF (s)

Lieberman D. Nonpolypoid Colorectal Neoplasia in the United States: The Parachute Is Open. Págs. 1068-1069 TC (s) PDF (s)

Páginas para los pacientes

Torpy JM, Kincaid JL, Glass RM. Peripheral Neuropathy. Págs. 1096 TC PDF

Annals of Internal Medicine. Vol. 148. Núm. 5

Originales

Dosanjh DPS, Hinks TSC, Innes JA, Deeks JJ, Pasvol G. Improved Diagnostic Evaluation of Suspected Tuberculosis. Págs. 325-336 R TC PDF

Tice JA, Cummings SR, Smith-Bindman R, Ichikawa L, Barlow WE, Kerlikowske K. Using Clinical Factors and Mammographic Breast Density to Estimate Breast Cancer Risk: Development and Validation of a New Predictive Model. Págs. 337-347 R TC (s) PDF (s)

Editoriales

Menzies D. Using Tests for Latent Tuberculous Infection to Diagnose Active Tuberculosis: Can We Eat Our Cake and Have It Too?. Págs. 398-399 TC (s) PDF (s)

Bakris GL, Berkwits M. Trials That Matter: The Effect of a Fixed-Dose Combination of an Angiotensin-Converting Enzyme Inhibitor and a Diuretic on the Complications of Type 2 Diabetes. Págs. 400-401 TC (s) PDF (s)

Revisiones

Marchionni L, Wilson RF, Wolff AC, Marinopoulos S, Parmigiani G, Bass EB, Goodman SN. Systematic Review: Gene Expression Profiling Assays in Early-Stage Breast Cancer. Págs. 358-369 R TC PDF

Raina P, Santaguida P, Ismaila A, Patterson C, Cowan D, Levine M et al. Effectiveness of Cholinesterase Inhibitors and Memantine for Treating Dementia: Evidence Review for a Clinical Practice Guideline. Págs. 379-397 R TC PDF

Guías de práctica clínica

Qaseem A, Snow V, Cross JT Jr, Forciea MA, Hopkins R Jr. Shekelle P et al for the the Joint American College of Physicians/American Academy of Family Physicians Panel on Dementia. Current Pharmacologic Treatment of Dementia: A Clinical Practice Guideline from the American College of Physicians and the American Academy of Family Physicians. Págs. 370-378 R TC PDF

Gut. Vol. 57. Núm. 3

Revisiones

El-Serag H. Role of obesity in GORD-related disorders. Págs. 281-284 R TC (s) PDF (s)

Circulation. Vol. 117. Núm. 9

Originales

Cesaroni G, Forastiere F, Agabiti N, Valente P, Zuccaro P, Perucci CA. Effect of the Italian Smoking Ban on Population Rates of Acute Coronary Events. Págs. 1183-1188 R TC PDF

Revisiones

McGill HC Jr, McMahan CA, Gidding SS. Preventing Heart Disease in the 21st Century: Implications of the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Study. Págs. 1216-1227 TC (s) PDF (s)

Rhodes JF, Hijazi ZM, Sommer RJ. Pathophysiology of Congenital Heart Disease in the Adult, Part II: Simple Obstructive Lesions. Págs. 1228-1237 TC (s) PDF (s)

American Journal of Public Health. Vol. 98. Núm. 3

Originales

Augustson EM, Wanke KL, Rogers S, Bergen AW, Chatterjee N, Synder K et al. Predictors of Sustained Smoking Cessation: A Prospective Analysis of Chronic Smokers From the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study. Págs. 549-555 R TC (s) PDF (s)

Diabetes care. Vol. 31. Núm. 3

Originales

Schwartz AV, Vittinghoff E, Sellmeyer DE, Feingold KR, de Rekeneire N, Strotmeyer ES et al. Diabetes-Related Complications, Glycemic Control, and Falls in Older Adults. Págs. 391-396 R TC (s) PDF (s)

Ziegler D, Rathmann W, Dickhaus T, Meisinger C, Mielck A for the KORA Study Group. Prevalence of Polyneuropathy in Pre-Diabetes and Diabetes Is Associated With Abdominal Obesity and Macroangiopathy: The MONICA/KORA Augsburg Surveys S2 and S3. Págs. 464-469 R TC (s) PDF (s)

Ziegler D, Zentai CP, Perz S, Rathmann W, Haastert B, Döring A, Meisinger C fo the KORA Study Group. Prediction of Mortality Using Measures of Cardiac Autonomic Dysfunction in the Diabetic and Nondiabetic Population: The MONICA/KORA Augsburg Cohort Study. Págs. 556-561 R TC (s) PDF (s)

Editoriales

Knip M. Should We Screen for Risk of Type 1 Diabetes?. Págs. 622-623 TC (s) PDF (s)

American Family Physician. Vol. 77. Núm. 5

Revisiones

Ely JW, Hansen MR, Clark EC. Diagnosis of Ear Pain. Págs. 621-628 TC PDF

Frank JE, Mistretta P, Will J. Diagnosis and Treatment of Female Sexual Dysfunction. Págs. 635-642 TC PDF

Selius BA, Subedi R. Urinary Retention in Adults: Diagnosis and Initial Management. Págs. 643-650 TC PDF

Kenney C, Kuo SH, Jiménez-Shahed J. Tourette´s Syndrome. Págs. 651-660 TC PDF

Páginas para los pacientes

Tourette´s Syndrome: What It Is and How It´s Treated. Págs. 659-660 TC

Thorax. Vol. 63. Núm. 3

Originales

Albers M, Schermer T, Heijdra Y, Molema J, Akkermans R, van Weel C. Predictive value of lung function below the normal range and respiratory symptoms for progression of chronic obstructive pulmonary disease. Págs. 201-207 R TC (s) PDF (s)

Revisiones

Chang AB, Bilton D. Exacerbations in cystic fibrosis: 4 · Non-cystic fibrosis bronchiectasis. Págs. 269-276 R TC (s) PDF (s)

Guías de práctica clínica

Fishwick D, Barber CM, Bradshaw LM, Harris-Roberts J, Francis M, Naylor S, Ayres J and the British Thoracic Society Standards of Care Subcommittee Guidelines on Occupational Asthma. Standards of care for occupational asthma. Págs. 240-250 TC PDF