DIRECTORIO DE DOCUMENTOS EDITADOS EN SEPTIEMBRE 2010 [*]
CIENCIAS MÉDICAS NEWS
CIENCIAS MÉDICAS APLICADAS
RESEARCH & CLINICAL DEVELOPMENT
► http://elbiruniblogspotcom.blogspot.com CIENCIAS MÉDICAS NEWS
► http://saludequitativa.blogspot.com GESTIÓN EN SALUD PÚBLICA
► http://herenciageneticayenfermedad.blogspot.com
Consultas acumuladas desde enero 2009 a la fecha: 239.054
Consultas totales conjuntas (todos los blogs): 955.000
Discriminadas como sigue:
1. ARGENTINA: 37.290 [15,6%]
2. ESPAÑA: 35.530 [14,9%]
3. MÉXICO: 32.769 [13,7%]
4. U.S.A.: 26.706 [11,2%]
5. COLOMBIA: 14.349 [ 6.0%]
6. PERÚ: 13.622 [ 5,7%]
7. VENEZUELA: 12.932 [ 5,4%]
8. CHILE: 8.508 [ 3,6%]
9. ECUADOR: 5.795 [ 2,4%]
10. BOLIVIA: 4.271 [ 1,8%]
11. LOS DEMÁS:47.282 [19.8%]
Total de consultas: 239.054
Documentos del mes de SEPTIEMBRE: 560
Documentos acumulados en 2010: 4.464
Documentos editados desde el inicio del blog: 8.970
Archivo del blog [*]
▼ 2010 (4464)
▼ septiembre (560)
Research Available for Comment | AHRQ Effective He...
Sickle Cell Anemia, What Is - guidelines for consu...
Travel to Saudi Arabia during the 2010 Hajj: Infor...
Bloodstream Infections Among HIV-Infected Outpatie...
Pulmonary Nontuberculous Mycobacterial Disease: Ch...
CDC - Highlights from state and local programs - T...
CDC - New CDC Publications - TB Notes 3, 2010 - TB...
NINDS awards new Udall Centers for Parkinson's Dis...
NIH awards Muscular Dystrophy Cooperative Research...
NIH Clinical Center offers sabbatical in clinical ...
NHLBI renews programs for nanotechnology research,...
Guidance Documents (Medical Devices and Radiation-...
Cost-Effectiveness of Using High-Sensitivity C-Rea...
Breast Cancer Incidence and Hormone Replacement Th...
Key Role of Phosphoinositide 3-Kinase Class IB in ...
Comparative Effectiveness Review Methods: Clinical...
Celiac Disease Seems to Be on the Rise, Mainly in ...
In Test of Stents, Old Standby Wins Out: MedlinePl...
September 2010 DMID Council-Approved Concepts -- N...
September 2010 DAIT Council-Approved Concepts -- N...
September 2010 DAIDS Council-Approved Concepts -- ...
News & Events > Safe Use Initiative; Public Worksh...
Development Resources > Medical, Statistical, and ...
Safety Reporting Requirements for INDs (Investigat...
FDA issues final rule on safety information during...
Drug Safety Podcasts > FDA Drug Safety Podcast: FD...
NIAID Media Availability: NIH Scientists Find More...
Research Activities, October 2010: Outcomes/Effect...
Research Activities, October 2010: Outcomes/Effect...
Research Activities, October 2010: Outcomes/Effect...
Research Activities, October 2010: Outcomes/Effect...
Association of Women's Health, Obstetric and Neona...
HIV Clinical Resource : Clinical Guidelines
National Guideline Clearinghouse | Palliative care...
National Guideline Clearinghouse | Prevention of u...
National Guideline Clearinghouse | Infection contr...
National Guideline Clearinghouse | HIV drug - drug...
National Guideline Clearinghouse | Diagnosis and m...
National Guideline Clearinghouse | Adapting your p...
National Guideline Clearinghouse | Evidence-based ...
National Guideline Clearinghouse | Best evidence s...
National Guideline Clearinghouse | Best evidence s...
The Next Step Towards a Better Life | SAMHSA
Incorporating Alcohol Pharmacotherapies Into Medic...
Substance Abuse Treatment for Persons With Co-Occu...
NIH Scientists Consider Fate of Pandemic H1N1 Flu ...
NIH Scientists Freeze Virus Fragment in Shape Reco...
Investigational New Drug (IND) Application > Final...
National Guideline Clearinghouse | Guideline for t...
National Guideline Clearinghouse | ACR Appropriate...
National Guideline Clearinghouse | ACR Appropriate...
National Guideline Clearinghouse | ACR Appropriate...
Hospitalizations for Peptic Ulcer Disease | CDC EI...
NIH and FDA announce awards to advance regulatory ...
Stress Hormone Causes Epigenetic Changes
Alternate Therapy for Poorly Controlled Asthma
Telomere Length Linked to Outcomes in Aplastic Ane...
Bloodstream Infections among HIV-Infected Patients...
Type 2 Diabetes and Malarial Infection | CDC EID
Comunicado conjunto de la SEEN y la SED en relació...
PLoS Biology: Post-Stroke Inhibition of Induced NA...
Cancer Screening in a Briefcase - Advances in Medi...
More Sensitive Stroke Detection - Advances in Medi...
Visualizing Heart Attacks - Advances in Medical Im...
Improving Epilepsy Surgery - Advances in Medical I...
Bye-bye Biopsies? - Advances in Medical Imaging - ...
Breast Cancer Cases in Canada Drop With Decrease i...
Mutations in connexin genes and disease. [Eur J Cl...
Reviews: A review of hereditary and acquired coagu...
GAPPKB|Home
HuGENavigator|HuGE Literature Finder|Search
What I wish I'd known before surgery: BRCA carrier...
SpringerLink - Familial Cancer, Online First™
KRAS gene mutations in lung cancer: particulars es...
A locus on 19p13 modifies risk of breast cancer in...
A genome-wide association study identifies suscept...
Using genetic and clinical data to understand resp...
Recalls, Market Withdrawals, & Safety Alerts > Amg...
Comparative evaluation of radiation treatments for...
Systematic Reviews on Selected Pharmacogenetic Tes...
Health News - Researchers Engineer Adult Stem Cell...
Interviews bring genetics to life in new book
Largest genetic study of asthma points towards bet...
Study Finds Possible 'Persistence' Switch For Tube...
AGTC Receives Second Grant From Food And Drug Admi...
Tuberculosis, Discovery Of New Genes Involved In T...
Groundbreaking Discovery Shows Rapid Evolution Of ...
Fast-Track Gene-ID Method Speeds Rare Disease Sear...
Genetic education: Reflections on Berkeley's stude...
Lack of access to healthy food may contribute to h...
Health News - CUHK Discovers Genetic Markers to Pr...
Kids And Diabetes Risk: Do Chromosomes Hold New Cl...
News - Genetic Variant of Atrial Natriuretic Pepti...
Demethylation Mechanism Pinpointed In APC Gene Mut...
PHG Foundation | Preventing cancer among BRCA muta...
PHG Foundation | Comparison of twenty human genome...
PLoS Genetics: The Characterization of Twenty Sequ...
Management patterns of childhood-onset nephrotic s...
FDA approves combination contraceptive containing ...
Specialty Differences in Primary Care Physician Re...
European Medicines Agency - News and press release...
European Medicines Agency - News and press release...
Penn Medicine News: At the Crossroads of Chromosom...
Scientists show Six3 gene essential for retinal de...
Subarachnoid hemorrhage more commonly caused by en...
2 studies find new genetic links to ovarian cancer...
UNC researchers identify genetic patterns that may...
Safety Alerts for Human Medical Products > Epogen ...
Imported Lassa Fever | CDC EID
Mortality Rate Patterns for HFRS | CDC EID
Oral Fluid Testing and Rubella, England and Wales ...
Human Monkeypox Outbreak, Sudan | CDC EID
Infectious Disease Surveillance, Sri Lanka | CDC E...
PPE and Oseltamivir Use | CDC EID
Klassevirus Infection in Children | CDC EID
PARV4 Infection in Sub-Saharan Africa | CDC EID
NCCN Webinar: Treatment Strategies for Mesotheliom...
Kidney Cancer Session from the NCCN 2010 Congress ...
An Overview of Stem Cell Transplants - NCCN Educat...
An Overview of Hematologic Malignancies - NCCN Edu...
NCCN Webinar: Maintenance Therapy for Non-Small Ce...
NCTR Centers of Excellence > Bioinformatics
Recalls (Biologics) > URGENT: Voluntary Market Wit...
UE pide retirar medicamento Avandia de Glaxo, FDA ...
Recent Stress May Reduce Cancer Therapy Effectiven...
Blood Thinners: Staying Active and Healthy -YouTu...
Information by Drug Class > Opioid Drugs and Risk ...
Internet Search Limitations and Pandemic Influenza...
Underlying Medical Conditions and Hospitalization ...
Healthcare Worker Acceptance of Pandemic (H1N1) 20...
Oseltamivir-Resistant Pandemic (H1N1) 2009 | CDC E...
CCR5 Δ32 Allele and Severe Pandemic (H1N1) 2009 | ...
Pandemic and Seasonal Influenza Co-infection | CDC...
Hospitalization and Pandemic (H1N1) 2009 | CDC EID...
Pandemic (H1N1) 2009 Virus on Swine Farm, Thailand...
Pandemic (H1N1) 2009 Seroconversion, Singapore | C...
Influenza A (H5N1) Viruses from Pigs, Indonesia | ...
ArrayTrackTM > ArrayTrack™ News
Announcements: Epidemiology in Action: Intermediat...
Announcements: Epi Info Training --- December 2010...
Announcements: World Heart Day --- September 26, 2...
Update: Detection of a Verona Integron-Encoded Met...
Racial Differences by Gestational Age in Neonatal ...
deficiencias BLOGGER
Safety Alerts for Human Medical Products > Avandia...
European Medicines Agency - News and press release...
European Medicines Agency - News and press release...
European Medicines Agency - News and press release...
European Medicines Agency - News and press release...
La EMEA suspende 'Avandia', de GSK - DiarioMedico....
Prevalence of Selected Risk Behaviors and Chronic ...
Postmarket Drug Safety Information for Patients an...
Development Resources List of Determinations Incl...
Development Resources Medical, Statistical, and C...
CONGRESO NACIONAL DE MEDICINA
Study IDs Risk Factors for Blood Clots After Hip S...
Atypical Antipsychotics Linked to Blood Clot Risk ...
Injections May Relieve Drooling in Nerve-Damaged K...
Pelvic Inflammatory Disease << Frequently Asked Qu...
P. vivax Malaria, Brazilian Amazon | CDC EID
Artesunate Misuse and P. falciparum Malaria | CDC ...
Type 2 Diabetes and Malarial Infection | CDC EID
Toxoplasma gondii Oocyst–specific Antibodies and S...
Superbug: The Fatal Menace of MRSA | CDC EID
Living Weapons: Biological Weapons and Internation...
Clostridium difficile Infections among Hospitalize...
Body Lice, Yersinia pestis Orientalis, and Black D...
Scrub Typhus Involving Central Nervous System, Ind...
New Rural Focus of Plague, Algeria | CDC EID
Human MRSA CC398, Finland, Table 1 | CDC EID
Erythema Migrans–like Illness in the Caribbean | C...
Changing Epidemiology of NTM Infections | CDC EID
Bloodstream Infections among HIV-Infected Patients...
Monitoring for Slow Response to TB Treatment | CDC...
Vol. 16, No. 10 Cover: And the Raven, Never Flitti...
Científicos españoles e internacionales se reúnen ...
Lot Release (Biologics) > Influenza Virus Vaccine ...
Approved Products > Rotarix
Approved Products > Information on Rotarix - Label...
FDA approves first oral drug to reduce MS relapses...
Plavix, Heartburn Drug Safe to Take Together: Stud...
Disc Battery Ingestion May Cause Severe Injuries i...
NIH releases Biennial Report of the Director, Sept...
NIH's National Children’s Study begins recruiting ...
NIH study models H1N1 flu spread, September 21, 20...
Evidence-based patient safety advisory :: American...
NIH celebrates ten years of research into health d...
Influenza vaccination, pneumococcal vaccination an...
Update: Detection of a Verona Integron-Encoded Met...
Depression high among youth victims of school cybe...
H1N1 today - NIH study models H1N1 flu spread
Metabolic Syndrome Doubles Heart Risk, Analysis Sh...
Increase in Seizures Seen in Kids With H1N1 Flu - ...
Drug Safety Podcasts FDA Drug Safety Podcast for ...
Screening for Testicular Cancer
Management of aneurysmal subarachnoid hemorrhage -...
Diagnosis and treatment of heel pain: a clinical p...
growth hormone use in growth hormone-deficient adu...
Alentar a la investigación local - Hospital Univer...
Possible alternate therapy for adults with poorly ...
Charting Brain Maturity
Blood Pressure and Kidney Disease in African-Ameri...
Ovarian Cancer: New Gene Tied to Deadly Ovarian Ca...
FDA Advisers Weigh Approval of Genetically Modifie...
IntraMed - Noticias médicas - El fallecimiento del...
Endometriosis
National Guideline Clearinghouse | Practice parame...
National Guideline Clearinghouse | Guideline Synth...
Safety Alerts for Human Medical Products > Aromata...
Doblar el período de tratamiento tras un cáncer de...
Emerging Infectious Diseases Journal Homepage | CD...
DENGUE HEMORRÁGICO, MUERTES -HONDURAS (02)
DENGUE, EPIDEMIA, CIFRAS OFICIALES CUESTIONADAS - ...
VIH/SIDA, PREVALENCIA CRECIENTE EN MAYORES DE 50 A...
Age Differences in Genetic Knowledge, Health Liter...
A Pilot Study to Evaluate Knowledge and Attitudes ...
Inherited metabolic rare disease. [Adv Exp Med Bio...
2010.09.19 -- Early Trial Suggests COPD Drug Might...
GAPPKB|Home
HuGENavigator|HuGE Literature Finder|Search
Pharmacogenetics and schizophrenia. [Clin Lab Med....
Nonresponders to clopidogrel: pharmacokinetics and...
Copy number variation in Parkinson's disease. [Gen...
Genetics of personality disorders. [Clin Lab Med. ...
Genetics of psychiatric disorders methods: molecul...
From genotype to EEG endophenotype: a route for po...
The possible contributory role of the S allele of ...
Frequency of known mutations in early-onset Parkin...
E2-2 protein and Fuchs's corneal dystrophy. [N Eng...
Defining genetic risk for graft-versus-host diseas...
Three periods of one and a half decade of ischemic...
Genome-wide association studies identify new targe...
From GWAS to the clinic: risk factors for intracra...
Applied Genetic Technologies, Corp.
Women's Health Research > OWH Presentations
ORWH 20th Anniversary Symposium
Consumer Updates > Registries Help Moms Measure Me...
Women's Health Research > List of Pregnancy Exposu...
Partnerships to Advance Patient Recruitment and Re...
The contribution of emotion and cognition to moral...
Disclosure Policies for Serious Adverse Events - N...
Genetic variation and risk of chronic lymphocytic ...
A systematic review evaluating the methodological ...
A randomized trial of genetic and environmental ri...
Joint influence of small-effect genetic variants o...
PLoS Currents: Evidence on Genomic Tests - a colle...
PLoS Currents is expanding | The Official PLoS Blo...
Family breast cancer: when to worry about genetics...
Breast cancer: Making the choice for genetic testi...
Seattle Genetics says leukemia drug fails trial | ...
deCODE Discovers Major Genetic Risk Factor for the...
Technology From Cloud Computing Greatly Increases ...
Improving Drug Therapy Using Gene Profiles
Newcastle To Coordinate An International Research ...
Scientists Zeroing In On Genes Tied To Two Immune ...
European Medicines Agency - News and press release...
European Medicines Agency - News and press release...
NCTR Publications > NCTR Research Highlights
PLoS Genetics: Allelic Variation at the 8q23.3 Col...
Drug Safety and Availability > FDA Drug Safety Com...
Seeing melanoma | Newsroom | Washington University...
PLoS Genetics: An Immune Response Network Associat...
PLoS Genetics: SNPs Associated with Cerebrospinal ...
Drug Safety and Availability > FDA Drug Safety Com...
NCD Alliance sets out plan of action for UN Summit...
Announcements: Environmental Microbiology: Control...
Anemia Drugs Could Pose Threat to Some Kidney Pati...
SpringerLink - Journal of Assisted Reproduction an...
Common genetic variation in the HLA region is asso...
Physical activity can reduce the genetic predispos...
New focus on 'sudden death' heart disorder
Enlarged hearts in women shrink faster than those ...
Cancer's 'penicillin moment'? Gene targeting drug ...
Therapeutic targets found for rare cancer in child...
Johns Hopkins scientists find genes related to bod...
NIH Blue Ribbon Panel on the National Emerging Inf...
Disruption at the PTCHD1 Locus on Xp22.11 in Autis...
Vaccines: ACIP/Meetings, Agendas, Dates, Registrat...
Peripheral arterial disease newest offering on NIH...
Personalized Epigenomic Signatures That Are Stable...
IntraMed - Artículos - ¿Como se hace? Cateterizaci...
National, State, and Local Area Vaccination Covera...
CDC Grand Rounds: Radiological and Nuclear Prepare...
Recalls, Market Withdrawals, & Safety Alerts > G.E...
Notes from the Field: Transplant-Transmitted Balam...
Balamuthia mandrillaris Transmitted Through Organ ...
New Drug-Resistant 'Superbug' Reaches U.S. Shores:...
Table of Contents — September 2010, 6 (5) — JOP
Tumor Board: Mantle Cell Lymphoma
National Practice Benchmark: 2010 Report on 2009 D...
Impact of Shifting From Office- to Hospital-Based ...
Role of Oncology Clinical Pharmacists in Light of ...
American Society of Clinical Oncology Clinical Pra...
Safety Information August 2010
Bone Morphogenetic Protein: The State of the Evide...
Genetic Tests for Non-Cancer Diseases/Conditions: ...
Creating a Framework for "Best Evidence" Approache...
ENTEROBACTERIAS, GEN NDM-1, DISEMINACIÓN - EEUU
EENFERMEDAD DE CHAGAS, DESAFIO MUNDIAL
European Medicines Agency - News and press release...
The Safety of Tiotropium — The FDA’s Conclusions |...
El Hospital Clínic de Barcelona y Grifols firman u...
NIH recognizes sickle cell disease awareness month...
$40 million awarded to trace human brain's connect...
Conference Registration | Sixth World Conference o...
Progestogens for Prevention of Preterm Birth
DENGUE, PRIMER CASO AUTÓCTONO - FRANCIA (NIZA)
Arch Neurol -- Abstract: A Serum Protein-Based Alg...
Cancer Cell - Pharmacological Inhibition of BMK1 S...
Cancer Cell - The Notch/Hes1 Pathway Sustains NF-κ...
Safety Alerts for Human Medical Products > Valcyte...
FDA issues new dosing guide for children using Val...
FDA Panel to Mull Ban on Diet Drug Meridia: Medlin...
Researchers identify potential new drug for neurod...
Open-Label Trial of Recombinant Human Insulin-like...
A Randomized Controlled Double-Masked Trial of Alb...
FDA approves new drug for gout: pegloticase
Screening Student Athletes for Sickle Cell Trait —...
YouTube - No Longer Germ Warfare
Genome.gov | 2010 News Feature: Exploring the Huma...
NHGRI funds development of third generation DNA se...
JAMA -- Adjuvant Chemotherapy With Fluorouracil Pl...
JAMA -- Abstract: Exposure to Oral Bisphosphonates...
Oral bisphosphonates and risk of cancer of oesopha...
Ghrelin secretion stimulated by β1-adrenergic rece...
Spatial correlation between brain aerobic glycolys...
National Guideline Clearinghouse | Diagnosis and i...
National Guideline Clearinghouse | Best evidence s...
National Guideline Clearinghouse | Best evidence s...
National Guideline Clearinghouse | Best evidence s...
National Guideline Clearinghouse | Care of the mov...
HIV/AIDS Update - Availability of draft guidance r...
FDA Hepatitis Update - Availability of draft Guida...
Drug Safety Podcasts > FDA Drug Safety Podcast for...
Chronic Hepatitis C Virus Infection: Developing Di...
Adverse Events Reporting System (AERS) Adverse Ev...
Las Redes de Investigación Cooperativa (RETICS) te...
Generalized anxiety disorder // Journal of Affecti...
Médicos canadienses realizan la primera anestesia ...
National Guideline Clearinghouse | Guideline Synth...
Promising Malaria Drug Candidate Emerges
New Test Detects TB in Less than 2 Hours
A Third-Generation Map of Human Genetic Variation
National Guideline Clearinghouse | Expert Commenta...
IDIOMA ESPAÑOL EN LAS CIENCIAS MÉDICAS - IntraMed ...
Interview with clinical pharmacist Dr. Julie Johns...
Findings, March 2010 - The Right Fit - National In...
innovation.org - Newsletters
Actualidad Ultimas noticias - JANOes - Red de Cons...
PLoS ONE: Homocysteine-Lowering by B Vitamins Slow...
Environmental Health Perspectives: What’s in the P...
Informa Healthcare - Annals of Human Biology - 0(0...
LQTS gene LOVD database - Zhang - 2010 - Human Mut...
The promise of genetics and autism | Psychology To...
All Genes In One Go
Low Grades In Adolescence Linked To Dopamine Genes...
BioNews - Genetic tests for autism, blindness and ...
Science Report - www.cedepap.tv // SEPTIEMBRE 2010...
IntraMed - Artículos - La resolución del caso clín...
Research Activities, September 2010: Announcements...
Research Activities, September 2010: Elderly/Long-...
Research Activities, September 2010: Elderly/Long-...
Research Activities, September 2010: Chronic Disea...
Osteoporosis: Prevention and Treatment - Universit...
The genetics of obstructive sleep apnoea. [Curr Op...
Nailing down the genetic and immunological basis f...
PLoS ONE: Extreme Evolutionary Disparities Seen in...
Advances in the Etiology of Chronic Pancreatitis
CDC - Blogs - Safe Healthcare – Preventing CLABSIs...
CDC - Blogs - Safe Healthcare – Sharing Successes ...
Genetics of asthma and allergy: What have we learn...
Unintended Transplantation of Three Organs from an...
SpringerLink - Human Genetics, Online First™
GAPPKB|Home
HuGENavigator|HuGE Literature Finder|Search
Approved Products > ProQuad
Approved Products > Twinrix
Tideglusib para la parálisis supranuclear progresi...
Association of risk-reducing surgery in BRCA1 or B...
Genetic Link for ALS Risk Confirmed - insciences
PHG Foundation | Common susceptibility variant ass...
New Treatment Activates Death Program In Cancer Ce...
Complete Genomics to Sequence and Analyze 100 Geno...
Pharmacy Choice - Pharmaceutical News - Targeted d...
European Medicines Agency - Calendar - First joint...
European Medicines Agency - Calendar - European Me...
Nuclear Phospho-Akt Increase Predicts Synergy of P...
Genome-Wide Association Studies Identify New Targe...
Integration of Early Physiological Responses Predi...
Humanidades médicas - José Lázaro y Juan C Hernánd...
MEDICAMENTOS BIOLÓGICOS . Actualidad - En portad...
Frequent Mutations of Chromatin Remodeling Gene AR...
FDA approves pediatric use of chemical poisoning t...
NIH Statement regarding Stay of Stem Cell Injuncti...
Immune System Genes Show Links to Type 1 Diabetes:...
Long-Term Use of Bone Drugs May Be Linked to Esoph...
Updated Recommendations for Prevention of Invasive...
Red de Información Científico-Técnica en Vacunas
Chromosomal Rearrangement, Gene Copy Number Method...
Gene Set Identified That Shows Which Patients Bene...
Researchers Identify Genes Tied To Deadliest Ovari...
New Treatment Activates Death Program In Cancer Ce...
The Role Of CEP290 In Maintaining Ciliary Function...
Progeria, The Rare Aging Disease, Linked To Aging ...
Use of informatics, EMRs enable genetic study of v...
Why chromosomes never tie their shoelaces
Use of World Health Organization and CDC Growth Ch...
FDA: New warnings required on use of gadolinium-ba...
Pancreatic Chemo Comparison Finds No Survival Boos...
Suicidality: Prospective Assessment of Occurrence ...
Long-term survival of the very elderly undergoing ...
Ocular Loiasis - NEJM
MDR Tuberculosis — Critical Steps for Prevention a...
Rapid Molecular Detection of Tuberculosis and Rifa...
Icatibant, a New Bradykinin-Receptor Antagonist, i...
A trans-acting locus regulates an anti-viral expre...
Improving Your Health Literacy
"Las enfermedades olvidadas también nos están afec...
Best evidence statement (BESt). Pediatric patient ...
Best evidence statement (BESt). Management of warf...
Best evidence statement (BESt). Management of ther...
Best evidence statement (BESt). Management of low ...
Best evidence statement (BESt). Formal education p...
Best evidence statement (BESt). Evidenced based be...
Best evidence statement (BESt). Audiologic managem...
Clinical efficacy of a RAF inhibitor needs broad t...
Discovery and Canine Preclinical Assessment of a N...
Decoding spoken words using local field potentials...
Rotavirus Vaccine, Live, Oral, Pentavalent - Appro...
Rotavirus Vaccine, Live, Oral // Approved Products...
Workshops, Meetings & Conferences (Biologics) Age...
HUMAN MICROBIOME - Funds awarded for disease demon...
NIH to launch Gulf oil spill health study
Patient’s Whole Genome Reveals Risk of Diseases an...
Could Genetics Improve Warfarin Dosing? - National...
NIH expands key pharmacogenomics resource
NIH study shows how insulin stimulates fat cells t...
NIH expands network focused on how genes affect dr...
Policy guidelines for collaborative TB and HIV ser...
Mild cognitive impairment more common in older men...
Mammography Quality Standards Act and Program
Long-Term Use of Bone Drugs May Be Linked to Esoph...
Phosphoinositide 3-Kinase Signaling Mediates β-Cat...
Therapeutic Liver Reconstitution With Murine Cells...
Organ Failure and Infection of Pancreatic Necrosis...
Susceptibility Genetic Variants Associated With Co...
Prevention and control of influenza with vaccines....
Recommendations for use of antiretroviral drugs in...
Summary of recommendations for clinical preventive...
Ivabradine and outcomes in chronic heart failure (...
SpringerLink - Cancer Causes and Control, Online F...
SpringerLink - Cancer Causes and Control, Online F...
SpringerLink - Cancer Causes and Control, Online F...
SpringerLink - Cancer Causes and Control, Online F...
SpringerLink - Cancer Causes and Control, Online F...
Aspirin Intake and Survival After Breast Cancer — ...
SpringerLink - Cancer Causes and Control, Volume 2...
cervical radiculopathy from degenerative disorders...
e- Boletín DROGAS Y MEDICAMENTOS - Año Nº I - Nº 8...
MALARIA , AUMENTO DE CASOS POR DEFORESTACIÓN - BRA...
SCIENCE REPORT
"Integrating Comparative Effectiveness Research in...
Cancer Control P.L.A.N.E.T. - Tobacco Control
Cancer Control P.L.A.N.E.T. - Survivorship
Cancer Control P.L.A.N.E.T. - Sun Safety
Cancer Control P.L.A.N.E.T. - Public Health Genomi...
Cancer Control P.L.A.N.E.T. - Physical Activity
Cancer Control P.L.A.N.E.T. - Informed Decision Ma...
Cancer Control P.L.A.N.E.T. - Diet
Cancer Control P.L.A.N.E.T. - Colorectal Cancer Sc...
Cancer Control P.L.A.N.E.T. - Cervical Cancer Scre...
Cancer Control P.L.A.N.E.T. - Breast Cancer Screen...
Cancer Control - P.L.A.N.E.T.
Mental disorders and/or substance abuse related to...
X Jornadas Bioinformática 2010- Málaga
DENGUE, CASOS, MUERTES: ACTUALIZACIÓN - REPÚBLICA ...
SARAMPIÓN, CASOS: ALERTA EPIDEMIOLÓGICA, OPS - REG...
CDC - Grand Rounds: Chlamydia Prevention
The Value of Genetic and Genomic Technologies - In...
GAPPKB|Home
HuGENavigator|HuGE Literature Finder|Search
Could the inter-individual variability in cocaine-...
Access : Genome-wide association study of migraine...
JAMA -- Genome-wide Association Study of Genetic L...
Chromosome 9p21 in sporadic amyotrophic lateral sc...
Chromosome 9p21 in amyotrophic lateral sclerosis i...
SpringerLink - Journal of Genetic Counseling, Onli...
Proteomic investigation of epigenetics in neuropsy...
Lung Cancer Genomic Signatures. [J Thorac Oncol. 2...
Influence of XRCC1 Genetic Polymorphisms on Ionizi...
PTPN22 gene polymorphisms in autoimmune diseases w...
Cell - GPR120 Is an Omega-3 Fatty Acid Receptor Me...
Aumenta viruela de los monos cuando la viruela est...
Diet Pill Meridia Ups Heart Attack Risk: Study: Me...
Microsoft Excel-based Algorithm Predicts Cancer Pr...
Anti-Cancer Gene To Be Activated By Researchers
Genetic Variations Associated With Development Of ...
Cause Of Lou Gehrig's Disease, Amyotrophic Lateral...
Genetic Link To Migraine Found, In DNA Variant On ...
Rare Gene For Mabry Syndrome Found With Faster Sim...
New Parkinson's Gene Is Linked To Immune System
Analysis Of Ashkenazi Jewish Genomes Reveals Diver...
The First Atomic View Of A Key Genetic Processes
Yale team finds a genetic rarity: A mutation that ...
New genomic marker for tuberculosis may help ident...
Guidance Documents (Medical Devices and Radiation-...
Toscana Virus Infection in American Traveler Retur...
Family Outbreak of Shiga Toxin–producing E. coli O...
Recurrent Granulibacter bethesdensis Infections | ...
MDR TB, California, USA, 2004–2007 | CDC EID
Tuberculosis in Rural Vietnam | CDC EID
XDR TB, Pakistan | CDC EID
Acute Cervical Lymphadenitis Caused by Mycobacteri...
Access : Gamma-secretase activating protein is a t...
Aprueban el uso de velaglucerasa alfa para la Enfe...
Announcements: Preventive Medicine Residency and F...
Announcements: Clinical Vaccinology Course --- Nov...
Use of a Self-Assessment Questionnaire for Food Sa...
CDC - Outbreak of Enteritidis Infections - August ...
NIH-sponsored research yields promising malaria dr...
Lower blood pressure goal benefits African-America...
New TB Diagnostic Proves Effective, Expedient, Stu...
Curriculum on Helping Children Cope with a Traumat...
Drug-Related Suicide Attempts: Teens and Young Adu...
estudio TEAMSTA :: EL MÉDICO INTERACTIVO :: ESPAÑA...
Search for Guides, Reviews, and Reports - AHRQ Eff...
Multiple-Serotype Salmonella Gastroenteritis Outbr...
Updated Recommendations for Prevention of Invasive...
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Research Available for Comment | AHRQ Effective Health Care Program
Research Available for Comment
The Effective Health Care Program encourages the public to participate in the development of its research projects. Comments can be submitted for:
* Research key questions
* Draft reports of research findings
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When key questions, draft reports, and white papers of research projects are available for comment, they are posted on this Web page.
For timeliness, comments must be submitted during the 4-week period that the key questions, draft reports and white papers are posted on this Web page.
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Research Available for Comment | AHRQ Effective Health Care Program
The Key Questions available for comment are:
► * Comparative Effectiveness of Screening for MRSA Carriage
Sept. 7–Oct. 5, 2010
Research Available for Comment | AHRQ Effective Health Care Program
The Key Questions available for comment are:
Proposed Research Title for the Topic:
Comparative Effectiveness of Screening for MRSA Carriage
Open for comment until Oct. 5, 2010.
Search for Guides, Reviews, and Reports | AHRQ Effective Health Care Program
Supporting material:
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Research Available for Comment | AHRQ Effective Health Care Program
► * Comparative Effectiveness of Case Management for Adults with Medical Illness and Complex Care Needs
Sept. 13–Oct. 11, 2010
Research Available for Comment | AHRQ Effective Health Care Program
The Key Questions available for comment are:
Proposed Research Title for the Topic:
Comparative Effectiveness of Case Management for Adults with Medical Illness and Complex Care Needs
Open for comment until Oct. 11, 2010.
Search for Guides, Reviews, and Reports | AHRQ Effective Health Care Program
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Research Available for Comment | AHRQ Effective Health Care Program
.....................
The Draft Reports and White Papers available for comment are:
► * Progestogens for the Prevention of Preterm Birth
Sept. 15–Oct. 13, 2010
Comment on Draft Reports and White Papers | AHRQ Effective Health Care Program
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► * Future Research Needs: Integration of Mental Health/Substance Abuse and Primary Care
Sept. 27–Oct. 25, 2010
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► * Future Research Needs: Comparative Effectiveness of Percutaneous Coronary Interventions and Coronary Artery Bypass
Grafting for Patients with Coronary Artery Disease
Sept. 24–Oct. 22, 2010
Comment on Draft Reports and White Papers | AHRQ Effective Health Care Program
Supporting documents:
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http://www.effectivehealthcare.ahrq.gov/ehc/products/232/535/FutureR%20Needs1PCIvsCABGFINAL.pdf
► * Future Research Needs: Reducing the Risk of Primary Breast Cancer
Sept. 27–Oct. 25, 2010
Comment on Draft Reports and White Papers | AHRQ Effective Health Care Program
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► * Future Research Needs: Clinically Localized Prostate Cancer
Sept. 27–Oct. 25, 2010
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► * Future Research Needs: Treatments of Common Hip Fractures
Sept. 27–Oct. 25, 2010
Comment on Draft Reports and White Papers | AHRQ Effective Health Care Program
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http://www.effectivehealthcare.ahrq.gov/ehc/products/235/538/Future02--HipFractures-09-23-2010.pdf
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Research Available for Comment | AHRQ Effective Health Care Program
Sickle Cell Anemia, What Is - guidelines for consumers (briefs)
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What Is Sickle Cell Anemia?
Sickle cell anemia (uh-NEE-me-uh) is a serious disease in which the body makes sickle-shaped red blood cells. “Sickle-shaped” means that the red blood cells are shaped like a "C."
Normal red blood cells are disc-shaped and look like doughnuts without holes in the center. They move easily through your blood vessels. Red blood cells contain the protein hemoglobin (HEE-muh-glow-bin). This iron-rich protein gives blood its red color and carries oxygen from the lungs to the rest of the body.
Sickle cells contain abnormal hemoglobin that causes the cells to have a sickle shape. Sickle-shaped cells don’t move easily through your blood vessels. They’re stiff and sticky and tend to form clumps and get stuck in the blood vessels. (Other cells also may play a role in this clumping process.)
The clumps of sickle cells block blood flow in the blood vessels that lead to the limbs and organs. Blocked blood vessels can cause pain, serious infections, and organ damage.
open here to see the full-text:
Sickle Cell Anemia, What Is
What Is Sickle Cell Anemia?
Sickle cell anemia (uh-NEE-me-uh) is a serious disease in which the body makes sickle-shaped red blood cells. “Sickle-shaped” means that the red blood cells are shaped like a "C."
Normal red blood cells are disc-shaped and look like doughnuts without holes in the center. They move easily through your blood vessels. Red blood cells contain the protein hemoglobin (HEE-muh-glow-bin). This iron-rich protein gives blood its red color and carries oxygen from the lungs to the rest of the body.
Sickle cells contain abnormal hemoglobin that causes the cells to have a sickle shape. Sickle-shaped cells don’t move easily through your blood vessels. They’re stiff and sticky and tend to form clumps and get stuck in the blood vessels. (Other cells also may play a role in this clumping process.)
The clumps of sickle cells block blood flow in the blood vessels that lead to the limbs and organs. Blocked blood vessels can cause pain, serious infections, and organ damage.
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Sickle Cell Anemia, What Is
Travel to Saudi Arabia during the 2010 Hajj: Information for U.S. Travelers | CDC Travelers' Health
In the News
Health Requirements and Recommendations for Travel to Saudi Arabia during the 2010 Hajj: Information for U.S. Travelers
This information is current as of today, September 30, 2010 at 09:39 EDT
Released: September 27, 2010
Each year, millions of people travel to the Kingdom of Saudi Arabia to perform the Hajj, a pilgrimage to the holy places of Islam. This year, the week of the Hajj begins November 14.
If you are traveling to Saudi Arabia for the Hajj, you can expect large crowds. This overcrowding may lead to an increased risk of accidental injury and infectious diseases, such as meningitis, flu, and other diseases spread easily from person to person.
To help protect the health and safety of pilgrims, the government of Saudi Arabia recommends that pilgrims should be 12-65 years old and in good health. The Saudi Arabia Ministry of Health recommends that people with chronic diseases, such as heart, liver, or kidney diseases, complications of diabetes, obesity, or any other condition that affects a person’s overall health, do not travel to the Hajj
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Travel to Saudi Arabia during the 2010 Hajj: Information for U.S. Travelers | CDC Travelers' Health
Bloodstream Infections Among HIV-Infected Outpatients, Southeast Asia: Abstract and Introduction
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From Emerging Infectious Diseases
Bloodstream Infections Among HIV-Infected Outpatients, Southeast Asia CME
Jay K. Varma, MD; Kimberly D. McCarthy, MS; Theerawit Tasaneeyapan, MSc; Patama Monkongdee, MSc; Michael Kimerling, MD, MPH; Eng Buntheoun, MD; Delphine Sculier, MD, MSc; Chantary Keo; Praphan Phanuphak, MD, PhD; Nipat Teeratakulpisarn, MD; Nibondh Udomsantisuk, MD; Nguyen H. Dung, MD, MS; Nguyen T.N. Lan, MD, PhD; Nguyen T.B. Yen, MD; Kevin P. Cain, MD
Authors and Disclosures
CME Released: 09/20/2010; Valid for credit through 09/20/2011
Abstract and Introduction
Abstract
Bloodstream infections (BSIs) are a major cause of illness in HIV-infected persons. To evaluate prevalence of and risk factors for BSIs in 2,009 HIV-infected outpatients in Cambodia, Thailand, and Vietnam, we performed a single Myco/F Lytic blood culture. Fifty-eight (2.9%) had a clinically significant BSI (i.e., a blood culture positive for an organism known to be a pathogen). Mycobacterium tuberculosis accounted for 31 (54%) of all BSIs, followed by fungi (13 [22%]) and bacteria (9 [16%]). Of patients for whom data were recorded about antiretroviral therapy, 0 of 119 who had received antiretroviral therapy for ≥14 days had a BSI, compared with 3% of 1,801 patients who had not. In multivariate analysis, factors consistently associated with BSI were fever, low CD4+ T-lymphocyte count, abnormalities on chest radiograph, and signs or symptoms of abdominal illness. For HIV-infected outpatients with these risk factors, clinicians should place their highest priority on diagnosing tuberculosis.
Introduction
Bloodstream infections (BSIs) are a major cause of illness in HIV-infected persons. A series of studies, most of which were conducted in sub-Saharan Africa during the 1990s, demonstrated a high prevalence of BSIs (ranging from 10% to 63%) among hospitalized HIV-infected persons who had fever.[1-17] In studies that measured clinical outcomes, the in-hospital death rate for patients with a BSI was high (19%-47%). A variety of pathogens cause BSIs in febrile, hospitalized persons with HIV, most notably non-Typhi Salmonella spp. (6%—15%) and Mycobacterium tuberculosis (2%—19%). BSI with M. tuberculosis appears to be particularly lethal, causing death during hospitalization in up to 47% of patients.[9] Although untreated BSIs are believed to lead rapidly to severe illness, sepsis, and death, patients with BSIs may be able to be identified before they are ill enough to require hospitalization, potentially improving clinical outcomes. Despite the large number of studies that have evaluated BSIs in HIV-infected persons, all previous studies have focused on patients seeking care at hospitals because of fever and did not evaluate infections among outpatients with or without fever.
Although overall transmission rates have declined and antiretroviral therapy (ART) has become more widely available, HIV infection remains a major public health problem in Southeast Asia.[18] Previous studies of BSI in Southeast Asia enrolled only inpatients, and only 1 evaluated a predominantly HIV-infected population.[1,19-21] In this study, we prospectively enrolled patients from multiple HIV testing and treatment clinics in Cambodia, Thailand, and Vietnam to assess BSI prevalence, etiology, and risk factors in outpatients with HIV.
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Bloodstream Infections Among HIV-Infected Outpatients, Southeast Asia: Abstract and Introduction
Disclaimer
The material presented here does not necessarily reflect the views of Medscape, LLC or companies that support educational programming on www.medscapecme.com. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.
Emerging Infectious Diseases CME. 2010;16(10):1569-1575. © 2010 Centers for Disease Control and Prevention (CDC)
Earn Continuing Education Credit from CDC’s Emerging Infectious Diseases® (EID)
Emerging Infectious Diseases® (EID) Journal Articles
CDC’s Emerging Infectious Diseases® journal provides an exceptional opportunity to earn continuing education (CE) with its October articles titled “Changing Epidemiology of Pulmonary Nontuberculous Mycobacterial Disease” and “Bloodstream Infections among Outpatients with HIV, Southeast Asia.” Physicians, physicians’ assistants, nurses, and healthcare professionals can receive CE credit by simply reading this article and answering a series of related, multiple-choice questions that follow. To complete the questions and earn continuing medical education (Medscape CME) credit, please visit www.medscapecme.com/journal/eid.
Pulmonary Nontuberculous Mycobacterial Disease: Changing Epidemiology : Abstract and Introduction
http://cme.medscape.com/
Changing Epidemiology of Pulmonary Nontuberculous Mycobacteria Infections CME
Rachel M. Thomson, MD
Authors and Disclosures
CME Released: 09/21/2010; Valid for credit through 09/21/2011
Abstract
Nontuberculous mycobacteria (NTM) disease is a notifiable condition in Queensland, Australia. Mycobacterial isolates that require species identification are forwarded to the Queensland Mycobacterial Reference Laboratory, providing a central opportunity to capture statewide data on the epidemiology of NTM disease. We compared isolates obtained in 1999 and 2005 and used data from the Queensland notification scheme to report the clinical relevance of these isolates. The incidence of notified cases of clinically significant pulmonary disease rose from 2.2 (1999) to 3.2 (2005) per 100,000 population. The pattern of disease has changed from predominantly cavitary disease in middle-aged men who smoke to fibronodular disease in elderly women. Mycobacterium intracellulare is the main pathogen associated with the increase in isolates speciated in Queensland.
Introduction
Worldwide, pulmonary disease caused by nontuberculous mycobacteria (NTM) appears to be increasing,[1–4] yet accurate data to support this assumption are difficult to produce. Patients traditionally described are middle-aged men with underlying chronic lung disease, such as chronic obstructive pulmonary disease, who have upper lobe cavity formation and nodules of various sizes. An increasing number of patients have nodules, bronchiolitis, and bronchiectasis involving the middle lobe and lingula. These patients are more commonly female nonsmokers and have no preexisting lung disease.[5,6]
NTM disease is not a reportable condition in most countries because no evidence of human-to-human transmission exists; therefore, it is not considered a public health concern. However, the organisms are ubiquitous in the environment, and substantial evidence shows that the environmental niche for Mycobacterium intracellulare (the most common pulmonary pathogen) is in biofilms lining suburban water pipes. Many NTM pathogens have been isolated from drinking water.[7] Some clinicians believe the condition should be classified as an environmental health concern, similar to that caused by Legionella spp.
Globally, geographic variability in environmental exposure and prevalence of NTM disease is significant.[8] Without detailed clinical information, differentiating between contamination of specimens, colonization/infection, and disease is difficult; laboratory reports of isolates do not always reflect the true incidence of disease. To determine if disease is present, sputum specimens and often a bronchoscopic sample of a patient’s lower respiratory tract must be collected. In addition, computed tomography scanning and clinical appointments with primary care providers and specialists are needed. Because this investigative process is costly to the healthcare system and the patient, accurate epidemiologic data on this condition should be of interest to public health experts.
Studies of avian versus human Mantoux testing in schoolchildren have shown that exposure to NTM organisms is common in Queensland.[9–11] Therefore, since the introduction of TB control services, disease caused by NTM in Queensland has been notifiable. This practice has been continued primarily to avoid confounding of smear-positive cases with TB. The notification process provides a unique opportunity to study the clinical significance of isolates positive for NTM and the features such as age and sex, symptoms, underlying conditions, and radiology results of patients with disease, avoiding the inherent bias that occurs in case series that are reported by tertiary and quaternary referral centers. The incidence of clinically reported cases of pulmonary disease caused by M. avium complex (MAC) in Queensland has been increasing (1985, 0.63/100,000 population; 1994, 1.21/100,000; and 1999, 2.2/100,000). In 2005, the Queensland Tuberculosis Control Centre (QTBCC) revised the notification process to ensure collection of meaningful clinical data and follow-up of clinically significant NTM cases.
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Pulmonary Nontuberculous Mycobacterial Disease: Changing Epidemiology : Abstract and Introduction
CDC - Highlights from state and local programs - TB Notes 3, 2010 - TB
TB Notes Newsletter
(PDF - 1.6M)
http://www.cdc.gov/tb/publications/newsletters/notes/TBN_3_10/images/tbn310.pdf
No. 3, 2010
HIGHLIGHTS FROM STATE AND LOCAL PROGRAMS
Background. The Public Health Prevention Service (PHPS) is a 3-year training program that assigns prevention specialists to public health organizations in order to prepare them for leadership positions in health programs. The program provides invaluable learning experiences for the prevention specialists, as well as important assistance for public health programs willing to invest in mentoring. The qualifications for the PHPS include a master’s degree in public health or in a management-related field, strong interest in a leadership and management career in public health, 1 year of public health work experience, and 1 year of on-the-job training at CDC.
The North Carolina TB Control Program (TCP) received a Request for Applications (RFA) e-mail from CDC in November 2008, and despite the lengthy process such applications entail, the program decided it was well worth the effort. The TCP had a critical need for program evaluation assistance and an interest in providing a meaningful experience for the right individual.
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CDC - Highlights from state and local programs - TB Notes 3, 2010 - TB
CDC - New CDC Publications - TB Notes 3, 2010 - TB
TB Notes Newsletter
(PDF - 1.6M)
download, 40 pages:
http://www.cdc.gov/tb/publications/newsletters/notes/TBN_3_10/images/tbn310.pdf
No. 3, 2010
New CDC Publications
contents:
Anger HA, Dworkin F, Sharma S, Munsiff SS, Nilsen DM, Ahuja SD. Linezolid use for treatment of multidrug-resistant and extensively drug-resistant tuberculosis, New York City, 2000-06. J Antimicrobial Chemotherapy 2010 April; 65(4): 775-783.
Anuwatnonthakate A, Jittimanee SX, Cain J, Nateniyom S, Wattanaamornkiat W, Komsakorn S, Moolphate S, Banyati P, Chiengsorn N, Limsomboon P, Kaewsa-Ard S, Varma JK. Barriers to human immunodeficiency virus testing of tuberculosis patients in Thailand, 2004-2007. Int J Tuberc Lung Dis 2010 Aug;14(8):980-5.
Blaya JA, Shin SS, Yale G, Suarez C, Asencios L, Contreras C, Rodriguez P, Kim J, Cegielski P, Fraser HSF. Electronic laboratory system reduces errors in National Tuberculosis Program: a cluster randomized controlled trial. Int J Tuberc Lung Dis 2010 Aug; 14 (8): 1009-1015.
Buff AM, Moonan PK, Desai MA, McKenna TL, Harris DA, Rogers BJ, Rabley SS, Oeltmann JE. South Carolina tuberculosis genotype cluster investigation: a tale of substance abuse and recurrent disease. [Notes from the field.] Int J Tuberc Lung Dis 2010 Oct; 14(10): 1347-1349.
Chauhan LS, Wares F, Sahu S, Dewan P, Chadha S, Thirumala A, Ramachandran R. Drug resistance in Kerala. [Correspondence.] Int J Tuberc Lung Dis 2010 May; 14(5): 660-661.
Goldberg S, LoBue P. Pulmonary tuberculosis: focus on the fluoroquinolones. Clinical Medicine Insights: Therapeutics 2010;2: 341–352.
Kane S, Dewan PK, Gupta D, Wi T, Das A, Singh A, Bitra G, Chauhan LS, Dallabetta G. Large-scale public-private partnership for improving TB-HIV services for high-risk groups in India. [Notes from the Field.] Int J Tuberc Lung Dis 2010 Aug; 14(8):1066–1068.
Kornylo-Duong K, Kim C, Cramer EH, Buff AM, Rodriguez-Howell D, Doyle J, Higashi J, Fruthaler CS, Robertson CL, Marienau KJ. Three air travel-related contact investigations associated with infectious tuberculosis, 2007–2008. Travel Medicine and Infectious Disease 2010 March; 8(2): 120-128.
Leinhardt C, Vernon A, Raviglione Mario C. New drugs and new regimens for the treatment of tuberculosis: review of the drug development pipeline and implications for national programmes. Current Opinion in Pulmonary Medicine 2010 May; 16(3): 186-193.
LoBue PA, Enarson DA, Thoen CO. Tuberculosis in humans and animals: an overview. [Serialised article. Tuberculosis: a re-emerging disease in animals and humans. Number 1 in the series]. Int J Tuberc Lung Dis 2010 Sept; 14(9): 1075-1078.
LoBue PA, Enarson DA, Thoen TC. Tuberculosis in humans and its epidemiology, diagnosis and treatment in the United States. [Serialised article. Tuberculosis: a re-emerging disease in animals and humans. Number 2 in the series]. Int J Tuberc Lung Dis 2010 Oct; 14(10): 1226-1232.
LoBue P, Menzies D. Treatment of latent tuberculosis infection: an update. Respirology 2010 May; 15(4): 603-622.
Lönnroth K, Castro KG, Chakaya JM, Chauhan LS, Floyd K, Glaziou P, Raviglione MC. Tuberculosis control and elimination 2010-50: cure, care, and social development. Lancet 2010 May 18. [Epub ahead of print.]
Lönnroth K, Williams BG, Cegielski P, Dye C. A consistent log-linear relationship between tuberculosis incidence and body mass index. Int J Epidemiology 2010 Feb; 39(1): 149-155.
Menzies HJ, Winston CA, Holtz TH, Cain KP, Mac Kenzie WR. Epidemiology of tuberculosis among US- and foreign-born children and adolescents in the United States, 1994–2007. Am J Public Health July 15, 2010. [Epub ahead of print.]
Metcalfe JZ, Cattamanchi A, Vittinghoff E, Ho C, Grinsdale J, Hopewell PC, Kawamura LM, Nahid P. Evaluation of quantitative IFN-{gamma} response for risk stratification of active tuberculosis suspects. Am J Respir Crit Care Med 2010;181:87-93.
Nabbuye-Sekandi J, Okot-Chono R, Rusen ID, Dlodlo RA, Katamba A, Tumwesigye NM, Fujiwara PI. Factors associated with human immunodeficiency virus testing among tuberculosis patients receiving treatment at health facilities in Uganda. Int J Tuberc Lung Dis 2010 July; 14(7): 896-902.
Nahid P, Bliven EE, Kim EY, Mac Kenzie WR, Stout JE, Diem L, Johnson JL, Gagneux S, Hopewell PC, Kato-Maeda M; for the Tuberculosis Trials Consortium. Influence of M. tuberculosis lineage variability within a clinical trial for pulmonary tuberculosis. PLoS One 2010 May 20;5(5):e10753.
Pai M, Castro K, Mori T, Lienhardt C. Proceedings of the Second Global Symposium on Interferon-Gamma Release Assays. Session 9, Guidelines. Int J Tuberc Lung Dis 2010 June Suppl 1; 14: S64-S69.
Ramirez MV, Cowart KC, Campbell PJ, Morlock GP, Sikes D, Winchell JM, Posey JE. Rapid detection of multidrug resistant tuberculosis using real-time PCR and high resolution melt analysis. J Clin Microbiol 2010 Sep 1. [Epub ahead of print.]
Rodwell TC, Barnes RFW, Moore M, Strathdee SA, Raich A, Moser KS, Garfein RS. HIV-tuberculosis coinfection in southern California: evaluating disparities in disease burden. Am J Public Health 2010 April; 100 Suppl 1: S178-S185.
Schecter GF, Scott C, True L, Raftery A, Flood J, and Mase S. Linezolid in the treatment of multidrug‐resistant tuberculosis. Clin Infect Dis 2010 Jan; 50:49–55.
Tedla Z, Nyirenda S, Peeler C, Agizew T, Sibanda T, Motsamai O, Vernon A, Wells CD, and Samandari T. Isoniazid-associated hepatitis and antiretroviral drugs during tuberculosis prophylaxis in HIV-infected adults in Botswana. Am J Respir Crit Care Med 2010; 182: 278-285.
Thoen CO, LoBue PA, de Kantor I. Why has zoonotic tuberculosis not received much attention? [Editorial.] Int J Tuberc Lung Dis 2010 Sept; 14(9):1073–1074.
Vinnard C, Winston CA, Wileyto EP, MacGregor RR, Bisson GP. Isoniazid resistance and death in patients with tuberculous meningitis: retrospective cohort study. BMJ 2010 Sept 7. [Epub ahead of print.]
Weiner M, Peloquin C, Burman W, Luo CC, Engle M, Prihoda TJ, Mac Kenzie WR, Bliven-Sizemore E, Johnson JL, Vernon A. The effects of tuberculosis, race and human gene SLCO1B1 polymorphisms on rifampin concentrations. Antimicrob Agents Chemother 2010 Jul 26. [Epub ahead of print].
Winston C, Navin T. Birth cohort effect on latent tuberculosis infection prevalence, United States. BMC Infectious Diseases 2010; 10:206.
Wongsrichanalai C, Varma JK, Juliano JJ, Kimerling ME, MacArthur JR. Extensive drug resistance in malaria and tuberculosis. Emerg Infect Dis [online] 2010 Jul.
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CDC - New CDC Publications - TB Notes 3, 2010 - TB
NINDS awards new Udall Centers for Parkinson's Disease Research, September 29, 2010 News Release - National Institutes of Health (NIH)
Wednesday, September 29, 2010
7:30 a.m. EDT Contact:
Gregory Roa, NINDS
groa@ninds.nih.gov
301-496-5751
NINDS awards new Udall Centers for Parkinson's Disease Research
The National Institute of Neurological Disorders and Stroke (NINDS), a component of the National Institutes of Health, has established two new sites as part of the Morris K. Udall Centers of Excellence in Parkinson’s Disease Research. The NINDS grants will provide a five-year investment totaling more than $16 million for Emory University in Atlanta and the Feinstein Institute for Medical Research in Manhasset, N.Y.
NINDS Director Story Landis, Ph.D., announced the awards today at the World Parkinson Congress in Glasgow, Scotland. The congress is an international, interdisciplinary forum designed to showcase the latest developments in the world of Parkinson's disease, featuring a network of scientists, clinicians, patients, caregivers and allied health professionals from 66 countries.
"For more than a decade, the Udall Centers of Excellence have represented our commitment to bring together the talent and effort of the foremost investigators advancing research in Parkinson's disease," said Dr. Landis. "I look forward to these new centers partnering with us to accelerate basic, translational and clinical research to find a cure for this devastating illness."
Parkinson's disease is a degenerative disorder that attacks neurons in the substantia nigra, a part of the brain that controls movement. Symptoms include involuntary shaking, stiffened muscles and impaired balance. Although certain drugs, such as levodopa, can reduce Parkinson's disease symptoms, there is no proven method to slow its progressive course.
With the new centers announced today, NINDS is supporting 11 Udall Centers of Excellence across the United States. The grants provide funding for a wide range of independent and collaborative projects. These include genetic and genomic studies, research to pinpoint the disease's underlying mechanisms, work to improve animal models, the development and testing of potential therapeutics, and clinical research with Parkinson's disease patients. The NINDS launched the network in 1997. The Udall Centers are named in honor of U.S. Rep. Morris K. Udall (D-Ariz.), who died in 1998 after a long battle with Parkinson's disease.
Thomas Wichmann, M.D., professor of neurology at Emory University, will direct the new Udall Center. One of its objectives is to enhance collaboration between basic scientists with the university's clinical movement disorders group, which works with Parkinson's disease patients in the Atlanta region. The program will bring together experts in electrophysiology, pharmacology and related disciplines investigating brain circuits disrupted by Parkinson's disease and the effects of treating them with pharmacological and surgical therapy. The center also will include a research component at Vanderbilt University in Nashville. "Our goal is to increase understanding of how existing therapies work, and develop and explore the mechanisms of action of new antiparkinsonian treatments," said Dr. Wichmann.
The director of the new Udall Center at the Feinstein Institute for Medical Research is David Eidelberg, M.D., a pioneer in the use of functional brain imaging and network analysis for the study of neurodegenerative diseases and Parkinson's disease. The new center will focus on working with patients who suffer serious clinical side effects from levodopa and examining individual differences in the cognitive response to treatment.
"Understanding these phenomena should not only help improve the lives of patients, but also provide unique insight into the pathophysiology of Parkinson's disease and its treatment," said Dr. Eidelberg. He added that the center will work toward validating a novel method for imaging brain circuits to aid early diagnosis, which could help streamline trials of new therapies for Parkinson's disease as well as for atypical parkinsonian syndromes.
NINDS program director Beth-Anne Sieber, Ph.D., said, "By virtue of cutting-edge, collaborative research approaches, the Udall Centers of Excellence are uniquely poised to advance scientific discovery toward improved understanding of this disease, as well as treatment of people with Parkinson's disease. We look forward to working with the Emory, Feinstein and other Udall Centers on these important goals."
To learn more about the Udall Centers, visit www.ninds.nih.gov/research/parkinsonsweb/udall_centers/. For additional information from the NINDS about Parkinson’s disease, visit www.ninds.nih.gov/disorders/PD.
The NINDS (www.ninds.nih.gov) is the nation's leading funder of research on the brain and nervous system. The NINDS mission is to reduce the burden of neurological disease — a burden borne by every age group, by every segment of society, by people all over the world.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NINDS awards new Udall Centers for Parkinson's Disease Research, September 29, 2010 News Release - National Institutes of Health (NIH)
NIH awards Muscular Dystrophy Cooperative Research Center grants, September 29, 2010 News Release - National Institutes of Health (NIH)
Wednesday, September 29, 2010 Contact:
Trish Reynolds
reynoldsp2@mail.nih.gov
301-496-8190
NIH awards Muscular Dystrophy Cooperative Research Center grants
Three grants totaling more than $4.5 million, from agencies of the National Institutes of Health, will be used to explore novel treatment strategies for muscular dystrophy.
The grants were awarded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institute of Neurological Disorders and Stroke (NINDS) and Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) for year one of five-year cooperative agreements.
The grants designate Nationwide Children's Hospital, Columbus, Ohio, as a Senator Paul D. Wellstone Muscular Dystrophy Cooperative Research Center (MDCRC), and continue funding of crucial research by two previously established MDCRCs at the University of Pennsylvania, Philadelphia and the University of Iowa, Iowa City.
Researchers at Nationwide Children's Hospital, under the direction of Jerry Mendell, M.D., will further develop methods to overcome immune barriers to gene correction for Duchenne muscular dystrophy (DMD). A form of muscular dystrophy that affects children and young adults, DMD is caused by an absence of dystrophin, a protein that helps keep muscle cells intact. Gene therapy for DMD includes injecting genes for a functional version of the muscle protein dystrophin, encased in a virus designed to deliver the gene into the muscle cells. In an early trial of this experimental therapy, blood analyses and biopsy slides showed that the immune system in more than half of the children mounted a response to dystrophin or the viral delivery vehicle.
The goal of the research will be to see how many patients have pre-existing immunity to dystrophin that could block the gene transfer. Researchers also will determine if the immune reaction could be circumvented by removing antibodies with a blood-purifying procedure called plasmapheresis or administering drugs that suppress the immune response.
At the University of Pennsylvania, researchers led by H. Lee Sweeney, Ph.D., will research treatments to inhibit muscle fibrosis, or scarring, that causes muscle dysfunction. By reducing scar formation, such treatments may not only improve muscle function, but may also enhance muscle regeneration and increase the effectiveness of drug, gene and stem cell therapies for muscular dystrophies (MD). The research aims to identify existing drugs that inhibit fibrosis, as well as drive the development of new classes of fibrosis inhibitors. The center's goal is to develop non-invasive imaging techniques to assess the replacement of skeletal and cardiac muscle with fat and scar tissue associated with MD progression.
Research at the University of Iowa, directed by Kevin Campbell, Ph.D., will explore therapeutic strategies for the treatment of various muscular dystrophies arising from the abnormal processing of muscle proteins called dystroglycans. This will involve investigating what happens on a molecular level in these dystrophies (called dystroglycanopathies) and evaluating various treatment strategies, using mouse models and cells with known mutations from dystroglycanopathy patients. It will also entail identifying and characterizing dystroglycanopathy patients and developing infrastructure for trials of dystroglycanopathy treatment in defined patient groups.
Muscular dystrophy is a group of debilitating, and often fatal, diseases characterized by progressive weakness and degeneration of the skeletal or voluntary muscles, which control movement and breathing. MD can affect people of all ages. Although some forms first become apparent in infancy or childhood, others may not appear until middle age or later.
The Senator Paul D. Wellstone Muscular Dystrophy Cooperative Research Centers spring from the Muscular Dystrophy Community Assistance, Research and Education Act passed by Congress in 2001. The centers work individually and collaboratively, and are guided by a steering committee that includes representatives from each center. Each center has basic and clinical research projects, and one or more core facilities to support them. Centers must also make core resources or services available to the national muscular dystrophy research community. More information on muscular dystrophy can be found at http://www.ninds.nih.gov/disorders/md/detail_md.htm.
The mission of the NIAMS is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (toll-free call) or visit the NIAMS Web site at www.niams.nih.gov.
The mission of the NINDS is to reduce the burden of neurological disease – a burden borne by every age group, by every segment of society, by people all over the world. For more information about NINDS, call (800) 352-9424 or visit the NINDS website at www.ninds.nih.gov.
The mission of the Eunice Kennedy Shriver NICHD is to ensure that every person is born healthy and wanted, that women suffer no harmful effects from reproductive processes, and that all children have the chance to achieve their full potential for healthy and productive lives, free from disease or disability, and to ensure the health, productivity, independence, and well-being of all people through optimal rehabilitation. For more information about NICHD, call the Information Resource Center at (800) 370-2943 or visit the NICHD Web site at www.nichd.nih.gov.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NIH awards Muscular Dystrophy Cooperative Research Center grants, September 29, 2010 News Release - National Institutes of Health (NIH)
NIH Clinical Center offers sabbatical in clinical research management, September 29, 2010 News Release - National Institutes of Health (NIH)
Wednesday, September 29, 2010 Contact:
schmalfeldtb@cc.nih.gov
301-917-5507
NIH Clinical Center offers sabbatical in clinical research management
The National Institutes of Health Clinical Center is accepting applications for a sabbatical program in clinical research management. After a successful pilot, during which three experienced researchers completed their sabbaticals, the Clinical Center is seeking more professionals for this training to help ensure that medical research programs are safe, ethical, and efficient.
"The Clinical Center's new sabbatical is an innovative approach to assuring leadership in clinical research management, which will lead — in turn — to more rapidly moving advancements in medical science to improvements in health and health care for all," said Dr. John I. Gallin, Clinical Center director. "Our hope is that participants will go on to help lead major clinical research programs in the United States and abroad. We are pleased to be at the forefront of this endeavor."
The program is open to clinical investigators, health care managers and administrators, and others who oversee clinical trials, including international research studies. Participants can expect flexible and specialized education in this field and the opportunity to work and learn with the full complement of clinical research experts at NIH and components of the U.S. Department of Health and Human Services, including the Food and Drug Administration.
Re-engineering the clinical research enterprise — including training in the discipline — is one of the initiatives in the NIH Common Fund (formerly the NIH Roadmap for Medical Research), launched in 2004. The concept for the sabbatical program was also recommended by the NIH Director's Blue Ribbon Panel in 2004.
"The program will help demystify the complexities of governmental regulatory agencies while providing an opportunity to achieve excellence in clinical research management," Gallin said.
Sabbatical participants select electives from six core modules that offer exposure to all aspects of the clinical research environment: critical infrastructure, support services, legal and regulatory infrastructure, communications and outreach, strategic management, and funding opportunities.
"All have been structured to provide the training and hands-on experience required to manage a clinical research program of the highest quality," said Dr. Frederick P. Ognibene, Clinical Center deputy director for educational affairs and strategic partnerships and director of the Office of Clinical Research Training and Medical Education.
Electives within the modules include topics such as protocol writing and tracking, bioethics and human subjects’ protections, international clinical research, informatics, research nursing, scientific review, patient recruitment, and budget management. Electives are primarily led by scientists and administrators in the Clinical Center, but participants also have the option of electives at the FDA, the HHS Office for Human Research Protections, and the Foundation for NIH.
"I am really glad that I had an opportunity to participate in the sabbatical program," said Dr. Roman Ivanov, a pilot participant and clinical researcher at the Pirogov National Medical-Surgical Center in Moscow. "It provided me with a unique opportunity to get a better understanding of infrastructure required for investigator-associated clinical trials and regulatory issues associated with them. I will do my best to share this knowledge with my colleagues and I hope that this will contribute to development of medical science in Russia."
There is no fee for participating in the program, and applications are accepted year-round. The Clinical Center expects to have approximately 10 participants per year. Stipends are not provided by the NIH for travel or living expenses, so it is expected that most individuals will be self-supported or supported by their home institution.
For more information, visit the program website: http://clinicalcenter.nih.gov/training/sabbatical/index.html or contact Dr. Ognibene at 301-496-9425 or ccsabbatical@mail.nih.gov.
The NIH Clinical Center is the clinical research hospital for the National Institutes of Health. Through clinical research, physician-investigators translate laboratory discoveries into better treatments, therapies and interventions to improve the nation's health. For more information, visit http://clinicalcenter.nih.gov.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NIH Clinical Center offers sabbatical in clinical research management, September 29, 2010 News Release - National Institutes of Health (NIH)
NHLBI renews programs for nanotechnology research, September 29, 2010 News Release - National Institutes of Health (NIH)
Wednesday, September 29, 2010 Contact:
NHLBI Communications Office
nhlbi_news@nhlbi.nih.gov
301-496-4236
NHLBI renews programs for nanotechnology research
$65 million in contracts to help advance disease detection, delivery of therapies
The National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, is awarding $65 million to renew its Programs for Nanotechnology Research to help researchers develop tools based on materials designed at the molecular level to detect and deliver treatments for heart, lung, and blood diseases.
The four contracts, to be funded over five years, bring chemists, engineers, and physical and material scientists together with physicians, biologists, and clinical researchers from the heart, lung, and blood research fields. These interdisciplinary teams will create nanotechnology solutions for projects such as detecting pulmonary infections and repairing heart tissue damage.
The programs build upon progress made since the original funding in 2005. The new projects will have a greater focus on moving technological advances into practice. Each award will also support techniques to establish a pool of investigators capable of applying nanotechnology solutions to problems in cardiovascular, pulmonary, and blood disease. The programs will be supported by an administrative coordinating center, to be awarded in 2011.
"Nanotechnology has enormous potential for faster and more sensitive detection of disease and for targeted disease treatments," said Susan B. Shurin, M.D., acting director of the NHLBI. "We are committed to harnessing these new technologies for heart, lung, and blood diseases, and moving them towards application in the real world."
The four awards involve teams spread across 17 institutions.
•Massachusetts General Hospital (Ralph Weissleder, M.D.) leads a consortium of six Boston-area institutions, including Harvard Medical School, the Harvard School of Engineering and Applied Sciences, Massachusetts Institute of Technology, Brigham and Women’s Hospital, and the Broad Institute of Harvard and MIT. The group is developing nanomaterials to diagnose and treat cardiovascular diseases and create a point-of-care system for the rapid detection of pulmonary infections.
•Georgia Institute of Technology (Gang Bao, Ph.D.) is collaborating with Emory University and the University of California, Davis to develop nanoparticle-based tools to image and deliver therapeutics to atherosclerotic plaque and to enhance stem cell repair of damaged heart tissue.
•Washington University (Michael Welch, Ph.D.) and Texas A&M University (Karen Wooley, Ph.D.) head a collaboration that also includes the University of California, Santa Barbara, the University of California, Berkeley, and the University of Texas-Southwestern Medical Center. Their work will include the nanoparticle-based diagnosis and treatment of acute lung diseases, as well as imaging and treating cardiovascular diseases.
•Mount Sinai Medical School (Zahi Fayad, Ph.D.) and Massachusetts Institute of Technology (Robert Langer, Ph.D.) are collaborating with New York University, Columbia University, and Brigham and Women’s Hospital. The group is focused on developing therapies for early- and late-stage cardiac disease, treatment for atherosclerotic plaque to prevent heart attack, and delivery of regeneration factors to repair heart tissue damaged by heart attack.
To interview an NHLBI spokesperson, contact the NHLBI Communications Office at 301-496-4236 or at nhlbi_news@nhlbi.nih.gov.
Part of the National Institutes of Health, the National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics. NHLBI press releases and other materials are available online at www.nhlbi.nih.gov.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NHLBI renews programs for nanotechnology research, September 29, 2010 News Release - National Institutes of Health (NIH)
Guidance Documents (Medical Devices and Radiation-Emitting Products) Draft Guidance for Industry and FDA Staff - Class II Special Controls Guidance Document: Herpes Simplex Virus Types 1 and 2 Serological Assays
Draft Guidance for Industry and FDA Staff - Class II Special Controls Guidance Document: Herpes Simplex Virus Types 1 and 2 Serological Assays
This guidance document is being distributed for comment purposes only.
Document issued on: September 28, 2010
Comments and suggestions regarding this draft document should be submitted within 90 days of publication in the Federal Register of the notice announcing the availability of the draft guidance. Submit written comments to the Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. Alternatively, electronic comments may be submitted to http://www.regulations.gov.disclaimer icon All comments should be identified with the docket number listed in the notice of availability that publishes in the Federal Register.
For questions regarding this document contact Haja Sittana El Mubarak, Ph.D., Division of Microbiology Devices at 301-796-6193 or by email: HajaSittana.ElMubarak@fda.hhs.gov,
download pdf file:
http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM227597.pdf
full-text:
Guidance Documents (Medical Devices and Radiation-Emitting Products) Draft Guidance for Industry and FDA Staff - Class II Special Controls Guidance Document: Herpes Simplex Virus Types 1 and 2 Serological Assays
miércoles, 29 de septiembre de 2010
Cost-Effectiveness of Using High-Sensitivity C-Reactive Protein to Identify Intermediate- and Low-Cardiovascular-Risk Individuals for Statin Therapy -- Lee et al., 10.1161/CIRCULATIONAHA.110.947960 -- Circulation
Submitted on October 30, 2009
Accepted on August 2, 2010
Cost-Effectiveness of Using High-Sensitivity C-Reactive Protein to Identify Intermediate- and Low-Cardiovascular-Risk Individuals for Statin Therapy
Keane K. Lee MD, MS*, Lauren E. Cipriano BSc, BA, Douglas K. Owens MD, MS, Alan S. Go MD, and Mark A. Hlatky MD
From the Stanford University Schools of Medicine (K.K.L., D.K.O., M.A.H.) and Engineering (L.E.C.), Stanford, Calif; Division of Research, Kaiser Permanente of Northern California, Oakland (A.S.G.); Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif (D.K.O.); and University of California, San Francisco (A.S.G.).
* To whom correspondence should be addressed. E-mail: Keane.K.Lee@kp.org.
Background
—Many myocardial infarctions and strokes occur in individuals with low-density lipoprotein cholesterol levels below recommended treatment thresholds. High sensitivity C-reactive protein (hs-CRP) testing has been advocated to identify low- and intermediate-risk individuals who may benefit from statin therapy.
Methods and Results
—A decision analytic Markov model was used to follow hypothetical cohorts of individuals with normal lipid levels but without coronary artery disease, peripheral arterial disease, or diabetes mellitus. The model compared current Adult Treatment Panel III practice guidelines, a strategy of hs-CRP screening in those without an indication for statin treatment by current practice guidelines followed by treatment only in those with elevated hs-CRP levels, and a strategy of statin therapy at specified predicted risk thresholds without hs-CRP testing. Risk-based treatment without hs-CRP testing was the most cost-effective strategy, assuming that statins were equally effective regardless of hs-CRP status. However, if normal hs-CRP levels identified a subgroup with little or no benefit from statin therapy (<20% relative risk reduction), then hs-CRP screening would be the optimal strategy. If harms from statin use were greater than generally recognized, then use of current clinical guidelines would be the optimal strategy.
Conclusion
—Risk-based statin treatment without hs-CRP testing is more cost-effective than hs-CRP screening, assuming that statins have good long-term safety and provide benefits among low-risk people with normal hs-CRP.
Key words: cost-benefit analysis • C-reactive protein • primary prevention • screening • statins, HMG-CoA
Cost-Effectiveness of Using High-Sensitivity C-Reactive Protein to Identify Intermediate- and Low-Cardiovascular-Risk Individuals for Statin Therapy -- Lee et al., 10.1161/CIRCULATIONAHA.110.947960 -- Circulation
CARDIOLOGÍA
Actualidad Ultimas noticias - JANOes y agencias -
El uso de estatinas en más pacientes es una medida coste-efectiva
JANO.es y agencias · 29 Septiembre 2010 11:18
Una investigación publicada en “Circulation” vuelve a demostrar la efectividad de estos fármacos a la hora de prevenir infartos de miocardio
Investigadores de la Facultad de Medicina de la Universidad de Stanford (Estados Unidos) han publicado en “Circulation” que administrar estatinas para reducir los niveles de colesterol a más pacientes puede ser una medida coste-efectiva para prevenir infartos de miocardio.
Este trabajo siguió los pasos del estudio Júpiter sobre salud cardíaca, realizado durante dos años, y que demostró que administrar una estatina a pacientes con un nivel de colesterol medio-bajo, pero con otros riesgos cardíacos -como niveles elevados de proteína C reactiva (CRP)- ayudaba a prevenir ictus e infartos de miocardio.
La investigación de la Universidad de Stanford ha analizado si administrar estatinas a más pacientes podría ser coste-efectivo, un factor muy valorado por los políticos y las compañías aseguradoras de Estados Unidos como forma de encontrar nuevas vías para ahorrar en el marco de la reforma sanitaria.
Según las actuales guías, los médicos deben recomendar estatinas si el paciente tiene un 20% o mayor riesgo de sufrir un infarto o un ictus en los próximos 10 años.
El equipo de Stanford probó dos estrategias, una en la que simplemente administraron estatinas a más personas de las recomendadas por las guías y otra en la que sólo se dieron estos fármacos a personas con altos niveles de CRP.
Según Mark Hlatky, autor de este trabajo, “el resultado fue que ambas estrategias obtuvieron mejores resultados que las que tenemos ahora”. “De las dos alternativas, la simple idea de bajar el umbral, sin fijarse en los tests de CRP, sacó ventaja”, indica.
Este equipo ha desarrollado también un modelo informático para analizar tres aproximaciones: seguir las recomendaciones de las guías actuales; tratar a los pacientes para los que no se recomiendan las estatinas en las guías, pero presentan altos niveles de CRP; y tratar a aquellos con riesgos cardíacos, pero están registrados en las actuales guías como candidatos para recibir estatinas.
Los investigadores han evaluado los costes basándose en una fórmula de probada eficacia denominada calidad ajustada a los años de vida, que toma en cuenta el coste del tratamiento, la calidad de vida del paciente y cuánto prolonga su vida. En general, los tratamientos que cuestan menos de 50.000 dólares por calidad ajustada a los años de vida se juzgan coste-efectivos.
Descubrieron que administrar estatinas basándose en el riesgo era la actuación más coste-efectiva. No obstante, según Hlatky, “probablemente sea necesario conseguir más información sobre cómo es la seguridad y la eficacia de estos fármacos en las poblaciones de bajo riesgo”.
Circulation 2010;10.1161/CIRCULATIONAHA.110.947960
Cost-Effectiveness of Using High-Sensitivity C-Reactive Protein to Identify Intermediate- and Low-Cardiovascular-Risk Individuals for Statin Therapy -- Lee et al., 10.1161/CIRCULATIONAHA.110.947960 -- Circulation
Circulation
Circulation
Stanford University
Stanford University
Actualidad Ultimas noticias - JANOes y agencias - El uso de estatinas en mas pacientes es una medida coste-efectiva - JANO.es - ELSEVIER
Accepted on August 2, 2010
Cost-Effectiveness of Using High-Sensitivity C-Reactive Protein to Identify Intermediate- and Low-Cardiovascular-Risk Individuals for Statin Therapy
Keane K. Lee MD, MS*, Lauren E. Cipriano BSc, BA, Douglas K. Owens MD, MS, Alan S. Go MD, and Mark A. Hlatky MD
From the Stanford University Schools of Medicine (K.K.L., D.K.O., M.A.H.) and Engineering (L.E.C.), Stanford, Calif; Division of Research, Kaiser Permanente of Northern California, Oakland (A.S.G.); Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif (D.K.O.); and University of California, San Francisco (A.S.G.).
* To whom correspondence should be addressed. E-mail: Keane.K.Lee@kp.org.
Background
—Many myocardial infarctions and strokes occur in individuals with low-density lipoprotein cholesterol levels below recommended treatment thresholds. High sensitivity C-reactive protein (hs-CRP) testing has been advocated to identify low- and intermediate-risk individuals who may benefit from statin therapy.
Methods and Results
—A decision analytic Markov model was used to follow hypothetical cohorts of individuals with normal lipid levels but without coronary artery disease, peripheral arterial disease, or diabetes mellitus. The model compared current Adult Treatment Panel III practice guidelines, a strategy of hs-CRP screening in those without an indication for statin treatment by current practice guidelines followed by treatment only in those with elevated hs-CRP levels, and a strategy of statin therapy at specified predicted risk thresholds without hs-CRP testing. Risk-based treatment without hs-CRP testing was the most cost-effective strategy, assuming that statins were equally effective regardless of hs-CRP status. However, if normal hs-CRP levels identified a subgroup with little or no benefit from statin therapy (<20% relative risk reduction), then hs-CRP screening would be the optimal strategy. If harms from statin use were greater than generally recognized, then use of current clinical guidelines would be the optimal strategy.
Conclusion
—Risk-based statin treatment without hs-CRP testing is more cost-effective than hs-CRP screening, assuming that statins have good long-term safety and provide benefits among low-risk people with normal hs-CRP.
Key words: cost-benefit analysis • C-reactive protein • primary prevention • screening • statins, HMG-CoA
Cost-Effectiveness of Using High-Sensitivity C-Reactive Protein to Identify Intermediate- and Low-Cardiovascular-Risk Individuals for Statin Therapy -- Lee et al., 10.1161/CIRCULATIONAHA.110.947960 -- Circulation
CARDIOLOGÍA
Actualidad Ultimas noticias - JANOes y agencias -
El uso de estatinas en más pacientes es una medida coste-efectiva
JANO.es y agencias · 29 Septiembre 2010 11:18
Una investigación publicada en “Circulation” vuelve a demostrar la efectividad de estos fármacos a la hora de prevenir infartos de miocardio
Investigadores de la Facultad de Medicina de la Universidad de Stanford (Estados Unidos) han publicado en “Circulation” que administrar estatinas para reducir los niveles de colesterol a más pacientes puede ser una medida coste-efectiva para prevenir infartos de miocardio.
Este trabajo siguió los pasos del estudio Júpiter sobre salud cardíaca, realizado durante dos años, y que demostró que administrar una estatina a pacientes con un nivel de colesterol medio-bajo, pero con otros riesgos cardíacos -como niveles elevados de proteína C reactiva (CRP)- ayudaba a prevenir ictus e infartos de miocardio.
La investigación de la Universidad de Stanford ha analizado si administrar estatinas a más pacientes podría ser coste-efectivo, un factor muy valorado por los políticos y las compañías aseguradoras de Estados Unidos como forma de encontrar nuevas vías para ahorrar en el marco de la reforma sanitaria.
Según las actuales guías, los médicos deben recomendar estatinas si el paciente tiene un 20% o mayor riesgo de sufrir un infarto o un ictus en los próximos 10 años.
El equipo de Stanford probó dos estrategias, una en la que simplemente administraron estatinas a más personas de las recomendadas por las guías y otra en la que sólo se dieron estos fármacos a personas con altos niveles de CRP.
Según Mark Hlatky, autor de este trabajo, “el resultado fue que ambas estrategias obtuvieron mejores resultados que las que tenemos ahora”. “De las dos alternativas, la simple idea de bajar el umbral, sin fijarse en los tests de CRP, sacó ventaja”, indica.
Este equipo ha desarrollado también un modelo informático para analizar tres aproximaciones: seguir las recomendaciones de las guías actuales; tratar a los pacientes para los que no se recomiendan las estatinas en las guías, pero presentan altos niveles de CRP; y tratar a aquellos con riesgos cardíacos, pero están registrados en las actuales guías como candidatos para recibir estatinas.
Los investigadores han evaluado los costes basándose en una fórmula de probada eficacia denominada calidad ajustada a los años de vida, que toma en cuenta el coste del tratamiento, la calidad de vida del paciente y cuánto prolonga su vida. En general, los tratamientos que cuestan menos de 50.000 dólares por calidad ajustada a los años de vida se juzgan coste-efectivos.
Descubrieron que administrar estatinas basándose en el riesgo era la actuación más coste-efectiva. No obstante, según Hlatky, “probablemente sea necesario conseguir más información sobre cómo es la seguridad y la eficacia de estos fármacos en las poblaciones de bajo riesgo”.
Circulation 2010;10.1161/CIRCULATIONAHA.110.947960
Cost-Effectiveness of Using High-Sensitivity C-Reactive Protein to Identify Intermediate- and Low-Cardiovascular-Risk Individuals for Statin Therapy -- Lee et al., 10.1161/CIRCULATIONAHA.110.947960 -- Circulation
Circulation
Circulation
Stanford University
Stanford University
Actualidad Ultimas noticias - JANOes y agencias - El uso de estatinas en mas pacientes es una medida coste-efectiva - JANO.es - ELSEVIER