Presentation by Gustavo Zabert, M.D., a pulmonologist and the Global Bridges regional director for the Latin American region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Clinical research in Latin America: constraints and opportunitiesCER Clinical Trials
The number of patients enrolled in international multi-centre clinical trials has increased in some countries of Latin America. Eduardo Gotuzzo, M.D. FACP
Clinical research in Latin America: constraints and opportunitiesCER Clinical Trials
The number of patients enrolled in international multi-centre clinical trials has increased in some countries of Latin America. Eduardo Gotuzzo, M.D. FACP
Overview of Tobacco Treatment Provisions at a National Level -- Martin RawGlobal Bridges
Presentation by Martin Raw, UK Centre for Tobacco Control Studies and National Institute of Alcohol and Drug Policies, Brazil, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Public Health Agency of Catalonia: Tobacco Control and Prevention.Tobacco control research workshop Barcelona. September 22nd. 2015
•Josep M Suelves •Guadalupe Ortega •Araceli Valverde •Carmen Cabezas
Lecture 12 from a college level neuropharmacology course taught in the spring 2012 semester by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University. Focus is on pharmacokinetics, pharmacodynamics, epidemiology, and health risks
Uso ed abuso dei farmaci - Applicazione delle informazioni genetiche per un u...Digital for Academy
Il seminario dello scorso 17 Aprile 2015 ha affrontato i temi dell’aderenza alla terapia e dell’appropriatezza prescrittiva toccando, tra le varie specialità aziendali, l’antibiotico terapia, i vaccini, la farmacogenetica e il suo uso nelle cure psichiatriche. Sono state inoltre analizzate delle possibili strategie digitali che consentano a medici, farmacisti e aziende di scegliere la cura più adatta per una determinata patologia e che agevolino il paziente nel seguirla al meglio.
Presentazione del dott. Marco Marchetti, CEO - FB Health.
Virginia Llera - Cómo optimizar la investigación en Enfermedades RarasFundación Ramón Areces
La Doctora Virginia Llera, Virginia A. Llera ofreció una conferencia el 17/09/2014 en la Fundación Ramón Areces. Llera es la Fundadora de la primera organización de Enfermedades Raras y drogas huérfanas en Latino América y Caribe, GEISER, y Presidenta del Foro Internacional, ICORD (International Conference on Rare Diseases & Orphan Drugs). Su conferencia, titulada 'Optimizando los procesos de investigación en enfermedades raras y medicamentos huérfanos', tuvo lugar dentro del ciclo sobre patologías poco frecuentes organizado por Fundación Ramón Areces en colaboración con Vall d'Hebron Institute of Research, Barcelona.
The Critical Importance of Health Care Worker Leadership in the Tobacco Contr...Global Bridges
Presentation by Eduardo Bianco, M.D., Framework Convention Alliance, Uruguay, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Overview of Tobacco Treatment Provisions at a National Level -- Martin RawGlobal Bridges
Presentation by Martin Raw, UK Centre for Tobacco Control Studies and National Institute of Alcohol and Drug Policies, Brazil, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Public Health Agency of Catalonia: Tobacco Control and Prevention.Tobacco control research workshop Barcelona. September 22nd. 2015
•Josep M Suelves •Guadalupe Ortega •Araceli Valverde •Carmen Cabezas
Lecture 12 from a college level neuropharmacology course taught in the spring 2012 semester by Brian J. Piper, Ph.D. (psy391@gmail.com) at Willamette University. Focus is on pharmacokinetics, pharmacodynamics, epidemiology, and health risks
Uso ed abuso dei farmaci - Applicazione delle informazioni genetiche per un u...Digital for Academy
Il seminario dello scorso 17 Aprile 2015 ha affrontato i temi dell’aderenza alla terapia e dell’appropriatezza prescrittiva toccando, tra le varie specialità aziendali, l’antibiotico terapia, i vaccini, la farmacogenetica e il suo uso nelle cure psichiatriche. Sono state inoltre analizzate delle possibili strategie digitali che consentano a medici, farmacisti e aziende di scegliere la cura più adatta per una determinata patologia e che agevolino il paziente nel seguirla al meglio.
Presentazione del dott. Marco Marchetti, CEO - FB Health.
Virginia Llera - Cómo optimizar la investigación en Enfermedades RarasFundación Ramón Areces
La Doctora Virginia Llera, Virginia A. Llera ofreció una conferencia el 17/09/2014 en la Fundación Ramón Areces. Llera es la Fundadora de la primera organización de Enfermedades Raras y drogas huérfanas en Latino América y Caribe, GEISER, y Presidenta del Foro Internacional, ICORD (International Conference on Rare Diseases & Orphan Drugs). Su conferencia, titulada 'Optimizando los procesos de investigación en enfermedades raras y medicamentos huérfanos', tuvo lugar dentro del ciclo sobre patologías poco frecuentes organizado por Fundación Ramón Areces en colaboración con Vall d'Hebron Institute of Research, Barcelona.
The Critical Importance of Health Care Worker Leadership in the Tobacco Contr...Global Bridges
Presentation by Eduardo Bianco, M.D., Framework Convention Alliance, Uruguay, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Webinar: Waterpipe use from the Middle East to Western CountriesGlobal Bridges
This presentation will discuss the epidemiology, toxicology, and harms of waterpipes, as well as what further research is needed and the challenges in providing treatment for those interested in quitting. Presented as a webinar for Global Bridges on 26 February, 2014.
Dr. Bianco: Humo de segunda mano y riesgos cardiovascularesGlobal Bridges
Los profesionales de la salud, incluso aquellos relacionados con la salud cardiovascular, son conscientes
que el tabaco es uno de los principales factores de riesgo para muchas enfermedades, pero la
mayoría de ellos no han sido entrenados para reconocer al consumo de tabaco como una adicción,
no son conscientes de los mecanismos por los cuales el consumo de tabaco y la exposición al humo
del tabaco causan daños cardiovasculares. La mayoría de ellos tampoco han sido entrenados sobre
cómo abordar al paciente fumador en su práctica clínica diaria y como usar los medicamentos para el
tratamiento de la dependencia al tabaco. Esta conferencia tiene la intención de informar a los asistentes
sobre todos estos temas y estimularlos a obtener más información sobre ellos.
Going mobile: the potential of mHealth for tobacco dependence treatmentGlobal Bridges
Erik Augustson, PhD, MPH, is the Program Director of the Tobacco Control Research Branch of the National Cancer Institute. He serves on a number of national committees in the United States to improve population-based tobacco control such as the Department of Health and Human Services eHealth and mHealth Cessation Interventions committee, Smoking Cessation Subcommittee of the DHHS, the National Tobacco Control Strategy Committee and the North American Quitline Consortium. In addition, Dr. Augustson serves as the federal co-lead on the Smokefree.gov Initiative which represents the first web and mobile based cessation resource developed by the United States federal government.
During this webinar, Dr. Augustson discussed the use of mHealth for health behavior interventions, particularly in tobacco dependence. MHealth has been defined as “health related services delivered by mobile communication devices,” which can be in the form of SMS messaging, smartphone applications, or the mobile web. This webinar focused on text-message based interventions such as NCI’s SmokefreeTXT and the opportunity to implement such interventions at an international level. Dr. Augustson has worked on mHealth interventions not only in the United States but also in China and shared preliminary results from program evaluations and discussed the future potential of mobile interventions to treat tobacco dependence on a population level.
WEBINAR: Secondhand Smoke: The Science and Big Tobacco's SmokescreenGlobal Bridges
Webinar presented for Global Bridges on February 27, 2013
By Dr. Richard Hurt, Director of Mayo Clinic Nicotine Dependence Center
The science behind the harmful effects of tobacco smoke will be reviewed in detail, including results from Dr. Hiryama’s landmark study of female Japanese lung cancer patients who are non-smoking wives of smoking husbands, as well as the most recent study showing that smoke-free workplace laws are associated with a reduction in the incidence of acute myocardial infarctions.
The presentation also highlights Big Tobacco’s decades long public relations and media campaigns to deceive the public and create doubt and controversy about the harmful effects of secondhand smoke. These data come from previously secret tobacco industry documents made public as a result of the Minnesota Tobacco Trial of 1998 and the Department of Justice case that resulted in the conviction of Big Tobacco for violating the U.S. racketeering laws.
Global Bridges: Pharmacotherapy for Tobacco DependenceGlobal Bridges
May 2012: Dr. Richard Hurt, director of the Nicotine Dependence Center at the Mayo Clinic and chair of Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, discusses pharmacotherapy for tobacco dependence at a workshop in Jamaica.
Global Bridges: Farmacoterapia para la dependencia del tabaco (español)Global Bridges
On April 4, 2012, Global Bridges presented the webinar "Farmacoterapia para la dependencia del tabaco," which featured Dr. Richard Hurt, founder and director of the Mayo Clinic Nicotine Dependence Center and chair of Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment.
Pharmacotherapy for Tobacco Dependence -- Richard D. Hurt, M.D., Mayo ClinicGlobal Bridges
On April 4, 2012, Global Bridges presented the webinar "Pharmacotherapy for Tobacco Dependence," which featured Richard D. Hurt, M.D., founder and director of the Mayo Clinic Nicotine Dependence Center.
For the audio/video from this presentation, please visit http://www.youtube.com/watch?v=NqndR9wWfZo
Competence-Based Training for a National Stop-Smoking Service: An English Cas...Global Bridges
Presentation by Andy McEwen, Ph.D., National Centre for Smoking Cessation and Training, UK, at the 15th World Conference on Tobacco OR Health in Singapore.
Challenges in Expanding the Role of Health Care Providers and Delivering Trea...Global Bridges
Presentation by Lekan Ayo-Yusuf, D.D.S., M.P.H., Ph.D., regional director of the Global Bridges African region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Challenges to Tobacco Dependence Treatment in Europe -- Hayden McRobbie, M.B....Global Bridges
Presentation by Hayden McRobbie, M.B., Ch.B., Ph.D., Auckland University of Technology, New Zealand, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Challenges in Expanding the Role of Health Care Providers and Delivering Trea...Global Bridges
Presentation by Jagdish Kaur, MBBS, Union Health Ministry, India, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Challenges in Implementing Tobacco Dependence Treatment in Jordan and the Eas...Global Bridges
Presentation by Feras Hawari, M.D., a pulmonologist and the Global Bridges regional director for the Eastern Mediterranean region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Tobacco Dependence Treatment Training -- J. Taylor Hays, M.D.Global Bridges
Presentation by J. Taylor Hays, M.D., a Global Bridges co-investigator and professor of medicine at Mayo Clinic, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Introduction to Global Bridges -- Richard D. Hurt, M.D.Global Bridges
Presentation by Richard D. Hurt, M.D., chair of Global Bridges and founding director of the Mayo Clinic Nicotine Dependence Center, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Women and Smoking -- Ivana Croghan, Ph.D., Mayo ClinicGlobal Bridges
On March 8, 2012, Global Bridges presented the webinar "Women and Smoking," which featured Ivana Croghan, Ph.D., coordinator of the Mayo Clinic Nicotine Dependence Center's Research Program.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Role of Health Care Systems and Providers in Changing Tobacco Dependence Treatment and Policy in Latin America -- Gustavo Zabert, M.D.
1. Workshop
Role of healthcare systems and
providers in changing tobacco
dependence treatment and
tobacco policy
Latin America 2011
1
2. 15th World Conference on Tobacco or Health
Singapore March 19th 2012
Company Type of relationship Content Area
Pfizer Principal investigator for Investigator iniciated research in
MOTIVARE001 research protocol motivation to quit
Astra National Coordinator (independent COPD research project in Argentina
Zeneca contractor) for PUMA research
project
Novartis Principal investigator for a COPD Cross sectional study to explored
prevalence´s protocol in Argentina COPD in Argentina
I never had any relationship with tobacco industries
Gustavo Zabert
Disclosure of COI
2
3. Latin America
• South of Rio Bravo
•Area 21,069,500 km²
(7,880,000 sq mi),
•2010 pop 590 million
•Languages : Spanish,
Portuguese, Quechua, Maya,
Guaraní, Aymara, Nahuatl, and
others.
•Combined GDP at 5.16
trillion (US 6.27 trillion)
•33 countries (CA-Ca-SA)
3
4. Smoking in Latin America
• 1/3 of population smoke
• Highest prevalence
•Males: Cuba and Chile
•Females: Argentina and Chile
•Teens: Argentina and Chile
•Physicians Cuba, Argentina and Chile
•Tobacco related mortality 265.000 death per
year (underestimated)
4
5. Smoking in Latin America
FCTC (except Argentina, Cuba, Dominican Republic, El
Salvador, Haiti, and St. Vincent and Grenadines)
• Art 6 Panama and Venezuela
• Art 8 Smoke free envitoment
•Nat'l smoke free law: Uruguay (2006), Panamá (2008),
Guatemala (2009), Colombia (2009), Perú (2010), Trinidad y
Tobago (2010), Honduras (2010), Barbados (2010),
Venezuela (2011)
•State smoke free law: 7 in Brazil and 9 in Argentina
•After IAHF report Paraguay (2011), Argentina (2011) y
Ecuador (2011) had launched Nat'l smoke free law.
Allemani, L., et al., Convenio Marco para el Control del Tabaco: desafíos para
América Latina y el Caribe. Reporte de la Sociedad Civil. 2010, IAHF
5
6. Smoking in Latin America
•Art 11 Warning and images at least 30% of surface
(Bolivia, Brasil, Chile, Colombia, Honduras, México,
Nicaragua Panamá, Paraguay, Perú, Uruguay y
Venezuela)
•Art 14 7 Guidelines, CTS less than 10 points (top
Brazil)
•Art 15 Smuggling CARICOM 50%, Bolivia 46%, Brazil
35%., (Paraguay export 90% of production but only 5%
legally)
Allemani, L., et al., Convenio Marco para el Control del Tabaco: desafíos para
América Latina y el Caribe. Reporte de la Sociedad Civil. 2010, IAHF
6
7. Informal Survey among TDT
(early in 2011)
Brasil Chile México Argentina Uruguay Perú Paraguay
Si Si Si Si Si Si Si
Nat´l Guidelines
2008 2003 2008 2005† 2009 2010 2010
Person Si Si Si Si Si
No Si
responsible Parcial Parcial Parcial Parcial Parcial
Score de tratamiento (máximo 10 puntos)
Treatment score 9 6 6 7 8 5 3
Nat´l Quitline 2 1 1 2 1 1 0
Nat´l treatment
6 4 4 4 5 4 3
System
Reimbursement
1 1 1 1 2 0 0
of treatment.
† Update process in 2011
7
8. Treatment affordability in Latin
America Mac
Drug/Marlboro and Drug/Big
Full treatment in U$ - OTC prices
Marlboro Big Mac
NRT Mexico 21 Mexico 28
NRT Argentina 157 Paraguay 183
Bupropion Uruguay 10 Brazil 6
Nortriptiline Brazil 11 Brazil 6,6
Varenicline Argentina 175 Paraguay 200
Varenicline Uruguay 50 Chile 48
Drug/ Marlboro higher index favors smoking (not quitting)
Drug/ Big Mac lower index Tt is more affordable (quitting)
Informal Survey among TDT (early in 2011)
8
10. Doctors and tobacco in LA
< 30% had ever been trainned
<10% recalled 5A strategy
<15% recognize NRT as effective
Smoking behavior bias their attitude
Medical students showed similar figures
Subset population showed
Worst scenario (psychologists, Surgeons,
GO)
Better scenario (pulmonologists, GP)
Zabert G Los Medicos y el Tabaco en MEDEF II: Tiempo de Intervenir
Ed Polemos
10
12. LA Global Bridges: aims for 2011
• Aim 1: to develop a large network of health care providers
and organizations to promote tobacco dependence
treatment and fully implementation of the Article 14th of
FCTC.
• Aim 2: to survey the smoking cessation training programs in
Latin America as well as the organization that provide
support and/or endorse the curricula.
• Aim3: To develop a training strategy for HCP and train at
least
• 150 HCP in a basic level
• 20 HCP in an advance level to act as faculty for the
basic level for the following years
12
14. GLOBAL BRIDGES LA: Metrics
Date Course Attendees Hours
April 28, 2011 Puebla (Mexico) 70 8
May 7, 2011 Neuquén (Argentina) 15 8
March 31, 2011 Neuquén (Argentina) 42 12
Julio 1, 2011 Asuncion (Paraguay) 86 8
August 4, 2011 Cordoba (Argentina) 62 4
August 8, 2011 Parana (Argentina) 39 8
September 7, 2011 San José (Costa Rica) 43 8
October 15, 2011 Lima (Peru) 17 4
October 25, 2011 Quito (Ecuador) 36 12
Total 406
14
15. GLOBAL BRIDGES Latin America
Evaluation scores
Maximum 20 point
Maximum score achieved 20
point
Mean score for post training
14, 9 points (range 11- 20)
Mean score for pre training
11, 3 points (range 4-18)
Difference 3, 6 points (Δ 32%
15
16. GLOBAL BRIDGES Latin America
Evaluation scores
Percentage of questions scored correctly
Concept Pre Post Change OR
P1 Epidemiology 29,41% 63,95% 117,44% 2,17 (1,73-2,73)
P2 FCTC 26,92% 46,28% 71,92% 1,71 (1,33-2,106)
P3 Epidemiology 41,58% 60,34% 45,12% 1,45 (1,20-1,75)
P4 CO Biomarker 58,91% 92,88% 57,66% 1,57 (1,39-1,77)
P5 Smoking behav 88,94% 94,28% 6,00% 1,06 (1,01-1,12=
P6 Initiation during teen 81,07% 87,84% 8,35% 1,08 (1,00-1,17)
P7 Neurobiology reward 50,49% 83,45% 65,28% 1,65 (1,42-1,91)
P8 Why brief intervention 43,63% 53,72% 23,13% 1,23 (1,02-1,34)
P9 Prochaska 62,75% 84,46% 34,60% 1,34 (1,19-1,51)
P10 FNDT 48,73% 71,86% 47,47% 1,47 (1,25-1,73)
16
17. GLOBAL BRIDGES Latin America
Evaluation scores
Percentage of questions scored correctly
Concept Pre Post Change OR
P11 Cognitive and drugs treat 94,03% 94,94% 0,97% 0,99 (0,95-1,04)
P12 NRT 52,00% 49,65% -4,52% 0,98 (0,88-1,20)
P13 Craving 57,29% 80,20% 39,99% 1,22(1,59-1,65)
P14 Non nicotine Drugs 27,08% 44,78% 65,36% 1,65 (1,26-2,15)
P15 Physician Role 77,39% 88,59% 14,47% 1,14(1,05-1,24)
P16 Relaps and success 83,17% 87,59% 5,31% 1,05(0,99-1,13)
P17 Antidepressant drugs 67,88% 75,27% 10,89% 1,19(0,98-1,24)
P18 Adverse effects Varenicline 22,87% 86,17% 276,78% 3,74(2,88-4,01)
P19 Laser for smk cessation 81,05% 91,17% 12,49% 1,12(1,04-1,21)
P20 NRT in CV pts 60,82% 77,66% 27,69% 1,27(1,12-1,45)
Average 57,80% 75,75% 46,32%
17
18. LA Global Bridges team
LA Regional Director
Gustavo Zabert- gzabert@gmail.com
LA Regional secretary
Vicki Baldi victoriabaldi@gmail.com
LA Host Organization
Interamerican Heart Foundation (IAHF)
Beatriz Champagne beatriz.champagne@interamericanheart.org
Javier Valenzuela Javier.valenzuela@interamericanheart.org
Faculty team
Carlos Jimenez Ruiz (Spain) Raul Sansores Martinez (Mexico)
Erika Urdapilleta (Mexico) Eduardo Bianco (Uruguay)
Daniel Buljuvacich (Argentina) Rogelio Pendino (Argentina)
Edgardo Sandoya (Uruguay) Victor San Martin (Paraguay)
Roberto Castro Cordoba (Costa Rica) Fernando Müller (Argentina)
Justino Regalado Pineda (Mexico) Andres Mainini (Argentina)
Luis D Larrateguy (Argentina)
18
20. “Every breath we draw (without
tobacco smoke), every step we
take, every meal we eat, is an
attempt to fight off death”
Arthur Schopenhauer
(free version)
20
Editor's Notes
Evaluación por expertos sobre los servicios de tratamiento en 7 países de LA
Los estudios realizados sobre la prevalencia del fumar en los profesionales de la salud, pone en evidencia que, aunque han habido cambios positivos en los últimos años, el número de fumadores en el personal de salud, sigue siendo elevado Treinta por ciento o más de los médicos en Cuba, Argentina, Chile y Uruguay fuman, comparado con México y Guatemala donde fuman 22% y menos del 20%, respectivamente. La mayoría de los médicos reconoce que no han recibido entrenamiento formal en tabaquismo y en cesación tabáquica durante su formación de pregrado ni tampoco durante el postgrado. En general refieren poca confianza en su efectividad para ayudar a sus pacientes para dejar de fumar
Los estudios realizados sobre la prevalencia del fumar en los profesionales de la salud, pone en evidencia que, aunque han habido cambios positivos en los últimos años, el número de fumadores en el personal de salud, sigue siendo elevado Treinta por ciento o más de los médicos en Cuba, Argentina, Chile y Uruguay fuman, comparado con México y Guatemala donde fuman 22% y menos del 20%, respectivamente. La mayoría de los médicos reconoce que no han recibido entrenamiento formal en tabaquismo y en cesación tabáquica durante su formación de pregrado ni tampoco durante el postgrado. En general refieren poca confianza en su efectividad para ayudar a sus pacientes para dejar de fumar