miércoles, 23 de abril de 2014

Thunderclap: National Women’s Health Week

Thunderclap: National Women’s Health Week

Support the National Women's Health Week Thunderclap!



NWHW 2014 Header

Support the National Women’s Health Week Thunderclap on Monday, May 12!
Thunderclap is a tool that amplifies a message by getting a lot of people to say it together. By joining our National Women’s Health Week Thunderclap, you and others will share the same message at the same time across Facebook and Twitter.
Please join the National Women’s Health Week Thunderclap before 12:00 p.m. (EDT) on May 12, and ask your friends, family, and coworkers to support the message, too.
If you have any questions, please email womenshealth@hhs.gov.



Consumer Updates > What Kind of Fish Is That?

Consumer Updates > What Kind of Fish Is That?



What Kind of Fish Is That?

Jonathan Deeds Paddle Fish DNA Barcoding (350x230)Jonathan Deeds Fish DNA Barcoding (350x230)
FDA research biologist Jonathan Deeds, Ph.D., is working to assure that U.S. seafood is both safe and accurately labeled. DNA from fish such as these are being used as part of a new testing program to enforce the accurate labeling of seafood sold in the U.S. For more photos of this project available for redistribution, go to Flickr.


On this page:
Have you sometimes wondered if that "wild caught" salmon actually came from an aqua farm? Or if the "U.S. catfish" in the display case might have been born and raised in Vietnam?
Is that "red snapper" actually red snapper and worth the premium price?
Scientists at the Food and Drug Administration (FDA) are able to answer those questions through a project that creates DNA barcodes to identify individual fish species. The massive project is part of an effort aimed at solving the problem of species substitution.
Species substitution can result in cheap fish being labeled as pricy ones, but mislabeling can also threaten public health. For example, in 2007, a prohibited and highly toxic variety of puffer fish, also known as fugu or blowfish, was smuggled into the U.S. in boxes labeled as "headless monkfish." This deception resulted in illnesses in multiple states.
A series of cutting-edge tests must be conducted to create the barcodes, which look much like the lines of different thicknesses on Universal Product Code (UPC) labels used to identify and scan manufactured products. However, unlike the barcodes you see on packages in the supermarket, the barcodes that identify different fish species will not be attached to the fish.
Instead, once a fish species is identified through DNA testing and other high-tech techniques in FDA labs, the newly created barcode unique to that species is entered into a database, which could be thought of as a library or catalogue of commercial fish species.
When encountering a fish or fish product (fillets, fish sticks, sushi, etc.) whose species is unknown, inspectors with the equipment and know-how can create a barcode for that fish and compare it against FDA's database to seek a known match.
The agency has trained more than 20 FDA analysts around the country to use that procedure in many of its regional field laboratories and are now performing the analysis on a regular basis.

Collecting Samples

The first step in FDA's species identification project involves collecting fresh fish to be tested.
Jonathan Deeds, Ph.D., an FDA research biologist, has been showing up at fishing tournaments and seafood conventions in the U.S., asking for donations of fish he can bring back to suburban Maryland for testing.
Meanwhile, Jeffrey Williams, Ph.D., has led three expeditions to markets in the Philippines, collecting nearly a thousand fish to be used by the FDA for species testing. FDA contracted with the Smithsonian Institution's Division of Fisheries, and Laboratories of Analytical Biology for their expertise in taxonomy—the naming of species, and for their expertise in storing species long term.
The Smithsonian already has the world's largest fish collection, started in the 1800s. However, modern genetic tests cannot be performed on fish stored using standard museum practices of preserving with formaldehyde. By collecting new species, Smithsonian scientists like Williams are doing work critical to FDA's species substitution project, but are also serving their mission of building the national fish collections.
When a fresh fish arrives at FDA labs, Deeds removes a small piece. He turns this over to FDA molecular biologist Sara Handy, Ph.D., to test its DNA—the nucleic acid that carries genetic information. Deeds saves a larger chunk in case future DNA sampling is needed. The piece is stored for long-term use in freezers at ultra-low temperatures of -80 degrees Celsius.
The remainder of the whole fish is sent to Williams and his team at the Smithsonian for authentication and indefinite safekeeping.
As a final step, FDA information technology specialist Frederick Fry, Jr., Ph.D., has created a public database of barcodes for commercial seafood, available through the FDA website, that is used by regulators both inside and outside the FDA, by private laboratory scientists on behalf of seafood suppliers, and by academic researchers around the world.

The Need Is Critical

While the technology is still evolving, the ability to prevent mislabeling is increasingly critical. Worldwide, about 30,000 species of fish are thought to exist, about 1,500 of which currently are sold commercially in the U.S. As we run out of the most popular fish types, the number of species harvested is expected to increase. That in turn will likely lead to more confusion about what's being bought and sold.
Although new species are still being added to the database, DNA evidence has already been used by FDA in support of enforcement actions against fish wholesalers found to be substituting one fish for another. In 2013, for example, the Department of Justice charged the owner of an Illinois seafood distributor with mislabeling fish. The owner subsequently pleaded guilty and received a maximum $100,000 fine and was sentenced to five years' probation.
It also has been used to test and reject imported fish that are misbranded, and has helped investigators trace the source of illness outbreaks. DNA testing can pinpoint with much greater accuracy what kind of fish was involved in an outbreak. For example, scientists may suspect that the source of an illness was a "snapper" or a "grouper." But there are more than 100 species that can be marketed within those two categories alone. Being able to determine the exact species involved in an illness provides critical clues to finding and eliminating the source of the problem.
Scientists at the Canadian Centre for DNA Barcoding have proposed creating a portable barcoding device so that this process can move beyond the laboratory.
Previously, to identify a species the FDA relied on a combination of physical characteristics and a protein analysis that wasn't as exact and that didn't work well on fish that had been cooked. Moreover, protein in the fish broke down over time, so there was a constant need to refurbish fresh fish samples. Moreover, making comparisons between the fish in question and reference samples was difficult and time consuming.

The Science of Identifying Species

The fish barcoding project demonstrates the advanced science practiced in FDA labs. Procedures include some similar to those used to create the human genome, a genetic map of the body.
The DNA of all living things is made up of just four chemical bases—adenine (A), guanine (G), cystosine (C), and thymine (T). Millions of those four bases are present in an organism as complex as a fish. The order, or "sequence," of those bases is unique to every species.
Sequencing all the DNA in a fish sample would provide too much information—specifically, the order of all those millions of bases that make up the DNA of a fish. Instead, scientists can now identify one specific piece of DNA that has just 650 bases. That fragment typically provides enough genetic information to identify a fish species.
Requiring only a pinhead-sized piece of fish tissue, that specific piece of DNA is isolated and replicated, in other words copying it and separating it from all of the other DNA, using a technique called Polymerase Chain Reaction or PCR. The PCR technique, performed on an instrument called a thermocycler, can isolate this particular fragment of DNA from nearly all fish species. Several other steps, including analyzing with a DNA sequencer, will eventually lead to a unique bar code for each species.
The technique can be used to identify anything from skinned fish fillets to tiny bits of fish in a cooked soup.
"We know that our team's DNA project has immediate practical applications to prevent seafood fraud and increase the safety of seafood," says Deeds. "The additional benefits in the future to science and the public we can only imagine."
This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products.
April 21, 2014

Health Awareness Topics - April 2014

National Guideline Clearinghouse (NGC)

April 21, 2014


Health Awareness Topics - April 2014

National Guideline Clearinghouse | Mobile Resources

National Guideline Clearinghouse | Mobile Resources

National Guideline Clearinghouse (NGC)

April 21, 2014

Mobile Device Resources

NGC Guideline Summaries are available in HTML format downloadable to mobile devices – just click the "HTML" link at the top of any summary page.
Information concerning the availability of full-text guidelines and/or companion documents available in mobile versions through the guideline developer is listed in the Companion Documents field in the guideline summary. In addition to the content available on NGC, several guideline developers provide other downloadable resources at their Web sites. The list below is organized alphabetically by guideline developer and provides a brief description of the available resources.
Copyright and other restrictions may apply to the use of these files. Users should thoroughly review all information provided by the guideline developer before using these files.
American Academy of Dermatology (AAD)
AAD guidelines are available in a mobile-friendly format from the AAD Web site External Web Site Policy.
American Association for the Study of Liver Diseases (AASLD)
AASLD guidelines are available for download from the APPRISOR Web site External Web Site Policy. The APPRISOR™ Document Viewer and technical support information are available at www.apprisor.com External Web Site Policy.
American Academy of Orthopaedic Surgeons (AAOS)
AAOS Appropriate Use Criteria are available as a web-based mobile application on traditional Internet browsers and on Apple and Android mobile devices from the AAOS Web site External Web Site Policy.
American College of Cardiology Foundation (ACCF)
Recommendations from the ACCF/American Heart Association (AHA) clinical practice guidelines are available for Palm or Pocket PC PDA or Smartphone from the ACC Web site External Web Site Policy.
American College of Chest Physicians (ACCP)
ACCP guidelines are available for download from the APPRISOR Web site External Web Site Policy. The APPRISOR™ Document Viewer and technical support information are available at www.apprisor.com External Web Site Policy.
American College of Emergency Physicians (ACEP)
ACEP clinical policies are available for mobile applications from the ACEP Web site External Web Site Policy.
American College of Physicians (ACP)
ACP's PDA & Mobile Computing Center External Web Site Policy offers a variety of applications, mobile web resources, and mobile documents to support your clinical practice.
American Diabetes Association (ADA)
The 2013 Clinical Practice Recommendations are available for viewing on a Palm or Pocket PC or as an iPhone App from the American Diabetes Association Web site External Web Site Policy.
American Geriatrics Society (AGS)
Mobile apps that aid in providing high-quality health care for older adults are available from the AGS Web site External Web Site Policy.
American Heart Association (AHA)
AHA has made a number of its guidelines, jointly developed with the American College of Cardiology (ACC), available in mobile format. Guidelines may be viewed with the APPRISOR™ Document Viewer for Palm OS, or by the iSilo document reader for Palm OS or Pocket PC. AHA guidelines are available for download from the APPRISOR Web site External Web Site Policy. The APPRISOR™ Document Viewer and technical support information are available at www.apprisor.com External Web Site Policy.
American Society for Anesthesiologists (ASA)
Most ASA guidelines are available in EPUB for eBook devices from the Anesthesiology Journal Web site External Web Site Policy.
Centers for Disease Control and Prevention (CDC)
  • CDC sexually transmitted diseases guidelines 2010 are available in ebook version from the CDC Web site External Web Site Policy.
  • Child and adolescent immunization schedules are available for download mobile devices from the CDC Web site External Web Site Policy.
  • HIV/AIDS guidelines and related resources are available in a mobile-optimized format from the AIDSinfo Web site External Web Site Policy.
Comprehensive Cancer Centre the Netherlands
The Comprehensive Cancer Centre the Netherlands Web site External Web Site Policy makes several of it's guidelines available for download.
European Association of Urology (EAU)
Guidelines are available for download for a variety of handheld devices from the EAU Web site External Web Site Policy.
European Society of Cardiology (ESC)
Download pocket guidelines for Palm, Pocket PC/Windows Mobile, and smartphones from the European Society of Cardiology (ESC) Web site External Web Site Policy.
Hartford Institute for Geriatric Nursing
The ConsultGeriRN app is designed to help healthcare professionals with their decision making in providing the best quality care for older adults without needing to leave their side. This mobile reference is available from the Hartford Institute for Geriatric Nursing Web site External Web Site Policy.
Infectious Diseases Society of America (IDSA)
IDSA practice guidelines are available for mobile devices from the IDSA Web site External Web Site Policy.
Medical Services Commission, British Columbia
Guidelines can be easily viewed from any mobile device, such as iPhone, Android and Blackberry from the British Columbia Ministry of Health Web site External Web Site Policy.
National Heart, Lung and Blood Institute (NHLBI) (U.S.)
NHLBI guidelines are available forPalm OS and PocketPC devices from the NHLBI Web site External Web Site Policy.
Registered Nurses' Association of Ontario (RNAO)
RNAO Nursing Best Practice guidelines are available for PDAs and smartphones on the RNAO Web site External Web Site Policy.
Scottish Intercollegiate Guidelines Network (SIGN)
The SIGN guideline app for Apple and Android devices is available from the SIGN Web site External Web Site Policy.
U.S. Preventive Services Task Force (USPSTF)
The Electronic Preventive Services Selector (ePSS) External Web Site Policy is an application designed to help primary care clinicians identify the screening, counseling, and preventive medication services that are appropriate for their patients.
The ePSS is available both as a web application and a mobile application. The ePSS information is based on the current recommendations of the USPSTF and can be searched by specific patient characteristics, such as age, sex, and selected behavioral risk factors.

National Guideline Clearinghouse | ACR Appropriateness Criteria® renal failure.

full-text ►

National Guideline Clearinghouse | ACR Appropriateness Criteria® renal failure.



American College of Radiology

National Guideline Clearinghouse (NGC)

Guideline Title
ACR Appropriateness Criteria® renal failure.
Bibliographic Source(s)
Remer EM, Papanicolaou N, Casalino DD, Bishoff JT, Blaufox MD, Coursey CA, Dighe M, Eberhardt SC, Goldfarb S, Harvin HJ, Heilbrun ME, Leyendecker JR, Nikolaidis P, Oto A, Preminger GM, Raman SS, Sheth S, Vikram V, Weinfeld RM, Expert Panel on Urologic Imaging. ACR Appropriateness Criteria® renal failure. [online publication]. Reston (VA): American College of Radiology (ACR); 2013. 12 p. [86 references]
Guideline Status
This is the current release of the guideline.
This guideline updates a previous version: Papnicolaou N, Francis IR, Casalino DD, Arellano RS, Baumgarten DA, Curry NS, Dighe M, Israel GM, Jafri SZ, Kawashima A, Leyendecker JR, Prasad S, Ramchandani P, Remer EM, Sheth S, Fulgham P, Expert Panel on Urologic Imaging. ACR Appropriateness Criteria® renal failure. [online publication]. Reston (VA): American College of Radiology (ACR); 2008. 10 p.

National Guideline Clearinghouse | ACR Appropriateness Criteria® screening for pulmonary metastases.

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National Guideline Clearinghouse | ACR Appropriateness Criteria® screening for pulmonary metastases.



American College of Radiology

National Guideline Clearinghouse (NGC)

April 21, 2014

Guideline Title
ACR Appropriateness Criteria® screening for pulmonary metastases.
Bibliographic Source(s)
Mohammed TH, Kirsch J, Brown K, Chung JH, Dyer DS, Ginsburg ME, Heitkamp DE, Kanne JP, Kazerooni EA, Ketai LH, Parker JA, Ravenel JG, Saleh AG, Shah RD, Steiner RM, Suh RD, Expert Panel on Thoracic Imaging. ACR Appropriateness Criteria® screening for pulmonary metastases. [online publication]. Reston (VA): American College of Radiology (ACR); 2013. 11 p. [53 references]
Guideline Status
This is the current release of the guideline.
This guideline updates a previous version: Mohammed TH, Chowdhry A, Reddy GP, Amoroso JK, Brown K, Dyer DS, Ginsburg ME, Heitkamp DE, Jeudy J, Kirsch J, MacMahon H, Parker JA, Ravenel JG, Saleh AG, Shah RD, Expert Panel on Thoracic Imaging. ACR Appropriateness Criteria® screening for pulmonary metastases. [online publication]. Reston (VA): American College of Radiology (ACR); 2010. 8 p.

National Guideline Clearinghouse | ACR Appropriateness Criteria® post-treatment follow-up of renal cell carcinoma.

full-text ►

National Guideline Clearinghouse | ACR Appropriateness Criteria® post-treatment follow-up of renal cell carcinoma.



American College of Radiology

National Guideline Clearinghouse (NGC)

April 21, 2014

Guideline Title
ACR Appropriateness Criteria® post-treatment follow-up of renal cell carcinoma.
Bibliographic Source(s)
Casalino DD, Remer EM, Bishoff JT, Coursey CA, Dighe M, Harvin HJ, Heilbrun ME, Majd M, Nikolaidis P, Preminger GM, Raman SS, Sheth S, Vikram R, Weinfeld RM, Expert Panel on Urologic Imaging. ACR Appropriateness Criteria® post-treatment follow-up of renal cell carcinoma. [online publication]. Reston (VA): American College of Radiology (ACR); 2013. 9 p. [63 references]
Guideline Status
This is the current release of the guideline.
This guideline updates a previous version: Casalino DD, Francis IR, Arellano RS, Baumgarten DA, Curry NS, Dighe M, Fulgham P, Israel GM, Leyendecker JR, Papanicolaou N, Prasad S, Ramchandani P, Remer EM, Sheth S, Expert Panel on Urologic Imaging. ACR Appropriateness Criteria® follow-up of renal cell carcinoma. [online publication]. Reston (VA): American College of Radiology (ACR); 2009. 6 p.