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World Health Officials Describe Progress Against Tetanus, H.I.V. and Malaria

    Infant and maternal tetanus was officially eliminated from the Americas this year, the Pan American Health Organization announced on Thursday. At one time, the infection killed about 10,000 newborns annually in the Western Hemisphere; tetanus still kills about 35,000 infants around the world. It was one of several significant global health advances, including new programs against malaria and H.I.V., announced last week in conjunction with the meeting of the United Nations General Assembly in New York.
    Haiti was the last country in the Americas to eliminate neonatal tetanus. That does not mean complete eradication, because the bacteria that cause tetanus exist everywhere in soil and animal droppings. Rather, elimination means that thanks to vaccination of mothers and clean birth procedures — less than one case occurs per 1,000 live births.
    The Americas have generally led the world in eliminating diseases for which vaccines exist. In this hemisphere, smallpox was eliminated in 1971, polio in 1994, rubella in 2015 and measles in 2016 (the diseases are sometimes reintroduced, as measles was at Disneyland in 2014, but outbreaks are usually brought quickly under control).
    Also this week, the President’s Malaria Initiative said it would expand its work to new countries in West and Central Africa, protecting 90 million more people. The initiative, founded in 2005 as part of the United States Agency for International Development, has been a major force in driving down worldwide malaria deaths by about 40 percent in the past decade. The disease most often kills young children and pregnant women. The expansion in Cameroon, Ivory Coast, Niger, Sierra Leone and Burkina Faso was made possible because Congress increased funding for the initiative in fiscal year 2017, a representativ said
    In his speech to the United Nations on Tuesday, President Trump praised the malaria initiative and the President’s Emergency Plan for AIDS Relief as examples of leadership in humanitarian assistance by the United States.
    A combination of aid agencies, drug companies and g cocktail to treat H.I.V. would soon be available to 92 countries, including virtually all of Africa, for about $75 a year. The new AIDS cocktail is the first available in poor countries to contain dolutegravir, which is widely used in wealthy countries because it is highly effective and has few side effects. The pill also contains lamivudine, an older but still effective drug, and tenof disoproxil fumarate, another modern drug whose inclus effects and resistance.
    Almost 37 million people in the world have H.I.V., according to Unaids, the U.N.’s AIDS-fighting agency, but fewer than 20 million are now on antiretroviral medicine, which not only saves their lives but prevents them from passing on the disease.

McNEIL Jr., Donald. Disponível em: < https://www.nytimes.com/2017/09/22/health/world-health-tetanus-infants.html?mcubz=1>. Acesso em: 22/09/2017. 

Read TEXT 1 below and answer question

TEXT 1

World Health Officials Describe Progress Against Tetanus, H.I.V. and Malaria

    Infant and maternal tetanus was officially eliminated from the Americas this year, the Pan American Health Organization announced on Thursday. At one time, the infection killed about 10,000 newborns annually in the Western Hemisphere; tetanus still kills about 35,000 infants around the world. It was one of several significant global health advances, including new programs against malaria and H.I.V., announced last week in conjunction with the meeting of the United Nations General Assembly in New York.
    Haiti was the last country in the Americas to eliminate neonatal tetanus. That does not mean complete eradication, because the bacteria that cause tetanus exist everywhere in soil and animal droppings. Rather, elimination means that thanks to vaccination of mothers and clean birth procedures — less than one case occurs per 1,000 live births.
    The Americas have generally led the world in eliminating diseases for which vaccines exist. In this hemisphere, smallpox was eliminated in 1971, polio in 1994, rubella in 2015 and measles in 2016 (the diseases are sometimes reintroduced, as measles was at Disneyland in 2014, but outbreaks are usually brought quickly under control).
    Also this week, the President’s Malaria Initiative said it would expand its work to new countries in West and Central Africa, protecting 90 million more people. The initiative, founded in 2005 as part of the United States Agency for International Development, has been a major force in driving down worldwide malaria deaths by about 40 percent in the past decade. The disease most often kills young children and pregnant women. The expansion in Cameroon, Ivory Coast, Niger, Sierra Leone and Burkina Faso was made possible because Congress increased funding for the initiative in fiscal year 2017, a representativ said
    In his speech to the United Nations on Tuesday, President Trump praised the malaria initiative and the President’s Emergency Plan for AIDS Relief as examples of leadership in humanitarian assistance by the United States.
    A combination of aid agencies, drug companies and g cocktail to treat H.I.V. would soon be available to 92 countries, including virtually all of Africa, for about $75 a year. The new AIDS cocktail is the first available in poor countries to contain dolutegravir, which is widely used in wealthy countries because it is highly effective and has few side effects. The pill also contains lamivudine, an older but still effective drug, and tenof disoproxil fumarate, another modern drug whose inclus effects and resistance.
    Almost 37 million people in the world have H.I.V., according to Unaids, the U.N.’s AIDS-fighting agency, but fewer than 20 million are now on antiretroviral medicine, which not only saves their lives but prevents them from passing on the disease.

McNEIL Jr., Donald. Disponível em: < https://www.nytimes.com/2017/09/22/health/world-health-tetanus-infants.html?mcubz=1>. Acesso em: 22/09/2017. 

Text 2

Your Meal Has Six Times More Salt Than You Think  

How much salt was in your lunch? Whatever your guess, chances are you’re off. By a lot. 
In a new study, published in the journal Appetite, researchers stood outside fast-food restaurants and asked people to guess how much sodium they just ate. Their answers were almost always six times too low.
That's because people don't tend to use a lot of salt to season meals cooked at home, but restaurants use much more of it to enhance the flavor of their meals. It’s also used in food additives and as a preservative to extend shelf life, so even foods that don’t taste salty, like pastries, donuts and bread, can have a lot of it. 
As a result, 89% of Americans eat too much salt. People should get no more than 2,300 milligrams of sodium a day — about one teaspoon, public health groups recommend — but the average American eats about 3,600 mg every day. Eating too much salt makes the body retain more water, which raises blood pressure and can affect the heart, blood vessels, brain and kidneys. Overconsuming sodium can lead to hypertension, heart attack and stroke, according to the Harvard T.H. Chan School of Public Health.
To test the sodium knowledge of real-world eaters, researchers stationed themselves at several fast-food restaurants — McDonald’s, Burger King, Subway, Wendy’s, Kentucky Fried Chicken and Dunkin’ Donuts — and polled adolescents and adults on their sodium consumption. When people approached the entrance, the researchers asked them to save their receipts; on their way out, they estimated how much sodium they ate. 
Adults ate about 1,300 mg of sodium in a single fast-food sitting, which is more than half of the upper recommended limit for the day. Yet the average guess was just 200 mg, says study author Alyssa Moran, a registered dietitian and doctoral student at the Harvard School of Public Health. They were off by about 650%.
That's when they ventured a guess at all. “25% of the people we approached had absolutely no idea about the amount of sodium in their meal and couldn’t even provide an estimate,” Moran says. 
Sodium information isn't visibly published in chain restaurants. But in 2015, New York became the first city in the country to require chains to post warning labels on menu items with more than 2,300 mg of sodium. "Right now it's only in New York City, but we have a feeling that other local governments will probably follow suit," Moran says. "We saw that that happened when New York City started posting calories on menu boards." 
Doing so may finally help people learn how much sodium is in their food, and it may even encourage companies to reformulate the worst offenders.

Text1

Autism's Drug Problem 

Many people on the spectrum take multiple medications, which can lead to serious side effects and may not even be effective

Connor was diagnosed with autism early — when he was just 18 months old. His condition was already obvious by then. “He was lining things up, switching lights on and off, on and off,” says his mother, Melissa. He was bright, but he didn’t speak much until age 3, and he was easily frustrated. Once he started school, he couldn’t sit still in class, called out answers without raising his hand and got visibly upset when he couldn’t master a math concept or a handwriting task quickly enough. “One time, he rolled himself up into the carpet like a burrito and wouldn’t come out until I got there,” Melissa recalls. (All families in this story are identified by first name only, to protect their privacy.) 
Connor was prescribed his first psychiatric drug, methylphenidate (Ritalin), at age 6. That didn’t last long, but when he was 7, his parents tried again. A psychiatrist suggested a low dose of amphetamine and dextroamphetamine (Adderall), a stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD). The drug seemed to improve his time at school: He was able to sit still for longer periods of time and focus on what his teachers were saying. His chicken-scratch handwriting became legible. Then, it became neat. Then perfect. And then it became something Connor began to obsess over.
“We were told that these are the gives and takes; if it’s helping him enough to get through school, you have to decide if it’s worth it,” Melissa says. It was worth it — for a while.  
But when the Adderall wore off each day, Connor had a tougher time than ever. He spent afternoons crying and refusing to do much of anything. The stimulant made it difficult for him to fall asleep at night. So after a month or two, his psychiatrist added a second medication — guanfacine (Intuniv), which is commonly prescribed for ADHD, anxiety and hypertension, but can also help with insomnia. The psychiatrist hoped it might both ease Connor’s afternoons and help him sleep. 
In some ways, it had the opposite effect. His afternoons did get slightly better, but Connor developed intense mood swings and was so irritable that every evening was a struggle. Rather than simply tossing and turning in bed, he refused to even get under the covers. “He wouldn’t go to bed because he was always angry about something,” Melissa says. “He was getting himself all wound up, carrying on, getting upset at night and crying.” 
 wound up, carrying on, getting upset at night and crying.” After seven months, his parents declared the combination unsustainable. They swapped guanfacine for over-the-counter melatonin, which helped Connor fall asleep with no noticeable side effects. But within a year, he had acquired a tolerance for Adderall. Connor’s psychiatrist increased his dosage and that, in turn, triggered tics: Connor began jerking his head and snorting. Finally, at his 9-year physical, his doctor discovered that he’d only grown a few inches since age 7. He also hadn’t gained any weight in two years; he’d dropped from the 50th percentile in weight to the 5th. That was the end of all the experiments. His parents took him off all prescription drugs, and today, at almost 13 years old, Connor is still medication-free. His tics have mostly disappeared. Although he has trouble maintaining focus in class, his mother says that the risk-benefit ratio of trying another drug doesn’t seem worth it. “Right now we’re able to handle life without it, so we do.”
(...)
For Connor, eliminating prescription drugs was difficult, but doable. For others, multiple medications may seem indispensable. It’s not unusual for children with autism to take two, three, even four medications at once. Many adults with the condition do so, too. Data are scant in both populations, but what little information there is suggests multiple prescriptions are even more common among adults with autism than in children. Clinicians are particularly concerned about children with the condition because psychiatric medications can have long-lasting effects on their developing brains, and yet are rarely tested in children. 
In general, polypharmacy — most often defined as taking more than one prescription medication at once — is commonplace in people with autism. In one study of more than 33,000 people under age 21 with the condition, at least 35 percent had taken two psychotropic medications simultaneously; 15 percent had taken three.
“Psychotropic medications are used pretty extensively in people with autism because there aren’t a lot of treatments available,” says Lisa Croen, director of the Autism Research Program at Kaiser Permanente in Oakland, California. “Is heavy drug use bad? That’s the question. We don’t know; it hasn’t been studied.”

  Disponível em: <https://www.scientificamerican.com/article/autisms-drug-problem/>. Texto adaptado. 

Text1

Autism's Drug Problem 

Many people on the spectrum take multiple medications, which can lead to serious side effects and may not even be effective

Connor was diagnosed with autism early — when he was just 18 months old. His condition was already obvious by then. “He was lining things up, switching lights on and off, on and off,” says his mother, Melissa. He was bright, but he didn’t speak much until age 3, and he was easily frustrated. Once he started school, he couldn’t sit still in class, called out answers without raising his hand and got visibly upset when he couldn’t master a math concept or a handwriting task quickly enough. “One time, he rolled himself up into the carpet like a burrito and wouldn’t come out until I got there,” Melissa recalls. (All families in this story are identified by first name only, to protect their privacy.) 
Connor was prescribed his first psychiatric drug, methylphenidate (Ritalin), at age 6. That didn’t last long, but when he was 7, his parents tried again. A psychiatrist suggested a low dose of amphetamine and dextroamphetamine (Adderall), a stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD). The drug seemed to improve his time at school: He was able to sit still for longer periods of time and focus on what his teachers were saying. His chicken-scratch handwriting became legible. Then, it became neat. Then perfect. And then it became something Connor began to obsess over.
“We were told that these are the gives and takes; if it’s helping him enough to get through school, you have to decide if it’s worth it,” Melissa says. It was worth it — for a while.  
But when the Adderall wore off each day, Connor had a tougher time than ever. He spent afternoons crying and refusing to do much of anything. The stimulant made it difficult for him to fall asleep at night. So after a month or two, his psychiatrist added a second medication — guanfacine (Intuniv), which is commonly prescribed for ADHD, anxiety and hypertension, but can also help with insomnia. The psychiatrist hoped it might both ease Connor’s afternoons and help him sleep. 
In some ways, it had the opposite effect. His afternoons did get slightly better, but Connor developed intense mood swings and was so irritable that every evening was a struggle. Rather than simply tossing and turning in bed, he refused to even get under the covers. “He wouldn’t go to bed because he was always angry about something,” Melissa says. “He was getting himself all wound up, carrying on, getting upset at night and crying.” 
 wound up, carrying on, getting upset at night and crying.” After seven months, his parents declared the combination unsustainable. They swapped guanfacine for over-the-counter melatonin, which helped Connor fall asleep with no noticeable side effects. But within a year, he had acquired a tolerance for Adderall. Connor’s psychiatrist increased his dosage and that, in turn, triggered tics: Connor began jerking his head and snorting. Finally, at his 9-year physical, his doctor discovered that he’d only grown a few inches since age 7. He also hadn’t gained any weight in two years; he’d dropped from the 50th percentile in weight to the 5th. That was the end of all the experiments. His parents took him off all prescription drugs, and today, at almost 13 years old, Connor is still medication-free. His tics have mostly disappeared. Although he has trouble maintaining focus in class, his mother says that the risk-benefit ratio of trying another drug doesn’t seem worth it. “Right now we’re able to handle life without it, so we do.”
(...)
For Connor, eliminating prescription drugs was difficult, but doable. For others, multiple medications may seem indispensable. It’s not unusual for children with autism to take two, three, even four medications at once. Many adults with the condition do so, too. Data are scant in both populations, but what little information there is suggests multiple prescriptions are even more common among adults with autism than in children. Clinicians are particularly concerned about children with the condition because psychiatric medications can have long-lasting effects on their developing brains, and yet are rarely tested in children. 
In general, polypharmacy — most often defined as taking more than one prescription medication at once — is commonplace in people with autism. In one study of more than 33,000 people under age 21 with the condition, at least 35 percent had taken two psychotropic medications simultaneously; 15 percent had taken three.
“Psychotropic medications are used pretty extensively in people with autism because there aren’t a lot of treatments available,” says Lisa Croen, director of the Autism Research Program at Kaiser Permanente in Oakland, California. “Is heavy drug use bad? That’s the question. We don’t know; it hasn’t been studied.”

  Disponível em: <https://www.scientificamerican.com/article/autisms-drug-problem/>. Texto adaptado. 

         Drinking coffee could help you live longer Coffee not only helps you feel full of beans, it might add years to your life as well, two major studies have shown. Scientists in Europe and the US have uncovered the clearest evidence yet that drinking coffee reduces the risk of death.

         One study of more than half a million people from 10 European countries found that men who downed at least three cups of coffee a day were 18% less likely to die from any cause than non-coffee drinkers. Women drinking the same amount benefited less, but still experienced an 8% reduction in mortality over the period measured.

        Similar results were reported by American scientists who conducted a separate investigation, recruiting 185855 participants from different ethnic backgrounds. Irrespective of ethnicity, people who drank two to three cups of coffee daily had an 18% reduced risk of death.

        Each of the studies, both published in the journal Annals of Internal Medicine, showed no advantage from drinking either caffeinated or decaffeinated coffee. Experts believe the antioxidant plant compounds in coffee rather than caffeine are responsible for the life-extending effect. Previous research has suggested that drinking coffee can reduce the risk of heart disease, diabetes, liver disease, and some cancers.

         Dr Marc Gunter, from the International Agency for Research on Cancer, who led the European study with colleagues from Imperial College London, said: “We found that higher coffee consumption was associated with a lower risk of death from any cause and specifically for circulatory diseases and digestive diseases. Importantly, these results were similar across all of the 10 European countries, with variable coffee drinking habits and customs. Our study also offers important insights into the possible mechanisms for the beneficial health effects of coffee.”

(www.huffingtonpost.co.uk, 11.07.2017. Adaptado.)