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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabe
...
tes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients with DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
more
Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nat
...
ionally representative data on the current patterns of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
more
In resource-limited countries, the number of available antiretroviral (ARV) drugs is relatively limited. Hence, caregivers face some caution and constraints in the changes of ARV treatment (ART) in people living with HIV (PLHIV). Our objective was t
...
o calculate the incidence, to describe the main causes and to identify the predictive factors of the first change of ARV treatment in Senegal.
more
The conduct of paediatric anaesthesia presents many unique challenges. One of the most striking is the variabilityof behaviour and responses of children and their parents at inductio
...
n. Behavioural problems, the need for restraint,difficult IV accessandco-morbiditiesadd complexity andcan make the art of maintaining a calm and smooth induction incredibly difficult. This tutorial will discuss sixof the common problems that arise at induction and how these may best be overcome.
more
Indian J Psychiatry. 2017 Jan; 59(Suppl 1): S67–S73.
doi: 10.4103/0019-5545.196975: 10.4103/0019-5545.196975
For most people in displacement contexts, there are simply not enough vaccines available in the places where they are hosted: 85% of refugees are hosted in lower- and middle-income countries, while in the first six months of this year 85% of vaccine
...
s went to wealthy countries; lower- and middle income countries have still received only a fraction of the vaccine doses they require.3 Shortages in these countries can also pose particular risks to vaccination campaigns aimed at displaced populations, as they can result in them being deprioritized.
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This brief highlights the urgency of addressing gender inequalities across the Rio Conventions, provides examples of where progress has been made, and identifies clear entry points for addressing gender equality considerations across the Conventions
...
. It makes recommendations for actions to accelerate the synergistic implementation of the gender provisions and action plans of the Conventions.
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The report – the first of its kind – shows how the pandemic has driven up food insecurity and increased vulnerability among migrants, families reliant on remittances and communities forced from
...
their homes by conflict, violence and disasters.
The two UN agencies warn the social and economic toll of the pandemic could be devastating and call on the world to prevent it by stepping up support in response to immediate and rising humanitarian needs, addressing the socioeconomic impacts of the crisis and ensuring that the most vulnerable are not forgotten.
more
The use of explosive weapons, such as bombs, rockets, and mortar and
artillery shells, in cities, towns and villages
...
and in other populated areas
has devastating humanitarian consequences. Explosive weapons act mainly
through the projection of blast and fragmentation within an area. Their use,
in populated areas, causes severe suffering to civilians, both in terms of
death and serious injury resulting directly from the explosion, and in terms
of damage to property and public infrastructure, which can indirectly affect
civilian well-being and survival, sometimes for many years after a conflict
has ended. Explosive weapons also leave behind explosive remnants that
pose a threat to populations until those remnants are removed. [...] The study finds that the regulation of explosive weapons under international
law and policy is fragmentary and incoherent.
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This study addresses part of the Terms of Reference for a scoping report ‘An analysis of approaches to laboratory capacity strengthening for drug resistant infections in low and middle income countries’. It has been produced as a separate report
...
because it is also very relevant for a second study ‘Supporting Surveillance Capacity for Antimicrobial Resistance: Regional Networks and Educational Resources’. This study compares antimicrobial surveillance systems in three low and middle income countries in order to describe the components of these systems and to understand which surveillance models are best suited to particular contexts. Ghana, Nigeria and Nepal were selected as study countries because they cover different continents and include one ‘fragile’ context (Nigeria). Brief information from Malawi is also included.
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This report presents examples from different agencies on how they approached community engagement in their Covid-19 responses, the tools and methodologies used, as well as the challenges they encountered a
...
nd how they attempted to overcome these. It discusses what community engagement means to the various agencies interviewed and in the literature consulted. And it puts forward some reflections on how CCCM and other sector agencies can take steps to ensure community participation in this and future pandemic responses.
more
On February 29, 2020, the United States and the Taliban signed an agreement outlining a phased withdrawal of US forces from Afghanistan in exchange for Taliban commitments not to allow attacks on the US or its allies from Afghan territory. The troop
...
withdrawal is expected to take place in parallel with negotiations between representatives from the Afghan government and other Afghan political groups and Taliban leaders aimed at achieving a political settlement after decades of armed conflict.
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Infectious Diseases of Poverty (2020) 9:74
To detect acute schistosomiasis, low-intensity infections, or to verify the success of treatment with
praziquantel, highly sensitive test methods are required. The aim of this study was therefore to demonstrate the
performance of Schistosoma mansoni spec
...
ific DNA detection in serum and urine using real-time polymerase chain
reaction (PCR) in an endemic area before and after treatment.
more
(Research Report)
This assessment relies on semi-structured interviews with 28 purposely-selected Afghan returnees who migrated to Europe and returned to Afghanistan between 2014 and 2017. Through
...
these interviews, the assessment seeks to better understand the socio-economic profile of Afghans returning from Europe, to identify the motivations behind their return, and to investigate the challenges and vulnerabilities they face once they arrive in Afghanistan.
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La Stratégie et plan d’action sur la promotion de la santé dans le contexte des objectifs de développement
durable 2019-2030 cherche à renouveler la promotion de la santé grâce à des interventions de nature sociale,
politique et technique, en agissant sur les déterminants sociaux de la s
...
anté, à savoir les conditions dans
lesquelles les personnes naissent, grandissent, vivent, travaillent et vieillissent (1). Ils visent à améliorer la
santé et à réduire les iniquités en matière de santé dans le cadre du Programme de développement durable à
l’horizon 2030
more