Interim Guidance 7 March 2020
This document provides technical guidance for government authorities, health workers, and other key stakeholders to guide response to community spread. It will be updated as new information or technical guidance become available. For countries that are already preparin...g or responding, this document can also serve as a checklist to identify any remaining gaps.
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Eur Respir J 2016; 48: 808–817 | DOI: 10.1183/13993003.00840-2016
The war is having a devastating impact on health and human capital in Ukraine and is expected to affect generations to come. The most obvious effects on health are immediate: an estimated 4,339 conflict-related deaths and 5,246 people injured. Less visible is the illness caused, and exacerbated, by ...people not being able to access care for acute and chronic conditions.
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Infection Prevention and Control Programmes
January 2020
Medical Journal of Zambia, Volume 36 Number 4 (2009)
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. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h 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.
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