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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Los residuos generados por las actividades sanitarias, desde agujas infectadas hasta isótopos radiactivos, pueden ser una fuente de infecciones o lesiones y su gestión inadecuada puede tener graves consecuencias para la salud pública y efectos nocivos para el medio ambiente.
...staca los aspectos clave de la gestión segura de los residuos médicos para orientar a los responsables políticos, a los profesionales y a los gestores de las instalaciones para mejorar estos servicios en los centros sanitarios.
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Le HCSP a fondé ses recommandations sur les connaissances actuellement disponibles en particulier les publications scientifiques relatives au COVID-19 mais aussi de recommandations relatives à la prise en charge des pneumonies post grippales, et des pneumonies sévères en réanimation.
Cet avi...s du HCSP délivre également des indications sur la prise en charge non spécifique, et de possibles thérapeutiques antivirales, dans l’attente de la mise en place d’essais thérapeutiques académiques afin de progresser dans la connaissance de la maladie. Ces recommandations relatives aux traitements spécifiques seront adaptées en fonction des résultats des essais cliniques lorsqu’ils seront disponibles.
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Petersenet al.International Journal of Mental Health Systems2011,5:8http://www.ijmhs.com/content/5/1/8
The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir...ometry, and insufficient knowledge among healthcare workers. The review also highlights the stigma associated with asthma and the absence of relevant diagnostic guidelines. Solutions proposed include community education, development and adherence to diagnostic guidelines, and strengthening healthcare systems. The study aims to inform policymakers and healthcare providers to improve asthma diagnosis and care for children in these regions.
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The environment in which young people live, learn and play significantly affects their decisions about whether to consume alcohol. Environmental factors are the main risk factors driving alcohol consumption and related harm among young people. Environments that normalize alcohol consumption – term...ed alcogenic environments – include contexts with unregulated advertising and marketing of alcoholic beverages, higher alcohol outlet density, products designed to facilitate affordability and low prices of alcoholic beverages. A recent body of research evidence has emerged related to the measurement, functional significance and consequences of living in alcogenic environments. This includes findings on the complex and bidirectional interactions among alcohol acceptability, availability and affordability and how they create and perpetuate alcogenic environments. Comprehensive and enforced alcohol control policies are effective at delaying the age of onset and lowering alcohol prevalence and frequency among young people. Evidence consistently confirms the effectiveness of designing and implementing alcohol control policies that regulate upstream the drivers of alcogenic environment, including alcohol availability, acceptability and affordability. These policies need to be multipronged and address the complex interactions between these drivers and the local alcohol culture
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation...). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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В настоящем документе представлен первоначальный обзор поступающей информации
(по состоянию на 2 июля 2020 г.) о взаимосвязи между COVID-19, НИЗ и факторами
риска НИЗ. Ре...цензируемые статьи взяты из баз данных NCBI PubMed, PMC и Google
Scholar. Данный обзор свидетельствует о том, что лица, живущие с НИЗ, подвержены
более высокому риску развития тяжелого заболевания и смерти в связи с COVID-19,
и об ограниченности данных для оценки риска. Наряду с этим в нем обобщаются
результаты двух проведенных ВОЗ обследований, указывающих на то, что с началом
пандемии была серьезно нарушена система предоставления услуг по профилактике и
лечению НИЗ.
Response to non-communicable diseases during and after the COVID-19 pandemic
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This document sets out, therefore, to explain the socioeconomic value of investing in the fight against NTDs and highlights priorities for global investment attention. Our work was guided by the need not only for
additional funding and funders but also for the need to understand the current funding... climate, in which value for money and the efficient use of resources to fill the most critical of gaps are more relevant than ever.
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Guidance has been updated on a number of chemicals: asbestos, bentazone, chromium, iodine, manganese, microcystins, nickel, silver, tetrachloroethene and trichloroethene. Guidance has also been added for chemicals not previously assessed in the Guidelines: anatoxin-a and analogues, cylindrospermopsi...ns and saxitoxins. The new guidance on organotins has replaced the prior guidance focused on dialkyltins. With these updates, the guideline values for tetrachloroethene and trichloroethene have been revised while new guideline values for cylindrospermopsins, manganese, microcystins, and saxitoxins have been established .
Updated information on cyanobacteria has been included, introducing an alert level framework for early-warning and to guide short-term management responses. Guidance has also been updated in the sections on adequacy of water supply, climate change, emergencies, food production and processing, and radiological aspects, particularly on managing radionuclides when exceeding WHO screening values and guidance levels.
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In Deutschland leben ca. 200.000 Geflüchtete in Aufnahmeeinrichtungen und Gemeinschaftsunterkünften (Stand:31.12.2018). Massnahmen der physischen Distanzierung sind in der Sammelunterbringung für Geflüchtete meist nicht oder nur bedingt umsetzbar: Beengte Verhältnisse, Mehrbettzimmer und gemein...schaftliche Nutzung von Küchen und Sanitäranlagen stellen Kontexte dar, die eine Ausbreitung von Infektionserkrankungen begünstigen. Zunehmend werden in diesen Settings Infektionen mit dem neuartigen Coronavirus (SARS‐CoV‐2) bekannt. Die Ansätze zu Prävention und Management von SARS‐CoV‐2 sind regional unterschiedlich, Vorgaben fehlen bisher auf nationaler und internationaler Ebene. So werden vielerorts Aufnahmeeinrichtungen und Gemeinschaftsunterkünfte beim Auftreten einer SARS‐CoV‐2‐Infektion unter Geflüchteten kollektiv unter Quarantäne gestellt.
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A summary of the national drug situation
A resource for pesticide registrars and regulators.
The WHO urged governments to restrict access to highly toxic pesticides used for self-poisoning . Other effective interventions include education, youth intervention programs and follow-up of people at risk—and better data. Only 80 out of 183 WH...O member states reported high-quality vital registration data in 2016
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Updates for the integrated management of childhood illness (IMCI) - Guideline.
As part of its response to the global epidemic of obesity, WHO has issued guidelines to support primary healthcare workers identify and manage children who are overweight or obese. Specifically, all infants and children ...aged less than 5 years presenting to primary health-care facilities should have both weight and height measured in order to determine their weight-for-height and their nutritional status according to WHO child growth standards. Comparing a child's weight with norms for its length/height is an effective way to assess for both wasting and overweight
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his guidance provides interim guidance for the integration of SARS-CoV-2 and influenza virologic and genomic surveillance, from sentinel site case enrolment and sampling to the eventual sharing of the virus sequence data, a process known as end-to-end surveillance. This guidance builds on experience...s and lessons learned as countries adapted their influenza surveillance systems in the context of the COVID-19 pandemic and reviews new evidence to provide guidance on end-to-end surveillance. The guidance includes new algorithms and strategies to adapt sentinel systems to make them resilient and agile for addressing global and national surveillance needs for influenza and COVID-19.covid-
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