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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Report of the 23rd WHO Expert Committee on the selection and use of essential medicines
This executive summary reports the recommendations made by the Expert Committee for the 2021 update of the WHO Model List of Essential Medicines (EML) and the Model List of Essential Medicine for Children (EMLc)....
The 23rd meeting of the WHO Expert Committee on Selection and Use of Essential Medicines was coordinated from Geneva, Switzerland, and held virtually from 21 June to 2 July 2021. The Committee considered 88 applications proposing additions, changes and deletions of medicines, medicine classes and formulation on the Model Lists of Essential Medicines. The Committee evaluated the scientific evidence for comparative effectiveness, safety and cost-effectiveness of the medicines in question. The Committee also considered a review of the therapeutic alternatives for medicines on the Model Lists, and update to the AWaRe classification of antibiotics, and reviews and reports relevant to the selection and use of essential medicines.
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Research Article
PLOS ONE | https://doi.org/10.1371/journal.pone.0189770 January 2, 2018
Jin et al. Military Medical Research (2020) 7:4 https://doi.org/10.1186/s40779-020-0233-6
Position Article und Guideline
This Practice Parameter reviews the evidence from research and clinical experience and highlights significant advances in the assessment and treatment of posttraumatic stress disorder since the previous Parameter was published in 1998. It highlights the importance of early identification of posttrau...matic stress disorder, the importance of gathering information from parents and children, and the assessment and treatment of comorbid disorders. It presents evidence to support trauma-focused psychotherapy, medications, and a combination of interventions in a multimodal approach.
Journal of the American Academy of Children & Adolescents Psychiatry, Vol. 49 No. 4 APRIL 2010 pp.414-430
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This Framework offers a coherent approach for eliminating tuberculosis (TB) in low-incidence countries. It is designed to guide national policy-makers and those responsible for technical aspects of the national TB response in accelerating efforts towards elimination. The document will also be inform...ative for public health surveillance officers, practitioners and nongovernmental and civil society partners working on natioal TB care and prevention and serving the populations most vulnerable to TB.
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It provides guidance on care for use in resource-limited settings or in settings where families with sick young infants do not accept or cannot access referral care, but can be managed in outpatient settings by an appropriately trained health worker. The guideline seeks to provide programmatic guida...nce on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
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3rd edition!Large File 17 MB!
Esta guía trata de la primera ayuda psicológica, un modo práctico y humano para ayudar y apoyar a nuestros semejantes en graves situaciones de crisis. Se ha pensado para personas que se tienen la posibilidad de ayudar a
otras que han experimentado un hecho extremadamente angustiante. Proporciona... un marco de
trabajo para apoyar a las personas respetando su dignidad, cultura y capacidades. A pesar de su
nombre, la primera ayuda psicológica se ocupa tanto del apoyo social como del psicológico.
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La résistance aux antimicrobiens (ou RAM, cette abréviation étant est ici également employée en mode adjectif pour désigner les organismes « résistants aux antimicrobiens ») est une préoccupation majeure pour la santé publique mondiale et une question de sécurité san...itaire des aliments. Lorsque des pathogènes deviennent résistants aux agents antimicrobiens, ils peuvent présenter un risque plus important pour la santé découlant d’un éventuel échec thérapeutique, de la diminution de choix thérapeutiques et de la probabilité accrue d’apparition et de gravité de la maladie. Les problèmes en rapport avec la RAM sont liés de façon inhérente à l’usage des antimicrobiens dans tous les types d’environnements, y compris les utilisations humaines et non humaines. L'utilisation d’agents antimicrobiens dans la production alimentaire animale et végétale représente un facteur de risque important pour la sélection et la transmission de micro-organismes résistants aux antimicrobiens (micro-organismes RAM) et de déterminants de la résistance aux antimicrobiens (déterminants de la RAM) des animaux et des plantes alimentaires à l’humain par sa consommation d’aliments.
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