Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that may exist at any one of three stages: CIN1, CIN2, or CIN3. If left untreated, CIN2 or CIN3 (collectively referred to as CIN2+) can progress to cervical cancer. Instead of screening and diagnosis by the standard sequence of cytolo...gy, colposcopy, biopsy, and histological confirmation of CIN, an alternative method is to use a ‘screen-and-treat’ approach in which the treatment decision is based on a screening test and treatment is provided soon or, ideally, immediately after a positive screening test. This guideline provides recommendations for strategies for a screen-and-treat programme
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Mental health conditions affect one in 10 people at any one time and account for a large proportion of non-fatal disease burden. There is a high degree of comorbidity between mental health conditions such as depression and other noncommunicable diseases (NCDs), including cardiovascular disease, diab...etes and alcohol-use disorders. Mental disorders share common features with other NCDs, including many underlying causes and overarching consequences, their high interdependency and tendency to co-occur, and their predilection to being best managed using integrated approaches.
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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. 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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This section deals with implementing and improving infection control practices in hospitals, health centres and other health services in the outbreak area. It explains the need for, and implementation of, effective triage procedures, and basic requirements for infection control and supporting activi...ties. Further guidance can be found in the MSF Infection Control Guideline
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Overcoming barriers in low- and middle-income countries
For the first time, this year’s report includes information on hepatitis C diagnostics. With a focus on selected countries with diverse HCV epidemics, the report provides updates on the various dimensions of access to HCV diagnostics and pha...rmaceutical products, including product pricing, the regulatory environment and patent status, which together shape the national hepatitis response in different settings. It highlights key areas for action by ministries of health and other government decision-makers, pharmaceutical manufacturers and technical partners.
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Thirty-three years after its discovery, the Human Immunodeficiency Virus (HIV), responsible for the AIDS pandemic, remains a major public health problem despite advanced researches providing better diagnostic and therapeutic tools. The virus targets especially CD4+ T cells, leading to deficiency of ...the immune system and altering therefore defense against infections and cancer cells. Antiretroviral
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A recent study informed that ivermectin was successfully used in vitro for the treatment of SARS-CoV-2 in experimentally infected cells and two preprint publications on observational clinical studies reported the apparent utility of ivermectin to treat patients with COVID-19 needing mechanical venti...lation. However, neither of these studies were peer-reviewed nor formally published and one of them was later retracted.
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