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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The 2nd edition is publised in 2017.
Specific Objectives
• To increase the knowledge and awareness of personnel on chemical management.
• To educate the personnel on the potential adverse health effects of chemical exposure.
• To educate the personnel on the existing laws pertaining to handling of hazardous
chemicals.
• To... promote safe and healthy work practices among personnel during chemical handling.
• To guide the personnel on transportation, storage and disposal of hazardous chemicals.
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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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Jin et al. Military Medical Research (2020) 7:4 https://doi.org/10.1186/s40779-020-0233-6
Position Article und Guideline
Democratic dispensation in 1994 created a political and social platform that reshaped life in South Africa. There was a surge in common belief that the inequity and wrong of Apartheid should and could be rectified. Equity of access to water and sanitation were obvious targets for improvement. In 199...4, an estimated 14–15 million South Africans were without access to an improved water supply, while close to 21 million - more than half of the population at that time - did not have access to improved sanitation facilities. These problems were most severe in poorer rural areas. The water and sanitation sector became unified by the vision of universal access for all South Africans. This case study documents the progression of the sector between 1994 and 2016, and analyzes the impact of local systems created in South Africa to respond to the water and sanitation challenge.
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New and updated information.
Adverse health effects of hot weather and heat-waves are largely preventable. Prevention requires a portfolio of actions at different levels:from health system preparedness, coordinated with meteorological early warning systems, to timely public ... and medical advice andimprovements to housing and urban planning. This publication offers detailed information for various target audiences, and on medicaladvice and treatment practices
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Partout dans le monde, les sociétés ont produit, adapté et fait évoluer leur habitat pour répondre au mieux à leurs besoins et
aspirations, et ce en faisant le meilleur usage des ressources naturelles disponibles localement et en développant leurs propres
capacités. Les stratégies qui e...n résultent, à la fois techniques, architecturales ou encore sociales, tirent le meilleur parti de
l’environnement local tout en se protégeant de ses aléas. Il résulte de ce processus un corpus de connaissances locales uniques,
riches et variées
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A study conducted by the World Health Organisation Regional Office for Africa. The COVID-19 pandemic has had a significant impact on older persons both globally and in the African region. Although overall the region’s population is younger relative to many other world regions, the WHO AFRO region ...has a population just over 62 million older people and is ageing rapidly, with the number of older people expected to triple in the next three decades (Aboderin et al., 2020).
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Access to controlled medicines. 3rd edition
Known avoidable environmental risks to health cause at least 12.6 million deaths every year, and account for about one quarter of the global burden of disease (2016 data) (1). Air pollution alone causes about 7 million
deaths a year, placing it among the top global risks to health (2). Global envir...onmental challenges are on the rise, including climate change, rapid urbanization and increased resistance to drugs.
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AMR is a serious and growing global problem. A WHO report released in 2014 stated that this serious threat is no longer a prediction for the future it is happening now in every region of the world and has potential to affect anyone, of any age in any community – a real threat to the public health.... The coming together of the various important stakeholders to develop this document is the testimony of their agreement of how serious is the issue at hand and their intentions to combat AMR is translated into an Action Plan. WHO also reported that there are about 2 million people in the US are infected with the AMR organism while 23,000 die annually from AMR infections. Fiji is just 10 hours journey away from the United States of America therefore Fiji must act now to keep our population safe from AMR organisms.
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