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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the
...
disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
more
Chronic obstructive pulmonary disease (COPD) is a complex disease that requires differential diagnosis and proper classification to identify appropriate therapy. Nonpharmacologic therapy and preventative measures should be utilized to prevent worsening of disease, symptoms, and complications. The Gl
...
obal Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines classify a patient’s COPD and provide recommendations for first-line treatment. The 2021 update included information regarding the use of e-cigarettes as nicotine replacement, triple therapy, and how the SARS-CoV-2 virus impacted patients with COPD. This article will focus on the diagnosis, classification, and treatment of COPD, as well as recently updated information regarding the use of e-cigarettes and the impact of COVID-19.
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Severe and difficult asthma in a low- and middle-income country (LMIC) can relate to lack of availability of basic medications; potentially reversible factors such as poor adherence or comorbidities such as obesity inhibiting a good response to treatment; and (rarely) true severe, therapy-resistant
...
asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high-income countries (HICs). The first assessment step is to ensure another diagnosis is not being missed. Largely, political action is needed if children with asthma are to get access to basic medications. If a child is apparently not responding to low dose, simple medications, the next step is not to increase the dose but perform a detailed assessment of what factors (for example co-morbidities such as obesity, or social factors like poor adherence) are inhibiting a treatment response; in most cases, an underlying reason can be found. An assessment of risk of future severe asthma attacks, side-effects of medication and impaired lung development is also important. True severe, therapy-resistant asthma is rare and there are multiple underlying molecular pathologies. In HICs, steroid-resistant eosinophilia would be treated with omalizumab or mepolizumab, but the cost of these is prohibitive in LMICs, the biomarkers of successful therapy are likely only relevant to HICs. In LMICs, a raised blood eosinophil count may be due to parasites, so treating asthma based on the blood eosinophil count may not be appropriate in these settings.
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Guidelines for the Prevention of Tuberculosis in Health Care Facilities in Resource-limited Settings
These guidelines are designed for settings with limited resources to provide inexpensive and effective control strategies for prevention of TB transmission in health care workers (HCW).
2nd edition
DHS Working Papers No. 110 | Zimbabwe Working Papers No. 11
This report outlines the Ministry of Health’s National Health Research Agenda in which it identifies research priorities in health. It will be im
...
plemented in the same time frame as the Health Sector Strategic Plain 2012-2018. The Ministry of Health being the implementing agency of this document, is calling upon all partners, relevant ministries, higher learning institutions, students, development partners, etc to embrace this research agenda and ensure that researches conducted in Rwanda address priority areas identifies.
more
Accessed 4 March 2019.
7 May 2021
Clean and sustainable household energy and appliances, for cooking, heating and lighting can improve health, increase productivity, reduce poverty and protect the environment while addressing air pollution.
The Urban Health Initiative (UHI) goes beyond improving access to health care and promoting healthy behaviours, and focuses on how to build cities that enable and encourage good
...
health.
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The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health
Vaduganathan, M.; Mensah, G.A.; Turco, J.V. et al.
Journal of the American College of Cardiology
(2022)
CC
Cardiovascular diseases (CVDs) have collectively remained the leading causes of death worldwide and substantially contribute to loss of health and excess health system costs. The Global Burden of Di
...
seases, Injuries, and Risk Factors (GBD) Study has tracked trends in death and disability since 1990 and has provided an updated perspective on the status of cardiovascular health globally, regionally, and nationally.
more
This policy brief explores the impact of air pollution on health and address the air quality issue in the response to noncommunicable diseases (NCDs). It also provides key actions that policy makers, NGOs and
...
health professionals can take to ensure that every one can breathe clean air.
more
Air pollution is the top environmental threat to health in Europe. It leads to hundreds of thousands premature deaths per year and billions of Euros in health costs.
Sexual and Reproductive Health of Women and Adolescent Girls Living With HIV
EngenderHealt;; UNFPA
(2008)
guidance for health managers, health workers, and activists
A desk guide for health facilities . It outlines a comprehensive approach to respiratory health, which health facilities can adapt and implement in
...
resource-limited settings
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