Medical Journal of Zambia, Volume 36 Number 4 (2009)
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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Current evidence indicates that the COVID-19 virus is transmitted through respiratory droplets or contact. Contact transmission occurs when contaminated hands touch the mucosa of the mouth, nose, or eyes; the virus can also be transferred from one surface to another by contaminated hands, which fac...ilitates indirect contact transmission. Consequently, hand hygiene is extremely important to prevent the spread of the COVID-19 virus. It also interrupts transmission of other viruses and bacteria causing common colds, flu and pneumonia, thus reducing the general burden of disease.
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The story-book, a sequel to the immensely successful ‘My Hero is You: How kids can fight COVID-19!’, is being released in the second year of the COVID-19 pandemic. The new story, aimed primarily at children aged 6-11 years, sees the return of Ario, a fantasy creature who travels the world helpin...g children find hope in the future and joy in simple pleasures. Together with old and new friends, Ario addresses the fears, frustrations and concerns faced by children during this phase of the pandemic and explores with them the various coping mechanisms that they can use when faced with difficult emotions like fear, grief, anger and sadness. Through the voices of the children that Ario meets on his travels, the book provides a vivid illustration of the impact of COVID-19 on the mental health and well-being of children.
The content of the book drew from survey responses from more than 5000 children, parents, caregivers and teachers from around the world on the challenges they continue to face in the second year of the pandemic.
Available in different languages
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This document serves to provide interim guidance/ recommendations to carry out mpox surveillance activities mainly case investigation, contact tracing and isolation. For the development of this document WHO, UKHSA and CDC guidelines were referred to and adopted within the country context.
In December 2019 a novel coronavirus (2019-nCoV) was identified as the causative agent of a severe acute respiratory illness among people exposed in a seafood market in Wuhan, China; • Human-to-human transmission has been documented, including in healthcare workers, and aerosol-generating procedur...es (AGP)† may play a role in the spread of the disease; • There are uncertainties in the natural history of the 2019-nCoV, including source(s), transmissibility mechanisms, viral shedding, and persistence of the virus in the environment and on fomites; • As of 6 February 2020, the following precautions are recommended for the care of patients with suspected or confirmed cases of 2019-nCoV: o For any suspected or confirmed cases of 2019-nCoV: standard + contact + droplet precautions o For any suspected or confirmed cases of 2019-nCoV and AGP: standard + contact + airborne precautions • The use of personal protective equipment (PPE) by healthcare workers requires an evaluation of the risk related to healthcare-related activities;
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Целью этой главы является представление ключевых элементов, касающихся терапевтического использования психотропных лекарственных средств у детей и подростков, ... также знакомство
клиницистов с общими принципами фармакотерапии психиатрических расстройств в период развития. Для более детального ознакомления со специфическими медикаментами мы рекомендуем читателям обратиться к соответствующим главам, посвященным конкретным расстройствам.
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Lancet Glob Health 2021; 9: e782–92