BMC Family Practice201415:165, DOI: 10.1186/1471-2296-15-165
Open Access
Editorial Review
AIDS 2019, 33:1411–1420
Ansaätze zur interkulturellen Öffnung. Die von der Bundesbeauftragten für Migration, Flüchtlinge und Integration herausgegebene Publikation „Das kultursensible Krankenhaus“ liegt nun in einer vollständig aktualisierten und überarbeiteten Fassung vor und kann kostenfrei heruntergeladen und ...bestellt werden. Die Publikation stellt Konzepte und Praxisbeispiele vor, die dazu beitragen können, den Ar-beitsalltag im Krankenhaus besser auf Patient*innen sowie Beschäftigte mit Einwande-rungsgeschichte einzustellen
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Guidelines for Therapy and Management of Urothelial Urinary Bladder Cancer
Catalogage à la source : Bibliothèque de l’OMS Rapport mondial sur le vieillissement et la santé.
1.Vieillissement. 2.Espérance de vie. 3.Sujet âgé. 4.Services de santé pour personnes âgées. 5.Santé mondiale. 6.Dynamique des populations. 7.Prestations des soins de santé. I.Organisation... mondiale de la Santé.
ISBN 978 92 4 256504 1 (Classification NLM : WT 104) ISBN 978 92 4 069482 8 (ePub)
ISBN 978 92 4 069483 5 (Daisy)
ISBN 978 92 4 069484 2 (PDF)
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Цель этой главы – дать представление об эпидемиологических данных, возрасте начала, течении, подтипах, этиологии, клинических проявлениях, дифференциальной диагн...остике и лечении БР у детей и подростков.
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PLoS Medicine Vol. 6 no. 10 (2009) e1000165
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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Petersen et al. Int J Ment Health Syst (2016) 10:30 DOI 10.1186/s13033-016-0060-z
Dziva Chikwari et al. Implementation Science (2018) 13:70 https://doi.org/10.1186/s13012-018-0762-5
Au Burkina Faso, les personnes vivant avec le VIH (PvVIH) ont régulièrement recours à des substances naturelles pour traiter certaines infections opportunistes. C’est ainsi que le suc des feuilles fraîches de Mitracarpus scaber Zucc. ex Schult. & Schult. f. (Rubiaceae) et de Senna alata (L.) R...oxb. (Fabaceae) sont utilisés comme antimycosiques. En ce qui concerne le zona et les poussées herpétiques, les feuilles fraîches de Phyllanthus amarus Schumach. & Thonn. (Euphorbiaceae), la sève de Mangifera indica L. (Anacardiaceae), le gel de Aloe buettneri Berger (Liliaceae) et la galle de Guiera senegalensis J.F. Gmel. (Combretaceae), sont les drogues végétales les plus utilisées. Des substances naturelles sont également recommandées par les tradipraticiens de santé pour la récupération immunologique et nutritionnelle, le traitement précoce de l’infection à VIH et la réduction des effets secondaires des traitements ARV (antirétroviral). Il s’agit respectivement pour les plus importantes d’entre elles, des feuilles de Moringa oleifera Lam. (Moringaceae), de la pulpe du fruit de Detarium microcarpum Guill. & Perr. (Fabaceae), de la spiruline et du pollen issu de la ruche.
Les substances naturelles pouvant avoir une interaction avec les traitements conventionnels et plus particulièrement avec les médicaments ARV, les plantes contenant des tanins catéchiques, des dérivés 1,8 hydroxyanthracéniques laxatifs et des molécules hépatotropes ou inductrices enzymatiques, sont classées à risque, et leur utilisation par les PvVIH est étroitement surveillée.
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PlosOne https://doi.org/10.1371/journal.pone.0165797; Food production is a major driver of greenhouse gas (GHG) emissions, water and land use, and dietary risk factors are contributors to non-communicable diseases. Shifts in dietary patterns can therefore potentially provide benefits for both the en...vironment and health. However, there is uncertainty about the magnitude of these impacts, and the dietary changes necessary to achieve them.
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Front. Public Health, 30 April 2021 | https://doi.org/10.3389/fpubh.2021.628744
Recommandations formalisées d'experts
Chromoblastomycosis (CMB) is a chronic fungal infection of the skin and the subcutaneous tissue caused by a transcutaneous traumatic inoculation of a specific group of dematiaceous fungi occurring mainly in tropical and subtropical zones worldwide. If not diagnosed at early stages, patients with CBM... require long term therapy with systemic antifungals, sometimes associated with physical methods. Unlike other neglected endemic mycoses, comparative clinical trials have not been performed for this disease. Nowadays, therapy is based on a few open trials and on expert opinion. Itraconazole either as monotherapy or associated with other drugs, or with physical methods, is widely used. Recently, photodynamic therapy has been successfully employed in combination with antifungals in patients presenting with CBM. In the present revision the most used therapeutic options against CBM are reviewed as well as the several factors that may have impact on the patient's outcome.
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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