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South African cardiovascular risk stratification guideline for non-cardiac surgery

Alphonsus, C.; Naidoo, N.; Motshabi, P. et al. South African Medical Journal (2021) CC

The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in Africa. The guidelines were developed by updating the Canadian ...Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts. The recommendations in these guidelines are: 1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5% (conditional recommendation: moderate-quality evidence). 2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence). 3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence). 4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence). Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities. more

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Respiratory Effects of Exposure to Diesel Traffic in Persons with Asthma

McCreanor, J.; Cullinan, P.; Nieuwenhuijsen, M.J.; et al. The New England Journal of Medecine (2007) CC2

Air pollution from road traffic is a serious health hazard, and people with preexisting respiratory disease may be at increased risk. We investigated the effects of short-term exposure to diesel traffic in people with asthma in an urban, roadside environment.

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Common characteristics of upper and lower airways in rhinitis and asthma: ARIA update, in collaboration with GA2LEN

Cruz, A.A.; Popov, T.; Pawankar, R.; et al. Allergy: Volume62, Issues84 November 2007 Pages 1-41 (2007) CC2

This document updates the ARIA sections on the links between rhinitis and asthma. Relevant publications between January 2000 and December 2005 were included. Complementary and alternative medicine is not evaluated in this document since it has been published separately. Likewise, an update on pharma... more

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Identifying ‘well-controlled’ and ‘not well-controlled’ asthma using the Asthma Control Questionnaire

Juniper, E. F.; Bousquet, J.; Abetz, L.; et al. Respiratory Medicine (2006) 100, 616–621 (2006) CC2

The Asthma Control Questionnaire (ACQ) was developed to measure the primary goals of asthma management as identified by international guidelines. All guidelines indicate that to achieve good control, treatment should minimise day- and night-time symptoms, activity limitation, airway narrowing and re... more

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Measurement properties and interpretation of three shortened versions of the asthma control questionnaire

Juniper, E. F.; Svensson, K.; Mörk, A-C.; et al. Respiratory Medicine (2005) 99, 553–558 (2005) CC2

The Asthma Control Questionnaire (ACQ)1 was developed and validated to measure the primary clinical goal of asthma management as identified by international guidelines. They indicate that to achieve good control, treatment should minimise day and night time symptoms, activity limitation, airway narr... more

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Development of the asthma control test A survey for assessing asthma control

Nathan, R. A.; Sorkness, C. A.; Kosinski, M.; et al. (2004) CC2

Asthma guidelines indicate that the goal of treatment should be optimum asthma control. In a busy clinic practice with limited time and resources, there is need for a simple method for assessing asthma control with or without lung function testing.

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The global burden of asthma: executive summary of the GINA Dissemination Committee report

Masoli, M.; Fabian, D.; Holt, S.; Beasley, R. European Journal of allergy and clinical immunology: Volume59, Issue5 May 2004 Pages 469-478 (2004) CC2

It is estimated that as many as 300 million people of all ages, and all ethnic backgrounds, suffer from asthma and the burden of this disease to governments, health care systems, families, and patients is increasing worldwide. In 1989 the Global Initiative for Asthma (GINA) program was initiated in ... more

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Global Asthma Network survey suggests more national asthma strategies could reduce burden of asthma

Asher, I.; Haahtela, T.; Selroos, O.; et al. Science Direct (2017) CC2

Several countries or regions within countries have an effective national asthma strategy resulting in a reduction of the large burden of asthma to individuals and society. There has been no systematic appraisal of the extent of national asthma strategies in the world.

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2023 GINA Main Report, Global Strategy for Asthma Management and Prevention

Global Institute for Asthma (2023) CC2

The 2023 update of the Global Strategy for Asthma Management and Prevention incorporates new scientific information about asthma based on a review of recent scientific literature by an international panel of experts on the GINA Science Committee. This comprehensive and practical resource about one o... more

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How Asthma is treated

COU Family TV Youtube (2022) CC3

Video: How asthma is treated.

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Health Pot

COU Family TV (2022) CC3

Video :Health Pot about Prevention, Genetic Test, Prevention of Air Pollution and Spirometry.

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Asthma in children under 5 years old

Annamali, M. National Asthma Education Programme (2024) CC2

Asthma is chronic inflammation of the airways in the lungs. In asthma, the airways in the lung narrow due to swelling of the mucosa, increased mucus production, and spasm of the airways.

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Ambient air pollution and non-communicable respiratory illness in sub-Saharan Africa: a systematic review of the literature

Glenn, B. E.; Espira, L. M.; Larson, M. C.; Larson, P. S. BMC (2022) CC2

Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growt... more

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Asbestos-related cancers: the‘Hidden Killer’remains a global threat

van Zandwijk, N.; Reid, G.; Frank, A. EXPERT REVIEW OF ANTICANCER THERAPY2020, VOL. 20, NO. 4, 271–278 (2020) CC2

Asbestos, the most frequent cause of occupational cancer, continues to be consumed ona massive scale, with millions of people exposed on a daily basis. This review explains why we havefailed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestosvictims are like... more

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Asbestos

University of Cape Town - South Africa Faculty of Health Sciences (2024) CC2

South Africa has possibly the highest incidence of malignant mesothelioma anywhere, thanks to more than a century of mining asbestos in the Northern Cape, North- West, Limpopo and Mpumulanga provinces. There are three types of asbestos and all were mined in South Africa; the most carcinogenic is cro... more

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Adverse Effects of Crystalline Silica Exposure

American Thoracic Society (1996) CC2

This American Thoracic Society Statement was prepared by a Committee of the Scientific Assembly on Environmental and Occupational Health at the request of the American Lung Association Occupational Health Expert Advisory Group to emphasize the continuing importance of silicosis as a major lung disea... more

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Improving the global diagnosis and management of asthma in children

Lenney, W.; Bush, A.; Fitzgerald, D.A. et al. BMJ Journals (2018) CC

Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the tee... more

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Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden

Papadopoulos, N.G.; Custovic, A.; Deschildre, A. et al. The Journal of Allergy and Clinical Immunology: In Practice (2020) CC

Coronavirus disease 2019 has a mild disease course in children and adolescents. Chronic respiratory conditions, including asthma, have been suggested as risk factors; however, asthma in children is highly variable in both triggers and severity. During the pandemic, pediatric asthma services limite... more

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The burden of severe asthma in sub-Saharan Africa: Findings from the African Severe Asthma Project

Kirenga, B.J.; Chakaya, J.; Yimer, G. et al. Journal of Allergy and Clinical Immunology: Global (2024) CC

Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. This article wants to determine the burden (prevalence, mortality, and activity and work impairment) of severe asthma in 3 countries in East Africa: Uganda, Kenya, and Ethio... more

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The ‘jigsaw puzzle’ approach to building a diagnostic picture of asthma in primary care over time

Ryan, D.; Kocks, J.; Correia de Sousa, J. et al. International Primary Care Respiratory Group (2023) CC

Since there is no single objective diagnostic test for asthma this study suggests an approach of collecting and assembling pieces of clinical information to create a diagnostic picture, like making a jigsaw puzzle. These pieces should include demonstration of symptom and airway variability and/or br... more