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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Case Studies on Building Resilience in the Horn of Africa
Presently, there is no evidence that the virus responsible for the current COVID-19 pandemic is carried by domestic food-producing animals, such as chickens, ducks, other poultry, pigs, cattle, camels, horses, sheep, goats, rabbits, guinea pigs or fish. While live animals can be a source of pathogen...s, all types of food can potentially be contaminated through contact with contaminated equipment, surfaces or environments. Proper cleaning and the prevention of cross-contamination are critical in the control of foodborne illnesses. The application of sound principles of environmental sanitation, personal hygiene and established food safety practices will reduce the likelihood that harmful pathogens will threaten the safety of the food supply, regardless of whether the food is sourced from intensive agriculture, small stakeholders or wildlife.
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UNICEF Child Alert | February 2018
Back in Myanmar, an estimated half million Rohingya remain largely sealed off in their communities and displacement camps, fearful that the violence and horror that had driven so many of their relatives and neighbours to fl ee would engulf them too.
Today, t...here are an estimated 720,000 Rohingya children in southern Bangladesh and Myanmar’s Rakhine State, in dire need of humanitarian assistance and protection – and looking to the outside world for help.
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This resource will help learners to:
discuss their thoughts and feelings about COVID-19
investigate some of the incredible ways in which people have been responding to this crisis
understand the difference between information, disinformation and misinformation
consider their own ...responses to the pandemic and possible actions that they might take to manage their own wellbeing and support others
consider their own responses to the pandemic and possible actions that they might take to manage their own wellbeing and support others
You can download a resource pack and slide show
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16 Days of Activism against gender-based violence campaign ended on 10 December. A series of events organized by UNHCR and other agencies operating in the Rohingya response increased attention on issues in particular affecting women and girls: The Refugee Relief an...d Repatriation Commisisoner and camp authorities strongly collaborated with the agencies to
demonstate Bangladesh’s commitment to ending gender-based violence for refugees
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Consultancy to conduct desk review on impact of national policies and programs on disability rights and develop an action plan to make existing policies and programs and legislation disability friendly
Strengthening Community responses to HIv Treatment and Prevention
Act on the Residence, Economic Activity and Integration of Foreigners in the Federal Territory
Residence Act. Translation provided by the Language Service of the Federal Ministry of the Interior.
Version information: The translation includes the amendment(s) to the Act by Article 3 of the Act of 6....9.2013 (Federal Law Gazette I p. 3556).
Translations may not be updated at the same time as the German legal provisions displayed on this website. To compare with the current status of the German version, see http://www.gesetze-im-internet.de/aufenthg_2004/BJNR195010004.html.
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Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu...s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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PLoS Negl Trop Dis 16(11): e0010908. https://doi.org/10.1371/journal.pntd.0010908
Diagnostics 2019, 9(4), 204; https://doi.org/10.3390/diagnostics9040204