The document "COPD 101: Understanding the Basics" from the COPD Foundation provides foundational knowledge about chronic obstructive pulmonary disease (COPD). It explains what COPD is, common symptoms, risk factors, diagnosis methods, and treatment options, including medications and lifestyle change...s. The guide emphasizes early diagnosis and management to help patients live healthier lives and prevent disease progression.
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This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws o...f their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all the unwanted effects of medications are mentioned.
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A guide for community health workers, rehabilitation workers, and families.
This manual covers identifying primary and secondary disabilities, developing skills for daily living, and working through behavior problems. The new 2018 edition features new topics, including mental and developmental di...sabilities, microcephaly and Zika, causes of birth defects and childhood disability, epilepsy and seizures, hearing loss and vision problems, HIV, leprosy, and more, and has updated information on polio, cerebral palsy, juvenile arthritis, muscular dystrophy, and medications.
Readers will find instructions on how to build six different wheelchairs using local resources; useful therapy techniques, such as making fun and educational toys; ideas for improving playground accessibility for all children; and low-cost rehabilitation aids and adaptations for home and community.
You can download chapter 4 for free. The complete book is available at Hesperian Book STore
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The "Cystic Fibrosis Fact Sheet" by the National Heart, Lung, and Blood Institute provides an overview of cystic fibrosis (CF), a chronic and often fatal genetic disorder affecting the respiratory and digestive systems. The document outlines the causes, genetic inheritance patterns, and symptoms of ...CF, which include thick mucus buildup, respiratory issues, and digestive problems. It also discusses diagnostic methods, such as the sweat test and genetic testing, and highlights current treatment approaches focused on symptom management, including chest therapy, medications, and potential gene therapy. The fact sheet emphasizes patient and family education to improve quality of life and support coping strategies.
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This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws o...f their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all the unwanted effects of medications are mentioned.
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Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among youth and smoking cessation among established smokers are key for reducing smoking prevalence and the associated negative health co...nsequences. Proven tobacco cessation treatment includes pharmacotherapy and behavioral support, which are most effective when provided together. First-line medications (varenicline, bupropion, and nicotine replacement) are effective and safe for patients with CVD. Clinicians who care for patients with CVD should give as high a priority to treating tobacco use as to managing other CVD risk factors. Broader tobacco control efforts to raise tobacco taxes, adopt smoke-free laws, conduct mass media campaigns, and restrict tobacco marketing enhance clinicians' actions working with individual smokers.
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The document provides step-by-step instructions for using a Flexhaler dry powder inhaler effectively. It emphasizes proper inhalation technique, including priming the device, loading a dose, and breathing correctly. It also advises users to rinse their mouth after use and highlights the importance o...f bringing medications to appointments for review by healthcare providers.
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Heart failure (HF) is a leading global public health problem with >64 million prevalent cases globally. Patients with HF with reduced ejection fraction (HFrEF) from low- and middle-income countries experience a 22% to 58% higher 1-year mortality rate than those in high-income countries.1 Guideline-d...irected medical therapy (GDMT) consisting of ACE (angiotensin-converting enzyme) inhibitors or ARB (angiotensin receptor blockers) or ARNI (angiotensin receptor-neprilysin inhibitors), β-blockers, MRA (mineralocorticoid receptor antagonists), and SGLT2 (sodium-glucose cotransporter 2) inhibitors substantially reduces mortality among patients with HFrEF. These medicines are among the most cost-effective interventions and are thus included as the highest priority health system interventions recommended by the Disease Control Priorities Project.2 Despite this high-quality evidence, GDMT remains widely underutilized in low- and middle-income countries resulting in widespread undertreatment of patients with HFrEF due to health system-, provider-, and patient-level barriers.1 National essential medicines lists (EMLs) promoted by the World Health Organization (WHO) guide countries on which medications to purchase in the setting of limited resources and have resulted in higher procurement and availability of essential medicines in the public sector.3 We provide a cross-sectional analysis of national EMLs in 53 low- and middle-income countries, and availability, price, and affordability of GDMT in select countries to identify potential barriers to access to these essential medicines for patients with HFrEF.
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Type 2 diabetes mellitus (T2DM) is a chronic condition characterized by insulin resistance and an inability to properly regulate blood sugar levels. The two most important risk factors for T2DM are a family history of diabetes and obesity, though age, race, diet, and exercise level also impact risk.... Common symptoms include frequent urination, nerve damage, and dark skin patches. Treatment involves lifestyle changes like diet and exercise as well as medications like metformin, which improves insulin sensitivity and decreases glucose production in the liver. Patients are counseled on managing diabetes-related risks and provided support through organizations and groups.
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The World Health Organization's Regional Office for Africa webpage on diabetes provides an overview of the disease's impact in the African Region. It highlights that diabetes is a serious, chronic, and costly condition, with projections estimating cases to rise to 23.9 million by 2030. The page outl...ines risk factors such as physical inactivity, overweight and obesity, tobacco use, and diets high in unhealthy fats and calories. It also discusses the three main types of diabetes: type 1, type 2, and gestational diabetes. Recent surveys indicate that up to 15% of adults aged 25 to 64 in the region have diabetes, with many unaware of their condition. The lack of access to proper treatment and medications, especially insulin, often leads to complications like neurological, vascular, or visual disorders, heart disease, stroke, lower limb amputation, and kidney failure.
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The World Health Organization's fact sheet on hypertension provides a comprehensive overview of high blood pressure, highlighting its prevalence, risk factors, and health implications. It emphasizes that hypertension is a major cause of premature death worldwide, with an estimated 1.28 billion adult...s aged 30–79 years affected, two-thirds of whom live in low- and middle-income countries.
The document outlines modifiable risk factors, including unhealthy diets, physical inactivity, tobacco and alcohol use, and being overweight or obese. It also discusses non-modifiable risk factors such as family history, age over 65 years, and co-existing conditions like diabetes or kidney disease. The fact sheet underscores the importance of regular blood pressure monitoring, as hypertension often presents without symptoms, and highlights lifestyle changes and medications as effective treatments. Additionally, it mentions global targets aimed at reducing the prevalence of hypertension by 33% between 2010 and 2030.
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Über 1200 Vokabeln und komplexe Begriffe zu Beschwerden, Untersuchung und Behandlung praxis- und patientengerecht in einfachen Bildern mit mehrsprachigen Untertiteln,
erweitert und überarbeitet, ausführliche Untersuchungen, Therapieerläuterungen und Pflege.
Der Patient guckt sich „seine“... Bilder aus und tippt sie beim Arzt an. Der Arzt wiederum kreuzt die Therapie und Medikation an. So ist man über Notfälle hinaus auch für die Regelversorgung präpariert, kommt exakt auf den Punkt, Vertrauliches bleibt vertraulich. Der Patient wird sofort aktiv eingebunden.
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La Profilaxis Post-Exposición para el VIH (PEP) constituye una herramienta de prevención que consiste en el uso de medicamentos antiretrovirales para reducir el riesgo de infección luego de situaciones de potencial exposición del virus. Su incorporación está recomendada por la Organización Mu...ndial de la Salud en el marco de una estrategia de Prevención Combinada1,2. Cuando se inicia dentro de las 72 horas del episodio de potencial exposición al VIH, la PEP reduce en forma significativa el riesgo de transmisión, por lo que su uso se indica en exposiciones ocupacionales y no ocupacionales esporádicas. En la actualidad, una combinación de 3 drogas antirretrovirales durante 28 días es el esquema estándar empleado como PEP2.
A través de la Dirección de Sida, ETS, Hepatitis y TBC, se distribuye la medicación
necesaria para que la PEP esté disponible en efectores del sistema público de salud cuando está clínicamente indicada.
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Solidarity” is an international clinical trial to help find an effective treatment for COVID-19, launched by the World Health Organization and partners.
The Solidarity Trial will compare four treatment options against standard of care, to assess their relative effectiveness against COVID-19. By... enrolling patients in multiple countries, the Solidarity Trial aims to rapidly discover whether any of the drugs slow disease progression or improve survival. Other drugs can be added based on emerging evidence.
Until there is sufficient evidence, WHO cautions against physicians and medical associations recommending or administering these unproven treatments to patients with COVID-19 or people self-medicating with them. WHO is concerned by reports of individuals self-medicating with chloroquine and causing themselves serious harm.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa...l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris...k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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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.
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Diabetes mellitus has become a serious and chronic metabolic disorder that results from a complex interaction of genetic and environmental factors, principally characterized by hyperglycemia, polyuria, and polyphagia. Uncontrolled high blood sugar can result in a host of diabetic complications. Prol...onged diabetes leads to serious complications some of which are life-threatening. The prevalence of diabetes patients is rising at epidemic proportions throughout the world. Every year, a major portion of the annual health budget is spent on diabetes and related illnesses. Multiple risk factors are involved in the etiopathogenesis of the disease and turning the disease into an epidemic. Diabetes, for which there is no cure, apparently can be kept under control by maintaining self-care in daily living, effective diabetes education, with comprehensive improvements in knowledge, attitudes, skills, and management. In this review, we focused on the biochemical aspects of diabetes, risk factors including both environmental and genetic, disease complications, diagnosis, management, and currently available medications for the treatment of diabetes.
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Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite global efforts, asthma continues to be an important public health problem worldwide, particularly in poo...rly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant mor- bidity and mortality. Poverty, air pollution, climate change, exposure to indoor allergens, urbanization and diet are some of the factors that contribute to inadequate control and poor outcomes in developing countries. Although asthma guidelines have been developed to raise awareness and improve asthma diagnosis and treatment, problems with underdiagnosis and undertreatment are still common. In addition, important social, financial, cultural and healthcare barriers are common obstacles in LMICs in achieving control. Given the high burden of asthma in these countries, adaptation and implementation of national asthma guidelines tailored to local needs should be a public health priority. Governmental commitment, education, better health system infrastructure, access to care and effective asthma medications are the cornerstone of achieving success.
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Tercera versión, 1 de febrero del 2022. Estas orientaciones tienen por objetivo contribuir a que los sistemas de salud prioricen los medicamentos esenciales que deben estar disponibles y ser asequibles para manejar los pacientes en las unidades de cuidado intensivos durante las emergencias de salud.... Esta actualización incluye una sección sobre el tratamiento de pacientes graves o críticos, así como nuevos datos sobre la evidencia y la firmeza de las recomendaciones incluidas en versiones anteriores.
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