Q 7: For adults and children with convulsive epilepsy, which standard antiepileptic drugs (phenobarbital, phenytoin, carbamazepine, valproic acid) when compared to placebo/a comparator produce benefits/harm in the specified outcomes?
The world’s climate is changing. There is scientific consensus that since 1980 global temperatures have increased by almost 1°C. Most people experience climate change through extreme weather events, new and re-emerging infectious disease, and the long term effects of sea level rise, impoverishmen...t and armed conflict. This 30 minute film describes the range of morbidity and mortality of climate change related phenomena in six countries around the world.
The film describes the ways in which climate change will have – is already having – significant effects on human health. These effects are unequally distributed in terms of geographic location, social status, access to power or resources, and benefit from energy.
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The Medical Management Guidelines (MMGs) for Acute Chemical Exposures were developed by ATSDR to aid emergency department physicians and other emergency healthcare professionals who manage acute exposures resulting from chemical incidents. The MMGs are intended to aid healthcare professionals involv...ed in emergency response to effectively decontaminate patients, protect themselves and others from contamination, communicate with other involved personnel, efficiently transport patients to a medical facility, and provide competent medical evaluation and treatment to exposed persons.
The Medical Management Guidelines (MMGs) for Acute Chemical Exposures provide:
- basic chemical and exposure information,
- a summary of potential health effects,
- prehospital management information,
- emergency department management information, and
- information for the patient.
external homepage, accessed on 03/16/2018
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Bulletin of the World Health Organization, 2001, 79 (4)
This document adopts a health determinants framework for examining the evidence related to women’s poor mental health. From this perspective, public policy including economic policy, socio-cultural and environmental factors, community and social support, stressors and life events, personal behavio...ur and skills, and availability and access to health services, are all seen to exercise a role in determining women’s mental health status. Similarly, when considering the differences between women and men, a gender approach has been used. While this does not exclude biological or sex differences, it considers the critical roles that social and cultural factors and unequal power relations between men and women play in promoting or impeding mental health. Such inequalities create, maintain and exacerbate exposure to risk factors that endanger women’s mental health, and are most graphically illustrated in the significantly different rates of depression between men and women, poverty and its impact, and the phenomenal prevalence of violence against women.
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Scoping Question: For adults and children living with HIV, which antiepileptic medications (such as phenobarbital, phenytoin, carbamazepine or valproic acid) produce benefits and/or harms when compared to a placebo or controls?
Q11: 11a). In women with epilepsy, should antiepileptic therapy be prescribed as monotherapy or polytherapy to decrease the risk of fetal malformations?
11b). Does the use of folic acid preconceptually decrease the risk of foetal malformations in women with epilepsy?
11c). Do phenytoin, phenobarbi...tal, valproic acid or carbamazepine enter breast milk in quantities which are clinically significant to the baby?
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Bulletin de l'Organisation mondiale de la Santé 2012;90:871-871A. doi: 10.2471/BLT.12.113183
Bulletin de l'Organisation mondiale de la Santé Numéros précédents Volume 90: 2012 Volume 90, Numéro 12, décembre 2012, 869-944
ATLAS on substance use (2010)— Resources for the prevention and treatment of substance use disorder
Accessed: 14.03.2019
This paper explores the effect of inherent social inequalities on disability rights movements and their political activities in India and Nepal. The situation for persons with disabilities is similar in both countries. Many social and cultural phenomena coincide, and laws and policies are currently ...being formulated in line with the human rights agenda. In order to understand the current situation and the envisioned future for persons with disabilities, it is important to probe how, and under what circumstances, the disability issue is framed.
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With this World Health Day, WHO is drawing attention to a group of diseases that are spread by insects and other vectors, the heavy health and economic burdens they impose, and what needs to be done to reduce these burdens. Many of these diseases have been historically confined to distinct geographi...cal areas, but this situation has become more fluid due to a host of ills, including climate change, intensive farming, dams, irrigation, deforestation, population movements, rapid unplanned urbanization, and phenomenal increases in international travel and trade. The control of vector-borne diseases can make a major contribution to poverty reduction, as it precisely targets the poor
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The Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, presents evidence-
based recommendations on the preferred methods for cleaning, disinfection and sterilization of patient-
care medical devices and for cleaning and disinfecting the healthcare environment. This docume...nt
supercedes the relevant sections contained in the 1985 Centers for Disease Control (CDC) Guideline for
Handwashing and Environmental Control. 1 Because maximum effectiveness from disinfection and
sterilization results from first cleaning and removing organic and inorganic materials, this document also
reviews cleaning methods. The chemical disinfectants discussed for patient-care equipment include
alcohols, glutaraldehyde, formaldehyde, hydrogen peroxide, iodophors, ortho-phthalaldehyde, peracetic
acid, phenolics, quaternary ammonium compounds, and chlorine. The choice of disinfectant,
concentration, and exposure time is based on the risk for infection associated with use of the equipment
and other factors discussed in this guideline. The sterilization methods discussed include steam
sterilization, ethylene oxide (ETO), hydrogen peroxide gas plasma, and liquid peracetic acid. When
properly used, these cleaning, disinfection, and sterilization processes can reduce the risk for infection
associated with use of invasive and noninvasive medical and surgical devices. However, for these
processes to be effective, health-care workers should adhere strictly to the cleaning, disinfection, and
sterilization recommendations in this document and to instructions on product labels.
LAST UPDATE 2019
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This study aimed to analyze the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 20...20 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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In this edition, the Antimicrobial Resistance chapter discusses the growing, dangerous trend of antimicrobial resistance and the potential catastrophic consequences on global health.
The Nanomaterials chapter talks about this relatively new technology and its potential impacts on the environment a...nd health.
The Marine Protected Areas chapter draws attention to the plight of our oceans and the need for more and better managed protected areas.
The Sand and Dust Storms chapter discusses the human and environmental causes of such phenomena, their health impacts which include respiratory and cardiovascular diseases and lung cancer, and the need to manage the storms through sustainable land and water management.
The Solar Solutions chapter highlights how this renewable energy could help tackle climate change and bring much needed energy to off grid settlements.
The Environmental Displacement chapter shows how the impacts of climate change are displacing people, causing them to leave their homes.
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Human African Trypanosomiasis (HAT, sleeping sickness) and Animal African Trypanosomiasis (AAT) are neglected tropical diseases generally caused by the same etiological agent, Trypanosoma brucei. Despite important advances in the reduction or disappearance of HAT cases, AAT represents a risky reserv...oir of the infections. There is a strong need to control AAT, as is claimed by the European Commission in a recent document on the reservation of antimicrobials for human use. Control of AAT is considered part of the One Health approach established by the FAO program against African Trypanosomiasis. Under the umbrella of the One Health concepts, in this work, by analyzing the pharmacological properties of the therapeutic options against Trypanosoma brucei spp., we underline the need for clearer and more defined guidelines in the employment of drugs designed for HAT and AAT. Essential requirements are addressed to meet the challenge of drug use and drug resistance development. This approach shall avoid inter-species cross-resistance phenomena and retain drugs therapeutic activity.
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This review focusses on the interactions between the etiologic agent of Chagas disease, Trypanosoma cruzi, and its triatomine vector. The flagellate mainly colonizes the intestinal tract of the insect. The effect of triatomines on trypanosomes is indicated by susceptibility and refractoriness phenom...ena that vary according to the combination of the strains. Other effects are apparent in the different regions of the gut. In the stomach, the majority of ingested blood trypomastigotes are killed while the remaining transform to round stages. In the small intestine, these develop into epimastigotes, the main replicative stage. In the rectum, the population density is the highest and is where the infectious stage develops, the metacyclic trypomastigote. In all regions of the gut, starvation and feeding of the triatomine affect T. cruzi. In the small intestine and rectum, starvation reduces the population density and more spheromastigotes develop. In the rectum, feeding after short-term starvation induces metacyclogenesis and after long-term starvation the development of specific cells, containing several nuclei, kinetoplasts and flagella. When considering the effects of T. cruzi on triatomines, the flagellate seems to be of low pathogenicity. However, during stressful periods, which are normal in natural populations, effects occur often on the behaviour, eg, in readiness to approach the host, the period of time before defecation, dispersal and aggregation. In nymphs, the duration of the different instars and the mortality rates increase, but this seems to be induced by repeated infections or blood quality by the feeding on infected hosts. Starvation resistance is often reduced by infection. Longevity and reproduction of adults is reduced, but only after infection with some strains of T. cruzi. Only components of the surface coat of blood trypomastigotes induce an immune reaction. However, this seems to act against gut bacteria and favours the development of T. cruzi.
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