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Equity of resource flows for reproductive, maternal, newborn, and child health: are those most in need being left behind?

Martinez-Alvarez, M.; F. Federspiel; N. Singh et al. British Medical Journal (BMJ) (2020) CC

Since 2002 the distribution of external funding to reproductive, maternal, newborn, and child health (RMNCH) has become more equitable and better targeted at the poorest countries and those experiencing the highest mortality. The aid envelope is not large enough or well enough concentrated to close ... more

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2020 Heart Failure Society of South Africa perspective on the 2016 European Society of Cardiology Chronic Heart Failure Guidelines

Hitzeroth, J.; Mpe, M.; Klug, E. et al. The South African Medical Journal (2020) CC

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... more

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Pollution and the Heart

Rajagopalan, S.; Landrigan, P.J. The New England Journal of Medicine (2021) CC

Cardiovascular diseases are the world’s leading cause of disability and death. Such diseases were responsible in 2019 for an estimated 18.6 million deaths globally and 957,000 deaths in the United States.

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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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Epidemiology, Pathophysiology, Diagnosis and Treatment of Heart Failure in Diabetes

Park, J.J. Diabetes & Metabolism Journal (2021) CC

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... more

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2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes: Developed by the task force on the management of cardiovascular disease in patients with diabetes of the Eur

Marx, N.; Federici, M.; Schütt, K. et al. European Heart Journal (2023) CC

Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor f... more

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Prioritised research agenda for prevention and control of chronic respiratory diseases

Bousquet, J.; Kiley, J.; Bateman, E.D. European Respiratory Journal (ERJ) (2010) C_WHO

The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including... more

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The natural history of chronic obstructive pulmonary disease

Mannino, D.M.; Watt, G.; Hole, D.; et al. European Respiratory Journal (ERJ) (2006) CC2

The article from the European Respiratory Journal discusses the natural history of chronic obstructive pulmonary disease (COPD), emphasizing its increasing global impact on morbidity and mortality. It highlights that while cigarette smoking is a primary risk factor, other influences such as environm... more

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Pathogenesis of chronic obstructive pulmonary disease: An African perspective

Allwood, B.; Calligaro, G. South African Medical Journal (SAMJ) (2015) CC2

The article discusses the significant impact of chronic obstructive pulmonary disease (COPD) as a global health issue, with cigarette smoking as the main risk factor. However, in developing countries, the causes of COPD are often multifactorial, involving environmental tobacco smoke, biomass fuel sm... more

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The increasing burden of asthma in South African children: A call to action

Masekela, R.; Gray, C.L.; Green, R.J. et al. The South African Medical Journal (2018) CC

BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed. OBJE... more

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Parental understanding of wheeze and its impact on asthma prevalence estimates

Michel, G.; Silverman, M.; Strippoli, M-P. F. et al. European Respiratory Journal (2006) CC

The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”. In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct ... more

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International study of asthma and allergies in childhood (ISAAC): rationale and methods

Asher, M.I.; Keil, U.; Anderson, H.R. European Respiratory Journal (1995) CC

he aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized m... more

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Monitoring asthma in children

Pijnenburg, M.W.; Baraldi, E.; Brand, P.L. et al. European Respiratory Journal (2015) CC

The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist i... 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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The National Asthma Education Programme and asthma in Africa

South African Medical Journal; SAMJ (2019) CC2

The National Asthma Education Programme (NAEP) is a registered non-profit organisation whose mission is to provide asthma education to healthcare professionals, patients and the lay public. It was founded in 1994 by Dr Mike Greenblatt and Profs Dave Luyt and Robin Green. This year NAEP celebrates it... more

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Asthma traeatment in children: A pragmatic approach

Masekela, R.; Jeevanathrum, A.; Kling, S.; et al. South African Medical Journal (2018) CC

Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden... more

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European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years

Gaillard, E.A.; Kuehni, C.E.; Turner, S.; et al. European Respiratory Journal (2021) CC

Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence... more

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European Respiratory Society guidelines for the diagnosis of asthma in adults

Renaud, L.; Imran, S.; Inigo, O., et al. European Respiratory Journal (2022) CC

Although asthma is very common, affecting 5–10% of the population, the diagnosis of asthma in adults remains a challenge in the real world, which results in both over- and under-diagnosis. A taskforce was set up by the European Respiratory Society to systematically review the literature on the dia... more

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The diagnosis of asthma in children: An evidence-based approach to a common clinical dilemma

Masekala, R.; Risenga, S.M.; Kitchin, O.P. et al. South African Medical Journal (2018) CC

Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The diagnosis of asthma in young children is limited by the inability to perform objective lung function testing in this group of patients and the wi... more

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Summary of childhood asthma guidelines, 2021: A consensus document

Manjra, A.I.; van Niekerk, A.; White, D.A. et al. South African Medical Journal (2021) CC

Asthma is the most common chronic illness of childhood. The prevalence is rising and the mortality and morbidity from asthma are unacceptably high in South Africa. This article emphasizes the importance to make a correct diagnosis based, most importantly, on the clinical history and supported by inv... more