The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WASH) services in all health care facilities. Such services are needed to provide quality care, ensure ad...herence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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Le document est une boîte à outils sur le choléra élaborée par l'UNICEF, conçue pour soutenir la prévention, la préparation et la réponse aux épidémies de choléra. Il fournit des directives sur l'assainissement de l'eau, l'hygiène et l'éducation sanitaire, ainsi que des outils pratique...s et des ressources pour gérer les épidémies. Il est destiné aux équipes de l'UNICEF, aux gouvernements et aux partenaires afin d'intégrer la prévention du choléra dans les programmes de développement et les stratégies de réponse aux urgences.
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Rabies is entirely preventable, and vaccines, medicines, tools and technologies have long been available to prevent people from dying of dog-mediated rabies. Nevertheless, rabies still kills about 60 000 people a year, of whom over 40% are children under 15, mainly in rural areas of economically dis...advantaged countries in Africa and Asia. Of all human cases, up to 99% are acquired from the bite of an infected dog.
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BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b158 (Published 05 February 2009)
Cite this as: BMJ 2009;338:b158
Correspondence to: A Burns alistair.burns@manchester.ac.uk
Saving Lives: Universal access to Trauma Services in Kenya
Federal Bureau of Prisons
Clinical Practice Guidelines
January 1010
Over the past 50 years, dengue has spread from nine to over a hundred countries, making it the most rapidly spreading vector-borne disease. Yet, dengue continues to have a low profile among policy-makers and donors and does not receive the media attention it deserves. While there is no vaccine or cu...re for dengue, it can be managed and prevented. We need a renewed commitment to integrated programming that includes improved management and diagnosis, increased awareness and community participation in controlling the vector and enhanced environmental sanitation
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Results from a High Frequency Cell Phone Survey Round 1
The WHO Vision and eye screening implementation handbook (VESIH) offers a step-by-step guidance for conducting vision and eye screenings in community and primary care settings. The evidence-based interventions are drawn from the WHO Package of eye care interventions and developed with a focus on del...ivering screenings easily, safely, and effectively in low- and low–intermediate-resource settings. The early identification through screenings ensures timely treatments and management to avoid vision impairment in high-risk populations, including newborns, pre-school children, school children, and older adults.
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Suicides take a high toll. Over 800 000 people die by suicide every year and it is the second leading cause of
death in 15-29-year-olds. Most suicides occur in low- and middle-income countries where resources
and services, if they do exist, are often scarce and limited for early identification, tr...eatment and support of
people in need. These striking facts and the lack of implemented timely interventions make suicide a serious
global public health problem that needs to be tackled urgently.
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