L’utilisation excessive ou inadaptée des antibiotiques chez l’homme et chez l’animal contribue à amplifier la menace provenant de la résistance à ces produits. Certains types de bactéries susceptibles de provoquer des infections graves chez les humains sont déjà devenus ... résistants à la plupart des traitements disponibles et très peu d’options prometteuses sont actuellement en cours de développement pour prendre le relais
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Research Article
PLOS Medicine | https://doi.org/10.1371/journal.pmed.1002625 July 31, 2018 / 1-19
Research Article
PLOS Medicine | https://doi.org/10.1371/journal.pmed.1002374 August 8, 2017
Research Article
PLOS Medicine | DOI:10.1371/journal.pmed.1002253 April 4, 2017
PLOS Medicine | www.plosmedicine.org
January 2013 | Volume 10 | Issue 1 | e1001371
3rd edition!Large File 17 MB!
Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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A wide range of potential enablers and barriers were identified for influencing progress for the scale-up of severe wasting services within national health systems. Findings were categorised according to the six pillars of WHO’s health system strengthening framework.
PLOS Medicine | https://doi.org/10.1371/journal.pmed.1002514 March 1, 2018
PLoS Med 10(1): e1001366. https://doi.org/10.1371/journal.pmed.1001366
Published: January 8, 2013
PLoS Med 10(8): e1001501. https://doi.org/10.1371/journal.pmed.1001501
"This document provides recommendations for protecting healthcare providers and managing patients in the event of a hazardous materials exposure. Content was compiled through nationally recognized, current practice standards and formatted into user-friendly materials. "
Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc...ular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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Lancet Respir Med 2017; 5: 291–360Vol, 5 April 2017
Published: February 23, 2010
https://doi.org/10.1371/journal.pmed.1000235
Volume 7 | Issue 2 | e1000235