El objetivo de estas directrices es presentar el conjunto completo de recomendaciones y declaraciones de buenas prácticas de la OMS sobre el aborto
L’objectif de ces lignes directrices est de présenter l’ensemble complet des recommandations et des énoncés de meilleures pratiques de l’OMS en matière d’avortement
Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future d...evelopment needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
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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...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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Asbestos, the most frequent cause of occupational cancer, continues to be consumed ona massive scale, with millions of people exposed on a daily basis. This review explains why we havefailed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestosvictims are like...ly to remain high. Emerging and developed countries have to be reminded that asbestosexposure has yet to become a problem of the past. The worldwide spread of asbestos, followed by thesurge of asbestos-related cancers, resembles the lung cancer epidemic caused by smoking andstimulated by manufacturers.
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Fortbildung | VNR 2760602016064370005 | Hessisches Ärzteblatt 5/2016 | Die weltweit zu beobachtende Flucht von Menschen vor Krieg, Gewalt, Verfolgung und Hunger stellt auch für die medizinischen Versorgungssysteme in Deutschland eine große Herausforderung dar. Neben der Versorgung somatischer Kra...nkheiten kommt der Diagnostik und Therapie psychischer Erkrankungen eine hohe Bedeutung zu. In einer in einer bayrischen zentralen Aufnahmeeinrichtung für Flüchtlinge durchgeführten Studie wurden bei 63,6 Prozent der Flüchtlinge eine oder mehrere psychiatrische Diagnosen gestellt, wobei die Posttraumatische Belastungsstörung (PTBS) mit 32,2 Prozent am häufigsten vorkam. Die Angaben zur Prävalenz der PTBS in weniger belasteten Stichproben haben eine weite Bandbreite, die durch unterschiedliche Studiendesigns und durch unterschiedliche diagnostische Kriterien in der ICD 10 und dem DSM 5 bedingt sind. In den USA findet sich in der Allgemeinbevölkerung eine hochgerechnete Lebenszeitprävalenzrate von etwa 8 Prozent. In Europa liegen die Schätzungen mit 0,5–1 Prozent deutlich niedriger. Für Deutschland werden 1-Monatsprävalenzraten von 1–3 Prozent berichtet.
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