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
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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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Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries ove
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r the last 30 or so years. LA is a highly diverse region in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
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The Healthy Living Toolkit is developed to educate refugees, immigrants, resettlement agencies, clinics, community based organizations, and other service providers on refugee health issues. The toolkit presents material in a culturally appropriate manner and is intended to help health care-related p
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rofessionals more effectively assist refugees and immigrants and reduce health disparities among these populations. The toolkit is available in multiple languages
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Apart from implementation of TB infection Prevention and Control measures, treatment of those with active TB of the lungs is key in preventing the spread of the TB bacilli. The Public Health Act CAP 242, section 17 classify TB as notifiable infectious disease and under section 26 as part of preventi
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on and control of infectious diseases, those exposed or suffer from the notifiable infectious diseases should be isolated in designated place and detained while taking medication until in the assessment of the Medical officer of health confirm that the person is free from infection or able to be discharged without danger to public health.
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Guidelines for the Prevention of Cardiovascular Disease in Women in Indonesia
A manual for programme managers.
The document by the American Thoracic Society provides an overview of Chronic Obstructive Pulmonary Disease (COPD), explaining its causes, such as smoking and environmental factors, symptoms like breathlessness and chronic cough, and diagnostic meth
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ods including spirometry. It discusses treatment strategies, emphasizing smoking cessation, medication use, oxygen therapy, and pulmonary rehabilitation. The document also highlights that while COPD is a lifelong condition, effective management can improve symptoms and quality of life.
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Review Article:
The American Journal of the Medical Sciences 2011;341(6):493–498.]
Find featured COPD videos, toolkits, worksheets, guides and interactive tools for COPD patients and caregivers.
COPD Health Professionals & Educators
Whether you are a healthcare professional, COPD educator or patient advocate, it is important to stay informed about COPD care, resources and support options.
The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe asthma phenotypes in relation to genetics, natural history, pathobiology and p
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hysiology, as well as sections on evaluation and treatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice.
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The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
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Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex.
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La carga de la diabetes es enorme, posicionándola como uno de los principales desafíos que enfrenta la salud pública en la actualidad. Actualmente, se estima que 62 millones de personas viven con diabetes en la Región de las Américas y las proyecciones muestran que su prevalencia seguirá aumen
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tando en los próximos años. La Región muestra el mayor número de años de vida saludable perdidos (ya sea por discapacidad o muerte prematura) debido a la diabetes en todo el mundo. Los altos costes asociados a su tratamiento producen una pesada carga económica. Sus complicaciones pueden afectar seriamente la calidad de vida de las personas que viven con diabetes, sus familias y la sociedad y sobrecargar los sistemas de salud. Este informe muestra los últimos datos comparables internacionalmente sobre la diabetes y sus principales factores de riesgo por año, país y sexo. También incluye un resumen de la respuesta de los sistemas de salud de los países a la diabetes, incluidos planes nacionales, objetivos, vigilancia, directrices y acceso a medicamentos y tecnologías esenciales, y sintetiza información sobre las complicaciones relacionadas con la diabetes y la estrecha relación entre la diabetes y otras patologías, como enfermedades cardiovasculares, tuberculosis y COVID-19.
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Investigación original / Original research
Panam Salud Publica. 2016;39(1):38–43.
"The Emergency Response Guidelines for Anhydrous Hydrogen Fluoride (Guidelines) were prepared
by the American Chemistry Council’s (ACC) Hydrogen Fluoride Panel (Panel). This document is
intended to provide general information to persons addressi
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ng an emergency response in the course
of handling and transporting anhydrous hydrogen fluoride (AHF)."
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As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt
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ing a life course approach (LCA) to immunization, vaccination programs can be tailored to close immunity gaps at different stages of life. The life course approach foresees the establishment of multiple strategies to reduce missed opportunities for vaccination according to age group. This technical document explains the key concepts of the LCA with a focus on immunization by vaccination, as well as the underlying biological mechanisms that require the application different vaccines at different life stages according to changes to the immune system and in the epidemiological situation of a community.
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