A field manual for Red Cross/Red Crescent personnel and volunteers
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
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h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Yaws, an infectious disease caused by Treponema pallidum subspecies pertenue, is endemic in many parts of the world. A community-wide treatment program in Papua New Guinea, in which a single dose of azithromycin was administered, showed substantial
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disease control. Watch the new Quick Take animation. Click through to read the study.
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A Training Curriculum for Multidisciplinary Healthcare Teams. This innovative training package aims to empower multidisciplinary health workers to have the confidence and skills to provide comprehensive, youth-friendly HIV services that support adolescents’ healthy development, psychosocial well b
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eing, retention, adherence, sexual and reproductive health, and eventual transition to adult HIV services.
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Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi, and transmitted to humans by infected triatomine bugs, and less commonly by transfusion, organ transplant, from mother to infant, and in rare instances, by ingestion of contaminated food or drink.1-4 The
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hematophagous triatomine vectors defecate during or immediately after feeding on a person. The parasite is present in large numbers in the feces of infected bugs, and enters the human body through the bite wound, or through the intact conjunctiva or other mucous membrane.
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10 points from field experience
N Engl J Med 2015;372:703-10. Click on the external link to get access to the article
Click on the link to open the video
Medicina (Kaunas) 2013;49(7):335-40
13280–13285 / PNAS / September 9, 2008 / vol. 105 / no. 36
The purpose of this training is to prepare clinicians in first receiver settings to: (1) Identify factors impacting immediate medical response to mass casualties following major types of radiological incidents, and (2) Demonstrate appropriate patien
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t assessment, triage, treatment and disposition decision-making required during a radiological mass casualty incident.
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