Chagas heart disease (CHD) affects approximately 30% of patients chronically infected with the protozoa Trypanosoma cruzi. CHD is classified into four stages of increasing severity according to electrocardiographic, echocardiographic, and clinical criteria. CHD presents with a myriad of clinical man...ifestations, but its main complications are sudden cardiac death, heart failure, and stroke. Importantly, CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies, and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies. Among patients with CHD, approximately 90% of deaths can be attributed to complications of Chagas disease. Sudden cardiac death is the most common cause of death (55%-60%), followed by heart failure (25%-30%) and stroke (10%-15%). The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with. Therefore, the management of CHD is challenging, and in this review, we present the most updated available data to help clinicians and cardiologists in the care of these patients. We describe the clinical manifestations, diagnosis and classification criteria, risk stratification, and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.
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In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for their health care. Salaries were not paid for more than
six months and life for the general population wa...s very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
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The clinical guidelines and protocols for the practice of emergency medicine presented in this document are designed to be a useful resource not only for those wishing to become emergency medicine specialists, but also for general practitioners and other healthcare providers tasked with caring for p...atients in hospital emergency departments. Healthcare providers using this Emergency Medicine Clinical Guideline (EMCG) are provided with fundamental concepts and principles essential to emergency medicine and the management of patients with undifferentiated emergency conditions.
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La enfermedad de Chagas es el resultado de la infección por elTrypanosoma cruzi. En Colombia, zona endémica para la enfermedad, existe al menos un millón de personas infectadas y tres millones en riesgo. Por lo anterior, el Ministerio de la Protección Social avaló la creación de una Guía de a...tención de la enfermedad de Chagas para el país.
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Guía de Práctica Clínica para el manejo de la hipertensión arterial primaria (HTA)
В цьому документі описуються кроки, необхідні для вимірювання скоригованого інтервалу QT (QTc) при моніторингу електрокардіограми (ЕКГ) у пацієнтів, які або перебува...ть на короткостроковій схемі лікування, або використовують нові препарати для лікування туберкульозу з лікарською стійкістю (ХР ТБ). Крім того, наводяться настанови щодо вимог, які слід враховувати при закупівлі апаратів ЕКГ для моніторингу пацієнтів. До тих пір, поки автоматичний розрахунок інтервалу QT з коригуванням Фредеріція (QTcF) (як зазначено в документі) залежить від функціоналу прибору, вибір щодо закупівлі конкретного апарату залишатиметься на розсуд країн.
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World J Meta-Anal. Aug 26, 2017; 5(4): 103-123
Published online Aug 26, 2017. doi: 10.13105/wjma.v5.i4.103
В данном документе описываются шаги, необходимые для точного измерения интервала QT (QTc) при мониторинге электрокардиографии (ЭКГ) пациентов, получающих краткосроч...ый режим лечения лекарственно-устойчивого туберкулеза (ЛУ-ТБ) или режим, включающий в схему новые препараты. Кроме того, в данном руководстве представлены требования, которые должны быть учтены при приобретении аппарата ЭКГ для мониторинга безопасности лечения пациентов. В силу того, что каждая модель аппарата имеет особые характеристики расчета QTcF (указанные в описании модели), соответственно, это должно быть учтено при выборе и закупе той или иной модели аппарата.
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This article unites the latest guidelines on the management of arterial hypertension in primary health care in Portuguese speaking countries including Brazil, Angola, Mozambique, São Tomé e Príncipe, Cape Verde, among others.
Accessed February 6, 2020
CARDIOVASCULAR AFRICA JOURNAL OF AFRICA
Volume 27, No 4, July/August 2016