Tackling Antimicrobial Resistance

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The pressure on healthcare professionals to prescribe antibiotics is great. But we need to conserve antibiotics and use them appropriately or we risk losing the power of these medicines. 1. The scale of the problem 2. Why we need to act now 3. Antibiotic prescribing in England 4. How we can put down on inappropriate prescribing 5. We all have a role to play Sources: https://publichealthmatters.blog.gov.uk/2015/12/10/health-matters-tackling-antimicrobial-resistance/

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On this call, Dr. Skakkebaek presented his concerns about increasing trends in male reproductive disorders, including the significant global increase in incidence of germ cell tumors. He and colleagues from all over the world demonstrated that over half of all young men's semen quality does not meet the reference standard of the World Health Organization. Dr. Skakkebaek presented evidence linking testicular cancer, poor semen quality, childlessness, and rapidly decreasing fertility rates. He showed how there is little doubt that environmental factors, most likely associated with modern lifestyles, have - in a broad sense - had an adverse influence on male reproductive health. He and his group are examining a fundamental role that exposure to endocrine-disrupting chemicals may play in these trends, trends that in a few decades will result in decreasing populations in industrialized countries, and believes collaborative research is required to identify the causes of these adverse trends. Sources: http://healthandenvironment.org/partnership_calls/18355

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Why was screening implemented? What is overdiagnosis? The evidence for overdiagnosis Available data Facts from recent studies Risks of screening The illusion of early detection Harms due to overdiagnosis Benefit-risk balance So, what to do? About mammograms: https://desdaughter.wordpress.com/tag/mammograms/ About overdiagnosis: https://desdaughter.wordpress.com/tag/overdiagnosis/ About screening: https://desdaughter.wordpress.com/tag/screening/

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Une brochure permet de donner le choix aux femmes: visitez http://cancer-rose.fr/ Le dépistage organisé du cancer du sein, généralisé en France depuis 2004 et proposé aux femmes de 50 à 74 ans, fait l’objet de controverses. Celles-ci, publiées dans des revues scientifiques de premier plan, ont été longtemps minimisées auprès du grand public. Les doutes portent sur un faible bénéfice et des risques avérés. Ces derniers sont essentiellement les fausses alertes, c’est à dire l’annonce d’une lésion mammographique qui ne s’avère pas réelle, et le surdiagnostic. Le surdiagnostic est la découverte d’un cancer qui n’aurait pas affecté la santé de la femme de son vivant, s’il n’avait pas été détecté. Le bénéfice s’avère beaucoup plus faible que présenté officiellement, en raison notamment du faible risque en valeur absolue de mourir de ce cancer, et de la faible efficacité du dépistage. De ce constat est née une brochure indépendante, délivrant une information claire, qui se veut loyale, aussi complète que possible et facilement accessible. Elle est téléchargeable gratuitement directement sur la page d’accueil de "cancer rose". Seize auteurs l’ont élaborée. Destinée à la lectrice concernée par le dépistage, elle est aussi pensée comme aide au praticien démuni face aux interrogations d’une patiente. L’objectif de cette brochure, (unique en langue française alors qu’il en existe p.ex. en Allemagne pour les femmes) est de donner aux femmes le pouvoir de décider de façon rationnelle et sans être culpabilisées. Chacune se fera ainsi son opinion au travers des meilleures sources scientifiques disponibles. Même si le dépistage du cancer du sein est un programme dit de santé publique, il n’en reste pas moins que la participation est une décision individuelle qui ne peut être prise qu’en connaissance de cause, ni imposée ni subie.

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by the Collaborative on Health and the Environment Prenatal Exposure to EDCs and Obesity: Combining Toxicology and Epidemiology with Dr. Juliette Legler The incidence of childhood obesity has reached epidemic proportions globally and there is an urgent need to better understand the impact of early life exposure to chemical obesogens on the development of obesity. The European OBELIX (Obesogenic endocrine disrupting chemicals: linking prenatal exposure to the development of obesity later in life) project examined the hypothesis that prenatal exposure to endocrine disrupting compounds (EDCs) plays a role in the development of obesity later in life using a multidisciplinary approach that combined various approaches, including epidemiology and toxicology. The project focused on assessing prenatal exposure to major classes of EDCs including dioxins and dioxin-like polychlorinated biphenyls, non-dioxin-like PCBs, brominated flame retardants, organochlorine pesticides, phthalates, and perfluorinated alkyl acids. Toxicological studies in OBELIX demonstrated that perinatal dietary exposure to representatives of these EDC classes resulted in metabolic changes that persisted into adulthood, long after termination of exposure at weaning, and that effects were compound- and sex-specific. The observed effects were not consistently towards an obese phenotype; a lean phenotype was also observed in animal studies for some compounds. Epidemiological studies in birth cohorts throughout Europe indicated associations between pre- and postnatal exposure to EDCs and early growth trajectories and body mass index in children up to 7 years. This call reviewed the main findings of the largest project up to now to examine the obesogen hypothesis. Sources: http://www.healthandenvironment.org/partnership_calls/14860

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Held every 18 November, European Antibiotic Awareness Day (EAAD) is a day to encourage responsible use of antibiotics. The plan for EAAD 2014 is to increase measurable engagement by healthcare professionals and the public. Our main objective is that by 30th November we have a combined 10, 000 Antibiotic Guardian pledges from healthcare professionals and the public to at least one pledge for prudent use of antimicrobials. Sources: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/369778/EAAD-AG_Campaign_Resources_Toolkit_2014.pdf Posters and Leaflets: https://www.gov.uk/government/publications/european-antibiotic-awareness-day-and-antibiotic-guardian-posters-and-leaflets Video: http://youtu.be/7PhmyNBWGik?list=PL5iZsTMBd0hjSm71Z8WOYn3_CdPC09WCX Website: http://antibioticguardian.com/

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How the Next Generation's Brain Functions are Endangered by EDCs and Other Environmental Chemicals by the Collaborative on Health and the Environment Dr. Philippe Grandjean suggests that new scientific insights reveal that the next generation's brain functions are endangered by environmental chemicals. The fetus is not protected by the placenta and therefore shares the mother's cumulated exposures to toxic chemicals. Infants and children are likewise exposed to a cocktail of foreign substances against which the body has no innate defense. Prenatal and early postnatal brain development is an extremely complex process that we now know is uniquely vulnerable. Lead, mercury and a few other substances have long been known to be toxic to brain development. Recent research suggests that many chemicals, perhaps thousands, may cause similar effects because they can gain access to the developing brain and exert their toxicity to brain cells. This new insight needs to be translated into public policy to protect the brain functions of the next generation. On this call Dr. Grandjean discussed what he terms "chemical brain drain" and how we might work to protect the brain health of future generations. Sources: http://www.healthandenvironment.org/partnership_calls/14316?res

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by the Collaborative on Health and the Environment The call featured Dr. Frederica Perera who reviewed data from a longitudinal cohort study following mothers and children from pregnancy into adolescence. In this study, prenatal exposure to the combustion related air pollutants, polycyclic aromatic hydrocarbons, is associated with adverse neurodevelopmental outcomes as well as other disease endpoints. Prevention strategies were also discussed. Sources: http://www.healthandenvironment.org/partnership_calls/14035

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by the Collaborative on Health and the Environment Building on the January 8, 2014 teleconference featuring Dr. Rodney Dietert on how the developing immune system is a target for endocrine disrupting chemicals, Dr. Jamie DeWitt discussed how certain cells of the immune system may mediate endocrine signals to direct aspects of brain development. She also described scenarios where endocrine disrupting chemicals can alter brain development by changing signals to the immune cells that can mediate development of sex specificity in the brain. Sources: http://www.healthandenvironment.org/partnership_calls/13590

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by the Collaborative on Health and the Environment On this first in a series of calls on endocrine disrupting chemicals, Dr. Rodney Dietert discussed how the immune system is a target for endocrine disrupting chemicals, particularly during development. Numerous relatively ‘hidden’ effects can ensue from a single risk factor and emerge over a lifetime. He also discussed how current safety testing fails to appropriately assess misregulated inflammation as the greatest immune based health risk. Sources: http://www.healthandenvironment.org/partnership_calls/13389

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by the Collaborative on Health and the Environment On this call Drs. Ross and Desai presented evidence that prenatal exposure to EDCs, specifically the plastic component Bisphenol A, can increase the relative risk of adult obesity and metabolic syndrome. They also discussed the significance of these findings for neonatal and childhood care, and the need for strategies for the prevention and therapy of obesity to address programming effects of the early life environment. Sources: http://www.healthandenvironment.org/partnership_calls/15308

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These are simplified slides discussing the regulation of cardiac output and venous return. Learning objectives: 1. Comprehend the determinants of cardiac output and factors affecting cardiac output 2. Comprehend the factors affecting stroke volume and heart rate and total peripheral resistance 3. Identify the factors regulating venous return 4. Discuss the causes of high and low output cardiac failure 5. Enlist the functions of veins and recognise the significance of venous reservoirs Study Resources: 1. Chapter 20, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 30 and 32, Ganong’s Review of Medical Physiology, 26th edition 3. Chapter 10, Human Physiology by Lauralee Sherwood, 9th edition 4. Physiology, Cardiac Output - StatPearls https://www.ncbi.nlm.nih.gov/books/NBK470455/

Cardiac Output, Venous Return, and Their Regulation

Cardiac Output, Venous Return, and Their Regulation

Cardiac Output, Venous Return, and Their Regulation

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Circulatory Shock, types and stages, compensatory mechanisms

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Circulatory Shock, types and stages, compensatory mechanisms

Circulatory Shock, types and stages, compensatory mechanisms

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