Risk Assessment and Management of Cardiovascular Diseases - an English Approach. Lynam E. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).
Cardiovascular prevention. com is a website for prevention of cardiovascular disease. In this slide presentation you can find the burden of cardiovascular disease in same Countries
Represents 30% of all deaths worldwide (15 million deaths/year)
Leading cause of death and disability
CVD burden in developing countries
Risk factors worldwide
Instability and rupture of atherosclerotic plaques result in acute coronary syndrome.
LDL-C is usually related to ASCVD.
Statin medications are first-line therapy for LDL-C lowering Post ACS.
Rosuvastatin 20mg and 40 mg significantly increase HDL-C levels compared with Atorvastatin 80 mg
Risk Assessment and Management of Cardiovascular Diseases - an English Approach. Lynam E. Conference on Cardiovascular Diseases (Madrid: Ministry of Health and Social Policy; 2010).
Cardiovascular prevention. com is a website for prevention of cardiovascular disease. In this slide presentation you can find the burden of cardiovascular disease in same Countries
Represents 30% of all deaths worldwide (15 million deaths/year)
Leading cause of death and disability
CVD burden in developing countries
Risk factors worldwide
Instability and rupture of atherosclerotic plaques result in acute coronary syndrome.
LDL-C is usually related to ASCVD.
Statin medications are first-line therapy for LDL-C lowering Post ACS.
Rosuvastatin 20mg and 40 mg significantly increase HDL-C levels compared with Atorvastatin 80 mg
http://www.thinkred.co.za/get-involved/events | Thousands of people around the globe are affected by at least one type of Cardiovascular Disease (CVD) every day. This only emphasises the importance of heart health in this day and age. Learn what CVD is about the impact that it has had on people over the years. With simple diet and lifestyle changes many diagnosed individuals can overcome this threat.
El Dr. Juan F. Ascaso, presidente de la Sociedad Española de la Arteriosclerosis (SEA), participa en el acto de presentación de la 'Jornada Galáctica sobre Guías de Lípidos y objetivos a alcanzar en los pacientes de más alto riesgo cardiovascular' (Málaga, 4-5 abril, 2014).
Accede a la jornada completa en http://guiaslipidos.secardiologia.es
What are the cardiovascular disorders?
Public Health importance
Burden of disease
Risk factors of cardiovascular disorders
Causation
Prevention strategies
Global Action Plan for the Prevention and Control of NCDs
India - National programme (NPCDCS)
Improving the Physical health care of people with mental ill health: Cardiovascular health of people with serious mental illness National Learning Network Event 29th April 2015.
Main Slide: NHS IQ CVD SMI LNE 29 April 2015 slides - 1-152
BREAKOUT 1_PATIENT VOICE slides 153-161
BREAKOUT 2a_IMPROVING CARDIOVASCULAR CARE FOR PEOPLE WITH SMI - slides 162-188
BREAKOUT 2b_UCLP PROGRAMME ON CVDSMI - slides 188-195
BREAKOUT 3_PHYSICAL ACTIVITY IN MENTAL HEALTH - slides 196-212
BREAKOUT 4_REASONS FOR TEWVS SUCCESS - slides 213-225
BREAKOUT 5_ PHYSICAL HEALTH AND WELLBEING - slides 226-243
BREAKOUT 6_SHAPE - slides 244-271
BREAKOUT 7_SCREENING FOR CARDIOMETABOLIC RISK FACTORS - slides 272 -296
CORONARY ARTERY DISEASE is a modern epidemic in india. due to changes in living conditions and habits its prevalence is increasing day by day . in this presentation i have explained the various risk factors and innovations in diagnosis of CAD. IT is very useful for primary health care physicians and community medicine specialist
Addison’s Disease (AD) or primary adrenal insuffi ciency has been thought a rare disease for a long time, but recent epidemiological studies have reported a rising prevalence in developed countries. Among the causes of apparently idiopathic forms, autoimmunity plays a relevant role. This review will be focused on several aspects of autoimmune AD, which may manifest either as an isolated disorder or associated with other autoimmune diseases among the autoimmune polyglandular syndromes. HLA plays a key role in determining. T cell responses to antigens, and various HLA alleles have been shown to be associated with many T cell-mediated autoimmune
disorders, but the mechanism by which the adrenal cortex is destroyed in AD is still discussed. Cytotoxic T lymphocytes are thought. to be the most important effector cells in mediating the autoimmune tissue destruction, because Adrenal Cortex Autoantibodies (ACA) and/or autoantibodies against 21 idroxylase (21-OHAb) do not seem to be directly involved in the pathogenesis, being considered only good marker of the disease both in clinical and in preclinical stage. In fact, subclinical autoimmune AD can evolve trough 5 functional
stages from stage 0 (only presence of autoantibodies) to stage 4 (clinically overt disease). All the fi ve stages are characterized by the presence of these antibodies but only when they are present at high titre in subclinical stages are associated with the progression towards clinically overt autoimmune AD, whereas a spontaneous remission of subclinical adrenal dysfunction with their disappearance may occur when they are present at low titres. Treatment of AD is based on the use of hydrocortisone or cortisone for symptomatic patients; fl udrocortisone should be used as substitute for mineral-corticosteroids. In some cases, an early replacement therapy has been shown to be helpful to interrupt the progression towards the clinical stage with disappearance of these autoantibodies and recovery of adrenal
function. In addition, a life-threatening adrenal crisis in patients with chronic adrenal insuffi ciency under established replacement therapy. may occur. Clinical medicine must pay attention to these situations because an untreated Addisonian crisis is a medical emergency that requires hospitalization, and if not caught early can be fatal.
http://www.thinkred.co.za/get-involved/events | Thousands of people around the globe are affected by at least one type of Cardiovascular Disease (CVD) every day. This only emphasises the importance of heart health in this day and age. Learn what CVD is about the impact that it has had on people over the years. With simple diet and lifestyle changes many diagnosed individuals can overcome this threat.
El Dr. Juan F. Ascaso, presidente de la Sociedad Española de la Arteriosclerosis (SEA), participa en el acto de presentación de la 'Jornada Galáctica sobre Guías de Lípidos y objetivos a alcanzar en los pacientes de más alto riesgo cardiovascular' (Málaga, 4-5 abril, 2014).
Accede a la jornada completa en http://guiaslipidos.secardiologia.es
What are the cardiovascular disorders?
Public Health importance
Burden of disease
Risk factors of cardiovascular disorders
Causation
Prevention strategies
Global Action Plan for the Prevention and Control of NCDs
India - National programme (NPCDCS)
Improving the Physical health care of people with mental ill health: Cardiovascular health of people with serious mental illness National Learning Network Event 29th April 2015.
Main Slide: NHS IQ CVD SMI LNE 29 April 2015 slides - 1-152
BREAKOUT 1_PATIENT VOICE slides 153-161
BREAKOUT 2a_IMPROVING CARDIOVASCULAR CARE FOR PEOPLE WITH SMI - slides 162-188
BREAKOUT 2b_UCLP PROGRAMME ON CVDSMI - slides 188-195
BREAKOUT 3_PHYSICAL ACTIVITY IN MENTAL HEALTH - slides 196-212
BREAKOUT 4_REASONS FOR TEWVS SUCCESS - slides 213-225
BREAKOUT 5_ PHYSICAL HEALTH AND WELLBEING - slides 226-243
BREAKOUT 6_SHAPE - slides 244-271
BREAKOUT 7_SCREENING FOR CARDIOMETABOLIC RISK FACTORS - slides 272 -296
CORONARY ARTERY DISEASE is a modern epidemic in india. due to changes in living conditions and habits its prevalence is increasing day by day . in this presentation i have explained the various risk factors and innovations in diagnosis of CAD. IT is very useful for primary health care physicians and community medicine specialist
Addison’s Disease (AD) or primary adrenal insuffi ciency has been thought a rare disease for a long time, but recent epidemiological studies have reported a rising prevalence in developed countries. Among the causes of apparently idiopathic forms, autoimmunity plays a relevant role. This review will be focused on several aspects of autoimmune AD, which may manifest either as an isolated disorder or associated with other autoimmune diseases among the autoimmune polyglandular syndromes. HLA plays a key role in determining. T cell responses to antigens, and various HLA alleles have been shown to be associated with many T cell-mediated autoimmune
disorders, but the mechanism by which the adrenal cortex is destroyed in AD is still discussed. Cytotoxic T lymphocytes are thought. to be the most important effector cells in mediating the autoimmune tissue destruction, because Adrenal Cortex Autoantibodies (ACA) and/or autoantibodies against 21 idroxylase (21-OHAb) do not seem to be directly involved in the pathogenesis, being considered only good marker of the disease both in clinical and in preclinical stage. In fact, subclinical autoimmune AD can evolve trough 5 functional
stages from stage 0 (only presence of autoantibodies) to stage 4 (clinically overt disease). All the fi ve stages are characterized by the presence of these antibodies but only when they are present at high titre in subclinical stages are associated with the progression towards clinically overt autoimmune AD, whereas a spontaneous remission of subclinical adrenal dysfunction with their disappearance may occur when they are present at low titres. Treatment of AD is based on the use of hydrocortisone or cortisone for symptomatic patients; fl udrocortisone should be used as substitute for mineral-corticosteroids. In some cases, an early replacement therapy has been shown to be helpful to interrupt the progression towards the clinical stage with disappearance of these autoantibodies and recovery of adrenal
function. In addition, a life-threatening adrenal crisis in patients with chronic adrenal insuffi ciency under established replacement therapy. may occur. Clinical medicine must pay attention to these situations because an untreated Addisonian crisis is a medical emergency that requires hospitalization, and if not caught early can be fatal.
Concerns About Factory Safety and Worker Exploitation in Developing CountriesKimbo Ras
A Case Analysis in International Marketing, MGT 155
Department of Agribusiness Management and Entrepreneurship, College of Economics and Management, University of the Philippines Los Banos
College, Laguna
Design by Kimbo Ras, 2015
The Future of Cardiology (2018 – 2030): Advanced Treatments to Combat the Global Advance of Cardiovascular Diseases. I presented this at Conference Series Cardiology Conference 2017 in Philadelphia, Pennsylvania on 09/01/2017. I first look the the number of people globally affected by cardiovascular diseases. Then I look at the cumulative "lost productivity" globally as a result of people suffering from cardiovascular diseases. Following that, I look at the total costs of treating cardiovascular diseases globally. Then I present the reasons why cardiovascular diseases are rising so rapidly throughout the world - lifestyle/clinical. Then I look at the rates of smoking throughout the world; one of the main culprits of cardiovascular diseases (CVDs). The next slides look at the "Gold Standard" of care for coronary artery diseases (CAD), congestive heart failure (CHF), and aortic valve disease. I also present what is driving industry consolidation and associated major transactions. I then provide some perspective on the future of interventional cardiology. And finally, I provide some insight into "evolving technologies" for cardiovascular care and interventional cardiovascular care. It was a lengthy presentation, but I feel, all critical. This is a very complex field. It takes at least 12 continuous years of education and training to become an interventional or non-interventional cardiologist (4 years pre-med, 3 years medical school, 3 years medical residency, 2 years fellowship (where a cardiologist selects and trains on their cardiovascular specialties)). Some authorities are even calling for post-fellowship training for procedures like transcatheter aortic valve implantation (TAVI) and pacemaker/ICD implantation.
Cardiometabolic Risk (Managing High Risk Patients)simplyweight
This Slideshow we will be discussing about Cardiovascular disease and how it is a leading cause of death.
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Getting to grips with Population Health - 28th Feb 2018James Carter
A set of slides produced by Thames Valley Strategic Clinical Network to support the familiarisation event on Population Health held in Maidenhead on Wednesday 28th February 2018.
With thanks to all colleagues, attendees, chairs and speakers for their involvement on the day.
James Carter - Senior Network Manager TVSCN
james.carter1@nhs.net
Joachim Schüz - A Review of the European Code against CancerIrish Cancer Society
Joachim Schüz, Head of the Section of Environment and Radiation at the International Agency for Research on Cancer, spoke about the latest review of the European Code against Cancer at the European Week Against Cancer in Dublin, Ireland on May 29th, 2013.
Cardiovascular disease (CVD) reduces the quality of life in patients and remains the leading cause of mortality globally.
Despite a number of preventive strategies for CVD, recommended by multiple scientific societies, there is a clear barrier to their effective implementation.2 In this regard, regular evaluation of the implementation of the CVD prevention guidelines may find the gaps in effective implementation of the guidelines that may help in reducing premature mortality and improving the quality of life in coronary heart patients.
Are Electronic Cigarettes good for Tobacco Control in Ireland - Prof Luke Clancy
IPH, Open, Conference, Belfast, Northern, Ireland, Dublin, Titanic, October, 2014, Public, Health
Our aim is to alleviate human suffering related to diabetes and its complications among those least able to withstand the burden of the disease. From 2002 to March 2017, the World Diabetes Foundation provided USD 130 million in funding to 511 projects in 115 countries. For every dollar spent, the Foundation raises approximately 2 dollars in cash or as in-kind donations from other sources. The total value of the WDF project portfolio reached USD 377 million, excluding WDF’s own advocacy and strategic platforms.
Prof. DR. Dr. Rochmad Romdoni, SpJP(K), FINASIM, FIHA, FAsCC. 3rd Pekanbaru Cardiology Update, August 24th 2013. Pangeran Hotel Pekanbaru. Learn more at PerkiPekanbaru.com
Following our successful piece on HIV in Sex Workers, the Lancet asked us to produce an infographic to summarise the findings of the UK Commission on Liver Disease.
Producer: Aimée Stewart • Designers: Paulo Estriga & Caroline Leprovost for Graphic Digital Agency
Ponencia presentada por la Dra. Marisol Bravo Amaro en el CardioTV Live ‘Debatiendo estrategias actuales para la reducción de eventos CV tras síndrome coronario agudo reciente’, realizado el 21 de mayo de 2024 en la Casa del Corazón
Ponencia presentada por el Dr. Armando Oterino Manzanas en el CardioTV Live ‘Debatiendo estrategias actuales para la reducción de eventos CV tras síndrome coronario agudo reciente’, realizado el 21 de mayo de 2024 en la Casa del Corazón
Ponencia presentada por la Dra. Miriam Martín Toro en el CardioTV Live ‘Debatiendo estrategias actuales para la reducción de eventos CV tras síndrome coronario agudo reciente’, realizado el 21 de mayo de 2024 en la Casa del Corazón
Ponencia presentada por los Dres. M.ª Dolores Mesa Rubio, Javier Mora Robles, Margarita Reina Sánchez, M.ª José Castillo Moraga y José Luis Bianchi Llave en el CardioTV Focus, publicado el 25 de abril de 2024 en la Casa del Corazón (Madrid).
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
1. Diabetes and the Heart Meet the experts August 30 2009 Cardiovascular prevention in the context of chronic illness management Lars Rydén Cardiology Unit Karolinska Institutet Stockholm, Sweden Debates en Cardiología: Novedades más relevantes Barcelona October 22 2009
2. Health and disease The ideal solution Lucas Cranach 1546 - The Youth Fountain
3. Epidemiological reality Expanding technology Competing fields Health economy Reorientation The European Heart Health Charter John W Waterhouse 1902 Crystal ball with skull Health and disease A look in the crystal ball
8. A global health catastrophe underway over 350 million within a generation Diabetes in Europe The global picture
9.
10. Cardiovascular disease Chronic inflammatory diseases New theraputic options Inhibition of immune-defense signal transmission From relief to cure Yesterday 300 €/year + indirect costs Today 10 000 €/year for care providers
11. Cardiovascular disease Priori- tise!! Health economy Priority settings in health care Vertical Provider responsibility Prevention Diagnostics Screening Treatment Rehab
12. Reorientation Theraputic progress – obviously not enough .....what about preventing the disease??? 1952 Open heart surgery 1958 Implanted pacemaker 1958 Coronary angiography 1962 Beta-blockade 1964 By pass surgery 1965 ACE-inhibition 1967 Heart transplantation 1969 Calciumantagonism 1976 Intracoronary fibrinolysis 1977 PTCA 1980 Implanted defibrillator 1984 Statins 1988 Cardiovasc use of ASA and more…… W Morton´s first operation under ether 1846 Painting by RC Hinckley 1883
13. (By courtesy: The EUROASPIRE study group) Patients within recommended target (%) Why not better protection in particular among those at risk but still not with established CVD? Preventing cardiovascular disease EUROASPIRE III - Prevention in clinical practice 100 80 60 40 20 0 Blood pressure Total cholesterol Hospital Gen practice Abdominal obesity BMI >30 Smoking Life style oriented variables 100 80 60 40 20 0
14. It´s time to phase reality. We´re not exactly rocket scientists Reorientation Discrepancies between reality and clinical practice
15.
16. The European Heart Health Plan Challenges on the way towards the goal ♦ Create a s trong and simple message ♦ Harmonize the application of available knowledge ♦ Have strong belief in success ♦ Promote a unified approach based on collaboration with respect for autonomy ♦ Improve adherence & compliance ♦ Have patience & be persistant
17. The strong and simple message ♦ Heart disease kills more people in the European Union than any other disease ♦ The European Union spends more money on cardiovascular illness than any other disease ♦ Cardiovascular disease can be prevented by lifestyle changes and better use of medicines we already have ♦ This plan would decrease suffering and save money
18. The strong and simple message CVD behind > 50% of deaths in Europe Cardiovascular mortality (≤65 years) in Europe A major contributor to the almost 20 year difference in life expectancy across Europe
19. The strong and simple message Costs Primary care Inpatient care A&E Outpatient care Medications
20. Application of available knowledge The Interheart study All Smoking Diabetes Overweight Psykosoc 1+2+3 Hypertension ApoB/ApoA1 1+2+3+4 All combined (Yusuf et al. Lancet 2004; 364:937) Odds Ratio (99% CI) 2.9 2.4 1.9 3.3 13.0 42.3 68.5 182.9 337.7 Conclusion ”… .nine easily identified risk factors explain >90% of the risk to develop myocardial infarction…”
21. (The European Health Report 2005; WHO European Region) Application of available knowledge Blood pressure Tobacco Alcohol Cholesterol Overweight Low fruit and vegetable intake Physical inactivity Seven leading risk factors cause a great proportionate loss of DALYS in Europe 12.6 12.3 10.1 8.7 7.8 4.4 3.5 %
22. Diabetes and the Heart Meet the experts August 30 2009 1992 ” The primary determinants of disease are mainly economic and social. Therefore its remedies must also be economic and social. Medicine and politics cannot and should not be kept apart.” Geoffrey Rose 1926 - 1993
23. …… Have a strong belief in success Encouraged by the good example East Karelia the first example of community based prevention encourages
24. 1975 1980 1985 1990 -70 -60 -50 -40 -30 -20 -10 0 Percent decline Smoking Cholesterol Predicted reduction three factors Blood pressure Have a strong belief in success Observed CHD mortality in East Finland (Vartiainen et al. BMJ 1994;309:445)
25. 1975 1980 1985 1990 -70 -60 -50 -40 -30 -20 -10 0 Percent decline Observed mortality Smoking Cholesterol Predicted reduction three factors Blood pressure Have a strong belief in success Observed CHD mortality in East Finland (Vartiainen et al. BMJ 1994;309:445) Enhanced by treatment
26. Have a strong belief in success Explaining fall in CHD deaths in the US 1980-2000 (New Engl J Med 2007: 356:2388)
27. Actions and policies for a healthier Europe February 14th 2000 To promote a unified approach Based on alliances Every child born in the new millennium has the right to live until the age of at least 65 without suffering from avoidable cardiovascular disease In the parliament
28. To promote a unified approach Based on political support 2002 Spanish Presidency Declaration created an opportunity 2002-03 Positioning within the EC 2004 Irish Presidency Cork conference - Council Conclusions 2005 Luxembourg Presidency Luxembourg Declaration 2006 Austrian Presidency Declarations on diabetes and women
29. European phone number to health 14090530 The European Heart Health Charter The essential message 0 smoking 3 km of daily walking 5 portions of fruit & vegetables/day <140/90 mm Hg blood pressure <5.0 mmol/l total cholesterol <3.0 mmol/l LDL-cholesterol 0 diabetes
30. To promote a unified approach Based on political support 2002 Spanish Presidency Declaration created an opportunity 2002-03 Positioning within the EC 2004 Irish Presidency Cork conference - Council Conclusions 2005 Luxembourg Presidency Luxembourg Declaration 2006 Austrian Presidency Declarations on diabetes and women 2007 The European Heart Health Charter Launched at the European Parliament
31. Launched June 12 2007 by In collaboration with European Heart Health Charter The Launch
32. ♦ Minimum requirements to set up heart healthy environments ♦ Proposal of practical tools to implement Council Conclusions European Heart Health Charter What is it? and not the least a moral agreement between signatories
36. A group of European Parliamentarians has been created by ESC and EHN Regular meetings At the European Parliament 2-3 times/year Charter related topics European Heart Health Charter Parliamentarian support
37. Translations 24 languages European Heart Health Charter Present distribution Launches 30 nations Serbian Russian Czech
38. Using EU legislation to promote cardiovascular health Cardiovascular disease prevention Examples of succesful health policies
39. European phone number towards health 0-3-5-140-90-5-3-0 European Heart Health Charter The targets 0 smoking 3 km of daily walking 5 portions of fruit & vegetables/day <140/90 mm Hg blood pressure <5.0 mmol/l total cholesterol <3.0 mmol/l LDL-cholesterol 0 diabetes
40. Prepared by the ASPECT* consortium with funding from the Directorate-General for Health and Consumer Protection European Commission October 2004 *Analysis of the Science and Policy for European Control of Tobaccoo Obstacles to cardiovascular health Tobacco At a conservative estimate tobacco kills over 650 000 people each year in the EU
41. Oppositional voices Political achievements Smoking ban in public places European pioneers Early 2005 Ireland and ItalyC
42. The strong and simple message CVD behind > 50% of deaths in Europe Cardiovascular mortality (≤65 years) in Europe A major contributor to the almost 20 year difference in life expectancy across Europe
43. (Source http://www.smokefreepartnership.eu) February 2009 >200 million European citizens protected by smokefree laws Political achievements Smoking ban in EU Close or 100% according to article 8 Limited laws excemptions allowed Locally variable protection Currently updating the law Currently considering legislation No protection
44. (Glantz Preventive Medicine 2008; 47:452) Hospital admissions for AMI in eight studies 2004 - 2008 Reduction 19% (95% CI 14-24) Political achievements Impact of smoking ban in public places
45. Acute coronary syndromes in Scotland 67% Political achievements Impact of smoking ban in public places (Pell et al. N Engl J Med 2008; 359:482) Before After Category Reduction % (95% CI) Overall 17 (16 - 18) Smokers 14 (12 - 16) Former smokers 19 (17 - 21) Nonsmokers 21 (18 - 24)
46. Political achievements Tobacco advertising EC directive 2001/37 and 2003/33 Tobacco Advertising Directive National legislation July 2005
47. Directive 2001/37/EC increases size of health warnings front 30%; back 40% adopt rules for the use of color photos explaining consequences Belgium first November 2006 Romania July 2008 Latvia from March 2010 other nations will soon follow Political achievements Tobacco advertising
48.
49. The battle goes on… Price differences create an environment for Cross border shopping Smuggling Fraud Political plans Tobacco pricing and taxation € 400 300 200 100 0 Cigarette prices across EU (€/1000) Pre-tax Tax inclusive Price
50. European phone number towards health 0-3-5-140-90-5-3-0 European Heart Health Charter The targets 0 smoking 3 km of daily walking 5 portions of fruit & vegetables/day <140/90 mm Hg blood pressure <5.0 mmol/l total cholesterol <3.0 mmol/l LDL-cholesterol 0 diabetes
51. Vertumnus (Rudolf II) Giuseppe Arcimboldo 1591 Obstacles to cardiovascular health Fruit and vegetables Recommended >400 grams/capita/day
52. 1800 1500 1200 900 600 300 0 Tonnes x 10 3 1997/1998 1998/1999 1999/2000 2000/2001 (Elinder et al 2003) Obstacles to cardiovascular health Use of fruit and vegetables in EU 1997 - 2001 Compostation Distillation Animal feed Human consumption
53. gram/capita/day Apparent consumption in EU Obstacles to cardiovascular health Fruit and vegetable consumption (Source: DG AGRI ) GR PT ES IT CY DK NL FR MT EU SI AT DE BE LU RO SE UK IE BG HU FI LT EE PL CZ LV SK 800 700 600 500 400 300 200 100 0 WHO/FAO min recommended intake
54. 2000 2001 2002 2003 2004 2005 2006 415 405 395 385 375 gram/capita/day Evolution of consumption in EU Trend Obstacles to cardiovascular health Fruit and vegetable consumption (Source: DG AGRI )
55. Proportion obesity and overweight in 7-11 year-old children (Source: Internat Obesity Task Force 2005 ) Obstacles to cardiovascular health Childhood obesity Obese Overweight 30 20 10 0
56. Political achievements School fruit scheme TOWARDS A POSSIBLE EUROPEAN SCHOOL FRUIT SCHEME CONSULTATION DOCUMENT FOR IMPACT ASSESSMENT One of the objectives…. To reverse the declining consumption of fruit and vegetables
57.
58. European phone number towards health 0-3-5-140-90-5-3-0 European Heart Health Charter The targets 0 smoking 3 km of daily walking 5 portions of fruit & vegetables/day <140/90 mm Hg blood pressure <5.0 mmol/l total cholesterol <3.0 mmol/l LDL-cholesterol 0 diabetes
60. (Source: European Commission 2006) Proportion without moderate physical activity a typical week in European countries Obstacles to cardiovascular health Lack of physical activity Adults % 80 60 40 20 0
61. Obstacles to cardiovascular health Lack of physical activity 36 sec to the top 36 steps to health Your health – Your choice SvD Januari 2009 The environment must make physical activity a natural choice 10 000 steps not enough to keep your shape
62. 1 Amsterdam 2 Portland 3 Copenhagen 4 Boulder 5 Davis 6 Sandnes 7 Trondheim 8 San Francisco 9 Berlin 10 Barcelona 11 Basel Political possibilities Bicycle friendly cities
63. Future steps to be taken Cardiovascular disease prevention Towards a successful health policy
64. Lars Rydén Karolinska Institutet Stockholm, Sweden Represented organisations Cardiovascular Respiratory Cancer Diabetes Topics Smoking, alcohol, nutrition, overweight physical inactivity Policy conference June 2009 Cardiovascular disease prevention Transprofessional collaboration EC organised meeting November 10, 2009
65. Why Recommendations? ♦ Highest soft law tool in European Legislation ♦ Stronger sign than just new conclusions ♦ Politically commit Member States who adopt the recommendations European Heart Health Charter Towards Council Recommendations
66. Objective of Recommendations Give strong legal and political orientations from the EU Council indicating to Member States the right options for them to ♦ reduce the burden of CVD ♦ promote CV health European Heart Health Charter Towards Council Recommendations The platform
67. Timelines 15/10 2008 1/2010 3/2010 6/2010 Brussels meeting Spanish Presidency Council Recommendations Conference Spanish Presidency European Heart Health Charter Potential collaboration with Spain
68. European Heart Health Charter Closing the loop of a long process 2002 Spanish Presidency Declaration created an opportunity 2002-03 Positioning of ESC within EU/EC 2004 Irish Presidency Cork conference - Council Conclusions 2005 Luxembourg Presidency Luxembourg Declaration 2006 Austrian Presidency Declarations on women and diabetes 2010 Spanish Presidency Council recommendation ◄ ◄
70. Dante Gabriel Rosetti … .who disliked his physcian already 1862 My doctor ’ s issued his decree That too much wine is killing me And furthermore his ban he hurls Against my touching naked girls How then, must I no longer share Good wine and beauties dark and fair? Doctor, goodbye, my sail ’ s unfurl ’ d I ’ m off to try the other world
72. ” To enable people to make and to implement healthy choices requires information and facilities which must be centrally funded and provided.” Choices will and should always be made by the individual! Our task is to make the healthy choices attractive, affordable and available Geoffrey Rose 1926 - 1993
73. ♦ To work towards a better integration of preventive and curative medicine ♦ To build necessary alliances for the improvement of public health ♦ To take political initiatives Cardiovascular care of the future What is our responsibility
74. EC - Matti Rajala, Katrin Saluvere, Michael Huebel Ireland - Michael Martin, Emer Shelley, Peter Kearney, Chris Fitzgerald, Brian Brogan Luxemburg - Jean Beissel, Mars Bartolomeo Austria - Kurt Huber, Ines Stamm Spain - Maria Jesus Salvador, Esther Gil ESC- The Presidents, Board members, John Martin, Alan Howard, William Wijns, EU relations Cttee, Joint Prevention Cttee, EACPR particularly David Wood, Guy de Backer and Ian Graham, EHN - Peter Hollins, Susanne Logstrup, Susanne Volqvartz, Marleen Kestens, WHO - Jill Farington, Albena Arnaudova National Cardiac Societies - Presidents of Spain, Ireland, Luxemburg , Austria, Germany, Portugal, Sweden and Presidencies of National Cardiac Societies in the EuroHeart Programme. People who made this lecture possible Important collaborators during the years with the EHHC
75. People who made this lecture possible The marvelous “back up office” at the European Heart House Florence B Camille P Britta R Ilaria L Muriel M Sophie S Sophie O´K
76. People who made this lecture possible The great door opener and enthusiast John Martin
77. Diabetes and the Heart Meet the experts August 30 2009 Debates en Cardiología: Novedades más relevantes Barcelona October 22 2009 Thanks for listening to me!!!
Editor's Notes
Political progress Majority vote to take action against CVD All members of Eur Parl unite against CVD 12 July 2007
Political progress Majority vote to take action against CVD All members of Eur Parl unite against CVD 12 July 2007
Political progress Majority vote to take action against CVD All members of Eur Parl unite against CVD 12 July 2007