This document discusses the importance of prevention in treating cardiovascular disease. It outlines stages of heart failure progression from asymptomatic left ventricular dysfunction to refractory heart failure. Clinical trials show benefits of treating hypertension and post-MI left ventricular dysfunction to prevent heart failure. Treatment with ACE inhibitors reduces mortality and morbidity from heart failure. Prevention of risk factors is emphasized as the best strategy to avoid full-blown heart disease.
FOURIER: estudio de eventos cardiovasculares con evolocumab
30/03/2017 18:30h Casa del Corazón, Madrid
http://evolocumab.secardiologia.es
#evolocumab
Se abordarán los siguientes temas:
Presentación de resultados del estudio FOURIER
Interpretación de los datos en el contexto actual
Traslación clínica y aplicabilidad de los resultados
Coloquio y preguntas del público
FOURIER: estudio de eventos cardiovasculares con evolocumab
30/03/2017 18:30h Casa del Corazón, Madrid
http://evolocumab.secardiologia.es
#evolocumab
Se abordarán los siguientes temas:
Presentación de resultados del estudio FOURIER
Interpretación de los datos en el contexto actual
Traslación clínica y aplicabilidad de los resultados
Coloquio y preguntas del público
postgraduate education for cardiothoracic anaesthesia and intensive care doctors in cardiac operations on patients with unstable ischemic heart disease
Patients with Chronic stable angina and unstable angina also present a dilemma for further management based on results of coronary angiography alone. Estimation of Fractional flow reserve (FFR) allows to identify ischemia producing lesions in coronary tree. It has been proved beyond doubt that interventions for the lesions causing ischemia improves morbidity and mortality.
postgraduate education for cardiothoracic anaesthesia and intensive care doctors in cardiac operations on patients with unstable ischemic heart disease
Patients with Chronic stable angina and unstable angina also present a dilemma for further management based on results of coronary angiography alone. Estimation of Fractional flow reserve (FFR) allows to identify ischemia producing lesions in coronary tree. It has been proved beyond doubt that interventions for the lesions causing ischemia improves morbidity and mortality.
Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms.
Presented at AHA by: Faiez Zannad, M.D., Ph.D., John J.V. McMurray, M.D., Henry Krum, M.B., PhD., Dirk J. van Veldhuisen, M.D.,Ph.D., Karl Swedberg, M.D., Ph.D, Harry Shi, M.S., John Vincent, M.B., PhD., Stuart J Pocock, Ph.D. and Bertram Pitt, M.D. for the EMPHASIS-HF Study Group * Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure
Courtesy of http://www.cardiovascularbusiness.com
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
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Prevention is the best treatment
1. Prevention is the Best TreatmentPrevention is the Best Treatment
Marc A. Pfeffer, MD, PhDMarc A. Pfeffer, MD, PhD
Dzau Professor of Medicine, Harvard Medical SchoolDzau Professor of Medicine, Harvard Medical School
Cardiovascular Division, Brigham & Women’s HospitalCardiovascular Division, Brigham & Women’s Hospital
Boston, MassachusettsBoston, Massachusetts
Disclosures: Marc A. Pfeffer, M.D., Ph.D., reports having serves as consultant to Aastrom, Abbott Vascular, Amgen, Cleveland
Clinic, Concert, Daiichi Sankyo, Fibrogen, Genzyme, GlaxoSmithKline, Hamilton Health Sciences, Medtronic, Merck, Novartis, Novo
Nordisk, Roche, Salix, Sanderling, Sanofi Aventis, Servier, and Teva and having received grant support from Amgen, Celladon,
Novartis, and Sanofi-Aventis. The Brigham and Women’s Hospital has patents for the use of inhibitors of the renin-angiotensin
system in survivors of MI with Novartis. Dr. Pfeffer’s shares are irrevocably transferred to charity.
2. NORMAL
No symptoms
Normal exercise
Normal LV
No symptoms
Normal exercise
Abnormal LV
No symptoms
Exercise
Abnormal LV
Symptoms
Exercise
Abnormal LV
with treatment
Symptoms not controlled
Asymptomatic
LV Dysfunction
Compensated HF
Decompensated
Heart failure
Refractory Heart
Failure
Stage A
Stage B
Stage C
Stage D
NYHA Class
(I–IV)
NYHA IV
Stage C
2001
3. Effects of Treatment on Morbidity in Hypertension
VA Cooperative Study Group on Antihypertensive Agents
143 men (DBP 115 to 129 mm Hg), mean follow-up ~18 months, 29 events
Placebo group
(n=70)
HCTZ + Reserpine +
Hydralazine HCl group
(n=73)
Total events 27 2
Deaths (all CV) 4 0
Class A events* 10 0
Other treatment failures 7 1
Class B events† 6 1
CHF 4 0
*
Required treatment with known active agents and permanent removal from protocol assigned
therapy (nature of events included dissecting aortic aneurysm, sudden death, ruptured AAA,
fundi striate hemorrhage and papilledema, CHF, elevated BUN, rehospitalization,VA Cooperative Study Group. JAMA 1967;202(11);1028-33
5. Antihypertensive Rx CHF
SHEP Cooperative Research Group. JAMA 1991;265:3255–64
Dahlöf B et al. Lancet 1991;338:1281–5
SHEP
n
2365
2371
Active
Placebo
Relative
risk
6. Fatal or Nonfatal Stroke Heart Failure
HR = 0.70
(0.49-1.01)
HR = 0.36
(0.22-0.58)
Target blood pressure
150/80 mmHg
The Trial: International, multi centre,
randomised double-blind placebo controlled
Inclusion Criteria:
Aged 80 or more,
Systolic BP; 160 -199mmHg
+ diastolic BP; <110 mmHg
Primary Endpoint:
All strokes (fatal and non-fatal)
2008
7. Lewis EF. JACC 2003;42(8):1446-53
CARE: Multivariable Predictors of
Heart Failure
8. PEACE: Development of HF
Age 65 to <75 years (vs <65)
1.89 (1.4 - 2.5)
<0.00
Age ≥75 years (vs <65)
3.15 (2.2 - 4.5)
<0.00
Hx of Diabetes
2.10 (1.6 - 2.7) Lewis EF et al. Circulation: Heart Failure 2009;2:209-16
Baseline Characteristics
HR (95% CI)
p-value
9. Placebo n = 228/2223 (10.3%)
Simvastatin n = 184/2221 (8.3%)
p <0.015
10. Stages of HF and treatment options for
systolic heart failure
Jessup M and Brozena S. N Engl J Med 2003
ICD
Risk factor reduction, patient and family education
Treat hypertension, dyslipidemia, diabetes. ACE inhibitors (or ARB) in selected patients
ACE inhibitors (or ARB) in all patients; Beta blockers in selected patients.
1’ Prevention
11. NORMAL
No symptoms
Normal exercise
Normal LV
No symptoms
Normal exercise
Abnormal LV
No symptoms
Exercise
Abnormal LV
Symptoms
Exercise
Abnormal LV
with treatment
Symptoms not controlled
Asymptomatic
LV Dysfunction
Compensated HF
Decompensated
Heart failure
Refractory Heart
Failure
Stage A
Stage B
Stage C
Stage D
NYHA Class
(I–IV)
NYHA IV
Stage C
2001
12. Years following MI
0 2 4 6 8 10 12 14 16 18 20
Cupples et al. The Framingham Study. NIH Publication 1987;87:2703
MI male
Cumulativeprobability
ofevent
The Framingham Heart Study: 1987
Risk of Heart Failure After MI
(Age 35 to 94 at Diagnosis)
0
0.1
0.2
0.3
0.4
0.5
MI female
Matched male
Matched female
19. 1 2 3 4 5
14
12
10
8
6
4
2
Follow-Up (Years)
%
Heart Failure or Death
Heart Failure
HR Death post-HF = 9.8 (95% CI 7.7 – 13.5)
HF: 68 of 243 (28%) died within 3.5 years
Vs.
No HF: 252 of 3617 (7%) died within 5 years
2003
CARECARE
21. ICD
Risk factor reduction, patient and family education
Treat hypertension, dyslipidemia, diabetes. ACE inhibitors (or ARB) in selected patients
ACE inhibitors (or ARB) in all patients; Beta blockers in selected patients.
1’ Prevention
Stages of HF and treatment options for
systolic heart failure
Jessup M and Brozena S
2003
23. Superior doctors prevent the disease.
Mediocre doctors treat the disease before evident.
Inferior doctors treat the full blown disease.
- Huang Dee: Nai-Ching (2600 B.C. 1st Chinese Medical Text.)
24. Stages of HF and treatment options for
systolic heart failure
Jessup M and Brozena S. N Engl J Med 2003
ICD
Risk factor reduction, patient and family education
Treat hypertension, dyslipidemia, diabetes. ACE inhibitors (or ARB) in selected patients
ACE inhibitors (or ARB) in all patients; Beta blockers in selected patients.
1’ Prevention
