scholarly journals Diuretic treatment in chronic heart failure

2016 ◽  
Vol 11 (2) ◽  
pp. 155-159
Author(s):  
Camelia C. DIACONU ◽  
◽  
Alice BĂLĂCEANU ◽  
Mihaela Adela IANCU ◽  
◽  
...  
Keyword(s):  
Heart Failure ◽  
Diuretic Therapy ◽  
Medical Science ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Developed Countries ◽  
The Body ◽  
Major Public Health Problem ◽  
Important Place ◽  
Central Pillar

Heart failure is a major public health problem in developed countries. Many of the clinical manifestations of heart failure are due to congestion and fluid retention, therefore diuretic therapy occupied for a long time an important place in the management of these patients. All diuretics increase the excretion of water from the body, each of the classes of diuretics achieving this effect in a distinct manner. Given the magnitude of their effect, loop diuretics are the central pillar of diuretic therapy in many patients with heart failure. Resistance to diuretic therapy is one of the management issues for medical science, which is looking for solutions.

scholarly journals Clinico-Epidemiological Profile of Viral Sexually Transmitted Infections in Seropositive Patients Attending a Tertiary Care Hospital in North India

2017 ◽  
Vol 16 (4) ◽  
pp. 331-337 ◽  
Author(s):  
Shikha Chugh ◽  
Vijay Kumar Garg ◽  
Rashmi Sarkar ◽  
Kabir Sardana
Keyword(s):  
Sexually Transmitted Infections ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Developed Countries ◽  
North India ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
Sexually Transmitted ◽  
Hiv Seropositive

Sexually transmitted diseases are a major public health problem both in developing and in developed countries, and especially with the co-synergy with HIV infection, there is an increasing need to have a proper understanding of the clinicodemographic patterns of sexually transmitted infections (STIs) for planning and implementing control strategies. Worldwide, there is an increased preponderance of viral STIs. Increasing incidence and altered clinical presentation of viral STIs in patients with HIV pose a diagnostic challenge; thereby, we studied the demographic profile of HIV-seropositive patients and compared clinical manifestations of viral STIs in HIV-seropositive patients to those in seronegative individuals. Twenty-seven HIV-seropositive patients with viral STI (herpes/molluscum/warts) and same number of age-, sex-, and STI-matched seronegative patients were studied for variability in clinical profile. There were significant differences in the demographic factors (education, income, and migration) and sexual practices (number of contacts and source of infection) in the 2 groups. Lesional symptoms, increased extent of lesions, and resistance to treatment were significantly more common in HIV-seropositive patients.

scholarly journals WARAM-I MEDA (GASTRITIS) AND ITS MANAGEMENT FROM UNANI PERSPECTIVE

2021 ◽  
Vol 14 (2) ◽  
Author(s):  
Azma Waseem ◽  
Waseem Ahmad ◽  
Anwar Jamal ◽  
Mohammad Fazil ◽  
Asim Ali Khan
Keyword(s):  
Developing Countries ◽  
Bile Reflux ◽  
Public Health Problem ◽  
Developed Countries ◽  
The Body ◽  
Gastric Ulcers ◽  
Major Public Health Problem ◽  
Two Factors ◽  
Inflammatory Drugs ◽  
Continuous Use

In the present scenario, gastritis still remains a major public health problem that affects the population of both the developed as well as developing countries. More than 50% of the population in developing countries suffers from gastritis, whereas 34.7 % of the population in developed countries had health problems due to gastritis. Main causes of gastritis are infections, stress, continuous use of non steroidal anti-inflammatory drugs, alcohol and bile reflux. Gastritis if remains untreated or undiagnosed causes Quruh-i Meda (gastric ulcers). Prolonged and progressive inflammation results in destruction of gastric mucosa (Atrophic gastritis) and reduction in gastric acid secretions. These two factors are considered as the main risk factors in the pathogenesis of gastric cancer. Unani physicians have given much importance to this disease. In Unani system of medicine, there is elaborated description of gastritis under the heading of Waram-i Meda with causes, symptoms and its effective management. The fundamental principles of Unani treatment of gastritis is to restore the normalcy of the patient, correction of temperament (Mizaj ), humoral balance in the organ and the body, and toning up of the stomach. All these principles are achieved mostly by three modes of treatment i.e. Iaj bil Tadbeer (Regimenal therapy), Ilaj bil Ghiza (Dietotherapy) and Ilaj bil Dawa (Pharmacotherapy). In this review article, Waram-i Meda (gastritis) is elaborated with its type, causes and treatment in Unani perspective with the objective to reduce the burden of gastritis and prevention of complications associated with gastritis.

scholarly journals Euvolemia as a criterion of diuretic therapy efficacy in chronic heart failure: Literature review

2020 ◽  
Vol 35 (2) ◽  
pp. 13-25
Author(s):  
A. A. Garganeeva ◽  
E. A. Kuzheleva ◽  
V. Yu. Mareev
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Diuretic Therapy ◽  
Optimal Dose ◽  
Developed Countries ◽  
The Body ◽  
Hydration Status ◽  
Long Term Prognosis ◽  
Volume Retention

Chronic heart failure (CHF) is a typical outcome for all pathological processes affecting the cardiovascular system and is diagnosed in 1–2% of the population in developed countries. The strategy for managing patients with CHF involves the prescription of diuretics for the relief of volume retention syndrome in addition to pathogenetic pharmacotherapy. Considering the confl icting data concerning the effects of diuretics on the long-term prognosis and clinical course of CHF, a strict approach to the analysis of risk/benefit ratio is necessary while choosing a specific diuretic and determining its optimal dose and duration of use. The article reviews state-of-theart literature on the assessment of hydration status in patients with CHF. The euvolemia state, in which the optimal volume of fl uid is achieved in the body of a patient with CHF is viewed from the perspective of evaluating the efficacy and relevance of diuretic therapy.

scholarly journals Etiological diagnostics of cardiomyopathies in the cardiology unit of the HUEH internal medicine department from 8 January 2014 to 14 June 2014

2020 ◽  
Author(s):  
Axler Jean Paul ◽  
Lesly Ed Archer ◽  
Raema Mimrod Jean ◽  
Gérald Vernelus ◽  
Rodolphe Malebranche
Keyword(s):  
Internal Medicine ◽  
Heart Failure ◽  
Public Health Problem ◽  
Developed Countries ◽  
The State ◽  
Major Public Health Problem ◽  
State University ◽  
Medicine Department ◽  
Internal Medicine Department ◽  
Long Term Treatment

Introduction Dilated cardiomyopathy is one of the most frequent causes of heart failure in the world, which is now considered a major public health problem both in developed countries where it is predominant, especially in the elderly, over 65 years of age and in patients on long-term treatment for heart disease, and in underdeveloped countries.The diagnosis of cardiomyopathies is essentially based on para-clinical examinations, more precisely on echocardiography. In Haiti, cardiovascular diseases are the leading causes of hospitalization and mortality. These diseases are the main causes of hospitalization at the Hospital of the State University of Haiti (HUEH), the largest hospital in the country, and represent 30% of all cases received in the internal medicine department. Methodology This is a retrospective quantitative study conducted on a sample of patients in the Cardiology Unit of the Internal Medicine Department of the Hospital of the State University of Haiti (HUEH).The study was conducted on 54 patients registered in the Cardiology Unit, during the period from January 8, 2014 to June 11, 2014 for heart failure. Result and discussion The 50 patients showed a predominance for women, 31 (62%) versus 19 (38%) for men, P=0.04. The results of our study showed that the majority of patients are female (62%), which is similar to the last study conducted on the unit by Dr. Malebranche, who found 62.4%The data showed that the reference examination for the confirmatory diagnosis of cardiomyopathy is echocardiography, with 92% of diagnoses. It should be noted that the other diagnoses were made on an echocardiographic basis but were not complete. These findings are similar to data from a recently published Swedish study in which cardiomyopathy was diagnosed by echocardiography in 99.6% of cases. For chest radiography, 100% of cases have cardiomegaly.65.96% of all heart failure cases are dilated cardiomyopathies compared to undiluted cardiomyopathies 14.89%, p<0.0001

scholarly journals Wage Penalties or Wage Premiums? A Socioeconomic Analysis of Gender Disparity in Obesity in Urban China

2020 ◽  
Vol 17 (19) ◽  
pp. 7004
Author(s):  
Jiangli Dou ◽  
Limin Du ◽  
Ken Wang ◽  
Hailin Sun ◽  
Chenggang Zhang
Keyword(s):  
Public Health Problem ◽  
Developed Countries ◽  
Gender Disparity ◽  
The Body ◽  
Excess Weight ◽  
Major Public Health Problem ◽  
Business Practices ◽  
Healthy Weight ◽  
Socioeconomic Analysis ◽  
Variable Approach

Global obesity as a major public health problem has increased at pandemic rate, with men often outpacing women. Survey data show that the overall prevalence of obesity is higher among women than men, yet in high-income developed countries, the prevalence of overweight is higher among men than women. The differential impact of different economic stages has prompted research in transition economies such as China. Using an instrumental variable approach based on a sample of 13,574 individuals from nine provinces in the Chinese Household Income Project (CHIP), we find a 7% excess-weight premium in wages for overweight men and a 4.6% penalty for overweight women, compared to their healthy-weight peers. We also find an inverse u-shaped association between the body mass index (BMI) and logarithm of monthly income for men, with an implied optimum above the threshold of obesity, while women are better off the slimmer they are. The excess-weight premium in wages for Chinese urban men might be associated with entrenched business practices of excessive dining and drinking associated with senior positions. Policies aimed at reducing obesity in China must be adapted to its unique sociocultural context in order to have gender-differentiated effects.

OP116 Cost-Effectiveness Of Sacubitril/Valsartan In Heart Failure

2017 ◽  
Vol 33 (S1) ◽  
pp. 52-53
Author(s):  
Liang Lin ◽  
Mohamed Ismail Abdul Aziz ◽  
David Bin-Chia Wu ◽  
Kwong Ng
Keyword(s):  
Heart Failure ◽  
Cost Effectiveness ◽  
Public Health Problem ◽  
Cardiovascular Death ◽  
Sensitivity Analyses ◽  
Major Public Health Problem ◽  
Old Patients ◽  
Asian Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
The Cost

INTRODUCTION:Heart failure (HF) is a major public health problem worldwide and in Asia. Sacubitril/valsartan reduces cardiovascular death and hospitalizations for HF. However, decision makers need to determine whether its benefits are worth the additional costs, given the low-cost generic status of current standard of care.METHODS:Using a Markov model, we projected lifetime clinical and economic outcomes of sacubitril/valsartan versus enalapril for 66-year-old patients with HF in Singapore. Key health states included New York Heart Association (NYHA) classes; patients in each state incurred a monthly risk of hospitalization for HF and cardiovascular death. Probabilities of events were based on the PARADIGM-HF trial. The uncertain treatment effect of sacubtril/valsartan in Asian patients was modelled using a hazard ratio (HR) of 1 as upper limit in sensitivity analyses. Utilities were obtained from published literature. Local national epidemiological and cost data were applied. Analyses were conducted from the Singapore healthcare payer's perspective. Both one-way and Probabilistic Sensitivity Analyses (PSA) based on 10,000 Monte Carlo simulations were performed.RESULTS:Compared to enalapril, sacubitril/valsartan was associated with an incremental cost-effectiveness ratio (ICER) of SGD74k (USD52k) per quality-adjusted life year (QALY) gained. The cost-effectiveness of sacubitril/valsartan was highly dependent on its effectiveness in reducing the risk of cardiovascular death. However, this was uncertain, particularly in the Asian subgroup, where results were not statistically significant. In sensitivity analyses using results from Asian patients, the ICERs ranged from SGD41k (USD30k) to SGD1.3 million (USD 0.94 million) per QALY gained. PSA showed the probability of sacubitril/valsartan being cost-effective was below 1 percent, 12 percent and 71 percent at thresholds of SGD20k (USD14k), SGD50k (USD36k) and SGD100k (USD 72k) per QALY gained, respectively.CONCLUSIONS:Given the uncertain ICER, sacubtril/valsartan may not provide good value for money compared to enalapril in reducing cardiovascular morbidity and mortality in patients with HF at the current daily cost. Our study highlights the cost-benefit trade-off that healthcare professionals and patients face when considering HF therapy.

scholarly journals Pulmonary alterations in cocaine users

2004 ◽  
Vol 122 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Mário Terra Filho ◽  
Chen Chin Yen ◽  
Ubiratan de Paula Santos ◽  
Daniel Romero Muñoz
Keyword(s):  
Interstitial Fibrosis ◽  
Young Patients ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Lung Abscess ◽  
Pulmonary Complications ◽  
Major Public Health Problem ◽  
Pulmonary Infarction ◽  
Cocaine Use ◽  
Cocaine Users

CONTEXT: Brazilian researchers have recently recognized a marked increase in the number of people using abusable drugs and the consequences of this habit. It has become a major public health problem in a potentially productive segment of the general population. In the last few years, several medical articles have given special emphasis to pulmonary complications related to cocaine use. This review is based on this information and experience acquired with groups of cocaine users. OBJECTIVE: To present to physicians the pulmonary aspects of cocaine use and warn about the various effects this drug has on the respiratory system, stressing those related to long-term use. DESIGN: Narrative review. METHOD: Pulmonary complications are described. These may include infections (Staphylococcus aureus, pulmonary tuberculosis, acquired immunodeficiency syndrome/aids, etc.), aspiration pneumonia, lung abscess, empyema, septic embolism, non-cardiogenic pulmonary edema, barotrauma, pulmonary granulomatosis, bronchiolitis obliterans and organizing pneumonia, pneumonitis and interstitial fibrosis, pneumonitis hypersensitivity, lung infiltrates and eosinophilia in individuals with bronchial hyperreactivity, diffuse alveolar hemorrhage, vasculitis, pulmonary infarction, pulmonary hypertension and alterations in gas exchange. It is concluded that physicians should give special attention to the various pulmonary and clinical manifestations related to cocaine use, particularly in young patients.

Ventricular arrhythmias in seniors with heart failure: present dilemmas and therapeutic considerations: a systematic review

2021 ◽  
Vol 17 ◽  
Author(s):  
Tuoyo O Mene-Afejuku ◽  
Abayomi O Bamgboje ◽  
Modele O Ogunniyi ◽  
Ola Akinboboye ◽  
Uzoma N Ibebuogu
Keyword(s):  
Heart Failure ◽  
Ventricular Arrhythmias ◽  
Public Health Problem ◽  
Developed Countries ◽  
Cardiac Resynchronization ◽  
Cochrane Library ◽  
Global Public Health ◽  
Device Therapy ◽  
Ventricular Ejection Fraction ◽  
The Usa

Background: Heart failure (HF) is a global public health problem which affects over 23 million people worldwide. The prevalence of HF is higher among seniors in the USA and other developed countries. Ventricular arrhythmias (VAs) account for 50% of deaths among patients with HF. We aim to elucidate on the factors associated with VAs among seniors with HF, as well as therapies that may improve outcomes. Methods: PubMed, Web of Science, Scopus, Cochrane Library databases, Science Direct, and Google Scholar were searched using specific key words. The reference lists of relevant articles were searched for additional studies related to HF and VAs among seniors as well as associated outcomes. Results: The prevalence of VAs increases with worsening HF. 24-hour Holter electrocardiogram may be useful in risk stratifying patients for device therapy if they do not meet the criterion of low ventricular ejection fraction. Implantable cardiac defibrillators (ICDs) are superior to anti-arrhythmic drugs in reducing mortality in patients with HF. Guideline directed medical therapy (GDMT) together with device therapy to reduce symptoms may be required. In general, the proportion of seniors on GDMT is low. A combination of ICDs and cardiac resynchronization therapy may improve outcomes in select patients. Conclusion: Seniors with HF and VAs have a high mortality even with the use device therapy and GDMT. The holistic effect of device therapy on outcomes among seniors with HF is equivocal. More studies focused on seniors with advanced HF as well as therapeutic options is therefore required.

Cystic hydatid disease (Echinococcus granulosus)

2020 ◽  
pp. 1529-1533
Author(s):  
Pedro L. Moro ◽  
Hector H. Garcia ◽  
Armando E. Gonzalez
Keyword(s):  
Echinococcus Granulosus ◽  
Hydatid Disease ◽  
Imaging Techniques ◽  
Clinical Manifestations ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Cystic Hydatid Disease ◽  
Control Programmes ◽  
Domestic Livestock ◽  
Cystic Hydatid

Cystic hydatid disease, caused by Echinococcus granulosus, is a zoonotic disease principally transmitted between dogs and domestic livestock, particularly sheep. Humans are infected when they ingest tapeworm eggs, with disease occurring in most parts of the world where sheep are raised and dogs are used to herd livestock. The most common clinical manifestations are cysts in the liver (typically presenting with hepatomegaly) and/or lung (presenting with cough, haemoptysis, and dyspnoea). Diagnosis is usually made on the basis of serological tests in combination with imaging techniques. Treatment options include surgery, chemotherapy with anthelminthic agents, or—for liver cysts—PAIR (puncture–aspiration–injection–reaspiration). Echinococcosis is a major public health problem in several countries. Control programmes have been aimed at educating dog owners to prevent their animals from having access to infected offal. Vaccines against sheep hydatidosis and the dog tapeworm stage are promising alternatives.

scholarly journals Smoking in Latin America: a major public health problem

1998 ◽  
Vol 14 (suppl 3) ◽  
pp. S109-S115 ◽  
Author(s):  
Vera Luiza da Costa e Silva ◽  
Sergio Koifman
Keyword(s):  
Public Health ◽  
Latin America ◽  
Latin American ◽  
Health Problem ◽  
Public Health Problem ◽  
Lung Cancer Mortality ◽  
Developed Countries ◽  
Major Public Health Problem ◽  
Tobacco Epidemic ◽  
Latin American Countries

Smoking has become a major public health problem in Latin America, and its scope varies from country to country. Despite difficulties in obtaining methodologically consistent data for the region, we analyzed the results from prevalence surveys in 14 Latin American countries. Smoking prevalence among men varied from 24.1% (Paraguay) to 66.3% (Dominican Republic) and among women from 5.5% (Paraguay) to 26,6% (Uruguay). By applying point prevalence data to the stage model of the tobacco epidemic in developed countries, we concluded that the Latin American countries are in stage 2, i.e., with a clearly rising prevalence among men, a prevalence for women that is beginning to increase, and mortality attributable to smoking among men still not reflecting peak prevalence. None of the countries analyzed appeared to have reached stage 3, in which one observes a downward trend in prevalence of smoking among men and peak prevalence among women, with broad impact on tobacco-related mortality. The only exception appears to be Paraguay, which is still emerging from stage 1, i.e., with low prevalence rates among men, too. Nevertheless, high lung cancer mortality rates in Uruguay and Argentina are comparable to those of the developed countries.

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