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Felty syndrome weight loss pills used by oprah shuddha guggulu 60caps generic, ➨ systemic lupus erythematosus weight loss 80 lbs purchase shuddha guggulu in india, ➨ Sjögren syndrome weight loss vegan cheap 60 caps shuddha guggulu otc, ➨ mixed connective tissue disease) weight loss pills 81 order shuddha guggulu 60 caps otc. Diseases caused by autoimmune mediated inflammation and/or fibrosis: ➨ autoimmune hepatitis, ➨ primary biliary cirrhosis, and ➨ primary sclerosing cholangitis. Liver microsomal antibodies reacting with cyto chrome P4501A2 are found in patients with drug-induced hepatitis due to dihydralazine or in ➨ autoimmune hepatitis as part of auto immune polyendocrine syndrome type 1. Autoantibodies against soluble liver or liver–pancreas antigen are found in patients with autoimmune hepatitis. Autoantibodies against asialoglycoprotein receptor are frequently found in autoimmune liver diseases, but also in viral-induced and other liver inflammation. Bone marrow-derived cell with little cytoplasm, with the ability to migrate and exchange between the circulation and tissues, to home to sites of antigen exposure, and to be held back at these sites. The only cells that specifically recognize and respond to antigens (mainly with the help of accessory cells). Lymphocytes consist of various subsets differing in their function and products. Activated by different stimuli, they may appear in various forms, such as epitheloid cells and multinucleate giant cells. Macrophages found in different organs and connective tissues have been named according to the specific locations. A cluster of genes encoding cell surface antigens that are polymorphic within a species and have a crucial function in signalling between lymphocytes and cells expressing antigen and in recognition of self. Existence of a cross-reactive epitope between microbial proteins and ➨ autoantigens. Bone marrow-derived mononuclear phagocytic leu kocyte, with bean-shaped nucleus and fine granular cytoplasm con taining lysosomes, phagocytic vacuoles, and cytoskeletal filaments. Autoimmune disorder characterized by destruction of myelin in the central nervous system. Autoimmune diseases associated with profound weakness due to immunological injury of the myofibre (➨ myositis, autoimmune) or affecting the neuro muscular junction (➨ myasthenia gravis, acquired, ➨ Lambert Eaton myasthenic syndrome). Muscle weakness usually affecting ocular and oropharyngeal muscles due to an autoimmune attack against the neuromuscular junction. May be ➨ idiopathic, paraneoplastic (thymic tumour), or drug-induced (D-penicillamine). Rare systemic inflammatory myop athies, including primary polymyositis, primary dermatomyositis, myositis associated with malignancy, childhood dermatomyositis, and myositis with multisystem autoimmune disease. Part of the naturally occurring repertoire of polyreactive antibodies that bind to autoantigens with low affinity. In contrast, natural autoantibodies may become pathogenic in clonal B cell disorders. A subset of ➨ lymphocytes found in blood and some lymphoid tissues, derived from the bone marrow and appearing as large granular lymphocytes. Iron transporter that plays a critical role in macrophage activation and differentiation. Disease of the kidney that may involve either or both the glomeruli (specialized structures where blood is filtered) and the renal tubules (connected structures where the composition of the filtrate is greatly modified in accordance with the physiological needs of the body). A clinical disease in which damage to glomeruli has caused leaky filtration, resulting in major loss of protein from the body. Autoimmune diseases of the nervous system are a major concern in neurological practice. More 246 Terminology and more neuropathies are described as autoimmune or possibly autoimmune in nature. Little is known about ➨ xenobiotics in the pathogenesis, but infections may play an important role in the initiation of some diseases. Autoimmune neuropathies may be manifested at the neuromuscular junction, as central nervous system diseases. Granular leuko cytes having a nucleus with three to five lobes and fine cytoplasmic granules stainable by neutral dyes. The cells have properties of chemotaxis, adherence to immune complexes, and phagocytosis. The cells are involved in a variety of inflammatory processes, including late-phase allergic reactions. The interaction of opsonized complexes with Fc or complement receptors facilitates their uptake by the receptor bearing phagocytic cells. Double-radial immunodiffusion for the detection of precipitating autoantibodies against “extractable nuclear antigens”. Method of high diagnostic specificity but low sensitivity for diagnosis of autoimmune rheumatic diseases. Autoimmune dis eases that are caused by tumour-induced perturbations of the immune system with damaging effects on various organ systems. In most cases, autoantibodies generated by antitumour immunity are responsible for the tissue injury. Group of neuro logical disorders mainly caused by cancer-induced immune mechanisms. Acute or chronic inflammatory neuropathies leading to demyelination and axonal damage of nerves and nerve roots associated with high-titred autoantibodies against ➨ gangliosides. Guillain-Barré syn drome, Miller-Fisher syndrome, acute sensory ataxic neuropathy). End stage of 10–15% of ➨ autoimmune gastritis due to vitamin B12 malabsorption caused by depletion of gastric parietal cells and autoantibodies against intrinsic factor. A terminally differentiated B lymphocyte with little or no capacity for mitotic division that can synthesize and secrete antibody. Plasma cells have eccentric nuclei, abundant cytoplasm, and distinct perinuclear haloes. The cytoplasm contains dense rough endoplasmic reticulum and a large Golgi complex. In both types, organ-specific autoantibodies against a variety of endocrine glands are detectable. The number of cases of disease occurring in a given population at a designated time. Autoimmune liver disease that results in the destruction of bile ducts, leading to fibrosis and cirrhosis. Primary biliary cirrhosis-specific are ➨ antimitochondrial antibodies directed against proteins of the pyruvate dehydrogenase complex (mainly the E2 subunit). A versatile hormone that is involved in the regulation of proliferation and differentiation of a variety of cells in the immune system. May play a role in the pathogenesis and clinical expression of autoimmune diseases. They are also found in patients with other autoimmune systemic vasculitic dis eases. The products of proto-oncogenes are important regulators of biological processes. Mutations or aberrant expression of some proto-oncogenes may be involved in the pathogenesis of autoimmune diseases. Vasospastic condition characterized by acral circulatory disorders affecting the hands and feet. Occurs in all or virtually all patients with ➨ systemic sclerosis, ➨ mixed connective tissue disease, and polymyositis/scleroderma overlap syndrome. They are involved in controlling (anergizing or counter-regulating) autoreactive cells that escaped + from thymic negative selection. An episodic inflammatory systemic disease with autoimmune pathogenetic mechanisms. It primarily affects the joints, causing symmetrical lesions and severe damage to the affected joints. Rheumatoid arthritis is the most common form of inflammatory joint disease (prevalence about 0. Although detectable in various diseases, rheumatoid factor is used as a classification criterion of ➨ rheumatoid arthritis. Primary (➨ clonal deletion, ➨ anergy, ➨ clonal indifference) and secondary or regulatory (➨ interclonal competition, ➨ suppression, ➨ immune deviation, ➨ vetoing, feedback regulation by the ➨ idiotypic network) mechanisms are involved in the induction and maintenance of self-tolerance.
Circulation Anahtar sözcükler: Ateroskleroz; kardiyovasküler hastalık; tanı weight loss 77346 purchase 60caps shuddha guggulu mastercard, 2006;113:463-654 weight loss young living discount shuddha guggulu 60caps amex. Common symptoms of obstructive sleep apnea include snoring weight loss challenge purchase genuine shuddha guggulu on-line, stopping breathing during sleep weight loss pills ranked discount shuddha guggulu 60 caps on-line, frequent awakenings during the night and difculty staying asleep throughout the night. It is also common for people who have obstructive in people who have atrial fbrillation treated with sleep apnea to be tired and sleepy during the day. Obstructive apnea are 25% more likely to have their atrial sleep apnea can also have bad efects on your fbrillation return. What kinds of cardiovascular problems can I get Coronary artery disease (also known as the with obstructive sleep apnea? Narrowed if you have obstructive sleep apnea, you are more coronary arteries can lead to heart attacks and likely to have high blood pressure (hypertension) heart damage. Of all people with hypertension, about a heart attack in the future as those without 30% have obstructive sleep apnea. In addition, research shows that up to obstructive sleep apnea, there is a 50% chance you 70% of people admitted to the hospital because also have hypertension. It is thought that the frequent drops in Action Steps low oxygen levels during sleep damages the blood vessels that supply the heart. Also each time the ✔ If you have a cardiovascular disease such as heart oxygen level drops, your body tells your heart failure, irregular heartbeats and/or hypertension to beat faster and your blood pressure to go up. An enlarged heart does breathing at night), speak with your healthcare not pump as well and the heart and body gets even provider about referring you for a sleep study. This corrects your sleep American Thoracic Society apnea, prevents your blood oxygen levels from If you are having difculty, this information is a public service of the American Thoracic Society. It should not be used as a the right nasal or full-face mask and the right substitute for the medical advice of one’s healthcare provider. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. From the Cardiovascular Division, Brigham A 57-year-old man presents with an acute onset of left foot pain, numbness, and par and Women’s Hospital and Harvard Med tial loss of motor function. His popliteal Health and Science University Hospital, and pedal pulses are absent, and the foot is cool and mottled. Creager at the Cardiovascu lar Division, Brigham and Women’s Hos the Clinical Problem pital, 75 Francis St. Acute limb ischemia is defined as a sudden decrease in limb perfusion that threatens the viability of the limb. The clinical presentation is considered to be acute if it occurs within 2 weeks after symptom onset. Symptoms develop over a period of hours to days and range from new or worsening intermittent claudication to pain in the foot or leg when the patient is at rest, paresthesias, muscle weakness, and paraly sis of the affected limb. Physical findings may include an absence of pulses distal to the occlusion, cool and pale or mottled skin, reduced sensation, and decreased strength. These features of acute limb ischemia are often grouped into a mnemonic known as the six Ps: paresthesia, pain, pallor, pulselessness, poikilothermia (impaired regulation of body temperature, with the temperature of the limb usually cool, reflect An audio version ing the ambient temperature), and paralysis. In contrast to chronic limb ischemia, in which collateral blood vessels may circumvent an occluded artery, acute ischemia threatens limb viability because there is insufficient time for new blood-vessel growth to compensate for loss of perfu sion. Urgent recognition with prompt revascularization is required to preserve limb viability in most circumstances. Clinical events that cause acute limb ischemia include acute thrombosis of a limb artery or bypass graft, embolism from the heart or a diseased artery, dissection, and trauma (from severing of an artery or thrombosis). Acute thrombosis of a limb artery is most likely to occur at the site of an atherosclerotic plaque. Thrombosis may also occur in arterial aneurysms (particularly in the popliteal artery) and in bypass grafts. Thrombosis may complicate an autogenous vein bypass at anastomoses and sites of retained valve cusps, kinks, or other technical problems. Acute thrombosis of pros thetic grafts may occur anywhere in the graft conduit, even if there is no obvious predisposing abnormality. Thrombosis may also affect a previously normal limb artery in patients with thrombophilic conditions such as the antiphospholipid antibody syn 2198 n engl j med 366;23 nejm. Surgical revascularization is generally preferred for an immediately threatened limb or occlusion of more than 2 weeks’ duration. Sensation and muscle strength Rates of death and complications among pa should be assessed. The vascular examination in tients who present with acute limb ischemia are cludes palpation of pulses in the femoral, popliteal, high. Despite urgent revascularization with throm dorsalis pedis, and posterior tibial arteries in the bolytic agents or surgery, amputation occurs in legs and in the brachial, radial, and ulnar arteries 10 to 15% of patients during hospitalization. The presence of flow, particularly in A majority of amputations are above the knee. Acute limb ischemia should be distinguished from the severity of acute limb ischemia is catego critical limb ischemia caused by chronic disorders rized according to the clinical presentation and in which the duration of ischemia exceeds 2 weeks prognosis (Table 1). Optimal management requires prompt literans, other vasculitides, and connective-tissue administration of intravenous heparin to minimize disorders. Nonis raphy, or magnetic resonance angiography) to de chemic limb pain from acute gout, neuropathy, termine the nature and extent of the occlusion and n engl j med 366;23 nejm. Although such types Patients are treated with concomitant low-dose of testing have not been studied specifically for unfractionated heparin through a peripheral in acute limb ischemia, they have sensitivities and travenous cannula or the arterial sheath at the ac specificities exceeding 90% for chronic arterial cess site to prevent the formation of a pericatheter disease. In outflow arteries and the nature and length of most patients with acute limb ischemia, catheter thrombosis (Fig. Thereafter, the operator angiography remains the cornerstone approach crosses the occlusion with a guidewire and a (Fig. Clinical and angiographic examinations are9 angiographic capability and improved endovascu performed during the infusion to determine prog lar techniques for thromboembolectomy make it ress (Fig. Acute limb ischemia is treated by means of endo Thrombolytic agents work by converting plas vascular or open surgical revascularization. However, they the agents that are currently in use for most pe are reviewed here as discrete entities. Patients these agents are intended to selectively activate in whom ischemia for 12 to 24 hours would not plasminogen bound in the thrombus and are be safe and those with a nonviable limb, bypass administered over a period of 24 to 48 hours,11,12 graft with suspected infection, or contraindication although none are approved by the Food and Drug to thrombolysis. Streptokinase, rhage, recent major surgery, vascular brain neo an indirect plasminogen activator, was the first plasm, or active bleeding) should not undergo agent used for intraarterial thrombolysis, but its catheter-directed therapies. Three-Dimensional Reconstruction of a Computed Tomographic Angiogram in a Patient with a 3-Day History of Pain and Numbness in the Right Foot. This posterior view shows a focal occlusion of the right popliteal artery (arrow) with surrounding enlarged col lateral vessels, findings that are consistent with acute thrombosis of an underlying atherosclerotic lesion. The patient underwent surgical bypass with a reversed saphenous vein graft to the posterior tibial artery. States because of lesser efficacy and higher rates of bleeding, as compared with other thrombo lytic agents, and the potential for allergic reac tions. Catheters can be successfully positioned across the thrombosed vessel (an essential prerequisite) in 95% of cases. Major hem orrhage occurs in 6 to 9% of patients, including intracranial hemorrhage in less than 3%. Frequently, a combina comparing these devices with pharmacologic tion of these techniques is required. In Panel A, a digital subtraction angiogram of the proximal left thigh shows occlusion of the proximal superficial femoral artery, with reconstitution in the mid-thigh (arrows). An intraluminal filling defect is present in the proximal superficial femoral artery, which is consistent with an acute thrombus. The angiogram in Panel B, obtained after the infusion, shows that the thrombus has largely resolved, revealing the underlying stenosis (arrow). The angiogram in Panel C, obtained after angioplasty and placement of a self-expanding stent, shows a widely patent artery.
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Patients who failed to weight loss pills 400 buy shuddha guggulu with a visa meet specific glycemic goals during the studies were treated with pioglitazone rescue weight loss nutritionist buy generic shuddha guggulu from india. Rescue therapy was used in 8% of patients treated with add-on sitagliptin 100 mg and 29% of patients treated with add-on placebo weight loss zyprexa purchase 60caps shuddha guggulu otc. The patients treated with add-on sitagliptin had a mean increase in body weight of 1 weight loss pills canada purchase generic shuddha guggulu from india. In addition, add-on sitagliptin resulted in an increased rate of hypoglycemia compared to add-on placebo. Sitagliptin Add-on Therapy in Patients with Type 2 Diabetes Inadequately Controlled on the Combination of Metformin and Rosiglitazone A total of 278 patients with type 2 diabetes participated in a 54-week, randomized, double-blind, placebo-controlled study designed to assess the efficacy of sitagliptin in combination with metformin and rosiglitazone. Patients on dual therapy with metformin ≥1500 mg/day and rosiglitazone ≥4 mg/day or with metformin ≥1500 mg/day and pioglitazone ≥30 mg/day (switched to rosiglitazone ≥4 mg/day) entered a dose-stable run-in period of 6 weeks. Patients on other dual therapy were switched to metformin ≥1500 mg/day and rosiglitazone ≥4 mg/day in a dose titration/stabilization run-in period of up to 20 weeks in duration. Patients who failed to meet specific glycemic goals during the studies were treated with glipizide (or other sulfonylurea) rescue. Rescue therapy was used in 18% of patients treated with sitagliptin 100 mg and 40% of patients treated with placebo. There was no significant difference between sitagliptin and placebo in body weight change. Sitagliptin Add-on Therapy in Patients with Type 2 Diabetes Inadequately Controlled on the Combination of Metformin and Insulin A total of 641 patients with type 2 diabetes participated in a 24-week, randomized, double-blind, placebo-controlled study designed to assess the efficacy of sitagliptin as add-on to insulin therapy. Patients entered a 2-week, single-blind run-in treatment period on pre-mixed, long-acting, or intermediate-acting insulin, with or without metformin (≥1500 mg per day). Patients using short-acting insulins were excluded unless the short-acting insulin was administered as part of a pre-mixed insulin. Patients were on a stable dose of insulin prior to enrollment with no changes in insulin dose permitted during the run-in period. Patients who failed to meet specific glycemic goals during the double-blind treatment period were to have uptitration of the background insulin dose as rescue therapy. Among patients also receiving metformin, the median daily insulin (pre-mixed, intermediate or long acting) dose at baseline was 40 units in the sitagliptin-treated patients and 42 units in the placebo-treated patients. The median change from baseline in daily dose of insulin was zero for both groups at the end of the study. Maintenance of Sitagliptin During Initiation and Titration of Insulin Glargine A total of 746 patients with type 2 diabetes (mean baseline HbA1C 8. At randomization patients were randomized either to continue sitagliptin or to discontinue sitagliptin and switch to a matching placebo. On the day of randomization, insulin glargine was initiated at a dose of 10 units subcutaneously in the evening. Patients were instructed to uptitrate their insulin dose in the evening based on fasting blood glucose measurements to achieve a target of 72 100 mg/dL. At 30 weeks, the mean reduction in A1C was greater in the sitagliptin group than in the placebo group (Table 13). Model estimates calculated using multiple imputation to model washout of the treatment effect using placebo data for all subjects having missing Week 30 data. Glipizide Add-on Therapy in Patients with Type 2 Diabetes Inadequately Controlled on Metformin the efficacy of sitagliptin was evaluated in a 52-week, double-blind, glipizide-controlled noninferiority trial in patients with type 2 diabetes. Patients not on treatment or on other antihyperglycemic agents entered a run-in treatment period of up to 12 weeks duration with metformin monotherapy (dose of ≥1500 mg per day) which included washout of medications other than metformin, if applicable. Patients receiving glipizide were given an initial dosage of 5 mg/day and then electively titrated over the next 18 weeks to a maximum dosage of 20 mg/day as needed to optimize glycemic control. Thereafter, the glipizide dose was to be kept constant, except for down-titration to prevent hypoglycemia. After 52 weeks, sitagliptin and glipizide had similar mean reductions from baseline in A1C in the intent-to-treat analysis (Table 14). A conclusion in favor of the non-inferiority of sitagliptin to glipizide may be limited to patients with baseline A1C comparable to those included in the study (over 70% of patients had baseline A1C less than 8% and over 90% had A1C less than 9%). Table 14: Glycemic Parameters in a 52-Week Study Comparing Sitagliptin to Glipizide as Add-On Therapy in Patients Inadequately Controlled on Metformin (Intent-to-Treat Population)* Sitagliptin 100 mg Glipizide + Metformin + Metformin A1C (%) N = 576 N = 559 Baseline (mean) 7. Patients treated with sitagliptin exhibited a significant mean decrease from baseline in body weight compared to a significant weight gain in patients administered glipizide (-1. Lactic Acidosis Inform patients of the risks of lactic acidosis due to the metformin component, its symptoms, and conditions that predispose to its development, as noted in Warnings and Precautions (5. Although gastrointestinal symptoms that occur after stabilization are unlikely to be drug related, such an occurrence of symptoms should be evaluated to determine if it may be due to lactic acidosis or other serious disease. Instruct patients to contact their health care provider as soon as possible if they experience symptoms of heart failure, including increasing shortness of breath, rapid increase in weight or swelling of the feet [see Warnings and Precautions (5. Severe and Disabling Arthralgia Inform patients that severe and disabling joint pain may occur with this class of drugs. Bullous Pemphigoid Inform patients that bullous pemphigoid may occur with this class of drugs. Instruct patients to seek medical advice if blisters or erosions occur [see Warnings and Precautions (5. Administration Instructions Inform patients that the tablets must never be split or divided before swallowing. The recent development of biochemical and immune system examination methods has made diagnosis more accurate. However, naked-eye and dermoscopy inspection and palpation are always the most important in acquiring information on the nature of skin lesions, including their distribution, form, color, shape and firmness. Eruptions are divided into primary lesions, which occur in normal skin, and secondary lesions, which are caused secondarily by other eruptions. This chapter briefly discusses the terminology for describing the characteristics of various types of eruptions. Primary skin lesions An eruption that occurs in normal skin without any preexisting eruptions is called a primary lesion. These include patches, where the only change is color; papules, nodules and tumors, which are elevated; blisters, cysts and pustules, which contain serum, kera tinized substances, pus, etc. Erythema Erythema is patchy redness produced by vasodilation and hyperemia in the dermal papillae and the subpapillary layer Fig. In erythema, although the blood volume Annular erythema in a patient with Sjögren syn increases in the dermal blood vessels, there is no blood leakage drome. Erythema produced at the periphery of other eruptions such as papules, bullae and pustules is described as a red halo. The decrease of red does not fade by diascopy, unlike in the telangiectasia extravasation melanin deposition melanin usual erythema. Primary skin lesions 51 because hemorrhage causes blood leakage into the dermis, which distinguishes it from erythema. A purpura that is larger than a petechia is called ecchymosis, and an even larger elevated purpu 4 ra is called a hematoma. The red of a purpura is fairly bright shortly after bleeding begins (from the hemoglobin) but becomes Clinical images are available in hardcopy only. When macrophages phagocytose and decompose the leaked blood cells, the color fades. A pigmented macule is a patch of brown, yellow, blue or other Henoch-Schönlein purpura. It is most commonly caused by deposition of melanin, the next most common causes being deposition of hemosiderin, carotin, bile pigment, drugs or other foreign substances. The macule color changes from brown to blackish brown with increased melanins in the epidermal basal layer, and ranges from Clinical images are available in hardcopy only. Depigmentation is caused by abnormal production of melanins, such as in vitiligo vulgaris (Chapter 16). Papule A papule is a localized elevated lesion of 10 mm or less in diameter (Figs. It is characterized by a surface that can be smooth, eroded, ulcerative, hyperkeratotic or crusted. It may be caused by a proliferative or Clinical images are available in hardcopy only. Papules are distinguished by naked-eye observation as serous (with a vesicle on the top. Nodule, Tumor A nodule is a localized lesion that appears as a papule with a diameter of 10 to 20 mm (Fig. It can have various causes, such as tumor formation, granulomatous change, inflammation or edema.
Figure iq Total deaths due to weight loss with yoga buy line shuddha guggulu cerebrovascular disease by Figure ir Total deaths due to weight loss quotes funny generic 60 caps shuddha guggulu cerebrovascular disease by World Bank Income groups weight loss pills 8236 buy shuddha guggulu overnight delivery, 2008 (1) weight loss vacations purchase shuddha guggulu cheap online. Figure iu World map showing the density of physicians (per 100 000 population) (11). Figure jl World map showing the density of health workforce (nonphysicians) (per 100 000 population) (11). Q Best buys can be implemented even in low-income countries if there is a modest increase in investment in health. Q In the long run, investment in implementation research and impact evaluation can save resources. Figure jp Annual research and development expenditure as a proportion of national health expenditure for 2005 (comparable country estimates) (xxxiii). Q Monitoring and evaluation are tools for improving the accountability of different stakeholders. Exposure to risk factors Q Prevalence of tobacco smoking Q Prevalence of physical inactivity Q Prevalence of adult population consuming more than 5 grams of dietary sodium chloride per day Q Prevalence of population consuming less than 5 total servings (400 grams) of fruits and vegetables per day Q Adult per capita consumption in litres of pure alcohol (recorded and unrecorded) Q Prevalence of low weight at birth (<2. Q Civil society institutions are signiﬁcant providers of prevention and health-care services and often ﬁll gaps in services and training provided to the public and private sectors. Q An innovative ﬁnancing mechanism based on a global solidarity tobacco levy is feasible to promote sustainable health ﬁnancing. Q A solidarity tobacco levy has the dual beneﬁt of improving the health of the population by dissuading the use of a product dangerous to health, while raising more domestic funds for health. Working in partnershipto prevent and control the 4 noncommunicable diseases — cardiovascular diseases, diabetes, cancers and chronic respiratory diseases and the 4 shared risk factors — tobacco use, physical inactivity, unhealthy diets and the harmful use of alcohol. Q December 2006 – United Nations General Assembly As mandated by resolution 65/238, the High-level Meeting adopts resolution 61/225, encouraging Member States would result in a concise action-oriented Outcome Docu to develop national policies for the prevention, treat ment. Participants adopt the Doha Declaration tion and Control of Noncommunicable Diseases (213). The resolution is cosponsored by 78 Member States, as well as by Cameroon on behalf of the Group of African States. Q July 2010 – the United Nations Economic and Social Council adopts resolution 2010/8 on tobacco use and maternal and child health, urging Member States to consider the importance of tobacco control in improv ing maternal and child health as part of their public health policies and in their development cooperation programmes. Q September 2010 – the High-level Plenary Meeting of the sixty-ﬁfth session of the United Nations General As sembly on the Millennium Development Goals adopts resolution 65/1. Q December 2010 – the United Nations General Assem bly, at its sixty-ﬁfth session, unanimously adopts reso Global Atlas on Cardiovascular Diseases Prevention and Control 117 the World Health Organization World Health Organization is the United Nations Health Agency founded in 1948. World Heart Federation the World Heart Federation is dedicated to leading the global ﬁght against heart disease and stroke with a focus on low and middle-income countries via a united community of more than 200 member organiza tions. With its members, the World Heart Federation works to build glob al commitment to addressing cardiovascular health at the policy level, generates and exchanges ideas, shares best practice, advances scientiﬁc knowledge and promotes knowledge transfer to tackle cardiovascular disease – the world’s number one killer. It is a growing membership orga nization that brings together the strength of cardiac societies and heart foundations from more than 100 countries. Through our collective efforts we can help people all over the world to lead longer and better heart healthy lives. Its mission is to provide access to stroke care, promote research and knowledge by (1) promoting prevention and care for persons with stroke and vascular dementia (2) fostering the best stan dards of practice (3) education, in collaboration with other international, public, and private organizations and (4) facilitating clinical research. Global health risks: Mortality and burden of disease attributable to selected major risks. Prevention of cardiovascular disease: Guidelines for assessment and management of car 16. Seven countries: A multivariate analysis of death and of the World Health Organization and International Soci coronary heart disease. Erratum in: British Medical Journal, 2003, 13 September, 327(7415):586; British Medical Journal, 11. Global Health Observatory Data Repository, Geneva, World 2006, September, 60(9):823. Levi F, Chatenoud L, Bertuccio P, Lucchini F, Negri E, La Vec Management, 2005, 1(1):15–18. Mortality from cardiovascular and cerebrovascular diseases in Europe and other areas of the world: an up 24. British Medical Journal, health risks: Global and regional burden of disease attribut 2004, 328(7455):1519. Salt intake, stroke, and cardiovascular dis ease: Meta-analysis of prospective studies. Physical activity and stroke: A meta Food Standards Agency joint technical meeting, 1–2 July analysis of observational data. A meta-analysis of physical activity in vegetables and risk of cardiovascular disease. Effects of endurance training Management of cardiovascular risk factors in asymptom on blood pressure, blood pressure-regulating mecha atic high-risk patients in general practice: Cross-sectional nisms, and cardiovascular risk factors. Journal of Hypertension, 2005, 23(2):251– ease: Pocket guidelines for assessment and management of 259. Salt intakes around the world: Implications lipoproteins in overweight and obese adults: A meta-anal for public health. A meta-analysis of alcohol consumption health and current experience of worldwide salt reduc and the risk of 15 diseases. Journal of the in body-mass index since 1980: Systematic analysis of American College of Cardiology, 2010, 55:1328–1335. International Journal of Epidemiol serum total cholesterol since 1980: Systematic analysis of ogy, 2001, 30:1129–1136. Lancet, systolic blood pressure since 1980: Systematic analysis of 2011, 337(9765):578–586. Equity, social determinants and with 786 country-years and 54 million participants. Is non-diabetic hyperglycaemia a risk factor Health equality through action on the social determinants of for cardiovascular disease? Geneva, World of incident diabetes and incident nonfatal cardiovascular Health Organization, 2009 apps. Educational inequalities associated with health-related behaviours in the adult population of Sin 60. Biomedical diabetes relevant to mortality risk from all causes and car Central Public Health, 2010, 10:525–528. Effect of integration of supplemental nutri diovascular disease mortality in middle-aged men. Journal tion with public health programmes in pregnancy and of the American Medical Association, 2002, 288:2709–2716. The Diabetes Control and Complications Trial/Epidmiol British Medical Journal, 2008, 337:1–10. Anthropometry, glucose tolerance and cardiovascular disease in patients with type 1 diabe and insulin concentrations in Indian children: Relation tes. New England Journal of Medicine, 2005, 353(25):2643– ships to maternal glucose and insulin concentrations dur 2653. Racial/ethnic and socioeconomic differ cioeconomic status, and ethnicity on the weight status of ences in multiple risk factors for heart disease and stroke adolescents. Global strategy to reduce the harmful register-based follow-up study of three million men use of alcohol. The socioeconomic gradient in the incidence of stroke: A prospective study in middle-aged women in 81. The contribution of risk fac tors to stroke differentials, by socioeconomic position in 82. Differences in the management and prog stroke mortality in six European countries between 1981– nosis of women and men who suffer from acute coronary 1985 and 1991–1995. Avoidable mortality by neighbourhood trition, Metabolism, and Cardiovascular Diseases, 2010, July, income in Canada: 25 years after the establishment of uni 20(6):386–393. Urbanization, ethnicity and cardiovascular risk in a population in transition in Na 101. Protecting households from catastrophic health kuru, Kenya: A population-based survey. The emergence of cardiovascular disease dur universal coverage through structural reform. Kobe, Japan, World Health Organization, pay for health care in low and middle-income countries. The worldwide epidemiology of essential medicines for chronic diseases in six low and acute rheumatic fever and rheumatic heart disease.