The road to the United Nations High Level Meeting on chronic non-communicable diseases / El camino hacia la Reunión de Alto de Nivel de las Naciones Unidas en torno a las enfermedades no comunicables crónicas

The United Nations High Level Meeting (UNHLM) on non-communicable diseases (NCDs) will take place in New York on September 19 and 20, 2011. This historic event will focus world attention on the chronic non-communicable diseases (CNCDs) for the first time. In 2008, CNCDs, principally cardiovascular disease, cancer, chronic lung diseases and diabetes, accounted for 63% (or 36 million) of the 57 million deaths occurring worldwide. Many of these deaths may be considered premature (involving 9.1 million persons aged less than 60 years), and around 80% of overall deaths occurred in low and middle income countries. Chronic non-communicable diseases are therefore a major cause of premature death, with resulting enormous negative impact on national economies and global development, while continuing to increase at worrying rates particularly in the developing world. Without successful interventions, NCDrelated deaths are projected to reach 52 million by 2030.

La Reunión de Alto de Nivel de las Naciones Unidas sobre las enfermedades no comunicables crónicas, tendrá lugar en Nueva York el 19 de septiembre de 2011, Este acontecimiento histórico centrará por primera vez la atención mundial sobre las enfermedades no comunicables (ENCs). En el año 2008, las enfermedades no comunicables crónicas - principalmente las enfermedades cardiovasculares, el cáncer, las enfermedades pulmonares crónicas, y la diabetes - representaron el 63% (o 36 millones) de los 57 millones de muertes ocurridas a nivel mundial. Muchas de estas muertes pueden ser consideradas prematuras (abarcando 9.1 millones de personas con menos de 60 años), y alrededor del 80% de las muertes en general ocurrieron en países de ingreso bajo o medio. Por lo tanto, en la actualidad, las enfermedades no comunicables crónicas constituyen una de las principales causas de muertes prematuras. Estas tienen como resultado un impacto negativo en las economías nacionales y el desarrollo global, mientras que continúan aumentado a un ritmo alarmante, especialmente en los países en vías de desarrollo. A menos que se produzcan intervenciones exitosas, las muertes por ENC se estima que alcanzarán la cifra de 52 millones para el año 2030.

Urinary diagnostic indices in the management of leptospirosis: selection of patients for dialysis therapy

Cases of leptospirosis admitted to the Queen Elizabeth Hospital (QEH), Barbado, were assessed for the presence of "pre-renal azotaemia" (NON-ARF) as opposed to "acute renal failure" (ARF). Distinction between the two diagnoses was made on the basis of clinical course. Peritoneal dialysis was inappropriately utilised in 26% of patients receiving such therapy. This study evaluates diagnóstic tests for pre-renal azotaemia, and acute renal failure in leptospsirosis, and indicates guidelines for the management of azotaemia in such patientes. U/P urea and osmolar ratios show high sensitivity in diagnosing pre-renal azotaemia. While "early" dialysis is essential for patients with acute leptospiral renal failure, in those with plasma creatinines less than 600 micronmol/litre on entry and indices indicating NON-ARF, decisions regarding dialysis con safely be delayed for 48-72 hours while the effect of rehydration is assessed