Non-Communicable Diseases and Rehabilitation

Prevention and Control of Cardiovascular Diseases

heart – 1st leading cause of death ; blood vessels – 2nd
Congenital Heart Disease (CHD): Result of the abnormal development of the heart that exhibits septal defect, patent ductus arteriosus, aortic and pulmonary stenosis, and cyanosis; most prevalent in children
- Causes: environmental factors, maternal diseases or genetic aberrations
Rheumatic Fever or Rheumatic Heart Disease: Systematic inflammatory disease that may develop as a delayed reaction to repeated and an inadequately treated infection of the upper respiratory tract by group A beta-hemolytic streptococci.
Hypertension: Persistent elevation of the arterial blood pressure.(primary or essential) ;frequent among females but severe, malignat form is more common among males
Ischemic Heart Disease/ Atherosclerosis: Condition usually caused by the occlusion of the coronary arteries by thrombus or clot formation.
- higher among males than females for the latter are protected by estrogen before menopause
- Predisposing Factor: Hypertension (HPN),Diabetes Mellitus (DM), Smoking
- Minor Risk Factor: stress, strong family history, obesity

Cardiovascular Disease

Period of Life	Type of CVD	Prevalence
At birth to early childhood	Congenital Heart Disease	2/ 1000 school children (aged 5-15 yrs. old)
Early to late childhood	Rheumatic Fever/ Rheumatic Heart Disease	1/1000 school children (aged 5-15 yrs. old)
Early Adulthood	Diseases of Heart Muscles Essential Hypertension	10/100 adults
Middle age to old age	Coronary Artery Disease Cerebrovascular Accident	5/100 adults

Cardiovascular Disease

Diseases	Causes/ Risk factors
Congenital Heart Disease	Maternal Infections, Drug intake, Maternal Disease, Genetic
Rheumatic Fever/Rheumatic Heart Disease	Frequent Streptoccocal Sore Throat
Essential Hypertension	Heredity, High Salt Intake
Coronary Artery Disease (Heart Attack)	Smoking, Obesity, Hypertension, Stress Hyperlipidemia, Diabetes Mellitus Sedentary Life Style
Cerebrovascular Accident (Stroke)	Hypertension, Arteriosclerosis

Primary Prevention: CVD

Disease	Primordial	Specific Protection
Congenital Heart Disease	Prevention of viral infection and intake of harmful drugs during pregnancy. Avoidance of marriage between blood relatives	Adequate treatment of viral infection during pregnancy. Genetic counseling of blood related married couples.
Rheumatic Heart Disease	Prevention of recurrent sore throat thru adequate environmental sanitation; avoidance of overcrowding; adequate treatment	Identification of cases of rheumatic fever Prophylaxis with penicillin or erythromycin
Essential Hypertension	From early childhood low salt diet adequate physical exercise	Continued low salt diet and adequate exercise
Coronary Heart Disease (Heart Attack)	Prevention of development/ acquisition of risk factors cigarette smoking high fat intake high salt intake	cessation of smoking control /treatment of diabetes, hypertension weight reduction change to proper diet Adjustment of activities
Cerebrovascular Accident (Stroke)	all measures to prevent hypertension & arteriosclerosis	all measures to control hypertension & progression of arteriosclerosis

Primary Prevention thru health education is the main focus of the program:

Maintenance of ideal body wt.
diet – low fat
alcohol/smoking avoidance
exercise
regular BP check up

Cancer Prevention and Early Detection

Any malignant tumor arising from the abnormal and uncontrolled division of cells causing the destruction in the surrounding tissues.
Common Cancer: Lung cancer, cervical cancer, colon cancer, cancer of the mouth, breast cancer, skin cancer, prostate cancer.
3rd leading cause of illness and death (Phil.)
Incidence can only be reduced thru prevention and early detection

Nine Warning Signs of Cancer:

Change in blood bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or elsewhere
Indigestion or difficulty in swallowing
Obvious change in wart or mole
Nagging cough or hoarseness
Unexplained anemia
Sudden unexplained weight loss

Prevention & Early Detection

CA type	Prevention	Detection
Lung	No smoking	None
Uterine	Monogamy, Safe sex	Pap’s smear every 1-3 yrs
Cervical	Monogamy, Safe sex	Pap’s smear every 1-3 yrs
Liver	Hep B vaccination, Less alcohol intake, Avoidance of moldy foods	None
Colon	High fiber diet	Regular medical checkup after 40 yrs of age
Rectum	Low fat intake	Fecal occult blood test DRE Sigmoidoscopy
Mouth	No smoking, betel nut chewing, Oral hygiene	Regular dental check-ups
Breast	none	Monthly SBE, Yearly exam by doctor, Mammography for 50 yrs old and above females
Skin	No excessive sun exposure	Assessment of skin
Prostate	none	Digital transrectal exam

Principles of Treatment of Malignant Diseases

One third of all cancers are curable if detected early and treated properly.

Three major forms of treatment of cancer:

Surgery
Radiation Therapy
Chemotherapy

Nat’l Diabetes Prevention and Control Program

Aim:

Controlling and assimilating healthy lifestyle in the Filipino culture (2005- 2010) thru IEC

Main Concern:

modifiable risk factors ( diet, body wt., smoking, alcohol, stress, sedentary living, birth wt. ,migration

Prevention and Control of Kidney Disease

Acute or Rapidly Progressive Renal Failure : A sudden decline in renal function resulting from the failure of the renal circulation or by glomerular or tubular damage causing the accumulation of substances that is normally eliminated in the urine in the body fluids leading to disruption in homeostatic, endocrine, and metabolic functions.
Acute Nephritis: A severe inflammation of the kidney caused by infection, degenerative disease, or disease of the blood vessels.
Chronic Renal Failure: A progressive deterioration of renal function that ends as uremia and its complications unless dialysis or kidney transplant is performed.
Neprolithiasis: A disorder characterized by the presence of calculi in the kidney.
Nephrotic Syndrome: A clinical disorder of excessive leakage of plasma proteins into the urine because of increased permeability of the glomerular capillary membrane
Urinary Tract Infection: A disease caused by the presence of pathogenic microorganisms in the urinary tract with or without signs and symptoms.
Renal Tubular Defects: An abnormal condition in the reabsorption of selected materials back into the blood and secretion, collection, and conduction of urine.
Urinary Tract Obstruction: A condition wherein the urine flow is blocked or clogged.

Program on Mental Health and Mental Disorders

Mental Health

Mental health is not merely the absence of mental illness. According to the World Health Organization (WHO) Manual on Mental Health, a person is in a state of sound mental health when,
- He feels physically well
- His thought are organized
- His feelings are modulated
- His behaviors are coordinated and appropriate (*note: behaviors considered “normal” may vary according to cultural norms)
Any person may develop mental illness regardless of race, nationality, age, sex civil status and socio-economic background may develop mental illness.

Causes of Mental Illness

A Combination or One of These:

Biological factors
- Like hereditary predisposition, poor nutrition
Physical Factors
- Physical injuries, intoxication
Psychological Factors
- Failure to adjust to the difficulties in life.
Socio-economic Factors
- Unemployment, housing problems

How is Mental Illness Detected?

Interview and assessment by the Clinical Social Worker.
Psychological testing and evaluation.
Psychiatric interview and mental status examination.

Is Mental Illness Curable?

Yes. Mental illness is curable if detected early and prompt and adequate treatment is given. Treatment depends on severity of illness and includes:
- Pharmacotherapy (use of medicines)
- Various therapies (physical, recreational, occupational, environmental)
- Psychotherapy and others

Prevention of Mental Illness

Maintain good physical health.
Choose worthwhile activities and develop a hobby
Solve problems as they come and avoid excessive worrying.
Cultivate friendships and choose a friend to confide in.
Strike a happy medium between work and play.
Recognize early signs and symptoms.

Some Early Signs of Symptoms Mental Illness

Persistent disturbance in sleep and appetite
Over sensitiveness and excessive irritability
Loss of interest in activities or responsibilities of previous concern
Constant complaint of headaches, weakness of hands and feet and other bodily complaints.
Persistent seclusion of oneself from other people.
Frequent attacks of palpitations usually expressed as “nerbiyos” & associated with unexplained fears.
Frequent attacks of dizziness & fainting.
Exaggerated and /or unfounded suspicions
Persistent worrying, forgetfulness & absentmindedness.

Program on Drug Dependence/ Substance Abuse

Community-Based Rehabilitation Program

A creative application of the primary health care approach in rehabilitation services, which involves measures taken at the community level to use and build on the resources of the community with the community people, including impaired, disabled and handicapped persons as well.

Goal

To improve the quality of life and increase productivity of disabled, handicapped persons.

Aim:

To reduce the prevalence of disability through prevention, early detection and provision of rehabilitation services at the community level.

Program on the Elderly/Geriatric Nursing Services

Leading causes of illness: elderly

Influenza, HPN, diarrhea,
bronchitis, TB, diseases. of the heart,
pneumonia, malaria,
malignant neoplasm, chickenpox

Leading causes of death: elderly

Diseases of heart and vascular system
Pneumonia, TB, CCOPD
Malignant neoplasms
Diabetes
Nephritis
Accidents

Programs on Blindness, Deafness and Osteoporosis

Cataract- main causes of blindness
VAD- main cause of childhood blindness; most serious eye problem of Filipino children below 6 yrs. old
Osteoporosis special problem in women, highest bet. 50—79 yrs. old, MENOPAUSE main cause