Given the popularity of our blog and protocol Female phase training, this article provides additional information on how the menstrual cycle impacts weight loss. Do you need Keys, Food or Charms? How about Weapons, Tools or Trading Items? This document will tell you which collection to charge! Published by MMHA Documents Home. Bratislava travel guide - Wikitravel. Bratislava. View over the city and Danube River from the castle. Danube River in Bratislava. 1 GUIDELINES ON SCHOOL HEALTH PROGRAMME Introduction: School Health Program is envisaged as an important tool for the provision of preventive, promotive and curative. Estadística descriptiva 1. 2 CARRERAS PROFESIONALES CIBERTEC 3. ESTADÍSTICA I 3 Índice Presentación Red. Fanconi Disease Management Protocol for Veterinarians by Steve Gonto, MMSc, PhD, Medical Sciences Revised 2003. Hlavn. It has a population of almost 4. Before 1. 91. 9, it was known as Pre. The old town is centered on two squares, Hlavne namestie (main square) and Hviezdoslavovo namestie (Hviezdoslav square, named after a famous Slovak poet). Of a rather different architectural character are some of the communist- era buildings found in the modern parts of the city; a prime example is Petrzalka housing estate, the biggest Communist- era concrete block housing complex in Central Europe, which stretches on endlessly just across the river. Move further east and there are plenty of rural places to explore. Farms, vineyards, agricultural land, and tiny villages are situated less than 5. Bratislava. Then, it was conquered by the Soviets to recreate a new Czechoslovakia, but one that would be pro- Soviet and Communist this time. In 1. 99. 3, peaceful differences between Czechs and Slovaks when rebuilding their nation after the fall of Communism led to the dissolution of Czechoslovakia into two separate and independent nations: the Czech Republic, and of course Slovakia (Slovak Republic). To this day, Slovaks and Czechs have generally friendly relations, and the two nations cooperate together frequently on international issues. Since 1. 96. 0, it has been the capital of the federal state of Slovakia within Czechoslovakia and, since 1. Slovakia. Hungarians formed another important group in the city in the 1. First World War, many Germans and Hungarians left for Austria and Hungary respectively, and the remaining Germans were expelled at the end of World War II. The vast majority of scheduled flights are operated by the budget airline Ryanair . United Kingdom, Ireland, France, Spain, Italy and Belgium. Additional carriers are Danube Wings . Direct bus services operating in approximately hourly intervals connect the airport with Vienna airport and the city of Vienna (travel time to Vienna is ca. For example, you will not be allowed a small handbag/laptop bag AND hand luggage. If you are flying by Ryanair and have check- in luggage, do not let the small size of the airport fool you. Arrive at the airport well in advance of your flight, as the queue can get very long. City centre is 1. Main Railway Station. Bus drivers don't sell tickets in Bratislava (see . Use the vending machines at the bus stop but note that you will need euro coins as the vending machines don't take notes (there are also two big red ticket machines in the terminal building close to arrivals, which accept banknotes). Wienerschnitzel Nutrition Facts & Calorie Information A Nutrition Guide to the Wienerschnitzel Menu for Healthy Eating.You can also buy tickets in the tourist and exchange offices in the terminal, but they have only limited working hours. Be aware that the airport shops and kiosks are not very helpful when it comes to changing bills into coins. Bus 9. 6 goes to Slovinsk. Get out and take trolleybus 2. Autobusov. Avoid unofficial black taxis which will overcharge you. Public transport buses are cheaper. Bratislava, near to the town of Schwechat in Austria, after which the airport is named. The airport is the home base of the flag- carrier Austrian. Most European airlines and a significant number of international airlines have direct connections to Vienna from their respective hubs. A quick summary of transport options. Blaguss (Bus), . The buses alight at the bus terminal under the New Bridge and continue towards Bratislava Airport. Bus run almost every hour between Sudtiroler Platz and Vienna Airport and Bratislava Bus Station, some buses run as far as Bratislava Airport. Please check the timetable. You are allowed to transport two pieces of baggage per person at . The baggage tags can be purchased from ticket window or from the driver. It is possible to buy tickets online or at a driver. They speak (or understand) English. The bus tickets include Wi. Fi, a free cup of coffee/tea/capuccino, and an in- seat monitor with a variety of on- demand movie options. DO NOT take a taxi from the taxi line outside the bus station, or you will be fleeced. Even if the taxi driver claims to go by the meter, they will later show you a sheet showing a tariff of 2. Unfortunately, trains from Vienna to Bratislava do not stop at Vienna airport. However, there is a direct connection between both central train stations . It is possible to take the train (S7 or RSB7) from Vienna Airport to Wolfsthal on the Austrian border (4. VOR- Zone for . The buses leave at 5. Also note that the bus 9. Hauptstra. Walking to Bratislava from here will take an hour and is not recommended though there is a path near the Danube. All in all, this is not a preferable way to get to Bratislava, but could be useful if schedules have been checked or if you have a back- up plan to arrange a ride or taxi (which can be hard to explain if you don't speak Slovak or German) from Wolfsthal. Cab Fare could be anywhere from 4. Euro to 1. 45 Euro, depending on where you are going to in Bratislava and the Taxi Company you are hiring. It is very reasonable to book transportation in advance from a Private hire, which will lower your costs significantly and improve your comfort, because driver will wait for you directly at the Schwechat arriving hall. Uber offer a flat rate of 4. Euro from Bratislava to Vienna airport. Budapest and Prague airports are about a 4- 5 hour journey but can mean substantial savings on intercontinental trips, especially to New York City or Beijing. To get to the city center from the central train station, take Bus line 9. The other principal station is Bratislava- Petr. The station serves as a terminus for some of the trains from Vienna. Bus 8. 0 (direction: Koll. Buses 9. 1 and 1. Nov. DO NOT take a taxi from the taxi line outside the train station, or you will be fleeced. Even if the taxi driver claims to go by the meter, they will later show you a sheet showing a tariff of 2. There are two regional express services leaving from different stations in Bratislava - one from Bratislava Hlavn. As of November 2. There is no service either way at 2. Both services terminate at Wien Hauptbahnhof in Vienna. Tickets are valid for both routes. A return ticket called EURegio purchased in Vienna costs . Online tickets are much cheaper than the tickets purchased at the station, but you should buy them at least 3 days in advance. It is possible to get on a through sleeper car, attached to train R 7. The train shuttles every 2 hours from both stations. The first train from Bratislava departs at 5: 5. From Budapest, the first one departs at 5: 2. An alternative route is to take a domestic train from Keleti station to Komarom and walk across the border (bridge over the Danube) to Komarno in Slovakia and take a domestic Slovak train from there to Bratislava. Cost 6,5 plus 4,5 = 1. Recommended if you want to get an impression of rural life in both countries. Warsaw: Two daily direct trains, 7h for morning train or 8. There is a limited offer (Spar. Day for daytime trains, Spar. Night for sleepers) of discounted tickets to Budapest via Bratislava, they're much more cheaper than normal tickets to Bratislava. The train is often delayed. Minsk and Moscow: 1. The most frequent international coach connection by far is Vienna though, with three lines running every hour from Vienna's Sudtirolerplatz near Hauptbahnhof via Vienna International Airport: Blaguss . The tickets can be purchased from the driver or booked online . Regio. Jet buses are by far the cheapest and go for as little as . Regio. Jet buses start/terminate at Mlynsk. Seats can be prebooked online or at ticket windows (one is conveniently located at the Bratislava train station). A trip from/to Vienna takes 1. To get to/from the main railway station (Hlavn. If you need to get to/from the city centre, take trolleybus No 2. Tesco department store at Kamenn. There is also a bakery, a bar/canteen, a newspaper kiosk and several shops on the upper floor. The reconstruction should be finished by the end of 2. Central Coach Terminal will be in the basement of shopping centre. You can find routes and schedules here . A one- way ticket from Vienna to Bratislava by Twin City Liner costs about . The Twin City Liner's boats travel at 6. Vienna to Bratislava and about 1 hour and 3. Bratislava to Vienna (almost as much as the train). Unlike the train though, which stops at stations distant from the center (about 2- 3 km), the boat stops are in the very centres of both Vienna (Schwedenplatz) and Bratislava (Novy Most). Some people do their paddling all the way from Germany to Black Sea (more than 2. TID. Bratislava is well developed for paddling. There are several paddling clubs at . Free camping is possible along river shore; good places are around km. The town can be accessed by motorways (i. As a result, you can pass the town without having to leave the motorway at all. Similar as in Austria or Czech Republic it's required to have a sticker (vignette) on your windshield to drive on motorways. Stickers can be bought at any regular gas station - it's recommended to stop at the first gas station after crossing the border. Cheapest vignette costs . In the center of town you either can use one of the paid underground garages or buy a parking card from vendors in yellow vests and try to find a free spot in the streets. The former is recommended on weekends as finding a parking place in the one- ways can turn into a real head breaking puzzle. If you do find a spot in the street and it's a weekday between 8. AM and 4. PM, a parking card may be necessary. You need them in the center of the city only, parking on the streets is free otherwise. You can purchase parking cards from vendors in yellow vests or in newsstands; they cost . You can leave your car here and walk through the park and across the Danube to the city center, which is a 1. It is not recommended to leave the car in residential areas outside of the city center to avoid paid parking, as foreign cars may attract car thieves. Please make sure that Aupark's parking lots are open only from 1. Cardiovascular Disease Prevention. Observational studies over many decades have shown a close, direct relationship between dyslipidemia and coronary heart disease risk. Intervention trial data collected over the past 2 to 3 decades have also demonstrated that cholesterol modification, especially statin therapy (3- hydroxy- 3- methylglutaryl coenzyme A . The cholesterol- lowering guidelines therefore retain LDL- C as the primary target for lipid modification and statin therapy as the primary means of achieving LDL- C goals. In 1. 98. 8, the first National Cholesterol Education Program (NCEP) was begun in an effort to establish targets for cholesterol levels based on assessments of risk. These guidelines were written by a panel of experts and, in subsequent publications, have been referred to as the Adult Treatment Panel . The NCEP guidelines were evidence based, used CHD risk assessment for the recommended LDL- C targets, and were relatively simple for health care providers, patients, and payers to understand. Over the past 2 decades, the NCEP guidelines have changed in terms of lipid targets based on information obtained from clinical trials and observational studies. These guidelines have been supported by other organizations, including the American Heart Association (AHA), American College of Cardiology (ACC), American Diabetes Association (ADA), American Association of Clinical Endocrinologists (AACE), and American College of Physicians (ACP). This chapter reviews the history of the guidelines, how new information has resulted in changing targets, and current approaches to CHD risk assessment and gives a summary of approaches to lowering cholesterol. History. The Lipid Research Clinic Coronary Primary Prevention Trial. LDL- C lowering in high- risk men aged 3. At baseline, LDL- C levels were typically in the 1. L range. LDL- C values in the cholestyramine- treated subjects approached the 1. L range. This trial was the foundation for the first set of NCEP guidelines published in 1. CHD who had 2 or more risk factors for CHD have an LDL- C target of 1. L or lower. Lower risk patients with fewer risk factors had correspondingly higher LDL- C targets. The second set of NCEP guidelines, published in 1. LDL- C to . Since the publication of the ATP III, several additional clinical trials of statin cholesterol- lowering therapy were published, leading to updates in 2. In contrast to ATP I and II, ATP III placed greater emphasis on the prevention of CHD in patients with multiple risk factors, in addition to treatment for secondary prevention. The ATP III treatment algorithm divided patients into 3 risk categories based on clinical characteristics and the Framingham 1. Established CHD and CHD risk equivalents: High risk (1. Multiple (2 or more) risk factors: Moderately high risk (1. Zero to 1 (1 or none) risk factor: Lower risk (1. ATP III greatly expanded the high- risk category by defining CHD . ATP III major risk factors include the following: Age (men, 4. Cigarette smoking. Hypertension (blood pressure = 1. Hg or patient is on antihypertensive medications)Low high- density lipoprotein (HDL) cholesterol level (< 4. L in men, < 5. L in women; HDL cholesterol . For all patients in the high- risk category with LDL- C > 1. L, LDL- C- lowering dietary therapy should be initiated. In addition, for patients with LDL- C > 1. L, an LDL- C- lowering drug should be started. However, in the LDL- C range of 1. L, ATP III guidelines did not mandate drug therapy; rather, therapeutic options included intensified dietary therapy, LDL- C- lowering drugs, or drug therapy for elevated triglyceride or low HDL- C levels. At the time of publication of the guidelines for ATP III, there were not enough data to recommend more intensive drug therapy for this intermediate range of LDL- C. These recommendations were modified in the ATP III update of 2. LDL- C goal < 1. L for high- risk patients, with an optional goal of < 7. L for very high- risk patients (Table 1). This update also recommended initiating dietary therapy and LDL- C- lowering drugs for all patients over goal, with a planned LDL- C reduction of 3. The rationale for these changes was based on several randomized clinical trials, the results of which were published after the release of the ATP III guidelines. Table 1. Summary of ATP III Guidelines Update, 2. Risk Category. LDL- C Goal. Initiate TLCConsider Drug Therapy. High risk. CHD or CHD- risk equivalent(1. L; optimal goal, < 7. L. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Patients treated with simvastatin had a 2. LDL- C < 1. 00 mg/d. L. The Pravastatin or Atorvastatin Evaluation and Infection- Thrombolysis in Myocardial Infarction 2. PROVE IT- TIMI 2. Ultimately, it showed that intensive LDL- C level lowering with atorvastatin 8. The mean LDL- C level attained was 9. L with pravastatin and 6. L with atorvastatin. The study demonstrated a 1. P < 0. 0. 05). Other trials used to support these revised guidelines included the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER),1. Antihypertensive and Lipid- Lowering Treatment to Prevent Heart Attack Trial- Lipid- Lowering Trial (ALLHAT- LLT),1. Anglo- Scandinavian Cardiac Outcomes Trial- Lipid- Lowering Arm (ASCOT- LLA),2. Finally, in the evolution of the cholesterol guidelines, the AHA/ACC guidelines for secondary prevention of CHD released in 2. LDL- C < 7. 0 mg/d. L in high- risk patients with CHD, based on data accrued from the Treat to New Targets (TNT) and Incremental Decrease in Endpoints through Aggressive Lipid Lowering (IDEAL) trials. It was formulated as a Class IIa recommendation and stated that it is reasonable to treat to LDL < 7. L in such (secondary prevention) patients. When the < 7. 0- mg/d. L target is chosen, it may be prudent to increase statin therapy in a graded fashion to determine a patient’s response and tolerance. Furthermore, if it is not possible to attain LDL- C < 7. L because of a high baseline LDL- C, it generally is possible to achieve LDL- C reductions of > 5. LDL- C- lowering drug combinations. Back to Top. Risk assessment. Several variables have been taken into consideration to determine CHD risk. Any patient who has had a CHD event is at markedly increased risk for a subsequent event. Risk models such as the Framingham risk score. Any patient who has a > 2. CHD event based on the Framingham risk score is considered to be at equivalent risk to a patient with established CHD. The Framingham risk score does not take into account family history because of difficulty obtaining this measure in all patients. Furthermore, it does not include some of the newer markers such as high- sensitivity C- reactive protein (hs. CRP) or microalbuminuria. Current guidelines and many clinical studies consider diabetes mellitus as a CHD risk equivalent (> 2. LDL- C and non. Low HDL- C concentrations are associated with increased CHD risk. Studies such as AFCAPS/TEXCAPS have demonstrated that aggressive LDL- C lowering attenuates much of the adverse risk associated with low HDL- C. There are also extensive data showing that hs. CRP is associated with increased risk for CHD, even when adjustments are made for other risk factors. Current guidelines suggest that hs. CRP be used to help in ongoing risk assessment in patients judged to be at intermediate risk for CHD. In fact, the Reynolds Risk score is one such risk assessment tool that incorporates hs. CRP as well as family history of CHD in parents at age < 6. This risk calculator is modeled to project lifetime CHD risk, and may be useful for assessment of risk in women, for whom the Framingham score often tends to underestimate risk. Other markers of risk have not been consistently included in guidelines but should be considered in clinical practice. Renal dysfunction is associated with an increased risk for CHD. This is true for markers of renal disease such as albuminuria, but several studies have shown that impaired renal function is associated with marked increases in CHD risk, especially when associated with the need for renal replacement therapy (dialysis or renal transplantation). Peripheral vascular disease and cerebrovascular disease are also associated with increased risk for CHD events. Furthermore, most statin trials have shown a reduction in risk for stroke, although stroke event rates are consistently lower than CHD event rates in most studies. Several observational studies have suggested that patients who have systemic inflammatory disorders such as rheumatoid arthritis and systemic lupus erythematosus, especially if they are treated with glucocorticoids, are at increased risk for CHD. Similarly, organ transplant recipients, especially renal, heart, and lung transplants, may be at increased risk for CHD. Many CHD risk prevention clinics, including the Preventive Cardiology Clinic at the Cleveland Clinic, have set more aggressive LDL- C targets for such patients. This approach extends the general concept of more aggressive lipid lowering in patients at increased risk of disease. Back to Top. Lipid- lowering treatment. Diet and Lifestyle. All patients, whether in secondary or primary prevention categories, are urged to implement lifestyle and dietary strategies to prevent cardiovascular disease. Healthy eating habits, starting in childhood, are the cornerstone for cardiovascular risk reduction and, together with lifestyle goals, including maintenance of healthy body weight, avoidance of tobacco products, and adherence to a regimen of physical activity, may be termed elements of primordial prevention. Specifically, the American Heart Association recommends a diet low in fat, particularly saturated and trans fats, enriched in fruits, vegetables, whole grains, and fish, and low in added sugar and salt (Table 2). This approach, especially regarding fat intake, is supported by other nutrition guidelines. Consulta nuestras Condiciones de uso y nuestra Pol.
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