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1

Prion protein polymorphisms affect chronic wasting disease progression.  

PubMed

Analysis of the PRNP gene in cervids naturally infected with chronic wasting disease (CWD) suggested that PRNP polymorphisms affect the susceptibility of deer to infection. To test this effect, we orally inoculated 12 white-tailed deer with CWD agent. Three different PRNP alleles, wild-type (wt; glutamine at amino acid 95 and glycine at 96), Q95H (glutamine to histidine at amino acid position 95) and G96S (glycine to serine at position 96) were represented in the study cohort with 5 wt/wt, 3 wt/G96S, and 1 each wt/Q95H and Q95H/G96S. Two animals were lost to follow-up due to intercurrent disease. The inoculum was prepared from Wisconsin hunter-harvested homozygous wt/wt animals. All infected deer presented with clinical signs of CWD; the orally infected wt/wt had an average survival period of 693 days post inoculation (dpi) and G96S/wt deer had an average survival period of 956 dpi. The Q95H/wt and Q95H/G96S deer succumbed to CWD at 1,508 and 1,596 dpi respectively. These data show that polymorphisms in the PRNP gene affect CWD incubation period. Deer heterozygous for the PRNP alleles had extended incubation periods with the Q95H allele having the greatest effect. PMID:21445256

Johnson, Chad J; Herbst, Allen; Duque-Velasquez, Camilo; Vanderloo, Joshua P; Bochsler, Phil; Chappell, Rick; McKenzie, Debbie

2011-01-01

2

Prion Protein Polymorphisms Affect Chronic Wasting Disease Progression  

PubMed Central

Analysis of the PRNP gene in cervids naturally infected with chronic wasting disease (CWD) suggested that PRNP polymorphisms affect the susceptibility of deer to infection. To test this effect, we orally inoculated 12 white-tailed deer with CWD agent. Three different PRNP alleles, wild-type (wt; glutamine at amino acid 95 and glycine at 96), Q95H (glutamine to histidine at amino acid position 95) and G96S (glycine to serine at position 96) were represented in the study cohort with 5 wt/wt, 3 wt/G96S, and 1 each wt/Q95H and Q95H/G96S. Two animals were lost to follow-up due to intercurrent disease. The inoculum was prepared from Wisconsin hunter-harvested homozygous wt/wt animals. All infected deer presented with clinical signs of CWD; the orally infected wt/wt had an average survival period of 693 days post inoculation (dpi) and G96S/wt deer had an average survival period of 956 dpi. The Q95H/wt and Q95H/G96S deer succumbed to CWD at 1,508 and 1,596 dpi respectively. These data show that polymorphisms in the PRNP gene affect CWD incubation period. Deer heterozygous for the PRNP alleles had extended incubation periods with the Q95H allele having the greatest effect. PMID:21445256

Johnson, Chad J.; Herbst, Allen; Duque-Velasquez, Camilo; Vanderloo, Joshua P.; Bochsler, Phil; Chappell, Rick; McKenzie, Debbie

2011-01-01

3

Sociodemographic factors contribute to the depressive affect among African Americans with chronic kidney disease  

Microsoft Academic Search

Depression is common in end-stage renal disease and is associated with poor quality of life and higher mortality; however, little is known about depressive affect in earlier stages of chronic kidney disease. To measure this in a risk group burdened with hypertension and kidney disease, we conducted a cross-sectional analysis of individuals at enrollment in the African American Study of

Michael J Fischer; Paul L Kimmel; Tom Greene; Jennifer J Gassman; Xuelei Wang; Deborah H Brooks; Jeanne Charleston; Donna Dowie; Denyse Thornley-Brown; Lisa A Cooper; Marino A Bruce; John W Kusek; Keith C Norris; James P Lash

2010-01-01

4

Elevated depressive affect is associated with adverse cardiovascular outcomes among African Americans with chronic kidney disease.  

PubMed

This study was designed to examine the impact of elevated depressive affect on health outcomes among participants with hypertensive chronic kidney disease in the African-American Study of Kidney Disease and Hypertension (AASK) Cohort Study. Elevated depressive affect was defined by Beck Depression Inventory II (BDI-II) thresholds of 11 or more, above 14, and by 5-Unit increments in the score. Cox regression analyses were used to relate cardiovascular death/hospitalization, doubling of serum creatinine/end-stage renal disease, overall hospitalization, and all-cause death to depressive affect evaluated at baseline, the most recent annual visit (time-varying), or average from baseline to the most recent visit (cumulative). Among 628 participants at baseline, 42% had BDI-II scores of 11 or more and 26% had a score above 14. During a 5-year follow-up, the cumulative incidence of cardiovascular death/hospitalization was significantly greater for participants with baseline BDI-II scores of 11 or more compared with those with scores <11. The baseline, time-varying, and cumulative elevated depressive affect were each associated with a significant higher risk of cardiovascular death/hospitalization, especially with a time-varying BDI-II score over 14 (adjusted HR 1.63) but not with the other outcomes. Thus, elevated depressive affect is associated with unfavorable cardiovascular outcomes in African Americans with hypertensive chronic kidney disease. PMID:21633409

Fischer, Michael J; Kimmel, Paul L; Greene, Tom; Gassman, Jennifer J; Wang, Xuelei; Brooks, Deborah H; Charleston, Jeanne; Dowie, Donna; Thornley-Brown, Denyse; Cooper, Lisa A; Bruce, Marino A; Kusek, John W; Norris, Keith C; Lash, James P

2011-09-01

5

Sociodemographic factors contribute to the depressive affect among African Americans with chronic kidney disease.  

PubMed

Depression is common in end-stage renal disease and is associated with poor quality of life and higher mortality; however, little is known about depressive affect in earlier stages of chronic kidney disease. To measure this in a risk group burdened with hypertension and kidney disease, we conducted a cross-sectional analysis of individuals at enrollment in the African American Study of Kidney Disease and Hypertension Cohort Study. Depressive affect was assessed by the Beck Depression Inventory II and quality of life by the Medical Outcomes Study-Short Form and the Satisfaction with Life Scale. Beck Depression scores over 14 were deemed consistent with an increased depressive affect and linear regression analysis was used to identify factors associated with these scores. Among 628 subjects, 166 had scores over 14 but only 34 were prescribed antidepressants. The mean Beck Depression score of 11.0 varied with the estimated glomerular filtration rate (eGFR) from 10.7 (eGFR 50-60) to 16.0 (eGFR stage 5); however, there was no significant independent association between these. Unemployment, low income, and lower quality and satisfaction with life scale scores were independently and significantly associated with a higher Beck Depression score. Thus, our study shows that an increased depressive affect is highly prevalent in African Americans with chronic kidney disease, is infrequently treated with antidepressants, and is associated with poorer quality of life. Sociodemographic factors have especially strong associations with this increased depressive affect. Because this study was conducted in an African-American cohort, its findings may not be generalized to other ethnic groups. PMID:20200503

Fischer, Michael J; Kimmel, Paul L; Greene, Tom; Gassman, Jennifer J; Wang, Xuelei; Brooks, Deborah H; Charleston, Jeanne; Dowie, Donna; Thornley-Brown, Denyse; Cooper, Lisa A; Bruce, Marino A; Kusek, John W; Norris, Keith C; Lash, James P

2010-06-01

6

Chronic Diseases  

Microsoft Academic Search

Although diabetes mellitus, cardiovascular disease, and human immunodeficiency virus infection are three separate entities,\\u000a each has causal and non-causal risk factors that are common in the stage 5 chronic kidney disease population. The medical\\u000a nutrition therapies are similar, which emphasize adequate protein and energy intakes, fluid control, and possibly carbohydrate\\u000a and fat modifications. Each patient requires an individualized evaluation, taking

Sharon R. Schatz

7

Chronic obstructive pulmonary disease  

MedlinePLUS

COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... heart swelling and heart failure due to chronic lung disease) Pneumonia Pneumothorax Severe weight loss and malnutrition Thinning ...

8

Screening for Chronic Kidney Disease  

MedlinePLUS

... 1 Understanding Task Force Recommendations Screening for Chronic Kidney Disease The U.S. Preventive Services Task Force (Task Force) ... body needs to stay healthy. Screening for Chronic Kidney Disease CKD is a common condition that affects about ...

9

Chronic kidney disease  

MedlinePLUS

Kidney failure - chronic; Renal failure - chronic; Chronic renal insufficiency; Chronic kidney failure; Chronic renal failure ... Chronic kidney disease (CKD) slowly gets worse over months or years. you may not notice any symptoms for some ...

10

Factors affecting regional pulmonary blood flow in chronic ischemic heart disease  

SciTech Connect

To assess the effect of left heart disease on pulmonary blood flow distribution, we measured mean pulmonary arterial and wedge pressures, cardiac output, pulmonary vascular resistance, pulmonary blood volume, and arterial oxygen tension before and after treatment in 13 patients with longstanding ischemic heart failure and pulmonary edema. Pulmonary edema was evaluated by a radiographic score, and regional lung perfusion was quantified on a lung scan by the upper to lower third ratio (U:L ratio) of pulmonary blood flow per unit of lung volume. In all cases, redistribution of lung perfusion toward the apical regions was observed; this pattern was not affected by treatment. After treatment, pulmonary vascular pressures, resistance, and edema were reduced, while pulmonary blood volume did not change. At this time, pulmonary vascular resistance showed a positive correlation with the U:L ratio (r = 0.78; P less than 0.01), whereas no correlation was observed between U:L ratio and wedge pressure, pulmonary edema, or arterial oxygen tension. Hence, redistribution of pulmonary blood flow, in these patients, reflects chronic structural vascular changes prevailing in the dependent lung regions.

Pistolesi, M.; Miniati, M.; Bonsignore, M.; Andreotti, F.; Di Ricco, G.; Marini, C.; Rindi, M.; Biagini, A.; Milne, E.N.; Giuntini, C.

1988-07-01

11

Chronic Kidney Diseases  

MedlinePLUS

... for a long time, doctors call it a chronic kidney disease. Children's kidney problems may be congenital (say: kun- ... Do Doctors Treat Kidney Problems? The treatment for chronic kidney ... bone disease. Sometimes unhealthy kidneys have problems producing a hormone ...

12

Markers of Bone Metabolism Are Affected by Renal Function and Growth Hormone Therapy in Children with Chronic Kidney Disease  

PubMed Central

Objectives The extent and relevance of altered bone metabolism for statural growth in children with chronic kidney disease is controversial. We analyzed the impact of renal dysfunction and recombinant growth hormone therapy on a panel of serum markers of bone metabolism in a large pediatric chronic kidney disease cohort. Methods Bone alkaline phosphatase (BAP), tartrate-resistant acid phosphatase 5b (TRAP5b), sclerostin and C-terminal FGF-23 (cFGF23) normalized for age and sex were analyzed in 556 children aged 6–18 years with an estimated glomerular filtration rate (eGFR) of 10–60 ml/min/1.73m2. 41 children receiving recombinant growth hormone therapy were compared to an untreated matched control group. Results Standardized levels of BAP, TRAP5b and cFGF-23 were increased whereas sclerostin was reduced. BAP was correlated positively and cFGF-23 inversely with eGFR. Intact serum parathormone was an independent positive predictor of BAP and TRAP5b and negatively associated with sclerostin. BAP and TRAP5B were negatively affected by increased C-reactive protein levels. In children receiving recombinant growth hormone, BAP was higher and TRAP5b lower than in untreated controls. Sclerostin levels were in the normal range and higher than in untreated controls. Serum sclerostin and cFGF-23 independently predicted height standard deviation score, and BAP and TRAP5b the prospective change in height standard deviation score. Conclusion Markers of bone metabolism indicate a high-bone turnover state in children with chronic kidney disease. Growth hormone induces an osteoanabolic pattern and normalizes osteocyte activity. The osteocyte markers cFGF23 and sclerostin are associated with standardized height, and the markers of bone turnover predict height velocity. PMID:25659076

Doyon, Anke; Fischer, Dagmar-Christiane; Bayazit, Aysun Karabay; Canpolat, Nur; Duzova, Ali; Sözeri, Betül; Bacchetta, Justine; Balat, Ayse; Büscher, Anja; Candan, Cengiz; Cakar, Nilgun; Donmez, Osman; Dusek, Jiri; Heckel, Martina; Klaus, Günter; Mir, Sevgi; Özcelik, Gül; Sever, Lale; Shroff, Rukshana; Vidal, Enrico; Wühl, Elke; Gondan, Matthias; Melk, Anette; Querfeld, Uwe; Haffner, Dieter; Schaefer, Franz

2015-01-01

13

Sleep and Chronic Disease  

MedlinePLUS

... visit this page: About CDC.gov . Sleep and Sleep Disorders Share Compartir Sleep and Chronic Disease As chronic ... of depression be monitored among persons with a sleep disorder. 4, 5 References Knutson KL, Ryden AM, Mander ...

14

Chronic thyroiditis (Hashimoto disease)  

MedlinePLUS

Hashimoto thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis ... cases, the condition is called type 2 polyglandular autoimmune syndrome (PGA II). Less commonly, Hashimoto disease occurs ...

15

Children, Sports, and Chronic Disease.  

ERIC Educational Resources Information Center

Discusses four chronic diseases (cystic fibrosis, congenital heart disease, rheumatoid arthritis, and asthma) that affect American children. Many have their physical activities unnecessarily restricted, though sports and exercise can actually alleviate symptoms and improve their psychosocial development. Physicians are encouraged to prescribe…

Goldberg, Barry

1990-01-01

16

Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: protocol for a systematic review alongside a realist review  

PubMed Central

Introduction The burden of chronic disease is a global phenomenon, particularly among people aged 65?years and older. More than half of older adults have more than one chronic disease and their care is not optimal. Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions. Methods and analysis We will conduct a systematic review alongside a realist review to identify effective CDM tools that integrate one or more high-burden chronic diseases affecting older adults and to better understand for whom, under what circumstances, how and why they produce their outcomes. We will search MEDLINE, EMBASE, CINAHL, AgeLine and the Cochrane Library for experimental, quasi-experimental, observational and qualitative studies in any language investigating CDM tools that facilitate optimal disease management in one or more high-burden chronic diseases affecting adults aged ?65?years. Study selection will involve calibration of reviewers to ensure reliability of screening and duplicate assessment of articles. Data abstraction and risk of bias assessment will also be performed independently. Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (meta-analysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies. Ethics and dissemination Ethics approval is not required for this study. We anticipate that our findings, pertaining to gaps in care across high-burden chronic diseases affecting seniors and highlighting specific areas that may require more research, will be of interest to a wide range of knowledge users and stakeholders. We will publish and present our findings widely, and also plan more active dissemination strategies such as workshops with our key stakeholders. Trial registration number Our protocol is registered with PROSPERO (registration number CRD42014014489). PMID:25649215

Kastner, Monika; Perrier, Laure; Hamid, Jemila; Tricco, Andrea C; Cardoso, Roberta; Ivers, Noah M; Liu, Barbara; Marr, Sharon; Holroyd-Leduc, Jayna; Wong, Geoff; Graves, Lisa; Straus, Sharon E

2015-01-01

17

Anemia of chronic disease  

MedlinePLUS

... ulcerative colitis Cancer , including lymphoma and Hodgkin disease Chronic kidney disease Long-term infections, such as bacterial endocarditis, osteomyelitis (bone infection), HIV/AIDS , hepatitis B or hepatitis C

18

Chronic Disease Indicators  

NSDL National Science Digital Library

The Chronic Disease Indicators (CDI) is a cross-cutting set of 97 indicators that were developed by consensus and that allows states and territories and large metropolitan areas to uniformly define, collect, and report chronic disease data that are important to public health practice and available for states, territories and large metropolitan areas. 

Center for Disease Control

19

Asthma in Washington Asthma is a chronic lung disease that affects an estimated 16.4 million adults (aged 18 years)1  

E-print Network

Asthma in Washington Asthma is a chronic lung disease that affects an estimated 16.4 million adults of age, sex, race, or ethnicity. Although the exact cause of asthma is unknown and it cannot be cured to environmental triggers. The following data provide an overview of the burden of asthma in Washington (WA

20

Asthma in Hawaii Asthma is a chronic lung disease that affects an estimated 16.4 million adults (aged 18 years)1  

E-print Network

Asthma in Hawaii Asthma is a chronic lung disease that affects an estimated 16.4 million adults of age, sex, race, or ethnicity. Although the exact cause of asthma is unknown and it cannot be cured to environmental triggers. The following data provide an overview of the burden of asthma in Hawaii (HI) compared

21

Asthma in New York State Asthma is a chronic lung disease that affects an estimated 16.4 million adults (aged 18 years)1  

E-print Network

Asthma in New York State Asthma is a chronic lung disease that affects an estimated 16.4 million.S.), regardless of age, sex, race, or ethnicity. Although the exact cause of asthma is unknown and it cannot exposure to environmental triggers. The following data provide an overview of the burden of asthma in New

22

Asthma in California Asthma is a chronic lung disease that affects an estimated 16.4 million adults (aged 18 years)1  

E-print Network

Asthma in California Asthma is a chronic lung disease that affects an estimated 16.4 million adults of age, sex, race, or ethnicity. Although the exact cause of asthma is unknown and it cannot be cured to environmental triggers. The following data provide an overview of the burden of asthma in California (CA

23

Asthma is a widespread public health problem that has continued to increase in Texas and nationwide. In Texas, asthma affects more children than any other chronic disease and  

E-print Network

1 #12;Asthma is a widespread public health problem that has continued to increase in Texas and nationwide. In Texas, asthma affects more children than any other chronic disease and accounts a child from having asthma or cures for asthma, it can be controlled by medical treatment and by avoiding

24

Asthma in Wisconsin Asthma is a chronic lung disease that affects an estimated 16.4 million adults (aged 18 years)1  

E-print Network

Asthma in Wisconsin Asthma is a chronic lung disease that affects an estimated 16.4 million adults of age, sex, race, or ethnicity. Although the exact cause of asthma is unknown and it cannot be cured to environmental triggers. The following data provide an overview of the burden of asthma in Wisconsin (WI

25

Chronic Kidney Disease  

MedlinePLUS

You have two kidneys, each about the size of your fist. Their main job is to filter wastes and excess water out of ... help control blood pressure, and make hormones. Chronic kidney disease (CKD) means that your kidneys are damaged ...

26

Chronic Kidney Disease  

MedlinePLUS

... well as they should. Normal, healthy kidneys remove waste from the blood. The waste then leaves your body in your urine. The ... have chronic kidney disease, your kidneys cannot remove waste from the blood as well as they should. ...

27

Angiogenesis in Chronic Lung Disease  

PubMed Central

Chronic lung diseases like COPD, severe progressive pulmonary hypertension (PH), and interstitial lung diseases all have a lung vascular disease component. Cellular and molecular mechanisms of pulmonary vascular remodeling have been experimentally explored in many animal models, and it is now clear that microvessels are involved. In emphysema patients, there is a loss of lung microvessels, and in many forms of severe PH there is obliteration of precapillary arterioles by angioproliferation. Thus, COPD/emphysema and severe angioproliferative PH are on the opposite ends of a spectrum of vascular biology responses. Animal experiments have provided insight regarding some of the initiating events that shape the various forms of pulmonary vascular remodeling. In pulmonary fibrosis and in the postinjury phase of acute lung injury, the angiogenic/angiostatic balance is also affected. This review will therefore discuss angiogenesis in several chronic lung diseases and will speculate on how altered vascular homeostasis may contribute to lung disease development. PMID:17356107

Voelkel, Norbert F.; Douglas, Ivor S.; Nicolls, Mark

2015-01-01

28

Does HOXA9 Gene Expression in Egyptian Chronic Myelogenous Leukemia Patients Affect Disease Progression? A Retrospective Cohort Study  

PubMed Central

Objective: Chronic myelogenous leukemia (CML) is a clonal stem cell disease and is consistently associated with the BCR-ABL fusion gene. The chronic phase of the disease tends to pass into an accelerated phase and eventually leads to acute leukemia if left untreated. Oncoproteins necessary for leukemic transformation are both fundamentally and clinically relevant to identify as they might be new molecular targets for the development of specific anti-leukemic drugs. This study is an initial step to define the proportion of HOXA9 gene expression in some Egyptians with chronic-phase CML at diagnosis and to evaluate its relation with BCR-ABL expression and its clinical significance. Materials and Methods: Sixty-two newly diagnosed CML patients (56 in chronic phase, 1 in accelerated phase, and 5 in blastic crises) were enrolled in the study. HOXA9 and BCR-ABL gene expressions were detected by one-step RT-PCR. ABL was chosen as a control gene to calculate HOXA9/ABL and BCR-ABL/ABL ratios from densitometric values of PCR product intensities. Results: HOXA9 expression was encountered in 25/56 (44.6%) of newly diagnosed CML patients in the chronic phase. The median expression was 0.31 (range: 0.08-1.37) in relation to the ABL gene, with a higher frequency of expression in CML patients presenting with splenomegaly (p<0.001), high Sokal score (p<0.001), and BCR-ABL expression from the first round (p=0.004). No association could be detected with other clinical parameters, overall survival, or disease-free survival. Conclusion: HOXA9 expression is closely related to poor prognostic factors, but we could not demonstrate its relationship to patient survival. Conflict of interest:None declared. PMID:24385825

Mohamad Ismail, Manar Mohamd; Manar, Moneer M.

2013-01-01

29

Chronic obstructive pulmonary disease  

PubMed Central

The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD) in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec) to FVC (forced vital capacity) ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure), hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity), bone disease (osteoporosis and osteopenia), stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death) and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease guidelines recommend influenza and pneumococcal vaccinations. PMID:23563369

Vijayan, V.K.

2013-01-01

30

Chronic obstructive pulmonary disease.  

PubMed

The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD) in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec) to FVC (forced vital capacity) ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure), hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity), bone disease (osteoporosis and osteopenia), stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death) and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease guidelines recommend influenza and pneumococcal vaccinations. PMID:23563369

Vijayan, V K

2013-02-01

31

Anemia in Chronic Kidney Disease  

MedlinePLUS

... Topics and Titles : Anemia in Chronic Kidney Disease Anemia in Chronic Kidney Disease On this page: What is anemia? How is ... carry oxygen throughout the body. [ Top ] What causes anemia in chronic kidney disease? When kidneys are diseased or damaged, they do ...

32

Obesity and Chronic Kidney Disease  

Microsoft Academic Search

Background\\/Aims: The prevalence of obesity among U.S. adults has doubled within the past two decades, and if trends continue, over one-third of U.S. adults may be obese by the year 2008. Concurrent with the rising prevalence of obesity is an epidemic of chronic kidney disease (CKD) with an estimated 18 million U.S. adults currently affected. This review discusses the strong

Holly Kramer

2006-01-01

33

Chronic Wasting Disease  

USGS Publications Warehouse

Chronic wasting disease (CWD) is an always-fatal, neurological illness occurring in North American cervids (members of the deer family), including white-tailed deer, mule deer, elk and moose. Since its discovery in 1967, CWD has spread geographically and increased in prevalence locally. CWD is contagious; it can be transmitted freely within and among free-ranging populations. It is likely that diseased animals can transmit CWD to healthy animals long before they become clinically ill. Managing CWD in free-ranging populations is extremely difficult, therefore preventative measures designed to reduce the chance for disease spread are critically important.

Richards, Bryan

2007-01-01

34

Emerging Infectious Determinants of Chronic Diseases  

PubMed Central

Evidence now confirms that noncommunicable chronic diseases can stem from infectious agents. Furthermore, at least 13 of 39 recently described infectious agents induce chronic syndromes. Identifying the relationships can affect health across populations, creating opportunities to reduce the impact of chronic disease by preventing or treating infection. As the concept is progressively accepted, advances in laboratory technology and epidemiology facilitate the detection of noncultivable, novel, and even recognized microbial origins. A spectrum of diverse pathogens and chronic syndromes emerges, with a range of pathways from exposure to chronic illness or disability. Complex systems of changing human behavioral traits superimposed on human, microbial, and environmental factors often determine risk for exposure and chronic outcome. Yet the strength of causal evidence varies widely, and detecting a microbe does not prove causality. Nevertheless, infectious agents likely determine more cancers, immune-mediated syndromes, neurodevelopmental disorders, and other chronic conditions than currently appreciated. PMID:16836820

O'Connor, Siobhán M.; Taylor, Christopher E.; Hughes, James M.

2006-01-01

35

Modifiable lifestyle and social factors affect chronic kidney disease in high-risk individuals with type 2 diabetes mellitus.  

PubMed

This observational study examined the association between modifiable lifestyle and social factors on the incidence and progression of early chronic kidney disease (CKD) among those with type 2 diabetes. All 6972 people from the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) with diabetes but without macroalbuminuria were studied. CKD progression was defined as decline in GFR of more than 5% per year, progression to end-stage renal disease, microalbuminuria, or macroalbuminuria at 5.5 years. Lifestyle/social factors included tobacco and alcohol use, physical activity, stress, financial worries, the size of the social network and education. Adjustments were made for known risks such as age, diabetes duration, GFR, albuminuria, gender, body mass index, blood pressure, fasting plasma glucose, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers use. Competing risk of death was considered. At study end, 31% developed CKD and 15% had died. The social network score (SNS) was a significant independent risk factor of CKD and death, reducing the risk by 11 and 22% when comparing the third to the first tertile of the SNS (odds ratios of CKD 0.89 and death 0.78). Education showed a significant association with CKD but stress and financial worries did not. Those with moderate alcohol consumption had a significantly decreased CKD risk compared with nonusers. Regular physical activity significantly decreased the risk of CKD. Thus, lifestyle is a determinant of kidney health in people at high cardiovascular risk with diabetes.Kidney International advance online publication, 10 December 2014; doi:10.1038/ki.2014.370. PMID:25493953

Dunkler, Daniela; Kohl, Maria; Heinze, Georg; Teo, Koon K; Rosengren, Annika; Pogue, Janice; Gao, Peggy; Gerstein, Hertzel; Yusuf, Salim; Oberbauer, Rainer; Mann, Johannes F E

2014-12-10

36

Factors affecting conformity to renin-angiotensin system inhibitor usage in chronic kidney disease and diabetes mellitus.  

PubMed

Renin-angiotensin system inhibitor (RASi) agents improve renal and cardiovascular outcomes in patients with diabetes mellitus (DM) and chronic kidney disease (CKD). Studies examining conformity to guidelines have relied on pharmacy claims or filled prescriptions rather than provider-based information. The main outcome of RASi use was examined in 2889 patients with CKD and DM for its association with patient characteristics and specialty clinic visits. RASi use was 77% during the 2-year study period, and declined with worsening CKD stages (79%, 59%, and 48% in stages III, IV, and V, respectively; P<.0001). By multivariate analysis, hypertension (odds ratio [OR], 5.49, 95% confidence interval [CI], 4.16-7.25); older age (OR, 0.85; 95% CI, 0.78-0.93), and higher glomerular filtration rate (OR, 1.42; 95% CI, 1.31-1.53) were associated with RASi use. In a model examining the effect of each specialty, RASi use was greater in patients attending cardiology (OR, 3.52; 95% CI, 2.63-4.71), pharmacy (OR, 3.15; 95% CI, 2.49-3.98), endocrine (OR, 3.39; 95% CI, 2.22-5.16), and renal clinic visits (OR, 2.04; 95% CI, 1.54-2.71). Diagnosis of hypertension increases RASi usage, whereas older age and lower glomerular filtration rate reduce that likelihood. Appropriate specialty referrals improve conformity to guidelines in practice. PMID:21762359

Laflam, Paul; Schmitt, Kristen E; Edie, Christine F; Simbartl, Loretta A; Thakar, Charuhas V

2011-07-01

37

Preventing Chronic Disease  

NSDL National Science Digital Library

Persons with an interest in public health will want to make a beeline for this rather helpful and well-done journal offered by the Center for Disease Control (CDC). This online-only publication was started in January 2004, and contains a healthy mix of peer-reviewed articles, CDC announcements, and general interest pieces. The journal's interests are quite broad and include reproductive health, oral health, health risk behavior, and the value of policy and legislation in preventing chronic disease. Some of the recent articles in the journal have included pieces on childhood obesity prevention legislation, diabetes and tooth loss, and more specifically, "The Cradle to Prison Pipeline: An American Health Crisis". The site also contains an online archive and information for potential authors, peer reviewers, and information about email updates about new issues.

38

Chronic wasting disease  

PubMed Central

Transmissible spongiform encephalopathies (prion diseases) in animals may be associated with a zoonotic risk potential for humans as shown by the occurrence of variant Creutzfeldt-Jakob disease in the wake of the bovine spongiform encephalopathy epidemic. Thus, the increasing exposure of humans in North America to cervid prions of chronic wasting disease (CWD) in elk and deer has prompted comprehensive risk assessments. The susceptibility of humans to CWD infections is currently under investigation in different studies using macaques as primate models. The necessity for such studies was recently reinforced when disease-associated prion protein and its seeding activity were detected in muscles of clinically inconspicuous CWD-infected white-tailed deer (WTD). Increasing evidence points to the existence of different CWD strains and CWD prions may also change or newly emerge over time. Therefore, CWD isolates examined in macaques should be characterized as precisely as possible for their molecular identity. On this basis other CWD field samples collected in the past, present or future could be systematically compared with macaque-tested inocula in order to assess whether they are covered by the ongoing risk assessments in primates. CWD typing by Fourier transform-infrared spectroscopy of pathological prion protein may provide a method of choice for this purpose. PMID:22453172

Daus, Martin L

2012-01-01

39

Skin problems in chronic kidney disease  

Microsoft Academic Search

Skin disorders associated with chronic kidney disease (CKD) can markedly affect a patient's quality of life and can negatively impact their mental and physical health. Uremic pruritus, which is frequently encountered in patients with CKD, is considered to be an inflammatory systemic disease rather than a local skin disorder. Biomarkers of inflammation are increased in patients with uremic pruritus and

Dirk RJ Kuypers

2009-01-01

40

Cerebral Small Vessel Disease and Chronic Kidney Disease  

PubMed Central

Chronic kidney disease, defined by a decreased glomerular filtration rate or albuminuria, is recognized as a major global health burden, mainly because it is an established risk factor for cardiovascular and cerebrovascular diseases. The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity. Since the kidney and brain share unique susceptibilities to vascular injury due to similar anatomical and functional features of small artery diseases, kidney impairment can be predictive of the presence and severity of cerebral small vessel diseases. Chronic kidney disease has been reported to be associated with silent brain infarcts, cerebral white matter lesions, and cerebral microbleeds, independently of vascular risk factors. In addition, chronic kidney disease affects cognitive function, partly via the high prevalence of cerebral small vessel diseases. Retinal artery disease also has an independent relationship with chronic kidney disease and cognitive impairment. Stroke experts are no longer allowed to be ignorant of chronic kidney disease. Close liaison between neurologists and nephrologists can improve the management of cerebral small vessel diseases in kidney patients. PMID:25692105

2015-01-01

41

Cerebral small vessel disease and chronic kidney disease.  

PubMed

Chronic kidney disease, defined by a decreased glomerular filtration rate or albuminuria, is recognized as a major global health burden, mainly because it is an established risk factor for cardiovascular and cerebrovascular diseases. The magnitude of the effect of chronic kidney disease on incident stroke seems to be higher in persons of Asian ethnicity. Since the kidney and brain share unique susceptibilities to vascular injury due to similar anatomical and functional features of small artery diseases, kidney impairment can be predictive of the presence and severity of cerebral small vessel diseases. Chronic kidney disease has been reported to be associated with silent brain infarcts, cerebral white matter lesions, and cerebral microbleeds, independently of vascular risk factors. In addition, chronic kidney disease affects cognitive function, partly via the high prevalence of cerebral small vessel diseases. Retinal artery disease also has an independent relationship with chronic kidney disease and cognitive impairment. Stroke experts are no longer allowed to be ignorant of chronic kidney disease. Close liaison between neurologists and nephrologists can improve the management of cerebral small vessel diseases in kidney patients. PMID:25692105

Toyoda, Kazunori

2015-01-01

42

The Chronic Gastrointestinal Manifestations of Chagas Disease  

PubMed Central

Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease. The chronic gastrointestinal manifestations of Chagas disease are mainly a result of enteric nervous system impairment caused by T. cruzi infection. The anatomical locations most commonly described to be affected by Chagas disease are salivary glands, esophagus, lower esophageal sphincter, stomach, small intestine, colon, gallbladder and biliary tree. Chagas disease has also been studied in association with Helicobacter pylori infection, interstitial cells of Cajal and the incidence of gastrointestinal cancer. PMID:20037711

Matsuda, Nilce Mitiko; Miller, Steven M.; Evora, Paulo R. Barbosa

2009-01-01

43

Chronic Lung Disease Cerebral Palsy  

E-print Network

0 10 20 30 40 50 60 70 80 90 100 Chronic Lung Disease Diabetes Cerebral Palsy Sickle Cell Disease Hem ophilia Solid organ transplant Inflam m atory Bowel Disease Epilepsy Cystic Fibrosis Com plex Congential HeartDisease Acute Lym phoblastic Leukem ia Spina Bifida Medianencountersperyear Outpatient

Kay, Mark A.

44

Chronic Liver Disease and African Americans  

MedlinePLUS

... American > Chronic Liver Disease Chronic Liver Disease and African Americans Among African Americans, chronic liver disease is a ... White women. At a glance – Cancer Rates for African Americans (2005-2009) Cancer Incidence Rates per 100,000 – ...

45

Models of chronic kidney disease  

PubMed Central

Chronic kidney diseases result from recurrent or progressive injuries in glomeruli, tubules, interstitium and/or vasculature. In order to study pathogenesis, mechanisms and effects of interventions, many animal models have been developed, including spontaneous, genetic and induced models. However, these models do not exactly simulate human diseases, and most of them are strain, gender or age dependent. We review key information on various rodent models of chronic kidney diseases. PMID:21286234

Yang, Hai-Chun; Zuo, Yiqin; Fogo, Agnes B.

2010-01-01

46

Cardiac Disease in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

The cardiac manifestations of chronic obstructive pulmonary disease (COPD) are numerous. Impairments of right ventricular dysfunction and pulmonary vascular disease are well known to complicate the clinical course of COPD and correlate inversely with survival. The pathogenesis of pulmonary vascular disease in COPD is likely multi- factorial and related to alterations in gas exchange and vascular biology, as well as

Jeremy A. Falk; Steven Kadiev; Gerard J. Criner; Steven M. Scharf; Omar A. Minai; Philip Diaz

2008-01-01

47

Chronic Orchialgia and Associated Diseases  

Microsoft Academic Search

Objective: Chronic scrotal pain (CSP) is one of the difficult medical evaluations. Approximately 25% of patients with chronic orchialgia have no obvious cause for the pain. The aim of this study was to identify the frequency of CSP in daily urological practice and associated diseases for our patients. Patients and Methods: In this study, 2,375 men over 18 years of

Halil Ciftci; Murat Savas; Ercan Yeni; Ayan Verit; Ufuk Topal

2010-01-01

48

Chronic Beryllium Disease  

MedlinePLUS

... 800.222.5864. References Mroz MM, Balkissoon R, Newman LS. Beryllium. In: Bringham E, Cohrssen B, Powell ... John Wiley & Sons 2001, 177-220. Balkissoon RC, Newman LS. Beryllium cooper alloy (2%) causes chronic beryllium ...

49

Chronic obstructive pulmonary disease.  

PubMed

COPD is characterized by airflow limitation that is not fully reversible. The morphological basis for airflow obstruction results from a varying combination of obstructive changes in peripheral conducting airways and destructive changes in respiratory bronchioles, alveolar ducts, and alveoli. A reduction of vascularity within the alveolar septa has been reported in emphysema. Typical physiological changes reflect these structural abnormalities. Spirometry documents airflow obstruction when the FEV1/FVC ratio is reduced below the lower limit of normality, although in early disease stages FEV1 and airway conductance are not affected. Current guidelines recommend testing for bronchoreversibility at least once and the postbronchodilator FEV1/FVC be used for COPD diagnosis; the nature of bronchodilator response remains controversial, however. One major functional consequence of altered lung mechanics is lung hyperinflation. FRC may increase as a result of static or dynamic mechanisms, or both. The link between dynamic lung hyperinflation and expiratory flow limitation during tidal breathing has been demonstrated. Hyperinflation may increase the load on inspiratory muscles, with resulting length adaptation of diaphragm. Reduction of exercise tolerance is frequently noted, with compelling evidence that breathlessness and altered lung mechanics play a major role. Lung function measurements have been traditionally used as prognostic indices and to monitor disease progression; FEV1 has been most widely used. An increase in FVC is also considered as proof of bronchodilatation. Decades of work has provided insight into the histological, functional, and biological features of COPD. This has provided a clearer understanding of important pathobiological processes and has provided additional therapeutic options. PMID:24692133

Brusasco, Vito; Martinez, Fernando

2014-01-01

50

Association between Celiac Disease and Chronic Hepatitis C Virus Infection  

PubMed Central

Celiac disease affects the proximal small intestine and is caused by a local immune response to dietary gluten. Celiac disease usually presents with chronic diarrhea; however, presentations with elevated hepatic transaminase levels in blood or with iron-deficiency anemia have been described. Celiac disease has been reported to be associated with autoimmune liver diseases. Hepatitis C virus (HCV) can also initiate autoimmune disease process. Therefore, HCV infection and celiac disease may occur together. Here, we describe 4 cases of celiac disease associated with chronic hepatitis C. This small case series indicates that chronic HCV infection and celiac disease are not causally associated.

Garg, Ashish; Reddy, Chandrasekhar; Duseja, Ajay; Chawla, Yogesh; Dhiman, Radha K

2011-01-01

51

Chronic Disease and the Environment  

NSDL National Science Digital Library

This site provides an overview of chronic diseases such as asthma, cancer and birth defects (with respect to infant mortality) and their environmental causes. Special topics include disease tracking, biomonitoring, Hispanic Americans and environmental health, public health infrastructure, and bioterrorism. The site also features links to current news and related resources.

Physicians for Social Responsibility

52

Treatment of chronic kidney disease  

Microsoft Academic Search

Treatment of chronic kidney disease (CKD) can slow its progression to end-stage renal disease (ESRD). However, the therapies remain limited. Blood pressure control using angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) has the greatest weight of evidence. Glycemic control in diabetes seems likely to retard progression. Several metabolic disturbances of CKD may prove to be useful therapeutic

Jeffrey M Turner; Carolyn Bauer; Matthew K Abramowitz; Michal L Melamed; Thomas H Hostetter

2012-01-01

53

Framing international trade and chronic disease.  

PubMed

There is an emerging evidence base that global trade is linked with the rise of chronic disease in many low and middle-income countries (LMICs). This linkage is associated, in part, with the global diffusion of unhealthy lifestyles and health damaging products posing a particular challenge to countries still facing high burdens of communicable disease. We developed a generic framework which depicts the determinants and pathways connecting global trade with chronic disease. We then applied this framework to three key risk factors for chronic disease: unhealthy diets, alcohol, and tobacco. This led to specific 'product pathways', which can be further refined and used by health policy-makers to engage with their country's trade policy-makers around health impacts of ongoing trade treaty negotiations, and by researchers to continue refining an evidence base on how global trade is affecting patterns of chronic disease. The prevention and treatment of chronic diseases is now rising on global policy agendas, highlighted by the UN Summit on Noncommunicable Diseases (September 2011). Briefs and declarations leading up to this Summit reference the role of globalization and trade in the spread of risk factors for these diseases, but emphasis is placed on interventions to change health behaviours and on voluntary corporate responsibility. The findings summarized in this article imply the need for a more concerted approach to regulate trade-related risk factors and thus more engagement between health and trade policy sectors within and between nations. An explicit recognition of the role of trade policies in the spread of noncommunicable disease risk factors should be a minimum outcome of the September 2011 Summit, with a commitment to ensure that future trade treaties do not increase such risks. PMID:21726434

Labonté, Ronald; Mohindra, Katia S; Lencucha, Raphael

2011-01-01

54

Framing international trade and chronic disease  

PubMed Central

There is an emerging evidence base that global trade is linked with the rise of chronic disease in many low and middle-income countries (LMICs). This linkage is associated, in part, with the global diffusion of unhealthy lifestyles and health damaging products posing a particular challenge to countries still facing high burdens of communicable disease. We developed a generic framework which depicts the determinants and pathways connecting global trade with chronic disease. We then applied this framework to three key risk factors for chronic disease: unhealthy diets, alcohol, and tobacco. This led to specific 'product pathways', which can be further refined and used by health policy-makers to engage with their country's trade policy-makers around health impacts of ongoing trade treaty negotiations, and by researchers to continue refining an evidence base on how global trade is affecting patterns of chronic disease. The prevention and treatment of chronic diseases is now rising on global policy agendas, highlighted by the UN Summit on Noncommunicable Diseases (September 2011). Briefs and declarations leading up to this Summit reference the role of globalization and trade in the spread of risk factors for these diseases, but emphasis is placed on interventions to change health behaviours and on voluntary corporate responsibility. The findings summarized in this article imply the need for a more concerted approach to regulate trade-related risk factors and thus more engagement between health and trade policy sectors within and between nations. An explicit recognition of the role of trade policies in the spread of noncommunicable disease risk factors should be a minimum outcome of the September 2011 Summit, with a commitment to ensure that future trade treaties do not increase such risks. PMID:21726434

2011-01-01

55

Klotho and Chronic Kidney Disease  

PubMed Central

Through alternative splicing, Klotho protein exists both as a secreted and a membrane form whose extracellular domain could be shed from the cell surface by secretases and released into the circulation to act as endocrine factor. Unlike membrane Klotho which functions as a coreceptor for fibroblast growth factor-23 (FGF23) to modulate FGF23 signal transduction, soluble Klotho is a multi-function protein present in the biological fluids including blood, urine, cerebrospinal fluid and plays important roles in anti-aging, energy metabolism, inhibition of Wnt signaling, anti-oxidation, modulation of ion transport, control of parathyroid hormone and 1,25(OH)2VD3 production, and antagonism of renin-angiotensin-aldosterone system. Emerging evidence from clinical and basic studies reveal that chronic kidney disease is a state of endocrine and renal Klotho deficiency, which may serve as an early biomarker and a pathogenic contributor to chronic progression and complications in chronic kidney disease including vascular calcification, cardiac hypertrophy, and secondary hyperparathyroidism. Supplementation of exogenous Klotho and/or up-regulation of endogenous Klotho production by using rennin angiotensin system inhibitors, HMG CoA reductase inhibitors, vitamin D analogues, peroxisome proliferator-activated receptors-gamma agonists, or anti-oxidants may confer renoprotection from oxidation and suppression of renal fibrosis, and also on prevention or alleviation of complications in chronic kidney disease. Therefore, Klotho is a highly promising candidate on the horizon as an early biomarker, and as a novel therapeutic agent for chronic kidney disease. PMID:23652549

Hu, Ming Chang; Kuro-o, Makoto; Moe, Orson W.

2013-01-01

56

Advances in renal bone disease: Osteoporosis and chronic kidney disease  

Microsoft Academic Search

Osteoporosis is a common bone disease characterized by low bone density, microarchitectural deterioration of bone tissue,\\u000a and a consequent increase in fracture risk. Recent decades have seen major advances in the understanding of the pathophysiology,\\u000a prevention, and treatment of this disorder. Chronic kidney disease (CKD) affects more than 20 million Americans and is associated\\u000a with unique metabolic mineral disorders related

Sara Barnato; Stuart M. Sprague

2009-01-01

57

Diet and Chronic Disease  

Technology Transfer Automated Retrieval System (TEKTRAN)

Factors that improve insulin sensitivity usually lead to improvements in risk factors associated with the metabolic syndrome, diabetes and cardiovascular diseases. Naturally occurring bioactive compounds that have been shown to improve insulin sensitivity include chromium and polyphenols found in c...

58

About Chronic Kidney Disease  

MedlinePLUS

... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... KEEP Healthy - Free Kidney Health checks Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

59

Overweight + Inactivity = Increased Risk of Chronic Disease  

E-print Network

Overweight + Inactivity = Increased Risk of Chronic Disease Excessive weight and inactivity are consistently linked with increased incidence of chronic diseases such as heart disease, stroke, diabetes, high, severity and health care costs of other chronic diseases linked to excessive weight and inactivity. Contact

60

Nutrition and chronic kidney disease  

Microsoft Academic Search

The incidence of malnutrition disorders in chronic kidney disease (CKD) appears unchanged over time, whereas patient-care and dialysis techniques continue to progress. Despite some evidence for cost-effective treatments, there are numerous caveats to applying these research findings on a daily care basis. There is a sustained generation of data confirming metabolic improvement when patients control their protein intake, even at

Denis Fouque; Solenne Pelletier; Denise Mafra; Philippe Chauveau

2011-01-01

61

Complications of chronic liver disease.  

PubMed

Children with chronic liver disease (CLD) need a head to toe approach and an early suspicion of multi organ involvement. Nutritional assessment and management is the cornerstone of management. Consider immune dysfunction in everyday treatment decisions. Consider early heart-lung-brain involvement in transplant evaluation. PMID:22521556

Tsouka, Alexandra; McLin, Valérie A

2012-06-01

62

Mechanisms of progression of chronic kidney disease  

Microsoft Academic Search

Chronic kidney disease (CKD) occurs in all age groups, including children. Regardless of the underlying cause, CKD is characterized\\u000a by progressive scarring that ultimately affects all structures of the kidney. The relentless progression of CKD is postulated\\u000a to result from a self-perpetuating vicious cycle of fibrosis activated after initial injury. We will review possible mechanisms\\u000a of progressive renal damage, including

Agnes B. Fogo

2007-01-01

63

REVIEW THE CHRONIC GASTROINTESTINAL MANIFESTATIONS OF CHAGAS DISEASE  

E-print Network

Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart. The objective of this review is to revise the literature and summarize the main chronic gastrointestinal manifestations of Chagas disease

Nilce Mitiko Matsuda; I Steven; M. Miller

64

Anemia of Inflammation and Chronic Disease  

MedlinePLUS

... Besarab A, Coyne DW. Iron supplementation to treat anemia in patients with chronic kidney disease. Nature Reviews Nephrology. 2010;6(12):699–710. [ Top ] How is AI/ACD treated? Anemia of inflammation and chronic disease often is not ...

65

Chronic Lyme Disease: An appraisal  

PubMed Central

Synopsis “Chronic Lyme disease” is a confusing term that has been used to describe very different patient populations. Studies have shown that most patients diagnosed with “chronic Lyme disease” either have no objective evidence of previous or current infection with B. burgdorferi or are patients that should be classified as having post-Lyme disease syndrome, which is defined as continuing or relapsing non-specific symptoms (such as fatigue, musculoskeletal pain, and cognitive complaints) in a patient previously treated for Lyme disease. Despite extensive study, there is currently no clear evidence that post-Lyme disease syndrome is due to persistent infection with B. burgdorferi. Four randomized placebo-controlled studies have shown that antibiotic therapy offers no sustained benefit to patients with post-Lyme disease syndrome. These studies also showed a substantial placebo effect and a significant risk of treatment-related adverse events. Further research to elucidate the mechanisms underlying persistent symptoms after Lyme disease and controlled trials of new approaches to the treatment and management of these patients are needed. PMID:18452806

Marques, Adriana

2008-01-01

66

Epigenetic mechanisms in chronic obstructive pulmonary disease.  

PubMed

Epigenetic modification may affect the expression of multiple inflammatory genes in lungs of patients with chronic obstructive pulmonary disease (COPD). Major epigenetic events include DNA methylation and various post-translational modifications of histones, such as histone methylation, acetylation, phosphorylation, ubiquitination, and sumoylation. Enzymes which regulate these epigenetic modifications can be activated by smoking. Both environmental and genetic factors play significant effect in development of COPD which have been reported by most references; however, little is known about the epigenetic pathways involved in the disease. Understanding the epigenetic mechanisms can help us clarify the pathogenesis of COPD and identify novel targets for developing new therapies for patients with COPD. PMID:25807439

Zong, D-D; Ouyang, R-Y; Chen, P

2015-03-01

67

Chronic granulomatous disease: why an inflammatory disease?  

PubMed Central

Chronic granulomatous disease is a primary immunodeficiency caused by mutations in the genes encoding subunits of the phagocytic NADPH oxidase system. Patients can present with severe, recurrent infections and noninfectious conditions. Among the latter, inflammatory manifestations are predominant, especially granulomas and colitis. In this article, we systematically review the possible mechanisms of hyperinflammation in this rare primary immunodeficiency condition and their correlations with clinical aspects. PMID:25296353

Roxo-Junior, P.; Simão, H.M.L.

2014-01-01

68

Chronic Obstructive Pulmonary Disease (COPD)  

NSDL National Science Digital Library

This patient education program explains chronic obstructive pulmonary disease (COPD) and emphysema including the causes, symptoms, diagnosis, and treatment options for these diseases. It also reviews the anatomy of the respiratory system. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

Patient Education Institute

69

Mediterranean dietary pattern and chronic diseases.  

PubMed

The study of the relationship between the Mediterranean way of eating and the occurrence of diseases typical of the economically developed countries has been considered the starting point of nutritional epidemiology. From the Seven Countries Study in the 1950s to the recent European EPIC collaboration, the evaluation of the components of diet-affecting chronic diseases such as cardiovascular disease and cancer has been crucially based on the analysis of foods and nutrients characterizing the Mediterranean dietary habits. This long research history has been marked by a consistency of data over time when either single nutrients/food groups or more complex dietary patterns have been analyzed: The Mediterranean way of eating is a protective tool from cardiovascular diseases and many cancers. Italy has been a natural point of observation, starting from cardiovascular disease in the mid-1950s and continuing with major cancers. In spite of unfavorable lifestyle changes in the Italian population mostly due to globalization of unhealthy habits (richer diet and lower levels of physical activity), those individuals still close to the Mediterranean style are significantly protected. The very recent Italian data derived from the observation of about 50,000 individuals, participating in the Italian cohorts of the EPIC study, confirm these findings and are consistent with results from other European populations and in some cases also from North American populations. Moreover, several dietary trials suggest that such a way of eating improves both the metabolic risk condition for chronic disease and the occurrence of those diseases. In conclusion, a way of eating inspired by a Mediterranean dietary pattern is not only based on evidence but is also a palatable style that has contributed to protection from the epidemic of chronic diseases. PMID:24114475

Panico, Salvatore; Mattiello, Amalia; Panico, Camilla; Chiodini, Paolo

2014-01-01

70

Chronic Granulomatous Disease in an Adult Female with Granulomatous Cheilitis  

Microsoft Academic Search

We describe in this paper a female patient affected by chronic granulomatous disease with all the features of the classic X-linked form of the disease and presenting a mild form of the disease, the major clinical manifestation being a granulomatous cheilitis. The capability of the patient’s phagocytes to undergo a respiratory burst in response to different stimuli was markedly depressed

Stefano Dusi; Giovanni Poli; Giorgio Berton; Paola Catalano; Cleto Veller Fornas; Andrea Peserico

1990-01-01

71

How do high cost-sharing policies for physician care affect inpatient care use and costs among people with chronic disease?  

PubMed

Rapidly rising health care costs continue to be a significant concern in the United States. High cost-sharing strategies thus have been widely used to address rising health care costs. Since high cost-sharing policies can reduce needed care as well as unneeded care use, it raises the concern whether these policies for physician care are a good strategy for controlling costs among chronically ill patients, especially whether utilization and costs in inpatient care will increase in response. This study examined whether high cost sharing in physician care affects inpatient care utilization and costs differently between individuals with and without chronic conditions. Findings from this study will contribute to the insurance benefit design that can control care utilization and save costs of chronically ill individuals. Prior studies suffered from gaps that limit both internal validity and external validity of their findings. This study has its unique contributions by filling these gaps jointly. The study used data from the 2007 Medical Expenditure Panel Survey, a nationally representative sample, with a cross-sectional study design. Instrumental variable technique was used to address the endogeneity between health care utilization and cost-sharing levels. We used negative binomial regression to analyze the count data and generalized linear models for costs data. To account for national survey sampling design, weight and variance were adjusted. The study compared the effects of high cost-sharing policies on inpatient care utilization and costs between individuals with and without chronic conditions to answer the research question. The final study sample consisted of 4523 individuals; among them, 752 had hospitalizations. The multivariate analysis demonstrated consistent patterns. Compared with low cost-sharing policies, high cost-sharing policies for physician care were not associated with a greater increase in inpatient care utilization (P = .86 for chronically ill people and P = .67 for healthy people, respectively) and costs (P = .38 for chronically ill people and P = .68 for healthy people, respectively). The sensitivity analysis with a 10% cost-sharing level also generated consistent insignificant results for both chronically ill and healthy groups. Relative to nonchronically ill individuals, chronically ill individuals may increase their utilization and expenditures of inpatient care to a similar extent in response to increased physician care cost sharing. This may be due to cost pressure from inpatient care and short observation window. Although this study did not find evidence that high cost-sharing policies for physician care increase inpatient care differently for individuals with and without chronic conditions, interpretation of this finding should be cautious. It is possible that in the long run, these sick people would demonstrate substantial demands for medical care and there could be a total cost increase for health plans ultimately. Health plans need to be cautious of policies for chronically ill enrollees. PMID:25748258

Xin, Haichang

2015-01-01

72

Treatment of chronic kidney disease.  

PubMed

Treatment of chronic kidney disease (CKD) can slow its progression to end-stage renal disease (ESRD). However, the therapies remain limited. Blood pressure control using angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) has the greatest weight of evidence. Glycemic control in diabetes seems likely to retard progression. Several metabolic disturbances of CKD may prove to be useful therapeutic targets but have been insufficiently tested. These include acidosis, hyperphosphatemia, and vitamin D deficiency. Drugs aimed at other potentially damaging systems and processes, including endothelin, fibrosis, oxidation, and advanced glycation end products, are at various stages of development. In addition to the paucity of proven effective therapies, the incomplete application of existing treatments, the education of patients about their disease, and the transition to ESRD care remain major practical barriers to better outcomes. PMID:22166846

Turner, Jeffrey M; Bauer, Carolyn; Abramowitz, Matthew K; Melamed, Michal L; Hostetter, Thomas H

2012-02-01

73

Chronic Disease and Childhood Development: Kidney Disease and Transplantation.  

ERIC Educational Resources Information Center

As part of a larger study of transplantation and chronic disease and the family, 124 children (10-18 years old) who were chronically ill with kidney disease (n=72) or were a year or more post-transplant (n=52) were included in a study focusing on the effects of chronic kidney disease and transplantation on children's psychosocial development. Ss…

Klein, Susan D.; Simmons, Roberta G.

74

Chronic obstructive pulmonary disease, pulmonary function and cardiovascular disease   

E-print Network

Cardiovascular disease is common in Chronic Obstructive Pulmonary Disease (COPD), and forced expiratory volume in one second (FEV1) independently predicts cardiovascular morbidity and mortality. Pathological changes in ...

McAllister, David Anthony

2011-07-05

75

Economic aspects of chronic diseases in Vietnam  

PubMed Central

Introduction There remains a lack of information on economic aspects of chronic diseases. This paper, by gathering available and relevant research findings, aims to report and discuss current evidence on economic aspects of chronic diseases in Vietnam. Methods Data used in this paper were obtained from various information sources: international and national journal articles and studies, government documents and publications, web-based statistics and fact sheets. Results In Vietnam, chronic diseases were shown to be leading causes of deaths, accounting for 66% of all deaths in 2002. The burdens caused by chronic disease morbidity and risk factors are also substantial. Poorer people in Vietnam are more vulnerable to chronic diseases and their risk factors, other than being overweight. The estimated economic loss caused by chronic diseases for Vietnam in 2005 was about US$20 million (0.033% of annual national GDP). Chronic diseases were also shown to cause economic losses for families and individuals in Vietnam. Both population-wide and high-risk individual interventions against chronic disease were shown to be cost-effective in Vietnam. Conclusion Given the evidence from this study, actions to prevent chronic diseases in Vietnam are clearly urgent. Further research findings are required to give greater insights into economic aspects of chronic diseases in Vietnam. PMID:20057939

Van Minh, Hoang; Lan Huong, Dao; Bao Giang, Kim; Byass, Peter

2009-01-01

76

Chronic kidney disease and stroke.  

PubMed

Chronic kidney disease (CKD) is associated with an increased risk of both ischemic and hemorrhagic stroke. In addition to shared risk factors, this higher cerebrovascular risk is mediated by several CKD-associated mechanisms including platelet dysfunction, coagulation disorders, endothelial dysfunction, inflammation, and increased risk of atrial fibrillation. CKD can also modify the effect of treatments used in acute stroke and in secondary stroke prevention. We review the epidemiology and pathophysiology that link CKD and stroke and the impact of CKD on stroke outcomes. Interdisciplinary collaboration between nephrologists, pharmacists, hematologists, nutrition therapists, primary care physicians, and neurologists in providing care to these subjects may potentially improve outcomes. PMID:25443575

El Husseini, Nada; Kaskar, Omran; Goldstein, Larry B

2014-11-01

77

HIV and chronic kidney disease.  

PubMed

Chronic kidney disease (CKD) is a frequent complication of HIV infection, occurring in 3.5 - 48.5%, and occurs as a complication of HIV infection, other co-morbid disease and infections and as a consequence of therapy of HIV infection and its complications. The classic involvement of the kidney by HIV infection is HIV-associated nephropathy (HIVAN), occurring typically in young adults of African ancestry with advanced HIV disease in association with APOL1 high-risk variants. HIV-immune complex disease is the second most common diagnosis obtained from biopsies of patients with HIV-CKD. CKD is mediated by factors related to the virus, host genetic predisposition and environmental factors. The host response to HIV infection may influence disease phenotype through activation of cytokine pathways. With the introduction of antiretroviral therapy (ART), there has been a decline in the incidence of HIVAN, with an increasing prevalence of focal segmental glomerulosclerosis. Several studies have demonstrated the overall improvement in kidney function when initiating ART for HIV CKD. Progression to end stage kidney disease has been reported to be more likely when high grade proteinuria, severely reduced eGFR, hepatitis B and/C co-infection, diabetes mellitus, extensive glomerulosclerosis, and chronic interstitial fibrosis are present. Improved renal survival is associated with use of renin angiotensin system blockers and viral suppression. Many antiretroviral medications are partially or completely eliminated by the kidney and require dose adjustment in CKD. Certain drug classes, such as the protease inhibitors and the non-nucleoside reverse transcriptase inhibitors, are metabolized by the liver and do not require dose adjustment. HIV-infected patients requiring either hemoor peritoneal dialysis, who are stable on ART, are achieving survival rates comparable to those of dialysis patients without HIV infection. Kidney transplantation has been performed successfully in HIV-infected patients; graft and patient survival appears to be similar to that of HIV-uninfected recipients. Early detection of kidney disease by implementation of screening on diagnosis of HIV infection and annual screening thereafter will have an impact on the burden of disease, together with access to ART to those who require it. Programs for prevention of HIV infection are essential to prevent this lethal disease. PMID:25725239

Naicker, Saraladevi; Rahmanian, Sadaf; Kopp, Jeffrey B

2015-01-01

78

Risk factors and early origins of chronic obstructive pulmonary disease.  

PubMed

Chronic obstructive pulmonary disease is mainly a smoking-related disorder and affects millions of people worldwide, with a large effect on individual patients and society as a whole. Although the disease becomes clinically apparent around the age of 40-50 years, its origins can begin very early in life. Different risk factors in very early life--ie, in utero and during early childhood--drive the development of clinically apparent chronic obstructive pulmonary disease in later life. In discussions of which risk factors drive chronic obstructive pulmonary disease, it is important to realise that the disease is very heterogeneous and at present is largely diagnosed by lung function only. In this Review, we will discuss the evidence for risk factors for the various phenotypes of chronic obstructive pulmonary disease during different stages of life. PMID:25123778

Postma, Dirkje S; Bush, Andrew; van den Berge, Maarten

2015-03-01

79

Health literacy and knowledge of chronic disease  

Microsoft Academic Search

We sought to examine the relationship between health literacy and knowledge of disease among patients with a chronic disease. A total of 653 new Medicare enrollees aged 65 years or older who had at least one chronic disease (115 asthma, 266 diabetes, 166 congestive heart failure, 214 hypertension), completed both the in-person and telephone survey. Health literacy measured by the

Julie A Gazmararian; Mark V Williams; Jennifer Peel; David W Baker

2003-01-01

80

Hypertrophic osteoarthropathy of chronic inflammatory bowel disease  

SciTech Connect

The case of a 14-year old girl with painful periostitis and ulcerative colitis is reported. The association of chronic inflammatory bowel disease with osteoarthropathy is rare and has previously been reported in eight patients. The periosteal reaction found in association with inflammatory bowel disease is apparently related to a chronic disease course and may cause extreme localized pain.

Oppenheimer, D.A.; Jones, H.H.

1982-12-01

81

[Anemia in chronic kidney disease].  

PubMed

Anemia is almost unavoidable in the last stages of chronic kidney disease. It is defined as a condition where hemoglobin concentration is below 2 standard deviations from the mean hemoglobin level of the general population, corrected for age and sex (typically, hemoglobin < 13 g/dL in adults and 12 g/dL in women). Although the cause is multi-factorial, the most known is inadequate erythropoietin production. Anemia has been associated with poor prognosis in patients with several conditions such as cancer, chronic kidney disease and congestive heart failure. Treatment with erythropoiesis-stimulating agents, such as erythropoietin, is a logical strategy that has enabled clinical improvement and reduced transfusion requirements for the patients; however, total correction of anemia with erythropoiesis-stimulating agents has demonstrated an increase in the risk of mortality or cardiovascular complications associated with these agents. In randomized trials, the achievement of normal or nearly normal hemoglobin levels is not associated with improved survival and reduced cardiovascular risk; however the ideal hemoglobin level with the use of erythropoiesis-stimulating agents seems to be problematic. More information is needed in order to obtain definite conclusions; in the meantime, using the lowest possible dose of erythropoietin seems to be the most prudent approach. PMID:25354060

Amador-Medina, Lauro Fabián

2014-01-01

82

In vivo detection of Trypanosoma cruzi antigens in hearts of patients with chronic Chagas' heart disease  

Microsoft Academic Search

The heart is the most commonly affected organ in chronic Chagas' disease, and lymphocytic myocarditis is often observed. However, the pathogenesis of chronic Chagas' heart disease is controversial. The purpose of this study was to determine whether in vivo T. cruzi antigens could be detected in hearts from patients with chronic Chagas' disease and to investigate whether a correlation between

Giovanni Belloti; Edimar Alcides Bocchi; Alvaro Villela de Moraes; Maria de Lourdes Higuchi; Miguel Barbero-Marcial; Eduardo Sosa; Antonio Esteves-Filho; Roberto Kalil; Robert Weiss; Adib Jatene; Fulvio Pileggi

1996-01-01

83

Chronic idiopathic urticaria and Graves' disease.  

PubMed

Chronic urticaria is a common condition characterized by recurrent episodes of mast cell-driven wheal and flare-type skin reactions lasting for more than 6 weeks. In about 75% of cases, the underlying causes remain unknown, and the term chronic idiopathic urticaria (CIU) is used to emphasize that wheals develop independently of identified external stimuli. Although CIU affects about 1.0% of the general population, its etiopathogenesis is not yet well understood. It is now widely accepted that in many cases CIU should be regarded as an autoimmune disorder caused by circulating and functionally active IgG autoantibodies specific for the IgE receptor (FceRI) present on mast cells and basophils or for IgE itself. The well-known association of CIU with other autoimmune processes/diseases represents further indirect evidence of its autoimmune origin. Autoimmune thyroid diseases, especially autoimmune thyroiditis, represent the most frequently investigated diseases in association with CIU. Here we review this topic with particular regard to the association between Graves' disease and CIU. The possible pathogenetic mechanisms and the clinical implications of such an association are discussed. PMID:23609949

Ruggeri, R M; Imbesi, S; Saitta, S; Campennì, A; Cannavò, S; Trimarchi, F; Gangemi, S

2013-01-01

84

Disease management in chronic kidney disease.  

PubMed

Chronic kidney disease (CKD) is a growing health problem of epidemic proportions both in the United States and worldwide. The care of CKD patients, before and after starting dialysis, remains highly fragmented resulting in suboptimal clinical outcomes and high costs, creating a high burden of disease on patients and the health care system. Disease management (DM) is an approach to coordinating care for this complex population of patients that has the promise of improving outcomes and constraining costs. For CKD patients not yet on dialysis, the major goals of a DM program are (1) early identification of CKD patients and therapy to slow the progression of CKD, (2) identification and management of the complications of CKD per se, (3) identification and management of the complications of comorbid conditions, and (4) smooth transition to renal replacement therapy. For those CKD patients on dialysis, focused attention on avoidable hospitalizations is a key to a successful DM program. Multidisciplinary collaboration among physicians (nephrologist, primary care physician, cardiologist, endocrinologist, vascular surgeons, and transplant physicians) and participating caregivers (nurse, pharmacist, social worker, and dietician) is critical as well. There are several potential barriers to the successful implementation of a CKD/end-stage renal disease DM program, including lack of awareness of the disease state among patients and health care providers, late identification and referrals to a nephrologist, complex fragmented care delivered by multiple providers in many different sites of care, and reimbursement that does not align incentives for all involved. Recent experience suggests that these barriers can be overcome, with DM becoming a promising approach for improving outcomes for this vulnerable population. PMID:18155106

Rastogi, Anjay; Linden, Ariel; Nissenson, Allen R

2008-01-01

85

Physical Activity in the Prevention of Chronic Kidney Disease  

Microsoft Academic Search

Chronic kidney disease (CKD) is an important risk factor for cardiovascular disease (CVD) and mortality. The increase in CKD in recent decades has paralleled increases in obesity, diabetes, and the metabolic syndrome. Physical inactivity is a modifiable risk factor that may affect the development and course of CKD. It is well established that exercise training improves a number of metabolic

Craig S. Stump

2011-01-01

86

Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema  

MedlinePLUS

... Age-adjusted death rates for selected causes of death, by sex, race, and Hispanic origin (chronic lower respiratory disease ... lost before age 75 for selected causes of death, by sex, race, and Hispanic origin Health, United States, 2013, ...

87

Measurement of renal function in patients with chronic kidney disease  

PubMed Central

Chronic kidney disease affects millions of people worldwide and is associated with an increased morbidity and mortality as a result of kidney failure and cardiovascular disease. Accurate assessment of kidney function is important in the clinical setting as a screening tool and for monitoring disease progression and guiding prognosis. In clinical research, the development of new methods to measure kidney function accurately is important in the search for new therapeutic targets and the discovery of novel biomarkers to aid early identification of kidney injury. This review considers different methods for measuring kidney function and their contribution to the improvement of detection, monitoring and treatment of chronic kidney disease. PMID:23802624

Sandilands, Euan A; Dhaun, Neeraj; Dear, James W; Webb, David J

2013-01-01

88

Chronic Obstructive Pulmonary Disease in the elderly.  

PubMed

The prevalence of Chronic Obstructive Pulmonary Disease (COPD) dramatically increases with age, and COPD complicated by chronic respiratory failure may be considered a geriatric condition. Unfortunately, most cases remain undiagnosed because of atypical clinical presentation and difficulty with current respiratory function diagnostic standards. Accordingly, the disease is under-recognized and undertreated. This is expected to impact noticeably the health status of unrecognized COPD patients because a timely therapy could mitigate the distinctive and important effects of COPD on the health status. Comorbidity also plays a pivotal role in conditioning both the health status and the therapy of COPD besides having major prognostic implication. Several problems affect the overall quality of the therapy for the elderly with COPD, and current guidelines as well as results from pharmacological trials only to some extent apply to this patient. Finally, physicians of different specialties care for the elderly COPD patient: physician's specialty largely determines the kind of approach. In conclusion, COPD, in itself a complex disease, becomes difficult to identify and to manage in the elderly. Interdisciplinary efforts are desirable to provide the practicing physician with a multidisciplinary guide to the identification and treatment of COPD. PMID:24183233

Incalzi, Raffaele Antonelli; Scarlata, Simone; Pennazza, Giorgio; Santonico, Marco; Pedone, Claudio

2014-04-01

89

Graft-versus-host disease affecting oral cavity. A review.  

PubMed

Graft versus host disease (GVHD) is one of the most frequent and serious complications of hematopoietic stem cell transplantation, and is regarded as the leading cause of late mortality unrelated to the underlying malignant disease. GVHD is an autoimmune and alloimmune disorder that usually affects multiple organs and tissues, and exhibits a variable clinical course. It can manifest in either acute or chronic form. The acute presentation of GVHD is potentially fatal and typically affects the skin, gastrointestinal tract and liver. The chronic form is characterized by the involvement of a number of organs, including the oral cavity. Indeed, the oral cavity may be the only affected location in chronic GVHD. The clinical manifestations of chronic oral GVHD comprise lichenoid lesions, hyperkeratotic plaques and limited oral aperture secondary to sclerosis. The oral condition is usually mild, though moderate to severe erosive and ulcerated lesions may also be seen. The diagnosis is established from the clinical characteristics, though confirmation through biopsy study is sometimes needed. Local corticosteroids are the treatment of choice, offering overall response rates of close to 50%. Extracorporeal photopheresis and systemic corticosteroids in turn constitute second line treatment. Oral chronic GVHD is not considered a determinant factor for patient survival, which is close to 52% five years after diagnosis of the condition. Key words:Chronic graft-versus-host disease, oral chronic graft-versus-host disease, pathogenics, management, survival. PMID:25810826

Margaix-Muñoz, Maria; Bagán, José V; Jiménez, Yolanda; Sarrión, María-Gracia; Poveda-Roda, Rafael

2015-02-01

90

Graft-versus-host disease affecting oral cavity. A review  

PubMed Central

Graft versus host disease (GVHD) is one of the most frequent and serious complications of hematopoietic stem cell transplantation, and is regarded as the leading cause of late mortality unrelated to the underlying malignant disease. GVHD is an autoimmune and alloimmune disorder that usually affects multiple organs and tissues, and exhibits a variable clinical course. It can manifest in either acute or chronic form. The acute presentation of GVHD is potentially fatal and typically affects the skin, gastrointestinal tract and liver. The chronic form is characterized by the involvement of a number of organs, including the oral cavity. Indeed, the oral cavity may be the only affected location in chronic GVHD. The clinical manifestations of chronic oral GVHD comprise lichenoid lesions, hyperkeratotic plaques and limited oral aperture secondary to sclerosis. The oral condition is usually mild, though moderate to severe erosive and ulcerated lesions may also be seen. The diagnosis is established from the clinical characteristics, though confirmation through biopsy study is sometimes needed. Local corticosteroids are the treatment of choice, offering overall response rates of close to 50%. Extracorporeal photopheresis and systemic corticosteroids in turn constitute second line treatment. Oral chronic GVHD is not considered a determinant factor for patient survival, which is close to 52% five years after diagnosis of the condition. Key words:Chronic graft-versus-host disease, oral chronic graft-versus-host disease, pathogenics, management, survival.

Margaix-Muñoz, Maria; Bagán, José V.; Jiménez, Yolanda; Sarrión, María-Gracia; Poveda-Roda, Rafael

2015-01-01

91

Managing Anemia of Chronic Kidney Disease  

Microsoft Academic Search

Anemia begins early in the course of declining kidney function and is a frequent complication of chronic kidney disease. Both anemia and chronic kidney disease are underdiagnosed and undertreated. Anemia is associated with significantly increased risk of morbidity and mortality, including increased risks of left ventricular hypertrophy and heart failure. Although the detrimental effects of anemia are more common in

Susan A. Krikorian

2009-01-01

92

Prion protein gene heterogeneity in free-ranging white-tailed deer within the chronic wasting disease affected region of Wisconsin.  

PubMed

Chronic wasting disease (CWD) was first identified in Wisconsin (USA) in whitetailed deer (Odocoileus virginianus) in February 2002. To determine if prion protein gene (Prnp) allelic variability was associated with CWD in white-tailed deer from Wisconsin, we sequenced Prnp from 26 CWD-positive and 100 CWD-negative deer. Sequence analysis of Prnp suggests that at least 86-96% of the white-tailed deer in this region have Prnp allelic combinations that will support CWD infection. Four Prnp alleles were identified in the deer population, one of which, resulting in a glutamine to histidine change at codon 95, has not been previously reported. The predominant allele in the population encodes for glutamine at codon 95, glycine at codon 96, and serine at codon 138 (QGS). Less abundant alleles encoded QSS, QGN, and HGS at the three variable positions. Comparison of CWD-positive with CWD-negative deer suggested a trend towards an over-representation of the QGS allele and an under-representation of the QSS allele. PMID:14567218

Johnson, Chad; Johnson, Jody; Clayton, Murray; McKenzie, Debbie; Aiken, Judd

2003-07-01

93

582?Chronic Urticaria Associated with Thyroid Disease  

PubMed Central

Background Chronic urticaria has an incidence of 15% in the general population and sometimes is associated with chronic diseases such as rheumatoid arthritis, vitiligo and thyroid disorders. Chronic urticarial is characterized by wheals lasting more than 6 weeks, with alterations of the upper layers of the skin only. On histopathology there is a perivascular infiltrate characterized by T CD4 and CD8 lymphocytes and other inflammatory cells. Cytokines produced by lymphocytes, mast cells and other cells increase the expression of vascular adhesion molecules. Other mediators such as histamine increase vascular permeability causing edema, clinically represented by wheals. Treatment of chronic urticaria includes first and second generation antihistamines as first line treatment. Sometimes there is a poor response to there drugs and second line treatments such as immunosupressors are indicated. A search for systemic disorders is helpful to identify associated pathology which makes chronic urticaria reluctant to therapy. Methods We performed a retrospective study considering patients with chronic urticaria attending our clinic during the last 5 years. Three hundred patients with urticaria were considered, with 16% (50 patients) with a chronic disease. Six patients with chronic urticaria were associated with thyroid disease. Results We considered 6 patients with chronic urticaria with altered thyroid function tests; 4 with subclinical hypothyroidism and 2 with subclinical hyperthyroidism. All of them had a poor response to antihistamines. When a thyroid disorder was identified, they received appropriate treatment achieving control of chronic urticaria. Treatment with antihistamines was continued. Conclusions Chronic urticaria is a disease often associated with systemic disorders including thyroid disease. We found an association with thyroid pathology in 2% of patients with chronic urticaria, with remission of cutaneous symptoms after treatment of endocrinologic disorder. No patient had clinical manifestation of thyroid disease so it is important to perform thyroid function tests to patients with chronic urticaria since identification of these disorders and appropriate treatment helps to control cutaneous symptoms.

de Guadalupe Peñaloza-González, Flor; Velasco-Medina, Andrea Aida; Gonzalez-Carsolio, Aida; Burbano-Ceron, Andres-Leonardo; Barreto-Sosa, Adriana; Velázquez-Sámano, Guillermo

2012-01-01

94

28 CFR 79.67 - Proof of chronic renal disease.  

Code of Federal Regulations, 2011 CFR

...2011-07-01 false Proof of chronic renal disease. 79.67 Section 79.67 Judicial... § 79.67 Proof of chronic renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent employment...

2011-07-01

95

28 CFR 79.57 - Proof of chronic renal disease.  

Code of Federal Regulations, 2014 CFR

...2014-07-01 false Proof of chronic renal disease. 79.57 Section 79.57 Judicial... § 79.57 Proof of chronic renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent employment...

2014-07-01

96

28 CFR 79.57 - Proof of chronic renal disease.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Proof of chronic renal disease. 79.57 Section 79.57 Judicial... § 79.57 Proof of chronic renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent employment...

2013-07-01

97

28 CFR 79.67 - Proof of chronic renal disease.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 false Proof of chronic renal disease. 79.67 Section 79.67 Judicial... § 79.67 Proof of chronic renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent employment...

2013-07-01

98

28 CFR 79.57 - Proof of chronic renal disease.  

Code of Federal Regulations, 2012 CFR

...2012-07-01 false Proof of chronic renal disease. 79.57 Section 79.57 Judicial... § 79.57 Proof of chronic renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent employment...

2012-07-01

99

Nutrition for Advanced Chronic Kidney Disease in Adults  

MedlinePLUS

... Chronic Kidney Disease in Adults Nutrition for Advanced Chronic Kidney Disease in Adults On this page: Why is nutrition ... Why is nutrition important for someone with advanced chronic kidney disease (CKD)? A person may prevent or delay some ...

100

Nutrition for Early Chronic Kidney Disease in Adults  

MedlinePLUS

... Chronic Kidney Disease in Adults Nutrition for Early Chronic Kidney Disease in Adults On this page: Why is nutrition ... Why is nutrition important for someone with early chronic kidney disease (CKD)? Controlling blood glucose, also called blood sugar, ...

101

Chronic Kidney Disease: What Does It Mean for Me?  

MedlinePLUS

... Kidney Disease: What Does it Mean for Me? Chronic Kidney Disease: What Does it Mean for Me? Chronic Kidney ... and My Lifestyle CKD: Tracking My Test Results Chronic Kidney Disease: The Basics You've been told that you ...

102

Phosphate fertilizer is a main source of arsenic in areas affected with chronic kidney disease of unknown etiology in Sri Lanka.  

PubMed

Chronic Kidney Disease of unknown etiology (CKDu) has escalated into an epidemic in North Central Province (NCP) and adjacent farming areas in the dry zone of Sri Lanka. Studies have shown that this special type of CKD is a toxic nephropathy and arsenic may play a causative role along with a number of other heavy metals. We investigated the hypothesis that chemical fertilizers and pesticide could be a source of arsenic. 226 samples of Fertilizers and 273 samples of pesticides were collected and analyzed using atomic absorption spectrometry and inductively coupled plasma mass spectrometry for arsenic and other heavy metals in two university laboratories. Almost all the agrochemicals available to the farmers in the study area are contaminated with arsenic. The highest amount was in triple super phosphate (TSP) with a mean value of 31 mg/kg. Also TSP is a rich source of other nephrotoxic metals including Cr, Co, Ni, Pb and V. Annually more than 0.1 million tons of TSP is imported to Sri Lanka containing approximately 2100 kg of arsenic. The next highest concentration was seen in the rock phosphate obtained from an open pit mine in NCP (8.56 mg/kg). Organic fertilizer contained very low amounts of arsenic. Arsenic contamination in pesticides varied from 0.18 mg/kg to 2.53 mg/kg although arsenic containing pesticides are banned in Sri Lanka. Glyphosate the most widely used pesticide in Sri Lanka contains average of 1.9 mg/kg arsenic. Findings suggest that agrochemicals especially phosphate fertilizers are a major source of inorganic arsenic in CKDu endemic areas. Organic fertilizer available in Sri Lanka is comparatively very low in arsenic and hence the farmers in CKDu endemic areas in Sri Lanka should be encouraged to minimize the use of imported chemical fertilizer and use organic fertilizers instead. PMID:25763302

Jayasumana, Channa; Fonseka, Saranga; Fernando, Ashvin; Jayalath, Kumudika; Amarasinghe, Mala; Siribaddana, Sisira; Gunatilake, Sarath; Paranagama, Priyani

2015-01-01

103

Pathophysiology of chronic venous disease.  

PubMed

Chronic venous disease (CVD) is a debilitating condition with a prevalence between 60-70%. The disease pathophysiology is complex and involves genetic susceptibility and environmental factors, with individuals developing visible telengiectasias, reticular veins, and varicose veins. Patient with significant lower extremity symptoms have pain, dermal irritation, swelling, skin changes, and are at risk of developing debilitating venous ulceration. The signature of CVD is an increase in venous pressure referred to as venous hypertension. The various symptoms presenting in CVD and the clinical signs that are observed indicate that there is inflammation, secondary to venous hypertension, and it leads to a number of inflammatory pathways that become activated. The endothelium and glycocalyx via specialized receptors are critical at sensing changes in shear stress, and expression of adhesion molecules allows the activation of leukocytes leading to endothelial attachment, diapedisis, and transmigration into the venous wall/valves resulting in venous wall injury and inflammatory cells in the interstitial tissues. There is a complex of cytokines, chemokines, growth factors, proteases and proteinases, produced by activated leukocytes, that are expressed and unbalanced resulting in an environment of persistent inflammation with the clinical changes that are commonly seen, consisting of varicose veins to more advanced presentations of skin changes and venous ulceration. The structural integrity of protein and the extracellular matrix is altered, enhancing the progressive events of CVD. Work focusing on metabolic changes, miRNA regulation, inflammatory modulation and the glycocalyx will further our knowledge in the pathophysiology of CVD, and provide answers critical to treatment and prevention. PMID:24755829

Raffetto, J D; Mannello, F

2014-06-01

104

Genomic Biomarkers for Chronic Kidney Disease  

PubMed Central

Chronic kidney disease (CKD) remains a major challenge in nephrology and for public health care, affecting 14–15% of the adult U.S. population and consuming significant health care resources. In the next 20 years, the number of patients with end stage renal disease is projected to increase by 50%. Ideal biomarkers that allow early identification of CKD patients at high risk of progression are urgently needed for early and targeted treatment to improve patient care. Recent success of integrating molecular approaches for personalized management of neoplastic diseases, including diagnosis, staging, prognosis, treatment selection and monitoring, has strongly encouraged kidney researchers to pursue molecular definitions of patients with kidney disease. Challenges for molecular marker identification in CKD are a high degree of cellular heterogeneity of the kidney and the paucity of human tissue availability for molecular studies. Despite these limitations potential molecular biomarker candidates have been uncovered at multiple levels along the genome – phenome continuum. Here we will review the identification and validation of potential genomic biomarker candidates of CKD and CKD progression in clinical studies. The challenges in predicting CKD progression, as well as the promises and opportunities resulting from a molecular definition of CKD will be discussed. PMID:22424432

Ju, Wenjun; Smith, Shahaan; Kretzler, Matthias

2012-01-01

105

Development of a disease specific questionnaire to measure health related quality of life in patients with chronic liver disease  

Microsoft Academic Search

BACKGROUND AND AIMSTo develop and assess a disease specific instrument for measuring health related quality of life (HRQL) in patients with chronic liver disease (CLD).METHODSBased on responses from 60 patients with chronic liver disease, from 20 liver experts, and from a Medline search of the literature, items potentially affecting the HRQL of these patients were identified. A separate sample of

Z M Younossi; G Guyatt; M Kiwi; N Boparai; D King

1999-01-01

106

Sleep in chronic obstructive pulmonary disease.  

PubMed

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death, affecting 14 million adults in the United States. Symptoms related to sleep disturbances are common in moderate to severe COPD, particularly in elderly patients, in the form of morning tiredness and early awakenings. One major cause of morbidity in this population is abnormalities in gas exchange and resultant hypoxemia. Sleep has profound adverse effects on respiration and gas exchange in patients with COPD. There are several mechanisms underlying nonapneic oxygen desaturation during sleep. They include decreased functional residual capacity, diminished ventilatory responses to hypoxia and hypercapnia, impaired respiratory mechanical effectiveness, diminished arousal responses, respiratory muscle fatigue, diminished nonchemical respiratory drive, increased upper airway resistance, and the position of baseline saturation values on the oxyhemoglobin dissociation curve. Smoking cessation, bronchodilation, and pulmonary rehabilitation are cornerstones of treatment of COPD. Improvement in lung mechanics and gas exchange should lead to better sleep quality and health status. PMID:16052423

Mohsenin, Vahid

2005-02-01

107

Mechanisms of progression of chronic kidney disease  

PubMed Central

Chronic kidney disease (CKD) occurs in all age groups, including children. Regardless of the underlying cause, CKD is characterized by progressive scarring that ultimately affects all structures of the kidney. The relentless progression of CKD is postulated to result from a self-perpetuating vicious cycle of fibrosis activated after initial injury. We will review possible mechanisms of progressive renal damage, including systemic and glomerular hypertension, various cytokines and growth factors, with special emphasis on the renin–angiotensin–aldosterone system (RAAS), podocyte loss, dyslipidemia and proteinuria. We will also discuss possible specific mechanisms of tubulointerstitial fibrosis that are not dependent on glomerulosclerosis, and possible underlying predispositions for CKD, such as genetic factors and low nephron number. PMID:17647026

2007-01-01

108

Chronic obstructive pulmonary disease: emerging therapies  

Microsoft Academic Search

Despite the high prevalence of and mortality from chronic obstructive pulmonary disease, extensive research on the underlying pathophysiology and specific therapeutics for this disease is, relatively, in its infancy. Several novel molecular targets are being investigated as potential treatments for the disease. The most exciting new class of compounds is the phosphodiesterase 4 inhibitors; Ariflo® (SB 207499) — a member

Douglas WP Hay

2000-01-01

109

INTERGENERATIONAL TRANSMISSION OF NON COMMUNICABLE CHRONIC DISEASES  

E-print Network

regarding the prevalence of obesity and NCDs. Keywords: Health capital, Chronic diseases and obesity, Social prevalence rates. Indeed, according to Abegunde and Stanciole (2006), NCDs are increasing worldwide to substantial disability. Examples of NCDs are car- diovascular diseases (mainly heart disease and stroke

Paris-Sud XI, Université de

110

[Female sexual function and chronic disease].  

PubMed

Female sexual dysfunction (FSD) is a multifactorial set of conditions associated with multiple anatomical, physiological, biological, medical and psychological factors that can have major impact on self-esteem, quality of life, mood and relationships. Studies indicate that FSD is commonly seen in women who report a low level of satisfaction with partner relationship and in women with male partners who have erectile dysfunction. This complexity of FSD is augmented by the presence of chronic disease. Negative sexual effects are widely reported in studies of women with chronic diseases (such as metabolic syndrome, diabetes mellitus, chronic kidney disease, cancer, spinal cord injury, lupus, rheumatic diseases, Parkinson's disease, fibromyalgia and chronic pain) as compared to a general healthy female population. Physical problems, emotional problems and partnership difficulties arising from disease-related stress contribute to less active and less enjoyable sex life. Chronic pain, fatigue, low self-esteem as well as use of medications might reduce sexual function. These effects of chronic diseases on female sexual function still remain largely unstudied. The study by Manor and Zohar published in this issue of Harefuah draws our attention to the sexual dysfunction of women with breast cancer and examines their needs for information regarding their sexual function. In the absence of definite treatment evidence, psychological counseling, improved vaginal lubrication, low dose of hormonal therapy can be used to relieve FSD. Physicians must consider integrating diagnosis of their female patients' sexual needs and dysfunction, especially women with chronic diseases. Patients' education and counseling may contribute to a better quality of life in spite of their chronic disease. PMID:16509415

Bronner, Gila

2006-02-01

111

Chronic kidney disease and erectile dysfunction.  

PubMed

Erectile dysfunction (ED) is a common condition among male chronic kidney disease (CKD) patients. Its prevalence is estimated to be approximately 80% among these patients. It has been well established that the production of nitric oxide from the cavernous nerve and vascular endothelium and the subsequent production of cyclic GMP are critically important in initiating and maintaining erection. Factors affecting these pathways can induce ED. The etiology of ED in CKD patients is multifactorial. Factors including abnormalities in gonadal-pituitary system, disturbance in autonomic nervous system, endothelial dysfunction, anemia (and erythropoietin deficiency), secondary hyperparathyroidism, drugs, zinc deficiency, and psychological problems are implicated in the occurrence of ED. An improvement of general conditions is the first step of treatment. Sufficient dialysis and adequate nutritional intake are necessary. In addition, control of anemia and secondary hyperparathyroidism is required. Changes of drugs that potentially affect erectile function may be necessary. Further, zinc supplementation may be necessary when zinc deficiency is suspected. Phosphodiesterase type 5 inhibitors (PDE5Is) are commonly used for treating ED in CKD patients, and their efficacy was confirmed by many studies. Testosterone replacement therapy in addition to PDE5Is may be useful, particularly for CKD patients with hypogonadism. Renal transplantation may restore erectile function. ED is an early marker of cardiovascular disease (CVD), which it frequently precedes; therefore, it is crucial to examine the presence of ED in CKD patients not only for the improvement of the quality of life but also for the prevention of CVD attack. PMID:25374815

Suzuki, Etsu; Nishimatsu, Hiroaki; Oba, Shigeyoshi; Takahashi, Masao; Homma, Yukio

2014-11-01

112

Inflammation and cachexia in chronic kidney disease  

Microsoft Academic Search

Chronic inflammation is associated with cachexia and increased mortality risk in patients with chronic kidney disease (CKD)\\u000a and end-stage renal disease (ESRD). Inflammation suppresses appetite and causes the loss of protein stores. In CKD patients,\\u000a increased serum levels of pro-inflammatory cytokines may be caused by reduced renal function, volume overload, oxidative or\\u000a carbonyl stress, decreased levels of antioxidants, increased susceptibility

Wai W. Cheung; Kyung Hoon Paik; Robert H. Mak

2010-01-01

113

Sleep Disorders over the Full Range of Chronic Kidney Disease  

Microsoft Academic Search

Sleep disorders are common and underrecognized in patients at all stages of chronic kidney disease. They include sleep apnea, insomnia, excessive sleepiness, restless legs syndrome and periodic limb movement disorder. They can be related to underlying uremia or comorbidities. Sleep disorders can affect the quality of life, and some are associated with increased morbidity and mortality. Clinical assessment, polysomnography and

Andreas Pierratos; Patrick J. Hanly

2011-01-01

114

Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease  

Microsoft Academic Search

We undertook surgical bilateral lung volume reduction in 20 patients with severe chronic obstructive pulmonary disease to relieve thoracic distention and improve respiratory mechanics. The operation, done through median sternotomy, involves excision of 20% to 30% of the volume of each lung. The most affected portions are excised with the use of a linear stapling device fitted with strips of

J. D. Cooper; E. P. Trulock; A. N. Triantafillou; G. A. Patterson; M. S. Pohl; P. A. Deloney; R. S. Sundaresan; C. L. Roper

1995-01-01

115

Thyroid disorders and chronic kidney disease.  

PubMed

Thyroid hormones play a very important role regulating metabolism, development, protein synthesis, and influencing other hormone functions. The two main hormones produced by the thyroid are triiodothyronine (T3) and thyroxine (T4). These hormones can also have significant impact on kidney disease so it is important to consider the physiological association of thyroid dysfunction in relation to chronic kidney disease (CKD). CKD has been known to affect the pituitary-thyroid axis and the peripheral metabolism of thyroid hormones. Low T3 levels are the most common laboratory finding followed by subclinical hypothyroidism in CKD patients. Hyperthyroidism is usually not associated with CKD but has been known to accelerate it. One of the most important links between thyroid disorders and CKD is uremia. Patients who are appropriately treated for thyroid disease have a less chance of developing renal dysfunction. Clinicians need to be very careful in treating patients with low T3 levels who also have an elevation in TSH, as this can lead to a negative nitrogen balance. Thus, clinicians should be well educated on the role of thyroid hormones in relation to CKD so that proper treatment can be delivered to the patient. PMID:24829799

Mohamedali, Mohamed; Reddy Maddika, Srikanth; Vyas, Anix; Iyer, Viswanathan; Cheriyath, Pramil

2014-01-01

116

Virtual Communities for Diabetes Chronic Disease Healthcare  

PubMed Central

Diabetes is classified as the world's fastest-growing chronic illness that affects millions of people. It is a very serious disease, but the bright side is that it is treatable and can be managed. Proper education in this view is necessary to achieve essential control and prevent the aggregation of this chronic sickness. We have developed a healthcare social network that provides methods for distance learning; opportunities for creation of virtual self-help groups where patients can get information and establish interactions among each other in order to exchange important healthcare-related information; discussion forums; patient-to-healthcare specialist communication. The mission of our virtual community is to increase the independence of people with diabetes, self-management, empower them to take care of themselves, make their everyday activities easier, enrich their medical knowledge, and improve their health condition, make them more productive, and improve their communication with other patients with similar diagnoses. The ultimate goal is to enhance the quality of their life. PMID:22121358

Chorbev, Ivan; Sotirovska, Marija; Mihajlov, Dragan

2011-01-01

117

Current Treatment of Chronic Beryllium Disease  

PubMed Central

The current mainstay of management of chronic beryllium disease involves cessation of beryllium exposure and use of systemic corticosteroids. However, there are no randomized controlled trials to assess the effect of these interventions on the natural history of this disease. Despite this limitation, it is prudent to remove patients with chronic beryllium disease from further exposure and consider treating progressive disease early with long-term corticosteroids. The effect of treatment should be monitored using pulmonary function tests and high resolution computed tomography of chest. However, once pulmonary fibrosis has developed, corticosteroid therapy cannot reverse the damage. PMID:19894178

Sood, Akshay

2009-01-01

118

Chronic beryllium disease: computed tomographic findings.  

PubMed

Chronic beryllium disease is a rare multisystem granulomatous disease predominantly involving the lungs and resulting from an immunologic response to long-term occupational exposure. Computed tomography of the chest reveals important lung parenchymal and mediastinal findings and plays an important role in the diagnosis and follow-up assessment of patients with chronic beryllium disease. Its significance lies in the exact localization and evaluation of the extent of lesions. We present an overview of the subject and a pictorial review of the spectrum of computed tomographic features of beryllium disease. PMID:21084914

Sharma, Nidhi; Patel, Jeet; Mohammed, Tan-Lucien H

2010-01-01

119

Current treatment of chronic beryllium disease.  

PubMed

The current mainstay of management of chronic beryllium disease involves cessation of beryllium exposure and use of systemic corticosteroids. However, there are no randomized controlled trials to assess the effect of these interventions on the natural history of this disease. Despite this limitation, it is prudent to remove patients with chronic beryllium disease from further exposure and consider treating progressive disease early with long-term corticosteroids. The effect of treatment should be monitored using pulmonary function tests and high-resolution computed tomography of the chest. However, once pulmonary fibrosis has developed, corticosteroid therapy cannot reverse the damage. PMID:19894178

Sood, Akshay

2009-12-01

120

Chronic Diseases and Health Promotion  

MedlinePLUS

... 0d%0a . Accessed April 9, 2014. Robert Wood Johnson Foundation. Chronic Care: Making the Case for Ongoing Care . Princeton, NJ: Robert Wood Johnson Foundation; 2010:16. http://www.rwjf.org/content/ ...

121

The Causes of Skin Damage and Leg Ulceration in Chronic Venous Disease  

Microsoft Academic Search

Chronic venous disease with skin changes of the leg is a common condition affecting up to 1 in 20 people in westernized countries. The causes of this problem are not fully understood, although research in recent years has revealed a number of important mechanisms that contribute to the disease process. Patients with chronic venous disease suffer persistently raised pressures in

Philip Coleridge Smith

2006-01-01

122

Application of biomedical informatics to chronic pediatric diseases: a systematic review  

Microsoft Academic Search

BACKGROUND: Chronic diseases affect millions of children worldwide leading to substantial disease burden to the children and their families as well as escalating health care costs. The increasing trend in the prevalence of complex pediatric chronic diseases requires innovative and optimal delivery of care. Biomedical informatics applications play an important role in improving health outcomes while being cost-effective. However, their

Fatemeh Moeinedin; Rahim Moineddin; Alejandro R Jadad; Jemila S Hamid; Teresa To; Joseph Beyene

2009-01-01

123

Distress screening in chronic disease: essential for cancer survivors.  

PubMed

Distress is a psychological state that is often observed in patients with chronic disease. Many cancers are considered chronic in nature, with patients experiencing long, disease-free states and intervals of metastatic disease. Distress can negatively affect the biopsychosocial balance in cancer survivors and impede their progress along the cancer trajectory. Distress can also affect medical and psychological outcomes and hinder advancement into long-term survivorship. Distress may contribute to disease progression, although despite research findings, health-care providers seldom screen for indications of persistent or unresolved distress. This article discusses research findings related to the prevalence of distress in multiple chronic diseases. Validated instruments used to screen for distress in cancer survivors, such as the Distress Thermometer and symptom checklist from the National Comprehensive Cancer Network, are reviewed. With the availability of brief and concise instruments to screen for distress, providers have the ability to provide holistic and comprehensive care for cancer survivors. The overall financial impact of cancer-related distress is understudied, although similar psychological studies indicate that prevention or elimination of distress is beneficial. Cancer is a lifelong, chronic disease; patients have ongoing needs and varied sources of distress. As the number of cancer survivors exponentially increases, their psychosocial needs will likewise expand. PMID:25032045

Petty, Lorie; Lester, Joanne

2014-03-01

124

Adult Chronic Kidney Disease: Neurocognition in Chronic Renal Failure  

Microsoft Academic Search

In recent years there has been a keen interest in the neurocognitive sequelae of renal failure and subsequent end-stage renal\\u000a disease given its increasing prevalence and incidence. This review article summarizes the relevant information on cognitive\\u000a functioning in chronic kidney disease in adults before the initiation of dialysis, after the initiation of dialysis, and after\\u000a renal transplantation. In general, compared

Nikhil S. Koushik; Steven F. McArthur; Anne D. Baird

2010-01-01

125

[Chronic neuroborreliosis in Lyme disease].  

PubMed

Acute and chronic syndromes of Lyme neuroborreliosis are recognized. Acute syndromes are clinically pronounced and comprise meningitis, neuritis of the cranial nerve, radiculoneuritis. Chronic syndromes are less evident. These are moderate encephalopathy and radiculoneuropathy. The diagnosis of the chronic syndrome is based on the presence of early classic signs of BL. CSF must be tested for routine procedure and in pair with serum in the test for selective accumulation of antibodies to Bb in the CSF. Neurophysiological studies help detect memory defects. Electrophysiological tests verify radiculoneuropathy. NMR investigation of the brain and SPECT-scanning may demonstrate damage to the white brain matter. We have much experience with i.v. administration of ceftriaxone (2 g/day for 4 weeks) which relieved neurological syndromes several months later. PMID:9082597

Logigian, E L

1996-01-01

126

Regression Lines in Chronic Kidney Disease  

Microsoft Academic Search

Chronic kidney disease (CKD) has been recognized for millennia. The great physicians Rhazes (865-925 AD) and Abu Sina (aka Avicenna, 980 -1037 AD) in ancient Persia described kidney diseases in detail. In medieval times, the pisse prophets predicted outcomes for patients on the basis of uroscopy analyses. Catego- rization of CKD developed in the 20 th century from the nonspe-

AGNES B. FOGO

2003-01-01

127

The Western diet and chronic kidney disease.  

PubMed

Characteristics of the Western diet that fueled the obesity epidemic may also impact kidney disease incidence and progression. Enlarging portion sizes over the past half century has been accompanied by increased intake of protein, sodium, and processed foods while consumption of fruits and vegetables has declined. Overall dietary patterns play a strong role for chronic disease risk including chronic kidney disease. While dietary patterns high in fresh fruits and vegetables and low in red meats, such as the Mediterranean diet, decrease the risk of chronic diseases, the Western diet, characterized by high intake of red meat, animal fat, sweets, and desserts and low intake of fresh fruits and vegetables and low-fat dairy products, increases risk of chronic diseases. In this article, we review the potential mechanisms whereby several key characteristics of the typical Western diet may impact kidney disease incidence and progression. We also discuss a public health policy initiative to improve dietary choices. Reducing protein intake to the recommended daily allowance of 0.8 g/kg/day and increasing intake of fruit and vegetables and fiber may mitigate kidney disease progression and reduce risk of cardiovascular disease and mortality. PMID:25754321

Hariharan, Divya; Vellanki, Kavitha; Kramer, Holly

2015-04-01

128

Anemia of Inflammation and Chronic Disease  

MedlinePLUS

... Besarab A, Coyne DW. Iron supplementation to treat anemia in patients with chronic kidney disease. Nature Reviews Nephrology . 2010;6(12):699–710. ... Anemia in Kidney Disease and Dialysis at www.kidney.niddk.nih.gov. 4 Anemia of Inflammation ... Eating, Diet, and Nutrition People with anemia caused ...

129

Glycemic index in chronic disease: a review  

Microsoft Academic Search

Aim: The intent of this review is to critically analyze the scientific evidence on the role of the glycemic index in chronic Western disease and to discuss the utility of the glycemic index in the prevention and management of these disease states.Background: The glycemic index ranks foods based on their postprandial blood glucose response. Hyperinsulinemia and insulin resistance, as well

LS Augustin; S Franceschi; DJA Jenkins; CWC Kendall; C La Vecchia

2002-01-01

130

Chronic kidney disease and cardiovascular complications.  

PubMed

Cardiovascular diseases such as coronary artery disease, congestive heart failure, arrhythmias and sudden cardiac death represent main causes of morbidity and mortality in patients with chronic kidney disease (CKD). Pathogenesis includes close linkage between heart and kidneys and involves traditional and non-traditional cardiovascular risk factors. According to a well-established classification of cardiorenal syndrome, cardiovascular involvement in CKD is known as "type-4 cardiorenal syndrome" (chronic renocardiac). The following review makes an overview about epidemiology, pathophysiology, diagnosis and treatment of cardiovascular complications in CKD patients. PMID:25344016

Di Lullo, Luca; House, Andrew; Gorini, Antonio; Santoboni, Alberto; Russo, Domenico; Ronco, Claudio

2015-05-01

131

The impact of chronic pain on direct medical utilization and costs in chronic obstructive pulmonary disease  

PubMed Central

Objective To examine how pain affects health care utilization and direct medical costs in individuals with chronic obstructive pulmonary disease (COPD) compared to patients with other chronic diseases. Study design A retrospective cohort analysis using administrative data of a managed health care system in the Southwestern US for years 2006–2010. Methods COPD patients age ?40 years were matched to similar patients with other chronic conditions on age, sex, insurance type, and a health care event (outpatient visit, emergency department visit, or inpatient stay). Chronic pain was indicated by pain-associated diagnoses and procedures, or fills for prescription pain medications. The study population was also stratified into those with and without chronic pain to examine clinical factors and costs associated with chronic pain. Results Seven thousand nine hundred and fifty-two COPD patients (mean age 69 years, 58% women) were matched to 15,904 patients with other chronic disease. COPD patients had significantly higher utilization for pain-related services and for overall services. COPD patients had a higher prevalence of any pain medication use over a 12-month period (41.2% versus 31.5%) and, among those using pain medications, a higher mean number of pain medication prescription fills (10.1 versus 6.4). Factors associated with chronic pain included age 40–65 years, being female, having more than one chronic morbidity, insurance type, some emergency department or hospital utilization, and having either COPD, heart failure, arthritis, or stroke. Among COPD patients, those with chronic pain had a mean annual direct cost for overall utilization of $24,261 versus $10,390 among those without chronic pain (P<0.0001 for all comparisons). Conclusion COPD patients have substantially more utilization for pain medications and pain-related procedures than those with most other chronic diseases. Total direct medical costs among COPD patients who have chronic pain are more than double those of COPD patients without chronic pain. Pain management may be an opportunity for better and more cost-effective care for COPD patients.

Roberts, Melissa H; Mapel, Douglas W; Thomson, Heather N

2015-01-01

132

Modern treatment of chronic obstructive pulmonary disease  

Microsoft Academic Search

ABSTRACT: Chronic obstructive pulmonary,disease (COPD) is a major cause of ill health and medical expenditure,worldwide. Despite recent increases in the knowledge about the nature of the disease process and recognition of cytokine-mediated pathways of inflammation, current management is focussed on patient outcomes that relate to physiological measures,of dysfunction. The new,Global initiative in Obstructive Lung Disease (GOLD) management guidelines are evidence-based

P. M. A. Calverley

2001-01-01

133

Diphenylhydantoin (phenytoin)-induced chronic pulmonary disease  

PubMed Central

Drug-induced respiratory diseases are difficult to diagnose and therefore usually not identified, probably underestimated and under-reported. We report a case of diphenylhydantoin/phenytoin-induced chronic pulmonary disease in a 62-year-old male patient presenting with progressive dyspnea, eosinophilia, and pulmonary abnormalities. The importance of drug history in clinical history-taking and early diagnosis of drug-induced respiratory diseases is emphasized so as to prevent permanent pulmonary damage. PMID:20532004

Dixit, Ramakant; Dixit, Kalpana; Nuwal, Paras; Banerjee, Arunima; Sharma, Sidharth; Dave, Lokendra

2009-01-01

134

Christos Chatziantoniou at Inserm UMR 1155 Wins GSK's Discovery Fast Track Challenge to Investigate Chronic Kidney Disease  

E-print Network

Chronic Kidney Disease Paris, France - 1 December, 2014 - Christos Chatziantoniou, Director of Research medicines for Chronic Kidney Disease. Dr. Chatziantoniou, researcher in Inserm, is one of 14 winning of Chronic Kidney Disease (CKD), a pathology affecting millions of people over the world. CKD is defined

135

Systemic effects of chronic obstructive pulmonary disease  

Microsoft Academic Search

ABSTRACT: Chronic obstructive pulmonary,disease (COPD) is characterised by an inappropriate\\/excessive inflammatory response of the lungs to respiratory pollutants, mainly tobacco smoking. Recently, besides the typical pulmonary pathology of COPD (i.e. chronic bronchitis and emphysema), several effects occurring outside the lungs have been described, the so- called systemic effects of COPD. These effects are clinically relevant because they modify,and can help

A. G. N. Agusti; A. Noguera; J. Sauleda; E. Sala; J. Pons; X. Busquets

2003-01-01

136

The Olig family affects central nervous system development and disease  

PubMed Central

Neural cell differentiation and maturation is a critical step during central nervous system development. The oligodendrocyte transcription family (Olig family) is known to be an important factor in regulating neural cell differentiation. Because of this, the Olig family also affects acute and chronic central nervous system diseases, including brain injury, multiple sclerosis, and even gliomas. Improved understanding about the functions of the Olig family in central nervous system development and disease will greatly aid novel breakthroughs in central nervous system diseases. This review investigates the role of the Olig family in central nervous system development and related diseases. PMID:25206819

Tan, Botao; Yu, Jing; Yin, Ying; Jia, Gongwei; Jiang, Wei; Yu, Lehua

2014-01-01

137

Physical Activity Transitions and Chronic Disease.  

PubMed

The 20(th) century in the United States (U.S.) has experienced a dramatic increase in life expectancy among adult men and women, an increase unprecedented in the history of this country. As a result, the pattern of disease and conditions most responsible for death in the U.S. shifted during the past century from infectious diseases and unintentional injuries to the current array of the leading causes of mortality dominated by the chronic diseases. During this same period, daily lifestyle dramatically shifted from a life full of active living to one of inactivity. The argument has been made that in the case of human beings, there has been little or no change in our genotype within the past 50 years. However, there have been major changes documented in the living environment among economically developed societies during this same time period. Through the collection of epidemiologic, clinical, and experimental findings, evidence exists to suggest that physical inactivity is associated with the onset of chronic diseases of our day. Trends in physical inactivity evident through the monitoring of transport, recreational, sport, and purposeful activity have demonstrated that the current lifestyle of the 21(st) century has contributed substantially to the chronic disease burden in the U.S. and elsewhere. By addressing the domains that influence physical activity behaviors including the environment (both physical and social/cultural), health systems access, and behavioral correlates of physical activity and inactivity, the current chronic disease crisis can potentially be addressed. PMID:20161359

Heath, Gregory W

2009-07-01

138

Management of Pruritus in Chronic Liver Disease  

PubMed Central

Background. There continues to be uncertainty on the ideal treatment of pruritus in chronic liver disease. The aim of this study was to gather the latest information on the evidence-based management of pruritus in chronic liver disease. Methodology. A literature search for pruritus in chronic liver disease was conducted using Pubmed and Embase database systems using the MeSH terms “pruritus,” “chronic liver disease,” “cholestatic liver disease,” and “treatment.” Results. The current understanding of the pathophysiology of pruritus is described in addition to detailing research into contemporary treatment options of the condition. These medical treatments range from bile salts, rifampicin, and opioid receptor antagonists to antihistamines. Conclusion. The burden of pruritus in liver disease patients persists and, although it is a common symptom, it can be difficult to manage. In recent years there has been greater study into the etiology and treatment of the condition. Nonetheless, pruritus remains poorly understood and many patients continue to suffer, reiterating the need for further research to improve our understanding of the etiology and treatment for the condition.

Bhalerao, Angeline; Mannu, Gurdeep S.

2015-01-01

139

Fibromyalgia and chronic widespread pain in autoimmune thyroid disease.  

PubMed

Fibromyalgia and chronic widespread pain syndromes are among the commonest diseases seen in rheumatology practice. Despite advances in the management of these conditions, they remain significant causes of morbidity and disability. Autoimmune thyroid disease is the most prevalent autoimmune disorder, affecting about 10 % of the population, and is a recognized cause of fibromyalgia and chronic widespread pain. Recent reports are shedding light on the mechanisms of pain generation in autoimmune thyroid disease-associated pain syndromes including the role of inflammatory mediators, small-fiber polyneuropathy, and central sensitization. The gradual elucidation of these pain pathways is allowing the rational use of pharmacotherapy in the management of chronic widespread pain in autoimmune thyroid disease. This review looks at the current understanding of the prevalence of pain syndromes in autoimmune thyroid disease, their likely causes, present appreciation of the pathogenesis of chronic widespread pain, and how our knowledge can be used to find lasting and effective treatments for the pain syndromes associated with autoimmune thyroid disease. PMID:24435355

Ahmad, Jowairiyya; Tagoe, Clement E

2014-07-01

140

Systemic Diseases and Chronic Rhinosinusitis  

Microsoft Academic Search

Many systemic diseases can cause nasal symptoms, either as an initial presentation or a manifestation later in the disease process. When patients present with nasal symptoms resembling infection—such as purulent nasal discharge, crusting, and congestion—acute rhinosinusitis is likely to be diagnosed. However, when these symptoms persist despite appropriate medical therapy, other etiologies should be considered. In some cases, underlying inflammation

Christine Reger; Christina F. Herrera; Megan Abbott; Alexander G. Chiu

141

Chronic obstructive pulmonary disease and the risk of cardiovascular diseases  

Microsoft Academic Search

Previous large epidemiological studies reporting on the association between chronic obstructive pulmonary disease (COPD) and\\u000a cardiovascular diseases mainly focussed on prevalent diseases rather than on the incidence of newly diagnosed cardiovascular\\u000a outcomes. We used the UK-based General Practice Research Database (GPRD) to assess the prevalence and incidence of cardiovascular\\u000a diseases in COPD patients aged 40–79 between 1995 and 2005, and

Cornelia Schneider; Ulrich Bothner; Susan S. Jick; Christoph R. Meier

2010-01-01

142

SECRETED KLOTHO AND CHRONIC KIDNEY DISEASE  

PubMed Central

Soluble Klotho (sKl) in the circulation can be generated directly by alterative splicing of the Klotho transcript or the extracellular domain of membrane Klotho can be released from membrane-anchored Klotho on the cell surface. Unlike membrane Klotho which functions as a coreceptor for fibroblast growth factor-23 (FGF23), sKl, acts as hormonal factor and plays important roles in anti-aging, anti-oxidation, modulation of ion transport, and Wnt signaling. Emerging evidence reveals that Klotho deficiency is an early biomarker for chronic kidney diseases as well as a pathogenic factor. Klotho deficiency is associated with progression and chronic complications in chronic kidney disease including vascular calcification, cardiac hypertrophy, and secondary hyperparathyroidism. In multiple experimental models, replacement of sKl, or manipulated up-regulation of endogenous Klotho protect the kidney from renal insults, preserve kidney function, and suppress renal fibrosis, in chronic kidney disease. Klotho is a highly promising candidate on the horizon as an early biomarker, and as a novel therapeutic agent for chronic kidney disease. PMID:22396167

Hu, Ming Chang; Kuro-o, Makoto; Moe, Orson W.

2013-01-01

143

Heart Disease Affects Women of All Ages  

MedlinePLUS

Skip Navigation Bar Home Current Issue Past Issues Heart Disease Affects Women of All Ages Past Issues / Winter ... weeks of a heart attack. For Women with Heart Disease: About 6 million American women have coronary heart ...

144

Diabetes and Chronic Kidney Disease  

MedlinePLUS

... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... KEEP Healthy - Free Kidney Health checks Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

145

Sexuality and Chronic Kidney Disease  

MedlinePLUS

... Rate Your Risk Quiz Featured Story African Americans & Kidney Disease Did you know that African Americans are ... KEEP Healthy - Free Kidney Health checks Featured Story Kidney Walk The Kidney Walk is the nation's largest ...

146

Transgenic Mouse Model of Chronic Beryllium Disease  

SciTech Connect

Animal models provide powerful tools for dissecting dose-response relationships and pathogenic mechanisms and for testing new treatment paradigms. Mechanistic research on beryllium exposure-disease relationships is severely limited by a general inability to develop a sufficient chronic beryllium disease animal model. Discovery of the Human Leukocyte Antigen (HLA) - DPB1Glu69 genetic susceptibility component of chronic beryllium disease permitted the addition of this human beryllium antigen presentation molecule to an animal genome which may permit development of a better animal model for chronic beryllium disease. Using FVB/N inbred mice, Drs. Rubin and Zhu, successfully produced three strains of HLA-DPB1 Glu 69 transgenic mice. Each mouse strain contains a haplotype of the HLA-DPB1 Glu 69 gene that confers a different magnitude of odds ratio (OR) of risk for chronic beryllium disease: HLA-DPB1*0401 (OR = 0.2), HLA-DPB1*0201 (OR = 15), HLA-DPB1*1701 (OR = 240). In addition, Drs. Rubin and Zhu developed transgenic mice with the human CD4 gene to permit better transmission of signals between T cells and antigen presenting cells. This project has maintained the colonies of these transgenic mice and tested the functionality of the human transgenes.

Gordon, Terry

2009-05-26

147

Effects of iron overload on chronic metabolic diseases.  

PubMed

Iron can affect the clinical course of several chronic metabolic diseases such as type 2 diabetes, obesity, non-alcoholic fatty liver disease, and atherosclerosis. Iron overload can affect major tissues involved in glucose and lipid metabolism (pancreatic ? cells, liver, muscle, and adipose tissue) and organs affected by chronic diabetic complications. Because iron is a potent pro-oxidant, fine-tuned control mechanisms have evolved to regulate entry, recycling, and loss of body iron. These mechanisms include the interplay of iron with transferrin, ferritin, insulin, and hepcidin, as well as with adipokines and proinflammatory molecules. An imbalance of these homoeostatic mechanisms results in systemic and parenchymal siderosis that contributes to organ damage (such as ?-cell dysfunction, fibrosis in liver diseases, and atherosclerotic plaque growth and instability). Conversely, iron depletion can exert beneficial effects in patients with iron overload and even in healthy frequent blood donors. Regular assessment of iron balance should be recommended for patients with chronic metabolic diseases, and further research is needed to produce guidelines for the identification of patients who would benefit from iron depletion. PMID:24731656

Fernández-Real, José Manuel; Manco, Melania

2014-06-01

148

Chronic Kidney Disease Is Associated with Angiographic Coronary Artery Disease  

Microsoft Academic Search

Background\\/Aims: Patients with chronic kidney disease (CKD) have a dramatically increased risk for cardiovascular mortality. Few prior studies have examined the independent association of CKD with coronary anatomy. Methods: We evaluated the relationship between CKD and severe coronary artery disease (CAD) in 261 male veterans with nuclear perfusion imaging tests suggesting coronary ischemia. We used chart review and patient and

Michel Chonchol; Jeff Whittle; Angela Desbien; Michelle B. Orner; Laura A. Petersen; Nancy R. Kressin

2008-01-01

149

Vitamin D deficiency in chronic liver disease  

PubMed Central

Vitamin D is an important secosteroid hormone with known effect on calcium homeostasis, but recently there is increasing recognition that vitamin D also is involved in cell proliferation and differentiation, has immunomodulatory and anti-inflammatory properties. Vitamin D deficiency has been frequently reported in many causes of chronic liver disease and has been associated with the development and evolution of non-alcoholic fatty liver disease (NAFLD) and chronic hepatitis C (CHC) virus infection. The role of vitamin D in the pathogenesis of NAFLD and CHC is not completely known, but it seems that the involvement of vitamin D in the activation and regulation of both innate and adaptive immune systems and its antiproliferative effect may explain its importance in these liver diseases. Published studies provide evidence for routine screening for hypovitaminosis D in patients with liver disease. Further prospectives studies demonstrating the impact of vitamin D replacement in NAFLD and CHC are required. PMID:25544877

Iruzubieta, Paula; Terán, Álvaro; Crespo, Javier; Fábrega, Emilio

2014-01-01

150

[Phenotypes in chronic obstructive pulmonary disease].  

PubMed

Chronic Obstructive Pulmonary Disease (COPD) is a multi-dimensional disorder with multiple phenotypes. The GOLD guidelines, used for the diagnosis, staging and treatment of COPD, do not fully reflect the heterogeneous nature of the disease. Historically, the two most recognized clinical phenotypes of COPD are emphysema and chronic bronchitis. Most COPD patients encountered in practice actually share, both of these features. Genetic background, clinical presentation, variation in the response to treatment and propensity to exacerbations may also identify other phenotypes. Recently, using a mathematical approach, such as cluster analysis, which is based on pre-selected parameters, other interesting phenotypes were identified. A precise definition of COPD phenotypes should lead to a more targeted therapeutic approach based on these phenotypes. The purpose of this article is to point out that COPD is a heterogeneous disease and to summarize the current data available about the phenotypes of this disease. PMID:25158382

Corhay, J-L; Schleich, F; Louis, R

2014-01-01

151

Framing international trade and chronic disease  

Microsoft Academic Search

There is an emerging evidence base that global trade is linked with the rise of chronic disease in many low and middle-income\\u000a countries (LMICs). This linkage is associated, in part, with the global diffusion of unhealthy lifestyles and health damaging\\u000a products posing a particular challenge to countries still facing high burdens of communicable disease. We developed a generic\\u000a framework which

Ronald Labonté; Katia S Mohindra; Raphael Lencucha

2011-01-01

152

Magnesium in Chronic Kidney Disease: Unanswered Questions  

Microsoft Academic Search

Background: Magnesium ion is critical for life and is integrally involved in cellular function and a key component of normal bone mineral. In health, the kidneys, gastrointestinal tract and bone are responsible for maintaining serum magnesium concentrations in the normal range and magnesium balance. Most clinical disorders involving magnesium, other than chronic kidney disease (CKD), result in hypomagnesemia, either from

David M. Spiegel

2011-01-01

153

Hepatic disorders in chronic kidney disease  

Microsoft Academic Search

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection are the most common and serious causes of liver damage in patients with chronic kidney disease (CKD). The natural histories of HBV and HCV infections in patients with CKD are not fully understood; however, recent evidence has emphasized the adverse effect of HBV and\\/or HCV infection on survival in this

Piergiorgio Messa; Carlo Basile; Paul Martin; Fabrizio Fabrizi

2010-01-01

154

Peripheral nerve function in chronic liver disease  

Microsoft Academic Search

Peripheral nerve function has been studied in 50 patients with chronic liver disease. An increase in the latency or a reduction in the response amplitude of the evoked sensory potential of the median nerve was detected in 34 of the 50 subjects. This was in striking contrast to the paucity of neurological signs and symptoms suggestive of peripheral nerve damage

K. N. Seneviratne; O. A. Peiris

1970-01-01

155

Geroscience: linking aging to chronic disease.  

PubMed

Mammalian aging can be delayed with genetic, dietary, and pharmacologic approaches. Given that the elderly population is dramatically increasing and that aging is the greatest risk factor for a majority of chronic diseases driving both morbidity and mortality, it is critical to expand geroscience research directed at extending human healthspan. PMID:25417146

Kennedy, Brian K; Berger, Shelley L; Brunet, Anne; Campisi, Judith; Cuervo, Ana Maria; Epel, Elissa S; Franceschi, Claudio; Lithgow, Gordon J; Morimoto, Richard I; Pessin, Jeffrey E; Rando, Thomas A; Richardson, Arlan; Schadt, Eric E; Wyss-Coray, Tony; Sierra, Felipe

2014-11-01

156

Case Management of Adolescents with Chronic Disease.  

ERIC Educational Resources Information Center

This training guide presents a model for optimum delivery of the primary duties, tasks, and steps required in the comprehensive case management of adolescents with chronic disease. Using a team approach to coordinated health care, the guide involves the patient and family as key members of the care team along with the physician, nurse, dietitian,…

Lankard, Bettina A.

157

INTRODUCTION Chronic kidney disease impairs glomerular filtration  

E-print Network

INTRODUCTION Chronic kidney disease impairs glomerular filtration rate (GFR) which is detected as elevated serum levels of kidney biomarkers such as creatinine and cystatin C. Prior studies have related. Mapping Associations between Creatinine, Cystatin C and Brain Atrophy in the Elderly: An N=716 ADNI Study

Thompson, Paul

158

Functional Impairment in Chronic Renal Disease  

Microsoft Academic Search

Summary(1) The present study has attempted to characterize the acidifying defect in chronic renal disease and to delineate differences which may exist between glomerular and tubular disorders. (2) The ability to excrete an acid load was examined in 45 patients (30 tubular and 15 glomerular disorders) and ten normal controls, employing the short acid-loading test of Wrong and Davies (1959).

H. C. Gonick; C. R. Kleeman; M. E. Rubini; M. H. Maxwell

1969-01-01

159

End stage chronic obstructive pulmonary disease.  

PubMed

Many patients with chronic obstructive pulmonary disease (COPD) die each year as those with lung cancer but current guidelines make few recommendations on the care for the most severe patients i.e. those with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV with chronic respiratory failure. Only smoking cessation and long term oxygen therapy (LTOT) improve survival in COPD. Although non invasive positive pressure ventilation (NPPV) may have an adjunctive role in the management of chronic respiratory insufficiency there is little evidence for its use in the routine management of stable hypercapnic COPD patients. At difference, several prospective, randomised, controlled studies, systematic reviews and meta-analyses show good level of evidence for clinical efficacy of NPPV in the treatment of acute on chronic respiratory failure due to acute exacerbations of COPD. NPPV is also alternative to invasive ventilation for symptom relief in end stage COPD. Surgical interventions for end stage COPD like bullectomy, different modalities of lung volume reduction surgery and lung transplantation are likely to be of value to only a small percentage of patients. Nevertheless, there are specific indications, which, when added to pulmonary rehabilitation will further advance exercise capacity and quality of life. As in other chronic diseases when severity of disease increases along the natural history, therapy aimed to prolong life becomes less and less important in comparison to palliative therapy aimed to relieve symptoms. The most effective treatments for dyspnoea are bronchodilators, although also opiates may improve dyspnoea. Supplemental oxygen reduce exertional breathlessness and improve exercise tolerance in hypoxaemic COPD patients. There are difficulties in treating with antidepressant the frail and elderly COPD patients. Good clinical care can prevent or alleviate suffering by assessing symptoms and providing psychological and social support to the patients and their families. PMID:19462352

Ambrosino, Nicolino; Gherardi, Marco; Carpenè, Nicoletta

2009-01-01

160

Endothelial Dysfunction in Chronic Inflammatory Diseases  

PubMed Central

Chronic inflammatory diseases are associated with accelerated atherosclerosis and increased risk of cardiovascular diseases (CVD). As the pathogenesis of atherosclerosis is increasingly recognized as an inflammatory process, similarities between atherosclerosis and systemic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel diseases, lupus, psoriasis, spondyloarthritis and others have become a topic of interest. Endothelial dysfunction represents a key step in the initiation and maintenance of atherosclerosis and may serve as a marker for future risk of cardiovascular events. Patients with chronic inflammatory diseases manifest endothelial dysfunction, often early in the course of the disease. Therefore, mechanisms linking systemic inflammatory diseases and atherosclerosis may be best understood at the level of the endothelium. Multiple factors, including circulating inflammatory cytokines, TNF-? (tumor necrosis factor-?), reactive oxygen species, oxidized LDL (low density lipoprotein), autoantibodies and traditional risk factors directly and indirectly activate endothelial cells, leading to impaired vascular relaxation, increased leukocyte adhesion, increased endothelial permeability and generation of a pro-thrombotic state. Pharmacologic agents directed against TNF-?-mediated inflammation may decrease the risk of endothelial dysfunction and cardiovascular disease in these patients. Understanding the precise mechanisms driving endothelial dysfunction in patients with systemic inflammatory diseases may help elucidate the pathogenesis of atherosclerosis in the general population. PMID:24968272

Steyers, Curtis M.; Miller, Francis J.

2014-01-01

161

Stroke and cerebrovascular diseases in patients with chronic kidney disease.  

PubMed

Chronic kidney disease, defined as a reduced glomerular filtration rate or increased urinary albumin excretion, is recognised as a rapidly growing global health burden, and increasing evidence suggests that it contributes to the risk and severity of cerebrovascular diseases. In particular, chronic kidney disease is an established risk factor for stroke and is also strongly associated with subclinical cerebrovascular abnormalities and cognitive impairment, partly because it shares several traditional and non-traditional risk factors, and sometimes uraemia-related and dialysis-related factors, with cerebrovascular diseases. The effect of chronic kidney disease on incident stroke differs among regions and races and is greater in Asian than in non-Asian people. Chronic kidney disease seems to be predictive of severe neurological deficits and poor vital and functional outcomes after both ischaemic and haemorrhagic strokes, which is partly due to the limitations of pharmacotherapies, including limited use and effects of novel oral anticoagulants, other antithrombotic treatments, and reperfusion treatment for hyperacute ischaemic stroke. In view of the strong two-way association between stroke and kidney disease, the pathophysiological interactions between the brain and kidney should be the subject of intensive study. PMID:25030514

Toyoda, Kazunori; Ninomiya, Toshiharu

2014-08-01

162

MicroRNAs: New Insights into Chronic Childhood Diseases  

PubMed Central

Chronic diseases are the major cause of morbidity and mortality worldwide and have shown increasing incidence rates among children in the last decades. Chronic illnesses in the pediatric population, even if well managed, affect social, psychological, and physical development and often limit education and active participation and increase the risk for health complications. The significant pediatric morbidity and mortality rates caused by chronic illnesses call for serious efforts toward better understanding of the pathogenesis of these disorders. Recent studies have shown the involvement of microRNAs (miRNAs) in various aspects of major pediatric chronic non-neoplastic diseases. This review focuses on the role of miRNAs in four major pediatric chronic diseases including bronchial asthma, diabetes mellitus, epilepsy and cystic fibrosis. We intend to emphasize the importance of miRNA-based research in combating these major disorders, as we believe this approach will result in novel therapies to aid securing normal development and to prevent disabilities in the pediatric population. PMID:23878802

Omran, Ahmed; Elimam, Dalia; Yin, Fei

2013-01-01

163

Factors affecting the prevalence of chronic diseases in Palestinian people: an analysis of data from the Palestinian Central Bureau of Statistics.  

PubMed

This study determined whether there are significant differences in the prevalence of diabetes, hypertension, cardiovascular disease (CVD) and cancer among Palestinians with respect to different demographic variables using secondary data from the Palestinian Central Bureau of Statistics. Living in the Gaza Strip was a protective factor, with this group being 21% less likely to have diabetes, 35% less likely to have hypertension, and 48% less likely to have CVD than those living in the West Bank. No significant difference was found for cancer. Being a refugee was a significant risk factor for diabetes and CVD while being married/engaged or divorced/ separated/widowed was a risk factor for diabetes and hypertension. Gender was a risk factor for hypertension with females being 60% more likely to have hypertension than males. Living in a rural setting was protective against hypertension. As expected, age was a risk factor for diabetes, hypertension and CVD; the magnitude of this increased risk was alarming, 36 to 434 times greater in those aged 40-65 years compared with those aged 0-19 years. PMID:23882954

Abukhdeir, H F; Caplan, L S; Reese, L; Alema-Mensah, E

2013-04-01

164

Does chronic disease self-management have a role in preventing chronic disease in rural Australia?  

Microsoft Academic Search

Chronic disease accounts for nearly 43% of the total disease burden in Australia and is growing. The situation is much worse for Indigenous Australians. To make any impact on decreasing this burden, efforts need to be focused on the risk factors which cause these diseases: 30% of Australians aged 25 years and over have high blood pressure, 50% have high

Kate Warren; Spencer Gulf; Debra Misan; Gary Misan

165

PPAR? and chronic kidney disease  

Microsoft Academic Search

Peroxisome proliferator-activated receptor-? (PPAR?) agonists, exemplified by the thiazolidinediones (TZDs), have been used\\u000a extensively for their beneficial effects to improve insulin sensitivity and lipid metabolism in type 2 diabetic patients.\\u000a PPAR? receptors are part of the steroid hormone nuclear receptor family and, when activated by agonist binding, can affect\\u000a numerous target genes expressing PPAR response elements. Results from experimental studies

Agnes B. Fogo

2011-01-01

166

Hypoxia and chronic lung disease  

Microsoft Academic Search

The lung is both the conduit for oxygen uptake and is also affected by hypoxia and hypoxia signaling. Decreased ventilatory\\u000a drive, airway obstructive processes, intra-alveolar exudates, septal thickening by edema, inflammation, fibrosis, or damage\\u000a to alveolar capillaries will all interpose a significant and potentially life-threatening barrier to proper oxygenation, therefore\\u000a enhancing the alveolar\\/arterial pO2 gradient. These processes result in decreased

Rubin M. Tuder; Jeong H. Yun; Anil Bhunia; Iwona Fijalkowska

2007-01-01

167

Chronic obstructive pulmonary disease: a novel risk factor for cardiovascular disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in Canada and elsewhere. It affects 5% of all adult Canadians and is the fourth leading cause of death. Interestingly, the leading causes of hospitalizations and mortality among COPD patients are cardiovascular events. In the Lung Health Study, over 5 800 patients with mild to

Don D. Sin; S. F. Paul Man

2005-01-01

168

Pathophysiology of Exacerbations of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Smokers with stable chronic obstructive pulmonary disease have a chronic inflammation of the entire tracheobronchial tree character- ized by an increased number of macrophages and CD8 T lympho- cytes in the airway wall and of neutrophils in the airway lumen. Exacerbations of chronic obstructive pulmonary disease are consid- ered to reflect worsening of the underlying chronic inflammation ofthe airways,causedmainlybyviralandbacterialinfections andair

Alberto Papi; Fabrizio Luppi; Francesca Franco; Leonardo M. Fabbri

2006-01-01

169

Precordial chest pain in patients with chronic Chagas disease.  

PubMed

Precordial chest pain affects about 15% to 33% of patients with chronic Chagas disease. In the absence of megaesophagus, it should be ascribed to chronic Chagas heart disease. Precordial chest pain is atypical because it can usually neither be associated to physical exercise nor be alleviated by nitroglycerin. However, in certain circumstances, precordial chest pain can masquerade as acute coronary syndrome. Although obstructive coronary artery disease can occasionally be found, microvascular angina seems to be the mechanism behind such phenomenon. Precordial chest pain not always has a benign clinical course; sometimes, it can herald a dismal prognosis. On the basis of cases previously reported, it seems that nitrates, betablockers and/or calcium channel blockers can be of value in the treatment of this condition. PMID:25127335

Bestetti, Reinaldo B; Restini, Carolina Baraldi A

2014-09-20

170

Osteoporosis in Chronic Obstructive Pulmonary Disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a lifestyle-related chronic inflammatory pulmonary disease associated with significant morbidity and mortality worldwide. COPD is associated with various comorbidities found in all stages of COPD. The comorbidities have significant impact in terms of morbidity, mortality, and economic burden in COPD. Management of comorbidities should be incorporated into the comprehensive management of COPD as this will also have an effect on the outcome in COPD patients. Various comorbidities reported in COPD include cardiovascular disease, skeletal muscle dysfunction, anemia, metabolic syndrome, and osteoporosis. Osteoporosis is a significant comorbidity in COPD patients. Various risk factors, such as tobacco smoking, systemic inflammation, vitamin D deficiency, and the use of oral or inhaled corticosteroids (ICSs) are responsible for its occurrence in patients with COPD. This review will focus on the prevalence, pathogenesis, risk factors, diagnosis, and treatment of osteoporosis in COPD patients. PMID:25788838

Sarkar, Malay; Bhardwaj, Rajeev; Madabhavi, Irappa; Khatana, Jasmin

2015-01-01

171

Circulating progenitor cells in chronic lung disease.  

PubMed

Tissue regeneration and repair are fundamental both to recovery of the lung from injury and to the pathology of many chronic lung diseases. There are two potential sources for the adult progenitor cells that participate in this reparative process: resident lung progenitors and bone marrow-derived circulating cells. Bone marrow-derived cells, in particular, have been shown to give rise to airway and alveolar epithelial cells, as well as lung mesenchymal cells. Emerging data have linked specific chemokine ligand-receptor interactions to the recruitment of these cells to the lung and has implicated these cells in chronic lung disorders such as asthma and interstitial lung diseases. In this review, we summarize the current understanding of the biology of adult circulating progenitors as related to lung disease. PMID:20477275

Mehrad, Borna; Keane, Michael P; Gomperts, Brigitte N; Strieter, Robert M

2007-08-01

172

Animal models of chronic obstructive pulmonary disease  

PubMed Central

The mechanisms involved in the genesis of chronic obstructive pulmonary disease (COPD) are poorly defined. This area is complicated and difficult to model because COPD consists of four separate anatomic lesions (emphysema, small airway remodeling, pulmonary hypertension, and chronic bronchitis) and a functional lesion, acute exacerbation; moreover, the disease in humans develops over decades. This review discusses the various animal models that have been used to attempt to recreate human COPD and the advantages and disadvantages of each. None of the models reproduces the exact changes seen in humans, but cigarette smoke-induced disease appears to come the closest, and genetically modified animals also, in some instances, shed light on processes that appear to play a role. PMID:18456796

Wright, Joanne L.; Cosio, Manuel; Churg, Andrew

2008-01-01

173

[Triple therapy in chronic obstructive pulmonary disease].  

PubMed

Chronic obstructive pulmonary disease (COPD) is one of the most important respiratory diseases, characterized by its multicomponent complexity, with chronic inflammation, increased airway resistance and exacerbations. Several drugs are currently available for its treatment, which act on distinct targets. Bronchodilators, especially prolonged-action bronchodilators, are the most potent and there are two groups: beta-2 mimetics and anticholinergics. Inhaled corticosteroids are the main anti-inflammatory drugs but have modest efficacy and their use is reserved for patients with severe disease and frequent exacerbations and/or asthma traits. Associating these three drugs can improve symptom control, improve quality of life and reduce the number of exacerbations. The present article reviews the evidence supporting this triple combination, as well as published studies. PMID:21334553

Baloira, Adolfo

2010-01-01

174

Occurrence, Transmission, and Zoonotic Potential of Chronic Wasting Disease  

PubMed Central

Chronic wasting disease (CWD) is a fatal, transmissible prion disease that affects captive and free-ranging deer, elk, and moose. Although the zoonotic potential of CWD is considered low, identification of multiple CWD strains and the potential for agent evolution upon serial passage hinders a definitive conclusion. Surveillance for CWD in free-ranging populations has documented a continual geographic spread of the disease throughout North America. CWD prions are shed from clinically and preclinically affected hosts, and CWD transmission is mediated at least in part by the environment, perhaps by soil. Much remains unknown, including the sites and mechanisms of prion uptake in the naive host. There are no therapeutics or effective eradication measures for CWD-endemic populations. Continued surveillance and research of CWD and its effects on cervid ecosystems is vital for controlling the long-term consequences of this emerging disease. PMID:22377159

Saunders, Samuel E.; Bartelt-Hunt, Shannon L.

2012-01-01

175

Blood microvesicles during chronic lymphoproliferative diseases.  

PubMed

The levels of CD19 (+) and CD20(+) microvesicles were estimated in the blood of patients with B-cell chronic lymphocytic leukemia and indolent non-Hodgkin lymphoma by flow cytometry method. It was found that the number of B cell microvesicles is several times higher in patients than in volunteers. The level of CD20 (+) microvesicles directly correlated with the number of CD20(+) lymphocytes in patients with chronic lymphoproliferative diseases. Extramedullary tumors cells can be a source of CD19 (+) microvesicles. PMID:24319739

Domnikova, N P; Dolgikh, T Yu; Sholenberg, E V; Vorontsova, E V; Goreva, O B; Mel'nikova, E V; Gorbachenko, E A; Grishanova, A Yu

2013-11-01

176

Exacerbation of chronic obstructive pulmonary disease.  

PubMed

Acute exacerbations of chronic obstructive pulmonary disease (COPD) are important events in COPD patients and place a large burden on healthcare resources. COPD patients with frequent exacerbations have accelerated decline in lung function, poorer health status and are at higher risk of mortality. The mainstay of treatment includes increasing short acting bronchodilator therapy and systemic glucocorticosteroids with or without antibiotics. Non invasive ventilation is indicated in those with respiratory failure with acidosis or hypercapnia. Preventive strategies to reduce exacerbations include smoking cessation, immunisation against influenza and S. pneumonia, chronic maintenance inhaled pharmacotherapy, pulmonary rehabilitation and self management education. PMID:20527283

Ismail, T S

2009-09-01

177

Health-related quality of life in chronic liver disease: the impact of type and severity of disease  

Microsoft Academic Search

OBJECTIVE:The type and severity of chronic liver disease may have different effects on health-related quality of life (HRQL). The aim of our study was to determine whether HRQL in patients with chronic liver disease differs by type and severity of disease and to identify which clinical and physiological factors affect this impairment.METHODS:In this study, HRQL was measured with a generic

Zobair M. Younossi; Navdeep Boparai; Lori Lyn Price; Michelle L. Kiwi; Marilyn McCormick; Gordon Guyatt

2001-01-01

178

Age-Associated Chronic Diseases Require Age-Old Medicine: Role of Chronic Inflammation  

PubMed Central

Most chronic diseases - such as cancer, cardiovascular disease (CVD), Alzheimer disease, Parkinson disease, arthritis, diabetes and obesity - are becoming leading causes of disability and death all over the world. Some of the most common causes of these age-associated chronic diseases are lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption. All the risk factors linked to these chronic diseases have been shown to up-regulate inflammation. Therefore, downregulation of inflammation-associated risk factors could prevent or delay these age-associated diseases. Although modern science has developed several drugs for treating chronic diseases, most of these drugs are enormously expensive and are associated with serious side effects and morbidity. In this review, we present evidence on how chronic inflammation leads to age-associated chronic disease. Furthermore, we discuss diet and lifestyle as solutions for age-associated chronic disease. PMID:22178471

Prasad, Sahdeo; Sung, Bokyung; Aggarwal, Bharat B.

2012-01-01

179

[Chronic complications of sickle cell disease].  

PubMed

Chronic complications of sickle cell disease take an increasing role in the management of patients due to their morbidity and mortality impact. The prevalence of chronic organ damages increases as the age of patients followed in France. Few organs seem unaffected by the disease. The natural history of chronic complication is highly variable from one patient to another, and the distribution of those manifestations throughout life, is different depending on their nature and pathophysiology. Thus we can, for example, distinguish SS patients presenting a "hyperhemolytic" phenotype associated with dense red blood cells that have a high risk of vascular complications including kidney disease, pulmonary hypertension, leg ulcers and priapism, from SC patients with high hemoglobin levels, who have a higher risk of retinopathy, osteonecrosis and sensory syndrome, probably related to hyperviscosity. Dependent on the age, we could also oppose cerebral vasculopathy responsible of ischemic stroke since childhood, and kidney damage which effects are visible more gradually with aging. Sickle cell disease is one of the most systemic pathologies contrasting with its monogenic characteristic and its inter- and intra-individual variability. A better understanding of pathophysiological mechanisms responsible for those complications is necessary to develop new preventive and therapeutic approaches. PMID:25510140

Bartolucci, Pablo; Lionnet, François

2014-10-01

180

Chronic Kidney Disease-Mineral and Bone Disorder  

MedlinePLUS

... Chronic Kidney Disease-Mineral and Bone Disorder Chronic Kidney Disease-Mineral and Bone Disorder On this page: What ... Research For More Information Acknowledgments What is chronic kidney disease-mineral and bone disorder (CKD-MBD)? CKD-MBD ...

181

Affective cycling in thyroid disease  

SciTech Connect

Depression in an elderly man with primary recurrent unipolar depression responded to radioactive iodine treatment of a thyrotoxic nodule, without the addition of psychotropic medications. Two months later, manic symptoms developed concomitant with the termination of the hyperthyroid state secondary to the radioactive iodine treatment. Clinical implications of these findings in relation to the possible mechanism of action of thyroid hormones on affective cycling are discussed.

Tapp, A.

1988-05-01

182

Oral Disease Profiles in Chronic Graft versus Host Disease.  

PubMed

At least half of patients with chronic graft-versus-host-disease (cGVHD), the leading cause of morbidity and non-relapse mortality after allogeneic stem cell transplantation, have oral manifestations: mucosal lesions, salivary dysfunction, and limited mouth-opening. cGVHD may manifest in a single organ or affect multiple organ systems, including the mouth, eyes, and the skin. The interrelationship of the 3 oral manifestations of cGVHD with each other and with the specific manifestations of extraoral cGVHD has not been studied. In this analysis, we explored, in a large group of patients with cGVHD, the potential associations between: (1) oral mucosal disease and erythematous skin disease, (2) salivary gland dysfunction and lacrimal gland dysfunction, and (3) limited mouth-opening and sclerotic skin cGVHD. Study participants, enrolled in a cGVHD Natural History Protocol (NCT00331968, n = 212), underwent an oral examination evaluating: (1) mucosal cGVHD [NIH Oral Mucosal Score (OMS)], (2) salivary dysfunction (saliva flow and xerostomia), and (3) maximum mouth-opening measurement. Parameters for dysfunction (OMS > 2, saliva flow ? 1 mL/5 min, mouth-opening ? 35 mm) were analyzed for association with skin cGVHD involvement (erythema and sclerosis, skin symptoms), lacrimal dysfunction (Schirmer's tear test, xerophthalmia), Lee cGVHD Symptom Scores, and NIH organ scores. Oral mucosal disease (31% prevalence) was associated with skin erythema (P < 0.001); salivary dysfunction (11% prevalence) was associated with lacrimal dysfunction (P = 0.010) and xerostomia with xerophthalmia (r = 0.32, P = 0.001); and limited mouth-opening (17% prevalence) was associated with skin sclerosis (P = 0.008) and skin symptoms (P = 0.001). There was no association found among these 3 oral cGVHD manifestations. This analysis supports the understanding of oral cGVHD as 3 distinct diseases: mucosal lesions, salivary gland dysfunction, and mouth sclerosis. Clear classification of oral cGVHD as 3 separate manifestations will improve clinical diagnosis, observational research data collection, and the definitions of outcome measures in clinical trials. PMID:25740857

Bassim, C W; Fassil, H; Mays, J W; Edwards, D; Baird, K; Steinberg, S M; Cowen, E W; Naik, H; Datiles, M; Stratton, P; Gress, R E; Pavletic, S Z

2015-04-01

183

Cardiovascular disease and its relationship with chronic kidney disease.  

PubMed

Cardiovascular disease (CVD), the leading cause of death, is mostly precipitated by cardiometabolic risk and chronic kidney disease (CKD). CVD and kidney disease are closely interrelated and disease of one organ cause dysfunction of the other, ultimately leading to the failure of both organs. Patients with end-stage renal disease (ESRD) are at much higher risk of mortality due to CVD. Traditional CVD risk factors viz., hypertension, hyperlipidemia, and diabetes do not account for the high cardiovascular risk in CKD patients and also standard clinical interventions for managing CVD that are successful in the general population, are ineffective to lower the death rate in CKD patients. Nontraditional factors, related to disturbed mineral and vitamin D metabolism were able to provide some explanation in terms of vascular calcification, for the increased risk of CVD in CKD. Fibroblast Growth Factor 23, a bone-derived hormone that regulates vitamin D synthesis in renal proximal tubules and renal phosphate reabsorption, has been suggested to be the missing link between CKD and CVD. Acute Kidney Injury (AKI) is strongly related to the progress of CVD and its early diagnosis and treatment has significant positive effect on the outcomes of CVD in the affected patients. Besides this, non-dialysable protein-bound uraemic toxins such as indoxyl sulfate and p-cresyl sulfate, produced by colonic microbes from dietary amino acids, appear to cause renal dysfunction. Thus, therapeutic approaches targeting colonic microbiota, have led to new prospects in early intervention for CKD patients. Intervention targets for preventing CVD events in CKD patients ideally should include control of blood pressure and dyslipidemia, diabetes mellitus, lowering proteinuria, correction of anemia, management of mineral metabolism abnormalities and life style changes including smoking cessation, decreased consumption of salt, and achievement of normal body mass index. Use of ?-blockers, renin-angiotensin blockers, diuretics, statins, and aspirin are helpful in the early stages of CKD. In this review, we will address the biological, pathological and clinical relationship between CVD and CKD and their therapeutic management. PMID:25339487

Liu, M; Li, X-C; Lu, L; Cao, Y; Sun, R-R; Chen, S; Zhang, P-Y

2014-10-01

184

Severity of chronic Chagas disease is associated with cytokine/antioxidant imbalance in chronically infected individuals  

E-print Network

Severity of chronic Chagas disease is associated with cytokine/antioxidant imbalance in chronically the pathogenic mechanisms in chronic Chagas disease, a major cause of morbidity and mortality in Latin America of Chagas disease is a consequence of a long-term and complex relationship between parasite persistence

Roche, Benjamin

185

Optimizing Chronic Disease Management Mega-Analysis  

PubMed Central

Background As Ontario’s population ages, chronic diseases are becoming increasingly common. There is growing interest in services and care models designed to optimize the management of chronic disease. Objective To evaluate the cost-effectiveness and expected budget impact of interventions in chronic disease cohorts evaluated as part of the Optimizing Chronic Disease Management mega-analysis. Data Sources Sector-specific costs, disease incidence, and mortality were calculated for each condition using administrative databases from the Institute for Clinical Evaluative Sciences. Intervention outcomes were based on literature identified in the evidence-based analyses. Quality-of-life and disease prevalence data were obtained from the literature. Methods Analyses were restricted to interventions that showed significant benefit for resource use or mortality from the evidence-based analyses. An Ontario cohort of patients with each chronic disease was constructed and followed over 5 years (2006–2011). A phase-based approach was used to estimate costs across all sectors of the health care system. Utility values identified in the literature and effect estimates for resource use and mortality obtained from the evidence-based analyses were applied to calculate incremental costs and quality-adjusted life-years (QALYs). Given uncertainty about how many patients would benefit from each intervention, a system-wide budget impact was not determined. Instead, the difference in lifetime cost between an individual-administered intervention and no intervention was presented. Results Of 70 potential cost-effectiveness analyses, 8 met our inclusion criteria. All were found to result in QALY gains and cost savings compared with usual care. The models were robust to the majority of sensitivity analyses undertaken, but due to structural limitations and time constraints, few sensitivity analyses were conducted. Incremental cost savings per patient who received intervention ranged between $15 per diabetic patient with specialized nursing to $10,665 per patient wth congestive heart failure receiving in-home care. Limitations Evidence used to inform estimates of effect was often limited to a single trial with limited generalizability across populations, interventions, and health care systems. Because of the low clinical fidelity of health administrative data sets, intermediate clinical outcomes could not be included. Cohort costs included an average of all health care costs and were not restricted to costs associated with the disease. Intervention costs were based on resource use specified in clinical trials. Conclusions Applying estimates of effect from the evidence-based analyses to real-world resource use resulted in cost savings for all interventions. On the basis of quality-of-life data identified in the literature, all interventions were found to result in a greater QALY gain than usual care would. Implementation of all interventions could offer significant cost reductions. However, this analysis was subject to important limitations. Plain Language Summary Chronic diseases are the leading cause of death and disability in Ontario. They account for a third of direct health care costs across the province. This study aims to evaluate the cost-effectiveness of health care interventions that might improve the management of chronic diseases. The evaluated interventions led to lower costs and better quality of life than usual care. Offering these options could reduce costs per patient. However, the studies used in this analysis were of medium to very low quality, and the methods had many limitations. PMID:24228076

PATH-THETA Collaboration

2013-01-01

186

Chronic obstructive pulmonary disease: an overview.  

PubMed

Chronic obstructive pulmonary disease is a growing healthcare problem that is expected to worsen as the population ages and the worldwide use of tobacco products increases. Smoking cessation is the only effective means of prevention. Employers are in a unique position to help employees stop smoking. During the long asymptomatic phase, lung function nevertheless continues to decline; therefore, many patients seek medical attention only when they are at an advanced stage or when they have experienced an acute exacerbation. To help preserve patients' quality of life and reduce healthcare costs related to this chronic disease, clinicians need to accurately diagnose the condition and appropriately manage patients through the long course of their illness. This article discusses the current approach to patient management. PMID:25126252

Devine, John F

2008-09-01

187

Vascular calcification in chronic kidney disease  

Microsoft Academic Search

Vascular calcification is often encountered in advanced atherosclerotic lesions and is a common consequence of aging. Calcification\\u000a of the coronary arteries has been positively correlated with coronary atherosclerotic plaque burden, increased risk of myocardial\\u000a infarction, and plaque instability. Chronic kidney disease (CKD) patients have two to five times more coronary artery calcification\\u000a than healthy age-matched individuals. Vascular calcification is a

Shuichi Jono; Atsushi Shioi; Yuji Ikari; Yoshiki Nishizawa

2006-01-01

188

Vascular calcification in chronic kidney disease  

Microsoft Academic Search

Dialysis patients have increased cardiovascular morbidity, mortality, and vascular calcification, and the latter appears to impact the former. Recent evidence indicates that vascular calcification is an active, cell-mediated process. Osteoblast differentiation factor Cbfa1 and several bone-associated proteins (osteopontin, bone sialoprotein, alkaline phosphatase, type I collagen) are present in histologic sections of arteries obtained from patients with end-stage renal disease (chronic

Neal X Chen; Sharon M Moe

2004-01-01

189

Invasive Aspergillosis in Chronic Granulomatous Disease  

Microsoft Academic Search

\\u000a Chronic granulomatous disease (CGD) is a rare inherited disorder of the NADPH oxidase complex in which phagocytes are defective\\u000a in generating superoxide anion. NADPH oxidase activation leads to release of sequestered neutrophil granular proteases, which\\u000a are likely the principal antimicrobial effectors. CGD is characterized by recurrent life-threatening bacterial and fungal\\u000a infections and by inflammatory complications such as wound dehiscence, obstructive

Brahm H. Segal; Steven M. Holland

190

Sustainable chronic disease management in remote Australia.  

PubMed

The Sharing Health Care Initiative (SHCI) demonstration project, which aimed to improve management of chronic diseases, was implemented in four small remote communities in the Katherine region which are serviced by the Katherine West Health Board, a remote Aboriginal-community-controlled health organisation in the Northern Territory. We reviewed the project proposal, final report, evaluation reports and transitional funding proposal, and supplemented these with in-depth interviews with key individuals. We determined factors critical to the sustainability of the SHCI project in relation to context, community engagement, systems flexibility and adaptability, the availability and effect of information systems, and the human nature of health care and policy. The project had a significant impact on community awareness of chronic disease and an improvement in clinic processes. We found that a number of interrelated factors promoted sustainability, including: An implementation strategy sufficiently flexible to take account of local conditions; A high level of community engagement; Appropriate timeframes, timing and congruence between national policy and local readiness to implement a chronic disease project; Effective communication between participating organisations; Project champions (key individuals) in participating organisations; Effective use of monitoring and evaluation data; and Adequate and ongoing funding. The absence of a number of these factors, such as poor communication, inhibited sustainability. Other factors could both promote and inhibit. For example, the impact of key individuals was important, but could be idiosyncratic and have negative effects. PMID:16296955

Wakerman, John; Chalmers, Elizabeth M; Humphreys, John S; Clarence, Christine L; Bell, Andrew I; Larson, Ann; Lyle, David; Pashen, Dennis R

2005-11-21

191

Oxidants in Acute and Chronic Lung Disease  

PubMed Central

Oxidants play an important role in homeostatic function, but excessive oxidant generation has an adverse effect on health. The manipulation of Reactive Oxygen Species (ROS) can have a beneficial effect on various lung pathologies. However indiscriminate uses of anti-oxidant strategies have not demonstrated any consistent benefit and may be harmful. Here we propose that nuanced strategies are needed to modulate the oxidant system to obtain a beneficial result in the lung diseases such as Acute Lung Injury (ALI) and Chronic Obstructive Pulmonary Disease (COPD). We identify novel areas of lung oxidant responses that may yield fruitful therapies in the future. PMID:25705575

Mannam, Praveen; Srivastava, Anup; Sugunaraj, Jaya Prakash; Lee, Patty J; Sauler, Maor

2015-01-01

192

Treating patients with chronic obstructive pulmonary disease.  

PubMed

Chronic obstructive pulmonary disease (COPD) is a long-term lung disease characterised by breathlessness, cough and sputum production. Progressively worsening breathlessness for the patient with COPD limits everyday activity, reduces quality of life and increases the risk of premature death. Beyond reducing symptoms and the rate and severity of exacerbations, the aim of treatment is to increase exercise capacity and improve overall health and wellbeing. Nurses have an important role in ensuring advance care planning is implemented for every patient. This article describes the diagnosis, assessment and management of COPD, and includes practical points for patient care. PMID:25351094

Hodson, Matthew; Sherrington, Rebecca

2014-11-01

193

Chronic kidney disease in dogs and cats.  

PubMed

Chronic kidney disease (CKD) occurs commonly in older dogs and cats. Advances in diagnostics, staging, and treatment are associated with increased quality and quantity of life. Dietary modification has been shown to increase survival and quality of life and involves more than protein restriction as diets modified for use with CKD are lower in phosphorous and sodium, potassium and B-vitamin replete, and alkalinizing, and they contain n3-fatty acids. Additionally, recognition and management of CKD-associated diseases such as systemic arterial hypertension, proteinuria, and anemia benefit patients. This article summarizes staging and management of CKD in dogs and cats. PMID:22720808

Bartges, Joseph W

2012-07-01

194

Asthma and Chronic Obstructive Pulmonary Disease (COPD) – Differences and Similarities  

PubMed Central

Bronchial asthma and COPD (chronic obstructive pulmonary disease) are obstructive pulmonary diseases that affected millions of people all over the world. Asthma is a serious global health problem with an estimated 300 million affected individuals. COPD is one of the major causes of chronic morbidity and mortality and one of the major public health problems worldwide. COPD is the fourth leading cause of death in the world and further increases in its prevalence and mortality can be predicted. Although asthma and COPD have many similarities, they also have many differences. They are two different diseases with differences in etiology, symptoms, type of airway inflammation, inflammatory cells, mediators, consequences of inflammation, response to therapy, course. Some similarities in airway inflammation in severe asthma and COPD and good response to combined therapy in both of these diseases suggest that they have some similar patophysiologic characteristics. The aim of this article is to show similarities and differences between these two diseases. Today asthma and COPD are not fully curable, not identified enough and not treated enough and the therapy is still developing. But in future better understanding of pathology, adequate identifying and treatment, may be and new drugs, will provide a much better quality of life, reduced morbidity and mortality of these patients. PMID:23678316

Cukic, Vesna; Lovre, Vladimir; Dragisic, Dejan; Ustamujic, Aida

2012-01-01

195

Chronic beryllium disease: Diagnosis and management  

SciTech Connect

Chronic beryllium disease is predominantly a pulmonary granulomatosis that was originally described in 1946. Symptoms usually include dyspnea and cough. Fever, anorexia, and weight loss are common. Skin lesions are the most common extrathoracic manifestation. Granulomatous hepatitis, hypercalcemia, and kidney stones can also occur. Radiographic and physiologic abnormalities are similar to those in sarcoidosis. While traditionally the pathologic changes included granulomas and cellular interstitial changes, the hallmark of the disease today is the well-formed granuloma. Immunologic studies have demonstrated a cell-mediated response to beryllium that is due to an accumulation of CD4{sup +} T cells at the site of disease activity. Diagnosis depends on the demonstration of pathologic changes (i.e., granuloma) and evidence that the granuloma was caused by a hypersensitivity to beryllium (i.e., positive lung proliferative response to beryllium). Using these criteria, the diagnosis of chronic beryllium disease can now be made before the onset of clinical symptoms. Whether, with early diagnosis, the natural course of this condition will be the same as when it was traditionally diagnosed is not known. Currently, corticosteroids are used to treat patients with significant symptoms or evidence of progressive disease. 21 refs.

Rossman, M.D. [Hospital of the Univ. of Pennsylvania, Philadelphia, PA (United States)

1996-10-01

196

Chronic kidney disease (CKD) in disadvantaged populations  

PubMed Central

Twelve March 2015 will mark the 10th anniversary of World Kidney Day (WKD), an initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort ever mounted to raise awareness among decision-makers and the general public about the importance of kidney disease. Each year WKD reminds us that kidney disease is common, harmful and treatable. The focus of WKD 2015 is on chronic kidney disease (CKD) in disadvantaged populations. This article reviews the key links between poverty and CKD and the consequent implications for the prevention of kidney disease and the care of kidney patients in these populations. PMID:25713703

Garcia-Garcia, Guillermo; Jha, Vivekanand; Tao Li, Philip Kam; Garcia-Garcia, Guillermo; Couser, William G.; Erk, Timur; Zakharova, Elena; Segantini, Luca; Shay, Paul; Riella, Miguel C.; Osafo, Charlotte; Dupuis, Sophie; Kernahan, Charles

2015-01-01

197

Chronic Granulomatous Disease as a Risk Factor for Autoimmune Disease  

PubMed Central

Chronic granulomatous disease (CGD) is characterized by recurrent infections and granuloma formation. In addition, we have observed a number of diverse autoimmune conditions in our CGD population, suggesting that patients with CGD are at an elevated risk for development of autoimmune (AI) disorders. In this report, we describe antiphospholipid syndrome (aPL), recurrent pericardial effusion, juvenile idiopathic arthritis (JIA), IgA nephropathy, cutaneous lupus erythematosus, and autoimmune pulmonary disease in the setting of CGD. The presence and type of autoimmune disease has important treatment implications for patients with CGD. PMID:18823651

De Ravin, Suk See; Naumann, Nora; Cowen, Edward W.; Friend, Julia; Hilligoss, Dianne; Marquesen, Martha; Balow, James E.; Barron, Karyl S.; Turner, Maria L.; Gallin, John I.; Malech, Harry L.

2009-01-01

198

Airway inflammation in chronic obstructive pulmonary disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is an inflammatory airway disease whose incidence and mortality increases every year. It is associated with an abnormal inflammatory response of the lung to toxic particles or gases (usually cigarette smoke). A central role in the pathophysiology has been shown to play a chronic inflammation of the airways that is expressed primarily by hypersecretion of mucus, stenosis of the smaller airways and the establishment of pulmonary emphysema. There is an increasing trend for assessing the inflammatory pattern of inflammatory airway diseases through mediators measured by noninvasive techniques. Markers in biological fluids and exhaled air have been the subject of intense evaluation over the past few years, with some of them reaching their introduction into clinical practice, while others remain as research tools. Of particular interest for the scientific community is the discovery of clinically exploitable biomarkers associated with specific phenotypes of the disease. Studying the effects of therapeutic interventions in these biomarkers may lead to targeted therapy based on phenotype and this is perhaps the future of therapeutics in COPD. PMID:24672691

Angelis, Nikolaos; Porpodis, Konstantinos; Spyratos, Dionysios; Kioumis, Ioannis; Papaiwannou, Antonis; Pitsiou, Georgia; Tsakiridis, Kosmas; Mpakas, Andreas; Arikas, Stamatis; Tsiouda, Theodora; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Argyriou, Michael; Kessisis, George; Zarogoulidis, Konstantinos

2014-01-01

199

Neprilysin inhibition in chronic kidney disease.  

PubMed

Despite current practice, patients with chronic kidney disease (CKD) are at increased risk of progression to end-stage renal disease and cardiovascular events. Neprilysin inhibition (NEPi) is a new therapeutic strategy with potential to improve outcomes for patients with CKD. NEPi enhances the activity of natriuretic peptide systems leading to natriuresis, diuresis and inhibition of the renin-angiotensin system (RAS), which could act as a potentially beneficial counter-regulatory system in states of RAS activation such as chronic heart failure (HF) and CKD. Early NEPi drugs were combined with angiotensin-converting enzyme inhibitors but were associated with unacceptable rates of angioedema and, therefore, withdrawn. However, one such agent (omapatrilat) showed promise of NEP/RAS inhibition in treating CKD in animal models, producing greater reductions in proteinuria, glomerulosclerosis and tubulointerstitial fibrosis compared with isolated RAS inhibition. A new class of drug called angiotensin receptor neprilysin inhibitor (ARNi) has been developed. One such drug, LCZ696, has shown substantial benefits in trials in hypertension and HF. In CKD, HF is common due to a range of mechanisms including hypertension and structural heart disease (including left ventricular hypertrophy), suggesting that ARNi could benefit patients with CKD by both retarding the progression of CKD (hence delaying the need for renal replacement therapy) and reducing the risk of cardiovascular disease. LCZ696 is now being studied in a CKD population. PMID:25140014

Judge, Parminder; Haynes, Richard; Landray, Martin J; Baigent, Colin

2014-08-18

200

The spectrum of disease in chronic traumatic encephalopathy  

PubMed Central

Chronic traumatic encephalopathy is a progressive tauopathy that occurs as a consequence of repetitive mild traumatic brain injury. We analysed post-mortem brains obtained from a cohort of 85 subjects with histories of repetitive mild traumatic brain injury and found evidence of chronic traumatic encephalopathy in 68 subjects: all males, ranging in age from 17 to 98 years (mean 59.5 years), including 64 athletes, 21 military veterans (86% of whom were also athletes) and one individual who engaged in self-injurious head banging behaviour. Eighteen age- and gender-matched individuals without a history of repetitive mild traumatic brain injury served as control subjects. In chronic traumatic encephalopathy, the spectrum of hyperphosphorylated tau pathology ranged in severity from focal perivascular epicentres of neurofibrillary tangles in the frontal neocortex to severe tauopathy affecting widespread brain regions, including the medial temporal lobe, thereby allowing a progressive staging of pathology from stages I–IV. Multifocal axonal varicosities and axonal loss were found in deep cortex and subcortical white matter at all stages of chronic traumatic encephalopathy. TAR DNA-binding protein 43 immunoreactive inclusions and neurites were also found in 85% of cases, ranging from focal pathology in stages I–III to widespread inclusions and neurites in stage IV. Symptoms in stage I chronic traumatic encephalopathy included headache and loss of attention and concentration. Additional symptoms in stage II included depression, explosivity and short-term memory loss. In stage III, executive dysfunction and cognitive impairment were found, and in stage IV, dementia, word-finding difficulty and aggression were characteristic. Data on athletic exposure were available for 34 American football players; the stage of chronic traumatic encephalopathy correlated with increased duration of football play, survival after football and age at death. Chronic traumatic encephalopathy was the sole diagnosis in 43 cases (63%); eight were also diagnosed with motor neuron disease (12%), seven with Alzheimer’s disease (11%), 11 with Lewy body disease (16%) and four with frontotemporal lobar degeneration (6%). There is an ordered and predictable progression of hyperphosphorylated tau abnormalities through the nervous system in chronic traumatic encephalopathy that occurs in conjunction with widespread axonal disruption and loss. The frequent association of chronic traumatic encephalopathy with other neurodegenerative disorders suggests that repetitive brain trauma and hyperphosphorylated tau protein deposition promote the accumulation of other abnormally aggregated proteins including TAR DNA-binding protein 43, amyloid beta protein and alpha-synuclein. PMID:23208308

McKee, Ann C.; Stein, Thor D.; Nowinski, Christopher J.; Stern, Robert A.; Daneshvar, Daniel H.; Alvarez, Victor E.; Lee, Hyo-Soon; Hall, Garth; Wojtowicz, Sydney M.; Baugh, Christine M.; Riley, David O.; Kubilus, Caroline A.; Cormier, Kerry A.; Jacobs, Matthew A.; Martin, Brett R.; Abraham, Carmela R.; Ikezu, Tsuneya; Reichard, Robert Ross; Wolozin, Benjamin L.; Budson, Andrew E.; Goldstein, Lee E.; Kowall, Neil W.; Cantu, Robert C.

2013-01-01

201

The spectrum of disease in chronic traumatic encephalopathy.  

PubMed

Chronic traumatic encephalopathy is a progressive tauopathy that occurs as a consequence of repetitive mild traumatic brain injury. We analysed post-mortem brains obtained from a cohort of 85 subjects with histories of repetitive mild traumatic brain injury and found evidence of chronic traumatic encephalopathy in 68 subjects: all males, ranging in age from 17 to 98 years (mean 59.5 years), including 64 athletes, 21 military veterans (86% of whom were also athletes) and one individual who engaged in self-injurious head banging behaviour. Eighteen age- and gender-matched individuals without a history of repetitive mild traumatic brain injury served as control subjects. In chronic traumatic encephalopathy, the spectrum of hyperphosphorylated tau pathology ranged in severity from focal perivascular epicentres of neurofibrillary tangles in the frontal neocortex to severe tauopathy affecting widespread brain regions, including the medial temporal lobe, thereby allowing a progressive staging of pathology from stages I-IV. Multifocal axonal varicosities and axonal loss were found in deep cortex and subcortical white matter at all stages of chronic traumatic encephalopathy. TAR DNA-binding protein 43 immunoreactive inclusions and neurites were also found in 85% of cases, ranging from focal pathology in stages I-III to widespread inclusions and neurites in stage IV. Symptoms in stage I chronic traumatic encephalopathy included headache and loss of attention and concentration. Additional symptoms in stage II included depression, explosivity and short-term memory loss. In stage III, executive dysfunction and cognitive impairment were found, and in stage IV, dementia, word-finding difficulty and aggression were characteristic. Data on athletic exposure were available for 34 American football players; the stage of chronic traumatic encephalopathy correlated with increased duration of football play, survival after football and age at death. Chronic traumatic encephalopathy was the sole diagnosis in 43 cases (63%); eight were also diagnosed with motor neuron disease (12%), seven with Alzheimer's disease (11%), 11 with Lewy body disease (16%) and four with frontotemporal lobar degeneration (6%). There is an ordered and predictable progression of hyperphosphorylated tau abnormalities through the nervous system in chronic traumatic encephalopathy that occurs in conjunction with widespread axonal disruption and loss. The frequent association of chronic traumatic encephalopathy with other neurodegenerative disorders suggests that repetitive brain trauma and hyperphosphorylated tau protein deposition promote the accumulation of other abnormally aggregated proteins including TAR DNA-binding protein 43, amyloid beta protein and alpha-synuclein. PMID:23208308

McKee, Ann C; Stern, Robert A; Nowinski, Christopher J; Stein, Thor D; Alvarez, Victor E; Daneshvar, Daniel H; Lee, Hyo-Soon; Wojtowicz, Sydney M; Hall, Garth; Baugh, Christine M; Riley, David O; Kubilus, Caroline A; Cormier, Kerry A; Jacobs, Matthew A; Martin, Brett R; Abraham, Carmela R; Ikezu, Tsuneya; Reichard, Robert Ross; Wolozin, Benjamin L; Budson, Andrew E; Goldstein, Lee E; Kowall, Neil W; Cantu, Robert C

2013-01-01

202

Chronic Sorrow in Caregiving Spouses of Patients with Alzheimer's Disease  

Microsoft Academic Search

The article focuses on the concept of chronic sorrow in a sample of individuals with Alzheimer's disease (AD) and their caregiving spouses. A study was designed to determine the long-term grief or chronic sorrow that develops in caregiving spouses and to increase knowledge of the nature of chronic sorrow. Utilizing the Burke Nursing Consortium for Research on Chronic Sorrow questionnaire

Mira Mayer

2001-01-01

203

Mobile Health and Chronic Disease Management: Moving Towards a Holistic Approach  

Microsoft Academic Search

Mobile technologies are anticipated to offer cost effective and efficient information management solutions for the chronic care sector. The increasing incidence of chronic diseases is leading to severe pressure on healthcare services struggling to meet increased demand. Although mobile technical solutions are being developed, there is little understanding of the issues affecting acceptability and sustainability of mobile health initiatives and

Rosemary Stockdale; Tony Norris; Farhaan Mirza

204

Secondary Care Clinic for Chronic Disease: Protocol  

PubMed Central

Background The complexity of chronic disease management activities and the associated financial burden have prompted the development of organizational models, based on the integration of care and services, which rely on primary care services. However, since the institutions providing these services are continually undergoing reorganization, the Centre hospitalier affilié universitaire de Québec wanted to innovate by adapting the Chronic Care Model to create a clinic for the integrated follow-up of chronic disease that relies on hospital-based specialty care. Objective The aim of the study is to follow the project in order to contribute to knowledge about the way in which professional and management practices are organized to ensure better care coordination and the successful integration of the various follow-ups implemented. Methods The research strategy adopted is based on the longitudinal comparative case study with embedded units of analysis. The case study uses a mixed research method. Results We are currently in the analysis phase of the project. The results will be available in 2015. Conclusions The project’s originality lies in its consideration of the macro, meso, and micro contexts structuring the creation of the clinic in order to ensure the integration process is successful and to allow a theoretical generalization of the reorganization of practices to be developed. PMID:25689840

St-Pierre, Michèle; Juneau, Lucille; Legault-Mercier, Samuel; Bernardino, Elizabeth

2015-01-01

205

[Recurrent pyloric stenosis in a 7-year-old child with chronic granulomatous disease].  

PubMed

Hypertrophic pyloric stenosis is a common affection in infants aged 3-8 weeks and typically does not affect older children. We report a case of pyloric stenosis that occurred recurrently at the ages of 3 and 7 years in a boy with X-linked chronic granulomatous disease. We emphasize the inflammatory origin of such stenosis, whose progression was favorable thanks exclusively to drug treatment with corticosteroids. We note that chronic granulomatous disease can affect the entire digestive tract, similar to inflammatory bowel disease in children. PMID:24182666

Perdereau, S; Touzot, F; Robin, L; Hébert, C; Monceaux, F; Dimitrov, G

2013-12-01

206

Chronic kidney disease: considerations for nutrition interventions.  

PubMed

Chronic kidney disease (CKD) is highly prevalent and has major health consequences for patients. Caring for patients with CKD requires knowledge of the food supply, renal pathophysiology, and nutrition-related medications used to work synergistically with diet to control the signs and symptoms of the disease. The nutrition care process and International Dietetic and Nutrition Terminology allow for systematic, holistic, quality care of patients with this complex, progressive disease. Nutrition interventions must be designed with the individual patients needs in mind while prioritizing factors with the largest negative impact on health outcomes and mortality risk. New areas of nutrition treatment are emerging that involve a greater focus on micronutrient needs, the microbiome, and vegetarian-style diets. These interventions may improve outcomes by decreasing inflammation, improving energy and protein delivery, and lowering phosphorus, electrolytes, and fluid retention. PMID:24637245

Steiber, Alison L

2014-05-01

207

Chronic Fatigue Syndrome  

MedlinePLUS

... she had chronic fatigue syndrome. What Is Chronic Fatigue Syndrome? Chronic fatigue syndrome (CFS) is a complicated disease for doctors ... this and CFS. Continue Who Gets CFS? Chronic fatigue syndrome can affect people of all ages and ...

208

Obesity, hypertension, and chronic kidney disease.  

PubMed

Obesity is a major risk factor for essential hypertension, diabetes, and other comorbid conditions that contribute to development of chronic kidney disease. Obesity raises blood pressure by increasing renal tubular sodium reabsorption, impairing pressure natriuresis, and causing volume expansion via activation of the sympathetic nervous system and renin-angiotensin-aldosterone system and by physical compression of the kidneys, especially when there is increased visceral adiposity. Other factors such as inflammation, oxidative stress, and lipotoxicity may also contribute to obesity-mediated hypertension and renal dysfunction. Initially, obesity causes renal vasodilation and glomerular hyperfiltration, which act as compensatory mechanisms to maintain sodium balance despite increased tubular reabsorption. However, these compensations, along with increased arterial pressure and metabolic abnormalities, may ultimately lead to glomerular injury and initiate a slowly developing vicious cycle that exacerbates hypertension and worsens renal injury. Body weight reduction, via caloric restriction and increased physical activity, is an important first step for management of obesity, hypertension, and chronic kidney disease. However, this strategy may not be effective in producing long-term weight loss or in preventing cardiorenal and metabolic consequences in many obese patients. The majority of obese patients require medical therapy for obesity-associated hypertension, metabolic disorders, and renal disease, and morbidly obese patients may require surgical interventions to produce sustained weight loss. PMID:24600241

Hall, Michael E; do Carmo, Jussara M; da Silva, Alexandre A; Juncos, Luis A; Wang, Zhen; Hall, John E

2014-01-01

209

Obesity, hypertension, and chronic kidney disease  

PubMed Central

Obesity is a major risk factor for essential hypertension, diabetes, and other comorbid conditions that contribute to development of chronic kidney disease. Obesity raises blood pressure by increasing renal tubular sodium reabsorption, impairing pressure natriuresis, and causing volume expansion via activation of the sympathetic nervous system and renin–angiotensin–aldosterone system and by physical compression of the kidneys, especially when there is increased visceral adiposity. Other factors such as inflammation, oxidative stress, and lipotoxicity may also contribute to obesity-mediated hypertension and renal dysfunction. Initially, obesity causes renal vasodilation and glomerular hyperfiltration, which act as compensatory mechanisms to maintain sodium balance despite increased tubular reabsorption. However, these compensations, along with increased arterial pressure and metabolic abnormalities, may ultimately lead to glomerular injury and initiate a slowly developing vicious cycle that exacerbates hypertension and worsens renal injury. Body weight reduction, via caloric restriction and increased physical activity, is an important first step for management of obesity, hypertension, and chronic kidney disease. However, this strategy may not be effective in producing long-term weight loss or in preventing cardiorenal and metabolic consequences in many obese patients. The majority of obese patients require medical therapy for obesity-associated hypertension, metabolic disorders, and renal disease, and morbidly obese patients may require surgical interventions to produce sustained weight loss. PMID:24600241

Hall, Michael E; do Carmo, Jussara M; da Silva, Alexandre A; Juncos, Luis A; Wang, Zhen; Hall, John E

2014-01-01

210

[Chronic graft-versus-host disease: a multidisciplinary approach].  

PubMed

Chronic Graft-Versus-Host Disease (GVHD) is a frequent complication of allogeneic hematopoietic cell transplantation. This review article describes recent advances in the classification and treatment of chronic GVHD. PMID:20344918

Servais, S; Willems, E; Beguin, Y; Baron, F

2010-02-01

211

Chronic kidney disease in the neonate.  

PubMed

An increased emphasis has been placed on the early identification of chronic kidney disease (CKD) in the neonatal population, given the long-term health consequences that can accompany this diagnosis. The definition of CKD in neonates and young infants differs from that of children older than 2 years and, if severe, treatment may mandate dialysis with appropriate ethical considerations. Special attention must also be directed to optimal nutrition because of its impact on height, weight, and brain development in the young child experiencing impaired kidney function. There has been steady improvement in patient survival over the last decade. PMID:25155723

Zaritsky, Joshua J; Warady, Bradley A

2014-09-01

212

Chronic Wasting Disease Positive Tissue Bank  

USGS Publications Warehouse

In 2005, the USGS National Wildlife Health Center entered into an agreement with the Wyoming Game and Fish Department and the Department of Veterinary Sciences at the University of Wyoming to produce a collection of positive tissues from cervids intentionally infected with chronic wasting disease. This agreement was facilitated through the University of Wyoming Cooperative Fish and Wildlife Unit. Also, the investigators on this project sampled the animals incrementally over 2 years to show changes over time, and examined tissues from the animals by immunohistochemistry. CWD positive tissues are catalogued by species, sample site and time of infection. These data and more will soon be published.

Wright, Scott D.

2007-01-01

213

Health Technologies for the Improvement of Chronic Disease Management  

PubMed Central

Background As part of ongoing efforts to improve the Ontario health care system, a mega-analysis examining the optimization of chronic disease management in the community was conducted by Evidence Development and Standards, Health Quality Ontario (previously known as the Medical Advisory Secretariat [MAS]). Objective The purpose of this report was to identify health technologies previously evaluated by MAS that may be leveraged in efforts to optimize chronic disease management in the community. Data Sources The Ontario Health Technology Assessment Series and field evaluations conducted by MAS and its partners between January 1, 2006, and December 31, 2011. Review Methods Technologies related to at least 1 of 7 disease areas of interest (type 2 diabetes, coronary artery disease, atrial fibrillation, chronic obstructive pulmonary disease, congestive heart failure, stroke, and chronic wounds) or that may greatly impact health services utilization were reviewed. Only technologies with a moderate to high quality of evidence and associated with a clinically or statistically significant improvement in disease management were included. Technologies related to other topics in the mega-analysis on chronic disease management were excluded. Evidence-based analyses were reviewed, and outcomes of interest were extracted. Outcomes of interest included hospital utilization, mortality, health-related quality of life, disease-specific measures, and economic analysis measures. Results Eleven analyses were included and summarized. Technologies fell into 3 categories: those with evidence for the cure of chronic disease, those with evidence for the prevention of chronic disease, and those with evidence for the management of chronic disease. Conclusions The impact on patient outcomes and hospitalization rates of new health technologies in chronic disease management is often overlooked. This analysis demonstrates that health technologies can reduce the burden of illness; improve patient outcomes; reduce resource utilization intensity; be cost-effective; and be a viable contributing factor to chronic disease management in the community. Plain Language Summary People with chronic diseases rely on the health care system to help manage their illness. Hospital use can be costly, so community-based alternatives are often preferred. Research published in the Ontario Health Technology Assessment Series between 2006 and 2011 was reviewed to identify health technologies that have been effective or cost-effective in helping to manage chronic disease in the community. All technologies identified led to better patient outcomes and less use of health services. Most were also cost-effective. Two technologies that can cure chronic disease and 1 that can prevent chronic disease were found. Eight technologies that can help manage chronic disease were also found. Health technologies should be considered an important part of chronic disease management in the community. PMID:24228075

Nikitovic, M; Brener, S

2013-01-01

214

Oral transmission of chronic wasting disease in captive Shira's moose.  

PubMed

Three captive Shira's moose (Alces alces shirasi) were orally inoculated with a single dose (5 g) of whole-brain homogenate prepared from chronic wasting disease (CWD)-affected mule deer (Odocoileus hemionus). All moose died of causes thought to be other than CWD. Histologic examination of one female moose dying 465 days postinoculation revealed spongiform change in the neuropil, typical of transmissible spongiform encephalopathy. Immunohistochemistry staining for the proteinase-resistant isoform of the prion protein was observed in multiple lymphoid and nervous tissues. Western blot and enzyme-linked immunosorbent assays provided additional confirmation of CWD. These results represent the first report of experimental CWD in moose. PMID:17092895

Kreeger, Terry J; Montgomery, D L; Jewell, Jean E; Schultz, Will; Williams, Elizabeth S

2006-07-01

215

Mass spectrometry in Chronic Kidney Disease research  

PubMed Central

Proteomics has evolved into an invaluable tool for biomedical research and for research on renal diseases. A central player in the proteomic revolution is the mass spectrometer and its application to analyze biological samples. Our need to understand both the identity of proteins and their abundance has led to improvements in mass spectrometers and their ability to analyze complex tryptic peptide mixtures with high sensitivity and high mass accuracy in a high throughput fashion (such as the LTQ-Orbitrap). It should not be surprising that this occurred coincident with dramatic improvements in our understanding chronic kidney disease (CKD), the mechanisms through which CKD progresses and the development of candidate CKD biomarkers. This review attempts to present a basic framework for the operational components of mass spectrometers, basic insight into how they are used in renal research and a discussion of CKD research that was driven by mass spectrometry. PMID:21044768

Merchant, Michael L.

2010-01-01

216

Ghrelin and cachexia in chronic kidney disease.  

PubMed

Ghrelin is a growth hormone (GH) secretagogue and a potent orexigenic factor that stimulates feeding by interacting with hypothalamic feeding-regulatory nuclei. Its multifaceted effects are potentially beneficial as a treatment in human disease states. In both adult and pediatric chronic kidney disease (CKD) patients, decreased appetite plays a major role in wasting, which in turn is linked to morbidity and mortality; wasting has also been linked to high levels of leptin and proinflammatory cytokines. The beneficial effects of ghrelin treatment in CKD are potentially mediated by multiple concurrent actions, including the stimulation of appetite-regulating centers, anti-inflammatory effects, and direct kidney effects. Further evaluation of this appetite-regulating hormone in CKD is needed to confirm previous findings and to determine the underlying mechanisms. PMID:22760416

Suzuki, Hajime; Asakawa, Akihiro; Amitani, Haruka; Nakamura, Norifumi; Inui, Akio

2013-04-01

217

Is chronic traumatic encephalopathy a real disease?  

PubMed

Chronic traumatic encephalopathy (CTE) has received widespread media attention and is treated in the lay press as an established disease, characterized by suicidality and progressive dementia. The extant literature on CTE is reviewed here. There currently are no controlled epidemiological data to suggest that retired athletes are at increased risk for dementia or that they exhibit any type of unique neuropathology. There remain no established clinical or pathological criteria for diagnosing CTE. Despite claims that CTE occurs frequently in retired National Football League (NFL) players, recent studies of NFL retirees report that they have an all-cause mortality rate that is approximately half of the expected rate, and even lower suicide rates. In addition, recent clinical studies of samples of cognitively impaired NFL retirees have failed to identify any unique clinical syndrome. Until further controlled studies are completed, it appears to be premature to consider CTE a verifiable disease. PMID:24412888

Randolph, Christopher

2014-01-01

218

Musculoskeletal Disorders in Chronic Obstructive Pulmonary Disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by airway obstruction and inflammation but also accompanied by several extrapulmonary consequences, such as skeletal muscle weakness and osteoporosis. Skeletal muscle weakness is of major concern, since it leads to poor functional capacity, impaired health status, increased healthcare utilization, and even mortality, independently of lung function. Osteoporosis leads to fractures and is associated with increased mortality, functional decline, loss of quality of life, and need for institutionalization. Therefore, the presence of the combination of these comorbidities will have a negative impact on daily life in patients with COPD. In this review, we will focus on these two comorbidities, their prevalence in COPD, combined risk factors, and pathogenesis. We will try to prove the clustering of these comorbidities and discuss possible preventive or therapeutic strategies. PMID:24783225

Cielen, Nele; Maes, Karen

2014-01-01

219

Chronic Kidney Disease Management: Comparison between Renal Transplant Recipients and Nontransplant Patients with Chronic Kidney Disease  

Microsoft Academic Search

Background\\/Aim: Renal transplant recipients (RTR) and patients with native chronic kidney disease (CKD) have similar complications. It is not known how the management of CKD in RTR differs from that of patients with native CKD. This study compares the management of complications related to CKD between RTR and patients with native CKD. Methods: Cross-sectional study of all RTR with stage

Ayub Akbari; Naser Hussain; Jolanta Karpinski; Greg A. Knoll

2007-01-01

220

RAAS-mediated Redox effects in Chronic Kidney Disease  

PubMed Central

The renin-angiotensin-aldosterone-system (RAAS) is central to the pathogenesis of hypertension, cardiovascular and kidney disease. Emerging evidence support various pathways through which a local renal RAAS can affect kidney function, hypertension, and cardiovascular disease. A prominent mechanism appears to be loss of redox homeostasis and formation of excessive free radicals. Free radicals such as reactive oxygen species (ROS) are necessary in normal physiologic processes including development of nephrons, erythropoeisis and tubular sodium transport. However, loss of redox homeostasis contributes to pro-inflammatory and pro-fibrotic pathways in the kidney that in turn lead to reduced vascular compliance, podocyte pathology and proteinuria. Both blockade of the RAAS and oxidative stress produces salutary effects on hypertension and glomerular filtration barrier injury. Thus, the focus of current research is on understanding the pathophysiology of chronic kidney disease in the context of an elevated RAAS and unbalanced redox mechanisms. PMID:19218092

Nistala, Ravi; Wei, Yongzhong; Sowers, James R; Whaley-Connell, Adam

2009-01-01

221

Chronic Wasting Disease Prions in Elk Antler Velvet  

PubMed Central

Chronic wasting disease (CWD) is a contagious, fatal prion disease of deer and elk that continues to emerge in new locations. To explore the means by which prions are transmitted with high efficiency among cervids, we examined prion infectivity in the apical skin layer covering the growing antler (antler velvet) by using CWD-susceptible transgenic mice and protein misfolding cyclic amplification. Our finding of prions in antler velvet of CWD-affected elk suggests that this tissue may play a role in disease transmission among cervids. Humans who consume antler velvet as a nutritional supplement are at risk for exposure to prions. The fact that CWD prion incubation times in transgenic mice expressing elk prion protein are consistently more rapid raises the possibility that residue 226, the sole primary structural difference between deer and elk prion protein, may be a major determinant of CWD pathogenesis. PMID:19402954

Angers, Rachel C.; Seward, Tanya S.; Napier, Dana; Green, Michael; Hoover, Edward; Spraker, Terry; O’Rourke, Katherine; Balachandran, Aru

2009-01-01

222

Chronic wasting disease prions in elk antler velvet.  

PubMed

Chronic wasting disease (CWD) is a contagious, fatal prion disease of deer and elk that continues to emerge in new locations. To explore the means by which prions are transmitted with high efficiency among cervids, we examined prion infectivity in the apical skin layer covering the growing antler (antler velvet) by using CWD-susceptible transgenic mice and protein misfolding cyclic amplification. Our finding of prions in antler velvet of CWD-affected elk suggests that this tissue may play a role in disease transmission among cervids. Humans who consume antler velvet as a nutritional supplement are at risk for exposure to prions. The fact that CWD prion incubation times in transgenic mice expressing elk prion protein are consistently more rapid raises the possibility that residue 226, the sole primary structural difference between deer and elk prion protein, may be a major determinant of CWD pathogenesis. PMID:19402954

Angers, Rachel C; Seward, Tanya S; Napier, Dana; Green, Michael; Hoover, Edward; Spraker, Terry; O'Rourke, Katherine; Balachandran, Aru; Telling, Glenn C

2009-05-01

223

Chronic obstructive pulmonary disease: NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases.  

PubMed

Chronic obstructive pulmonary disease (COPD) is a complex set of conditions with multiple risk factors, disease mechanisms, and clinical manifestations. These characteristics make primary prevention of COPD challenging. Semantic issues related to prevalent and incident disease (e.g., the use of specific cut points on a continuous range) should not derail development of primary prevention initiatives. Potential targets for COPD prevention occur along the spectrum of disease development. Understanding risk factors early in life, whether specific to COPD or not, allows for study of interventions to optimize lung function at birth and to prolong the lung function plateau, potentially reducing the development of COPD. It is necessary to identify noninvasive ways to screen for early COPD in those at risk before progression to clinically significant disease. Identification of specific COPD subgroups, such as individuals with chronic bronchitis, those with ?1-antitrypsin deficiency, or early radiographic changes with normal spirometry, may offer specific opportunities for primary prevention. A better understanding of why COPD progresses despite smoking cessation is needed. Future research initiatives should also focus on identifying the underlying mechanisms and relevant interventions for nonsmokers with COPD, a currently poorly studied group. Ultimately, preventing the development of COPD will serve to reduce the tremendous burden of this chronic disease worldwide. PMID:24754824

Drummond, M Bradley; Buist, A Sonia; Crapo, James D; Wise, Robert A; Rennard, Stephen I

2014-04-01

224

Insulin resistance and chronic liver disease  

PubMed Central

Increased insulin resistance is frequently associated with chronic liver disease and is a pathophysiological feature of hepatogenous diabetes. Distinctive factors including hepatic parenchymal cell damage, portal-systemic shunting and hepatitis C virus are responsible for the development of hepatogenous insulin resistance/diabetes. Although it remains unclear whether insulin secretion from pancreatic beta cells is impaired as it is in type 2 diabetes, retinopathic and cardiovascular risk is low and major causes of death in cirrhotic patients with diabetes are liver failure, hepatocellular carcinoma and gastrointestinal hemorrhage. Hemoglobin A1c is an inaccurate marker for the assessment and management of hepatogenous diabetes. Moreover, exogenous insulin or sulfonylureas may be harmful because these agents may promote hepatocarcinogenesis. Thus, pathogenesis, cause of death, assessment and therapeutic strategy for hepatogenous insulin resistance/diabetes differ from those for lifestyle-related type 2 diabetes. In this article, we review features of insulin resistance in relationship to chronic liver disease. We also discuss the impact of anti-diabetic agents on interferon treatment and hepatocarcinogenesis. PMID:21731901

Kawaguchi, Takumi; Taniguchi, Eitaro; Itou, Minoru; Sakata, Masahiro; Sumie, Shuji; Sata, Michio

2011-01-01

225

Application of Direct Renin Inhibition to Chronic Kidney Disease  

Microsoft Academic Search

Purpose  Chronic kidney disease has serious implications with a high risk for progressive loss of renal function, increased cardiovascular\\u000a events as well as a substantial financial burden. The renin-angiotensin-aldosterone system (RAAS) is activated in chronic\\u000a kidney disease, especially in diabetes and hypertension, which are the leading causes of chronic kidney disease. Angiotensin\\u000a converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)

Christian W. Mende

2010-01-01

226

Evaluation of chronic kidney disease in chronic heart failure: From biomarkers to arterial renal resistances  

PubMed Central

Chronic kidney disease and its worsening are recurring conditions in chronic heart failure (CHF) which are independently associated with poor patient outcome. The heart and kidney share many pathophysiological mechanisms which can determine dysfunction in each organ. Cardiorenal syndrome is the condition in which these two organs negatively affect each other, therefore an accurate evaluation of renal function in the clinical setting of CHF is essential. This review aims to revise the parameters currently used to evaluate renal dysfunction in CHF with particular reference to the usefulness and the limitations of biomarkers in evaluating glomerular dysfunction and tubular damage. Moreover, it is reported the possible utility of renal arterial resistance index (a parameter associated with abnormalities in renal vascular bed) for a better assesment of kidney disfunction. PMID:25610846

Iacoviello, Massimo; Leone, Marta; Antoncecchi, Valeria; Ciccone, Marco Matteo

2015-01-01

227

Development and Application of Chronic Disease Risk Prediction Models  

PubMed Central

Currently, non-communicable chronic diseases are a major cause of morbidity and mortality worldwide, and a large proportion of chronic diseases are preventable through risk factor management. However, the prevention efficacy at the individual level is not yet satisfactory. Chronic disease prediction models have been developed to assist physicians and individuals in clinical decision-making. A chronic disease prediction model assesses multiple risk factors together and estimates an absolute disease risk for the individual. Accurate prediction of an individual's future risk for a certain disease enables the comparison of benefits and risks of treatment, the costs of alternative prevention strategies, and selection of the most efficient strategy for the individual. A large number of chronic disease prediction models, especially targeting cardiovascular diseases and cancers, have been suggested, and some of them have been adopted in the clinical practice guidelines and recommendations of many countries. Although few chronic disease prediction tools have been suggested in the Korean population, their clinical utility is not as high as expected. This article reviews methodologies that are commonly used for developing and evaluating a chronic disease prediction model and discusses the current status of chronic disease prediction in Korea. PMID:24954311

Oh, Sun Min; Stefani, Katherine M.

2014-01-01

228

Smoking cessation in chronic obstructive pulmonary disease.  

PubMed

Chronic obstructive pulmonary disease (COPD) is increasing in prevalence, and is predicted to become the third leading cause of deaths worldwide by 2020. The precise prevalence of COPD is not known, as many individuals with the disease are left undiagnosed, despite the requirement of only simple spirometry testing for disease detection. The major risk factor for the development of COPD is cigarette smoking, with 90% of deaths from COPD directly attributable to smoking. Therefore smoking cessation is the most effective means of halting or slowing the progress of this disease. This review summarizes and compares the differential characteristics of smokers with COPD vs. those without COPD in relation to their smoking behavior and quitting attempts, and discusses the various strategies that can be used to help patients quit and improve their likelihood of long-term smoking cessation. Of the various behavioral interventions available that can increase the likelihood of smoking cessation, one of the simplest and most effective strategies that physicians can use is simply to advise their patients to quit, particularly if this advice is combined with informing the patients of their "lung age". We also discuss the pharmacologic therapies used to enhance the likelihood of quitting, including nicotine replacement, bupropion SR and varenicline, along with novel nicotine vaccines, which are currently undergoing clinical trials. PMID:19285850

Tashkin, Donald P; Murray, Robert P

2009-07-01

229

Defining Disease Modification in Chronic Obstructive Pulmonary Disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a debilitating condition characterized by airflow limitation that is not fully reversible. It is a major cause of morbidity and mortality and represents substantial economic and social burden throughout the world. A range of interventions has been developed that decrease symptoms and address complications associated with COPD. However, to date few interventions have been unequivocally demonstrated to modify disease progression. Assessment of the potential for interventions to modify disease progression is complicated by the lack of a clear definition of disease modification and disagreement over appropriate markers by which modification should be evaluated. To clarify these issues, a working group of physicians and scientists from the USA, Canada and Europe was convened. The proposed working definition of disease modification resulting from the group discussions was “an improvement in, or stabilization of, structural or functional parameters as a result of reduction in the rate of progression of these parameters which occurs whilst an intervention is applied and may persist even if the intervention is withdrawn”. According to this definition, pharmacologic interventions may be considered disease-modifying if they provide consistent and sustained improvements in structural and functional parameters. Smoking cessation and lung volume reduction surgery would both qualify as disease-modifying interventions. PMID:19811377

Halpin, David M.G.; Tashkin, Donald P.

2009-01-01

230

[Pulmonary hypertension in chronic lung diseases].  

PubMed

Chronic obstructive lung disease (COPD) and diffuse parenchymal lung diseases (DPLD), including idiopathic pulmonary fibrosis (IPF) and sarcoidosis, are associated with a high incidence of pulmonary hypertension (PH), which is linked with exercise limitation and a worse prognosis. Patients with combined pulmonary fibrosis and emphysema (CPFE) are particularly prone to the development of PH. Echocardiography and right heart catheterization are the principal modalities for the diagnosis of COPD and DPLD. For discrimination between group 1 PH patients with concomitant respiratory abnormalities and group 3 PH patients (PH caused by lung disease), patients should be transferred to a center with expertise in both PH and lung diseases for comprehensive evaluation. The task force encompassing the .authors of this article provided criteria for this discrimination and suggested using the following definitions for group 3 patients, as exemplified for COPD, IPF, and CPFE: COPD/IPF/CPFE without PH (mean pulmonary artery pressure [mPAP]<25mmHg); COPD/IPF/CPFE with PH (mPAP25mmHg); PH-COPD, PH-IPF, and PH-CPFE); COPD/IPF/CPFE with severe PH (mPAP 35 mmHg or mPAP 25 mmHg with low cardiac index [CI <2.0.l/min/m2]; severe PH-COPD, severe PH-IPF, and severe PH-CPFE). The "severe PH group" includes only a minority of chronic lung disease patients who are suspected of having strong general vascular abnormalities (remodeling) accompanying the parenchymal disease and with evidence of an exhausted circulatory reserve rather than an exhausted ventilatory reserve underlying the limitation of exercise capacity. Exertional dyspnea disproportionate to pulmonary function tests, low carbon monoxide diffusion capacity, and rapid decline of arterial oxygenation upon exercise are typical clinical features of this subgroup with poor prognosis. Studies evaluating the effect of pulmonary arterial hypertension drugs currently not approved for group 3 PH patients should focus on this severe PH group, and for the time being, these patients should be transferred to expert centers for individualized patient care. (J Am Coll Cardiol 2013;62:D109-16) ©2013 by the American College of Cardiology Foundation. PMID:25697041

Seeger, Werner; Adir, Yochai; Barberà, Joan Albert; Champion, Hunter; Coghlan, John Gerard; Cottin, Vincent; De Marco, Teresa; Galiè, Nazzareno; Ghio, Stefano; Gibbs, Simon; Martinez, Fernando J; Semigran, Marc J; Simonneau, Gerald; Wells, Athol U; Vachiéy, Jean-Luc

2014-10-01

231

Pulmonary hypertension in chronic lung diseases.  

PubMed

Chronic obstructive lung disease (COPD) and diffuse parenchymal lung diseases (DPLD), including idiopathic pulmonary fibrosis (IPF) and sarcoidosis, are associated with a high incidence of pulmonary hypertension (PH), which is linked with exercise limitation and a worse prognosis. Patients with combined pulmonary fibrosis and emphysema (CPFE) are particularly prone to the development of PH. Echocardiography and right heart catheterization are the principal modalities for the diagnosis of COPD and DPLD. For discrimination between group 1 PH patients with concomitant respiratory abnormalities and group 3 PH patients (PH caused by lung disease), patients should be transferred to a center with expertise in both PH and lung diseases for comprehensive evaluation. The task force encompassing the authors of this article provided criteria for this discrimination and suggested using the following definitions for group 3 patients, as exemplified for COPD, IPF, and CPFE: COPD/IPF/CPFE without PH (mean pulmonary artery pressure [mPAP] <25 mm Hg); COPD/IPF/CPFE with PH (mPAP ?25 mm Hg); PH-COPD, PH-IPF, and PH-CPFE); COPD/IPF/CPFE with severe PH (mPAP ?35 mm Hg or mPAP ?25 mm Hg with low cardiac index [CI <2.0 l/min/m(2)]; severe PH-COPD, severe PH-IPF, and severe PH-CPFE). The "severe PH group" includes only a minority of chronic lung disease patients who are suspected of having strong general vascular abnormalities (remodeling) accompanying the parenchymal disease and with evidence of an exhausted circulatory reserve rather than an exhausted ventilatory reserve underlying the limitation of exercise capacity. Exertional dyspnea disproportionate to pulmonary function tests, low carbon monoxide diffusion capacity, and rapid decline of arterial oxygenation upon exercise are typical clinical features of this subgroup with poor prognosis. Studies evaluating the effect of pulmonary arterial hypertension drugs currently not approved for group 3 PH patients should focus on this severe PH group, and for the time being, these patients should be transferred to expert centers for individualized patient care. PMID:24355635

Seeger, Werner; Adir, Yochai; Barberà, Joan Albert; Champion, Hunter; Coghlan, John Gerard; Cottin, Vincent; De Marco, Teresa; Galiè, Nazzareno; Ghio, Stefano; Gibbs, Simon; Martinez, Fernando J; Semigran, Marc J; Simonneau, Gerald; Wells, Athol U; Vachiéry, Jean-Luc

2013-12-24

232

Phylloquinone and vitamin D status: associations with incident chronic kidney disease in the Framingham Offspring Cohort  

Technology Transfer Automated Retrieval System (TEKTRAN)

Cardiovascular risk factors are associated with the development of chronic kidney disease (CKD), and CKD and vascular disease are etiologically linked. Evidence suggests deficiencies of vitamins D and K may adversely affect the cardiovascular system, but data from longitudinal studies are lacking. W...

233

Comorbidity in chronic obstructive pulmonary disease. Related to disease severity?  

PubMed Central

Background and objective Several diseases commonly co-exist with chronic obstructive pulmonary disease (COPD), especially in elderly patients. This study aimed to investigate whether there is an association between COPD severity and the frequency of comorbidities in stable COPD patients. Patients and methods In this multicenter, cross-sectional study, patients with spirometric diagnosis of COPD attended to by internal medicine departments throughout Spain were consecutively recruited by 225 internal medicine specialists. The severity of airflow obstruction was graded using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) and data on demographics, smoking history, comorbidities, and dyspnea were collected. The Charlson comorbidity score was calculated. Results Eight hundred and sixty-six patients were analyzed: male 93%, mean age 69.8 (standard deviation [SD] 9.7) years and forced vital capacity in 1 second 42.1 (SD 17.7)%. Even, the mean (SD) Charlson score was 2.2 (2.2) for stage I, 2.3 (1.5) for stage II, 2.5 (1.6) for stage III, and 2.7 (1.8) for stage IV (P=0.013 between stage I and IV groups), independent predictors of Charlson score in the multivariate analysis were age, smoking history (pack-years), the hemoglobin level, and dyspnea, but not GOLD stage. Conclusion COPD patients attended to in internal medicine departments show high scores of comorbidity. However, GOLD stage was not an independent predictor of comorbidity. PMID:25429213

Echave-Sustaeta, Jose M; Comeche Casanova, Lorena; Cosio, Borja G; Soler-Cataluña, Juan Jose; Garcia-Lujan, Ricardo; Ribera, Xavier

2014-01-01

234

Exploring metabolic dysfunction in chronic kidney disease  

PubMed Central

Impaired kidney function and chronic kidney disease (CKD) leading to kidney failure and end-stage renal disease (ESRD) is a serious medical condition associated with increased morbidity, mortality, and in particular cardiovascular disease (CVD) risk. CKD is associated with multiple physiological and metabolic disturbances, including hypertension, dyslipidemia and the anorexia-cachexia syndrome which are linked to poor outcomes. Specific hormonal, inflammatory, and nutritional-metabolic factors may play key roles in CKD development and pathogenesis. These include raised proinflammatory cytokines, such as interleukin-1 and ?6, tumor necrosis factor, altered hepatic acute phase proteins, including reduced albumin, increased C-reactive protein, and perturbations in normal anabolic hormone responses with reduced growth hormone-insulin-like growth factor-1 axis activity. Others include hyperactivation of the renin-angiotensin aldosterone system (RAAS), with angiotensin II and aldosterone implicated in hypertension and the promotion of insulin resistance, and subsequent pharmacological blockade shown to improve blood pressure, metabolic control and offer reno-protective effects. Abnormal adipocytokine levels including leptin and adiponectin may further promote the insulin resistant, and proinflammatory state in CKD. Ghrelin may be also implicated and controversial studies suggest activities may be reduced in human CKD, and may provide a rationale for administration of acyl-ghrelin. Poor vitamin D status has also been associated with patient outcome and CVD risk and may indicate a role for supplementation. Glucocorticoid activities traditionally known for their involvement in the pathogenesis of a number of disease states are increased and may be implicated in CKD-associated hypertension, insulin resistance, diabetes risk and cachexia, both directly and indirectly through effects on other systems including activation of the mineralcorticoid receptor. Insight into the multiple factors altered in CKD may provide useful information on disease pathogenesis, clinical assessment and treatment rationale such as potential pharmacological, nutritional and exercise therapies. PMID:22537670

2012-01-01

235

[Bronchodilators in chronic obstructive pulmonary disease (COPD)].  

PubMed

Bronchodilators form the foundation of the pharmacotherapy of patients with chronic obstructive pulmonary disease (COPD). Scores of information from numerous large-scale clinical trials, mechanistic differences between classes of bronchodilators, and anti-inflammatory/bronchodilator fixed combinations make the decision what compound primarily to prefer in COPD treatment a challenge. In this review of large, double-blind, clinical trials with anticholinergic drugs, long- and short-acting beta(2)-agonists, xanthines and different application forms and combination of these compounds will be examined for clinical efficacy. The following practical objectives were accepted to define effective disease management: improvement of lung function, physical parameters such as 6-min walking distance, reduction of exacerbation rate and severity, improvement of quality of life and dyspnea score. Based on this review, inhalation therapy with a long-acting bronchodilator such as tiotropium, formoterol or salmeterol is proposed for early treatment algorithm. The combination of an anticholinergic compound and a long-acting bronchodilator may have an additive effect on bronchodilatation. The addition of inhaled corticosteroids is only recommended in stages III and IV. Besides, pharmacotherapy of COPD should always be flanked by smoking prevention programs, and supportive therapy, if indicated in severe disease stages. PMID:15902378

Gillissen, Adrian; Buhl, Roland; Rabe, Klaus Friedrich; Vogelmeier, Claus; Welte, Tobias

2005-05-13

236

[Prevention of chronic obstructive pulmonary disease exacerbations].  

PubMed

Exacerbations of chronic obstructive pulmonary disease (COPD) aggravate disease course, induce increased morbidity and mortality, impair quality of life, and raise the direct costs of COPD. Their prevention is essential and is an integral part of the COPD program defined by French health authorities for the 2005-2010 period. Both pharmacologic and nonpharmacologic approaches have been shown to be effective in preventing exacerbations, but these treatments are still underused and misused. Important nonpharmacologic therapies that directly decrease the risk of exacerbation or hospitalization include smoking cessation, oxygen therapy, pulmonary rehabilitation, and education. Most of the drugs available for long-term management of COPD have significant effects on the frequency of exacerbations: tiotropium and salmeterol, each used alone, as well as fixed combinations of salmeterol/fluticasone or formoterol/budesonide. Tiotropium reduces the frequency of exacerbation in both moderate and severe COPD. Inhaled glucocorticosteroid agents are not recommended alone. They must be prescribed only with a long-acting bronchodilator and only to patients with severe disease and repeated exacerbations. Influenza vaccination is recommended. PMID:18829252

Dusser, Daniel

2008-11-01

237

Addressing health disparities in chronic kidney disease.  

PubMed

According to the official health statistics, Taiwan has the highest prevalence of end stage renal disease (ESRD) in the world. Each year, around 60,000 ESRD patients in Taiwan consume 6% of the national insurance budget for dialysis treatment. The prevalence of chronic kidney disease (CKD) has been climbing during 2008–2012.However, the spatial disparities and clustering of CKD at the public health level have rarely been discussed. The aims of this study are to explore the possible population level risk factors and identify any clusters of CKD, using the national health insurance database.The results show that the ESRD prevalence in females is higher than that in males. ESRD medical expenditure constitutes 87% of total CKD medical expenditure. Pre-CKD and pre-ESRD disease management might slow the progression from CKD to ESRD. After applying ordinary least-squares regression, the percentages of high education status and the elderly in the townships are positively correlated with CKD prevalence. Geographically weighted regression and Local Moran's I are used for identifying the clusters in southern Taiwan. The findings can be important evidence for earlier and targeted community interventions and reducing the health disparities of CKD. PMID:25587608

Chan, Ta-Chien; Fan, I -Chun; Liu, Michael Shi-Yung; Su, Ming-Daw; Chiang, Po-Huang

2014-12-01

238

Addressing health disparities in chronic kidney disease.  

PubMed

According to the official health statistics, Taiwan has the highest prevalence of end stage renal disease (ESRD) in the world. Each year, around 60,000 ESRD patients in Taiwan consume 6% of the national insurance budget for dialysis treatment. The prevalence of chronic kidney disease (CKD) has been climbing during 2008-2012. However, the spatial disparities and clustering of CKD at the public health level have rarely been discussed. The aims of this study are to explore the possible population level risk factors and identify any clusters of CKD, using the national health insurance database. The results show that the ESRD prevalence in females is higher than that in males. ESRD medical expenditure constitutes 87% of total CKD medical expenditure. Pre-CKD and pre-ESRD disease management might slow the progression from CKD to ESRD. After applying ordinary least-squares regression, the percentages of high education status and the elderly in the townships are positively correlated with CKD prevalence. Geographically weighted regression and Local Moran's I are used for identifying the clusters in southern Taiwan. The findings can be important evidence for earlier and targeted community interventions and reducing the health disparities of CKD. PMID:25514144

Chan, Ta-Chien; Fan, I-Chun; Liu, Michael Shi-Yung; Su, Ming-Daw; Chiang, Po-Huang

2014-01-01

239

Sputum myeloperoxidase in chronic obstructive pulmonary disease  

PubMed Central

Background Airway inflammation, especially neutrophilic airway inflammation, is a cardinal pathophysiologic feature in chronic obstructive pulmonary disease (COPD) patients. The ideal biomarkers characterizing the inflammation might have important potential clinical applications in disease assessment and therapeutic intervention. Sputum myeloperoxidase (MPO) is recognized as a marker of neutrophil activity. The purpose of this meta-analysis is to determine whether sputum MPO levels could reflect disease status or be regulated by regular medications for COPD. Methods Studies were identified by searching PubMed, Embase, the Cochrane Database, CINAHL and http://www.controlled-trials.com for relevant reports published before September 2012. Observational studies comparing sputum MPO in COPD patients and healthy subjects or asthmatics, or within the COPD group, and studies comparing sputum MPO before and after treatment were all included. Data were independently extracted by two investigators and analyzed using STATA 10.0 software. Results A total of 24 studies were included in the meta-analysis. Sputum MPO levels were increased in stable COPD patients when compared with normal controls, and this increase was especially pronounced during exacerbations as compared with MPO levels during the stable state. Theophylline treatment was able to reduce MPO levels in COPD patients, while glucocorticoid treatment failed to achieve the same result. Conclusion Sputum MPO might be a promising biomarker for guiding COPD management; however, further investigations are needed to confirm this. PMID:24588870

2014-01-01

240

Addressing Health Disparities in Chronic Kidney Disease  

PubMed Central

According to the official health statistics, Taiwan has the highest prevalence of end stage renal disease (ESRD) in the world. Each year, around 60,000 ESRD patients in Taiwan consume 6% of the national insurance budget for dialysis treatment. The prevalence of chronic kidney disease (CKD) has been climbing during 2008–2012. However, the spatial disparities and clustering of CKD at the public health level have rarely been discussed. The aims of this study are to explore the possible population level risk factors and identify any clusters of CKD, using the national health insurance database. The results show that the ESRD prevalence in females is higher than that in males. ESRD medical expenditure constitutes 87% of total CKD medical expenditure. Pre-CKD and pre-ESRD disease management might slow the progression from CKD to ESRD. After applying ordinary least-squares regression, the percentages of high education status and the elderly in the townships are positively correlated with CKD prevalence. Geographically weighted regression and Local Moran’s I are used for identifying the clusters in southern Taiwan. The findings can be important evidence for earlier and targeted community interventions and reducing the health disparities of CKD. PMID:25514144

Chan, Ta-Chien; Fan, I.-Chun; Liu, Michael Shi-Yung; Su, Ming-Daw; Chiang, Po-Huang

2014-01-01

241

Biodiversity Loss Affects Global Disease Ecology  

NSDL National Science Digital Library

Changes in the type and prevalence of human diseases have occurred during shifts in human social organization, for example, from hunting and gathering to agriculture and with urbanization during the Industrial Revolution. The recent emergence and reemergence of infectious diseases appears to be driven by globalization and ecological disruption. We propose that habitat destruction and biodiversity loss associated with biotic homogenization can increase the incidence and distribution of infectious diseases affecting humans. The clearest connection between biotic homogenization and infectious disease is the spread of nonindigenous vectors and pathogens. The loss of predators and hosts that dilute pathogen transmission can also increase the incidence of vectorborne illnesses. Other mechanisms include enhanced abiotic conditions for pathogens and vectors and higher host-pathogen encounter rates. Improved understanding of these causal mechanisms can inform decisionmaking on biodiversity conservation as an effective way to protect human health.

Montira Pongsiri (US Environmental Protection Agency; Office of the Science Adviser)

2009-12-01

242

Alignment between Chronic Disease Policy and Practice: Case Study at a Primary Care Facility  

PubMed Central

Background Chronic disease is by far the leading cause of death worldwide and of increasing concern in low- and middle-income countries, including South Africa, where chronic diseases disproportionately affect the poor living in urban settings. The Provincial Government of the Western Cape (PGWC) has prioritized the management of chronic diseases and has developed a policy and framework (Adult Chronic Disease Management Policy 2009) to guide and improve the prevention and management of chronic diseases at a primary care level. The aim of this study is to assess the alignment of current primary care practices with the PGWC Adult Chronic Disease Management policy. Methods One comprehensive primary care facility in a Cape Town health district was used as a case study. Data was collected via semi-structured interviews (n?=?10), focus groups (n?=?8) and document review. Participants in this study included clinical staff involved in chronic disease management at the facility and at a provincial level. Data previously collected using the Integrated Audit Tool for Chronic Disease Management (part of the PGWC Adult Chronic Disease Management policy) formed the basis of the guide questions used in focus groups and interviews. Results The results of this research indicate a significant gap between policy and its implementation to improve and support chronic disease management at this primary care facility. A major factor seems to be poor policy knowledge by clinicians, which contributes to an individual rather than a team approach in the management of chronic disease patients. Poor interaction between facility- and community-based services also emerged. A number of factors were identified that seemed to contribute to poor policy implementation, the majority of which were staff related and ultimately resulted in a decrease in the quality of patient care. Conclusions Chronic disease policy implementation needs to be improved in order to support chronic disease management at this facility. It is possible that similar findings and factors are present at other primary care facilities in Cape Town. At a philosophical level, this research highlights the tension between primary health care principles and a diseased-based approach in a primary care setting. PMID:25141191

Draper, Claire A.; Draper, Catherine E.; Bresick, Graham F.

2014-01-01

243

[Chronic kidney disease, new therapeutic approaches].  

PubMed

Despite the use of angiotensin blockers, chronic kidney diseases still progress. New therapeutic approaches aim to strengthen and to complete angiotensin blocker effects. Endothelin receptor antagonists, in addition to angiotensin blockers reduce blood pressure and urinary albumin excretion in diabetic nephropathies but can induce fluid overload. A second therapeutic approach consists in preventing the development of interstitial renal fibrosis which is a prognostic factor of CKD. Transforming growth factor-beta (TGF-beta) plays a major role in this process. Several molecules such as pirfenidone, microARN are in development to block TGF-beta or its downstream signaling pathways. Another approach aims to promote resolution of inflammation and renal repair Interesting experimental results were obtained with tyrosine kinase inhibitors and with methyl of bardoxolone in humans. PMID:22335071

Boffa, Jean-Jacques; Dussaule, Jean-Claude; Ronco, Pierre; Chatziantoniou, Christos

2012-01-01

244

Chronic Beryllium Disease Prevention Program Report  

SciTech Connect

This document describes how Lawrence Livermore National Laboratory (LLNL) meets the requirements and management practices of federal regulation 10 CFR 850, 'Chronic Beryllium Disease Prevention Program (CBDPP).' This revision of the LLNL CBDPP incorporates clarification and editorial changes based on lessons learned from employee discussions, observations and reviews of Department of Energy (DOE) Complex and commercial industry beryllium (Be) safety programs. The information is used to strengthen beryllium safety practices at LLNL, particularly in the areas of: (1) Management of small parts and components; and (2) Communication of program status to employees. Future changes to LLNL beryllium activities and on-going operating experience will be incorporated into the program as described in Section S, 'Performance Feedback.'

Lee, S

2012-03-29

245

Endothelin system & its antagonism in chronic kidney disease   

E-print Network

Since its discovery in 1988 the powerful vasoconstrictor endothelin-1 (ET-1) has been widely implicated in the pathophysiology of chronic kidney disease (CKD) as well as the cardiovascular disease with which it is ...

Dhaun, Neeraj

2012-06-30

246

Chronic Respiratory Diseases of School-Age Children  

ERIC Educational Resources Information Center

The author examines the problems of chronic respiratory disease in school-age children from a medical viewpoint, including recognition and diagnosis, commonly encountered diseases, their effect on participation in physical exercise, emotional factors, medication, and emergency care. (MB)

McGovern, John P.

1976-01-01

247

Chronic kidney disease: supporting at-risk and diagnosed patients.  

PubMed

Aysha Mendes discusses the effects of chronic kidney disease and points out the indispensable role that community nurses can play in terms of prevention, diagnosis, treatment and helping patients to live with the disease. PMID:25651285

Mendes, Aysha

2015-02-01

248

Cardiovascular disease in chronic kidney disease. A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO)  

Microsoft Academic Search

Cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) is high, and the presence of CKD worsens outcomes of cardiovascular disease (CVD). CKD is associated with specific risk factors. Emerging evidence indicates that the pathology and manifestation of CVD differ in the presence of CKD. During a clinical update conference convened by the Kidney Disease: Improving Global Outcomes

Charles A Herzog; Richard W Asinger; Alan K Berger; David M Charytan; Javier Díez; Robert G Hart; Kai-Uwe Eckardt; Bertram L Kasiske; Peter A McCullough; Rod S Passman; Stephanie S DeLoach; Patrick H Pun; Eberhard Ritz

2011-01-01

249

A Preliminary Investigation of Affective Interaction in Chronic Pain Couples  

PubMed Central

The objective of this preliminary study was to examine the extent to which affective marital interaction related to depressive symptoms in persons with chronic pain and their spouses and to pain severity in persons with pain. Couples from the community completed self-report surveys and engaged in a videotaped conversation on a topic of mutual disagreement that was coded for three affect types (i.e., anger/contempt, sadness, humor). Humor was positively related to marital satisfaction in both partners. Spouse anger/contempt and sadness were positively related to depressive symptoms in spouses. Several significant interaction effects between couple pain status (i.e., whether one or both partners reported pain) and affect also emerged. Specifically, sadness in the participant designated as the person with pain was associated with greater depressive symptoms and pain severity when only he or she reported pain whereas sadness was related to fewer depressive symptoms and less pain severity when both partners reported pain. The relationships between spouse anger and spouse depressive symptoms and between spouse humor and pain severity in the person with pain were also moderated by couple pain status. These exploratory findings can be interpreted in light of emotion regulation and pain empathy theories. For example, partners who have not experienced pain themselves may fail to empathize with persons in pain, thus preventing effective emotion regulation. When both spouses report chronic pain, expressions of negative affect may instead promote emotion regulation because the affect is experienced with a spouse who may be more empathetic. PMID:17521810

Johansen, Ayna Beate; Cano, Annmarie

2007-01-01

250

Collagenolytic matrix metalloproteinases in chronic obstructive lung disease and cancer.  

PubMed

Chronic obstructive pulmonary disease (COPD) and lung cancer result in significant morbidity and mortality worldwide. In addition to the role of environmental smoke exposure in the development of both diseases, recent epidemiological studies suggests a connection between the development of COPD and lung cancer. Furthermore, individuals with concomitant COPD and cancer have a poor prognosis when compared with individuals with lung cancer alone. The modulation of molecular pathways activated during emphysema likely lead to an increased susceptibility to lung tumor growth and metastasis. This review summarizes what is known in the literature examining the molecular pathways affecting matrix metalloproteinases (MMPs) in this process as well as external factors such as smoke exposure that have an impact on tumor growth and metastasis. Increased expression of MMPs provides a unifying link between lung cancer and COPD. PMID:25664615

Woode, Denzel; Shiomi, Takayuki; D'Armiento, Jeanine

2015-01-01

251

Bioactive Nutritional Supplements for Chronic Kidney Disease: Potential Cost Benefits  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a 1. \\u000a \\u000a \\u000a Chronic kidney disease (CKD) affects approximately 10–15% of the adult population in industrialized countries and the incidence\\u000a of CKD, and its associated end stage kidney disease, are increasing each year.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a 2. \\u000a \\u000a \\u000a Renal replacement therapies are already a significant cost to health systems internationally, and this is expected to increase.\\u000a \\u000a \\u000a \\u000a \\u000a 3. \\u000a \\u000a \\u000a There could be significant benefits through sensible use of

Glenda C. Gobe; Robert G. Fassett; Jeff S. Coombes

252

Medicines for Early Stage Chronic Kidney Disease: A Review of the Research for Adults with Kidney Disease and Diabetes ....  

MedlinePLUS

... Summary – Oct. 11, 2012 Medicines for Early Stage Chronic Kidney Disease: A Review of the Research for Adults With ... gov/ckd.cfm . Understanding Your Condition What is chronic kidney disease? Chronic kidney disease (CKD) is a condition in ...

253

Chronic Disease Management: A Definition And Systematic Approach To Component Interventions  

Microsoft Academic Search

The burden of chronic diseases is tremendous, and traditional methods of healthcare delivery are unsuitable for addressing these needs. Chronic disease management has emerged as a new strategy for chronic disease care, but a consistent definition has not been utilized. Our objective is to present an operational definition of chronic disease management. Based on prior systematic reviews of chronic disease

Susan L. Norris; Russell E. Glasgow; Michael M. Engelgau; Patrick J. OConnor; David McCulloch

2003-01-01

254

Current trends in pharmacy benefit designs: a threat to disease management in chronic complex diseases.  

PubMed

With a focus on those patients who are candidates for treatment with biologic agents, we review the impact that current pharmacy benefit trends have on patients with chronic complex diseases and how they affect opportunities for disease management in this unique patient population. Dramatic increases in health care costs have led to a variety of strategies to manage cost. Many of these strategies either limit access to care or increase the patient's responsibility for choosing and paying for care, especially for medications. These strategies have a disproportionate impact on patients with chronic complex diseases, particularly those who require the use of biologic medications. A fundamental prerequisite of disease management has been coverage of disease-modifying therapies. If current pharmacy benefit trends continue, unintended consequences will likely occur including lost opportunities for disease management. Current pharmacy benefit trends could adversely impact disease management, particularly for patients requiring the use of biologic agents. Health plans should consider innovative benefit designs that reflect an appropriate level of cost sharing across all key stake-holders, ensuring appropriate access to needed therapies. Additional research is needed to clarify the value of newer approaches to therapies or benefit design changes. PMID:17444792

Owens, Gary; Emons, Matthew F; Christian-Herman, Jennifer; Lawless, Grant

2007-04-01

255

Arterial stiffness in chronic kidney disease: causes and consequences  

Microsoft Academic Search

Chronic kidney disease is associated with elevated cardiovascular risk, and heart failure and arrhythmias are the biggest causes of cardiovascular death in this population. Increased arterial stiffness is a hallmark of chronic kidney disease and is associated with adverse alterations in cardiac structure and function that may predispose to an increased risk of cardiovascular death. These changes are already apparent

Colin D Chue; Jonathan N Townend; Richard P Steeds; Charles J Ferro

2010-01-01

256

Pesticides and human chronic diseases: Evidences, mechanisms, and perspectives  

SciTech Connect

Along with the wide use of pesticides in the world, the concerns over their health impacts are rapidly growing. There is a huge body of evidence on the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson, Alzheimer, and amyotrophic lateral sclerosis (ALS), birth defects, and reproductive disorders. There is also circumstantial evidence on the association of exposure to pesticides with some other chronic diseases like respiratory problems, particularly asthma and chronic obstructive pulmonary disease (COPD), cardiovascular disease such as atherosclerosis and coronary artery disease, chronic nephropathies, autoimmune diseases like systemic lupus erythematous and rheumatoid arthritis, chronic fatigue syndrome, and aging. The common feature of chronic disorders is a disturbance in cellular homeostasis, which can be induced via pesticides' primary action like perturbation of ion channels, enzymes, receptors, etc., or can as well be mediated via pathways other than the main mechanism. In this review, we present the highlighted evidence on the association of pesticide's exposure with the incidence of chronic diseases and introduce genetic damages, epigenetic modifications, endocrine disruption, mitochondrial dysfunction, oxidative stress, endoplasmic reticulum stress and unfolded protein response (UPR), impairment of ubiquitin proteasome system, and defective autophagy as the effective mechanisms of action. - Highlights: ? There is a link between exposure to pesticides and incidence of chronic diseases. ? Genotoxicity and proteotoxicity are two main involved mechanisms. ? Epigenetic knowledge may help diagnose the relationships. ? Efficient policies on safe use of pesticides should be set up.

Mostafalou, Sara; Abdollahi, Mohammad, E-mail: Mohammad.Abdollahi@UToronto.Ca

2013-04-15

257

Prevalence of Chronic Diseases in Adolescents with Intellectual Disability  

ERIC Educational Resources Information Center

Valid community-based data on the prevalence of chronic diseases in adolescents (12-18 years) with intellectual disability (ID-adolescents) are scarce. The aim of this study was to assess the prevalence rates and the nature of chronic diseases in a population of ID-adolescents and to compare them with the rates among adolescents in the general…

Oeseburg, B.; Jansen, D. E. M. C.; Dijkstra, G. J.; Groothoff, J. W.; Reijneveld, S. A.

2010-01-01

258

Correction of Anemia with Epoetin Alfa in Chronic Kidney Disease  

Microsoft Academic Search

Background Anemia, a common complication of chronic kidney disease, usually develops as a consequence of erythropoietin deficiency. Recombinant human erythropoietin (epoetin alfa) is indicated for the correction of anemia associated with this condition. However, the optimal level of hemoglobin correction is not defined. Methods In this open-label trial, we studied 1432 patients with chronic kidney disease, 715 of whom were

Ajay K. Singh; Lynda Szczech; Kezhen L. Tang; Huiman Barnhart; Shelly Sapp; Marsha Wolfson; Donal Reddan

2006-01-01

259

CHRONIC EXPOSURE TO OZONE CAUSES RESTRICTIVE LUNG DISEASE  

EPA Science Inventory

A chronic study to determine the progression and or/reversibility of ozone-induced lung disease was conducted. ale rats were exposed to a diurnal pattern of ozone (O3) for 1 wk, 3 wk, 3 mo, 12 mo, or 18 mo. he occurrence of chronic lung disease was determined by structural and fu...

260

Skeletal Disproportion in Children with Chronic Renal Disease  

Microsoft Academic Search

Objectives: To assess stature and skeletal disproportion in children with chronic renal disease. Methods: Cross-sectional study of height (HT), sitting height (SH), subischial leg length (SILL), sitting height\\/height ratio (SH:HT) and disproportion score (SH SDS minus SILL SDS) in 56 children (M:35) with median age 11.4 years (range 4.5,18.7) with chronic renal disease. Results: There were 19 children with chronic

Nadia Qayyum; Lolita Alcocer; Heather Maxwell; T. James Beattie; Anna V. Murphy; Ian J. Ramage; S. Faisal Ahmed

2003-01-01

261

Can radioiodine be administered effectively and safely to a patient with severe chronic kidney disease?  

PubMed

Chronic kidney disease is an increasingly widespread problem. The progression of renal failure is associated with the development of various hormonal disorders, including those affecting the thyroid gland. The prevalence of multinodular goitre and differentiated thyroid cancer increases significantly in patients with renal failure. However, radioiodine treatment in patients with severe chronic kidney disease gives rise to a number of difficulties. The only conclusions regarding this treatment thus far have been derived from single case studies. It seems that prospective controlled studies can contribute to the creation of standards for radioiodine treatment in patients with various stages of chronic kidney disease, while maintaining the safety of such treatment for both patients and medical staff. This review gives the response to the question how nowadays to treat the patients with severe chronic kidney disease with radioiodine. PMID:24766441

Saracyn, Marek; Bilski, Marek; Kami?ski, Grzegorz; Niemczyk, Stanis?aw

2014-08-01

262

Asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS): current literature review  

PubMed Central

Asthma and chronic obstructive pulmonary disease (COPD) are chronic diseases, very common in general population. These obstructive airway illnesses are manifested with chronic inflammation affecting the whole respiratory tract. Obstruction is usually intermittent and reversible in asthma, but is progressive and irreversible in COPD. Asthma and COPD may overlap and converge, especially in older people [overlap syndrome—asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS)]. Although ACOS accounts approximately 15-25% of the obstructive airway diseases, is not well recognised because of the structure of clinical trials. COPD studies exclude asthma patients and asthma studies exclude COPD patients, respectively. It is crucial to define asthma, COPD and overlap syndrome (ACOS), as notable clinical entities, which they share common pathologic and functional features, but they are characterized from differences in lung function, acute exacerbations, quality of life, hospital impact and mortality. PMID:24672688

Papaiwannou, Antonis; Porpodis, Konstantinos; Spyratos, Dionysios; Kioumis, Ioannis; Pitsiou, Georgia; Pataka, Athanasia; Tsakiridis, Kosmas; Arikas, Stamatis; Mpakas, Andreas; Tsiouda, Theodora; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Siminelakis, Stavros; Kolettas, Alexander; Kessis, George; Beleveslis, Thomas; Zarogoulidis, Konstantinos

2014-01-01

263

Burden of Chronic Respiratory Diseases (CRD) in Middle East and North Africa (MENA).  

PubMed

Chronic respiratory diseases involve a heterogenous group of diseases, including, chronic obstructive pulmonary disease (COPD), asthma, sleep apnea syndrome, pulmonary hypertension, and many occupational diseases. They affect more than one billion people worldwide. Their medical, social, and economic impacts are heavy, especially in developing countries such as Middle East and North Africa countries, where they represent a public health problem. They are essentially represented by COPD, asthma, and allergic diseases. Chronic respiratory diseases are increasing in frequency, morbidity, and mortality. In addition, their economic and social impact is increasing rapidly in this region. Main risk factors are represented by tobacco smoking and exposure to biomass fuel. Smoking prevention and standardized management programs for asthma and COPD are now available but prompt actions are needed to make them more effective in this region and thus avoid an adverse impact on national economic development. PMID:23283069

Ben Abdallah, F Chermiti; Taktak, S; Chtourou, A; Mahouachi, R; Kheder, Ali Ben

2011-01-01

264

Vitamin D and chronic kidney disease  

PubMed Central

Chronic kidney disease (CKD) has been recognized as a significant global health problem because of the increased risk of total and cardiovascular morbidity and mortality. Vitamin D deficiency or insufficiency is common in patients with CKD, and serum levels of vitamin D appear to have an inverse correlation with kidney function. Growing evidence has indicated that vitamin D deficiency may contribute to deteriorating renal function, as well as increased morbidity and mortality in patients with CKD. Recent studies have suggested that treatment with active vitamin D or its analogues can ameliorate renal injury by reducing fibrosis, apoptosis, and inflammation in animal models; this treatment also decreases proteinuria and mortality in patients with CKD. These renoprotective effects of vitamin D treatment are far beyond its classical role in the maintenance of bone and mineral metabolism, in addition to its pleiotropic effects on extra-mineral metabolism. In this review, we discuss the altered metabolism of vitamin D in kidney disease, and the potential renoprotective mechanisms of vitamin D in experimental and clinical studies. In addition, issues regarding the effects of vitamin D treatment on clinical outcomes are discussed. PMID:25045287

Kim, Chang Seong

2014-01-01

265

Chronic obstructive pulmonary disease: definition and epidemiology.  

PubMed

Chronic obstructive pulmonary disease (COPD) continues to cause a heavy health and economic burden in the United States and around the world. Some of the risk factors for COPD are well known and include smoking, occupational exposures, air pollution, airway hyperresponsiveness, asthma, and certain genetic variations, although many questions remain, such as why < 20% of smokers develop substantial airway obstruction. There are several different definitions of COPD and the definitions depend on accurate diagnosis. Small differences in the definition can have large effects on the estimates of COPD in the population. In addition, newer measures, such as functional status or exercise capability, have emerged as important in determining the prognosis of COPD patients. Furthermore, evidence continues to emerge that COPD represents several different disease processes, with potentially different interventions required. In most of the world COPD prevalence and mortality are still increasing and will probably continue to rise in response to increases in smoking, particularly by women and adolescents. Resources aimed at smoking cessation and prevention, COPD education, early detection, and better treatment will be of the most benefit in our continuing efforts against this important cause of morbidity and mortality. PMID:14651759

Mannino, David M

2003-12-01

266

Chronic kidney disease in acute coronary syndromes  

PubMed Central

Chronic kidney disease (CKD) is associated with a high burden of coronary artery disease. In patients with acute coronary syndromes (ACS), CKD is highly prevalent and associated with poor short- and long-term outcomes. Management of patients with CKD presenting with ACS is more complex than in the general population because of the lack of well-designed randomized trials assessing therapeutic strategies in such patients. The almost uniform exclusion of patients with CKD from randomized studies evaluating new targeted therapies for ACS, coupled with concerns about further deterioration of renal function and therapy-related toxic effects, may explain the less frequent use of proven medical therapies in this subgroup of high-risk patients. However, these patients potentially have much to gain from conventional revascularization strategies used in the general population. The objective of this review is to summarize the current evidence regarding the epidemiology and the clinical and prognostic relevance of CKD in ACS patients, in particular with respect to unresolved issues and uncertainties regarding recommended medical therapies and coronary revascularization strategies. PMID:24175251

Marenzi, Giancarlo; Cabiati, Angelo; Assanelli, Emilio

2012-01-01

267

Molecular diagnosis of chronic granulomatous disease  

PubMed Central

Patients with chronic granulomatous disease (CGD) suffer from recurrent, life-threatening bacterial and fungal infections of the skin, the airways, the lymph nodes, liver, brain and bones. Frequently found pathogens are Staphylococcus aureus, Aspergillus species, Klebsiella species, Burkholderia cepacia and Salmonella species. CGD is a rare (?1:250 000 births) disease caused by mutations in any one of the five components of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in phagocytes. This enzyme generates superoxide and is essential for intracellular killing of pathogens by phagocytes. Molecular diagnosis of CGD involves measuring NADPH oxidase activity in phagocytes, measuring protein expression of NADPH oxidase components and mutation analysis of genes encoding these components. Residual oxidase activity is important to know for estimation of the clinical course and the chance of survival of the patient. Mutation analysis is mandatory for genetic counselling and prenatal diagnosis. This review summarizes the different assays available for the diagnosis of CGD, the precautions to be taken for correct measurements, the flow diagram to be followed, the assays for confirmation of the diagnosis and the determinations for carrier detection and prenatal diagnosis. PMID:24016250

Roos, D; Boer, M

2014-01-01

268

Molecular diagnosis of chronic granulomatous disease.  

PubMed

Patients with chronic granulomatous disease (CGD) suffer from recurrent, life-threatening bacterial and fungal infections of the skin, the airways, the lymph nodes, liver, brain and bones. Frequently found pathogens are Staphylococcus aureus, Aspergillus species, Klebsiella species, Burkholderia cepacia and Salmonella species. CGD is a rare (?1:250?000 births) disease caused by mutations in any one of the five components of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in phagocytes. This enzyme generates superoxide and is essential for intracellular killing of pathogens by phagocytes. Molecular diagnosis of CGD involves measuring NADPH oxidase activity in phagocytes, measuring protein expression of NADPH oxidase components and mutation analysis of genes encoding these components. Residual oxidase activity is important to know for estimation of the clinical course and the chance of survival of the patient. Mutation analysis is mandatory for genetic counselling and prenatal diagnosis. This review summarizes the different assays available for the diagnosis of CGD, the precautions to be taken for correct measurements, the flow diagram to be followed, the assays for confirmation of the diagnosis and the determinations for carrier detection and prenatal diagnosis. PMID:24016250

Roos, D; de Boer, M

2014-02-01

269

Burden of chronic kidney disease: North Africa.  

PubMed

North Africa (NAF) is composed of six countries located in the African Sahara, namely the Western Sahara, Morocco, Algeria, Tunisia, Libya, and Egypt. Common features between these countries include similar climate, ecology, population genetics, and the socioeconomic environment. This commonality reflects on the chronic kidney disease (CKD) profile in these countries. While there are some estimates on the epidemiology of end-stage kidney disease, that of earlier stages is unknown. Several national screening programs are currently addressing this issue, such as the EGIPT-CKD project in Egypt and the MAREMAR study in Morocco. Preliminary results from the former suggest a prevalence of proteinuria in 10.6% of the relatives of patients on regular dialysis treatment. Despite the lack of reliable registries, it was possible to gather information on the etiology of CKD by direct contact with leading nephrologists in those countries. It turns out that glomerulonephritis (GN) accounts for 9-20%, diabetes 11-18%, hypertensive nephrosclerosis 10-35%, chronic interstitial nephritis 7-17%, and polycystic disease 2-3%. Compared to two decades earlier, diabetes has become more common at the expense of GN, proliferative GN, and amyloidosis regressed in favor of IgA and membranous nephropathies in Tunisian adults. Conventional schistosomal nephropathies are regressing in favor of hepatitis C viral (HCV) nephropathy in Egyptians. Focal segmental glomerulosclerosis is increasing at the expense of proliferative GNs in the region at large. Access to regular dialysis has been optimized during the past decade, with favorable outcomes despite the high incidence of HCV infection, tuberculosis, and protein-calorie malnutrition. Kidney transplantation is available in all NAF countries except the Western Sahara. About 650 transplants are performed annually from live donors, the majority in Egypt, where data from the largest center in Mansoura display a 10-year graft survival of 62%. Many transplants are performed from living unrelated donors, particularly in Egypt, which creates an ethical debate. Legislation for deceased-donor transplantation has been passed successively over the past two decades in Tunisia, Morocco, Algeria, and Egypt, which is expected to reflect quantitatively and qualitatively on the transplantation activity in the near future. PMID:25018981

Barsoum, Rashad S

2013-05-01

270

Moraxella catarrhalis in Chronic Obstructive Pulmonary Disease  

PubMed Central

Rationale: Moraxella catarrhalis is frequently present in the sputum of adults with chronic obstructive pulmonary disease (COPD). Little is known about the role of M. catarrhalis in this common disease. Objective: To elucidate the burden of disease, the dynamics of carriage, and immune responses to M. catarrhalis in COPD. Methods: Prospective cohort study of 104 adults with COPD in an outpatient clinic at the Buffalo Veterans Affairs Medical Center. Measurements: Clinical information, sputum cultures, molecular typing of isolates, and immunoassays to measure antibodies to M. catarrhalis. Main Results: Over 81 months, 104 patients made 3,009 clinic visits, 560 during exacerbations. Molecular typing identified 120 episodes of acquisition and clearance of M. catarrhalis in 50 patients; 57 (47.5%) of the acquisitions were associated with clinical exacerbations. No instances of simultaneous acquisition of a new strain of another pathogen were observed. The duration of carriage of M. catarrhalis was shorter with exacerbations compared with asymptomatic colonization (median, 31.0 vs. 40.4 days; p = 0.01). Reacquisition of the same strain was rare. The intensity of the serum IgG response was greater after exacerbations than asymptomatic colonization (p = 0.009). Asymptomatic colonization was associated with a greater frequency of a sputum IgA response than exacerbation (p = 0.009). Conclusions: M. catarrhalis likely causes approximately 10% of exacerbations of COPD, accounting for approximately 2 to 4 million episodes annually. The organism is cleared efficiently after a short duration of carriage. Patients develop strain-specific protection after clearance of M. catarrhalis from the respiratory tract. PMID:15805178

Murphy, Timothy F.; Brauer, Aimee L.; Grant, Brydon J. B.; Sethi, Sanjay

2005-01-01

271

Hemoglobin Decline in Children with Chronic Kidney Disease: Baseline Results from the Chronic Kidney Disease in Children Prospective Cohort Study  

Microsoft Academic Search

Background and objectives: The level of glomerular filtration rate at which hemoglobin declines in chronic kidney disease is poorly described in the pediatric population. Design, setting, participants, & measurements: This cross-sectional study of North American children with chronic kidney disease examined the association of glomerular filtration rate, determined by the plasma disappearance of iohexol, and hemoglobin concentration. Results: Of the

Jeffrey J. Fadrowski; Christopher B. Pierce; Stephen R. Cole; Marva Moxey-Mims; Bradley A. Warady; Susan L. Furth

272

Effectiveness of innovations in nurse led chronic disease management for patients with chronic obstructive pulmonary disease: systematic review of evidence  

Microsoft Academic Search

Objective To determine the effectiveness of innovations in management of chronic disease involving nurses for patients with chronic obstructive pulmonary disease (COPD). Design Systematic review of randomised controlled trials. Data sources 24 electronic databases searched for English or Dutch language studies published between January 1980 and January 2005. Review methods Included studies described inpatient, outpatient, and community based interventions for

Stephanie J. C. Taylor; Bridget Candy; Rosamund M. Bryar; Jean Ramsay; Hubertus J. M. Vrijhoef; Glenda Esmond; Jadwiga A. Wedzicha; Chris J. Griffiths

2005-01-01

273

Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Cardiovascular Links  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a chronic, progressive lung disease resulting from exposure to cigarette smoke, noxious gases, particulate matter, and air pollutants. COPD is exacerbated by acute inflammatory insults such as lung infections (viral and bacterial) and air pollutants which further accelerate the steady decline in lung function. The chronic inflammatory process in the lung contributes to the extrapulmonary manifestations of COPD which are predominantly cardiovascular in nature. Here we review the significant burden of cardiovascular disease in COPD and discuss the clinical and pathological links between acute exacerbations of COPD and cardiovascular disease. PMID:24724085

Laratta, Cheryl R.; van Eeden, Stephan

2014-01-01

274

Common lung conditions: chronic obstructive pulmonary disease.  

PubMed

The etiology of chronic obstructive pulmonary disease (COPD) is chronic lung inflammation. In the United States, this inflammation most commonly is caused by smoking. COPD is diagnosed when an at-risk patient presents with respiratory symptoms and has irreversible airway obstruction indicated by a forced expiratory volume in 1 second/forced vital capacity ratio of less than 0.7. Management goals for COPD include smoking cessation, symptom reduction, exacerbation reduction, hospitalization avoidance, and improvement of quality of life. Stable patients with COPD who remain symptomatic despite using short-acting bronchodilators should start inhaled maintenance drugs to reduce symptoms and exacerbations, avoid hospitalizations, and improve quality of life. A long-acting anticholinergic or a long-acting beta2-agonist (LABA) can be used for initial therapy; these drugs have fewer adverse effects than inhaled corticosteroids (ICS). If patients remain symptomatic despite monotherapy, dual therapy with a long-acting anticholinergic and a LABA, or a LABA and an ICS, may be beneficial. Triple therapy (ie, a long-acting anticholinergic, a LABA, and an ICS) also is used, but it is unclear if triple therapy is superior to dual therapy. Roflumilast, an oral selective inhibitor of phosphodiesterase 4, is used to manage moderate to severe COPD. Continuous oxygen therapy is indicated for patients with COPD who have severe hypoxemia (ie, PaO2 less than 55 mm Hg or an oxygen saturation less than 88% on room air). Nonpharmacologic strategies also are useful to improve patient outcomes. Pulmonary rehabilitation improves dyspnea and quality of life. Pulmonary rehabilitation after an acute exacerbation reduces hospitalizations and mortality, and improves quality of life and exercise capacity. Smoking cessation is the most effective management strategy for reducing morbidity and mortality in patients with COPD. Lung volume reduction surgery, bullectomy, and lung transplantation are surgical interventions that are appropriate for some patients with COPD. PMID:23767419

Delzell, John E

2013-06-01

275

UPDATE ON FIBROBLAST GROWTH FACTOR 23 IN CHRONIC KIDNEY DISEASE  

PubMed Central

Chronic kidney disease (CKD) is a public health epidemic that affects millions of people worldwide. Presence of CKD predisposes individuals to high risks of end-stage renal disease, cardiovascular disease and premature death. Disordered phosphate homeostasis with elevated circulating levels of fibroblast growth factor 23 (FGF23) is an early and pervasive complication of CKD. CKD is likely the most common cause of chronically elevated FGF23 levels, and the clinical condition in which levels are most markedly elevated. Although increases in FGF23 levels help maintain serum phosphate in the normal range in CKD, prospective studies in populations of pre-dialysis CKD, incident and prevalent end-stage renal disease, and kidney transplant recipients demonstrate that elevated FGF23 levels are independently associated with progression of CKD and development of cardiovascular events and mortality. It was originally thought that these observations were driven by elevated FGF23 acting as a highly sensitive biomarker of toxicity due to phosphate. However, FGF23 itself has now been shown to mediate “off-target,” direct, end-organ toxicity in the heart, which suggests that elevated FGF23 may be a novel mechanism of adverse outcomes in CKD. This report reviews recent advances in FGF23 biology relevant to CKD, the classical effects of FGF23 on mineral homeostasis, and the studies that established FGF23 excess as a biomarker and novel mechanism of cardiovascular disease. The report concludes with a critical review of the effects of different therapeutic strategies targeting FGF23 reduction and how these might be leveraged in a future randomized trial aimed at improving outcomes in CKD. PMID:22622492

Wolf, Myles

2012-01-01

276

Indicators for chronic disease surveillance - United States, 2013.  

PubMed

Chronic diseases are an important public health problem, which can result in morbidity, mortality, disability, and decreased quality of life. Chronic diseases represented seven of the top 10 causes of death in the United States in 2010 (Murphy SL, Xu J, Kochanek KD. Deaths: final data for 2010. Natl Vital Stat Rep 2013;6. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf Adobe PDF file). Chronic diseases and risk factors vary by geographic area such as state and county, where essential public health interventions are implemented. The chronic disease indicators (CDIs) were established in the late 1990s through collaboration among CDC, the Council of State and Territorial Epidemiologists, and the Association of State and Territorial Chronic Disease Program Directors (now the National Association of Chronic Disease Directors) to enable public health professionals and policymakers to retrieve data for chronic diseases and risk factors that have a substantial impact on public health. This report describes the latest revisions to the CDIs, which were developed on the basis of a comprehensive review during 2011-2013. The number of indicators is increasing from 97 to 124, with major additions in systems and environmental indicators and additional emphasis on high-impact diseases and conditions as well as emerging topics. PMID:25578080

Holt, James B; Huston, Sara L; Heidari, Khosrow; Schwartz, Randy; Gollmar, Charles W; Tran, Annie; Bryan, Leah; Liu, Yong; Croft, Janet B

2015-01-01

277

Lipid lowering in liver and chronic kidney disease.  

PubMed

Lipid lowering, particularly with HMG CoA reductase inhibitors ("statins"), reduces the risk of cardiovascular disease. Patients with chronic liver and kidney disease present challenges to the use of lipid medications. In the case of most liver disorders, the concern has been one of safety. There is evidence that most lipid-lowering medications can be used safely in many situations, although large outcomes trials are not available. In contrast, in chronic kidney disease, dosing of lipid medications may require substantial modification depending on creatinine clearance. There are significant alterations in lipid metabolism in chronic kidney disease with concomitant increases in cardiovascular risk. Some data are available on cardiovascular outcomes with dyslipidemia treatment in renal patients. This review will examine lipid physiology and cardiovascular risk in specific liver and kidney diseases and review the evidence for lipid lowering and the use of statin and non-statin therapies in chronic liver and kidney disease. PMID:24840263

Herrick, Cynthia; Litvin, Marina; Goldberg, Anne Carol

2014-06-01

278

10 CFR Appendix A to Part 850 - Chronic Beryllium Disease Prevention Program Informed Consent Form  

Code of Federal Regulations, 2014 CFR

...2014-01-01 false Chronic Beryllium Disease Prevention Program Informed Consent Form...DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Pt. 850, App. A Appendix A to Part 850—Chronic Beryllium Disease Prevention Program Informed Consent...

2014-01-01

279

10 CFR Appendix A to Part 850 - Chronic Beryllium Disease Prevention Program Informed Consent Form  

Code of Federal Regulations, 2013 CFR

...2013-01-01 false Chronic Beryllium Disease Prevention Program Informed Consent Form...DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Pt. 850, App. A Appendix A to Part 850—Chronic Beryllium Disease Prevention Program Informed Consent...

2013-01-01

280

10 CFR Appendix A to Part 850 - Chronic Beryllium Disease Prevention Program Informed Consent Form  

Code of Federal Regulations, 2012 CFR

...2012-01-01 false Chronic Beryllium Disease Prevention Program Informed Consent Form...DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Pt. 850, App. A Appendix A to Part 850—Chronic Beryllium Disease Prevention Program Informed Consent...

2012-01-01

281

10 CFR Appendix A to Part 850 - Chronic Beryllium Disease Prevention Program Informed Consent Form  

Code of Federal Regulations, 2011 CFR

...2011-01-01 false Chronic Beryllium Disease Prevention Program Informed Consent Form...DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Pt. 850, App. A Appendix A to Part 850—Chronic Beryllium Disease Prevention Program Informed Consent...

2011-01-01

282

Autonomic dysfunction in patients with chronic obstructive pulmonary disease (COPD)  

PubMed Central

It has been recognized that chronic obstructive pulmonary disease (COPD) is a systemic disease which has been shown to negatively affect the cardiovascular and autonomic nerve system. The complexity of the physiologic basis by which autonomic dysfunction occurs in patients with COPD is considerable and the knowledge in this field remains elementary. The purpose of this review is to provide an overview of important potential mechanisms which might affect the autonomic nervous system in patients with COPD. This review aims to summarize the basic research in the field of autonomic dysfunction in patients with COPD. In COPD patients the activity of sympathetic nerves may be affected by recurrent hypoxemia, hypercapnia, increased intrathoracic pressure swings due to airway obstruction, increased respiratory effort, systemic inflammation and the use of betasympathomimetics. Furthermore, experimental findings suggest that autonomic dysfunction characterized by a predominance of sympathetic activity can significantly modulate further inflammatory reactions. The exact relationship between autonomic dysfunction and health status in COPD remains to be elucidated. Treatment aimed to restore the sympathovagal balance towards a reduction of resting sympathetic activity may modulate the inflammatory state, and possibly contributes to improved health status in COPD. PMID:22263050

van Gestel, Arnoldus JR; Steier, Joerg

2010-01-01

283

Chronic cerebrospinal venous insufficiency in patients with Ménière's disease.  

PubMed

To analyze the presence of chronic cerebrospinal venous insufficiency parameter and vascular abnormalities, in the internal jugular veins (IJVs) and/or vertebral veins in sitting and supine posture, in patients with Meniere's disease compared to healthy general population. A prospective study on 32 patients affected by definite Ménière was performed from February 2012 to January 2013. All subjects underwent an echo-color Doppler examination of the cerebrospinal venous flow. 21 of the 32 Menieric patients showed a statistically significant reflux in the intracranial veins versus healthy (65.6 vs 25%; P < 0.001). A high prevalence of IJVs stenosis with hemodynamic changes (increased velocity or absence of flow) was observed (66.7 vs 33.3%; P < 0.05). The other parameters considered did not show statistically significant differences among the two groups. The results obtained showed a vascular pattern of cerebrospinal venous system present in patients affected by definite Meniere. This vascular impairment significantly affects the vascular areas more directly involved in the venous drainage of the inner ear. Thus venous stasis may be considered a further pathogenetic mechanism for development of Meniere's disease. PMID:24318422

Filipo, R; Ciciarello, F; Attanasio, G; Mancini, P; Covelli, E; Agati, L; Fedele, F; Viccaro, M

2015-01-01

284

Prevalence of chronic kidney disease in an urban Mexican population  

Microsoft Academic Search

Prevalence of chronic kidney disease in an urban Mexican population.BackgroundThe present study was primarily designed to assess the prevalence of chronic kidney disease in a Mexican urban population residing in Mexico and to evaluate certain biologic and socioeconomic conditions as risk factors for the development of renal disease.MethodsA population-based cross-sectional survey was conducted, which included 3564 patients of either gender

DANTE AMATO; CLETO ALVAREZ-AGUILAR; RUTILA CASTAÑEDA-LIMONES; ERNESTO RODRIGUEZ; MARCELA AVILA-DIAZ; FRANCISCO ARREOLA; ANEL GOMEZ; HIRAM BALLESTEROS; RAQUEL BECERRIL; RAMON PANIAGUA

2005-01-01

285

Fundamental questions about genes, inactivity, and chronic diseases  

Microsoft Academic Search

Booth FW, Lees SJ. Fundamental questions about genes, inactivity, and chronic diseases. Physiol Genomics 28: 146-157, 2007. First pub- lished October 10, 2006; doi:10.1152\\/physiolgenomics.00174.2006.— Currently our society is faced with the challenge of understanding the biological basis for the epidemics of obesity and many chronic diseases, including Type 2 diabetes. Physical inactivity increases the relative risk of coronary artery disease

Frank W. Booth; Simon J. Lees

2006-01-01

286

Parathyroid hormone and growth in chronic kidney disease  

Microsoft Academic Search

Growth failure is common in children with chronic kidney disease, and successful treatment is a major challenge in the management\\u000a of these children. The aetiology is multi-factorial with “chronic kidney disease–metabolic bone disorder” being a key component\\u000a that is particularly difficult to manage. Parathyroid hormone is at the centre of this mineral imbalance, consequent skeletal\\u000a disease and, ultimately, growth failure.

Simon Waller

2011-01-01

287

Chronic Kidney Disease in India: Challenges and Solutions  

Microsoft Academic Search

Chronic diseases have become a major cause of global morbidity and mortality even in developing countries. The burden of chronic kidney disease (CKD) in India cannot be assessed accurately. The approximate prevalence of CKD is 800 per million population (pmp), and the incidence of end-stage renal disease (ESRD) is 150–200 pmp. The most common cause of CKD in population-based studies

S. K. Agarwal; R. K. Srivastava

2009-01-01

288

76 FR 22360 - Notice of Request for Extension of Approval of an Information Collection; Chronic Wasting Disease...  

Federal Register 2010, 2011, 2012, 2013, 2014

...cervid herds known to be affected with chronic wasting disease, contact Dr. Patrice N. Klein, Senior Staff Veterinarian, Ruminant Health Programs, NCAHP, VS, APHIS, 4700 Road Unit 43, Riverdale, MD 20737; (301) 734- 0738. For copies of more...

2011-04-21

289

[Acute bacterial exacerbation of chronic obstructive pulmonary disease and biofilm].  

PubMed

The lower respiratory tract of patients affected by COPD is constantly colonized by pathogenic microrganisms such as H. influenzae, M. catarrhalis and S. pneumoniae. Role of bacterial colonization of big and small airways in patients affected by COPD is still unclear but it is likely to play a role in directly or indirectly maintaining the vicious circle of infection/inflammation. Colonizer pathogens are capable to stimulate mucus production, to alter the ciliary function by inducing dyskinesia and stasis; in addition, they represent a strong stimulus for neutrophils to come in the airways, which release elastase that, in turn, inhibit the mucus-ciliary function. The same pathogens are responsible for epithelial damage and chronic inflammation, by releasing neutrophilic elastase, leading to the damage progression and obstruction. Recent studies have also shown that infection sustained by H. influenzae is not limited to bronchial mucosa, i.e. surface epithelial cells, but that the pathogen is capable to penetrate cells, so spreading the infection in sub-epithelial cellular layers. In addition, the ability to produce biofilm is another possible defence mechanism which allows them to grow and colonise. Such a mechanism could in part explain the lack of response to antimicrobials and contribute to stimulation of parenchymal inflammatory response, the cause of pathological-anatomic damage which occurs in COPD. The impossibility to eradicate chronic infection and bacterial exacerbations of COPD are likely the elements that promt and worsen obstruction, so determining the disease's progression. PMID:19696555

Legnani, Delfino

2009-07-01

290

Does chronic nicotine alter neurotransmitter receptors involved in Parkinson's disease  

SciTech Connect

Cigarette smokers are fewer in number among Parkinson's Disease (PD) patients than among groups of persons who do not have PD. Several hypotheses have been proposed to explain this observation. One which must be tested is the possibility that some pharmacologic agent present in cigarette smoke may interact with some central nervous system component involved in PD. To this end, they have investigated the effect of chronic nicotine administration on receptors for some of the neurotransmitters that are affected in PD. Rats were injected for six weeks with saline or nicotine 0.8 mg/kg S.C., then killed and brains removed and dissected. The binding of (/sup 3/H)-ketanserin to serotonin receptors in frontal cortex and of (/sup 3/H)-domperidone to dopamine receptors in caudate was not affected. However, the binding of (/sup 3/H)-domperidone in nucleus accumbens was altered: the K/sub d/ increased from 0.16 +/- 0.02 nM to 0.61 +/- 0.07 nM, and the B/sub max/ increased from 507 +/- 47 fmol/mg protein to 910 +/- 43 fmol/mg (p < 0.001 for both comparisons). These values are based on three ligand concentrations. Additional studies are in progress to substantiate the data. It is concluded that chronic nicotine administration may alter dopamine receptors in nucleus accumbens.

Reilly, M.A.; Lapin, E.P.; Lajtha, A.; Maker, H.S.

1986-03-05

291

Hypoxia and fibrosis in chronic kidney disease: crossing at pericytes  

PubMed Central

Chronic kidney disease (CKD) is placing an increasing burden on patients and societies because no decisive therapy has been established. Tubulointerstitial lesions accompanied by fibrosis, inflammatory cells, and capillary rarefaction not only characterize, but also aggravate renal dysfunction in CKD. In this setting, renal cells, particularly tubular cells, suffer from hypoxia caused by the imbalance of blood perfusion and oxygen demand despite their adaptive responses represented by upregulation of hypoxia-inducible factors (HIFs). Fibrosis is a pathological state characterized by excess extracellular matrix (ECM) deposition, which is also a hallmark and causative factor of many chronic diseases including CKD. Recent studies have suggested that the dominant origin of ECM-producing myofibroblasts (MFs) may be pericytes, which are indispensable cells for maintaining proper capillary functions, as they wrap capillaries and stabilize them through a fine-tuned interplay with endothelial cells. During fibrosis, pericytes are activated and detach from capillaries before conversion into MFs, which compromises capillaries and worsens hypoxia. We also discuss how hypoxia and HIFs affect fibrogenesis. Given that hypoxia is caused by insufficient angiogenesis and that fibrosis results from pericyte loss, restoration of pericytes should be an intriguing target for overcoming both hypoxia and fibrosis. We propose the deactivation of MFs to recover lost pericytes as a promising therapy for CKD. PMID:25401039

Kawakami, Takahisa; Mimura, Imari; Shoji, Kumi; Tanaka, Tetsuhiro; Nangaku, Masaomi

2014-01-01

292

Chronic obstructive pulmonary disease in Hispanics.  

PubMed

Hispanics are individuals whose ancestry can be traced to Spain and/or areas previously under Spanish control (e.g., Mexico, Puerto Rico). They are a rapidly growing subset of the population of the United States and are quite diverse in their racial ancestry, country of origin, area of residence, socioeconomic status, tobacco use, and access to health care. Current evidence suggests that the prevalence and morbidity of chronic obstructive pulmonary disease (COPD) vary widely among Hispanic-American nations, with similar but limited findings among Hispanic subgroups in the United States. Potential reasons for such variation include differences in racial ancestry and genetic susceptibility, exposure to tobacco smoke and/or biomass smoke, access to health care, and disease management. Future studies of COPD in Hispanics should include large samples of subgroups that are well defined with regard to self-reported ethnicity, country of origin, area of residence, tobacco use, and socioeconomic status. Areas that need to be carefully examined include validation of COPD diagnoses for epidemiologic studies (e.g., by radiologic assessment), COPD in high-risk groups (e.g., Puerto Ricans), impact of biomass smoke (in rural areas) and air pollution (in urban areas) on COPD morbidity, effects of migration and acculturation on COPD prevalence and morbidity among Hispanic subgroups in the United States, development of reference values for spirometry, smoking cessation, and overcoming barriers to management. Public health measures, such as effective smoking prevention and cessation programs, reduction of air pollution and exposure to biomass smoke, and improved access to health care, would help reduce the burden of COPD among Hispanics in the United States and Latin America. PMID:18029789

Brehm, John M; Celedón, Juan C

2008-03-01

293

Cognitive Impairment in Chronic Obstructive Pulmonary Disease  

PubMed Central

Background/Purpose Chronic obstructive pulmonary disease (COPD), especially in severe forms, is commonly associated with multiple cognitive problems. Montreal Cognitive Assessment test (MoCA) is used to detect cognitive impairment evaluating several areas: visuospatial, memory, attention and fluency. Our study aim was to evaluate the impact of stable COPD and exacerbation (AECOPD) phases on cognitive status using MoCA questionnaire. Methods We enrolled 39 patients (pts), smokers with COPD group D (30 stable and 9 in AECOPD) and 13 healthy subjects (control group), having similar level of education and no significant differences regarding the anthropometric measurements. We analyzed the differences in MoCA score between these three groups and also the correlation between this score and inflammatory markers. Results Patients with AECOPD had a significant (p<0.001) decreased MoCA score (14.6±3.4) compared to stable COPD (20.2±2.4) and controls (24.2±5.8). The differences between groups were more accentuated for the language abstraction and attention (p<0.001) and delayed recall and orientation (p<0.001) sub-topics. No significant variance of score was observed between groups regarding visuospatial and naming score (p?=?0.095). The MoCA score was significantly correlated with forced expiratory volume (r?=?0.28) and reverse correlated with C-reactive protein (CRP) (r?=??0.57), fibrinogen (r?=??0.58), erythrocyte sedimentation rate (ESR) (r?=??0.55) and with the partial pressure of CO2 (r?=??0.47). Conclusions According to this study, COPD significantly decreases the cognitive status in advanced and acute stages of the disease. PMID:25033379

Cri?an, Alexandru F.; Oancea, Cristian; Timar, Bogdan; Fira-Mladinescu, Ovidiu; Cri?an, Alexandru; Tudorache, Voicu

2014-01-01

294

Using online health communication to manage chronic sorrow: mothers of children with rare diseases speak.  

PubMed

Families affected by rare disease experience psychosocial reactions similar to families with prevalent chronic diseases. The ability to respond and manage the condition depends on psychosocial factors. This phenomenological study of 16 mothers of children with Alagille syndrome explored their lived experience in using online health communications to manage their chronic sorrow. Data consisted of semi-structured interviews analyzed using techniques described by van Manen. Analysis yielded four essential themes: connectedness, online triggers, empowerment, and seasons of online use contributed to online communication essential to a rare disease community. Findings suggest mothers need emotional support and help accessing appropriate online resources. PMID:25316198

Glenn, Adriana D

2015-01-01

295

[New treatments for chronic obstructive pulmonary disease].  

PubMed

Treatment of chronic obstructive pulmonary disease (COPD) has underwent a very important advance in the last five years. It has been developed a new long-lasting anticholynergic drug, tiotrope bromure, which has been found to improve lung function and exercise capacity and to decrease relapses. Also the combined treatment of long lasting beta 2 adrenergics with inhaled steroids (salmeterol/fluticasone and formoterol/budesonide) has proven similar results. However, the response to these new drugs is not the same in all patients. Individual characteristics such as gravity, degree of bronchial hyperresponsiveness, frequency of relapses, comorbidity, etc will determine the response to several agents. Thus, it is necessary to perform a detailed diagnostic study in COPD patients in order to select the best treatment in an individualized form. In the future, new specific antiinflammatories such as phosphodiesterase 4 inhibitors or agents with a potential action in tissue regeneration could lead to new perspectives, as well as to new questions, in COPD treatment. PMID:15970187

Miravitlles, Marc

2005-06-11

296

Thiazide diuretics in chronic kidney disease.  

PubMed

Widely prevalent in the general population, chronic kidney disease (CKD) is frequently complicated with hypertension. Control of hypertension in this high-risk population is a major modifiable cardiovascular and renal risk factor but often requires multiple medications. Although thiazides are an attractive agent, guidelines have previously recommended against thiazide use in stage 4 CKD. We review the updated guidelines on thiazide use in advanced CKD, the antihypertensive mechanism of thiazides, and the clinical studies of thiazides in CKD. Older uncontrolled studies have shown that metolazone reduces blood pressure in CKD, but more recently small randomized controlled trials of hydrochlorothiazide in CKD have shown significant improvement in mean arterial pressure of 15 mmHg. Two recent uncontrolled studies of chlorthalidone including one that used ambulatory blood pressure monitoring found significant improvements in blood pressure. These findings all suggest that thiazides may be efficacious even in advanced CKD; however, electrolyte abnormalities were common in the studies reviewed so close monitoring is necessary during use. Adequately powered randomized trials are now needed before the routine use of thiazide diuretics in advanced CKD can be recommended. PMID:25749608

Sinha, Arjun D; Agarwal, Rajiv

2015-04-01

297

Degenerative disease affecting the nervous system.  

PubMed

The term "degenerative disease" is one which is rather widely used in relation to the nervous system and yet one which is rarely formally and carefully defined. The term appears to be applied to disorders of the nervous system which often occur in later life and which are of uncertain cause. In the Shorter Oxford Dictionary the word degeneration is defined as "a change of structure by which an organism, or an organ, assumes the form of a lower type". However this is not quite the sense in which the word is applied in human neuropathology, where it is conventional to restrict the use of the word to those organic disorders which are of uncertain or poorly understood cause and in which there is a deterioration or regression in the level of functioning of the nervous system. The concept of degenerative disorder is applied to other organs as well as to the brain, and as disease elsewhere in the body may affect the nervous system, it seems reasonable to include within the topic of degenerative disorder affecting the nervous system those conditions in which the nervous system is involved as a result of primary degenerations in other parts of the body. PMID:25026144

Eadie, M J

1974-03-01

298

2014 National Chronic Kidney Disease Fact Sheet  

MedlinePLUS

... diseases are getting better treatments. Top of Page Cardiovascular disease Having kidney disease increases your chances of also having cardiovascular disease, heart attacks, and strokes. Keeping your blood pressure, ...

299

Chronic Kidney Disease and Sudden Death: Strategies for Prevention  

Microsoft Academic Search

The association between chronic kidney disease and cardiovascular death is accounted for, in part, by higher rates of serious arrhythmias. Research shows an independent relationship between worsened renal function and atrial fibrillation, heart block, ventricular tachycardia, ventricular fibrillation, and asystole. These higher rates also associate with underlying structural heart disease including left ventricular hypertrophy, cardiac fibrosis, valvular disease, and left

Peter A. McCullough; Keisha R. Sandberg

2004-01-01

300

Epidemiology of cardiovascular risk in patients with chronic kidney disease  

Microsoft Academic Search

Background. Chronic kidney disease (CKD) patients are highly prone to cardiovascular disease for a number of reasons. At the time of starting renal replacement treatment, their cardiovascular condition is already severely compromised, suggesting that cardiovascular risk factors begin to operate very early in the progression of CKD. Moreover, those patients reaching end-stage renal disease without cardiovascular abnormalities have a high

Francesco Locatelli; Pietro Pozzoni; Francesca Tentori; Lucia Del Vecchio

2003-01-01

301

A systems view of genetics in chronic kidney disease  

Microsoft Academic Search

A tight interplay of genetic predisposition and environmental factors define the onset and the rate of progression of chronic renal disease. We are seeing a rapid expansion of information about genetic loci associated with kidney function and complex renal disease. However, discovering the functional links that bridge the gap from genetic risk loci to disease phenotype is one of the

Benjamin J Keller; Sebastian Martini; John R Sedor; Matthias Kretzler

2012-01-01

302

Strain Fidelity of Chronic Wasting Disease upon Murine Adaptation  

Microsoft Academic Search

Chronic wasting disease (CWD), a prion disease of deer and elk, is highly prevalent in some regions of North America. The establishment of mouse-adapted CWD prions has proven difficult due to the strong species barrier between mice and deer. Here we report the efficient transmission of CWD to transgenic mice overex- pressing murine PrP. All mice developed disease 500 62

Christina J. Sigurdson; Giuseppe Manco; Petra Schwarz; Pawel Liberski; Edward A. Hoover; Simone Hornemann; Magdalini Polymenidou; Michael W. Miller; Markus Glatzel; Adriano Aguzzi

2006-01-01

303

An Economic Overview of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity. Relatively few pharmacoeconomic studies have been conducted on this disease. This article reviews available information about the utilisation of healthcare resources and cost of care, and the cost or cost effectiveness of therapeutic interventions reported for this disease. Burden-of-illness data indicate that hospital care, medications and oxygen

Hirsch S. Ruchlin; Erik J. Dasbach

2001-01-01

304

Chronic Chagas ’ heart disease – From pathogenesis to treatment regimes1  

E-print Network

Chagas ’ disease, caused by Trypanosoma cruzi infection, was discovered nearly 100 years ago (1909) by the Brazilian physician Carlos Chagas. Chronic Chagas ’ disease is still ranked as the most serious parasitic disease in Latin America. Infected patients remain lifelong parasite carri-ers. With a

Silvia Gilka Munoz-saravia; Annekathrin Haberl; Gerd Wallukat; Ingolf Schimke

305

INTRODUCTION Chronic ocular diseases, such as glaucoma, uveitis,  

E-print Network

; Ocular; Pump; Rabbit eye; Refilling Received 13 July 2009; accepted 01 December 2009 This manuscript192 INTRODUCTION Chronic ocular diseases, such as glaucoma, uveitis, and age-related macular plays a major role in the management of these diseases.2,3 Successful treat- ment of an ocular disease

Meng, Ellis

306

Restoring the renal microvasculature to treat chronic kidney disease  

Microsoft Academic Search

Chronic kidney disease is characterized by progressive loss of the renal microvasculature, which leads to local areas of hypoxia and induction of profibrotic responses, scarring and deterioration of renal function. Revascularization alone might be sufficient to restore kidney function and regenerate the structure of the diseased kidney. For revascularization to be successful, however, the underlying disease process needs to be

Jill T. Norman; Leon G. Fine; David A. Long

2012-01-01

307

Chronic unexplained hypertransaminasemia may be caused by occult celiac disease  

Microsoft Academic Search

In a subset of patients attending liver units, a chronic increase in serum transaminases may remain of undeter- mined cause despite thorough investigations. On the other hand, elevated levels of serum transaminases have been reported in about 40% of adult celiac patients. To evaluate the prevalence of subclinical celiac disease in patients with chronic unexplained hypertransaminasemia in comparison with that

Maria Teresa Bardella; Maurizio Vecchi; Dario Conte; Ersilio Del Ninno; Mirella Fraquelli; Stefania Pacchetti; Eliseo Minola; Marina Landoni; Bruno Mario Cesana; Roberto De Franchis

1999-01-01

308

Chronic Diseases in the Pediatric Age Group. Matrix No. 7.  

ERIC Educational Resources Information Center

This paper briefly outlines current problems associated with chronic diseases in children and youth and provides indications for the types of future research and analysis needed to facilitate the development of solutions. In general, these problems are associated with the following: malignancies, hereditary anemias, cystic fibrosis, other chronic

Katz, Michael

309

Challenges and opportunities in late-stage chronic kidney disease*  

PubMed Central

There is increasing recognition that chronic diseases are a major challenge for health delivery systems and treasuries. These are highly prevalent and costly diseases and frequency is expected to increase greatly as the population of many countries ages. Chronic kidney disease (CKD) has not received the same attention as other chronic diseases such as congestive heart failure; yet, the prevalence and costs of CKD are substantial. Greater recognition and support for CKD may require that the disease no longer be viewed as one continuous disease state. Early CKD stages require less complex care and generate lower costs. In contrast, late-stage CKD is every bit as complex and costly as other major chronic diseases. Health authorities may not recognize and fund CKD care appropriately until late-stage CKD is defined clearly as separate and distinct from earlier stages of disease. In this review, we describe the burden of chronic diseases, consider the challenges and barriers and propose processes to improve late-stage CKD care. In particular, we recommend the need for improved continuity of care, enhanced use of information technology, multidisciplinary care, timely referral to nephrologists, protocol use and improved patient engagement. PMID:25713711

Fishbane, Steven; Hazzan, Azzour D.; Halinski, Candice; Mathew, Anna T.

2015-01-01

310

Obesity, oxidative stress, and fibrosis in chronic kidney disease  

PubMed Central

Obesity in combination with diabetes and hypertension likely is contributing to the increasing incidence of chronic kidney disease (CKD) in the 21st century worldwide and requires novel insights and strategies for treatment. There is an increasing recognition that the kidney has an important role in the complex inter-organ communication that occurs with the development of inflammation and fibrosis with obesity. Inhibition of the adiponectin-AMPK pathway has now become established as a critical pathway regulating both inflammation and pro-fibrotic pathways for both obesity-related kidney disease and diabetic kidney disease. AMPK regulates NF?B activation and is a potent regulator of NADPH oxidases. Nox4 in particular has emerged as a key contribtor to the early inflammation of diabetic kidney disease. AMPK also regulates several transcription factors that contribute to stimulation of the transforming growth factor-beta (TGF-?) system. Another key aspect of AMPK regulation is its control of mammalian target of rapamycin (mTOR) and mitochondrial biogenesis. Inhibition of PGC-1?, the transcriptional co-activator of mitochondrial biogenesis is being recognized as a key pathway that is inhibited in diabetic kidney disease and may be linked to inhibition of mitochondrial function. Translation of this concept is emerging via the field of urine metabolomics, as several metabolites linked to mitochondria are consistently downregulated in human diabetic kidney disease. Further studies to explore the role of AMPK and related energy-sensing pathways will likely lead to a more comprehensive understanding of why the kidney is affected early on and in a progressive manner with obesity and diabetes. PMID:25401040

Sharma, Kumar

2014-01-01

311

Obesity, oxidative stress, and fibrosis in chronic kidney disease.  

PubMed

Obesity in combination with diabetes and hypertension likely is contributing to the increasing incidence of chronic kidney disease (CKD) in the 21st century worldwide and requires novel insights and strategies for treatment. There is an increasing recognition that the kidney has an important role in the complex inter-organ communication that occurs with the development of inflammation and fibrosis with obesity. Inhibition of the adiponectin-AMPK pathway has now become established as a critical pathway regulating both inflammation and pro-fibrotic pathways for both obesity-related kidney disease and diabetic kidney disease. AMPK regulates NF?B activation and is a potent regulator of NADPH oxidases. Nox4 in particular has emerged as a key contribtor to the early inflammation of diabetic kidney disease. AMPK also regulates several transcription factors that contribute to stimulation of the transforming growth factor-beta (TGF-?) system. Another key aspect of AMPK regulation is its control of mammalian target of rapamycin (mTOR) and mitochondrial biogenesis. Inhibition of PGC-1?, the transcriptional co-activator of mitochondrial biogenesis is being recognized as a key pathway that is inhibited in diabetic kidney disease and may be linked to inhibition of mitochondrial function. Translation of this concept is emerging via the field of urine metabolomics, as several metabolites linked to mitochondria are consistently downregulated in human diabetic kidney disease. Further studies to explore the role of AMPK and related energy-sensing pathways will likely lead to a more comprehensive understanding of why the kidney is affected early on and in a progressive manner with obesity and diabetes. PMID:25401040

Sharma, Kumar

2014-11-01

312

Chronic Inflammatory Disease and Osteopathy: A Systematic Review  

PubMed Central

Background Chronic inflammatory diseases (CID) are globally highly prevalent and characterized by severe pathological medical conditions. Several trials were conducted aiming at measuring the effects of manipulative therapies on patients affected by CID. The purpose of this review was to explore the extent to which osteopathic manipulative treatment (OMT) can be benefi-cial in medical conditions also classified as CID. Methods This review included any type of experimental study which enrolled sub-jects with CID comparing OMT with any type of control procedure. The search was conducted on eight databases in January 2014 using a pragmatic literature search approach. Two independent re-viewers conducted study selection and data extraction for each study. The risk of bias was evaluated according to the Cochrane methods. Heterogeneity was assessed and meta-analysis performed where possible. Results 10 studies met the inclusion criteria for this review enrolling 386 subjects. The search identified six RCTs, one laboratory study, one cross-over pilot studies, one observation-al study and one case control pilot study. Results suggest a potential effect of osteopathic medicine on patients with medical pathologies associated with CID (in particular Chronic Obstructive Pul-monary Disease (COPD), Irritable Bowel Syndrome, Asthma and Peripheral Arterial Disease) com-pared to no treatment or sham therapy although data remain elusive. Moreover one study showed possible effects on arthritis rat model. Meta-analysis was performed for COPD studies only show-ing no effect of any type of OMT applied versus control. No major side effects were reported by those receiving OMT. Conclusion The present systematic review showed inconsistent data on the effect of OMT in the treatment of medical conditions potentially associated with CID, however the OMT appears to be a safe approach. Further more robust trials are needed to determine the direction and magnitude of the effect of OMT and to generalize favorable results. PMID:25781621

Cicchitti, Luca; Martelli, Marta; Cerritelli, Francesco

2015-01-01

313

Pulmonary Rehabilitation for Patients With Chronic Pulmonary Disease (COPD)  

PubMed Central

Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Objective The objective of this evidence-based review was to determine the effectiveness and cost-effectiveness of pulmonary rehabilitation in the management of chronic obstructive pulmonary disease (COPD). Technology Pulmonary rehabilitation refers to a multidisciplinary program of care for patients with chronic respiratory impairment that is individually tailored and designed to optimize physical and social performance and autonomy. Exercise training is the cornerstone of pulmonary re

2012-01-01

314

Chronic hypoxia as a mechanism of progression of chronic kidney diseases: from hypothesis to novel therapeutics  

Microsoft Academic Search

In chronic kidney disease, functional impairment correlates with tubulointerstitial fibrosis characterised by inflammation, accumulation of extracellular matrix, tubular atrophy and rarefaction of peritubular capillaries. Loss of the microvasculature implies a hypoxic milieu and suggested an important role for hypoxia when the “chronic hypoxia hypothesis” was proposed a decade ago as an explanation for the progressive nature of fibrosis. Recent data

Leon G Fine; Jill T Norman

2008-01-01

315

Biomarkers of inflammation and progression of chronic kidney disease  

Microsoft Academic Search

Biomarkers of inflammation and progression of chronic kidney disease.BackgroundChronic kidney disease is associated with higher levels of inflammatory biomarkers. Statins have anti-inflammatory properties and may attenuate loss of kidney function. Although inflammation may mediate progressive renal injury, the relation between statin use, markers of inflammation, and the rate of kidney function loss has not been elucidated. We examined the association

MARCELLO TONELLI; FRANK SACKS; MARC PFEFFER; GIAN S JHANGRI; GARY CURHAN

2005-01-01

316

Bilateral versus single lung transplantation for chronic obstructive pulmonary disease  

Microsoft Academic Search

Objective: Traditionally, despite ventilation\\/perfusion mismatch, single lung transplantation has been the mainstay for end-stage chronic obstructive pulmonary disease. We tested the hypothesis that bilateral sequential lung transplantation has better short- and intermediate-term results than single lung transplantation for chronic obstructive pulmonary disease.Methods: One hundred twenty-six consecutive lung transplants have been performed from November 1991 to March 1996. Seventy-six have been

Joseph E. Bavaria; Robert Kotloff; Harold Palevsky; Bruce Rosengard; John R. Roberts; Peter M. Wahl; Nancy Blumenthal; Christine Archer; Larry R. Kaiser

1997-01-01

317

[Vitamins and microelements in patients with chronic kidney disease].  

PubMed

The supply of vitamins and microelements in patients with chronic kidney disease (CKD) is very important and requires special attention. CKD patients presented deficiency of these substances in the diet and in organism, but also excess of fat-soluble vitamins or trace elements is observed. Studies indicate that deficiency of vitamins and antioxidants in diet and also enhanced oxidative stress are cause of many complications for example: accelerated process of arteriosclerosis in patients with chronic kidney disease. PMID:25782215

Ma?gorzewicz, Sylwia; Jankowska, Magdalena; Kaczkan, Ma?gorzata; Czajka, Beata; Rutkowski, Boles?aw

2014-01-01

318

Sex Differences in Survival of Oxygen-dependent Patients with Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Rationale: Chronic obstructive pulmonary disease (COPD) is a lead- ing cause of death worldwide. The prevalence of COPD is rising among women and is approaching that of men, but it is not known if sex affects survival. Objectives: To measure the survival differences between men and women with oxygen-dependent COPD. Methods: We conducted a 7-yr prospective cohort study of 435

Maria-Christina L. Machado; Jerry A. Krishnan; Sonia A. Buist; Andrew L. Bilderback; Guilherme P. Fazolo; Michelle G. Santarosa; William M. Vollmer

2006-01-01

319

Effect of Exacerbation on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Exacerbations occur commonly in patients with moderate or severe chronic obstructive pulmonary disease (COPD) but factors affecting their severity and frequency or effects on quality of life are un- known. We measured daily peak expiratory flow rate (PEFR) and daily respiratory symptoms for 1 yr in 70 COPD patients (52 male, 18 female, mean age ( 6 SD) 67.5 6

TERENCE A. R. SEEMUNGAL; GAVIN C. DONALDSON; ELIZABETH A. PAUL; JANINE C. BESTALL; DONALD J. JEFFRIES; JADWIGA A. WEDZICHA

1998-01-01

320

Reconstitution of bactericidal activity in chronic granulomatous disease cells by glucose-oxidase-containing liposomes  

Microsoft Academic Search

Chronic granulomatous disease (CGD) is an inherited primary immunodeficiency characterized by phagocytes devoid of a functioning nicotinamide adenine dinucle- otide phosphate (NADPH) oxidase. The failure of CGD phagocytes to produce reactive oxygen species (ROS) results in a marked increase in the susceptibility of affected patients to life-threatening bacte- rial and fungal infections. This study in- vestigated whether loading of CGD

Claudia E. Gerber; Gernot Bruchelt; Ulrike B. Falk; Andrea Kimpfler; Oliver Hauschild; Selim Kuci; Thomas Bachi; Dietrich Niethammer; Rolf Schubert

2001-01-01

321

Spirometry Utilization After Hospitalization for Patients With Chronic Obstructive Pulmonary Disease Exacerbations  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the US population. An area of improvement hinges on early detection and proper monitoring. Spirometry is an important interventional tool; its underuse among hospitalized patients with COPD could affect quality of care. This study evaluates spirometry use at the Community Medical Center—Sierra in hospitalized patients with

Natalia B. Volkova; Ann Kodani; Dahlia Hilario; Sipho M. Munyaradzi; Michael W. Peterson

2009-01-01

322

Chronic kidney-disease screening service quality: questionnaire survey research evidence from Taichung city  

Microsoft Academic Search

BACKGROUND: Chronic kidney disease (CKD) is a serious public health problem in Taiwan and the world. The most effective, affordable treatments involve early prevention\\/detection\\/intervention, requiring screening. Successfully implementing CKD programs requires good patient participation, affected by patient perceptions of screening service quality. Service quality improvements can help make such programs more successful. Thus, good tools for assessing service quality perceptions

Deng-Juin Lin; Ya-Hsin Li; Jar-Yuan Pai; Ing-Cheau Sheu; Robert Glen; Ming-Jen Chou; Ching-Yi Lee

2009-01-01

323

High burden and unmet patient needs in chronic kidney disease  

PubMed Central

Chronic kidney disease (CKD) is a complex debilitating condition affecting more than 70 million people worldwide. With the increased prevalence in risk factors such as diabetes, hypertension, and cardiovascular disease in an aging population, CKD prevalence is also expected to increase. Increased awareness and understanding of the overall CKD burden by health care teams (patients, clinicians, and payers) is warranted so that overall care and treatment management may improve. This review of the burden of CKD summarizes available evidence of the clinical, humanistic, and economic burden of CKD and the current unmet need for new treatments and serves as a resource on the overall burden. Across countries, CKD prevalence varies considerably and is dependent upon patient characteristics. The prevalence of risk factors including diabetes, hypertension, cardiovascular disease, and congestive heart failure is noticeably higher in patients with lower estimated glomerular filtration rates (eGFRs) and results in highly complex CKD patient populations. As CKD severity worsens, there is a subsequent decline in patient health-related quality of life and an increased use of health care resources as well as burgeoning costs. With current treatment, nearly half of patients progress to unfavorable renal and cardiovascular outcomes. Although curative treatment that will arrest kidney deterioration is desired, innovative agents under investigation for CKD to slow kidney deterioration, such as atrasentan, bardoxolone methyl, and spherical carbon adsorbent, may offer patients healthier and more productive lives. PMID:23293534

Braun, LeeAnn; Sood, Vipan; Hogue, Susan; Lieberman, Bonnie; Copley-Merriman, Catherine

2012-01-01

324

Burden of chronic obstructive pulmonary disease: healthcare costs and beyond.  

PubMed

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating respiratory condition that leads to significant burden, both medically and financially. It affects millions of people worldwide and causes significant morbidity and mortality. Most detailed information related to its prevalence, morbidity, and mortality comes from high-income countries, but 90% of COPD-related deaths occur in low- and middle-income countries. Cigarette smoking is the main risk factor for developing COPD, but other risk factors do exist and need to be recognized. A majority of morbidity and mortality as well as health care costs occur from acute exacerbations of COPD with a known phenotype of patients being "frequent exacerbators." Health care costs for COPD are not only from treatment of exacerbations, such as hospitalization, but also medication costs for maintenance therapy and outpatient treatment. COPD has been linked with many comorbidities leading to significant burden of disease. The goal of this review is to evaluate the overall burden of disease including prevalence, morbidity, mortality, health care costs, and economic costs. PMID:25562549

May, Sara M; Li, James T C

2015-01-01

325

CFTR gene mutations in isolated chronic obstructive pulmonary disease  

SciTech Connect

In order to identify a possible hereditary predisposition to the development of chronic obstructive pulmonary disease (COPD), we have looked for the presence of cystic fibrosis transmembrane regulator (CFTR) gene DNA sequence modifications in 28 unrelated patients with no signs of cystic fibrosis. The known mutations in Italian CF patients, as well as the most frequent worldwide CF mutations, were investigated. In addition, a denaturing gradient gel electrophoresis analysis of about half of the coding sequence of the gene in 56 chromosomes from the patients and in 102 chromosomes from control individuals affected by other pulmonary diseases and from normal controls was performed. Nine different CFTR gene mutations and polymorphisms were found in seven patients, a highly significant increase over controls. Two of the patients were compound heterozygotes. Two frequent CF mutations were detected: deletion F508 and R117H; two rare CF mutations: R1066C and 3667ins4; and five CF sequence variants: R75Q (which was also described as a disease-causing mutation in male sterility cases due to the absence of the vasa deferentia), G576A, 2736 A{r_arrow}G, L997F, and 3271+18C{r_arrow}T. Seven (78%) of the mutations are localized in transmembrane domains. Six (86%) of the patients with defined mutations and polymorphisms had bronchiectasis. These results indicate that CFTR gene mutations and sequence alterations may be involved in the etiopathogenesis of some cases of COPD.

Pignatti, P.F.; Bombien, C.; Marigo, C. [and others

1994-09-01

326

Management of gouty arthritis in patients with chronic kidney disease.  

PubMed

Chronic kidney disease (CKD) is a comorbid condition that affects, based on recent estimates, between 47% and 54% of patients with gouty arthritis. However, data from randomized controlled trials in patients with gouty arthritis and CKD are limited, and current gouty arthritis treatment guidelines do not address the challenges associated with managing this patient population. Nonsteroidal anti-inflammatory drugs and colchicine are recommended first-line treatments for acute gouty arthritis attacks. However, in patients with CKD, nonsteroidal anti-inflammatory drugs are not recommended because their use can exacerbate or cause acute kidney injury. Also, colchicine toxicity is increased in patients with CKD, and dosage reduction is required based on level of kidney function. Allopurinol, febuxostat, and pegloticase are all effective treatments for controlling elevated uric acid levels after the treatment of an acute attack. However, in patients with CKD, required allopurinol dosage reductions may limit efficacy; pegloticase requires further investigation in this population, and febuxostat has not been studied in patients with creatinine clearance<30 mL/min. This article reviews the risks and benefits associated with currently available pharmacologic agents for the management of acute and chronic gouty arthritis including urate-lowering therapy in patients with CKD. Challenges specific to primary care providers are addressed, including guidance to help them decide when to collaborate with, or refer patients to, rheumatology and nephrology specialists based on the severity of gout and CKD. PMID:22960848

Abdellatif, Abdul A; Elkhalili, Naser

2014-01-01

327

Alteration of the platelet transcriptome in chronic kidney disease  

PubMed Central

SUMMARY Bleeding and thrombotic disorders are major complications affecting patients with chronic kidney disease (CKD). Exposure of circulating platelets to uremic toxins and contact with artificial surfaces during dialysis induce platelet abnormalities and alter the platelet proteome. We hypothesized that these changes may be subsequent to changes in the composition and/or regulation of the platelet transcriptome. In this study, we investigated the circulating platelets of 10 CKD patients (i.e. 5 chronic hemodialysis patients and 5 stage 4 CKD uremic patients) and 5 age- and sex-matched healthy subjects. We observed an alteration of the platelet messenger RNA (mRNA) and microRNA transcriptome in CKD patients. Impaired in uremic platelets, the levels of some mRNAs and of most microRNAs appeared to be corrected by dialysis, which is consistent with a beneficial effect of dialysis and a mRNA regulatory role of platelet microRNAs. Reduced in platelets of uremic patients, phosphatidylcholine transfer protein (PCTP) and WD repeat-containing protein 1 (WDR1) were found to be regulated by microRNAs, the latter of which involving hsa-miR-19b, a microRNA increased in platelets of uremic patients and involved in platelet reactivity. These results suggest that an alteration of microRNA-based mRNA regulatory mechanisms may underlie the platelet response to uremia and entail the development of platelet-related complications in CKD. PMID:22836280

Plé, Hélène; Maltais, Manon; Corduan, Aurélie; Rousseau, Guy; Madore, François; Provost, Patrick

2013-01-01

328

Building an Evidence Base for the Co-Occurrence of Chronic Disease and Psychiatric Distress and Impairment  

PubMed Central

Introduction Mental disorders and chronic diseases have been reported to independently affect half of the US population. The objective of this study was to evaluate the comorbid nature of these conditions. Methods We analyzed data from 39,954 participants from the 2009 California Health Interview Survey who reported both psychological distress and impairment, on the basis of the Kessler 6 and the Sheehan Disability Scale, and 1 or more of 4 chronic diseases (type 2 diabetes, high blood pressure, asthma, heart disease). Weighted and nonweighted multivariable logistic regression were used to investigate the association between psychological distress and impairment and chronic disease, after adjusting for sex, age, race, current smoking, binge drinking in the previous year, moderate physical activity, and body mass index. Results After controlling for covariates in the model, we found a significant dose–response relationship between reported chronic diseases and psychiatric distress and impairment that ranged from 1.50 for 1 reported chronic disease to 4.68 for 4 reported chronic diseases. Conclusion The growing chronic disease burden should be understood clinically in the context of mental health conditions. Further research is needed to identify ways to integrate mental health and chronic disease prevention in primary care. PMID:25340360

Smith, Tyler C.

2014-01-01

329

Chronic Venous Disease (Beyond the Basics)  

MedlinePLUS

... from the surface of the legs to the deep veins and back to the heart; the valves ... is located in the superficial veins or the deep veins. (See "Diagnostic evaluation of chronic venous insufficiency" .) ...

330

Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms  

Microsoft Academic Search

BACKGROUND: Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. AIM: The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare

Carmel M Martin; Chris Peterson; Rowena Robinson; Joachim P Sturmberg

2009-01-01

331

Chronic obstructive pulmonary disease--a treatable disease.  

PubMed

Chronic obstructive pulmonary disease (COPD) is a global health challenge and a leading cause of death worldwide. Several risk factors have been identified, with cigarette smoking being the most important. Diagnostic assessment is based on symptoms, risk of exacerbations and results of lung function testing. A fixed post-bronchodilator ratio for forced expiratory volume in one second to forced expiratory volume (FEV1/FVC) of <0.7 is required to make the diagnosis, and the severity of airflow obstruction defines the grade according to GOLD (Global Strategy for the Diagnosis, Management, and Prevention of COPD). The GOLD strategy makes therapeutic recommendations taking into account the grade, symptomatic assessment and future risk of exacerbations. This review focuses on the therapeutic options for COPD, in accordance with the GOLD strategy. Smoking cessation is the most effective treatment option in all COPD stages. Bronchodilators, namely long-acting antimuscarinic drugs and long-acting beta-agonists, form the mainstay of treatment in COPD. Patients with frequent exacerbations also benefited from the addition of inhaled corticosteroids. Roflumilast is an add-on option for patients with severe COPD. Several controversies are the subject of discussion: (1.) whether pharmacotherapy can modify the natural history of COPD; (2.) whether pharmacotherapy should be started in the early stages of COPD; (3.) the impact of therapy on comorbidities; (4.) whether patients benefit from a combination therapy with a long-acting beta-agonist, a long-acting antimuscarinic drug and an inhaled corticosteroid; (5.) step-down therapy. This overview also reviews the evidence for recommended vaccines in COPD, as well as nonpharmacological therapies. Rehabilitation is an essential part of COPD treatment. Oxygen therapy, noninvasive nocturnal ventilation and surgical treatment options only apply to a highly selected group of patients. Disease management programmes and guideline adherence are briefly discussed. In conclusion, although there is debate as to the extent with which pharmacological therapies influence mortality, adherence to the GOLD strategy is recommended. PMID:23592218

Osthoff, Mirjam; Jenkins, Christine; Leuppi, Jörg D

2013-01-01

332

Magnesium in Chronic Kidney Disease: Challenges and Opportunities  

Microsoft Academic Search

Cardiovascular disease is the leading cause of mortality and morbidity in patients with chronic kidney disease, which is partly explained by the fact that 40–70% of patients receiving dialysis have significant coronary artery disease. Recent clinical studies have shown that lower serum magnesium (Mg) levels are associated with vascular calcification and cardiovascular mortality among patients with end-stage renal disease (ESRD).

Mehmet Kanbay; David Goldsmith; Mehtap Erkmen Uyar; Faruk Turgut; Adrian Covic

2010-01-01

333

Cardiovascular risk factors in patients with chronic kidney disease  

Microsoft Academic Search

Patients with chronic kidney disease have a higher burden of cardiovascular disease, which increases in a dose-dependent fashion with worsening kidney function. Traditional cardiovascular risk factors, including advanced age, diabetes mellitus, hypertension and dyslipidemia, have an important role in the progression of cardiovascular disease in patients who have a reduced glomerular filtration rate, especially in those with mild-to-moderate kidney disease.

Sarina van der Zee; Usman Baber; Sammy Elmariah; Jonathan Winston; Valentin Fuster

2009-01-01

334

Chronic renal disease progression: treatment strategies and potassium intake.  

PubMed

Disordered potassium homeostasis is a common complication of chronic kidney disease and traditional management focuses on restricting potassium intake to avoid hyperkalemia. Permissive potassium intake carries the risk of hyperkalemia and hyperphosphatemia, and possibly may contribute to the development of uremic neuropathy. Excessive potassium restriction and removal by dialysis carries the risk of worsened chronic hypertension, intradialytic hypotension, renal fibrosis and cyst formation, and ventricular arrhythmias. Cohort studies have associated both hypokalemia and hyperkalemia with increased mortality in CKD. A single study of potassium intake in hemodialysis patients found increased intake associated with increased mortality despite adjustment for serum potassium concentration. We recommend avoiding mandatory potassium restriction in early chronic kidney disease. We endorse routine potassium restriction in advanced chronic kidney disease requiring hemodialysis and close monitoring of serum potassium concentration in any patients receiving renin-angiotensin-aldosterone system blockers. PMID:23953806

Sinha, Arjun D; Agarwal, Rajiv

2013-05-01

335

Cost Analysis of Chronic Disease Self-Management Programmes Being Delivered in South Florida  

ERIC Educational Resources Information Center

Background: Chronic disease accounts for the majority of healthcare costs. The Chronic Disease Self-Management Programme (CDSMP) has been shown to be effective in reducing the burden of chronic disease. Objectives: The objective of this study was to measure the cost of delivering the Chronic Disease Self-Management Programme (CDSMP) in order to…

Page, Timothy F.; Palmer, Richard C.

2014-01-01

336

Susceptibility of Domestic Cats to Chronic Wasting Disease  

PubMed Central

Domestic and nondomestic cats have been shown to be susceptible to feline spongiform encephalopathy (FSE), almost certainly caused by consumption of bovine spongiform encephalopathy (BSE)-contaminated meat. Because domestic and free-ranging nondomestic felids scavenge cervid carcasses, including those in areas affected by chronic wasting disease (CWD), we evaluated the susceptibility of the domestic cat (Felis catus) to CWD infection experimentally. Cohorts of 5 cats each were inoculated intracerebrally (i.c.) or orally (p.o.) with CWD-infected deer brain. At 40 and 42 months postinoculation, two i.c.-inoculated cats developed signs consistent with prion disease, including a stilted gait, weight loss, anorexia, polydipsia, patterned motor behaviors, head and tail tremors, and ataxia, and the cats progressed to terminal disease within 5 months. Brains from these two cats were pooled and inoculated into cohorts of cats by the i.c., p.o., and intraperitoneal and subcutaneous (i.p./s.c.) routes. Upon subpassage, feline CWD was transmitted to all i.c.-inoculated cats with a decreased incubation period of 23 to 27 months. Feline-adapted CWD (FelCWD) was demonstrated in the brains of all of the affected cats by Western blotting and immunohistochemical analysis. Magnetic resonance imaging revealed abnormalities in clinically ill cats, which included multifocal T2 fluid attenuated inversion recovery (FLAIR) signal hyperintensities, ventricular size increases, prominent sulci, and white matter tract cavitation. Currently, 3 of 4 i.p./s.c.- and 2 of 4 p.o. secondary passage-inoculated cats have developed abnormal behavior patterns consistent with the early stage of feline CWD. These results demonstrate that CWD can be transmitted and adapted to the domestic cat, thus raising the issue of potential cervid-to-feline transmission in nature. PMID:23236066

Nalls, Amy V.; Seelig, Davis M.; Kraft, Susan L.; Carnes, Kevin; Anderson, Kelly R.; Hayes-Klug, Jeanette; Hoover, Edward A.

2013-01-01

337

Susceptibility of domestic cats to chronic wasting disease.  

PubMed

Domestic and nondomestic cats have been shown to be susceptible to feline spongiform encephalopathy (FSE), almost certainly caused by consumption of bovine spongiform encephalopathy (BSE)-contaminated meat. Because domestic and free-ranging nondomestic felids scavenge cervid carcasses, including those in areas affected by chronic wasting disease (CWD), we evaluated the susceptibility of the domestic cat (Felis catus) to CWD infection experimentally. Cohorts of 5 cats each were inoculated intracerebrally (i.c.) or orally (p.o.) with CWD-infected deer brain. At 40 and 42 months postinoculation, two i.c.-inoculated cats developed signs consistent with prion disease, including a stilted gait, weight loss, anorexia, polydipsia, patterned motor behaviors, head and tail tremors, and ataxia, and the cats progressed to terminal disease within 5 months. Brains from these two cats were pooled and inoculated into cohorts of cats by the i.c., p.o., and intraperitoneal and subcutaneous (i.p./s.c.) routes. Upon subpassage, feline CWD was transmitted to all i.c.-inoculated cats with a decreased incubation period of 23 to 27 months. Feline-adapted CWD (Fel(CWD)) was demonstrated in the brains of all of the affected cats by Western blotting and immunohistochemical analysis. Magnetic resonance imaging revealed abnormalities in clinically ill cats, which included multifocal T2 fluid attenuated inversion recovery (FLAIR) signal hyperintensities, ventricular size increases, prominent sulci, and white matter tract cavitation. Currently, 3 of 4 i.p./s.c.- and 2 of 4 p.o. secondary passage-inoculated cats have developed abnormal behavior patterns consistent with the early stage of feline CWD. These results demonstrate that CWD can be transmitted and adapted to the domestic cat, thus raising the issue of potential cervid-to-feline transmission in nature. PMID:23236066

Mathiason, Candace K; Nalls, Amy V; Seelig, Davis M; Kraft, Susan L; Carnes, Kevin; Anderson, Kelly R; Hayes-Klug, Jeanette; Hoover, Edward A

2013-02-01

338

Lack of exercise is a major cause of chronic diseases.  

PubMed

Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause versus treatment; physical activity and inactivity mechanisms differ; gene-environment interaction (including aerobic training adaptations, personalized medicine, and co-twin physical activity); and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, nonalcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, pre-eclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life. PMID:23798298

Booth, Frank W; Roberts, Christian K; Laye, Matthew J

2012-04-01

339

Lack of exercise is a major cause of chronic diseases  

PubMed Central

Chronic diseases are major killers in the modern era. Physical inactivity is a primary cause of most chronic diseases. The initial third of the article considers: activity and prevention definitions; historical evidence showing physical inactivity is detrimental to health and normal organ functional capacities; cause vs. treatment; physical activity and inactivity mechanisms differ; gene-environment interaction [including aerobic training adaptations, personalized medicine, and co-twin physical activity]; and specificity of adaptations to type of training. Next, physical activity/exercise is examined as primary prevention against 35 chronic conditions [Accelerated biological aging/premature death, low cardiorespiratory fitness (VO2max), sarcopenia, metabolic syndrome, obesity, insulin resistance, prediabetes, type 2 diabetes, non-alcoholic fatty liver disease, coronary heart disease, peripheral artery disease, hypertension, stroke, congestive heart failure, endothelial dysfunction, arterial dyslipidemia, hemostasis, deep vein thrombosis, cognitive dysfunction, depression and anxiety, osteoporosis, osteoarthritis, balance, bone fracture/falls, rheumatoid arthritis, colon cancer, breast cancer, endometrial cancer, gestational diabetes, preeclampsia, polycystic ovary syndrome, erectile dysfunction, pain, diverticulitis, constipation, and gallbladder diseases]. The article ends with consideration of deterioration of risk factors in longer-term sedentary groups; clinical consequences of inactive childhood/adolescence; and public policy. In summary, the body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life. Taken together, conclusive evidence exists that physical inactivity is one important cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life. PMID:23798298

Booth, Frank W.; Roberts, Christian K.; Laye, Matthew J.

2014-01-01

340

Inflammatory Factors and Exercise in Chronic Kidney Disease  

PubMed Central

Patients with chronic kidney disease frequently present with chronic elevations in markers of inflammation, a condition that appears to be exacerbated by disease progression and onset of haemodialysis. Systemic inflammation is interlinked with malnutrition and muscle protein wasting and is implicated in a number of morbidities including cardiovascular disease: the most common cause of mortality in this population. Research in the general population and other chronic disease cohorts suggests that an increase in habitual activity levels over a prolonged period may help redress basal increases in systemic inflammation. Furthermore, those populations with the highest baseline levels of systemic inflammation appear to have the greatest improvements from training. On the whole, the activity levels of the chronic kidney disease population reflect a sedentary lifestyle, indicating the potential for increasing physical activity and observing health benefits. This review explores the current literature investigating exercise and inflammatory factors in the chronic kidney disease population and then attempts to explain the contradictory findings and suggests where future research is required. PMID:23737775

Hull, Katherine L.; Smith, Alice C.; Burton, James O.; Bishop, Nicolette C.

2013-01-01

341

END-STAGE RENAL DISEASE AND CHRONIC KIDNEY DISEASE IN BRAZIL  

Microsoft Academic Search

The world is facing an epidemic of chronic kidney disease (CKD). This report discusses the present state of chronic kidney disease care in Brazil. We report frequency of dialysis treat- ment and prevalence of kidney transplantation throughout Brazil. We estimated the number of CKD patients in the country through a mathematical extrapolation based on data generated by the NHANES. On

Jocemir R. Lugon

342

Impact of treating the metabolic syndrome on chronic kidney disease  

Microsoft Academic Search

The metabolic syndrome is defined by the concurrent presence of at least three metabolic disorders that are associated with an increased risk of cardiovascular disease and diabetes. Results from prospective and cross-sectional studies also point to an association between the metabolic syndrome and chronic kidney disease. Visceral obesity and insulin resistance are two important features of the metabolic syndrome that

Aashish Shah; Casey Rice; Barry A. Franklin; Peter A. McCullough; Varun Agrawal

2009-01-01

343

Vascular Calcification in Patients with Chronic Kidney Disease  

Microsoft Academic Search

Chronic kidney disease (CKD) represents an extremely common condition, and cardiovascular diseases are frequently reported in this patient population. Traditional risk factors are not accurate prognostic predictors in CKD patients, and new potential markers to predict the cardiovascular involvement in uremic patients need to be identified. Vascular calcification (VC) represents a hallmark of the atherosclerotic process in CKD. This review

Santo Dellegrottaglie; Javier Sanz; Sanjay Rajagopalan

2006-01-01

344

Use of vitamin D in chronic kidney disease patients  

Microsoft Academic Search

Chronic kidney disease (CKD) has been recognized as a significant public health problem, with 20 million Americans, or 11% of the adult population, currently living with CKD. Life expectancy in patients with CKD is limited by the development of disturbances of mineral metabolism, which occurs in virtually all patients during the progression of their disease, and is associated with bone

Anca Gal-Moscovici; Stuart M Sprague

2010-01-01

345

Emerging risk factors and markers of chronic kidney disease progression  

Microsoft Academic Search

Chronic kidney disease (CKD) is a common condition with an increasing prevalence. A number of comorbidities are associated with CKD and prognosis is poor, with many patients experiencing disease progression. Recognizing the factors associated with CKD progression enables high-risk patients to be identified and given more intensive treatment if necessary. The identification of new predictive markers might improve our understanding

Florian Kronenberg

2009-01-01

346

Nutrition and growth in children with chronic kidney disease  

Microsoft Academic Search

Poor growth in chronic kidney disease (CKD) is a marker of disease severity and of quality of care. Causes are multifactorial, and include malnutrition, cachexia, hematological factors, endocrine problems and metabolic abnormalities. In this Review, we focus on the impact of inadequate nutrition on growth disturbances in children with CKD, and discuss all aspects of the epidemiology, causes and potential

Robert H. Mak; Lesley Rees

2011-01-01

347

Sleep and Sleep Disorders in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the US. Numerous studies have demonstrated that sleep disturbances are common in COPD patients, with more prominent complaints in patients with more severe disease and with increasing age. Sleep disturbances may occur due to the effects of breathing abnormalities on sleep and sleep disruption. However, other

Nancy Collop

2010-01-01

348

Different CABG methods in patients with chronic obstructive pulmonary disease  

Microsoft Academic Search

Background. Pulmonary dysfunction is still a major problem in coronary artery bypass grafting (CABG). The purpose of this randomized study was to determine the effect of different CABG techniques on pulmonary function.Methods. Fifty eight patients with severe obstructive pulmonary disease had elective isolated coronary surgery. The surgical methods for the patients with chronic obstructive pulmonary disease (COPD) were standard CABG

Mustafa Güler; Kaan K?rali; Mehmet E Toker; Nilgün Bozbu?a; Suat N Ömero?lu; Esat Ak?nc?; Cevat Yakut

2001-01-01

349

Racial and survival paradoxes in chronic kidney disease  

Microsoft Academic Search

Most of the 20 million people in the US with chronic kidney disease (CKD) die before commencing dialysis. One of every five dialysis patients dies each year in the US. Although cardiovascular disease is the most common cause of death among patients with CKD, conventional cardiovascular risk factors such as hypercholesterolemia, hypertension and obesity are paradoxically associated with better survival

Csaba P Kovesdy; Stephen F Derose; Tamara B Horwich; Gregg C Fonarow; Kamyar Kalantar-Zadeh

2007-01-01

350

Management of Pediatric Patients With Chronic Kidney Disease Deborah Miller  

Microsoft Academic Search

Chronic kidney disease in children is associated with complications that require nursing interventions in both the inpatient and outpatient settings. Given the progressive nature of the disease and the com- plexity of the treatment regimen, it is important that nurses be com- fortable implementing acute and preventive care strategies and facili- tating the coordination of care. In addition, the need

Dina MacDonald

351

Atherosclerosis in chronic kidney disease: the role of macrophages  

Microsoft Academic Search

Patients with chronic kidney disease (CKD) are at increased risk of atherosclerotic cardiovascular disease and loss of renal parenchyma accelerates atherosclerosis in animal models. Macrophages are central to atherogenesis because they regulate cholesterol traffic and inflammation in the arterial wall. CKD influences macrophage behavior at multiple levels, rendering them proatherogenic. Even at normal creatinine levels, macrophages from uninephrectomized Apoe?\\/? mice

Valentina Kon; MacRae F. Linton; Sergio Fazio

2010-01-01

352

The Role of Statins in Chronic Kidney Disease  

Microsoft Academic Search

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality not only amongst the general population, but also in patients with chronic kidney disease (CKD). Persons with CKD are much more likely to die of CVD than to experience kidney failure. Clinical trials have demonstrated that statins are gaining widespread acceptance as a principal therapy for the primary and

Rigas G. Kalaitzidis; Moses S. Elisaf

2011-01-01

353

Different CABG Methods in Patients With Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Background. Pulmonary dysfunction is still a major problem in coronary artery bypass grafting (CABG). The purpose of this randomized study was to determine the effect of different CABG techniques on pulmonary function. Methods. Fifty eight patients with severe obstructive pulmonary disease had elective isolated coronary sur- gery. The surgical methods for the patients with chronic obstructive pulmonary disease (COPD) were

Mustafa Guler; Kaan Kirali; Mehmet E. Toker; Esat Akinci; Cevat Yakut

2010-01-01

354

Alzheimer's disease and chronic periodontitis: Is there an association?  

PubMed

Alzheimer's disease, an affliction of old age, is one of the leading causes for dementia worldwide. Various risk factors including family history, genetics and infections have been implicated in its pathogenesis. The cognitive decline in this condition is mainly a result of the formation of amyloid deposits that provoke neuroinflammation, ultimately resulting in cell death. Recently, an association between peripheral inflammation and Alzheimer's disease was hypothesized. It was suggested that chronic systemic inflammation worsened the inflammatory processes in the brain. This was mainly attributed to increased levels of pro-inflammatory mediators, such as interleukin-1, interleukin -6 and tumor necrosis factor-? in the plasma. As chronic periodontitis is a widespread peripheral immunoinflammatory condition, it has been proposed to play a significant role in the aggravation of Alzheimer's disease. With this background, the current review focuses on the relationship between Alzheimer's disease and chronic periodontitis, and its therapeutic implications. Geriatr Gerontol Int 2015; 15: 391-404. PMID:25511390

Gaur, Sumit; Agnihotri, Rupali

2015-04-01

355

Evaluating bone quality in patients with chronic kidney disease  

PubMed Central

Bone of normal quality and quantity can successfully endure physiologically imposed mechanical loads. Chronic kidney disease–mineral and bone disorder (CKD–MBD) adversely affects bone quality through alterations in bone turnover and mineralization, whereas bone quantity is affected through changes in bone volume. Changes in bone quality can be associated with altered bone material, structure, or microdamage, which can result in an elevated rate of fracture in patients with CKD–MBD. Fractures cannot always be explained by reduced bone quantity and, therefore, bone quality should be assessed with a variety of techniques from the macro-organ level to the nanoscale level. In this Review, we demonstrate the importance of evaluating bone from multiple perspectives and hierarchical levels to understand CKD–MBD-related abnormalities in bone quality. Understanding the relationships between variations in material, structure, microdamage, and mechanical properties of bone in patients with CKD–MBD should aid in the development of new modalities to prevent, or treat, these abnormalities. PMID:24100399

Malluche, Hartmut H.; Porter, Daniel S.; Pienkowski, David

2013-01-01

356

Chronic Oral Estrogen Affects Memory and Neurochemistry in Middle-Aged Female Mice  

E-print Network

Chronic Oral Estrogen Affects Memory and Neurochemistry in Middle-Aged Female Mice Stephanie M memory and alter neural plasticity in the hippocampus and neocortex of middle-aged female mice that chronic oral estrogen selectively affects memory and neural function in middle-aged female mice. Menopause

Frick, Karyn M.

357

Substance P at the Nexus of Mind and Body in Chronic Inflammation and Affective Disorders  

ERIC Educational Resources Information Center

For decades, research has demonstrated that chronic diseases characterized by dysregulation of inflammation are particularly susceptible to exacerbation by stress and emotion. Likewise, rates of depression and anxiety are overrepresented in individuals suffering from chronic inflammatory disease. In recent years, substance P has been implicated in…

Rosenkranz, Melissa A.

2007-01-01

358

Factors associated with chronic musculoskeletal pain in patients with chronic kidney disease  

PubMed Central

Background Chronic musculoskeletal (MS) pain is common in patients with chronic kidney disease (CKD) undergoing haemodialysis. However, epidemiological data for chronic MS pain and factors associated with chronic MS pain in patients with early- or late-stage CKD who are not undergoing dialysis are limited. Method A cross-sectional study to evaluate the prevalence of chronic MS pain and factors associated with chronic MS pain in patients with early- and late-stage CKD who were not undergoing dialysis, was conducted. In addition, the distribution of pain severity among patients with different stages of CKD was evaluated. Results Of the 456 CKD patients studied, 53.3% (n?=?243/456) had chronic MS pain. Chronic MS pain was independently and significantly associated with hyperuricemia as co-morbidity, as well as with the calcium?×?phosphate product levels. In CKD patients with hyperuricemia, chronic MS pain showed a negative, independent significant association with diabetes mellitus as a co-morbidity (odds ratio: 0.413, p?=?0.020). However, in the CKD patients without hyperuricemia as a co-morbidity, chronic MS pain showed an independent significant association with the calcium?×?phosphate product levels (odds ratio: 1.093, p?=?0.027). Furthermore, stage-5 CKD patients seemed to experience more severe chronic MS pain than patients with other stages of CKD. Conclusion Chronic MS pain is common in CKD patients. Chronic MS pain was independently and significantly associated with hyperuricemia as co-morbidity, and with the calcium?×?phosphate product levels in early- and late-stage CKD patients who were not on dialysis. PMID:24400957

2014-01-01

359

Chronic kidney disease with three cases of oxalate-like nephrosis in Ragdoll cats.  

PubMed

Two unrelated Ragdoll cat mothers in Norway were found dead from renal disease. The histopathology was consistent with oxalate nephrosis with chronic or acute-on-chronic underlying kidney disease. Both cats had offspring and relatives with signs of urinary tract disease, including a kitten dead with urethral gravel. Eleven living Ragdoll cats, including nine relatives of the dead cats and the male father of a litter with similarly affected animals, were tested for primary hyperoxaluria (PH) type 1 and 2 by urine oxalate and liver enzyme analysis. Renal ultrasound revealed abnormalities in five living cats. One of these was azotaemic at the time of examination and developed terminal kidney disease 9 months later. A diagnosis of PH was excluded in 11 cats tested. The inheritance and aetiological background of the renal disease present in the breed remains unresolved at this point in time. PMID:19095478

Heiene, Reidun; Rumsby, Gill; Ziener, Martine; Dahl, Stein A; Tims, Christopher; Teige, Jon; Ottesen, Nina

2009-06-01

360

Clinical application of expectorant therapy in chronic inflammatory airway diseases (Review)  

PubMed Central

Airway mucus hypersecretion is a significant clinical and pathological feature of chronic inflammatory airway diseases. Its clinical presentations include recurrent coughing and phlegm. Airway mucus is closely associated with the occurrence, development and prognosis of chronic inflammatory airway diseases and critically affects the lung function, quality of life, hospitalization rate and mortality of patients with chronic inflammatory airway diseases. Therefore, expectorant therapies targeting the potential mechanisms of mucus hypersecretion have been the focus of numerous studies. Conventional expectorants are mainly mucoactive medicines, including nausea-stimulating expectorants, mucolytics, mucokinetics, and proteases and nucleases. In addition, certain traditional Chinese herbal medicines and non-mucoactive agents, including muscarinic acetylcholine receptor antagonists, corticosteroids, leukotriene receptor antagonists and macrolide antibiotics, have also shown expectorant effects. Several novel medicines for expectorant therapy have emerged, including cholesterol-lowering statins, epidermal growth factor receptor tyrosine kinase inhibitors, phosphodiesterase-4 inhibitors, stanozolol, surfactants, flavonoids, tachykinin receptor antagonists, protease inhibitors, cytokine antagonists and purinergic agonists. With the increasing number of multidisciplinary studies, the effectiveness of expectorant therapy for the treatment of chronic inflammatory airway diseases has been confirmed. Therefore, the development of novel expectorants and the standardization of expectorant therapy are the direction and focus of future studies, thus benefiting patients who have a chronic inflammatory airway disease. PMID:24660026

ZHANG, TING; ZHOU, XIANGDONG

2014-01-01

361

Chronic diseases influence major life changing decisions: a new domain in quality of life research.  

PubMed

The purpose of this review is to identify knowledge about the influence of chronic disease on major life changing decisions (MLCDs). This review was carried out in three stages: identification of key search terms; selection of databases and searching parameters; and evaluation of references. Only two articles matched the main search term 'major life changing decisions'. No article reviewed or measured the influence of chronic disease on major life changing decisions. However, 76 articles and various sections of seven books were identified that provided insight into this area and these are reviewed in detail. This literature review has brought together previously scattered information on chronic disease impact on important patient life decisions. These include decisions related to having children, marriage and divorce, job and career choice, social life, holidays, travelling and education. Lifestyle decisions viewed by patients as major decisions are also documented. The influence of cancer on life decisions is discussed, as are affected life decisions of other family members. Very little information is available about the long-term impact of chronic disease on patients' lives and methodology to assess long-term impact is incomplete. This review points to a novel dimension to health-related outcome research, the impact of chronic disease on major life changing decisions, and its possible implication for patients' future health. PMID:21659399

Bhatti, Zu; Salek, Ms; Finlay, Ay

2011-06-01

362

Hydrocarbon exposure and chronic renal disease  

Microsoft Academic Search

The study objective was to investigate further the potential role of long-term exposure to hydrocarbons (HCs) in the development of idiopathic chronic glomerulopathy (ICG) using a more refined measurement of HC exposure. A total of 321 pairs of cases and controls, matched by age, gender, and geographical area, were assembled. A detailed questionnaire was blindly administered to cases and controls

Nabih R. Asal; Harold L. Cleveland; Christian Kaufman; Wato Nsa; Deborah I. Nelson; Robert Y. Nelson; Elisa T. Lee; Beverly Kingsley

1996-01-01

363

Chronic Recurrent Multifocal Osteomyelitis Associated with Chronic Inflammatory Bowel Disease in Children  

Microsoft Academic Search

Chronic recurrent multifocal osteomyelitis(CRMO) is a rare disease of children characterized byaseptic inflammation of the long bones and clavicles. Noinfectious etiology has been identified, and CRMO has been associated with a number of autoimmunediseases (including Wegener's granulomatosis andpsoriasis). The relationship between CRMO andinflammatory bowel disease is poorly described. Throughan internet bulletin board subscribed to by 500pediatric gastroenterologists, we identified sixinflammatory

Athos Bousvaros; Margaret Marcon; William Treem; Peter Waters; Robert Issenman; Richard Couper; Richard Burnell; Allan Rosenberg; Egla Rabinovich; Barbara S. Kirschner

1999-01-01

364

Metabolic Syndrome, Components, and Cardiovascular Disease Prevalence in Chronic Kidney Disease: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study  

Microsoft Academic Search

Background\\/Aims: Metabolic syndrome may increase the risk for incident cardiovascular disease (CVD) and all-cause mortality in the general population. It is unclear whether, and to what degree, metabolic syndrome is associated with CVD in chronic kidney disease (CKD). We determined metabolic syndrome prevalence among individuals with a broad spectrum of kidney dysfunction, examining the role of the individual elements of

Raymond R. Townsend; Amanda H. Anderson; Jing Chen; Crystal A. Gadebegku; Harold I. Feldman; Jeffrey C. Fink; Alan S. Go; Marshall Joffe; Lisa A. Nessel; Akinlolu Ojo; Daniel J. Rader; Muredach P. Reilly; Valerie Teal; Karen Teff; Jackson T. Wright; Dawei Xie

2011-01-01

365

Hypertension, left ventricular hypertrophy and chronic kidney disease  

Microsoft Academic Search

Left ventricular hypertrophy (LVH) is a cardiovascular complication highly prevalent in patients with chronic kidney disease\\u000a (CKD) and end-stage renal disease. LVH in CKD patients has generally a negative prognostic value, because it represents an\\u000a independent risk factor for the development of arrhythmias, sudden death, heart failure and ischemic heart disease. LVH in\\u000a CKD patients is secondary to both pressure

Stefano Taddei; Renato Nami; Rosa Maria Bruno; Ilaria Quatrini; Ranuccio Nuti

2011-01-01

366

Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey  

PubMed Central

Overview. The Centers for Disease Control and Prevention (CDC) health-related quality of life (HRQoL) indicators are widely used in the general population to determine the burden of disease, identify health needs, and direct public health policy. These indicators also allow the burden of illness to be compared across different diseases. Although Lyme disease has recently been acknowledged as a major health threat in the USA with more than 300,000 new cases per year, no comprehensive assessment of the health burden of this tickborne disease is available. This study assesses the HRQoL of patients with chronic Lyme disease (CLD) and compares the severity of CLD to other chronic conditions. Methods. Of 5,357 subjects who responded to an online survey, 3,090 were selected for the study. Respondents were characterized as having CLD if they were clinically diagnosed with Lyme disease and had persisting symptoms lasting more than 6 months following antibiotic treatment. HRQoL of CLD patients was assessed using the CDC 9-item metric. The HRQoL analysis for CLD was compared to published analyses for the general population and other chronic illnesses using standard statistical methods. Results. Compared to the general population and patients with other chronic diseases reviewed here, patients with CLD reported significantly lower health quality status, more bad mental and physical health days, a significant symptom disease burden, and greater activity limitations. They also reported impairment in their ability to work, increased utilization of healthcare services, and greater out of pocket medical costs. Conclusions. CLD patients have significantly impaired HRQoL and greater healthcare utilization compared to the general population and patients with other chronic diseases. The heavy burden of illness associated with CLD highlights the need for earlier diagnosis and innovative treatment approaches that may reduce the burden of illness and concomitant costs posed by this illness. PMID:24749006

Johnson, Lorraine; Wilcox, Spencer; Mankoff, Jennifer

2014-01-01

367

Osteoporosis in chronic liver disease: a case–control study  

Microsoft Academic Search

Osteoporosis has become an increasingly recognized complication among patients with chronic liver disease (CLD). The aim of\\u000a the present study was to assess the prevalence and risk factors of osteoporosis in patients with CLD (primary biliary cirrhosis\\u000a and chronic viral hepatitis B or C patients) in comparison with a group of age- and sex-matched controls. Sixty-four patients\\u000a with CLD (mean

Ghizlane Wariaghli; Aziza Mounach; Lahsen Achemlal; Imane Benbaghdadi; Aziz Aouragh; Ahmed Bezza; Abdellah El Maghraoui

2010-01-01

368

Extracorporeal photopheresis in chronic graft-versus-host disease  

Microsoft Academic Search

Despite significant advances in stem cell manipulation and post-transplant immunosuppression, chronic graft-versus-host disease (cGVHD) remains a cause of major long-term morbidity in survivors of allogeneic stem cell transplantation. Extracorporeal photopheresis (ECP) is a novel therapeutic intervention which has demonstrated efficacy in patients with refractory acute and chronic GVHD. Clinical responses have been reported in skin and visceral GVHD. While the

FM Foss; G Gorgun; KB Miller

2002-01-01

369

Impacts of hot and cold spells differ for acute and chronic ischaemic heart diseases  

PubMed Central

Background Many studies have reported associations between temperature extremes and cardiovascular mortality but little has been understood about differences in the effects on acute and chronic diseases. The present study examines hot and cold spell effects on ischaemic heart disease (IHD) mortality in the Czech Republic during 1994–2009, with emphasis upon differences in the effects on acute myocardial infarction (AMI) and chronic IHD. Methods We use analogous definitions for hot and cold spells based on quantiles of daily average temperature anomalies, thus allowing for comparison of results for summer hot spells and winter cold spells. Daily mortality data were standardised to account for the long-term trend and the seasonal and weekly cycles. Periods when the data were affected by epidemics of influenza and other acute respiratory infections were removed from the analysis. Results Both hot and cold spells were associated with excess IHD mortality. For hot spells, chronic IHD was responsible for most IHD excess deaths in both male and female populations, and the impacts were much more pronounced in the 65+ years age group. The excess mortality from AMI was much lower compared to chronic IHD mortality during hot spells. For cold spells, by contrast, the relative excess IHD mortality was most pronounced in the younger age group (0–64 years), and we found different pattern for chronic IHD and AMI, with larger effects on AMI. Conclusions The findings show that while excess deaths due to IHD during hot spells are mainly of persons with chronic diseases whose health had already been compromised, cardiovascular changes induced by cold stress may result in deaths from acute coronary events rather than chronic IHD, and this effect is important also in the younger population. This suggests that the most vulnerable population groups as well as the most affected cardiovascular diseases differ between hot and cold spells, which needs to be taken into account when designing and implementing preventive actions. PMID:24886566

2014-01-01

370

Relevance of Chronic Lyme Disease to Family Medicine as a Complex Multidimensional Chronic Disease Construct: A Systematic Review  

PubMed Central

Lyme disease has become a global public health problem and a prototype of an emerging infection. Both treatment-refractory infection and symptoms that are related to Borrelia burgdorferi infection remain subject to controversy. Because of the absence of solid evidence on prevalence, causes, diagnostic criteria, tools and treatment options, the role of autoimmunity to residual or persisting antigens, and the role of a toxin or other bacterial-associated products that are responsible for the symptoms and signs, chronic Lyme disease (CLD) remains a relatively poorly understood chronic disease construct. The role and performance of family medicine in the detection, integrative treatment, and follow-up of CLD are not well studied either. The purpose of this paper is to describe insights into the complexity of CLD as a multidimensional chronic disease construct and its relevance to family medicine by means of a systematic literature review. PMID:25506429

Goderis, Geert

2014-01-01

371

In Search of a Germ Theory Equivalent for Chronic Disease  

PubMed Central

The fight against infectious disease advanced dramatically with the consolidation of the germ theory in the 19th century. This focus on a predominant cause of infections (ie, microbial pathogens) ultimately led to medical and public health advances (eg, immunization, pasteurization, antibiotics). However, the resulting declines in infections in the 20th century were matched by a rise in chronic, noncommunicable diseases, for which there is no single underlying etiology. The discovery of a form of low-grade systemic and chronic inflammation (“metaflammation”), linked to inducers (broadly termed “anthropogens”) associated with modern man-made environments and lifestyles, suggests an underlying basis for chronic disease that could provide a 21st-century equivalent of the germ theory. PMID:22575080

2012-01-01

372

Sickle cell disease: a neglected chronic disease of increasing global health importance.  

PubMed

Sickle cell disease (SCD) is a single gene disorder causing a debilitating systemic syndrome characterised by chronic anaemia, acute painful episodes, organ infarction and chronic organ damage and by a significant reduction in life expectancy. The origin of SCD lies in the malarial regions of the tropics where carriers are protected against death from malaria and hence enjoy an evolutionary advantage. More recently, population migration has meant that SCD now has a worldwide distribution and that a substantial number of children are born with the condition in higher-income areas, including large parts of Europe and North and South America. Newborn screening, systematic clinical follow-up and prevention of sepsis and organ damage have led to an increased life expectancy among people with SCD in many such countries; however, in resource-limited settings where the majority continue to be born, most affected children continue to die in early childhood, usually undiagnosed, due to the lack of effective programmes for its early detection and treatment. As new therapies emerge, potentially leading to disease amelioration or cure, it is of paramount importance that the significant burden of SCD in resource-poor countries is properly recognised. PMID:25239949

Chakravorty, Subarna; Williams, Thomas N

2015-01-01

373

Sickle cell disease: a neglected chronic disease of increasing global health importance  

PubMed Central

Sickle cell disease (SCD) is a single gene disorder causing a debilitating systemic syndrome characterised by chronic anaemia, acute painful episodes, organ infarction and chronic organ damage and by a significant reduction in life expectancy. The origin of SCD lies in the malarial regions of the tropics where carriers are protected against death from malaria and hence enjoy an evolutionary advantage. More recently, population migration has meant that SCD now has a worldwide distribution and that a substantial number of children are born with the condition in higher-income areas, including large parts of Europe and North and South America. Newborn screening, systematic clinical follow-up and prevention of sepsis and organ damage have led to an increased life expectancy among people with SCD in many such countries; however, in resource-limited settings where the majority continue to be born, most affected children continue to die in early childhood, usually undiagnosed, due to the lack of effective programmes for its early detection and treatment. As new therapies emerge, potentially leading to disease amelioration or cure, it is of paramount importance that the significant burden of SCD in resource-poor countries is properly recognised. PMID:25239949

Chakravorty, Subarna; Williams, Thomas N

2015-01-01

374

Osteoporosis and skeletal fractures in chronic liver disease.  

PubMed Central

In order to determine the prevalence and severity of hepatic osteodystrophy by non-invasive means we compared 115 consecutive ambulant patients with histologically proven chronic liver disease to 113 age and sex matched control subjects. Methods used included the assessment of fracture prevalence rates, spinal radiography, and measurements of bone mineral density in the spine and the forearm. Spinal and peripheral fractures were more prevalent in the patients than in the control subjects (p less than 0.03 and p less than 0.01 respectively). The type of the underlying liver disease did not significantly affect the fracture prevalence rates, but alcoholic patients sustained more peripheral fractures than patients with other hepatic disorders (p less than 0.05). The bone mineral densities of the spines and the forearms were significantly reduced in male patients of all age groups and in female patients aged 60 years or more (p less than 0.001 for men and p less than 0.01 for women for both measurements). The prevalence rates of spinal and forearm osteoporosis were twice as high among patients with liver disease than in control subjects regardless of the definitions used. The presence of cirrhosis and hypogonadism were major risk factors for development of both spinal (Beta coef = 0.190 and 0.176; SE = 0.079 and 0.086 respectively) and forearm osteoporosis (Beta coef = 0.20 and 0.29; SE = 0.073 and 0.80 respectively). Spinal bone density was the predominant determinant of spinal fractures (Beta coef = -0.007; SE = 0.001), while hypogonadism (Beta coef = 0.363; SE = 0.075) and cirrhosis (Beta coef = 0.185; SE = 0.068) were the major predictors of peripheral fractures. The concentrations of serum calcium and serum vitamin D metabolites and the use of corticosteroids were apparently without effect on the prevalence of skeletal fractures or bone density. PMID:2318434

Diamond, T; Stiel, D; Lunzer, M; Wilkinson, M; Roche, J; Posen, S

1990-01-01

375

A public health framework for chronic disease prevention and control.  

PubMed

Chronic noncommunicable diseases are leading causes of death and disability in many developing countries. Several low-income countries lack mortality and morbidity data and do not yet know their burden of noncommunicable diseases. Cost studies are scarce, but in middle-income countries such as those of Latin America and the Caribbean, the cost of illness not only represents much of the direct costs of medical care, but also has an impact on family disposable income. Studies have reported that in low-resource settings, given incomplete health coverage and partial insurance, out-of-pocket expenses are high. Persons with chronic conditions, in many instances, have to forego care because of their inability to pay. Poverty and chronic noncommunicable diseases have a two-way interaction. These conditions warrant attention from poverty-reduction programs. Evidence shows that to have an impact on the burden of chronic diseases, action must occur at three levels: population-wide policies, community activities, and health services. The latter includes both preventive services and appropriate care for persons with chronic conditions. A public health approach embodies a systems perspective, containing the continuum of prevention and control, from determinants to care. In this framework it is critical to identify and address interactions and interventions that connect between and among the three levels of action. PMID:15214266

Robles, Sylvia C

2004-06-01

376

Why do young people with chronic kidney disease die early?  

PubMed Central

Cardiovascular disease poses the greatest risk of premature death seen among patients with chronic kidney disease (CKD). Up to 50% of mortality risk in the dialysis population is attributable to cardiovascular disease and the largest relative excess mortality is observed in younger patients. In early CKD, occlusive thrombotic coronary disease is common, but those who survive to reach end-stage renal failure requiring dialysis are more prone to sudden death attributable mostly to sudden arrhythmic events and heart failure related to left ventricular hypertrophy, coronary vascular calcification and electrolyte disturbances. In this review, we discuss the basis of the interaction of traditional risk factors for cardiovascular disease with various pathological processes such as endothelial dysfunction, oxidative stress, low grade chronic inflammation, neurohormonal changes and vascular calcification and stiffness which account for the structural and functional cardiac changes that predispose to excess morbidity and mortality in young people with CKD. PMID:25374808

Kumar, Shankar; Bogle, Richard; Banerjee, Debasish

2014-01-01

377

Cutaneous miliary tuberculosis in a chronic kidney disease patient.  

PubMed

A 79-year-old Thai woman with advanced renal failure, dyslipidemia and anemia of chronic disease was admitted to hospital with prolonged fever, productive cough and multiple discrete small pustules on her face, trunk and extremities. A chest X-ray revealed diffuse miliary infiltration. Mycobacterium tuberculosis complex DNA was detected by polymerase chain reaction in sputum and scrapings of pustules from her skin. Blood culture identified M. tuberculosis complex. Pulmonary and cutaneous miliary tuberculosis was diagnosed. The patient's symptoms improved after 3 weeks of treatment with isoniazid, rifampicin, ethambutol and pyrazinamide. This report details a case of cutaneous miliary tuberculosis in a non-dialysis chronic kidney disease patient. PMID:25493081

Suraprasit, Pudit; Silpa-Archa, Narumol; Triwongwaranat, Daranporn

2014-09-01

378

Definition and classification of chronic kidney disease: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)  

Microsoft Academic Search

Definition and classification of chronic kidney disease: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Chronic kidney disease (CKD) is a worldwide public health problem, with adverse outcomes of kidney failure, cardiovascular disease (CVD), and premature death. A simple definition and classification of kidney disease is necessary for international development and implementation of clinical practice guidelines. Kidney Disease:

Andrew S. Levey; KAI-UWE ECKARDT; YUSUKE TSUKAMOTO; ADEERA LEVIN; JOSEF CORESH; JEROME ROSSERT; DICK DE ZEEUW; Thomas H. Hostetter; NORBERT LAMEIRE; GARABED EKNOYAN

2005-01-01

379

Carbon Nanotubes and Chronic Granulomatous Disease  

PubMed Central

Use of nanomaterials in manufactured consumer products is a rapidly expanding industry and potential toxicities are just beginning to be explored. Combustion-generated multiwall carbon nanotubes (MWCNT) or nanoparticles are ubiquitous in non-manufacturing environments and detectable in vapors from diesel fuel, methane, propane, and natural gas. In experimental animal models, carbon nanotubes have been shown to induce granulomas or other inflammatory changes. Evidence suggesting potential involvement of carbon nanomaterials in human granulomatous disease, has been gathered from analyses of dusts generated in the World Trade Center disaster combined with epidemiological data showing a subsequent increase in granulomatous disease of first responders. In this review we will discuss evidence for similarities in the pathophysiology of carbon nanotube-induced pulmonary disease in experimental animals with that of the human granulomatous disease, sarcoidosis. PMID:25525507

Barna, Barbara P.; Judson, Marc A.; Thomassen, Mary Jane

2014-01-01

380

[Peripheral neurological changes in chronic Chagas' disease].  

PubMed

The authors review the literature about the cronic nervous form of Chagas' disease, directing their attention toward peripheral neurological aspects. Specifically, they analyse the results obtained from a "bind" research realized in a small community in the countryside of the state of Bahia, Brazil, where a high frequency of infection by Trypanosoma cruzi is reported. From 99 individuals examined, 50 showed a positive sorological test for Chagas' disease. The most frequent neurological findings in the total of 99 individuals were sensory loss and impairment of the deep reflexes. Among those with abolition of deep reflexes, there were 18 cases carrying a positive sorology for Chagas' disease, being that 15 from these 18 cases additionally presented a mild sensory deficit, characterizing a polyneuritic syndrome. In conclusion, they suggest that there is a neuritic form, as subdivision of a nervous form of Chagas' disease, particularly identified as a mixed polyneuritis. PMID:6773510

Fortes-Rêgo, J; Macedo, V O; Prata, A

1980-03-01

381

Blocking Interleukin-1? in Acute and Chronic Autoinflammatory Diseases  

PubMed Central

An expanding spectrum of acute and chronic inflammatory diseases are considered “autoinflammatory” diseases. This review considers autoinflammatory diseases as being distinct from “autoimmune” diseases. Autoimmune diseases are associated with dysfunctional T-cells and treated with “biologicals” including anti-TNF?, CTLA-Ig, anti-IL-12/23, anti-CD20, anti-IL-17 and anti-IL-6 receptor. In contrast, autoinflammatory diseases are uniquely due to a dysfunctional monocyte caspase-1 activity and secretion of IL-1?; indeed, blocking IL-1? results in a rapid and sustained reduction in the severity of most autoinflammatory diseases. Flares of gout, Type-2 diabetes, heart failure and smoldering multiple myeloma are examples of seemingly unrelated diseases, which are uniquely responsive to IL-1? neutralization. PMID:21158974

Dinarello, Charles A.

2010-01-01

382

Update on the management of chronic kidney disease.  

PubMed

Chronic kidney disease is common and associated with significant morbidity. Given the high risk of cardiovascular morbidity and mortality in patients with chronic kidney disease, it is important to identify and treat related risk factors. However, there is growing uncertainty about the benefits of some recommended treatment targets. The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative guidelines recommend an A1C level of less than 7 percent in patients with diabetes mellitus, although there is no evidence that treatment to this goal reduces cardiovascular events or progression to end-stage renal disease. Optimal blood pressure goals are controversial, and further study is needed to determine these goals in relation to amount of proteinuria. Concurrent use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers leads to worsening kidney function and is not recommended. Lipid-lowering therapy has been shown to reduce the risk of cardiovascular events and mortality, but not progression of chronic kidney disease. The treatment of anemia in patients with chronic kidney disease, particularly the use of erythropoiesis-stimulating agents and optimal hemoglobin goals, is also controversial. Studies have shown increased morbidity and mortality with use of erythropoiesis-stimulating agents aimed at normalizing hemoglobin levels. Patients with chronic kidney disease are at high risk of morbidity and mortality from the use of intravenous contrast agents. Isotonic intravenous hydration with sodium bicarbonate or saline has been shown to prevent contrast-induced nephropathy. Gadolinium-based contrast agents should be avoided if the glomerular filtration rate is less than 30 mL per minute per 1.73 m2 because of the risk of nephrogenic systemic fibrosis. PMID:23062158

Rivera, Josette A; O'Hare, Ann M; Harper, G Michael

2012-10-15

383

Semen quality in men with chronic kidney disease and its correlation with chronic kidney disease stages.  

PubMed

The aim of this study was to assess whether chronic kidney disease (CKD) has any impact on semen quality parameters in men with CKD stage 1-5. Results were collected from 66 men with different CKD stages (age 18-50 years). Age and BMI (body mass index) were recorded for each male. Higher CKD stage had a significant negative linear trend on semen volume (P < 0.05), progressive motility (P < 0.01), nonprogressive motility (P < 0.001), sperm concentration (P < 0.01), total sperm number (P < 0.01), cytoplasmic droplets (P < 0.01), teratozoospermia index (P < 0.05) and accessory gland markers, ?-glucosidase activity (P < 0.05), zinc (P < 0.01) and fructose (P < 0.01). BMI per se had no significant effect on semen volume, sperm number, sperm concentration, morphology, ?-glucosidase activity, fructose concentration or zinc level. A significant negative correlation between BMI and sexual-hormone-binding globulin (SHBG) (P < 0.01) was observed but not with other sex hormones. Age per se was related to a significant decrease of sperm concentration (P < 0.05), normal forms (P < 0.01) and testosterone level (P < 0.05). Our results indicate that CKD stage per se is a factor determining the number of spermatozoa available in the epididymis for ejaculation, in part independent of age-related decrease of testosterone level and BMI. PMID:25487067

Lehtihet, M; Hylander, B

2014-12-01

384

Effects of an external resistance on maximum flow in chronic obstructive lung disease: implications for recognition of coincident upper airway obstruction  

Microsoft Academic Search

To determine how the presence of generalised airflow limitation due to chronic obstructive lung disease affects the recognition of simulated upper airway obstruction, a study was carried out in 12 patients (mean (SD) age 57 (7) years) with chronic obstructive lung disease (FEV1% predicted 53 (22), range 21-70) and 12 matched control subjects. Patients and control subjects performed maximal inspiratory

D R Robertson; C R Swinburn; T N Stone; G J Gibson

1989-01-01

385

Penalizing Hospitals for Chronic Obstructive Pulmonary Disease Readmissions  

PubMed Central

In October 2014, the U.S. Centers for Medicare and Medicaid Services (CMS) will expand its Hospital Readmission Reduction Program (HRRP) to include chronic obstructive pulmonary disease (COPD). Under the new policy, hospitals with high risk-adjusted, 30-day all-cause unplanned readmission rates after an index hospitalization for a COPD exacerbation will be penalized with reduced reimbursement for the treatment of Medicare beneficiaries. In this perspective, we review the history of the HRRP, including the recent addition of COPD to the policy. We critically assess the use of 30-day all-cause COPD readmissions as an accountability measure, discussing potential benefits and then highlighting the substantial drawbacks and potential unintended consequences of the measure that could adversely affect providers, hospitals, and patients with COPD. We conclude by emphasizing the need to place the 30-day COPD readmission measure in the context of a reconceived model for postdischarge quality and review several frameworks that could help guide this process. PMID:24460431

Au, David H.

2014-01-01

386

Chronic obstructive pulmonary disease and sleep: the interaction.  

PubMed

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death, affecting 14 millions adults in the United States. Symptoms related to sleep disturbances are common in individuals with moderate to severe COPD, particularly in the elderly, which is commonly manifested as morning fatigue and early awakenings. One major cause of morbidity in this population is abnormalities in gas exchange and resultant hypoxemia as they can lead to elevated pulmonary pressures, dyspnea and in severe cases right ventricular overload and failure. Sleep has profound adverse effects on respiration and gas exchange in patients with COPD. There are several mechanisms underlying nonapneic oxygen desaturation during sleep. They include decreased functional residual capacity, diminished ventilatory responses to hypoxia and hypercapnia, impaired respiratory mechanics, diminished arousal, respiratory muscle fatigue, diminished nonchemical respiratory drive, increased upper airway resistance, and the starting point of baseline saturation values while awake on the oxyhemoglobin dissociation curve. Smoking cessation, bronchodilation, inhaled steroids in those with a reversible component and pulmonary rehabilitation are corner stones of treatment of COPD. The goals of therapy for the clinician should be to improve lung mechanics as well as gas exchange ultimately leading to better sleep quality and health status. PMID:17215794

Urbano, F; Mohsenin, V

2006-12-01

387

Significance of bioinformatics in research of chronic obstructive pulmonary disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is an inflammatory disease characterized by the progressive deterioration of pulmonary function and increasing airway obstruction, with high morality all over the world. The advent of high-throughput omics techniques provided an opportunity to gain insights into disease pathogenesis and process which contribute to the heterogeneity, and find target-specific and disease-specific therapies. As an interdispline, bioinformatics supplied vital information on integrative understanding of COPD. This review focused on application of bioinformatics in COPD study, including biomarkers searching and systems biology. We also presented the requirements and challenges in implementing bioinformatics to COPD research and interpreted these results as clinical physicians. PMID:22185624

2011-01-01

388

Subcutaneous treprostinil for pulmonary hypertension in chronic lung disease of infancy.  

PubMed

Pulmonary arterial hypertension (PAH) associated with chronic lung disease of infancy can be a life-threatening disease affecting an increasing number of former premature infants. There is a need for improved delivery of targeted PAH therapies for this subgroup of patients who have severe and persistent PAH despite standard respiratory care for chronic lung disease. Currently infants who have severe PAH despite oral or inhaled therapy receive continuous intravenous prostanoid therapy (mostly epoprostenol), which is complicated because of the need for central venous access and associated catheter-related complications. We present a series of 5 infants who were successfully treated with a continuous infusion of subcutaneous treprostinil, which is a longer-acting prostanoid with similar hemodynamic effects. There were improvements in echocardiographic assessment of right ventricular function and estimated pulmonary hypertension, and in respiratory support required within weeks of therapy. Unlike commonly in adults, these 5 infants had no instances of severe site erythema, bleeding, bruising, or infection. In our experience with 5 former extremely preterm infants who had PAH associated with chronic lung disease, subcutaneous treprostinil was safe, efficacious, and well tolerated. We believe that subcutaneous treprostinil can be beneficial in a select group of former premature infants who have chronic lung disease and severe pulmonary arterial hypertension who have not responded adequately to conservative therapies. PMID:24982101

Ferdman, Dina J; Rosenzweig, Erika B; Zuckerman, Warren A; Krishnan, Usha

2014-07-01

389

Chronic pancreatitis: A surgical disease? Role of the Frey procedure  

PubMed Central

Although medical treatment and endoscopic interventions are primarily offered to patients with chronic pancreatitis, approximately 40% to 75% will ultimately require surgery during the course of their disease. Although pancreaticoduodenectomy has been considered the standard surgical procedure because of its favorable results on pain control, its high postoperative complication and pancreatic exocrine or/and endocrine dysfunction rates have led to a growing enthusiasm for duodenal preserving pancreatic head resection. The aim of this review is to better understand the rationale underlying of the Frey procedure in chronic pancreatitis and to analyze its outcome. Because of its hybrid nature, combining both resection and drainage, the Frey procedure has been conceptualized based on the pathophysiology of chronic pancreatitis. The short and long-term outcome, especially pain relief and quality of life, are better after the Frey procedure than after any other surgical procedure performed for chronic pancreatitis. PMID:25068010

Roch, Alexandra; Teyssedou, Jérome; Mutter, Didier; Marescaux, Jacques; Pessaux, Patrick

2014-01-01

390

Anti-Inflammatory Therapy in Chronic Disease: Challenges and Opportunities  

PubMed Central

A number of widespread and devastating chronic diseases, including atherosclerosis, type 2 diabetes, and Alzheimer’s disease, have a pathophysiologically important inflammatory component. In these diseases, the precise identity of the inflammatory stimulus is often unknown and, if known, is difficult to remove. Thus, there is interest in therapeutically targeting the inflammatory response. Although there has been success with anti-inflammatory therapy in chronic diseases triggered by primary inflammation dysregulation or autoimmunity, there are considerable limitations. In particular, the inflammatory response is critical for survival. As a result, redundancy, compensatory pathways, and necessity narrow the risk:benefit ratio of anti-inflammatory drugs. However, new advances in understanding inflammatory signaling and its links to resolution pathways, together with new drug development, offer promise in this area of translational biomedical research. PMID:23307734

Tabas, Ira; Glass, Christopher K.

2013-01-01

391

“SICKLE CELL DISEASE AFFECTS PHYSICAL GROWTH”  

E-print Network

Anthropometric measurements were used to study the physical growth of 294 sickle cell disease(SS) children and compared with 180 normal(AA) children from the Nagpur district of Maharashtra. Both sickle cell disease male and female children were shown to have statistically significant lower weights

R. A. Nandanwar; N. Y. Kamdi; N. Y. Kamdi

392

Gas exchange in disease: asthma, chronic obstructive pulmonary disease, cystic fibrosis, and interstitial lung disease.  

PubMed

Ventilation-perfusion (VA/Q) inequality is the underlying abnormality determining hypoxemia and hypercapnia in lung diseases. Hypoxemia in asthma is characterized by the presence of low VA/Q units, which persist despite improvement in airway function after an attack. This hypoxemia is generally attenuated by compensatory redistribution of blood flow mediated by hypoxic vasoconstriction and changes in cardiac output, however, mediator release and bronchodilator therapy may cause deterioration. Patients with chronic obstructive pulmonary disease have more complex patterns of VA/Q inequality, which appear more fixed, and changes in blood flow and ventilation have less benefit in improving gas exchange efficiency. The inability of ventilation to match increasing cardiac output limits exercise capacity as the disease progresses. Deteriorating hypoxemia during exacerbations reflects the falling mixed venous oxygen tension from increased respiratory muscle activity, which is not compensated by any redistribution of VA/Q ratios. Shunt is not a feature of any of these diseases. Patients with cystic fibrosis (CF) have no substantial shunt when managed according to modern treatment regimens. Interstitial lung diseases demonstrate impaired oxygen diffusion across the alveolar-capillary barrier, particularly during exercise, although VA/Q inequality still accounts for most of the gas exchange abnormality. Hypoxemia may limit exercise capacity in these diseases and in CF. Persistent hypercapnic respiratory failure is a feature of advancing chronic obstructive pulmonary disease and CF, closely associated with sleep disordered breathing, which is not a prominent feature of the other diseases. Better understanding of the mechanisms of hypercapnic respiratory failure, and of the detailed mechanisms controlling the distribution of ventilation and blood flow in the lung, are high priorities for future research. PMID:23737199

Young, Iven H; Bye, Peter T P

2011-04-01

393

The Global Burden of Chronic Diseases Overcoming Impediments to Prevention and Control  

Microsoft Academic Search

Chronic diseases are the largest cause of death in the world. In 2002, the leading chronic diseases—cardiovascular disease, cancer, chronic respira- tory disease, and diabetes—caused 29 million deaths worldwide. Despite growing evidence of epidemiological and economic impact, the global re- sponse to the problem remains inadequate. Stakeholders include govern- ments, the World Health Organization and other United Nations bodies, aca-

Derek Yach; Corinna Hawkes; C. Linn Gould; Karen J. Hofman

394

Bone Marrow and Kidney Transplant for Patients With Chronic Kidney Disease and Blood Disorders  

ClinicalTrials.gov

Chronic Kidney Disease; Acute Myeloid Leukemia (AML); Acute Lymphoblastic Leukemia (ALL); Chronic Myelogenous Leukemia (CML); Chronic Lymphocytic Leukemia (CLL); Non-Hodgkin's Lymphoma (NHL); Hodgkin Disease; Multiple Myeloma; Myelodysplastic Syndrome (MDS); Aplastic Anemia; AL Amyloidosis; Diamond Blackfan Anemia; Myelofibrosis; Myeloproliferative Disease; Sickle Cell Anemia; Autoimmune Diseases; Thalassemia

2014-11-03

395

Quality of life and emotional state in chronic skin disease.  

PubMed

The aim of this study was to evaluate the associations between chronic inflammatory skin conditions and patients' emotional state and quality of life. The following self-rated questionnaires were used: Emotional State Questionnaire, a self-report scale assessing depression and anxiety symptoms; Dermatology Life Quality Index (DLQI); and RAND-36, a measure of health-related quality of life. The study group comprised 40 patients with psoriasis, 40 with eczema, 40 with acne, 15 with seborrhoeic dermatitis and 40 healthy controls. Patients with chronic skin diseases had lower DLQI and lower RAND-36 physical functioning scores, more perceived physical limitations and pain, and lower emotional well-being and general health ratings compared with the control group. In conclusion, chronic skin diseases are associated with symptoms of emotional distress, in particular insomnia and general anxiety. PMID:24978135

Pärna, Ene; Aluoja, Anu; Kingo, Külli

2015-03-01

396

Therapeutic strategies to slow chronic kidney disease progression  

Microsoft Academic Search

Childhood chronic kidney disease commonly progresses toward end-stage renal failure, largely independent of the underlying\\u000a disorder, once a critical impairment of renal function has occurred. Hypertension and proteinuria are the most important independent\\u000a risk factors for renal disease progression. Therefore, current therapeutic strategies to prevent progression aim at controlling\\u000a blood pressure and reducing urinary protein excretion. Renin-angiotensin-system (RAS) antagonists preserve

Elke Wühl; Franz Schaefer

2008-01-01

397

Understanding the role of genetic polymorphisms in chronic kidney disease  

Microsoft Academic Search

Although no valid studies clearly indicate increasing or decreasing numbers of incident paediatric patients, the prevalence\\u000a of chronic kidney disease (CKD) and end-stage renal disease (ESRD) is growing worldwide. This is mainly due to improved access\\u000a to renal replacement therapy (RRT), increased survival after dialysis and kidney transplantation and an increase in diagnosis\\u000a and referral of these patients. Although the

Karin Luttropp; Peter Stenvinkel; Juan Jesús Carrero; Roberto Pecoits-Filho; Bengt Lindholm; Louise Nordfors

2008-01-01

398

The origin of interstitial myofibroblasts in chronic kidney disease  

Microsoft Academic Search

Chronic kidney diseases (CKD), independent of their primary cause, lead to progressive, irreversible loss of functional renal\\u000a parenchyma. Renal pathology in CKD is characterized by tubulointerstitial fibrosis with excessive matrix deposition produced\\u000a by myofibroblasts. Because blocking the formation of these scar-forming cells represents a logical therapeutic target for\\u000a patients with progressive fibrotic kidney disease, the origin of renal myofibroblasts is

Ivica Grgic; Jeremy S. Duffield; Benjamin D. Humphreys

399

Prevalence of Heart Disease in Asymptomatic Chronic Cocaine Users  

Microsoft Academic Search

To determine the prevalence of heart disease in outpatient young asymptomatic chronic cocaine users, 35 cocaine users and 32 age-matched controls underwent resting and exercise electrocardiography (ECG) and Doppler echocardiography. Findings consistent with coronary artery disease were detected in 12 (34%) patients and 3 (9%) controls (p = 0.01). Decreased left ventricular systolic function was demonstrated in 5 (14%) patients,

Carlos A. Roldan; Darius Aliabadi; Michael H. Crawford

2001-01-01

400

Friends, social networks, and progressive chronic kidney disease.  

PubMed

A report by Dunkler et al. reminds us that social factors are relevant for today's clinical scientist and practitioner. They report that an increasing number of friends reduces the incidence and progression of chronic kidney disease in type 2 diabetes. The observation that 'friends don't let friends' develop kidney disease suggests that social factors, as well as biomarkers, may be relevant in developing 'personalized renal medicine' and may identify areas for future nephrology research and education. PMID:25826543

McClellan, William M; Doran, John J

2015-04-01

401

The contribution of chronic kidney disease to the global burden of major noncommunicable diseases  

Microsoft Academic Search

Noncommunicable diseases (NCDs) are the most common causes of premature death and morbidity and have a major impact on health-care costs, productivity, and growth. Cardiovascular disease, cancer, diabetes, and chronic respiratory disease have been prioritized in the Global NCD Action Plan endorsed by the World Health Assembly, because they share behavioral risk factors amenable to public-health action and represent a

William G Couser; Giuseppe Remuzzi; Shanthi Mendis; Marcello Tonelli

2011-01-01

402

Chronic Kidney Disease, Mortality, and Treatment Strategies among Patients with Clinically Significant Coronary Artery Disease  

Microsoft Academic Search

Cardiovascular disease is an important cause of mortal- ity among patients with chronic kidney disease (CKD). This study describes associations between CKD, cardiac revascularization strategies, and mortality among patients with CKD and cardio- vascular disease. All patients undergoing cardiac catheterization at Duke University Medical Center (1995 to 2000) with documented stenosis 75% of at least one coronary artery and available

DONAL N. REDDAN; LYNDA ANNE SZCZECH; ROBERT H. TUTTLE; LINDA K. SHAW; ROBERT H. JONES; STEVE J. SCHWAB; MARK STAFFORD SMITH; ROBERT M. CALIFF; DANIEL B. MARK; WILLIAM F. OWEN JR

2003-01-01

403

Anemia and bone disease of chronic kidney disease: pathogenesis, diagnosis, and management.  

PubMed

Anemia and metabolic bone disease accompany chronic kidney disease (CKD), and worsen as CKD progresses. It is likely that both processes contribute to the increased morbidity and mortality seen in CKD. This paper briefly reviews the pathogenesis and diagnosis of anemia and bone disease in CKD, and summarizes recent consensus guidelines for treatment. PMID:25463623

Shemin, Douglas

2014-12-01

404

Relationship between coronary artery disease and pulmonary arterial pressure in patients with chronic obstructive pulmonary disease  

PubMed Central

The aim of the present study was to determine whether there is a relationship between coronary artery disease and pulmonary hypertension and whether pulmonary hypertension is an additional risk factor for the presence and extent of coronary artery disease in patients with chronic obstructive pulmonary disease. Patients diagnosed with chronic obstructive pulmonary disease and pulmonary hypertension, and undergone diagnostic coronary angiography for evaluation of suspected coronary artery disease constituted the study group. Patients were divided into two groups according to the presence or absence of coronary artery disease and compared for age, gender, accompanying chronic disease, and pulmonary function tests. A total of 95 patients were recruited in the study. Comparison of the groups revealed that two groups were significantly different on gender (p=0.029), presence of hypertension (p=0.027), and biomass (p=0.040). Correlation analysis of variables revealed that male gender (rs=0.224, p=0.029), hypertension (rs=0.227, p=0.07) were positively correlated with the presence of coronary artery disease. FEV1/FVC ratio (rs=-0.253, p=0.013) and sPAP (rs=-0.215, p=0.037) were negatively correlated with the presence of coronary artery disease. High prevalence of coronary artery disease in patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease was found. However, no correlation between the presence and severity of coronary artery disease and pulmonary hypertension was detected. PMID:25664116

Asker, Muntecep; Asker, Selvi; Kucuk, Ugur; Kucuk, Hilal Olgun; Ozbay, Bulent

2014-01-01

405

Self-Management Support Interventions for Persons With Chronic Disease  

PubMed Central

Background Self-management support interventions such as the Stanford Chronic Disease Self-Management Program (CDSMP) are becoming more widespread in attempt to help individuals better self-manage chronic disease. Objective To systematically assess the clinical effectiveness of self-management support interventions for persons with chronic diseases. Data Sources A literature search was performed on January 15, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database for studies published between January 1, 2000, and January 15, 2012. A January 1, 2000, start date was used because the concept of non-disease-specific/general chronic disease self-management was first published only in 1999. Reference lists were examined for any additional relevant studies not identified through the search. Review Methods Randomized controlled trials (RCTs) comparing self-management support interventions for general chronic disease against usual care were included for analysis. Results of RCTs were pooled using a random-effects model with standardized mean difference as the summary statistic. Results Ten primary RCTs met the inclusion criteria (n = 6,074). Nine of these evaluated the Stanford CDSMP across various populations; results, therefore, focus on the CDSMP. Health status outcomes: There was a small, statistically significant improvement in favour of CDSMP across most health status measures, including pain, disability, fatigue, depression, health distress, and self-rated health (GRADE quality low). There was no significant difference between modalities for dyspnea (GRADE quality very low). There was significant improvement in health-related quality of life according to the EuroQol 5-D in favour of CDSMP, but inconsistent findings across other quality-of-life measures. Healthy behaviour outcomes: There was a small, statistically significant improvement in favour of CDSMP across all healthy behaviours, including aerobic exercise, cognitive symptom management, and communication with health care professionals (GRADE quality low). Self-efficacy: There was a small, statistically significant improvement in self-efficacy in favour of CDSMP (GRADE quality low). Health care utilization outcomes: There were no statistically significant differences between modalities with respect to visits with general practitioners, visits to the emergency department, days in hospital, or hospitalizations (GRADE quality very low). All results were measured over the short term (median 6 months of follow-up). Limitations Trials generally did not appropriately report data according to intention-to-treat principles. Results therefore reflect “available case analyses,” including only those participants whose outcome status was recorded. For this reason, there is high uncertainty around point estimates. Conclusions The Stanford CDSMP led to statistically significant, albeit clinically minimal, short-term improvements across a number of health status measures (including some measures of health-related quality of life), healthy behaviours, and self-efficacy compared to usual care. However, there was no evidence to suggest that the CDSMP improved health care utilization. More research is needed to explore longer-term outcomes, the impact of self-management on clinical outcomes, and to better identify responders and non-responders. Plain Language Summary Self-management support interventions are becoming more common as a structured way of helping patients learn to better manage their chronic disease. To assess the effects of these support interventions, we looked at the results of 10 studies involving a total of 6,074 people with various chronic diseases, such as arthritis and chronic pain, chronic respiratory diseases, depression, diabetes, heart disease, and stroke. Most trials focused on a program called the Stanford Chronic Disease Self-Management Program (CDSMP). W

Franek, J

2013-01-01

406

Risk Factors for Chronic Kidney Disease  

MedlinePLUS

Home » Kidney Info » 1 in 9 Adults Risk Factors for CKD When you have a risk factor, it means you are more likely to have a problem than someone who does ... to prevent or delay kidney failure. Kidney Disease Risk Factors You Can Change Diabetes Type 2 diabetes ...

407

Understanding panic disorder in chronic respiratory disease.  

PubMed

As well as being physically debilitating, respiratory diseases present significant challenges to the psychological well-being of individuals and their families and are recognized to have an impact on health-care services, resources and time. Panic attacks and disorder are particularly prevalent in people with respiratory conditions and appear to be associated with reduced lung function. However, recent evidence suggests that the aetiology of panic in this area may be related more to underlying psychological processes, which can influence cognitions that are related to the experience of respiratory disease and its symptoms. The aim of this article is to give a brief overview of the literature to identify key psychological factors associated with panic and respiratory diseases. The article concludes that panic has a complex aetiology, which requires the presence of specific respiratory-related cognitions. The self-regulatory model can foster understanding of the combination of beliefs/cognitions that can increase the prevalence of negative mood for patients with respiratory diseases. PMID:19448578

Hallas, Claire; Howard, Claire; Wray, Jo

408

Myocardial fibrosis in chronic kidney disease: potential benefits of torasemide  

Microsoft Academic Search

Interstitial and perivascular fibrosis is a constant finding in heart biopsies and necropsy studies in patients with chronic kidney disease and hypertension, namely in those with left ventricular hypertrophy. Fibrosis is the result of the unbalance between exaggerated collagen synthesis and unchanged or depressed collagen degradation. A number of factors linked to hypertension and the progressive deterioration of renal function

Begoña López; Arantxa González; Nerea Hermida; Concepción Laviades; Javier Díez

2008-01-01

409

Regulation of fibroblast growth factor-23 in chronic kidney disease  

Microsoft Academic Search

Background. Fibroblast growth factor-23 (FGF23) is a circulating factor that regulates the renal reabsorption of inorganic phosphate (Pi) and is increased in chronic kidney disease (CKD). The aim of the current investigation was to study the regulation of FGF23 in CKD subjects with various degree of renal function. As such, we analysed the relationship between FGF23, Pi, calcium, parathyriod hormone

Per-Anton Westerberg; Torbjorn Linde; Bjorn Wikstrom; Osten Ljunggren; Mats Stridsberg; Tobias E. Larsson

2007-01-01

410

The importance of early detection of chronic kidney disease  

Microsoft Academic Search

Despite the absence of precise epidemiological data, we know there are a great many patients in the conservative phase of chronic kidney disease (CKD). The incidence and prevalence of renal replacement therapy (RRT) is increasing worldwide. As well as being a large and growing clinical problem, CKD is of an economic and organizational concern, since RRT consumes a considerable proportion

Francesco Locatelli; Lucia Del Vecchio; Pietro Pozzoni

411

Circulating Leptin in Patients with Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Unexplained weight loss is common in patients with chronic obstructive pulmonary disease (COPD). Since leptin, an obesity gene product, is known to play important roles in the control of body weight and energy expenditure, we investigated serum leptin levels, along with circulating tumor necrosis factor- a (TNF- a ) and soluble TNF receptor (sTNF-R55 and -R75) levels, in 31 patients

NORIAKI TAKABATAKE; HIDENORI NAKAMURA; SHUICHI ABE; TOSHIHIKO HINO; HIROSHI SAITO; HIDEKI YUKI; SHUICHI KATO; HITONOBU TOMOIKE

1999-01-01

412

Mineral and bone disorders in children with chronic kidney disease  

Microsoft Academic Search

As children with chronic kidney disease (CKD) have a long lifespan, optimal control of bone and mineral homeostasis is essential not only for the prevention of debilitating skeletal complications and for achieving adequate growth but also for preserving long-term cardiovascular health. As the growing skeleton is highly dynamic and at particular risk of deterioration, close control of bone and mineral

Otto Mehls; Claus Peter Schmitt

2011-01-01

413

DOES CHRONIC OZONE EXPOSURE LEAD TO LUNG DISEASE?  

EPA Science Inventory

The potential role of ozone in the induction of chronic lung diseases remains unclear. sing an ambient profile adopted from aerometric data from the Southwest Air Basin, rats were exposed to O3 for up to 18 months before assessments of pulmonary structure, function and biochemist...

414

New vitamin D analogues for osteodystrophy in chronic kidney disease  

Microsoft Academic Search

Vitamin D therapy for patients with chronic kidney disease has until recently comprised alfacalcidol or calcitriol, both of which effectively attenuate secondary hyperparathyroidism and the target organ consequences thereof. Unfortunately, both these agents also have significant calcaemic and phosphataemic actions leading to frequent episodes of hypercalcaemia, hyperphosphataemia and an increase in the CaxP product. It is likely that these in

John Cunningham

2004-01-01

415

Palliative care provision for patients with chronic obstructive pulmonary disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a major cause of disability, morbidity and mortality in old age. Patients with advanced stage COPD are most likely to be admitted three to four times per year with acute exacerbations of COPD (AECOPD) which are costly to manage. The adverse events of AECOPD are associated with poor quality of life, severe physical disability,

Abebaw Mengistu Yohannes

2007-01-01

416

A Quantitative Approach to Drug Dosing in Chronic Kidney Disease  

Microsoft Academic Search

Chronic kidney disease (CKD) is increasing at an alarming rate. Medication prescribing in this growing population is especially difficult. Many pharmacological agents or their metabolites are eliminated unchanged through the kidney. Drug dosing in CKD is challenging as most patients have a number of comorbid conditions. Patients with CKD take pharmacological agents with potential for drug interactions. Most patients also

Ali J. Olyaei; Jessica L. Steffl

2011-01-01

417

Hepatitis E virus superinfection in patients with chronic liver disease  

Microsoft Academic Search

Infection with hepatitis A virus (HAV) can cause severe illness in adult patients with chronic liver disease (CLD) caused by hepatitis C. In endemic areas such as South Asia, however, most adult patients already have been exposed to HAV but could still be susceptible to hepatitis E virus (HEV) infection. We document that HEV superinfection in 4 of our CLD

Saeed S. Hamid; Muslim Atiq; Farooq Shehzad; Aneela Yasmeen; Tayyabun Nissa; Abdul Salam; Anwar Siddiqui; Wasim Jafri

2002-01-01

418

Home telecare: system architecture to support chronic disease management  

Microsoft Academic Search

A system architecture to support information transfer between hospital, general practitioner and the home is described in the context of a Home Telecare System (HTS). The HTS facilitates the acquisition, review, analysis and archiving of a longitudinal clinical record to support chronic disease management. The system allows the clinician to schedule for his,her patient the regular recording of clinical measurements

Farah Magrabi; Nigel H. Lovell; Khang Huynh; Branko G. Celler

2001-01-01

419

Mechanisms and treatment of extraosseous calcification in chronic kidney disease  

Microsoft Academic Search

Strong and unidirectional associations exist between the severity of cardiovascular calcifications and mortality in patients with advanced chronic kidney disease. In the past 10 years, a wealth of experimental and clinical information has been published on the key pathophysiological events that contribute to the development and progression of vascular and soft-tissue calcifications. These processes involve a sensitive balance of calcification

Hansjörg Rothe; Thilo Krüger; Patrick H. Biggar; Georg Schlieper; Markus Ketteler

2011-01-01

420

Participatory Research for Chronic Disease Prevention in Inuit Communities  

ERIC Educational Resources Information Center

Objective: To develop a community-based chronic disease prevention program for Inuit in Nunavut, Canada. Methods: Stakeholders contributed to intervention development through formative research [in-depth interviews (n = 45), dietary recalls (n = 42)], community workshops, group feedback and implementation training. Results: Key cultural themes…

Gittelsohn, Joel; Roache, Cindy; Kratzmann, Meredith; Reid, Rhonda; Ogina, Julia; Sharma, Sangita

2010-01-01

421

Itraconazole to Prevent Fungal Infections in Chronic Granulomatous Disease  

Microsoft Academic Search

background Chronic granulomatous disease is a rare disorder in which the phagocytes fail to pro- duce hydrogen peroxide. The patients are predisposed to bacterial and fungal infec- tions. Prophylactic antibiotics and interferon gamma have reduced bacterial infec- tions, but there is also the danger of life-threatening fungal infections. We assessed the efficacy of itraconazole as prophylaxis against serious fungal infections

John I. Gallin; David W. Alling; Harry L. Malech; Robert Wesley; Deloris Koziol; Beatriz Marciano; Eli M. Eisenstein; Maria L. Turner; Ellen S. DeCarlo; Judith M. Starling; Steven M. Holland

2003-01-01

422

Evaluation and treatment of gout as a chronic disease.  

PubMed

Gout is a disease caused by deposition of monosodium urate crystals in tissues. One of the limitations for successful treatment of gout is to consider it as an intermittent disease rather than a chronic inflammatory disease which, if improperly treated, leads to chronic clinical manifestations. In addition, gout is linked to increased cardiovascular morbidity and mortality.Urate-lowering therapy comprises both nonpharmacologic and pharmacologic interventions, but most patients will need urate-lowering drugs to achieve target therapeutic serum urate levels. Reaching target serum urate levels is associated with improvement in clinical outcomes, including a reduction of acute inflammation episodes, resolution of tophi, and improvement in health-related quality of life perception.A number of urate-lowering drugs are available but a number of patients fail to achieve or maintain therapeutic serum urate levels and go on to develop refractory chronic gout. For such patients, efforts have been made to develop new treatments (e.g., febuxostat or pegloticase).This review intends to increase the awareness of gout as a chronic deposition disease, and show that efforts should be made to properly control serum urate levels in order to achieve complete disappearance of urate crystal deposition. PMID:23104464

Perez-Ruiz, Fernando; Herrero-Beites, Ana Maria

2012-11-01

423

Chronic systemic pesticide exposure reproduces features of Parkinson's disease  

Microsoft Academic Search

The cause of Parkinson's disease (PD) is unknown, but epidemiological studies suggest an association with pesticides and other environmental toxins, and biochemical studies implicate a systemic defect in mitochondrial complex I. We report that chronic, systemic inhibition of complex I by the lipophilic pesticide, rotenone, causes highly selective nigrostriatal dopaminergic degeneration that is associated behaviorally with hypokinesia and rigidity. Nigral

Ranjita Betarbet; Todd B. Sherer; Gillian MacKenzie; Monica Garcia-Osuna; Alexander V. Panov; J. Timothy Greenamyre

2000-01-01

424

Prevalence of Comorbidities in Patients with Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Background: Chronic obstructive pulmonary disease (COPD) is associated with many comorbidities, but the percentage of COPD patients who develop comorbidities has not been clearly defined. Objectives: We aimed to examine the relationship between COPD and comorbidities using information obtained from the Health Search Database (HSD) owned by the Italian College of General Practitioners (SIMG), which stores information on about 1.5%

Mario Cazzola; Germano Bettoncelli; Emiliano Sessa; Claudio Cricelli; Gianluca Biscione

2010-01-01

425

The clinical use of HVPG measurements in chronic liver disease  

Microsoft Academic Search

Portal hypertension is a severe, almost unavoidable complication of chronic liver diseases and is responsible for the main clinical consequences of cirrhosis. Measurement of the hepatic venous pressure gradient (HVPG) is currently the best available method to evaluate the presence and severity of portal hypertension. Clinically significant portal hypertension is defined as an increase in HVPG to ?10 mmHg; above

Juan G. Abraldes; Annalisa Berzigotti; Juan Carlos García-Pagan; Jaime Bosch

2009-01-01

426

Management of cardiovascular disease risk in chronic inflammatory disorders  

Microsoft Academic Search

Patients with chronic inflammatory disorders are at increased risk of developing premature cardiovascular disease. Despite significant advances in our understanding of the effects of inflammatory pathways on the vasculature, clear guidelines on the management of traditional and nontraditional cardiovascular risk factors in patients with systemic autoimmunity are lacking. Thus, rigorous studies assessing the individual contributions of the various treatments used

Mariana J. Kaplan

2009-01-01

427

Vascular calcification and cardiovascular function in chronic kidney disease  

Microsoft Academic Search

Background. Vascular calcification and arterial stiff- ening are independent predictors of all causes and cardiovascular mortality in chronic kidney disease (CKD). Few data are currently available comparing vascular calcification and its attendant functional cardiovascular consequences between CKD stage 4 patients and both peritoneal dialysis (PD) and haemodialysis (HD) (CKD stage 5) patients. Method. We studied 134 subjects (60 HD, 28

Mhairi Sigrist; Peter Bungay; Maarter W. Taal; Christopher W. McIntyre

2005-01-01

428

IMPROVING CHRONIC DISEASE CARE USING PREDICTIVE MODELING AND DATA MINING  

Microsoft Academic Search

We use simulation technology to investigate patterns of physician treatments predictive of healthcare outcomes for patients with a specific chronic disease. Clinical encounters are simulated using statistical models of real patient data and explanatory models of physician treatment strategies. From these simulations, features representative of real physician-patient encounters are captured in a database. We perform subgroup analysis and then apply

Gregory W. Ramsey; Paul E. Johnson; Gediminas Adomavicius; Ryan M McCabe

429

Prognostic Value of Nutritional Status in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

The association between low body mass index (BMI) and poor prognosis in patients with chronic ob- structive pulmonary disease (COPD) is a common clinical observation. We prospectively examined whether BMI is an independent predictor of mortality in subjects with COPD from the Copenhagen City Heart Study. In total, 1,218 men and 914 women, aged 21 to 89 yr, with airway

CHARLOTTE LANDBO; EVA PRESCOTT; PETER LANGE; JØRGEN VESTBO; THOMAS P. ALMDAL

1999-01-01

430

Cause and Consequences of Sympathetic Hyperactivity in Chronic Kidney Disease  

Microsoft Academic Search

Patients with chronic kidney disease and patients undergoing hemodialysis treatment show a sustained overactivity of the sympathetic nervous system, which originates from signals arising in the failing kidneys and traveling via afferent renal nerves to cardiovascular centers in the brainstem. Additional important factors are increased levels of angiotensin II and asymmetrical dimethylarginine. The sympathetic overactivity contributes to hypertension and cardiovascular

Peter Kotanko

2006-01-01

431

Drugs in Clinical Development for Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Many drugs may be potentially useful in the treatment of chronic obstructive pulmonary disease (COPD), but relatively few become available for human use due to lack of safety, lack of efficacy, or both. This is an inherent risk in the drug development process, which coupled with the limited understanding of the molecular pathogenesis of COPD, has produced a trend toward

Néstor A. Molfino

2005-01-01

432

Students with Chronic Diseases: Nature of School Physician Support  

ERIC Educational Resources Information Center

Background: To educate children with chronic diseases in the least restrictive environment, schools must prevent, recognize, and react appropriately to symptom exacerbations. Schools are often pushed to their limits of knowledge, resources, and comfort level. This study determined the health conditions of students for whom districts seek school…

Taras, Howard; Brennan, Jesse J.

2008-01-01

433

Experimental chronic wasting disease (CWD) in fallow deer  

Technology Transfer Automated Retrieval System (TEKTRAN)

To determine the transmissibility of chronic wasting disease (CWD) to fallow deer (Cervus dama) and to provide information about clinical course, lesions and suitability of currently used diagnostic procedures for detection of CWD in this species, 13 fawns were inoculated intracerebrally with CWD br...

434

Gender Differences in Chronic Kidney Disease: Underpinnings and Therapeutic Implications  

Microsoft Academic Search

In nephrology, gender differences exist with regard to the epidemiology, evolution and prognosis of chronic kidney disease (CKD). In some cases, these differences run contrary to the general population trends. This review discusses such gender and sex disparities, including differing impact of traditional and novel risk factors, prescription patterns, differences in the responses to therapies, as well as hormonal factors,

Juan Jesús Carrero

2010-01-01

435

CHRONIC WASTING DISEASE OF CAPTIVE MULE DEER: A SPONGIFORM ENCEPHALOPATHY  

Microsoft Academic Search

In the past 12 years (1967-79) a syndrome we identify as chronic wasting disease has been observed in 53 mule deer (Odocoileus hemionus hemionus) and one black-tailed deer (Odocoileus hemionus columbianus) held in captivity in several wildlife facilities in Colorado and more recently in Wyoming. Clinical signs were seen in adultdeerand includedbehavioral alterations, progressive weight loss and death in 2

E. S. WILLIAMS; S. YOUNG

436

Children with Rare Chronic Skin Diseases: Hemangiomas and Epidermolysis Bullosa.  

ERIC Educational Resources Information Center

The paper reports on studies involving children having the rare chronic skin diseases of hemangiomas and epidermolysis bullosa (characterized by easy blistering). One study compared the self-concept and psychosocial development of young (mean age 46 months) children (N=19) with hemangiomas with 19 children without hemangiomas. Findings indicated…

Jones, Sheila Dove; Miller, Cynthia Dieterich

437

Consensus statement on chronic and subacute high altitude diseases.  

PubMed

This is an international consensus statement of an ad hoc committee formed by the International Society for Mountain Medicine (ISMM) at the VI World Congress on Mountain Medicine and High Altitude Physiology (Xining, China; 2004) and represents the committee's interpretation of the current knowledge with regard to the most common chronic and subacute high altitude diseases. It has been developed by medical and scientific authorities from the committee experienced in the recognition and prevention of high altitude diseases and is based mainly on published, peer-reviewed articles. It is intended to include all legitimate criteria for choosing to use a specific method or procedure to diagnose or manage high altitude diseases. However, the ISMM recognizes that specific patient care decisions depend on the different geographic circumstances involved in the development of each chronic high altitude disease. These guidelines are established to inform the medical services on site who are directed to solve high altitude health problems about the definition, diagnosis, treatment, and prevention of the most common chronic high altitude diseases. The health problems associated with life at high altitude are well documented, but health policies and procedures often do not reflect current state-of-the-art knowledge. Most of the cases of high altitude diseases are preventable if on-site personnel identify the condition and implement appropriate care. PMID:16060849

León-Velarde, Fabiola; Maggiorini, Marco; Reeves, John T; Aldashev, Almaz; Asmus, Ingrid; Bernardi, Luciano; Ge, Ri-Li; Hackett, Peter; Kobayashi, Toshio; Moore, Lorna G; Penaloza, Dante; Richalet, Jean-Paul; Roach, Robert; Wu, Tianyi; Vargas, Enrique; Zubieta-Castillo, Gustavo; Zubieta-Calleja, Gustavo

2005-01-01

438

Community perceptions of health and chronic disease in South Indian rural transitional communities: a qualitative study  

PubMed Central

Background Chronic diseases are now the leading cause of death and disability worldwide; this epidemic has been linked to rapid economic growth and urbanisation in developing countries. Understanding how characteristics of the physical, social, and economic environment affect behaviour in the light of these changes is key to identifying successful interventions to mitigate chronic disease risk. Design We undertook a qualitative study consisting of nine focus group discussions (FGDs) (n=57) in five villages in rural Andhra Pradesh, South India, to understand people's perceptions of community development and urbanisation in relation to chronic disease in rural transitional communities. Specifically, we sought to understand perceptions of change linked to diet, physical activity, and pollution (because these exposures are most relevant to chronic diseases), with the aim of defining future interventions. The transcripts were analysed thematically. Results Participants believed their communities were currently less healthy, more polluted, less physically active, and had poorer access to nutritious food and shorter life expectancies than previously. There were contradictory perceptions of the effects of urbanisation on health within and between individuals; several of the participants felt their quality of life had been reduced. Conclusions In the present study, residents viewed change and development within their villages as an inevitable and largely positive process but with some negative health consequences. Understanding how these changes are affecting populations in transitional rural areas and how people relate to their environment may be useful to guide community planning for health. Measures to educate and empower people to make healthy choices within their community may help reduce the spread of chronic disease risk factors in future years. PMID:25669238

Hayter, Arabella K. M.; Jeffery, Roger; Sharma, Chitra; Prost, Audrey; Kinra, Sanjay

2015-01-01

439

Severity grading of chronic obstructive pulmonary disease: the confounding effect of phenotype and thoracic gas compression.  

PubMed

Current guidelines recommend severity of chronic obstructive pulmonary disease be graded by using forced expiratory volume in 1 s (FEV1). But this measurement is biased by thoracic gas compression depending on lung volume and airflow resistance. The aim of this study was to test the hypothesis that the effect of thoracic gas compression on FEV1 is greater in emphysema than chronic bronchitis because of larger lung volumes, and this influences severity classification and prognosis. FEV1 was simultaneously measured by spirometry and body plethysmography (FEV1-pl) in 47 subjects with dominant emphysema and 51 with dominant chronic bronchitis. Subjects with dominant emphysema had larger lung volumes, lower diffusion capacity, and lower FEV1 than those with dominant chronic bronchitis. However, FEV1-pl, patient-centered variables (dyspnea, quality of life, exercise tolerance, exacerbation frequency), arterial blood gases, and respiratory impedance were not significantly different between groups. Using FEV1-pl instead of FEV1 shifted severity distribution toward less severe classes in dominant emphysema more than chronic bronchitis. The body mass, obstruction, dyspnea, and exercise (BODE) index was significantly higher in dominant emphysema than chronic bronchitis, but this difference significantly decreased when FEV1-pl was substituted for FEV1. In conclusion, the FEV1 is biased by thoracic gas compression more in subjects with dominant emphysema than in those with chronic bronchitis. This variably and significantly affects the severity grading systems currently recommended. PMID:25414244

Pellegrino, Riccardo; Crimi, Emanuele; Gobbi, Alessandro; Torchio, Roberto; Antonelli, Andrea; Gulotta, Carlo; Baroffio, Michele; Papa, Giuseppe Francesco Sferrazza; Dellacà, Raffaele; Brusasco, Vito

2015-04-01

440

Benefit packages for chronic disease outpatients in the New Rural Cooperative Medical Scheme in 32 Chinese counties  

PubMed Central

Introduction: Chronic disease has become a major problem affecting the health of the Chinese population. In response to this situation, the New Rural Cooperative Medical Scheme (NRCMS) has begun to provide health cover for outpatients with chronic disease expenses, made possible by the increased risk pool of previous years. We compare the differences between Benefit Packages for Chronic Diseases Outpatients (BPCDO) in order to produce a reference for policy makers. Methods: Information on the various BPCDO was located by searching the official NRCMS website in Chinese, using certain criteria to select the ideal BPCDO. Population coverage, service coverage and cost of coverage were chosen to form the analytical framework for this paper. The diseases were classified according to the World Health Organisation's (WHO) International Classification of Diseases (ICD-10). Results: To avoid “moral hazard”, complex processes have been created. This has resulted in chronic disease patients finding it very difficult to become beneficiaries. Forty-one types of chronic diseases were listed in 32 different BPCDO. We found that different counties have different co-payment rates, deductible lines, ceilings, coverage of drugs and tests, appointed hospitals and reimbursement frequencies. Conclusion: High mortality diseases and diseases with a heavier cost burden should be the priority on the list of reimbursement. The BPCDO scheme should be introduced urgently at the national level. It should include twenty-one types of disease and eight essential factors. PMID:24358897

Gericke, Christian A

2013-01-01

441

Contextual poverty, nutrition, and chronic kidney disease.  

PubMed

Nutrition plays an important role in CKD outcomes. One of the strongest factors that affects nutrition is socioeconomic status as evidenced by the large body of epidemiologic data showing that income and education are directly associated with diet quality. Apart from individual-level markers of socioeconomic status such as income and education, contextual factors such as availability of and transportation to food outlets that provide healthy food options and the density of fast-food restaurants within particular regions markedly affect the ability of individuals to comply with nutrition recommendations. This is particularly true for nutrition guidelines most specific to individuals with CKD such as the consumption of protein, saturated fat, sodium, and phosphorus, all of which have been shown to affect CKD health and are influenced by the availability of healthy food options within individual neighborhood food environments. Because of the strong association of contextual poverty with the diet quality, any serious attempt to improve the diet of CKD patients must include a discussion of the environmental barriers that each individual faces in trying to access healthy foods, and health care providers should take account of these barriers when tailoring specific recommendations. PMID:25573510

Gutiérrez, Orlando M

2015-01-01

442

Inflammation in chronic kidney disease: role in the progression of renal and cardiovascular disease  

Microsoft Academic Search

Inflammation is the response of the vasculature or tissues to various stimuli. An acute and chronic pro-inflammatory state\\u000a exists in patients with chronic kidney disease (CKD), contributing substantially to morbidity and mortality. There are many\\u000a mediators of inflammation in adults with CKD and end-stage kidney disease (ESKD), including hypoalbuminemia\\/malnutrition,\\u000a atherosclerosis, advanced oxidation protein products, the peroxisome proliferators-activated receptor, leptin, the

Douglas M. Silverstein

2009-01-01

443

How we treat chronic graft-versus-host disease.  

PubMed

Chronic graft-versus-host disease (GVHD) remains a common and potentially life-threatening complication of allogeneic hematopoietic stem cell transplantation (HCT). The 2-year cumulative incidence of chronic GVHD requiring systemic treatment is ~30% to 40% by National Institutes of Health criteria. The risk of chronic GVHD is higher and the duration of treatment is longer after HCT with mobilized blood cells than with marrow cells. Clinical manifestations can impair activities of daily living and often linger for years. Hematology and oncology specialists who refer patients to centers for HCT are often subsequently involved in the management of chronic GVHD when patients return to their care after HCT. Treatment of these patients can be optimized under shared care arrangements that enable referring physicians to manage long-term administration of immunosuppressive medications and supportive care with guidance from transplant center experts. Keys to successful collaborative management include early recognition in making the diagnosis of chronic GVHD, comprehensive evaluation at the onset and periodically during the course of the disease, prompt institution of systemic and topical treatment, appropriate monitoring of the response, calibration of treatment intensity over time in order to avoid overtreatment or undertreatment, and the use of supportive care to prevent complications and disability. PMID:25398933

Flowers, Mary E D; Martin, Paul J

2015-01-22

444

Approach to chronic obstructive pulmonary disease in primary care  

PubMed Central

OBJECTIVE To review the diagnosis, assessment of severity, and management of chronic obstructive pulmonary disease (COPD) and to address the systemic manifestations associated with COPD. SOURCES OF INFORMATION PubMed was searched from January 2000 to December 2007 using the key words COPD, practice guidelines, randomized controlled trials, therapy, and health outcomes. The Canadian Thoracic Society guideline on management of COPD was carefully reviewed. The authors, who have extensive experience in care of patients with COPD, provided expert opinion. MAIN MESSAGE Chronic obstructive pulmonary disease is a common systemic disease caused primarily by smoking. Spirometry is essential for diagnosis of COPD and should be integrated into primary care practice. Pharmacologic and nonpharmacologic therapy improves symptoms, capacity for exercise, and quality of life. Smoking cessation is the only intervention shown to slow disease progression. The systemic manifestations and comorbidity associated with COPD need to be identified and addressed to optimize health and quality of life. CONCLUSION An evidence-based approach to managing COPD along with a primary care chronic disease management model could improve quality of life for patients with COPD. PMID:18474704

Todd, David C.; McIvor, R. Andrew; Pugsley, Stewart O.; Cox, Gerard

2008-01-01

445

Innate Immune Responses and Chronic Obstructive Pulmonary Disease  

PubMed Central

Innate immune responses appear to be partially responsible for maintaining inflammation and tissue destruction in chronic obstructive pulmonary disease. In the early stages of the disease in smokers, the airways are bombarded with large quantities of particulate material, and activation of phagocytic cells results in the release of many of the mediators believed to remodel the airways. Ironically, failure of the innate immune defense system, either by inherited deficiency or as a result of chronic smoke inhalation, is likely to result in increased susceptibility to infectious disease and exacerbations of chronic obstructive pulmonary disease. It is well known that deficiencies in the production of collectins, pentraxins, and complement can lead to increased infections, and several studies indicate that deficiency in one or another innate defense component is associated with increased exacerbations. Corticosteroids reduce exacerbations in part because of their ability to boost the production of innate host-defense molecules. Therapeutic approaches that stimulate the generation of antimicrobial molecules in the lungs might be able to reduce disease exacerbations. PMID:16267360

Schleimer, Robert P.

2005-01-01

446

Hereditary Causes of Kidney Stones and Chronic Kidney Disease  

PubMed Central

Adenine phosphoribosyltransferase (APRT) deficiency, cystinuria, Dent disease, familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) and primary hyperoxaluria (PH) are rare but important causes of severe kidney stone disease and/or chronic kidney disease in children. Recurrent kidney stone disease and nephrocalcinosis, particularly in pre-pubertal children, should alert the physician to the possibility of an inborn error of metabolism as the underlying cause. Unfortunately, the lack of recognition and knowledge of the five disorders has frequently resulted in an unacceptable delay in diagnosis and treatment, sometimes with grave consequences. A high index of suspicion coupled with early diagnosis may reduce or even prevent the serious long-term complications of these diseases. In this paper, we review the epidemiology, clinical features, diagnosis, treatment and outcome of patients with APRT deficiency, cystinuria, Dent disease, FHHNC and PH with emphasis on childhood manifestations. PMID:23334384

Edvardsson, Vidar O.; Goldfarb, David S.; Lieske, John C.; Beara-Lasic, Lada; Anglani, Franca; Milliner, Dawn S.; Palsson, Runolfur

2013-01-01

447