These are representative sample records from Science.gov related to your search topic.
For comprehensive and current results, perform a real-time search at Science.gov.
1

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

2

Chronic obstructive pulmonary disease  

MedlinePLUS

COPD; Chronic obstructive airways disease; Chronic obstructive lung disease; Chronic bronchitis; Emphysema; Bronchitis - chronic ... Systems Improvement. Diagnosis and Management of Chronic ... Disease (COPD). Updated March 2013. Available at: https://www. ...

3

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

4

Does Swimming Exercise Affect Experimental Chronic Kidney Disease in Rats Treated with Gum Acacia?  

PubMed Central

Different modes of exercise are reported to be beneficial in subjects with chronic kidney disease (CKD). Similar benefits have also been ascribed to the dietary supplement gum acacia (GA). Using several physiological, biochemical, immunological, and histopathological measurements, we assessed the effect of swimming exercise (SE) on adenine –induced CKD, and tested whether SE would influence the salutary action of GA in rats with CKD. Eight groups of rats were used, the first four of which were fed normal chow for 5 weeks, feed mixed with adenine (0.25% w/w) to induce CKD, GA in the drinking water (15% w/v), or were given adenine plus GA, as above. Another four groups were similarly treated, but were subjected to SE during the experimental period, while the first four groups remained sedentary. The pre-SE program lasted for four days (before the start of the experimental treatments), during which the rats were made to swim for 5 to 10 min, and then gradually extended to 20 min per day. Thereafter, the rats in the 5th, 6th, 7th, and 8th groups started to receive their respective treatments, and were subjected to SE three days a week for 45 min each. Adenine induced the typical signs of CKD as confirmed by histopathology, and the other measurements, and GA significantly ameliorated all these signs. SE did not affect the salutary action of GA on renal histology, but it partially improved some of the above biochemical and physiological analytes, suggesting that addition of this mode of exercise to GA supplementation may improve further the benefits of GA supplementation. PMID:25048380

Ali, Badreldin H.; Al-Salam, Suhail; Al Za'abi, Mohammed; Al Balushi, Khalid A.; Ramkumar, Aishwarya; Waly, Mostafa I.; Yasin, Javid; Adham, Sirin A.; Nemmar, Abderrahim

2014-01-01

5

Does swimming exercise affect experimental chronic kidney disease in rats treated with gum acacia?  

PubMed

Different modes of exercise are reported to be beneficial in subjects with chronic kidney disease (CKD). Similar benefits have also been ascribed to the dietary supplement gum acacia (GA). Using several physiological, biochemical, immunological, and histopathological measurements, we assessed the effect of swimming exercise (SE) on adenine-induced CKD, and tested whether SE would influence the salutary action of GA in rats with CKD. Eight groups of rats were used, the first four of which were fed normal chow for 5 weeks, feed mixed with adenine (0.25% w/w) to induce CKD, GA in the drinking water (15% w/v), or were given adenine plus GA, as above. Another four groups were similarly treated, but were subjected to SE during the experimental period, while the first four groups remained sedentary. The pre-SE program lasted for four days (before the start of the experimental treatments), during which the rats were made to swim for 5 to 10 min, and then gradually extended to 20 min per day. Thereafter, the rats in the 5th, 6th, 7th, and 8th groups started to receive their respective treatments, and were subjected to SE three days a week for 45 min each. Adenine induced the typical signs of CKD as confirmed by histopathology, and the other measurements, and GA significantly ameliorated all these signs. SE did not affect the salutary action of GA on renal histology, but it partially improved some of the above biochemical and physiological analytes, suggesting that addition of this mode of exercise to GA supplementation may improve further the benefits of GA supplementation. PMID:25048380

Ali, Badreldin H; Al-Salam, Suhail; Al Za'abi, Mohammed; Al Balushi, Khalid A; Ramkumar, Aishwarya; Waly, Mostafa I; Yasin, Javid; Adham, Sirin A; Nemmar, Abderrahim

2014-01-01

6

Long-term treatment with 'Duovent' in elderly patients affected by chronic obstructive lung disease.  

PubMed

Twelve patients, aged over 60 years and suffering from chronic obstructive lung disease, were treated for 12 weeks with Duovent (fenoterol + ipratropium bromide). The clinical check-ups and indices of bronchial obstruction (FEV1, VC, RV, sGaw) were performed every 14 days. Improvement in symptoms corresponded to a significant improvement in the functional parameters. No negative cardiovascular effects, significant side-effects, or tolerance were seen after drug administration. PMID:2951815

Cecere, L; Funaro, G; De Cataldis, G; Carnicelli, P; Pinto, R

1986-01-01

7

Pathology Affects Different Organs in Two Mouse Strains Chronically Infected by a Trypanosoma cruzi Clone: a Model for Genetic Studies of Chagas' Disease  

Microsoft Academic Search

Chagas' disease is a chronic infection caused by Trypanosoma cruzi and represents an important public health burden in Latin America. Frequently the disease evolves undetectable for decades, while in a significant fraction of the affected individuals it culminates in death by heart failure. Here, we describe a novel murine model of the chronic infection with T. cruzi using a stable

Claudio R. F. Marinho; Daniella Z. Bucci; M. L. Z. Dagli; K. R. B. Bastos; M. G. Grisotto; L. R. Sardinha; C. R. G. M. Baptista; C. Penha Goncalves; M. R. D. Lima; J. M. Alvarez

2004-01-01

8

Chronic granulomatous disease  

MedlinePLUS

CGD; Fatal granulomatosis of childhood; Chronic granulomatous disease of childhood; Progressive septic granulomatosis ... Chronic granulomatous disease (CGD) is a genetic disorder in which certain immune system cells are unable to kill some ...

9

Parkinson disease (PD) is a chronic, progressive neurodegenera-tive disorder that affects at least 1% of people by age 70 (13).  

E-print Network

History Parkinson disease (PD) is a chronic, progressive neurodegenera- tive disorder that affects to the development of motor complications including wearing-off (the Diagnosis and treatment of Parkinson disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. Parkinson disease (PD

Hayar, Abdallah

10

Chronic Obstructive Pulmonary Disease (COPD)  

MedlinePLUS

MENU Return to Web version Chronic Obstructive Pulmonary Disease (COPD) Overview What is chronic obstructive pulmonary disease (COPD)? Chronic obstructive pulmonary disease (also called COPD) is a lung disease that makes it ...

11

Chronic Beryllium Disease  

MedlinePLUS

... LS. Epidemiology of beryllium sensitizations and disease in nuclear workers. Am Rev Respir Dis 1993; 148:985- ... chronic beryllium disease. In: Rossman MD, Preuss OP, Powers MB, eds. Beryllium: Biomedical and Environmental Aspects. Baltimore: ...

12

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

13

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

14

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

15

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

16

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

17

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

18

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

19

Heritability of chronic venous disease  

Microsoft Academic Search

Varicose veins without skin changes have a prevalence of approximately 20% in Northern and Western Europe whereas advanced\\u000a chronic venous insufficiency affects about 3% of the population. Genetic risk factors are thought to play an important role\\u000a in the aetiology of both these chronic venous diseases (CVD). We evaluated the relative genetic and environmental impact upon\\u000a CVD risk by estimating

Andreas Fiebig; Petra Krusche; Andreas Wolf; Michael Krawczak; Birgitt Timm; Susanna Nikolaus; Norbert Frings; Stefan Schreiber

2010-01-01

20

Anemia of chronic disease  

MedlinePLUS

Anemia of inflammation; AOCD; ACD ... Anemia is a lower-than-normal number of red blood cells in the blood. Some conditions can lead to anemia of chronic disease include: Autoimmune disorders , such as ...

21

Chronic Obstructive Pulmonary Disease (COPD)  

MedlinePLUS

... treated? Learn More What is COPD? Chronic Obstructive Pulmonary Disease, or COPD, refers to a group of diseases ... Centers for Disease Control and Prevention. Chronic obstructive pulmonary disease among adults—United States, 2011. MMWR . 2012;61( ...

22

Chronic viral diseases.  

PubMed Central

Until 20 years ago the only chronic viral diseases known were those considered to be confined to the nervous system. As a result of recent advances in epidemiology, molecular biology and immunology, new viral diseases have been recognized and their clinical features and pathogenesis elucidated. Chronic disease may result from infection with the hepatitis B and D viruses and whatever agent or agents cause hepatitis non-A, non-B, the herpesviruses, Epstein-Barr virus, cytomegalovirus and human T-lymphotropic virus type III. These diseases have common features, including long-term or even lifetime asymptomatic carriage, viremia, with virus free in the plasma or attached to circulating mononuclear cells, presence of virus in body secretions, irreversible tissue injury in target organs and oncogenic potential. New information on these diseases is reviewed. Other chronic diseases for which the cause is currently unknown may eventually prove to be due to viral infection. In addition, vaccines may be developed for prophylaxis of some chronic viral diseases and associated malignant diseases. PMID:3022903

Berris, B

1986-01-01

23

Chronic Obstructive Pulmonary Disease (COPD)  

MedlinePLUS

... COPD > In-Depth Resources > Facts & Figures Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet May 2014 Mortality Prevalence Gender ... Centers for Disease Control and Prevention. Chronic Obstructive Pulmonary Disease Surveillance – United States, 1971-2000 . Morbidity and Mortality ...

24

Chronic Obstructive Pulmonary Disease (COPD)  

MedlinePLUS

... takes no energy to empty the Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable disease that ... Education Series © 2013 American Thoracic Society Chronic Obstructive Pulmonary Disease (COPD) AIR FLO W Swelling Restricted air ow ...

25

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

26

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

27

Chronic Kidney Disease  

MedlinePLUS

... suspects you might have chronic kidney disease: Blood pressure test Urine albumin (a test to see how much protein is in the urine) Serum creatinine (a test to see how much creatinine, a ... or high blood pressure, talk to your doctor about whether you should ...

28

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

29

[Chronic diseases of the ankle joint].  

PubMed

The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemophilic patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use of MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or high-resolution coils, the investigation of the ankle joint still offers a wide spectrum of innovation for the next years, which is particularly enforced by the increasing demand for specific diagnosis of chronic diseases in orthopedic medicine. PMID:10065476

Rand, T; Trattnig, S; Breitenseher, M; Kreuzer, S; Wagesreither, S; Imhof, H

1999-01-01

30

Adipokines promote chronic kidney disease.  

PubMed

The rapid growth in obesity worldwide contributes to an increase in metabolic syndrome and obesity-related kidney disease with an enhanced increased risk for chronic kidney disease, finally progressing to end-stage renal disease. Adipose tissue is a highly active endocrine organ secreting numerous factors that contribute to renal and cardiovascular complications. In renal damage, various adipokines are involved through mediating endothelial dysfunction, inducing oxidative stress and inflammation as well as stimulating renal sympathetic nervous activity, and it reduces cancellous bone but conversely increases cortical bone. Adipokines may also be involved in the development of renal anaemia. A balance exists between more protective adipokines (adiponectin) and factors mediating pathophysiological effects (angiotensin II, TNF?). Obesity may cause a disruption of this delicate balance, thereby inducing renal disease. Consequently, weight reduction and lifestyle changes affecting all components of the metabolic syndrome are essential to disrupt this vicious cycle. PMID:24179016

Rüster, Christiane; Wolf, Gunter

2013-11-01

31

Cigarette smoke affects dendritic cell maturation in the small airways of patients with chronic obstructive pulmonary disease  

PubMed Central

The aim of the present study was to characterize and quantify the numbers and expression levels of cells markers associated with dendritic cell (DC) maturation in small airways in current smokers and non-smokers with or without chronic obstructive pulmonary disease (COPD). Lung tissues from the following 32 patients were obtained during resection for lung cancer: Eight smokers with COPD, eight non-smokers with COPD, eight current smokers without COPD and eight non-smokers without COPD, serving as a control. The tissue sections were immunostained for cluster of differentiation (CD)83+ and CD1a+ to delineate mature and immature DCs, and chemokine receptor type 7 (CCR7+) to detect DC migratory ability. Myeloid DCs were collected from the lung tissues, and subsequently the CD83+ and CCR7+ expression levels in the lung myeloid DCs were detected using flow cytometry. The expression levels of CD83+, CD1a+ and CCR7+ mRNA in total lung RNA were evaluated by reverse transcription quantitative polymerase chain reaction (RT-qPCR). Evident chronic bronchitis and emphysema pathological changes were observed in the lung tissues of patients with COPD. The results revealed that the numbers of CD83+ and CCR7+ DCs were reduced but the numbers of CD1a+ DCs were significantly increased in the COPD group as compared with the control group (P<0.05, respectively). Using RT-qPCR, the expression levels of CCR7+ and CD83+ mRNA were found to be reduced in the smokers with COPD as compared with the non-smokers without COPD group (P<0.05, respectively). Excessive local adaptive immune responses are key elements in the pathogenesis of COPD. Cigarette smoke may stimulate immune responses by impairing the homing of airway DCs to the lymph nodes and reduce the migratory potential of DCs. The present study revealed that COPD is associated with reduced numbers of mature CD83+ DCs and lower CCR7+ expression levels in small airways. PMID:25338516

LIAO, SHI-XIA; DING, TING; RAO, XI-MIN; SUN, DE-SHENG; SUN, PENG-PENG; WANG, YA-JUN; FU, DAN-DAN; LIU, XIAO-LI; OU-YANG, YAO

2015-01-01

32

Cigarette smoke affects dendritic cell maturation in the small airways of patients with chronic obstructive pulmonary disease.  

PubMed

The aim of the present study was to characterize and quantify the numbers and expression levels of cells markers associated with dendritic cell (DC) maturation in small airways in current smokers and non?smokers with or without chronic obstructive pulmonary disease (COPD). Lung tissues from the following 32 patients were obtained during resection for lung cancer: Eight smokers with COPD, eight non?smokers with COPD, eight current smokers without COPD and eight non?smokers without COPD, serving as a control. The tissue sections were immunostained for cluster of differentiation (CD)83+ and CD1a+ to delineate mature and immature DCs, and chemokine receptor type 7 (CCR7+) to detect DC migratory ability. Myeloid DCs were collected from the lung tissues, and subsequently the CD83+ and CCR7+ expression levels in the lung myeloid DCs were detected using flow cytometry. The expression levels of CD83+, CD1a+ and CCR7+ mRNA in total lung RNA were evaluated by reverse transcription quantitative polymerase chain reaction (RT?qPCR). Evident chronic bronchitis and emphysema pathological changes were observed in the lung tissues of patients with COPD. The results revealed that the numbers of CD83+ and CCR7+ DCs were reduced but the numbers of CD1a+ DCs were significantly increased in the COPD group as compared with the control group (P<0.05, respectively). Using RT?qPCR, the expression levels of CCR7+ and CD83+ mRNA were found to be reduced in the smokers with COPD as compared with the non?smokers without COPD group (P<0.05, respectively). Excessive local adaptive immune responses are key elements in the pathogenesis of COPD. Cigarette smoke may stimulate immune responses by impairing the homing of airway DCs to the lymph nodes and reduce the migratory potential of DCs. The present study revealed that COPD is associated with reduced numbers of mature CD83+ DCs and lower CCR7+ expression levels in small airways. PMID:25338516

Liao, Shi-Xia; Ding, Ting; Rao, Xi-Min; Sun, De-Sheng; Sun, Peng-Peng; Wang, Ya-Jun; Fu, Dan-Dan; Liu, Xiao-Li; Ou-Yang, Yao

2015-01-01

33

Anemia of chronic disease.  

PubMed

Anemia of chronic disease (ACD) or inflammation may be secondary to infections, autoimmune disorders, chronic renal failure, or malignancies. It is characterized by an immune activation with an increase in inflammatory cytokines and resultant increase in hepcidin levels. In addition, inappropriate erythropoietin levels or hyporesponsiveness to erythropoietin and reduced red blood cell survival contribute to the anemia. Hepcidin being the central regulator of iron metabolism plays a key role in the pathophysiology of ACD. Hepcidin binds to the iron export protein, ferroportin, present on macrophages, hepatocytes, and enterocytes, causing degradation of the latter. This leads to iron trapping within the macrophages and hepatocytes, resulting in functional iron deficiency. Production of hepcidin is in turn regulated by iron stores, inflammation, and erythropoiesis via the BMP-SMAD and JAK-STAT signaling pathways. Treatment of anemia should primarily be directed at the underlying disease, and conventional therapy such as red blood cell transfusions, iron, erythropoietin, and novel agents targeting the hepcidin-ferroportin axis and signaling pathways (BMP-SMAD, JAK-STAT) involved in hepcidin production also may be considered. PMID:23953340

Gangat, Naseema; Wolanskyj, Alexandra P

2013-07-01

34

Chronic Conditions and Disease Prevention  

E-print Network

, pulmonary disease, fibromyalgia, or any other chronic condition. Participants will meet for six weeksChronic Conditions and Disease Prevention A resource for faculty and staff on Purdue's health plans, diabetes, heart disease and osteoarthritis. One-on-One Nutrition Counseling Help with weight management

35

Heritability of chronic venous disease  

PubMed Central

Varicose veins without skin changes have a prevalence of approximately 20% in Northern and Western Europe whereas advanced chronic venous insufficiency affects about 3% of the population. Genetic risk factors are thought to play an important role in the aetiology of both these chronic venous diseases (CVD). We evaluated the relative genetic and environmental impact upon CVD risk by estimating the heritability of the disease in 4,033 nuclear families, comprising 16,434 individuals from all over Germany. Upon clinical examination, patients were classified according to the CEAP guidelines as either C2 (simple varicose veins), C3 (oedema), C4 (skin changes without ulceration), C5 (healed ulceration), or C6 (active ulcers). The narrow-sense heritability (h2) of CVD equals 17.3% (standard error 2.5%, likelihood ratio test P = 1.4 × 10?13). The proportion of disease risk attributable to age (at ascertainment) and sex, the two main risk factors for CVD, was estimated as 10.7% (Kullback–Leibler deviance R2). The heritability of CVD is high, thereby suggesting a notable genetic component in the aetiology of the disease. Systematic population-based searches for CVD susceptibility genes are therefore warranted. PMID:20354728

Krusche, Petra; Wolf, Andreas; Krawczak, Michael; Timm, Birgitt; Nikolaus, Susanna; Frings, Norbert; Schreiber, Stefan

2010-01-01

36

COPD (Chronic Obstructive Pulmonary Disease)  

MedlinePLUS

... therapy does not prevent exacerbations of chronic obstructive pulmonary disease (COPD) or lower mortality from acute respiratory distress ... the cholesterol-lowering drugs on outcomes in the lung diseases. View all COPD Press Releases Related Director's Message ...

37

Hyperphosphatemia of Chronic Kidney Disease  

PubMed Central

Observational studies have determined hyperphosphatemia to be a cardiovascular risk factor in chronic kidney disease. Mechanistic studies have elucidated that hyperphosphatemia is a direct stimulus to vascular calcification, which is one cause of morbid cardiovascular events contributing to the excess mortality of chronic kidney disease. This review describes the pathobiology of hyperphosphatemia that develops as a consequence of positive phosphate balance in chronic kidney disease and the mechanisms by which hyperphosphatemia acts on neointimal vascular cells that are stimulated to mineralize in chronic kidney disease. The characterization of hyperphosphatemia of chronic kidney disease as a distinct syndrome in clinical medicine with unique disordered skeletal remodeling, heterotopic mineralization and cardiovascular morbidity is presented. PMID:18449174

Hruska, Keith A; Mathew, Suresh; Lund, Richard; Qiu, Ping; Pratt, Raymond

2009-01-01

38

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

39

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

MedlinePLUS

... Territorial Data NCHS Home FastStats Home Chronic Obstructive Pulmonary Disease (COPD) Includes: Chronic Bronchitis and Emphysema Data are ... Number of noninstitutionalized adults with diagnosed chronic Obstructive Pulmonary Disease in the past year: 6.8 million Percent ...

40

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

41

Systemic infections and inflammation affect chronic neurodegeneration  

Microsoft Academic Search

It is well known that systemic infections cause flare-ups of disease in individuals with asthma and rheumatoid arthritis, and that relapses in multiple sclerosis can often be associated with upper respiratory-tract infections. Here we review evidence to support our hypothesis that in chronic neurodegenerative diseases such as Alzheimer's disease, with an ongoing innate immune response in the brain, systemic infections

Colm Cunningham; Clive Holmes; V. Hugh Perry

2007-01-01

42

Multimorbidity and chronic disease: an emergent perspective.  

PubMed

The concept of emergence offers a new way of thinking about multimorbidity and chronic disease. Multimorbidity and chronic disease are the end result of ongoing perturbations and interconnected activities of simpler substructures that collectively constitute the complex adaptive superstructure known as us, the person or patient. Medical interventions cause perturbations of many different sub-systems within the patient, hence they are not limited to the person's bodily function, but also affect his general health perception and his interactions with his external environments. Changes in these domains inevitably have consequences on body function, and close the feedback loop of illness/disease, recovery and regained health. PMID:24702685

Sturmberg, Joachim P

2014-08-01

43

Change in darbepoetin alfa administration schedule affects erythropoiesis-stimulating agent resistance in patients with chronic kidney disease receiving hemodialysis.  

PubMed

One hundred and four patients receiving hemodialysis and undergoing anaemia treatment with darbepoetin alfa intravenously once weekly were switched to a biweekly dosing schedule and followed for 24 weeks. The darbepoetin alfa dose was adjusted to maintain the target Hb concentration of 11-14 g/dL. A significant decline in the erythropoiesis-stimulating agent resistance index was observed over the 24-week follow-up, beginning with week 16, whereas the mean dose of darbepoetin alfa did not change significantly after switching to the biweekly dosing schedule. Other factors that might affect resistance to erythropoiesis remained unchanged. PMID:18791951

Molina, Manuel; Navarro, Maria Jose; de Gracia, Carmen; Alvarez, Gracia; de Alarcon, Rosa; Garcia, Maria Angeles

2008-01-01

44

Acetaminophen in chronic liver disease  

Microsoft Academic Search

The safety of acetaminophen in therapeutic doses was evaluated in subjects with stable chronic liver disease. Six subjects with chronic liver disease were given 4.0 gm daily for 5 days. Although the mean half-life (t½) acetaminophen was 3.42 hr, there was no evidence of drug cumulation or hepatotoxicity. A double-blind, two-period crossover design was also used to evaluate acetaminophen in

Gordon D Benson

1983-01-01

45

National Institutes of Health (NIH) Chronic GVHD Staging in Severely Affected Patients: Organ and Global Scoring Correlate with Established Indicators of Disease Severity and Prognosis  

PubMed Central

Between 2004 and 2010, 189 adult patients were enrolled on the National Cancer Institute (NCI) cross-sectional chronic Graft-versus-Host disease (cGVHD) natural history study. Patients were evaluated by multiple disease scales and outcome measures including the 2005 NIH Consensus Project cGVHD severity score. The purpose of this study is to assess the validity of the NIH scoring variables as determinants of disease severity in severely affected patients in order to standardize clinician evaluation and staging of cGVHD. 125 of 189 patients met criteria for severe cGVHD on the NIH global score and 62 had moderate disease, with a median of 4 (range 1–8) involved organs. Clinician average NIH organ score and the corresponding organ scores performed by subspecialists were highly correlated (r=0.64). NIH global severity scores showed significant associations with nearly all functional and quality of life outcome measures including Lee Scale, SF-36 Physical Component Scale (PCS), 2 minutes walk, grip strength, range of motion and Human Activity Profile (HAP). Joints/fascia, skin, and lung involvement impacted function and quality of life most significantly and showed highest number of correlations with outcome measures. The final Cox model showing factors jointly predictive for survival contained the time from cGVHD diagnosis (>49 vs. ?49 months, HR=0.23; p=0.0011), absolute eosinophil count of (0–0.5 vs. >0.5 cells/µL, HR=3.95; p=0.0006) at the time of NIH evaluation, and NIH lung score (3 vs. 0–2, HR=11.02; p <0.0001). These results demonstrate that NIH organs and global severity scores are reliable measures of cGVHD disease burden. Strong association with subspecialist evaluation suggests that NIH organs and global severity scores are appropriate for clinical and research assessments, and may serve as a surrogate for more complex sub-specialist exams. In this population of severely affected patients, NIH lung score is the strongest predictor of poor overall survival, both alone and after adjustment for other important factors. PMID:23340040

Baird, K.; Steinberg, S.M.; Grkovic, L.; Pulanic, D.; Cowen, E.W.; Mitchell, S.A.; Williams, K.M.; Datiles, M.B.; Bishop, R.; Bassim, C.W.; Mays, J.W.; Edwards, D.; Cole, K.; Avila, D.N.; Taylor, T.; Urban, A.; Joe, G.O.; Comis, L.E.; Berger, A.; Stratton, P.; Zhang, D.; Shelhamer, J.H.; Gea-Banacloche, J.C.; Sportes, C.; Fowler, D.H.; Gress, R.E.; Pavletic, S.Z.

2013-01-01

46

Chronic kidney disease in primary care  

Microsoft Academic Search

SUMMARY It has been estimated that chronic kidney disease (CKD) affects about one in 200 of the population in the UK. There is an increased awareness of the need to identify patients in primary care with CKD at an earlier stage, so that treatments can be initiated to delay progression and prevent complications and appropriate nephrological referral can be made.

Prabir Kumar Mitra; John R Bradley

47

Genetics of Chronic Kidney Disease  

Microsoft Academic Search

The current review collates what is already known of the genetics of chronic kidney disease (CKD), and focuses on new trends in genome-wide assessment of the inherited component of susceptibility to this condition. Early efforts to identify kidney disease susceptibility genetic loci using linkage and candidate gene strategies proved disappointing. More recently, genome-wide association studies have yielded highly promising results

Conall M. O’Seaghdha; Caroline S. Fox

2011-01-01

48

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

49

Chronic wasting disease of cervids.  

PubMed

Chronic wasting disease (CWD) has recently emerged in North America as an important prion disease of captive and free-ranging cervids (species in the deer family). CWD is the only recognized transmissible spongiform encephalopathy (TSE) affecting free-ranging species. Three cervid species, mule deer (Odocoileus hemionus), white-tailed deer (O. virginianus), and Rocky Mountain elk (Cervus elaphus nelsoni), are the only known natural hosts of CWD. Endemic CWD is well established in southern Wyoming and northern Colorado, and has been present in this 'core area' for two decades or more. Apparently CWD has also infected farmed cervids in numerous jurisdictions, and has probably been endemic in North America's farmed deer and elk for well over a decade. Several free-ranging foci distant to the Colorado-Wyoming core area have been discovered since 2000, and new or intensified surveillance may well identify even more foci of infection. Whether all of the identified captive and free-ranging foci are connected via a common original exposure source remains undetermined. Some of this recently observed 'spread' may be attributable to improved detection or natural movements of infected deer and elk, but more distant range extensions are more likely caused by movements of infected captive deer and elk in commerce, or by some yet unidentified exposure risk factor. Research on CWD over the last 5 years has resulted in a more complete understanding of its pathogenesis and epidemiology. CWD is infectious, transmitting horizontally from infected to susceptible cervids. Early accumulation of PrP(CWD) in alimentary tract-associated lymphoid tissues during incubation suggests agent shedding in feces or saliva as plausible transmission routes. Residual infectivity in contaminated environments also appears to be important in sustaining epidemics. Improved tests allow CWD to be reliably diagnosed long before clinical signs appear. Implications of CWD are not entirely clear at this time. Natural transmission to humans or traditional domestic livestock seems relatively unlikely, but the possibility still evokes public concerns; impacts on wildlife resources have not been determined. Consequently, where CWD is not known to occur surveillance programs and regulations that prevent or reduce the likelihood that CWD will be introduced into these jurisdictions should be encouraged. Where CWD is known to occur, affected jurisdictions are conducting surveillance to estimate and monitor trends in geographic distribution and prevalence, managing deer and elk populations in attempts to limit spread, and developing and evaluating techniques for further controlling and perhaps eradicating CWD. Programs for addressing the challenges of CWD management will require interagency cooperation, commitment of funds and personnel, and applied research. Chronic wasting disease (CWD) is perhaps the most enigmatic of the naturally occurring prion diseases. Although recognized as a transmissible spongiform encephalopathy (TSE) since the late 1970s (Williams and Young 1980, 1982), interest in and concern about CWD has only recently emerged. CWD most closely resembles scrapie in sheep in most respects, but recent media and public reaction to CWD has been more reminiscent of that afforded to bovine spongiform encephalopathy (BSE) less than a decade ago. Yet, with the exception of transmissible mink encephalopathy (TME), CWD is the rarest of the known animal TSEs: fewer than 1,000 cases have been diagnosed worldwide, and all but two of these occurred in North America. CWD is unique among the TSEs in that it affects free-living species (Spraker et al. 1997; Miller et al. 2000). The three natural host species for CWD, mule deer (Odocoileus hemionus), white-tailed deer (O. virginianus), and Rocky Mountain elk (Cervus elaphus nelsoni), are all in the family Cervidae and native to North America. Like scrapie, CWD is contagious: epidemics are self-sustaining in both captive and free-ranging cervid populations (Miller et al. 1998, 2000). The geographic extent of endemic CWD in free-ra

Miller, M W; Williams, E S

2004-01-01

50

Stem cell treatment for chronic lung diseases.  

PubMed

Chronic lung diseases such as idiopathic pulmonary fibrosis and cystic fibrosis or chronic obstructive pulmonary disease and asthma are leading causes of morbidity and mortality worldwide with a considerable human, societal and financial burden. In view of the current disappointing status of available pharmaceutical agents, there is an urgent need for alternative more effective therapeutic approaches that will not only help to relieve patient symptoms but will also affect the natural course of the respective disease. Regenerative medicine represents a promising option with several fruitful therapeutic applications in patients suffering from chronic lung diseases. Nevertheless, despite relative enthusiasm arising from experimental data, application of stem cell therapy in the clinical setting has been severely hampered by several safety concerns arising from the major lack of knowledge on the fate of exogenously administered stem cells within chronically injured lung as well as the mechanisms regulating the activation of resident progenitor cells. On the other hand, salient data arising from few 'brave' pilot investigations of the safety of stem cell treatment in chronic lung diseases seem promising. The main scope of this review article is to summarize the current state of knowledge regarding the application status of stem cell treatment in chronic lung diseases, address important safety and efficacy issues and present future challenges and perspectives. In this review, we argue in favor of large multicenter clinical trials setting realistic goals to assess treatment efficacy. We propose the use of biomarkers that reflect clinically inconspicuous alterations of the disease molecular phenotype before rigid conclusions can be safely drawn. PMID:23364286

Tzouvelekis, Argyris; Ntolios, Paschalis; Bouros, Demosthenes

2013-01-01

51

The role of neutrophil chemotactic cytokines in the pathogenesis of equine chronic obstructive pulmonary disease (COPD)  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is defined as a chronic obstructive inflammatory disease affecting the small airways associated with hay dust exposure (Lowell, F.C., 1964. Observation on heaves. An asthma like syndrome in the horse, J. Allergy 35, 322–330). The disease corresponds histopathologically to a chronic bronchiolitis (Gerber, H., 1973. Chronic pulmonary disease in the horse, Equine Vet. J. 5,

M Franchini; U Gilli; M. K Akens; R. V Fellenberg; V Bracher

1998-01-01

52

Chronic Granulomatous Disease (CGD)  

MedlinePLUS

... Rhinitis (Hay Fever) School Key School Tools Secondary Immune Deficiency Disease Selective IgA Deficiency Selective IgA Deficiency Severe ... CGD. To learn more about PIDDs visit the Immune Deficiency Foundation website . Look to the experts The AAAAI’s ...

53

Chronic Pulmonary Disease and Pregnancy  

Microsoft Academic Search

The gravida state causes a profound number of biochemical, anatomical, and physiological changes throughout the gestational\\u000a period. These changes impact respiratory physiology in only a minor way in females with no underlying lung disease, but in\\u000a an individual with chronic pulmonary disease, any alteration in the balance of their pre-pregnancy respiratory physiology\\u000a can lead to devastating consequences during the pregnancy,

Shirley F. Jones; Marie M. Budev; Alejandro C. Arroliga

54

Comorbidity of chronic diseases in general practice  

Microsoft Academic Search

With the increasing number of elderly people in The Netherlands the prevalence of chronic diseases will rise in the next decades. It is recognized in general practice that many older patients suffer from more than one chronic disease (comorbidity). The aim of this study is to describe the extent of comorbidity for the following diseases: hypertension, chronic ischemic heart disease,

F. G. Schellevis; J. van der Velden; E. van de Lisdonk; J. T. M. van Eijk; C. van Weel

1993-01-01

55

Corticosteroids in infant chronic lung disease  

Microsoft Academic Search

Corticosteroids in infant chronic lung disease. C. May, A. Greenough. Chronic lung disease (CLD), defined as chronic oxygen dependency at 36 weeks postmenstrual age, is increasing and associated with chronic respiratory morbidity and high health care utilisation at follow up. Many strategies, tested in randomised trials, have failed to reduce CLD. In contrast, corticosteroids if given systemically within the first

A. Greenough; Lung Biology; Anne Greenough

56

Chronic obstructive pulmonary disease - adults - discharge  

MedlinePLUS

... breathing problems that are caused by chronic obstructive pulmonary disease (COPD). COPD damages your lungs. This makes it ... Systems Improvement. Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). https://www.icsi.org/_asset/yw83gh/COPD. ...

57

Chronic granulomatous disease: why an inflammatory disease?  

PubMed

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

2014-11-01

58

Health Psychology: Psychological Adjustment to Chronic Disease  

Microsoft Academic Search

Chronic diseases carry important psychological and social con- sequences that demand significant psychological adjustment. The literature is providing increasingly nuanced conceptualizations of adjustment, demonstrating that the experience of chronic disease necessitates adaptation in multiple life domains. Heterogeneity in adjustment is apparent between individuals and across the course of the disease trajectory. Focusing on cancer, cardiovascular disease, and rheumatic diseases, we

Annette L. Stanton; Tracey A. Revenson; Howard Tennen

2007-01-01

59

[Treating chronic occlusive arterial disease].  

PubMed

The basis for the treatment of chronic occlusive arterial disease, in whatever stage, is the management of the cardiovascular risk factors as a secondary preventive measure. In the absence of contraindications, every symptomatic POAD patient should be given an antiplatelet agent. In stage I disease, prevention of progression is the overriding aim. In stage II, risk factor management and an antiplatelet agent are indicated. In addition to a walking exercise program, the reconstruction of occluded vessels may be indicated. The decision to apply interventional treatment or vascular surgery in stage II and IV disease; must be based on the morphology of the vascular lesion and concomitant diseases. If revascularization is not possible, treatment with PGE1 is recommended. As a life-saving measure when all else has failed, an amputation must be done. PMID:15934585

Rottman, M; Koepchen, J; Angelkort, B

2005-05-01

60

Idiopathic thrombocytopenic purpura: predictors of chronic disease.  

PubMed Central

We studied the extent to which patient characteristics influenced outcome in childhood idiopathic thrombocytopenic purpura in a historical cohort of 289 children over a 20 year period (1968-87). Outcome was classified as acute or chronic depending on whether the platelet count had returned to normal (150 X 10(9)/l) by six months after diagnosis. Fifty three cases (18%) had chronic idiopathic thrombocytopenic purpura. The likelihood of chronic disease was determined by logistic regression analysis of five patient variables: age, sex, season of onset of symptoms, history of recent viral illness, and duration of symptoms at presentation. A history of symptoms of greater than 14 days at presentation, adjusted for the other variables, was strongly predictive of chronic idiopathic thrombocytopenic purpura; the other variables did not significantly affect outcome. At 28 days after diagnosis 138 (47%) of the study cohort had normal platelet counts. Children whose platelet counts were less than 150 X 10(9)/l had a threefold risk of progressing to chronic idiopathic thrombocytopenic purpura, which increased to fivefold if counts were less than 50 X 10(9)/l. Two thirds of patients in the chronic group, irrespective of treatment, remained thrombocytopenic two years after diagnosis. We conclude that a history of symptoms for greater than two weeks at presentation is strongly predictive of chronic idiopathic thrombocytopenic purpura. If platelet counts are subnormal 28 days after diagnosis the risk of chronic idiopathic thrombocytopenic purpura is increased with prolonged thrombocytopenia being very likely if platelet counts remain low three months after diagnosis. PMID:2357088

Robb, L G; Tiedeman, K

1990-01-01

61

[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

62

Chronic intestinal graft-versus-host disease: clinical, histological and immunohistochemical analysis of 17 children  

Microsoft Academic Search

Graft-versus-host disease (GVHD) can be acute or chronic. The pathogenesis of chronic GVHD is unclear. Chronic GVHD affects mainly skin, liver and digestive tract. Intestinal involvement is uncommon and histological features are poorly described. We report here the clinical, histological and immunohistochemical features of chronic GVHD with intestinal involvement. Intestinal biopsies from children with chronic GVHD (n = 17) were

N Patey-Mariaud de Serre; D Reijasse; V Verkarre; D Canioni; V Colomb; E Haddad; N Brousse

2002-01-01

63

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

64

Bidirectional Relationship between Chronic Kidney Disease & Periodontal Disease  

PubMed Central

Non communicable diseases (NCDs) affect the life of an individual in terms of mortality, morbidity and financial crises. Main NCDs are diabetes mellitus (DM), cardiovascular diseases (CVD), pulmonary diseases, osteoporosis and chronic kidney diseases (CKD). About 40% of the total deaths can be controlled by eliminating the risk factors for NCDs. Periodontitis have recently been labeled as an important potential risk factor for NCDs. CKD affect the oral health status of patients by inducing gingival hyperplasia, xerostomia, calcification of root canals and delayed eruption of teeth. Periodontitis increases systemic inflammatory burden leading to worsening of CKD which in turn has been has been found to negatively affect CKD of patients on hemodialysis therapy by altering their serum albumin and C-reactive protein levels. As hypoalbuminemia leads to increased mortality in CKD patients, it needs to be avoided by reducing systemic inflammatory burden in patients receiving HD therapy. Treating periodontal disease could be one factor that might decrease the systemic inflammatory burden and thereby improve quality of life of these patients. Sources of Data: Data from descriptive, cross sectional and longitudinal studies published between 2000 and 2012 were included. Data searches based on human studies only. Data Extraction: The key words, periodontitis, chronic kidney disease and hemodialysis, on MEDLINE, approximately 120 studies were identified. 35 of them were relevant to all three keywords. Most of them were cross sectional studies and total 7 clinical trials were identified regarding checking of serum levels after periodontal therapy with variable results. Conclusion: Patients with CKD have higher prevalence of periodontal disease while non-surgical periodontal therapy has been indicated to decrease the systemic inflammatory burden in patients with CKD specially those undergoing HD therapy. PMID:24353542

Wahid, Arsalan; Chaudhry, Saima; Ehsan, Afifa; Butt, Sidra; Ali Khan, Ayyaz

2013-01-01

65

Psychiatric aspects of chronic lung disease  

Microsoft Academic Search

Chronic lung diseases continue to be common and cause significant morbidity and mortality. There is a complex interplay between\\u000a psychiatric issues and pulmonary diseases. This review aims to summarize the recent literature and advances involving psychiatric\\u000a aspects of lung diseases, including chronic obstructive pulmonary disease, asthma, restrictive lung disease, and cystic fibrosis.\\u000a The authors include the latest findings in epidemiology,

Abhishek Jain; Sermsak Lolak

2009-01-01

66

Prevention of chronic lung disease  

PubMed Central

Considerable effort has been devoted to the development of strategies to reduce the incidence of chronic lung disease, including use of medications, nutritional therapies, and respiratory care practices. Unfortunately, most of these strategies have not been successful. To date, the only two treatments developed specifically to prevent CLD whose efficacy is supported by evidence from randomized, controlled trials are the parenteral administration of vitamin A and corticosteroids. Two other therapies, the use of caffeine for the treatment of apnea of prematurity and aggressive phototherapy for the treatment of hyperbilirubinemia were evaluated for the improvement of other outcomes and found to reduce CLD. Cohort studies suggest that the use of CPAP as a strategy for avoiding mechanical ventilation might also be beneficial. Other therapies reduce lung injury in animal models but do not appear to reduce CLD in humans. The benefits of the efficacious therapies have been modest, with an absolute risk reduction in the 7–11% range. Further preventive strategies are needed to reduce the burden of this disease. However, each will need to be tested in randomized, controlled trials, and the expectations of new therapies should be modest reductions of the incidence of the disease. PMID:19736053

Laughon, Matthew M.; Smith, P. Brian; Bose, Carl

2010-01-01

67

Obesity and chronic kidney disease.  

PubMed

Obesity is a common contributing factor to the development of chronic kidney disease (CKD). Obesity participates in the genesis of CKD by predisposing to diabetic nephropathy, hypertensive nephrosclerosis, and focal and segmental glomerular sclerosis. It also predisposes to calcium oxalate and urate stones. Additionally, obesity is associated with an increased prevalence and magnitude of proteinuria and a more rapid progression to CKD. There are many mechanisms by which obesity alters renal physiology and metabolism. More effective methods for treating obesity and preventing the development and progression of obesity-associated CKD are clearly needed. Therefore, there is a greater need for a better understanding of the causes of the excessive energy intake that leads to obesity and the mechanisms responsible for the refractoriness of obese individuals to treatment. PMID:20797567

Kopple, Joel D

2010-09-01

68

A chronic disease prevention program.  

PubMed

In a pilot chronic disease prevention program at the Hinds County Health Department in Jackson, Mississippi, 1030 patients were evaluated with yearly complete physical evaluation, Pap Smears, screening mammography, and other appropriate tests and procedures. The patients were also provided with nutritional and healthy lifestyle education. The study lasted for 3 1/2 years. It was done in conjunction with a pre-existing hypertension program. Although the benefits of the educational effort were more intangible in the relatively short period of time of the study, it is significant that mammography identified eight (8) occult breast cancers. We believe this pilot study only touches the surface of what could be done with more extensive preventive measures. PMID:10128265

Grillo, D

1993-01-01

69

Epidemiology of Comorbidities in Chronic Obstructive Pulmonary Disease.  

E-print Network

??abstract__Abstract__ Chronic Obstructive Pulmonary Disease (COPD) is defined by the Global initiative for chronic Obstructive Lung Disease (GOLD) as a common preventable and treatable disease,… (more)

L. Lahousse (Lies)

2014-01-01

70

Chronic obstructive pulmonary disease: towards pharmacogenetics  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a common problem worldwide, and it is recognized that the term encompasses overlapping sub-phenotypes of disease. The development of a sub-phenotype may be determined in part by an individual's genetics, which in turn may determine response to treatment. A growing understanding of the genetic factors that predispose to COPD and its sub-phenotypes and the pathophysiology of the condition is now leading to the suggestion of individualized therapy based on the patients' clinical phenotype and genotype. Pharmacogenetics is the study of variations in treatment response according to genotype and is perhaps the next direction for genetic research in COPD. Here, we consider how knowledge of the pathophysiology and genetic risk factors for COPD may inform future management strategies for affected individuals. PMID:19951401

2009-01-01

71

[Hypogonadism and chronic obstructive pulmonary disease].  

PubMed

Chronic obstructive pulmonary disease (COPD) is a systemic disease that affects not only the respiratory system. Sex hormones deficiency in men can be correlated with the COPD stages and make a negative contribution during its progression. Up to date, there are no long-term trials evaluating the effects of androgens on the parameters of respiratory function in patients with COPD. Changes of testosterone levels in patients with COPD correlate with forced expiratory volume, and hypoxemia and hypercapnia levels. Glucocorticosteroids exacerbate androgen deficiency in patients with COPD, and the use of hormone replacement therapy with testosterone in these patients is justified. Androgens, in particular drug nebido, testosterone depot, can be effectively used in treatment and rehabilitation of patients with COPD. PMID:24437255

Vertkin, A L; Morgunov, L Iu; Shakhmanaev, Kh A

2013-01-01

72

Pulmonary hypertension in chronic obstructive pulmonary disease  

Microsoft Academic Search

Pulmonary hypertension in chronic obstructive pulmonary disease. J.A. Barbera `, V.I. Peinado, S. Santos. #ERS Journals Ltd 2003. ABSTRACT: Pulmonary hypertension is a common complication of chronic obstructive pulmonary disease (COPD). Its presence is associated with shorter survival and worse clinical evolution. In COPD, pulmonary hypertension tends to be of moderate severity and progresses slowly. However, transitory increases of pulmonary

J. A. Barbera; V. I. Peinado; S. Santos

2003-01-01

73

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

74

Chronic kidney disease: global dimension and perspectives.  

PubMed

Chronic kidney disease is defined as a reduced glomerular filtration rate, increased urinary albumin excretion, or both, and is an increasing public health issue. Prevalence is estimated to be 8-16% worldwide. Complications include increased all-cause and cardiovascular mortality, kidney-disease progression, acute kidney injury, cognitive decline, anaemia, mineral and bone disorders, and fractures. Worldwide, diabetes mellitus is the most common cause of chronic kidney disease, but in some regions other causes, such as herbal and environmental toxins, are more common. The poorest populations are at the highest risk. Screening and intervention can prevent chronic kidney disease, and where management strategies have been implemented the incidence of end-stage kidney disease has been reduced. Awareness of the disorder, however, remains low in many communities and among many physicians. Strategies to reduce burden and costs related to chronic kidney disease need to be included in national programmes for non-communicable diseases. PMID:23727169

Jha, Vivekanand; Garcia-Garcia, Guillermo; Iseki, Kunitoshi; Li, Zuo; Naicker, Saraladevi; Plattner, Brett; Saran, Rajiv; Wang, Angela Yee-Moon; Yang, Chih-Wei

2013-07-20

75

Impact of Chronic Hypercortisolemia on Affective Processing  

PubMed Central

Cushing syndrome (CS) is the classic condition of cortisol dysregulation, and cortisol dysregulation is the prototypic finding in Major Depressive Disorder (MDD). We hypothesized that subjects with active CS would show dysfunction in frontal and limbic structures relevant to affective networks, and also manifest poorer facial affect identification accuracy, a finding reported in MDD.Twenty-one patients with confirmed CS (20 ACTH-dependent and 1 ACTH-independent) were compared to 21 healthy controlsubjects. Identification of affective facial expressions (Facial Emotion Perception Test) was conducted in a 3 Tesla GE fMRI scanner using BOLD fMRI signal. The impact of disease (illness duration, current hormone elevation and degree of disruption of circadian rhythm), performance, and comorbid conditions secondary to hypercortisolemia were evaluated.CS patients made more errors in categorizing facial expressions and had less activation in left anterior superior temporal gyrus, a region important in emotion processing. CS patients showed higher activation in frontal, medial, and subcortical regions relative to controls. Two regions of elevated activation in CS, left middle frontal and lateral posterior/pulvinar areas, were positively correlated with accuracy in emotion identification in the CS group, reflecting compensatory recruitment. In addition, within the CSgroup, greater activation in left dorsal anterior cingulatewas related to greater severity of hormone dysregulation. In conclusion, cortisol dysregulation in CS patients is associated with problems in accuracy of affective discrimination and altered activation of brain structures relevant to emotion perception, processing and regulation, similar to the performance decrements and brain regions shown to be dysfunctional in MDD. PMID:21787793

Langenecker, Scott A.; Weisenbach, Sara L.; Giordani, Bruno; Briceno, Emily M.; GuidottiBreting, Leslie M.; Schallmo, Michael-Paul; Leon, Hadia M.; Noll, Douglas C.; Zubieta, Jon-Kar; Schteingart, David E.; Starkman, Monica N.

2011-01-01

76

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

77

[Pathology of chronic obstructive pulmonary disease].  

PubMed

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the lung characterized by poorly reversible airflow limitation. It is not a unique disease entity but rather a complex of conditions which include emphysema, chronic bronchitis and, sometimes, asthma. Moreover, COPD is a progressive disease often associated with exacerbations. Cigarette smoking, which is the most important risk factor for the development of COPD, induces pathological changes involving lung parenchyma, peripheral airways and central airways. Since lung parenchyma and peripheral airways are the sites responsible for airflow limitation and central airways are the main site of mucus hypersecretion, pathological changes in these compartments may be relevant in the development of COPD. PMID:15098572

Turato, Graziella; Zuin, Renzo; Baraldo, Simonetta; Badin, Chiara; Beghé, Bianca; Saetta, Marina

2003-01-01

78

The genetics of chronic obstructive pulmonary disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease caused by the interaction of genetic susceptibility and environmental influences. There is increasing evidence that genes link to disease pathogenesis and heterogeneity by causing variation in protease anti-protease systems, defence against oxidative stress and inflammation. The main methods of genomic research for complex disease traits are described, together with the genes implicated in COPD thus far, their roles in disease causation and the future for this area of investigation. PMID:17054776

Wood, Alice M; Stockley, Robert A

2006-01-01

79

Cardiovascular complications of pediatric chronic kidney disease  

PubMed Central

Cardiovascular disease (CVD) mortality is a leading cause of death in adult chronic kidney disease (CKD), with exceptionally high rates in young adults, according to the Task Force on Cardiovascular Disease. Recent data indicate that cardiovascular complications are already present in children with CKD. This review summarizes the current literature on cardiac risk factors, mortality and morbidity in children with CKD. PMID:17120060

2006-01-01

80

Epidemiology of Chronic Obstructive Pulmonary Disease (COPD)  

Microsoft Academic Search

Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of morbidity and mortality in the industrialized and the developing countries. During 1997, COPD has been estimated to be the number four cause of death after cardiovascular diseases, tumors and cerebrovascular diseases in the United States. In 2020 COPD will probably become the third leading cause of death all

G. Viegi; A. Scognamiglio; S. Baldacci; F. Pistelli; L. Carrozzi

2001-01-01

81

Pathogenesis of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

The current paradigm for the pathogenesis of chronic obstructive pulmonary disease is that chronic airflow limitation results from an abnormal inflammatory response to inhaled particles and gases in the lung. Airspace inflammation appears to be different in suscepti- ble smokers and involves a predominance of CD8 T lymphocytes, neutrophils, and macrophages. Studies have characterized inflam- mation in the peripheral airspaces

William MacNee

2005-01-01

82

Microalbuminuria in chronic obstructive pulmonary disease  

Microsoft Academic Search

Microalbuminuria in chronic obstructive pul- monary disease. A. Kömürcüog ?lu, S. Kalenci, D. Kalenci, B. Kömürcüog ?lu, G. Tibet. Background. In this study, the presence of microalbu- minuria in patients with chronic obstructive pulmonary dis- ease (COPD) in whom no proteinuria was determined by conventional methods, has been studied taking into account the possible relationship between microalbuminuria and res- piratory

A. Kömürcüog; S. Kalenci; D. Kalenci; G. Tibet

83

The genetics of chronic obstructive pulmonary disease  

E-print Network

Abstract Chronic obstructive pulmonary disease (COPD) is a significant cause of global morbidity and mortality. Previous studies have shown that COPD aggregates in families, suggesting a genetic predisposition to airflow obstruction. Many candidate...

2001-01-11

84

Anemia of Inflammation and Chronic Disease  

MedlinePLUS

... body’s tissues are depleted. In AI/ACD, however, iron stores are normal or high. Low blood iron levels occur in AI/ACD, despite normal iron stores, because inflammatory and chronic diseases interfere with the ...

85

Chronic obstructive pulmonary disease - control drugs  

MedlinePLUS

Anderson B, Conner Anderson B, Conner K, Dunn C, et al. Institute for Clinical Systems Improvement. Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD). https://www.icsi.org/_asset/yw83gh/ ...

86

Chronic Venous Disease (Beyond the Basics)  

MedlinePLUS

... problems, and preventing and treating ulcers. (See "Medical management of lower extremity chronic venous disease" .) Leg elevation — Simply elevating the legs above heart level for 30 minutes three or four times per ...

87

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

88

Chronic kidney disease and erectile dysfunction  

PubMed Central

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

2014-01-01

89

WILDLIFE DISEASES SURVEILLANCE TO DETECT CHRONIC WASTING DISEASE IN  

E-print Network

Chronic wasting disease (CWD) is a fatal neurodegenerative disease of mule deer (Odocoileus hemionus of 2002 and 2003 to determine the distribution of CWD in white-tailed deer (Odocoileus virginianus). Deer wasting disease, disease surveillance, Odocoileus virginianus, white- tailed deer, Wisconsin. INTRODUCTION

Mladenoff, David

90

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

91

Thyroid Disorders and Chronic Kidney Disease  

PubMed Central

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

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

2014-01-01

92

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

93

Pneumocystis jirovecii colonization in chronic pulmonary disease  

PubMed Central

Pneumocystis jirovecii causes pneumonia in immunosuppressed individuals. However, it has been reported the detection of low levels of Pneumocystis DNA in patients without signs and symptoms of pneumonia, which likely represents colonization. Several studies performed in animals models and in humans have demonstrated that Pneumocystis induces a local and a systemic response in the host. Since P. jirovecii colonization has been found in patients with chronic pulmonary diseases it has been suggested that P. jirovecii may play a role in the physiopathology and progression of those diseases. In this report we revise P. jirovecii colonization in different chronic pulmonary diseases such us, chronic obstructive pulmonary disease, interstitial lung diseases, cystic fibrosis and lung cancer. PMID:21678787

Gutiérrez, S.; Respaldiza, N.; Campano, E.; Martínez-Risquez, M.T.; Calderón, E.J.; De La Horra, C.

2011-01-01

94

Prevalence of chronic obstructive pulmonary disease in rural women of  

E-print Network

Prevalence of chronic obstructive pulmonary disease in rural women of Tamilnadu: implications Ramachandra University, Chennai, India Background: Chronic obstructive pulmonary disease (COPD) is the 13th pulmonary disease; prevalence; biomass fuel users; rural women; disease burden Received: 25 April 2011

Silver, Whendee

95

Chronic Kidney Disease and Its Complications  

PubMed Central

Chronic kidney disease (CKD) is a complex disease impacting more than twenty million individuals in the United States. Progression of CKD is associated with a number of serious complications, including increased incidence of cardiovascular disease, hyperlipidemia, anemia and metabolic bone disease. CKD patients should be assessed for the presence of these complications and receive optimal treatment to reduce their morbidity and mortality. A multidisciplinary approach is required to accomplish this goal. PMID:18486718

Thomas, Robert; Kanso, Abbas; Sedor, John R.

2008-01-01

96

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

97

Exercise for Persons with Chronic Obstructive Pulmonary Disease (COPD)  

MedlinePLUS

Exercise for Persons with Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease (COPD), such as emphysema, chronic bronchitis and asthma, is defined by the American Thoracic Society as a condition ...

98

Distress Screening in Chronic Disease: Essential for Cancer Survivors  

PubMed Central

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

2014-01-01

99

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

100

Cardiac troponins and chronic kidney disease  

Microsoft Academic Search

The prevalence of coronary artery disease in patients with chronic kidney disease (CKD) is high, and acute myocardial infarction contributes significantly to the steep mortality rate in this population. Diagnosing an acute coronary syndrome in these patients is often difficult though essential. Traditional diagnostic tools such as symptoms and electrocardiographic manifestations are not entirely helpful in patients with CKD, and

A S Kanderian; G S Francis

2006-01-01

101

Biomarkers in chronic kidney disease: a review  

Microsoft Academic Search

Chronic kidney disease (CKD) is a major public health problem. The classification of CKD by KDOQI and KDIGO and the routine eGFR reporting have resulted in increased identification of CKD. It is important to be able to identify those at high risk of CKD progression and its associated cardiovascular disease (CVD). Proteinuria is the most sensitive marker of CKD progression

Robert G Fassett; Sree K Venuthurupalli; Glenda C Gobe; Jeff S Coombes; Matthew A Cooper; Wendy E Hoy

2011-01-01

102

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

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

103

Total body irradiation correlates with chronic graft versus host disease and affects prognosis of patients with acute lymphoblastic leukemia receiving an HLA identical allogeneic bone marrow transplant  

Microsoft Academic Search

Purpose: To investigate whether different procedure variables involved in the delivery of fractionated total body irradiation (TBI) impact on prognosis of patients affected by acute lymphoblastic leukemia (ALL) receiving allogeneic bone marrow transplant (BMT).Methods and Materials: Ninety-three consecutive patients with ALL receiving a human leukocyte antigen (HLA) identical allogeneic BMT between 1 August 1983 and 30 September 1995 were conditioned

Renzo Corvò; Gabriella Paoli; Salvina Barra; Almalina Bacigalupo; Maria Teresa Van Lint; Paola Franzone; Francesco Frassoni; Daniele Scarpati; Andrea Bacigalupo; Vito Vitale

1999-01-01

104

Dermatological diseases in patients with chronic kidney disease  

PubMed Central

Context: There are a variety of dermatological diseases that are more commonly seen in patients with chronic kidney disease (CKD) and renal transplants than the general population. Evidence Acquisitions: Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science has been searched. Results: Some cutaneous diseases are clearly unique to this population. Of them, Lindsay’s Nails, xerosis cutis, dryness of the skin, nephrogenic systemic fibrosis and acquired perforating dermatosis have been described in chronic kidney disease patients. The most common malignancy found in all transplant recipients is non-melanoma skin cancer. Conclusions: It is important for patients and physicians to recognize the manifestations of skin disease in patients suffering from chronic kidney disease to mitigate the morbidity associated with these conditions. PMID:24475435

Gagnon1, Amy L.; Desai, Tejas

2013-01-01

105

Chronic Liver Disease in the Intensive Care  

Microsoft Academic Search

\\u000a Chronic liver disease (CLD) accounts for a significant portion of the current health burden. If figures and projections are\\u000a extrapolated from historical data for the viral hepatitides, particularly hepatitis C, then this is set to rise significantly\\u000a over the coming decades. Furthermore, the incidence of alcoholic liver disease and non-alcoholic fatty liver disease will\\u000a add to this workload, primarily due

Andrew Slack; Julia Wendon

106

Heart Disease Affects Women of All Ages  

MedlinePLUS

... Home Current Issue Past Issues Heart Disease Affects Women of All Ages Past Issues / Winter 2007 Table ... of this page please turn Javascript on. Young Women: Lifestyle-related factors that increase heart disease risk ...

107

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

108

Epidemiology of chronic obstructive pulmonary disease  

Microsoft Academic Search

ABSTRACT: Chronic obstructive pulmonary,disease (COPD) is a leading cause of world-wide mortality and disability. On average y5–15% of adults in industrialized countries have COPD defined by spirometry. In 1990, COPD was considered to be at the twelfth position world-wide as a cause of combined,mortality and disability but is expected,to become,the fifth cause by the year 2020. COPD has a chronic

J. M. Antó; P. Vermeire; J. Vestbo; J. Sunyer

2001-01-01

109

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

110

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

111

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

112

Chronic Obstructive Pulmonary Disease (COPD): Data and Statistics  

MedlinePLUS

... visit this page: About CDC.gov . Chronic Obstructive Pulmonary Disease (COPD) Share Compartir Data and Statistics Work-Related ... and several other respiratory conditions including chronic obstructive pulmonary disease. Learn more about the Work-Related Lung Disease ...

113

COPD (Chronic Obstructive Pulmonary Disease)  

MedlinePLUS Videos and Cool Tools

... COPD and emphysema. Exposure to other irritants and pollution can also harm the lungs. There are also ... associated with these diseases. Avoiding other irritants and pollution is also important. Likewise, repairing lung damage is ...

114

Occupational causes of chronic obstructive pulmonary disease.  

PubMed

The relation between Chronic Obstructive Pulmonary Disease (COPD, including chronic bronchitis and emphysema (CBE), and exposure to coal dust is well established. This paper reviews the evidence relating to other occupational causes of COPD, including industries associated with exposure to fumes, chemical substances, and dusts. A review of key literature has been carried out with a focus on the magnitude of risks and levels of exposure causing disabling health effects. The literature suggests that elevated risks of developing COPD are clearly associated with several occupations, with risk estimates being high in some, even after taking into account the effect of confounders, such as smoking. Of particular concern are agricultural workers who can be exposed to a variety of gases and organic dusts, among whom CBE is clearly elevated, particularly for pig farmers and exposure to endotoxins, with an increased annual decline in lung function. Similarly, cotton textile workers are exposed to a mixture of substances affecting development of atopy, byssinosis, and CBE, and across-shift and long-term decline in lung function. Atopy also has an important role in the development of COPD in flour mill workers and bakers, with those sensitized to bakery allergens having a greater lung function decline than non-sensitized individuals. Welding processes involve a range of potential chemical, physical and radiation hazards. The average reduction in FEV1 associated with welding fumes is similar to that associated with smoking. Challenges in assessing the evidence include variation in diagnostic methods; concurrent exposure to cigarette smoke (direct or second-hand) and multiple work-place irritants; healthy worker selection/survivor effects; poor exposure definition. Raising awareness of occupational causes of COPD among employers, employees, and health service professionals is important. PMID:18078004

Rushton, Lesley

2007-01-01

115

Staphylococcus aureus and Chronic Airway Disease.  

PubMed

Staphylococcus aureus (S. aureus) is correlated with the development of persistent severe inflammatory disease of the upper airway including chronic rhinosinusitis with nasal polyps. This inflammation of the upper airways is characterized by a T-helper 2-driven disease: interleukin-5 is significantly increased and local production of immunoglobulin E is observed. S. aureus and its enterotoxins are deregulating the tissue inflammation at different levels: structural cells and the innate and adaptive immune system. Knowing the triggers of the pathomechanisms involved will greatly help us to find new therapeutic approaches to resolve this chronic inflammatory process. PMID:23282714

Derycke, Lara; Pérez-Novo, Claudina; Van Crombruggen, Koen; Corriveau, Marie-Noëlle; Bachert, Claus

2010-08-01

116

[Chronic urticaria from the aspect of autoimmune diseases].  

PubMed

At some time in their lives one in a five persons is affected by urticaria and/or angioedema. The cause of urticaria may never be found in up to one quarter of patients with acute urticaria and in up to 90-95% with chronic urticaria. In this study we present results of our compounded approach (clinical follow up, laboratory findings, allergological testing) to patients with chronic urticaria and autoimmune diseases that progressed into chronic urticaria or started before the onset of the chronic urticaria. Our first case was a 56 year old woman with a 10 month history of chronic urticaria, angioedema and chronic gastritis before the diagnoses of insulin dependent Diabetes mellitus and Hypothyreoidismus primarius were established. Allergological testing reveals specific clinical significant immediate reaction to Balsam Peru. After adequate substitutional therapy was advocated and with specific clinical avoidance of offended allergen, remission was obtained. The second case was a 46 year old female suffering from chronic urticaria (with clinical features of urticaria like vasculitis) associated with hypocomplementemia (particularly C4 depressed) with negative antinuclear antibodies but positive circulating immune complexes after a 2 year follow up the patient developed Systemic lupus erythematosus. The third case was a 63 year old woman who developed chronic urticaria 3 years after total thyroidectomy, with pathological finding of Thyroiditis lymphocytaria-Hashimoto; after the allergological testing, positive lymphocyte transformation test revealed allergical sensitization to Vobenol was substituted with Thyvoral, complete remission was obtained. PMID:7565341

Jovanovi?, M; Lenert, P; Poljacki, M; Miti?, I; Duran, V

1995-01-01

117

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

118

Chronic Diseases in Captive Geriatric Female Chimpanzees (Pan troglodytes)  

PubMed Central

The current aging population of captive chimpanzees is expected to develop age-related diseases and present new challenges to providing their veterinary care. Spontaneous heart disease and sudden cardiac death are the main causes of death in chimpanzees (especially of male animals), but little is known about the relative frequency of other chronic diseases. Furthermore, female chimpanzees appear to outlive the males and scant literature addresses clinical conditions that affect female chimpanzees. Here we characterize the types and prevalence of chronic disease seen in geriatric (older than 35 y) female chimpanzees in the colony at Alamogordo Primate Facility. Of the 16 female chimpanzees that fit the age category, 87.5% had some form of chronic age-related disease. Cardiovascular-related disease was the most common (81.25%) followed by metabolic syndrome (43.75%) and renal disease (31.25%). These data show the incidence of disease in geriatric female chimpanzees and predict likely medical management challenges associated with maintaining an aging chimpanzee population. PMID:22546920

Nunamaker, Elizabeth A; Lee, D Rick; Lammey, Michael L

2012-01-01

119

Cardiovascular disease and chronic kidney disease: Insights and an update  

Microsoft Academic Search

Despite the high prevalence and significant morbidity and mortality rates of chronic kidney disease (CKD) related to cardiovascular disease, it remains vastly understudied. Most of the current practice recommendations come from small under-powered prospective studies, retrospective reviews, and assuming patients with CKD will similarly benefit from medications and treatments as patients with normal renal function. In addition, because of the

Patricia J. M. Best; Donal N. Reddan; Peter B. Berger; Lynda A. Szczech; Peter A. McCullough; Robert M. Califf

2004-01-01

120

Illness experience in a chronic disease--ALS  

Microsoft Academic Search

The representative case study method was used in a 1-year longitudinal study of two individuals with a chronic, degenerative, terminal neurological disease, ALS (amyotrophic lateral sclerosis, also known as Lou Gehrig's Disease). Participants were interviewed in their homes every 2 months to examine the effects of the illness on relationships with family, friends and the health care system. Changing ideas

Ann Kuckelman Cobb; Edna Hamera

1986-01-01

121

Pulmonary epithelium, cigarette smoke, and chronic obstructive pulmonary disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a complex chronic inflammatory disease involving a wide variety of cells and inflammatory mediators. The most important etiological factor in the development of this disease is cigarette smoking. Much of the research into the mechanisms of COPD has been concerned with the induction of inflammation and the role of neutrophils and macrophages in the pathophysiology of the disease. The possible contribution of the epithelium to the development of COPD has only recently become apparent and remains unclear. In this article we review research into the effect of cigarette smoke on the pulmonary epithelium with particular emphasis on oxidative stress, proteolytic load, pro-inflammatory cytokine and chemokine profile and epithelial secretions. In addition, we have also reviewed how cigarette smoke may affect epithelial damage and repair processes. PMID:18268916

Thorley, Andrew J; Tetley, Teresa D

2007-01-01

122

An Update on Coronary Artery Disease and Chronic Kidney Disease  

PubMed Central

Despite the improvements in diagnostic tools and medical applications, cardiovascular diseases (CVD), especially coronary artery disease (CAD), remain the most common cause of morbidity and mortality in patients with chronic kidney disease (CKD). The main factors for the heightened risk in this population, beside advanced age and a high proportion of diabetes and hypertension, are malnutrition, chronic inflammation, accelerated atherosclerosis, endothelial dysfunction, coronary artery calcification, left ventricular structural and functional abnormalities, and bone mineral disorders. Chronic kidney disease is now recognized as an independent risk factor for CAD. In community-based studies, decreased glomerular filtration rate (GFR) and proteinuria were both found to be independently associated with CAD. This paper will discuss classical and recent epidemiologic, pathophysiologic, and clinical aspects of CAD in CKD patients. PMID:24734178

Covic, Adrian; Kanbay, Mehmet

2014-01-01

123

An update on coronary artery disease and chronic kidney disease.  

PubMed

Despite the improvements in diagnostic tools and medical applications, cardiovascular diseases (CVD), especially coronary artery disease (CAD), remain the most common cause of morbidity and mortality in patients with chronic kidney disease (CKD). The main factors for the heightened risk in this population, beside advanced age and a high proportion of diabetes and hypertension, are malnutrition, chronic inflammation, accelerated atherosclerosis, endothelial dysfunction, coronary artery calcification, left ventricular structural and functional abnormalities, and bone mineral disorders. Chronic kidney disease is now recognized as an independent risk factor for CAD. In community-based studies, decreased glomerular filtration rate (GFR) and proteinuria were both found to be independently associated with CAD. This paper will discuss classical and recent epidemiologic, pathophysiologic, and clinical aspects of CAD in CKD patients. PMID:24734178

Afsar, Baris; Turkmen, Kultigin; Covic, Adrian; Kanbay, Mehmet

2014-01-01

124

Chronic Obstructive Pulmonary Disease and the workplace.  

PubMed

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disease associated with increasing morbidity and mortality worldwide. Whilst tobacco smoking is the important cause, other causes are recognized. This article discusses the contribution that harmful inhaled occupational exposures make to the overall burden of COPD, and goes on to discuss other aspects of the COPD workplace interface. Prevention is key. All healthcare professionals have a responsibility to consider workplace issues when dealing with their COPD patients. PMID:20185481

Fishwick, David; Barber, Chris M; Darby, Anthony C

2010-01-01

125

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

126

Epidemiology of chronic kidney disease in children  

Microsoft Academic Search

In the past 30 years there have been major improvements in the care of children with chronic kidney disease (CKD). However,\\u000a most of the available epidemiological data stem from end-stage renal disease (ESRD) registries and information on the earlier\\u000a stages of pediatric CKD is still limited. The median reported incidence of renal replacement therapy (RRT) in children aged\\u000a 0–19 years

Jérôme Harambat; Karlijn J. van Stralen; Jon Jin Kim; E. Jane Tizard

127

Affective and Psychiatric Disorders in Celiac Disease  

Microsoft Academic Search

Several extraintestinal clinical manifestations have been reported in celiac disease (CD). Among them, growing evidence suggests the association between CD and affective and psychiatric disorders. In this review the most frequent affective and psychiatric disorders associated with CD and the possible mechanisms involved in these associations were analyzed. The available data suggest that screening for CD in patients with affective

Giovanni Addolorato; Lorenzo Leggio; Cristina D’Angelo; Antonio Mirijello; Anna Ferrulli; Silvia Cardone; Luisa Vonghia; Ludovico Abenavoli; Veruscka Leso; Antonio Nesci; Salvatore Piano; Esmeralda Capristo; Giovanni Gasbarrini

2008-01-01

128

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

129

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

130

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

131

Chronic Disease Modeling and Simulation Software  

PubMed Central

Computers allow describing the progress of a disease using computerized models. These models allow aggregating expert and clinical information to allow researchers and decision makers to forecast disease progression. To make this forecast reliable, good models and therefore good modeling tools are required. This paper will describe a new computer tool designed for chronic disease modeling. The modeling capabilities of this tool were used to model the Michigan model for diabetes. The modeling approach and its advantages such as simplicity, availability, and transparency are discussed. PMID:20558320

Barhak, Jacob; Isaman, Deanna JM; Ye, Wen; Lee, Donghee

2010-01-01

132

Bone health and vascular calcification relationships in chronic kidney disease  

Microsoft Academic Search

Abnormal bone in chronic kidney disease (CKD) may adversely affect vascular calcification via disordered calcium and phosphate\\u000a metabolism. In this context, bone health should be viewed as a prerequisite for the successful prevention\\/treatment of vascular\\u000a calcification (VC) along with controlled parathyroid hormone (PTH) secretion, the use of calcium-based phosphate binders and\\u000a vitamin D therapy. In CKD patients, VC occurs more

Goce B. Spasovski

2007-01-01

133

Physical Therapy for Children with Chronic Lung Disease  

Microsoft Academic Search

Chronic lung disease is a major health problem among children. Estimates suggest that one child in six has a chronic respiratory condition. This article reviews three common chronic respiratory conditions occurring in childhood for which physical therapy is usually recommended. The cause, pathophysiology, and medical treatment are explained for asthma, respiratory complications of chronic neuromuscular disease, and cystic fibrosis. The

JAN STEPHEN TECKLIN

134

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

135

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

136

Comparative effectiveness research in chronic obstructive pulmonary disease  

PubMed Central

Chronic obstructive pulmonary disease affects millions worldwide. It is America’s third leading cause of death, and results in significant morbidity and cost. Although many therapies exist and are being developed to alleviate symptoms and decrease morbidity and mortality in chronic obstructive pulmonary disease, most have only been studied in placebo-controlled efficacy studies in highly selected populations. Comparative effectiveness and translational research in chronic obstructive pulmonary disease will require the development of infrastructures to support collaboration between researchers and the stakeholders who generate, disseminate and use new knowledge. Methodologies need to evolve to both prioritize research questions and to conduct collaborative comparative effectiveness research studies. Given the impracticality of testing every clinical intervention in comparative pragmatic trials for comparative effectiveness research in chronic obstructive pulmonary disease, we advocate expanding methodology that includes the use of observational databases with serially performed effectiveness analyses and quasi-experimental designs that include following healthcare changes longitudinally over time to assess benefit, harm, subgroups and cost. PMID:23105965

Mularski, Richard A; McBurnie, Mary Ann; Lindenauer, Peter K; Lee, Todd A; Vollmer, William M; Au, David H; Carson, Shannon S; Krishnan, Jerry A

2012-01-01

137

Chronic Kidney Disease and Medicines: What You Need to Know  

MedlinePLUS

Chronic Kidney Disease and Medicines What You Need to Know kidneys Because you have chronic kidney disease, you should take steps to protect your kidneys. Make changes to what you eat, manage your ...

138

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

139

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

140

Urban trauma: a chronic recurrent disease.  

PubMed

Urban trauma, often presumed to be an acute episodic event, may actually be a chronic recurrent disease related to the lifestyle, environment, and other factors of its victims. To test this idea an attempt was made to obtain 5-year followup for 501 consecutive survivors of violent trauma seen at one hospital, 1980-1981. Followup information for these patients was obtained from medical records at four local Level I trauma centers, death certificates, Medical Examiner's records, and police crime computer files. Of the 501 patients, 263 had medical followup including 148 patients with one trauma and 115 patients with recurrent trauma. Of these 263 patients, 200 (76%) were unemployed and 164 (62%) abused alcohol or drugs. From 1982-1987 142 out of 263 patients were involved in 133 crimes and 52 died. These data suggest that urban trauma is a chronic disease with a recurrent rate of 44% and a 5-year mortality rate of 20%. PMID:2746704

Sims, D W; Bivins, B A; Obeid, F N; Horst, H M; Sorensen, V J; Fath, J J

1989-07-01

141

Osteoporosis in chronic obstructive pulmonary disease  

Microsoft Academic Search

ABSTRACT: Osteoporosis is one of the systemic,effects associated with chronic obstructive pulmonary,disease (COPD). Potential risk factors of osteoporosis may,be due to the lifestyle, genetics, treatment with corticosteroids, endocrine abnormalities or the impairment,of the body composition,and peripheral skeletal muscles. Evidence for the possible contribution of such factors is reviewed. The occurrence of fractures, as a consequence of osteoporosis, can contribute to

A. A. Ionescu; E. Schoon

2003-01-01

142

Nutritional Aspects of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Itisclearthatbeingunderweightisapoorprognosticsigninchronic obstructive pulmonary disease (COPD). It is also clear that undernu- trition is at least in part associated with the severity of airflow ob- struction.Whilebothweightandbodymassindexareusefulscreen- ingtoolsintheinitialnutritionalevaluation,fat-freemass(FFM)may be a better marker of undernutrition in patients with COPD. The causes of cachexia in patients with COPD are multifactorial and in- cludedecreasedoralintake,theeffectofincreasedworkofbreathing due to abnormal respiratory mechanics, and the effect of chronic systemic

Daniel A. King; Francis Cordova; Steven M. Scharf

2008-01-01

143

The genetics of chronic obstructive pulmonary disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a significant cause of global morbidity and mortality. Previous studies have shown that COPD aggregates in families, suggesting a genetic predisposition to airflow obstruction. Many candidate genes have been assessed, but the data are often conflicting. We review the genetic factors that predispose smokers to COPD and highlight the future role of genomic scans in identifying novel susceptibility genes. PMID:11686861

Lomas, David A; Silverman, Edwin K

2001-01-01

144

Unreferred chronic kidney disease: a longitudinal study  

Microsoft Academic Search

Background: Chronic kidney disease (CKD) is a major health problem. A better understanding of the epidemiological characteristics of the different stages of CKD and the associated adverse outcomes is needed to establish and implement appropriate management strategies. Methods: A serum creatinine (SCr) level of 2.03 mg\\/dL or greater (?180 ?mol\\/L) in men and 1.53 mg\\/dL or greater (?135 ?mol\\/L) in

Robert John; Michelle Webb; Alan Young; Paul E Stevens

2004-01-01

145

Calciphylaxis presenting in early chronic kidney disease with mixed hyperparathyroidism  

PubMed Central

Calciphylaxis is a disabling and life-threatening complication that primarily affects patients who are dialysis dependent. Reports have grown in the literature of cases occurring in those who have advanced chronic kidney disease (pre-end-stage renal disease) or in the setting of transplantation. There are also a few reports of cases occurring in those without any form of chronic kidney disease but with primary hyperparathyroidism. This disease entity is characterized by calcification, intimal hypertrophy, and thrombosis of small vessels that result in necrotizing, nonhealing ulcers – many of which are life threatening. Although several strategies aimed at treating and preventing this affliction have been reported in the literature, the outcome for most patients with calciphylaxis remains quite poor. We describe a patient with comparatively early stage-3 chronic kidney disease who developed calciphylaxis in the setting of both primary and secondary hyperparathyroidism. Predictably, after subtotal parathyroidectomy, her wounds did not completely heal and her biochemical markers of hyperparathyroidism did not completely normalize until her underlying secondary hyperparathyroidism was treated medically. It was only after initiating cinacalcet that the patient experienced complete wound healing and resolution of her calciphylaxis. It also supports other authors’ findings that cinacalcet may be an important adjunct in the treatment of calciphylaxis. PMID:22259253

Brucculeri, Michael; Haydon, Allan H

2011-01-01

146

Chronic Diseases among Older Cancer Survivors  

PubMed Central

Objective. To compare the occurrence of pre-existing and subsequent comorbidity among older cancer patients (?60 years) with older non-cancer patients. Material and Methods. Each cancer patient (n = 3835, mean age 72) was matched with four non-cancer patients in terms of age, sex, and practice. The occurrence of chronic diseases was assessed cross-sectionally (lifetime prevalence at time of diagnosis) and longitudinally (incidence after diagnosis) for all cancer patients and for breast, prostate, and colorectal cancer patients separately. Cancer and non-cancer patients were compared using logistic and Cox regression analysis. Results. The occurrence of the most common pre-existing and incident chronic diseases was largely similar in cancer and non-cancer patients, except for pre-existing COPD (OR 1.21, 95% CI 1.06–1.37) and subsequent venous thrombosis in the first two years after cancer diagnosis (HR 4.20, 95% CI 2.74–6.44), which were significantly more frequent (P < 0.01) among older cancer compared to non-cancer patients. Conclusion. The frequency of multimorbidity in older cancer patients is high. However, apart from COPD and venous thrombosis, the incidence of chronic diseases in older cancer patients is similar compared to non-cancer patients of the same age, sex, and practice. PMID:22956953

Deckx, Laura; van den Akker, Marjan; Metsemakers, Job; Knottnerus, Andre; Schellevis, Francois; Buntinx, Frank

2012-01-01

147

Chronic Coronary Artery Disease: Diagnosis and Management  

PubMed Central

Coronary artery disease (CAD) is the single most common cause of death in the developed world, responsible for about 1 in every 5 deaths. The morbidity, mortality, and socioeconomic importance of this disease make timely accurate diagnosis and cost-effective management of CAD of the utmost importance. This comprehensive review of the literature highlights key elements in the diagnosis, risk stratification, and management strategies of patients with chronic CAD. Relevant articles were identified by searching the PubMed database for the following terms: chronic coronary artery disease or stable angina. Novel imaging modalities, pharmacological treatment, and invasive (percutaneous and surgical) interventions have revolutionized the current treatment of patients with chronic CAD. Medical treatment remains the cornerstone of management, but revascularization continues to play an important role. In the current economic climate and with health care reform very much on the horizon, the issue of appropriate use of revascularization is important, and the indications for revascularization, in addition to the relative benefits and risks of a percutaneous vs a surgical approach, are discussed. PMID:19955250

Cassar, Andrew; Holmes, David R.; Rihal, Charanjit S.; Gersh, Bernard J.

2009-01-01

148

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

2014-10-29

149

Chronic cutaneous graft-versus-host disease in man.  

PubMed Central

This clinicopathologic study of patients with chronic graft-versus-host disease (GVHD) after allogeneic marrow transplantation emphasizes the most prominent feature of the syndrome, the cutaneous aspects, and describes the ophthalmic-oral sicca syndrome with sialoadenitis and the neurologic findings. Chronic cutaneous GVHD affected 19 of 92 recipients surviving 150 days or more. In 6 patients chronic GVHD presented as a continuation of acute GVHD; in 8 it occurred after the resolution of acute GVHD; and in 5 it arose without preceding acute GVHD, ie, de novo late onset. Two cutaneous types were distinguished. The generalized type affected 16 patients and ran a progressive course resulting in late complications of poikiloderma, diffuse dermal and subcutaneous fibrosis, and contractures. Microscopically, it resembled generalized morphea and lupus erythermatosus hypertrophicus et profundus. The local type affected 3 patients with a more variable picture of poikiloderma, dermal sclerosis, and contractures. Microscopically, it resembled lupus of erythematosus profundus and scleroderma. Guidelines for defining and subclassifying chronic cutaneous GVHD are proposed. Images Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Figure 18 Figure 19 Figure 20 Figure 1 Figure 2 Figure 3 Figure 4 PMID:26221

Shulman, H. M.; Sale, G. E.; Lerner, K. G.; Barker, E. A.; Weiden, P. L.; Sullivan, K.; Gallucci, B.; Thomas, E. D.; Storb, R.

1978-01-01

150

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

151

[Chronic obstructive pulmonary disease: a cardiologist's point of view].  

PubMed

Chronic obstructive pulmonary disease is often associated with cardiovascular diseases, such as pulmonary hypertension, ischemic heart disease, arrhythmias or heart failure. These co-morbidities may cause diagnostic or therapeutic difficulties and significantly worsen the morbidity and mortality of patients with chronic obstructive pulmonary disease. In this work the author reviews special considerations for the treatment of patients with chronic obstructive pulmonary disease who have cardiovascular co-morbidities. Orv. Hetil., 2014, 155(37), 1480-1484. PMID:25194870

Faludi, Réka

2014-09-01

152

Cardiovascular disease in chronic renal insufficiency.  

PubMed

Cardiovascular illness is an important contributor to the morbidity of kidney disease. The spectrum of cardiovascular disease (CVD) in patients with chronic renal insufficiency (CRI) includes left ventricular hypertrophy (LVH) and dilatation, ischemic heart disease, and peripheral vascular disease. Both "traditional" and "uremia-specific" factors contribute to the occurrence and progression of cardiac disease in renal patients. A growing body of recent evidence indicates that the processes contributing to CVD commence early in CRI, leading to concentric LVH, left ventricular dilatation, congestive heart failure, and ischemic heart disease. Many of the coexisting conditions that have been identified consistently as contributing to the burden of cardiovascular illness in renal populations can be modified through medical interventions. Specific therapies exist for hypertension, anemia, hyperparathyroidism, and dyslipidemia. Studies to date have demonstrated that treatment of many of these factors-such as anemia and hypertension during end-stage renal disease-appear to benefit the cardiovascular system. Earlier intervention may offer the best opportunity to reduce the burden of illness in all groups of CRI patients. Identification of patients at the onset of kidney disease and attention to the known traditional and "uremic" risk factors are emerging as promising strategies. Long-term interventional studies are needed to determine costs, benefits, and risks of such strategies. PMID:11118155

Levin, A; Foley, R N

2000-12-01

153

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

154

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

155

Household Food Insecurity and Obesity, Chronic Disease, and Chronic Disease Risk Factors  

Microsoft Academic Search

Context. Studies examining the association between food insecurity and obesity in adults have produced conflicting results, and information is limited on the relationship between food insecurity and adult chronic health conditions, particularly in a high-risk population.Objective. To examine the association between household food insecurity and self-reported weight status and chronic disease in the Lower Mississippi Delta.Design. A two-stage stratified cluster

Patrick H. Casey; Carol L. Connell; Catherine M. Champagne; Jeffrey M. Gossett; David Harsha; Beverly McCabe-Sellers; James M. Robbins; Pippa M. Simpson; Kitty L. Szeto; Judith L. Weber; Margaret L. Bogle

2007-01-01

156

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

157

Pathogenesis of chronic obstructive pulmonary disease.  

PubMed

The current epidemic of chronic obstructive pulmonary disease (COPD) has produced a worldwide health care burden, approaching that imposed by transmittable infectious diseases. COPD is a multidimensional disease, with varied intermediate and clinical phenotypes. This Review discusses the pathogenesis of COPD, with particular focus on emphysema, based on the concept that pulmonary injury involves stages of initiation (by exposure to cigarette smoke, pollutants, and infectious agents), progression, and consolidation. Tissue damage entails complex interactions among oxidative stress, inflammation, extracellular matrix proteolysis, and apoptotic and autophagic cell death. Lung damage by cigarette smoke ultimately leads to self-propagating processes, resulting in macromolecular and structural alterations - features similar to those seen in aging. PMID:22850885

Tuder, Rubin M; Petrache, Irina

2012-08-01

158

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

159

Anemia in children with chronic kidney disease.  

PubMed

Anemia in children with chronic kidney disease (CKD) is common secondary to inadequate erythropoietin production, iron deficiency, blood loss, inflammation, secondary hyperparathyroidism, uremic toxins, and nutritional deficiencies. Anemia has a variety of deleterious consequences, including associations with increased mortality and left ventricular hypertrophy. Recombinant human erythropoietin is effective in treating anemia in children with CKD, and recent studies show that darbepoetin alpha is an attractive alternative because it requires less frequent injections. Iron deficiency is a major cause of anemia that is resistant to erythropoietin or darbepoetin alpha. Although oral iron is effective in some patients, many children, especially those receiving hemodialysis, require intravenous iron to replenish their iron stores. Both acute dosing and chronic dosing of intravenous iron are effective in pediatric patients. PMID:16198278

Greenbaum, Larry A

2005-10-01

160

Targeted resistive ventilatory muscle training in chronic obstructive pulmonary disease  

E-print Network

Targeted resistive ventilatory muscle training in chronic obstructive pulmonary disease MICHAEL J with chronic obstructive pulmonary disease(COPD). In apreliminary study (study A ), we showed ventilatory muscle training in chronic obstructive pul- monary diseas e. J. Appl. Physiol. 65(6): 2726

Shadmehr, Reza

161

A Study of Malnutrition among Chronic Liver Disease Patients  

Microsoft Academic Search

3 Abstract: Malnutrition is as an important complication of chronic liver disease with prognostic implications. This study was carried out with the objectives to identify the frequency and severity of malnutrition among patients suffering from chronic liver disease and to assess relationship between malnutrition and dietary intake in these patients. A total of 231 patients (175 cirrhosis, 56 chronic hepatitis)

Shaheen Butt; Parvez Ahmed; Perveen Liaqat; Hajira Ahmad

2009-01-01

162

Placental type isoferritins in chronic liver diseases.  

PubMed

Serum ferritin levels in chronic liver diseases were measured by an enzyme-linked immunosorbent assay (ELISA) using two monoclonal antibodies (McAb) against placental ferritin. One of the McAbs (CM-H9) recognizes a specific placental-like isoferritin (PLF) only, while the other McAb (CM-G8) recognizes an isoform (CF) common to human placenta, liver and spleen. The different diseases studied were primary biliary cirrhosis (PBC-14 patients), chronic active hepatitis (CAH-12 patients), alcoholic cirrhosis (AC-18 patients) and cryptogenic cirrhosis (CRY-26 patients). Increased levels of both isoferritine were found in all these liver disorders, with an overall incidence of 80% for CF and 40% for PLF. The mean level of CF was significantly above normal in PBC, AC and CRY and that of PLF in PBC and CRY. Circulating placental-type isoferritins have not been previously described in patients with liver disorders. Our findings indicate that elevation of serum ferritin in liver diseases is caused by different isoferritin components. PMID:3596458

Konikoff, F; Shoenfeld, Y; Isenberg, D A; Theodor, F; Moroz, C

1987-04-01

163

Altered Expression Pattern of Polycystin-2 in Acute and Chronic Renal Tubular Diseases  

E-print Network

and chronic renal failure was analyzed. During ischemic acute renal failure, which affects primarily the S3Altered Expression Pattern of Polycystin-2 in Acute and Chronic Renal Tubular Diseases NICHOLAS under certain instances. Therefore, the distribution of polycystin-2 under conditions leading to acute

Witzgall, Ralph - Naturwissenschaftliche Fakultät III

164

[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

165

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

166

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

167

Vitamin K Status in Chronic Kidney Disease  

PubMed Central

The purpose of this review is to summarize the research to date on vitamin K status in chronic kidney disease (CKD). This review includes a summary of the data available on vitamin K status in patients across the spectrum of CKD as well as the link between vitamin K deficiency in CKD and bone dynamics, including mineralization and demineralization, as well as ectopic mineralization. It also describes two current clinical trials that are underway evaluating vitamin K treatment in CKD patients. These data may inform future clinical practice in this population. PMID:24212088

McCabe, Kristin M.; Adams, Michael A.; Holden, Rachel M.

2013-01-01

168

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

169

Musculoskeletal disorders in chronic obstructive pulmonary disease.  

PubMed

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; Gayan-Ramirez, Ghislaine

2014-01-01

170

Aldosterone blockade in chronic kidney disease.  

PubMed

Although blockade of the renin-angiotensin-aldosterone system with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers has become standard therapy for chronic kidney disease (CKD), renewed interest in the role of aldosterone in mediating the injuries and progressive insults of CKD has highlighted the potential role of treatments targeting the mineralocorticoid receptor (MR). Although salt restriction is an important component of mitigating the profibrotic effects of MR activation, a growing body of literature has shown that MR antagonists, spironolactone and eplerenone, can reduce proteinuria and blood pressure in patients at all stages of CKD. These agents carry a risk of hyperkalemia, but this risk likely can be predicted based on baseline renal function and mitigated using dietary modifications and adjustments of concomitant medications. Data on hard outcomes, such as progression to end-stage renal disease and overall mortality, still are lacking in patients with CKD. PMID:25016401

Hirsch, Jamie S; Drexler, Yelena; Bomback, Andrew S

2014-05-01

171

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

172

Oxygen Therapy in Chronic Obstructive Pulmonary Disease  

PubMed Central

Since the introduction of oxygen as a therapeutic agent 70 years ago, much has been learned regarding the detrimental effects of hypoxemia and the beneficial impact of oxygen therapy. It is projected that there are close to 800,000 patients receiving long-term oxygen therapy (LTOT) in the United States, at a cost of approximately $1.8 billion annually. The large numbers of patients receiving supplemental oxygen as treatment and the high costs incurred in providing oxygen therapy necessitate the practitioner to know the indications for LTOT as well its effects on survival, pulmonary hemodynamics, sleep, and exercise capacity. It is now recognized that the basis for LTOT prescription for all patients is founded on data that are over 25 years old and that only involve a very select cohort of patients. It is clear that further studies are required to assess the effects of oxygen on patients with chronic obstructive pulmonary disease with only mild hypoxemia, not only survival but also on neurocognitive function, quality of life, exercise physiology, and sleep quality. In addition, although proven to be safe when prescribed long term to individuals with lung disease, there are some concerns about worsening carbon dioxide retention and increased oxidant injury. The goals of this article are to briefly describe the indications for chronic oxygen administration, the physiologic effects of treatment, and potential toxicities, as well as its effect on morbidity and mortality. PMID:18453364

Kim, Victor; Benditt, Joshua O.; Wise, Robert A.; Sharafkhaneh, Amir

2008-01-01

173

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

174

Hepatitis G virus infection in chronic liver disease  

PubMed Central

Background—The hepatitis G virus (HGV), a recently identified member of the Flaviviridae family, can cause chronic infection in man but the role of this agent in chronic liver disease is poorly understood. ?Aims—To evaluate the prevalence and meaning of HGV infection in a large series of patients with chronic liver disease. ?Subjects—Two hundred volunteer blood donors, 179 patients with chronic hepatitis C, 111 with chronic hepatitis B, 104 with alcoholic liver disease, 136 with hepatocellular carcinoma, and 24 with cryptogenic chronic liver disease were studied. ?Methods—HGV RNA was investigated in serum samples by reverse transcription and polymerase chain reaction amplification of the 5' non-coding region of HCV and hybridisation to a specific probe. The main features of HGV RNA seropositive and seronegative patients were compared. ?Results—The prevalence of HGV infection was 3% in blood donors, 7% in chronic hepatitis C, 8% in chronic hepatitis B, 2% in alcoholic liver disease, 4% in hepatocellular carcinoma, and 8% in cryptogenic chronic liver disease. HGV infected patients tended to be younger than non-infected patients but no differences concerning sex, possible source of infection, clinical manifestations, biochemical and virological parameters, or severity of liver lesions were found. ?Conclusions—The prevalence of HGV infection in chronic liver disease seems to be relatively low in our area. Infection with HGV does not seem to play a significant pathogenic role in patients with chronic liver disease related to chronic HBV or HCV infection or to increased alcohol consumption, or in those with cryptogenic chronic liver disease. ?? Keywords: chronic liver disease; hepatitis G virus PMID:9505895

Guilera, M; Saiz, J; Lopez-Labrador, F; Olmedo, E; Ampurdanes, S; Forns, X; Bruix, J; Pares, A; Sanchez-Tapias, J; de Anta, M T J.; Rodes, J

1998-01-01

175

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

176

Task force on chronic interstitial lung disease in immunocompetent children  

Microsoft Academic Search

Task force on chronic interstitial lung disease in immunocompetent children. A. Clement, and committee members. #ERS Journals Ltd 2004. ABSTRACT: Chronic interstitial lung diseases in children represent a heterogeneous group of disorders of both known and unknown causes that share common histological features. Despite many efforts these diseases continue to present clinical management dilemmas, principally because of their rare frequency

A. Clement; J. Allen; B. Corrin; R. Dinwiddie; H. Ducou; E. Eber; G. Laurent; R. Marshall; F. Midulla; A. G. Nicholson

177

[Update on chronic obstructive pulmonary disease].  

PubMed

Chronic obstructive pulmonary disease (COPD), mainly caused by smoking, is predicted to be the third most frequent cause of death in the world by 2020. It is a multicomponent, progressive, disabling condition that ultimately ends in respiratory failure and death. There is evidence that systemic inflammation and extra pulmonary effects are also common in COPD, although the association between systemic inflammation and systemic manifestations of COPD is still not entirely clear. COPD is not only preventable but also treatable and the past decade has witnessed great progress in COPD research. New drugs have been developed and tested and a growing base of scientific evidence now documents the efficacy of several therapies for symptoms and exacerbations. It is clear that many patients with the disease can benefit from an aggressive management, with a decrease in the frequency of hospitalizations and improvements in symptoms and quality of life. Moreover, basic and clinical scientists have now identified cells, mechanisms, and molecules that play key roles in its pathogenesis. The advent of newer and more effective therapies will lead to a decline in the contribution of this disease to worldwide disease burden. COPD is now viewed under a new paradigm as preventable and treatable. PMID:21526305

Silva, Rafael

2010-12-01

178

Treatment of mild chronic obstructive pulmonary disease.  

PubMed

Chronic obstructive pulmonary disease (COPD) is an epidemic in many parts of the world. Most patients with COPD demonstrate mild disease. The cornerstone of management of mild disease is smoking cessation, which is the only proven intervention to relieve symptoms, modify its natural history and reduce mortality. For asymptomatic patients, it is the only required therapy. Short-acting bronchodilators can be added on an as needed basis for those with intermittent symptoms and regularly for those with persistent symptoms. Long-acting bronchodilators can be substituted for those who remain symptomatic despite regular use of short-acting bronchodilators. Inhaled corticosteroids do not modify the natural history of COPD and as such cannot be recommended as standalone therapy for mild COPD. However, for patients with refractory and intractable symptoms, they may be used in combination with long-acting beta-2 agonists. Influenza and pneumococcal vaccination and pulmonary rehabilitation are other therapies that may be considered for select patients with mild disease. In this paper, we summarize the current standard of care for patients with mild COPD. PMID:19281074

Chee, Alex; Sin, Don D

2008-01-01

179

Epidemiology and treatment effects in Chronic Obstructive Pulmonary Disease.  

E-print Network

??abstractChronic obstructive pulmonary disease (COPD) is a major health epidemic, which has important consequences for patients and community, and still receives insufficient attention from the… (more)

A.S.M. Afonso (Ana)

2011-01-01

180

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.

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

2014-01-01

181

Glycosaminoglycan sulodexide modulates inflammatory pathways in chronic venous disease.  

PubMed

Inflammation represents an important epiphenomenon in the etiopathogenesis of chronic venous disease, a worldwide debilitating condition affecting millions of subjects. The pathophysiology of chronic venous disease (CVD) is based on the hemodynamic abnormalities in conjunction to alterations in cellular and extracellular matrix biocompounds. The endothelial dysfunction results from early perturbation in the endothelium linked to glycocalyx injury and promoted by inflammatory cells and mediators (such as matrix metalloproteinases and interleukins), which lead to progressive dilation of the vein resulting in chronic venous insufficiency. Activated leukocytes during the inflammatory process release enzymes, free radicals, chemokines and inflammatory cytokines in the vessel microenvironment, which are responsible for the changes of the venous wall and venous valve, reflux and venous hypertension, and the development/progression of tissue destruction and skin changes. Sulodexide, a highly purified mixture of glycosaminoglycans composed by 80% fast moving heparin and 20% of dermatan sulphate, exhibits anti-thrombotic and profibrinolytic properties, restoring also the essential endothelial glycocalyx. Glycosaminoglycan sulodexide has been also characterized to reduce the release of inflammatory cytokines/chemokines and to inhibit the matrix metalloproteinases-related proteolytic cascades, counteracting endothelial dysfunctions. The pleiotropic effects of sulodexide set the basis for a very promising agent in treating the spectrum of CVD. PMID:24936532

Mannello, F; Ligi, D; Raffetto, J D

2014-06-01

182

Bisphenol A in chronic kidney disease.  

PubMed

The estrogenic endocrine-disrupting substance bisphenol A (BPA) is extensively used as a starting material for a variety of consumer plastic products including dialyzer materials. The present study was performed to explore plasma BPA levels in patients with impaired renal function and to investigate if dialyzers differing in elutable BPA influence plasma levels in patients on maintenance hemodialysis. In vitro BPA was eluted from high-flux polyethersulfone (PUREMA H, referred as PUR-H), high-flux polysulfone (referred as HF-PSu), and low-flux polysulfone (referred as LF-PSu) dialyzers by recirculation with water for 180?min. In a cross-sectional clinical study, plasma BPA levels of outpatients with different stages of chronic kidney disease (CKD) from four different centers were determined. Furthermore, in a prospective, randomized, and crossover setting, 18 maintenance dialysis patients were subjected successively to 4 weeks of thrice-weekly hemodialysis with each LF-PSu, HF-PSu, and PUR-H. In addition, the fractions of protein-bound and free BPA were determined in a subset of dialysis patients. The mass of BPA eluted from the blood compartments in vitro under aqueous conditions varied for the three dialyzers being very low for PUR-H (6.2?±?2.5?ng; P?affecting plasma BPA concentrations. Dialyzers are one additional source of BPA, but differences in the elutable BPA content are not associated with a significant effect on BPA plasma levels in Western European maintenance dialysis patients. Due to high protein binding, the removal of BPA by hemodialysis is limited. PMID:23145999

Krieter, Detlef H; Canaud, Bernard; Lemke, Horst-Dieter; Rodriguez, Annie; Morgenroth, Andreas; von Appen, Kai; Dragoun, Gerd-Peter; Wanner, Christoph

2013-03-01

183

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

184

Metabolic syndrome and chronic kidney disease  

PubMed Central

Obesity is fast becoming a bane for the present civilization, as a result of sedentary lifestyle, atherogenic diet, and a susceptible thrifty genotype. The concept of metabolic syndrome, which is a constellation of metabolic disturbances, has crystallized over the last 80 years with the aim of identifying those at greater risk of developing type 2 diabetes and cardiovascular disease. These patients have visceral obesity and insulin resistance characterized by hypertyriglyceridemia. Recently, it has been realized that they are also at an increased risk of chronic renal disease. Release of adipocytokines leads to endothelial dysfunction. There is also activation of systemic and local renin-angiotensin-aldosterone system, oxidative stress, and impaired fibrinolysis. This leads to glomerular hyperfiltration, proteinuria, focal segmental glomerulosclerosis (FSGS), and ultimately end-stage renal disease (ESRD). Treatment consists of lifestyle modifications along with optimal control of blood pressure, blood sugar and lipids. Metformin and thiazolidenidiones reduce insulin resistance; while angiotensin converting enzyme inhibitors and angiotensin receptor blockers reduce proteinuria and have a renoprotective effect. Exciting new medical therapies on the horizon include rimonabant a cannabinoid receptor type 1 antagonist, soy proteins, and peroxisome proliferator-activated receptor (PPAR) agonist. Bariatric surgery for morbid obesity has also been shown to be effective in treating metabolic syndrome. PMID:20368911

Bhowmik, D.; Tiwari, S. C.

2008-01-01

185

Dirty electricity, chronic stress, neurotransmitters and disease.  

PubMed

Dirty electricity, also called electrical pollution, is high-frequency voltage transients riding along the 50 or 60 Hz electricity provided by the electric utilities. It is generated by arcing, by sparking and by any device that interrupts current flow, especially switching power supplies. It has been associated with cancer, diabetes and attention deficit hyperactivity disorder in humans. Epidemiological evidence also links dirty electricity to most of the diseases of civilization including cancer, cardiovascular disease, diabetes and suicide, beginning at the turn of the twentieth century. The dirty electricity level in a public library was reduced from over 10 000 Graham/Stetzer (G/S) units to below 50 G/S units by installing plug-in capacitive filters. Before cleanup, the urinary dopamine level of only one of seven volunteers was within normal levels, while four of seven phenylethylamine levels were normal. After an initial decline, over the next 18 weeks the dopamine levels gradually increased to an average of over 215 ?g/g creatinine, which is well above 170 ?g/g creatinine, the high normal level for the lab. Average phenylethylamine levels also rose gradually to slightly above 70 ?g/g creatinine, the high normal level for the lab. Neurotransmitters may be biomarkers for dirty electricity and other electromagnetic field exposures. We believe that dirty electricity is a chronic stressor of electrified populations and is responsible for many of their disease patterns. PMID:23323864

Milham, Samuel; Stetzer, David

2013-12-01

186

Phosphorus and Nutrition in Chronic Kidney Disease  

PubMed Central

Patients with renal impairment progressively lose the ability to excrete phosphorus. Decreased glomerular filtration of phosphorus is initially compensated by decreased tubular reabsorption, regulated by PTH and FGF23, maintaining normal serum phosphorus concentrations. There is a close relationship between protein and phosphorus intake. In chronic renal disease, a low dietary protein content slows the progression of kidney disease, especially in patients with proteinuria and decreases the supply of phosphorus, which has been directly related with progression of kidney disease and with patient survival. However, not all animal proteins and vegetables have the same proportion of phosphorus in their composition. Adequate labeling of food requires showing the phosphorus-to-protein ratio. The diet in patients with advanced-stage CKD has been controversial, because a diet with too low protein content can favor malnutrition and increase morbidity and mortality. Phosphorus binders lower serum phosphorus and also FGF23 levels, without decreasing diet protein content. But the interaction between intestinal dysbacteriosis in dialysis patients, phosphate binder efficacy, and patient tolerance to the binder could reduce their efficiency. PMID:22701173

Gonzalez-Parra, Emilio; Gracia-Iguacel, Carolina; Egido, Jesus; Ortiz, Alberto

2012-01-01

187

Beryllium Sensitization Progresses to Chronic Beryllium Disease A Longitudinal Study of Disease Risk  

Microsoft Academic Search

The blood beryllium lymphocyte proliferation test is used in medical surveillance to identify both beryllium sensitization and chronic beryllium disease. Approximately 50% of individuals with beryllium sensitization have chronic beryllium disease at the time of their initial clinical evaluation; however, the rate of progression from beryllium sensitization to chronic beryllium disease is unknown. We monitored a cohort of beryllium-sensitized patients

Lee S. Newman; Margaret M. Mroz; Ronald Balkissoon; Lisa A. Maier

2004-01-01

188

Air pollution and chronic obstructive pulmonary disease.  

PubMed

Limited data suggest that outdoor air pollution (such as ambient air pollution or traffic-related air pollution) and indoor air pollution (such as second-hand smoking and biomass fuel combustion exposure) are associated with the development of chronic obstructive pulmonary disease (COPD), but there is insufficient evidence to prove a causal relationship at this stage. It also appears that outdoor air pollution is a significant environmental trigger for acute exacerbation of COPD, leading to increasing symptoms, emergency department visits, hospital admissions and even mortality. Improving ambient air pollution and decreasing indoor biomass combustion exposure by improving home ventilation are effective measures that may substantially improve the health of the general public. PMID:22142380

Ko, Fanny W S; Hui, David S C

2012-04-01

189

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

190

The neurophysiology of dissociation and chronic disease.  

PubMed

Dissociation as a clinical psychiatric condition has been defined primarily in terms of the fragmentation and splitting of the mind, and perception of the self and the body. Its clinical manifestations include altered perceptions and behavior, including derealization, depersonalization, distortions of perception of time, space, and body, and conversion hysteria. Using examples of animal models, and the clinical features of the whiplash syndrome, we have developed a model of dissociation linked to the phenomenon of freeze/immobility. Also employing current concepts of the psychobiology of posttraumatic stress disorder (PTSD), we propose a model of PTSD linked to cyclical autonomic dysfunction, triggered and maintained by the laboratory model of kindling, and perpetuated by increasingly profound dorsal vagal tone and endorphinergic reward systems. These physiologic events in turn contribute to the clinical state of dissociation. The resulting autonomic dysregulation is presented as the substrate for a diverse group of chronic diseases of unknown origin. PMID:11387861

Scaer, R C

2001-03-01

191

Growth hormone in chronic renal disease  

PubMed Central

Severe growth retardation (below the third percentile for height) is seen in up to one-third children with chronic kidney disease. It is thought to be multifactorial and despite optimal medical therapy most children are unable to reach their normal height. Under-nutrition, anemia, vitamin D deficiency with secondary hyperparathyroidism, metabolic acidosis, hyperphosphatemia, renal osteodystrophy; abnormalities in the growth hormone/insulin like growth factor system and sex steroids, all have been implicated in the pathogenesis of growth failure. Therapy includes optimization of nutritional and metabolic abnormalities. Failure to achieve adequate height despite 3–6 months of optimal medical measures mandates the use of recombinant GH (rGH) therapy, which has shown to result in catch-up growth, anywhere from 2 cm to 10 cm with satisfactory liner, somatic and psychological development. PMID:22470855

Gupta, Vishal; Lee, Marilyn

2012-01-01

192

Health care provider perception of chronic kidney disease: knowledge and behavior among African American patients  

PubMed Central

Background Chronic Kidney disease (CKD) is prevalent in the population, but also disproportionately affects African Americans. Disparities in care of chronic kidney disease and transplant for African Americans have also been reported. The purpose of this study is to determine the knowledge and reactions of chronic kidney disease patients regarding their disease, as perceived by nephrologists and clinic nurses in South Carolina. Methods Using a qualitative approach, key informant interviews were conducted with nephrologists, and three focus groups were held with nurses who specialize in chronic kidney disease. The results were recorded, transcribed, and analyzed using Qualrus software and the Grounded Theory Method. Results Dominant themes in the interviews and focus groups include: reaction to chronic kidney disease, differences in race, patient thoughts on dialysis, patient knowledge of types of treatment available, information availability, compliance to treatment, information source, and thoughts on kidney transplantation. The study found that the majority of clinicians agreed that there is typically a wide range of reactions in patients with chronic kidney disease. Conclusions The majority of chronic kidney disease patients remain in denial of their diagnosis and do not want to agree to the necessary treatment to improve their condition. In addition, the clinicians reported that the incidence of chronic kidney disease is highest in the African American population and this population of patients typically gets their information on the disease from peers, others they have known that have had renal failure. We find clinicians report that patients typically do not remain compliant to recommended treatment regimens due to lack of knowledge and feelings of denial and fear, and frequently use religiosity as a coping mechanism. Silent progression and complexity of chronic kidney disease frequently result in many patients lacking essential knowledge and developing poor coping mechanisms to seek appropriate follow-up care and prevent progression and optimize outcome. Health care providers are aware of the barriers but may lack the tools and resources to overcome them. PMID:25012542

2014-01-01

193

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

194

HIV\\/AIDS as a Chronic DiseaseEmergence From the Plague Model  

Microsoft Academic Search

The reframing of acquired immune deficiency syndrome (AIDS)from an acute to a chronic disease brought about a different focus for public policy. Now viewed as the end stage of the human immunodeficiency virus (HIV), AIDS has emerged from the plague model. Many biological and social forces affected this change, including an increased understanding of HIV and its associated disease processes,

Christy L. Beaudin; Susan M. Chambré

1996-01-01

195

Chronic obstructive pulmonary disease and glucose metabolism: a bitter sweet symphony.  

PubMed

Chronic obstructive pulmonary disease, metabolic syndrome and diabetes mellitus are common and underdiagnosed medical conditions. It was predicted that chronic obstructive pulmonary disease will be the third leading cause of death worldwide by 2020. The healthcare burden of this disease is even greater if we consider the significant impact of chronic obstructive pulmonary disease on the cardiovascular morbidity and mortality. Chronic obstructive pulmonary disease may be considered as a novel risk factor for new onset type 2 diabetes mellitus via multiple pathophysiological alterations such as: inflammation and oxidative stress, insulin resistance, weight gain and alterations in metabolism of adipokines. On the other hand, diabetes may act as an independent factor, negatively affecting pulmonary structure and function. Diabetes is associated with an increased risk of pulmonary infections, disease exacerbations and worsened COPD outcomes. On the top of that, coexistent OSA may increase the risk for type 2 DM in some individuals. The current scientific data necessitate a greater outlook on chronic obstructive pulmonary disease and chronic obstructive pulmonary disease may be viewed as a risk factor for the new onset type 2 diabetes mellitus. Conversely, both types of diabetes mellitus should be viewed as strong contributing factors for the development of obstructive lung disease. Such approach can potentially improve the outcomes and medical control for both conditions, and, thus, decrease the healthcare burden of these major medical problems. PMID:23101436

Mirrakhimov, Aibek E

2012-01-01

196

Chronic obstructive pulmonary disease and glucose metabolism: a bitter sweet symphony  

PubMed Central

Chronic obstructive pulmonary disease, metabolic syndrome and diabetes mellitus are common and underdiagnosed medical conditions. It was predicted that chronic obstructive pulmonary disease will be the third leading cause of death worldwide by 2020. The healthcare burden of this disease is even greater if we consider the significant impact of chronic obstructive pulmonary disease on the cardiovascular morbidity and mortality. Chronic obstructive pulmonary disease may be considered as a novel risk factor for new onset type 2 diabetes mellitus via multiple pathophysiological alterations such as: inflammation and oxidative stress, insulin resistance, weight gain and alterations in metabolism of adipokines. On the other hand, diabetes may act as an independent factor, negatively affecting pulmonary structure and function. Diabetes is associated with an increased risk of pulmonary infections, disease exacerbations and worsened COPD outcomes. On the top of that, coexistent OSA may increase the risk for type 2 DM in some individuals. The current scientific data necessitate a greater outlook on chronic obstructive pulmonary disease and chronic obstructive pulmonary disease may be viewed as a risk factor for the new onset type 2 diabetes mellitus. Conversely, both types of diabetes mellitus should be viewed as strong contributing factors for the development of obstructive lung disease. Such approach can potentially improve the outcomes and medical control for both conditions, and, thus, decrease the healthcare burden of these major medical problems. PMID:23101436

2012-01-01

197

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

198

Chronic kidney disease alters intestinal microbial flora.  

PubMed

The population of microbes (microbiome) in the intestine is a symbiotic ecosystem conferring trophic and protective functions. Since the biochemical environment shapes the structure and function of the microbiome, we tested whether uremia and/or dietary and pharmacologic interventions in chronic kidney disease alters the microbiome. To identify different microbial populations, microbial DNA was isolated from the stools of 24 patients with end-stage renal disease (ESRD) and 12 healthy persons, and analyzed by phylogenetic microarray. There were marked differences in the abundance of 190 bacterial operational taxonomic units (OTUs) between the ESRD and control groups. OTUs from Brachybacterium, Catenibacterium, Enterobacteriaceae, Halomonadaceae, Moraxellaceae, Nesterenkonia, Polyangiaceae, Pseudomonadaceae, and Thiothrix families were markedly increased in patients with ESRD. To isolate the effect of uremia from inter-individual variations, comorbid conditions, and dietary and medicinal interventions, rats were studied 8 weeks post 5/6 nephrectomy or sham operation. This showed a significant difference in the abundance of 175 bacterial OTUs between the uremic and control animals, most notably as decreases in the Lactobacillaceae and Prevotellaceae families. Thus, uremia profoundly alters the composition of the gut microbiome. The biological impact of this phenomenon is unknown and awaits further investigation. PMID:22992469

Vaziri, Nosratola D; Wong, Jakk; Pahl, Madeleine; Piceno, Yvette M; Yuan, Jun; DeSantis, Todd Z; Ni, Zhenmin; Nguyen, Tien-Hung; Andersen, Gary L

2013-02-01

199

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

200

Respiratory rehabilitation in chronic obstructive pulmonary disease: predictors of nonadherence  

Microsoft Academic Search

Respiratory rehabilitation in chronic obstructive pulmonary disease: predictors of non- adherence. P. Young, M. Dewse, W. Fergusson, J. Kolbe. #ERS Journals Ltd 1999. ABSTRACT: Rehabilitation is now an integral part of chronic obstructive pulmonary disease (COPD) management. The objective of the study was to determine predictors of nonadherence to a COPD rehabilitation programme. Patients attending a COPD clinic were invited

P. Young; M. Dewse; W. Fergusson; J. Kolbe

1999-01-01

201

Granulomatous cystitis in chronic granulomatous disease: ultrasound diagnosis.  

PubMed

Chronic granulomatous disease (CGD) is a fatal hereditary disease of childhood characterized by chronic recurrent bacterial infections. Involvement of the genitourinary tract is uncommon. We report a child with CGD with granulomatous cystitis demonstrated by both ultrasound and computed tomography. PMID:3295735

Hassel, D R; Glasier, C M; McConnell, J R

1987-01-01

202

Non-suppressible secondary hyperparathyroidism in chronic progressive renal disease  

Microsoft Academic Search

Non-suppressible secondary hyperparathyroidism in chronic progressive renal disease. Secondary hyperparathyroidism is a frequent, and almost universal, concomitant of advancing chronic renal disease. When renal failure is of long standing, the degree of secondary hyperparathyroidism may be quite marked. Under such circumstances, short-term elevation of serum calcium concentration does not lead to a decrease in radioimmunoassayable parathyroid hormone to normal levels

Eduardo Slatopolsky; W Ernest Rutherford; Phillip E Hoffsten; Ivan O Elkan; Harvey R Butcher; Neal S Bricker

1972-01-01

203

Home Telecare for the Management of Chronic Disease  

Microsoft Academic Search

We present a home telecare system for the management of chronic disease as an example of the use of integrated information technology for chronic disease self-management. We also report briefly on the outcomes of a clinical trial of patients located in Sydney and Wagga Wagga, which demonstrated a high level of user compliance and satisfaction. A clinical case study is

B. G. Celler; N. H. Lovell; J. Basilakis

2003-01-01

204

Chronic Beryllium Disease Prevention Environment, Safety, Health, and Quality Division  

E-print Network

Chronic Beryllium Disease Prevention Program Environment, Safety, Health, and Quality Division SLAC-I-730-0A09M-001-R003 24 September 2013 #12;Publication Data This document was developed by the Beryllium program and published by ESHQ Publishing. Document Title: Chronic Beryllium Disease Prevention Program

Wechsler, Risa H.

205

Persistent activation of an innate immune response translates respiratory viral infection into chronic lung disease  

Microsoft Academic Search

To understand the pathogenesis of chronic inflammatory disease, we analyzed an experimental mouse model of chronic lung disease with pathology that resembles asthma and chronic obstructive pulmonary disease (COPD) in humans. In this model, chronic lung disease develops after an infection with a common type of respiratory virus is cleared to only trace levels of noninfectious virus. Chronic inflammatory disease

Edy Y Kim; John T Battaile; Anand C Patel; Yingjian You; Eugene Agapov; Mitchell H Grayson; Loralyn A Benoit; Derek E Byers; Yael Alevy; Jennifer Tucker; Suzanne Swanson; Rose Tidwell; Jeffrey W Tyner; Jeffrey D Morton; Mario Castro; Deepika Polineni; G Alexander Patterson; Reto A Schwendener; John D Allard; Gary Peltz; Michael J Holtzman

2008-01-01

206

Chronic kidney Disease and the Aging Population.  

PubMed

Youth, which is forgiven everything, forgives itself nothing: age, which forgives itself everything, is forgiven nothing. George Bernard Shaw The proportion of older people in the general population is steadily increasing worldwide, with the most rapid growth in low-and middle-income countries [1]. This demographic change is to be celebrated, because it is the consequence of socioeconomic development and better life expectancy. However, population aging also has important implications for society - in diverse areas including health systems, labor markets, public policy, social programs, and family dynamics [2]. A successful response to the aging population will require capitalizing on the opportunities that this transition offers, as well as effectively addressing its challenges. Chronic kidney disease (CKD) is an important public health problem that is characterized by poor health outcomes and very high health care costs. CKD is a major risk multiplier in patients with diabetes, hypertension, heart disease and stroke - all of which are key causes of death and disability in older people [3]. Since the prevalence of CKD is higher in older people, the health impact of population aging will depend in part on how the kidney community responds. March 13, 2014 will mark the celebration of the 9th World Kidney Day (WKD), an annual event jointly sponsored by the International Society of Nephrology and the International Federation of Kidney Foundations. Since its inception in 2006, WKD has become the most successful effort to raise awareness among policymakers and the general public about the importance of kidney disease. The topic for WKD 2014 is "CKD in older people". This article reviews the key links between kidney function, age, health and illness - and discusses the implications of the aging population for the care of people with CKD. PMID:24702528

Tonelli, Marcello; Riellae, Miguel

2014-01-01

207

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

208

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

209

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

210

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

211

Anemia of Chronic Disease in Chronic Obstructive Pulmonary Disease: A Case-Control Study of Cardiopulmonary Exercise Responses  

Microsoft Academic Search

Background: Anemia may be present in patients with chronic obstructive pulmonary disease (COPD) and further impair their functional capacity. Objectives: This study investigated the prevalence of anemia of chronic disease (ACD) in COPD patients and its impact on dyspnea and exercise capacity, utilizing cardiopulmonary exercise testing (CPET). Methods: ACD prevalence was assessed in 283 consecutive patients with stable COPD (263

Afroditi K. Boutou; Ioannis Stanopoulos; Georgia G. Pitsiou; Theodoros Kontakiotis; George Kyriazis; Lazaros Sichletidis; Paraskevi Argyropoulou

2011-01-01

212

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

213

Exhaled Nitric Oxide in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow obstruction and a neutrophilic inflammation. Exhaled nitric oxide (NO) may be a marker of disease activity in a variety of lung diseases. We measured exhaled NO in patients with documented COPD and investi- gated whether the concentration of exhaled NO is related to the severity of disease as defined by

WASIM MAZIAK; STELIOS LOUKIDES; SARAH CULPITT; PAUL SULLIVAN; SERGEI A. KHARITONOV; PETER J. BARNES

1998-01-01

214

HEALTH PSYCHOLOGY: Psychosocial and Biobehavioral Aspects of Chronic Disease Management  

Microsoft Academic Search

? Abstract Psychosocial factors appear to impact upon the development and pro- gression of such chronic diseases as coronary heart disease, cancer, and HIV\\/AIDS. Similarly, psychosocial interventions have been shown to improve the quality of life of patients with established disease and seem to influence biological processes thought to ameliorate disease progression. Small-scale studies are useful for specifying the conditions

Neil Schneiderman; Michael H. Antoni; Patrice G. Saab; Gail Ironson

2001-01-01

215

Chronic obstructive pulmonary disease as a systemic disease: an epidemiological perspective  

Microsoft Academic Search

Chronic obstructive pulmonary disease as a systemic disease: an epidemiological perspective. H. Andreassen, J. Vestbo. #ERS Journals Ltd 2003. ABSTRACT: Chronic obstructive pulmonary disease (COPD) has been increasingly recognised as a systemic disease. The hormonal, metabolic and musculoskeletal implications of the generalised processes involving oxidative stress, inflammatory mediators, cytokines, and endocrine hormones have only begun to be understood. Only a

H. Andreassen; J. Vestbo

2003-01-01

216

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

217

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

218

Chronic Obstructive Pulmonary Disease in Hispanics  

PubMed Central

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.; Celedon, Juan C.

2008-01-01

219

Circulating Adipocytokines and Chronic Kidney Disease  

PubMed Central

Background Adipokines have been associated with atherosclerotic heart disease, which shares many common risk factors with chronic kidney disease (CKD), but their relationship with CKD has not been well characterized. Methods We investigated the association of plasma leptin, resistin and adiponectin with CKD in 201 patients with CKD and 201 controls without. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or presence of albuminuria. Quantile regression and logistic regression models were used to examine the association between adipokines and CKD adjusting for multiple confounding factors. Results Compared to controls, adjusted median leptin (38.2 vs. 17.2 ng/mL, p<0.0001) and adjusted mean resistin (16.2 vs 9.0 ng/mL, p<0.0001) were significantly higher in CKD cases. The multiple-adjusted odds ratio (95% confidence interval) of CKD comparing the highest tertile to the lower two tertiles was 2.3 (1.1, 4.9) for leptin and 12.7 (6.5, 24.6) for resistin. Median adiponectin was not significantly different in cases and controls, but the odds ratio comparing the highest tertile to the lower two tertiles was significant (1.9; 95% CI, 1.1, 3.6). In addition, higher leptin, resistin, and adiponectin were independently associated with lower eGFR and higher urinary albumin levels. Conclusions These findings suggest that adipocytokines are independently and significantly associated with the risk and severity of CKD. Longitudinal studies are warranted to evaluate the prospective relationship of adipocytokines to the development and progression of CKD. PMID:24116180

Mills, Katherine T.; Hamm, L. Lee; Alper, A. Brent; Miller, Chad; Hudaihed, Alhakam; Balamuthusamy, Saravanan; Chen, Chung-Shiuan; Liu, Yanxi; Tarsia, Joseph; Rifai, Nader; Kleinpeter, Myra; He, Jiang; Chen, Jing

2013-01-01

220

Weight loss in chronic obstructive pulmonary disease.  

PubMed

Weight loss occurs in about a third or more disabled patients with chronic obstructive pulmonary disease (COPD), and appears to be a poor prognostic factor. As such, it correlates only weakly with FEV1, transfer factor and other measures of respiratory physiology and is probably, to a certain extent, independent of them. Recent studies of basal metabolic rate (BMR) in COPD using steady-state, non-invasive calorimetry, have shown it to be elevated by 10-20% in up to 40% of such patients. It is likely that this represents true hypermetabolism per kilogram of fat free mass. An elevated BMR cannot be predicted from combinations of detailed lung function tests or arterial gases, as patients with similar physiology have differing BMRs. Thus, although an increased work of breathing is the probable explanation for some of the increase, other factors such as cytokines or possibly drug therapy almost certainly contribute. Muscle loss in weight-losing COPD appears to involve both type I and type II fibres, because of a combination of reduced calorie intake and disuse atrophy. Respiratory muscles share this fibre loss. Review of the controlled studies on nutritional supplementation in COPD suggests that an energy increase of about 30% is needed to achieve substantial weight gain and improve exercise tolerance. Fat-rich supplements have some theoretical advantages. Further work is needed particularly with regard to the determinants of the increased BMR in COPD, and the effect of longer term nutritional supplements on prognosis. PMID:8519385

Muers, M F; Green, J H

1993-05-01

221

Resistant Hypertension in Nondialysis Chronic Kidney Disease  

PubMed Central

Resistant hypertension (RH) is defined as blood pressure (BP) that remains above the target of less than 140/90?mmHg in the general population and 130/80?mmHg in people with diabetes mellitus or chronic kidney disease (CKD) in spite of the use of at least three full-dose antihypertensive drugs including a diuretic or as BP that reaches the target by means of four or more drugs. In CKD, RH is a common condition due to a combination of factors including sodium retention, increased activity of the renin-angiotensin system, and enhanced activity of the sympathetic nervous system. Before defining the hypertensive patient as resistant it is mandatory to exclude the so-called “pseudoresistance.” This condition, which refers to the apparent failure to reach BP target in spite of an appropriate antihypertensive treatment, is mainly caused by white coat hypertension that is prevalent (30%) in CKD patients. Recently we have demonstrated that “true” RH represents an independent risk factor for renal and cardiovascular outcomes in CKD patients. PMID:23710342

Stanzione, Giovanna; Conte, Giuseppe

2013-01-01

222

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

223

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

224

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.

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

2014-01-01

225

Prospective study of cured meats consumption and risk of chronic obstructive pulmonary disease in men  

E-print Network

Prospective study of cured meats consumption and risk of chronic obstructive pulmonary disease and the risk of newly diagnosed chronic obstructive pulmonary disease (COPD). Between 1986 and 1998, we Models ; Prospective Studies ; Pulmonary Disease ; Chronic Obstructive ; epidemiology ; Questionnaires

Paris-Sud XI, Université de

226

Prospective study of dietary patterns and chronic obstructive pulmonary disease among US men  

E-print Network

Prospective study of dietary patterns and chronic obstructive pulmonary disease among US men foods are associated with chronic obstructive pulmonary disease (COPD) symptoms or lung function ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Disease ; Chronic Obstructive ; epidemiology

Boyer, Edmond

227

Update on fibroblast growth factor 23 in chronic kidney disease.  

PubMed

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 (ESRD), 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 ESRD, 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 levels 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 levels 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

2012-10-01

228

Barriers to Adherence to Outpatient Chronic Obstructive Pulmonary Disease Guidelines among Primary Care Providers.  

E-print Network

?? Background: The Global initiative for Chronic Obstructive Lung Disease (GOLD) guidelines were developed to standardized the treatment of patients with chronic obstructive pulmonary disease.… (more)

Perez, Xavier

2011-01-01

229

Patient Self-management of Chronic Disease in Primary Care  

Microsoft Academic Search

Patients with chronic conditions make day-to-day decisions about—self- manage—their illnesses. This reality introduces a new chronic disease para- digm: the patient-professional partnership, involving collaborative care and self-management education. Self-management education complements tra- ditional patient education in supporting patients to live the best possible quality of life with their chronic condition. Whereas traditional patient edu- cation offers information and technical skills,

Thomas Bodenheimer; Kate Lorig; Halsted Holman; Kevin Grumbach

2005-01-01

230

Bronchoscopic interventions for chronic obstructive pulmonary disease.  

PubMed

Over the past decade, several non-surgical and minimally invasive bronchoscopic lung volume reduction (BLVR) techniques have been developed to treat patients with severe chronic obstructive pulmonary disease (COPD). BLVR can be significantly efficacious, suitable for a broad cohort of patients, and associated with a solid safety profile at a reasonable expense. The introduction of BLVR is also expected to accelerate the further development of interventional pulmonology worldwide. Recently, results from clinical studies on BLVR techniques have been published, providing valuable information about the procedure's indications, contraindications, patient-selection criterion and outcomes. BLVR utilizing one-way endobronchial valves is gaining momentum as an accepted treatment in regular medical practice because of the identification of best responders. Patients with a heterogeneous emphysema distribution and without inter-lobar collateral ventilation show encouraging results. Furthermore, for patients with collateral ventilation, who are not considered candidates for valve treatment, and for patients with homogeneous emphysema, the introduction of lung volume reduction coil treatment is a promising solution. Moreover, with the development of newer treatment modalities, that is, biochemical sealant and thermal water vapor, the potential to treat emphysema irrespective of collateral flow, may be further increased. Nevertheless, patient selection for BLVR treatment will be crucial for the procedure's success and should be performed using a multidisciplinary team approach. Consequently, BLVR needs to be concentrated in high-volume centres that will offer better quality and experience with treatment challenges and adverse events. This review gives a general overview of BLVR from an expert and scientific perspective. PMID:25124070

Mineshita, Masamichi; Slebos, Dirk-Jan

2014-11-01

231

Genetic risk factors for chronic obstructive pulmonary disease  

Microsoft Academic Search

Cigarette smoking is the major risk factor for chronic obstructive pulmonary disease (COPD). However, only a minority of cigarette smokers develop symptomatic disease. Studies of families and twins suggest that genetic factors also contribute to the development of COPD. We present a detailed literature review of the genes which have been investigated as potential risk factors for this disease. The

A. J. Sandford; T. D. Weir; P. D. Paré

1997-01-01

232

An integrated framework for the geographic surveillance of chronic disease  

Microsoft Academic Search

BACKGROUND: Geographic public health surveillance is concerned with describing and disseminating geographic information about disease and other measures of health to policy makers and the public. While methodological developments in the geographical analysis of disease are numerous, few have been integrated into a framework that also considers the effects of case ascertainment bias on the effectiveness of chronic disease surveillance.

Nikolaos Yiannakoulias; Lawrence W Svenson; Donald P Schopflocher

2009-01-01

233

Current Medical Therapy for Chronic Inflammatory Bowel Diseases  

Microsoft Academic Search

Chronic idiopathic inflammatory bowel disease (IBD) is a term for Crohn's disease (CD), ulcerative colitis (UC), and colonic IBD type unclas- sified (IBDU) (1); the latter was referred to previously as indeterminate colitis (IC). The full spectrum of IBD may include disorders such as lymphocytic colitis, collagenous colitis, diverticular disease-associated colitis, and others. This article focuses upon current medical therapies

Cyrus P. Tamboli; Lucille A. Carver

234

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

235

Urban air pollution and chronic obstructive pulmonary disease: a review  

Microsoft Academic Search

There is consistency in the findings that relate the acute increases in urban air pollution (mainly the particulate matter) and the short-term health effects (i.e. mortality and hospital admissions) on patients suffering from chronic obstructive pulmonary disease (COPD). Beyond the acute effects, a relevant public health and scientific question is to what extent chronic exposure to air pollution is related

J. Sunyer

2001-01-01

236

Nitric Oxide in Patients with Chronic Liver Diseases  

Microsoft Academic Search

Aim. Chronic liver disease (CLD) may be accompanied by portal hypertension (PHT). Nitric oxide (NO) system disturbances seem to play a key role in the pathogenesis of CLD and PHT. In this study we aim to assess if in chronic active hepatitis (CAH) and cirrhosis (CIR), CLD severity and etiology can be correlated with the serum level of NO metabolites.

Alina Elena Pârvu; Vasile Negrean; Luminiþa Ple; Angela Cosma; Anton Drãghici; Ana Uifãlean

237

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

238

Multimorbidity of chronic diseases and health care utilization in general practice  

PubMed Central

Background Multimorbidity is common among ageing populations and it affects the demand for health services. The objective of this study was to examine the relationship between multimorbidity (i.e. the number of diseases and specific combinations of diseases) and the use of general practice services in the Dutch population of 55 years and older. Methods Data on diagnosed chronic diseases, contacts (including face-to-face consultations, phone contacts, and home visits), drug prescription rates, and referral rates to specialised care were derived from the Netherlands Information Network of General Practice (LINH), limited to patients whose data were available from 2006 to 2008 (N?=?32,583). Multimorbidity was defined as having two or more out of 28 chronic diseases. Multilevel analyses adjusted for age, gender, and clustering of patients in general practices were used to assess the association between multimorbidity and service utilization in 2008. Results Patients diagnosed with multiple chronic diseases had on average 18.3 contacts (95% CI 16.8 19.9) per year. This was significantly higher than patients with one chronic disease (11.7 contacts (10.8 12.6)) or without any (6.1 contacts (5.6 6.6)). A higher number of chronic diseases was associated with more contacts, more prescriptions, and more referrals to specialized care. However, the number of contacts per disease decreased with an increasing number of diseases; patients with a single disease had between 9 to 17 contacts a year and patients with five or more diseases had 5 or 6 contacts per disease per year. Contact rates for specific combinations of diseases were lower than what would be expected on the basis of contact rates of the separate diseases. Conclusion Multimorbidity is associated with increased health care utilization in general practice, yet the increase declines per additional disease. Still, with the expected rise in multimorbidity in the coming decades more extensive health resources are required. PMID:24708798

2014-01-01

239

[The home health care experience in a model chronic, degenerative, genetic pathology: Huntington's disease].  

PubMed

Home assistance has recently received wide approval among the facilities provided to the individuals suffering from chronic-degenerative diseases. This mode of caring seems to offer both the opportunities to reduce costs and to allow the affected individual to live in a familiar environment. The increasing relevance of genetic diseases in the context of the National Health Service suggested the authors to analyze, by means of an ad hoc questionnaire, the experience of home assistance in a group of families with Huntington's Disease (HD). HD is a chronic, degenerative, genetic disease characterized by neurological and/or mental symptoms. The article underlines the peculiar and complex needs of individuals affected by genetic diseases and of their families. PMID:11293303

Jacopini, A G; Zinzi, P; Frustaci, A; Salmaso, D

2000-01-01

240

28 CFR 79.57 - Proof of chronic renal disease.  

Code of Federal Regulations, 2010 CFR

...medical documentation in support of a claim that the claimant contracted chronic renal disease. (1) Pathology report of tissue biopsy; (2) If laboratory or radiographic tests exist: (i) Abnormal plasma creatinine values; and (ii) Abnormal...

2010-07-01

241

28 CFR 79.67 - Proof of chronic renal disease.  

Code of Federal Regulations, 2010 CFR

...medical documentation in support of a claim that the claimant contracted chronic renal disease. (1) Pathology report of tissue biopsy; (2) If laboratory or radiographic tests exist: (i) Abnormal plasma creatinine values; (ii) Abnormal...

2010-07-01

242

Chronic obstructive pulmonary disease - quick-relief drugs  

MedlinePLUS

Quick-relief medicines for chronic obstructive pulmonary disease (COPD) work quickly to help you breathe better. You take them when you are coughing, wheezing, or having trouble breathing, such as ...

243

[Bio-ecological control of chronic liver disease and encephalopathy].  

PubMed

Minimal encephalopathy was originally associated with chronic liver disease but is increasingly associated with most other chronic diseases and particularly with diabetes and also chronic disorders in other organs: kidneys, lungs, thyroid and with obesity. It is increasingly with dramatically increased and more or less permanent increase in systemic inflammation, most likely a result of Western lifestyle. Frequent physical exercise and intake of foods rich in vitamins, antioxidants, fibres, lactic acid bacteria etc in combination with reduction in intake of refined and processed foods is known to reduce systemic inflammation and prevent chronic diseases. Some lactic acid bacteria, especially Lb paracasei, lb plantarum and pediococcus pentosaceus have proven effective to reduce inflammation and eliminate encephalopathy. Significant reduction in blood ammonia levels and endotoxin levels were reported in parallel to improvement of liver disease. Subsequent studies with other lactic acid bacteria seem to demonstrate suppression of inflammation and one study also provides evidence of clinical improvement. PMID:21959704

Bengmark, S; Di Cocco, P; Clemente, K; Corona, L; Angelico, R; Manzia, T; Famulari, A; Pisani, F; Orlando, G

2011-08-01

244

Bio-ecological control of chronic liver disease and encephalopathy.  

PubMed

Minimal encephalopathy was originally associated with chronic liver disease but is increasingly associated with most other chronic diseases and particularly with diabetes and also chronic disorders in other organs: kidneys, lungs, thyroid and with obesity. It is increasingly with dramatically increased and more or less permanent increase in systemic inflammation, most likely a result of Western lifestyle. Frequent physical exercise and intake of foods rich in vitamins, antioxidants, fibres, lactic acid bacteria etc in combination with reduction in intake of refined and processed foods is known to reduce systemic inflammation and prevent chronic diseases. Some lactic acid bacteria, especially Lb paracasei, lb plantarum and pediococcus pentosaceus have proven effective to reduce inflammation and eliminate encephalopathy. Significant reduction in blood ammonia levels and endotoxin levels were reported in parallel to improvement of liver disease. Subsequent studies with other lactic acid bacteria seem to demonstrate suppression of inflammation and in one study also evidence of clinical improvement. PMID:19104922

Bengmark, Stig

2009-03-01

245

Chronic lung disease in the Papua New Guinea Highlands.  

PubMed Central

In the Eastern Highlands of Papua New Guinea 46 men and 24 women with chronic lung disease underwent clinical and lung function investigations. In all cases the sole or predominant abnormality was irreversible airways obstruction, probably from chronic bronchitis with variable amounts of acompanying emphysema. There were close similarities to chronic obstructife lung disease in European populations in terms of symptoms, airways obstruction, transfer factor, and radiographic emphysema and inflammatory changes. Bronchiectasis and local fibrosis were present in a few subjects, but previous reports that pulmonary and pleural fibrosis are features of the disease were not confirmed. Possibly environmental and genetic factors may increase the associated blood gas disturbances leading to pulmonary hypertension. Unlike chronic obstructive lung disease in European populations, tobacco smoking is not an important aetiological factor. Although there is no direct evidence, the most likely possibilities are domestic wood smoke and acute chest infections. PMID:515985

Anderson, H R

1979-01-01

246

Technology-supported apprenticeship in the management of chronic disease  

E-print Network

Chronic disease is the most important cause of morbidity and mortality worldwide, but the current standard of care is woefully ineffective. It is paternalistic, episodic, and perversely incentivized based on volume, resulting ...

Moore, John Oliver

2013-01-01

247

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.

Sharma, Kumar

2014-01-01

248

Systematic Review of the Chronic Care Model in Chronic Obstructive Pulmonary Disease Prevention and Management  

Microsoft Academic Search

Background: Implementation of the chronic care model (CCM) has been shown to be an effective preventative strategy to improve outcomes in diabetes mellitus, de- pression, and congestive heart failure, but data are lack- ing regarding the effectiveness of this model in prevent- ing complications in patients with chronic obstructive pulmonary disease. Methods: We searched the MEDLINE, CINAHL, and Cochrane databases

Sandra G. Adams; Paulla K. Smith; Patrick F. Allan; Antonio Anzueto; Jacqueline A. Pugh; John E. Cornell

2007-01-01

249

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

250

OXIDATIVE STRESS RELATED APOPTOSIS IN SMOKERS AND CHRONIC LUNG DISEASES  

Microsoft Academic Search

Cigarette smoke contains various carcinogens, reactive oxygen species (ROS) and reactive nitrogen species (RNS). It has been found that cigarette smoking causes several chronic lung diseases including chronic obstructive pulmonary diseases (COPD). There are mul- tiple markers used for oxidative damage\\/stress in smokers such as urinary 8- hydroxydeoxyguanosine (8-OHdG), serum hydrogen peroxide (H2O2), interleukin-8 (IL-8) and H2O2 in breath condensate.

Ratana Banjerdpongchai

2006-01-01

251

Subclinical peripheral arterial disease in patients with chronic kidney disease: Prevalence and related risk factors  

Microsoft Academic Search

Subclinical peripheral arterial disease in patients with chronic kidney disease: Prevalence and related risk factors.BackgroundAtherosclerotic artery disease is a common condition in patients with chronic kidney disease (CKD); however, there are few published data on the prevalence of peripheral arterial disease (PAD) in nondialyzed patients with renal insufficiency. The ankle-brachial index (ABI) is a simple, noninvasive, and reliable method to

SOLEDAD GARCIA DE VINUESA; MAYRA ORTEGA; PATRICIA MARTINEZ; MARIAN GOICOECHEA; FRANCISCO GOMEZ CAMPDERA; JOSE LUÑO

2005-01-01

252

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

253

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

254

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

255

Time Course and Recovery of Exacerbations in Patients with Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Although exacerbations of chronic obstructive pulmonary disease (COPD) are associated with symptomatic and physiological deterio- ration, little is known of the time course and duration of these changes. We have studied symptoms and lung function changes as- sociated with COPD exacerbations to determine factors affecting recovery from exacerbation. A cohort of 101 patients with moder- ate to severe COPD (mean

TERENCE A. R. SEEMUNGAL; GAVIN C. DONALDSON; ANGSHU BHOWMIK; DONALD J. JEFFRIES; JADWIGA A. WEDZICHA

2000-01-01

256

Burden of chronic obstructive pulmonary disease in medicare beneficiaries residing in long-term care facilities  

Microsoft Academic Search

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. COPD increases health care resource utilization and spending and adversely affects quality of life. Data from the clinical and economic outcomes in Medicare beneficiaries with COPD who reside in long-term care (LTC) facilities are limited.Objective: The purpose of this study was to investigate the clinical

Linda Simoni-Wastila; Christopher M. Blanchette; Jingjing Qian; Hui-wen Keri Yang; Lirong Zhao; Ilene H. Zuckerman; Grace H. Pak; Harris Silver; Anand A. Dalal

2009-01-01

257

An integrated advanced communication and coaching platform for enabling personalized management of chronic cardiovascular diseases  

Microsoft Academic Search

Chronic cardiovascular diseases directly account for millions of deaths, billions of Euros and a big number of disabilities affecting the world's population. Even though primary and secondary prevention factors are well known, the awareness and the concern of citizens and patients is not big enough to cause a significant change in lifestyle that modifies the increasing trends. Patients and families,

Teresa Meneu; Alvaro Martinez-Romero; Antonio Martinez-Millana; Sergio Guillen

2011-01-01

258

Peripheral arterial disease in patients with stages IV and V chronic renal failure  

Microsoft Academic Search

Background. Cardiovascular disorders are frequently found among chronic renal failure (CRF) patients due to their higher susceptibility to develop atherosclerosis. However, peripheral arterial disease (PAD), that is associated with a high mortality rate, is not usually assessed in these patients. The aims of this study are to find out the prevalence of PAD affecting lower limbs in a population of

Angeles Guerrero; Rafael Montes; Alberto Gil-Peralta; Javier Toro; Macarena Naranjo; Paloma Gonzalez-Perez; Carmen Martin-Herrera; Ana Ruiz-Fernandez

2006-01-01

259

Functional Status and Quality of Life in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Exertional dyspnea often causes patients with chronic obstructive pulmonary disease (COPD) to unconsciously reduce their activities of daily living (ADLs) to reduce the intensity of their distress. The reduction in ADLs leads to deconditioning which, in turn, further increases dyspnea. Both dyspnea and fatigue are important factors affecting health-related quality of life (HRQOL). The functional status of patients relates to

Jane Z. Reardon; Suzanne C. Lareau; Richard ZuWallack

2006-01-01

260

Scanning the Chronic Disease Terrain: Prospects and Opportunities  

PubMed Central

The disease burden in the United States has changed radically in the past 100 years. A striking decrease in infectious diseases as causes of morbidity and mortality has been followed by a steady increase in morbidity and mortality rates from chronic disease, which is now the dominant health issue facing the country, at levels justifying considering chronic disease as having reached epidemic proportions. Research in recent years has shown that many of the common chronic diseases are malleable, i.e., susceptible to therapeutic or preventive efforts aimed at risk factors and susceptible age eras and populations. Although clinical and population-oriented interventions have been increasingly successful in recent decades, more intensive and coordinated preventive efforts will be required, including effective partnerships between clinical medicine and other sectors, particularly at-risk individuals, government, and public health. Robust joint efforts are not only needed, but are likely to be successful. PMID:25125717

Barondess, Jeremiah A.

2014-01-01

261

Infectious causes of chronic inflammatory diseases and cancer.  

PubMed Central

Powerful diagnostic technology, plus the realization that organisms of otherwise unimpressive virulence can produce slowly progressive chronic disease with a wide spectrum of clinical manifestations and disease outcomes, has resulted in the discovery of new infectious agents and new concepts of infectious diseases. The demonstration that final outcome of infection is as much determined by the genetic background of the patient as by the genetic makeup of the infecting agent is indicating that a number of chronic diseases of unknown etiology are caused by one or more infectious agents. One well-known example is the discovery that stomach ulcers are due to Helicobacter pylori. Mycoplasmas may cause chronic lung disease in newborns and chronic asthma in adults, and Chlamydia pneumoniae, a recently identified common cause of acute respiratory infection, has been associated with atherosclerosis. A number of infectious agents that cause or contribute to neoplastic diseases in humans have been documented in the past 6 years. The association and causal role of infectious agents in chronic inflammatory diseases and cancer have major implications for public health, treatment, and prevention. PMID:9716980

Cassell, G. H.

1998-01-01

262

MRI-based Three dimensional shape analysis of thigh muscles: people with Chronic Obstructive Pulmonary Disease versus healthy older adults.  

E-print Network

Pulmonary Disease versus healthy older adults. Bahareh HajGhanbari, Ghassan Hamarneh, Neda Changizi, Aaron in Chronic Obstructive Pulmonary Disease (COPD). However, the distribution of the atrophy among individual, the systemic effects of the disease affect them differently and non- uniformly. The purpose of this study

Hamarneh, Ghassan

263

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

264

Personality Traits and Chronic Disease: Implications for Adult Personality Development  

PubMed Central

Objective. Personality traits have been associated with chronic disease. Less is known about the longitudinal relation between personality and disease and whether chronic disease is associated with changes in personality. Method. Participants from the Baltimore Longitudinal Study of Aging (N = 2,008) completed the Revised NEO Personality Inventory and a standard medical interview at regularly scheduled visits; the Charlson Comorbidity Index, a weighted sum of 19 serious diseases, was derived from this interview. Using data from 6,685 visits, we tested whether personality increased risk of disease and whether disease was associated with personality change. Results. Measured concurrently, neuroticism and conscientiousness were associated with greater disease burden. The impulsiveness facet of neuroticism was the strongest predictor of developing disease across the follow-up period: For every standard deviation increase in impulsiveness, there was a 26% increased risk of developing disease and a 36% increased risk of getting more ill. Personality traits changed only modestly with disease: As participants developed chronic illnesses, they became more conservative (decreased openness). Discussion. This research indicates that personality traits confer risk for disease, in part, through health-risk behaviors. These traits, however, were relatively resistant to the effect of serious disease. PMID:23685925

2013-01-01

265

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

266

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

267

Screening and prevention of chronic kidney disease.  

PubMed Central

The burden of kidney disease is disproportionately high in African Americans, and the condition often remains undiagnosed until late-stage disease. In order to reduce this burden, strategies must be implemented to improve the detection of kidney disease, and preventative measures must be targeted at those at greatest risk of disease. Important risk factors among African Americans in the US include hypertension, diabetes, and obesity. In this review, we discuss screening strategies that will allow earlier detection of kidney disease. The sensitivity of serum creatinine, proteinuria, and microalbuminuria as markers of disease are discussed, as is the importance of calculating glomerular filtration rates in individual patients. Implementation of community-based programs, such as the Kidney Early Evaluation Program developed by the National Kidney Foundation, can offer screening for kidney disease and its risk factors, and can educate and protect African Americans at risk of this prevalent disease. PMID:12152913

Crook, Errol D.; Washington, David O.; Flack, John M.

2002-01-01

268

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

269

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

270

Research note: Chronic Disease Management in Europe  

Microsoft Academic Search

Across Europe and increasingly the rest of the world, the economic costs of chronic illness dwarf the costs of acute illnesses, both for the health care system and for other stakeholders. Employers must contend with substantial productivity losses, while the indirect costs of treatment that patients and families cope with can be debilitating, particularly when insurance coverage is less comprehensive.

Marin Gemmill

271

Health status measurement in chronic obstructive pulmonary disease  

Microsoft Academic Search

Health status measurement is a common feature of studies in chronic obstructive pulmonary disease (COPD). This review assesses recent evidence for the validity of these measurements and their role as measures of the overall impact of the disease on the patient's daily life and wellbeing. It reviews the mostly widely used COPD specific questionnaires and examines the contribution that they

P W Jones

2001-01-01

272

Bronchodilator reversibility testing in chronic obstructive pulmonary disease  

Microsoft Academic Search

Background: A limited or absent bronchodilator response is used to classify chronic obstructive pulmonary disease (COPD) and can determine the treatment offered. The reliability of the recommended response criteria and their relationship to disease progression has not been established.Methods: 660 patients meeting European Respiratory Society (ERS) diagnostic criteria for irreversible COPD were studied. Spirometric parameters were measured on three occasions

P M A Calverley; P S Burge; S Spencer; J A Anderson; P W Jones

2003-01-01

273

Surrogates of Mortality in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) remains a leading cause of disability and death in the United States. The identification and amelioration of systemic manifestations of COPD may improve long-term outcomes, including survival. These systemic manifestations often correlate with increased risk of mortality and may be considered surrogates of disease severity. Several potential clinical surrogates are evaluated, including airflow obstruction, dyspnea,

Claudia G. Cote

2006-01-01

274

User Interaction for people living with a chronic disease  

Microsoft Academic Search

Ambient Intelligence (AmI) allows the intelligent and natural interaction between the context and individuals. This paradigm will facilitate user support through novel medical protocol design for chronic disease treatment, based on the healthy lifestyle promotion. Cardiovascular Diseases (CVD) account for 45% of all deaths in the western world according to the 2004 World Health Organization statistic report. Heart Failure (HF),

Elena Villalba; Manuel Ottaviano; Dario Salvi; Ignacio Peinado; María Teresa Arredondo; Mili Docampo

275

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

276

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

277

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

278

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

279

Chronic kidney disease and bone fracture: a growing concern  

Microsoft Academic Search

Susceptibility to fracture is increased across the spectrum of chronic kidney disease (CKD). Moreover, fracture in patients with end-stage kidney disease (ESKD) results in significant excess mortality. The incidence and prevalence of CKD and ESKD are predicted to increase markedly over the coming decades in conjunction with the aging of the population. Given the high prevalence of both osteoporosis and

Thomas L Nickolas; Mary B Leonard; Elizabeth Shane

2008-01-01

280

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

281

The factorial structure of the Chronic Liver Disease Questionnaire (CLDQ)  

Microsoft Academic Search

Objective  The Chronic Liver Disease Questionnaire (CLDQ) is a disease-specific instrument designed to assess health-related quality\\u000a of life in patients with chronic liver disease. The aim of this paper is to present the psychometric properties of a German\\u000a version of this questionnaire. A special focus is placed on the analysis of the CLDQ’s factorial structure.\\u000a \\u000a \\u000a \\u000a Methods  Five hundred and twenty-four patients completed

Karl-Heinz Schulz; Sylvia Kroencke; Heike Ewers; Holger Schulz; Zobair M. Younossi

2008-01-01

282

Eosinophilic pneumonia as a presentation of occult chronic granulomatous disease.  

PubMed

We present a case of invasive pulmonary aspergillosis (IPA) in a previously healthy young woman who presented with what initially appeared to be an acute eosinophilic pneumonia. A second lung biopsy taken after treatment with steroids showed invasive Aspergillus with associated necrotizing granulomas, a pattern commonly found in chronic granulomatous disease (CGD). Both siblings, and by extrapolation, the patient, were actually found to have CGD. A review of the literature revealed other cases of presumed immunocompetent patients with IPA with presentations and lung histopathology similar to that of our patient. We conclude that chronic granulomatous disease presenting in the adult may be more common than previously assumed, and that patients previously presumed immunocompetent, but with granulomatous invasive pulmonary aspergillosis, may have chronic granulomatous disease. Furthermore, and most devastatingly in this case, the presentation may simulate a recently described steroid responsive acute lung disease, acute eosinophilic pneumonia. PMID:9311521

Trawick, D; Kotch, A; Matthay, R; Homer, R J

1997-09-01

283

Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions  

PubMed Central

Background Falls and chronic disease are both important health issues in older adults. The objectives of this study were to quantify the prevalence of falls and multi-morbidity (?2 chronic conditions) in Canadian older adults; examine associations between falls and number of chronic conditions; and explore whether certain patterns of chronic disease were associated with a greater risk of falling. Methods Data were derived from the Canadian Community Health Survey- Healthy Aging. Primary outcomes from 16,357 community-dwelling adults aged 65 years and over were self-reported falls in the previous 12 months and presence of 13 chronic conditions. Prevalence estimates were calculated with normalized sampling weights, and hierarchical cluster analysis was used to identify clusters based on chronic condition patterns, and tested for association to falls with logistic regression. Results Overall prevalence of falling and multi-morbidity were 19.8% and 62.0% respectively. Fall risk was significantly greater in individuals with one, two, four, five and six or more chronic conditions relative to those with none (all p?chronic disease, or high prevalence of hypertension and arthritis, visual impairment, hypertension, chronic obstructive pulmonary disease (COPD), diabetes, or heart disease and hypertension. Only the hypertension cluster (Odds Ratio [OR]?=?1.2) and COPD cluster (OR?=?1.6) were significantly associated with increased falls relative to the low prevalence group. Conclusions Both the number and pattern of chronic conditions were related to falls. COPD emerged as a significant predictor of falls despite affecting a smaller proportion of respondents. Continued study is warranted to verify this association and determine how to incorporate consideration of chronic disease and multi-morbidity into fall risk assessments. PMID:24529293

2014-01-01

284

Endothelin and endothelin antagonists in chronic kidney disease.  

PubMed

The incidence and prevalence of chronic kidney disease (CKD), with diabetes and hypertension accounting for the majority of cases, is on the rise, with up to 160 million individuals worldwide predicted to be affected by 2020. Given that current treatment options, primarily targeted at the renin-angiotensin system, only modestly slow down progression to end-stage renal disease, the urgent need for additional effective therapeutics is evident. Endothelin-1 (ET-1), largely through activation of endothelin A receptors, has been strongly implicated in renal cell injury, proteinuria, inflammation, and fibrosis leading to CKD. Endothelin receptor antagonists (ERAs) have been demonstrated to ameliorate or even reverse renal injury and/or fibrosis in experimental models of CKD, whereas clinical trials indicate a substantial antiproteinuric effect of ERAs in diabetic and nondiabetic CKD patients even on top of maximal renin-angiotensin system blockade. This review summarizes the role of ET in CKD pathogenesis and discusses the potential therapeutic benefit of targeting the ET system in CKD, with attention to the risks and benefits of such an approach. PMID:24805108

Kohan, Donald E; Barton, Matthias

2014-11-01

285

Epigenetic modifications of chronic hypoxia-mediated neurodegeneration in Alzheimer's disease  

PubMed Central

Alzheimer’s disease (AD) is the most common neurodegenerative disorder affecting the elderly people. AD is characterized by progressive and gradual decline in cognitive function and memory loss. While familial early-onset AD is usually associated with gene mutations, the etiology of sporadic late-onset form of AD is largely unknown. It has been reported that environmental factors and epigenetic alterations significantly contribute to the process of AD. Our previous studies have documented that chronic hypoxia is one of the environmental factors that may trigger the AD development and aggravate the disease progression. In this review, we will summarize the pathological effects of chronic hypoxia on the onset and development of AD and put forward the possible molecule mechanisms underlying the chronic hypoxia mediated AD pathogenesis. Finally, we propose that epigenetic regulations may represent new opportunity for the therapeutic intervention of this disease. PMID:24650677

2014-01-01

286

Measurement of affective state during chronic nicotine treatment and withdrawal by affective taste reactivity in mice: The role of endocannabinoids  

Microsoft Academic Search

Despite tobacco being highly addictive, it is unclear if nicotine has significant affective properties. To address this, we studied taste reactions to gustatory stimuli, palatable sucrose and unpalatable quinine, which are believed to reflect ongoing affective state. Taste reactivity was assessed during chronic nicotine administration and spontaneous withdrawal and the role of the endogenous cannabinoids was also investigated. C57BL6J mice

Victoria C. Wing; Barbara Cagniard; Niall P. Murphy; Mohammed Shoaib

2009-01-01

287

Wildlife surveillance systems : chronic wasting disease.  

E-print Network

??Increased demand for animal disease surveillance information has led to the development and refinement of methodologies for qualitative and quantitative surveillance system evaluations to maximize… (more)

Tataryn, Joanne Rosemary

2010-01-01

288

Diarrhea in chronic inflammatory bowel diseases.  

PubMed

Diarrhea is a common clinical feature of inflammatory bowel diseases and may be accompanied by abdominal pain, urgency, and fecal incontinence. The pathophysiology of diarrhea in these diseases is complex, but defective absorption of salt and water by the inflamed bowel is the most important mechanism involved. In addition to inflammation secondary to the disease, diarrhea may arise from a variety of other conditions. It is important to differentiate the pathophysiologic mechanisms involved in the diarrhea in the individual patient to provide the appropriate therapy. This article reviews microscopic colitis, ulcerative colitis, and Crohn's disease, focusing on diarrhea. PMID:22917170

Wenzl, Heimo H

2012-09-01

289

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

290

Metabolic acidosis and the progression of chronic kidney disease  

PubMed Central

Metabolic acidosis is a common complication of chronic kidney disease. Accumulating evidence identifies acidosis not only as a consequence of, but as a contributor to, kidney disease progression. Several mechanistic pathways have been identified in this regard. The dietary acid load, even in the absence of overt acidosis, may have deleterious effects. Several small trials now suggest that the treatment of acidosis with oral alkali can slow the progression of kidney disease. PMID:24708763

2014-01-01

291

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

292

Stress Affects Women, Men with Heart Disease Differently  

MedlinePLUS

... this page, please enable JavaScript. Stress Affects Women, Men With Heart Disease Differently, Study Shows Finding suggests ... different physical and mental reactions in women and men with heart disease, new research indicates. The study ...

293

Global health: chronic diseases and other emergent issues in global health.  

PubMed

Infectious diseases have had a decisive and rapid impact on shaping and changing health policy. Noncommunicable diseases, while not garnering as much interest or importance over the past 20 years, have been affecting public health around the world in a steady and critical way, becoming the leading cause of death in developed and developing countries. This article discusses emergent issues in global health related to noncommunicable diseases and conditions, with focus on defining the unique epidemiologic features and relevant programmatic, health systems, and policy responses concerning noncommunicable chronic diseases, mental health, accidents and injuries, urbanization, climate change, and disaster preparedness. PMID:21896363

Koehlmoos, Tracey Pérez; Anwar, Shahela; Cravioto, Alejandro

2011-09-01

294

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

295

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

296

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

297

Spectrum of anemia associated with chronic liver disease  

PubMed Central

Anemia of diverse etiology is a common complication of chronic liver diseases. The causes of anemia include acute or chronic gastrointestinal hemorrhage, and hypersplenism secondary to portal hypertension. Severe hepatocellular disease predisposes to hemorrhage because of impaired blood coagulation caused by deficiency of blood coagulation factors synthesized by hepatocytes, and/or thrombocytopenia. Aplastic anemia, which is characterized by pancytopenia and hypocellular bone marrow, may follow the development of hepatitis. Its presentation includes progressive anemia and hemorrhagic manifestations. Hematological complications of combination therapy for chronic viral hepatitis include clinically significant anemia, secondary to treatment with ribavirin and/or interferon. Ribavirin-induced hemolysis can be reversed by reducing the dose of the drug or discontinuing it altogether. Interferons may contribute to anemia by inducing bone marrow suppression. Alcohol ingestion is implicated in the pathogenesis of chronic liver disease and may contribute to associated anemia. In patients with chronic liver disease, anemia may be exacerbated by deficiency of folic acid and/or vitamin B12 that can occur secondary to inadequate dietary intake or malabsorption. PMID:19787828

Gonzalez-Casas, Rosario; Jones, E Anthony; Moreno-Otero, Ricardo

2009-01-01

298

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

299

Why do young people with chronic kidney disease die early?  

PubMed

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

2014-11-01

300

Fitness, nutrition and the molecular basis of chronic disease.  

PubMed

The onset of chronic disease is often the prelude to the subsequent physiological and mental twilight in the aging population of modern society. While rates of obesity, specific types of cancer and cardiovascular disorders seem to be on the rise in this group, many new therapies have addressed diseases that have been largely untreatable in the past. Alzheimer's disease has also recently come to the forefront of ongoing maladies most typically associated with an aging population. Ironically, though, many people seem to be living longer than expected. Recent biochemical, nutritional and genomic approaches have been able to elucidate some of the complex mechanisms, which lead to chronic diseases associated with an aging population such as Alzheimer's, metabolic syndrome, tumor metastasis and cardiovascular disease. These diseases and their sequalae seem to be related in many respects, with the common culprit being the inflammatory environment created by the presence of excess fat - particularly within the vascular network. Although a substantial effort has been focused on the development of new-line therapeutics to address these issues, nutrition and overall fitness and their effects on stalling or potentially reversing the advent of these diseases has not been fully embraced in the research arena. This review discusses the role of the inflammatory environment in the development of chronic diseases in the aging population and also proposes a common pathology. The benefits that improvements and dedication in nutrition and fitness approaches may offer at the molecular level are also discussed. PMID:24568249

McAtee, C Patrick

2013-01-01

301

Paracetamol metabolism in chronic liver disease  

Microsoft Academic Search

The plasma concentrations and urinary excretion of paracetamol and its glucuronide, sulphate, cysteine and mercapturic acid conjugates were measured in eight normal subjects, eight patients with mild liver disease and seven patients with severe liver disease following an oral dose of 1.5 g of paracetamol. The mean plasma paracetamol half-life was similar in normal subjects (2.43 h±0.19) and those with

John A. H. Forrest; P. Adriaenssens; N. D. C. Finlayson; L. F. Prescott

1979-01-01

302

Identity and psychological ownership in chronic illness and disease state  

PubMed Central

Psychological ownership is rarely considered in health discourse related to chronic illness or disease state. Construction of identity is an important consideration within this framework. This autoethnographic study explores psychological ownership and identity related to prostate cancer and chronic illness. Conclusions about the nature of psychological ownership and identity were gathered from the relevant literature and personal experience. Themes include the patient–healthcare professional relationship and that psychological ownership is personal and grounded in an individual's sense of identity, control and perceived capacity to control illness or disease. Personal reflection through autoethnography guides discussion of psychological ownership and identity. PMID:20738388

Karnilowicz, W

2011-01-01

303

A biopsychosocial-spiritual model of chronic pain in adults with sickle cell disease.  

PubMed

Chronic pain in adults with sickle cell disease (SCD) is a complex multidimensional experience that includes biologic, psychologic, sociologic, and spiritual factors. To date, three models of pain associated with SCD (i.e., biomedical model, biopsychosocial model for SCD pain, and Health Beliefs Model) have been published. The biopsychosocial multidimensional approach to chronic pain developed by Turk and Gatchel is a widely used model of chronic pain. However, this model has not been applied to chronic pain associated with SCD. In addition, a spiritual/religious dimension is not included in this model. Because spirituality/religion is central to persons affected by SCD, that dimension needs to be added to any model of chronic pain in adults with SCD. In fact, data from one study suggest that spirituality/religiosity is associated with decreased pain intensity in adults with chronic pain from SCD. A biopsychosocial-spiritual model is proposed for adults with chronic pain from SCD, because it embraces the whole person. This model includes the biologic, psychologic, sociologic, and spiritual factors relevant to adults with SCD based on past and current research. The purpose of this paper is to describe an adaptation of Turk and Gatchel's model of chronic pain for adults with SCD and to summarize research findings that support each component of the revised model (i.e., biologic, psychologic, sociologic, spiritual). The paper concludes with a discussion of implications for the use of this model in research. PMID:24315252

Taylor, Lou Ella V; Stotts, Nancy A; Humphreys, Janice; Treadwell, Marsha J; Miaskowski, Christine

2013-12-01

304

[Rare, but important chronic liver diseases].  

PubMed

The presence of steatosis and inflammatory infiltrate in liver biopsies is essential for the diagnosis of non-alcoholic steatohepatitis (NASH). These findings are similar to those with alcoholic liver disease. However, in the NASH-situation alcohol doesn't play an important role. Risk factors for the development of NASH are obesity and diabetes. Most of the patients are clinically asymptomatic. This means, that a diagnosis of NASH is a diagnosis of exclusion: Viral induced, autoimmune, metabolic and toxic liver disease have to be excluded. The disease has a benign clinical course. The risk of cirrhosis is low. So far, there is no established treatment. Preliminary reports suggest a positive effect of weight-loss and ursodeoxycholic acid. Wilson's disease, a copper storage disorder, in which biliary copper excretion is reduced, is inherited as an autosomal recessive trait. Most patients with Wilson disease become symptomatic between the ages of 6 and 15. In about 90% of patients serum ceruloplasmin levels and serum copper concentrations are reduced. Copper excreation is increased. Histologic examination of liver biopsy specimens reveals fatty infiltration, Mallory bodies and ballooned glycogen nuclei, abnormalities which are also found in alcoholic liver disease. The definitive diagnostic parameter is the quantitative determination of liver copper content (> 250 micrograms/g dryweight). Untreated Wilson disease is always fatal. Lifelong treatment with anti-copper drugs are essential, D-penicillamine being the firstline therapy. Hereditary hemochromatosis (HH) is an iron overload disease inherited as an autosomal recessive trait. The frequency of the disease is high. The first symptoms usually can be found at the age of 20-50 years. Arthralgia develops in up to 50% of the patients. Many organs are involved, most often the liver. The organ is usually enlarged, transaminases are always moderately elevated. Laboratory findings disclose a marked elevation in serum ferritin and transferrin saturation. More than 80% of HH-patients are homozygous for the C282Y-mutation in the HFE-gene. The firstline treatment of HH is phlebotomy. Treatment is lifelong. When serum ferritin drops below 50 micrograms/l, the frequency of phlebotomy should be reduced (4-12 per year). If the patient already has cirrhosis, the risk of HCC is very high. PMID:12508671

Maier, K P

2002-11-27

305

Sulodexide in the treatment of chronic venous disease.  

PubMed

Chronic venous disease encompasses a range of venous disorders, including those involving the lower limbs resulting from venous hypertension. The spectrum of chronic venous disease signs and symptoms shows variable severity, ranging from mild (aching, pain, and varicose veins) to severe (venous ulcers). The pathophysiology of chronic venous disease is characterized by venous hypertension, which triggers endothelial dysfunction and inflammation leading to microcirculatory and tissue damage, and eventually to varicose veins and venous ulcers. Sulodexide is an orally active mixture of glycosaminoglycan (GAG) polysaccharides with established antithrombotic and profibrinolytic activity. The agent is used in the treatment of a number of vascular disorders with increased risk of thrombosis, including intermittent claudication, peripheral arterial occlusive disease and post-myocardial infarction. Sulodexide differs from heparin because it is orally bioavailable and has a longer half-life and a smaller effect on systemic clotting and bleeding. An increasing body of preclinical evidence shows that sulodexide also exerts anti-inflammatory, endothelial-protective, and pleiotropic effects, supporting its potential efficacy in the treatment of chronic venous disease. Clinical studies of sulodexide have shown that the agent is associated with significant improvements in the clinical signs and symptoms of venous ulcers, and is therefore a recommended therapy in combination with local wound care and bandages for patients with persistent venous leg ulcers. Preliminary evidence supports the use of sulodexide in the prevention of recurrent deep venous thrombosis. Sulodexide was generally safe and well tolerated in clinical trials, without hemorrhagic complications. Sulodexide therefore appears to be a favorable option for the treatment of all stages of chronic venous disease and for the prevention of disease progression. PMID:22329592

Andreozzi, Giuseppe Maria

2012-04-01

306

Late appearance of chronic pericardial disease in patients treated by radiotherapy for Hodgkin's disease  

SciTech Connect

Radiation-induced chronic pericardial disease was recognized in nine patients 53 to 124 months (mean, 88 months) after radiotherapy for Hodgkin's disease. Depending on whether abnormal cardiac hemodynamics occurred before or after a fluid challenge, patients were considered to have either constrictive pericarditis (Group I) or occult constrictive pericarditis (Group II). There were no differences between these groups in various radiotherapy data, the use of chemotherapy, or the interval after treatment when the diagnosis of chronic pericardial disease was made. There were no consistent noninvasive variables to support the diagnosis of radiation-induced chronic pericardial disease before cardiac catheterization. Four patients underwent pericardiectomy. Two of the four operated patients had an excellent surgical result; a third patient died 4 months postoperatively of drug-induced granulocytopenia; the fourth patient has persistent visceral constrictive pericarditis 18 months after surgery. Speculation over the causes of radiation-induced chronic pericardial disease is made and our recommendations for its treatment given.

Applefeld, M.M.; Cole, J.F.; Pollock, S.H.; Sutton, F.J.; Slawson, R.G.; Singleton, R.T.; Wiernik, P.H.

1981-03-01

307

CD46 Protects against Chronic Obstructive Pulmonary Disease  

PubMed Central

Background Chronic obstructive pulmonary disease and emphysema develops in 15% of ex-smokers despite sustained quitting, while 10% are free of emphysema or severe lung obstruction. The cause of the incapacity of the immune system to clear the inflammation in the first group remains unclear. Methods and Findings We searched genes that were protecting ex-smokers without emphysema, using microarrays on portions of human lungs surgically removed; we found that loss of lung function in patients with chronic obstructive pulmonary disease and emphysema was associated with a lower expression of CD46 and verified this finding by qRT-PCR and flow cytometry. Also, there was a significant association among decreased CD46+ cells with decreased CD4+T cells, apoptosis mediator CD95 and increased CD8+T cells that were protecting patients without emphysema or severe chronic obstructive pulmonary disease. CD46 not only regulates the production of T regulatory cells, which suppresses CD8+T cell proliferation, but also the complement cascade by degradation of C3b. These results were replicated in the murine smoking model, which showed increased C5a (produced by C3b) that suppressed IL12 mediated bias to T helper 1 cells and elastin co-precipitation with C3b, suggesting that elastin could be presented as an antigen. Thus, using ELISA from elastin peptides, we verified that 43% of the patients with severe early onset of chronic obstructive pulmonary disease tested positive for IgG to elastin in their serum compared to healthy controls. Conclusions These data suggest that higher expression of CD46 in the lungs of ex-smoker protects them from emphysema and chronic obstructive pulmonary disease by clearing the inflammation impeding the proliferation of CD8+ T cells and necrosis, achieved by production of T regulatory cells and degradation of C3b; restraining the complement cascade favors apoptosis over necrosis, protecting them from autoimmunity and chronic inflammation. PMID:21573156

Grumelli, Sandra; Lu, Bao; Peterson, Leif; Maeno, Toshitaka; Gerard, Craig

2011-01-01

308

Pain and Opioid Use in Chronic Liver Disease  

PubMed Central

Background Pain is common in patients with liver disease, difficult to treat, and poorly understood. Aims The aim of this study was to determine factors associated with pain and prescription opioid use in a large cohort of patients with confirmed chronic liver. Methods This was a retrospective cohort study of consecutive patients with chronic liver disease visiting a tertiary-care hepatology clinic. Pain was determined by self-report and rated numerically from 0–10. Symptoms of mood and sleep disorders and emotional distress were based on a symptom checklist. Etiology and stage of liver disease and use of prescribed opioids were abstracted from the electronic medical record. Logistic regression was used to establish factors associated with pain and prescription opioid use. Results Among 1286 patients with chronic liver disease, 34% had pain and 25% used opioids. The strongest predictor of pain in multivariate modeling was emotional distress (OR=3.66, CI=2.40,5.64), followed by non-white race (OR=1.87, CI=1.24,2.79), mood symptoms (OR=1.47, CI=1.04,2.07), sleep disturbance/fatigue (OR=1.70, CI=1.24,2.32), and advanced liver disease (Child class B: OR=1.73, CI=1.15,2.60; Child class C: OR=2.78 CI=1.49,5.24) compared to no cirrhosis. Emotional distress, mood-related symptoms, and advanced liver disease were also significant predictors of prescription opioid use, as were age, nicotine use, and etiology of liver disease. Conclusions This large cohort study demonstrates the high prevalence of pain and opioid use in chronic liver disease. While disease variables contribute to pain, psychological symptoms were most strongly associated with pain and opioid use, providing rationale and target for therapeutic interventions. PMID:23512406

Rogal, Shari S.; Winger, Daniel; Bielefeldt, Klaus; Szigethy, Eva

2013-01-01

309

Information Resources Diseases Affecting Homeostasis and Cardiology  

E-print Network

Medicine Clinical Knowledge Base, which contains articles on 7,000 diseases and disorders. The evidence-based to publication. eMedicine Clinical Knowledge Base contains 30,000 multimedia files and features the largest online repository of medical education credits for physicians, nurses, and optometrists. Lexi

Kim, Duck O.

310

Inherited metabolic diseases affecting the carrier  

Microsoft Academic Search

The objective of this review is to draw attention to those inherited metabolic traits which are potentially harmful also for the carrier, and to outline preventive measures, at least for obligate heterozygotes, i.e. parents of homozygous children. Concerning carriers of food-dependent abnormalities, early vascular disease in homocystinuria, hyperammonaemic episodes in ornithine transcarbamylase deficiency, presenile cataracts in galactosaemia as well as

W. Endres

1997-01-01

311

Blood pressure in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children study.  

PubMed

To characterize the distribution of blood pressure (BP), prevalence, and risk factors for hypertension in pediatric chronic kidney disease, we conducted a cross-sectional analysis of baseline BPs in 432 children (mean age 11 years; 60% male; mean glomerular filtration rate 44 mL/min per 1.73 m(2)) enrolled in the Chronic Kidney Disease in Children cohort study. BPs were obtained using an aneroid sphygmomanometer. Glomerular filtration rate was measured by iohexol disappearance. Elevated BP was defined as BP >or=90th percentile for age, gender, and height. Hypertension was defined as BP >or=95th percentile or as self-reported hypertension plus current treatment with antihypertensive medications. For systolic BP, 14% were hypertensive and 11% were prehypertensive (BP 90th to 95th percentile); 68% of subjects with elevated systolic BP were taking antihypertensive medications. For diastolic BP, 14% were hypertensive and 9% were prehypertensive; 53% of subjects with elevated diastolic BP were taking antihypertensive medications. Fifty-four percent of subjects had either systolic or diastolic BP >or=95th percentile or a history of hypertension plus current antihypertensive use. Characteristics associated with elevated BP included black race, shorter duration of chronic kidney disease, absence of antihypertensive medication use, and elevated serum potassium. Among subjects receiving antihypertensive treatment, uncontrolled BP was associated with male sex, shorter chronic kidney disease duration, and absence of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use. Thirty-seven percent of children with chronic kidney disease had either elevated systolic or diastolic BP, and 39% of these were not receiving antihypertensives, indicating that hypertension in pediatric chronic kidney disease may be frequently under- or even untreated. Treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may improve BP control in these patients. PMID:18725579

Flynn, Joseph T; Mitsnefes, Mark; Pierce, Christopher; Cole, Steven R; Parekh, Rulan S; Furth, Susan L; Warady, Bradley A

2008-10-01

312

[Ultrasonic examination in the diagnosis of chronic diseases of the veins of the lower extremities].  

PubMed

Noninvasive diagnosis of chronic diseases of the lower limb venous system is an urgent problem of modern phlebology. Ultrasonic examination (USE) makes it possible to judge adequately the condition of the deep and surface veins and, consequently, to improve significantly the management of varicose and post-thrombophlebitic diseases. The authors elaborated an original method for the diagnosis and appraisal of the condition of the lower limb venous system by means of ultrasonic scanning and various functional tests for determining the character of affection of the venous valvular apparatus. Examination of more than 200 patients with primary varicosities and post-thrombophlebitic disease, the use of highly-resolving ultrasonic equipment, and comparison of the results of USE with the findings of radiocontrast phlebography (agreement in 99.8% of cases) allow the conclusion that noninvasive ultrasonic methods must be used widely in appraising the venous status in patients with chronic diseases of the venous system of the lower limbs. PMID:1803077

Konstantinova, G D; Bogachev, V Iu; Zubarev, A R; Bogdanov, A E

1991-10-01

313

Primary Prevention in Chronic Ischemic Heart Disease  

Microsoft Academic Search

Despite the remarkable advances in cardiovascular therapeutics over the last two decades, sudden death still remains a substantially large proportion of all deaths in patients with ischemic heart disease. Patients in the early stages of AMI are at high risk of dying suddenly, often from ventricular ~brillation [1]. Survivors of AMI, especially those with frequent ventricular ectopy, are also at

Koon K. Teo

1999-01-01

314

Febuxostat for hyperuricemia in patients with advanced chronic kidney disease.  

PubMed

Febuxostat is a nonpurine xanthine oxidase (XO) inhibitor, which recently received marketing approval. However, information regarding the experience with this agent among advanced chronic kidney disease (CKD) patients is limited. In the current study, we investigated the effects of oral febuxostat in patients with advanced CKD with asymptomatic hyperuricemia. We demonstrated, for the first time, that not only the serum levels of uric acid (UA) but also those of 8-hydroxydeoxyguanosine, an oxidative stress marker, were significantly reduced after six months of febuxostat treatment, with no adverse events. These results encouraged us to pursue further investigations regarding the clinical impact of lowering the serum UA levels with febuxostat in advanced CKD patients in terms of concomitantly reducing oxidative stress via the blockade of XO. More detailed studies with a larger number of subjects and assessments of the effects of multiple factors affecting hyperuricemia, such as age, sex, and dietary habits, would shed light on the therapeutic challenges of treating asymptomatic hyperuricemia in patients with various stages of CKD. PMID:25210423

Akimoto, Tetsu; Morishita, Yoshiyuki; Ito, Chiharu; Iimura, Osamu; Tsunematsu, Sadao; Watanabe, Yuko; Kusano, Eiji; Nagata, Daisuke

2014-01-01

315

Febuxostat for Hyperuricemia in Patients with Advanced Chronic Kidney Disease  

PubMed Central

Febuxostat is a nonpurine xanthine oxidase (XO) inhibitor, which recently received marketing approval. However, information regarding the experience with this agent among advanced chronic kidney disease (CKD) patients is limited. In the current study, we investigated the effects of oral febuxostat in patients with advanced CKD with asymptomatic hyperuricemia. We demonstrated, for the first time, that not only the serum levels of uric acid (UA) but also those of 8-hydroxydeoxyguanosine, an oxidative stress marker, were significantly reduced after six months of febuxostat treatment, with no adverse events. These results encouraged us to pursue further investigations regarding the clinical impact of lowering the serum UA levels with febuxostat in advanced CKD patients in terms of concomitantly reducing oxidative stress via the blockade of XO. More detailed studies with a larger number of subjects and assessments of the effects of multiple factors affecting hyperuricemia, such as age, sex, and dietary habits, would shed light on the therapeutic challenges of treating asymptomatic hyperuricemia in patients with various stages of CKD.

Akimoto, Tetsu; Morishita, Yoshiyuki; Ito, Chiharu; Iimura, Osamu; Tsunematsu, Sadao; Watanabe, Yuko; Kusano, Eiji; Nagata, Daisuke

2014-01-01

316

CD137 in chronic graft-versus-host disease.  

PubMed

Chronic graft-versus-host disease (GVHD) occurs in recipients of allogeneic hematopoietic stem cell transplantation with a high frequency. Preclinical animal chronic GVHD models outlined in this chapter allow for the delineation of events that occur during chronic GVHD development. The DBA/2 ? (C56BL/6 × DBA/2)F1 (BDF1) model is characterized by systemic lupus erythematosus (SLE)-like phenotype. The B10.D2 ? Balb/c model presents many features of autoimmune scleroderma. The former model is useful in defining how alloreactive donor CD4(+) T cells break B-cell tolerance, whereas the latter model is suitable for dissecting the pathogenesis of organ fibrosis. Our laboratory has demonstrated that injection of a single dose of strong CD137 agonists can prevent or cure chronic GVHD in these two models. In general, these models are particularly suited to screening the immunomodulatory therapeutics. PMID:24788176

Kim, Juyang; Cho, Hong R; Kwon, Byungsuk

2014-01-01

317

[Migration flow and imported diseases: chronic chagasic cardiomyopathy].  

PubMed

Chagas disease, caused by the parasite Trypanosoma cruzi, is transmitted by triatomine bugs in endemic regions of the American continent and less frequently by blood transfusion and congenital transmission. Immigration rates explain why the disease can be found worldwide. Non-endemic countries that receive a significant amount of Latin American immigrants should be familiarized with the disease to allow prevention, diagnosis and early treatment. In Italy, where no serologic screening is routinely performed to detect Trypanosoma cruzi in blood donations, a special consideration must be held. Accordingly, attention to congenital transmissions of the disease should be drawn considering the lack of newborn screening. Though commonly unrecognized, chronic chagasic cardiomyopathy is the most common type of chronic myocarditis in the world. PMID:19475878

Guerri-Guttenberg, Roberto A; Di Girolamo, Chiara; Ciannameo, Anna; Milei, José

2009-04-01

318

Successful Treatment with Posaconazole of a Patient with Chronic Chagas Disease and Systemic Lupus Erythematosus  

PubMed Central

American Trypanosomiasis or Chagas disease (CD) is a neglected disease that affects Latin American people worldwide. Two old antiparasitic drugs, benznidazole and nifurtimox, are currently used for specific CD treatment with limited efficacy in chronic infections and frequent side effects. New drugs are needed for patients with chronic CD as well as for immunosuppressed patients, for whom the risk of reactivation is life-threatening. We describe a case of chronic CD and systemic lupus erythematosus (SLE) that required immunosuppression to control the autoimmune process. It was found that benznidazole induced a reduction, but not an elimination, of circulating Trypanosoma cruzi levels, whereas subsequent treatment with posaconazole led to a successful resolution of the infection, despite the maintenance of immunosuppressive therapy. PMID:20348503

Pinazo, Maria-Jesus; Espinosa, Gerard; Gallego, Montserrat; Lopez-Chejade, Paulo Luis; Urbina, Julio A.; Gascon, Joaquim

2010-01-01

319

Chronic Ankle Instability Does Not Affect Lower Extremity Functional Performance  

Microsoft Academic Search

Objective: To determine if functional performance is impaired in individuals with self-reported chronic ankle instability. Design and Setting: We used a between-groups design to assess 3 functional variables. All data were collected at a Division III college and a military academy. Before testing, all subjects performed a 5-minute warm-up, followed by a series of stretches for the lower extremity muscles.

Kerry M. Demeritt; Sandra J. Shultz; Carrie L. Docherty; Bruce M. Gansneder; D. H. J Athl

2002-01-01

320

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

321

Should prevention of chronic kidney disease start before pregnancy?  

Microsoft Academic Search

Objective  The objective was to evaluate whether there is a role for the prevention of future chronic kidney disease (CKD) in children\\u000a by improving maternal health at conception, this review addresses: the risk of childhood obesity in the development of CKD,\\u000a trends in childhood obesity and body composition in children with renal diseases, trends in pre-pregnancy BMI and its association\\u000a with

Guido Filler; Meera S. Rayar; Orlando da Silva; Ilan Buffo; Dion Pepelassis; Ajay P. Sharma

2008-01-01

322

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

323

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

324

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

325

The natural history of beryllium sensitization and chronic beryllium disease  

SciTech Connect

With the advent of in vitro immunologic testing, we can now detect exposed individuals who are sensitized to beryllium and those who have chronic beryllium disease (CBD) with lung pathology and impairment. Earlier detection and more accurate diagnostic tools raise new questions about the natural history of sensitization and granulomatous disease. Preliminary data suggest that early detection identifies people who are sensitized to beryllium and that these individuals are at risk for progressing into clinical disease. This article discusses the historical, recent, and ongoing studies germane to our understanding of CBD natural history, including the immunologic and inflammatory basis of the disease, the environmental and host risk factors for disease progression, biological markers of disease severity and activity that may help predict outcome, and the implications for broad-based workplace screening to identify patients at the earliest stages of beryllium sensitization and disease. 29 refs., 2 figs.

Newman, L.S. [National Jewish Center for Immunology and Respiratory Medicine, Denver, CO (United States)]|[Univ. of Colorado, Denver, CO (United States); Lloyd, J.; Daniloff, E. [National Jewish Center for Immunology and Respiratory Medicine, Denver, CO (United States)

1996-10-01

326

Evaluation of Continuing Medical Education for Chronic Obstructive Pulmonary Diseases.  

ERIC Educational Resources Information Center

A continuing medical education program is discussed that addresses chronic obstructive pulmonary disease and that links primary care physicians to a source of needed clinical knowledge at a relatively low cost. The educational methods, evaluation design, diagnosis of educational needs, selection of program content and behavioral outcomes are…

Li Wang, Virginia; And Others

1979-01-01

327

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

328

Anxiety and Chronic Obstructive Pulmonary Disease: Prevalence, Impact, and Treatment  

Microsoft Academic Search

Objective: This article reviews the prevalence of anxiety disorders in patients with chronic obstructive pulmonary disease (COPD) as well as the impact of comorbid anxiety on quality of life in patients with COPD. Published studies on three types of treatments for anxiety are then reviewed: psychopharmacology, psychotherapy, and pulmonary rehabilitation programs. Materials and Methods: A PubMed search was conducted of

GRETCHEN A. BRENES

2003-01-01

329

Abdominal muscle and quadriceps strength in chronic obstructive pulmonary disease  

Microsoft Academic Search

Background: Quadriceps muscle weakness is common in chronic obstructive pulmonary disease (COPD) but is not observed in a small hand muscle (adductor pollicis). Although this could be explained by reduced activity in the quadriceps, the observation could also be explained by anatomical location of the muscle or fibre type composition. However, the abdominal muscles are of a similar anatomical and

W D-C Man; N S Hopkinson; F Harraf; D Nikoletou; M I Polkey; J Moxham

2005-01-01

330

Chronic Obstructive Pulmonary Disease and Lung Cancer: New Molecular Insights  

Microsoft Academic Search

Both chronic obstructive pulmonary disease (COPD) and lung cancer are major causes of death worldwide. In most cases this reflects cigarette smoke exposure which is able to induce an inflammatory response in the airways of smokers. Indeed, COPD is characterized by lower airway inflammation, and importantly, the presence of COPD is by far the greatest risk factor for lung cancer

Ian M. Adcock; Gaetano Caramori; Peter J. Barnes

2011-01-01

331

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

332

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

333

Precipitating Factors of Acute Illness in Patients with Chronic Disease  

PubMed Central

The precipitating causes of acute illness in patients with chronic organic disease can often be prevented, reversed or controlled. The various kinds of precipitating factors are described, and their anticipation and the prompt institution of remedial measures are emphasized. PMID:5843867

Munroe, D. S.

1965-01-01

334

Depression among Parents of Children with Chronic and Disabling Disease  

Microsoft Academic Search

Background: The parent's awareness about chronic disabling disease in their children definitely distresses the parents. Chil- dren of such parents show behavior & cognitive disturbances with long term negative impact on the family. Objective: The present study was carried out to investigate the prevalence of depression in parents of disabled children. Methods: Following a cross-sectiona l study, 50 parents of

A. Tahamtan

2004-01-01

335

Chronic Chagas’ Heart Disease in the Elderly: A Clinicopathologic Study  

Microsoft Academic Search

A retrospective study of the medical records of our hospital from 1965 to 1985 was carried out to characterize for the first time chronic Chagas’ heart disease in the elderly (more than 70 years old). A total of 25 patients (mean age = 76) were suitable for the study. Congestive heart failure, sudden cardiac death, thromboembolism and atypical chest pain

Reinaldo B. Bestetti; Carmen P. Ramos; Renato A. Godoy; Samuel M. Oliveira

1987-01-01

336

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...

337

Chronicity and control: framing ‘noncommunicable diseases’ in Africa  

Microsoft Academic Search

This paper proposes a way of framing the study of ‘noncommunicable diseases’ within the more general area of chronic conditions. Focusing on Africa, it takes as points of departure the situation in Uganda, and the approach to health issues developed by a group of European and African colleagues over the years. It suggests a pragmatic analysis that places people's perceptions

Susan Reynolds Whyte

2012-01-01

338

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

339

Cell Death, Remodeling, and Repair in Chronic Obstructive Pulmonary Disease?  

Microsoft Academic Search

Apoptotic cells can be detected in the parenchyma and airways of patients with chronic obstructive pulmonary disease (COPD) in greater numbers than seen in normal lungs or those from smokers without COPD. Implications include more apoptosis and\\/or de- creased clearance of apoptotic cells. Both epithelial and endothelial cells become apoptotic. What role does the apoptosis play in the emphysema or

Peter M. Henson; R. William Vandivier; Ivor S. Douglas

2006-01-01

340

Motivational Interviewing to Engage Patients in Chronic Kidney Disease Management  

Microsoft Academic Search

Patients with chronic kidney disease (CKD) must manage numerous medical treatments and lifestyle changes that strain their treatment adherence. An important strategy to improve adherence is to activate the patients’ motivation to manage their CKD. This article describes an approach for enhancing patients’ motivation for change, called motivational interviewing (MI), a treatment that is increasingly being used in health care

Steve Martino

2011-01-01

341

Antipyrine, paracetamol, and lignocaine elimination in chronic liver disease  

Microsoft Academic Search

The plasma half lives of antipyrine, paracetamol, and lignocaine given by mouth were measured in 23 patients with stable chronic liver diseases of varying severity. Fifteen patients received all three drugs and 19 at least two. The half life of paracetamol was abnormally prolonged in nine out of 17 patients (mean 2-9 hours, normal 2-0 hours), of antipyrine in 10

J A Forrest; N D Finlayson; K K Adjepon-Yamoah; L F Prescott

1977-01-01

342

Medicament contact dermatitis in patients with chronic inflammatory ear disease.  

PubMed

Patch testing of 40 patients with chronic inflammatory ear disease demonstrated medicament allergic contact dermatitis in 35%. The most frequent sensitizers were neomycin, framycetin, clioquinol and gentamicin. Although allergic contact dermatitis to dewaxing ear drops was unusual, irritant reactions were common. PMID:6460100

Holmes, R C; Johns, A N; Wilkinson, J D; Black, M M; Rycroft, R J

1982-01-01

343

Corticosteroid Therapy for Liver Abscess in Chronic Granulomatous Disease  

PubMed Central

Liver abscesses in chronic granulomatous disease (CGD) are typically difficult to treat and often require surgery. We describe 9 X-linked CGD patients with staphylococcal liver abscesses refractory to conventional therapy successfully treated with corticosteroids and antibiotics. Corticosteroids may have a role in treatment of Staphylococcus aureus liver abscesses in CGD. PMID:22157170

Leiding, Jennifer W.; Freeman, Alexandra F.; Marciano, Beatriz E.; Anderson, Victoria L.; Uzel, Gulbu; Malech, Harry L.; DeRavin, SukSee; Wilks, David; Venkatesan, Aradhana M.; Zerbe, Christa S.; Heller, Theo

2012-01-01

344

Depression in elderly outpatients with disabling chronic obstructive pulmonary disease  

Microsoft Academic Search

Introduction: depression is common in both young adults and elderly people with chronic obstructive pulmonary disease (COPD). Methods: we compared the prevalence of depressive symptomatology in elderly outpatients with stable disabling COPD with that in healthy controls and age-matched patients with other disabilities, and also assessed the relation between degree of disability, quality of life and depressive symptoms. The subjects

ABEBW M. YOHANNES; JAMAL ROOMI; ROBERT C. BALDWIN; MARTIN J. CONNOLLY

1998-01-01

345

Wood smoke exposure and risk of chronic obstructive pulmonary disease  

Microsoft Academic Search

It was hypothesised that wood smoke exposure could be a risk factor for chronic obstructive pulmonary disease (COPD) in Spain. The present study was designed as a case- control study of 120 females requiring hospitalisation during 2001-2003 at Hospital del Mar (Barcelona, Spain). Cases were recruited from hospital records as females who had been admitted for an exacerbation of COPD.

M. Orozco-Levi; J. Garcia-Aymerich; J. Villar; A. Ramirez-Sarmiento; J. M. Anto; J. Gea

2006-01-01

346

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

347

Selected Pharmacokinetic Issues in Patients with Chronic Kidney Disease  

Microsoft Academic Search

Pharmacotherapy plays an important role in the care of a chronic kidney disease (CKD) patient but delivering this therapy can be challenging. Besides alterations in the pharmacokinetic parameters of absorption, distribution, metabolism and elimination, the average CKD patient must take multiple medications each day. The likelihood of an adverse drug reaction increases with each medication added to these patients’ daily

Mariann D. Churchwell; Bruce A. Mueller

2007-01-01

348

Prevalence of comorbidity of chronic diseases in Australia  

PubMed Central

Background The prevalence of comorbidity is high, with 80% of the elderly population having three or more chronic conditions. Comorbidity is associated with a decline in many health outcomes and increases in mortality and use of health care resources. The aim of this study was to identify, review and summarise studies reporting the prevalence of comorbidity of chronic diseases in Australia. Methods A systematic review of Australian studies (1996 – May 2007) was conducted. The review focused specifically on the chronic diseases included as national health priorities; arthritis, asthma, cancer, cardiovascular disease (CVD), diabetes mellitus and mental health problems. Results A total of twenty five studies met our inclusion criteria. Over half of the elderly patients with arthritis also had hypertension, 20% had CVD, 14% diabetes and 12% mental health problem. Over 60% of patients with asthma reported arthritis as a comorbidity, 20% also had CVD and 16% diabetes. Of those with CVD, 60% also had arthritis, 20% diabetes and 10% had asthma or mental health problems. Conclusion There are comparatively few Australian studies that focused on comorbidity associated with chronic disease. However, they do show high prevalence of comorbidity across national health priority areas. This suggests integration and co-ordination of the national health priority areas is critical. A greater awareness of the importance of managing a patients' overall health status within the context of comorbidity is needed together with, increased research on comorbidity to provide an appropriate scientific basis on which to build evidence based care guidelines for these multimorbid patients. PMID:18582390

Caughey, Gillian E; Vitry, Agnes I; Gilbert, Andrew L; Roughead, Elizabeth E

2008-01-01

349

Heart failure and chronic obstructive pulmonary disease: An ignored combination?  

Microsoft Academic Search

Aims: To quantify the prevalence of heart failure and left ventricular systolic dysfunction (LVSD) in chronic obstructive pulmonary disease (COPD) patients and vice versa. Further, to discuss diagnostic and therapeutic implications of the co-existence of both syndromes. Methods and results: We performed a Medline search from 1966 to March 2005. The reported prevalence of LVSD among COPD patients varied considerably,

Frans H. Rutten; Maarten-Jan M. Cramer; Jan-Willem J. Lammers; Diederick E. Grobbee; Arno W. Hoes

2006-01-01

350

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

351

Glucocorticoid Pathways in Chronic Obstructive Pulmonary Disease Therapy  

Microsoft Academic Search

Lung function measures in patients with chronic obstructive pulmo- nary disease remain insensitive to corticosteroid actions, in contrast totheclinicalimprovementsobservedinmostpatientswithasthma. By uncovering the reason for this paradox, physicians should be able to implement treatment regimens that restore corticosteroid sensitivity. Corticosteroids exert their effects by binding to a cyto- plasmic glucocorticoid receptor, which is subjected to post-transla- tional modification by phosphorylation. Receptor

Ian M. Adcock; Kazuhiro Ito

2005-01-01

352

Selection in the social network: effects of chronic diseases  

Microsoft Academic Search

Background: this article deals with the consequences of disease for someone's personal social network. It is hypothesized that the duration of a socially severe disease will affect the social network in such a way that the proportions of women, kin, long-standing relationships and people living nearby are higher for people suffering from a disease longer. Contacts with colleagues will decline.

M. A. R. Tijhuis; HENK D. FLAP; MARLEEN FOETS; PETER P. GROENEWEGEN

1998-01-01

353

WAIS-III and WMS-III performance in chronic Lyme disease.  

PubMed

There is controversy regarding the nature and degree of intellectual and memory deficits in chronic Lyme disease. In this study, 81 participants with rigorously diagnosed chronic Lyme disease were administered the newest revisions of the Wechsler Adult Intelligence Scale (WAIS-III) and Wechsler Memory Scale (WMS-III), and compared to 39 nonpatients. On the WAIS-III, Lyme disease participants had poorer Full Scale and Performance IQ's. At the subtest level, differences were restricted to Information and the Processing Speed subtests. On the WMS-III, Lyme disease participants performed more poorly on Auditory Immediate, Immediate, Auditory Delayed, Auditory Recognition Delayed, and General Memory indices. Among WMS-III subtests, however, differences were restricted to Logical Memory (immediate and delayed) and Family Pictures (delayed only), a Visual Memory subtest. Discriminant analyses suggest deficits in chronic Lyme are best characterized as a combination of memory difficulty and diminished processing speed. Deficits were modest, between one-third and two-thirds of a standard deviation, consistent with earlier studies. Depression severity had a weak relationship to processing speed, but little other association to test performance. Deficits in chronic Lyme disease are consistent with a subtle neuropathological process affecting multiple performance tasks, although further work is needed to definitively rule out nonspecific illness effects. PMID:16433951

Keilp, John G; Corbera, Kathy; Slavov, Iordan; Taylor, Michael J; Sackeim, Harold A; Fallon, Brian A

2006-01-01

354

Survival after bilateral lung transplantation versus single lung transplantation for patients with chronic obstructive pulmonary disease.  

E-print Network

with chronic obstructive pulmonary disease. Gabriel Thabut1,4 , Jason D. Christie7,8 , Philippe Ravaud3-stage chronic obstructive pulmonary disease (COPD); however, the choice of procedure leading to longer survival Among such diseases, chronic obstructive pulmonary disease (COPD) represents one of the major

Paris-Sud XI, Université de

355

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

2014-02-11

356

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

357

The scope of coronary heart disease in patients with chronic kidney disease.  

PubMed

Chronic kidney disease (CKD) affects approximately 13% of the U.S. population and is associated with increased risk of cardiovascular complications. Once renal replacement therapy became available, it became apparent that the mode of death of patients with advanced CKD was more likely than not related to cardiovascular compromise. Further observation revealed that such compromise was related to myocardial disease (related to hypertension, stiff vessels, coronary heart disease, or uremic toxins). Early on, the excess of cardiovascular events was attributed to accelerated atherosclerosis, inadequate control of blood pressure, lipids, or inflammatory cytokines, or perhaps poor glycemia control. In more recent times, outcome research has given us further information that relates even lesser degrees of renal compromise to an excess of cardiovascular events in the general population and in those with already present atherosclerotic disease. As renal function deteriorates, certain physiologic changes occur (perhaps due to hemodynamic, inflammatory, or metabolic changes) that decrease oxygen-carrying capacity of the blood by virtue of anemia, make blood vessels stiffer by altering collagen or through medial calcinosis, raise the blood pressure, increase shearing stresses, or alter the constituents of atherosclerotic plaque or the balance of thrombogenesis and thrombolysis. At further levels of renal dysfunction, tangible metabolic perturbations are recognized as requiring specific therapy to reduce complications (such as for anemia and hyperparathyroidism), although outcome research to support some of our current guidelines is sorely lacking. Understanding the process by which renal dysfunction alters the prognosis of cardiac disease might lead to further methods of treatment. This review will outline the relationship of CKD to coronary heart disease with respect to the current understanding of the traditional and nontraditional risk factors, the role of various imaging modalities, and the impact of coronary revascularization on outcome. PMID:19497438

Hage, Fadi G; Venkataraman, Rajesh; Zoghbi, Gilbert J; Perry, Gilbert J; DeMattos, Angelo M; Iskandrian, Ami E

2009-06-01

358

Microbial Translocation in Chronic Liver Diseases  

PubMed Central

The intestinal microflora is not only involved in the digestion of nutrients, but also in local immunity, forming a barrier against pathogenic microorganisms. The derangement of the gut microflora may lead to microbial translocation, defined as the passage of viable microorganisms or bacterial products (i.e., LPS, lipopeptides) from the intestinal lumen to the mesenteric lymph nodes and other extraintestinal sites. The most recent evidence suggests that microbial translocation (MT) may occur not only in cirrhosis, but also in the early stage of several liver diseases, including alcoholic hepatopathy and nonalcoholic fatty liver disease. Different mechanisms, such as small intestinal bacterial overgrowth, increased permeability of intestinal mucosa, and impaired immunity, may favor MT. Furthermore, MT has been implicated in the pathogenesis of the complications of cirrhosis, which are a significant cause of morbidity and mortality in cirrhotic subjects. Therapeutic strategies aiming at modulating the gut microflora and reducing MT have focused on antibiotic-based options, such as selective intestinal decontamination, and nonantibiotic-based options, such as prokinetics and probiotics. In particular, probiotics may represent an attractive strategy, even though the promising results of experimental models and limited clinical studies need to be confirmed in larger randomized trials. PMID:22848224

Pinzone, Marilia Rita; Celesia, Benedetto Maurizio; Di Rosa, Michele; Cacopardo, Bruno; Nunnari, Giuseppe

2012-01-01

359

Chronic fatigue is associated with increased disease-related worries and concerns in inflammatory bowel disease  

PubMed Central

AIM: To investigate the impact of chronic fatigue on disease-related worries in inflammatory bowel disease (IBD) and the potential multicolinearity between subjective questionnaires. METHODS: Patients in remission or with mild-to-moderate disease activity completed the fatigue questionnaire (FQ), the rating form of IBD patient concerns (RFIPC), the Short-Form 36 (SF-36), and IBD questionnaire (N-IBDQ). In addition, clinical and epidemiological data were obtained. RESULTS: In total, 140 patients were included; of which 92 were diagnosed with ulcerative colitis and 48 with Crohn’s disease. The mean age of patients with chronic fatigue was 44.2 years (SD = 15.8) and for non-fatigued patients was 44.7 years (SD = 16.0). Chronic fatigued patients had clinically significantly increased levels of disease-related worries, as measured by Cohen’s d effect size. Worries about having an ostomy bag, loss of bowel control, and energy levels were most prominent in both chronic fatigued and non-chronic fatigued IBD patients. Variance inflation factor (VIF) and tolerance indicated that there were no problematic multicolinearity among the FQ, RFIPC, SF-36 and N-IBDQ responses (VIF < 5 and tolerance > 2). CONCLUSION: Chronic fatigue is associated with increased levels of disease-related worries and concerns in IBD. Increased levels of worries were also associated with impaired health-related quality of life. PMID:22346250

Jelsness-J?rgensen, Lars-Petter; Bernklev, Tomm; Henriksen, Magne; Torp, Roald; Moum, Bj?rn

2012-01-01

360

Global initiative for chronic obstructive lung disease for chronic obstructive pulmonary disease: GOLD opportunity for lung disorders  

Microsoft Academic Search

Background. The purpose of this study was to assess the agreement of asthma and chronic obstructive pulmonary disease (COPD) treatment prescribed by physicians and pulmonologists in comparison to asthma and COPD guidelines and the need of the implementation of COPD guidelines in primary health care physicians.Methods. Eighty-three asthma patients and 100 COPD patients were chosen and classified in relation to

M. Minas; K. Dimitropoulos; Ch. Pastaka; D. Papadopoulos; N. Markoulis; K. I. Gourgoulianis

2005-01-01

361

Hereditary causes of kidney stones and chronic kidney disease.  

PubMed

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 an 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

2013-10-01

362

Chronic HIV Disease and Activation of the Coagulation System  

PubMed Central

With current effective antiretroviral treatment, the spectrum of morbidity and mortality during chronic HIV disease has shifted away from AIDS defining clinical events. Persistent abnormalities in coagulation appear to contribute to excess risk for a broad spectrum of non-AIDS defining complications, including, but not limited to, venous and arterial thrombotic disease. Mechanisms specific to HIV disease, antiretroviral therapy, and lifestyle or behavioral factors contribute to a pro-coagulant state, in part, through increased tissue factor activity coupled with a paradoxical decline in the anti-coagulant response. Alterations in coagulation biology in the context of HIV disease appear to be largely a consequence of persistent systemic immune activation, micro- and macro-vascular disease, and, potentially, impaired hepatic synthesis of coagulation factors. The clinical consequences of HIV-related changes in coagulation biology, the degree to which they are unique to HIV disease, and whether they can be mitigated through adjunct treatments, remains a focus of current research. PMID:24034985

Baker, Jason V.

2014-01-01

363

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

364

Physical activity recommendations for children and adolescents with chronic disease.  

PubMed

Youth with low physical activity and fitness levels and high body fat levels are more likely to develop additional risk factors for cardiovascular disease, such as elevated blood pressure and serum cholesterol levels. Participation in daily physical activity can reduce body fat, encourage weight loss, and improve aerobic fitness in youth without disabilities. Recent research involving youth with cerebral palsy, spinal cord injury, cystic fibrosis, asthma, diabetes, juvenile idiopathic arthritis, and hemophilia suggest positive effects of exercise therapy upon the aerobic capacity, functional ability, and quality of life of children and adolescents with disabilities and chronic diseases. Strategies exist for introducing exercise as a lifelong intervention in pediatric populations with chronic diseases. PMID:19005359

Morris, Patrick J

2008-01-01

365

Chronic unremitting headache associated with Lyme disease-like illness.  

PubMed

The Brazilian Lyme-disease-like illness (BLDLI) or Baggio-Yoshinari syndrome is a unique zoonosis found in Brazil. It reproduces all the clinical symptoms of Lyme disease except for the high frequencies of relapse and the presence of autoimmune manifestations. Two cases of borreliosis manifesting with unremitting headache, which is a symptom associated with late-stage BLDLI, were presented. Clinical, therapeutic, and prognostic aspects of the BLDLI and its associated headaches were showed and discussed in this article. BLDLI diagnosis requires additional attention by physicians, since the disease has a tendency to progress to the late, recurrent stage or the chronic form, and the associated headache can be confused with chronic primary headache or with analgesic-overuse one. Special attention should be paid to patients with headaches who have traveled to endemic areas. PMID:23857618

Kowacs, Pedro André; Martins, Rodrigo Tomazini; Piovesan, Elcio Juliato; Pinto, Maria Cristina Araujo; Yoshinari, Natalino Hagime

2013-07-01

366

Neopterin: a potential marker in chronic peripheral arterial disease.  

PubMed

Neopterin is a marker of macrophage activation that has exhibited high plasma levels in atherosclerotic diseases including coronary heart disease and critical limb ischemia. The role of neopterin in chronic peripheral arterial disease (PAD) has yet to be elucidated. In the present study, neopterin (?) serum concentrations were analyzed in asymptomatic (AsP) and symptomatic (SyP) patients with PAD as well as controls (C). In total 120 subjects, 40 AsP [ankle brachial index (ABI) ?0.90], 40 SyP (ABI ?0.90 plus pain in legs) and 40 controls (ABI >0.9) were enrolled. The results of the present study showed that neopterin plasma levels were statistically different among the groups. These findings demonstrated that activation of N?mediated monocyte?macrophage, was also observed in chronic PAD. PMID:23563241

Signorelli, Salvatore Santo; Anzaldi, Massimiliano; Fiore, Valerio; Candido, Saverio; Di Marco, Roberto; Mangano, Katia; Quattrocchi, Cinzia; Neri, Sergio

2013-06-01

367

Analysis of urinary microRNAs in chronic kidney disease.  

PubMed

Kidney biopsy is the gold-standard diagnostic test for intrinsic renal disease, but requires hospital admission and carries a 3% risk of major complications. Current non-invasive prognostic indicators such as urine protein quantification have limited predictive value. Better diagnostic and prognostic tests for chronic kidney disease patients are a major focus for industry and academia, with efforts to date directed largely at urinary proteomic approaches. microRNAs constitute a recently identified class of endogenous short non-coding single-stranded RNA oligonucleotides that regulate gene expression post-transcriptionally. Quantification of urinary microRNAs offers an alternative approach to the identification of chronic kidney disease biomarkers. PMID:22817751

Beltrami, Cristina; Clayton, Aled; Phillips, Aled O; Fraser, Donald J; Bowen, Timothy

2012-08-01

368

Chronic Obstructive Pulmonary Disease: Respiratory Review of 2014  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is characterized by a diverse array of pulmonary and nonpulmonary manifestations, but our understanding of COPD pathogenesis and the factors that influence its heterogeneity in disease presentation is poor. Despite this heterogeneity, treatment algorithms are primarily driven by a single measurement, forced expiratory volume in 1 second (FEV1) as a percentage of its predicted value (FEV1%). In 2011, a major shift in Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment recommendations was proposed that stratifies patients with COPD on the basis of symptoms and exacerbation history. This article reviews the work reported in 2013 that enlightens our understanding of COPD with respect to COPD classification systems, phenotype, biomarker, exacerbation, and management for patients with COPD. PMID:25368660

2014-01-01

369

Bisphenol A in Chronic Kidney Disease  

PubMed Central

Phenols are uremic toxins of intestinal origin formed by bacteria during protein metabolism. Of these molecules, p-cresol is the most studied and has been associated with renal function impairment and vascular damage. Bisphenol A (BPA) is a molecule with structural similarity with phenols found in plastic food and beverage containers as well as in some dialyzers. BPA is considered an environmental toxicant based on animal and cell culture studies. Japanese authorities recently banned BPA use in baby bottles based on observational association studies in newborns. BPA is excreted in urine and uremic patients present higher serum levels, but there is insufficient evidence to set cut-off levels or to link BPA to any harmful effect in CKD. However, the renal elimination and potential exposure during dialysis warrant the monitoring of BPA exposure and the design of observational studies in which the potential health risks of BPA for end-stage renal disease patients are evaluated. PMID:23997953

González-Parra, Emilio; Herrero, Jose Antonio; Elewa, Usama; Arduán, Alberto Ortiz; Egido, Jesus

2013-01-01

370

Bisphenol a in chronic kidney disease.  

PubMed

Phenols are uremic toxins of intestinal origin formed by bacteria during protein metabolism. Of these molecules, p-cresol is the most studied and has been associated with renal function impairment and vascular damage. Bisphenol A (BPA) is a molecule with structural similarity with phenols found in plastic food and beverage containers as well as in some dialyzers. BPA is considered an environmental toxicant based on animal and cell culture studies. Japanese authorities recently banned BPA use in baby bottles based on observational association studies in newborns. BPA is excreted in urine and uremic patients present higher serum levels, but there is insufficient evidence to set cut-off levels or to link BPA to any harmful effect in CKD. However, the renal elimination and potential exposure during dialysis warrant the monitoring of BPA exposure and the design of observational studies in which the potential health risks of BPA for end-stage renal disease patients are evaluated. PMID:23997953

González-Parra, Emilio; Herrero, Jose Antonio; Elewa, Usama; Bosch, Ricardo J; Arduán, Alberto Ortiz; Egido, Jesus

2013-01-01

371

Chronic Granulomatous Disease: The European Experience  

PubMed Central

CGD is an immunodeficiency caused by deletions or mutations in genes that encode subunits of the leukocyte NADPH oxidase complex. Normally, assembly of the NADPH oxidase complex in phagosomes of certain phagocytic cells leads to a “respiratory burst”, essential for the clearance of phagocytosed micro-organisms. CGD patients lack this mechanism, which leads to life-threatening infections and granuloma formation. However, a clear picture of the clinical course of CGD is hampered by its low prevalence (?1?250,000). Therefore, extensive clinical data from 429 European patients were collected and analyzed. Of these patients 351 were males and 78 were females. X-linked (XL) CGD (gp91phox deficient) accounted for 67% of the cases, autosomal recessive (AR) inheritance for 33%. AR-CGD was diagnosed later in life, and the mean survival time was significantly better in AR patients (49.6 years) than in XL CGD (37.8 years), suggesting a milder disease course in AR patients. The disease manifested itself most frequently in the lungs (66% of patients), skin (53%), lymph nodes (50%), gastrointestinal tract (48%) and liver (32%). The most frequently cultured micro-organisms per episode were Staphylococcus aureus (30%), Aspergillus spp. (26%), and Salmonella spp. (16%). Surprisingly, Pseudomonas spp. (2%) and Burkholderia cepacia (<1%) were found only sporadically. Lesions induced by inoculation with BCG occurred in 8% of the patients. Only 71% of the patients received antibiotic maintenance therapy, and 53% antifungal prophylaxis. 33% were treated with ?-interferon. 24 patients (6%) had received a stem cell transplantation. The most prominent reason of death was pneumonia and pulmonary abscess (18/84 cases), septicemia (16/84) and brain abscess (4/84). These data provide further insight in the clinical course of CGD in Europe and hopefully can help to increase awareness and optimize the treatment of these patients. PMID:19381301

van den Berg, J. Merlijn; van Koppen, Elsbeth; Ahlin, Anders; Belohradsky, Bernd H.; Bernatowska, Ewa; Corbeel, Lucien; Espanol, Teresa; Fischer, Alain; Kurenko-Deptuch, Magdalena; Mouy, Richard; Petropoulou, Theoni; Roesler, Joachim; Seger, Reinhard; Stasia, Marie-Jose; Valerius, Niels H.; Weening, Ron S.; Wolach, Baruch; Roos, Dirk; Kuijpers, Taco W.

2009-01-01

372

Recurrent eosinophilic cystitis in a child with chronic granulomatous disease.  

PubMed

Eosinophilic cystitis is an uncommon disease in children, and its association with chronic granulomatous disease (CGD) has been previously reported in only five patients. In all those patients the disease showed either a self-limited benign course or a rapid response to corticosteroid treatment. The authors describe a child with X-linked CGD who developed eosinophilic cystitis with a recurrent course and difficult therapeutic management. The authors also discuss the pathogenesis of granuloma formation in CGD and review the literature for current therapies for these complications. PMID:15125617

Barese, Cecilia N; Podestá, Miguel; Litvak, Edith; Villa, Mariana; Rivas, Eva María

2004-03-01

373

Oxysterols in the pathogenesis of major chronic diseases?  

PubMed Central

Pathological accumulation of 27-carbon intermediates or end-products of cholesterol metabolism, named oxysterols, may contribute to the onset and especially to the development of major chronic diseases in which inflammation, but also oxidative damage and to a certain extent cell death, are hallmarks and primary mechanisms of progression. Indeed, certain oxysterols exercise strong pro-oxidant and pro-inflammatory effects at concentrations detectable in the lesions typical of atherosclerosis, neurodegenerative diseases, inflammatory bowel diseases, age-related macular degeneration, and other pathological conditions characterized by altered cholesterol uptake and/or metabolism. PMID:24024145

Poli, Giuseppe; Biasi, Fiorella; Leonarduzzi, Gabriella

2013-01-01

374

Chronic kidney disease of unknown aetiology in Sri Lanka: is cadmium a likely cause?  

Microsoft Academic Search

Background  The rising prevalence of chronic kidney disease (CKD) and subsequent end stage renal failure necessitating renal replacement\\u000a therapy has profound consequences for affected individuals and health care resources. This community based study was conducted\\u000a to identify potential predictors of microalbuminuria in a randomly selected sample of adults from the North Central Province\\u000a (NCP) of Sri Lanka, where the burden of

Kamani P Wanigasuriya; Roshini J Peiris-John; Rajitha Wickremasinghe

2011-01-01

375

Hepatitis C in patients with chronic kidney disease: Course and management  

Microsoft Academic Search

The prevalence of chronic hepatitis C (CHC) is significantly higher in patients with end-stage renal disease undergoing hemodialysis\\u000a than in the general population. CHC adversely affects survival in patients on hemodialysis and those who have undergone renal\\u000a transplantation (RT); routine screening for hepatitis C virus infection is recommended for both groups. Treatment of CHC in\\u000a post-RT patients and those undergoing

Charles S. Whang; Ke-Qin Hu

2007-01-01

376

A retrospective study of clinical signs and epidemiology of chronic valve disease in a group of 207 Dachshunds in Poland  

PubMed Central

Background Chronic mitral valve disease is frequently seen in the Dachshund. Dachshunds (n=207) made up 11.73% of the dogs admitted to the Cardiology Service at the Small Animal Clinic, Warsaw University of Life Sciences, Poland (first visits only). Results Of these, 35 dogs had no clinically detectable heart disease while 172 had chronic valve disease with the mitral valve affected most often (130 dogs), both mitral and tricuspid valves infrequently (39 dogs) and rarely the tricuspid valve (3 dogs). Males were affected more frequently than females and the average age of dogs with chronic valve disease was 11.9 years for females and 11.3 years for males. A majority of the diseased Dachshunds were classified as ISACHC 2 (79), followed by ISACHC 1 (60). Most frequent clinical signs noted by owners included coughing, exercise intolerance, dyspnea and tachypnea. Heart murmurs were generally louder with increased disease severity; however there were 20 dogs in the ISACHC 1 group with no audible heart murmurs. The most frequent electrocardiographic abnormalities included an increased P wave and QRS complex duration, increased R wave amplitude and tachycardia. With increased disease severity, echocardiography revealed an increase in heart size. A higher ISACHC class was related to increased heart size (based on echocardiography) and increased percentage of patients exhibiting enlargement of both left atrium and left ventricle (based on radiography). Conclusions The Dachshund is often affected by chronic mitral valvular disease with a late onset of associated clinical signs and few cardiac complications. PMID:23844824

2013-01-01

377

An integrated advanced communication and coaching platform for enabling personalized management of chronic cardiovascular diseases.  

PubMed

Chronic cardiovascular diseases directly account for millions of deaths, billions of Euros and a big number of disabilities affecting the world's population. Even though primary and secondary prevention factors are well known, the awareness and the concern of citizens and patients is not big enough to cause a significant change in lifestyle that modifies the increasing trends. Patients and families, professionals and healthcare systems are not prepared to fight against this burden in an effective and aligned way. Some disease management programmes based on ICT solutions have and are currently being tested around the world but their relative impaction has been very limited. This paper proposes a new turn into Personal Health Systems applied to chronic disease management by increasing the capabilities for personalization, providing the patients with motivation and coaching support and enabling the work of the professionals with intelligent tools for strategic and clinical decision making based on the newest medical evidence. PMID:22254620

Meneu, Teresa; Martínez-Romero, Álvaro; Martínez-Millana, Antonio; Guillén, Sergio

2011-01-01

378

Role of kidney biomarkers of chronic kidney disease: An update  

PubMed Central

Chronic kidney disease (CKD) is a progressive pathological condition marked by deteriorating renal function over time. Diagnostic of kidney disease depend on serum creatinine level and glomerular filtration rate which is detectable when kidney function become half. The detection of kidney damage in an early stage needs robust biomarkers. Biomarkers allow monitoring the disease progression at initial stages of disease. On the onset of impairment in cellular organization there is perturbation in signaling molecules which are either up-regulated or down-regulated and act as an indicator or biomarker of diseased stage. This review compiled the cell signaling of different kidney biomarkers associated with the onset of chronic kidney diseases. Delay in diagnosis of CKD will cause deterioration of nephron function which leads to End stage renal disease and at that point patients require dialysis or kidney transplant. Detailed information on the complex network in signaling pathway leading to a coordinated pattern of gene expression and regulation in CKD will undoubtedly provide important clues to develop novel prognostic and therapeutic strategies for CKD. PMID:25183938

Khan, Zeba; Pandey, Manoj

2014-01-01

379

Etiology of hyperparathyroidism and bone disease during chronic hemodialysis  

PubMed Central

The present study was prompted by the observation that, in patients with chronic renal failure being followed at this center, renal osteodystrophy developed almost exclusively in those who were treated by chronic hemodialysis at home rather than in our center. A systematic comparison was made between the 10 patients with roentgenographic evidence of the bone disease and 18 patients without demonstrable bone disease. The two groups were similar in age, sex, nature of renal disease, and duration of dialysis. The mean duration of kidney disease was almost 2 yr longer in the patients without bone disease than in those with bone disease. Other significant differences related to where the hemodialysis was performed and to the calcium concentration in the dialysate (6.0-7.4 mg/100 ml in the hospital and 4.9-5.6 mg/100 ml at home). If the unknown factors related to where the dialysis was performed were of no consequence, the major factor contributing to the production of bone disease observed in these patients was the use of a dialysate with a calcium concentration less than 5.7 mg/100 ml. PMID:5101783

Fournier, Albert E.; Johnson, William J.; Taves, Donald R.; Beabout, John W.; Arnaud, Claude D.; Goldsmith, Ralph S.

1971-01-01

380

Role of kidney biomarkers of chronic kidney disease: An update.  

PubMed

Chronic kidney disease (CKD) is a progressive pathological condition marked by deteriorating renal function over time. Diagnostic of kidney disease depend on serum creatinine level and glomerular filtration rate which is detectable when kidney function become half. The detection of kidney damage in an early stage needs robust biomarkers. Biomarkers allow monitoring the disease progression at initial stages of disease. On the onset of impairment in cellular organization there is perturbation in signaling molecules which are either up-regulated or down-regulated and act as an indicator or biomarker of diseased stage. This review compiled the cell signaling of different kidney biomarkers associated with the onset of chronic kidney diseases. Delay in diagnosis of CKD will cause deterioration of nephron function which leads to End stage renal disease and at that point patients require dialysis or kidney transplant. Detailed information on the complex network in signaling pathway leading to a coordinated pattern of gene expression and regulation in CKD will undoubtedly provide important clues to develop novel prognostic and therapeutic strategies for CKD. PMID:25183938

Khan, Zeba; Pandey, Manoj

2014-09-01

381

Macrolide Therapy in Chronic Inflammatory Diseases  

PubMed Central

Macrolides are a group of antibiotics with a distinctive macrocyclic lactone ring combined with sugars (cladinose, desosamine). The action of macrolides is to block protein synthesis by binding to the subunit of 50S ribosome of bacteria. Prototype macrolide was erythromycin, which came into clinical practice in the 50s of the 20th century. Its antimicrobial spectrum covers the scope of the penicillins but is extended to the impact of atypical bacteria. In the 90s more drugs of this group were synthesized—they have less severe side effects than erythromycin, extended spectrum of Gram-negative bacteria. Macrolides are effective in treating mycobacterial infections especially in patients infected with HIV. It is now known that in addition to antibacterial abilities, macrolides have immunomodulatory effects—they inhibit the production of proinflammatory cytokines (TNF, IL1, 6, and 8) affect transcription factors (NF-?B) as well as costimulaton (CD 80) and adhesion molecules (ICAM). This review article focused not only on the their antimicrobial abilities but also on efficacy in the treatment of several inflammatory disorders independent of the infectious agent. Their wider use as immunomodulators requires further study, which can lead to an extension of indications for their administration. PMID:22969171

Kwiatkowska, Brygida; Maslinska, Maria

2012-01-01

382

Hydration status substantially affects chronic cerebrospinal venous insufficiency assessments  

PubMed Central

Summary We sought to determine the effect of hydration on the criteria for chronic cerebrospinal venous insufficiency (CCSVI), a proposed hypothesis for the etiology of multiple sclerosis (MS). Sixteen subjects (11 MS and 5 controls) were asked to fast overnight. The following morning, 2 CCSVI ultrasound examinations were performed: 1 in the mildly dehydrated state, and another 30–45 minutes after rehydrating with 1.5 L of Gatorade. Seven subjects fulfilled CCSVI criteria in the dehydrated state. Of these, 5 (71%) no longer fulfilled CCSVI criteria after rehydration. One additional subject met CCSVI criteria only after rehydration. Hydration status has a substantial effect on CCSVI criteria, suggesting that the sonographic findings of CCSVI may represent a physiologic rather than pathologic state. PMID:24175155

Diaconu, Claudiu I.; Fox, Robert J.; Grattan, Alia; Rae-Grant, Alexander; Lu, Mei; Gornik, Heather L.

2013-01-01

383

Advances in geroscience: impact on healthspan and chronic disease.  

PubMed

Population aging is unprecedented, without parallel in human history, and the 21st century will witness even more rapid aging than did the century just past. Improvements in public health and medicine are having a profound effect on population demographics worldwide. By 2017, there will be more people over the age of 65 than under age 5, and by 2050, two billion of the estimated nine billion people on Earth will be older than 60 (http://unfpa.org/ageingreport/). Although we can reasonably expect to live longer today than past generations did, the age-related disease burden we will have to confront has not changed. With the proportion of older people among the global population being now higher than at any time in history and still expanding, maintaining health into old age (or healthspan) has become a new and urgent frontier for modern medicine. Geroscience is a cross-disciplinary field focused on understanding the relationships between the processes of aging and age-related chronic diseases. On October 30-31, 2013, the trans-National Institutes of Health GeroScience Interest Group hosted a Summit to promote collaborations between the aging and chronic disease research communities with the goal of developing innovative strategies to improve healthspan and reduce the burden of chronic disease. PMID:24833579

Burch, John B; Augustine, Alison Deckhut; Frieden, Leslie A; Hadley, Evan; Howcroft, T Kevin; Johnson, Ron; Khalsa, Partap S; Kohanski, Ronald A; Li, Xiao Ling; Macchiarini, Francesca; Niederehe, George; Oh, Young S; Pawlyk, Aaron C; Rodriguez, Henry; Rowland, Julia H; Shen, Grace L; Sierra, Felipe; Wise, Bradley C

2014-06-01

384

Use of a Soluble Epoxide Hydrolase Inhibitor in Smoke-Induced Chronic Obstructive Pulmonary Disease  

E-print Network

Use of a Soluble Epoxide Hydrolase Inhibitor in Smoke-Induced Chronic Obstructive Pulmonary Disease Tobacco smoke-induced chronic obstructive pulmonary disease (COPD) is a prolonged inflammatory condition; anti-inflammatory agents; airway obstruction Chronic obstructive pulmonary disease (COPD) is a major

Hammock, Bruce D.

385

Chronic hypoxia does not affect guinea pig skeletal muscle capillarity.  

PubMed

The soleus and gastrocnemius muscles of chronically hypoxic guinea pigs were analyzed for capillary supply and myoglobin concentration. Weanling male guinea pigs were exposed to a simulated altitude of 5,100 m and an average ambient temperature of 22% C for 2, 4, 6, 10 and 14 weeks (range of BW 244--965 g). The soleus and gastrocnemius-plantaris muscles of one leg were analyzed for myoglobin concentration while the soleus and medial head of the gastrocnemius of the contralateral leg were cut at the midpoint, frozen and sectioned in a cryostat. The myosin ATPase method was used to visualize fibers and capillaries. Values of muscle weight, fiber cross sectional area, capillary density, capillary to fiber ratio and the number of capillaries around the fiber were compared to the values of the same parameters from normoxic guinea pigs selected to match the average body weights of the hypoxic animals. The growth rates of the two groups were not different. No significant differences in the regression lines for the normoxic and hypoxic animals were found so that when the data were combined no significant differences in the normoxic lines were introduced by adding the values of the hypoxic animals. The myoglobin values were significantly higher only in the hypoxic soleus after 14 weeks of exposure. PMID:7191962

Sillau, A H; Aquin, L; Bui, M V; Banchero, N

1980-07-01

386

Competing Risk Factor Analysis of End-Stage Renal Disease and Mortality in Chronic Kidney Disease  

Microsoft Academic Search

Background: Death and dialysis are competing outcomes in patients with chronic kidney disease (CKD). The factors associated with end-stage renal disease (ESRD) versus death in this population are unknown. The purpose of our study was to evaluate the competing risk of ESRD versus mortality and to evaluate the risk factors associated with these two outcomes. Methods: We prospectively recruited 220

Rajiv Agarwal; Zerihun Bunaye; Dagim M. Bekele; Robert P. Light

2008-01-01

387

Nonalcoholic fatty liver disease predicts chronic kidney disease in nonhypertensive and nondiabetic Korean men  

Microsoft Academic Search

In the absence of significant research, we performed a prospective study to examine the association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD). The study cohort comprised a total of 8329 healthy men, with normal baseline kidney functions and no proteinuria, working in a semiconductor manufacturing company and its 13 affiliates. Alcohol intake was assessed with a

Yoosoo Chang; Seungho Ryu; Eunju Sung; Hee-Yeon Woo; Eunock Oh; Kyungsoo Cha; Eunmi Jung; Won Sool Kim

2008-01-01

388

Experiences from an interprofessional student-assisted chronic disease clinic.  

PubMed

Abstract Faced with significant health and workforce challenges in the region, the Central Queensland Health Service District (CQHSD) commenced a student-assisted clinical service. The Capricornia Allied Health Partnership (CAHP) is an interprofessional clinical placement program in which pre-entry students from exercise physiology, nutrition and dietetics, occupational therapy, pharmacy, podiatry and social work are embedded in a collaborative chronic disease service delivery model. The model coordinates multiple student clinical placements to: address service delivery gaps for previously underserved people with chronic disease in need of early intervention and management; provide an attractive clinical placement opportunity for students that will potentially lead to future recruitment success, and demonstrate leadership in developing future health workforce trainees to attain appropriate levels of interprofessional capacity. The CAHP clinic commenced student placements and client services in February 2010. This report provides early evaluative information regarding student experiences included self-reported changes in practice. PMID:24841001

Frakes, Kerrie-Anne; Brownie, Sharon; Davies, Lauren; Thomas, Janelle; Miller, Mary-Ellen; Tyack, Zephanie

2014-11-01

389

Sexual and gonadal dysfunction in chronic kidney disease: Pathophysiology  

PubMed Central

Sexual and gonadal dysfunction/infertility are quite common in patients with chronic kidney disease. Forty percent of male and 55% of female dialysis patients do not achieve orgasm. The pathophysiology of gonadal dysfunction is multifactorial. It is usually a combination of psychological, physiological, and other comorbid factors. Erectile dysfunction in males is mainly due to arterial factors, venous leakage, psychological factors, neurogenic factors, endocrine factors, and drugs. Sexual dysfunction in females is mainly due to hormonal factors and manifests mainly as menstrual irregularities, amenorrhea, lack of vaginal lubrication, and failure to conceive. Treatment of gonadal dysfunction in chronic kidney disease is multipronged and an exact understanding of underlying pathology is essential in proper management of these patients. PMID:22470857

Rathi, Manish; Ramachandran, Raja

2012-01-01

390

IL6 in autoimmune disease and chronic inflammatory proliferative disease  

Microsoft Academic Search

Interleukin 6 (IL-6), which was originally identified as a B-cell differentiation factor, is now known to be a multifunctional cytokine that regulates the immune response, hematopoiesis, the acute phase response, and inflammation. Deregulation of IL-6 production is implicated in the pathology of several disease processes. The expression of constitutively high levels of IL-6 in transgenic mice results in fatal plasmacytosis,

Katsuhiko Ishihara; Toshio Hirano

2002-01-01

391

Prophylactic antibiotic therapy in chronic obstructive pulmonary disease.  

PubMed

CLINICAL QUESTION Is prophylactic antibiotic treatment associated with fewer exacerbations or improved health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD)? BOTTOM LINE Continuous macrolide antibiotic use for prophylaxis was associated with a clinically significant reduction in COPD exacerbations. Pulsed antibiotic use was not associated with benefit. Continuous and pulsed antibiotics were associated with improved HRQOL, but this was not clinically significant. PMID:24893090

Herath, Samantha C; Poole, Phillippa

2014-06-01

392

Risk factors in chronic obstructive pulmonary disease (COPD).  

PubMed

In a genetic-epidemiologic study of chronic obstructive pulmonary disease (COPD) observations adjusted for age, sex, race, and smoking indicate certain factors to be associated with increased pulmonary function aberrancy, and suggest that they are risk factors for COPD. These presumptive "risk factors" include not only cigarette smoking, but also alpha1-antitrypsin (Pi system) variation, one or more other familial components, low socioeconomic status (SES), and, in whites, ABO blood type (either absence of "B" or presence of "A"). PMID:300564

Cohen, B H; Ball, W C; Brashears, S; Diamond, E L; Kreiss, P; Levy, D A; Menkes, H A; Permutt, S; Tockman, M S

1977-03-01

393

Positive Association between Plasma Homocysteine Level and Chronic Kidney Disease  

Microsoft Academic Search

Background: Increasing experimental evidence, including recently developed animal models, supports a role for homocysteine in the development of chronic kidney disease (CKD). However, relatively few clinical\\/epidemiological studies have examined this hypothesis in humans. We examined the relationship between plasma homocysteine level and CKD in a population-based study of older Australians. Methods: Community-based study (1992–1994) among 2,609 individuals (58.6% women), aged

Anoop Shankar; Jie Jin Wang; Brian Chua; Elena Rochtchina; Vicki Flood; Paul Mitchell

2008-01-01

394

The central nervous system in childhood chronic kidney disease  

Microsoft Academic Search

Neurodevelopmental deficits in pediatric and adult survivors of childhood onset chronic kidney disease (CKD) have been documented\\u000a for many years. This paper reviews the available literature on central nervous system involvement incurred in childhood CKD.\\u000a The studies reviewed include recent work in neuroimaging, electrophysiology, and neuropsychology, along with commentary on\\u000a school functioning and long-term outcomes. The paper concludes with suggestions

Debbie S. Gipson; Peter J. Duquette; Phil F. Icard; Stephen R. Hooper

2007-01-01

395

Chronic graft-versus-host disease complicated by nephrotic syndrome  

Microsoft Academic Search

Chronic graft-versus-host disease (cGVHD) is one of the most frequent and serious complications of allogeneic hematopoietic stem cell transplantation (HSCT). Nephrotic syndrome (NS) is an uncommon and underrecognized manifestation of cGVHD. We report a patient who developed NS 18 months after allogeneic bone marrow transplantation. The onset of NS was accompanied by active manifestations of cGVHD, and immunosuppressants had not

Hsin-Hui Wang; An-Hang Yang; Ling-Yu Yang; Giun-Yi Hung; Jei-Wen Chang; Chun-Kai Wang; Tzong-Yann Lee; Ren-Bin Tang

2011-01-01

396

Smell and taste function in children with chronic kidney disease  

Microsoft Academic Search

Loss of appetite and poor growth are common in children with chronic kidney disease (CKD), and changes in smell and\\/or taste\\u000a function may be responsible, but the hypothesis has not been proven. This aims of this prospective age- and gender-controlled\\u000a study were to determine whether: (1) changes in smell and taste function occur in children with CKD; (2) smell or

Jessica E. Armstrong; David G. Laing; Fiona J. Wilkes; Gad Kainer

2010-01-01

397

An introduction to biomarkers: applications to chronic kidney disease  

Microsoft Academic Search

Diagnosis and management of chronic kidney disease (CKD) will be characterized in the future by an increasing use of biomarkers—quantitative\\u000a indicators of biologic or pathologic processes that vary continuously with progression of the process. “Classical” biomarkers\\u000a of CKD progression include quantitative proteinuria, the percentage of sclerotic glomeruli or fractional interstitial fibrosis.\\u000a New candidate biomarkers (e.g., urinary proteomic patterns) are being

Kevin V. Lemley

2007-01-01

398

[Echocardiographic diagnosis of pulmonary hypertension in chronic lung diseases].  

PubMed

For the time between 1985 and 1990 we found in the literature 14 reports on 483 patients with chronic lung diseases and 140 healthy controls which were investigated by right ventricular catheter and echocardiographic methods. The critical review about ability of echocardiography to recognise the pulmonary hypertension secondary to chronic lung diseases shows following results: 1. Acceleration time (time to peak velocity) revealed correlations to mean or systolic pulmonary artery pressure (SPAP) of -0.72 to -0.92. The sample volume of pulsed Doppler should be taken near the pulmonary valve and in the middle of pulmonary artery diameter. Correction of acceleration time by heart frequency is necessary in children (Akiba). 2. Tricuspid regurgitation to SPAP: r = 0.65-0.92, but sensitivity to recognise pulmonary hypertension was only 20 (to 91)%. Accurate quantitative measurement is possible only in 24 to 66% of the patients with chronic lung diseases. 3. Isovolemic relaxation time: r = 0.70-0.89, limitations by some cardiac influences--but also the ability to reflect effects of medication (Hatle). 4. End-diastolic diameter of tricuspid valve/m2 of body surface: r = 0.84, in connection with right ventricular end-diastolic diameter r = 0.90. Diameters of pulmonary valve, of right pulmonary artery, of right ventricle and characteristics of the flow in the Vena cava inferior have a smaller diagnostic value. Thickness of right ventricular systolic time intervals are without reliable informations about pulmonary hypertension. In conclusion there are some echocardiographic parameters with high diagnostic value in the noninvasive diagnostic of pulmonary hypertension secondary to chronic pulmonary diseases. A table of practicable values and regression equations completes this review. PMID:1579562

Paditz, E

1992-04-01

399

Memory and Executive Functions in Pediatric Chronic Kidney Disease  

Microsoft Academic Search

This study examined the memory and executive functioning of children and adolescents with chronic kidney disease (CKD). The sample included 20 children and adolescents with CKD ranging in age from 7.50 to 19.04 years (M = 13.41, SD = 3.20). Intellectual function for the group was within the low average to average range (M = 89.32, SD = 14.80). Of

Debbie S. Gipson; Stephen R. Hooper; Peter J. Duquette; Crista E. Wetherington; Kurt K. Stellwagen; Tonya L. Jenkins; Maria E. Ferris

2006-01-01

400

A stepwise approach for effective management of chronic pain in autosomal-dominant polycystic kidney disease.  

PubMed

Chronic pain, defined as pain existing for >4-6 weeks, affects >60% of patients with autosomal-dominant polycystic disease (ADPKD). It can have various causes, indirectly or directly related to the increase in kidney and liver volume in these patients. Chronic pain in ADPKD patients is often severe, impacting physical activity and social relationships, and frequently difficult to manage. This review provides an overview of pathophysiological mechanisms that can lead to pain and discusses the sensory innervation of the kidneys and the upper abdominal organs, including the liver. In addition, the results of a systematic literature search of ADPKD-specific treatment options are presented. Based on pathophysiological knowledge and evidence derived from the literature an argumentative stepwise approach for effective management of chronic pain in ADPKD is proposed. PMID:25165181

Casteleijn, Niek F; Visser, Folkert W; Drenth, Joost P H; Gevers, Tom J G; Groen, Gerbrand J; Hogan, Marie C; Gansevoort, Ron T

2014-09-01

401

RAGE: a new frontier in chronic airways disease  

PubMed Central

Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous inflammatory disorders of the respiratory tract characterized by airflow obstruction. It is now clear that the environmental factors that drive airway pathology in asthma and COPD, including allergens, viruses, ozone and cigarette smoke, activate innate immune receptors known as pattern-recognition receptors, either directly or indirectly by causing the release of endogenous ligands. Thus, there is now intense research activity focused around understanding the mechanisms by which pattern-recognition receptors sustain the airway inflammatory response, and how these mechanisms might be targeted therapeutically. One pattern-recognition receptor that has recently come to attention in chronic airways disease is the receptor for advanced glycation end products (RAGE). RAGE is a member of the immunoglobulin superfamily of cell surface receptors that recognizes pathogen- and host-derived endogenous ligands to initiate the immune response to tissue injury, infection and inflammation. Although the role of RAGE in lung physiology and pathophysiology is not well understood, recent genome-wide association studies have linked RAGE gene polymorphisms with airflow obstruction. In addition, accumulating data from animal and clinical investigations reveal increased expression of RAGE and its ligands, together with reduced expression of soluble RAGE, an endogenous inhibitor of RAGE signalling, in chronic airways disease. In this review, we discuss recent studies of the ligand–RAGE axis in asthma and COPD, highlight important areas for future research and discuss how this axis might potentially be harnessed for therapeutic benefit in these conditions. PMID:22506507

Sukkar, Maria B; Ullah, Md Ashik; Gan, Wan Jun; Wark, Peter AB; Chung, Kian Fan; Hughes, J Margaret; Armour, Carol L; Phipps, Simon

2012-01-01

402

The Case for Chronic Disease Management for Addiction  

PubMed Central

Chronic disease (care) management (CDM) is a patient-centered model of care that involves longitudinal care delivery; integrated, and coordinated primary medical and specialty care; patient and clinician education; explicit evidence-based care plans; and expert care availability. The model, incorporating mental health and specialty addiction care, holds promise for improving care for patients with substance dependence who often receive no care or fragmented ineffective care. We describe a CDM model for substance dependence and discuss a conceptual framework, the extensive current evidence for component elements, and a promising strategy to reorganize primary and specialty health care to facilitate access for people with substance dependence. The CDM model goes beyond integrated case management by a professional, colocation of services, and integrated medical and addiction care—elements that individually can improve outcomes. Supporting evidence is presented that: 1) substance dependence is a chronic disease requiring longitudinal care, although most patients with addictions receive no treatment (eg, detoxification only) or short-term interventions, and 2) for other chronic diseases requiring longitudinal care (eg, diabetes, congestive heart failure), CDM has been proven effective. PMID:19809579

Saitz, Richard; Larson, Mary Jo; LaBelle, Colleen; Richardson, Jessica; Samet, Jeffrey H.

2009-01-01

403

[Erythrocyte changes during alcoholism and chronic liver diseases].  

PubMed

50 patients with chronic liver disease and/or alcoholism were studied. 28 cases of anemia were found and macrocytes (and target m.), spurr-cells, spherocytes and stomatocytes observed. For each of these abnormalities the authors report the observed incidence and discuss the literature's data about the pathogenesis. A personal research on the influence of the liver's impaired capability of protein synthesis was also carried out. The usefulness of a careful examination of the blood film is finally stressed, in patients with liver disease and to discover alcoholic subjects still "healthy". PMID:756712

Triolo, L; Magris, D; Mian, G; D'Agnolo, B

1978-01-01

404

Prevalence of chronic kidney disease in the Japanese general population  

Microsoft Academic Search

Background  We previously estimated the prevalence of chronic kidney disease (CKD) stages 3–5 at 19.1 million based on data from the Japanese\\u000a annual health check program for 2000–2004 using the Modification of Diet in Renal Disease (MDRD) equation multiplied by the\\u000a coefficient 0.881 for the Japanese population. However, this equation underestimates the GFR, particularly for glomerular\\u000a filtration rates (GFRs) of over 60 ml\\/min\\/1.73 m2.

Enyu Imai; Masaru Horio; Tsuyoshi Watanabe; Kunitoshi Iseki; Kunihiro Yamagata; Shigeko Hara; Nobuyuki Ura; Yutaka Kiyohara; Toshiki Moriyama; Yasuhiro Ando; Shoichi Fujimoto; Tsuneo Konta; Hitoshi Yokoyama; Hirofumi Makino; Akira Hishida; Seiichi Matsuo

2009-01-01

405

T-cell characterization in chronic allergic eye disease.  

PubMed

Chronic allergic eye disease encompasses several disorders, but it is vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) that have sight-threatening sequelae. T cells, eosinophils, and mast cells are all found in the conjunctiva, and are thought to play a role in disease pathogenesis. Recently, the conjunctival epithelium has also been considered to play a key role. New and effective therapeutic strategies for the future for these patients depend on achieving a greater understanding of the roles and interactions of the cell populations in these sight-threatening disorders. PMID:12791216

Zhan, Hong; Calder, Virginia; Lightman, Susan

2003-07-01

406

Management of atrial fibrillation in chronic kidney disease: double trouble.  

PubMed

Chronic kidney disease (CKD) has a very well-established link with cardiovascular disease. Below stage 3 CKD (glomerular filtration rate <60 mL/min), there is a progressive increase in both total mortality and cardiovascular-specific mortality as kidney function declines; indeed, it is more likely for a patient with CKD stage 3 to die of cardiovascular disease than to progress to CKD stage 4 and beyond. Arrhythmia is particularly common in patients with CKD. Depending on the study and measurement used, the prevalence of patients with CKD with chronic atrial fibrillation (AF) is quoted at 7% to 18%, rising to 12% to 25% for those older than 70 years. These rates are up to 2 to 3 times higher than in the general population. Of all patients with AF, 10% to 15% will have CKD. However, not all standard rate and rhythm methods are suitable for this population and those that are tend to be less effective. Meanwhile, anticoagulation has long been a thorny subject, with much conflicting evidence around the balance between bleeding and stroke risk. To help clarify this, we first highlight the challenges of performing evidence-based medicine in the patient with renal disease, and then review recent and emerging research to suggest an approach to the management of patients with renal disease who have AF. We also review the potential role of the different new oral anticoagulant drugs in CKD. PMID:23895805

Nimmo, Camus; Wright, Matthew; Goldsmith, David

2013-08-01

407

BEYOND GENETICS: EPIGENETIC CODE IN CHRONIC KIDNEY DISEASE  

PubMed Central

Epigenetics refers to a heritable change in the pattern of gene expression that is mediated by a mechanism specifically not due to alterations in the primary nucleotide sequence. Well known epigenetic mechanisms encompass DNA methylation, chromatin remodeling (histone modifications) and RNA interference. Functionally, epigenetics provides an extra layer of transcriptional control and plays a crucial role in normal physiological development, as well as in pathological conditions. Aberrant DNA methylation is implicated in immune dysfunction, inflammation and insulin resistance. Epigenetic changes may be responsible for “metabolic memory” and development of micro- and macrovascular complications of diabetes. MicroRNAs are critical in the maintenance of glomerular homeostasis and hence RNA interference may be important in the progression of renal disease. Recent studies have shown that epigenetic modifications orchestrate the epithelial-mesenchymal transition and eventually fibrosis of the renal tissue. Oxidative stress, inflammation, hyperhomocysteinemia and uremic toxins could induce epimutations in chronic kidney disease. Epigenetic alterations are associated with inflammation and cardiovascular disease in patients with chronic kidney disease. Reversible nature of the epigenetic changes gives an unique opportunity to halt or even reverse the disease process through targeted therapeutic strategies. PMID:20881938

Dwivedi, Rama S.; Herman, James G.; McCaffrey, Timothy; Raj, Dominic SC

2013-01-01

408

Chronic disease surveillance systems within the US Associated Pacific Island jurisdictions.  

PubMed

In recent years, illness and death due to chronic disease in the US Associated Pacific Islands (USAPI) jurisdictions have dramatically increased. Effective chronic disease surveillance can help monitor disease trends, evaluate public policy, prioritize resource allocation, and guide program planning, evaluation, and research. Although chronic disease surveillance is being conducted in the USAPI, no recently published capacity assessments for chronic disease surveillance are available. The objective of this study was to assess the quality of existing USAPI chronic disease data sources and identify jurisdictional capacity for chronic disease surveillance. The assessment included a chronic disease data source inventory, literature review, and review of surveillance documentation available from the web or through individual jurisdictions. We used the World Health Organization's Health Metric Network Framework to assess data source quality and to identify jurisdictional capacity. Results showed that USAPI data sources are generally aligned with widely accepted chronic disease surveillance indicators and use standardized data collection methodology to measure chronic disease behavioral risks, preventive practices, illness, and death. However, all jurisdictions need to strengthen chronic disease surveillance through continued assessment and expanded support for valid and reliable data collection, analysis and reporting, dissemination, and integration among population-based and institution-based data sources. For sustained improvement, we recommend investment and technical assistance in support of a chronic disease surveillance system that integrates population-based and institution-based data sources. An integrated strategy that bridges and links USAPI data sources can support evidence-based policy and population health interventions. PMID:21672410

Hosey, Gwen; Ichiho, Henry; Satterfield, Dawn; Dankwa-Mullan, Irene; Kuartei, Stevenson; Rhee, Kyu; Belyeu-Camacho, Tayna; deBrum, Ione; Demei, Yorah; Lippwe, Kipier; Luces, Patrick Solidum; Roby, Faiese

2011-07-01

409

[Influence of early stage of chronic renal disease on risk of cardiac diseases and stroke].  

PubMed

Cardiovascular diseases are the main cause of death among people with kidney diseases. The early stage of chronic kidney disease, with mild decrease of glomerular filtration rate (GFR) and small increase of creatinine concentration in serum and/or occurrence of microalbuminuria, is related to the increase of cardiovascular morbidity and mortality. Kidney insufficiency is also independently connected with the risk of stroke. Patients with early stage of kidney insufficiency should be qualified as those in a cardiovascular high risk group. PMID:16969907

Szkó?ka, Tomasz; My?liwiec, Michal

2006-01-01

410

Inhaled nitric oxide in chronic obstructive lung disease  

SciTech Connect

During an investigation of the effect of nitric oxide on the pulmonary circulation the authors had the opportunity to give nitric oxide to a patient with longstanding obstructive airway disease, with successful results. A 72-year-old man with chronic obstructive pulmonary disease was referred to the institution for assessment of pulmonary vascular reactivity to acetylcholine and nitric oxide. Acetylcholine was infused into the main pulmonary artery followed 15 min later by an inhalation of 80 parts per million (ppm) nitric oxide. Heart rate and systemic arterial and pulmonary arterial pressures were continuously monitored. Throughout the study the inspired oxygen concentration was kept constant at 98%. Nitrogen dioxide and nitric oxide concentrations were monitored while nitric oxide was delivered. The infusion of acetylcholine resulted in a small increase in pulmonary artery pressure and pulmonary vascular resistance. Nitric oxide produced a substantial fall in pulmonary artery pressure and pulmonary vascular resistance with a concomitant increase in systemic arterial oxygen tension. These results suggest that endothelium-dependent relaxation of the pulmonary vasculature was impaired in the patient and that exogenous nitric oxide was an effective pulmonary vasodilator. In-vitro investigation of explanted airways disease suggests not only that endothelium-dependent pulmonary artery relaxation is impaired but also that the dysfunction is related to pre-existing hypoxemia and hypercapnia. Nitric oxide inhibits proliferation of cultured vascular smooth muscle cells and might alter the pulmonary vascular remodeling characteristic of patients with chronic obstructive airways disease.

Tiihonen, J.; Hakola, P.; Paanila, J.; Turtiainen (Univ. of Kuopio (Finland). Dept. of Forensic Psychiatry)

1993-01-30

411

Expression and Function of Methylthioadenosine Phosphorylase in Chronic Liver Disease  

PubMed Central

To study expression and function of methylthioadenosine phosphorylase (MTAP), the rate-limiting enzyme in the methionine and adenine salvage pathway, in chronic liver disease. Design MTAP expression was analyzed by qRT-PCR, Western blot and immunohistochemical analysis. Levels of MTA were determined by liquid chromatography-tandem mass spectrometry. Results MTAP was downregulated in hepatocytes in murine fibrosis models and in patients with chronic liver disease, leading to a concomitant increase in MTA levels. In contrast, activated hepatic stellate cells (HSCs) showed strong MTAP expression in cirrhotic livers. However, also MTA levels in activated HSCs were significantly higher than in hepatocytes, and there was a significant correlation between MTA levels and collagen expression in diseased human liver tissue indicating that activated HSCs significantly contribute to elevated MTA in diseased livers. MTAP suppression by siRNA resulted in increased MTA levels, NF?B activation and apoptosis resistance, while overexpression of MTAP caused the opposite effects in HSCs. The anti-apoptotic effect of low MTAP expression and high MTA levels, respectively, was mediated by induced expression of survivin, while inhibition of survivin abolished the anti-apoptotic effect of MTA on HSCs. Treatment with a DNA demethylating agent induced MTAP and reduced survivin expression, while oxidative stress reduced MTAP levels but enhanced survivin expression in HSCs. Conclusion MTAP mediated regulation of MTA links polyamine metabolism with NF?B activation and apoptosis in HSCs. MTAP and MTAP modulating mechanisms appear as promising prognostic markers and therapeutic targets for hepatic fibrosis. PMID:24324622

Czech, Barbara; Dettmer, Katja; Valletta, Daniela; Saugspier, Michael; Koch, Andreas; Stevens, Axel P.; Thasler, Wolfgang E.; Muller, Martina; Oefner, Peter J.; Bosserhoff, Anja-Katrin; Hellerbrand, Claus

2013-01-01

412

Emerging therapies for chronic kidney disease: what is their role?  

PubMed

The prevalence of chronic kidney disease (CKD) is increasing worldwide. The best therapies currently available focus on the control of blood pressure and optimization of renin-angiotensin-aldosterone system blockade. Currently available agents are only partially effective against hard end points such as the development of end-stage renal disease and are not discussed in this Review. Many other agents have been shown to reduce proteinuria and delay progression in animal models of CKD. Some of these agents, including tranilast, sulodexide, thiazolidinediones, pentoxifylline, and inhibitors of advanced glycation end-products and protein kinase C, have been tested to a limited extent in humans. A small number of randomized controlled human trials of these agents have used surrogate markers such as proteinuria as end points rather than hard end points such as end-stage renal disease or doubling of serum creatinine level. Emerging therapies that specifically target and reverse pathological hallmarks of CKD such as inflammation, fibrosis and atrophy are needed to reduce the burden of this chronic disease and its associated morbidity. This Review examines the evidence for emerging pharmacological strategies for slowing the progression of CKD. PMID:19455178

Vilayur, Eswari; Harris, David C H

2009-07-01

413

The effect of physician's recommendation on seasonal influenza immunization in children with chronic diseases  

PubMed Central

Background Despite recommendations by Health Authorities, influenza immunization coverage remains low in children with chronic diseases. Different medical providers involved in the management of children with chronic conditions may affect the pattern of influenza vaccine recommendations and coverage. The likelihood of vaccination by type of provider in children with chronic conditions is poorly understood. Therefore, the objectives of this study were to analyze the pattern and the effect of recommendations for seasonal influenza immunization provided by different physician profiles to families of children with chronic diseases and to measure the frequency of immunization in the study population. Methods We recruited children with chronic diseases aged 6 months–18 years who subsequently presented to specialty clinics for routine follow-up visits, during spring 2009, in three Italian Regions Families of children with chronic diseases were interviewed during routine visits at reference centers through a face-to-face interview. We analyzed the following immunization predictors: having received a recommendation toward influenza immunization by a health provider; child’s sex and age; mothers and fathers’ age; parental education and employment; underlying child’s disease; number of contacts with health providers in the previous year. Influenza immunization coverage was calculated as the proportion of children who received at least one dose of seasonal influenza vaccine in the previous season. We calculated prevalence ratios and we used a generalized linear model with Poisson family, log link and robust error variance to assess the effect of socio-demographic variables, underlying diseases, and recommendations provided by physicians on influenza immunization. Results We enrolled 275 families of children with chronic diseases. Overall influenza coverage was 57.5%, with a low of 25% in children with neurological diseases and a high of 91.2% in those with cystic fibrosis. While 10.6% of children who did not receive any recommendation toward influenza immunization were immunized, among those who received a recommendation 87.5-94.7% did, depending on the health professional providing the recommendation. Receiving a recommendation by any provider is a strong predictor of immunization (PR?=?8.5 95% CI 4.6;15.6) Most children received an immunization recommendation by a specialty (25.8%) or a family pediatrician (23.3%) and were immunized by a family pediatrician (58.7%) or a community vaccinator (55.2%). Conclusions Receiving a specific recommendation by a physician is a strong determinant of being immunized against seasonal influenza in children with chronic diseases independently of other factors. Heterogeneity exists among children with different chronic diseases regarding influenza recommendation despite international guidelines. Increasing the frequency of appropriate recommendations toward influenza immunization by physicians is a single powerful intervention that may increase coverage in children with chronic conditions. PMID:23153092

2012-01-01

414

Chronic lead poisoning: a "forgotten" cause of renal disease.  

PubMed

Chronic lead nephropathy occurs as a result of years of lead exposure. Nowadays, with the induction of high standards for industrial hygiene, symptomatic lead intoxication has become extremely rare. We report a case of chronic lead nephropathy in a 59-year-old man who worked in a battery-recycling unit and was diagnosed with plumbism during a regular health screening few years ago. The diagnosis was suggested by the following findings: serum creatinine 160 microg/L, creatinine clearance 46 ml/min, daily urine protein excretion 0.1 g, uric acid 9.7 mg/dl, blood lead 9.2 microg/dl, and a urinary excretion of 850 microg lead/72 h after a mobilisation test by a Na2-Ca-EDTA chelating agent. Renal ultrasound showed bilateral borderline small kidneys. The kidney biopsy revealed moderate focal atrophy, loss of proximal tubules, and prominent interstitial fibrosis. The patient was prescribed angiotensin-converting-enzyme inhibitors to slow the progression of renal insufficiency and control the blood pressure. Hyperuricemia was also treated and controlled. During the regular follow-up, renal function remained stable with no proteinuria. A high index of suspicion for lead intoxication in chronic kidney disease patients should be practiced, especially in patients with hyperuricemia. Chelation of lead urinary excretion is helpful in the diagnosis of this disease. PMID:17237897

Benjelloun, Meryem; Tarrass, Faissal; Hachim, Khadija; Medkouri, Ghislaine; Benghanem, Mohamed Gharbi; Ramdani, Benyounes

2007-03-01

415

Metformin in patients with chronic kidney disease: strengths and weaknesses.  

PubMed

A wide array of benefits has been attributed to metformin. These include attenuation of abnormal glucose metabolism (diabetes treatment and prevention), weight neutrality or weight loss, improvement in the pathophysiologic components of metabolic syndrome (insulin resistance, subclinical inflammation, and endothelial dysfunction), lipid-lowering properties, cardiovascular protection, and antineoplastic potential. Metformin itself is not a nephrotoxic drug. Initially appointed as the safest hypoglycemic agent in chronic kidney disease, its use has been limited in these patients because of the perceived risk of lactic acidosis. A fear perpetuated by numerous case reports in which it is implicated. Current guidelines stipulate that it must be used with caution in estimated glomerular filtration rates (eGFRs) of less than 60 mL/minute and not at all in eGFRs of less than 30 mL/minute. Identified risk factors for metformin-associated lactic acidosis include acute kidney injury, hypoxemia, sepsis, alcohol abuse, liver failure, myocardial infarction, and shock. Treatment may include supportive care and dialysis techniques. On the other hand, it is likely that the use of metformin would be beneficial in many with chronic kidney disease according to the advantages associated with attenuation of metabolic syndrome and cardiovascular protection. The reality of severe metformin-induced lactic acidosis in the absence of chronic renal impairment raises the question of limitation of its use in these patients. PMID:22641582

Rocha, Ana; Almeida, Marta; Santos, Josefina; Carvalho, André

2013-01-01

416

Beyond Type D personality: reduced positive affect (anhedonia) predicts impaired health status in chronic heart failure  

Microsoft Academic Search

Objective  Type D personality has been associated with impaired health status in chronic heart failure (CHF), but other psychological\\u000a factors may also be important.\\u000a \\u000a \\u000a \\u000a Aim  To determine whether non-Type D patients with low positive affect and Type D patients report lower health status, compared\\u000a with non-Type D patients with high positive affect at 12-month follow-up in chronic heart failure.\\u000a \\u000a \\u000a \\u000a Methods  Consecutive CHF outpatients

Aline J. Pelle; Susanne S. Pedersen; Balázs M. Szabó; Johan Denollet

2009-01-01

417

Pathogenesis and treatment of anaemia of chronic disease.  

PubMed

Anaemia of chronic disease (ACD), the most frequent anaemia among hospitalized patients, develops under chronic inflammatory disorders such as chronic infections, cancer or autoimmune diseases. A number of different pathways contribute to ACD, such as diversion of iron traffic, a diminished erythropoiesis, a blunted response to erythropoietin, erythrophagocytosis and bone marrow invasion by tumour cells and pathogens. Nevertheless, ACD is a reflection of an activated immune system and possibly results from an innovative defence strategy of the body in order to withdraw the essential growth factor iron from invading pathogens and to increase the efficacy of cell-mediated immunity. Diagnosis of ACD can be assessed by examination of chances in serum iron parameters with low to normal serum iron, transferrin saturation and transferrin concentrations on the one hand and normal to increased ferritin, zinc protoporphyrin IX and cytokine levels on the other side. Therapy of ACD includes the cure of the underlying the disease. Apart from this transfusions for rapid correction of haemoglobin levels, and human recombinant erythropoietin for prolonged therapy are used. However, response rates to recombinant erythropoietin are sometimes low. Iron alone should be strictly avoided due to its growth-promoting effect towards micro-organisms and tumour cells and because of it capacity to inhibit T-cell-mediated immune effector pathways. We urgently need prospective clinical trials to gain knowledge about the effects of anaemia correction and/or the use of erythropoietin towards the course of the underlying disease, to find out if a combination therapy with erythropoietin and iron may be beneficial in ACD and to define therapeutic end-points. PMID:12127952

Weiss, Günter

2002-06-01

418

Is TWEAK a Biomarker for Autoimmune/Chronic Inflammatory Diseases?  

PubMed Central

The TWEAK/Fn14 pathway is now well-known for its involvement in the modulation of inflammation in various human autoimmune/chronic inflammatory diseases (AICID) including lupus, rheumatoid arthritis, and multiple sclerosis. A panel of data is now available concerning TWEAK expression in tissues or biological fluids of patients suffering from AICID, suggesting that it could be a promising biological marker in these diseases. Evidences from several teams support the hypothesis that blocking TWEAK/Fn14 pathway is an attractive new therapeutic lead in such diseases and clinical trials with anti-TWEAK-blocking antibodies are in progress. In this mini-review we discuss the potential use of TWEAK quantification in AICD management in routine practice and highlight the challenge of standardizing data collection to better estimate the clinical utility of such a biological parameter. PMID:24409182

Bertin, Daniel; Stephan, Delphine; Khrestchatisky, Michel; Desplat-Jego, Sophie

2013-01-01

419

Advances in the management of chronic obstructive pulmonary disease.  

PubMed

Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death, seems to be increasing in worldwide prevalence, and carries with it a significant health and economic burden. Smoking cessation is the only available intervention proven to halt disease progression. The authors discuss the role of the newly approved agent, varenicline, in promotion of smoking cessation. The remainder of presently available therapies treat the symptoms of COPD, but do not impact progression of disease. As the understanding of the pathogenesis of COPD improves, new targets for therapies are emerging. Given the large number of potential targets and the results of recent studies, it seems unlikely that a single new agent will result in a cure. Rather, management of COPD should involve a multi-pronged approach including smoking cessation, bronchodilators, treatment of infection, and eventual targeting of inflammatory pathways and genetic predispositions. In this article, the authors discuss presently available therapies as well as agents under development. PMID:17163804

Meinke, Laura; Chitkara, Rajinder; Krishna, Ganesh

2007-01-01

420

Biomarkers in chronic obstructive pulmonary disease: confusing or useful?  

PubMed Central

The field of biomarker research has almost reached unmanageable proportions in chronic obstructive pulmonary disease (COPD). The developments of new technology platforms have generated a huge information data base, both cross sectionally and increasingly, longitudinally. The knowledge emerging provides an enormous potential for understanding the disease pathophysiology, for developing markers specific for long-term outcomes, and for developing new therapeutic strategies. However, the excitement must be tempered with an understanding of the limitations of the data collection techniques, and of the variations in disease state, activity, impact, and progression. Nevertheless, the most crucial aspect in interpreting the current literature is the recognition of the relatively superficial characterization of what is a complex group of pathological processes with a common end point of airflow limitation. The current review explores some of these issues together with those areas where real progress appears to have been made, and provides caution on interpretation. PMID:24532968

Stockley, Robert A

2014-01-01

421

Collaborative Help in Chronic Disease Management: Supporting Individualized Problems  

PubMed Central

Coping with chronic illness disease is a long and lonely journey, because the burden of managing the illness on a daily basis is placed upon the patients themselves. In this paper, we present our findings for how diabetes patient support groups help one another find individualized strategies for managing diabetes. Through field observations of face-to-face diabetes support groups, content analysis of an online diabetes community, and interviews, we found several help interactions that are critical in helping patients in finding individualized solutions. Those are: (1) patients operationalize their experiences to easily contextualize and share executable strategies; (2) operationalization has to be done within the larger context of sharing illness trajectories; and (3) the support groups develop common understanding towards diabetes management. We further discuss how our findings translate into design implications for supporting chronic illness patients in online community settings.

Huh, Jina; Ackerman, Mark S.

2013-01-01

422

Chronic obstructive pulmonary disease in non-smokers.  

PubMed

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Tobacco smoking is established as a major risk factor, but emerging evidence suggests that other risk factors are important, especially in developing countries. An estimated 25-45% of patients with COPD have never smoked; the burden of non-smoking COPD is therefore much higher than previously believed. About 3 billion people, half the worldwide population, are exposed to smoke from biomass fuel compared with 1.01 billion people who smoke tobacco, which suggests that exposure to biomass smoke might be the biggest risk factor for COPD globally. We review the evidence for the association of COPD with biomass fuel, occupational exposure to dusts and gases, history of pulmonary tuberculosis, chronic asthma, respiratory-tract infections during childhood, outdoor air pollution, and poor socioeconomic status. PMID:19716966

Salvi, Sundeep S; Barnes, Peter J

2009-08-29

423

Hepatic inflammation and progressive liver fibrosis in chronic liver disease  

PubMed Central

Chronic liver inflammation drives hepatic fibrosis, and current immunosuppressive, anti-inflammatory, and anti-viral therapies can weaken this driver. Hepatic fibrosis is reversed, stabilized, or prevented in 57%-79% of patients by conventional treatment regimens, mainly by their anti-inflammatory actions. Responses, however, are commonly incomplete and inconsistently achieved. The fibrotic mechanisms associated with liver inflammation have been clarified, and anti-fibrotic agents promise to improve outcomes as adjunctive therapies. Hepatitis C virus and immune-mediated responses can activate hepatic stellate cells by increasing oxidative stress within hepatocytes. Angiotensin can be synthesized by activated hepatic stellate cells and promote the production of reactive oxygen species. Anti-oxidants (N-acetylcysteine, S-adenosyl-L-methionine, and vitamin E) and angiotensin inhibitors (losartin) have had anti-fibrotic actions in preliminary human studies, and they may emerge as supplemental therapies. Anti-fibrotic agents presage a new era of supplemental treatment for chronic liver disease. PMID:24627588

Czaja, Albert J

2014-01-01

424

Egr-1 Regulates Autophagy in Cigarette Smoke-Induced Chronic Obstructive Pulmonary Disease  

E-print Network

Egr-1 Regulates Autophagy in Cigarette Smoke-Induced Chronic Obstructive Pulmonary Disease Zhi obstructive pulmonary disease (COPD) is a progressive lung disease characterized by abnormal cellular-Induced Chronic Obstructive Pulmonary Disease. PLoS ONE 3(10): e3316. doi:10.1371/journal.pone.0003316 Editor

425

Clinical Implication of the Renin-angiotensin-aldosterone Blockers in Chronic Kidney Disease Undergoing Hemodialysis  

PubMed Central

The renin-angiotensin-aldosterone system (RAAS) blockers have been widely used in chronic kidney disease patients undergoing hemodialysis; however, whether RAAS blockers have beneficial effects for cardiovascular disease in those patients has not been fully defined. This review focuses on the effects of RAAS blockers in chronic kidney disease undergoing hemodialysis for cardiovascular disease. PMID:24611082

Morishita, Yoshiyuki; Kusano, Eiji; Nagata, Daisuke

2014-01-01

426

Hemoglobin Targets for the Anemia of Chronic Kidney Disease: A Meta-analysis of Randomized, Controlled Trials  

Microsoft Academic Search

Anemia affects almost all patients with chronic kid- ney disease (CKD), reduces quality of life, and is a risk factor for early death. Higher hemoglobin (Hb) targets have been widely advocated because of data from observational studies showing that higher Hb is associated with improved survival and quality of life, but higher Hb targets may cause access thrombosis and hypertension

GIOVANNI F. M. STRIPPOLI; JONATHAN C. CRAIG; CARLO MANNO; FRANCESCO P. SCHENA

427

Dose response study of ipratropium bromide aerosol on maximum exercise performance in stable patients with chronic obstructive pulmonary disease  

Microsoft Academic Search

BACKGROUND: Although the bronchodilating effect of inhaled anticholinergics has been established in patients with chronic obstructive pulmonary disease (COPD), their effects on exercise capacity are still controversial. Previous studies have suggested that the standard dosage hardly affects exercise tolerance, whereas higher doses might elicit an improvement. The aim of the present study was to determine the dose of ipratropium bromide

A. Ikeda; K. Nishimura; H. Koyama; M. Tsukino; M. Mishima; T. Izumi

1996-01-01

428

Improved lung growth and function through hypoxia-inducible factor in primate chronic lung disease of prematurity  

Microsoft Academic Search

Bronchopulmonary dysplasia (BPD), a chronic lung disease affecting preterm neonates, is asso- ciated with significant childhood and adult health prob- lems. Histopathologic features of BPD include impaired vascular and distal airway development. We previously showed that activation of hypoxia-inducible factors (HIFs) by inhibition of prolyl hydroxylase domain-con- taining proteins (PHDs) is feasible and that it stimulates vascular endothelial growth factor

Tiina M. Asikainen; Ling-Yi Chang; Jacqueline J. Coalson; Barbara K. Schneider; Nahid S. Waleh; Machiko Ikegami; John M. Shannon; Vicki T. Winter; Peter Grubb; Ronald I. Clyman; Bradley A. Yoder; James D. Crapo; Carl W. White

2006-01-01

429

Expansions of T-cell Subsets Expressing Particular T-cell Receptor Variable Regions in Chronic Beryllium Disease  

Microsoft Academic Search

Chronic beryllium disease (CBD) is a granulomatous disorder characterized by the presence of noncaseat- ing granulomas and mononuclear cell inflammation, occurring in 1 to 5% of people exposed to beryllium in the workplace. In the lungs of affected patients, CD4 1 T cells accumulate. Using anti-T-cell receptor (TCR) monoclonal antibodies, we investigated the TCR beta and alpha variable (V b

Andrew P. Fontenot; Brian L. Kotzin; Lee S. Newman

1998-01-01

430

The relationship between health-promoting behaviors and resilience in patients with chronic kidney disease.  

PubMed

This cross-sectional research study explored differences in health-promoting behavior and resilience among three groups of chronic kidney disease patients (high-risk, early chronic kidney disease; early CKD and pre-end stage renal disease; pre-ESRD) treated at the Nephrology outpatient clinic in northern Taiwan. A total of 150 CKD outpatients were interviewed using structured questionnaires including a CKD Health to Promote Lifestyle Scale, and resilience scale. We found that the pre-ESRD group had lower resilience than either high-risk or early CKD groups. Factors affecting pre-ESRD resilience were gender, occupational status, diabetes and health-promoting behaviors. Factors affecting resilience of the high-risk group included level of education and health-promoting behaviors while factors affecting resilience in the early CKD group involved whether they are employed and health promoting behaviors. A significant positive correlation was found between health promoting behavior and resilience in all study subjects. Multiple regression analysis found that factors which could effectively predict resilience in patients at high-risk for CKD were gender, whether the patient had a job, nutrition, self-actualization, and stress level, accounting for 69.7% of the variance. Therefore, nursing education should focus on health promotion advocacy throughout the life of not only patients but also their families. PMID:23589703

Ma, Li-Ching; Chang, Hong-Jer; Liu, Yueh-Min; Hsieh, Hsiang-Li; Lo, Lan; Lin, Mei-Yu; Lu, Kuo-Cheng

2013-01-01

431

Vascular risk in chronic obstructive pulmonary disease: role of inflammation and other mediators.  

PubMed

Chronic obstructive pulmonary disease (COPD) is an inflammatory lung condition that affects 3 million adult Canadians aged 40 years or older. Most patients have mild to moderate disease and as such have only modest symptoms of cough and breathlessness. However, many will go on to experience ischemic heart disease and stroke and die of cardiovascular complications rather than from their lung disease. Indeed, nearly 50% of all hospitalizations and 25% of all deaths in patients with mild to moderate COPD are cardiovascular system related. Experimental and epidemiologic data from the past 20 years provide compelling evidence that chronic lung inflammation (related to COPD or exposure to irritants such as tobacco smoke or air pollution) contributes to atherosclerotic plaque progression and that acute inflammatory stimulus such as acute respiratory tract infections or acute exacerbations of COPD induce plaque rupture, leading to cardiovascular events. In this paper, we provide an overview of the epidemiologic and experimental data linking COPD with cardiovascular disease and highlight the clinical implications of this linkage for clinicians who evaluate and manage patients with COPD, cardiovascular diseases, or both. PMID:22902150

Man, S F Paul; Van Eeden, Stephan; Sin, Don D

2012-01-01

432

Chronic acalculous gallbladder disease: multiimaging evaluation with clinical-pathologic correlation  

Microsoft Academic Search

Despite the recent advances in hepatobiliary imaging, the diagnosis of chronic acalculous gallbladder disease remains difficult. A retrospective study was undertaken to assess the value of a multiimaging approach in detecting chronic acalculous gallbladder disease and in predicting which patients would obtain symptomatic relief after cholecystectomy. Of 199 patients with chronic cholecystitis, 26 (13%) had no gallstones. Of these 26,

Vassilios Raptopoulos; Carolyn C. Compton; Paul Doherty; Edward H. Smith; Carl J. DOrsi; Nilima A. Patwardhan; Robert J. Goldberg

1986-01-01

433

National Study of Chronic Disease Self-Management: Age Comparison of Outcome Findings  

ERIC Educational Resources Information Center

Introduction: The adult population is increasingly experiencing one or more chronic illnesses and living with such conditions longer. The Chronic Disease Self-Management Program (CDSMP) helps participants cope with chronic disease-related symptomatology and improve their health-related quality of life. Nevertheless, the long-term effectiveness of…

Ory, Marcia G.; Smith, Matthew Lee; Ahn, SangNam; Jiang, Luohua; Lorig, Kate; Whitelaw, Nancy

2014-01-01

434

Psychiatric Comorbidity and Other Psychological Factors in Patients with "Chronic Lyme Disease"  

PubMed Central

Background There is no evidence of current or previous B. burgdorferi infection in most patients evaluated at University-based Lyme disease referral centers. Instead, psychological factors likely exacerbate the persistent diffuse symptoms or “Chronic Multisymptom Illness” incorrectly ascribed to an ongoing chronic infection with B. burgdorferi. The objective of this study was to assess the medical and psychiatric status of such patients and compare these findings to those from patients without CMI. Methods 240 consecutive patients undergoing medical evaluation at an academic Lyme disease referral center in New Jersey were screened for clinical disorders (e.g. depression and anxiety) with diagnoses confirmed by structured clinical interviews. Personality disorders, catastrophizing, and negative and positive affect were also evaluated and all factors were compared between groups and to functional outcomes. Results 60.4% of our sample had symptoms that could not be explained by current Lyme disease or another medical condition other than CMI. After adjusting for age and gender, clinical disorders were more common in CMI than in the comparison group (p<.001, OR 3.54, 95% CI, 1.97 to 6.55), but personality disorders were not significantly more common. CMI patients had higher negative affect, lower positive affect and a greater tendency to catastrophize pain (p<.001) than did the comparison group. Except for personality disorders, all psychological factors were related to worse functioning. Our explanatory model based on these factors was confirmed. Conclusions Psychiatric comorbidity and other psychological factors are prominent in the presentation and outcome of some patients who inaccurately ascribe long-standing symptoms to “chronic Lyme disease.” PMID:19699380

Hassett, Afton L.; Radvanski, Diane C.; Buyske, Steven; Savage, Shantal V.; Sigal, Leonard H.

2009-01-01

435

Pathogenesis of hyperinflation in chronic obstructive pulmonary disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable lung disease characterized by airflow limitation that is not fully reversible. In a significant proportion of patients with COPD, reduced lung elastic recoil combined with expiratory flow limitation leads to lung hyperinflation during the course of the disease. Development of hyperinflation during the course of COPD is insidious. Dynamic hyperinflation is highly prevalent in the advanced stages of COPD, and new evidence suggests that it also occurs in many patients with mild disease, independently of the presence of resting hyperinflation. Hyperinflation is clinically relevant for patients with COPD mainly because it contributes to dyspnea, exercise intolerance, skeletal muscle limitations, morbidity, and reduced physical activity levels associated with the disease. Various pharmacological and nonpharmacological interventions have been shown to reduce hyperinflation and delay the onset of ventilatory limitation in patients with COPD. The aim of this review is to address the more recent literature regarding the pathogenesis, assessment, and management of both static and dynamic lung hyperinflation in patients with COPD. We also address the influence of biological sex and obesity and new developments in our understanding of hyperinflation in patients with mild COPD and its evolution during progression of the disease. PMID:24600216

Gagnon, Philippe; Guenette, Jordan A; Langer, Daniel; Laviolette, Louis; Mainguy, Vincent; Maltais, Francois; Ribeiro, Fernanda; Saey, Didier

2014-01-01

436

Role of Nrf2 in chronic liver disease  

PubMed Central

Nuclear erythroid 2-related factor 2 (Nrf2) is a central regulator of antioxidative response elements-mediated gene expression. It has a significant role in adaptive responses to oxidative stress by interacting with the antioxidant response element, which induces the expression of a variety of downstream targets aimed at cytoprotection. Previous studies suggested oxidative stress and associated damage could represent a common link between different forms of diseases. Oxidative stress has been implicated in various liver diseases, including viral hepatitis, nonalcoholic fatty liver disease/steatohepatitis, alcoholic liver disease and drug-induced liver injury. Nrf2 activation is initiated by oxidative or electrophilic stress, and aids in the detoxification and elimination of potentially harmful exogenous chemicals and their metabolites. The expression of Nrf2 has been observed throughout human tissue, with high expression in detoxification organs, especially the liver. Thus, Nrf2 may serve as a major regulator of several cellular defense associated pathways by which hepatic cells combat oxidative stress. We review the relevant literature concerning the crucial role of Nrf2 and its signaling pathways against oxidative stress to protect hepatic cell from oxidative damage during development of common chronic liver diseases. We also review the use of Nrf2 as a therapeutic target to prevent and treat liver diseases. PMID:25278702

Tang, Wei; Jiang, Yong-Fang; Ponnusamy, Murugavel; Diallo, Mamadou

2014-01-01

437

[Preparing patients with chronic pulmonary disease for air travel].  

PubMed

Flying is the most important way of travelling in the continually growing international tourism. Number of passengers and those with preexisting diseases, mainly with cardiopulmonary problems, is increasing over years. One of the main tasks of the pre-travel advice is to assess tolerance to hypoxia of the traveler, and specify the necessity, as well as the type and volume of supplementary oxygen therapy. It is indispensable to know the cabin-environment and impact of that on the travelers' health. Travel medicine specialist has to be aware of the examinations which provide information for the appropriate decision on the fit-to-fly condition of the patient. The physician who prepares the patient with chronic obstructive pulmonary disease for repatriation by regular flight and the escorting doctor have to be fully aware of the possibilities, modalities, advantages and contraindications of the on-board oxygen supply and therapy. In this review, the authors give a summary of literature data, outline the tools of in-flight oxygen therapy as well as discuss possibilities for the preflight assessment of patients' condition including blood gas parameters required for safe air travel, as recommended in international medical literature. The preparation process for repatriation of patients with chronic obstructive pulmonary disease is also discussed. PMID:23434882

Felkai, Péter; Böszörményi Nagy, György; Gyarmati, Ildikó

2013-03-01