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Last update: November 12, 2013.
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

Epidemic! The World of Infectious Disease - Exhibit  

NSDL National Science Digital Library

This Web site, created to complement the museum's Epidemic! exhibit, provides an in-depth look at the world of infectious disease. It includes information on how environmental changes can affect the spread of disease, the three major groups of microbes and how disease is spread, and the factors that determine whether an outbreak will become an epidemic or a pandemic. There is a list, organized by topic and specific disease, of more than 250 Web sites and a glossary.

3

Chronic Disease Indicators  

NSDL National Science Digital Library

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

Control, Center F.

4

Chronic wasting disease  

Technology Transfer Automated Retrieval System (TEKTRAN)

Chronic wasting disease (CWD) is an emerging prion disease of deer, elk, and moose in North America. This fatal neurodegenerative disease was first recognized 50 years ago and its distribution was limited to the Rocky Mountains for several decades. In the past few years, CWD has been found in the ea...

5

Chronic granulomatous disease  

MedlinePLUS

CGD; Fatal granulomatosis of childhood; Chronic granulomatous disease of childhood; Progressive septic granulomatosis ... The condition is often discovered in very early childhood. Milder forms may be diagnosed during the teen ...

6

Chronic Kidney Disease  

MedlinePLUS

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

7

Chronic Granulomatous Disease  

Microsoft Academic Search

Chronic granulomatous disease (CGD) was first described in the 1950s and has become a paradigm for genetic neutrophil diseases.\\u000a It is characterized by recurrent infections with a narrow spectrum of bacteria and fungi as well as a common set of inflammatory\\u000a complications most notably including inflammatory bowel disease. Over the last half century major advances in management have\\u000a profoundly altered

Steven M. Holland

2010-01-01

8

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.

Vijayan, V.K.

2013-01-01

9

Sleep and Chronic Disease  

MedlinePLUS

... found at http://www.usa.gov . Sleep and Sleep Disorders ? Sleep About Us About Sleep Key Sleep Disorders Sleep and Chronic Disease How Much Sleep Do ... of depression be monitored among persons with a sleep disorder. 4, 5 References Knutson KL, Ryden AM, Mander ...

10

Chronic Wasting Disease  

Microsoft Academic Search

Chronic wasting disease (CWD) is a unique transmissible spongiform encephalopathy (TSE) of mule deer (Odocoileus hemionus), white-tailed deer (O. virginianus), and Rocky Mountain elk (Cervus elaphus nelsoni). The natural history of CWD is incompletely understood, but it differs from scrapie and bovine spon- giform encephalopathy (BSE) by virtue of its occurrence in nondomestic and free-ranging species. CWD has many features

E. S. Williams

2005-01-01

11

Chronic obstructive pulmonary disease  

Microsoft Academic Search

Chronic Obstructive Pulmonary disease (COPD), characterized by poorly reversible airflow limitation, and strongly associated with tobacco smoking, is estimated to cause >2.5 million deaths per year worldwide. Active smokers have more acute exacerbations, which correlate with long-term decline in lung function. The diagnosis, severity assessment and monitoring of COPD rely heavily but not exclusively on spirometry. Smoking cessation reduces exacerbation

S Singh

2003-01-01

12

Chronic Wasting Disease  

USGS Publications Warehouse

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

Richards, Bryan

2007-01-01

13

Chronic Obstructive Pulmonary Disease: A Chronic Systemic Inflammatory Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation in both the airways causing airway obstruction and the lung tissues causing emphysema. The disease is induced by inhalation of noxious gasses and particulate matter resulting in a chronic persistent inflammatory response in the lung, and the extent of the inflammatory reaction correlates with the severity of the disease. This

Stephan F. van Eeden; Don D. Sin

2008-01-01

14

Ghrelin in Chronic Kidney Disease  

PubMed Central

Patients with chronic kidney disease (CKD) often exhibit symptoms of anorexia and cachexia, which are associated with decreased quality of life and increased mortality. Chronic inflammation may be an important mechanism for the development of anorexia, cachexia, renal osteodystrophy, and increased cardiovascular risk in CKD. Ghrelin is a gastric hormone. The biological effects of ghrelin are mediated through the growth hormone secretagogue receptor (GHSR). The salutary effects of ghrelin on food intake and meal appreciation suggest that ghrelin could be an effective treatment for anorexic CKD patients. In addition to its appetite-stimulating effects, ghrelin has been shown to possess anti-inflammatory properties. The known metabolic effects of ghrelin and the potential implications in CKD will be discussed in this review. The strength, shortcomings, and unanswered questions related to ghrelin treatment in CKD will be addressed.

Cheung, Wai W.; Mak, Robert H.

2010-01-01

15

Chronic wasting disease  

PubMed Central

Until recently, chronic wasting disease of cervids, the only wildlife prion disease, was believed to be geographically concentrated to Colorado and Wyoming within the United States. However, increased surveillance has unveiled several additional pockets of CWD-infected deer and elk in 12 additional states and 2 Canadian provinces. Deer and elk with CWD have extensive aggregates of PrPSc not only in the central nervous system, but also in peripheral lymphoid tissues, skeletal muscle, and other organs, perhaps influencing prion shedding. Indeed, CWD is transmitted efficiently among animals by horizontal routes, although the mechanism of spread is unknown. Genetic polymorphisms in the Prnp gene may affect CWD susceptibility, particularly at codon 225 (S/F) in deer and codon 132 (M/L) in elk. Since CWD infects free-ranging animals and is efficiently spread, disease management will be a challenge.

Sigurdson, Christina J.; Aguzzi, Adriano

2009-01-01

16

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

17

Chronic granulomatous disease mimicking Crohn's disease.  

PubMed

A 34-month-old boy with intermittent diarrhoea and abdominal distension from 2 months of age, a chronic microabscess of the cheek, gastric antral narrowing, and perianal abscesses containing granulomata was found at colonscopy to have extensive, noncaseating, submucosal ileal and colonic granulomata. He was initially thought to have Crohn's disease, but then developed a cervical abscess, and a diagnosis of chronic granulomatous disease was established. This is an important, although rare, differential diagnosis of chronic inflammatory bowel disease in childhood. PMID:3894611

Isaacs, D; Wright, V M; Shaw, D G; Raafat, F; Walker-Smith, J A

1985-06-01

18

COPD (Chronic Obstructive Pulmonary Disease)  

MedlinePLUS

Chronic Obstructive Pulmonary Disease (COPD) makes it hard for you to breathe. Coughing up mucus is often the first sign of ... common COPDs. Your airways branch out inside your lungs like an upside-down tree. At the end ...

19

Chronic Kidney Diseases  

MedlinePLUS

... pressure at a healthy level. Continue Kinds of Kidney Diseases Like any complicated machine, not all kidneys work ... to work the way they should. How Are Kidney Diseases Diagnosed? Kidney problems are often not noticed at ...

20

Anemia of Chronic Disease (Anemia of Inflammation)  

Microsoft Academic Search

Mild-to-moderate anemia often develops in the setting of acute or chronic immune activation and is termed anemia of chronic disease (ACD) or anemia of inflammation. Anemia of chronic disease is the second most common type of anemia (after anemia of iron deficiency) and results in increased morbidity and mortality of the underlying disease. Anemia of chronic disease is mediated by

Neeraj Agarwal; Josef T. Prchal

2009-01-01

21

Chronic Disease and the Environment  

NSDL National Science Digital Library

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

Responsibility, Physicians F.; Envirohealthaction

22

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

23

Treatment of chronic kidney disease  

Microsoft Academic Search

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

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

2012-01-01

24

Uromodulin and Chronic Kidney Disease  

Microsoft Academic Search

Uromodulin (Tamm-Horsfall protein) is produced in the kidney by cells of the thick ascending limb and distal tubule. Recent genetic studies suggest a role of uromodulin in chronic kidney disease. Mutations in the UMOD gene cause uromodulin storage disease. They code for amino acid substitutions that lead to misfolding of the molecule and its retention in the endoplasmic reticulum. Single

Karl Lhotta

2010-01-01

25

Rethinking chronic obstructive pulmonary disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a complex polygenic disease characterized by an abnormal inflammatory response to smoke, and results in a progressive and debilitating condition with declining lung function. The reasons why some smokers get COPD are not known.We suggest that corticosteroid resistance, which derives from oxidative stress, might actually be the cause of COPD and represent the starting

Antonella Tonello; Giovanni Poli

2011-01-01

26

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

27

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

28

Chronic diseases among older cancer patients  

Microsoft Academic Search

Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of chronic diseases among older cancer patients. Aim: We aim to examine the frequency of pre-existing and subsequent chronic

L. D. Deckx; M. A. van der Akker; J. M. Metsemakers; A. K. Knottnerus; F. G. Schellevis; F. B. Buntinx

2011-01-01

29

Nutrition and chronic kidney disease  

Microsoft Academic Search

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

Denis Fouque; Solenne Pelletier; Denise Mafra; Philippe Chauveau

2011-01-01

30

CHRONIC ALLOGENEIC DISEASE  

PubMed Central

Glomerulonephritis, often accompanied by the nephrotic syndrome, developed in CAF1 mice following the administration of spleen cells from normal BALB/c mice. The renal lesion was membranous glomerulonephritis. When studied with fluorescein-conjugated antisera to either mouse gamma globulin or ?1C-globulin, the glomeruli contained beaded and irregular deposits of these immunoproteins. The ultrastructure of the lesion was characterized by thickening of the glomerular basement membranes and the presence of electron-dense subepithelial deposits. Acid eluates of the diseased kidneys contained gamma globulin that failed to bind to sections of normal kidneys. These findings conform to the type of nephritis provoked by immune complexes. They indicate that this type of immune injury can be based on the reaction of intolerant immunocytes to normal antigens.

Lewis, Robert M.; Armstrong, Martine Y. K.; Andre-Schwartz, Janine; Muftuoglu, Asuman; Beldotti, Lorraine; Schwartz, Robert S.

1968-01-01

31

Food insecurity and chronic disease.  

PubMed

Household food insecurity has been previously hypothesized to promote dependence on inexpensive, highly palatable foods that are energy dense. Such dependence, and the cyclical nature of having enough food in the beginning of the month followed by food scarcity at the end of the month, could lead to weight gain over a short period of time. Such dependence on energy-dense foods and weight gain may play a direct role in the development of chronic conditions. Other compounding factors that result from exposure to household food insecurity have been well described, including pathways by which stress promotes visceral fat accumulation and chronic disease. This symposium review paper summarizes the literature on the link between food insecurity and the following: 1) diet, 2) weight gain, and 3) chronic disease, especially among women. This paper also proposes a framework for considering how the lived experience of household food insecurity may potentiate the development of chronic disease by activating the stress response among individuals at critical developmental periods in a food-impoverished environment. PMID:23493536

Laraia, Barbara A

2013-03-01

32

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

33

Osteodystrophy in chronic liver diseases.  

PubMed

Osteoporosis and osteomalacia are, to date, among the most common metabolic diseases in the world. Lately, an association between metabolic bone diseases and chronic liver disease has been increasingly reported, inducing many authors to create a new nosographic entity known as 'hepatic osteodystrophy.' The importance of such a condition is further increased by the morbidity of these two diseases, which greatly reduce the quality of life because of frequent fractures, especially vertebral and femoral neck ones. For this reason, early identification of high-risk patients should be routinely performed by measuring bone mass density. The explanation for the association between bone diseases and chronic liver disease is still uncertain, and involves many factors: from hypogonadism to use of corticosteroid drugs, from genetic factors to interferon therapy. To date, few studies have been conducted, and all with a small number of patients to establish definitive conclusions about the possible treatment, but some evidence is beginning to emerge about the safety and efficacy of bisphosphonates. PMID:22241574

Mansueto, Pasquale; Carroccio, Antonio; Seidita, Aurelio; Di Fede, Gaetana; Craxì, Antonio

2012-01-13

34

Cardiac Disease in Chronic Obstructive Pulmonary Disease  

PubMed Central

The cardiac manifestations of chronic obstructive pulmonary disease (COPD) are numerous. Impairments of right ventricular dysfunction and pulmonary vascular disease are well known to complicate the clinical course of COPD and correlate inversely with survival. The pathogenesis of pulmonary vascular disease in COPD is likely multifactorial and related to alterations in gas exchange and vascular biology, as well as structural changes of the pulmonary vasculature and mechanical factors. Several modalities currently exist for the assessment of pulmonary vascular disease in COPD, but right heart catheterization remains the gold standard. Although no specific therapy other than oxygen has been generally accepted for the treatment of pulmonary hypertension in this population, there has been renewed interest in specific pulmonary vasodilators. The coexistence of COPD and coronary artery disease occurs frequently. This association is likely related to shared risk factors as well as similar pathogenic mechanisms, such as systemic inflammation. Management strategies for the care of patients with COPD and coronary artery disease are similar to those without COPD, but care must be given to address their respiratory limitations. Arrhythmias occur frequently in patients with COPD, but are rarely fatal and can generally be treated medically. Use of ?-blockers in the management of cardiac disease, while a theoretical concern in patients with increased airway resistance, is generally safe with the use of cardioselective agents.

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

2008-01-01

35

Bisalbuminemia in chronic kidney disease.  

PubMed

Hereditary and acquired bisalbuminemia, in which the serum contains an albumin variant differing from albumin A by single amino-acid substitutions, have been reported in different races or ethnic groups and in association with various pathologic states. The importance of this rare condition in the pathophysiology of established diseases is uncertain. We evaluated a 68-year-old woman with chronic kidney disease who presented with worsened serum creatinine concentration despite lack of dietary or medical changes. Serum protein electrophoresis was performed with an automated rapid electrophoresis system. Bisalbuminemia was noted as an incidental finding on serum protein electrophoresis. The serum creatinine level stabilized with dietary protein restriction and a beta-blocking agent/diuretic combination for blood pressure control. Although the possibility that some physiologic or pharmacologic substances may not bind to abnormal albumin variants as well as they bind to normal albumin should not be discounted, the finding of bisalbuminemia did not influence the diagnosis, management, course, or prognosis of chronic kidney disease. The role of persistent bisalbuminemia in renal disease is uncertain. PMID:15480907

Ejaz, A Ahsan; Krishna, Murli; Wasiluk, Andrew; Knight, Janice D

2004-09-01

36

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.

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

2010-01-01

37

The unrecognized prevalence of chronic kidney disease in diabetes  

Microsoft Academic Search

Background. Diabetes mellitus and chronic kidney disease (CKD) are common and exhibit synergistic associations with premature mortality. Current diabetes guidelines in the UK recommend annual urinary albumin and serum creatinine determinations to screen for diabetic kidney disease. The aim of this study was to estimate the burden of CKD in patients with diabetes and examine the ability of serum creatinine

Rachel J. Middleton; Robert N. Foley; Janet Hegarty; Ching M. Cheung; Patrick McElduff; J. Martin Gibson; Philip A. Kalra; Donal J. O'Donoghue; John P. New

2005-01-01

38

Neuropsychological Functioning in Chronic Lyme Disease  

Microsoft Academic Search

Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with

Holly James Westervelt; Robert J. McCaffrey

2002-01-01

39

Neuropsychological functioning in chronic Lyme disease.  

PubMed

Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease. PMID:12428915

Westervelt, Holly James; McCaffrey, Robert J

2002-09-01

40

Chronic Disease and Childhood Development: Kidney Disease and Transplantation.  

ERIC Educational Resources Information Center

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

Klein, Susan D.; Simmons, Roberta G.

41

Optimizing Disease Management of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. It is the fourth leading cause of chronic morbidity and mortality in the US, and is projected to rank seventh in burden of disease worldwide by 2020. In contrast with a number of chronic diseases, COPD is most often associated with one or more co-morbid conditions, and this

Philip Corsello; David Tinkelman

2008-01-01

42

Chronic thyroiditis (Hashimoto’s disease)  

MedlinePLUS

Hashimoto's thyroiditis; Chronic lymphocytic thyroiditis; Autoimmune thyroiditis ... Chronic thyroiditis or Hashimoto's disease is a common thyroid gland disorder. It can occur at any age, but is most often seen in middle- ...

43

Rethinking chronic obstructive pulmonary disease.  

PubMed

Chronic obstructive pulmonary disease (COPD) is a complex polygenic disease characterized by an abnormal inflammatory response to smoke, and results in a progressive and debilitating condition with declining lung function. The reasons why some smokers get COPD are not known. We suggest that corticosteroid resistance, which derives from oxidative stress, might actually be the cause of COPD and represent the starting point of the pathology. The absence of response to corticosteroids would let the disease develop, impairing the organism capacity to suppress any kind of inflammatory process. Corticosteroid resistance may derive from smoke induced oxidative stress and plausibly impairs the organism capacity to suppress inflammation. Many factors may contribute to the development and persistence of corticosteroid resistance: inefficient antioxidant defences, a corticosteroid response less efficient or more sensitive to oxidative conditions, and also any other concomitant factor, environmental, genetic or intercurrent, which would contribute to amplify inflammation and hence oxidative stress. One or more of these factors might represent the variable component of the disease, which gives origin to COPD heterogeneity. This hypotheses may also explain why the disease persists after quitting smoking, as an inflammatory process severe enough to generate a strong oxidative stress may support itself by maintenance of corticosteroid resistance. PMID:21075542

Tonello, Antonella; Poli, Giovanni

2010-11-13

44

GARD (Global Alliance against chronic Respiratory Diseases)  

Microsoft Academic Search

ABSTRACT: Hundreds,of millions,of people,of all ages,suffer from,chronic,respiratory,diseases which include asthma and respiratory allergies, chronic obstructive pulmonary disease, occupational,lung,diseases,and,pulmonary,hypertension.,More than,500 million patients,live in developing,countries,or in deprived,populations.,Chronic,respiratory,diseases,are increasing,in prevalence. Although the cost of inaction is clear and unacceptable, chronic respiratory diseases and their risk factors receive insufficient attention from the healthcare community, government officials, media, patients and families. The Fifty-Third World Health

J. Bousquet; R. Dahl; N. Khaltaev

2006-01-01

45

Kidneys in chronic liver diseases  

PubMed Central

Acute kidney injury (AKI), defined as an abrupt increase in the serum creatinine level by at least 0.3 mg/dL, occurs in about 20% of patients hospitalized for decompensating liver cirrhosis. Patients with cirrhosis are susceptible to developing AKI because of the progressive vasodilatory state, reduced effective blood volume and stimulation of vasoconstrictor hormones. The most common causes of AKI in cirrhosis are pre-renal azotemia, hepatorenal syndrome and acute tubular necrosis. Differential diagnosis is based on analysis of circumstances of AKI development, natriuresis, urine osmolality, response to withdrawal of diuretics and volume repletion, and rarely on renal biopsy. Chronic glomerulonephritis and obstructive uropathy are rare causes of azotemia in cirrhotic patients. AKI is one of the last events in the natural history of chronic liver disease, therefore, such patients should have an expedited referral for liver transplantation. Hepatorenal syndrome (HRS) is initiated by progressive portal hypertension, and may be prematurely triggered by bacterial infections, nonbacterial systemic inflammatory reactions, excessive diuresis, gastrointestinal hemorrhage, diarrhea or nephrotoxic agents. Each type of renal disease has a specific treatment approach ranging from repletion of the vascular system to renal replacement therapy. The treatment of choice in type 1 hepatorenal syndrome is a combination of vasoconstrictor with albumin infusion, which is effective in about 50% of patients. The second-line treatment of HRS involves a transjugular intrahepatic portosystemic shunt, renal vasoprotection or systems of artificial liver support.

Hartleb, Marek; Gutkowski, Krzysztof

2012-01-01

46

Hypertrophic osteoarthropathy of chronic inflammatory bowel disease  

SciTech Connect

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

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

1982-12-01

47

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

48

Angiogenesis and chronic kidney disease  

PubMed Central

The number of patients requiring renal replacement therapy due to end-stage renal disease (ESRD) is increasing worldwide. The prevalence of chronic kidney disease (CKD), and the importance of CKD as a risk factor in development of ESRD and in complicating cardiovascular disease (CVD) have been confirmed. In recent years, the involvement of angiogenesis-related factors in the progression of CKD has been studied, and the potential therapeutic effects on CKD of modulating these factors have been identified. Vascular endothelial growth factor (VEGF)-A, a potent pro-angiogenic factor, is involved in the development of the kidney, in maintenance of the glomerular capillary structure and filtration barrier, and in the renal repair process after injury. VEGF-A is also involved in the development of early diabetic nephropathy, demonstrated by the therapeutic effects of anti-VEGF-A antibody. Angiopoietin (Ang)-1 induces the maturation of newly formed blood vessels, and the therapeutic effects of Ang-1 in diabetic nephropathy have been described. In experimental models of diabetic nephropathy, the therapeutic effects of angiogenesis inhibitors, including angiostatin, endostatin and tumstatin peptides, the isocoumarin NM-3, and vasohibin-1, have been reported. Further analysis of the involvement of angiogenesis-related factors in the development of CKD is required. Determining the disease stage at which therapy is most effective and developing an effective drug delivery system targeting the kidney will be essential for pro-or anti-angiogenic strategies for patients with CKD.

2010-01-01

49

Nutrition and Chronic Kidney Disease  

Microsoft Academic Search

\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a The development and progression of chronic kidney disease (CKD) is influenced by a number of dietary factors, including salt\\u000a and protein intake and energy balance (obesity).\\u000a \\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a While the benefits of a low-protein intake in preventing the development of CKD are not firmly established, it is likely that\\u000a a high-protein intake is detrimental to individuals with even mild impairment

Srinivasan Beddhu

50

Chronic kidney disease and cardiovascular disease in the Medicare population  

Microsoft Academic Search

Chronic kidney disease and cardiovascular disease in the Medicare population.BackgroundThe extent of diabetes, chronic kidney disease (CKD), and cardiovascular disease (CVD) in the Medicare population is relatively unknown. Also unknown is the effect of these diseases on patient survival before end-stage renal disease (ESRD).MethodsPrevalent cohorts of Medicare enrollees from 1996 to 2000 were assessed for diabetes and CKD, presence of

Allan J. Collins; Shuling Li; David T. Gilbertson; Jiannong Liu; Shu-Cheng Chen; Charles A. Herzog

2003-01-01

51

68 FR 3326 - Chronic Disease Prevention and Health Promotion Programs  

Federal Register 2010, 2011, 2012, 2013

...Chronic Disease Prevention and Health Promotion Programs; Notice Federal Register...Chronic Disease Prevention and Health Promotion Programs The Centers for Disease...Chronic Disease Prevention and Health Promotion Programs. Table of...

2003-01-23

52

The burden of chronic obstructive pulmonary disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a disease state characterized by chronic airflow limitation that is not fully reversible, with a precise definition varying between different management guidelines.The burden of COPD is considerable from all relevant viewpoints. From the perspective of society, the mortality is already considerable, and it is likely to increase from the sixth to the third most

P. Vermeire

2002-01-01

53

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

54

Chronic Obstructive Pulmonary Disease (COPD)  

MedlinePLUS

... jcorn@thoracic.org. www.thoracic.org available for COPD patients for education and opportunities to share experience with other patients and families. Will COPD ever go away? The term chronic in chronic ...

55

Chronic Kidney Disease in Octogenarians  

PubMed Central

Summary Background and objectives There are limited data on the prevalence of chronic kidney disease (CKD) and its clinical importance in the very old. We examined the prevalence of CKD in octogenarians and its association with cardiovascular disease (CVD). Design, setting, participants, & measurements In a cross-sectional analysis of 1028 participants from the Cardiovascular Health Study All Stars, we evaluated association of prevalent CKD with CVD using multivariable logistic regression. CKD was defined as eGFR of <60 ml/min per 1.73 m2. GFR was estimated using CKD-Epi creatinine and cystatin C equations that incorporate coefficients for age, gender, and race (eGFREPI, eGFRCYS3var) and the one-variable cystatin C equation (eGFRCYS1var). Prevalent CVD was defined as a composite of coronary heart disease, heart failure, and stroke. Results Mean age was 86 years, 64% were women, 86% were Caucasians, 14% had diabetes, and 39% had prevalent CVD. Mean eGFREPI, eGFRCYS3var, and eGFRCYS1var were 59, 62, and 70 ml/min per 1.73 m2, and 51%, 46%, and 33% had CKD, respectively. Associations of CKD with CVD varied by equation in adjusted analyses: CKDEPI (OR, 1.53; 95% CI, 1.15 to 2.03), CKDCYS3var (OR, 1.67; 95% CI, 1.25, 2.23), and CKDCYS1var (OR, 2.09; 95% CI, 1.55, 2.83). Conclusions Reduced eGFR is highly prevalent in octogenarians, and the eGFRCYS1var equation yielded the lowest prevalence of CKD but the strongest association with prevalent CVD. Because there are no validated estimating equations in the elderly, estimation of kidney function on the basis of on any one equation should be interpreted with caution.

Shastri, Shani; Tighiouart, Hocine; Katz, Ronit; Rifkin, Dena E.; Fried, Linda F.; Shlipak, Michael G.; Newman, Anne B.

2011-01-01

56

Diarrheal Diseases - Acute and Chronic  

MedlinePLUS

... doctor if you have a family history of celiac disease, inflammatory bowel disease (IBD), have unintentional weight loss, ... common small bowel disease in the U.S. is celiac disease, also called celiac sprue. Crohn’s disease can also ...

57

28 CFR 79.57 - Proof of chronic renal disease.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 false Proof of chronic renal disease. 79.57 Section 79.57...Millers § 79.57 Proof of chronic renal disease. (a) In determining whether a claimant developed chronic renal disease following pertinent...

2010-07-01

58

HIV/AIDS, chronic diseases and globalisation  

PubMed Central

HIV/AIDS has always been one of the most thoroughly global of diseases. In the era of widely available anti-retroviral therapy (ART), it is also commonly recognised as a chronic disease that can be successfully managed on a long-term basis. This article examines the chronic character of the HIV/AIDS pandemic and highlights some of the changes we might expect to see at the global level as HIV is increasingly normalised as "just another chronic disease". The article also addresses the use of this language of chronicity to interpret the HIV/AIDS pandemic and calls into question some of the consequences of an uncritical acceptance of concepts of chronicity.

2011-01-01

59

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.

2006-01-01

60

Non-Hormonal Medications and Chronic Diseases  

Microsoft Academic Search

\\u000a This chapter explores the relation between breast cancer risk and the use of non-hormonal medications and chronic diseases.\\u000a Many drugs and diseases have been linked with breast cancer in case reports and epidemiologic studies. This chapter covers\\u000a those major medications and diseases where there is adequate epidemiologic evidence for evaluation.

Patricia F. Coogan

61

Natural Histories of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Concepts relating to the natural history of chronic obstructive pulmonary disease (COPD) arise most importantly from the classic study of Fletcher and colleagues (The Natural History of Chronic Bronchitis and Emphysema, Oxford University Press, New York, 1976). This study, which evaluated working English men over 8 years, was used to construct a proposed life-long natural history. Although this is a

Stephen I. Rennard; Jørgen Vestbo

2008-01-01

62

Chronic Diseases and Health Promotion  

MedlinePLUS

... chronic conditions have one or more daily activity limitations. 5 Arthritis is the most common cause of disability, with nearly 19 million Americans reporting activity limitations. 6 Diabetes continues to be the leading cause ...

63

Serum elastase 1 in chronic pancreatic disease  

Microsoft Academic Search

Summary Elastase 1 and immunoreactive trypsin were assessed by a RIA technique in the sera of 29 control subjects, 24 pancreatic cancer patients, 22 patients with chronic pancreatitis and 31 with extra-pancreatic diseases to ascertain and compare their usefulness in chronic pancreatic disease diagnosis. Increased levels of elastase 1 were detected in 60.9% of pancreatic cancer and in 61.1% of

G. Del Favero; C. Fabris; M. Plebani; A. Panucci; A. Piccoli; L. Perobelli; A. Burlina; R. Naccarato

1985-01-01

64

Exacerbation phenotyping in chronic obstructive pulmonary disease.  

PubMed

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are crucial events but causes remain poorly defined. A method to clinically 'phenotype' AECOPD have been proposed, and 52 hospitalized chronic obstructive pulmonary disease exacerbations according to underlying aetiology have now been prospectively phenotyped. Multiple exacerbation phenotypes were identified. A subpopulation coinfected with virus and bacteria had a significantly longer length of hospital stay, and this pilot study indicates that exacerbation phenotyping may be advantageous. PMID:24164687

Macdonald, Martin; Korman, Tony; King, Paul; Hamza, Kais; Bardin, Philip

2013-11-01

65

Controversies in Chronic Kidney Disease Staging  

PubMed Central

In 2002, a new chronic kidney disease staging system was developed by the US National Kidney Foundation. The classification system represented a new conceptual framework for the diagnosis of chronic kidney disease (moving to a schema based on disease severity defined by the glomerular filtration rate). While the introduction of the staging system stimulated significant clinical and research interest in kidney disease, there has been vigorous debate on its merits. This mini-review aims to summarise the recent controversies that have been raised since the introduction of the new classification.

Polkinghorne, Kevan R

2011-01-01

66

Lung Compliance and Chronic Obstructive Pulmonary Disease  

PubMed Central

Chronic obstructive pulmonary disease, namely, pulmonary emphysema and chronic bronchitis, is a chronic inflammatory response of the airways to noxious particles or gases, with resulting pathological and pathophysiological changes in the lung. The main pathophysiological aspects of the disease are airflow obstruction and hyperinflation. The mechanical properties of the respiratory system and its component parts are studied by determining the corresponding volume-pressure (P-V) relationships. The consequences of the inflammatory response on the lung structure and function are depicted on the volume-pressure relationships.

Papandrinopoulou, D.; Tzouda, V.; Tsoukalas, G.

2012-01-01

67

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.

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

2008-01-01

68

Increased plasma vascular endothelial growth factor among patients with chronic venous disease  

Microsoft Academic Search

Skin damage in the presence of chronic venous disease is partially mediated through leukocytes. The endothelium is activated and exhibits proliferation in the skin. Up-regulation of vascular endothelial growth factor (VEGF) expression in the skin of patients with chronic venous disease has been demonstrated with immunohistologic techniques. Abnormal VEGF expression can have local deleterious effects. The aim of this study

S. Sulaiman Shoab; J. H. Scurr; P. D. Coleridge-Smith

1998-01-01

69

A subset of Rosai-Dorfman disease exhibits features of IgG4-related disease.  

PubMed

In this study we investigated the distribution of IgG4+ plasma cells and regulatory T (T(REG)) cells, a major regulator of IgG4 production, in nodal and extranodal Rosai-Dorfman disease (RDD). Twenty-six specimens (15 nodal, 11 extranodal) were examined, with reactive lymph nodes and site-matched extranodal specimens as controls. Overall, 84.6% (22/26) of the specimens showed various degrees of sclerosis (7 mild, 8 moderate, and 7 severe). Nineteen cases (73.1%) exhibited more than 10 IgG4+ cells/0.060 mm(2) (photographed area at ×40), and 8 cases (30.8%) showed more than 40% of IgG+ cells being IgG4+. Only 1 control case exhibited more than 10 IgG4+ cells/0.060 mm(2) (P < .05). The number of T(REG) cells was comparable between nodal RDD and controls, whereas extranodal RDD exhibited significantly higher numbers of T(REG) cells than controls. These findings demonstrate that a subset of RDD shows features of IgG4-related disease and indicate an overlap between certain aspects of the 2 diseases. PMID:23596114

Zhang, Xuefeng; Hyjek, Elizabeth; Vardiman, James

2013-05-01

70

Comorbidities in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Comorbidities such as cardiac disease, diabetes mellitus, hyper- tension, osteoporosis, and psychological disorders are commonly reported in patients with chronic obstructive pulmonary disease (COPD) but with great variability in reported prevalence. Tobacco smokingis a risk factorfor many of these comorbidities as well as for COPD,makingit difficultto draw conclusions aboutthe relationship between COPD and these comorbidities. However, recent large epi- demiologic

Wissam M. Chatila; Byron M. Thomashow; Omar A. Minai; Gerard J. Criner; Barry J. Make

2008-01-01

71

Updated guidelines for managing chronic kidney disease.  

PubMed

Chronic kidney disease (CKD) is the most costly disease covered by Medicare, and two common causes of CKD, diabetes and hypertension, are increasing worldwide. More than 60% of Americans will develop CKD in their lifetimes. This article reviews updated guidelines for managing CKD in primary care. PMID:24103894

Dobkowski, Darlene; Zuber, Kim; Davis, Jane

2013-11-01

72

Systemic Effects of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) affects various struc- tural and functional domains in the lungs. It also has significant extrapulmonary effects, the so-called systemic effects of COPD. Weight loss, nutritional abnormalities, and skeletal muscle dysfunc- tion are well-recognized systemic effects of COPD. Other less well- known but potentially important systemic effects include an in- creased risk of cardiovascular disease and

Alvar G. N. Agusti

2005-01-01

73

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

74

Respiratory failure in chronic obstructive pulmonary disease  

Microsoft Academic Search

Respiratory failure is still an important complication of chronic obstructive pulmonary disease (COPD) and hospitalisation with an acute episode being a poor prognostic marker. However, other comorbid conditions, especially cardiovascular disease, are equally powerful predictors of mortality. The physiological basis of acute respiratory failure in COPD is now clear. Significant ventilation\\/perfusion mismatching with a relative increase in the physiolo- gical

P. M. A. Calverley

2003-01-01

75

Glycemic index in chronic disease: a review  

Microsoft Academic Search

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

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

2002-01-01

76

Chronic liver disease in Aboriginal North Americans  

Microsoft Academic Search

A structured literature review was performed to detail the frequency and etiology of chronic liver disease (CLD) in Aboriginal North Americans. CLD affects Aboriginal North Americans disproportionately and is now one of the most common causes of death. Alcoholic liver disease is the leading etiology of CLD, but viral hepatitis, particularly hepatitis C, is an important and growing cause of

John D Scott; Naomi Garland

2008-01-01

77

Nutrition for Chronic Kidney Disease in Children.  

National Technical Information Service (NTIS)

Chronic kidney disease (CKD) is any disease that causes the kidneys to function less efficiently over a long period of time. In the early stages of CKD, the kidneys continue to work. They just dont do their job as well as healthy kidneys. Because the decl...

2011-01-01

78

Aetiology of chronic suppurative lung disease.  

PubMed Central

Forty one (1%) of 4000 children referred for respiratory disease had chronic suppurative lung disease not due to cystic fibrosis. Further investigations showed congenital malformations in six (15%), primary ciliary dyskinesia syndrome in seven (17%), 11 had immunological abnormalities (27%), and two bronchiectasis due to aspiration (5%). Therefore the underlying cause for the disease was found in 63%. Identification of predisposing causes may facilitate prevention of further bronchial damage.

Nikolaizik, W H; Warner, J O

1994-01-01

79

Major and chronic diseases, report 2007  

Microsoft Academic Search

Blind spots in European health information\\u000aOn June 6th 2008 the European Commission has published the Major and Chronic Diseases Report 2007. This report describes the state of the art of health information in Europe on 13 prevalent chronic conditions. Large differences between the Member States of the European Union became apparent. \\u000a\\u000aFor example, as compared to the old Member

S. Giampaoli; H. van Oyen; W. Devillé; M. Verschuuren

2008-01-01

80

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

81

Chronic myelogenous leukemia: mechanisms underlying disease progression  

Microsoft Academic Search

Chronic myelogenous leukemia (CML), characterized by the BCR-ABL gene rearrangement, has been extensively studied. Significant progress has been made in the area of BCR-ABL-mediated intracellular signaling, which has led to a better understanding of BCR-ABL-mediated clinical features in chronic phase CML. Disease progression and blast crisis CML is associated with characteristic non-random cytogenetic and molecular events. These can be viewed

AS Shet; BN Jahagirdar; CM Verfaillie

2002-01-01

82

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

83

Framing international trade and chronic disease.  

PubMed

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

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

2011-07-04

84

Framing international trade and chronic disease  

PubMed Central

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

2011-01-01

85

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.

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

2013-01-01

86

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 ...

87

Beneficial effect of salmon roe phosphatidylcholine in chronic liver disease.  

PubMed

Phosphatidylcholine (PC), especially dilinoleoyl-PC, has been reported to be effective in preventing hepatic fibrosis in chronically alcohol-fed baboons. Continuous hepatic inflammation predisposes the structure of the liver to fibrosis. Since n-3 polyunsaturated fatty acids (PUFA) have been shown to exhibit an anti-inflammatory effect, we tested the hypothesis that n-3 PUFA PC as a dietary supplement has a beneficial effect on chronic liver disease susceptible to fibrosis. Salmon roe phospholipids, 90% of which are PC, were extracted and encapsulated. Almost a third of the PC fatty acids were docosahexaenoic acid (22:6 n3) and 10% were eicosapentanoic acid (20:5 n3). About 1600 mg/day of the phospholipids was administered for six months to six chronic liver disease patients, four with hepatitis B infection (three with cirrhosis, one with chronic hepatitis), one with hepatitis C virus cirrhosis and one with alcoholic cirrhosis. There was no change in the results of blood chemistry studies related to liver function, except in globulin, which decreased from 3.80 g/dl to 3.67 g/dl (p < 0.05). Among the lipid parameters, HDL-cholesterol, apolipoprotein A-I and apolipoprotein E increased significantly. Although this was a small trial, n-3 PUFA PC may be beneficial in the treatment of chronic liver diseases. PMID:10621924

Hayashi, H; Tanaka, Y; Hibino, H; Umeda, Y; Kawamitsu, H; Fujimoto, H; Amakawa, T

1999-01-01

88

Chronic Kidney Disease-Mineral and Bone Disorder  

MedlinePLUS

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

89

The potential impact of anaemia of chronic disease in COPD  

Microsoft Academic Search

Anaemia of chronic disease (ACD), with chronically low levels of circulating haemoglobin, is an immune driven abnormality that occurs in many inflammatory diseases, and also in chronic heart failure. Although chronic obstructive pulmonary disease (COPD) is ''traditionally'' associated with polycythaemia, the systemic inflammation that is now recognised as a feature of COPD makes it a possible cause of ACD. If

T. Similowski; A. Agusti; W. MacNee; B. Schonhofer

2006-01-01

90

Kimura's disease in a chronic hemodialysis patient.  

PubMed

Eosinophilia is not an uncommon finding in chronic dialysis patients. It is usually benign in nature although definite pathogenesis is unknown. We have encountered a young uremic Chinese adult who developed Kimura's disease after being on maintenance hemodialysis for about 3 years. Asymptomatic eosinophilia had been noted for 1 year and 8 months prior to the development of progressively enlarged neck masses, which leads to the diagnosis of Kimura's disease. In contrast to most cases, eosinophilia was first noticed before the neck masses appeared. There is often a close correlation between Kimura's disease and glomerular disease, where renal involvement is considered as a systemic manifestation. However, we do not have strong evidence to support this relationship between terminal renal failure and Kimura's disease in this patient. To our knowledge, our patient is the first reported case of Kimura's disease occurring in chronic hemodialysis patients. Eosinophilia persisted for nearly 2 years before the neck mass developed and recurred after the excision. Besides, our patient also demonstrated a chronic and recurrent course typical of Kimura's disease. PMID:11275632

Lee, C T; Huang, C C; Lam, K K; Chen, J B

91

Chronic pain: a non-use disease.  

PubMed

One of the major problems in modern medicine is to find remedies for the group of people with chronic pain syndromes. Low back pain is one of the most frequent syndromes and perhaps the most invalidating of all of them. Chronic pain seems to develop through several pathways affecting the spinal cord and the brain: (1) neuro-anatomical reorganisation, (2) neuro-physiological changes, and (3) activation of glia cells (immune reaction in the central nervous system). Although all of these pathways seem to provide a (partial) plausible explanation for chronic pain, treatments influencing these pathways often fail to alleviate chronic pain patients. This could be because of the probability that chronic pain develops by all three mechanisms of disease. A treatment influencing just one of these mechanisms can only be partially successful. Other factors that seem to contribute to the development of chronic pain are psychosocial. Fear, attention and anxiety are part of the chronic pain syndrome being cause or consequence. The three pathways and the psycho-emotional factors constitute a psycho-neuro-immunological substrate for chronic pain syndromes; a substrate which resembles the substrate for phantom pain and functional invalidity after stroke. Both phantom pain and functional invalidity are considered non-use syndromes. The similarity of the substrate of both these two neurological disorders and chronic pain makes it reasonable to consider chronic pain a non-use disease (the hypothesis). To test this hypothesis, we developed a "paradoxal pain therapy". A therapy which combines the constraint induced movement therapy and strategies to dissociate pain from conditioning factors like fear, anxiety and attention. The aim of the therapy is to establish a behaviour perpendicular on the pathological pain-behaviour. Clinically, the treatment seems promising, although we just have preliminary results. Further clinical and laboratory studies are needed to measure eventual changes at neuro-anatomical and neuro-psychological level using modern neuro-imaging instruments (PET, SPECT, fMRI). Randomised clinical trials should be carried out to test our hypothesis for all-day use in clinical practice. The hypothesis: chronic pain is a non-use disease produced by psycho-emotional factors like fear, attention and anxiety. Optimal treatment should be based on physiological use, and dissociation of pain and the mentioned psycho-emotional factors. Paradoxal pain therapy could serve these treatment conditions. PMID:17071012

Pruimboom, L; van Dam, A C

2006-10-30

92

Chronic Kidney Disease Is Associated with Angiographic Coronary Artery Disease  

Microsoft Academic Search

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

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

2008-01-01

93

Antioxidants and prevention of chronic disease.  

PubMed

The generation of reactive oxygen species (ROS) and other free radicals (R) during metabolism is a necessary and normal process that ideally is compensated for by an elaborate endogenous antioxidant system. However, due to many environmental, lifestyle, and pathological situations, excess radicals can accumulate, resulting in oxidative stress. Oxidative stress has been related to cardiovascular disease, cancer, and other chronic diseases that account for a major portion of deaths today. Antioxidants are compounds that hinder the oxidative processes and thereby delay or prevent oxidative stress. This article examines the process of oxidative stress and the pathways by which it relates to many chronic diseases. We also discuss the role that endogenous and exogenous antioxidants may play in controlling oxidation and review the evidence of their roles in preventing disease. PMID:15462130

Willcox, Joye K; Ash, Sarah L; Catignani, George L

2004-01-01

94

Cognitive impairment in chronic kidney disease  

Microsoft Academic Search

Background. Although end-stage renal disease (ESRD) has been associated with cognitive impairment, the relation between lesser degrees of chronic kidney disease (CKD) and cognitive impairment is less well understood. The objective of this study was to assess the cognitive function in patients with varying severity of CKD using P3 event-related potentials (P3ERPs). Methods. In this cross-sectional study, 15 neuro- logically

Pankaj Madan; Om P. Kalra; Sunil Agarwal; Om P. Tandon

95

Anemia in children with chronic kidney disease  

PubMed Central

Anemia is a common feature of chronic kidney disease, but the management of anemia in children is complex. Erythropoietin and supplemental iron are used to maintain hemoglobin levels. The National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) clinical practice guidelines for the management of anemia specifically in children were recently published. Pediatric nephrologists are encouraged to use current clinical practice guidelines and best evidence in conjunction with their clinical experience to optimally manage patients with anemia.

Koshy, Susan M.

2007-01-01

96

Chronic Graft-Versus-Host Disease  

Microsoft Academic Search

\\u000a Chronic graft-versus-host disease (cGVHD) is a complex, immune phenomenon that occurs after allogeneic stem cell transplant\\u000a (SCT) and resembles a plethora of autoimmune diseases [1]. It can have minimal features like a dry eye or can be disabling\\u000a with sclerodermatous fascitis and bronchiolitis obliterans. The incidence and time course is variable. Despite improvement\\u000a in other areas of SCT, little significant

Madan Jagasia; Steven Pavletic

97

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

98

New Therapies for Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a major global health problem which is increasing throughout the world and a major cause of death. However, current therapies fail to prevent disease progression or mortality. The mainstay of current drug therapy are long-acting bronchodilators; several longer-acting inhaled ?2-agonists and muscarinic antagonists (and combinations) are now in development. No treatments have so far

Peter J. Barnes

2010-01-01

99

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

100

3xTgAD mice exhibit altered behavior and elevated A? after chronic mild social stress  

Microsoft Academic Search

Chronic stress may be a risk factor for developing Alzheimer's disease (AD), but most studies of the effects of stress in models of AD utilize acute adverse stressors of questionable clinical relevance. The goal of this work was to determine how chronic psychosocial stress affects behavioral and pathological outcomes in an animal model of AD, and to elucidate underlying mechanisms.

Sarah M. Rothman; Nathan Herdener; Simonetta Camandola; Sarah J. Texel; Mohamed R. Mughal; Wei-Na Cong; Bronwen Martin; Mark P. Mattson

101

End stage chronic obstructive pulmonary disease.  

PubMed

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

Ambrosino, Nicolino; Gherardi, Marco; Carpenè, Nicoletta

2009-01-01

102

Magnesium in Chronic Kidney Disease: Unanswered Questions  

Microsoft Academic Search

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

David M. Spiegel

2011-01-01

103

Dental disease in children with chronic illness  

PubMed Central

We focus on the role of the general paediatrician in promoting the importance of good dental health for all children and in particular those children "at risk". We present preventive measures, evidence based where available, that may improve dental care and promote the role of paediatric dental services in the multidisciplinary management of chronic disease.

Foster, H; Fitzgerald, J

2005-01-01

104

Theophylline in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Although theophylline has side effects when used in bronchodilator doses, increasing evidence shows that it has significant antiinflam- matory effects in chronic obstructive pulmonary disease at lower plasma concentrations. These antiinflammatory effects are unlikely to be accounted for by phosphodiesterase inhibition or adenosine receptor antagonism, which require higher concentrations. There isnowevidencethattheophyllineatlowtherapeuticconcentrations is an activator of histone deacetylases and that this

Peter J. Barnes

2005-01-01

105

Update on Pregnancy in Chronic Kidney Disease  

Microsoft Academic Search

The occurrence of pregnancy in patients with chronic kidney disease (CKD) has been considered a dangerous event both for the mother and for the fetus. However, increasing evidence shows that the stage of CKD is the leading factor that can predict possible acceleration in the declining of renal function and complications of pregnancy. This review summarizes recent data on pregnancy

Giuseppe Castellano; Vincenzo Losappio; Loreto Gesualdo

2011-01-01

106

Chronic beryllium disease: Diagnosis and management  

Microsoft Academic Search

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

Rossman

1996-01-01

107

Gene Therapy for Chronic Granulomatous Disease  

Microsoft Academic Search

Identification of gene mutations responsible for leukocyte dysfunction along with the application of gene transfer technology has made genetic correction of such disorders possible. Much of the research into molecular therapy for inherited disorders of phagocytes has been focused on chronic granulomatous disease (CGD). CGD results from mutations in any one of the four genes encoding essential subunits of respiratory

W. Scott Goebel; Mary C. Dinauer

2003-01-01

108

Fluid homeostasis in chronic obstructive lung disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) often leads to massive oedema and the development of what is usually called cor pulmonale. The mechanisms by which patients with COPD retain salt and water are not completely understood. Several abnormalities have been found including reduced renal blood flow with relatively preserved glomerular filtration rate and elevated levels of renin, aldosterone, arginine vasopressin and

P. W. de Leeuw; A. Dees

2003-01-01

109

Dietary Fiber and the Relationship to Chronic Diseases  

Microsoft Academic Search

Preventative medicine is targeting chronic diseases such as heart disease, cancer, diabetes, and obesity. Populations that consume more dietary fiber have less chronic disease. Intake of dietary fiber has beneficial effects on the risk factors for developing several chronic diseases. Dietary reference intakes recommend the consumption of 14 g of dietary fiber per 1000 kcal, or 25 g for women

Derek A. Timm; Joanne L. Slavin

2008-01-01

110

Future of chronic obstructive pulmonary disease management.  

PubMed

Bronchodilators play a pivotal role in the management of symptomatic chronic obstructive pulmonary disease. Inhaled short-acting bronchodilators are used for all stages of chronic obstructive pulmonary disease, primarily for the immediate relief of symptoms; inhaled long-acting bronchodilators are recommended for maintenance therapy in patients with moderate-to-very severe disease and those with daily symptoms. When symptoms are not adequately controlled by a single bronchodilator, combining bronchodilators of different classes may prove effective. Several long-acting ?(2)-agonists and long-acting muscarinic antagonists with 24-h duration of action and inhalers combining different classes of long-acting, once-daily bronchodilators are in development. The place of these agents in the treatment algorithm will be determined by their efficacy and safety profiles and their long-term impact on relevant clinical outcomes. PMID:22788943

D'Urzo, Anthony; Vogelmeier, Claus

2012-06-01

111

Angiogenesis and vascular remodeling in chronic airway diseases.  

PubMed

Asthma and chronic obstructive pulmonary disease remain a global health problem, with increasing morbidity and mortality. Despite differences in the causal agents, both diseases exhibit various degrees of inflammatory changes, structural alterations of the airways leading to airflow limitation. The existence of transient disease phenotypes which overlap both diseases and which progressively decline the lung function has complicated the search for an effective therapy. Important characteristics of chronic airway diseases include airway and vascular remodeling, of which the molecular mechanisms are complex and poorly understood. Recently, we and others have shown that airway smooth muscle (ASM) cells are not only structural and contractile components of airways, rather they bear capabilities of producing large number of pro-inflammatory and mitogenic factors. Increase in size and number of blood vessels both inside and outside the smooth muscle layer as well as hyperemia of bronchial vasculature are contributing factors in airway wall remodeling in patients with chronic airway diseases, proposing for the ongoing mechanisms like angiogenesis and vascular dilatation. We believe that vascular changes directly add to the airway narrowing and hyper-responsiveness by exudation and transudation of proinflammatory mediators, cytokines and growth factors; facilitating trafficking of inflammatory cells; causing oedema of the airway wall and promoting ASM accumulation. One of the key regulators of angiogenesis, vascular endothelial growth factor in concerted action with other endothelial mitogens play pivotal role in regulating bronchial angiogenesis. In this review article we address recent advances in pulmonary angiogenesis and remodelling that contribute in the pathogenesis of chronic airway diseases. PMID:23975597

Alagappan, Vijay K T; de Boer, Willem I; Misra, Virendra K; Mooi, Wolter J; Sharma, Hari S

2013-11-01

112

Pathophysiology of Exacerbations of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

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

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

2006-01-01

113

Mediterranean dietary pattern and chronic diseases.  

PubMed

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

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

2014-01-01

114

FastStats: Chronic Liver Disease/Cirrhosis  

MedlinePLUS

... Related Links Accessibility NCHS Home FastStats Home Chronic Liver Disease and Cirrhosis (Data are for the U.S.) ... Hospital Inpatient Care Number of discharges with chronic liver disease and cirrhosis as the first-listed diagnosis: ...

115

Coexistence of chronic calcific pancreatitis and celiac disease.  

PubMed

Coexistence of celiac disease with chronic calcific pancreatitis is rare. We describe a 26-year-old woman with chronic calcific pancreatitis in whom non-response to treatment was due to celiac disease. PMID:17401240

Sood, Ajit; Midha, Vandana; Sood, Neena; Bansal, Manu; Kaur, Manpreet; Goyal, Anuza; Sharma, Nidhi

116

64 FR 11915 - National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control...  

Federal Register 2010, 2011, 2012, 2013

...Chronic Disease Prevention and Health Promotion, Centers for Disease Control...Chronic Disease Prevention and Health Promotion's pending funding announcement...is committed to achieving the health promotion and disease prevention...

1999-03-10

117

Caloric restriction and chronic inflammatory diseases.  

PubMed

A reduction in calorie intake [caloric restriction (CR)] appears to consistently decrease the biological rate of aging in a variety of organisms as well as protect against age-associated diseases including chronic inflammatory disorders such as cardiovascular disease and diabetes. Although the mechanisms behind this observation are not fully understood, identification of the main metabolic pathways affected by CR has generated interest in finding molecular targets that could be modulated by CR mimetics. This review describes the general concepts of CR and CR mimetics as well as discusses evidence related to their effects on inflammation and chronic inflammatory disorders. Additionally, emerging evidence related to the effects of CR on periodontal disease in non-human primates is presented. While the implementation of this type of dietary intervention appears to be challenging in our modern society where obesity is a major public health problem, CR mimetics could offer a promising alternative to control and perhaps prevent several chronic inflammatory disorders including periodontal disease. PMID:21749581

González, O A; Tobia, C; Ebersole, J L; Novak, M J

2011-07-13

118

Analgesic use and chronic renal disease.  

PubMed

To examine the use of analgesics as a cause of chronic renal disease, we performed a multicenter case-control study of 554 adults with newly diagnosed kidney disease (serum creatinine, greater than or equal to 130 mumol per liter [1.5 mg per deciliter]) and 516 matched control subjects selected randomly from the same area of North Carolina. Histories of use of analgesics (phenacetin, acetaminophen, and aspirin) were obtained by telephone interview with the patients or their proxies. Daily users of analgesics had significantly more renal disease than infrequent users (odds ratio, 2.79; 95 percent confidence interval, 1.85 to 4.21). The risk of renal disease was highest in daily users of phenacetin (odds ratio, 5.11; confidence interval, 1.76 to 14.9, after adjustment for the effects of other analgesics). The risk of renal disease was also increased in daily users of acetaminophen; after adjustment for the use of aspirin and phenacetin, the odds ratio was 3.21 (confidence interval, 1.05 to 9.80). There was no increased risk in daily aspirin users (adjusted odds ratio, 1.32; confidence interval, 0.69 to 2.51). The risks with daily use of either phenacetin or acetaminophen changed little after adjustment for diabetes, hypertension, and the indication for analgesic use. We conclude that the long-term, regular use of phenacetin may increase the risk of chronic renal disease. The long-term, daily use of acetaminophen, the major metabolite of phenacetin, is associated independently with an increased risk of chronic renal disease. We could find no increased risk in daily users of aspirin. PMID:2651928

Sandler, D P; Smith, J C; Weinberg, C R; Buckalew, V M; Dennis, V W; Blythe, W B; Burgess, W P

1989-05-11

119

Chronic wasting disease in Canada: Part 1  

PubMed Central

Abstract The purpose of part 1 is to provide an overview of published literature (1980–2002) on chronic wasting disease (CWD) to inform Canadian readers about the disease and to explain Canadian regulatory approaches to the surveillance and control of CWD. Much of the scientific information is drawn from American publications obtained from internet searches in PubMed and Medline databases. The following keywords were used: chronic wasting disease, prion, diagnosis, transmissible spongiform encephalopathies, CWD and deer, CWD and elk, and CWD and environment. The article also presents information from Canadian publications and unpublished observations, Canadian Food Inspection Agency (CFIA) documents, and both government and nongovernment internet Web sites. The article highlights some different features of CWD in Canada, as compared with the situation in the United States, and mentions public health implications of the disease. It also describes the basis for development of Canada’s surveillance and control program. Part 2 will detail the activities and results of the surveillance and control program during 2000 to 2002 and discuss factors that will influence the feasibility of eradicating CWD. Chronic wasting disease appears to have been introduced into Canada through the importation of infected farmed elk from the United States in the late 1980s and early 1990s, at a time when little was known about the disease. Since then, eradication efforts in Canada have led to the control of the spread of CWD in the farmed elk industry. Still, management of this disease, especially in free-ranging cervids, is a challenge.

2004-01-01

120

Age-associated chronic diseases require age-old medicine: role of chronic inflammation.  

PubMed

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

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

2011-12-09

121

Chronic inflammatory rheumatic diseases in black Zimbabweans.  

PubMed Central

The pattern of chronic inflammatory rheumatic diseases seen in 52 black Zimbabweans was determined. These diseases constituted 2% of all treatable chronic endemic medical diseases registered around Gweru City. Rheumatoid arthritis (RA) and gout were the commonest, 38.8% and 28.8% of the total respectively. Systemic lupus erythematosus (SLE), polymyositis, progressive systemic sclerosis, mixed connective tissue disease, ankylosing spondylitis, and Reiter's diseases were seen less frequently. While the rarity of ankylosing spondylitis was not surprising, that of SLE was striking. RA seen in Zimbabwe was as severe as in East Africa, with a mean age of onset of 43.6 (SD 9.6) years, mean ESR 67 (SD 33) mm/h, seropositivity 78%, subcutaneous nodules 10%, and overall deformities in 35% of all cases. Gout was as seen elsewhere, with a mean age of onset 41.5 (SD 7.95) years, M:F ratio 6.5:1, mean male serum uric acid 10.8 (SD 2.69) mg/dl (0.64 +/- 0.16 mmol/l). Alcohol as a precipitating and aggravating factor was supported by a high mean drunkenness score of 10.3 (SD 3.89) out of a maximum of 17. Unawareness and underdiagnosis of these diseases are still likely problems in this part of the world.

Lutalo, S K

1985-01-01

122

[Vaccination scheme in advanced chronic kidney disease].  

PubMed

1. VACCINATION AGAINST HEPATITIS B a) All patients with chronic advanced renal disease and negative serology for HBsAg and antiHBs are to be vaccinated against hepatitis B (Evidence level: B). b) For classic vaccines (Engerix B and HBVAxpro) the adult vaccine dose is 40 mcg (20 mcg in the paediatric population). There are two dose regimens based on the medicinal product used: 0, 1 and 6 months with HBVAxpro and 0, 1, 2 and 6 months with Engerix B. With the new vaccine Fendrix, the dose is 20 mcg and the schedule 0, 1, 2 and 6 months (Evidence level: C). c) The antiHBs titre is to be measured 1-2 months after administration of the last dose. In patients whose antibody titres are below 10 mIU/mL, a booster may be administered, checking the response or administering a second full vaccination (Evidence level: B). d) In responders, antibody levels are to be tested at least once a year. If the antiHBs titre is below 10 mIU/mL, a booster is to be administered (Evidence level: C). 2. VACCINATION AGAINST INFLUENZA a) All patients with chronic advanced renal disease are to be vaccinated every year against influenza (Evidence level: B). b) The vaccination dose and regimen are the same as recommended for the general population (Evidence level: C) 3. VACCINATION AGAINST PNEUMOCOCCUS a) Vaccination against pneumococcus is recommended in patients with chronic renal disease associated with nephrotic syndrome or who may be future candidates for renal transplant (Evidence level: B). b) There is no evidence of the clinical value of the pneumococcal vaccine in adult patients with chronic renal failure, not transplanted. However, some regions are recommending routine vaccination in the population aged >or= 60 years, the age of a high percentage of our patients. c) To maintain immunisation, revaccination is required every 3- 5 years. 4. OTHER VACCINES a) Vaccination against hepatitis A is recommended in patients with renal failure associated with chronic liver disease or who are candidates for renal transplant (Evidence level: C). b) The recommendations for vaccination against tetanus and diphtheria are the same as for the general population (Evidence level: C). c) Chickenpox vaccine is indicated in children with chronic renal disease, particularly if they are candidates for transplant (Evidence level: B). Although there is no evidence of the value of this vaccine in adults, it is advisable to perform it in those who may be candidates for renal transplant with no protecting antibodies. d) There is no evidence of the clinical value of the vaccine against Staphylococcus aureus. PMID:19018745

Barril, G; Teruel, J L

2008-01-01

123

Diseases of the parathyroid gland in chronic kidney disease  

Microsoft Academic Search

During the past few years, remarkable advances have been made in the understanding and the management of parathyroid diseases\\u000a in patients with chronic kidney disease (CKD). One of the important insights is the identification of fibroblastic growth\\u000a factor 23, which has greatly reshaped our understanding of secondary hyperparathyroidism (SHPT). The recent introduction of\\u000a calcimimetic cinacalcet hydrochloride has led to a

Hirotaka Komaba; Takatoshi Kakuta; Masafumi Fukagawa

124

Chronic GVHD as an autoimmune disease.  

PubMed

Many of the clinical, histological and serological manifestations of chronic graft-versus-host disease (GVHD) resemble autoimmune disease (AD), and although the differences are significant, they may be more semantic than biological. Indeed, studies suggest that some ADs may represent a fetal-versus-maternal chronic GVHD. Both conditions involve dysregulated immune responses resulting in tissue inflammation, damage, scarring and organ dysfunction, and both may be associated with a genetic predisposition. Epitope-specific autoaggressive phenomena such as immune thrombocytopenic purpura (ITP) are often seen following allogeneic hematopoietic stem-cell transplantation (HCT), implying a loss of specific tolerance to self structures. However, the more widespread manifestations of GVHD such as the well-known scleroderma-like symptoms differ in many fundamental respects from de-novo scleroderma, and other multisystem ADs such as systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). PMID:18503993

Tyndall, Alan; Dazzi, Francesco

2008-06-01

125

Nursing management of chronic obstructive pulmonary disease.  

PubMed

Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality, which imposes a major burden on both society and the health service. It is a common condition that is on the increase and predominantly caused by smoking. Progressive damage to the lung tissue renders the patient increasingly breathless resulting in a frightening existence causing varying degrees of disability and handicap. It is therefore essential that healthcare professionals understand how this condition affects patients not only from a physical perspective, but also from a psychological and social perspective to provide effective nursing management. Nursing management of patients suffering from this disease is aimed at helping to control individual patient's symptoms and improve their quality of life. PMID:19060812

Barnett, Margaret

126

Mice with Chronically Elevated Dopamine Exhibit Enhanced Motivation, but not Learning, for a Food Reward  

Microsoft Academic Search

Dopamine has been critically implicated in learning and motivation, although its precise role remains to be determined. In order to investigate the involvement of dopamine in learning and motivation for a food reward, we used dopamine transporter knockdown mice (DAT KD) that have chronically elevated levels of extracellular dopamine. The present study demonstrates that chronically elevated dopamine enhances tendency to

Barbara Cagniard; Peter D Balsam; Daniela Brunner; Xiaoxi Zhuang

2006-01-01

127

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.

Lomas, David A; Silverman, Edwin K

2001-01-01

128

Anemia management in chronic kidney disease  

Microsoft Academic Search

Anemia is one of the most common and morbid complications of chronic kidney disease, causing unpleasant symptoms and reducing the quality of life. The availability of recombinant human erythropoietin (rHuEPO) in 1989 has been one of the most important developments in the care of this population in the past several decades. Treatment with erythropoiesis-stimulating agents (ESAs) has improved patients’ lives,

Steven Fishbane; Allen R Nissenson

2010-01-01

129

Preventive care in chronic liver disease  

Microsoft Academic Search

OBJECTIVE: To identify preventive care measures that are appropriate for and specific to patients with chronic liver disease and to\\u000a provide recommendations and information that can be shared with patients.\\u000a \\u000a \\u000a MEASUREMENTS: A review of the literature was undertaken using MEDLINE from 1970 to present. Priority was given to randomized controlled studies, but case reports, case-control studies, and reviews\\u000a were included.

Thomas R. Riley; Jill P. Smith

1999-01-01

130

Mechanisms of progression of chronic kidney disease  

Microsoft Academic Search

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

Agnes B. Fogo

2007-01-01

131

Endocrinological disturbances in chronic obstructive pulmonary disease  

Microsoft Academic Search

ABSTRACT: In this overview, the available literature on endocrinological disturbances in chronic obstructive pulmonary disease (COPD) is reviewed, with stress on growth hormone\\/insulin-like growth factor I (IGF-I), thyroid hormone and the anabolic steroids. In COPD, little is known about circulating growth hormone or IGF-I concentrations. Some authors find a decrease in growth hormone or IGF-I, others an increase. An increase

E. C. Creutzberg; R. Casaburi

2003-01-01

132

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

133

Interstitial Lung Disease in a Patient with Chronic Granulomatous Disease  

PubMed Central

Background Chronic granulomatous disease (CGD) is an inherited phagocytes defect, characterized by defects of NADPH-oxidase and inability of bacterial killing, which leads to recurrent life-threatening infections. Respiratory problems, which are the major cause of morbidity in CGD, usually result from recurrent severe infections; however, vigorous inflammatory response could also cause respiratory diseases. Case Presentation Herein, an 11 year-old patient with CGD is presented who suffered from chronic cough and dyspnea for 7 years. Considering the results of chest X-ray, high-resolution computed tomography, and pulmonary function test, the diagnosis of interstitial lung disease was made. Conclusion Early recognition of manifestations associated with CGD and appropriate treatment could prevent further complications and reduce morbidity and mortality in this group of patients.

Moghtaderi, Mozhgan; Kashef, Sara; Rezaei, Nima

2012-01-01

134

Chronic granulomatous disease as a risk factor for autoimmune disease.  

PubMed

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 disorders. In this report, we describe antiphospholipid syndrome, recurrent pericardial effusion, juvenile idiopathic arthritis, IgA nephropathy, cutaneous lupus erythematosus, and autoimmune pulmonary disease in the setting of CGD. The presence and type of autoimmune disease have 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

2008-09-26

135

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

136

[Cardiovascular diseases in patients with chronic renal diseases].  

PubMed

The risk of cardiovascular disease in patients with chronic renal disease appears to be far greater than in the general population and the risk of cardiovascular death is much higher than the risk of eventually requiring renal replacement therapy. Heart failure is important finding and it is evident even before the initiation of dialysis; the frequency of heart failure is 10 to 30 times higher in patients on dialysis than in the general population. Left ventricular hypertrophy has incidence of nearly 75-80% and is closely related to heart failure, ventricular arrhythmias, fatal myocardial infarction, aortic root dilatation and cerebrovascular event. Ischaemic heart disease is usually the consequence of coronary artery disease, but 27% of haemodialysis patients may have symptoms without atherosclerotic changes in coronary arteries. Silent myocardial ischemia is more frequent in dialysis population. Hypertension is present in 80-85% of patients and its prevalence is linearly related to glomerular filtration rate. Patients with end-stage renal disease are more likely to have an increase in pulse pressure and isolated systolic hypertension and they may not demonstrate the normal nocturnal decline in blood pressure. Patients on dialysis are prone to calcification of media and intima due to disbalance of promoters and inhibitors of calcification process. Now, there are no valid data about the privilege of one dialysis method over another in cardiovascular morbidity and mortality. Numerous traditional and non-traditional risk factors urge for preventive measures for cardiovascular diseases in patients with chronic renal diseases. PMID:18924484

Dimkovi?, Nada

2008-05-01

137

The Indiana Chronic Disease Management Program  

PubMed Central

The Indiana Chronic Disease Management Program (ICDMP) is intended to improve the quality and cost-effectiveness of care for Medicaid members with congestive heart failure (chronic heart failure), diabetes, asthma, and other conditions. The ICDMP is being assembled by Indiana Medicaid primarily from state and local resources and has seven components: (1) identification of eligible participants to create regional registries, (2) risk stratification of eligible participants, (3) nurse care management for high-risk participants, (4) telephonic intervention for all participants, (5) an Internet-based information system, (6) quality improvement collaboratives for primary care practices, and (7) program evaluation. The evaluation involves a randomized controlled trial in two inner-city group practices, as well as a statewide observational design. This article describes the ICDMP, highlights challenges, and discusses approaches to its evaluation.

Rosenman, Marc B; Holmes, Ann M; Ackermann, Ronald T; Murray, Michael D; Doebbeling, Caroline Carney; Katz, Barry; Li, Jingjin; Zillich, Alan; Prescott, Victoria M; Downs, Stephen M; Inui, Thomas S

2006-01-01

138

An Informatics-based Chronic Disease Practice  

PubMed Central

The authors present the case study of a 35-year informatics-based single subspecialty practice for the management of patients with chronic thyroid disease. This extensive experience provides a paradigm for the organization of longitudinal medical information by integrating individual patient care with clinical research and education. The kernel of the process is a set of worksheets easily completed by the physician during the patient encounter. It is a structured medical record that has been computerized since 1972, enabling analysis of different groups of patients to answer questions about chronic conditions and the effects of therapeutic interventions. The recording process and resulting studies severe as an important vehicle for medical education about the nuances of clinical practice. The authors suggest ways in which computerized medical records can become an integral part of medical practice, rather than a luxury or novelty.

Nordyke, Robert A.; Kulikowski, Casimir A.

1998-01-01

139

The Relationship Between Chronic Kidney Disease and SYNTAX Score  

Microsoft Academic Search

Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease and death. We evaluated the association between CKD and severity of coronary artery stenosis by calculating SYNTAX Score in patients with left main coronary artery and\\/or 3-vessel coronary artery disease. Coronary angiograms of 217 patients were assessed. Chronic kidney disease was staged using the estimated glomerular filtration rate

Ugur Coskun; Kadriye Orta Kilickesmez; Okay Abaci; Cuneyt Kocas; Cem Bostan; Ahmet Yildiz; Murat Baskurt; Alev Arat; Murat Ersanli; Tevfik Gurmen

2011-01-01

140

Disturbances of rhythm in chronic lung disease.  

PubMed

Patients with chronic obstructive lung disease have a high incidence and wide variety of cardiac arrhythmias. These arrhythmias are often clinically significant and may be life threatening. Although they occur particularly in the context of acute respiratory failure, arrhythmias are not infrequent in clinically stable patients. The relatively high incidence of sudden arrhythmias seen in acute respiratory failure are associated with a very poor prognosis, in particular, ventricular premature beats and multifocal atrial tachycardia. Long-term electrocardiographic monitoring is valuable in increasing the detection of these arrhythmias and in assessing their clinical significance and response to therapy. The mechanisms producing these arrhythmias are poorly understood and probably multiple. However, disturbances of blood gases, blood pH, and electrolytes or the presence of cor pulmonale or associated coronary artery disease is probably important. The therapy of these arrhythmias must include efforts to improve the patient's ventilatory status as well as careful use of standard antiarrhythmic drugs. Further investigation is needed to define the mechanisms, determine the prognosis, and improve the therapy of the arrhythmias found in chronic obstructive lung disease. PMID:584715

Biggs, F D; Lefrak, S S; Kleiger, R E; Senior, R M; Oliver, G C

141

[Chronic obstructive pulmonary disease in women].  

PubMed

For the past several years the number of women suffering from chronic obstructive pulmonary disease (COPD) has been steadily increasing. This fact prompts the debate which factors, in addition to considerably increasing prevalence of cigarette smoking among young women, are responsible for these epidemiologic changes. Differences in the natural history and prognosis of COPD in females and males are presented in the paper, as well as the number of potential ethiopathogenetic and pathophysiologic factors influencing these variations. Among them, differences in the COPD risk factors spectrum in both genders and in airways anatomy are pointed out, and the mechanisms responsible for greater women's susceptibility to components of cigarette smoke, which reflect genetic (enzyme polymorphisms), epigenetic (diminished DNA methylation) and hormonal (estrogens) influences on xenobiotics metabolism. Further, sex-related differences regarding COPD phenotypes (chronic bronchitis vs. emphysema), immunological markers and clinical manifestation of disease are underlined in the paper. More frequent coexistence of anxiety and depression, COPD exacerbations and worse quality of life in women are also emphasized. Other differences, pointed out by authors include autoimmunological conception of pathogenesis of COPD (greater female susceptibility to produce autoantibodies), risk factors of disease exacerbation and, at last, response to certain forms of COPD treatment (nicotine replacement therapy, long-term oxygen therapy). PMID:22370982

Uci?ska, Romana; Damps-Konsta?ska, Iwona; Siemi?ska, Alicja; Jassem, Ewa

2012-01-01

142

Effect of 6 Months of Erythromycin Treatment on Inflammatory Cells in Induced Sputum and Exacerbations in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Background: Chronic obstructive pulmonary disease (COPD) is characterized by airway inflammation and is associated with acute exacerbations. Macrolide antibiotics have been shown to exhibit anti-inflammatory effects in some chronic airway inflammatory diseases. Objective: The aim of this study was to assess the effect of treatment with erythromycin on airway inflammation and health outcome in COPD patients. Methods: We conducted a

Zhi-Yi He; Li-Mei Ou; Jian-Quan Zhang; Jing Bai; Guang-Nan Liu; Mei-Hua Li; Jing-Min Deng; William MacNee; Xiao-Ning Zhong

2010-01-01

143

Activity Monitoring in Chronic Obstructive Pulmonary Disease  

PubMed Central

The measurement of daily physical activity (PA) has become a significant outcome in patients with chronic obstructive pulmonary disease (COPD). Recent data have shown the independent association between PA markers, hospitalizations, and mortality. Daily PA can be quantified by direct observation, assessment of energy expenditure, questionnaires, and activity monitors (motion sensors). This review aims to describe the methods used to quantify daily PA in COPD on the basis of the published literature and to suggest potential applications of activity monitoring methods in clinical research and daily care of COPD patients.

Benzo, Roberto

2012-01-01

144

Increased taste intensity perception exhibited by patients with chronic back pain  

Microsoft Academic Search

There is overlap between brain regions involved in taste and pain perception, and cortical injuries may lead to increases as well as decreases in sensitivity to taste. Recently it was shown that chronic back pain (CBP) is associated with a specific pattern of brain atrophy. Since CBP is characterized by increased sensitivity to pain, we reasoned that the sense of

Dana M. Small; A. Vania Apkarian

2006-01-01

145

Oral corticosteroids for stable chronic obstructive pulmonary disease  

Microsoft Academic Search

Background: Chronic obstructive pulmonary disease (COPD) is a common chronic lung disorder, usually related to cigarette smoking, representing a major and increasing cause of morbidity and mortality. It is defined \\

Julia A E Walters; Haydn Walters; Richard Wood-Baker

2005-01-01

146

Achieving Salt Restriction in Chronic Kidney Disease  

PubMed Central

There is consistent evidence linking excessive dietary sodium intake to risk factors for cardiovascular disease and chronic kidney disease (CKD) progression in CKD patients; however, additional research is needed. In research trials and clinical practice, implementing and monitoring sodium intake present significant challenges. Epidemiological studies have shown that sodium intake remains high, and intervention studies have reported varied success with participant adherence to a sodium-restricted diet. Examining barriers to sodium restriction, as well as factors that predict adherence to a low sodium diet, can aid researchers and clinicians in implementing a sodium-restricted diet. In this paper, we critically review methods for measuring sodium intake with a specific focus on CKD patients, appraise dietary adherence, and factors that have optimized sodium restriction in key research trials and discuss barriers to sodium restriction and factors that must be considered when recommending a sodium-restricted diet.

McMahon, Emma J.; Campbell, Katrina L.; Mudge, David W.; Bauer, Judith D.

2012-01-01

147

Achieving salt restriction in chronic kidney disease.  

PubMed

There is consistent evidence linking excessive dietary sodium intake to risk factors for cardiovascular disease and chronic kidney disease (CKD) progression in CKD patients; however, additional research is needed. In research trials and clinical practice, implementing and monitoring sodium intake present significant challenges. Epidemiological studies have shown that sodium intake remains high, and intervention studies have reported varied success with participant adherence to a sodium-restricted diet. Examining barriers to sodium restriction, as well as factors that predict adherence to a low sodium diet, can aid researchers and clinicians in implementing a sodium-restricted diet. In this paper, we critically review methods for measuring sodium intake with a specific focus on CKD patients, appraise dietary adherence, and factors that have optimized sodium restriction in key research trials and discuss barriers to sodium restriction and factors that must be considered when recommending a sodium-restricted diet. PMID:23320173

McMahon, Emma J; Campbell, Katrina L; Mudge, David W; Bauer, Judith D

2012-12-23

148

Epidemiology of Chronic Kidney Disease in Heart Failure  

PubMed Central

Synopsis Heart failure is common and is associated with poor prognosis. Chronic kidney disease is common in heart failure, and shares many risk factors with heart failure such as age, hypertension, diabetes, and coronary artery disease. Over half of all heart failure patients may have moderate to severe chronic kidney disease. The presence of chronic kidney disease is associated with increased morbidity and mortality, yet it is also associated with underutilization of evidence-based heart failure therapy that may reduce morbidity and mortality. Understanding the epidemiology and outcomes of chronic kidney disease in heart failure is essential to ensure proper management of these patients.

Ahmed, Ali; Campbell, Ruth C.

2010-01-01

149

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.

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

2011-01-01

150

Immunology of asthma and chronic obstructive pulmonary disease  

Microsoft Academic Search

Asthma and chronic obstructive pulmonary disease (COPD) are both obstructive airway diseases that involve chronic inflammation of the respiratory tract, but the type of inflammation is markedly different between these diseases, with different patterns of inflammatory cells and mediators being involved. As described in this Review, these inflammatory profiles are largely determined by the involvement of different immune cells, which

Peter J. Barnes

2008-01-01

151

Early cardiovascular involvement in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Early cardiovascular involvement in Chronic Obstructive Pulmonary Disease. M. Malerba, G. Romanelli. Cardiovascular (CV) disease represents a consider- able risk factor in terms of both morbidity and mortality in elderly patients with chronic obstructive pulmonary disease (COPD). In fact, there is a considerable evidence of this association: for only 20 years forced expiratory vol- ume in 1 second (FEV1) has

M. Malerba; G. Romanelli

2009-01-01

152

New treatments for chronic obstructive pulmonary disease using ergogenic aids  

Microsoft Academic Search

Chronic obstructive pulmonary disease is currently considered a systemic disease, presenting structural and metabolic alterations that can lead to skeletal muscle dysfunction. This negatively affects the performance of respiratory and peripheral muscles, functional capacity, health-related quality of life and even survival. The decision to prescribe ergogenic aids for patients with chronic obstructive pulmonary disease is based on the fact that

DEBORA STROSE VILLAÇA; MARIA CRISTINA LERARIO; SIMONE DAL CORSO; JOSÉ ALBERTO NEDER

2005-01-01

153

Treatment of mild chronic obstructive pulmonary disease  

PubMed Central

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.

Chee, Alex; Sin, Don D

2008-01-01

154

Genomic Biomarkers for Chronic Kidney Disease  

PubMed Central

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

Ju, Wenjun; Smith, Shahaan; Kretzler, Matthias

2012-01-01

155

Application of Direct Renin Inhibition to Chronic Kidney Disease  

Microsoft Academic Search

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

Christian W. Mende

2010-01-01

156

Hypertension in chronic kidney disease: navigating the evidence.  

PubMed

Hypertension is both an important cause and consequence of chronic kidney disease. Evidence from numerous clinical trials has demonstrated the benefit of blood pressure control. However, it remains unclear whether available results could be extrapolated to patients with chronic kidney diseases because most studies on hypertension have excluded patients with kidney failure. In addition, chronic kidney disease encompasses a large group of clinical disorders with heterogeneous natural history and pathogenesis. In this paper, we review current evidence supporting treatment of hypertension in various forms of chronic kidney disease and highlight some of the gaps in the extant literature. PMID:21747971

Tedla, F M; Brar, A; Browne, R; Brown, C

2011-05-24

157

Natriuretic Peptides in Chronic Kidney Disease  

PubMed Central

Background and objectives: B-type natriuretic peptide (BNP) and amino-terminal pro-B-type natriuretic peptide (NT-proBNP) are biomarkers of cardiovascular disease that is common in patients with chronic kidney disease (CKD). Conflicting data on the influence of glomerular filtration rate (GFR) on BNP and NT-proBNP levels in CKD may stem from failure to account fully for the effects of coexistent cardiac disease, dysfunction, and volume overload. Design, setting, participants, & measurements: Prospective head-to-head comparison of plasma BNP and NT-proBNP in ambulatory euvolemic CKD patients with normal LV ejection fraction and no manifest cardiac or vascular disease. GFR was estimated by the Modification of Diet in Renal Disease formula, BNP and NT-proBNP measured using Abbott AxSYM and Roche Elecsys assays, respectively, and cardiac morphology and function assessed by transthoracic echocardiography. Results: In 142 patients (42% female) of mean age 60 ± 11 yr, mean left ventricular ejection fraction was 71% ± 6%, GFR 38 ± 14 ml/min per 1.73 m2, and median BNP and NT-proBNP level 59 and 311 pg/ml, respectively. Multivariate predictors of NT-proBNP level were GFR, ?-blocker usage, LV mass index, and hemoglobin level. Plasma BNP was independently predicted by LV mass index and ?-blocker usage but not GFR. In the 74 patients without diastolic dysfunction, there was a significant rise in NT-proBNP but not BNP as GFR declined. Conclusions: Unlike NT-proBNP, plasma BNP level is relatively independent of GFR. BNP may therefore be the more appropriate biomarker to screen for cardiac dysfunction in CKD.

Tagore, Rajat; Ling, Lieng H.; Yang, Hong; Daw, Hla-Yee; Chan, Yiong-Huak; Sethi, Sunil K.

2008-01-01

158

Exploring metabolic dysfunction in chronic kidney disease.  

PubMed

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

Slee, Adrian D

2012-04-26

159

Neuromotor control in chronic obstructive pulmonary disease.  

PubMed

Neuromotor control of skeletal muscles, including respiratory muscles, is ultimately dependent on the structure and function of the motor units (motoneurons and the muscle fibers they innervate) comprising the muscle. In most muscles, considerable diversity of contractile and fatigue properties exists across motor units, allowing a range of motor behaviors. In diseases such as chronic obstructive pulmonary disease (COPD), there may be disproportional primary (disease related) or secondary effects (related to treatment or other concomitant factors) on the size and contractility of specific muscle fiber types that would influence the relative contribution of different motor units. For example, with COPD there is a disproportionate atrophy of type IIx and/or IIb fibers that comprise more fatigable motor units. Thus fatigue resistance may appear to improve, while overall motor performance (e.g., 6-min walk test) and endurance (e.g., reduced aerobic exercise capacity) are diminished. There are many coexisting factors that might also influence motor performance. For example, in COPD patients, there may be concomitant hypoxia and/or hypercapnia, physical inactivity and unloading of muscles, and corticosteroid treatment, all of which may disproportionately affect specific muscle fiber types, thereby influencing neuromotor control. Future studies should address how plasticity in motor units can be harnessed to mitigate the functional impact of COPD-induced changes. PMID:23329816

Mantilla, Carlos B; Sieck, Gary C

2013-01-17

160

Dyslipidemia in Chronic Kidney Disease: An Approach to Pathogenesis and Treatment  

Microsoft Academic Search

Background\\/Aims: Cardiovascular disease (CVD) is a major cause of mortality in patients with mild to moderate chronic kidney disease (CKD) and end-stage renal disease (ESRD). Dyslipidemia has been established as a well-known traditional risk factor for CVD in the general population and it is well known that patients with CKD exhibit significant alterations in lipoprotein metabolism. In this review the

Vasilis Tsimihodimos; Evangelia Dounousi; Kostas C. Siamopoulos

2008-01-01

161

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

162

[Chronic obstructive pulmonary disease and heart failure].  

PubMed

Chronic obstructive pulmonary disease (COPD) is commonly associated with heart failure. Individuals with COPD have a 4.5-fold greater risk of developing heart failure than those without. The sensitivity and specificity of clinical judgment in the diagnosis of heart failure in patients with COPD can be enhanced by biological markers such as B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide. Correct interpretation of imaging results (mainly echocardiographic findings) and lung function tests can also help establish the co-occurrence of both conditions. There is little evidence on the management of patients with COPD and heart failure, although treatment of COPD undeniably affects the clinical course of patients with heart failure and viceversa. PMID:19595494

Villar Alvarez, Felipe; Méndez Bailón, Manuel; de Miguel Díez, Javier

2009-07-12

163

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

164

Diseases of the parathyroid gland in chronic kidney disease.  

PubMed

During the past few years, remarkable advances have been made in the understanding and the management of parathyroid diseases in patients with chronic kidney disease (CKD). One of the important insights is the identification of fibroblastic growth factor 23, which has greatly reshaped our understanding of secondary hyperparathyroidism (SHPT). The recent introduction of calcimimetic cinacalcet hydrochloride has led to a major breakthrough in the management of SHPT. Recognition of circulating molecular forms of parathyroid hormone (PTH) is also a major milestone in the accurate assessment of parathyroid function in CKD. Primary hyperparathyroidism should also be considered in patients with CKD, because it can cause various renal manifestations and can also occur as a sporadic disease in these patients. Hypoparathyroidism is occasionally seen in dialysis patients in the setting of diabetes mellitus and malnutrition-inflammation complex syndrome, as well as after parathyroidectomy for advanced SHPT. For patients with adynamic bone disease due to hypoparathyroidism and/or skeletal resistance to PTH, teriparatide, a PTH analog, may have potential for improving bone metabolism and reducing the risk of fracture. In this review, we summarize our current knowledge on diseases of the parathyroid gland in CKD patients, with a particular focus on recent work in the field. PMID:21818548

Komaba, Hirotaka; Kakuta, Takatoshi; Fukagawa, Masafumi

2011-08-06

165

[Chronic diseases and quality of life in primary health care].  

PubMed

The aim of this cross-sectional study was to evaluate quality of life in chronic patients treated at primary care services associated with the Catholic University of Pelotas, Rio Grande do Sul State, Brazil. Quality of life was assessed by WHOQOL-Bref, and data on chronic diseases were obtained from patients' medical records and categorized as cardiovascular diseases, respiratory diseases, endocrine diseases, mental illness, and other musculoskeletal diseases. A total of 920 subjects were interviewed. Low self-rated quality of life was associated with female gender, older age, low socioeconomic status, single conjugal status, and chronic disease. In all domains of quality of life, mean levels were lower in patients with diseases of the nervous system, except in the environmental domains, which were lower in patients with mental illness. The results corroborate that quality of life in patients with chronic diseases is a priority for public health policies. PMID:24068223

Azevedo, Ana Lucia Soares de; Silva, Ricardo Azevedo da; Tomasi, Elaine; Quevedo, Luciana de Ávila

2013-09-01

166

Hormones and arterial stiffness in patients with chronic kidney disease.  

PubMed

Cardiovascular disease constitutes the major cause of mortality in patients with chronic kidney disease. Arterial stiffness is an important contributor to the occurrence and progression of cardiovascular disease. Various risk factors, including altered hormone levels, have been suggested to be associated with arterial stiffness. Based on the background that chronic kidney disease predisposes individuals to a wide range of hormonal changes, we herein review the available data on the association between arterial stiffness and hormones in patients with chronic kidney disease and summarize the data for the general population. PMID:23911970

Gungor, Ozkan; Kircelli, Fatih; Voroneanu, Luminita; Covic, Adrian; Ok, Ercan

2013-08-02

167

Chronic kidney disease in acute coronary syndromes  

PubMed Central

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

Marenzi, Giancarlo; Cabiati, Angelo; Assanelli, Emilio

2012-01-01

168

Epidemiology of chronic kidney disease in children.  

PubMed

In the past 30 years there have been major improvements in the care of children with chronic kidney disease (CKD). However, most of the available epidemiological data stem from end-stage renal disease (ESRD) registries and information on the earlier stages of pediatric CKD is still limited. The median reported incidence of renal replacement therapy (RRT) in children aged 0-19 years across the world in 2008 was 9 (range: 4-18) [corrected] per million of the age-related population). [corrected] The prevalence of RRT in 2008 ranged from 18 to 100 per million of the age-related population. Congenital disorders, including congenital anomalies of the kidney and urinary tract (CAKUT) and hereditary nephropathies, are responsible for about two thirds of all cases of CKD in developed countries, while acquired causes predominate in developing countries. Children with congenital disorders experience a slower progression of CKD than those with glomerulonephritis, resulting in a lower proportion of CAKUT in the ESRD population compared with less advanced stages of CKD. Most children with ESRD start on dialysis and then receive a transplant. While the survival rate of children with ERSD has improved, it remains about 30 times lower than that of healthy peers. Children now mainly die of cardiovascular causes and infection rather than from renal failure. PMID:21713524

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

2011-06-29

169

Bioecological control of chronic liver disease and encephalopathy  

Microsoft Academic Search

Minimal encephalopathy was originally associated with chronic liver disease but is increasingly associated with most other\\u000a chronic diseases and particularly with diabetes and also chronic disorders in other organs: kidneys, lungs, thyroid and with\\u000a obesity. It is increasingly with dramatically increased and more or less permanent increase in systemic inflammation, most\\u000a likely a result of Western lifestyle. Frequent physical exercise

Stig Bengmark

2009-01-01

170

Prevalence of Chronic Diseases in Adolescents with Intellectual Disability  

ERIC Educational Resources Information Center

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

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

2010-01-01

171

Workplace problems and solutions for employees with chronic diseases  

Microsoft Academic Search

Background While many employees who have a chronic disease manage their jobs well, others are hampered in work performance, experience work-related problems and are at risk for job loss. Aims To identify the practical and psychosocial barriers recognized by employees with chronic disease who experience work-related problems and to examine preferred work accommodations. Methods A questionnaire was sent by mail

I. Varekamp; Dijk van F. J. H

2010-01-01

172

Chronic Disease Health Beliefs and Lifestyle Practices Among Vietnamese Adults  

Microsoft Academic Search

There is growing alarm about the dramatic increase of chronic diseases among more acculturated Vietnamese (Yee, 1999). There were 180 Vietnamese adults, stratified by gender and age: 93 males and 87 females; young (ages 18–34), middle aged (ages 35–58), and older (ages 59+). A MANOVA was performed with nine Chronic Diseases Risk subscales, health behaviors, acculturation, depression, and health locus

Barbara W. K. Yee; Ha T. Nguyen; Martin Ha

2003-01-01

173

Oxygen therapy during exacerbations of chronic obstructive pulmonary disease  

Microsoft Academic Search

Oxygen therapy during exacerbations of chronic obstructive pulmonary disease. A.G.N. Agusti´, M. Carrera, F. Barbe ´, A. Munoz, B. Togores. #ERS Journals Ltd 1999. ABSTRACT: Venturi masks (VMs) and nasal prongs (NPs) are widely used to treat acute respiratory failure (ARF) in chronic obstructive pulmonary disease (COPD). In this study, these devices were compared in terms of their potentiality to

A. G. N. Agusti; M. Carrera; F. Barbe; A. Munoz; B. Togores

174

Amenorrhoea in women with non-alcoholic chronic liver disease  

Microsoft Academic Search

Amenorrhoea is common in women with non-alcoholic chronic liver disease, but little is known about its causes or consequences. We investigated 12 young women with non-alcoholic chronic liver disease and amenorrhoea and compared them with 11 healthy age matched controls studied in the follicular phase of the menstrual cycle. None of the patients had raised serum concentrations of follicle stimulating

T F Cundy; J Butler; R M Pope; A K Saggar-Malik; M J Wheeler; R Williams

1991-01-01

175

Flavonoid intake and risk of chronic diseases1,2  

Microsoft Academic Search

Background: Flavonoids are effective antioxidants and may pro- tect against several chronic diseases. Objective: The association between flavonoid intake and risk of several chronic diseases was studied. Design: The total dietary intakes of 10 054 men and women dur- ing the year preceding the baseline examination were determined with a dietary history method. Flavonoid intakes were estimated, mainly on the

Paul Knekt; Jorma Kumpulainen; Ritva Järvinen; Harri Rissanen; Markku Heliövaara; Antti Reunanen; Timo Hakulinen; Arpo Aromaa

176

Vitamin D and Chronic Kidney Disease  

PubMed Central

Chronic kidney disease (CKD) is an emerging public health problem and one of the most powerful predictors of premature cardiovascular disease. Emerging evidence suggests that the progression of CKD and many of the cardiovascular complications may be linked to hypovitaminosis D. Patients with CKD have an exceptionally high rate of severe vitamin D deficiency that is further exacerbated by the reduced ability to convert 25-(OH)vitamin D into the active form, 1,25 dihydroxy-vitamin D. As new evidence has improved our understanding of classical, as well as the non-classical, functions for vitamin D, it has become apparent that the autocrine role of vitamin D is an important modulator of several systems including the immune, renal and cardiovascular systems. In addition to the traditional supplementation of 1,25-vitamin D to CKD patients, by assessing and repleting 25-(OH)vitamin D deficiency, physicians will adequately fuel both the renal and extra-renal pathways of calcitriol synthesis maintaining the classical, as well as the non-classical, functions of vitamin D that ultimately influence clinical outcomes in this high-risk group of patients. Because of the high rates of hypovitaminosis D and progression of CKD to end-stage renal disease in minority populations, these findings are highly relevant to the national efforts to reduce health disparities. Healthcare providers are called to join the intensified efforts of public health officials to disseminate and implement updated guidelines and recommendations to halt the growing epidemic of vitamin D deficiency, particularly in high-risk populations.

Williams, Sandra; Malatesta, Karla; Norris, Keith

2010-01-01

177

Common lung conditions: chronic obstructive pulmonary disease.  

PubMed

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

Delzell, John E

2013-06-01

178

Therapeutic vaccines for chronic diseases: successes and technical challenges  

PubMed Central

Chronic, non-communicable diseases are the major cause of death and disability worldwide and have replaced infectious diseases as the major burden of society in large parts of the world. Despite the complexity of chronic diseases, relatively few predisposing risk factors have been identified by the World Health Organization. Those include smoking, alcohol abuse, obesity, high cholesterol and high blood pressure as the cause of many of these chronic conditions. Here, we discuss several examples of vaccines that target these risk factors with the aim of preventing the associated diseases and some of the challenges they face.

Bachmann, Martin F.; Jennings, Gary T.

2011-01-01

179

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

Microsoft Academic Search

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

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

180

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

Microsoft Academic Search

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

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

2005-01-01

181

Genetics of Sputum Gene Expression in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Previous expression quantitative trait loci (eQTL) studies have performed genetic association studies for gene expression, but most of these studies examined lymphoblastoid cell lines from non-diseased individuals. We examined the genetics of gene expression in a relevant disease tissue from chronic obstructive pulmonary disease (COPD) patients to identify functional effects of known susceptibility genes and to find novel disease genes.

Weiliang Qiu; Michael H. Cho; John H. Riley; Wayne H. Anderson; Dave Singh; Per Bakke; Amund Gulsvik; Augusto A. Litonjua; David A. Lomas; James D. Crapo; Terri H. Beaty; Bartolome R. Celli; Stephen Rennard; Ruth Tal-Singer; Steven M. Fox; Edwin K. Silverman; Craig P. Hersh; Mark M. Wurfel

2011-01-01

182

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

183

The Microvasculature in Chronic Kidney Disease  

PubMed Central

Summary Background and objectives Individuals with chronic kidney disease (CKD) stages 3 to 5 have an increased risk of cardiac and other vascular disease. Here we examined the association of CKD 3 to 5 with small vessel caliber. Design, setting, participants, & measurements This was a cross-sectional observational study of 126 patients with CKD stages 3 to 5 (estimated GFR [eGFR] <60 ml/min per 1.73 m2) and 126 age- and gender-matched hospital patients with CKD 1 or 2. Retinal vessel diameters were measured from digital fundus images by a trained grader using a computer-assisted method and summarized as the central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE). Results Patients with CKD 3 to 5 had a smaller mean CRAE and CRVE than hospital controls (139.4 ± 17.8 ?m versus 148.5 ± 16.0 ?m, P < 0.001; and 205.0 ± 30.7 ?m versus 217.4 ± 25.8 ?m, respectively; P = 0.001). CRAE and CRVE decreased progressively with each stage of renal failure CKD1–2 to 5 (P for trend = 0.08 and 0.04, respectively). CKD and hypertension were independent determinants of arteriolar narrowing after adjusting for age, gender, diabetes, dyslipidemia, and smoking history. Patients with CKD 5 and diabetes had a larger mean CRAE and CRVE than nondiabetics (141.4 ± 14.9 ?m versus 132.9 ± 14.2 ?m; 211.1 ± 34.4 ?m versus 194.8 ± 23.8 ?m). Conclusions The microvasculature is narrowed in patients with reduced eGFR.

Ooi, Qi Lun; Tow, Foong Kien Newk-Fon Hey; Deva, Raj; Alias, Mohamad Afzal; Kawasaki, Ryo; Wong, Tien Y.; Mohamad, Nor; Colville, Deb; Hutchinson, Anastasia

2011-01-01

184

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.

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

185

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.

Stanzione, Giovanna; Conte, Giuseppe

2013-01-01

186

[Chronic inflammatory intestinal diseases. Pathophysiology and therapy].  

PubMed

The pathogenesis and therapy of chronic inflammatory intestinal diseases are characterized by an obvious discrepancy. There is extensive agreement that the pathogenesis is substantially based on a disruption of the barrier of the intestinal mucous membrane against luminal bacteria. This has been demonstrated in recent years by evidence from various disciplines, in particular from genetics, microbiology, morphology and innate immunology. However, there is also the evidence-based therapy which, as in the past, is aimed against the effectors of the adaptive immune system. In this case the therapy with biologicals is more aggressive and takes the risk of a series of undesired side-effects. This dichotomy of pathological knowledge and therapeutic innovation is not only medically unsatisfactory but also makes it difficult to present a consistent picture of these symptoms. Despite this an attempt will be made to bridge these inconsistencies and to demonstrate possible future developments which will lead to a final causal therapy. An extended version of this article appears in our newly published book "Colitis ulcerosa und Morbus Crohn". PMID:19777197

Herrlinger, K; Wittig, B; Stange, E F

2009-10-01

187

Patients with chronic urticaria exhibit increased rates of sensitisation to Candida albicans, but not to common moulds.  

PubMed

Patients with chronic spontaneous urticaria (CU) frequently exhibit increased levels of total IgE (tIgE). However, sensitisations to relevant allergens are rarely detected in CU patients by standard prick testing suggesting that CU symptoms, at least in some patients, may represent hypersensitivity reactions to less common allergens. The objective of this study was to characterise skin reactivity and serum levels of IgE to Candida albicans (CA) and mould allergens in CU patients. A total of 112 CU patients and 35 healthy control subjects were subjected to intracutaneous skin testing for CA and seven ubiquitous moulds. Allergen specific and tIgE were determined using the Pharmacia CAP System. CU patients exhibited higher levels of tIgE than healthy subjects, but comparable rates of skin reactivity to CA and moulds and similar levels of specific IgE to mould allergens. However, increased IgE-anti-CA could only be detected in CU patients (13%). Almost all IgE-anti-CA positive CU patients showed high levels of tIgE. These data suggest that IgE-anti-CA expression contributes, at least in part, to increased tIgE levels in CU patients. Our findings call for further studies to characterise the relevance of CA hypersensitivity in CU, particularly in IgE-anti-CA positive CU patients that exhibit colonisation with Candida albicans. PMID:18793264

Staubach, Petra; Vonend, Anneke; Burow, Gerhard; Metz, Martin; Magerl, Markus; Maurer, Marcus

2008-09-12

188

Calciphylaxis presenting in early chronic kidney disease with mixed hyperparathyroidism  

Microsoft Academic Search

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

Michael Brucculeri; Allan H Haydon

2011-01-01

189

Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients  

Microsoft Academic Search

Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients.BackgroundCardiovascular diseases are the most common causes of death among chronic hemodialysis patients, yet the risk factors for these events have not been well established.MethodsIn this cross-sectional study, we examined the relationship between several traditional cardiovascular disease risk factors and the presence or history of cardiovascular events in 936 hemodialysis patients enrolled in

Alfred K. Cheung; Mark J. Sarnak; Guofen Yan; Johanna T. Dwyer; Robert J. Heyka; Michael V. Rocco; Brendan P. Teehan; Andrew S. Levey

2000-01-01

190

Chronic Kidney Disease in India: Challenges and Solutions  

Microsoft Academic Search

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

S. K. Agarwal; R. K. Srivastava

2009-01-01

191

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

192

CHRONIC WASTING DISEASE: IMPLICATIONS AND CHALLENGES FOR WILDLIFE MANAGERS  

Microsoft Academic Search

Abstract ,Chronic wasting disease (CWD) is a transmissible spongiformencephalopathy (TSE) of deer (Odocoileusspp.) and RockyMountain,elk (Cervus elaphus nelsoni). Other TSEs include important diseases of domestic animals (scrapie, bovine spongiformencephalopathy )and rare fatal diseases of humans (Creutzfeldt-Jakob disease and variant Creutzfeldt-Jakob disease); the bovine spongiform encephalopathyagent apparentlycauses variant Creutzfeldt-Jakob disease. In recent years intense interest in CWD has developed because of

Elizabeth S. Williams; Michael W. Miller; E. Tomthorne

193

Factors associated with chronic lung disease in preterm infants.  

PubMed Central

Among 659 infants of 30 weeks' gestation or less born in a regional perinatal centre between 1983 and 1989, 195 were ventilated for four days or more and survived to 28 days, and 87 of these developed chronic lung disease. There was a sevenfold increase in the annual incidence of chronic lung disease over time. During the same period there were significant increases in the number of infants who survived, the incidence of septicaemia, and the use of parenteral lipid emulsions. Chronic lung disease was significantly associated with low birth weight, shorter gestation, duration of ventilation, vaginal delivery, sepsis, and the use of lipid. Respiratory and physiological measurements at 96 hours were significantly worse in infants who subsequently developed chronic lung disease. Initial logistic regression showed that gestation, arterial carbon dioxide tension (PaCO2), and ventilation rate at 96 hours; and birth in 1988 or 1989, were independently associated with chronic lung disease, but when septicaemia and use of lipid during the first 21 days were included, only gestational age (odds ratio 0.64, 95% confidence interval (CI), 0.49 to 0.81 for each week) and use of lipid (odds ratio 8.1, 95% CI, 2.32 to 28.0) remained significantly associated with chronic lung disease. The observed increase in incidence of chronic lung disease in this population was associated with earlier use of parenteral lipids in infants of very low gestation rather than with changes in population, survival, or ventilator treatment of respiratory distress syndrome.

Cooke, R W

1991-01-01

194

Pesticides and human chronic diseases: evidences, mechanisms, and perspectives.  

PubMed

Along with the wide use of pesticides in the world, the concerns over their health impacts are rapidly growing. There is a huge body of evidence on the relation between exposure to pesticides and elevated rate of chronic diseases such as different types of cancers, diabetes, neurodegenerative disorders like Parkinson, Alzheimer, and amyotrophic lateral sclerosis (ALS), birth defects, and reproductive disorders. There is also circumstantial evidence on the association of exposure to pesticides with some other chronic diseases like respiratory problems, particularly asthma and chronic obstructive pulmonary disease (COPD), cardiovascular disease such as atherosclerosis and coronary artery disease, chronic nephropathies, autoimmune diseases like systemic lupus erythematous and rheumatoid arthritis, chronic fatigue syndrome, and aging. The common feature of chronic disorders is a disturbance in cellular homeostasis, which can be induced via pesticides' primary action like perturbation of ion channels, enzymes, receptors, etc., or can as well be mediated via pathways other than the main mechanism. In this review, we present the highlighted evidence on the association of pesticide's exposure with the incidence of chronic diseases and introduce genetic damages, epigenetic modifications, endocrine disruption, mitochondrial dysfunction, oxidative stress, endoplasmic reticulum stress and unfolded protein response (UPR), impairment of ubiquitin proteasome system, and defective autophagy as the effective mechanisms of action. PMID:23402800

Mostafalou, Sara; Abdollahi, Mohammad

2013-02-09

195

77 FR 43092 - Agency Information Collection Activities; Proposed Collection; Comment Request; Chronic Disease...  

Federal Register 2010, 2011, 2012, 2013

...Comment Request; Chronic Disease Self-Management Education Program Standardized...relating to the Chronic Disease Self-Management Education Program. DATES...Disabilities through Chronic Disease Self-Management Education (CDSME)...

2012-07-23

196

62 FR 28042 - Development of State Health Promotion and Chronic Disease Prevention Databases/Clearinghouses  

Federal Register 2010, 2011, 2012, 2013

...Number 766] Development of State Health Promotion and Chronic Disease Prevention...program for development of State health promotion and chronic disease prevention...bibliographies, literature, and health promotion and chronic disease...

1997-05-22

197

64 FR 28000 - The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); Meeting  

Federal Register 2010, 2011, 2012, 2013

...Chronic Disease Prevention and Health Promotion (NCCDPHP); Meeting The National...Chronic Disease Prevention and Health Promotion (NCCDPHP) of the Centers for...Chronic Disease Prevention and Health Promotion's funding announcement...

1999-05-24

198

66 FR 8405 - Health Promotion and Disease Prevention Initiatives Related to Chronic Disease Prevention and...  

Federal Register 2010, 2011, 2012, 2013

...Program Announcement 01018] Health Promotion and Disease Prevention Initiatives...Chronic Disease Prevention and Health Promotion World Health Organization...a cooperative agreement for Health Promotion and Disease Prevention...

2001-01-31

199

Venous thromboembolism in patients with chronic obstructive pulmonary disease  

PubMed Central

Purpose Our aim was to compare clinical characteristics, prophylaxis, treatment, and outcomes of venous thromboembolism in patients with and without previously diagnosed chronic obstructive pulmonary disease. Methods We analyzed the population-based Worcester Venous Thromboembolism Study of 2,488 consecutive patients with validated venous thromboembolism to compare clinical characteristics, prophylaxis, treatment, and outcomes in patients with and without chronic obstructive pulmonary disease. Results Of 2,488 venous thromboembolism patients, 484 (19.5%) had a history of clinical chronic obstructive pulmonary disease and 2,004 (80.5%) did not. Chronic obstructive pulmonary disease patients were older (mean age 68 years vs. 63 years) and had a higher frequency of heart failure (35.5% vs. 12.9%) and immobility (53.5% vs. 43.3%) than patients without chronic obstructive pulmonary disease (all p<0.0001). Chronic obstructive pulmonary disease patients were more likely to suffer in-hospital death (6.8% vs. 4%, p=0.01) and death within 30 days of venous thromboembolism diagnosis (12.6% vs. 6.5%, p<0.0001). Chronic obstructive pulmonary disease patients demonstrated increased mortality despite a higher frequency of venous thromboembolism prophylaxis. Immobility doubled the risk of in-hospital death (adjusted odds ratio 2.21; 95% confidence interval 1.35–3.62) and death within 30 days of venous thromboembolism diagnosis (adjusted odds ratio 2.04; 95% confidence interval 1.43–2.91). Conclusion Patients with chronic obstructive pulmonary disease have an increased risk of dying during hospitalization and within 30 days of venous thromboembolism diagnosis. Immobility in chronic obstructive pulmonary disease patients is an ominous risk factor for adverse outcomes.

Piazza, Gregory; Goldhaber, Samuel Z.; Kroll, Aimee; Goldberg, Robert J.; Emery, Catherine; Spencer, Frederick A.

2012-01-01

200

Adolescents' Perception of Epilepsy Compared With Other Chronic Diseases: “Through a Teenager's Eyes”  

Microsoft Academic Search

Adolescent perception of physical and social impact of chronic illness was assessed to determine (1) if there is greater prejudice toward epilepsy than other chronic disease and (2) if adolescents with chronic disease have less prejudice toward similarly affected peers with all types of chronic disease or just their specific chronic disease. Cognitively normal teens aged 13 to 18 years

Christina Cheung; Elaine Wirrell

2006-01-01

201

Corynebacterium aquaticum infection in a patient with chronic granulomatous disease.  

PubMed

Patients with chronic granulomatous disease are uniquely susceptible to infection with catalase-producing bacteria. Staphylococcus aureus, Klebsiella, Escherichia coli and Serratia marcescans are common infecting organisms. A 17-month-old boy with Corynebacterium aquaticum bacteremia is reported. This is only the third documented infection with this non-JK diphtheroid and the first case infection in a patient with chronic granulomatous disease. It is likely that our patient's underlying immune defect predisposed him to infection with this unusual, catalase-producing organism. Although these bacteria are common contaminants and rarely infecting agents, true infection should be considered in patients with chronic granulomatous disease from whom a diphtheroid is isolated. PMID:3407679

Kaplan, A; Israel, F

1988-07-01

202

Stories of chronic kidney disease: listening for the unsayable.  

PubMed

AIMS: To explore individuals' stories of chronic kidney disease, particularly those aspects of experience that are difficult to discuss using language (i.e. unsayable). BACKGROUND: Chronic kidney disease is continuous, but it is also life-threatening and sometimes people ask difficult questions about life and death that can be challenging and for some, impossible to discuss. These 'unsayables' are the focus of this article. The unsayable may reside both within and beyond language. Careful analysis of narratives of illness for sayable and unsayable aspects of the experience can help illuminate new areas of concern for people with chronic kidney disease. DESIGN: Narrative inquiry, located in a social constructionist framework, guided this study. METHODS: Secondary data analysis was conducted with 46 in-depth interviews (collected between 2008-2011) with 14 people living with chronic kidney disease. FINDINGS: Through narrative thematic analysis, we identify that the unsayable includes the following five themes: living with death, embodied experiences that were difficult to language, that which was unthinkable, unknowable mystery and that which was untold/unheard. Whereas the first four themes attend to that which is unsayable for people living with chronic kidney disease, the last theme acknowledges that which is unsayable to people living with chronic kidney disease. CONCLUSION: Not all experiences of illness can be explicitly articulated in language. Listening for both the sayable and unsayable aspects of life with chronic and life-threatening illness is an important nursing role. PMID:23594086

Makaroff, Kara L Schick; Sheilds, Laurene; Molzahn, Anita

2013-04-17

203

OCCUPATIONAL SILICA EXPOSURE AND CHRONIC KIDNEY DISEASE  

PubMed Central

Introduction Occupational exposure to silica may be associated with chronic kidney disease (CKD). Most studies have been conducted in occupational cohorts with high levels of exposure but small numbers of cases. We analyzed data from a population-based case-control study of occupational silica exposure and CKD. Methods Cases were hospital patients with newly diagnosed CKD and community controls were selected using random digit dialing and frequency matched by age, gender, race and proximity to the hospital. Silica exposure estimates were assigned by industrial hygiene review of lifetime job history data and weighted for certainty and intensity. Conditional logistic regression was used to estimate the odds ratios (ORs) for CKD conditioned on demographic, lifestyle and clinical variables. Results The mean age of participants was 62 years (range, 30-83 years), 56% were male and 54% were white. Any silica exposure (compared to none) was associated with a 40% increased risk of CKD (OR=1.40, 95% confidence interval [CI]: 1.04, 1.89) in a multivariable adjusted model. The mean cumulative duration of silica exposure was significantly higher in exposed cases than in exposed controls (33.4 vs. 24.8 years, respectively). Overall, compared to non-exposed participants, the ORs (95% CI) for those below and above the median duration of silica exposure were 1.20 (95% CI: 0.77, 1.86) and 1.76 (95% CI: 1.14, 2.71), respectively. Conclusions We found a positive relationship between occupational silica exposure and CKD. A dose-response trend of increasing CKD risk with increasing duration of silica exposure was observed and was particularly strong among non-whites.

Vupputuri, Suma; Parks, Christine G.; Nylander-French, Leena A.; Owen-Smith, Ashli; Hogan, Susan L.; Sandler, Dale P.

2012-01-01

204

Management of Chronic Infectious Diseases in School Children.  

ERIC Educational Resources Information Center

This document contains guidelines for developing policies and procedures related to chronic infectious diseases, as recommended by the Illinois Task Force on School Management of Infectious Disease. It is designed to help school personnel understand how infectious diseases can be transmitted, and to assist school districts in the development and…

Illinois State Board of Education, Springfield.

205

[Disorders of the larynx and chronic inflammatory diseases].  

PubMed

Chronic inflammatory diseases including tuberculosis, rheumatic disorders (rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus, Wegeners's granulomatosis, relapsing polychondritis) and reflux disease are considered as systemic diseases, and may affect the larynx. The clinical symptoms are often unspecific, leading to prolonged intervals to diagnosis. Solid and haematological tumours should be considered in differential diagnosis and may require bioptic sampling. Treatment may require interdisciplinary approach. PMID:23044789

Pickhard, A; Smith, E; Rottscholl, R; Brosch, S; Reiter, R

2012-10-08

206

A systems view of genetics in chronic kidney disease  

Microsoft Academic Search

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

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

2012-01-01

207

Chronic Granulomatous Disease; fundamental stages in our understanding of CGD  

Microsoft Academic Search

It has been 50 years since chronic granulomatous disease was first reported as a disease which fatally affected the ability of children to survive infections. Various milestone discoveries from the insufficient ability of patients' leucocytes to destroy microbial particles to the underlying genetic predispositions through which the disease is inherited have had important consequences. Longterm antibiotic prophylaxis has helped to

Tracy Assari

2006-01-01

208

Epidemiology of cardiovascular risk in patients with chronic kidney disease  

Microsoft Academic Search

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

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

2003-01-01

209

Chronic obstructive pulmonary disease and asthma in the ICU  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) and asthma are both common respiratory problems that can present acutely with severe respiratory failure. Both are characterized by the presence of air flow limitation, which is variable in asthma and usually fixed in COPD. Chronic respiratory failure usually develops in COPD once FEV1 falls to less than 30% of predicted. Patients are often hospitalized

Simon Baudouin

2004-01-01

210

Serum Pancreatic Enzyme Concentrations in Chronic Viral Liver Diseases  

Microsoft Academic Search

Serum amylase and lipase concentrations weredetermined in 78 patients with chronic liver diseases[26 chronic active hepatitis (CAH) and 52 livercirrhosis] and in 15 healthy subjects. Pancreaticisoamylase concentrations and macroamylase complexes wereassayed in hyperamylasemic sera. Serum amylase levelswere abnormally elevated in 27 patients (35%; 22 livercirrhosis, 5 CAH), whereas serum lipase levels were elevated in 16 patients (21%; 15 livercirrhosis, 1

Raffaele Pezzilli; Pietro Andreone; Antonio Maria Morselli-Labate; Claudia Sama; Paola Billi; Carmela Cursaro; Bahjat Barakat; Annagiulia Gramenzi; Manuela Fiocchi; Federico Miglio; Mauro Bernardi

1999-01-01

211

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

212

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

213

Prevalence of comorbidity of chronic diseases in Australia  

Microsoft Academic Search

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

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

2008-01-01

214

FAMILIAL BENIGN CHRONIC PEMPHIGUS (HAILEY-HAILEY DISEASE)  

Microsoft Academic Search

SUMMARY: Familial benign chronic pemphigus (Hailey-Hailey disease) is a blistering dermatosis, which is inherited as an autosomal dominant trait and usually presents around the third and fourth decades. Painful erosions, vesico-pustules and scaly erythematous plaques appear at sites of friction such as the sides of the neck, the axillae, the groins and the perineum. A case of familial benign chronic

Ivelina Yordanova; Dimitar Gospodinov; Valentina Chavdarova; Savelina Popovska

2007-01-01

215

A Humidity-Sensitive Arabidopsis Copine Mutant Exhibits Precocious Cell Death and Increased Disease Resistance  

PubMed Central

The copines are a newly identified class of calcium-dependent, phospholipid binding proteins that are present in a wide range of organisms, including Paramecium, plants, Caenorhabditis elegans, mouse, and human. However, the biological functions of the copines are unknown. Here, we describe a humidity-sensitive copine mutant in Arabidopsis. Under nonpermissive, low-humidity conditions, the cpn1-1 mutant displayed aberrant regulation of cell death that included a lesion mimic phenotype and an accelerated hypersensitive response (HR). However, the HR in cpn1-1 showed no increase in sensitivity to low pathogen titers. Low-humidity-grown cpn1-1 mutants also exhibited morphological abnormalities, increased resistance to virulent strains of Pseudomonas syringae and Peronospora parasitica, and constitutive expression of pathogenesis-related (PR) genes. Growth of cpn1-1 under permissive, high-humidity conditions abolished the increased disease resistance, lesion mimic, and morphological mutant phenotypes but only partially alleviated the accelerated HR and constitutive PR gene expression phenotypes. The disease resistance phenotype of cpn1-1 suggests that the CPN1 gene regulates defense responses. Alternatively, the primary function of CPN1 may be the regulation of plant responses to low humidity, and the effect of the cpn1-1 mutation on disease resistance may be indirect.

Jambunathan, Niranjani; Siani, Jennifer M.; McNellis, Timothy W.

2001-01-01

216

A humidity-sensitive Arabidopsis copine mutant exhibits precocious cell death and increased disease resistance.  

PubMed

The copines are a newly identified class of calcium-dependent, phospholipid binding proteins that are present in a wide range of organisms, including Paramecium, plants, Caenorhabditis elegans, mouse, and human. However, the biological functions of the copines are unknown. Here, we describe a humidity-sensitive copine mutant in Arabidopsis. Under nonpermissive, low-humidity conditions, the cpn1-1 mutant displayed aberrant regulation of cell death that included a lesion mimic phenotype and an accelerated hypersensitive response (HR). However, the HR in cpn1-1 showed no increase in sensitivity to low pathogen titers. Low-humidity-grown cpn1-1 mutants also exhibited morphological abnormalities, increased resistance to virulent strains of Pseudomonas syringae and Peronospora parasitica, and constitutive expression of pathogenesis-related (PR) genes. Growth of cpn1-1 under permissive, high-humidity conditions abolished the increased disease resistance, lesion mimic, and morphological mutant phenotypes but only partially alleviated the accelerated HR and constitutive PR gene expression phenotypes. The disease resistance phenotype of cpn1-1 suggests that the CPN1 gene regulates defense responses. Alternatively, the primary function of CPN1 may be the regulation of plant responses to low humidity, and the effect of the cpn1-1 mutation on disease resistance may be indirect. PMID:11595798

Jambunathan, N; Siani, J M; McNellis, T W

2001-10-01

217

Patient-Centered Medical Home in chronic obstructive pulmonary disease  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a progressive and debilitating but preventable and treatable disease characterized by cough, phlegm, dyspnea, and fixed or incompletely reversible airway obstruction. Most patients with COPD rely on primary care practices for COPD management. Unfortunately, only about 55% of US outpatients with COPD receive all guideline-recommended care. Proactive and consistent primary care for COPD, as for many other chronic diseases, can reduce hospitalizations. Optimal chronic disease management requires focusing on maintenance rather than merely acute rescue. The Patient-Centered Medical Home (PCMH), which implements the chronic care model, is a promising framework for primary care transformation. This review presents core PCMH concepts and proposes multidisciplinary team-based PCMH care strategies for COPD.

Ortiz, Gabriel; Fromer, Len

2011-01-01

218

COPD (Chronic Obstructive Pulmonary Disease) - Multiple Languages: MedlinePlus  

MedlinePLUS

... Hindi (??????) Japanese (???) Korean (???) Portuguese (português) Russian (???????) Somali (af Soomaali) Spanish (español) Tagalog ( ... PDF Health Information Translations Return to top Portuguese (português) Chronic Obstructive Pulmonary Disease (COPD) Doença Pulmonar Obstrutiva ...

219

Enzymes in feces: Useful markers of chronic inflammatory bowel disease  

Microsoft Academic Search

BackgroundUlcerative colitis and Crohn's disease are characterized by a chronic intestinal inflammation. Since the precise etiology is still unknown, current therapies are aimed at reducing or eliminating inflammation.

Imerio Angriman; Marco Scarpa; Renata D'Incà; Daniela Basso; Cesare Ruffolo; Lino Polese; Giacomo C. Sturniolo; Davide F. D'Amico; Mario Plebani

2007-01-01

220

Complications of Chronic Kidney Disease Occur Earlier in Children  

MedlinePLUS

... lead to a shift in treatment, the largest prospective study of children with chronic kidney disease (CKD) has ... from these findings.” CKiD is a multi-center, prospective study of children and teenagers ages 1 to 16 ...

221

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

2008-12-23

222

Research involving participants with chronic diseases: overcoming recruitment obstacles.  

PubMed

Chronic diseases are rampant in the United States and account for the majority of healthcare costs in this country. The implementation of research studies involving members of chronic disease populations is necessary to the development of interventions aimed at preventing these conditions and improving outcomes. The implementation of such studies hinges on the successful recruitment of an adequate number of study participants. Difficulties surrounding participant recruitment in behavioral studies are well documented and present a barrier to researchers aiming to conduct research involving persons with chronic diseases. Common recruitment challenges associated with recruiting chronic disease participants are reviewed, and a highly effective, alternative recruitment strategy used by the authors in a qualitative study involving persons with epilepsy is discussed in detail. PMID:24107754

Miller, Wendy R; Bakas, Tamilyn; Buelow, Janice M; Habermann, Barbara

223

Hyperuricemia and Urate Excretion in Chronic Renal Disease.  

National Technical Information Service (NTIS)

Standard renal clearances were performed in 92 subjects, comparing uric acid excretion, glomerular filtration and renal plasma flow in normal people and people with proven chronic renal disease with normal and sub-normal glomerular filtration. Despite com...

J. J. McPhaul

1967-01-01

224

Pulmonary Rehabilitation for Patients With Chronic Pulmonary Disease (COPD)  

PubMed Central

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

2012-01-01

225

Significant improvement from chronic beryllium disease following corticosteroid pulse therapy.  

PubMed

Chronic beryllium disease (CBD) is a rare disease characterized by diffuse interstitial pulmonary granulomatosis. We report a case of CBD which exhibited marked improvement both subjectively and objectively following pulse therapy. The patient was a 36-year-old man whose chief complaint was dyspnea and a dry cough. Since July 1990, the patient had been working in the development of an automatic or mechanical technique for producing beryllium-copper alloy. It appeared likely that the patient may have been exposed to metal beryllium fumes generated from an opening located just above the furnace. The Be concentration exceeded 25 microg/m3 transiently in the breathing zone in this workplace. A chest X-ray film taken in October 1994 showed fine granular shadows throughout the entire lung fields. Around August 1998, the patient's dyspnea became aggravated. An X-ray taken at that time showed linear and reticular shadows, in addition to the diffuse fine granular shadow. In October 1998, after 3 days of methylprednisolone pulse therapy, oral prednisolone 30 mg was initiated. With this treatment, the patient's pulmonary function tests and blood gases improved. Once the patient's condition had improved sufficiently, the dosage of prednisolone was decreased by 2.5 mg every two weeks. The patient continues to be monitored. PMID:16716007

Nagaoka, Kaoru; Yoshida, Tsutomu; Sakakibara, Hiroki; Kurita, Hideki; Taniwaki, Hiroshige; Ono, Yuichiro

2006-04-01

226

Formoterol in the management of chronic obstructive pulmonary disease  

PubMed Central

Bronchodilators represent the hallmark of symptomatic treatment of Chronic Obstructive Pulmonary Disease (COPD). There are four categories of bronchodilators: anticholinergics, methylxanthines, short-acting ?2-agonists, and long-acting ?2-agonists such as formoterol. Significant research has been performed to investigate the efficacy, safety and tolerability of formoterol in the therapeutic field of COPD. Formoterol exhibits a rapid onset of bronchodilation similar to that observed with salbutamol, yet its long bronchodilatory duration is comparable to salmeterol. In addition, formoterol presents with a clear superiority in lung function improvement compared with either ipratropium bromide or oral theophylline, while its efficacy improves when administered in combination with ipratropium. Formoterol has been shown to better reduce dynamic hyperinflation, which is responsible for exercise intolerance and dyspnea in COPD patients, compared with other bronchodilators, whereas it exerts synergistic effect with tiotropium. Moreover, formoterol reduces exacerbations, increases days free of use of rescue medication and improves patients’ quality of life and disease symptoms. Formoterol has a favorable safety profile and is better tolerated than theophylline. Collectively, data extracted from multicenter clinical trials support formoterol as a valid therapeutic option in the treatment of COPD.

Steiropoulos, Paschalis; Tzouvelekis, Argyris; Bouros, Demosthenes

2008-01-01

227

Beryllium copper alloy (2%) causes chronic beryllium disease.  

PubMed

We describe two newly confirmed cases of chronic beryllium disease who presented to our clinic from a facility that only used 2% beryllium copper alloy. These cases illustrate that the 2% beryllium copper alloy continues to cause chronic beryllium disease and that appropriate preventive measures must be taken to control exposures and educate industries and their workers about the hazards of beryllium alloys. PMID:10224597

Balkissoon, R C; Newman, L S

1999-04-01

228

Urinary phospholipase A2 excretion in chronic pancreatic diseases  

Microsoft Academic Search

Summary  This study was performed to investigate the behavior of phospholipase A2 (PLA2) in serum and urine of patients with chronic\\u000a pancreatic diseases and to ascertain whether any factors influenced the results. In 30 controls, 45 patients with pancreatic\\u000a cancer, 54 with chronic pancreatitis, and 64 with extrapancreatic diseases, serum and urinary PLA2, pancreatic isoamylase\\u000a and RNase, and urinary N-acetylglucosaminidase (NAG)

C. Fabris; D. Basso; M. P. Panozzo; G. Del Favero; T. Meggiato; M. Plebani; C. Ferrara; P. Fogar; M. Zaninotto; R. Naccarato

1992-01-01

229

Physical activity, genes, and lifetime predisposition to chronic disease  

Microsoft Academic Search

This mini-review summarizes the main associations between physical activity and chronic diseases and discusses the basic concepts\\u000a related to the role of genetic factors in studies evaluating the effects of physical activity\\/exercise therapy on chronic\\u000a disease prevention\\/treatment during the life course. Many observational cohort studies have shown that high physical activity\\u000a during young adulthood or middle age is associated with

Urho M. Kujala

2011-01-01

230

Increased Serum Angiotensin-Converting Enzyme in Chronic Renal Disease  

Microsoft Academic Search

Serum angiotensin-converting enzyme (SACE) was significantly elevated in 16 of 48 patients with various types of chronic renal disease not on hemodialysis [45.6 ± (SD)16.7 nmol\\/min\\/ml, p < 0.001] and in 17 of 52 patients with chronic renal disease on maintenance hemodialysis (43.2 ± 13.8, p < 0.001) in comparison with 58 healthy adult controls (32.2 ± 9.8). There was

Emanuel Silverstein; John Brunswick; Sreepada Rao; Joan Friedland

1984-01-01

231

Metagenomic Applications and the Potential for Understanding Chronic Liver Disease  

Microsoft Academic Search

\\u000a Liver fibrosis is characterized by an excessive deposition of extracellular matrix proteins that occurs in chronic liver disease\\u000a of any origin. Cirrhosis occurs with the development of regenerating nodules of hepatocytes. Patients with decompensated liver\\u000a cirrhosis have a poor prognosis, and liver transplantation is often necessary. There are no effective antifibrotic treatments\\u000a for patients with chronic liver diseases. Intestinal dysbiosis

Bernd Schnabl

232

Exercise in chronic pulmonary disease: aerobic exercise prescription  

Microsoft Academic Search

ABSTRACT COOPER, C. B. Exercise in chronic pulmonary disease: aerobic exercise prescription. Med. Sci. Sports Exerc.,Vol. 33, No. 7, Suppl., pp. S671?S679, 2001. Endurance exercise training (EXT) is singly the most important aspect of rehabilitation for patients with chronic pulmonary disease. When effective, this modality of physical reconditioning leads to improved functional exercise capacity and reduced breathlessness. Early implementation is

CHRISTOPHER B. COOPER

2001-01-01

233

Anemia and pregnancy: a link to maternal chronic diseases.  

PubMed

Anemia is a global public health problem. It has serious short- and long-term consequences during pregnancy and beyond. The anemic condition is often worsened by the presence of other chronic diseases such as malaria, tuberculosis, HIV, and diabetes. Untreated anemia also leads to increased morbidity and mortality from these chronic conditions as well. It is surprising that despite these chronic conditions (such as malaria, tuberculosis, and HIV) often being preventable, they still pose a real threat to public health. This article aims to review the current understanding of the pathophysiology, risks, prevention, and treatment of anemia in the light of these chronic conditions. PMID:22099433

Gangopadhyay, Raja; Karoshi, Mahantesh; Keith, Louis

2011-11-01

234

Decrease in Irisin in Patients with Chronic Kidney Disease  

PubMed Central

Patients with chronic kidney disease have abnormal energy expenditure and metabolism. The mechanisms underlying altered energy expenditure in uremia are unknown and remain to be elucidated. Irisin is a peroxisome proliferator-activated receptor ? coactivator 1-?–dependent myokine, and it increases energy expenditure in the absence of changes in food intake or activity. We hypothesize that chronic kidney disease patients have altered irisin levels. We measured resting irisin levels in 38 patients with stage 5 chronic kidney disease and in 19 age- and sex-matched normal subjects. Plasma irisin levels were significantly decreased in chronic kidney disease patients (58.59%; 95% CI 47.9%–69.2%, p<0.0001). The decrease in irisin levels was inversely correlated with the levels of blood urea nitrogen and creatinine. Further association analysis revealed that irisin level is independently associated with high-density lipoprotein cholesterol level. Our results suggest that chronic kidney disease patients have lower than normal irisin levels at rest. Furthermore, irisin may play a major role in affecting high-density lipoprotein cholesterol levels and abnormal energy expenditure in chronic kidney disease patients.

Wen, Ming-Shien; Wang, Chao-Yung; Lin, Shuei-Liong; Hung, Kuo-Chun

2013-01-01

235

Total inspiratory and expiratory impedance in patients with severe chronic obstructive pulmonary disease  

PubMed Central

OBJECTIVES: Several studies have confirmed the high potential of the forced oscillation technique for the assessment of respiratory modifications related to chronic obstructive pulmonary disease. However, most of these studies did not employ within-breath analyses of the respiratory system. The aim of this study is to analyze respiratory impedance alterations in different phases of the respiratory cycle of chronic obstructive pulmonary disease patients and to evaluate their clinical use. METHODS: 39 individuals were evaluated, including 20 controls and 19 individuals with chronic obstructive pulmonary disease who experienced severe airway obstruction. We evaluated the mean respiratory impedance (Zm) as well as values for inspiration (Zi) and expiration cycles (Ze), at the beginning of inspiration (Zbi) and expiration (Zbe). The peak-to-peak impedance (Zpp), and the impedance change (?Zrs) were also analyzed. The clinical usefulness was evaluated by investigating the sensibility, specificity and the area under the receiver operating characteristic curve. RESULTS: The respiratory impedance increased in individuals with chronic obstructive pulmonary disease in all of the studied parameters (Zm, Zi, Ze, Zbi, Zbe, ?Zrs and Zpp). These changes were inversely associated with spirometric parameters. Higher impedances were observed in the expiratory phase of individuals with chronic obstructive pulmonary disease. All of the studied parameters, except for ?Zrs (area under the receiver operating characteristic <0.8), exhibited high accuracy for clinical use (area under the receiver operating characteristic >0.90; Sensibility ? 0.85; Sp ? 0.85). CONCLUSIONS: The respiratory alterations in severe chronic obstructive pulmonary disease may be identified by the increase in respiratory system impedance, which is more evident in the expiratory phase. These results confirm the potential of within-breath analysis of respiratory impedance for the assessment of respiratory modifications related to chronic obstructive pulmonary disease.

Silva, Karla Kristine Dames; Lopes, Agnaldo Jose; Jansen, Jose Manoel; de Melo, Pedro Lopes

2011-01-01

236

Measurement of renal function in patients with chronic kidney disease.  

PubMed

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

2013-10-01

237

Fish consumption and risk of major chronic disease in men  

PubMed Central

Background Although fish consumption may reduce specific disease endpoints, such as sudden cardiac death and prostate cancer, the effects on total burden of major chronic disease, reflecting sums of effects on a variety of endpoints and risk pathways, are not well established. Higher n-6 fatty acid consumption has also been hypothesized to reduce the health benefits of n-3 fatty acids in fish. Objective The aim was to study associations of fish and n-3 fatty acid consumption with risk of total major chronic disease (cardiovascular disease, cancer, and death), and to determine whether a high n-6 intake modifies the associations. Design Lifestyle and other risk factors were assessed every 2 y and diet every 4 y in 40,230 U.S. male health professionals aged 40–75 years and free of major chronic disease at baseline in 1986. During 18 y follow-up, 9715 major chronic disease events occurred, including 3639 cardiovascular disease events, 4690 cancers, and 1386 deaths from other causes. Results After multivariable adjustment, neither fish nor dietary n-3 fatty acid consumption was significantly associated with risk of total major chronic disease. Compared with fish consumption of <1 serving/mo, consumption of 1 serving/wk and 2–4 servings/wk was associated with a lower risk of total cardiovascular disease of ~15%. No significant associations were seen with cancer risk. Higher or lower n-6 fatty acid intake did not significantly modify the results (P for interaction >0.10). Conclusions Modest fish consumption was associated with a lower risk of total cardiovascular disease, consistent with cardiac mortality benefits, but not with total cancer or overall major chronic disease; n-6 fatty acid consumption did not influence these relations.

Virtanen, Jyrki K.; Mozaffarian, Dariush; Chiuve, Stephanie E.; Rimm, Eric B.

2008-01-01

238

Cardiovascular risk factors in patients with chronic kidney disease  

Microsoft Academic Search

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

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

2009-01-01

239

Magnesium in Chronic Kidney Disease: Challenges and Opportunities  

Microsoft Academic Search

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

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

2010-01-01

240

A life course approach to chronic disease epidemiology.  

PubMed

A life course approach to chronic disease epidemiology uses a multidisciplinary framework to understand the importance of time and timing in associations between exposures and outcomes at the individual and population levels. Such an approach to chronic diseases is enriched by specification of the particular way that time and timing in relation to physical growth, reproduction, infection, social mobility, and behavioral transitions, etc., influence various adult chronic diseases in different ways, and more ambitiously, by how these temporal processes are interconnected and manifested in population-level disease trends. In this review, we discuss some historical background to life course epidemiology and theoretical models of life course processes, and we review some of the empirical evidence linking life course processes to coronary heart disease, hemorrhagic stroke, type II diabetes, breast cancer, and chronic obstructive pulmonary disease. We also underscore that a life course approach offers a way to conceptualize how underlying socio-environmental determinants of health, experienced at different life course stages, can differentially influence the development of chronic diseases, as mediated through proximal specific biological processes. PMID:15760279

Lynch, John; Smith, George Davey

2005-01-01

241

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.

Cassell, G. H.

1998-01-01

242

Chronic renal disease progression: treatment strategies and potassium intake.  

PubMed

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

Sinha, Arjun D; Agarwal, Rajiv

2013-05-01

243

Chronic pediatric pulmonary disease and primary humoral antibody based immune disease.  

PubMed

Chronic inflammation of the larger airways is a common occurrence in children. A number of factors such as younger age, premature birth, male gender, exposure to environmental smoke or pollution, and crowded housing can increase a child's susceptibility to chronic lung disease. Chronic bronchitis may be caused by an underlying humoral immunodeficiency if the clinical course is recurrent or prolonged. Primary humoral immunodeficiency accounts for approximately 70% of all immunodeficiencies. The differential of chronic bronchitis also includes Cystic Fibrosis, ciliary defects and immune cellular and phagocytic defects. This review will summarize the most common humoral antibody based immune based deficiencies associated with chronic pulmonary disease. PMID:21144721

Dosanjh, A

2010-12-08

244

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

245

Evaluation of the chronic disease self-management program (CDSMP) among chronically ill older people in the Netherlands  

Microsoft Academic Search

Many chronically ill older patients in the Netherlands have a combination of more than one chronic disease. There is therefore a need for self-management programs that address general management problems, rather than the problems related to a specific disease. The Chronic Disease Self-Management Program (CDSMP) seems to be very suitable for this purpose. In evaluations of the program that have

Henrike Elzen; Joris P. J. Slaets; Tom A. B. Snijders; Nardi Steverink

2007-01-01

246

Screening and Management of Depression for Adults With Chronic Diseases  

PubMed Central

Background Depression is the leading cause of disability and the fourth leading contributor to the global burden of disease. In Canada, the 1-year prevalence of major depressive disorder was approximately 6% in Canadians 18 and older. A large prospective Canadian study reported an increased risk of developing depression in people with chronic diseases compared with those without such diseases. Objectives To systematically review the literature regarding the effectiveness of screening for depression and/or anxiety in adults with chronic diseases in the community setting. To conduct a non-systematic, post-hoc analysis to evaluate whether a screen-and-treat strategy for depression is associated with an improvement in chronic disease outcomes. Data Sources A literature search was performed on January 29, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, OVID PsycINFO, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published from January 1, 2002 until January 29, 2012. Review Methods No citations were identified for the first objective. For the second, systematic reviews and randomized controlled trials that compared depression management for adults with chronic disease with usual care/placebo were included. Where possible, the results of randomized controlled trials were pooled using a random-effects model. Results Eight primary randomized controlled trials and 1 systematic review were included in the post-hoc analysis (objective 2)—1 in people with diabetes, 2 in people with heart failure, and 5 in people with coronary artery disease. Across all studies, there was no evidence that managing depression improved chronic disease outcomes. The quality of evidence (GRADE) ranged from low to moderate. Some of the study results (specifically in coronary artery disease populations) were suggestive of benefit, but the differences were not significant. Limitations The included studies varied in duration of treatment and follow-up, as well as in included forms of depression. In most of the trials, the authors noted a significant placebo response rate that could be attributed to spontaneous resolution of depression or mild disease. In some studies, placebo groups may have had access to care as a result of screening, since it would be unethical to withhold all care. Conclusions There was no evidence to suggest that a screen-and-treat strategy for depression among adults with chronic diseases resulted in improved chronic disease outcomes. Plain Language Summary People with chronic diseases are more likely to have depression than people without chronic diseases. This is a problem because depression may make the chronic disease worse or affect how a person manages it. Discovering depression earlier may make it easier for people to cope with their condition, leading to better health and quality of life. We reviewed studies that looked at screening and treating for depression in people with chronic diseases. In people with diabetes, treatment of depression did not affect clinical measures of diabetes management. In people with heart failure and coronary artery disease, treatment of depression did not improve heart failure management or reduce rates of heart attacks or death. At present, there is no evidence that screening and treating for depression improves the symptoms of chronic diseases or lead to use of fewer health care services.

2013-01-01

247

Hydrocarbon exposure and chronic renal disease  

Microsoft Academic Search

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

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

1996-01-01

248

Gender and human chronic renal disease  

Microsoft Academic Search

Background: Gender affects the incidence, prevalence, and progression of renal disease. In animal models of the disease, female sex appears to modify the course of progression. Hormonal manipulation by male or female castration also changes the course of renal disease progression, suggesting direct effects of sex hormones in influencing the course of these maladies.Objective: This review examines the pertinent animal

Sharon Silbiger; Joel Neugarten

2008-01-01

249

Subjects harboring presenilin familial Alzheimer's disease mutations exhibit diverse white matter biochemistry alterations  

PubMed Central

Alzheimer’s disease (AD) dementia impacts all facets of higher order cognitive function and is characterized by the presence of distinctive pathological lesions in the gray matter (GM). The profound alterations in GM structure and function have fostered the view that AD impacts are primarily a consequence of GM damage. However, the white matter (WM) represents about 50% of the cerebrum and this area of the brain is substantially atrophied and profoundly abnormal in both sporadic AD (SAD) and familial AD (FAD). We examined the WM biochemistry by ELISA and Western blot analyses of key proteins in 10 FAD cases harboring mutations in the presenilin genes PSEN1 and PSEN2 as well as in 4 non-demented control (NDC) individuals and 4 subjects with SAD. The molecules examined were direct substrates of PSEN1 such as Notch-1 and amyloid precursor protein (APP). In addition, apolipoproteins, axonal transport molecules, cytoskeletal and structural proteins, neurotrophic factors and synaptic proteins were examined. PSEN-FAD subjects had, on average, higher amounts of WM amyloid-beta (A?) peptides compared to SAD, which may play a role in the devastating dysfunction of the brain. However, the PSEN-FAD mutations we examined did not produce uniform increases in the relative proportions of A?42 and exhibited substantial variability in total A? levels. These observations suggest that neurodegeneration and dementia do not depend solely on enhanced A?42 levels. Our data revealed additional complexities in PSEN-FAD individuals. Some direct substrates of ?-secretase, such as Notch, N-cadherin, Erb-B4 and APP, deviated substantially from the NDC group baseline for some, but not all, mutation types. Proteins that were not direct ?-secretase substrates, but play key structural and functional roles in the WM, likewise exhibited varied concentrations in the distinct PSEN mutation backgrounds. Detailing the diverse biochemical pathology spectrum of PSEN mutations may offer valuable insights into dementia progression and the design of effective therapeutic interventions for both SAD and FAD.

Roher, Alex E; Maarouf, Chera L; Malek-Ahmadi, Michael; Wilson, Jeffrey; Kokjohn, Tyler A; Daugs, Ian D; Whiteside, Charisse M; Kalback, Walter M; Macias, MiMi P; Jacobson, Sandra A; Sabbagh, Marwan N; Ghetti, Bernardino; Beach, Thomas G

2013-01-01

250

Subjects harboring presenilin familial Alzheimer's disease mutations exhibit diverse white matter biochemistry alterations.  

PubMed

Alzheimer's disease (AD) dementia impacts all facets of higher order cognitive function and is characterized by the presence of distinctive pathological lesions in the gray matter (GM). The profound alterations in GM structure and function have fostered the view that AD impacts are primarily a consequence of GM damage. However, the white matter (WM) represents about 50% of the cerebrum and this area of the brain is substantially atrophied and profoundly abnormal in both sporadic AD (SAD) and familial AD (FAD). We examined the WM biochemistry by ELISA and Western blot analyses of key proteins in 10 FAD cases harboring mutations in the presenilin genes PSEN1 and PSEN2 as well as in 4 non-demented control (NDC) individuals and 4 subjects with SAD. The molecules examined were direct substrates of PSEN1 such as Notch-1 and amyloid precursor protein (APP). In addition, apolipoproteins, axonal transport molecules, cytoskeletal and structural proteins, neurotrophic factors and synaptic proteins were examined. PSEN-FAD subjects had, on average, higher amounts of WM amyloid-beta (A?) peptides compared to SAD, which may play a role in the devastating dysfunction of the brain. However, the PSEN-FAD mutations we examined did not produce uniform increases in the relative proportions of A?42 and exhibited substantial variability in total A? levels. These observations suggest that neurodegeneration and dementia do not depend solely on enhanced A?42 levels. Our data revealed additional complexities in PSEN-FAD individuals. Some direct substrates of ?-secretase, such as Notch, N-cadherin, Erb-B4 and APP, deviated substantially from the NDC group baseline for some, but not all, mutation types. Proteins that were not direct ?-secretase substrates, but play key structural and functional roles in the WM, likewise exhibited varied concentrations in the distinct PSEN mutation backgrounds. Detailing the diverse biochemical pathology spectrum of PSEN mutations may offer valuable insights into dementia progression and the design of effective therapeutic interventions for both SAD and FAD. PMID:24093083

Roher, Alex E; Maarouf, Chera L; Malek-Ahmadi, Michael; Wilson, Jeffrey; Kokjohn, Tyler A; Daugs, Ian D; Whiteside, Charisse M; Kalback, Walter M; Macias, Mimi P; Jacobson, Sandra A; Sabbagh, Marwan N; Ghetti, Bernardino; Beach, Thomas G

2013-09-18

251

Older Adults, Chronic Disease and Leisure-time Physical Activity  

PubMed Central

Background Participating in regular physical activity is an important part of healthy aging. There is an increased risk for inactivity associated with aging and the risk becomes greater for adults who have a chronic disease. However, there is limited information on current physical activity levels for older adults and even less for those with chronic diseases. Objective Our primary objective was to determine the proportion of older adults who achieved a recommended amount of weekly physical activity (?1000 kcal/week). The secondary objectives were to identify variables associated with meeting guideline leisure-time physical activity (LTPA), and to describe the type of physical activities that respondents reported across different chronic diseases. Methods In this study we used the Canadian Community Health Survey Cycle 1.1 (2000/2001) to report LTPA for adults aged 65 years and older. This was a population-based self-report telephone survey. We used univariate logistic regression to provide odds ratios to determine differences in activity and the likelihood of meeting guideline recommendations. Results For adults over 65 years of age with no chronic diseases, 30% reported meeting guideline LTPA, while only 23% met the recommendations if they had one or more chronic diseases. Factors associated with achieving the guideline amount of physical activity included a higher level of education, higher income and moderate alcohol consumption. Likelihood for not achieving the recommended level of LTPA included low BMI, pain and the presence of mobility and dexterity problems. Walking, gardening and home exercises were the three most frequent types of reported physical activities. Conclusion This study provides the most recent evidence to suggest that older Canadians are not active enough and this is accentuated if a chronic disease is present. It is important to develop community-based programs to facilitate LTPA, in particular for older people with a chronic disease.

Ashe, Maureen C.; Miller, William C.; Eng, Janice J.; Noreau, Luc

2011-01-01

252

Inflammatory factors and exercise in chronic kidney disease.  

PubMed

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

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

2013-05-13

253

Anti-inflammatory treatments for chronic diseases: a review.  

PubMed

Inflammation is viewed as one of the major causes for the development of different diseases like cancer, cardiovascular disease, diabetes, obesity, osteoporosis, rheumatoid arthritis, inflammatory bowel disease, asthma, and CNS related diseases such as depression and parkinson's disease; and this fervent phenomenon provides space for understanding different inflammatory markers. Increasing evidences have elucidated the outcome of inflammatory pathways dysregulation resulting in many symptoms of chronic diseases. The detection of transcription factors such as nuclear factor kappa-B (NF-?B), STAT and their gene products such as COX-2, cytokines, chemokines and chemokine receptors has laid molecular foundation for the important role of inflammation in chronic diseases in which the NF-?B is reported as a major mediator which makes a possible way for the development of new therapeutic approaches using synthetic and natural compounds that might eventually decrease the prevalence of these diseases. Even if many inflammatory markers like TNF-?, IL-1, IL-6, IL-8 and C-reactive protein (CRP) are reported to be the major key factors with proved role in several inflammatory diseases, IL-1 and TNF-? are the important cytokines that can induce the expression of NF-?B which is the potential target in these inflammatory diseases. This review aims to explore and summarize that how some drugs and natural compounds show their modulatory activity in inflammatory pathways and chronic inflammatory markers in these inflammatory diseases. PMID:23876224

Laveti, Durgaprasad; Kumar, Manoj; Hemalatha, R; Sistla, Ramakrishna; Naidu, V G M; Talla, Venu; Verma, Vinod; Kaur, Navrinder; Nagpal, Ravinder

2013-10-01

254

Angiotensin1 Converting Enzyme Polymorphisms in Chronic Beryllium Disease  

Microsoft Academic Search

To test the hypothesis that the angiotensin converting enzyme (ACE) genotype is associated with chronic beryllium disease (CBD) and disease severity, we studied 50 cases of CBD and compared their ACE genotype to that of two different control groups, consisting of: ( 1 ) 50 participants from a beryl- lium machining facility; and ( 2 ) 50 participants from a

LISA A. MAIER; MARY V. RAYNOLDS; DAVID A. YOUNG; ELIZABETH A. BARKER; LEE S. NEWMAN

1999-01-01

255

Vascular Calcification in Patients with Chronic Kidney Disease  

Microsoft Academic Search

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

Santo Dellegrottaglie; Javier Sanz; Sanjay Rajagopalan

2006-01-01

256

Emerging risk factors and markers of chronic kidney disease progression  

Microsoft Academic Search

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

Florian Kronenberg

2009-01-01

257

Chronic kidney disease in the United States: An underrecognized problem  

Microsoft Academic Search

The continued growth of the population with end-stage renal disease (ESRD) is partially related to the underrecognition of earlier stages of chronic kidney disease (CKD) and risk factors for the development of CKD. There are several published estimates of the prevalence of CKD in the United States. From Third National Health and Nutrition Examination Survey data it has been estimated

Gregorio T. Obrador; Brian J. G. Pereira; Annamaria T. Kausz

2002-01-01

258

Defective tryptophan catabolism underlies inflammation in mouse chronic granulomatous disease  

Microsoft Academic Search

Half a century ago, chronic granulomatous disease (CGD) was first described as a disease fatally affecting the ability of children to survive infections. Various milestone discoveries have since been made, from an insufficient ability of patients' leucocytes to kill microbes to the underlying genetic abnormalities. In this inherited disorder, phagocytes lack NADPH oxidase activity and do not generate reactive oxygen

Luigina Romani; Francesca Fallarino; Antonella de Luca; Claudia Montagnoli; Carmen D'Angelo; Teresa Zelante; Carmine Vacca; Francesco Bistoni; Maria C. Fioretti; Ursula Grohmann; Brahm H. Segal

2008-01-01

259

Nutrition and growth in children with chronic kidney disease  

Microsoft Academic Search

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

Robert H. Mak; Lesley Rees

2011-01-01

260

Arterial Stiffness and Osteoporosis in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Rationale: Chronic obstructive pulmonary disease (COPD) is associ- ated with an increased risk of cardiovascular events and osteoporo- sis. Increasedarterialstiffnessis anindependentpredictorofcardio- vascular disease. Objectives: Wetested thehypothesisthat patientswithCOPD would have increased arterial stiffness, which would be associated with osteoporosis and systemic inflammation. Methods: We studied 75 clinically stable patients with a range of severity of airway obstruction and 42 healthy smoker

Ramsey Sabit; Charlotte E. Bolton; Peter H. Edwards; Rebecca J. Pettit; William D. Evans; Carmel M. McEniery; Ian B. Wilkinson; John R. Cockcroft; Dennis J. Shale

2007-01-01

261

Nutritional and metabolic modulation in chronic obstructive pulmonary disease management  

Microsoft Academic Search

In this paper the perspective for nutritional modulation of systemic impairment in patients with chronic obstructive pulmonary disease (COPD) is discussed. Progressive weight loss is characterised by disease-specific elevated energy requirements unbalanced by dietary intake. Weight gain per se can be achieved by caloric supplementation while future studies may prove efficacy of amino acid modulation to stimulate protein synthesis and

A. M. W. J. Schols

2003-01-01

262

Total burden of chronic diseases among older cancer patients  

Microsoft Academic Search

Introduction: Both chronic diseases and cancer are associated with ageing. As the population ages, also the number of older cancer patients with comorbidity will increase dramatically. In the future, general practitioners will be confronted with older patients with cancer and two, three or more concomitant diseases. Aim: We aim to assess the occurrence of comorbidity among older cancer patients as

L. D. Deckx; M. A. van der Akker; S. B. Bartholomeeusen; J. M. Metsemakers; A. K. Knottnerus; F. G. Schellevis; F. B. Buntinx

2011-01-01

263

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

264

Alterations in Serum Leptin in Chronic Liver Disease  

Microsoft Academic Search

The role of leptin in anorexia associated with liver cirrhosis remains controversial. The aim of this study was to quantify the serum leptin level in patients with hepatocellular or cholestatic liver disease and to assess its relationship with serum insulin, body mass index, and serum lipoproteins. The study population included 30 women, 15 with chronic hepatocellular liver disease and 15

Ziv Ben-Ari; Zahava Schafer; Jaqueline Sulkes; Varda Manhaim; Ran Tur-Kaspa; Menahem Fainaru

2002-01-01

265

The Neglected Global Burden of Chronic Oral Diseases  

Microsoft Academic Search

The global burden of oral diseases, in fact, has been outlined in a very recent Bulletin of the World Health Organization: The vast majority of diseases affecting the soft and hard tissues of the oral cavity, in fact, have a chronic nature, are strongly associated with socio-behavioral risk factors, and represent a larger problem in underprivileged groups in both developing

M. D. Mignogna; S. Fedele

2006-01-01

266

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

267

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

268

Anticholinergics in the Treatment of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality in the world. In the majority of cases, the disease is the result of years of cigarette smoking. Contributing factors leading to bronchial obstruction in COPD include mucus hypersecretion and an increase in bronchial muscle tone, which is triggered mainly by cholinergic mechanisms. Anticholinergic bronchodilators

Kai-Michael Beeh; Tobias Welte; Roland Buhl

2002-01-01

269

Histological diagnosis of chronic inflammatory bowel disease in childhood  

Microsoft Academic Search

One hundred and four children were initially assessed by clinical, radiological, and endoscopic criteria as chronic inflammatory bowel disease. All were assessed independently using precise histological diagnostic criteria. Fifty eight patients were diagnosed as Crohn's disease, 25 as ulcerative colitis, 15 remained provisionally categorised as indeterminate colitis and six proved to be normal. Diagnostic granulomas were found in 36% of

S K Chong; A J Blackshaw; S Boyle; C B Williams; J A Walker-Smith

1985-01-01

270

Intergenerational transmission of non-communicable chronic diseases  

Microsoft Academic Search

We introduce a theoretical framework that contributes to the understanding of non-communicable chronic diseases' (NCDs) epidemics: even if NCDs are non-infectious diseases, they may spread due to the social transmission of unhealthy activities such as unhealthy diet, physical inactivity, and smoking. In particular, we study the intergener- ational dimension of this mechanism. We find that, due to the social transmission

Catarina Goulao; Agustin Pérez-Barahona

2012-01-01

271

Racial and survival paradoxes in chronic kidney disease  

Microsoft Academic Search

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

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

2007-01-01

272

Direct Renin Inhibitor: Aliskiren in Chronic Kidney Disease  

PubMed Central

The renin-angiotensin-aldosterone system (RAAS) plays pivotal roles in the pathogenesis of chronic kidney disease (CKD) progression and its increased complications such as hypertension (HT) and cardiovascular diseases (CVD). Previous studies suggested that aliskiren a direct renin inhibitor, blocks RAAS and may be effective for the management of CKD and its complications. This review focuses on the effects of aliskiren on CKD.

Morishita, Yoshiyuki; Kusano, Eiji

2012-01-01

273

Chronic Obstructive Pulmonary Disease Outcome Measurements: What's Important? What's Useful?  

Microsoft Academic Search

The severity of chronic obstructive pulmonary disease (COPD) and patients' response to therapy are difficult to assess. The traditional measure, spirometry, correlates poorly with important clinical fea- tures of the disease, such as survival and quality of life (QOL). Moreover, COPD has recently been recognized as a systemic dis- ease,anditssystemicmanifestations,suchasweightlossandmuscle weakness, are only poorly related to lung function. Therefore, al-

Nicholas J. Gross

2005-01-01

274

Uremia-related cardiovascular risk factors in chronic kidney disease  

Microsoft Academic Search

Cardiovascular disease is the leading cause of mortality in the dialysis population and a major cause of morbidity and mortality in patients with chronic renal failure. The conventional Framingham cardiovascular (CV) risk factors (ie, hypertension, smoking, age, hyper- cholesterolemia, and a family history of CV disease) have typically been the focus of risk stratification and subse- quent primary and\\/or secondary

Caroline E. Stigant

275

Clinical application of ghrelin for chronic respiratory diseases.  

PubMed

The discovery of ghrelin has resulted in the development of potential therapeutics for cachexia caused by multiple underlying diseases. When chronic respiratory diseases progress to their advanced stages, cachexia often occurs, thereby worsening the patient's prognosis. A small clinical trial that enrolled cachectic patients with chronic respiratory disease revealed that administration of ghrelin improved their nutritional status and exercise tolerance. Short-term administration of ghrelin was found to be safe and tolerated with adverse events, including suffusion, sleepiness, peristalsis, hunger, and sweating. Further large-scale and long-term clinical trials are needed. PMID:22975067

Matsumoto, Nobuhiro; Nakazato, Masamitsu

2012-01-01

276

[Chronic disease management: mistaken approach in the elderly].  

PubMed

Lifestyle changes, including unhealthy eating habits and high rates of physical inactivity and stress, along with an increase in life expectancy have been accompanied by increasing rates of chronic non-communicable diseases. Chronic diseases are the main causes of death and disability in Brazil. Chronic disease management is one of the most important challenges facing health managers who are constantly seeking interventions and strategies to reduce costs and hospital admissions and to prevent other conditions. However, most existing models of health care have focused exclusively on disease, but it is a mistaken approach. An integrated approach is required to effectively meet patient needs. The purpose of this article was to further discuss policies and strategies for the development of new models of care for the elderly with an emphasis on prevention and resolution actions. PMID:23503534

Veras, Renato Peixoto

2012-12-01

277

Treatment of chronic graft-versus-host disease in 2011  

PubMed Central

Purpose of review This article summarizes recent reports on the risks, pathogenesis and treatment of chronic graft-versus-host disease (GVHD). Recent findings Chronic GVHD remains an elusive disorder to characterize and to treat. Recent evidence on tolerance induction by regulatory T cells and on B cells involvement shed some insights in the pathogenesis of chronic GVHD. In a recent large comparative study, the overall risk profiles for acute and for chronic GVHD were similar, but risks factors were not changed after adjustment for prior acute GVHD, supporting the concept that chronic GVHD is not an end stage of acute GVHD. Glucocorticoids remain the standard initial treatment of chronic GVHD, but the outcomes are not satisfactory, particularly for patients with high-risk features. Many treatments for chronic GVHD including extracorporeal photopheresis, rituximab, sirolimus, mycofenolate mofetil, imatinib, pentostatin and infusion of mesenchymal stem cells have been reported in several retrospective and relatively small phase I/II studies with a wide range of overall responses. Summary No current therapies used for chronic GVHD have been approved by the Food and Drug Administration. Large well-designed prospective studies are warranted to establish better treatments. Targeted therapies based on the pathogenesis of chronic GVHD may lead to better outcomes.

Inamoto, Yoshihiro; Flowers, Mary E.D.

2012-01-01

278

A randomized trial of nocturnal oxygen therapy in chronic obstructive pulmonary disease patients  

Microsoft Academic Search

The beneficial effects of nocturnal oxygen therapy (NOT) in chronic obstructive pulmonary disease (COPD) patients with mild-to-moderate daytime hypoxaemia (arterial oxygen tension (Pa,O2) in the range 7.4-9.2 kPa (56-69 mmHg)) and exhibiting sleep-related oxygen desaturation remains controversial. The effec- tiveness of NOT in that category of COPD patients was studied. The end points included pulmonary haemodynamic effects after 2 yrs

A. Chaouat; E. Weitzenblum; R. Kessler; C. Charpentier; M. Ehrhart; R. Schott; P. Levi-Valensi; J. Zielinski; L. delaunois; R. Cornudella; J. Moutinho dos Santos

1999-01-01

279

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

Microsoft Academic Search

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

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

1999-01-01

280

[Chronic inflammation in patients with acute coronary syndrome and chronic kidney disease].  

PubMed

Chronic kidney disease is a worldwide growing problem in public health. It is a risk factor for complications in patients with acute coronary syndrome (ACS). Diabetes, hypertension (hypertrophy and left ventricular failure), impaired fibrinolysis and coagulation processes, as well as the rapid development of atherosclerosis (partly associated with chronic inflammation) are responsible for higher prevalence of cardiovascular diseases in patients with chronic kidney disease. Inflammatory process of unknown aetiology belongs to the so-called non-traditional risk factors in development of cardiovascular system diseases. It is thought that this process is responsible for adverse remodelling of atherosclerosis plaque and its instability which causes plaque rupture and as a result a coronary syndrome occurrence. Important inflammatory mediators, which take part in pathogenesis of ACS, are acute phase proteins such as: C-reactive protein, adhesion molecules VCAM-1, ICAM-1, selectins, plasma amyloid A, metalloproteinases, interleukins-1 and -6, tumour necrosis factor-a and vascular endothelial growth factor. PMID:21523678

Owczarek, Aleksander; Babi?ska, Magdalena; Szygu?a-Jurkiewicz, Bo?ena; Chudek, Jerzy

2011-01-01

281

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

2012-07-12

282

Asthma, chronic obstructive pulmonary disease (COPD), and the overlap syndrome.  

PubMed

Asthma and chronic obstructive pulmonary disease (COPD) are highly prevalent chronic diseases in the general population. Both are characterized by heterogeneous chronic airway inflammation and airway obstruction. In both conditions, chronic inflammation affects the whole respiratory tract, from central to peripheral airways, with different inflammatory cells recruited, different mediators produced, and thus differing responses to therapy. Airway obstruction is typically intermittent and reversible in asthma but is progressive and largely irreversible in COPD. However, there is a considerable pathologic and functional overlap between these 2 heterogeneous disorders, particularly among the elderly, who may have components of both diseases (asthma-COPD overlap syndrome). The definitions for asthma and COPD recommended by current guidelines are useful but limited because they do not illustrate the full spectrum of obstructive airway diseases that is encountered in clinical practice. Defining asthma and COPD as separate entities neglects a considerable proportion of patients with overlapping features and is largely based on expert opinion rather than on the best current evidence. The presence of different phenotypes or components of obstructive airway diseases, therefore, needs to be addressed to individualize and optimize treatment to achieve the best effect with the fewest side effects for the patient. Although specific interventions vary by disease, the treatment goals of obstructive airway diseases are similar and driven primarily by the need to control symptoms, optimize health status, and prevent exacerbations. PMID:23833163

Nakawah, Mohammad Obadah; Hawkins, Clare; Barbandi, Farouk

283

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

284

Chronic colonization by Pseudomonas aeruginosa of patients with obstructive lung diseases: cystic fibrosis, bronchiectasis, and chronic obstructive pulmonary disease  

Microsoft Academic Search

Pseudomonas aeruginosa is isolated in sputum cultures from cystic fibrosis (CF) patients and adults with bronchiectasis (BS) and chronic obstructive pulmonary disease, but it is not well known if the characteristics of colonization in these latter patients are similar to those with CF. We examined 125 P. aeruginosa isolates obtained from 31 patients suffering from these diseases by pulsed field

Andrea D. Valderrey; María José Pozuelo; Pedro A. Jiménez; María D. Maciá; Antonio Oliver; Rafael Rotger

2010-01-01

285

Chronic lyme disease: psychogenic fantasy or somatic infection?  

PubMed Central

Sigal and Hassett published an article about Lyme disease in the EHP Supplements (Sigal and Hassett 2002), suggesting that chronic Lyme disease is "psychogenic." I do not think that Sigal and Hassett, non-psychiatrists, are qualified to speak about psychiatric matters. I, however, actually have had the disease, which they characterize as "medically unexplained," for over 25 years and have 15 years of experience as a patient advocate and educator. I beg to differ.

Mervine, Phyllis

2003-01-01

286

Quantitative sputum gram stains in chronic bronchial disease  

Microsoft Academic Search

The assessment of bacterial flora of the bronchial system can provide useful information for determining the presence of acute\\u000a bacterial infections in patients with chronic bronchial disease. The authors examined the value of quantitative sputum gram\\u000a stains performed in patients during acute bronchial exacerbations, recovery from such exacerbations, acute allergic exacerbations\\u000a of chronic extrinsic asthma, and a stable period. The

W. Baigelman; S. Chodosh; D. Pizzuto; T. Sadow

1979-01-01

287

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

288

The management of chronic diseases in rural Missouri practices.  

PubMed

This qualitative study describes the challenges of managing chronic diseases in small, rural, health care practices in Missouri. Four recurrent themes were identified from each of the nine focus groups: the similarity of their patient population and community characteristics, their unfamiliarity with aspects of the chronic care model, the consistent problem of poverty as a barrier to health care access for patients, and the uncertainty about what health care reform will mean for rural practice settings. PMID:22860289

Enriquez, Maithe; Moormeier, Jill; Lafferty, William

289

Urinary Kallikrein Excretion in Chronic Pancreatic Diseases  

Microsoft Academic Search

Variations in urinary kallikrein in pancreatic diseases were ascertained, and possible influencing factors were investigated. Serum amylase and urinary excretion of glandular kallikrein, pancreatic ribonuclease (RNase),?-glutamyltransferase (GGT) and amylase were measured in 24 control subjects, 39 patients with pancreatic cancer, 49 with pancreatitis and 63 with extra-pancreatic diseases. Urinary kallikrein was found to be elevated in a substantial number of

Carlo Fabris; Maria Piera Panozzo; Daniela Basso; Giuseppe Del Favero; Mario Plebani; Martina Zaninotto; Paola Fogar; Tamara Meggiato; Paola Scalon; Chiara Ferrara; Remo Naccarato

1991-01-01

290

Screening for Chronic Kidney Disease: Unresolved Issues  

Microsoft Academic Search

End-stage renal disease is epidemic in the United States. As a measure to control this epidemic, it has been recommended that individuals who are at risk for CKD be tested for undetected kidney disease during routine health care encounters. There are generally accepted criteria against which screening recommendations for CKD control and prevention programs should be judged. If detection strategies

WILLIAM M. MCCLELLAN; SYLVIA P. B. RAMIREZ; CLAUDINE JURKOVITZ

2003-01-01

291

Psychological impact of chronic hepatitis C: Comparison with other stressful life events and chronic diseases  

Microsoft Academic Search

AIM: To examine the psychological impact of chronic hepatitis C (CHC) diagnosis in a large cohort of CHC patients as compared with other stressful life events and chronic diseases carrying a risk of life-threatening complications. METHODS: One hundred and eighty-five outpatients with compensated CHC were asked to self-grade, using a 100-mm visual analogue scale (VAS), the degree of stress caused

Laurent Castera; Aymery Constant; Pierre-Henri Bernard; Victor de Ledinghen; Patrice Couzigou

2006-01-01

292

In Search of a Germ Theory Equivalent for Chronic Disease  

PubMed Central

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

2012-01-01

293

Revisions to chronic disease surveillance indicators, United States, 2004.  

PubMed

To allow public health officials to uniformly define, collect, and report chronic disease data, Indicators for Chronic Disease Surveillance was released by the Council of State and Territorial Epidemiologists in 1999. This publication provided standard definitions for 73 indicators developed by epidemiologists and chronic disease program directors at the state and federal levels. The indicators were selected because of their importance to public health and the availability of state-level data. This report describes the latest revisions to the chronic disease indicators published in 2004. The revised set of 92 indicators includes 24 for cancer; 15 for cardiovascular disease; 11 for diabetes; 7 for alcohol; 5 each for nutrition and tobacco; 3 each for oral health, physical activity, and renal disease; and 2 each for asthma, osteoporosis, and immunizations. The remaining 10 indicators cover such overarching conditions as poverty, education, and life expectancy. Although multiple states have used the indicators, wider adoption depends on increased epidemiology capacity at the state level and improved access to surveillance data. PMID:15963317

Pelletier, Andrew R; Siegel, Paul Z; Baptiste, Mark S; Maylahn, Christopher

2005-06-15

294

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.

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

2009-01-01

295

Chronic Kidney Disease and Kidney Failure  

MedlinePLUS

... suffered from disabling bone disease, dementia caused by aluminum intoxication, and severe fatigue from uncontrollable anemia. High ... life of dialysis patients. Dialysis dementia due to aluminum toxicity no longer occurs. Premature death due to ...

296

Chronic Venous Disease (Beyond the Basics)  

MedlinePLUS

... Patient information: Doppler ultrasound (The Basics) Patient information: Pulmonary embolism (blood clot in the lungs) (The Basics) Patient ... disease in the legs (The Basics) Patient information: Pulmonary embolism (blood clot in the lungs) (The Basics) Patient ...

297

69 FR 64057 - National Center for Chronic Disease Prevention and Health Promotion Conference Support Program  

Federal Register 2010, 2011, 2012, 2013

...Chronic Disease Prevention and Health Promotion Conference Support Program Announcement...Chronic Disease Prevention and Health Promotion Conference Support Program...conferences in the areas of health promotion and disease prevention...

2004-11-03

298

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.

Karnilowicz, W

2011-01-01

299

Drug dosing adjustments in patients with chronic kidney disease.  

PubMed

Chronic kidney disease affects renal drug elimination and other pharmacokinetic processes involved in drug disposition (e.g., absorption, drug distribution, nonrenal clearance [metabolism]). Drug dosing errors are common in patients with renal impairment and can cause adverse effects and poor outcomes. Dosages of drugs cleared renally should be adjusted according to creatinine clearance or glomerular filtration rate and should be calculated using online or electronic calculators. Recommended methods for maintenance dosing adjustments are dose reductions, lengthening the dosing interval, or both. Physicians should be familiar with commonly used medications that require dosage adjustments. Resources are available to assist in dosing decisions for patients with chronic kidney disease. PMID:17555141

Munar, Myrna Y; Singh, Harleen

2007-05-15

300

Chronic inflammatory diseases and cardiovascular risk: a systematic review.  

PubMed

Despite recent advancements in the treatment of coronary artery disease (CAD), it remains the number one cause of death in the world. While traditional risk factors partially account for the development of CAD, other novel risk factors have recently been implicated. Specifically, chronic inflammation has been postulated to play a role in the development and propagation of this disease. The purpose of this systematic review is to examine the available evidence to determine if patients with chronic inflammatory diseases have higher rates of cardiovascular disease. A MEDLINE search was conducted for articles published between 1980-2009. We focused on studies that assessed hard cardiovascular endpoints in subjects with chronic inflammatory conditions such as systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, polymyositis/dermatomyositis, and inflammatory bowel disease. Although largely based on small studies, our review indicates that patients with chronic inflammatory conditions are likely at elevated risk for the development of CAD. Further research consisting of prospective cohort studies is needed to better quantify this risk. PMID:21459266

Roifman, Idan; Beck, Paul L; Anderson, Todd J; Eisenberg, Mark J; Genest, Jacques

301

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.

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

2011-01-01

302

CHRONIOUS: an open, ubiquitous and adaptive chronic disease management platform for chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD) and renal insufficiency.  

PubMed

CHRONIOUS is an highly innovative Information and Communication Technologies (ICT) research Initiative that aspires to implement its vision for ubiquitous health and lifestyle monitoring. The 17 European project partners are strictly working together since February 2008 to realize and open platform to manage and monitor elderly patients with chronic diseases and many difficulties to reach hospital centers for routine controls. The testing activities will be done in Italy and Spain involving COPD (Chronic Obstructive Pulmonary Disease) and CKD (Chronic Kidney Disease) patients, these being widespread and highly expensive in terms of social and economic costs. Patients, equipped by wearable technologies and sensors and interacting with lifestyle interfaces, will be assisted by healthcare personnel able to check the health record and critical conditions through the Chronious platform data analysis and decision support system. Additionally, the new ontology based literature search engine will help the clinicians in the standardization of care delivery process. This paper is to present the main project objectives and its principal components from the intelligent system point of view. PMID:21096301

Rosso, R; Munaro, G; Salvetti, O; Colantonio, S; Ciancitto, F

2010-01-01

303

Chronic acalculous gallbladder disease: A clinical enigma  

Microsoft Academic Search

Patients with classic symptoms of gallbladder disease who have negative oral cholecystograms (OCG) or ultrasonography present perplexing management problems. The surgical literature attests to the fact that there is a marked difference of opinion as to the role of surgery in these patients. The high recurrence rate of symptoms in patients following surgery reported in some series has been a

Paul F. Nora; Robert P. Davis; Michael J. Fernandez

1984-01-01

304

Neuropsychiatric complications of chronic kidney disease  

Microsoft Academic Search

Evidence is emerging that cognitive impairment, delirium and depression are very common in patients with renal disease. All of these conditions are associated with prolonged hospitalization and an increased risk of mortality. A good understanding of these conditions is key to their prevention, early intervention and management. This Review summarizes the clinical features of various forms of cognitive dysfunction that

Rory McQuillan; Sarbjit V. Jassal

2010-01-01

305

Malnutrition in chronic obstructive pulmonary disease.  

PubMed

Malnutrition in patients with COPD is associated with an impaired pulmonary status, reduced diaphragmatic mass, lower exercise capacity, and higher mortality rate when compared with adequately nourished individuals with COPD. Deterioration in patients with COPD may be the result of malnutrition. In addition, malnutrition could be a sign of other factors directly altered by the disease. PMID:17150429

Schwartz, Denise Baird

2006-12-01

306

Chronic Liver Diseases as Liver Tumor Precursors  

Microsoft Academic Search

Liver cancer is a major global health problem and hepatocellular carcinoma (HCC) accounts for 75% of all liver carcinoma. HCC occurs more often in men than in women and mostly in people 50 to 60 years old. The disease is more common in parts of sub-Saharan Africa and Asia than in North and South America and Europe. Nevertheless its incidence

Jan Lata

2010-01-01

307

MicroRNAs: new insights into chronic childhood diseases.  

PubMed

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

2013-06-27

308

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

Microsoft Academic Search

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

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

2005-01-01

309

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.

Thorley, Andrew J; Tetley, Teresa D

2007-01-01

310

Chronic Kidney Disease in an Adult with Propionic Acidemia.  

PubMed

We report an adult male with classic propionic acidemia (PA) who developed chronic kidney disease in the third decade of his life. This diagnosis was recognized by an increasing serum creatinine and confirmed by reduced glomerular filtration on a (99m)Tc-diethylenetriamine pentaacetate (DTPA) scan. Histopathology of the kidney showed moderate glomerulo- and tubulointerstitial fibrosis with very segmental mesangial IgA deposits. This is the second reported case of kidney disease in an individual with propionic acidemia possibly indicating that chronic kidney disease may be a late-stage complication of propionic acidemia. Additionally, this is the first description of the histopathology of kidney disease in an individual with propionic acidemia. As more cases emerge, the clinical course and spectrum of renal pathology in this disorder will be better defined. PMID:23756992

Vernon, H J; Bagnasco, S; Hamosh, A; Sperati, C J

2013-06-12

311

Using information technology to improve the management of chronic disease.  

PubMed

Information and communications technology (ICT) is increasingly being used in management of chronic illness to facilitate shared services (virtual health networks and electronic health records), knowledge management (care rules and protocols, scheduling, information directories), as well as consumer-based health education and evidence-based clinical protocols. Common applications of ICT include home monitoring of vital signs for patients with chronic disease, as well as replacing home visits by nurses in person with telemedicine videophone consultations. A patient-managed Home Telecare System with integrated clinical signs monitoring, automated scheduling and medication reminders, as well as access to health education and daily logs, is presented as an example of ICT use for chronic disease self-management. A clinical case study demonstrates how early identification of adverse trends in clinical signs recorded in the home can either avoid hospital readmission or reduce the length of hospital stay. PMID:12924970

Celler, Branko G; Lovell, Nigel H; Basilakis, Jim

2003-09-01

312

Contribution of Chronic Disease to the Burden of Disability  

PubMed Central

Background Population ageing is expected to lead to strong increases in the number of persons with one or more disabilities, which may result in substantial declines in the quality of life. To reduce the burden of disability and to prevent concomitant declines in the quality of life, one of the first steps is to establish which diseases contribute most to the burden. Therefore, this paper aims to determine the contribution of specific diseases to the prevalence of disability and to years lived with disability, and to assess whether large contributions are due to a high disease prevalence or a high disabling impact. Methodology/Principal Findings Data from the Dutch POLS-survey (Permanent Onderzoek Leefsituatie, 2001–2007) were analyzed. Using additive regression and accounting for co-morbidity, the disabling impact of selected chronic diseases was calculated, and the prevalence and years lived with ADL and mobility disabilities were partitioned into contributions of specific disease. Musculoskeletal and cardiovascular disease contributed most to the burden of disability, but chronic non-specific lung disease (males) and diabetes (females) also contributed much. Within the musculoskeletal and cardiovascular disease groups, back pain, peripheral vascular disease and stroke contributed particularly by their high disabling impact. Arthritis and heart disease were less disabling but contributed substantially because of their high prevalence. The disabling impact of diseases was particularly high among persons older than 80. Conclusions/Significance To reduce the burden of disability, the extent diseases such as back pain, peripheral vascular disease and stroke lead to disability should be reduced, particularly among the oldest old. But also moderately disabling diseases with a high prevalence, such as arthritis and heart disease, should be targeted.

Klijs, Bart; Nusselder, Wilma J.; Looman, Caspar W.; Mackenbach, Johan P.

2011-01-01

313

Treating Alcoholism as a Chronic Disease  

PubMed Central

For many patients, alcohol and other drug (AOD) use disorders are chronic, recurring conditions involving multiple cycles of treatment, abstinence, and relapse. To disrupt this cycle, treatment can include continuing care to reduce the risk of relapse. The most commonly used treatment approach is initial intensive inpatient or outpatient care based on 12-step principles, followed by continuing care involving self-help groups, 12-step group counseling, or individual therapy. Although these programs can be effective, many patients drop out of initial treatment or do not complete continuing care. Thus, researchers and clinicians have begun to develop alternative approaches to enhance treatment retention in both initial and continuing care. One focus of these efforts has been the design of extended treatment models. These approaches increasingly blur the distinction between initial and continuing care and aim to prolong treatment participation by providing a continuum of care. Other researchers have focused on developing alternative treatment strategies (e.g., telephone-based interventions) that go beyond traditional settings and adaptive treatment algorithms that may improve outcomes for clients who do not respond well to traditional approaches

McKay, James R.; Hiller-Sturmhoefel, Susanne

2011-01-01

314

[Chronic peripheral arterial disease induced by cocaine].  

PubMed

Cocaine induced acute peripheral thrombosis, though a rare complication, has been described in the literature. Although there are reports describing the chronic effects of cocaine on the peripheral arterial system, there are no published cases of this complication when other risk factors are lacking. We report on a 22 year old female patient, with intranasal consumption of 3 grams of cocaine per week for a year, who consulted for intermittent claudication at 200 meters, associated to left lower limb pain and paresthesiae for the last two months. Arterial Doppler ultrasonography showed a stenosis greater than 70% in the superficial left femoral artery. Other probable etiologies were excluded. Treatment was initiated with acetylsalicylic acid, cilostazol and graded physical exercise, associated to support therapy in order to maintain cocaine consumption avoidance, with good response. This case emphasizes the relevance of patients information, as most people ignore the cardiovascular complication of this addiction. It is also essential to inquire about cocaine consumption in young patients with peripheral arteriopathy and no apparent risk factors. PMID:22257455

Pankl, Sonia; Pellegrini, Débora; Bruetman, Julio E

2012-01-01

315

Economic Modeling in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Calculating the cost-effectiveness of interventions is an important step in accurately assessing the health and financial burdens of a disease. Although clinical trials that include cost data can be used to compare the cost-effectiveness of specific interventions, they only deal with outcomes within the time frame of the trial. Health economic models can synthesize epidemiologic, clinical, economic, andquality-of-lifedatafrommanydifferentsourcesandextrapolate results to

Maureen Rutten-van Molken; Todd A. Lee

2006-01-01

316

Sympatho-renal axis in chronic disease  

Microsoft Academic Search

Essential hypertension, insulin resistance, heart failure, congestion, diuretic resistance, and functional renal disease are\\u000a all characterized by excessive central sympathetic drive. The contribution of the kidney’s somatic afferent nerves, as an\\u000a underlying cause of elevated central sympathetic drive, and the consequences of excessive efferent sympathetic signals to\\u000a the kidney itself, as well as other organs, identify the renal sympathetic nerves

Paul A. Sobotka; Felix Mahfoud; Markus P. Schlaich; Uta C. Hoppe; Michael Böhm; Henry Krum

317

SERUM OSTEOPROTEGERIN AND RANKL LEVELS IN CHRONIC ALCOHOLIC LIVER DISEASE  

Microsoft Academic Search

Objectives: Osteoprotegerin (OPG) is a decoy receptor that binds RANK-ligand (RANKL) and prevents osteoclast activation. Oestrogens, androgens, corticosteroids, parathyroid hormone (PTH), vitamin D, and several cytokines exert their effects on bone modulating the OPG\\/RANKL system. Since these substances become altered in chronic alcoholic liver disease, we investigated the OPG\\/RANKL system in alcoholic liver disease, its relation with bone mineral density

ELENA GARCIA-VALDECASAS-CAMPELO; EMILIO GONZALEZ-REIMERS; FRANCISCO SANTOLARIA-FERNANDEZ; MARIA JOSEDE LA VEGA-PRIETO; ANTONIO MILENA-ABRIL; MARIA JOSESANCHEZ-PEREZ; ANTONIO MARTINEZ-RIERA

2006-01-01

318

Therapeutic strategies to slow chronic kidney disease progression  

Microsoft Academic Search

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

Elke Wühl; Franz Schaefer

2008-01-01

319

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

320

Elderly people at home disabled by chronic obstructive pulmonary disease  

Microsoft Academic Search

Background: we compared uptake of hospital and community-based support in elderly people disabled by chronic obstructive pulmonary disease (COPD), normal controls (NCs) and patients with Parkinsons disease, stroke, amputation, or arthritis (disabled controls; DCs). Methods: there were 65 subjects (35 men) aged 70-93 years (mean 78) with COPD, 55 NCs (23 men; age range 71-90 years (mean 78)) and 53

ABEBAW M. YOHANNES; JAMAL ROOMI; MARTIN J. CONNOLLY

1998-01-01

321

Factors Influencing Survival in Children with Chronic Interstitial Lung Disease  

Microsoft Academic Search

To investigate factors influencing survival in children with chronic interstitial lung disease (ILD), we extracted specific clinical information from a data base of 99 children with ILD who met entry criteria for our study. The effects of a weight below the fifth percentile for the patient's age, crackles, club- bing, family history of ILD, symptom duration, and severity-of-illness score on

LELAND L. FAN; CLAUDIA A. KOZINETZ

1997-01-01

322

Enhanced neutrophil response in chronic obstructive pulmonary disease  

Microsoft Academic Search

BACKGROUNDNeutrophils are likely to play a major role in the inflammatory response seen in chronic obstructive pulmonary disease (COPD). This study sought to address the hypothesis that an enhanced neutrophil response to proinflammatory agents in COPD may contribute to their recruitment and activation in the lungs.METHODSCirculating neutrophils were obtained from 10 patients with COPD, eight long term smokers with normal

A Noguera; S Batle; C Miralles; J Iglesias; X Busquets; W MacNee; A G N Agustí

2001-01-01

323

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

324

Quality of sleep in patients with chronic kidney disease  

Microsoft Academic Search

Background. Sleep disorders are common in patients with renal failure on dialysis; however, the prevalence of 'poor sleep' in patients with chronic kidney disease (CKD) not yet on dialysis is not known. This study aimed to measure the prevalence of 'poor sleep' in CKD patients and to examine the association between quality of sleep and the degree of renal impairment

Eduard A. Iliescu; Karen E. Yeates; David C. Holland

2004-01-01

325

Postnatal steroids and chronic lung disease in the newborn  

Microsoft Academic Search

Introduction: Chronic lung disease (CLD) represents a condition of persistent inflammation within the airways which may have its origin either in utero or after birth. Corticosteroids, because of their anti- inflammatory actions, have been used to modify the course of CLD. There have been almost 40 randomised controlled trials of postnatal dexamethasone and 12 of inhaled steroids. Methods: Systematic reviews

Henry L. Halliday

2004-01-01

326

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

327

Chronic hepatitis in childhood: the spectrum of the disease  

Microsoft Academic Search

During a multicentre study of chronic hepatitis in childhood diagnosed by biopsy, the spectrum of the disease has been evaluated in 196 consecutive patients, including 157 from Northern Italy and 39 from Southern Italy. Only 31% of patients in the former group and 27% in the latter were symptomatic when first seen: the majority of cases being seen after familial

F Bortolotti; R Calzia; A Vegnente; P Cadrobbi; M Rugge; M Armigliato; M G Marazzi; R Iorio; C Crivellaro; R Piscopo

1988-01-01

328

Nitric Oxide Inhalation During Exercise in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Patients with chronic obstructive pulmonary disease (COPD) may develop hypoxemia and pulmonary hypertension when exercising. To investigate whether inhaled nitric oxide (NO), a selective pulmo- nary vasodilator, modifies the changes induced by exercise in pulmonary hemodynamics and gas ex- change in COPD, we studied nine patients (FEV 1 5 39 6 2% predicted), at rest and at submaximal ex- ercise,

NÚRIA ROGER; JOAN A. BARBERÀ; JOSEP ROCA; IRENE ROVIRA; FEDERICO P. GÓMEZ; ROBERT RODRIGUEZ-ROISIN

1997-01-01

329

Management of cardiovascular disease risk in chronic inflammatory disorders  

Microsoft Academic Search

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

Mariana J. Kaplan

2009-01-01

330

Air travel in patients with chronic obstructive pulmonary disease.  

PubMed

Air travel exposes patients with chronic obstructive pulmonary disease to the risk of severe hypoxemia. We sought to determine the frequency and outcome of airline travel in patients with chronic obstructive pulmonary disease. A cohort of 100 patients (76 men and 24 women; age 67 +/- 7 years [mean +/- SD]) with severe chronic pulmonary obstructive disease examined by means of spirometry (forced expiratory volume in the first second, 0.04 +/- 0.35 L), all military retirees, or their dependents, comprised the study population. Forty-four patients traveled by commercial air carrier over a 28-month interval, giving an annual frequency of 18.9% of these patients per year. The group that did not travel by air (n = 56) had a lower mean value for forced expiratory volume in the first second and greater prevalence of home oxygen use than did the group that did travel by air. Twelve of the travelers (27.3%) consulted a physician beforehand. Flights reached foreign destinations for 22.7% of patients. The median duration of the longest flight segment was 3 hours. A minority of patients (34.3%) occupied seats in the smoking sections of aircraft. A majority (56.8%) ambulated aboard the aircraft during flights. Eight patients (18.2%) reported transient symptoms during air travel. We conclude that patients with chronic obstructive pulmonary disease travel with appreciable frequency, often without medical consultation, and develop symptoms in some cases. PMID:1888245

Dillard, T A; Beninati, W A; Berg, B W

1991-09-01

331

Exercise in patients with chronic obstructive pulmonary disease  

Microsoft Academic Search

Sporadic visits to the local doctor followed sometimes by changes in oral and inhaled bronchodilators and occasionally by the addition of steroids frequently does little to significantly improve symptoms and function in the disabled patient with COPD. As in other chronic diseases, the management of these patients is facilitated by a team approach in conjunction with general rehabilitation principles. The

M J Belman

1993-01-01

332

CHRONIC WASTING DISEASE OF CAPTIVE MULE DEER: A SPONGIFORM ENCEPHALOPATHY  

Microsoft Academic Search

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

E. S. WILLIAMS; S. YOUNG

333

Dietary change, nutrition education and chronic obstructive pulmonary disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a prevalent and serious condition. Nutrition might play a role in COPD prevention and is definitely important in COPD management. There are some indications from epidemiological studies that dietary factors such as ample consumption of fruit and fish may decrease COPD risk. The available evidence is, however, not substantial enough to warrant dietary recommendations

Johannes Brug; Annemie Schols; Ilse Mesters

2004-01-01

334

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

335

Vascular calcification and cardiovascular function in chronic kidney disease  

Microsoft Academic Search

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

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

2005-01-01

336

Inhaled corticosteroids and mortality in chronic obstructive pulmonary disease  

Microsoft Academic Search

Background: Clinical studies suggest that inhaled corticosteroids reduce exacerbations and improve health status in chronic obstructive pulmonary disease (COPD). However, their effect on mortality is unknown.Methods: A pooled analysis, based on intention to treat, of individual patient data from seven randomised trials (involving 5085 patients) was performed in which the effects of inhaled corticosteroids and placebo were compared over at

D D Sin; L Wu; J A Anderson; N R Anthonisen; A S Buist; P S Burge; P M Calverley; J E Connett; B Lindmark; R A Pauwels; D S Postma; J B Soriano; W Szafranski; J Vestbo

2005-01-01

337

Regulation of fibroblast growth factor-23 in chronic kidney disease  

Microsoft Academic Search

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

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

2007-01-01

338

Chronic Wasting Disease and Potential Transmission to Humans  

Microsoft Academic Search

Chronic wasting disease (CWD) of deer and elk is endemic in a tri-corner area of Colorado, Wyoming, and Nebraska, and new foci of CWD have been detected in other parts of the United States. Although detection in some areas may be related to increased surveillance, introduction of CWD due to translocation or natural migration of animals may account for some

Ermias D. Belay; Ryan A. Maddox; Elizabeth S. Williams; Michael W. Miller; Pierluigi Gambetti; Lawrence B. Schonberger

2004-01-01

339

Clinical Effects of Inhaled Corticosteroids in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) has multiple patho- physiologic effects that are not confined to the lungs. Similarly, treatment for COPD may have a number of different beneficial effects, and although each of these may be small, their cumulative effect may add up to a worthwhile overall outcome. Many of the effects of COPD are only weakly related to FEV1,

Paul W. Jones

2004-01-01

340

Proinflammatory effects of iron sucrose in chronic kidney disease  

Microsoft Academic Search

Inflammation is a central component of progressive chronic kidney disease (CKD). Iron promotes oxidative stress and inflammatory response in animals and promotes progressive CKD. Parenteral iron provokes oxidative stress in patients with CKD; however, its potential to provoke an inflammatory response is unknown. In 20 veterans with CKD, 100 mg iron sucrose was administered intravenously over 5 min and urinary

R Agarwal

2006-01-01

341

Markers of exacerbation severity in chronic obstructive pulmonary disease  

Microsoft Academic Search

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) can experience 'exacerbations' of their conditions. An exacerbation is an event defined in terms of subjective descriptors or symptoms, namely dyspnoea, cough and sputum that worsen sufficiently to warrant a change in medical management. There is a need for reliable markers that reflect the pathological mechanisms that underlie exacerbation severity and that

Luigi G Franciosi; Clive P Page; Bartolome R Celli; Mario Cazzola; Michael J Walker; Meindert Danhof; Klaus F Rabe; Oscar E Della Pasqua

2006-01-01

342

Prevalence of celiac disease in patients with juvenile chronic arthritis  

Microsoft Academic Search

We estimated the prevalence of celiac disease in children with juvenile chronic arthritis (JCA), using antiendomysium antibodies as the screening test to select patients for intestinal biopsy. We studied 119 children with JCA and found four patients with antiendomysium antibodies. In three of these patients (2.5%), intestinal biopsy revealed villous atrophy; in the fourth the intestinal mucosa was normal. We

Loredana Lepore; Stefano Martelossi; Marco Pennesi; Fernanda Falcini; Maria Luisa Ermini; Roberto Ferrari; Sandra Perticarari; Gianni Presani; Ariella Lucchesi; Manuela Lapini; Alessandro Ventura

1996-01-01

343

Animal models of obesity-associated chronic kidney disease.  

PubMed

Dramatic advances in basic science have been made in the past 50 years on the basis of animal models of obesity and type II diabetes. Positional-cloning strategies in rodents with spontaneous obesity have enabled landmark scientific breakthroughs and defined the molecular scaffolding for the regulation of energy homeostasis. Recently, studies in the general population suggest that obesity is an independent risk factor for chronic kidney disease. To date, most of the animal studies that investigated chronic kidney disease associated with obesity and type II diabetes have largely been descriptive. We aim to provide an overview of animal models used to investigate the mechanisms of obesity-associated chronic kidney disease. Our overview is not meant to be an exhaustive list of all animal models in the literature on this subject, but rather to illustrate the experimental approaches. Because of space limitations, we have chosen to concentrate on rodent models. These animal models will provide excellent tools for in vivo testing of molecular mechanisms. Further hypothesis-driven research into the mechanism of chronic kidney disease and their progression by use of these models will provide important insights necessary to develop therapeutic strategies for this significant complication of the worldwide epidemic of obesity and type II diabetes. PMID:17045223

Mak, Robert H; Kuo, Huey-Ju; Cheung, Wai W

2006-10-01

344

Combination Therapy for Chronic Obstructive Pulmonary Disease: Clinical Aspects  

Microsoft Academic Search

Anticholinergics and -agonists reduce bronchoconstriction through different mechanisms, and there is a long history of combination therapy with short-acting agents in these classes for chronic ob- structive pulmonary disease. Such combinations may allow lower doses and thereby improve safety. Oral theophylline has also been combined with short-acting bronchodilators for many years. Most studies, however, show only mild improvements in bronchodilation

James F. Donohue

2005-01-01

345

Alpha 1-antitrypsin deficiency, complement activation, and chronic liver disease  

Microsoft Academic Search

Activation of the complement system, the main humoral mediator of inflammation, is restrained by the action of enzyme inhibitors including alpha 1-antitrypsin. Deficiency leads to chronic liver disease in about one in five children with this genetic defect. Complement activation was investigated in 34 children with alpha 1 AT deficiency (12 with minimal, 10 with moderate, and 12 with severe

E T Littleton; L Bevis; L J Hansen; M Peakman; A P Mowat; G Mieli-Vergani; D Vergani

1991-01-01

346

Home hospitalisation of exacerbated chronic obstructive pulmonary disease patients  

Microsoft Academic Search

It was postulated that home hospitalisation (HH) of selected chronic obstructive pulmonary disease (COPD) exacerbations admitted at the emergency room (ER) could facilitate a better outcome than conventional hospitalisation. To this end, 222 COPD patients (3.2% female; 71 +10 yrs (mean+SD)) were randomly assigned to HH (n =121) or conventional care (n =101). During HH, integrated care was delivered by

C. Hernandez; A. Casas; J. Escarrabill; J. Alonso; J. Puig-Junoy; E. Farrero; G. Vilagut; B. Collvinent; R. Rodriguez-Roisin; J. Roca

2003-01-01

347

Palliative care provision for patients with chronic obstructive pulmonary disease  

Microsoft Academic Search

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

Abebaw Mengistu Yohannes

2007-01-01

348

Calcimimetics in chronic kidney disease: evidence, opportunities and challenges  

Microsoft Academic Search

Secondary hyperparathyroidism (SHPT) remains a highly prevalent and important complication in patients with chronic kidney disease (CKD). Indeed, SHPT may compromise bone health and contribute to the increased cardiovascular risks of these patients. Calcimimetic agents may help to control SHPT and to achieve the stringent mineral metabolism targets in patients with CKD stage 5D. Whether this will translate in improved

Pieter Evenepoel

2008-01-01

349

Frequency of Hypoglycemia and Its Significance in Chronic Kidney Disease  

Microsoft Academic Search

Background and objectives: This study set out to determine the incidence of hypoglycemia in patients with chronic kidney disease (CKD), with and without diabetes, and the association of hypoglycemia with mortality. Design, setting, participants, & measurements: This was a retrospective cohort analysis of 243,222 patients who had 2,040,206 glucose measurements and were cared for at the Veterans Health Administration. CKD

Maureen F. Moen; Lori D. Walker; Lisa M. Einhorn; Stephen L. Seliger; Jeffrey C. Fink

350

21st Century Perspective on Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

The prediction that chronic obstructive pulmonary disease (COPD) will be the third leading cause of death worldwide by 2020 has enormous economic repercussions. Yet many issues and questions remain unresolved. For example, how can population studies of morbidity and mortality be viewed as comparable, without a worldwide consensus on the definition of COPD? How can the early diagnosis of COPD

Susan A. Ward; Richard Casaburi

2001-01-01

351

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...

352

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

353

Chronic Granulomatous Disease and Other Disorders of Phagocyte Function  

Microsoft Academic Search

The analysis of specific gene defects in disorders of phagocyte function has shed light on important aspects of the innate immune response. Each disor- der has distinctive features in the clinical presentation and characteristic microbial pathogens. Chronic granulomatous disease has been extensively studied both in patient series and in mouse models. New insights continue to be obtained regarding the role

Mary C. Dinauer

354

Correlates of osteoporosis in chronic obstructive pulmonary disease  

Microsoft Academic Search

The aim of this study was to analyse the correlates of reduced bone mineral density in patients with chronic obstructive pulmonary disease (COPD), with special regard to a possible protective role of hypercapnia.One hundred and four consecutive COPD inpatients in stabilized respiratory conditions underwent a comprehensive assessment of their health status. Bone mineral density was measured by X-ray absorptiometry at

R. ANTONELLI INCALZI; P. CARADONNA; P. RANIERI; S. BASSO; L. FUSO; F. PAGANO; G. CIAPPI; R. PISTELLI

2000-01-01

355

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

356

Circulating Leptin in Patients with Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

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

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

1999-01-01

357

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

358

Hunters' General Disease Risk Sensitivity and Behaviors Associated with Chronic Wasting Disease  

Microsoft Academic Search

This article examines deer hunters' general disease risk sensitivity relative to specific behaviors and beliefs about chronic wasting disease (CWD). Data were obtained from the 2003–04 Illinois Hunter Harvest Survey (n = 1521). Cluster analysis of perceived risks from CWD, Bovine Spongiform Encephalopathy (i.e., mad cow), Salmonella, Escheria coli (E. coli), West Nile Virus, and Lyme disease identified three hunter

Craig A. Miller; Lori B. Shelby

2009-01-01

359

Chronic Obstructive Pulmonary Disease, Risk Factors, and Outcome Trials: Comparisons with Cardiovascular Disease  

Microsoft Academic Search

Chronic obstructive pulmonary disease (COPD) is a major health problem and now ranks fifth in terms of the global burden of disease. Although COPD is a disease that is characterized by pro- gressive respiratory symptoms and functional decline, exacerba- tions pose the greatest risk for morbidity and early mortality, have a dramatic effect on quality of life, and are the

Scott D. Ramsey; F. D. Richard Hobbs

2006-01-01

360

Central Blood Pressure and Chronic Kidney Disease Progression  

PubMed Central

Hypertension, diabetes, and proteinuria are well-recognized risk factors for progressive kidney function loss. However, despite excellent antihypertensive and antidiabetic drug therapies, which also often lower urinary protein excretion, there remains a significant reservoir of patients with chronic kidney disease who are at high risk for progression to end-stage kidney disease. This has led to the search for less traditional cardiovascular risk factors that will help stratify patients at risk for more rapid kidney disease progression. Among these are noninvasive estimates of vascular structure and function. Arterial stiffness, manifested by the pulse wave velocity in the aorta, has been established in a number of studies as a significant risk factor for kidney disease progression and cardiovascular endpoints. Much less well studied in chronic kidney disease are measures of central arterial pressures. In this paper we cover the physiology behind the generation of the central pulse wave contour and the studies available using these approaches and conclude with some speculations on the rationale for why measurements of central pressure may be informative for the study of chronic kidney disease progression.

Cohen, Debbie L.; Townsend, Raymond R.

2011-01-01

361

Chronic lymphoproliferative disease of large granular lymphocytes.  

PubMed

An 80-year-old patient has been followed for hepato- and splenomegaly, hemolytic anemia, neutropenia with lymphocytosis with large granular lymphocyte predominance in his peripheral blood, with infiltration of bone marrow, liver and probably also spleen. Determination of surface markers of proliferating lymphocytes in peripheral blood showed a mixed phenotype of T suppressor/cytotoxic and natural killer cells (SIg-, E+, T3+, T8+, EAC+, Leu7-, N901+, NK9+, VIB C5 and VIB E3-, Ia-). An in vitro cytotoxic test showed the functional inactivity of the cells tested also after human leukocyte interferon stimulation. Chromosomal analysis neither of peripheral blood lymphocytes nor of bone marrow cells proved the monoclonality marker. Following long-term prednisone therapy, the improvement of anemia, later also neutropenia accompanied by the decrease of lymphocytes has been achieved. As the disease present in our patient was distinguished only in recent years and in our country has not been reported yet, the details on its clinical, morphologic, hematologic, cytogenetic and mainly immunophenotypic characteristics are given in this paper. The problems concerning classification of the disease and determination of its biological nature are discussed. PMID:3352841

Vahancík, A; Babusíková, O; Ujházy, P; Klobusická, M; Jakubovský, J; Izakovic, V

1988-01-01

362

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.

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

2012-01-01

363

Chronic disease epidemiology, cancer and mobile global approaches to disease prevention.  

PubMed

The focus of this symposium was worldwide prevention of chronic disease through the use of inexpensive Internet pathways, as demonstrated with the Supercourse project, and other initiatives, including promoting mobile phone technology (m-health). This symposium highlighted the need to use the Supercourse to prevent cancer and other chronic diseases. It also highlighted several components of the Supercourse library, including the former Soviet Union network, the Latin American network, and some other initiatives. PMID:22414605

Linkov, F; Shubnikov, E; Padilla, N; McCallum, A; LaPorte, R

2012-03-01

364

Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease  

Microsoft Academic Search

Background. Chronic renal replacement therapy patients exhibit reduction in skeletal muscle function as a result of a combination of metabolic effects and muscle fibre size reduction. The aim of this study was to compare muscle mass with function in patients with chronic kidney disease (CKD) at stages 4 and 5 on haemodialysis (HD) and peritoneal dialysis (PD), and investigate the

Christopher W. McIntyre; Nicholas M. Selby; Mhairi Sigrist; Lyndsay E. Pearce; Thomas H. Mercer; Patrick F. Naish

2006-01-01

365

Does chronic stress enhance the risk of diseases?  

PubMed

In the everyday life, stress is deemed as something unfavorable that may enhance the risk for the development or worsen a disease. However, in its nature, stress is adaptive reaction of the body. Its main characteristic is the activation of the hypothalamic-pituitary-adrenocortical (HPA) axis. Previously, we have shown that activation of the HPA axis plays a gastroprotective role during acute stress. The aim of our study was to clarify the effects of chronic stress and chronically elevated basal corticosterone levels on the gastric ulceration and cardiovascular vulnerability in rats.Methods. Male Wistar rats were repeatedly restrained 60 min daily for 14 days and examined on day 15th. The gastric ulceration was induced by a s.c. injection of indomethacin (35 mg/kg). The cardiovascular vulnerability was examined in urethane-anaesthetized rats in an experimental angina pectoris model (epinephrine, 10 µg/kg, 30 s later phentolamine, 15 mg/kg, both i.v.).Results. We confirmed the development of chronic stress consequences by changes in several somatic parameters (body weight decrease, thymus involution, adrenal gland hypertrophy), and elevated resting corticosterone levels. However, the gastroprotective effect of chronic stress was not manifested and there was no aggravation of indomethacin-induced gastric ulceration, either. In the experimental angina pectoris model, previous chronic stress did not have any profound effect on the blood pressure, heart rate, and electrocardiogram changes.Conclusions. In contrast to the general view on the harmfulness nature of the stress, we were unable to find a harmful effect of chronic stress on the internal diseases (gastric ulceration and angina pectoris). However, its protective effect was also missing among present experimental conditions. Keywords: chronic stress, indomethacin-induced gastric ulceration, experimental angina pectoris. PMID:24156706

Filaretova, L; Morozova, O; Laszlo, F; Morschl, E; Zelena, D

2013-10-01

366

[Surgical treatment of chronic obstructive pulmonary disease].  

PubMed

Treatment of advanced emphysema is not limited to medical management. Surgical options can also be envisioned for some cases, and physicians must know about them. A bullectomy may be considered for giant bullae, defined by a volume greater than a third of a hemithorax. This option must be discussed even in cases of advanced obstructive disease. Lung volume reduction surgery is useful for emphysema that is heterogeneously distributed but without individual giant bullae. A large-scale controlled study helped to identify its indications and results. The third possible surgical option is lung transplantation. It offers the greatest functional benefits but also involves considerable risks. One of the key points is therefore to define the optimal moment in a patient's life when this option should be discussed. Recent guidelines developed by a panel of international experts provide clinicians with the criteria for considering transplantation. PMID:19150209

Mal, Hervé

2009-01-15

367

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.

Gonzalez-Parra, Emilio; Herrero, Jose Antonio; Elewa, Usama; Arduan, Alberto Ortiz; Egido, Jesus

2013-01-01

368

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.

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

369

Lung disease with chronic obstruction in opium smokers in Singapore  

PubMed Central

Fifty-four opium smokers with chronic obstructive lung disease were studied for two-and-a-half years. Forty-eight patients had a cough for at least two years before the onset of inappropriate exertional dyspnoea. Fine, bubbling adventitious sounds suggesting small airway disease were heard on auscultation over the middle and lower lobes in 38 patients. The prevalence of inflammatory lung disease and chronic respiratory failure in this series is suggested as the main cause for the frequent finding of right ventricular hypertrophy and congestive heart failure. Physiological studies revealed moderate to severe airways obstruction with gross over-inflation and, in 32 patients, an additional restrictive defect probably due to peribronchiolar fibrosis. Radiological evidence of chronic bronchitis and bronchiolitis was observed in 45 patients, `pure' chronic bronchiolitis in six patients, and `widespread' emphysema in 25 patients respectively. Necropsy examinations in nine patients, however, showed destructive emphysema of variable severity in all. Chronic bronchiolitis often associated with striking bronchiolectasis was present in six cases. More severe bronchiolar rather than bronchial inflammation was noted. The heavy opium smokers had characteristic nodular shadows on chest radiography, sometimes associated with a striking reticular pattern not seen in `pure' cigarette smokers. This was due to gross pigmented dust (presumably carbon) deposition in relation to blood vessels, lymphatics, and bronchioles, and also within the alveoli. It is speculated that the initial lesion is an acquired bronchiolitis. Opium smoking induces an irritative bronchopathy favouring repeated attacks of acute bronchiolitis and eventually resulting in obliterative bronchiolitis, peribronchiolar fibrosis, chronic bronchitis, and destructive emphysema. Images

Da Costa, J. L.; Tock, E. P. C.; Boey, H. K.

1971-01-01

370

Calciphylaxis presenting in early chronic kidney disease with mixed hyperparathyroidism.  

PubMed

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

2011-12-20

371

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.

Brucculeri, Michael; Haydon, Allan H

2011-01-01

372

Innate Immune Responses and Chronic Obstructive Pulmonary Disease  

PubMed Central

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

Schleimer, Robert P.

2005-01-01

373

Cancer screening in people who have chronic disease: the example of kidney disease.  

PubMed

Cancer screening in people with chronic illness has been the subject of considerable debate recently. Despite the increased incidence of cancer and higher risk of cancer deaths in selected populations, such as those with kidney disease, the benefits-to-harms ratio of cancer screening is uncertain and is likely to be different to people without chronic illnesses because of the expected higher competing risk of death from disease other than cancer, and a higher risk of complications associated with the screening, the diagnostic, and the treatment processes. Using kidney disease as an example, the authors reviewed the current evidence for early cancer detection through screening in people with two or more coexistent chronic diseases, discussed the accepted principles underpinning cancer screening, and the applicability of these concepts to individuals with chronic disease. This review suggests that future research that evaluates the screening test accuracy, quality of life of having cancer, and cancer treatment effectiveness, targeting those with chronic illnesses are necessary for the development of an effective, safe, and acceptable cancer screening program among people with two or more chronic diseases. PMID:21338395

Wong, Germaine; Howard, Kirsten; Tong, Allison; Craig, Jonathan C

374

Pharmacogenetics of chronic obstructive pulmonary disease: challenges and opportunities  

PubMed Central

Similar to other common chronic diseases, chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder with multiple disease subtypes. Candidate gene studies have found genetic associations for COPD-related phenotypes that may be relevant for pharmacogenetics studies, including lung function decline and COPD exacerbations. However, few COPD pharmacogenetics studies have been completed. Most studies have focused on the role of variants in the ?2-adrenergic receptor gene on bronchodilator response, but the findings have been inconclusive. Candidate gene studies highlight the concept that genes for COPD susceptibility may also be relevant in COPD pharmacogenetics. Currently, there are no clinical applications of pharmacogenetics to COPD therapy, but the use of pharmacogenetics to determine initial smoking cessation therapy may be closer to clinical application.

Hersh, Craig P

2010-01-01

375

Metabolic Syndrome, Chronic Kidney, and Cardiovascular Diseases: Role of Adipokines  

PubMed Central

Obesity is a chronic disease, whose incidence is alarmingly growing. It is associated with metabolic abnormalities and cardiovascular complications. These complications are clustered in the metabolic syndrome (MetS) leading to high cardiovascular morbidity and mortality. Obesity predisposes to diabetic nephropathy, hypertensive nephrosclerosis, and focal and segmental glomerular sclerosis and represents an independent risk factor for the development and progression of chronic kidney disease (CKD). Albuminuria is a major risk factor for cardiovascular diseases (CVDs). Microalbuminuria has been described as early manifestation of MetS-associated kidney damage and diabetic nephropathy. Obesity and MetS affect renal physiology and metabolism through mechanisms which include altered levels of adipokines such as leptin and adiponectin, oxidative stress, and inflammation. Secretory products of adipose tissue also deeply and negatively influence endothelial function. A better understanding of these interactions will help in designing more effective treatments aimed to protect both renal and cardiovascular systems.

Tesauro, Manfredi; Canale, Maria Paola; Rodia, Giuseppe; Di Daniele, Nicola; Lauro, Davide; Scuteri, Angelo; Cardillo, Carmine

2011-01-01

376

Factors promoting acute and chronic diseases caused by yersiniae.  

PubMed Central

The experimental system constructed with the medically significant yersiniae provides a powerful basic model for comparative study of factors required for expression of acute versus chronic disease. The system exploits the close genetic similarity between Yersinia pestis, the etiological agent of bubonic plague, and enteropathogenic Yersinia pseudotuberculosis and Yersinia enterocolitica. Y. pestis possesses three plasmids, of which one, shared by the enteropathogenic species, mediates a number of virulence factors that directly or indirectly promote survival within macrophages and immunosuppression. The two remaining plasmids are unique and encode functions that promote acute disease by enhancing bacterial dissemination in tissues and resistance to phagocytosis by neutrophils and monocytes. These properties are replaced in the enteropathogenic yersiniae by host cell invasins and an adhesin which promote chronic disease; the latter are cryptic in Y. pestis. Additional distinctions include specific mutational losses in Y. pestis which result in loss of fitness in natural environments plus gain of properties that facilitate transmission and infection via fleabite. Images

Brubaker, R R

1991-01-01

377

Calorie restriction and prevention of age-associated chronic disease  

PubMed Central

Life expectancy in the world has increased dramatically during the last century; the number of older adults is expected to rise while the number of youths will decline in the near future. This demographic shift has considerable public health and economic implications since aging is associated with the development of serious chronic diseases. Calorie restriction (CR) is the most effective nutritional intervention for slowing aging and preventing chronic disease in rodents. In non-human and human primates, CR with adequate nutrition protects against abdominal obesity, diabetes, hypertension and cardiovascular diseases. Cancer morbidity and mortality are also diminished in CR monkeys, and data obtained from individuals practicing long-term CR show a reduction of metabolic and hormonal factors associated with increased cancer risk.

Omodei, Daniela; Fontana, Luigi

2012-01-01

378

Chronic HIV disease and activation of the coagulation system.  

PubMed

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

2013-08-29

379

Association Between Retinopathy and Cardiovascular Disease in Patients with Chronic Kidney Disease (From the Chronic Renal Insufficiency Cohort [CRIC] Study)  

PubMed Central

Patients with chronic kidney disease (CKD) experience co-morbid illneses including cardiovascular disease (CVD) and retinopathy. The purpose of this study was to assess the association between retinopathy and self reported CVD in a subgroup of the participants of the Chronic Renal Insufficiency Cohort (CRIC) study. In this observational, ancillary investigation, 2605 CRIC participants were invited to participate in this study, and non-mydriatic fundus photographs in both eyes were obtained in 1936 subjects. Photographs were reviewed in a masked fashion at a central photograph reading center. Presence and severity of retinopathy (diabetic, hypertensive or other) and vessel diameter caliber were assessed using standard protocols by trained graders masked to information about study participants. History of self-reported cardiovascular disease was obtained using a medical history questionnaire. Kidney function measurements, traditional and non-traditional risk factors for CVD were obtained from the CRIC study. Greater severity of retinopathy was associated with higher prevalence of any cardiovascular disease and this association persisted after adjustment for traditional risk factors for CVD. Presence of vascular abnormalities usually associated with hypertension was also associated with increased prevalence of CVD. We found a direct relationship between CVD prevalence and mean venular caliber. In conclusion, presence of retinopathy was associated with CVD, suggesting that retinovascular pathology may be indicative of macrovascular disease even after adjustment for renal dysfunction and traditional CVD risk factors. This would make assessment of retinal morphology a valuable tool in chronic kidney disease studies of CVD outcomes.

Grunwald, Juan E.; Ying, Gui-Shuang; Maguire, Maureen; Pistilli, Maxwell; Daniel, Ebenezer; Alexander, Judith; Whittock-Martin, Revell; Parker, Candace; Mohler, Emile; Chia-Mei Lo, Joan; Townsend, Raymond; Gadegbeku, Crystal Ann; Lash, James Phillip; Fink, Jeffrey Craig; Rahman, Mahboob; Feldman, Harold; Kusek, John Walter; Xie, Dawei; Coleman, Martha; Keane, Martin Gerard

2012-01-01

380

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

2012-12-02

381

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.

Poli, Giuseppe; Biasi, Fiorella; Leonarduzzi, Gabriella

2013-01-01

382

The strength to cope: spirituality and faith in chronic disease.  

PubMed

The lifelong management of a chronic condition requires considerable mental fortitude and commitment in social adjustment and adherence to medical advice. In examining strategies of adaptation, we draw on ethnographic research, including interviews with 69 people with type 2 diabetes and/or cardiovascular disease. We explore how they incorporate spirituality into their self-management routines, with positive impact on their health and wellbeing, and highlight the role of spiritual practices in supporting people with chronic conditions mentally, physically and socially, so encouraging personal responsibility for one's health and wellbeing. PMID:22083464

Unantenne, Nalika; Warren, Narelle; Canaway, Rachel; Manderson, Lenore

2013-12-01

383

Management of degenerative disk disease and chronic low back pain.  

PubMed

Degenerative disk disease is a strong etiologic risk factor of chronic low back pain (LBP). A multidisciplinary approach to treatment is often warranted. Patient education, medication, and cognitive behavioral therapies are essential in the treatment of chronic LBP sufferers. Surgical intervention with a rehabilitation regime is sometimes advocated. Prognostic factors related to the outcome of different treatments include maladaptive pain coping and genetics. The identification of pain genes may assist in determining individuals susceptible to pain and in patient selection for appropriate therapy. Biologic therapies show promise, but clinical trials are needed before advocating their use in humans. PMID:21944588

Karppinen, Jaro; Shen, Francis H; Luk, Keith D K; Andersson, Gunnar B J; Cheung, Kenneth M C; Samartzis, Dino

2011-10-01

384

[Ultrasound and color Doppler applications in chronic kidney disease].  

PubMed

Chronic kidney disease (CKD) encompasses all clinical features and complications during the progression of various kidney conditions towards end-stage renal disease. These conditions include immune and inflammatory diseases such as primary and HCV-related glomerulonephritis; infectious diseases such as pyelonephritis with or without reflux and tuberculosis; vascular diseases such as chronic ischemic nephropathy; hereditary and congenital diseases such as polycystic disease and congenital cystic dysplasia; metabolic diseases including diabetes and hyperuricemia; and systemic diseases (collagen disease, vasculitis, myeloma). During the progression of CKD, ultrasound imaging can differentiate the nature of the renal damage in only 50-70% of cases. Infact, the end-stage kidney appears shrunken, reduced in volume (Ø <9 cm), unstructured, amorphous, with acquired cystic degeneration (small and multiple cysts involving the cortex and medulla) or nephrocalcinosis, but there are rare exceptions, such as polycystic kidney disease, diabetic nephropathy, and secondary inflammatory nephropathies. The main difficulties in the differential diagnosis are encountered in multifactorial CKD, which is commonly presented to the nephrologist at stage 4-5, when the kidney is shrunken, unstructured and amorphous. As in acute renal injury and despite the lack of sensitivity, ultrasonography is essential for assessing the progression of the renal damage and related complications, and for evaluating all conditions that increase the risk of CKD, such as lithiasis, recurrent urinary tract infections, vesicoureteral reflux, polycystic kidney disease and obstructive nephropathy. The timing and frequency of ultrasound scans in CKD patients should be evaluated case by case. In this review we will consider the morphofunctional features of the kidney in all nephropathies that may lead to progressive CKD. PMID:23229668

Meola, Mario; Petrucci, Ilaria

385

The macrobiotic diet in chronic disease.  

PubMed

The macrobiotic diet is a low-fat, high-fiber, high-complex carbohydrate, mainly vegetarian diet. It is associated with a lifestyle system and a spiritual philosophy of life. Unlike many diets, the composition is not fixed and may be altered depending on a person's health status, among other considerations. Studies indicating lower serum lipid levels and blood pressure in people following a macrobiotic diet than in the general population suggest it to be an effective preventive strategy for cardiovascular disease. Many of its components suggest macrobiotics would be a valuable approach to cancer prevention. On the other hand, it has been the subject of controversy, especially with respect to its use in patients suffering from malignancies. Several remarkable anecdotal case reports have supported a therapeutic effect in patients with advanced cancers. However, to date, the few studies attempted have been inadequate to prove effectiveness and further research is warranted. Concerns include potential delay in conventional treatment for cancer, risks associated with nutrition deficiencies, and social limitations related to the complexities of strict adherence to this diet. Many aspects of currently popular dietary recommendations such as eating locally grown, in-season, fresh, organic foods are legacies of the macrobiotic lifestyle and diet. PMID:21139126

Lerman, Robert H

2010-12-01

386

Comorbidity Patterns in Patients with Chronic Diseases in General Practice  

PubMed Central

Introduction Healthcare management is oriented toward single diseases, yet multimorbidity is nevertheless the rule and there is a tendency for certain diseases to occur in clusters. This study sought to identify comorbidity patterns in patients with chronic diseases, by reference to number of comorbidities, age and sex, in a population receiving medical care from 129 general practitioners in Spain, in 2007. Methods A cross-sectional study was conducted in a health-area setting of the Madrid Autonomous Region (Comunidad Autónoma), covering a population of 198,670 individuals aged over 14 years. Multiple correspondences were analyzed to identify the clustering patterns of the conditions targeted. Results Forty-two percent (95% confidence interval [CI]: 41.8–42.2) of the registered population had at least one chronic condition. In all, 24.5% (95% CI: 24.3–24.6) of the population presented with multimorbidity. In the correspondence analysis, 98.3% of the total information was accounted for by three dimensions. The following four, age- and sex-related comorbidity patterns were identified: pattern B, showing a high comorbidity rate; pattern C, showing a low comorbidity rate; and two patterns, A and D, showing intermediate comorbidity rates. Conclusions Four comorbidity patterns could be identified which grouped diseases as follows: one showing diseases with a high comorbidity burden; one showing diseases with a low comorbidity burden; and two showing diseases with an intermediate comorbidity burden.

Garcia-Olmos, Luis; Salvador, Carlos H.; Alberquilla, Angel; Lora, David; Carmona, Montserrat; Garcia-Sagredo, Pilar; Pascual, Mario; Munoz, Adolfo; Monteagudo, Jose Luis; Garcia-Lopez, Fernando

2012-01-01

387

[Chronic inflammatory bowel disease: Crohn's disease and ulcerative colitis].  

PubMed

Inflammatory bowel diseases comprise Crohn's disease, ulcerative colitis and indeterminate colitis, generally beginning in young subjects and increasing in frequency in Western countries. Despite their still unknown aetiologies, some pathogenic mechanisms have been elucidated after the recent discovery of numerous susceptibility genes and rare environmental factors. These diseases have a course consisting of episodes of flare-up alternating with periods of remission. Medical treatment for induction of a remission comprises besides aminosalicylates, corticosteroids including budesonide and immunosuppressive drugs, anti-TNF-alpha drugs (infliximab, adalimumab) indicated in case of failure of previous therapies. Surgery is indicated for complications and failure of medical treatment.With current therapy, most of the patients are able to fulfil their familial, social and professional projects. PMID:20432590

Fiasse, R; Denis, M A; Dewit, O

2010-03-01

388

78 FR 17214 - Agency Information Collection Activities; Proposed Collection; Comment Request; Chronic Disease...  

Federal Register 2010, 2011, 2012, 2013

...Proposed Collection; Comment Request; Chronic Disease Self-Management Education Program Standardized Data Collection AGENCY...Adults with Disabilities through Chronic Disease Self-Management Education (CDSME) Programs'' cooperative...

2013-03-20

389

Utilization of Telehealth Technology to Develop and Implement a Comprehensive Management Initiative for Chronic Diseases.  

National Technical Information Service (NTIS)

Chronic diseases affect over 90 million Americans and result in high health care costs and tremendous personal and societal burden. Diabetes is, arguably, among the most pervasive and researched chronic diseases. Research shows that much of the costs and ...

R. A. Vigersky

2011-01-01

390

65 FR 57816 - National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive...  

Federal Register 2010, 2011, 2012, 2013

...National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Program Services...National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health, Program...

2000-09-26

391

Quality of life in patients with chronic respiratory disease: the Spanish version of the Chronic Respiratory Questionnaire (CRQ)  

Microsoft Academic Search

Quality of life in patients with chronic respiratory disease: the Spanish version of the Chronic Respiratory Questionnaire (CRQ). R. Güell, P. Casan, M. Sangenís, F. Morante, J. Belda, G.H. Guyatt. ?ERS Journals Ltd 1998. ABSTRACT: The aim of this study was to translate the Chronic Respiratory Questionnaire (CRQ) into Spanish and to test its measurement properties. The study was performed

R. Güell; P. Casan; M. Sangenís; F. Morante; J. Belda; G. H. Guyatt

1998-01-01

392

Emergence of chronic non-communicable diseases in China.  

PubMed

China has experienced an epidemiological transition shifting from the infectious to the chronic diseases in much shorter time than many other countries. The pace and spread of behavioural changes, including changing diets, decreased physical activity, high rates of male smoking, and other high risk behaviours, has accelerated to an unprecedented degree. As a result, the burden of chronic diseases, preventable morbidity and mortality, and associated health-care costs could now increase substantially. China already has 177 million adults with hypertension; furthermore, 303 million adults smoke, which is a third of the world's total number of smokers, and 530 million people in China are passively exposed to second-hand smoke. The prevalence of overweight people and obesity is increasing in Chinese adults and children, because of dietary changes and reduced physical activity. Emergence of chronic diseases presents special challenges for China's ongoing reform of health care, given the large numbers who require curative treatment and the narrow window of opportunity for timely prevention of disease. PMID:18930526

Yang, Gonghuan; Kong, Lingzhi; Zhao, Wenhua; Wan, Xia; Zhai, Yi; Chen, Lincoln C; Koplan, Jeffrey P

2008-10-17

393

The end of AIDS: HIV infection as a chronic disease.  

PubMed

The success of antiretroviral therapy has led some people to now ask whether the end of AIDS is possible. For patients who are motivated to take therapy and who have access to lifelong treatment, AIDS-related illnesses are no longer the primary threat, but a new set of HIV-associated complications have emerged, resulting in a novel chronic disease that for many will span several decades of life. Treatment does not fully restore immune health; as a result, several inflammation-associated or immunodeficiency complications such as cardiovascular disease and cancer are increasing in importance. Cumulative toxic effects from exposure to antiretroviral drugs for decades can cause clinically-relevant metabolic disturbances and end-organ damage. Concerns are growing that the multimorbidity associated with HIV disease could affect healthy ageing and overwhelm some health-care systems, particularly those in resource-limited regions that have yet to develop a chronic care model fully. In view of the problems inherent in the treatment and care for patients with a chronic disease that might persist for several decades, a global effort to identify a cure is now underway. PMID:24152939

Deeks, Steven G; Lewin, Sharon R; Havlir, Diane V

2013-10-23

394

Cardiovascular Disease in Children with Chronic Kidney Disease  

PubMed Central

More than a decade ago, cardiovascular disease (CVD) was recognized as a major cause of death in children with advanced CKD. This observation has sparked the publication of multiple studies assessing cardiovascular risk, mechanisms of disease, and early markers of CVD in this population. Similar to adults, children with CKD have an extremely high prevalence of traditional and uremia-related CVD risk factors. Early markers of cardiomyopathy, such as left ventricular hypertrophy and dysfunction, and early markers of atherosclerosis, such as increased carotid artery intima-media thickness, carotid arterial wall stiffness, and coronary artery calcification, are frequently present in these children, especially those on maintenance dialysis. As a population without preexisting symptomatic cardiac disease, children with CKD potentially receive significant benefit from aggressive attempts to prevent and treat CVD. Early CKD, before needing dialysis, is the optimal time to both identify modifiable risk factors and intervene in an effort to avert future CVD. Slowing the progression of CKD, avoiding long-term dialysis and, if possible, conducting preemptive transplantation may represent the best strategies to decrease the risk of premature cardiac disease and death in children with CKD.

2012-01-01

395

Developmental Origins of Chronic Renal Disease: An Integrative Hypothesis  

PubMed Central

Cardiovascular diseases are one of the leading causes of mortality. Hypertension (HT) is one of the principal risk factors associated with death. Chronic kidney disease (CKD), which is probably underestimated, increases the risk and the severity of adverse cardiovascular events. It is now recognized that low birth weight is a risk factor for these diseases, and this relationship is amplified by a rapid catch-up growth or overfeeding during infancy or childhood. The pathophysiological and molecular mechanisms involved in the “early programming” of CKD are multiple and partially understood. It has been proposed that the developmental programming of arterial hypertension and chronic kidney disease is related to a reduced nephron endowment. However, this mechanism is still discussed. This review discusses the complex relationship between birth weight and nephron endowment and how early growth and nutrition influence long term HT and CKD. We hypothesize that fetal environment reduces moderately the nephron number which appears insufficient by itself to induce long term diseases. Reduced nephron number constitutes a “factor of vulnerability” when additional factors, in particular a rapid postnatal growth or overfeeding, promote the early onset of diseases through a complex combination of various pathophysiological pathways.

Boubred, F.; Saint-Faust, M.; Buffat, C.; Ligi, I.; Grandvuillemin, I.; Simeoni, U.

2013-01-01

396

Unraveling the genetics of chronic kidney disease using animal models.  

PubMed

Identifying genes underlying common forms of kidney disease in humans has proven difficult, expensive, and time consuming. Quantitative trait loci (QTL) for several complex traits are concordant among mice, rats, and humans, suggesting that genetic findings from these animal models are relevant to human disease. Therefore, we reviewed the literature on genetic studies of kidney disease in rat and mouse and examined the concordance between kidney disease QTL across species. Fifteen genomic regions contribute to kidney disease in the rat, with 12 replicated either in a separate rat cross or in another species. Five loci found in humans were concordant to QTL found in the rat. Two of these were found by homology to a previously identified rat QTL on chromosome 1, demonstrating that kidney disease loci in animal models can predict the location of kidney disease loci in humans. In contrast to the rat, the mouse has been underutilized in the genetic analysis of polygenic kidney disease, although mutagenesis and QTL analysis in the mouse are likely to contribute new findings in the near future. Knowledge of kidney disease loci conserved between the mouse and rat will identify prime candidate loci to test for association with chronic kidney disease in humans. PMID:15297276

Korstanje, Ron; DiPetrillo, Keith

2004-09-01

397

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

Code of Federal Regulations, 2010 CFR

...2009-01-01 2009-01-01 false Chronic Beryllium Disease Prevention Program Informed Consent...Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Pt. 850, App. A Appendix A to Part 850âChronic Beryllium Disease Prevention Program Informed...

2009-01-01

398

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

Code of Federal Regulations, 2010 CFR

...2010-01-01 2010-01-01 false Chronic Beryllium Disease Prevention Program Informed Consent...Energy DEPARTMENT OF ENERGY CHRONIC BERYLLIUM DISEASE PREVENTION PROGRAM Pt. 850, App. A Appendix A to Part 850âChronic Beryllium Disease Prevention Program Informed...

2010-01-01

399

Association of anemia and erythropoiesis stimulating agents with inflammatory biomarkers in chronic kidney disease  

Microsoft Academic Search

Inflammatory cytokines are important predictors of cardiovascular mortality especially in patients with chronic kidney disease. Here we explored the relationship of anemia and epoetin treatment to inflammatory cytokine levels in patients with chronic kidney disease. One hundred non-dialysis patients with chronic kidney disease over 18 years of age were evenly split into anemic and non-anemic cohorts. Of the 50 anemic

Sai Ram Keithi-Reddy; Francesco Addabbo; Tejas V Patel; Bharati V Mittal; Michael S Goligorsky; Ajay K Singh

2008-01-01

400

Urgent call for reconsideration of chronic kidney disease  

PubMed Central

Circulating toxins namely: free radicals, cytokines and metabolic products induce glomerular endothelial dysfunction, hemodynamic maladjustment and chronic ischemic state;this leads to tubulointerstitial fibrosis in chronic kidney disease (CKD). Altered vascular homeostasis observed in late stage CKD revealed defective angiogenesis and impaired nitric oxide production explaining therapeutic resistance to vasodilator treatment in late stage CKD. Under current practice, CKD patients are diagnosed and treated at a rather late stage due to the lack of sensitivity of the diagnostic markers available. This suggests the need for an alternative therapeutic strategy implementing the therapeutic approach at an early stage. This view is supported by the normal or mildly impaired vascular homeostasis observed in early stage CKD. Treatment at this early stage can potentially enhance renal perfusion, correct the renal ischemic state and restore renal function. Thus, this alternative therapeutic approach would effectively prevent end-stage renal disease.

Futrakul, Narisa; Futrakul, Prasit

2012-01-01

401

Lipoproteins and apolipoproteins during the progression of chronic renal disease.  

PubMed

The association between lipoprotein and apolipoprotein levels and the degree of renal failure was investigated in 72 conservatively treated patients with chronic renal disease. The progression of renal insufficiency was attended by marked increases in total triglycerides, and very-low-density (VLDL), low-density (LDL) and high-density (HDL) lipoprotein triglycerides. Total cholesterol was slightly elevated due to a rise in VLDL cholesterol. There was no change in LDL cholesterol, whereas HDL cholesterol decreased. Apo C-II and C-III showed distinct increases, their mass ratio decreasing only insignificantly. Apo B and A-I were unaffected by the degree of renal insufficiency, whereas apo A-II decreased. The findings reflect compositional changes within HDL and the accumulation to triglyceride-rich lipoproteins in chronic renal disease. The alterations in the plasma lipoprotein pattern were demonstrable even in early stages of renal failure and, therefore, may bear a serious risk for the acceleration of atherosclerosis. PMID:3221949

Grützmacher, P; März, W; Peschke, B; Gross, W; Schoeppe, W

1988-01-01

402

Extracorporeal lung support in patients with chronic obstructive pulmonary disease.  

PubMed

When patients with chronic obstructive lung disease (COPD) and acute on chronic respiratory insufficiency fail non-invasive ventilation (NIV) they are commonly intubated and treated with invasive mechanical ventilation (IMV) to ensure adequate gas exchange. However, IMV itself is associated with considerable complications which can aggravate any pre-existing lung disease and contribute to morbidity and mortality. When lung protective ventilation fails or cannot be maintained, full or partial extracorporeal lung assist (ECLA) is increasingly used to provide oxygenation and/or carbon dioxide removal. This can rescue patients' lives, help resting their lungs until recovery or transplantation or even avoiding intubation and IMV in the first place. Recent technological improvements of extracorporeal devices have made ECLA more efficient and safe. This article discusses different types of ECLA, their potential indications in patients with COPD as well as the preliminary clinical evidence for their effectiveness and safety. PMID:23698548

Braune, S A; Kluge, S

2013-05-23

403

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.

Rathi, Manish; Ramachandran, Raja

2012-01-01

404

Oxidative stress and inflammation, a link between chronic kidney disease and cardiovascular disease  

Microsoft Academic Search

Patients with chronic kidney disease (CKD) show a high cardiovascular morbidity and mortality. This seems to be consequence of the cardiovascular risk factor clustering in CKD patients. Non traditional risk factors such as oxidative stress and inflammation are also far more prevalent in this population than in normal subjects. Renal disease is associated with a graded increase in oxidative stress

Victoria Cachofeiro; Marian Goicochea; Soledad García de Vinuesa; Pilar Oubiña; Vicente Lahera; José Luño

2008-01-01

405

Nontraditional risk factors for cardiovascular disease in patients with chronic kidney disease  

Microsoft Academic Search

Patients with chronic kidney disease (CKD) have a reduced lifespan, and a substantial proportion of these individuals die from cardiovascular disease. Although a large percentage of patients with CKD have traditional cardiac risk factors such as diabetes, hypertension and abnormalities in cholesterol, interventions to address these factors—which have significantly decreased cardiovascular mortality in the general population—have not shown such benefit

Jessica Kendrick; Michel B Chonchol

2008-01-01

406

Screening of Cognitive Impairment in Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Cognitive dysfunction is common and clinically important in severe chronic obstructive pulmonary disease (COPD). We investigated the diagnostic accuracy of the Mini Mental State Examination (MMSE) and Instrumental Activities of Daily Living (IADL) scale in screening severe cognitive dysfunction in 149 patients with COPD, mean age 69.3 ± 8.5 years, forced expiratory volume in 1 s = 36.6 ± 17.8%

Raffaele Antonelli-Incalzi; Andrea Corsonello; Luigi Trojano; Claudio Pedone; Domenico Acanfora; Aldo Spada; Orsola Izzo; Franco Rengo

2007-01-01

407

Neonatal Chronic Lung Disease in Extremely Immature Baboons  

Microsoft Academic Search

A borderline viability model of bronchopulmonary dysplasia (BPD)\\/chronic lung disease of infancy (CLD) with pathophysiologic parameters consistent with those in extremely immature humans with BPD\\/CLD is described. After prenatal steroid treatment of pregnant dams, 12 premature baboons were delivered by cesarean-section at 125 d (term gestation, 185 d), treated with exogenous surfac- tant, and maintained on appropriate oxygen and positive

JACQUELINE J. COALSON; VICKI T. WINTER; THERESA SILER-KHODR; BRADLEY A. YODER

1999-01-01

408

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

409

Patient education in Switzerland: from diabetes to chronic diseases  

Microsoft Academic Search

The Division of Therapeutic Education for Chronic Diseases at the University Hospital of Geneva has been playing an important role in the field of therapeutic patient education for more than 25 years. More than 16,000 patients have been hospitalised and an excess of 75,000h have been spent with a rather novel interdisciplinary approach involving doctors, nurses, dieticians, psychologists, podiatrists and

Jean-Philippe Assal; Alain Golay

2001-01-01

410

Regulation of Airway Nucleotides in Chronic Lung Diseases  

Microsoft Academic Search

\\u000a The physiological relevance of the purinergic signaling network for airway defenses is emerging through cumulating reports\\u000a of abnormal ATP and adenosine (ADO) levels in the airway secretions of patients with asthma, chronic pulmonary obstructive\\u000a diseases, cystic fibrosis and idiopathic pulmonary fibrosis. The consequences for airway defenses range from abnormal clearance\\u000a responses to the destruction of lung tissue by excessive inflammation.

Charles R. Esther Jr; Neil E. Alexis; Maryse Picher

411

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

412

Surgical treatment of chronic inflammatory bowel disease in children  

Microsoft Academic Search

Surgery for chronic inflammatory bowel disease (IBD) is increasingly often necessary in children. This study aimed at assessing\\u000a the results of these operations in order to facilitate adequate preoperative counseling. We reviewed patients treated from\\u000a 1992 to 2009. The operations, complications and functional outcome were recorded. For those with preserved rectal defecation,\\u000a continence (Koivusalo score) and quality of life (standardized

S. Barrena; L. Martínez; F. Hernandez; L. Lassaletta; M. Lopez-Santamaria; G. Prieto; J. Larrauri; J. A. Tovar

2011-01-01

413

Docosahexaenoic Acid and Smoking-Related Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

If the inflammatory response to inhalation of cigarette smoke causes chronic obstructive pulmonary disease (COPD), suppression of that natural response might be beneficial. We hypothesized that a smoker's risk of developing COPD is inversely related to physiologic levels of two fatty acids that have antiinflammatory properties: eicosapentaenoic acid (EPA, C20:5) and docosahexaenoic acid (DHA, C22:6). The proportion of each fatty

EYAL SHAHAR; LORI L. BOLAND; AARON R. FOLSOM; MELVYN S. TOCKMAN; PAUL G. M C GOVERN; JOHN H. ECKFELDT

1999-01-01

414

Theophylline kinetics in chronic obstructive airway disease in the elderly  

Microsoft Academic Search

Theophylline kinetic studies, serial spirometric function tests, and arterial blood gas determinations were performed in 39 adult men with stable chronic obstructive airway disease (COPD). Subjects were given an intravenous aminophylline loading dose of 5.6 mg\\/kg and a maintenance dose of 0.9 mg\\/kg\\/hr for 6 hours. Elderly (>60 years old) nonsmoking subjects had 36% lower theophylline clearance (Cl) and a

William Y W Au; Asim K Dutt; Neil DeSoyza

1985-01-01

415

Chronic Venous Disease Treated by Ultrasound Guided Foam Sclerotherapy  

Microsoft Academic Search

Aim. To report the outcome of a series of patients with chronic venous disease due to incompetence of saphenous trunks managed by ultrasound guided foam sclerotherapy (UFS). Patients and methods. A group of 808 patients comprise this series. CEAP clinical class for limbs was C1: 15%, C2: 81%, C3: 0.5%, C4: 2%, C5: 0.2%, C6: 0.4%. UFS using 1% polidocanol

P. Coleridge Smith

2006-01-01

416

Aldosterone in the Pathogenesis of Chronic Kidney Disease and Proteinuria  

Microsoft Academic Search

There has been much recent interest in the role of aldosterone as an independent contributor to the progression of chronic\\u000a kidney disease. Despite treatment with agents such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers,\\u000a many studies have shown that there is incomplete blockade of the renin-angiotensin cascade evidenced by persistent or rising\\u000a plasma aldosterone levels despite therapeutic renin-angiotensin blockade.

Yee Lu; Elaine Ku; Vito M. Campese

2010-01-01

417

Future Treatments for Chronic Obstructive Pulmonary Disease and Its Comorbidities  

Microsoft Academic Search

The recognition that patients with chronic obstructive pulmonary disease (COPD) may have systemic manifestations and often suffer from comorbid conditions has important implications for therapy thatrequirefurtherresearch.ThemostlikelylinkbetweenCOPDand extrapulmonary effects is that inflammation in the lung periphery ''spillsover''intothesystemiccirculationandeffectsonotherorgans that may also be affected by the systemic effects of cigarette smoking. The peripheral lung inflammation of COPD and systemic inflammatory effectscouldbetreatedbysystemicantiinflammatory treatments, but

Peter J. Barnes

2008-01-01

418

Autoantibodies in Patients with Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

Rationale: Adaptive immune responses are present in patients with chronic obstructive pulmonary disease (COPD), and it has been postulated that these processes could be autoreactive. Objectives: To ascertain if humoral autoimmunity could play a role in COPD pathogenesis. Methods: Circulating IgG autoantibodies were detected by immuno- fluorescenceandimmunoprecipitation.Immunohistochemistryand immunofluorescencewereusedtoevaluateintrapulmonaryIgGand complement(C3)depositioninhumanlungexplants. Autoantibody pathogenicity was also investigated with an antibody-dependent cell-mediated cytotoxicity assay.

Carol A. Feghali-Bostwick; Aneal S. Gadgil; Leo E. Otterbein; Joseph M. Pilewski; Michael W. Stoner; Eva Csizmadia; Yingze Zhang; Frank C. Sciurba; Steven R. Duncan

2007-01-01

419

Fibrosis as a Major Mechanism of Chronic Liver Disease  

Microsoft Academic Search

\\u000a Hepatic fibrosis and even cirrhosis have emerged as treatable and reversible consequences of chronic liver disease. With dramatic\\u000a advances in understanding the cellular and molecular basis of fibrosis, there is increasing enthusiasm for new treatments\\u000a that attack hepatic fibrosis directly. Basic research has focused on the hepatic stellate cell, which undergoes activation\\u000a into a proliferative and fibrogenic myofibroblast-like cell during

Lars P. Bechmann; Scott L. Friedman

420

Aortic PWV in Chronic Kidney Disease: A CRIC Ancillary Study  

PubMed Central

Background Aortic PWV is a measure of arterial stiffness and has proved useful in predicting cardiovascular morbidity and mortality in several populations of patients, including the healthy elderly, hypertensives and those with end stage renal disease receiving hemodialysis. Little data exist characterizing aortic stiffness in patients with chronic kidney disease who are not receiving dialysis, and in particular the effect of reduced kidney function on aortic PWV. Methods We performed measurements of aortic PWV in a cross-sectional cohort of participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study to determine factors which predict increased aortic PWV in chronic kidney disease. Results PWV measurements were obtained in 2564 participants. The tertiles of aortic PWV (adjusted for waist circumference) were < 7.7 m/sec, 7.7–10.2 m/sec and > 10.2 m/sec with an overall mean (± S.D.) value of 9.48 ± 3.03 m/sec [95% CI = 9.35–9.61 m/sec]. Multivariable regression identified significant independent positive associations of age, blood glucose concentrations, race, waist circumference, mean arterial blood pressure, gender, and presence of diabetes with aortic PWV and a significant negative association with the level of kidney function. Conclusions The large size of this unique cohort, and the targeted enrollment of chronic kidney disease participants provides an ideal situation to study the role of reduced kidney function as a determinant of arterial stiffness. Arterial stiffness may be a significant component of the enhanced cardiovascular risk associated with kidney failure.

Townsend, Raymond R.; Wimmer, Neil J.; Chirinos, Julio A.; Parsa, Afshin; Weir, Matthew; Perumal, Kalyani; Lash, James P.; Chen, Jing; Steigerwalt, Susan P.; Flack, John; Go, Alan S.; Rafey, Mohammed; Rahman, Mahboob; Sheridan, Angela; Gadegbeku, Crystal A.; Robinson, Nancy A.; Joffe, Marshall

2009-01-01

421

Chronic kidney disease after hematopoietic stem cell transplantation  

PubMed Central

Acute and chronic kidney diseases occur after hematopoietic stem cell transplantation. These are caused by the transplant itself, and the complications of transplant. Recent estimates show that near 15% of subjects undergoing HSCT will develop CKD, which is a complication rate that can affect outcome and reduce survival. Investigation of the causes of CKD is needed, as are ways to prevent, mitigate and treat it.

Cohen, Eric P; Pais, Priya; Moulder, John E

2010-01-01

422

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.

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

2009-01-01

423

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.

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

424

Modern statistical methods in chronic disease epidemiology: Proceedings  

SciTech Connect

Since the publication of Mantel and Haenszel's pioneering paper in 1959, has seen a veritable explosion of statistical methodology in chronic disease epidemiology. The central methodologic issues revolve around environmental and genetic risk assessment, and risk extrapolation. The tenth Research Application Conference held under the auspices of SIMS brought together experts from around the world to discuss the theory and applications of statistical methods in chronic disease epidemiology. This volume represents the proceedings of that conference. Relative risk regression models provide flexible and powerful tools for the analysis of epidemiologic data. These models have been the objects of intense study in the past several years, and it seems reasonable to predict that relative risk regression methods will become a, or perhaps, the, central analytical tool in chronic disease epidemiology. Thus, a major emphasis of the conference was on relative risk regression, and various papers in this volume deal with time-dependent covariates, new study designs, multivariate failure time data, methods of model criticism, parameter transformations for optimal inference, and issues in matching, covariate adjustment, and incomplete and missing covariate information.

Moolgavkar, S.H.; Prentice, R.L. (eds.)

1986-01-01

425

The nervous system and chronic kidney disease in children  

PubMed Central

This paper provides a review of the literature on the nervous system involvement incurred by children and adolescents with chronic kidney disease (CKD), with a particular focus on neuropsychological functioning. In addition to an historical overview of earlier literature, published studies from the past 14 years that address both central and peripheral nervous system function in children with CKD are reviewed (1990–2003). These studies span work in neuroimaging, electrophysiology, and neuropsychology. A key focus for this review is on variables that might affect neurodevelopmental status in these children. The paper concludes with suggestions for achieving progress in the understanding of this complication of kidney disease in children.

Wetherington, Crista E.; Duquette, Peter J.; Hooper, Stephen R.

2004-01-01

426

Chronic recurrent multifocal osteomyelitis associated with Crohn's disease.  

PubMed

Chronic recurrent multifocal osteomyelitis (CRMO) was first described by Giedion in 1972 as a self-limited relapsing noninfectious inflammatory condition usually affecting children and adolescents. The association of CRMO with psoriasis, palmoplantar pustulosis, and SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteitis) has been described. In this case report, we present a 49-year-old man with CRMO coexisting with Crohn's disease. To our knowledge, this is the first report of CRMO with Crohn's disease without the presence of pustular skin lesions or other features of SAPHO syndrome. PMID:9472913

Bognar, M; Blake, W; Agudelo, C

1998-02-01

427

The relationship between chronic kidney disease and SYNTAX score.  

PubMed

Chronic kidney disease (CKD) is associated with increased risk of cardiovascular disease and death. We evaluated the association between CKD and severity of coronary artery stenosis by calculating SYNTAX Score in patients with left main coronary artery and/or 3-vessel coronary artery disease. Coronary angiograms of 217 patients were assessed. Chronic kidney disease was staged using the estimated glomerular filtration rate (eGFR, mL/min per 1.73 m(2)) prior to coronary angiography. Patients were divided into 5 groups according to the National Kidney Foundation Kidney Disease Outcome Quality Initiative (NKF KDOQI) Clinical Practice Guidelines (14). Patients with eGFR >90 mL/min per 1.73 m(2) (group 1), patients with eGFR 60 to 89 mL/min per 1.73 m(2) (group 2), patients with eGFR 30 to 59 mL/min per 1.73 m(2) (group 3), patients with eGFR >15 to < 30 per 1.73 m(2) and dialysis patients with eGFR < 15 per 1.73 m(2) were combined as group 4. The risk of significant lesion complexity increased progressively with decreasing kidney function (P = .001). Estimated glomerular filtration rate was a strong predictor of higher SYNTAX Score. PMID:21422054

Coskun, Ugur; Orta Kilickesmez, Kadriye; Abaci, Okay; Kocas, Cuneyt; Bostan, Cem; Yildiz, Ahmet; Baskurt, Murat; Arat, Alev; Ersanli, Murat; Gurmen, Tevfik

2011-03-21

428

Fibrocytes in chronic lung disease--facts and controversies.  

PubMed

Fibrocytes are bone marrow-derived mesenchymal cell precursors, defined primarily by their ability to co-express markers of both haematopoietic (e.g. CD45 or CXCR4) and stromal (e.g. collagen) lineages. Fibrocytes in culture also have ultrastructural cell surface features that distinguish them from other leukocytes. Extensive efforts have helped to characterise fibrocytes phenotypically and functionally, but it is still unclear exactly how these cells contribute to tissue repair and/or pathologic fibrosis. Nevertheless, the varied levels of fibrocytes in blood have raised considerable interest as a biomarker of disease activity, such as chronic lung diseases, including pulmonary fibrosis, asthma and pulmonary hypertension. These cells also may become a novel therapeutic target for these difficult to treat disorders. This review will briefly summarize the current knowledge about fibrocytes in human lung disease and in animal disease models and highlight areas of consensus as well as issues that remain controversial to date. PMID:21951688

Maharaj, Shyam S; Baroke, Eva; Gauldie, Jack; Kolb, Martin R J

2011-09-20

429

The obesity paradox in chronic disease: facts and numbers.  

PubMed

Body size, particularly large, is a matter of concern among the lay public. Whether this is justified depends upon the state of health and should be judged individually. For patients with established chronic disease, there is sufficient evidence to support the benefits of large body size, i.e., the obesity paradox. This uniform finding is shared over a variety of cardiovascular, pulmonary, and renal diseases and is counterintuitive to the current concepts on ideal body weight. The scientific community has to increase the awareness about differences for optimal body size in health and disease. Simultaneously, clinicians have to be aware about body weight dynamics implications and should interpret the changes in the context of an underlying disease in order to implement the best available management. PMID:22450395

Lainscak, Mitja; von Haehling, Stephan; Doehner, Wolfram; Anker, Stefan D

2012-03-14

430

[Evolutionary ontogenetic aspects of pathogenetics of chronic human diseases].  

PubMed

This article is a review of scientific publications, in which issues of pathogenetics of multifactorial diseases (MFDs) are considered from the viewpoint of evolution and ontogeny. Concepts explaining significance of evolutionary processes in the formation of genetic architecture of human chronic diseases ("thrifty" genomes and phenotypes, "drifting genes," decanalization) are analyzed. The roles of natural selection and genetic drift in the formation of hereditary diversity of genes for susceptibility to MFDs are considered. The modern concept of disease ontogeny (somatic mosaicism, loss ofheterozygosity, paradominant inheritance, epigenetic variability) is discussed. It is demonstrated that the evolutionary and ontogenetic approaches to analysis of genimuc and other "-omic" data are essential for understanding the biology of diseases. PMID:22384685

Puzyrev, V P; Kucher, A N

2011-12-01

431

Long term outcome of patients with active Crohn's disease exhibiting extensive and deep ulcerations at colonoscopy  

Microsoft Academic Search

OBJECTIVE:Prediction of the clinical course of Crohn's disease (CD) is difficult in the long term. Our aim was to determine whether the presence of severe endoscopic lesions (SELs) may predict a higher risk of colectomy and penetrating complications.METHODS:All patients at our institution with active ileocolonic CD who had colonoscopies between 1990 and 1996 were included in the study. SELs were

Matthieu Allez; Marc Lemann; Joëlle Bonnet; Pierre Cattan; Raymond Jian; Robert Modigliani

2002-01-01

432

Foot-and-mouth disease type O viruses exhibit genetically and geographically distinct evolutionary lineages (topotypes)  

Microsoft Academic Search

Serotype O is the most prevalent of the seven serotypes of foot-and-mouth disease (FMD) virus and occurs in many parts of the world. The UPGMA method was used to construct a phylogenetic tree based on nucleotide sequences at the 3« end of the VP1 gene from 105 FMD type O viruses obtained from samples submitted to the OIE\\/FAO World Reference

A. R. Samuel; N. J. Knowles

2001-01-01

433

Prevalence of chronic obstructive pulmonary disease among stable chronic disease subjects in primary care in Trinidad, West Indies.  

PubMed

The prevalence of COPD in the Caribbean is uncertain. Spirometric indices were assessed at chronic disease clinics in 353 subjects (African, 66; East Indian, 198; 109 male), mean age 56.51 years (non-COPD) vs 59.30 years (COPD). 77 (21.8%) patients had COPD. 33.3% of COPD subjects had chronic cough vs 19.7% of subjects without COPD. A history of at least one chest infection was related to low FEV1 (P=0.005). In subjects presenting with vascular disease the FVC was reduced when compared to other subjects. Prevalence of COPD is 21.8%. A history of chest infections is related to decreased FEV1%. PMID:22263085

Thorington, Peterson; Rios, Maria; Avila, Gina; Henry, Josia; Haynes, C; Pinto Pereira, Lexley M; Seemungal, Terence Ar

2011-09-01

434

Prevalence of chronic obstructive pulmonary disease among stable chronic disease subjects in primary care in Trinidad, West Indies  

PubMed Central

The prevalence of COPD in the Caribbean is uncertain. Spirometric indices were assessed at chronic disease clinics in 353 subjects (African, 66; East Indian, 198; 109 male), mean age 56.51 years (non-COPD) vs 59.30 years (COPD). 77 (21.8%) patients had COPD. 33.3% of COPD subjects had chronic cough vs 19.7% of subjects without COPD. A history of at least one chest infection was related to low FEV1 (P=0.005). In subjects presenting with vascular disease the FVC was reduced when compared to other subjects. Prevalence of COPD is 21.8%. A history of chest infections is related to decreased FEV1%.

Thorington, Peterson; Rios, Maria; Avila, Gina; Henry, Josia; Haynes, C.; Pereira, Lexley M Pinto; Seemungal, Terence AR

2011-01-01

435

Cardiovascular Disease Risk Factors in Chronic Kidney Disease: Traditional, Nontraditional, and Uremia-related Threats  

Microsoft Academic Search

\\u000a Cardiovascular disease remains the leading cause of morbidity and mortality in chronic kidney disease (CKD), and there is\\u000a an urgent need to develop novel therapeutic strategies to reduce this excessive risk. In the context of uremia, this has been\\u000a problematic, as the extremely high cardiovascular disease (CVD) risk seems to be the result of a complex interplay between\\u000a a vast

Juan J. Carrero; Peter Stenvinkel

436

Antioxidant trace elements in serum of draft horses with acute and chronic lower airway disease.  

PubMed

The aim of the present study was to evaluate the oxidative stress level and antioxidant trace elements status associated with lower airway disease in draft horses. For this purpose, venous blood samples were obtained from draft horses exhibiting signs of lower respiratory tract disorders (n?=?83) and from control group (n?=?20). Serum trace elements including selenium (Se), copper (Cu), zinc (Zn), manganese (Mn), and iron (Fe) were assayed. Serum malondialdehyde (MDA) and low-density lipoprotein (LDL) levels as well as plasma hydrogen peroxides (H?O?) concentration and activity of plasma glutathione reductase (GR), glutathione-S-transferase (GST) and catalase (CAT) were measured. There was a significant (p?diseased horses compared with healthy ones, but the Cu/Zn ratio and Mn were increased (p?chronically affected horses compared with acute cases, but Mn was increased (p?diseased cases compared with healthy horses. However, there was a significant (p?chronic respiratory disease compared to acute cases, but CAT activity was decreased (p?disease, there was a negative correlation between GR and H?O? (r?=?-0.458), and LDL and CAT (r?=?-0.816). However, in chronic disease, a negative correlation was recorded between Se and MDA (r?=?-0.590). The results of the present study indicate that oxidative stress, with alteration of antioxidant trace element levels, is a feature of respiratory disease in draft horses. PMID:22767430

Youssef, Mohamed Ahmed; El-Khodery, Sabry Ahmed; Ibrahim, Hussam Mohamed Mohamed

2012-07-06

437

Intensive Blood-Pressure Control in Hypertensive Chronic Kidney Disease  

PubMed Central

BACKGROUND In observational studies, the relationship between blood pressure and end-stage renal disease (ESRD) is direct and progressive. The burden of hypertension-related chronic kidney disease and ESRD is especially high among black patients. Yet few trials have tested whether intensive blood-pressure control retards the progression of chronic kidney disease among black patients. METHODS We randomly assigned 1094 black patients with hypertensive chronic kidney disease to receive either intensive or standard blood-pressure control. After completing the trial phase, patients were invited to enroll in a cohort phase in which the blood-pressure target was less than 130/80 mm Hg. The primary clinical outcome in the cohort phase was the progression of chronic kidney disease, which was defined as a doubling of the serum creatinine level, a diagnosis of ESRD, or death. Follow-up ranged from 8.8 to 12.2 years. RESULTS During the trial phase, the mean blood pressure was 130/78 mm Hg in the intensive-control group and 141/86 mm Hg in the standard-control group. During the cohort phase, corresponding mean blood pressures were 131/78 mm Hg and 134/78 mm Hg. In both phases, there was no significant between-group difference in the risk of the primary outcome (hazard ratio in the intensive-control group, 0.91; P = 0.27). However, the effects differed according to the baseline level of proteinuria (P = 0.02 for interaction), with a potential benefit in patients with a protein-to-creatinine ratio of more than 0.22 (hazard ratio, 0.73; P = 0.01). CONCLUSIONS In overall analyses, intensive blood-pressure control had no effect on kidney disease progression. However, there may be differential effects of intensive blood-pressure control in patients with and those without baseline proteinuria. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Center on Minority Health and Health Disparities, and others.)

Appel, Lawrence J.; Wright, Jackson T.; Greene, Tom; Agodoa, Lawrence Y.; Astor, Brad C.; Bakris, George L.; Cleveland, William H.; Charleston, Jeanne; Contreras, Gabriel; Faulkner, Marquetta L.; Gabbai, Francis B.; Gassman, Jennifer J.; Hebert, Lee A.; Jamerson, Kenneth A.; Kopple, Joel D.; Kusek, John W.; Lash, James P.; Lea, Janice P.; Lewis, Julia B.; Lipkowitz, Michael S.; Massry, Shaul G.; Miller, Edgar R.; Norris, Keith; Phillips, Robert A.; Pogue, Velvie A.; Randall, Otelio S.; Rostand, Stephen G.; Smogorzewski, Miroslaw J.; Toto, Robert D.; Wang, Xuelei

2013-01-01

438

Molecular and in VitroAnalysis of Eight Dengue Type 2 Viruses Isolated from Patients Exhibiting Different Disease Severities  

Microsoft Academic Search

Potential genetic determinants of dengue virulence were studied by sequencing the entire genomes of eight dengue 2 virus strains isolated from patients exhibiting different disease severities during an epidemic season in northeastern Thailand in 1993. The isolates came from one dengue shock syndrome (ThNH-7\\/93), three dengue hemorrhagic fever, and four dengue fever patients. Phylogenetic analysis showed that the isolates belonged

Marlou Noel M. Mangada; Akira Igarashi

1998-01-01

439

Detecting the Emergence of Chronic Pain in Sickle Cell Disease  

PubMed Central

Context Sickle cell disease (SCD) is an inherited hematological disease marked by intense pain. Early in life the pain is episodic, but it becomes increasingly chronic in many cases. Little is known about this emergence of a chronic pain state. Objectives The goal of this study was to determine whether adult SCD patients whose pain is still largely episodic show early signs of the disturbed pain processing (hyperalgesia, increased temporal summation) and cognition (hypervigilance and catastrophizing) that are characteristic of a chronic pain state. Methods SCD patients (n=22) and healthy controls (n=52) received noxious pressure stimulation for up to three minutes, and periodically reported pain intensity and unpleasantness on 0–10 scales, allowing the rate of pain increase (temporal summation) to be determined. Pain intensity discrimination also was measured, and attitudes toward pain were assessed. Results There were no overall differences in pain ratings or temporal summation between patient and control groups. However, patients’ experimental pain ratings tended to increase with age, and those reporting a history of very painful episodes showed particularly rapid temporal summation of pain unpleasantness. Patients were significantly impaired at discriminating intensities of noxious stimulation. Patients were more hypervigilant than controls, but catastrophizing was elevated only during pain episodes. Conclusion Most SCD patients whose pain remits entirely between episodes are not in a chronic pain state, but some—those who are older and have a history of highly painful episodes—appear to be transitioning into it. These early signs of disturbed processing may aid clinicians seeking to forestall disease progression.

Hollins, Mark; Stonerock, Gregory L.; Kisaalita, Nkaku R.; Jones, Susan; Orringer, Eugene; Gil, Karen M.

2012-01-01

440

Fatigue, anxiety and depression levels, activities of daily living of patients with chronic obstructive pulmonary disease.  

PubMed

The aim of this cross-sectional study was to determine the fatigue, anxiety and depression levels, activities of daily living of patients with chronic obstructive pulmonary disease (n?=?255). It was found that there was significant difference between Visual Analogue Scale for Fatigue (VAS-F) point averages and gender, education levels, marital status and economical status of patient with chronic obstructive pulmonary disease. Among the participants in this study, 36.5% had an anxiety disorder whereas 69.0% exhibited depression. In the study, it was determined that 85.5% of those were independent in their Katz's Index of Activities of Daily Living (ADLs) and 49.4% of those were independent in their Lawton and Brody's Index of Instrumental Activities of Daily Living (IADLs). This study has shown that VAS-F, the Hospital Anxiety and Depression Scale, ADL and IADL instruments that measure the various aspects of health-related quality of living can contribute considerably to a more diversified understanding of the patients' situation with chronic obstructive pulmonary disease. PMID:23577980

Karakurt, Papatya; Ünsal, Ayla

2013-04-01

441

Cystic Fibrosis Pigs Develop Lung Disease and Exhibit Defective Bacterial Eradication at Birth  

PubMed Central

Lung disease causes most of the morbidity and mortality in cystic fibrosis (CF). However, understanding its pathogenesis has been hindered by lack of an animal model with characteristic features of CF. To overcome this problem, we recently generated pigs with targeted CFTR genes. We now report that, within months of birth, CF pigs spontaneously develop hallmark features of CF lung disease including airway inflammation, remodeling, mucus accumulation, and infection. Their lungs contained multiple bacterial species, suggesting an equal opportunity host defense defect. In humans, the temporal and causal relationships between inflammation and infection have remained uncertain. To investigate these processes, we studied newborn pigs. Their lungs showed no inflammation, but were less often sterile than controls. Moreover, after intrapulmonary bacterial challenge, CF pigs failed to eradicate bacteria as effectively as wild-type pigs. These results suggest that impaired bacterial elimination is the pathogenic event that initiates a cascade of inflammation and pathology in CF lungs. Finding that CF pigs have a bacterial host defense defect within hours of birth provides an opportunity to further investigate pathogenesis and to test therapeutic and preventive strategies before secondary consequences develop.

Stoltz, David A; Meyerholz, David K; Pezzulo, Alejandro A; Ramachandran, Shyam; Rogan, Mark P; Davis, Greg J; Hanfland, Robert A; Wohlford-Lenane, Chris; Dohrn, Cassie L; Bartlett, Jennifer A; Nelson, George A; Chang, Eugene H; Taft, Peter J; Ludwig, Paula S; Estin, Mira; Hornick, Emma E; Launspach, Janice L; Samuel, Melissa; Rokhlina, Tatiana; Karp, Philip H; Ostedgaard, Lynda S; Uc, Aliye; Starner, Timothy D; Horswill, Alexander R; Brogden, Kim A; Prather, Randall S; Richter, Sandra S; Shilyansky, Joel; McCray, Paul B; Zabner, Joseph; Welsh, Michael J

2010-01-01

442

Chronic liver disease prevention strategies and liver transplantation.  

PubMed

Chronic liver disease is a considerable burden on society, being one of the three main causes of death in certain regions of Africa and Asia. Liver transplant is the only treatment option for cirrhosis, which is the end stage of many chronic liver diseases. This article reviews the preventable causes of cirrhosis and the preventive strategies which could be implemented in order to avoid the catastrophic consequences of cirrhosis. With small variations around the world, 70 to 80% of the end stage liver diseases are caused by excessive alcohol consumption and by viral hepatitis, both of which are potentially preventable. Excessive alcohol consumption has important public health consequences because of its involvement not only with cirrhosis, but also with motor vehicle accidents, unemployment, domestic violence etc. Among the viral causes, Hepatitis Virus B and C have the greatest impact on public health. Effective vaccine is available for Hepatitis Virus B and must be put in use. While a vaccine for Hepatitis Virus C is awaited, effective preventive strategies should be undertaken to avoid the preventable cases of end stage liver disease. PMID:17013520

Silva, Anderson Soares da; Santos, Luciane Loures dos; Passos, Afonso Dinis Costa; Sankarankutty, Ajith Kumar; Martinelli, Ana de Lourdes Candolo; Silva, Orlando de Castro e

2006-01-01

443

Predicting drug efficacy using integrative models for chronic respiratory diseases.  

PubMed

Animal models are vital instruments of the drug discovery process. In addition to assessing the efficacy of candidate molecules, in vivo disease models also help validate the therapeutic potential of molecular targets. Over recent years, several molecules that have shown efficacy in preclinical models of respiratory diseases have failed to translate into new medicines for chronic respiratory conditions such as asthma, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis. As such, many scientists have argued that these systems are of limited value; however, we propose that a more careful and thorough approach to the characterization of these models and the interpretation of data generated using these systems would improve their translational utility. Herein, we describe two key elements of our strategy aiming to improve the predictive nature of these models: 1) Novel bioinformatics methods that can be used to identify animal models that best represent specific patient populations; and 2) Innovative physiological techniques that will improve our ability to discover drugs that can restore the functional capacity of lungs damaged during the course of the disease. PMID:23517645

Stevenson, Christopher S; Sridhar, Sriram; Phillips, Jonathan E

2013-04-01

444

Probiotics and prebiotics in chronic inflammatory bowel diseases.  

PubMed

The prokaryotic and eukaryotic cells of the colon exist in a highly complex, but harmonious relationship. Disturbances in this remarkable symbiosis can result in the development of inflammatory bowel diseases (IBD). Although the etiology of IBD is not entirely understood, it is known that the chronic inflammation of Crohn's disease, ulcerative colitis and chronic pouchitis are a result of an overly aggressive immune response to the commensal intestinal flora in genetically susceptible hosts. Recent studies have enhanced our ability to understand the interaction between the host and its intestinal microflora and the role the microflora plays in maintaining intestinal homeostasis. As we begin to understand the benefits conferred to the intestine by the microflora, the notion of modifying the composition of the bacterial load to improve human health has arisen. A significant body of research now exists investigating the role of probiotics and prebiotics in ameliorating chronic intestinal inflammation. This article will begin with an overview of the role of the commensal microflora in maintaining mucosal immune homeostasis, and how a dysregulated immune response to the intestinal microflora results in IBD. This will be followed by a summary of the use of probiotics and prebiotics in experimental and human IBD. PMID:17009391

Ewaschuk, Julia B; Dieleman, Levinus A

2006-10-01

445

Treatment of experimental chronic chagas disease with trifluralin.  

PubMed

We tested trifluralin against Trypanosoma cruzi in a model of chronic Chagas disease in mice. CF1 mice (n=148) were intraperitoneally infected with 10(5) trypomastigotes of T. cruzi, H510C8C3 clone. One hundred mice were partially treated with benznidazole. Mortality was 100% at day 41 in the control group (n=48). At day 90 of the chronic disease (74% survival) mice were divided into three groups and treated orally with trifluralin (50 mg/kg/day, n=26), benznidazole (50 mg/kg/day, n=25) and vehicle (peanut oil; control group, n=23) for 60 days. Electrocardiography (under pentobarbital anaesthesia, 30 mg/kg/dose), serologic immunofluorescence and microstrout were performed at the beginning and at the end of the treatment. Mice were sacrificed at day 10 after treatment; cardiac tissue was studied histopathologically and polymerase chain reaction (PCR) was performed. Spontaneous mortality was 30.43%, 3.85% and 4% in the control, trifluralin and benznidazole groups, respectively (significant survival, P=0.03). Microstrouts were negative in all three groups. Negative immunofluorescence titers were 0%, 16% (P=0.05) and 29% (P<0.02) in the control, trifluralin and benznidazole groups, respectively. The prevailing electrocardiographic disorder was prolongation of the PR interval in the control group, which was not significantly altered in trifluralin- and benznidazole-treated mice, suggesting that trifluralin and benznidazole improve or even stop the damage caused by the disease on the conduction system. Trifluralin- and benznidazole-treated animals showed similar histologic patterns of myocarditis. PCR results were negative for benznidazole and trifluralin (100% and 70.8%, respectively). These results show the therapeutic potential of trifluralin in the treatment of chronic Chagas disease. PMID:16623857

Zaidenberg, Anibal; Luong, Tai; Lirussi, Darío; Bleiz, Jorge; Del Buono, María Beatriz; Quijano, Graciela; Drut, Ricardo; Kozubsky, Leonora; Marron, Adriana; Buschiazzo, Héctor

2006-04-01

446

Methods for characterizing differences in longitudinal glomerular filtration rate changes between children with glomerular chronic kidney disease and those with nonglomerular chronic kidney disease.  

PubMed

The rate of decline of glomerular filtration rate (GFR) in children with chronic kidney disease (CKD) can vary, even among those with similar diagnoses. Classic regression methods applied to the log-transformed GFR (i.e., lognormal) quantify only rigid shifts in a given outcome. The generalized gamma distribution offers an alternative approach for characterizing the heterogeneity of effect of an exposure on a positive, continuous outcome. Using directly measured GFR longitudinally assessed between 2005 and 2010 in 529 children enrolled in the Chronic Kidney Disease in Children Study, the authors characterized the effect of glomerular CKD versus nonglomerular CKD diagnoses on the outcome, measured as the annualized GFR ratio. Relative percentiles were used to characterize the heterogeneity of effect of CKD diagnosis across the distribution of the outcome. The rigid shift assumed by the classic mixed models failed to capture the fact that the greatest difference between the glomerular and nonglomerular diagnosis' annualized GFR ratios was in children who exhibited the fastest GFR declines. Although this difference was enhanced in children with an initial GFR level of 45 mL/minute/1.73 m(2) or less, the effect of diagnosis on outcome was not significantly modified by level. Generalized gamma models captured heterogeneity of effect more richly and provided a better fit to the data than did conventional lognormal models. PMID:21828368

Pierce, Christopher B; Cox, Christopher; Saland, Jeffrey M; Furth, Susan L; Muñoz, Alvaro

2011-08-09

447

Methods for Characterizing Differences in Longitudinal Glomerular Filtration Rate Changes Between Children With Glomerular Chronic Kidney Disease and Those With Nonglomerular Chronic Kidney Disease  

PubMed Central

The rate of decline of glomerular filtration rate (GFR) in children with chronic kidney disease (CKD) can vary, even among those with similar diagnoses. Classic regression methods applied to the log-transformed GFR (i.e., lognormal) quantify only rigid shifts in a given outcome. The generalized gamma distribution offers an alternative approach for characterizing the heterogeneity of effect of an exposure on a positive, continuous outcome. Using directly measured GFR longitudinally assessed between 2005 and 2010 in 529 children enrolled in the Chronic Kidney Disease in Children Study, the authors characterized the effect of glomerular CKD versus nonglomerular CKD diagnoses on the outcome, measured as the annualized GFR ratio. Relative percentiles were used to characterize the heterogeneity of effect of CKD diagnosis across the distribution of the outcome. The rigid shift assumed by the classic mixed models failed to capture the fact that the greatest difference between the glomerular and nonglomerular diagnosis’ annualized GFR ratios was in children who exhibited the fastest GFR declines. Although this difference was enhanced in children with an initial GFR level of 45 mL/minute/1.73 m2 or less, the effect of diagnosis on outcome was not significantly modified by level. Generalized gamma models captured heterogeneity of effect more richly and provided a better fit to the data than did conventional lognormal models.

Pierce, Christopher B.; Cox, Christopher; Saland, Jeffrey M.; Furth, Susan L.; Munoz, Alvaro

2011-01-01

448

Vaccinations in juvenile chronic inflammatory diseases: an update.  

PubMed

Vaccination is a powerful tool to reduce the burden of infectious diseases in paediatric patients with chronic rheumatic diseases. Live attenuated vaccines are not recommended for profoundly immunosuppressed patients, but nonlive vaccines have adequate safety and efficacy profiles in the few (admittedly underpowered) studies published to date. No severe vaccine-specific or disease-specific adverse events have been observed in patients with juvenile idiopathic arthritis (JIA) or childhood-onset systemic lupus erythematosus (SLE) who have been vaccinated with live or nonlive agents. The immune response to live vaccines is variable in these patients but generally adequate, despite concomitant use of immunosuppressive and biologic agents. The proposal that onset of autoimmune rheumatic diseases could be induced by vaccination is controversial and primarily based on case reports; however, patients with mevalonate kinase deficiency can experience febrile attacks after immunizations. Adequately powered studies of live and nonlive vaccination in patients with paediatric rheumatic diseases are necessary to clarify safety and efficacy issues. This narrative Review discusses vaccination in patients with JIA, childhood-onset SLE, juvenile dermatomyositis, juvenile systemic sclerosis, primary vasculitis and autoinflammatory syndromes. Vaccine safety, short-term and long-term changes in disease parameters, and the immunogenicity and influence of immunosuppressive agents are outlined for each combination of disease and vaccine. PMID:23820860

Silva, Clovis A; Aikawa, Nadia E; Bonfa, Eloisa

2013-07-02

449

A novel corticotropin-releasing factor receptor splice variant exhibits dominant negative activity: a putative link to stress-induced heart disease  

PubMed Central

A growing body of experimental and clinical studies supports a strong association between psychological stress and cardiovascular disease. An important endogenous cardioprotective role in heart physiology has been attributed to corticotropin-releasing factor receptor type 2? (CRFR2?). Here, we report the isolation of cDNA from mouse (m) heart encoding a novel CRFR2? splice variant. Translation of this insertion variant (iv)-mCRFR2? isoform produces a 421-aa protein that includes a unique C-terminal cytoplasmic tail. Our functional analysis and cellular localization studies demonstrated that when coexpressed with wild-type mCRFR2?, iv-mCRFR2? significantly inhibited the wild-type mCRFR2? membrane expression and its functional signaling by ER-Golgi complex retention, suggesting a dose-dependent dominant negative effect. Interestingly, mice exposed to a 4-wk paradigm of chronic variable stress, a model of chronic psychological stress in humans, presented significantly lower levels of mCRFR2? and higher levels of iv-mCRFR2? mRNA expression in their hearts, compared to nonstressed control mice. The dominant-negative effect of iv-mCRFR2? and its up-regulation by psychological stress suggest a new form of regulation of the mCRFR2? cardioprotective effect and a potential role for this novel isoform in stress-induced heart disease.—Sztainberg, Y., Kuperman, Y., Issler, O., Gil, S., Vaughan, J., Rivier, J., Vale, W., Chen, A. A novel corticotropin-releasing factor receptor splice variant exhibits dominant negative activity: a putative link to stress-induced heart disease.

Sztainberg, Yehezkel; Kuperman, Yael; Issler, Orna; Gil, Shosh; Vaughan, Joan; Rivier, Jean; Vale, Wylie; Chen, Alon

2009-01-01

450

The Chronic Kidney Disease Model: A General Purpose Model of Disease Progression and Treatment  

Microsoft Academic Search

Background  Chronic kidney disease (CKD) is the focus of recent national policy efforts; however, decision makers must account for multiple\\u000a therapeutic options, comorbidities and complications. The objective of the Chronic Kidney Disease model is to provide guidance\\u000a to decision makers. We describe this model and give an example of how it can inform clinical and policy decisions.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Monte Carlo simulation of

Lori A Orlando; Eric J Belasco; Uptal D Patel; David B Matchar

2011-01-01

451

Neural Precursors Exhibit Distinctly Different Patterns of Cell Migration Upon Transplantation During Either the Acute or Chronic Phase of EAE: A Serial MR Imaging Study  

PubMed Central

As the complex pathogenesis of multiple sclerosis contributes to spatiotemporal variations in the trophic micromilieu of the central nervous system, the optimal intervention period for cell-replacement therapy must be systematically defined. We applied serial, 3D high-resolution magnetic resonance imaging to transplanted neural precursor cells (NPCs) labeled with superparamagnetic iron oxide nanoparticles and 5-bromo-2-deoxyuridine, and compared the migration pattern of NPCs in acute inflamed (n = 10) versus chronic demyelinated (n = 9) brains of mice induced with experimental allergic encephalomyelitis (EAE). Serial in vivo and ex-vivo 3D magnetic resonance imaging revealed that NPCs migrated 2.5 ± 1.3 mm along the corpus callosum in acute EAE. In chronic EAE, cell migration was slightly reduced (2.3 ± 1.3 mm) and only occurred in the lateral side of transplantation. Surprisingly, in 6/10 acute EAE brains, NPCs were found to migrate in a radial pattern along RECA-1+ cortical blood vessels, in a pattern hitherto only reported for migrating glioblastoma cells. This striking radial biodistribution pattern was not detected in either chronic EAE or disease-free control brains. In both acute and chronic EAE brain, Iba1+ microglia/macrophage number was significantly higher in central nervous system regions containing migrating NPCs. The existence of differential NPC migration patterns is an important consideration for implementing future translational studies in multiple sclerosis patients with variable disease.

Muja, Naser; Cohen, Mikhal E.; Zhang, Jiangyang; Kim, Heechul; Gilad, Assaf A.; Walczak, Piotr; Ben-Hur, Tamir; Bulte, Jeff W.M.

2011-01-01

452

Behavioral Medicine Approaches to Chronic Obstructive Pulmonary Disease  

PubMed Central

Background Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory disease and associated with considerable individual and socioeconomic burden. Recent research started examining the role of psychosocial factors for course and management of the disease. Purpose This review provides an overview on recent findings on psychosocial factors and behavioral medicine approaches in COPD. Results Research has identified several important psychosocial factors and effective behavioral medicine interventions in COPD. However, there is considerable need for future research in this field. Conclusions Although beneficial effects of some behavioral medicine interventions have been demonstrated in COPD, future research efforts are necessary to study the effects of distinct components of these interventions, to thoroughly examine promising but yet not sufficiently proven interventions, and to develop new creative interventions.

Fritzsche, Anja; Trueba, Ana F.; Meuret, Alicia E.; Ritz, Thomas

2013-01-01

453

Experimental Chronic Wasting Disease in Wild Type VM Mice.  

PubMed

Chronic wasting disease (CWD) is a naturally occurring prion disease in North American deer (Odocoileus species), Rocky mountain elk (Cervus elaphus nelsoni) and moose (Alces alces). The disease was first confirmed in the Republic of Korea in 2001, and subsequent cases were diagnosed in 2004, 2005 and 2010. The experimental host range of CWD includes ferrets, several species of voles, white-footed mice, deer mice and Syrian golden hamsters. In addition, CWD was transmitted to the transgenic mouse over-expressing elk or deer prion protein efficiently, but not to wild type mouse. Here, we report the experimental transmission of elk CWD to conventional VM/Dk mice reaching 100% attack rate after second passage. The CWD-prion-affected wild type mice will be a useful model for future CWD studies. PMID:23708962

Lee, Yoon-Hee; Sohn, Hyun-Joo; Kim, Min-Jeong; Kim, Hyo-Jin; Park, Kyung-Je; Lee, Won-Yong; Yun, Eun-Im; Tark, Dong-Seob; Choi, Young-Pyo; Cho, In-Soo; Balachandran, Aru

2013-04-03

454

Association between retinopathy and cardiovascular disease in patients with chronic kidney disease (from the Chronic Renal Insufficiency Cohort [CRIC] Study).  

PubMed

Patients with chronic kidney disease experience co-morbid illnesses, including cardiovascular disease (CVD) and retinopathy. The purpose of the present study was to assess the association between retinopathy and self-reported CVD in a subgroup of the participants in the Chronic Renal Insufficiency Cohort study. For this observational, ancillary investigation, 2,605 Chronic Renal Insufficiency Cohort participants were invited to participate in the present study, and nonmydriatic fundus photographs in both eyes were obtained for 1,936 subjects. The photographs were reviewed in a masked fashion at a central photograph reading center. The presence and severity of retinopathy (diabetic, hypertensive, or other) and vessel diameter caliber were assessed using standard protocols by trained graders who were masked to the information about the study participants. A history of self-reported CVD was obtained using a medical history questionnaire. Kidney function measurements and traditional and nontraditional risk factors for CVD were obtained from the Chronic Renal Insufficiency Cohort study. A greater severity of retinopathy was associated with a greater prevalence of any CVD, and this association persisted after adjustment for the traditional risk factors for CVD. The presence of vascular abnormalities usually associated with hypertension was also associated with increased prevalence of CVD. We found a direct relation between CVD prevalence and mean venular caliber. In conclusion, the presence of retinopathy was associated with CVD, suggesting that retinovascular pathology might indicate macrovascular disease, even after adjustment for renal dysfunction and traditional CVD risk factors. This would make the assessment of retinal morphology a valuable tool in CKD studies of CVD outcomes. PMID:22516527

Grunwald, Juan E; Ying, Gui-Shuang; Maguire, Maureen; Pistilli, Maxwell; Daniel, Ebenezer; Alexander, Judith; Whittock-Martin, Revell; Parker, Candace; Mohler, Emile; Lo, Joan Chia-Mei; Townsend, Raymond; Gadegbeku, Crystal Ann; Lash, James Phillip; Fink, Jeffrey Craig; Rahman, Mahboob; Feldman, Harold; Kusek, John Walter; Xie, Dawei; Coleman, Martha; Keane, Martin Gerard

2012-04-18

455

An NMR Metabolomics Study of Elk Inoculated with Chronic Wasting Disease  

Microsoft Academic Search

Chronic wasting disease (CWD) is a fatal neurodegenerative disease affecting both farmed and wild cervids, specifically deer and elk, and is a member of the larger family of prion diseases. Prion disease transmission is believed to occur through exposure to infectious prion material—a misfolded and infectious form of the prion protein that is normally present in the host. Chronic wasting

M. Jake Pushie; Rustem Shaykhutdinov; Alsu Nazyrova; Catherine Graham; Hans J. Vogel

2011-01-01

456

Influences on Hunter Support for Deer Herd Reduction as a Chronic Wasting Disease (CWD) Management Strategy  

Microsoft Academic Search

The extent to which wildlife diseases like chronic wasting disease (CWD) are density dependent creates opportunities to manage them by implementing population reduction to disrupt disease spread and lower its prevalence. We tested a model to investigate the influence of risk perceptions and other salient beliefs on deer hunter support for deer density reduction as chronic wasting disease strategy in

Erin E. Cooney; Robert H. Holsman

2010-01-01

457

Prevention of chronic kidney and vascular disease: Toward global health equity—The Bellagio 2004 Declaration  

Microsoft Academic Search

Prevention of chronic kidney and vascular disease: Toward global health equity—The Bellagio 2004 Declaration Chronic kidney disease (CKD) not only reflects target organ injury in systemic vascular disease in the general population and in association with diabetes, hypertension, and smoking, but it is recognized as one of the major risk factors in the pathogenesis and outcome of cardiovascular disease. Recent

John H. Dirks; DICK DE ZEEUW; Sanjay K. Agarwal; Robert C. Atkins; RICARDO CORREA-ROTTER; GIUSEPPE D'AMICO; Peter H. Bennett; MEGUID EL NAHAS; RAUL HERRERA VALDES; DAN KASEJE; Ivor J. Katz;