Science.gov

Sample records for communicable disease update

  1. ISS Update: High Rate Communications System

    NASA Video Gallery

    ISS Update Commentator Pat Ryan interviews Diego Serna, Communications and Tracking Officer, about the High Rate Communications System. Questions? Ask us on Twitter @NASA_Johnson and include the ha...

  2. [Update on celiac disease].

    PubMed

    Moscoso J, Felipe; Quera P, Rodrigo

    2016-02-01

    The prevalence of Celiac disease in the general population is approximately 1% and remains undiagnosed in a significant proportion of individuals. Its clinical presentation includes the classical malabsorption syndrome, unspecific and extra-intestinal manifestations, and silent celiac disease. The serologic diagnosis has an elevated sensitivity and specificity and, at least in adult population, it must be confirmed by biopsy in every case. Diagnosis in subjects already on gluten free diet includes HLA typing and gluten challenge with posterior serologic and histologic evaluation. The core of the treatment is the gluten free diet, which must be supervised by an expert nutritionist. Monitoring must be performed with serology beginning at 3-6 months, and with histology two years after the diagnosis, unless the clinical response is poor. Poor disease control is associated with complications such as lymphoma and small bowel adenocarcinoma. In the future, it is likely that new pharmacologic therapies will be available for the management of celiac disease. PMID:27092676

  3. [Ebola virus disease: Update].

    PubMed

    de la Calle-Prieto, Fernando; Arsuaga-Vicente, Marta; Mora-Rillo, Marta; Arnalich-Fernandez, Francisco; Arribas, Jose Ramon

    2016-01-01

    The first known Ebola outbreak occurred in 1976. Since then, 24 limited outbreaks had been reported in Central Africa, but never affecting more than 425 persons. The current outbreak in Western Africa is the largest in history with 28,220 reported cases and 11,291 deaths. The magnitude of the epidemic has caused worldwide alarm. For the first time, evacuated patients were treated outside Africa, and secondary cases have occurred in Spain and the United States. Since the start of the current epidemic, our knowledge about the epidemiology, clinical picture, laboratory findings, and virology of Ebola virus disease has considerably expanded. For the first time, experimental treatment has been tried, and there have been spectacular advances in vaccine development. A review is presented of these advances in the knowledge of Ebola virus disease. PMID:26774254

  4. Teratogen update: Lyme disease.

    PubMed

    Elliott, D J; Eppes, S C; Klein, J D

    2001-11-01

    We reviewed the world literature concerning the reproductive effects of Lyme disease (LD). Borrelia burgdorferi, which is the etiology of LD, is a spirochete and, as such, may share the potential for causing fetal infection, which may occur in the setting of maternal spirochetemia. Information concerning the effects of gestational LD derives from case reports and series, epidemiologic studies, and experimental animal models. Although provocative, these studies fail to define a characteristic teratogenic effect. However, skin and cardiac involvement have predominated in some reports. Pregnancy wastage has been suggested primarily by animal studies. Gestational LD appears to be associated with a low risk of adverse pregnancy outcome, particularly with appropriated antibiotic therapy. Suggestions for management of clinical situations are presented. PMID:11745834

  5. Agent Communication for Dynamic Belief Update

    NASA Astrophysics Data System (ADS)

    Kobayashi, Mikito; Tojo, Satoshi

    Thus far, various formalizations of rational / logical agent model have been proposed. In this paper, we include the notion of communication channel and belief modality into update logic, and introduce Belief Update Logic (BUL). First, we discuss that how we can reformalize the inform action of FIPA-ACL into communication channel, which represents a connection between agents. Thus, our agents can send a message only when they believe, and also there actually is, a channel between him / her and a receiver. Then, we present a static belief logic (BL) and show its soundness and completeness. Next, we develop the logic to BUL, which can update Kripke model by the inform action; in which we show that in the updated model the belief operator also satisfies K45. Thereafter, we show that every sentence in BUL can be translated into BL; thus, we can contend that BUL is also sound and complete. Furthermore, we discuss the features of CUL, including the case of inconsistent information, as well as channel transmission. Finally, we summarize our contribution and discuss some future issues.

  6. [Parkinson disease and communication].

    PubMed

    Barat, M; Daverat, P; Mazaux, J M

    1992-01-01

    Communication abilities imply multifactorial analysis. These disorders in Parkinson's disease involve speech, graphism, functional and paraverbal gestures. The patient's isolation in a major form of disease is dramatic. Functional study requires an analysis of each factor; progress should be realized for an objective approach. With a therapeutic objective in view, the most impaired features, and the patients real situation and way of life must be evaluated. Some training measures are useful especially for social adjustment and motivational reinforcement. PMID:1344546

  7. Communicable Diseases in Childhood Settings.

    ERIC Educational Resources Information Center

    Networks, 1994

    1994-01-01

    This newsletter addresses managing the spread of communicable diseases in childhood settings as well as educational program concerns for children who are HIV infected. Noting that communicable diseases are a source of concern no matter how minor they might appear, the newsletter suggests that it is important for individuals who work with the…

  8. [Update in Infectious Diseases 2016].

    PubMed

    Candel, F J; García-García, A B; Peñuelas, M; García-Alvarez, A; Chiarella, F; López-González, L; García-Salguero, C; Lejárraga, C; Rodríguez-Avial, I

    2016-09-01

    Antimicrobial resistance increases it health, social and economic impact. in all areas (state, regional and local), initiatives to try to contain the problem of resistance arise. In the update of this year 2016, we study microbiological, epidemiological and clinical aspects of multi-resistant bacteria, as well as resources for therapeutic approach, from ancient to modern drugs from therapeutic combinations to optimization Stewardship programs. In the case of fungal infection, we analyze clinical scenarios with different species in yeast or new clinical settings in filamentous fungi. Taking paediatric population, homologies and differences with adults in invasive fungal infection were compared. Finally in the field of parasitology, treatment of severe malaria imported or that resistant to antimalarial drugs were reviewed. PMID:27608304

  9. [Diabetic kidney disease - Update 2016].

    PubMed

    Sourij, Harald; Edlinger, Roland; Prischl, Friedrich; Auinger, Martin; Kautzky-Willer, Alexandra; Säemann, Marcus D; Prager, Rudolf; Clodi, Martin; Schernthaner, Guntram; Mayer, Gert; Oberbauer, Rainer; Rosenkranz, Alexander R

    2016-04-01

    Recent epidemiological evaluations have shown that approximately 5% of all Austrians suffer from diabetes including renal involvement, i. e. 400.000 people in Austria are affected. The risk of start and progression of this disease can be ameliorated by lifestyle interventions as well as optimization of blood pressure and glucose levels. The present article represents the joint recommendations of the Austrian Diabetes Association and the Austrian Society for Nephrology for the prevention and treatment of diabetic kidney disease. PMID:27052231

  10. Congenital Chagas disease: an update

    PubMed Central

    Carlier, Yves; Sosa-Estani, Sergio; Luquetti, Alejandro O; Buekens, Pierre

    2015-01-01

    Congenital infection with Trypanosoma cruzi is a global problem, occurring on average in 5% of children born from chronically infected mothers in endemic areas, with variations depending on the region. This presentation aims to focus on and update epidemiological data, research methods, involved factors, control strategy and possible prevention of congenital infection with T. cruzi. Considering that etiological treatment of the child is always effective if performed before one year of age, the diagnosis of infection in pregnant women and their newborns has to become the standard of care and integrated into the surveillance programs of syphilis and human immunodeficiency virus. In addition to the standard tests, polymerase chain reaction performed on blood of neonates of infected mothers one month after birth might improve the diagnosis of congenital infection. Recent data bring out that its transmission can be prevented through treatment of infected women before they become pregnant. The role of parasite genotypes and host genetic factors in parasite transmission and development of infection in foetuses/neonates has to be more investigated in order to better estimate the risk factors and impact on health of congenital infection with T. cruzi. PMID:25760448

  11. Complete Edentulism and Comorbid Diseases: An Update.

    PubMed

    Felton, David A

    2016-01-01

    The relationship between complete edentulism, which is the terminal outcome of a multifactorial oral disease process and other comorbid diseases, was first reported in 2009. Although the relationship between edentulism and a multitude of systemic diseases was reported, none of the publications studied could determine causality of tooth loss on the incidence of any comorbid disease. Since that publication, there has been a renewed interest in this relationship, and a plethora of new articles have been published. This article will provide an update on articles published since 2008 on the relationship between edentulism and comorbid diseases, and will include the relationship between complete edentulism and such comorbid conditions as malnutrition, obesity, cardiovascular disease, rheumatoid arthritis, pulmonary diseases (including chronic obstructive pulmonary disease), cancer, and even mortality. PMID:26371954

  12. Update on pleural diseases - 2007

    PubMed Central

    Bishay, Ayman; Raoof, Suhail; Esan, Adebayo; Sung, Arthur; Wali, Siraj; Lee, Leonard Y.; George, Liziamma; Saleh, Anthony; Baumann, Michael

    2007-01-01

    BACKGROUND: New information is available on pleural diseases. The authors selected articles to make recommendations on diagnostic and treatment aspects of pleural diseases. MATERIALS AND METHODS: Eleven articles published in the English language between 2004 and 2007 were chosen. The basis of selection of the articles was the impact on daily practice, change in prior thinking of a disease process or specific treatment modality, as well as proper design and execution of the study. 5-amino-laevulinic acid with fluorescent light combined with white light may allow further diagnostic yield in undiagnosed pleural disease. FDG-PET may allow prognostication of patients with pleural tumors. Utilizing ultrasound by trained Emergency Department physicians is a rapid and effective technique to evaluate non-traumatic pleural effusions in symptomatic patients. Serum osteopontin levels may distinguish patients exposed to asbestos with benign disease from those with pleural mesothelioma. Administration of streptokinase in patients with empyema does not need for surgical drainage, length of hospital stay, or mortality as compared to conventional treatment with chest tube drainage and intravenous antibiotics. Silver nitrate may be an alternative agent to talc for producing pleurodesis. Routine use of graded talc (50% particles greater than 25 microns) is recommended to reduce the morbidity associated with talc pleurodesis. Study design does not permit us to conclude that aspiration of spontaneous pneumothorax is as effective as chest tube drainage. Pleural catheter may prove to be an important palliative modality in treating debilitated patients or patients with trapped lung who show symptomatic improvement with drainage; however, at the present time, these catheters cannot be considered a first line treatment option for patients with malignant pleural effusion. One of the studies reviewed showed no significant difference in tract metastasis in patients with malignant mesothelioma

  13. [Update on gastroesophageal reflux disease].

    PubMed

    Serra Pueyo, Jordi

    2014-02-01

    Gastroesophageal reflux disease is a highly frequent disorder classically characterized by the presence of heartburn and/or acid regurgitation that improves with drug therapy that reduces acid content in the stomach. However, especially in patients with non-erosive disease, response to proton pump inhibitors is unsatisfactory in approximately 1 out of 3 patients, and consequently, in these patients, it is important to establish a definitive diagnosis and an alternative therapeutic strategy. In the last few years, advances have been made in knowledge of the physiopathology of reflux, such as identification of the role of the acid pocket in producing reflux, technological advances that allow differentiation among acid reflux, non-acid reflux and slightly acid reflux, and advances in the treatment of reflux with drugs that attempt to act on the barrier function of the esophagogastric junction. PMID:24355558

  14. Underground communications and tracking systems update

    SciTech Connect

    Fiscor, S.

    2008-01-15

    Today, when it comes to having systems to communicate with track and locate underground coal miners, mining companies have many equipment choices, as a direct response to the USA's 2006 MINER Act and the West Virginia Legislative Rule 56-4-8. Coal Age spoke to several companies about their leaky feeder and purely wireless systems which are either approved by the US MSHA or have been submitted for approval. The article gives details of: a UHF leaky feeder system developed by Pillar Innovations, designed to exit a mine at multiple points and then tie the leads back together on the surface; the Venture/Helicomm MineTrader system for tracking, monitoring and emergency messaging for mines; Rajant Corp.'s BreadCrumb wireless system using battery-powered wireless access nodes that enable voice and data communications across a self-healing network; the SubterraCom Wireless Solution's communications systems; a wireless mesh peer-to-peer communications system and an ultra widebade (UWB)-base real-time location tracking system from L-3 Communications; and VHF and UHF leaky feeder amplifiers from Tunnel Radio. MSHA approved communications and tracking systems are tabulated. 11 photos., 1 tab.

  15. Alzheimer's disease therapy - an update.

    PubMed

    Nikolov, R

    1998-05-01

    The 5th International Geneva/Springfield Symposium on Advances in Alzheimer Therapy focused on new therapeutic approaches for the treatment of Alzheimer 's disease (AD) based on the latest basic science data. The two major pharmacological principles of cholinergic therapy are 1) reduction of acetylcholine hydrolysis by means of acetylcholinesterase (AChE) inhibitors; and 2) direct stimulation of nicotinic or muscarinic receptors with selective agonists. Currently used AChE inhibitors are tacrine, donepezil hydrochloride, rivastigmine and metrifonate. In the area of muscarinic and nicotinic receptor modulation, studies were presented on AF-102B and AF-150(S), BIBN-99, CI-1017, RJR-2403, ABT-418, ABT-089, GTS-21 and SIB-1553A. Based on evidence of inflammatory mechanisms in the pathogenesis of AD, selective COX-2 inhibitors for the prevention and treatment of AD are a target of several pharmaceutical companies. Concerning known antiinflammatory drugs, results from controlled trials are expected soon. Estrogen replacement has been reported to produce cognitive and affective improvement in women with AD, and results from a number of studies were presented. Age-associated increases in oxidative stress may play a role in AD and thus antioxidants may also have a place in the therapy of this disease. The antioxidants vitamin E and selegiline are being investigated. Other drugs under investigation are propentofylline, Cerebrolysin, citicoline sodium, CDP-choline, memantine, Egb-761, calagualine and AIT-082. Iododoxorubicin may represent a new class of compounds able to interfere with the beta-amyloid cascade in AD and other brain amyloid diseases. Future preventive strategies in AD include genotype analysis and screening, presymptomatic diagnosis and avoidance of environmental risk factors. PMID:15616667

  16. [Update in Infectious Diseases 2015].

    PubMed

    Candel, Francisco Javier; López González, Laura; García-García, Ana Belén; Chiarella, Flavia; Picazo, Juan José

    2015-09-01

    Infectious disease remains current worldwide. During the second half of 2014 an outbreak of ebolavirus hit West Africa with implications in the rest of the world. In fact, Spain declared the first imported case of this infection. Multiresistant enterobacteria outbreaks are emerging all around the world in a moment on which WHO draws attention to the limited resources, coining the term "post antibiotic era". On the other hand, 2014 went down in history as one in which hepatitis C is cured. Are also current HIV epidemiological control or strategies for antiviral and antifungal prophylaxis in immunocompromised hosts. PMID:26365724

  17. Nephrology Update: Chronic Kidney Disease.

    PubMed

    Saha, Sharmeela; Rahman, Mahboob

    2016-05-01

    Chronic kidney disease (CKD) affects more than 1 in 10 individuals in the United States. The care of these patients must be managed by family physicians and nephrology subspecialists. The kidneys often are affected by systemic processes such as diabetes and hypertension, and optimal management of these conditions is critical to slow decline in renal function in CKD patients. These patients are at high risk of cardiovascular disease, and statin therapy is recommended for adults with CKD who are at least age 50 years and not receiving dialysis. Patients with CKD and anemia can be treated with iron therapy and often with an erythropoietin-stimulating agent. Electrolyte abnormalities are managed with dietary changes and drugs. Sodium restriction and modification of dietary protein intake also may be needed. Consultation with a renal dietitian may be helpful. Because many drugs are metabolized by the kidneys, physicians should ensure that drug dosages are appropriate for the level of renal function. Early consultation with or referral to a nephrology subspecialist for patients with reduced renal function, resistant hypertension or electrolyte levels, and other conditions have been associated with improved outcomes in CKD patients. PMID:27163761

  18. Update on Oxalate Crystal Disease

    PubMed Central

    Lorenz, Elizabeth C.; Michet, Claude J.; Milliner, Dawn S.; Lieske, John C.

    2013-01-01

    Oxalate arthropathy is a rare cause of arthritis characterized by deposition of calcium oxalate crystals within synovial fluid. This condition typically occurs in patients with underlying primary or secondary hyperoxaluria. Primary hyperoxaluria constitutes a group of genetic disorders resulting in endogenous overproduction of oxalate, whereas secondary hyperoxaluria results from gastrointestinal disorders associated with fat malabsorption and increased absorption of dietary oxalate. In both conditions oxalate crystals can deposit in the kidney leading to renal failure. Since oxalate is primarily renally eliminated, it accumulates throughout the body in renal failure, a state termed oxalosis. Affected organs can include bones, joints, heart, eyes and skin. Since patients can present with renal failure and oxalosis before the underlying diagnosis of hyperoxaluria has been made, it is important to consider hyperoxaluria in patients who present with unexplained soft tissue crystal deposition. The best treatment of oxalosis is prevention. If patients present with advanced disease, treatment of oxalate arthritis consists of symptom management and control of the underlying disease process. PMID:23666469

  19. International law and communicable diseases.

    PubMed Central

    Aginam, Obijiofor

    2002-01-01

    Historically, international law has played a key role in global communicable disease surveillance. Throughout the nineteenth century, international law played a dominant role in harmonizing the inconsistent national quarantine regulations of European nation-states; facilitating the exchange of epidemiological information on infectious diseases; establishing international health organizations; and standardization of surveillance. Today, communicable diseases have continued to re-shape the boundaries of global health governance through legally binding and "soft-law" regimes negotiated and adopted within the mandate of multilateral institutions - the World Health Organization, the World Trade Organization, the Food and Agriculture Organization, and the Office International des Epizooties. The globalization of public health has employed international law as an indispensable tool in global health governance aimed at diminishing human vulnerability to the mortality and morbidity burdens of communicable diseases. PMID:12571722

  20. Mobile satellite communications - Vehicle antenna technology update

    NASA Technical Reports Server (NTRS)

    Bell, D.; Naderi, F. M.

    1986-01-01

    This paper discusses options for vehicle antennas to be used in mobile satellite communications systems. Two types of antennas are identified. A non-steerable, azimuthally omnidirectional antenna with a modest gain of 3 to 5 dBi is suggested when a low cost is desired. Alternatively, mechanically or electronically steerable antennas with a higher gain of 10 to 12 dBi are suggested to alleviate power and spectrum scarcity associated with mobile satellite communications. For steerable antennas, both open-loop and closed-loop pointing schemes are discussed. Monopulse and sequential lobing are proposed for the mechanically steered and electronically steered antennas, respectively. This paper suggests a hybrid open-loop/closed-loop pointing technique as the best performer in the mobile satellite environment.

  1. Communicable Disease Research

    NASA Technical Reports Server (NTRS)

    1982-01-01

    The COSMIC program FITLOS is used regularly by the Centers for Disease Control (CDC), for analyzing data from radioimmunoassays, which involve testing human body substances to provide information on how deficits or excesses of those substances affect a body's ability to ward off disease. A liquid scintillation counter's data is analyzed by the FITLOS program. FITLOS data, then aids in establishing reference methods for hospitals and other health laboratories in their radioimmunoassays. CDC's use of this program enabled them to avoid the cost of designing and developing a new program.

  2. Heart Disease and Stroke Statistics—2011 Update

    PubMed Central

    Roger, Véronique L.; Go, Alan S.; Lloyd-Jones, Donald M.; Adams, Robert J.; Berry, Jarett D.; Brown, Todd M.; Carnethon, Mercedes R.; Dai, Shifan; de Simone, Giovanni; Ford, Earl S.; Fox, Caroline S.; Fullerton, Heather J.; Gillespie, Cathleen; Greenlund, Kurt J.; Hailpern, Susan M.; Heit, John A.; Ho, P. Michael; Howard, Virginia J.; Kissela, Brett M.; Kittner, Steven J.; Lackland, Daniel T.; Lichtman, Judith H.; Lisabeth, Lynda D.; Makuc, Diane M.; Marcus, Gregory M.; Marelli, Ariane; Matchar, David B.; McDermott, Mary M.; Meigs, James B.; Moy, Claudia S.; Mozaffarian, Dariush; Mussolino, Michael E.; Nichol, Graham; Paynter, Nina P.; Rosamond, Wayne D.; Sorlie, Paul D.; Stafford, Randall S.; Turan, Tanya N.; Turner, Melanie B.; Wong, Nathan D.; Wylie-Rosett, Judith

    2015-01-01

    Summary Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update. The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on disease morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document. Indeed, since 1999, the Statistical Update has been cited more than 8700 times in the literature (including citations of all annual versions). In 2009 alone, the various Statistical Updates were cited ≈1600 times (data from ISI Web of Science). In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas. For this year’s edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year and added a new chapter detailing how family history and genetics play a role in cardiovascular disease (CVD) risk. Also, the 2011 Statistical Update is a major source for monitoring both cardiovascular health and disease in the population, with a focus on progress toward achievement of the AHA’s 2020 Impact Goals. Below are a few highlights from this year’s Update. Death Rates From CVD Have Declined, Yet the Burden of Disease Remains High The 2007 overall death rate from CVD (International Classification of Diseases 10, I00–I99) was 251.2 per 100 000. The rates were 294

  3. Communicable Diseases and Outbreak Control.

    PubMed

    Ameli, Jonathan

    2015-10-01

    Infectious disease during an emergency condition can raise the death rate 60 times in comparison to other causes including trauma. An epidemic, or outbreak, can occur when several aspects of the agent (pathogen), population (hosts), and the environment create an ideal situation for spread. Overcrowding, poor regional design and hygiene due to poverty, dirty drinking water, rapid climate changes, and natural disasters, can lead to conditions that allow easier transmission of disease. Once it has been established that an emergency condition exists, there must be a prompt and thorough response for communicable disease control. A camp should be created, and the disease managed rapidly. The overall goals are rapid assessment, prevention, surveillance, outbreak control, and disease management. PMID:27437528

  4. Biologic therapy for autoimmune diseases: an update

    PubMed Central

    2013-01-01

    Biologic therapies for rheumatologic diseases, which are targeted at molecules involved in the mechanisms of the immune system, provide an alternative to the existing treatment methods of disease-modifying anti-rheumatic drugs and other immunosuppressive medications. However, the current drawbacks of biologic therapies, including the inconvenience of intravenous administration, the high costs of these drugs, and the adverse events associated with them, prevent their wide use as first-line medications. This review provides an update of the recent literature on the new biologic therapies available. The review concentrates on nine drugs: tocilizumab, rituximab, ofatumumab, belimumab, epratuzumab, abatacept, golimumab, certolizumab, and sifalimumab, which are used as therapies for rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus, systemic sclerosis, or vasculitis. PMID:23557513

  5. Estrogen receptors and human disease: an update

    PubMed Central

    Burns, Katherine A.

    2016-01-01

    A myriad of physiological processes in mammals are influenced by estrogens and the estrogen receptors (ERs), ERα and ERβ. As we reviewed previously, given the widespread role for estrogen in normal human physiology, it is not surprising that estrogen is implicated in the development or progression of a number of diseases. In this review, we are giving a 5-year update of the literature regarding the influence of estrogens on a number of human cancers (breast, ovarian, colorectal, prostate, and endometrial), endometriosis, fibroids, and cardiovascular disease. A large number of sophisticated experimental studies have provided insights into human disease, but for this review, the literature citations were limited to articles published after our previous review (Deroo and Korach in J Clin Invest 116(3):561–570, 2006) and will focus in most cases on human data and clinical trials. We will describe the influence in which estrogen’s action, through one of or both of the ERs, mediates the aforementioned human disease states. PMID:22648069

  6. Recent updates in chronic obstructive pulmonary disease.

    PubMed

    Garvey, Christine

    2016-01-01

    Chronic obstructive pulmonary disease (COPD), characterized by chronic airways inflammation and progressive airflow limitation, is a common, preventable and treatable disease. Worldwide, COPD is a major cause of morbidity and mortality; smoking tobacco is the most important risk factor. This translational review of recent updates in COPD care for the primary care audience, includes recommendations from the 2015 Global Initiative for chronic obstructive lung disease (GOLD) report on diagnosis, pharmacological and non-pharmacological treatment, prevalence of comorbidities, management of exacerbations and the asthma and COPD overlap syndrome, with a focus on the importance and benefit of physical activity and exercise in COPD patients. Exacerbations and comorbidities contribute to the overall severity of COPD in individual patients. Management of exacerbations includes reducing the impact of the current exacerbation and preventing development of subsequent episodes. Healthcare professionals need to be alert to comorbidities, such as cardiovascular disease, anxiety/depression, lung cancer, infections and diabetes, which are common in COPD patients and can have a significant impact on HRQoL and prognosis. Pulmonary rehabilitation is recommended by a number of guidelines for all symptomatic COPD patients, regardless of severity, and involves exercise training, patient education, nutritional advice and psychosocial support. At all stages of COPD, regular physical activity and exercise can aid symptom control, improve HRQoL, reduce rates of hospitalization, and improve morbidity and respiratory mortality. Healthcare professionals play a pivotal role in improving HRQoL and health-related outcomes in COPD patients to meet their specific needs and in providing appropriate diagnosis, management and advice on smoking cessation. PMID:26560514

  7. Chronic non-communicable diseases.

    PubMed

    Unwin, N; Alberti, K G M M

    2006-01-01

    Chronic non-communicable diseases (NCD) account for almost 60% of global mortality, and 80% of deaths from NCD occur in low- and middle-income countries. One quarter of these deaths--almost 9 million in 2005--are in men and women aged <60 years. Taken together, NCD represent globally the single largest cause of mortality in people of working age, and their incidences in younger adults are substantially higher in the poor countries of the world than in the rich. The major causes of NCD-attributable mortality are cardiovascular disease (30% of total global mortality), cancers (13%), chronic respiratory disease (7%) and diabetes (2%). These conditions share a small number of behavioural risk factors, which include a diet high in saturated fat and low in fresh fruit and vegetables, physical inactivity, tobacco smoking, and alcohol excess. In low- and middle-income countries such risk factors tend to be concentrated in urban areas and their prevalences are increasing as a result of rapid urbanization and the increasing globalisation of the food, tobacco and alcohol industries. Because NCD have a major impact on men and women of working age and their elderly dependents, they result in lost income, lost opportunities for investment, and overall lower levels of economic development. Reductions in the incidences of many NCD and their complications are, however, already possible. Up to 80% of all cases of cardiovascular disease or type-2 diabetes and 40% of all cases of cancer, for example, are probably preventable based on current knowledge. In addition, highly cost-effective measures exist for the prevention of some of the complications of established cardiovascular disease and diabetes. Achieving these gains will require a broad range of integrated, population-based interventions as well as measures focused on the individuals at high risk. At present, the international-assistance community provides scant resources for the control of NCD in poor countries, partly, at least

  8. Alzheimer's disease. Physician-patient communication.

    PubMed Central

    Orange, J. B.; Molloy, D. W.; Lever, J. A.; Darzins, P.; Ganesan, C. R.

    1994-01-01

    The number of cognitively impaired elderly in Canada has increased greatly during the past two decades; nearly all have Alzheimer's disease (AD). The memory problems and changes in language and communication of these patients place tremendous strain on physicians who are searching for a differential diagnosis and are trying to communicate with them. Reviewing the salient language and communication features of AD patients leads to strategies for improving effective physician-patient communication. PMID:8019193

  9. [Thromboangiitis obliterans (Buerger's disease): update 2015].

    PubMed

    Klein-Weigel, Peter; Volz, Theresa Sophie; Richter, Jutta

    2015-10-01

    Thromboangiitis obliterans (Buerger's disease) is a vasculitis with undulating clinical course multisegmentarily affecting small and medium-sized arteries and veins. The disease is closely linked to tobacco-use. Increasing knowledge of autoimmunologic mechanisms in the complex pathophyiology of the disease let to the formulation of an autoimmunity-hypothesis now serving as a new paradigma. New treatment options comprise progenitor-cell-therapy, immunoadsorption, use of sendothelin-receptor-blocking agent Bosentan, and prescriptions of antiphosphodiesterase-V-inhibitors. PMID:26445249

  10. Enhancing Disease Surveillance Event Communication Among Jurisdictions

    PubMed Central

    Tabernero, Nathaniel R.; Loschen, Wayne A.; Jorgensen, Joel; Suereth, Joshua; Coberly, Jacqueline S.; Holtry, Rekha S.; Sikes, Marvin L.; Babin, Steven M.; Lewis, Sheryl L. Happel

    2009-01-01

    Automated disease surveillance systems are becoming widely used by the public health community. However, communication among non-collocated and widely dispersed users still needs improvement. A web-based software tool for enhancing user communications was completely integrated into an existing automated disease surveillance system and was tested during two simulated exercises and operational use involving multiple jurisdictions. Evaluation of this tool was conducted by user meetings, anonymous surveys, and web logs. Public health officials found this tool to be useful, and the tool has been modified further to incorporate features suggested by user responses. Features of the automated disease surveillance system, such as alerts and time series plots, can be specifically referenced by user comments. The user may also indicate the alert response being considered by adding a color indicator to their comment. The web-based event communication tool described in this article provides a common ground for collaboration and communication among public health officials at different locations. PMID:27325909

  11. ADVANCES AND UPDATE ON MAREK'S DISEASE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Marek's disease virus has evolved toward greater forms of virulence within the last 50 years. The two consequences of such evolution to the poultry industry are the more complicated diagnosis and the lower protection conferred by the currently available vaccines. Diagnosis of Marek's disease has bec...

  12. UPDATE ON SWINE DISEASE AND GENOMICS RESEARCH

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This review will summarize advances in swine genomics and how it has altered approaches for swine disease and vaccination research. The swine has been a major biomedical model species, for transplantation, heart disease, allergies and asthma, as well as normal neonatal development and reproductive p...

  13. Clinical update in sexually transmitted diseases-2014.

    PubMed

    Fanfair, Robyn Neblett; Workowski, Kimberly A

    2014-02-01

    Sexually transmitted diseases (STDs) and their associated syndromes are extremely common in clinical practice. Early diagnosis, appropriate treatment, and partner management are important to ensure sexual, physical, and reproductive health in our patients. PMID:24493491

  14. THERAPIES FOR CROHN'S DISEASE: a clinical update.

    PubMed

    Sobrado, Carlos Walter; Leal, Raquel Franco; Sobrado, Lucas Faraco

    2016-01-01

    The main objectives of clinical therapy in Crohn's disease are clinical and endoscopic remission without the use of corticosteroids for long periods of time, prevention of hospitalization and surgery, and improvement of quality of life. The main limitation of drug therapy is the loss of response over the long term, which makes incorporation of new drugs to the therapeutic arsenal necessary. This review analyses the main drugs currently used in clinical treatment of Crohn's disease. PMID:27438429

  15. Rheumatoid Arthritis and Periodontal Disease. An Update.

    PubMed

    Venkataraman, Archana; Almas, Khalid

    2015-01-01

    A review of the epidemiological, pathological and immunological relationships between two chronic inflammatory diseases: rheumatoid arthritis (RA) and periodontal disease (PD). RA is a chronic inflammatory disease of the joints, characterized by loss of connective tissue and mineralized structures, the so-called "synovial membrane." Periodontitis is the inflammatory destruction of the periodontal attachment and alveolar bone. While the etiology of these two diseases may differ, the underlying pathogenic mechanisms are similar. And it is possible that individuals manifesting both PD and RA may suffer from a unifying underlying systemic deregulation of the inflammatory response. There is an overproduction of a variety of cytokines and MMPs that appears to be common in both diseases. Oral health parameters should be more closely monitored in patients with RA, an autoimmune disease. Data suggest that periodontal therapies combined with routine RA treatments further improve RA status. Interventions to prevent, minimize or treat periodontitis in arthritis patients will definitely promise a better quality of life for these patients. PMID:26521325

  16. Human autoimmune diseases: a comprehensive update.

    PubMed

    Wang, Lifeng; Wang, Fu-Sheng; Gershwin, M Eric

    2015-10-01

    There have been significant advances in our understanding of human autoimmunity that have led to improvements in classification and diagnosis and, most importantly, research advances in new therapies. The importance of autoimmunity and the mechanisms that lead to clinical disease were first recognized about 50 years ago following the pioneering studies of Macfarlane Burnett and his Nobel Prize-winning hypothesis of the 'forbidden clone'. Such pioneering efforts led to a better understanding not only of autoimmunity, but also of lymphoid cell development, thymic education, apoptosis and deletion of autoreactive cells. Contemporary theories suggest that the development of an autoimmune disease requires a genetic predisposition and environmental factors that trigger the immune pathways that lead, ultimately, to tissue destruction. Despite extensive research, there are no genetic tools that can be used clinically to predict the risk of autoimmune disease. Indeed, the concordance of autoimmune disease in identical twins is 12-67%, highlighting not only a role for environmental factors, but also the potential importance of stochastic or epigenetic phenomena. On the other hand, the identification of cytokines and chemokines, and their cognate receptors, has led to novel therapies that block pathological inflammatory responses within the target organ and have greatly improved the therapeutic effect in patients with autoimmune disease, particularly rheumatoid arthritis. Further advances involving the use of multiplex platforms for diagnosis and identification of new therapeutic agents should lead to major breakthroughs within the next decade. PMID:26212387

  17. Crohn’s disease: a clinical update

    PubMed Central

    Ha, Francis; Khalil, Hanan

    2015-01-01

    Crohn’s disease is increasing in prevalence worldwide. It arises from a complex interplay between both genetic predisposition and environmental influence. A search of databases and clinical practice guidelines was performed to provide the most up-to-date evidence-based approach for diagnosing and managing patients with Crohn’s disease. No single gold standard investigation exists. Whilst full ileocolonoscopy with biopsies remains the mainstay for diagnosis, other less invasive imaging modalities are being actively considered in the workup, as well as the use of serological markers. Management should incorporate dietary and lifestyle modifications where necessary, the use of medications in induction and remission of disease, and consideration of surgical intervention where medical therapy has failed. PMID:26557891

  18. ISS Update: Alvin Drew Talks about Delayed Communications

    NASA Video Gallery

    ISS Update commentator Brandi Dean interviews NASA astronaut Alvin Drew about the Autonomous Mission Operations Test. Drew, who is the commander for the test, talks about the past, current and futu...

  19. Nephrology Update: Glomerular Disease in Children.

    PubMed

    Vogt, Beth

    2016-05-01

    Although kidney disease is much less common in children than in adults, clinicians must remain alert for the renal conditions that occur in this population because prompt diagnosis and management are essential. Acute postinfectious glomerulonephritis occurs as an uncommon sequela of streptococcal and other infections. Management is focused on providing supportive measures, including management of fluid-electrolyte imbalance and hypertension, until the patient recovers. Immunoglobulin (Ig) A nephropathy is a primary glomerulonephritis related to abnormal IgA glycosylation. The most common renal issue in children involves recurrent episodes of painless macroscopic hematuria during times of acute infection. Renal involvement occurs in the majority of children with Henoch-Schönlein purpura (HSP), with most experiencing asymptomatic hematuria and low level proteinuria. More severe forms of HSP nephritis, including rapidly progressive glomerulonephritis, may progress to end-stage kidney disease. Nephrotic syndrome commonly is related to steroid-responsive minimal change disease, and follows a course of relapses and remissions over time. However, a minority of children have steroid-resistant disease with potential for poor renal outcome. PMID:27163763

  20. Avian Disease & Oncology Lab (ADOL) Research Update

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Employing Genomics, Epigenetics, and Immunogenetics to Control Diseases Induced by Avian Tumor Viruses - Gene expression is a major factor accounting for phenotypic variation. Taking advantage of allele-specific expression (ASE) screens, we found the use of genetic markers was superior to traditiona...

  1. Communicable disease epidemiology training in Northern Europe.

    PubMed

    Aavitsland, P; Andresen, S

    2001-03-01

    The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have a long tradition of collaboration in communicable disease epidemiology and control. The state epidemiologists and the immunisation programme managers have met regularly to discuss common challenges and exchange experiences in surveillance and control of communicable diseases. After the three Baltic countries (Estonia, Latvia and Lithuania) regained independence in 1991 and the Soviet Union dissolved, contacts were made across the old iron curtain in several areas, such as culture, education, business, military and medicine. Each of the Nordic communicable disease surveillance institutes started projects with partners in Estonia, Latvia, Lithuania or the Russian Federation. The projects were in such diverse areas as HIV surveillance and prevention, vaccination programmes and antibiotic resistance. PMID:11682716

  2. Update on Charcot-Marie-Tooth Disease

    PubMed Central

    Patzkó, Ágnes; Shy, Michael E.

    2011-01-01

    Charcot-Marie-Tooth disease (CMT) disease encompasses a genetically heterogeneous group of inherited neuropathies, also known as hereditary motor and sensory neuropathies. CMT results from mutations in more than 40 genes expressed in Schwann cells and neurons causing overlapping phenotypes. The classic CMT phenotype reflects length-dependent axonal degeneration characterized by distal sensory loss and weakness, deep tendon reflex abnormalities, and skeletal deformities. Recent articles have provided insight into the molecular pathogenesis of CMT, which, for the first time, suggest potential therapeutic targets. Although there are currently no effective medications for CMT, multiple clinical trials are ongoing or being planned. This review will focus on the underlying pathomechanisms and diagnostic approaches of CMT and discuss the emerging therapeutic strategies. PMID:21080241

  3. [Coeliac disease in children--an update].

    PubMed

    Benkebil, F; Nydegger, A

    2007-02-28

    Coeliac disease (CD), considered as an autoimmune disease with genetic predisposition can occur at any age. Several types can be observed: a) typical cases presenting early in life with signs of intestinal malabsorption; b() atypical cases showing milder, often extraintestinal symptoms; c() silent cases that are occasionally discovered because of serological screening and (d) potential/latent cases showing isolated positivity of celiac serology at first testing and eventually the typical intestinal damage later in life. To date, the method of choice to make a diagnosis is the dosage of anti-transglutaminase IgA antibodies (including total IgA to prevent false negative results), followed by intestinal biopsy. Addition of moderate amounts of oats to a gluten-free diet does not prevent clinical or small bowel mucosal healing in children. PMID:17410937

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

    PubMed

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

    2011-09-01

    Cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) is high, and the presence of CKD worsens outcomes of cardiovascular disease (CVD). CKD is associated with specific risk factors. Emerging evidence indicates that the pathology and manifestation of CVD differ in the presence of CKD. During a clinical update conference convened by the Kidney Disease: Improving Global Outcomes (KDIGO), an international group of experts defined the current state of knowledge and the implications for patient care in important topic areas, including coronary artery disease and myocardial infarction, congestive heart failure, cerebrovascular disease, atrial fibrillation, peripheral arterial disease, and sudden cardiac death. Although optimal strategies for prevention, diagnosis, and management of these complications likely should be modified in the presence of CKD, the evidence base for decision making is limited. Trials targeting CVD in patients with CKD have a large potential to improve outcomes. PMID:21750584

  5. Respiratory Conditions Update: Restrictive Lung Disease.

    PubMed

    Robinson, H Coleman

    2016-09-01

    Restrictive lung diseases are a heterogeneous group of conditions characterized by a restrictive pattern on spirometry and confirmed by a reduction in total lung volume. Patients with more severe symptoms may have a reduced diffusing capacity of the lung for carbon monoxide. Etiologies can be intrinsic with lung parenchymal involvement, as in interstitial lung diseases, or extrinsic to the lung, as in obesity and neuromuscular disorders. Idiopathic pulmonary fibrosis is a chronic progressive interstitial pneumonia with fibrosis for which treatment is primarily supportive with oxygen therapy, pulmonary rehabilitation, and management of comorbid conditions. Newer drugs for idiopathic pulmonary fibrosis, such as pirfenidone and nintedanib, can slow disease progression. Referral for evaluation for lung transplantation is recommended for appropriate patients. Obstructive sleep apnea and obesity hypoventilation syndrome increasingly are common health issues, with symptoms that can include snoring, daytime somnolence, difficulty concentrating, fatigue, witnessed apneas, and morning headaches. Serum bicarbonate may serve as a biomarker in screening for subclinical obesity hypoventilation syndrome. Preoperative evaluations should assess pulmonary risk in addition to cardiac risk with a thorough history, laboratory tests, and functional capacity assessments. Optimization of management may include weight loss, pulmonary rehabilitation, oxygen therapy, and respiratory support. PMID:27576233

  6. Periodontal Disease and Systemic Diseases: An Update for the Clinician.

    PubMed

    John, Vanchit; Alqallaf, Hawra; De Bedout, Tatiana

    2016-01-01

    A link between periodontal disease and various systemic diseases has been investigated for several years. Interest in unearthing such a link has grown as the health care profession is looking for a better understanding of disease processes and their relationships to periodontal and other oral diseases. The article aims to provide recent information on the relationship between periodontal disease and systemic diseases such as; cardiovascular, respiratory, endocrine, musculoskeletal, and reproductive system related abnormalities. PMID:26939411

  7. Respiratory Conditions Update: Chronic Obstructive Pulmonary Disease.

    PubMed

    Karel, Daphne J

    2016-09-01

    Chronic obstructive pulmonary disease (COPD) is defined as persistent airflow limitation due to irritant-induced chronic inflammation. A postbronchodilator forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) ratio of 0.7 or less is diagnostic in a patient with dyspnea, chronic cough or sputum production, and a history of irritant exposure. Tobacco smoking is the most significant etiology, and smoking cessation is the only intervention shown to slow disease progression. Long-acting beta2-agonists and long-acting muscarinic antagonists are first-line treatments for patients with persistently symptomatic COPD with an FEV1 of 80% or less of predicted. When COPD is uncontrolled with a long-acting bronchodilator, combination therapy with a long-acting muscarinic antagonist-long-acting beta2-agonist or long-acting beta2-agonist-inhaled corticosteroid should be prescribed. Patients with COPD and reduced exercise tolerance should undergo pulmonary rehabilitation and be evaluated for supplemental oxygen therapy. Other treatment options for persistently symptomatic COPD include inhaler triple therapy (ie, long-acting muscarinic antagonist, long-acting beta2-agonist, inhaled corticosteroid), phosphodiesterase type 4 inhibitors, oxygen, and surgical interventions. PMID:27576232

  8. Treatment of Cushing's disease: a mechanistic update.

    PubMed

    Cuevas-Ramos, Daniel; Fleseriu, Maria

    2014-11-01

    Cushing's disease (CD) is characterized by an ACTH-producing anterior corticotrope pituitary adenoma. If hypothalamus-pituitary-adrenal (HPA) axis physiology is disrupted, ACTH secretion increases, which in turn stimulates adrenocortical steroidogenesis and cortisol production. Medical treatment plays an important role for patients with persistent disease after surgery, for those in whom surgery is not feasible, or while awaiting effects of radiation. Multiple drugs, with different mechanisms of action and variable efficacy and tolerability for controlling the deleterious effects of chronic glucocorticoid excess, are available. The molecular basis and clinical data for centrally acting drugs, adrenal steroidogenesis inhibitors, and glucocorticoid receptor antagonists are reviewed, as are potential novel molecules and future possible targets for CD treatment. Although progress has been made in the understanding of specific corticotrope adenoma receptor physiology and recent clinical studies have detected improved effects with a combined medical therapy approach, there is a clear need for a more efficacious and better-tolerated medical therapy for patients with CD. A better understanding of the molecular mechanisms in CD and of HPA axis physiology should advance the development of new drugs in the future. PMID:25134660

  9. Heart Failure Update: Chronic Disease Management Programs.

    PubMed

    Fountain, Lorna B

    2016-03-01

    With high mortality and readmission rates among patients with heart failure (HF), multiple disease management models have been and continue to be tested, with mixed results. Early postdischarge care improves outcomes for patients. Telemonitoring also can assist in reducing mortality and HF-related hospitalizations. Office-based team care improves patient outcomes, with important components including rapid access to physicians, partnerships with clinical pharmacists, education, monitoring, and support. Pay-for-performance measures developed for HF, primarily use of angiotensin-converting enzyme inhibitors and beta blockers, also improve patient outcomes, but the influence of adherence to other measures has been minimal. Evaluating comorbid conditions, including diabetes and hypertension, and making drug adjustments for patients with HF to include blood pressure control and use of metformin, when possible, can reduce mortality and morbidity. PMID:26974003

  10. Celiac disease 2015 update: new therapies.

    PubMed

    Veeraraghavan, Gopal; Leffler, Daniel A; Kaswala, Dharmesh H; Mukherjee, Rupa

    2015-07-01

    Celiac disease (CD) is a chronic, small intestinal, immune-mediated enteropathy triggered by exposure to dietary gluten in genetically susceptible individuals. Currently, lifelong adherence to a gluten-free diet (GFD) is the only available treatment. However, GFD alone is not sufficient to relieve symptoms, control small intestinal inflammation and prevent long-term complications in many patients. The GFD has its challenges including issues related to adherence, lifestyle restrictions and cost. As a result, there is growing interest in and a need for non-dietary therapies to manage this condition. In recent years, different targets in the immune-mediated cascade of CD have been identified in clinical and pre-clinical trials for potential therapies. This review will discuss the latest non-dietary therapies in CD, including endopeptidases, modulators of enterocyte tight junctions and agents involved in gluten tolerization and immunomodulation. We will also discuss the potential implications of approved therapeutics on CD clinical practice. PMID:25864708

  11. ISS Update: Communication Delays During Deep Space Missions

    NASA Video Gallery

    NASA Public Affairs Officer Brandi Dean talks with Jeremy Frank, Autonomous Mission Operations Test Principal Investigator, about how communication delays will affect future deep space missions and...

  12. Pelvic radiation disease: Updates on treatment options.

    PubMed

    Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo

    2015-12-10

    Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

  13. Pelvic radiation disease: Updates on treatment options

    PubMed Central

    Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo

    2015-01-01

    Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

  14. Practice improvement, part II: update on patient communication technologies.

    PubMed

    Roett, Michelle A; Coleman, Mary Thoesen

    2013-11-01

    Patient portals (ie, secure web-based services for patient health record access) and secure messaging to health care professionals are gaining popularity slowly. Advantages of web portals include timely communication and instruction, access to appointments and other services, and high patient satisfaction. Limitations include inappropriate use, security considerations, organizational costs, and exclusion of patients who are uncomfortable with or unable to use computers. Attention to the organization's strategic plan and office policies, patient and staff expectations, workflow and communication integration, training, marketing, and enrollment can facilitate optimal use of this technology. Other communication technologies that can enhance patient care include automated voice or text reminders and brief electronic communications. Social media provide another method of patient outreach, but privacy and access are concerns. Incorporating telehealthcare (health care provided via telephone or Internet), providing health coaching, and using interactive health communication applications can improve patient knowledge and clinical outcomes and provide social support. PMID:24261435

  15. Biomarkers in Parkinson's disease (recent update).

    PubMed

    Sharma, Sushil; Moon, Carolyn Seungyoun; Khogali, Azza; Haidous, Ali; Chabenne, Anthony; Ojo, Comfort; Jelebinkov, Miriana; Kurdi, Yousef; Ebadi, Manuchair

    2013-09-01

    Parkinson's disease (PD) is the second most common neurodegenerative disorder mostly affecting the aging population over sixty. Cardinal symptoms including, tremors, muscle rigidity, drooping posture, drooling, walking difficulty, and autonomic symptoms appear when a significant number of nigrostriatal dopaminergic neurons are already destroyed. Hence we need early, sensitive, specific, and economical peripheral and/or central biomarker(s) for the differential diagnosis, prognosis, and treatment of PD. These can be classified as clinical, biochemical, genetic, proteomic, and neuroimaging biomarkers. Novel discoveries of genetic as well as nongenetic biomarkers may be utilized for the personalized treatment of PD during preclinical (premotor) and clinical (motor) stages. Premotor biomarkers including hyper-echogenicity of substantia nigra, olfactory and autonomic dysfunction, depression, hyposmia, deafness, REM sleep disorder, and impulsive behavior may be noticed during preclinical stage. Neuroimaging biomarkers (PET, SPECT, MRI), and neuropsychological deficits can facilitate differential diagnosis. Single-cell profiling of dopaminergic neurons has identified pyridoxal kinase and lysosomal ATPase as biomarker genes for PD prognosis. Promising biomarkers include: fluid biomarkers, neuromelanin antibodies, pathological forms of α-Syn, DJ-1, amyloid β and tau in the CSF, patterns of gene expression, metabolomics, urate, as well as protein profiling in the blood and CSF samples. Reduced brain regional N-acetyl-aspartate is a biomarker for the in vivo assessment of neuronal loss using magnetic resonance spectroscopy and T2 relaxation time with MRI. To confirm PD diagnosis, the PET biomarkers include [(18)F]-DOPA for estimating dopaminergic neurotransmission, [(18)F]dG for mitochondrial bioenergetics, [(18)F]BMS for mitochondrial complex-1, [(11)C](R)-PK11195 for microglial activation, SPECT imaging with (123)Iflupane and βCIT for dopamine transporter, and urinary

  16. From Sirtuin Biology to Human Diseases: An Update*

    PubMed Central

    Sebastián, Carlos; Satterstrom, F. Kyle; Haigis, Marcia C.; Mostoslavsky, Raul

    2012-01-01

    Originally rising to notoriety for their role in the regulation of aging, sirtuins are a family of NAD+-dependent enzymes that have been connected to a steadily growing set of biological processes. In addition to regulating aging, sirtuins play key roles in the maintenance of organismal metabolic homeostasis. These enzymes also have primarily protective functions in the development of many age-related diseases, including cancer, neurodegeneration, and cardiovascular disease. In this minireview, we provide an update on the known roles for each of the seven mammalian sirtuins in these areas. PMID:23086954

  17. Update on Bone Health in Pediatric Chronic Disease.

    PubMed

    Williams, Kristen M

    2016-06-01

    Children and adolescents with chronic disease are predisposed to impaired bone health. Pediatric illness, including type 1 diabetes mellitus, celiac disease, and cystic fibrosis, have significant risk of low bone mineralization and fracture due to underlying inflammation, malabsorption, lack of physical activity, and delayed puberty. Dual-energy x-ray absorptiometry is the primary imaging method to assess bone health in this population. The purpose of this review is to update readers about the assessment and management of bone health in children with common pediatric chronic illnesses and review recent advances in the prevention and treatment of impaired bone health. PMID:27241973

  18. Remembering the forgotten non-communicable diseases.

    PubMed

    Lopez, Alan D; Williams, Thomas N; Levin, Adeera; Tonelli, Marcello; Singh, Jasvinder A; Burney, Peter G J; Rehm, Jürgen; Volkow, Nora D; Koob, George; Ferri, Cleusa P

    2014-01-01

    The forthcoming post-Millennium Development Goals era will bring about new challenges in global health. Low- and middle-income countries will have to contend with a dual burden of infectious and non-communicable diseases (NCDs). Some of these NCDs, such as neoplasms, COPD, cardiovascular diseases and diabetes, cause much health loss worldwide and are already widely recognised as doing so. However, 55% of the global NCD burden arises from other NCDs, which tend to be ignored in terms of premature mortality and quality of life reduction. Here, experts in some of these 'forgotten NCDs' review the clinical impact of these diseases along with the consequences of their ignoring their medical importance, and discuss ways in which they can be given higher global health priority in order to decrease the growing burden of disease and disability. PMID:25604462

  19. Dreamweaver and Flash: Strategies for Updating Communication Systems Instruction

    ERIC Educational Resources Information Center

    Hill, Roger B.

    2004-01-01

    The rate of innovation and change impacting technology education communication systems instruction has been vigorous for longer than most people can remember. Trends have included analog systems being replaced by digital systems, integration of networks and system devices, computerization, optical storage, and wireless transmission of data. The…

  20. 42 CFR 70.3 - All communicable diseases.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false All communicable diseases. 70.3 Section 70.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.3 All communicable diseases. A person who has a communicable disease in...

  1. 42 CFR 70.3 - All communicable diseases.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false All communicable diseases. 70.3 Section 70.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.3 All communicable diseases. A person who has a communicable disease in...

  2. 42 CFR 70.3 - All communicable diseases.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false All communicable diseases. 70.3 Section 70.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.3 All communicable diseases. A person who has a communicable disease in...

  3. 42 CFR 70.3 - All communicable diseases.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false All communicable diseases. 70.3 Section 70.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.3 All communicable diseases. A person who has a communicable disease in...

  4. 42 CFR 70.3 - All communicable diseases.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false All communicable diseases. 70.3 Section 70.3 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.3 All communicable diseases. A person who has a communicable disease in...

  5. Central Venous Disease in Hemodialysis Patients: An Update

    SciTech Connect

    Modabber, Milad; Kundu, Sanjoy

    2013-08-01

    Central venous occlusive disease (CVD) is a common concern among the hemodialysis patient population, with the potential to cause significant morbidity. Endovascular management of CVD, comprising percutaneous balloon angioplasty and bare-metal stenting, has been established as a safe alternative to open surgical treatment. However, these available treatments have poor long-term patency, requiring close surveillance and multiple repeat interventions. Recently, covered stents have been proposed and their efficacy assessed for the treatment of recalcitrant central venous stenosis and obstruction. Moreover, newly proposed algorithms for the surgical management of CVD warrant consideration. Here, we seek to provide an updated review of the current literature on the various treatment modalities for CVD.

  6. Health systems, communicable diseases and integration.

    PubMed

    Shigayeva, Altynay; Atun, Rifat; McKee, Martin; Coker, Richard

    2010-11-01

    The HIV/AIDS, tuberculosis and malaria pandemics pose substantial challenges globally and to health systems in the countries they affect. This demands an institutional approach that can integrate disease control programmes within health and social care systems. Whilst integration is intuitively appealing, evidence of its benefits remains uncertain and evaluation is beset by lack of a common understanding of what it involves. The aim of this paper is to better define integration in health systems relevant to communicable disease control. We conducted a critical review of published literature on concepts, definitions, and analytical and methodological approaches to integration as applied to health system responses to communicable disease. We found that integration is understood and pursued in many ways in different health systems. We identified a variety of typologies that relate to three fundamental questions associated with integration: (1) why is integration a goal (that is, what are the driving forces for integration); (2) what structures and/or functions at different levels of health system are affected by integration (or the lack of); and (3) how does integration influence interactions between health system components or stakeholders. The frameworks identified were evaluated in terms of these questions, as well as the extent to which they took account of health system characteristics, the wider contextual environment in which health systems sit, and the roles of key stakeholders. We did not find any one framework that explicitly addressed all of these three questions and therefore propose an analytical framework to help address these questions, building upon existing frameworks and extending our conceptualization of the 'how' of integration to identify a continuum of interactions that extends from no interactions, to partial integration that includes linkage and coordination, and ultimately to integration. We hope that our framework may provide a basis for

  7. Acoustic communication in insect disease vectors

    PubMed Central

    Vigoder, Felipe de Mello; Ritchie, Michael Gordon; Gibson, Gabriella; Peixoto, Alexandre Afranio

    2013-01-01

    Acoustic signalling has been extensively studied in insect species, which has led to a better understanding of sexual communication, sexual selection and modes of speciation. The significance of acoustic signals for a blood-sucking insect was first reported in the XIX century by Christopher Johnston, studying the hearing organs of mosquitoes, but has received relatively little attention in other disease vectors until recently. Acoustic signals are often associated with mating behaviour and sexual selection and changes in signalling can lead to rapid evolutionary divergence and may ultimately contribute to the process of speciation. Songs can also have implications for the success of novel methods of disease control such as determining the mating competitiveness of modified insects used for mass-release control programs. Species-specific sound “signatures” may help identify incipient species within species complexes that may be of epidemiological significance, e.g. of higher vectorial capacity, thereby enabling the application of more focussed control measures to optimise the reduction of pathogen transmission. Although the study of acoustic communication in insect vectors has been relatively limited, this review of research demonstrates their value as models for understanding both the functional and evolutionary significance of acoustic communication in insects. PMID:24473800

  8. Noise and communication: a three-year update.

    PubMed

    Brammer, Anthony J; Laroche, Chantal

    2012-01-01

    Noise is omnipresent and impacts us all in many aspects of daily living. Noise can interfere with communication not only in industrial workplaces, but also in other work settings (e.g. open-plan offices, construction, and mining) and within buildings (e.g. residences, arenas, and schools). The interference of noise with communication can have significant social consequences, especially for persons with hearing loss, and may compromise safety (e.g. failure to perceive auditory warning signals), influence worker productivity and learning in children, affect health (e.g. vocal pathology, noise-induced hearing loss), compromise speech privacy, and impact social participation by the elderly. For workers, attempts have been made to: 1) Better define the auditory performance needed to function effectively and to directly measure these abilities when assessing Auditory Fitness for Duty, 2) design hearing protection devices that can improve speech understanding while offering adequate protection against loud noises, and 3) improve speech privacy in open-plan offices. As the elderly are particularly vulnerable to the effects of noise, an understanding of the interplay between auditory, cognitive, and social factors and its effect on speech communication and social participation is also critical. Classroom acoustics and speech intelligibility in children have also gained renewed interest because of the importance of effective speech comprehension in noise on learning. Finally, substantial work has been made in developing models aimed at better predicting speech intelligibility. Despite progress in various fields, the design of alarm signals continues to lag behind advancements in knowledge. This summary of the last three years' research highlights some of the most recent issues for the workplace, for older adults, and for children, as well as the effectiveness of warning sounds and models for predicting speech intelligibility. Suggestions for future work are also discussed

  9. Updates in vaccination: Recommendations for adult inflammatory bowel disease patients

    PubMed Central

    Chaudrey, Khadija; Salvaggio, Michelle; Ahmed, Aftab; Mahmood, Sultan; Ali, Tauseef

    2015-01-01

    Treatment regimens for inflammatory bowel disease (IBD) incorporate the use of a variety of immunosuppressive agents that increase the risk of infections. Prevention of many of these infections can be achieved by the timely and judicious use of vaccinations. IBD patients tend to be under-immunized. Some of the contributing factors are lack of awareness regarding the significance of vaccinating IBD patients, misperception about safety of vaccinations in immunocompromised patients, ambiguity about the perceived role of the gastroenterologist in contrast to the primary care physician and unavailability of vaccination guidelines focused on IBD population. In general, immunocompetent IBD patients can be vaccinated using standard vaccination recommendations. However there are special considerations for IBD patients receiving immunosuppressive therapy, IBD travelers and pregnant women with IBD. This review discusses current vaccination recommendations with updates for adult IBD patients. Centers for Disease Control and Prevention 2013 vaccination guidelines with 2014 updates and the Advisory Committee on Immunization Practices recommendations have been highlighted as a primary source of recommendations. PMID:25805924

  10. Treatment of Nongout Joint Deposition Diseases: An Update

    PubMed Central

    Richette, Pascal; Flipo, René-Marc

    2014-01-01

    This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson's disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators' effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson's disease. NSAIDs should be avoided because of the liver affection they may worsen. PMID:24895535

  11. Treatment of nongout joint deposition diseases: an update.

    PubMed

    Pascart, Tristan; Richette, Pascal; Flipo, René-Marc

    2014-01-01

    This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson's disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators' effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson's disease. NSAIDs should be avoided because of the liver affection they may worsen. PMID:24895535

  12. The Right Ventricle: Biologic Insights and Response to Disease: Updated

    PubMed Central

    Walker, Lori A; Buttrick, Peter M

    2013-01-01

    Despite ample evidence that right ventricular function is a critical determinant of the clinical response to a spectrum of cardiovascular diseases, there has been only a limited analysis of the unique and distinguishing physiologic properties of the RV under normal circumstances and in response to pathologic insults. This knowledge deficit is increasingly acknowledged. This review highlights some of these features and underscores the fact that rational therapy in RV failure needs to acknowledge its unique physiology and ought to be chamber specific. That is proven therapies for LV dysfunction do not necessarily apply to the RV. The updated version of this review now acknowledges recent advances in the understanding of metabolic, inflammatory and gender-specific influences on the right ventricle. PMID:23092273

  13. Center for Disease Control's Diethylstilbestrol Update: a case for effective operationalization of messaging in social marketing practice.

    PubMed

    Mattson, Marifran; Basu, Ambar

    2010-07-01

    The Center for Disease Control's (CDC) Diethylstilbestrol (DES) Update, a campaign to educate people who may have been exposed to the drug DES, is framed on the premises of the social marketing model, namely formative research, audience segmentation, product, price, placement, promotion, and campaign evaluation. More than that, the campaign takes a critical step in extending the social marketing paradigm by highlighting the need to situate the messaging process at the heart of any health communication campaign. This article uses CDC's DES Update as a case study to illustrate an application of a message development tool within social marketing. This tool promotes the operationalization of messaging within health campaigns. Ultimately, the goal of this project is to extend the social marketing model and provide useful theoretical guidance to health campaign practitioners on how to accomplish stellar communication within a social marketing campaign. PMID:19116422

  14. To Your Health: NLM update transcript - Endometriosis linked to heart disease

    MedlinePlus

    ... transcript052316.html To Your Health: NLM update Transcript Endometriosis linked to heart disease : 05/23/2016 To ... use MedlinePlus to follow up on weekly topics. Endometriosis significantly increases the risk of developing heart disease ...

  15. To Your Health: NLM update transcript - Salt linked to heart disease among CKD patients

    MedlinePlus

    ... transcript072516.html To Your Health: NLM update Transcript Salt linked to heart disease among CKD patients : 07/ ... kidney disease - and eat a diet high in salt - comparatively increase their odds of a heart attack ...

  16. Communicable Diseases Report, NSW, November and December 2008.

    PubMed

    2009-01-01

    For updated information, including data and facts on specific diseases, visit www.health.nsw.gov.au and click on Infectious Diseases or access the site directly at: http://www.health.nsw.gov.au/publichealth/infectious/index.asp. PMID:19261214

  17. 42 CFR 70.5 - Certain communicable diseases; special requirements.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Certain communicable diseases; special requirements. 70.5 Section 70.5 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES QUARANTINE, INSPECTION, LICENSING INTERSTATE QUARANTINE § 70.5 Certain communicable diseases; special requirements. The following provisions...

  18. Psychiatric aspects of Parkinson's disease--an update.

    PubMed

    Schrag, Anette

    2004-07-01

    In patients with Parkinson's disease (PD) disturbances of mental state constitute some of the most difficult treatment challenges of advanced disease, often limiting effective treatment of motor symptoms and leading to increased disability and poor quality of life. This article provides an update on the current knowledge of these complications and the use of old and new drugs in their management. Mental state alterations in PD include depression, anxiety, cognitive impairment, apathy, and treatment-related psychiatric symptoms. The latter range from vivid dreams and hallucinations to delusions, manic symptoms, hypersexuality, dopamine dysregulation syndrome and delirium. While some of these symptoms may be alleviated by anti-parkinsonian medication, especially if they are off-period related, treatment-related phenomena are usually exacerbated by increasing the number or dosage of antiparkinsonian drugs. Elimination of exacerbating factors and simplification of drug regimes are the first and most important steps in improvement of such symptoms. However, the advent of atypical antipsychotics such as clozapine has dramatically helped the management of treatment-related psychiatric complications in PD. In patients with dementia associated with PD cognitive functioning and behavioural problems appear to respond to cholinesterase inhibitors, such as rivastigmine or donepezil. Depression is a common problem in early as well as advanced PD, and selective serotonin reuptake inhibitors, reboxetine, and tricyclic antidepressants have been reported to be effective and well tolerated antidepressants. Randomised, controlled studies are required to assess the differential efficacy and tolerability of antidepressants in patients with PD, including the newer antidepressants with serotonergic and noradrenergic properties. PMID:15258780

  19. Some Aspects of Communicable and Non-Communicable Diseases in Pacific Island Countries

    ERIC Educational Resources Information Center

    Gani, Azmat

    2009-01-01

    This study provides an overview of the incidence of the communicable and non-communicable diseases in Pacific Island countries. Available health statistics confirms that children continue to die annually due to neonatal causes, diarrhoeal diseases, pneumonia and measles. The adult population in several countries reveals presence and emergence of…

  20. Recommendations for kidney disease guideline updating: a report by the KDIGO Methods Committee.

    PubMed

    Uhlig, Katrin; Berns, Jeffrey S; Carville, Serena; Chan, Wiley; Cheung, Michael; Guyatt, Gordon H; Hart, Allyson; Lewis, Sandra Zelman; Tonelli, Marcello; Webster, Angela C; Wilt, Timothy J; Kasiske, Bertram L

    2016-04-01

    Updating rather than de novo guideline development now accounts for the majority of guideline activities for many guideline development organizations, including Kidney Disease: Improving Global Outcomes (KDIGO), an international kidney disease guideline development entity that has produced guidelines on kidney diseases since 2008. Increasingly, guideline developers are moving away from updating at fixed intervals in favor of more flexible approaches that use periodic expert assessment of guideline currency (with or without an updated systematic review) to determine the need for updating. Determining the need for guideline updating in an efficient, transparent, and timely manner is challenging, and updating of systematic reviews and guidelines is labor intensive. Ideally, guidelines should be updated dynamically when new evidence indicates a need for a substantive change in the guideline based on a priori criteria. This dynamic updating (sometimes referred to as a living guideline model) can be facilitated with the use of integrated electronic platforms that allow updating of specific recommendations. This report summarizes consensus-based recommendations from a panel of guideline methodology professionals on how to keep KDIGO guidelines up to date. PMID:26994574

  1. Disease Ontology 2015 update: An expanded and updated database of human diseases for linking biomedical knowledge through disease data

    SciTech Connect

    Kibbe, Warren A.; Arze, Cesar; Felix, Victor; Mitraka, Elvira; Bolton, Evan; Fu, Gang; Mungall, Christopher J.; Binder, Janos X.; Malone, James; Vasant, Drashtti; Parkinson, Helen; Schriml, Lynn M.

    2014-10-27

    The current version of the Human Disease Ontology (DO) (http://www.disease-ontology.org) database expands the utility of the ontology for the examination and comparison of genetic variation, phenotype, protein, drug and epitope data through the lens of human disease. DO is a biomedical resource of standardized common and rare disease concepts with stable identifiers organized by disease etiology. The content of DO has had 192 revisions since 2012, including the addition of 760 terms. Thirty-two percent of all terms now include definitions. DO has expanded the number and diversity of research communities and community members by 50+ during the past two years. These community members actively submit term requests, coordinate biomedical resource disease representation and provide expert curation guidance. Since the DO 2012 NAR paper, there have been hundreds of term requests and a steady increase in the number of DO listserv members, twitter followers and DO website usage. DO is moving to a multi-editor model utilizing Protégé to curate DO in web ontology language. In conclusion, this will enable closer collaboration with the Human Phenotype Ontology, EBI's Ontology Working Group, Mouse Genome Informatics and the Monarch Initiative among others, and enhance DO's current asserted view and multiple inferred views through reasoning.

  2. Disease Ontology 2015 update: An expanded and updated database of human diseases for linking biomedical knowledge through disease data

    DOE PAGESBeta

    Kibbe, Warren A.; Arze, Cesar; Felix, Victor; Mitraka, Elvira; Bolton, Evan; Fu, Gang; Mungall, Christopher J.; Binder, Janos X.; Malone, James; Vasant, Drashtti; et al

    2014-10-27

    The current version of the Human Disease Ontology (DO) (http://www.disease-ontology.org) database expands the utility of the ontology for the examination and comparison of genetic variation, phenotype, protein, drug and epitope data through the lens of human disease. DO is a biomedical resource of standardized common and rare disease concepts with stable identifiers organized by disease etiology. The content of DO has had 192 revisions since 2012, including the addition of 760 terms. Thirty-two percent of all terms now include definitions. DO has expanded the number and diversity of research communities and community members by 50+ during the past two years.more » These community members actively submit term requests, coordinate biomedical resource disease representation and provide expert curation guidance. Since the DO 2012 NAR paper, there have been hundreds of term requests and a steady increase in the number of DO listserv members, twitter followers and DO website usage. DO is moving to a multi-editor model utilizing Protégé to curate DO in web ontology language. In conclusion, this will enable closer collaboration with the Human Phenotype Ontology, EBI's Ontology Working Group, Mouse Genome Informatics and the Monarch Initiative among others, and enhance DO's current asserted view and multiple inferred views through reasoning.« less

  3. Disease Ontology 2015 update: an expanded and updated database of human diseases for linking biomedical knowledge through disease data.

    PubMed

    Kibbe, Warren A; Arze, Cesar; Felix, Victor; Mitraka, Elvira; Bolton, Evan; Fu, Gang; Mungall, Christopher J; Binder, Janos X; Malone, James; Vasant, Drashtti; Parkinson, Helen; Schriml, Lynn M

    2015-01-01

    The current version of the Human Disease Ontology (DO) (http://www.disease-ontology.org) database expands the utility of the ontology for the examination and comparison of genetic variation, phenotype, protein, drug and epitope data through the lens of human disease. DO is a biomedical resource of standardized common and rare disease concepts with stable identifiers organized by disease etiology. The content of DO has had 192 revisions since 2012, including the addition of 760 terms. Thirty-two percent of all terms now include definitions. DO has expanded the number and diversity of research communities and community members by 50+ during the past two years. These community members actively submit term requests, coordinate biomedical resource disease representation and provide expert curation guidance. Since the DO 2012 NAR paper, there have been hundreds of term requests and a steady increase in the number of DO listserv members, twitter followers and DO website usage. DO is moving to a multi-editor model utilizing Protégé to curate DO in web ontology language. This will enable closer collaboration with the Human Phenotype Ontology, EBI's Ontology Working Group, Mouse Genome Informatics and the Monarch Initiative among others, and enhance DO's current asserted view and multiple inferred views through reasoning. PMID:25348409

  4. Disease Ontology 2015 update: an expanded and updated database of human diseases for linking biomedical knowledge through disease data

    PubMed Central

    Kibbe, Warren A.; Arze, Cesar; Felix, Victor; Mitraka, Elvira; Bolton, Evan; Fu, Gang; Mungall, Christopher J.; Binder, Janos X.; Malone, James; Vasant, Drashtti; Parkinson, Helen; Schriml, Lynn M.

    2015-01-01

    The current version of the Human Disease Ontology (DO) (http://www.disease-ontology.org) database expands the utility of the ontology for the examination and comparison of genetic variation, phenotype, protein, drug and epitope data through the lens of human disease. DO is a biomedical resource of standardized common and rare disease concepts with stable identifiers organized by disease etiology. The content of DO has had 192 revisions since 2012, including the addition of 760 terms. Thirty-two percent of all terms now include definitions. DO has expanded the number and diversity of research communities and community members by 50+ during the past two years. These community members actively submit term requests, coordinate biomedical resource disease representation and provide expert curation guidance. Since the DO 2012 NAR paper, there have been hundreds of term requests and a steady increase in the number of DO listserv members, twitter followers and DO website usage. DO is moving to a multi-editor model utilizing Protégé to curate DO in web ontology language. This will enable closer collaboration with the Human Phenotype Ontology, EBI's Ontology Working Group, Mouse Genome Informatics and the Monarch Initiative among others, and enhance DO's current asserted view and multiple inferred views through reasoning. PMID:25348409

  5. To Your Health: NLM update transcript - Preventing disease spillover from animals to humans

    MedlinePlus

    ... update Transcript Preventing disease spillover from animals to humans : 07/11/2016 To use the sharing features ... accessible by entering the terms 'PREDICT (in all capital letters) - and UC Davis' in any search engine. ...

  6. INFECTIOUS AND COMMUNICABLE DISEASES. RESOURCE MATERIAL FOR TEACHERS.

    ERIC Educational Resources Information Center

    ABRAMS, IRVING; HAWKINS, BARBARA A.

    DESCRIPTIONS OF TWENTY-FIVE INFECTIOUS AND COMMUNICABLE DISEASES INCLUDE CAUSES, SYMPTOMS, EFFECTS, TREATMENT AND PREVENTIVE MEASURES. IT HAS BEEN DISCOVERED THAT RESPIRATORY AILMENTS OF A COMMUNICABLE NATURE ARE THE MOST COMMON CAUSE OF ABSENTEEISM AMONG STUDENTS. INFORMATION IS INTENDED FOR THE USE OF TEACHERS OF HEALTH EDUCATION OR OTHER…

  7. Non-communicable diseases in the Arab world.

    PubMed

    Rahim, Hanan F Abdul; Sibai, Abla; Khader, Yousef; Hwalla, Nahla; Fadhil, Ibtihal; Alsiyabi, Huda; Mataria, Awad; Mendis, Shanthi; Mokdad, Ali H; Husseini, Abdullatif

    2014-01-25

    According to the results of the Global Burden of Disease Study 2010, the burden of non-communicable diseases (cardiovascular disease, cancer, chronic lung diseases, and diabetes) in the Arab world has increased, with variations between countries of different income levels. Behavioural risk factors, including tobacco use, unhealthy diets, and physical inactivity are prevalent, and obesity in adults and children has reached an alarming level. Despite epidemiological evidence, the policy response to non-communicable diseases has been weak. So far, Arab governments have not placed a sufficiently high priority on addressing the high prevalence of non-communicable diseases, with variations in policies between countries and overall weak implementation. Cost-effective and evidence-based prevention and treatment interventions have already been identified. The implementation of these interventions, beginning with immediate action on salt reduction and stricter implementation of tobacco control measures, will address the rise in major risk factors. Implementation of an effective response to the non-communicable-disease crisis will need political commitment, multisectoral action, strengthened health systems, and continuous monitoring and assessment of progress. Arab governments should be held accountable for their UN commitments to address the crisis. Engagement in the global monitoring framework for non-communicable diseases should promote accountability for effective action. The human and economic burden leaves no room for inaction. PMID:24452044

  8. Some observations on the communicable diseases as public health problems

    PubMed Central

    Cockburn, W. Chas.; Assaad, F.

    1973-01-01

    Notwithstanding the deficiencies in reporting, an attempt is made in the present study to provide some useful information on the importance of the communicable diseases in the world over the decade 1957-58 to 1967-68. In this period health authorities in the developing countries almost invariably reported communicable diseases as their main public health problems, whereas, in the developed countries, the only communicable diseases still considered as public health problems were tuberculosis, venereal diseases, and hepatitis. In the developing countries nearly half of the principal causes of death were communicable diseases, and in both the developing and developed countries respiratory infections ranked high on the list. Deaths from tuberculosis have come down markedly in the developed countries and to a lesser degree in the developing countries. Infectious diseases of childhood are no longer a problem in the developed countries but are still important in the developing countries. The communicable diseases of importance to the developing countries may be divided into two groups—those requiring long-term development for their solution (e.g., dysentery, typhoid fever, parasitic diseases, and respiratory infections) and those that would respond rapidly to control by such methods as immunization. PMID:4545151

  9. Learning Rate Updating Methods Applied to Adaptive Fuzzy Equalizers for Broadband Power Line Communications

    NASA Astrophysics Data System (ADS)

    Ribeiro, Moisés V.

    2004-12-01

    This paper introduces adaptive fuzzy equalizers with variable step size for broadband power line (PL) communications. Based on delta-bar-delta and local Lipschitz estimation updating rules, feedforward, and decision feedback approaches, we propose singleton and nonsingleton fuzzy equalizers with variable step size to cope with the intersymbol interference (ISI) effects of PL channels and the hardness of the impulse noises generated by appliances and nonlinear loads connected to low-voltage power grids. The computed results show that the convergence rates of the proposed equalizers are higher than the ones attained by the traditional adaptive fuzzy equalizers introduced by J. M. Mendel and his students. Additionally, some interesting BER curves reveal that the proposed techniques are efficient for mitigating the above-mentioned impairments.

  10. Research update: Avian Disease and Oncology Laboratory avian tumor viruses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Genomics and Immunogenetics Use of genomics to identify QTL, genes, and proteins associated with resistance to Marek’s disease. Marek’s disease (MD), a lymphoproliferative disease caused by the highly oncogenic herpesvirus Marek's disease virus (MDV), continues to be a major disease concern to the p...

  11. The burden of non-communicable diseases in South Africa.

    PubMed

    Mayosi, Bongani M; Flisher, Alan J; Lalloo, Umesh G; Sitas, Freddy; Tollman, Stephen M; Bradshaw, Debbie

    2009-09-12

    15 years after its first democratic election, South Africa is in the midst of a profound health transition that is characterised by a quadruple burden of communicable, non-communicable, perinatal and maternal, and injury-related disorders. Non-communicable diseases are emerging in both rural and urban areas, most prominently in poor people living in urban settings, and are resulting in increasing pressure on acute and chronic health-care services. Major factors include demographic change leading to a rise in the proportion of people older than 60 years, despite the negative effect of HIV/AIDS on life expectancy. The burden of these diseases will probably increase as the roll-out of antiretroviral therapy takes effect and reduces mortality from HIV/AIDS. The scale of the challenge posed by the combined and growing burden of HIV/AIDS and non-communicable diseases demands an extraordinary response that South Africa is well able to provide. Concerted action is needed to strengthen the district-based primary health-care system, to integrate the care of chronic diseases and management of risk factors, to develop a national surveillance system, and to apply interventions of proven cost-effectiveness in the primary and secondary prevention of such diseases within populations and health services. We urge the launching of a national initiative to establish sites of service excellence in urban and rural settings throughout South Africa to trial, assess, and implement integrated care interventions for chronic infectious and non-communicable diseases. PMID:19709736

  12. Communicable Disease Reporting Systems in the World: A Systematic Review Article

    PubMed Central

    JANATI, Ali; HOSSEINY, Mozhgan; GOUYA, Mohammad Mehdi; MORADI, Ghobad; GHADERI, Ebrahim

    2015-01-01

    Background: Communicable disease reporting and surveillance system has poor infrastructure and supporters in most of countries. Its quality improvement is a challenge and requires an accurate and efficient care and reporting systems at all levels to achieve new and simple models. This study evaluates reporting systems of communicable diseases using systematic review. Methods: This was a systematic review study. For data collection, we used the following database and search engines: Proquest, Science direct, Pub MED, Scopes, Springer, and EBESCO. For Persian databases, we used SID, Iranmedex and Magiran. Our key words were “Communicable Diseases”, “Notifiable Disease”, “Disease Notification”, “Reporting System”,” Surveillance Systems” and “evaluation”. Two independent researchers reviewed the resources and the results were classified in different domains. Results: From 1889 cases, only 66 resources were studied. The results were classified in several domains, including those who were reporting, reporting methods and procedures, responsibilities and reporting system characteristics, problems and solutions of the report, the reporting process, and receptor level. Conclusion: Disease-reporting system has similar problems in all parts of the world. Change, improve, update and continuous monitoring of the reporting system are very important. Although the reporting process can vary in different regions, but being perfect and timely are important principles in system design. Detailed explanations of tasks and providing appropriate instructions are the most important points to integrate an efficient reporting system. PMID:26744702

  13. Research update: Avian Disease and Oncology Laboratory avian tumor viruses

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Genomics and Immunogenetics Marek’s disease (MD), a lymphoproliferative disease caused by the highly oncogenic herpesvirus Marek's disease virus (MDV), continues to be a major disease concern to the poultry industry. The fear of MD is further enhanced by unpredictable vaccine breaks that result in ...

  14. Primary Immunodeficiency Diseases: An Update on the Classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency

    PubMed Central

    Al-Herz, Waleed; Bousfiha, Aziz; Casanova, Jean-Laurent; Chapel, Helen; Conley, Mary Ellen; Cunningham-Rundles, Charlotte; Etzioni, Amos; Fischer, Alain; Franco, Jose Luis; Geha, Raif S.; Hammarström, Lennart; Nonoyama, Shigeaki; Notarangelo, Luigi Daniele; Ochs, Hans Dieter; Puck, Jennifer M.; Roifman, Chaim M.; Seger, Reinhard; Tang, Mimi L. K.

    2011-01-01

    We report the updated classification of primary immunodeficiency diseases, compiled by the ad hoc Expert Committee of the International Union of Immunological Societies. As compared to the previous edition, more than 15 novel disease entities have been added in the updated version. For each disorders, the key clinical and laboratory features are provided. This updated classification is meant to help in the diagnostic approach to patients with these diseases. PMID:22566844

  15. Policies for control of communicable disease in day care centres.

    PubMed Central

    Chouillet, A; Maguire, H; Kurtz, Z

    1992-01-01

    A survey was carried out to identify the availability and quality of guidelines for the prevention and control of communicable disease and procedures in use in child day care centres within the South West Thames Regional Health Authority. A sample of 50 day care centres was investigated including those funded by social services and privately funded day care centres. Policies for the prevention and control of communicable disease for children and staff showed a wide variation between different centres. Exclusion criteria were unclear especially in relation to carriers of the hepatitis B virus and HIV positive children. Channels for reporting and seeking advice were inconsistent. It is recommended that clear and up to date written guidelines on the prevention and control of communicable diseases should be available in all day care centres with clear indications of good practice and channels for reporting and advice. It is desirable that guidelines are agreed by the different health and local authorities throughout the region. PMID:1417054

  16. Update on viral diseases of the equine respiratory tract.

    PubMed

    Gilkerson, James R; Bailey, Kirsten E; Diaz-Méndez, Andrés; Hartley, Carol A

    2015-04-01

    Many viral agents have been associated with respiratory disease of the horse. The most important viral causes of respiratory disease in horses are equine influenza and the equine alphaherpesviruses. Agents such as equine viral arteritis virus, African horse sickness virus, and Hendra virus establish systemic infections. Clinical signs of disease resulting from infection with these agents can manifest as respiratory disease, but the respiratory tract is not the major body system affected by these viruses. Treatment of viral respiratory disease is generally limited to supportive therapies, whereas targeted antimicrobial therapy is effective in cases of bacterial infection. PMID:25648568

  17. Glycogen storage disease types I and II: treatment updates.

    PubMed

    Koeberl, D D; Kishnani, P S; Chen, Y T

    2007-04-01

    Prior to 2006 therapy for glycogen storage diseases consisted primarily of dietary interventions, which in the case of glycogen storage disease (GSD) type II (GSD II; Pompe disease) remained essentially palliative. Despite improved survival and growth, long-term complications of GSD type I (GSD I) have not responded to dietary therapy with uncooked cornstarch or continuous gastric feeding. The recognized significant risk of renal disease and liver malignancy in GSD I has prompted efforts towards curative therapy, including organ transplantation, in those deemed at risk. Results of clinical trials in infantile Pompe disease with alglucosidase alfa (Myozyme) showed prolonged survival reversal of cardiomyopathy, and motor gains. This resulted in broad label approval of Myozyme for Pompe disease in 2006. Furthermore, the development of experimental therapies, such as adeno-associated virus (AAV) vector-mediated gene therapy, holds promise for the availability of curative therapy in GSD I and GSD II/Pompe disease in the future. PMID:17308886

  18. Glycogen storage disease types I and II: Treatment updates

    PubMed Central

    Kishnani, P. S.; Chen, Y. T.

    2009-01-01

    Summary Prior to 2006 therapy for glycogen storage diseases consisted primarily of dietary interventions, which in the case of glycogen storage disease (GSD) type II (GSD II; Pompe disease) remained essentially palliative. Despite improved survival and growth, long-term complications of GSD type I (GSD I) have not responded to dietary therapy with uncooked cornstarch or continuous gastric feeding. The recognized significant risk of renal disease and liver malignancy in GSD I has prompted efforts towards curative therapy, including organ transplantation, in those deemed at risk. Results of clinical trials in infantile Pompe disease with alglucosidase alfa (Myozyme) showed prolonged survival reversal of cardiomyopathy, and motor gains. This resulted in broad label approval of Myozyme for Pompe disease in 2006. Furthermore, the development of experimental therapies, such as adeno-associated virus (AAV) vector-mediated gene therapy, holds promise for the availability of curative therapy in GSD I and GSD II/Pompe disease in the future. PMID:17308886

  19. Celiac Disease and Overweight in Children: An Update

    PubMed Central

    Diamanti, Antonella; Capriati, Teresa; Basso, Maria Sole; Panetta, Fabio; Di Ciommo Laurora, Vincenzo Maria; Bellucci, Francesca; Cristofori, Fernanda; Francavilla, Ruggiero

    2014-01-01

    The clinical presentation of celiac disease in children is very variable and differs with age. The prevalence of atypical presentations of celiac disease has increased over the past 2 decades. Several studies in adults and children with celiac disease indicate that obesity/overweight at disease onset is not unusual. In addition, there is a trend towards the development of overweight/obesity in celiac patients who strictly comply with a gluten-free diet. However, the pathogenesis and clinical implications of the coexistence of classic malabsorption (e.g., celiac disease) and overweight/obesity remain unclear. This review investigated the causes and main clinical factors associated with overweight/obesity at the diagnosis of celiac disease and clarified whether gluten withdrawal affects the current trends of the nutritional status of celiac disease patients. PMID:24451308

  20. Performance Assessment of Communicable Disease Surveillance in Disasters: A Systematic Review

    PubMed Central

    Babaie, Javad; Ardalan, Ali; Vatandoost, Hasan; Goya, Mohammad Mehdi; Akbarisari, Ali

    2015-01-01

    Background: This study aimed to identify the indices and frameworks that have been used to assess the performance of communicable disease surveillance (CDS) in response to disasters and other emergencies, including infectious disease outbreaks. Method: In this systematic review, PubMed, Google Scholar, Scopus, ScienceDirect, ProQuest databases and grey literature were searched until the end of 2013. All retrieved titles were examined in accordance with inclusion criteria. Abstracts of the relevant titles were reviewed and eligible abstracts were included in a list for data abstraction. Finally, the study variables were extracted. Results: Sixteen articles and one book were found relevant to our study objectives. In these articles, 31 criteria and 35 indicators were used or suggested for the assessment/evaluation of the performance of surveillance systems in disasters. The Centers for Disease Control (CDC) updated guidelines for the evaluation of public health surveillance systems were the most widely used. Conclusion: Despite the importance of performance assessment in improving CDS in response to disasters, there is a lack of clear and accepted frameworks. There is also no agreement on the use of existing criteria and indices. The only relevant framework is the CDC guideline, which is a common framework for assessing public health surveillance systems as a whole. There is an urgent need to develop appropriate frameworks, criteria, and indices for specifically assessing the performance of CDS in response to disasters and other emergencies, including infectious diseases outbreaks. Key words: Disasters, Emergencies, Communicable Diseases, Surveillance System, Performance Assessment PMID:25774323

  1. 2013 Update on Celiac Disease and Eosinophilic Esophagitis

    PubMed Central

    Pellicano, Rinaldo; De Angelis, Claudio; Ribaldone, Davide Giuseppe; Fagoonee, Sharmila; Astegiano, Marco

    2013-01-01

    Celiac disease is a chronic, immune-mediated disorder, characterized by small intestinal inflammation and villous atrophy after the ingestion of gluten by genetically susceptible individuals. Several extraintestinal manifestations have been associated to celiac disease. Eosinophilic esophagitis is a primary disorder of the esophagus characterized by upper gastrointestinal symptoms, absence of gastroesophageal reflux disease and more than 15 eosinophils per high-power field in biopsy specimens. Both celiac disease and eosinophilic esophagitis are caused by aberrant, but distinct, immune responses to ingested antigens and can be responsive to restricted food intake. The aim of this review is to assess whether there is an association between these two pathologies. In the majority of the studies examined, including the studies in pediatric population, the prevalence of eosinophilic esophagitis in subjects with celiac disease was about 10-times that of the general population. We suggest searching for eosinophilic esophagitis in all children undergoing endoscopy for suspicious celiac disease. PMID:23974065

  2. Drug-induced valvular heart disease: an update.

    PubMed

    Andrejak, Michel; Tribouilloy, Christophe

    2013-05-01

    Numerous reports have shown an unquestionable association between fibrotic valve disease and the following drugs: ergot alkaloids (such as methysergide and ergotamine), ergot-derived dopaminergic agonists (such as pergolide and cabergoline) and drugs metabolized into norfenfluramine (such as fenfluramine, dexfenfluramine and benfluorex). This review focuses on different aspects of drug-induced valvular heart disease: historical background; echocardiographic features; different drugs recognized as being responsible for valvular heart disease; and pathophysiology. PMID:23769407

  3. Update and new approaches in the treatment of Castleman disease

    PubMed Central

    Chan, Kah-Lok; Lade, Stephen; Prince, H Miles; Harrison, Simon J

    2016-01-01

    First described 60 years ago, Castleman disease comprises a rare and heterogeneous cluster of disorders, characterized by lymphadenopathy with unique histological features and associated with cytokine-driven constitutional symptoms and biochemical disturbances. Although unicentric Castleman disease is curable with complete surgical excision, its multicentric counterpart is a considerable therapeutic challenge. The recent development of biological agents, particularly monoclonal antibodies to interleukin-6 and its receptor, allow for more targeted disease-specific intervention that promises improved response rates and more durable disease control; however, further work is required to fill knowledge gaps in terms of underlying pathophysiology and to facilitate alternative treatment options for refractory cases. PMID:27536166

  4. Vaccination against Alzheimer disease: an update on future strategies.

    PubMed

    Fettelschoss, Antonia; Zabel, Franziska; Bachmann, Martin F

    2014-01-01

    Alzheimer disease is a devastating chronic disease without adequate therapy. More than 10 years ago, it was demonstrated in transgenic mouse models that vaccination may be a novel, disease-modifying therapy for Alzheimer. Subsequent clinical development has been a roller-coaster with some positive and many negative news. Here, we would like to summarize evidence that next generation vaccines optimized for old people and focusing on patients with mild disease stand a good chance to proof efficacious for the treatment of Alzheimer. PMID:24535580

  5. Intestinal Ultrasound in Rare Gastrointestinal Diseases, Update, Part 2.

    PubMed

    Dietrich, C F; Lembcke, B; Jenssen, C; Hocke, M; Ignee, A; Hollerweger, A

    2015-10-01

    Intestinal ultrasound has become an established and valid diagnostic method for inflammatory bowel disease, diverticulitis, appendicitis, bowel obstruction, perforation and intussusception. However, little is known about sonographic findings in other rarer intestinal diseases. Ultrasound may display the transformation of the intestinal wall from a normal to a pathological state both in inflammatory and neoplastic disease. Besides demonstrating the transmural aspect, it also shows the mesenteric reaction as well as complications such as fistula, abscesses, stenosis, or ileus. Furthermore, in some diseases intestinal ultrasound may serve as a diagnostic clue if typical patterns of the bowel wall and impaired peristalsis can be demonstrated. This may lead to an important reduction of invasive and expensive (follow-up) procedures. The information gained by ultrasound regarding intestinal disease, however, is as important and valid as e. g. in case of focal lesions of the liver. Serving as tertiary referral centers for a broad spectrum of intestinal diseases, we therefore report some aspects of ultrasound in patients with less often recognized diseases. The article is divided into two parts, the first focusing on examination techniques, infectious diseases and celiac sprue and the second on hereditary, vascular and neoplastic diseases and varia. PMID:26091002

  6. Research update on exotic and emerging poultry diseases

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Exotic and emerging diseases of poultry continue to be a threat to US poultry. Studies over the past year have demonstrated: 1) cooking poultry meat at minimum of 70C kills avian influenza (AI) and Newcastle disease (ND) viruses in a few seconds, 2) low pathogenicity (LP) AI viruses isolated from fr...

  7. An Update on Laboratory Diagnosis of Liver Inherited Diseases

    PubMed Central

    Elce, Ausilia; Amato, Felice

    2013-01-01

    Liver inherited diseases are a group of genetically determined clinical entities that appear with an early chronic liver involvement. They include Wilson's disease (hepatolenticular degeneration), hereditary hemochromatosis, and alpha-1-antitrypsin deficiency. In addition, cystic fibrosis, although it is not specifically a liver disease, may cause a severe liver involvement in a significant percentage of cases. For all these pathologies, the disease gene is known, and molecular analysis may contribute to the unequivocal diagnosis. This approach could avoid the patient invasive procedures and limit complications associated with a delay in diagnosis. We review liver inherited diseases on the basis of the genetic defect, focusing on the contribution of molecular analysis in the multistep diagnostic workup. PMID:24222913

  8. Update on the Management of Aspirin-Exacerbated Respiratory Disease.

    PubMed

    Buchheit, Kathleen M; Laidlaw, Tanya M

    2016-07-01

    Aspirin-exacerbated respiratory disease (AERD) is an adult-onset upper and lower airway disease consisting of eosinophilic nasal polyps, asthma, and respiratory reactions to cyclooxygenase 1 (COX-1) inhibitors. Management includes guideline-based treatment of asthma and sinus disease, avoidance of COX-1 inhibitors, and for some patients aspirin desensitization followed by high-dose aspirin therapy. Despite this, many patients have inadequately controlled symptoms and require multiple sinus surgeries. In this review, we discuss the current standard approaches to the management of AERD, and we introduce several therapeutics under development that may hold promise for the treatment of AERD. PMID:27126722

  9. Reporting of ethnicity in research on chronic disease: update

    PubMed Central

    O'Loughlin, J; Dugas, E; Maximova, K; Kishchuk, N

    2006-01-01

    This paper examines the inclusion of ethnicity and race as variables in current, leading edge research on chronic disease and its risk factors. Of 100 randomly selected original research articles published in high‐impact journals in 2005, 85% did not report either a definition of ethnicity or its conceptualisation in terms of theoretical reasoning, and 98% did not report an actual measurement item. Ethnicity and race remain non‐standardised and largely underdescribed variables in research on chronic disease. This represents an important loss of opportunity to articulate and test hypotheses about the mechanisms underlying ethnic group differences in chronic disease. PMID:17099093

  10. [Update on the use of PET radiopharmaceuticals in inflammatory disease].

    PubMed

    Martínez-Rodríguez, I; Carril, J M

    2013-01-01

    The use of molecular imaging with PET/CT technology using different radiotracers, especially the (18)F-FDG is currently spreading beyond the area of oncology, the most interest being placed on inflammatory and infectious diseases. This article presents a review of its contribution in different inflammatory conditions in the context of structural and conventional nuclear medicine imaging. Special emphasis is placed on the more significant diseases such as large-vessel vasculitis, sarcoidosis, rheumatoid arthritis and inflammatory bowel disease and the study of the atheroma plaque. PMID:24028819

  11. Update on Janus kinase antagonists in inflammatory bowel disease.

    PubMed

    Boland, Brigid S; Sandborn, William J; Chang, John T

    2014-09-01

    Janus kinase (JAK) inhibitors have emerged as a novel orally administered small-molecule therapy for the treatment of ulcerative colitis and possibly Crohn disease. These molecules are designed to selectively target the activity of specific JAKs and to offer a targeted mechanism of action without risk of immunogenicity. Based on data from clinical trials in rheumatoid arthritis and phase 2 studies in inflammatory bowel disease, tofacitinib and other JAK inhibitors are likely to become a new form of medical therapy for the treatment of inflammatory bowel disease. PMID:25110261

  12. Update on the Management of Aspirin-Exacerbated Respiratory Disease

    PubMed Central

    Laidlaw, Tanya M.

    2016-01-01

    Aspirin-exacerbated respiratory disease (AERD) is an adult-onset upper and lower airway disease consisting of eosinophilic nasal polyps, asthma, and respiratory reactions to cyclooxygenase 1 (COX-1) inhibitors. Management includes guideline-based treatment of asthma and sinus disease, avoidance of COX-1 inhibitors, and for some patients aspirin desensitization followed by high-dose aspirin therapy. Despite this, many patients have inadequately controlled symptoms and require multiple sinus surgeries. In this review, we discuss the current standard approaches to the management of AERD, and we introduce several therapeutics under development that may hold promise for the treatment of AERD. PMID:27126722

  13. Update on Berberine in Nonalcoholic Fatty Liver Disease

    PubMed Central

    Liu, Yang; Zhang, Li; Song, Haiyan

    2013-01-01

    Berberine (BBR), an active ingredient from nature plants, has demonstrated multiple biological activities and pharmacological effects in a series of metabolic diseases including nonalcoholic fatty liver disease (NAFLD). The recent literature points out that BBR may be a potential drug for NAFLD in both experimental models and clinical trials. This review highlights important discoveries of BBR in this increasing disease and addresses the relevant targets of BBR on NAFLD which links to insulin pathway, adenosine monophosphate-activated protein kinase (AMPK) signaling, gut environment, hepatic lipid transportation, among others. Developing nuanced understanding of the mechanisms will help to optimize more targeted and effective clinical application of BBR for NAFLD. PMID:23843872

  14. When Are High-Tech Communicators Effective in Parkinson's Disease?

    ERIC Educational Resources Information Center

    Ferriero, Giorgio; Caligari, Marco; Ronconi, Gianpaolo; Franchignoni, Franco

    2012-01-01

    This report describes a 63-year-old woman with Parkinson's disease showing loss of intelligibility of speech and severely impaired handwriting, despite undergoing physical and speech therapies. As the patient had sufficient residual motor abilities and adequate cognitive function and motivation, a computer-based communication aid with a software…

  15. JAK Kinases in Health and Disease: An Update

    PubMed Central

    Laurence, Arian; Pesu, Marko; Silvennoinen, Olli; O’Shea, John

    2012-01-01

    Janus kinases (Jaks) are critical signaling elements for a large subset of cytokines. As a consequence they play pivotal roles in the patho-physiology of many diseases including neoplastic and autoimmune diseases. Small molecule Jak inhibitors as therapeutic agents have become a reality and the palette of such inhibitors will likely expand. This review will summarize our current knowledge on these key enzymes and their associated pharmaceutical inhibitors. PMID:23028408

  16. [Non-communicable disease and their significance for dental medicine].

    PubMed

    Türp, Jens Christoph; Spranger, Heinz

    2016-01-01

    Non-communicable diseases (NCDs), such as cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes mellitus, are responsible for most deaths worldwide. In view of the rising prevalence and the long-term consequences of NCDs, their prevention is a public health priority. Dentistry plays an important role in this endeavor. Since oral and general diseases share common risk factors (e.g., poor oral hygiene, unhealthy diet, alcohol abuse, tobacco consumption, distress), preventive measures may target both oral diseases (e.g., dental caries, periodontal diseases, oral tumors) and medical NCDs. Consequently, dental medicine assumes an important medical and social role, which has been recognized by the World Health Organization and the General Assembly of the United Nations. To fulfill its mission successfully, consideration of the principles of evidence-based dentistry is a prerequisite. At the same time, the new development provides dentistry with the opportunity to critically reflect on its current and future orientation. PMID:27279058

  17. Update on persistent symptoms associated with Lyme disease

    PubMed Central

    Oliveira, Carlos R.; Shapiro, Eugene D.

    2015-01-01

    Purpose of review Lyme disease, caused by Borrelia burgdorferi, is the most common vector-borne illness in the United States. The pathogenesis, ecology, and epidemiology of Lyme disease have been well described, and antimicrobial treatment is very effective. There has been controversy about whether infection can persist and cause chronic symptoms despite treatment with antimicrobials. This review summarizes recent studies that have addressed this issue. Recent findings The pathogenesis of persistent nonspecific symptoms in patients who were treated for Lyme disease is poorly understood, and the validity of results of attempts to demonstrate persistent infection with B. burgdorferi has not been established. One study attempted to use xenodiagnosis to detect B. burgdorferi in patients who have been treated for Lyme disease. Another study assessed whether repeated episodes of erythema migrans were due to the same or different strains of B. burgdorferi. A possible cause of persistent arthritis in some treated patients is slow clearance of nonviable organisms that may lead to prolonged inflammation. The results of all of these studies continue to provide evidence that viable B. burgdorferi do not persist in patients who receive conventional antimicrobial treatment for Lyme disease. Summary Patients with persistent symptoms possibly associated with Lyme disease often provide a challenge for clinicians. Recent studies have provided additional evidence that viable B. burgdorferi do not persist after conventional treatment with antimicrobials, indicating that ongoing symptoms in patients who received conventional treatment for Lyme disease should not be attributed to persistent active infection. Video abstract http://links.lww.com/MOP/A23 PMID:25490690

  18. Milk, milk products, and disease free health: an updated overview.

    PubMed

    Nagpal, R; Behare, P V; Kumar, M; Mohania, D; Yadav, M; Jain, S; Menon, S; Parkash, O; Marotta, F; Minelli, E; Henry, C J K; Yadav, H

    2012-01-01

    The cow and its milk have been held sacred in the world since the dawn of human civilization. Indian ancient Vedic texts describe the virtues of milk and dairy products, as is authenticated by modern scientific principles and proofs. Therefore, milk has been considered as one of the most natural and highly nutritive part of a daily balanced diet. Currently, the integration of advanced scientific knowledge with traditional information is gaining incredible momentum toward developing the concept of potential therapeutic foods. Furthermore, new advances toward understanding the therapeutic roles of milk and milk products have also given a new impetus for unraveling the age old secrets of milk. At present, the best-known examples of therapeutic foods are fermented milk products containing health promoting probiotic bacteria. In the present article, we have tried to review the various aspects of the therapeutic nature of milk and fermented dairy products in a highly up-dated manner, and offer an in-depth insight into the development of targeted therapeutic future foods as per the requirements of consumers. PMID:22332596

  19. Personalized medicine: an update of salivary biomarkers for periodontal diseases.

    PubMed

    Korte, Dina L; Kinney, Janet

    2016-02-01

    This article provides an up-to-date review of the more robust salivary biomarkers, as well as of panels of combinatorial markers and periodontal pathogens, that reveal high sensitivity and specificity for enhancing clinical decision-making in periodontal disease progression, risk and diagnosis. Periodontal diseases are complex and require an inflammatory response to bacterial pathogens in a susceptible host to stimulate tissue destruction. When used alone, traditional clinical assessments provide a diagnosis of periodontitis only after the biologic onset of the disease process, and are unable to substantiate disease activity or future risk. New technologies are becoming available that are capable of measuring combinations of inflammatory cytokines and proteinases for rapid chair-side testing. Utilizing saliva to identify and measure specific phenotypes and host-derived mediators will allow highly individualized diagnosis, prognosis and treatments for periodontal diseases. This personalized medicine approach will strengthen the power of the clinical oral examination and medical history assessments, providing patients with evidence-based, targeted risk care. PMID:26662480

  20. Inflammation in neurodegenerative diseases – an update

    PubMed Central

    Amor, Sandra; Peferoen, Laura A N; Vogel, Daphne Y S; Breur, Marjolein; Valk, Paul; Baker, David; Noort, Johannes M

    2014-01-01

    Neurodegeneration, the progressive dysfunction and loss of neurons in the central nervous system (CNS), is the major cause of cognitive and motor dysfunction. While neuronal degeneration is well-known in Alzheimer's and Parkinson's diseases, it is also observed in neurotrophic infections, traumatic brain and spinal cord injury, stroke, neoplastic disorders, prion diseases, multiple sclerosis and amyotrophic lateral sclerosis, as well as neuropsychiatric disorders and genetic disorders. A common link between these diseases is chronic activation of innate immune responses including those mediated by microglia, the resident CNS macrophages. Such activation can trigger neurotoxic pathways leading to progressive degeneration. Yet, microglia are also crucial for controlling inflammatory processes, and repair and regeneration. The adaptive immune response is implicated in neurodegenerative diseases contributing to tissue damage, but also plays important roles in resolving inflammation and mediating neuroprotection and repair. The growing awareness that the immune system is inextricably involved in mediating damage as well as regeneration and repair in neurodegenerative disorders, has prompted novel approaches to modulate the immune system, although it remains whether these approaches can be used in humans. Additional factors in humans include ageing and exposure to environmental factors such as systemic infections that provide additional clues that may be human specific and therefore difficult to translate from animal models. Nevertheless, a better understanding of how immune responses are involved in neuronal damage and regeneration, as reviewed here, will be essential to develop effective therapies to improve quality of life, and mitigate the personal, economic and social impact of these diseases. PMID:24329535

  1. Non-alcoholic fatty liver disease and dyslipidemia: An update.

    PubMed

    Katsiki, Niki; Mikhailidis, Dimitri P; Mantzoros, Christos S

    2016-08-01

    Non-alcoholic fatty liver (NAFLD) is the most common liver disease worldwide, progressing from simple steatosis to necroinflammation and fibrosis (leading to non-alcoholic steatohepatitis, NASH), and in some cases to cirrhosis and hepatocellular carcinoma. Inflammation, oxidative stress and insulin resistance are involved in NAFLD development and progression. NAFLD has been associated with several cardiovascular (CV) risk factors including obesity, dyslipidemia, hyperglycemia, hypertension and smoking. NAFLD is also characterized by atherogenic dyslipidemia, postprandial lipemia and high-density lipoprotein (HDL) dysfunction. Most importantly, NAFLD patients have an increased risk for both liver and CV disease (CVD) morbidity and mortality. In this narrative review, the associations between NAFLD, dyslipidemia and vascular disease in NAFLD patients are discussed. NAFLD treatment is also reviewed with a focus on lipid-lowering drugs. Finally, future perspectives in terms of both NAFLD diagnostic biomarkers and therapeutic targets are considered. PMID:27237577

  2. The Non-Surgical Treatment of Peyronie Disease: 2013 Update

    PubMed Central

    Shaw, Eric James; Mitchell, Gregory Clyde; Tan, Ronny B.; Sangkum, Premsant

    2013-01-01

    Peyronie disease is a common cause of penile deformity and sexual dysfunction. Although surgery is regarded as the definitive management for this condition, there are many medical and minimally invasive therapies available, with widely varying efficacy reported in the literature. The purpose of this review is to describe the current state-of-the-art for each of the most commonly used as well as several developing non-surgical treatments. Further, we hope to offer perspectives that will aid practitioners in deciding among these treatments that are either already in use or have the potential to be used as alternatives to surgery in the management of this frustrating disease. PMID:24459651

  3. The non-surgical treatment of peyronie disease: 2013 update.

    PubMed

    Shaw, Eric James; Mitchell, Gregory Clyde; Tan, Ronny B; Sangkum, Premsant; Hellstrom, Wayne John G

    2013-12-01

    Peyronie disease is a common cause of penile deformity and sexual dysfunction. Although surgery is regarded as the definitive management for this condition, there are many medical and minimally invasive therapies available, with widely varying efficacy reported in the literature. The purpose of this review is to describe the current state-of-the-art for each of the most commonly used as well as several developing non-surgical treatments. Further, we hope to offer perspectives that will aid practitioners in deciding among these treatments that are either already in use or have the potential to be used as alternatives to surgery in the management of this frustrating disease. PMID:24459651

  4. A technological update of molecular diagnostics for infectious diseases

    PubMed Central

    Liu, Yu-Tsueng

    2008-01-01

    Identification of a causative pathogen is essential for the choice of treatment for most infectious diseases. Many FDA approved molecular assays; usually more sensitive and specific compared to traditional tests, have been developed in the last decade. A new trend of high throughput and multiplexing assays are emerging thanks to technological developments for the human genome sequencing project. The applications of microarray and ultra high throughput sequencing technologies for diagnostic microbiology are reviewed. The race for the $1000 genome technology by 2014 will have a profound impact in diagnosis and treatment of infectious diseases in the near future. PMID:18782035

  5. AN UPDATE OF RESEARCH AT THE NATIONAL ANIMAL DISEASE CENTER

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Salmonella associated human illnesses, linked to consumption of contaminated poultry, have remained significantly above public health targets of the Centers for Disease Control (CDC) whereas E. coli O157:H7, Campylobacter, and Listeria associated morbidities are approaching Healthy People 2010 goals...

  6. Fatty acids in cardiovascular health and disease: a comprehensive update

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Research dating back to the 1950s reported an association between the consumption of saturated fatty acids (SFAs) and risk of coronary heart disease. Recent epidemiological evidence, however, challenges these findings. It is well accepted that the consumption of SFAs increases low-density lipoprotei...

  7. Implications of prion diseases for dentistry: an update.

    PubMed

    Palacios-Sánchez, Begoña; Esparza-Gómez, Germán C; Campo-Trapero, Julián; Cerero-Lapiedra, Rocío

    2008-03-01

    Prions are normal proteins present in all mammals, especially in the central nervous system (CNS) and lymphoreticular tissue. Their transformation into a highly infectious molecule gives rise to a group of diseases known as transmissible spongiform encephalopathies (TSEs), which cause vacuolar degeneration of gray matter and produce a fatal neurodegenerative disorder. Prion diseases have attracted considerable attention in recent years, and this review of the literature was designed to determine their implications for dentistry, studying the possibility of cross-transmission in the dental office and describing their oral manifestations. The main oral manifestations are dysphagia, dysarthria, paresthesias, dysesthesias, and dysgeusia. The most frequently involved oral tissues are the trigeminal ganglion, posterior third of the tongue, tonsils, and, much less commonly, alveolar nerves, gingiva, and salivary glands. Although no contagion has been reported in the dental setting to date, prions resist the usual dental sterilization systems and transmission of this type of disease remains a potential risk. It is therefore important for dentists to be aware of these diseases, to identify high-risk patients by obtaining an adequate clinical history, and to know the appropriate procedures to be followed. PMID:18280965

  8. Update on pulmonary disease due to non-tuberculous mycobacteria.

    PubMed

    Stout, Jason E; Koh, Won-Jung; Yew, Wing Wai

    2016-04-01

    Non-tuberculous mycobacteria (NTM) are emerging worldwide as significant causes of chronic pulmonary infection, posing a number of challenges for both clinicians and researchers. While a number of studies worldwide have described an increasing prevalence of NTM pulmonary disease over time, population-based data are relatively sparse and subject to ascertainment bias. Furthermore, the disease is geographically heterogeneous. While some species are commonly implicated worldwide (Mycobacterium avium complex, Mycobacterium abscessus), others (e.g., Mycobacterium malmoense, Mycobacterium xenopi) are regionally important. Thoracic computed tomography, microbiological testing with identification to the species level, and local epidemiology must all be taken into account to accurately diagnose NTM pulmonary disease. A diagnosis of NTM pulmonary disease does not necessarily imply that treatment is required; a patient-centered approach is essential. When treatment is required, multidrug therapy based on appropriate susceptibility testing for the species in question should be used. New diagnostic and therapeutic modalities are needed to optimize the management of these complicated infections. PMID:26976549

  9. UPDATE OF GRAY KERNEL DISEASE OF MACADAMIA - 2006

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Gray kernel is an important disease of macadamia that affects the quality of kernels with gray discoloration and a permeating, foul odor that can render entire batches of nuts unmarketable. We report on the successful production of gray kernel in raw macadamia kernels artificially inoculated with s...

  10. Organelle communication: signaling crossroads between homeostasis and disease.

    PubMed

    Bravo-Sagua, Roberto; Torrealba, Natalia; Paredes, Felipe; Morales, Pablo E; Pennanen, Christian; López-Crisosto, Camila; Troncoso, Rodrigo; Criollo, Alfredo; Chiong, Mario; Hill, Joseph A; Simmen, Thomas; Quest, Andrew F; Lavandero, Sergio

    2014-05-01

    Cellular organelles do not function as isolated or static units, but rather form dynamic contacts between one another that can be modulated according to cellular needs. The physical interfaces between organelles are important for Ca2+ and lipid homeostasis, and serve as platforms for the control of many essential functions including metabolism, signaling, organelle integrity and execution of the apoptotic program. Emerging evidence also highlights the importance of organelle communication in disorders such as Alzheimer's disease, pulmonary arterial hypertension, cancer, skeletal and cardiac muscle dysfunction. Here, we provide an overview of the current literature on organelle communication and the link to human pathologies. PMID:24534274

  11. The pathogenesis of autosomal dominant polycystic kidney disease: an update.

    PubMed

    Somlo, S; Markowitz, G S

    2000-07-01

    The identification of PKD1 and PKD2, the two major genes responsible for autosomal dominant polycystic kidney disease, are the seminal discoveries upon which much of the current investigation into the pathogenesis of this common heritable disease is based. A major mechanistic insight was achieved with the discovery that autosomal dominant polycystic kidney disease occurs by a two-hit mechanism requiring somatic inactivation of the normal allele in individual polarized epithelial cells. Most recent advances are focused on the function of the respective protein products, polycystin-1 and polycystin-2. Indirect evidence supports an interaction between polycystin-1 and -2, albeit it is unlikely that they work in concert in all tissues and at all times. They associate in yeast two hybrid and cotransfection assays and there is a striking similarity in the renal and pancreatic cystic phenotypes of Pkd2-/- and Pkd1del34/del34 mice. Also, the respective homologues of both proteins are expressed in the same sensory neuronal cells in the nematode and the human disease phenotypes remain completely overlapping with the major difference being in relative severity. Mounting evidence supports the hypothesis that polycystin-1 is a cell surface receptor. A close homologue in the sea urchin sperm mediates the acrosome reaction in response to contact with egg-jelly, the nematode homologue functions in mechano- or chemosensation, and the solution structure of the repeated extracellular polycystic kidney disease domains reveals a beta-sandwich fold commonly found in surface receptor molecules. Indirect evidence also supports the initial hypothesis that polycystin-2 is a calcium channel subunit. Several closely related homologues retain the calcium channel signature motif but differ in their predicted interaction domains, and one of these homologues has been shown to be a calcium regulated cation channel. Several important distinctions in polcystin-1 and -2 function have also been

  12. Nonsurgical Interventions for Peyronie's Disease: Update as of 2016.

    PubMed

    Joice, Gregory A; Burnett, Arthur L

    2016-08-01

    Peyronie's disease (PD) is a debilitating condition of the penis that leads to significant pain, erectile dysfunction, and emotional distress in men. PD is likely underreported due to lack of knowledge of the disease and the absence of well-established available treatments. Surgical treatment can lead to sustained improvements, but is often associated with penile shortening and places the patient at risk for perioperative morbidity. Nonsurgical management has been studied for several years as an alternative to surgery for men with PD. Currently, much of the data on nonsurgical management is conflicting, with only one treatment that has been recently approved by the US Food and Drug Administration. Significant effort has been devoted to advancing non-surgical treatments for PD that can be implemented outside of the operating room. This review aims to describe the research behind current nonsurgical therapies for PD and to highlight the recent advances that have been made within the last three years. PMID:27574590

  13. Update of fecal markers of inflammation in inflammatory bowel disease.

    PubMed

    Judd, Thomas A; Day, Andrew S; Lemberg, Daniel A; Turner, Dan; Leach, Steven T

    2011-10-01

    The diagnosis, prognosis, and assessment of disease activity of inflammatory bowel disease (IBD) require investigating clinical, radiological, and histological criteria, as well as serum inflammatory markers. However, a range of fecal inflammatory markers now appears to have the potential to greatly assist in these processes. Calprotectin, a prominent neutrophil protein, was identified two decades ago as a potentially revolutionary marker for IBD. Following this discovery, numerous additional markers, including S100A12, lactoferrin, and M2-pyruvate kinase, have also been suggested as novel markers of IBD. In the present study, we provide an up-to-date review of fecal markers of IBD, and further, provide a novel analysis of each of these fecal markers in severe ulcerative colitis and compare their expression pattern in contrast to calprotectin. PMID:21777275

  14. Nonsurgical Interventions for Peyronie's Disease: Update as of 2016

    PubMed Central

    Burnett, Arthur L

    2016-01-01

    Peyronie's disease (PD) is a debilitating condition of the penis that leads to significant pain, erectile dysfunction, and emotional distress in men. PD is likely underreported due to lack of knowledge of the disease and the absence of well-established available treatments. Surgical treatment can lead to sustained improvements, but is often associated with penile shortening and places the patient at risk for perioperative morbidity. Nonsurgical management has been studied for several years as an alternative to surgery for men with PD. Currently, much of the data on nonsurgical management is conflicting, with only one treatment that has been recently approved by the US Food and Drug Administration. Significant effort has been devoted to advancing non-surgical treatments for PD that can be implemented outside of the operating room. This review aims to describe the research behind current nonsurgical therapies for PD and to highlight the recent advances that have been made within the last three years. PMID:27574590

  15. Matrix Metalloproteinases in Inflammatory Bowel Disease: An Update

    PubMed Central

    O'Sullivan, Shane; Gilmer, John F.

    2015-01-01

    Matrix metalloproteinases (MMPs) are known to be upregulated in inflammatory bowel disease (IBD) and other inflammatory conditions, but while their involvement is clear, their role in many settings has yet to be determined. Studies of the involvement of MMPs in IBD since 2006 have revealed an array of immune and stromal cells which release the proteases in response to inflammatory cytokines and growth factors. Through digestion of the extracellular matrix and cleavage of bioactive proteins, a huge diversity of roles have been revealed for the MMPs in IBD, where they have been shown to regulate epithelial barrier function, immune response, angiogenesis, fibrosis, and wound healing. For this reason, MMPs have been recognised as potential biomarkers for disease activity in IBD and inhibition remains a huge area of interest. This review describes new roles of MMPs in the pathophysiology of IBD and suggests future directions for the development of treatment strategies in this condition. PMID:25948887

  16. The Worldwide Alzheimer's Disease Neuroimaging Initiative: An update.

    PubMed

    Hendrix, James A; Finger, Brad; Weiner, Michael W; Frisoni, Giovanni B; Iwatsubo, Takeshi; Rowe, Christopher C; Kim, Seong Yoon; Guinjoan, Salvador M; Sevlever, Gustavo; Carrillo, Maria C

    2015-07-01

    The Alzheimer's Disease Neuroimaging Initiative (ADNI), launched in 2004, has worked to accelerate drug development by validating imaging and blood/cerebrospinal fluid biomarkers for Alzheimer's disease clinical treatment trials. ADNI is a naturalistic (nontreatment) multisite longitudinal study. A true public-private partnership, the initiative has set a new standard for data sharing without embargo and for the use of biomarkers in dementia research. The ADNI effort in North America is not the only such effort in the world. The Alzheimer's Association recognized these global efforts and formed Worldwide ADNI (WW-ADNI). By creating a platform for international collaboration and cooperation, WW-ADNI's goals are to harmonize projects and results across geographical regions and to facilitate data management and availability to investigators around the world. WW-ADNI projects include those based in North America, Europe, Japan, Australia, Korea, and Argentina. PMID:26194318

  17. MPTP Mouse Models of Parkinson’s Disease: An Update

    PubMed Central

    Meredith, Gloria E.; Rademacher, David J.

    2012-01-01

    Among the most widely used models of Parkinson’s disease (PD) are those that employ toxins, especially 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Depending on the protocol used, MPTP yields large variations in nigral cell loss, striatal dopamine loss and behavioral deficits. Motor deficits do not fully replicate those seen in PD. Nonetheless, MPTP mouse models mimic many aspects of the disease and are therefore important tools for understanding PD. In this review, we will discuss the ability of MPTP mouse models to replicate the pathophysiology of PD, the mechanisms of MPTP-induced neurotoxicity, strain differences in susceptibility to MPTP, and the models’ roles in testing therapeutic approaches. PMID:23275799

  18. [Multimodal imaging of ischemic heart diseases: A 2015 update].

    PubMed

    Di Marco, L; Rosset, M; Zhang-Yin, J; Ohana, M

    2016-05-01

    Current realities and future possibilities of imaging in the ischemic heart diseases are very broad and constantly evolving, with the improvement of existing technologies and the introduction of new features such as dual-energy CT, strain ultrasound, multimodality fusion or perfusion MRI. Regular collaboration between prescribing clinicians, cardiologists, radiologists and nuclear radiologists is therefore essential to tailor the examination to the specific clinical question. The indications for each modality will therefore depend on its diagnostic performance, cost, acquisition and post-processing times and eventual radiation exposure. This review will detail principles and applications of current cardiac imaging examinations: echocardiography, nuclear medicine, MRI, CT and coronary angiography, emphasizing their current strengths and weaknesses in the ischemic heart diseases management. PMID:26775644

  19. Hypertension management in patients with vascular disease: An update.

    PubMed

    Kohlman-Trigoboff, Debra

    2016-09-01

    Hypertension (HTN) is a major risk factor for cardiovascular disease. About 80 million U.S. adults (33%) have HTN. Of these individuals, approximately 77% use antihypertensive medication, however, only 54% have controlled HTN. Studies have demonstrated that patients whose blood pressures are controlled achieve a minimum of 50% reduction in cardiovascular events compared to similar patients with poorly controlled blood pressure. This article will define HTN and its consequences. Diagnostic evaluation and evidence-based treatment guidelines for HTN to include lifestyle modifications and pharmacotherapy will be discussed. Finally, this article will examine why the treatment of HTN can prevent the development and reduce the progression of atherosclerosis in vascular disease. PMID:27568315

  20. An update: vitamin E supplementation and heart disease.

    PubMed

    Blumberg, Jeffrey B

    2002-01-01

    In vitro studies and experiments in animal models provide a large and compelling body of evidence that oxidation of low-density lipoprotein (LDL) and/or related oxidative mechanisms play a critical role in the initiation and progression of atherogenesis. A corollary to the theory that reactive oxygen and nitrogen species ("free radicals") are the key molecules in this process is that antioxidants that can protect LDL from peroxidation should decrease the risk of developing atherosclerosis, attenuate its progression, or even reverse established disease. However, recently, clinical trials employing the principal lipid-soluble dietary antioxidant, vitamin E, have provided mixed results indicating either benefit, no effect, or an adverse impact on patients with cardiovascular disease (CVD). Consideration of the design and outcome of these studies together with new reports about the action of antioxidants suggests approaches for new studies as well as a basis for current advice to patients. PMID:12134710

  1. Update in tuberculosis and nontuberculous mycobacterial disease 2012.

    PubMed

    Menzies, Dick; Nahid, Payam

    2013-10-15

    In 2012, new publications in the Journal described both the predictive value of the new IFN-γ release assays for diagnosis of latent tuberculosis (TB), but also provided evidence that these new tests cannot be interpreted simply as positive or negative, as initially hoped. Surgical masks can reduce transmission of TB infection, but other measures such as state-wide implementation of targeted testing and treatment of latent TB or active case finding require substantial and sustained effort to successfully reduce TB morbidity and mortality. A quasiexperimental study revealed that a package of social interventions could substantially reduce risk of TB disease in heavily exposed (and infected) children in the preantibiotic era. A study in a high-TB burden setting suggested that a new rapid drug-susceptibility test for TB may be more practical for implementation than traditional culture-based phenotypic tests. And two studies of TB vaccines revealed that currently used bacillus Calmette-Guérin strains vary in their ability to affect correlates of immunogenicity, whereas a new candidate vaccine, MVA85A, was safe and immunogenic in adults. Studies of nontuberculous mycobacteria (NTM) described a rapid rise in the prevalence and spatial clustering of NTM in the United States over the past decade. Although risk factors for pulmonary NTM such as advanced age and low BMI are known, the mechanisms underlying infection and disease remain mysterious. Four studies of therapy of NTM disease highlighted the pressing need for well-designed international randomized controlled trials to improve our management of NTM disease. PMID:24127799

  2. Updating our understanding of pulmonary disease associated with HIV infection.

    PubMed

    Estébanez-Muñoz, Miriam; Soto-Abánades, Clara I; Ríos-Blanco, Juan J; Arribas, Jose R

    2012-04-01

    The introduction of highly active antiretroviral therapy (HAART) has resulted in a reduction of opportunistic infections associated with cellular and humoral immunosuppression. However, what is still unclear is the impact of HAART on the development of other diseases not associated with AIDS, such as lung cancer and COPD. The aim of this paper is to review the most innovative and relevant aspects of lung pathology in patients infected with HIV. PMID:22257776

  3. An update on the treatment of Parkinson's disease.

    PubMed

    Jankovic, Joseph

    2006-07-01

    Although levodopa remains the most effective symptomatic drug for Parkinson's disease (PD), its use is limited by the emergence of motor fluctuations and dyskinesias, particularly in young-onset patients. Dopamine agonists, catechol-O-methyltransferasee inhibitors and other anti-parkinsonian drugs have been found to diminish or prevent these complications and possibly to exert disease-modifying effects. The finding that the subthalamic nucleus (STN) and the globus pallidum internus (GPi) are abnormally active in PD has led to effective surgical treatments designed to improve patients' quality of life. The relative benefits of targeting STN or GPi with high-frequency stimulation are still being debated. Experimental therapeutics of PD include novel delivery systems, anti-apoptotic strategies and implantation of genetically engineered cells, and stem cells. Despite encouraging results from early pre-clinical and clinical studies, trials of human fetal grafts and intraventricular and intraparenchymal infusion of glial cell-line-derived neurotrophic factor have not shown clinically meaningful benefits. Future therapeutic strategies should focus not only on ameliorating the symptoms of PD, but also on neuroprotective or neurorescue therapies that can favorably modify the natural course of the disease and slow the progression of both motor and nonmotor manifestations of PD. PMID:16878274

  4. Impact of Diabetes on Cardiovascular Disease: An Update

    PubMed Central

    Matheus, Alessandra Saldanha de Mattos; Tannus, Lucianne Righeti Monteiro; Cobas, Roberta Arnoldi; Palma, Catia C. Sousa; Negrato, Carlos Antonio; Gomes, Marilia de Brito

    2013-01-01

    Cardiovascular diseases are the most prevalent cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The proposed mechanisms that can link accelerated atherosclerosis and increased cardiovascular risk in this population are poorly understood. It has been suggested that an association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction. Recently, epigenetic factors by different types of reactions are known to be responsible for the interaction between genes and environment and for this reason can also account for the association between diabetes and cardiovascular disease. The impact of clinical factors that may coexist with diabetes such as obesity, dyslipidemia, and hypertension are also discussed. Furthermore, evidence that justify screening for subclinical atherosclerosis in asymptomatic patients is controversial and is also matter of this review. The purpose of this paper is to describe the association between poor glycemic control, oxidative stress, markers of insulin resistance, and of low-grade inflammation that have been suggested as putative factors linking diabetes and cardiovascular disease. PMID:23533715

  5. Tarui disease and distal glycogenoses: clinical and genetic update.

    PubMed

    Toscano, A; Musumeci, O

    2007-10-01

    Phosphofructokinase deficiency (Tarui disease) was the first disorder recognized to directly affect glycolysis. Since the discovery of the disease, in 1965, a wide range of biochemical, physiological and molecular studies have greatly contributed to our knowledge concerning not only phosphofructokinase function in normal muscle but also on the general control of glycolysis and glycogen metabolism. Studies on phosphofructokinase deficiency vastly enriched the field of glycogen storage diseases, making a relevant improvement also in the molecular genetic area. So far, more than one hundred patients have been described with prominent clinical symptoms characterized by muscle cramps, exercise intolerance, rhabdomyolysis and myoglobinuria, often associated with haemolytic anaemia and hyperuricaemia. The muscle phosphofructokinase gene is located on chromosome 12 and about 20 mutations have been described. Other glycogenoses have been recognised in the distal part of the glycolytic pathway: these are infrequent but some may induce muscle cramps, exercise intolerance and rhabdomyolysis. Phosphoglycerate Kinase, Phosphoglycerate Mutase, Lactate Dehydrogenase, beta-Enolase and Aldolase A deficiencies have been described as distal glycogenoses. From the molecular point of view, the majority of these enzyme deficiencies are sustained by "private" mutations. PMID:18421897

  6. Update on Legionnaires’ disease: pathogenesis, epidemiology, detection and control

    PubMed Central

    Hilbi, Hubert; Jarraud, Sophie; Hartland, Elizabeth; Buchrieser, Carmen

    2010-01-01

    Summary Legionellosis or Legionnaires’ disease is an emerging and often-fatal form of pneumonia that is most severe in elderly and immunocompromised people, an ever-increasing risk group for infection. In recent years, the genomics of Legionella spp. has significantly increased our knowledge of the pathogenesis of this disease by providing new insights into the evolution and genetic and physiological basis of Legionella–host interactions. The 7th international conference on Legionella, Legionella 2009, illustrated many recent conceptual advances in epidemiology, pathogenesis and ecology. Experts in different fields presented new findings on basic mechanisms of pathogen–host interactions and bacterial evolution, as well as the clinical management and environmental prevalence and persistence of Legionella. The presentations revealed remarkable facts about the genetic and metabolic basis of the intracellular lifestyle of Legionella and reported on its striking ability to manipulate host cell processes by molecular mimicry. Together, these investigations will lead to new approaches for the treatment and prevention of Legionnaires’ disease. PMID:20149105

  7. Update on hand-foot-and-mouth disease.

    PubMed

    Ventarola, Daniel; Bordone, Lindsey; Silverberg, Nanette

    2015-01-01

    Hand-foot-and-mouth disease is a viral exanthem caused, primarily by Coxsackie A16 and enterovirus 71 with typical clinical features of fever, painful papules and blisters over the extremities and genitalia and an enanthem involving ulceration of the mouth, palate, and pharynx. Other enteroviruses have recently been noted to cause severe neurologic illness and paralysis (enterovirus 68) with variable cutaneous features. A recent outbreak of Coxsackie A6 infection has been seen worldwide with cases reported in the United States, Japan, Southeast Asia, and Europe. These cases have caused extensive cutaneous disease variants, some of which are not previously recognized in Coxsackie infection, namely vesicobullous and erosive eruptions, extensive cutaneous involvement, periorificial lesions, localization in areas of atopic dermatitis or in children with atopic dermatitis (the so-called eczema coxsackium), Gianotti-Crosti-like lesions, petechial/purpuric eruptions, delayed onychomadesis, and palmoplantar desquamation. Finally, adult cases appear to occur with this form of hand-foot-and-mouth disease, likely due to fecal-oral transmission in a household setting. PMID:25889136

  8. Thyroid disease among the Rongelap and Utirik population - an update

    SciTech Connect

    Howard, J.E.; Vaswani, A.; Heotis, P.

    1997-07-01

    In 1954, 253 Marshallese were accidentally exposed to fallout radiation from the hydrogen bomb, BRAVO. The Marshall Islands Medical Program (MIMP) was established by the Department of Energy in 1955 to monitor and treat radiation-related disease pursuant to this accident. Medical teams from Brookhaven National laboratory, a federal institution, regularly visit the Marshall Islands to give medical care to the exposed population. The most significant complication of the exposure has been found to be thyroid disease due to the ingestion of radioactive iodides from the fallout. In 1963 the first thyroid nodules were found in Rongelap subjects and in 1969 in Utirik. Non-neoplastic adenomatous nodules were associated with higher doses of radiation and neoplastic nodules developed in individuals receiving lower doses of radiation. Women were more susceptible to the development of palpable thyroid nodules than men. In 1994 the MIMP initiated examination of the thyroid by ultrasound to supplement the clinical examination. One hundred and sixty-four patients were evaluated. No significant differences were found in the incidence of thyroid nodules or the mean nodule count between the three groups of Rongelap and Utirik exposed and a comparison patient population. There was no significant difference in the incidence of thyroid nodules in males vs. females. Five exposed patients were referred for surgical excision of a nodule detected only by ultrasound. These ultrasound findings are unexpected in that females are known to have a higher incidence of thyroid disease than males and we expected that the incidence of ultrasound nodules would be higher in the exposed population. 36 refs., 2 figs., 8 tabs.

  9. AB005. Treatment of Peyronie’s disease: 2016 updates

    PubMed Central

    Lue, Tom F.

    2016-01-01

    The approval of Xiaflex (collagenase clostridium histolyticum) by the FDA in the US in December of 2013 has significantly changed the management of Peyronie’s disease. Based on author’s experience in treating the disease for more than 25 years and giving more than 1,000 Xiaflex injections, a refined medical and surgical approach is proposed. (I) Detailed history and focused physical examination: should obtain the following critical information: duration of disease, symptoms (the tetrad of pain, deformity, plaque, and erectile dysfunction), prior treatment and outcome, emotional stress and expectations; (II) physical examination: thorough examination of the genitalia, hands and feet if history suggests. The number, size, consistency, and location of plaques, local tenderness should be documented; (III) assessment: evaluate and document penile deformity and erectile function- by patient’s own erection photos, erection in clinic by manual stimulation, as well as oral or injection of vasoactive agent. A high-resolution penile ultrasound is a valuable tool in identification of septal fibrosis, calcification, and intracavernous fibrosis; (IV) discussion of therapies at first visit: we recommend pentoxifylline for 3 to 6 months in men with the following: recent onset (a few months), calcifications, pain, and tenderness. The goal is to stop progression of deformity and calcification and give the patient some time to understand the more effective but more invasive therapies; (V) discussion of more invasive therapies: pentoxifylline + vacuum device or penile stretching device; collagenase (Xiaflex) injection + modeling, plication surgery, extratunical grafting surgery, tunica-sparing excision of ossified plaque, penile prosthesis. More detailed discussion and clinical examples will be presented at the meeting.

  10. Update on Epidemiology, Diagnosis, and Disease Course of Atopic Dermatitis.

    PubMed

    Simpson, Eric L; Irvine, Alan D; Eichenfield, Lawrence F; Friedlander, Sheila F

    2016-06-01

    Studies of the prevalence of atopic dermatitis (AD) have provided insights into associated environmental risk factors, demonstrating the complex interactions between the presence of filaggrin (FLG) gene defects and environment. Among other important findings is that elevated transepidermal water loss (TEWL) in newborns is a strong predictor of AD, regardless of FLG status. Recently recognized predictors of disease course and severity include onset of AD signs and symptoms before 12 months of age and the presence of an FLG mutation and concomitant immunoglobulin E sensitization early in life. Semin Cutan Med Surg 35(supp5):S84-S88. PMID:27525380

  11. Update on the Pharmacological Treatment of Alzheimer’s Disease

    PubMed Central

    Massoud, Fadi; Gauthier, Serge

    2010-01-01

    Alzheimer’s disease (AD) is the most common neurodegenerative disorder. Worldwide prevalence of the disease is estimated at more than 24 million cases. With aging of populations, this number will likely increase to more than 80 million cases by the year 2040. The annual incidence worldwide is estimated at 4.6 million cases which is the equivalent of one new case every seven seconds! The pathophysiology of AD is complex and largely misunderstood. It is thought to start with the accumulation of beta-amyloid (Aβ) that leads to deposition of insoluble neuritic or senile plaques. Secondary events in this “amyloid cascade” include hyperphosphorylation of the protein tau into neurofibrillary tangles, inflammation, oxidation, and excitotoxicity that eventually cause activation of apoptotis, cell death and neurotransmitter deficits. This review will briefly summarize recent advances in the pathophysiology of AD and focus on the pharmacological treatment of the cognitive and functional symptoms of AD. It will discuss the roles of vascular prevention, cholinesterase inhibitors and an NMDA-antagonist in the management of AD. It will address the issues thought to be related to the lack of persistence or discontinuation of therapy with cholinesterase inhibitors shown in recent studies and some of the solutions proposed. These include setting realistic expectations in light of a neurodegenerative condition and available symptomatic treatments, slowly titrating medications, and using alternate routes of administration. Finally, it will introduce future therapeutic options currently under study. PMID:20808547

  12. Advances in alcoholic liver disease: An update on alcoholic hepatitis

    PubMed Central

    Liang, Randy; Liu, Andy; Perumpail, Ryan B; Wong, Robert J; Ahmed, Aijaz

    2015-01-01

    Alcoholic hepatitis is a pro-inflammatory chronic liver disease that is associated with high short-term morbidity and mortality (25%-35% in one month) in the setting of chronic alcohol use. Histopathology is notable for micro- and macrovesicular steatosis, acute inflammation with neutrophil infiltration, hepatocellular necrosis, perivenular and perisinusoidal fibrosis, and Mallory hyaline bodies found in ballooned hepatocytes. Other findings include the characteristic eosinophilic fibrillar material (Mallory’s hyaline bodies) found in ballooned hepatocytes. The presence of focal intense lobular infiltration of neutrophils is what typically distinguishes alcoholic hepatitis from other forms of hepatitis, in which the inflammatory infiltrate is primarily composed of mononuclear cells. Management consists of a multidisciplinary approach including alcohol cessation, fluid and electrolyte correction, treatment of alcohol withdrawal, and pharmacological therapy based on the severity of the disease. Pharmacological treatment for severe alcoholic hepatitis, as defined by Maddrey’s discriminant factor ≥ 32, consists of either prednisolone or pentoxifylline for a period of four weeks. The body of evidence for corticosteroids has been greater than pentoxifylline, although there are higher risks of complications. Recently head-to-head trials between corticosteroids and pentoxifylline have been performed, which again suggests that corticosteroids should strongly be considered over pentoxifylline. PMID:26576078

  13. Coeliac disease in children - an update for general dental practitioners.

    PubMed

    Paul, S P; Kirkham, E N; John, R; Staines, K; Basude, D

    2016-05-13

    Coeliac disease (CD) is an immune-mediated systemic disorder caused by ingestion of gluten found in wheat, rye and barley. It affects around 1% of children, but 90% of cases are considered to remain undiagnosed. CD classically presents with gastrointestinal manifestations including diarrhoea, bloating, weight loss and abdominal pain, but extra-intestinal features (including oral and dental manifestations) are increasingly being reported. Dental and oral manifestations such as dental enamel defects, delayed eruption of teeth, recurrent aphthous ulcers are well-recognised manifestations of CD. In patients with yet undiagnosed CD, these can sometimes be the only presenting features. Dentists have regular contact with well children, and therefore the visit to the dentist is an opportunity to suspect CD. When CD is suspected, Dental practitioners can liaise with the general medical practitioner to organise screening for coeliac disease. Positive serology will prompt onward referral to a paediatric gastroenterologist to confirm the diagnosis. The recent European Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines revised in 2012 have streamlined the diagnostic pathway for faster diagnosis of CD. Management involves strict adherence to a gluten free diet, which should lead to resolution of symptoms, recovery of intestinal mucosa and prevention of long-term complications associated with it. This article aims to describe CD, inform of recent changes to the diagnostic pathway and highlight the dental manifestations of the condition to equip dental practitioners to aid early diagnosis and initiation of treatment for children with CD. PMID:27173708

  14. Mucin function in inflammatory bowel disease: an update.

    PubMed

    Boltin, Doron; Perets, Tsachi T; Vilkin, Alex; Niv, Yaron

    2013-02-01

    MUC2 is the primary component of the mucin barrier that separates the intestinal microbiota and the intestinal epithelium. This mucous barrier is affected by both luminal/microbial factors and host/immune factors, both of which have genetic and environmental determinants. The complex interactions between these players in health and disease states are not fully understood. Inflammatory bowel disease (IBD) has both genetic and environmental etiologies that lead to the breakdown of the epithelial barrier. In this review, we explore the up-to-date evidence that implicates mucin in the pathogenesis of IBD. In IBD, quantitative changes in mucin secretion occur, as well as structural changes in mucin's glycoprotein core and the sulfation and sialylation of mucin's oligosaccharide residues. These changes are associated with a diminished functionality of the mucous barrier. We identify the various genetic mutations associated with these changes and outline the animal models that have enhanced the current understanding of the genetic basis for IBD. Further study is needed to better characterize the immune and genetic influences on mucin expression and secretion and role of endoplasmic reticulum stress and a defective unfolded protein response in mediating these changes. PMID:23164684

  15. A family living with Alzheimer's disease: The communicative challenges.

    PubMed

    Jones, Danielle

    2015-09-01

    Alzheimer's disease irrevocably challenges a person's capacity to communicate with others. Earlier research on these challenges focused on the language disorders associated with the condition and situated language deficit solely in the limitations of a person's cognitive and semantic impairments. This research falls short of gaining insight into the actual interactional experiences of a person with Alzheimer's and their family. Drawing on a UK data set of 70 telephone calls recorded over a two-and-a-half year period (2006-2008) between one elderly woman with Alzheimer's disease, and her daughter and son-in-law, this paper explores the role which communication (and its degeneration) plays in family relationships. Investigating these interactions, using a conversation analytic approach, reveals that there are clearly communicative difficulties, but closer inspection suggests that they arise due to the contingencies that are generated by the other's contributions in the interaction. That being so, this paper marks a departure from the traditional focus on language level analysis and the assumption that deficits are intrinsic to the individual with Alzheimer's, and instead focuses on the collaborative communicative challenges that arise in the interaction itself and which have a profound impact on people's lives and relationships. PMID:24339113

  16. Communicative function in patients with questionable Alzheimer's disease.

    PubMed

    Heller, R B; Dobbs, A R; Rule, B G

    1992-09-01

    The communicative skills of patients with questionable Alzheimer's disease (AD) were examined by having patients describe events shown in a silent video cartoon. As anticipated, questionable AD patients provided fewer clauses in their descriptions than did education- and age-matched controls. This finding was independent of differences in word finding ability. More important, the patients failed to describe as many of the thematically important events as did the controls, a difference that affected the overall informativeness of the communication. Even though the patients were sensitive to event importance, there was no evidence of compensation in their descriptions (i.e., a greater concentration of important events). Several interpretations are presented that focus on possible deficits in the pragmatic or semantic systems of language or both as an early symptom of Alzheimer's disease. PMID:1388860

  17. Parkinson's disease. Update in diagnosis and symptom management.

    PubMed

    Marjama-Lyons, J M; Koller, W C

    2001-08-01

    Parkinson's disease (PD) is a progressive neurodegenerative disorder with a high burden of morbidity. Because no diagnostic test exists for PD, clinical knowledge and skill are key to making an early, accurate diagnosis. Diagnostic criteria for PD require at least two of three motor signs: tremor, rigidity, or bradykinesia. Levodopa and the dopamine agonists are considered first-line drug therapy. Recent studies have shown a lower incidence of dyskinesia in patients who began therapy with a dopamine agonist, although levodopa may be better tolerated by patients age 70 or older. Combinations of medications and rehabilitative, alternative, and surgical therapies can often help patients achieve adequate control of PD motor symptoms and maintain a high quality of independent living. PMID:11505857

  18. Solar disinfection of water reduces diarrhoeal disease: an update.

    PubMed

    Conroy, R M; Meegan, M E; Joyce, T; McGuigan, K; Barnes, J

    1999-10-01

    349 Maasai children younger than 6 years old were randomised by alternate household to drink water either left in plastic bottles exposed to sunlight on the roof of the house or kept indoors (control). The trial was run in Maasai by Maasai community elders. Children drinking solar disinfected water had a significantly lower risk of severe diarrhoeal disease over 8705 two weekly follow up visits; two week period prevalence was 48.8% compared with 58.1% in controls, corresponding to an attributable fraction of 16.0%. While this reduction is modest, it was sustained over a year in free living children. It confirms solar disinfection as effective in vivo as a free, low technology, point of consumption method of improving water quality. The continuing use of solar disinfection by the community underlines the value of community participation in research. PMID:10490440

  19. Alzheimer's Disease Clinical and Research Update for Health Care Practitioners

    PubMed Central

    DeFina, Philip A.; Lichtenstein, Jonathan D.; Fellus, Jonathan

    2013-01-01

    Of the approximately 6.8 million Americans who have been diagnosed with dementia, over 5 million have been diagnosed with Alzheimer's Disease (AD). Due to the rise in the aging population, these figures are expected to double by 2050. The following paper provides an up-to-date review of clinical issues and relevant research. Research related to the methods of the earliest possible detection of AD is ongoing. Health care professionals should play a critical role in differentially diagnosing AD patients, as well as supporting their families. Novel interventions, including medications, natural supplements, and behavioral techniques, are constantly appearing in the literature. It is necessary for the health practitioner to remain current, regarding AD, as such information will facilitate better care for patients and their families. PMID:24083026

  20. Communication strategies employed by rare disease patient organizations in Spain.

    PubMed

    Castillo-Esparcia, Antonio; López-Villafranca, Paloma

    2016-08-01

    The current study focuses on communication strategies employed by rare disease patient organizations. The aims of these organizations are: educate and inform the public about rare diseases, raise awareness of the problems related to rare diseases, and achieve social legitimacy in order give visibility to their demands. We analyzed the portrayal of rare disease and patient organizations by Spain's major media organizations in terms of circulation and viewership - the press (El País, El Mundo, La Vanguardia,ABC and El Periódico), radio (CadenaSer, Onda Cero, Cope and RNE), and television (Telecinco, Antena 3, La 1, La Sexta, Cuatro) -between 2012 and 2014.We then carried out a descriptive analysis of communication activities performed via the World Wide Web and social networks by 143 national organizations. Finally, we conducted a telephone questionnaire of a representative sample of 90 organizations in order to explore the association between media presence and funding and public image. The triangulation of quantitative and qualitative methods allowed us to meet the study's objectives. Increased visibility of the organizations afforded by an increase in the coverage of the topic by the medialed to an increase in membership - but not in donations - and increased awareness of these diseases. PMID:27557016

  1. Creutzfeldt-Jakob disease surveillance in Australia: update to December 2014.

    PubMed

    Klug, Genevieve M; Boyd, Alison; Sarros, Shannon; Stehmann, Christiane; Simpson, Marion; McLean, Catriona; Masters, Colin L; Collins, Steven J

    2016-01-01

    Nation-wide surveillance of human transmissible spongiform encephalopathies (also known as prion diseases), the most common being Creutzfeldt-Jakob disease, is performed by the Australian National Creutzfeldt-Jakob Disease Registry, based at the University of Melbourne. Prospective surveillance has been undertaken since 1993 and over this dynamic period in transmissible spongiform encephalopathy research and understanding, the unit has evolved and adapted to changes in surveillance practices and requirements concomitant with the emergence of new disease subtypes, improvements in diagnostic capabilities and the overall heightened awareness of prion diseases in the health care setting. In 2014, routine national surveillance continued and this brief report provides an update of the cumulative surveillance data collected by the Australian National Creutzfeldt-Jakob Disease Registry prospectively from 1993 to December 2014, and retrospectively to 1970. PMID:27522131

  2. Pharmacokinetic drug interactions in liver disease: An update

    PubMed Central

    Palatini, Pietro; De Martin, Sara

    2016-01-01

    Inhibition and induction of drug-metabolizing enzymes are the most frequent and dangerous drug-drug interactions. They are an important cause of serious adverse events that have often resulted in early termination of drug development or withdrawal of drugs from the market. Management of such interactions by dose adjustment in clinical practice is extremely difficult because of the wide interindividual variability in their magnitude. This review examines the genetic, physiological, and environmental factors responsible for this variability, focusing on an important but so far neglected cause of variability, liver functional status. Clinical studies have shown that liver disease causes a reduction in the magnitude of interactions due to enzyme inhibition, which is proportional to the degree of liver function impairment. The effect of liver dysfunction varies quantitatively according to the nature, reversible or irreversible, of the inhibitory interaction. The magnitude of reversible inhibition is more drastically reduced and virtually vanishes in patients with advanced hepatocellular insufficiency. Two mechanisms, in order of importance, are responsible for this reduction: decreased hepatic uptake of the inhibitory drug and reduced enzyme expression. The extent of irreversible inhibitory interactions is only partially reduced, as it is only influenced by the decreased expression of the inhibited enzyme. Thus, for appropriate clinical management of inhibitory drug interactions, both the liver functional status and the mechanism of inhibition must be taken into consideration. Although the inducibility of drug-metabolizing enzymes in liver disease has long been studied, very conflicting results have been obtained, mainly because of methodological differences. Taken together, the results of early animal and human studies indicated that enzyme induction is substantially preserved in compensated liver cirrhosis, whereas no definitive conclusion as to whether it is

  3. Dengue disease surveillance: an updated systematic literature review

    PubMed Central

    Runge-Ranzinger, S; McCall, P J; Kroeger, A; Horstick, O

    2014-01-01

    Objectives To review the evidence for the application of tools for dengue outbreak prediction/detection and trend monitoring in passive and active disease surveillance systems in order to develop recommendations for endemic countries and identify important research needs. Methods This systematic literature review followed the protocol of a review from 2008, extending the systematic search from January 2007 to February 2013 on PubMed, EMBASE, CDSR, WHOLIS and Lilacs. Data reporting followed the PRISMA statement. The eligibility criteria comprised (i) population at risk of dengue, (ii) dengue disease surveillance, (iii) outcome of surveillance described and (iv) empirical data evaluated. The analysis classified studies based on the purpose of the surveillance programme. The main limitation of the review was expected publication bias. Results A total of 1116 papers were identified of which 36 articles were included in the review. Four cohort-based prospective studies calculated expansion factors demonstrating remarkable levels of underreporting in the surveillance systems. Several studies demonstrated that enhancement methods such as laboratory support, sentinel-based reporting and staff motivation contributed to improvements in dengue reporting. Additional improvements for passive surveillance systems are possible by incorporating simple data forms/entry/electronic-based reporting; defining clear system objectives; performing data analysis at the lowest possible level (e.g. district); seeking regular data feedback. Six studies showed that serotype changes were positively correlated with the number of reported cases or with dengue incidence, with lag times of up to 6 months. Three studies found that data on internet searches and event-based surveillance correlated well with the epidemic curve derived from surveillance data. Conclusions Passive surveillance providing the baseline for outbreak alert should be strengthened and appropriate threshold levels for outbreak

  4. Update on pulmonary hypertension complicating chronic obstructive pulmonary disease

    PubMed Central

    Jyothula, Soma; Safdar, Zeenat

    2009-01-01

    Pulmonary hypertension (PH) is the hemodynamic manifestation of various pathological processes that result in elevated pulmonary artery pressures (PAP). The National Institutes of Health Registry defined pulmonary arterial hypertension as the mean PAP of more than 25 mm Hg with a pulmonary capillary wedge pressure or left atrial pressure equal to or less than 15 mm Hg. This definition remains the currently accepted definition of PH that is used to define PH related to multiple clinical conditions including chronic obstructive pulmonary disease (COPD). The estimated US prevalence of COPD by the National Health Survey in 2002 in people aged >25 was 12.1 million. There is a lack of large population-based studies in COPD to document the correct prevalence of PH and outcome. The major cause of PH in COPD is hypoxemia leading to vascular remodeling. Echocardiogram is the initial screening tool of choice for PH. This simple noninvasive test can provide an estimate of right ventricular systolic and right atrial pressures. Right heart catheterization remains the gold standard to diagnose PH. It provides accurate measurement of mean PAP and pulmonary capillary wedge pressure. Oxygen therapy remains the cornerstone therapeutic for hypoxemia in COPD patients. Anecdotal reports suggest utility of PDE5-inhibitors and prostacyclin to treat COPD-related PH. Large randomized clinical trials are needed before the use of these drugs can be recommended. PMID:19802350

  5. Macular diseases: update on diagnostic and therapeutic techniques

    NASA Astrophysics Data System (ADS)

    Fortunato, P.; De Libero, C.; Donati, C.; La Torre, A.

    2004-09-01

    Purpose of this course is to review the principles that guide the diagnosis and the classification of macular diseases, and the new options available for this purpose. Among new treatments modalities, photodynamic therapy (PDT) has been recently introduced in the clinical practice for treating subfoveal choroidal neovascularization (CNV). In age-related macular degeneration (AMD), eyes in which the classic CNV components covers at least 50% of the entire lesion, called predominantly classic lesions, benefit from a substantial reduction of the rate of moderate visual loss during the first year. Preliminary results in other types of CNV also indicate a possible efficacy. We will present the theoretical basis and mechanisms of action of PDT and then comment on the main results of the TAP study; the preliminary results available from the VIP will also be displayed. Numerous cases treated with PDT, one year after its introduction in the clinical practice, will be shown and discussed. The introduction of PDT has probably reduced the applicability of surgical techniques for treating CNV. Yet, surgeons are developing less invasive techniques to minimize the complications associated with membrane removal and the various types of translocation. This innovation will be illustrated, as well as the criteria for patients selection in the era of PDT.

  6. Cat-scratch disease in Crete: an update

    PubMed Central

    Minadakis, Georgios; Angelakis, Emmanouil; Chochlakis, Dimosthenis; Tselentis, Yannis; Psaroulaki, Anna

    2011-01-01

    There are few epidemiological and clinical studies about the presence of cat scratch disease (CSD) on the island of Crete. The objective of this study was to analyze a large number of patients with suspected CSD to define the frequency of Bartonella infections in Crete. From January 2005 to October 2008, we studied patients with suspected CSD from hospitals in Crete. Sera of the referred patients were tested by immunofluorescence assay (IFA). For some patients, we also received lymph nodes and blood samples that we tested for the presence of Bartonella henselae by molecular assays. Overall, we tested 507 serum samples and we found 56 (11%) cases of CSD. PCR assay was positive for 2 patients; one had a B. henselae positive lymph node and the other a positive whole blood sample. Significantly more CSD cases (62.5%, 35 of 56) were reported in children than in infants and adults (P<0.05). Moreover, we identified that most cases of CSD occurred between May and September (P=0.002) and December and January. CSD is prevalent in Crete and is mostly associated with an increase in outdoor activity. PMID:24470912

  7. Alcoholic Liver Disease: Update on the Role of Dietary Fat

    PubMed Central

    Kirpich, Irina A.; Miller, Matthew E.; Cave, Matthew C.; Joshi-Barve, Swati; McClain, Craig J.

    2016-01-01

    Alcoholic liver disease (ALD) spans a spectrum of liver pathology, including fatty liver, alcoholic steatohepatitis, and cirrhosis. Accumulating evidence suggests that dietary factors, including dietary fat, as well as alcohol, play critical roles in the pathogenesis of ALD. The protective effects of dietary saturated fat (SF) and deleterious effects of dietary unsaturated fat (USF) on alcohol-induced liver pathology are well recognized and documented in experimental animal models of ALD. Moreover, it has been demonstrated in an epidemiological study of alcoholic cirrhosis that dietary intake of SF was associated with a lower mortality rates, whereas dietary intake of USF was associated with a higher mortality. In addition, oxidized lipids (dietary and in vivo generated) may play a role in liver pathology. The understanding of how dietary fat contributes to the ALD pathogenesis will enhance our knowledge regarding the molecular mechanisms of ALD development and progression, and may result in the development of novel diet-based therapeutic strategies for ALD management. This review explores the relevant scientific literature and provides a current understanding of recent advances regarding the role of dietary lipids in ALD pathogenesis. PMID:26751488

  8. Hormone therapy in menopause: An update on cardiovascular disease considerations.

    PubMed

    Hale, Georgina E; Shufelt, Chrisandra L

    2015-08-01

    Cardiovascular disease (CVD) remains the number one cause of death and morbidity worldwide, and while overall CVD incidence rates declined in both genders between 1999 and 2007, age-specific data suggest that coronary risk factors in women are on the rise. While early observational data favored menopausal hormone therapy's (MHT's) role in primary CVD prevention, the initial interventional study data from the WHI did not. Further detailed analyses of both observational and interventional data have pointed to the possibility that MHT may play a role in primary CVD prevention if initiated within 10 years of menopause and less than 60 years of age (the timing hypothesis). Unanswered questions remain regarding the optimal route and dosage of estrogen in MHT. Data so far, favor transdermal estradiol over conventional-dose CEE with respect to CVD risk and oral estradiol over conventional-dose CEE with respect to stroke risk. Low-dose oral CEE may similarly have benefit over conventional-dose oral CEE for some CVD events. In addition, the transdermal route of delivery may avoid the excess risk of certain CVD events associated with MHT and lower doses of estrogen may have fewer adverse effects than the doses previously tested in WHI. Because questions regarding benefits versus risks remain, MHT is yet to be recommended for CVD prevention. However, it is indicated for menopausal symptom management in women within 10 years of menopause and under the age of 60 years, in whom it does not appear to carry increased cardiovascular risk. Additional research is ongoing and needed to confirm or refute the comparative safety of the various MHT options. PMID:26270318

  9. Effect of the vegetarian diet on non-communicable diseases.

    PubMed

    Li, Duo

    2014-01-30

    A vegetarian diet generally includes plenty of vegetables and fruits, which are rich in phytochemicals, antioxidants, fiber, magnesium, vitamins C and E, Fe³⁺, folic acid and n-6 polyunsaturated fatty acid (PUFA), and is low in cholesterol, total fat and saturated fatty acid, sodium, Fe²⁺, zinc, vitamin A, B₁₂ and D, and especially n-3 PUFA. Mortality from all-cause, ischemic heart disease, and circulatory and cerebrovascular diseases was significantly lower in vegetarians than in omnivorous populations. Compared with omnivores, the incidence of cancer and type 2 diabetes was also significantly lower in vegetarians. However, vegetarians have a number of increased risk factors for non-communicable diseases such as increased plasma homocysteine, mean platelet volume and platelet aggregability compared with omnivores, which are associated with low intake of vitamin B₁₂ and n-3 PUFA. Based on the present data, it would seem appropriate for vegetarians to carefully design their diet, specifically focusing on increasing their intake of vitamin B₁₂ and n-3 PUFA to further reduce already low mortality and morbidity from non-communicable diseases. PMID:23965907

  10. Role of the kidney in the fetal programming of adult cardiovascular disease: an update.

    PubMed

    Singh, Reetu R; Denton, Kate M

    2015-04-01

    It is well established that an adverse in utero environment can impinge upon fetal development and place the offspring on a track leading to future cardiovascular disease. Significantly, this may occur in the absence of any outward manifestations at birth. In this brief review, we focus on potential renal mechanisms that lead to adaptations in glomerular and tubular function that initiate hypertension of developmental origin and examine potential therapeutic interventions. This report updates recent data in this field. PMID:25588322

  11. [Update assessment of mental health diseases for sick pay--experience of the AWMF guideline].

    PubMed

    Dörmann, M

    2016-03-01

    In August 2012, we reported (VersMed 1/2014, S. 9) the results for the first 12 months following implementation of AWMF guideline 051-029 in the medical assessment of mental health diseases with a view to sick pay and supplementary disability insurance (BU). Today we provide an update of the experience gained in the last three years. We are glad to report that the results have remained stable. PMID:27111955

  12. International Dermatology Outcome Measures Initiative as Applied to Psoriatic Disease Outcomes: An Update.

    PubMed

    Merola, Joseph F; Armstrong, April W; Saraiya, Ami; Latella, John; Garg, Amit; Callis Duffin, Kristina; Gottlieb, Alice B

    2016-05-01

    Previous publications have described the International Dermatology Outcome Measures (IDEOM) group, comprising patients, physicians, health economists, participating pharmaceutical industry partners, payers, and regulatory agencies. The goal of IDEOM is to create patient-centered, validated measures of dermatologic disease progression and treatment efficacy for use in both clinical trials and clinical practice. We provide an update of IDEOM activities as of our 2015 IDEOM meeting in Washington, DC, USA. PMID:27134269

  13. Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review.

    PubMed

    Geddes, E Lynne; O'Brien, Kelly; Reid, W Darlene; Brooks, Dina; Crowe, Jean

    2008-12-01

    The purpose was to update an original systematic review to determine the effect of inspiratory muscle training (IMT) on inspiratory muscle strength and endurance, exercise capacity, dyspnea and quality of life for adults with chronic obstructive pulmonary disease (COPD). The original MEDLINE and CINAHL search to August 2003 was updated to January 2007 and EMBASE was searched from inception to January 2007. Randomized controlled trials, published in English, with adults with stable COPD, comparing IMT to sham IMT or no intervention, low versus high intensity IMT, and different modes of IMT were included. Nineteen of 274 articles in the original search met the inclusion criteria. The updated search revealed 17 additional articles; 6 met the inclusion criteria, all of which compared targeted, threshold or normocapneic hyperventilation IMT to sham IMT. An update of the sub-group analysis comparing IMT versus sham IMT was performed with 10 studies from original review and 6 from the update. Sixteen meta-analyses are reported. Results demonstrated significant improvements in inspiratory muscle strength (PI(max), PI(max) % predicted, peak inspiratory flow rate), inspiratory muscle endurance (RMET, inspiratory threshold loading, MVV), exercise capacity (Ve(max), Borg Score for Respiratory Effort, 6MWT), Transitional Dyspnea Index (focal score, functional impairment, magnitude of task, magnitude of effort), and the Chronic Respiratory Disease Questionnaire (quality of life). Results suggest that targeted, threshold or normocapneic hyperventilation IMT significantly increases inspiratory muscle strength and endurance, improves outcomes of exercise capacity and one measure of quality of life, and decreases dyspnea for adults with stable COPD. PMID:18708282

  14. When are high-tech communicators effective in Parkinson's disease?

    PubMed

    Ferriero, Giorgio; Caligari, Marco; Ronconi, Gianpaolo; Franchignoni, Franco

    2012-03-01

    This report describes a 63-year-old woman with Parkinson's disease showing loss of intelligibility of speech and severely impaired handwriting, despite undergoing physical and speech therapies. As the patient had sufficient residual motor abilities and adequate cognitive function and motivation, a computer-based communication aid with a software program for word prediction and voice output was tested, and was prescribed after a training period. One year later, the patient was still using the customized device to communicate and for leisure time, showing a high degree of satisfaction with the aid (assessed by QUEST 2.0), which had a positive impact on her well-being and quality of life (assessed by Psychosocial Impact of Assistive Devices Scales). In conclusion, in selected patients with Parkinson's disease, high-tech augmentative and alternative communication devices may be considered, tested, and prescribed after a positive training period. Follow-ups are necessary to monitor the effectiveness of the assistive device and respond to specific patient needs that may arise with using the device. PMID:22186614

  15. Prevention of cancer and non-communicable diseases.

    PubMed

    Cannon, Geoffrey; Gupta, Prakash; Gomes, Fabio; Kerner, Jon; Parra, William; Weiderpass, Elisabete; Kim, Jeongseon; Moore, Malcolm; Sutcliffe, Catherine; Sutcliffe, Simon

    2012-01-01

    Cancer is a leading cause of death worldwide, accounting for approximately 7.6 million deaths (13% of all deaths) in 2008. Cancer mortality is projected to increase to 11 million deaths in 2030, with the majority occurring in regions of the world with the least capacity to respond. However, cancer is not only a personal, societal and economic burden but also a potential societal opportunity in the context of functional life - the years gained through effective prevention and treatment, and strategies to enhance survivorship. The United Nations General Assembly Special Session in 2011 has served to focus attention on key aspects of cancer prevention and control. Firstly, cancer is largely preventable, by feasible means. Secondly, cancer is one of a number of chronic, non- communicable diseases that share common risk factors whose prevention and control would benefit a majority of the world's population. Thirdly, a proportion of cancers can be attributed to infectious, communicable causal factors (e.g., HPV, HBV, H.pylori, parasites, flukes) and that strategies to control the burden of infectious diseases have relevance to the control of cancer. Fourthly, that the natural history of non-communicable diseases, including cancer, from primary prevention through diagnosis, treatment and care, is underwritten by the impact of social, economic and environmental determinants of health (e.g., poverty, illiteracy, gender inequality, social isolation, stigma, socio-economic status). Session 1 of the 4th International Cancer Control Congress (ICCC-4) focused on the social, economic and environmental, as well as biological and behavioural, modifiers of the risk of cancer through one plenary presentation and four interactive workshop discussions. The workshop sessions concerned 1) the Global Adult Tobacco Survey and social determinants of tobacco use in high burden low- and middle-income countries; 2) the role of diet, including alcohol, and physical activity in modifying the

  16. Communicable Disease Case Entry Using PDAs and Public Wireless Networks

    PubMed Central

    Lober, WB; Bliss, D; Dockrey, MR; Davidson, AJ; Karras, BT

    2003-01-01

    Concerns about detecting and responding to attacks with biowarfare agents have resulted in the development of deployable case reporting systems, e.g. RSVP1. We implement a proof of concept web-based information system to be used securely from personal digital assistants over public wireless networks, by public health field workers for routine and emergent case reporting. The system collects data for a local health jurisdiction, provides content- and event-based notification, and forwards case reports to the Colorado State communicable disease reporting system (CEDRS). We believe this demonstrates a useful integration of portable and web-based technologies with public health practice. PMID:14728422

  17. Update on host-pathogen interactions in cystic fibrosis lung disease.

    PubMed

    Hector, Andreas; Frey, Nina; Hartl, Dominik

    2016-12-01

    Bacterial and fungal infections are hallmarks of cystic fibrosis (CF) lung disease. In the era of long-term inhaled antibiotics and increasing CF patient survival, new "emerging" pathogens are detected in CF airways, yet their pathophysiological disease relevance remains largely controversial and incompletely defined. As a response to chronic microbial triggers, innate immune cells, particularly neutrophils, are continuously recruited into CF airways where they combat pathogens but also cause tissue injury through release of oxidants and proteases. The coordinated interplay between host immune cell activation and pathogens is essential for the outcome of CF lung disease. Here, we provide a concise overview and update on host-pathogen interactions in CF lung disease. PMID:26905568

  18. Chinese new immigrant mothers' perception about adult-onset non-communicable diseases prevention during childhood.

    PubMed

    Wang, Linda Dong Ling; Lam, Wendy Wing Tak; Wu, Joseph Tsz Kei; Fielding, Richard

    2015-12-01

    Many non-communicable diseases (NCDs) are largely preventable via behaviour change and healthy lifestyle, which may be best established during childhood. This study sought insights into Chinese new immigrant mothers' perceptions about adult-onset NCDs prevention during childhood. Twenty-three semi-structured interviews were carried out with new immigrant mothers from mainland China who had at least one child aged 14 years or younger living in Hong Kong. Interviews were audio taped, transcribed and analysed using a Grounded Theory approach. The present study identified three major themes: perceived causes of adult NCDs, beliefs about NCDs prevention and everyday health information practices. Unhealthy lifestyle, contaminated food and environment pollution were perceived as the primary causes of adult NCDs. Less than half of the participants recognized that parents had responsibility for helping children establish healthy behaviours from an early age to prevent diseases in later life. Most participants expressed helplessness about chronic diseases prevention due to lack of knowledge of prevention, being perceived as beyond individual control. Many participants experienced barriers to seeking health information, the most common sources of health information being interpersonal conversation and television. Participants' everyday information practice was passive and generally lacked awareness regarding early prevention of adult-onset NCDs. Updated understanding of this issue has notable implications for future health promotion interventions. PMID:24842077

  19. Updates to the zoonotic niche map of Ebola virus disease in Africa.

    PubMed

    Pigott, David M; Millear, Anoushka I; Earl, Lucas; Morozoff, Chloe; Han, Barbara A; Shearer, Freya M; Weiss, Daniel J; Brady, Oliver J; Kraemer, Moritz Ug; Moyes, Catherine L; Bhatt, Samir; Gething, Peter W; Golding, Nick; Hay, Simon I

    2016-01-01

    As the outbreak of Ebola virus disease (EVD) in West Africa is now contained, attention is turning from control to future outbreak prediction and prevention. Building on a previously published zoonotic niche map (Pigott et al., 2014), this study incorporates new human and animal occurrence data and expands upon the way in which potential bat EVD reservoir species are incorporated. This update demonstrates the potential for incorporating and updating data used to generate the predicted suitability map. A new data portal for sharing such maps is discussed. This output represents the most up-to-date estimate of the extent of EVD zoonotic risk in Africa. These maps can assist in strengthening surveillance and response capacity to contain viral haemorrhagic fevers. PMID:27414263

  20. Updates to the zoonotic niche map of Ebola virus disease in Africa

    PubMed Central

    Pigott, David M; Millear, Anoushka I; Earl, Lucas; Morozoff, Chloe; Han, Barbara A; Shearer, Freya M; Weiss, Daniel J; Brady, Oliver J; Kraemer, Moritz UG; Moyes, Catherine L; Bhatt, Samir; Gething, Peter W; Golding, Nick; Hay, Simon I

    2016-01-01

    As the outbreak of Ebola virus disease (EVD) in West Africa is now contained, attention is turning from control to future outbreak prediction and prevention. Building on a previously published zoonotic niche map (Pigott et al., 2014), this study incorporates new human and animal occurrence data and expands upon the way in which potential bat EVD reservoir species are incorporated. This update demonstrates the potential for incorporating and updating data used to generate the predicted suitability map. A new data portal for sharing such maps is discussed. This output represents the most up-to-date estimate of the extent of EVD zoonotic risk in Africa. These maps can assist in strengthening surveillance and response capacity to contain viral haemorrhagic fevers. DOI: http://dx.doi.org/10.7554/eLife.16412.001 PMID:27414263

  1. 21 CFR 1271.145 - Prevention of the introduction, transmission, or spread of communicable diseases.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... spread of communicable diseases. 1271.145 Section 1271.145 Food and Drugs FOOD AND DRUG ADMINISTRATION... diseases. You must recover, process, store, label, package, and distribute HCT/Ps, and screen and test cell... diseases....

  2. 21 CFR 1271.145 - Prevention of the introduction, transmission, or spread of communicable diseases.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... spread of communicable diseases. 1271.145 Section 1271.145 Food and Drugs FOOD AND DRUG ADMINISTRATION... diseases. You must recover, process, store, label, package, and distribute HCT/Ps, and screen and test cell... diseases....

  3. 21 CFR 1271.145 - Prevention of the introduction, transmission, or spread of communicable diseases.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... spread of communicable diseases. 1271.145 Section 1271.145 Food and Drugs FOOD AND DRUG ADMINISTRATION... diseases. You must recover, process, store, label, package, and distribute HCT/Ps, and screen and test cell... diseases....

  4. 21 CFR 1271.145 - Prevention of the introduction, transmission, or spread of communicable diseases.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... spread of communicable diseases. 1271.145 Section 1271.145 Food and Drugs FOOD AND DRUG ADMINISTRATION... diseases. You must recover, process, store, label, package, and distribute HCT/Ps, and screen and test cell... diseases....

  5. Using Talking Mats to Support Communication in Persons with Huntington's Disease

    ERIC Educational Resources Information Center

    Ferm, Ulrika; Sahlin, Anna; Sundin, Linda; Hartelius, Lena

    2010-01-01

    Background: Many individuals with Huntington's disease experience reduced functioning in cognition, language and communication. Talking Mats is a visually based low technological augmentative communication framework that supports communication in people with different cognitive and communicative disabilities. Aims: To evaluate Talking Mats as a…

  6. Presymptomatic risk assessment for chronic non-communicable diseases.

    PubMed

    Padhukasahasram, Badri; Halperin, Eran; Wessel, Jennifer; Thomas, Daryl J; Silver, Elana; Trumbower, Heather; Cargill, Michele; Stephan, Dietrich A

    2010-01-01

    The prevalence of common chronic non-communicable diseases (CNCDs) far overshadows the prevalence of both monogenic and infectious diseases combined. All CNCDs, also called complex genetic diseases, have a heritable genetic component that can be used for pre-symptomatic risk assessment. Common single nucleotide polymorphisms (SNPs) that tag risk haplotypes across the genome currently account for a non-trivial portion of the germ-line genetic risk and we will likely continue to identify the remaining missing heritability in the form of rare variants, copy number variants and epigenetic modifications. Here, we describe a novel measure for calculating the lifetime risk of a disease, called the genetic composite index (GCI), and demonstrate its predictive value as a clinical classifier. The GCI only considers summary statistics of the effects of genetic variation and hence does not require the results of large-scale studies simultaneously assessing multiple risk factors. Combining GCI scores with environmental risk information provides an additional tool for clinical decision-making. The GCI can be populated with heritable risk information of any type, and thus represents a framework for CNCD pre-symptomatic risk assessment that can be populated as additional risk information is identified through next-generation technologies. PMID:21217814

  7. [Economic crisis and communicable diseases. SESPAS report 2014].

    PubMed

    Llácer, Alicia; Fernández-Cuenca, Rafael; Martínez-Navarro, Ferrán

    2014-06-01

    Past economic crises have increased the impact of communicable diseases especially on groups particularly vulnerable to the social and health consequences of the recession. However, it has been shown that the impact of these crises largely depends on the response of governments and the inhabitants of affected countries. We describe the consequences of the current crisis in the causal chain of infectious disease, including the response of the health system, and explore whether there is evidence of its impact in Spain. It is assumed that the possible effect of the crisis on living and working conditions is due to individual and social debt coupled with high unemployment as defining features of the crisis. We highlight the potential negative consequences of healthcare cuts on vulnerable populations, which have been partly excluded with the recent reform of health coverage. We compare mortality and morbidity data between two periods: before and after 2008, integrating, where possible, observed trends and institutional reports. Overall, no effect on infectious disease has been detected so far, although some signs of worsening, which could be compatible with the effects of the crisis, have been observed and need to be monitored and confirmed. We review the limitations of data sources that may not be sufficiently sensitive or up-to-date to detect changes that may require a latency period to become manifest. Instead of cutting resources, surveillance of these diseases should be improved, and an equitable social health response, which targets the population most affected by the crisis, should be guaranteed. PMID:24863999

  8. Visual Communication en Masse: An Update on the Purdue University Virtual Visit.

    ERIC Educational Resources Information Center

    Mohler, James L.

    2001-01-01

    Discusses issues related to delivering spatially oriented data to the general public, since communication through computer graphics should be accessible to the masses as well as to specialists. The second half of the paper describes the Purdue University Virtual Visit, a resource being used for visualization and communication at Purdue University…

  9. An update of neurological manifestations of vasculitides and connective tissue diseases: a literature review

    PubMed Central

    Bougea, Anastasia; Anagnostou, Evangelos; Spandideas, Nikolaos; Triantafyllou, Nikolaos; Kararizou, Evangelia

    2015-01-01

    Vasculitides comprise a heterogeneous group of autoimmune disorders, occurring as primary or secondary to a broad variety of systemic infectious, malignant or connective tissue diseases. The latter occur more often but their pathogenic mechanisms have not been fully established. Frequent and varied central and peripheral nervous system complications occur in vasculitides and connective tissue diseases. In many cases, the neurological disorders have an atypical clinical course or even an early onset, and the healthcare professionals should be aware of them. The purpose of this brief review was to give an update of the main neurological disorders of common vasculitis and connective tissue diseases, aiming at accurate diagnosis and management, with an emphasis on pathophysiologic mechanisms. PMID:26313435

  10. Frameworks for risk communication and disease management: the case of Lyme disease and countryside users

    PubMed Central

    Quine, Christopher P.; Barnett, Julie; Dobson, Andrew D. M.; Marcu, Afrodita; Marzano, Mariella; Moseley, Darren; O'Brien, Liz; Randolph, Sarah E.; Taylor, Jennifer L.; Uzzell, David

    2011-01-01

    Management of zoonotic disease is necessary if countryside users are to gain benefit rather than suffer harm from their activities, and to avoid disproportionate reaction to novel threats. We introduce a conceptual framework based on the pressure–state–response model with five broad responses to disease incidence. Influencing public behaviour is one response and requires risk communication based on an integration of knowledge about the disease with an understanding of how publics respond to precautionary advice. A second framework emphasizes how risk communication involves more than information provision and should address dimensions including points-of-intervention over time, place and audience. The frameworks are developed by reference to tick-borne Lyme borreliosis (also known as Lyme disease), for which informed precautionary behaviour is particularly relevant. Interventions to influence behaviour can be directed by knowledge of spatial and temporal variation of tick abundance, what constitutes risky behaviour, how people respond to information of varying content, and an understanding of the social practices related to countryside use. The frameworks clarify the response options and help identify who is responsible for risk communication. These aspects are not consistently understood, and may result in an underestimation of the role of land-based organizations in facilitating appropriate precautionary behaviour. PMID:21624921

  11. Preventing & Managing Communicable Diseases. Training Guides for the Head Start Learning Community.

    ERIC Educational Resources Information Center

    Bowman (James) Associates, San Francisco, CA.

    This training guide is intended to improve the skills of Head Start staff and families in dealing with communicable diseases. The guide addresses attitudes toward communicable diseases, how to reduce the spread of disease, and how to recognize and manage illnesses more effectively. The guide consists of six working sections. The first three are…

  12. Communicable disease control: a 'Global Public Good' perspective.

    PubMed

    Smith, Richard; Woodward, David; Acharya, Arnab; Beaglehole, Robert; Drager, Nick

    2004-09-01

    Despite the increasing 'globalization' of health, the responsibility for it remains primarily national, generating a potential mismatch between global health problems and current institutions and mechanisms to deal with them. The 'Global Public Good' (GPG) concept has been suggested as a framework to address this mismatch in different areas of public policy. This paper considers the application of the GPG concept as an organizing principle for communicable disease control (CDC), considering in particular its potential to improve the health and welfare of the developing world. The paper concludes that there are significant limitations to the GPG concept's effectiveness as an organizing principle for global health priorities, with respect to CDC. More specifically, there are few areas of CDC which qualify as GPG, and even among those that can be considered GPGs, it is not necessarily appropriate to provide everything which can be considered a GPG. It is therefore suggested that it may be more useful to focus instead on the failure of 'collective action', where the GPG concept may then: (1) provide a rationale to raise funds additional to aid from developed countries' domestic budgets; (2) promote investment by developed countries in the health systems of developing countries; (3) promote strategic partnerships between developed and developing countries to tackle major global communicable diseases; and (4) guide the political process of establishing, and mechanisms for providing and financing, global CDC programmes with GPG characteristics, and GPGs which have benefits for CDC. In short, the GPG concept is not without limitations and weaknesses as an organizing principle, but does provide, at least in some areas, guidance in improving collective action at the international level for the improvement of global CDC. PMID:15310662

  13. Communication and Huntington's Disease: Qualitative Interviews and Focus Groups with Persons with Huntington's Disease, Family Members, and Carers

    ERIC Educational Resources Information Center

    Hartelius, Lena; Jonsson, Maria; Rickeberg, Anneli; Laakso, Katja

    2010-01-01

    Background: As an effect of the cognitive, emotional and motor symptoms associated with Huntington's disease, communicative interaction is often dramatically changed. No study has previously included the subjective reports on this subject from individuals with Huntington's disease. Aims: To explore the qualitative aspects of how communication is…

  14. Communicable disease control in China: From Mao to now.

    PubMed

    Hipgrave, David

    2011-12-01

    China's progress on communicable disease control (CDC) in the 30 years after establishment of the People's Republic in 1949 is widely regarded as remarkable. Life expectancy soared by around 30 years, infant mortality plummeted and smallpox, sexually transmitted diseases and many other infections were either eliminated or decreased massively in incidence, largely as a result of CDC. By the mid-1970s, China was already undergoing the epidemiologic transition, years ahead of other nations of similar economic status. These early successes can be attributed to population mobilization, mass campaigns and a focus on sanitation, hygiene, clean water and clean delivery, and occurred despite political instability and slow economic progress. The 10-year Cultural Revolution from 1966 brought many hardships, but also clinical care and continuing public health programs to the masses through community-funded medical schemes and the establishment of community-based health workers. These people-focused approaches broke down with China's market reforms from 1980. Village doctors turned to private practice as community funding ceased, and the attention paid to rural public health declined. CDC relied on vertical programs, some of them successful (such as elimination of lymphatic filariasis and child immunisation), but others (such as control of schistosomiasis and tuberculosis) demonstrating only intermittent progress due to failed strategies or reliance on support by the poorest governments and health workers, who could not or would not collaborate. In addition, China's laissez-faire approach to public health placed it at great risk, as evidenced by the outbreak in 2003 of the Severe Acute Respiratory Syndrome. Since then, major changes to disease reporting, the priority given to CDC including through major new domestic resources and reform of China's health system offer encouragement for CDC. While decentralized funding and varying quality diagnosis, reporting and treatment of

  15. Communicable disease control in China: From Mao to now

    PubMed Central

    Hipgrave, David

    2011-01-01

    China’s progress on communicable disease control (CDC) in the 30 years after establishment of the People’s Republic in 1949 is widely regarded as remarkable. Life expectancy soared by around 30 years, infant mortality plummeted and smallpox, sexually transmitted diseases and many other infections were either eliminated or decreased massively in incidence, largely as a result of CDC. By the mid-1970s, China was already undergoing the epidemiologic transition, years ahead of other nations of similar economic status. These early successes can be attributed to population mobilization, mass campaigns and a focus on sanitation, hygiene, clean water and clean delivery, and occurred despite political instability and slow economic progress. The 10-year Cultural Revolution from 1966 brought many hardships, but also clinical care and continuing public health programs to the masses through community-funded medical schemes and the establishment of community-based health workers. These people-focused approaches broke down with China’s market reforms from 1980. Village doctors turned to private practice as community funding ceased, and the attention paid to rural public health declined. CDC relied on vertical programs, some of them successful (such as elimination of lymphatic filariasis and child immunisation), but others (such as control of schistosomiasis and tuberculosis) demonstrating only intermittent progress due to failed strategies or reliance on support by the poorest governments and health workers, who could not or would not collaborate. In addition, China’s laissez-faire approach to public health placed it at great risk, as evidenced by the outbreak in 2003 of the Severe Acute Respiratory Syndrome. Since then, major changes to disease reporting, the priority given to CDC including through major new domestic resources and reform of China’s health system offer encouragement for CDC. While decentralized funding and varying quality diagnosis, reporting and

  16. Granulomatosis with polyangiitis (Wegener's disease): An updated review of ocular disease manifestations

    PubMed Central

    Kubaisi, Buraa; Abu Samra, Khawla; Foster, C. Stephen

    2016-01-01

    Summary Granulomatosis with polyangiitis (GPA) is a potentially lethal systemic disorder that is characterized by necrotizing vasculitis of small arteries and veins. The respiratory system is most commonly affected in limited forms of the disease, however upper and lower respiratory system, systemic vasculitis, and necrotizing glomerulonephritis are the characteristic components of the disease triad. The peak incidence is observed at 64–75 years of age, with a prevalence of 8–10 per million depending on geographic location. In this review we focus on the ocular manifestations of the disease which occur in nearly in one third of the patients. In addition we describe the neuro-ophthalmic complications which occur in up to half of cases. We also discuss the current systemic treatment options including corticosteroids, cyclophosphamide, azathioprine, and the available biologic response modifiers including rituximab. The disease remains difficult to diagnose due to the generalized symptomatic presentation of patients with GPA. As a result, several sets of diagnostic criteria have been developed which include clinical, serological, and histopathological findings to varying extents. Early diagnosis and multi-specialty collaboration among physicians is necessary to adequately manage the disease and the potential complications that may result from drugs used in the treatment of the disease. Despite recent advances, more research is necessary to prevent the high rates of mortality from the disease itself and from therapeutic side effects. PMID:27195187

  17. Mycoplasmosis and upper respiratory tract disease of tortoises: a review and update

    USGS Publications Warehouse

    Jacobson, Elliott R.; Brown, Mary B.; Wendland, Lori; Brown, Daniel R.; Klein, Paul A.; Christopher, Mary M.; Berry, Kristin H.

    2014-01-01

    Tortoise mycoplasmosis is one of the most extensively characterized infectious diseases of chelonians. A 1989 outbreak of upper respiratory tract disease (URTD) in free-ranging Agassiz's desert tortoises (Gopherus agassizii) brought together an investigative team of researchers, diagnosticians, pathologists, immunologists and clinicians from multiple institutions and agencies. Electron microscopic studies of affected tortoises revealed a microorganism in close association with the nasal mucosa that subsequently was identified as a new species, Mycoplasma agassizii. Over the next 24 years, a second causative agent, Mycoplasma testudineum, was discovered, the geographic distribution and host range of tortoise mycoplasmosis were expanded, diagnostic tests were developed and refined for antibody and pathogen detection, transmission studies confirmed the pathogenicity of the original M. agassizii isolate, clinical (and subclinical) disease and laboratory abnormalities were characterized, many extrinsic and predisposing factors were found to play a role in morbidity and mortality associated with mycoplasmal infection, and social behavior was implicated in disease transmission. The translation of scientific research into management decisions has sometimes led to undesirable outcomes, such as euthanasia of clinically healthy tortoises. In this article, we review and assess current research on tortoise mycoplasmosis, arguably the most important chronic infectious disease of wild and captive North American and European tortoises, and update the implications for management and conservation of tortoises in the wild.

  18. Neurologic manifestations, diagnosis and management of Wilson's disease in children - an update.

    PubMed

    Alam, S T; Rahman, M M; Islam, K A; Ferdouse, Z

    2014-01-01

    Wilson's disease (WD) is a genetic disorder of copper (Cu) metabolism. It is a progressive hepatolenticular degenerative disease due to toxic accumulation of copper in the various tissues particularly in the liver, brain and eyes. The neurologic manifestations of Wilson's disease are extremely varied like simple behavioral change such as irritability, depression, deterioration of school performance to severe form of neurologic presentations like dystonia, dysarthria, tremor and gait disturbance. Early diagnosis is possible by history of progressive neurologic dysfunction, clinical examination of Kayser Flescher rings (K-F rings) in eyes, along with some important investigations like low serum ceruloplasmin, high 24 hours urinary excretion of copper, presence of basal ganglia lesion in neuro imaging of the brain. Though hepatic copper estimation done by liver biopsy is the gold standard, is not available in Bangladesh. Most of the neurodegenerative diseases have no specific treatment and worse outcome. But it has a specific treatment with life long medication that reduces copper absorption or removes the excess copper from the body. Children on therapy must be monitored regularly for response, side effects and compliance. The aim of this article is to gather update information of neurologic manifestations of Wilson's disease and proper management as well to prevent the major neurological complications and better out come. PMID:24584398

  19. Gastrointestinal cancers in inflammatory bowel disease: An update with emphasis on imaging findings.

    PubMed

    Barral, Matthias; Dohan, Anthony; Allez, Matthieu; Boudiaf, Mourad; Camus, Marine; Laurent, Valérie; Hoeffel, Christine; Soyer, Philippe

    2016-01-01

    Inflammatory bowel diseases (IBD) are associated with an increased risk of gastrointestinal cancers depending on the specific type of IBD, the extent of the disease and its location. Patients with IBD and extensive colonic involvement are at increased risk of colorectal cancer whereas patients with Crohn disease have an increased risk for small-bowel and anal carcinoma. These cancers preferentially develop on sites of longstanding inflammation. In regards to colon cancer, several key pathogenic events are involved, including chromosomal instability, microsatellite instability and hypermethylation. The risk for colon cancer in IBD patients correlates with longer disease duration, presence of sclerosing cholangitis, pancolitis, family history of colorectal cancer, early onset of the disease and severity of bowel inflammation. Identification of increased colorectal cancer risk in individual IBD patients has led to formal surveillance guidelines. Conversely, although an increased risk for other types of cancer has been well identified, no specific formal screening recommendations exist. Consequently, the role of the radiologist is crucial to alert the referring gastroenterologist when a patient with IBD presents with unusual imaging findings at either computed tomography (CT) or magnetic resonance (MR) imaging. This review provides an update on demographics, molecular, clinical and histopathological features of gastrointestinal cancers in IBD patients including colorectal carcinoma, small bowel adenocarcinoma, neuroendocrine tumors and anal carcinoma, along with a special emphasis on the current role of CT and MR imaging. PMID:26315381

  20. Update - The Earth Observing System (EOS) forward and return link data processing and communications services

    NASA Technical Reports Server (NTRS)

    Ramapriyan, H. K.; Kelly, A. C.; Smith, G. A.

    1992-01-01

    An overview is presented of the EOS ground support services in order to identify interfaces to and drivers of the data processing and communication systems. Generic system requirements are compared with those specifically needed for EOS, including processing requirements for forward link and return link data. Communications requirements for transporting the forward link data from the EOS Operations Center and for the transfer of level zero data to the EOS Data and Information System (EOSDIS) Distributed Active Archive Centers are specified. The forward and return link processing requirements of the EOS instruments from the international partners are also addressed. The overall context of EOSDIS in the Mission to Planet Earth Program is addressed.

  1. Disease, communication, and the ethics of (in) visibility.

    PubMed

    Pietrzak-Franger, Monika Monika; Holmes, Martha Stoddard

    2014-12-01

    As the recent Ebola outbreak demonstrates, visibility is central to the shaping of political, medical, and socioeconomic decisions. The symposium in this issue of the Journal of Bioethical Inquiry explores the uneasy relationship between the necessity of making diseases visible, the mechanisms of legal and visual censorship, and the overall ethics of viewing and spectatorship, including the effects of media visibility on the perception of particular "marked" bodies. Scholarship across the disciplines of communication, anthropology, gender studies, and visual studies, as well as a photographer's visual essay and memorial reflection, throw light on various strategies of visualization and (de)legitimation and link these to broader socioeconomic concerns. Questions of the ethics of spectatorship, such as how to evoke empathy in the representation of individuals' suffering without perpetuating social and economic inequalities, are explored in individual, (trans-)national, and global contexts, demonstrating how disease (in)visibility intersects with a complex nexus of health, sexuality, and global/national politics. A sensible management of visibility--an "ecology of the visible"--can be productive of more viable ways of individual and collective engagement with those who suffer. PMID:25391918

  2. Communicative competence in Alzheimer's disease: metaphor and sarcasm comprehension.

    PubMed

    Maki, Yohko; Yamaguchi, Tomoharu; Koeda, Tatsuya; Yamaguchi, Haruyasu

    2013-02-01

    The purpose of this study was to evaluate the deficits of metaphor and sarcasm comprehension in Alzheimer's disease (AD), as pragmatic interpretation such as metaphor and sarcasm comprehension is required in social communication. A total of 31 young normal controls, 104 aged normal controls (ANC), 42 patients with amnesic mild cognitive impairment (aMCI), and 30 patients with mild AD were evaluated by Metaphoric and Sarcastic Scenario Test, which consists of 5 metaphoric and 5 sarcastic questions with 5 answer choices. Scores were analyzed using the repeated measures analysis of variance (metaphor/sarcasm vs 4 participant groups). Sarcasm comprehension, which requires second-order Theory of Mind (ToM), started to deteriorate in ANC, and metaphor comprehension, which requires first-order ToM, started to deteriorate in aMCI, and both deteriorated as disease progressed. Literal interpretation of pragmatic language is characteristic in patients with mild AD. Such misinterpretation would result in social miscommunication, even if they still retained semantic-lexical competence. PMID:23221027

  3. Communication, Control, and Computer Access for Disabled and Elderly Individuals. ResourceBook 4: Update to Books 1, 2, and 3.

    ERIC Educational Resources Information Center

    Borden, Peter A., Ed.; Vanderheiden, Gregg C., Ed.

    This update to the three-volume first edition of the "Rehab/Education ResourceBook Series" describes special software and products pertaining to communication, control, and computer access, designed specifically for the needs of disabled and elderly people. The 22 chapters cover: speech aids; pointing and typing aids; training and communication…

  4. Medical Education and Communication Companies Involved in CME: An Updated Profile

    ERIC Educational Resources Information Center

    Peterson, Eric D.; Overstreet, Karen M.; Parochka, Jacqueline N.; Lemon, Michael R.

    2008-01-01

    Introduction: Medical Education and Communication Companies (MECCs) represent approximately 21% of the providers accredited by the Accreditation Council for Continuing Medical Education (ACCME), yet relatively little is known about these organizations in the greater continuing medical education (CME) community. Two prior studies described them,…

  5. Preparation in Augmentative and Alternative Communication: An Update for Speech-Language Pathology Training

    ERIC Educational Resources Information Center

    Ratcliff, Ann; Koul, Rajinder; Lloyd, Lyle L.

    2008-01-01

    Purpose: To report on data from the current survey about academic and clinical education in augmentative and alternative communication (AAC), as well as to compare these findings with earlier surveys in an attempt to identify any changes being made as programs in the United States implement the new certification standards of the American…

  6. Update: Creutzfeldt-Jakob disease associated with cadaveric dura mater grafts--Japan, 1978-2008.

    PubMed

    2008-10-24

    Creutzfeldt-Jakob disease (CJD) is the most common of the human prion diseases (also known as transmissible spongiform encephalopathies), which, according to the leading hypothesis, are caused by an abnormal protein (i.e., prion) that is able to induce abnormal folding of normal cellular prion proteins. Annual worldwide incidence of these always fatal neurodegenerative diseases is estimated at 0.5-2.0 cases per million population. CJD can occur sporadically, or as a genetic disease, or can be transmitted iatrogenically. In 1996, a new human prion disease, variant CJD (vCJD), was first described in the United Kingdom. This disease was believed to have resulted from human consumption of cattle products contaminated with the prions responsible for bovine spongiform encephalopathy (BSE, commonly known as mad cow disease). That year, in part to check for possible vCJD cases, a national survey was conducted in Japan; 821 CJD cases were identified, including 43 cases associated with receipt of cadaveric dura mater grafts. A single brand of dural graft (Lyodura) produced by a German manufacturer before May 1987 was identified as the most likely vehicle of transmission in all but one case. By 2003, continued surveillance in Japan had identified a total of 97 such cases. Since then, an additional 35 cases have been identified. This report updates previous reports and summarizes the investigation of all 132 cases to date linked to dural grafts. The results suggest that, because of the long incubation period between graft receipt and symptom onset (possibly >24.8 years), continued surveillance in Japan might identify additional CJD cases associated with dural grafts. PMID:18946463

  7. Mild Cognitive Impairment: an update in Parkinson's Disease and lessons learned from Alzheimer's Disease

    PubMed Central

    Goldman, Jennifer G.; Aggarwal, Neelum T.; Schroeder, Cynthia D.

    2016-01-01

    Summary Cognitive dysfunction is an important focus of research in Parkinson's disease (PD) and Alzheimer's disease (AD). While the concept of amnestic mild cognitive impairment (MCI) as a prodrome to AD has been recognized for many years, the construct of MCI in PD is a relative newcomer with recent development of diagnostic criteria, biomarker research programs, and treatment trials. Controversies and challenges, however, regarding PD-MCI's definition, application, heterogeneity, and different trajectories have arisen. This review will highlight current research advances and challenges in PD-MCI. Furthermore, lessons from the AD field, which has witnessed an evolution in MCI/AD definitions, relevant advances in biomarker research, and development of disease-modifying and targeted therapeutic trials will be discussed. PMID:26517759

  8. Helicobacter pylori: Effect of coexisting diseases and update on treatment regimens

    PubMed Central

    Chang, Shen-Shong; Hu, Hsiao-Yun

    2015-01-01

    The presence of concomitant diseases is an independent predictive factor for non-Helicobacter pylori (H. pylori) peptic ulcers. Patients contracting concomitant diseases have an increased risk of developing ulcer disease through pathogenic mechanisms distinct from those of H. pylori infections. Factors other than H. pylori seem critical in peptic ulcer recurrence in end stage renal disease (ESRD) and cirrhotic patients. However, early H. pylori eradication is associated with a reduced risk of recurrent complicated peptic ulcers in patients with ESRD and liver cirrhosis. Resistances to triple therapy are currently detected using culture-based and molecular methods. Culture susceptibility testing before first- or second-line therapy is unadvisable. Using highly effective empiric first-line and rescue regimens can yield acceptable results. Sequential therapy has been included in a recent consensus report as a valid first-line option for eradicating H. pylori in geographic regions with high clarithromycin resistance. Two novel eradication regimens, namely concomitant and hybrid therapy, have proven more effective in patients with dual- (clarithromycin- and metronidazole-) resistant H. pylori strains. We aim to review the prevalence of and eradication therapy for H. pylori infection in patients with ESRD and cirrhosis. Moreover, we summarized the updated H. pylori eradication regimens. PMID:26558147

  9. The beneficial role of curcumin on inflammation, diabetes and neurodegenerative disease: A recent update.

    PubMed

    Ghosh, Shatadal; Banerjee, Sharmistha; Sil, Parames C

    2015-09-01

    The concept of using phytochemicals has ushered in a new revolution in pharmaceuticals. Naturally occurring polyphenols (like curcumin, morin, resveratrol, etc.) have gained importance because of their minimal side effects, low cost and abundance. Curcumin (diferuloylmethane) is a component of turmeric isolated from the rhizome of Curcuma longa. Research for more than two decades has revealed the pleiotropic nature of the biological effects of this molecule. More than 7000 published articles have shed light on the various aspects of curcumin including its antioxidant, hypoglycemic, anti-inflammatory and anti-cancer activities. Apart from these well-known activities, this natural polyphenolic compound also exerts its beneficial effects by modulating different signalling molecules including transcription factors, chemokines, cytokines, tumour suppressor genes, adhesion molecules, microRNAs, etc. Oxidative stress and inflammation play a pivotal role in various diseases like diabetes, cancer, arthritis, Alzheimer's disease and cardiovascular diseases. Curcumin, therefore, could be a therapeutic option for the treatment of these diseases, provided limitations in its oral bioavailability can be overcome. The current review provides an updated overview of the metabolism and mechanism of action of curcumin in various organ pathophysiologies. The review also discusses the potential for multifunctional therapeutic application of curcumin and its recent progress in clinical biology. PMID:26066364

  10. Random Assignment to Illness: Teaching Illness and Disease in the Introductory Health Communication Course

    ERIC Educational Resources Information Center

    Gray, Jennifer B.; Riley, Sarah

    2011-01-01

    A key concept in health communication is the difference between disease and illness: disease refers to the physical manifestations of a condition, while illness encompasses the physical, emotional, social, communicative, and psychological experience of living with a condition. The individual illness experience takes into account the full story of…

  11. Safety Measures with Communicable Diseases. Courseware Evaluation for Vocational and Technical Education.

    ERIC Educational Resources Information Center

    Yarbrough, Stephen

    This courseware evaluation rates the "Safety Measures with Communicable Diseases" program developed by Lane Community College in Eugene, Oregon. (This program--not contained in this document--is designed to teach means of preventing the spread of communicable respiratory diseases and ways of protecting oneself.) Part A describes the program in…

  12. Impact of an EMR-Based Daily Patient Update Letter on Communication and Parent Engagement in a Neonatal Intensive Care Unit

    PubMed Central

    Palma, Jonathan P.; Keller, Heather; Godin, Margie; Wayman, Karen; Cohen, Ronald S.; Rhine, William D.; Longhurst, Christopher A.

    2013-01-01

    Summary Objective To evaluate the impact of using electronic medical record (EMR) data in the form of a daily patient update letter on communication and parent engagement in a level II neonatal intensive care unit (NICU). Study Design Parents of babies in a level II NICU were surveyed before and after the introduction of an EMR-generated daily patient update letter, Your Baby’s Daily Update (YBDU). Results Following the introduction of the EMR-generated daily patient update letter, 89% of families reported using YBDU as an information source; 83% of these families found it “very useful”, and 96% of them responded that they “always” liked receiving it. Rates of receiving information from the attending physician were not statistically significantly different pre- and post-implementation, 81% and 78%, respectively (p = 1). Though there was no statistically significant improvement in parents’ knowledge of individual items regarding the care of their babies, a trend towards statistical significance existed for several items (p <.1), and parents reported feeling more competent to manage information related to the health status of their babies (p =.039). Conclusion Implementation of an EMR-generated daily patient update letter is feasible, resulted in a trend towards improved communication, and improved at least one aspect of parent engagement—perceived competence to manage information in the NICU. PMID:23730532

  13. The Oral HIV/AIDS Research Alliance: updated case definitions of oral disease endpoints.

    PubMed

    Shiboski, C H; Patton, L L; Webster-Cyriaque, J Y; Greenspan, D; Traboulsi, R S; Ghannoum, M; Jurevic, R; Phelan, J A; Reznik, D; Greenspan, J S

    2009-07-01

    The Oral HIV/AIDS Research Alliance (OHARA) is part of the AIDS Clinical Trials Group (ACTG), the largest HIV clinical trials organization in the world. Its main objective is to investigate oral complications associated with HIV/AIDS as the epidemic is evolving, in particular, the effects of antiretrovirals on oral mucosal lesion development and associated fungal and viral pathogens. The OHARA infrastructure comprises: the Epidemiologic Research Unit (at the University of California San Francisco), the Medical Mycology Unit (at Case Western Reserve University) and the Virology/Specimen Banking Unit (at the University of North Carolina). The team includes dentists, physicians, virologists, mycologists, immunologists, epidemiologists and statisticians. Observational studies and clinical trials are being implemented at ACTG-affiliated sites in the US and resource-poor countries. Many studies have shared end-points, which include oral diseases known to be associated with HIV/AIDS measured by trained and calibrated ACTG study nurses. In preparation for future protocols, we have updated existing diagnostic criteria of the oral manifestations of HIV published in 1992 and 1993. The proposed case definitions are designed to be used in large-scale epidemiologic studies and clinical trials, in both US and resource-poor settings, where diagnoses may be made by non-dental healthcare providers. The objective of this article is to present updated case definitions for HIV-related oral diseases that will be used to measure standardized clinical end-points in OHARA studies, and that can be used by any investigator outside of OHARA/ACTG conducting clinical research that pertains to these end-points. PMID:19594839

  14. THE RARE DISEASES CLINICAL RESEARCH NETWORK CONTACT REGISTRY UPDATE: FEATURES AND FUNCTIONALITY

    PubMed Central

    Richesson, Rachel; Sutphen, Rebecca; Shereff, Denise; Krischer, Jeff

    2013-01-01

    The Rare Diseases Clinical Research Network (RDCRN) Contact Registry has grown in size and scope since it was first reported in this journal in 2007. In this paper, we reflect on our seven years’ experience developing and expanding the RDCRN Contact Registry to include many more rare diseases. We present the functional and data requirements that motivated this registry, and the new features and policies that have been developed since. Given the high costs and long-term commitment required to build patient registries, the RDCRN Contact Registry experience represents a reasonable approach for identifying and cultivating potential research populations, with minimal resources and patient burden. The basic model of a patient-reported registry has not changed since our 2007 report, but the number of diseases has grown from 42 to 201, and the types of information that are exchanged with participants has expanded. A patient-directed information-sharing feature has been added to reduce barriers to communication between investigators and patients affected by rare and genetic diseases. As specific data and research needs arise, the Contact Registry can be leveraged to access needed data or to solicit patients for particular research opportunities. This multiple-disease registry is scalable, expandable, and standards-driven, and has become a model for clinical and translational research across rare and many other diseases. PMID:22405970

  15. Communication.

    ERIC Educational Resources Information Center

    Strauss, Andre

    The following essays on communication are presented: communication as a condition of survival, communication for special purposes, the means of transmission of communication, communication within social and economic structures, the teaching of communication through the press, the teaching of modern languages, communication as a point of departure,…

  16. Chronic beryllium disease: an updated model interaction between innate and acquired immunity.

    PubMed

    Sawyer, Richard T; Maier, Lisa A

    2011-02-01

    During the last decade, there have been concerted efforts to reduce beryllium (Be) exposure in the workplace and thereby reduce potential cases of this occupational lung disorder. Despite these efforts, it is estimated that there are at least one million Be-exposed individuals in the U.S. who are potentially at risk for developing chronic beryllium disease (CBD). Previously, we reviewed the current CBD literature and proposed that CBD represents a model interaction between innate and acquired immunity (Sawyer et al., Int Immunopharmacol 2:249-261, 2002). We closed this review with a section on "future directions" that identified key gaps in our understanding of the pathogenesis of CBD. In the intervening period, progress has been made to fill in some of these gaps, and the current review will provide an update on that progress. Based on recent findings, we provide a new hypothesis to explain how Be drives sustained chronic inflammation and granuloma formation in CBD leading to progressive compromised lung function in CBD patients. This paradigm has direct implications for our understanding of the development of an immune response to Be, but is also likely applicable to other immune-mediated lung diseases of known and unknown etiology. PMID:20981472

  17. [Human herpesvirus-6-associated diseases in hematopoietic stem cell transplantation: an update].

    PubMed

    Ogata, Masao

    2016-03-01

    Human herpesvirus (HHV)-6 belongs to the Betaherpesvirinae subfamily of human herpesviruses. Primary HHV-6 infection commonly causes exanthem subitum. Like other herpesviruses, HHV-6 is capable of persisting in the host after the primary infection. Under conditions of immunosuppression, latent HHV-6 can be reactivated. Between 30% and 70% of patients who undergo allogeneic hematopoietic cell transplantation (allo-HCT) experience HHV-6 reactivation at 2-4 weeks after transplantation. Accumulating evidence indicates that HHV-6 is an actual cause of encephalitis after allo-HCT. Risk factors for HHV-6 encephalitis include cord blood transplantation and an inflammatory milieu, which occurs in the early period after allo-HCT. Although HHV-6 encephalitis is associated with a poor prognosis, no validated treatments or preventative measures have as yet been established. HHV-6 reactivation may also cause myelitis, bone marrow suppression, lung disease, hepatitis, delirium, and graft-versus-host disease. However, such associations have not been consistently demonstrated and causality remains uncertain. This review updates the latest information regarding the clinical syndrome accompanying HHV-6 reactivation, with a particular focus on HHV-6 encephalitis, in the form of a series of questions and answers. PMID:27076241

  18. Primary Immunodeficiency Diseases: An Update on the Classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency

    PubMed Central

    Al-Herz, Waleed; Bousfiha, Aziz; Casanova, Jean-Laurent; Chatila, Talal; Conley, Mary Ellen; Cunningham-Rundles, Charlotte; Etzioni, Amos; Franco, Jose Luis; Gaspar, H. Bobby; Holland, Steven M.; Klein, Christoph; Nonoyama, Shigeaki; Ochs, Hans D.; Oksenhendler, Erik; Picard, Capucine; Puck, Jennifer M.; Sullivan, Kate; Tang, Mimi L. K.

    2014-01-01

    We report the updated classification of primary immunodeficiencies (PIDs) compiled by the Expert Committee of the International Union of Immunological Societies. In comparison to the previous version, more than 30 new gene defects are reported in this updated version. In addition, we have added a table of acquired defects that are phenocopies of PIDs. For each disorder, the key clinical and laboratory features are provided. This classification is the most up-to-date catalog of all known PIDs and acts as a current reference of the knowledge of these conditions and is an important aid for the molecular diagnosis of patients with these rare diseases. PMID:24795713

  19. [Tooth color matching systems and communication with dental laboratory in indirect restorations: 2011 update].

    PubMed

    Ginzburg, M; Gilboa, I

    2012-01-01

    There has been many technological developments in the last decade. Today's shade-matching technologies have been developed in an effort to increase the success of color matching, communication, reproduction and verification in clinical dentistry and, ultimately, to increase the efficiency of esthetic restorative work within any practice. In general, the output of the color measurements can be classified and specified in several ways. The most common systems for describing color are Munsell's System and the international Commission on Illumination (CIE) L a b color system. Albert Munsell described color as a three-dimensional phenomenon. He described the three dimensions as hue, value (brightness), and chroma (saturation). Visual colour determination by comparison of teeth and shade guides is the most frequently applied method in dentistry. Vitapan Classical (Vita Zahnfabrik, Germany) and its derivations(evidence-based Vitapan 3D-Master shade guide and Linearguide) are the most commonly used shade guides. However, several factors can influence consistency of visual colour selection and specification: individual colour matching ability may vary, the colour perception of any individual may show temporal variation, the range of shades available is inadequate and does not cover the complete colour space of natural teeth, the shade guide tabs are not systematically distributed in their colour space, and changes in lighting conditions can cause alterations in perceived colour. instruments for clinical shade-matching encompass spectrophotometers, colorimeters and digital imaging systems. It can be concluded that different devices have different accuracy and precision. Colorimeters are significantly less reliable than spectrophotometers and digital cameras. Benefits and limitations exist, and the clinician must consider how the technology relates to expectations and needs. Combination of visual colour determination (Vitapan 3D-Master shade guide and Linearguide) with

  20. Global Foot-and-Mouth Disease Research Update and Gap Analysis: 3 - Vaccines.

    PubMed

    Robinson, L; Knight-Jones, T J D; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

    2016-06-01

    This study assessed research knowledge gaps in the field of FMDV (foot-and-mouth disease virus) vaccines. The study took the form of a literature review (2011-15) combined with research updates collected in 2014 from 33 institutes from across the world. Findings were used to identify priority areas for future FMD vaccine research. Vaccines play a vital role in FMD control, used both to limit the spread of the virus during epidemics in FMD-free countries and as the mainstay of disease management in endemic regions, particularly where sanitary controls are difficult to apply. Improvements in the performance or cost-effectiveness of FMD vaccines will allow more widespread and efficient disease control. FMD vaccines have changed little in recent decades, typically produced by inactivation of whole virus, the quantity and stability of the intact viral capsids in the final preparation being key for immunogenicity. However, these are exciting times and several promising novel FMD vaccine candidates have recently been developed. This includes the first FMD vaccine licensed for manufacture and use in the USA; this adenovirus-vectored FMD vaccine causes in vivo expression of viral capsids in vaccinated animals. Another promising vaccine candidate comprises stabilized empty FMDV capsids produced in vitro in a baculovirus expression system. Recombinant technologies are also being developed to improve otherwise conventionally produced inactivated vaccines, for example, by creating a chimeric vaccine virus to increase capsid stability and by inserting sequences into the vaccine virus for desired antigen expression. Other important areas of ongoing research include enhanced adjuvants, vaccine quality control procedures and predicting vaccine protection from immune correlates, thus reducing dependency on animal challenge studies. Globally, the degree of independent vaccine evaluation is highly variable, and this is essential for vaccine quality. Previously neglected, the

  1. Global Foot-and-Mouth Disease Research Update and Gap Analysis: 7 - Pathogenesis and Molecular Biology.

    PubMed

    Robinson, L; Knight-Jones, T J D; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

    2016-06-01

    We assessed research knowledge gaps in the fields of FMDV (foot-and-mouth disease virus) pathogenesis and molecular biology by performing a literature review (2011-15) and collecting research updates (2014) from 33 institutes from across the world. Findings were used to identify priority areas for future research. There have been important advances in FMDV pathogenesis; FMDV remains in lymph nodes of many recovered animals that otherwise do not appear persistently infected, even in species previously not associated with the carrier state. Whether virus retention helps maintain host immunity and/or virus survival is not known. Studies of FMDV pathogenesis in wildlife have provided insights into disease epidemiology, in endemic and epidemic settings. Many aspects of FMDV infection and virus entry remain unknown; however, at the cellular level, we know that expression level and availability of integrins (that permit viral entry), rate of clearance of infected cells and strength of anti-viral type I IFN (interferon) response are key determinants of tissue tropism. Extending findings to improved understanding of transmission requires a standardized approach and adoption of natural routes of infection during experimental study. There has been recognition of the importance of autophagosomes for FMDV entry into the cytoplasm following cell surface receptor binding, and that distinct internal cellular membranes are exploited for viral replication and immune evasion. New roles for viral proteins in blocking type I IFN production and downstream signalling have been identified facilitating research in anti-viral therapeutics. We know more about how infection affects cell protein expression, and research into molecular determinants of capsid stability has aided the development of stable vaccines. We have an expanding knowledge of viral and host molecular determinates of virulence and infectiousness, and of how phylogenetics may be used to estimate vaccine match and strain

  2. The current situation of meningococcal disease in Latin America and updated Global Meningococcal Initiative (GMI) recommendations.

    PubMed

    Sáfadi, Marco Aurélio P; O'Ryan, Miguel; Valenzuela Bravo, Maria Teresa; Brandileone, Maria Cristina C; Gorla, Maria Cecília O; de Lemos, Ana Paula S; Moreno, Gabriela; Vazquez, Julio A; López, Eduardo L; Taha, Muhamed-Kheir; Borrow, Ray

    2015-11-27

    The Global Meningococcal Initiative (GMI) was established in 2009 and comprises an international team of scientists, clinicians, and public health officials with expertise in meningococcal disease (MD). Its primary goal is to promote global prevention of MD through education, research, international cooperation, and developing recommendations that include decreasing the burden of severe disease. The group held its first roundtable meeting with experts from Latin American countries in 2011, and subsequently proposed several recommendations to reduce the regional burden of MD. A second roundtable meeting was convened with Latin American representatives in June 2013 to reassess MD epidemiology, vaccination strategies, and unmet needs in the region, as well as to update the earlier recommendations. Special emphasis was placed on the emergence and spread of serogroup W disease in Argentina and Chile, and the control measures put in place in Chile were a particular focus of discussions. The impact of routine meningococcal vaccination programs, notably in Brazil, was also evaluated. There have been considerable improvements in MD surveillance systems and diagnostic techniques in some countries (e.g., Brazil and Chile), but the lack of adequate infrastructure, trained personnel, and equipment/reagents remains a major barrier to progress in resource-poor countries. The Pan American Health Organization's Revolving Fund is likely to play an important role in improving access to meningococcal vaccines in Latin America. Additional innovative approaches are needed to redress the imbalance in expertise and resources between countries, and thereby improve the control of MD. In Latin America, the GMI recommends establishment of a detailed and comprehensive national/regional surveillance system, standardization of laboratory procedures, adoption of a uniform MD case definition, maintaining laboratory-based surveillance, replacement of polysaccharide vaccines with conjugate

  3. Communication strategies to help reduce the prevalence of non-communicable diseases: Proceedings from the inaugural IFIC Foundation Global Diet and Physical Activity Communications Summit

    PubMed Central

    Fernstrom, Madelyn H; Reed, Kimberly A; Rahavi, Elizabeth B; Dooher, Carrie C

    2012-01-01

    Non-communicable diseases (NCDs), which include cardiovascular disease, cancer, and diabetes, all of which are associated with the common risk factors of poor diet and insufficient physical activity, caused 63% of all deaths globally in 2008. The increasing discussion of global NCDs, including at the 2011 United Nations General Assembly High-level Meeting on the Prevention and Control of Non-communicable Diseases, and a request for multi-stakeholder engagement, prompted the International Food Information Council Foundation to sponsor the Global Diet and Physical Activity Communications Summit: “Insights to Motivate Healthful, Active Lifestyles” on September 19, 2011, in New York City. The Summit brought together a diverse group of stakeholders, representing 34 nations from governments; communication, health, nutrition, and fitness professions; civil society; nonprofits; academia; and the private sector. The Summit provided expert insights and best practices for the use of science-based, behavior-focused communications to motivate individuals to achieve healthful, active lifestyles, with the goal of reducing the prevalence of NCDs. Presented here are some of the highlights and key findings from the Summit. PMID:22537216

  4. Prion Diseases: Update on Mad Cow Disease, Variant Creutzfeldt-Jakob Disease, and the Transmissible Spongiform Encephalopathies.

    PubMed

    Janka, Jacqueline; Maldarelli, Frank

    2004-08-01

    Transmissible spongiform encephalopathies (TSEs) are a group of progressive, fatal neurodegenerative disorders that share a common spongiform histopathology. TSEs may be transmitted in a sporadic, familial, iatrogenic, or zoonotic fashion. The putative infectious agent of TSE, the prion, represents a novel paradigm of infectious disease with disease transmission in the absence of nucleic acid. Several small but spectacular epidemics of TSEs in man have prompted widespread public health and food safety concerns. Although TSEs affect a comparatively small number of individuals, prion research has revealed fascinating insights of direct relevance to common illnesses. This paper reviews recent advances that have shed new light on the nature of prions and TSEs. PMID:15265460

  5. Communicating risk and promoting disease mitigation measures in epidemics and emerging disease settings

    PubMed Central

    Schiavo, Renata; Leung, May May; Brown, Mason

    2014-01-01

    Objective This review aims to identify and assess evidence on interventions to communicate risk and promote disease mitigation measures in epidemics and emerging disease outbreak settings. The study focuses on data that are relevant to low and middle-income country (LMIC) settings. Methods We conducted a comprehensive literature search using five major electronic databases (Pubmed Medline, Biomed Central, EMBASE, Science of Citation Index, and Cochrane Library) and other sources to identify relevant studies published from January 2002 to July 2013. The review was guided by the socio-ecological model/perspective of public health and the ideation theory and focused on interventions at the community, healthcare, and multi-sectoral settings, which also reflect key intervention levels of the Ottawa Charter for Health Promotion. Eligible quantitative studies were selected according to specific study criteria and assessed using the Critical Appraisal Skills Program (CASP) framework. Conversely, qualitative studies, reviews, case studies, and editorials were not included. Studies were selected by two independent reviewers. Results Twenty-nine relevant studies from 16 countries were included. Most studies focused on a single intervention or intervention level, rather than multi-sectoral interventions. The majority of the evidence relates to programs aimed at behavioral and social results (or relevant intermediate steps) within a specific population group. Two studies included implications for improvements in health service delivery, two studies examined the intervention’s impact on health systems-related outcomes, and three had also implications for environmental health outcomes. Cost- and health equity-related implications for select evidence were also discussed. Conclusions The paucity of well-designed quantitative evaluations of interventions to communicate health risk and promote disease control measures in LMICs does not allow for any definitive conclusions. Yet, the

  6. Developmental determinants in non-communicable chronic diseases and ageing.

    PubMed

    Bousquet, J; Anto, J M; Berkouk, K; Gergen, P; Antunes, J Pinto; Augé, P; Camuzat, T; Bringer, J; Mercier, J; Best, N; Bourret, R; Akdis, M; Arshad, S H; Bedbrook, A; Berr, C; Bush, A; Cavalli, G; Charles, M A; Clavel-Chapelon, F; Gillman, M; Gold, D R; Goldberg, M; Holloway, J W; Iozzo, P; Jacquemin, S; Jeandel, C; Kauffmann, F; Keil, T; Koppelman, G H; Krauss-Etschmann, S; Kuh, D; Lehmann, S; Carlsen, K C Lodrup; Maier, D; Méchali, M; Melén, E; Moatti, J P; Momas, I; Nérin, P; Postma, D S; Ritchie, K; Robine, J M; Samolinski, B; Siroux, V; Slagboom, P E; Smit, H A; Sunyer, J; Valenta, R; Van de Perre, P; Verdier, J M; Vrijheid, M; Wickman, M; Yiallouros, P; Zins, M

    2015-06-01

    Prenatal and peri-natal events play a fundamental role in health, development of diseases and ageing (Developmental Origins of Health and Disease (DOHaD)). Research on the determinants of active and healthy ageing is a priority to: (i) inform strategies for reducing societal and individual costs of an ageing population and (ii) develop effective novel prevention strategies. It is important to compare the trajectories of respiratory diseases with those of other chronic diseases. PMID:25616486

  7. Update on pathogenesis and predictors of response of therapeutic strategies used in inflammatory bowel disease

    PubMed Central

    Quetglas, Emilio G; Mujagic, Zlatan; Wigge, Simone; Keszthelyi, Daniel; Wachten, Sebastian; Masclee, Ad; Reinisch, Walter

    2015-01-01

    The search for biomarkers that characterize specific aspects of inflammatory bowel disease (IBD), has received substantial interest in the past years and is moving forward rapidly with the help of modern technologies. Nevertheless, there is a direct demand to identify adequate biomarkers for predicting and evaluating therapeutic response to different therapies. In this subset, pharmacogenetics deserves more attention as part of the endeavor to provide personalized medicine. The ultimate goal in this area is the adjustment of medication for a patient’s specific genetic background and thereby to improve drug efficacy and safety rates. The aim of the following review is to utilize the latest knowledge on immunopathogenesis of IBD and update the findings on the field of Immunology and Genetics, to evaluate the response to the different therapies. In the present article, more than 400 publications were reviewed but finally 287 included based on design, reproducibility (or expectancy to be reproducible and translationable into humans) or already measured in humans. A few tests have shown clinical applicability. Other, i.e., genetic associations for the different therapies in IBD have not yet shown consistent or robust results. In the close future it is anticipated that this, cellular and genetic material, as well as the determination of biomarkers will be implemented in an integrated molecular diagnostic and prognostic approach to manage IBD patients. PMID:26640330

  8. Update on molecular mechanisms of corticosteroid resistance in chronic obstructive pulmonary disease.

    PubMed

    Jiang, Zhilong; Zhu, Lei

    2016-04-01

    Chronic obstructive pulmonary disease (COPD) is an inflammatory and irreversible pulmonary disorder that is characterized by inflammation and airway destruction. In recent years, COPD has become a global epidemic due to increased air pollution and exposure to cigarette smoke. Current therapeutics using bronchiodialator and anti-inflammatory corticosteroids are most widely used for all patients with persistent COPD, but these approaches are disappointing due to limited improvement in symptom control and survival rate. More importantly, a certain number of COPD patients are resistant to the corticosteroid treatment and their symptoms worsen. Therefore, more effective anti-inflammatory drugs and combinational treatment are required. Understanding of the underlying molecular and immunological mechanisms is critical to developing new therapeutics. Lung inflammation and the released pro-inflammatory cytokines affect glucocorticoid receptor (GR), histone deacetylase 2 (HDAC2) and surfactant protein D (SP-D) activities in many cell types. Macrophages, neutrophils, airway epithelial cells and lymphocytes are involved in the induction of corticosteroid resistance. This review updated the recent advances in molecular and immunological mechanisms of steroid resistance among patients and animal models with COPD. Meanwhile we discussed novel therapeutic approaches in controlling lung inflammation and improving corticosteroid sensitivity among the steroid resistant patients with COPD. PMID:26805715

  9. Molecular determinants of selective dopaminergic vulnerability in Parkinson’s disease: an update

    PubMed Central

    Brichta, Lars; Greengard, Paul

    2014-01-01

    Numerous disorders of the central nervous system (CNS) are attributed to the selective death of distinct neuronal cell populations. Interestingly, in many of these conditions, a specific subset of neurons is extremely prone to degeneration while other, very similar neurons are less affected or even spared for many years. In Parkinson’s disease (PD), the motor manifestations are primarily linked to the selective, progressive loss of dopaminergic (DA) neurons in the substantia nigra pars compacta (SNpc). In contrast, the very similar DA neurons in the ventral tegmental area (VTA) demonstrate a much lower degree of degeneration. Elucidating the molecular mechanisms underlying the phenomenon of differential DA vulnerability in PD has proven extremely challenging. Moreover, an increasing number of studies demonstrate that considerable molecular and electrophysiologic heterogeneity exists among the DA neurons within the SNpc as well as those within the VTA, adding yet another layer of complexity to the selective DA vulnerability observed in PD. The discovery of key pathways that regulate this differential susceptibility of DA neurons to degeneration holds great potential for the discovery of novel drug targets and the development of promising neuroprotective treatment strategies. This review provides an update on the molecular basis of the differential vulnerability of midbrain DA neurons in PD and highlights the most recent developments in this field. PMID:25565977

  10. Alterations of the IKBKG locus and diseases: an update and a report of 13 novel mutations.

    PubMed

    Fusco, Francesca; Pescatore, Alessandra; Bal, Elodie; Ghoul, Aida; Paciolla, Mariateresa; Lioi, Maria Brigida; D'Urso, Michele; Rabia, Smail Hadj; Bodemer, Christine; Bonnefont, Jean Paul; Munnich, Arnold; Miano, Maria Giuseppina; Smahi, Asma; Ursini, Matilde Valeria

    2008-05-01

    Mutations in the inhibitor of kappa light polypeptide gene enhancer in B-cells, kinase gamma (IKBKG), also called nuclear factor-kappaB (NF-kB) essential modulator (NEMO), gene are the most common single cause of incontinentia pigmenti (IP) in females and anhydrotic ectodermal dysplasia with immunodeficiency (EDA-ID) in males. The IKBKG gene, located in the Xq28 chromosomal region, encodes for the regulatory subunit of the inhibitor of kappaB (IkB) kinase (IKK) complex required for the activation of the NF-kB pathway. Therefore, the remarkably heterogeneous and often severe clinical presentation reported in IP is due to the pleiotropic role of this signaling transcription pathway. A recurrent exon 4_10 genomic rearrangement in the IKBKG gene accounts for 60 to 80% of IP-causing mutations. Besides the IKBKG rearrangement found in IP females (which is lethal in males), a total of 69 different small mutations (missense, frameshift, nonsense, and splice-site mutations) have been reported, including 13 novel ones in this work. The updated distribution of all the IP- and EDA-ID-causing mutations along the IKBKG gene highlights a secondary hotspot mutation in exon 10, which contains only 11% of the protein. Furthermore, familial inheritance analysis revealed an unexpectedly high incidence of sporadic cases (>65%). The sum of the observations can aid both in determining the molecular basis of IP and EDA-ID allelic diseases, and in genetic counseling in affected families. PMID:18350553

  11. Lung cancer and its association with chronic obstructive pulmonary disease: update on nexus of epigenetics

    PubMed Central

    Sundar, Isaac K.; Mullapudi, Nandita; Yao, Hongwei; Spivack, Simon D.; Rahman, Irfan

    2013-01-01

    Purpose of review Chronic obstructive pulmonary disease (COPD) and lung cancer are the leading causes of morbidity and mortality worldwide. The current research is focused on identifying the common and disparate events involved in epigenetic modifications that concurrently occur during the pathogenesis of COPD and lung cancer. The purpose of this review is to describe the current knowledge and understanding of epigenetic modifications in pathogenesis of COPD and lung cancer. Recent findings This review provides an update on advances of how epigenetic modifications are linked to COPD and lung cancer, and their commonalities and disparities. The key epigenetic modification enzymes (e.g. DNA methyltransferases – CpG methylation, histone acetylases/deacetylases and histone methyltransferases/demethylases) that are identified to play an important role in COPD and lung tumorigenesis and progression are described in this review. Summary Distinct DNA methyltransferases and histone modification enzymes are differentially involved in pathogenesis of lung cancer and COPD, although some of the modifications are common. Understanding the epigenetic modifications involved in pathogenesis of lung cancer or COPD with respect to common and disparate mechanisms will lead to targeting of epigenetic therapies against these disorders. PMID:21537190

  12. Update on the effect of estradiol in postmenopause women with Alzheimer's disease: a systematic review.

    PubMed

    Lan, Yu-Long; Zou, Shuang; Zhang, Changfu; Li, Jun; Xu, Yinghui; Li, Shao

    2016-09-01

    Estradiol (E2) has been used in the treatment of Alzheimer's disease (AD) for many years but with various responses. Evidence from clinical studies, randomized clinical trials (RCTs), and observational studies further underscores the importance of E2 in postmenopause women diagnosed with AD. The purpose of this article is to review all clinical trials to date focusing on the E2 in AD patients to explore the evidence regarding use of E2 in AD treatments. To achieve this objective, clinical studies regarding E2 levels in AD patients and RCTs assessing AD treatment in postmenopause women were identified through searches of MEDLINE, The Cochrane Library, EMBASE, Web of Science, Ovid, and Google Scholar. E2 has demonstrated good therapeutic effectiveness in AD patients, however, further larger scale, double-blind RCTs are required before a definitive conclusion can be reached and the results need to be compared with other drugs. This update reviews the newest clinical information regarding the role of E2 in postmenopause women with AD. To our knowledge, this is the only systematic review of this area. PMID:26931740

  13. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease – 2007 update

    PubMed Central

    O’Donnell, Denis E; Aaron, Shawn; Bourbeau, Jean; Hernandez, Paul; Marciniuk, Darcy D; Balter, Meyer; Ford, Gordon; Gervais, Andre; Goldstein, Roger; Hodder, Rick; Kaplan, Alan; Keenan, Sean; Lacasse, Yves; Maltais, Francois; Road, Jeremy; Rocker, Graeme; Sin, Don; Sinuff, Tasmin; Voduc, Nha

    2007-01-01

    Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Canada that is both preventable and treatable. Our understanding of the pathophysiology of this complex condition continues to grow and our ability to offer effective treatment to those who suffer from it has improved considerably. The purpose of the present educational initiative of the Canadian Thoracic Society (CTS) is to provide up to date information on new developments in the field so that patients with this condition will receive optimal care that is firmly based on scientific evidence. Since the previous CTS management recommendations were published in 2003, a wealth of new scientific information has become available. The implications of this new knowledge with respect to optimal clinical care have been carefully considered by the CTS Panel and the conclusions are presented in the current document. Highlights of this update include new epidemiological information on mortality and prevalence of COPD, which charts its emergence as a major health problem for women; a new section on common comorbidities in COPD; an increased emphasis on the meaningful benefits of combined pharmacological and nonpharmacological therapies; and a new discussion on the prevention of acute exacerbations. A revised stratification system for severity of airway obstruction is proposed, together with other suggestions on how best to clinically evaluate individual patients with this complex disease. The results of the largest randomized clinical trial ever undertaken in COPD have recently been published, enabling the Panel to make evidence-based recommendations on the role of modern pharmacotherapy. The Panel hopes that these new practice guidelines, which reflect a rigorous analysis of the recent literature, will assist caregivers in the diagnosis and management of this common condition. PMID:17885691

  14. Global Foot-and-Mouth Disease Research Update and Gap Analysis: 5 - Biotherapeutics and Disinfectants.

    PubMed

    Robinson, L; Knight-Jones, T J D; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

    2016-06-01

    We assessed knowledge gaps in foot-and-mouth disease (FMD) research. Findings are reported in a series of papers, and in this article, we consider biotherapeutics and disinfectants. The study took the form of a literature review (2011-2015) combined with research updates collected in 2014 from 33 institutes from across the world. Findings were used to identify priority areas for future FMD research. While vaccines will remain the key immunological intervention used against FMD virus (FMDV) for the foreseeable future, it takes a few days for the immune system to respond to vaccination. In an outbreak situation, protection could potentially be provided during this period by the application of rapid, short-acting biotherapeutics, aiming either to stimulate a non-specific antiviral state in the animal or to specifically inhibit a part of the viral life cycle. Certain antiviral cytokines have been shown to promote rapid protection against FMD; however, the effects of different immune-modulators appear to vary across species in ways and for reasons that are not yet understood. Major barriers to the effective incorporation of biotherapeutics into control strategies are cost, limited understanding of their effect on subsequent immune responses to vaccines and uncertainty about their potential impact if used for disease containment. Recent research has highlighted the importance of environmental contamination in FMDV transmission. Effective disinfectants for FMDV have long been available, but research is being conducted to further develop methods for quantitatively evaluating their performance under field, or near-field, conditions. During outbreaks in South Korea in 2010 there was public concern about potential environmental contamination after the mass use of disinfectant and mass burial of culled stock; this should be considered during outbreak contingency planning. PMID:27320166

  15. Global Foot-and-Mouth Disease Research Update and Gap Analysis: 2 - Epidemiology, Wildlife and Economics.

    PubMed

    Knight-Jones, T J D; Robinson, L; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

    2016-06-01

    We assessed knowledge gaps in foot-and-mouth disease (FMD) research, and in this study, we consider (i) epidemiology, (ii) wildlife and (iii) economics. The study took the form of a literature review (2011-2015) combined with research updates collected in 2014 from 33 institutes from across the world. Findings were used to identify priority areas for future FMD research. During 2011-2015, modelling studies were dominant in the broad field of epidemiology; however, continued efforts are required to develop robust models for use during outbreaks in FMD-free countries, linking epidemiologic and economics models. More guidance is needed for both the evaluation and the setting of targets for vaccine coverage, population immunity and vaccine field efficacy. Similarly, methods for seroprevalence studies need to be improved to obtain more meaningful outputs that allow comparison across studies. To inform control programmes in endemic countries, field trials assessing the effectiveness of vaccination in extensive smallholder systems should be performed to determine whether FMD can be controlled with quality vaccines in settings where implementing effective biosecurity is challenging. Studies need to go beyond measuring only vaccine effects and should extend our knowledge of the impact of FMD and increase our understanding of how to maximize farmer participation in disease control. Where wildlife reservoirs of virus exist, particularly African Buffalo, we need to better understand when and under what circumstances transmission to domestic animals occurs in order to manage this risk appropriately, considering the impact of control measures on livelihoods and wildlife. For settings where FMD eradication is unfeasible, further ground testing of commodity-based trade is recommended. A thorough review of global FMD control programmes, covering successes and failures, would be extremely valuable and could be used to guide other control programmes. PMID:27320163

  16. Contrast enhancement and elastography in endoscopic ultrasound: an update of clinical applications in pancreatic diseases.

    PubMed

    Serrani, Marta; Lisotti, Andrea; Caletti, Giancarlo; Fusaroli, Pietro

    2016-08-01

    It is well established that endoscopic ultrasound (EUS) is fundamental in the characterization of many diseases concerning different organs, i.e. pancreaticobiliary diseases, gastrointestinal pathologic conditions, and lymph nodes of unknown origin. It is also well known that many factors can hamper the accuracy of EUS, i.e. biliary stents, chronic pancreatitis, poor operator's expertise. These factors can also lead to suboptimal accuracy when cytological confirmation through EUS-fine needle aspiration (EUS-FNA) is indicated. In recent years, new technological tools have rapidly increased their clinical impact improving the diagnostic power of EUS and EUS-FNA. Among these new tools, the most investigated and useful ones are represented by contrast harmonic-EUS (CH-EUS) and EUS-elastography (EUS-E). The purpose of this paper is to provide, through a review of the literature, an update of the applications of CH-EUS and EUS-E in the routine clinical practice in pancreatic diseases. We discussed the first reports and applications of these techniques in our previous review published in Minerva Medica. The applications of CH-EUS and EUS-E to the study of pancreatic diseases appear feasible and safe. The use of both techniques is very simple and does not require any relevant additional workload for the endoscopic personnel. CH-EUS is now considered an important and accurate tool in the diagnosis of solid pancreatic masses and in the differential diagnosis of pancreatic cystic lesions. CH-EUS targeted FNA is an active field of research. However the available studies show that CH-EUS increases FNA accuracy by a little extent, without statistical significance; moreover, CH-EUS FNA showed a trend toward being more efficient vs. simple EUS FNA (less needle passes and more abundance in cytological material) but this trend did not reach statistical significance. On the other hand, the clinical impact of EUS-E in terms of differential diagnosis of pancreatic masses is still under

  17. Guidelines for Communicable Disease Control Policies in Montana Schools: A Guide and Model Policy for Communicable Diseases Including HIV Infected Students and Staff.

    ERIC Educational Resources Information Center

    Montana State Dept. of Public Instruction, Helena.

    This guide was developed to help local school districts review existing policies or establish new policies to address communicable diseases. Based on current scientific and medical information about the safety in allowing human immunodeficiency virus (HIV) infected students and staff to remain at school, it contains a suggested policy for local…

  18. Guidelines for Analysis of Communicable Disease Control Planning in Developing Countries. Volume 1: Communicable Diseases Control Planning. International Health Planning Methods Series.

    ERIC Educational Resources Information Center

    Chin, James

    Intended to assist Agency for International Development (AID) officers, advisors, and health officials in incorporating health planning into national plans for economic development, this first of ten manuals in the International Health Planning Methods Series deals with planning and evaluation of communicable disease control programs. The first…

  19. Genetic polymorphisms of interleukin genes and the risk of Alzheimer's disease: An update meta-analysis

    PubMed Central

    Mun, Myung-Jin; Kim, Jin-Ho; Choi, Ji-Young; Jang, Won-Cheoul

    2016-01-01

    Objectives Recently, several meta-analyses have reported an association between interleukin (IL) gene polymorphisms and the risk of Alzheimer's disease (AD). Several further papers discussing the relationship with the risk of AD have recently been published. The aim of this meta-analysis was to re-evaluate and update the associations between IL gene polymorphisms and the risk of AD. Methods The search sources were PubMed, Science Direct, Scopus, and Google Scholar up to July 2015, and the following search terms were used: “interleukin 1 or interleukin 6 or interleukin 10” and “variant or polymorphism or SNP” in combination with “Alzheimer's disease”. A meta-analysis using the pooled odds ratios and 95% confidence intervals was carried out to assess the associations between four polymorphisms of IL genes (− 889C > T in IL-1α, − 511C > T in IL-1β, − 174G > C in IL-6 and − 1082G > A in IL-10) and the risk of AD under the heterozygous, homozygous, dominant, and recessive models with fixed- or random-effects models. Results A total of 21,864 cases and 40,321 controls from 93 individual studies were included in this meta-analysis. Our results indicated that the − 889C > T polymorphism was strongly associated with the increased risk of AD. However, three polymorphisms were not associated with the risk of AD. Conclusions Similar to previous meta-analyses, our updated meta-analysis suggested that the − 889C > T polymorphism may be a factor in AD. However, the results of our meta-analysis of the − 174G > C polymorphism differed from those of previous meta-analyses. Consequently, we suggest that the − 174G > C polymorphism may not be a risk factor for AD. PMID:27014584

  20. The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis

    PubMed Central

    Hollands, Gareth J; French, David P; Griffin, Simon J; Prevost, A Toby; Sutton, Stephen; King, Sarah

    2016-01-01

    Objective To assess the impact of communicating DNA based disease risk estimates on risk-reducing health behaviours and motivation to engage in such behaviours. Design Systematic review with meta-analysis, using Cochrane methods. Data sources Medline, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials up to 25 February 2015. Backward and forward citation searches were also conducted. Study selection Randomised and quasi-randomised controlled trials involving adults in which one group received personalised DNA based estimates of disease risk for conditions where risk could be reduced by behaviour change. Eligible studies included a measure of risk-reducing behaviour. Results We examined 10 515 abstracts and included 18 studies that reported on seven behavioural outcomes, including smoking cessation (six studies; n=2663), diet (seven studies; n=1784), and physical activity (six studies; n=1704). Meta-analysis revealed no significant effects of communicating DNA based risk estimates on smoking cessation (odds ratio 0.92, 95% confidence interval 0.63 to 1.35, P=0.67), diet (standardised mean difference 0.12, 95% confidence interval −0.00 to 0.24, P=0.05), or physical activity (standardised mean difference −0.03, 95% confidence interval −0.13 to 0.08, P=0.62). There were also no effects on any other behaviours (alcohol use, medication use, sun protection behaviours, and attendance at screening or behavioural support programmes) or on motivation to change behaviour, and no adverse effects, such as depression and anxiety. Subgroup analyses provided no clear evidence that communication of a risk-conferring genotype affected behaviour more than communication of the absence of such a genotype. However, studies were predominantly at high or unclear risk of bias, and evidence was typically of low quality. Conclusions Expectations that communicating DNA based risk estimates changes behaviour is not supported by existing evidence

  1. The general population cohort in rural south-western Uganda: a platform for communicable and non-communicable disease studies

    PubMed Central

    Asiki, Gershim; Murphy, Georgina; Nakiyingi-Miiro, Jessica; Seeley, Janet; Nsubuga, Rebecca N; Karabarinde, Alex; Waswa, Laban; Biraro, Sam; Kasamba, Ivan; Pomilla, Cristina; Maher, Dermot; Young, Elizabeth H; Kamali, Anatoli; Sandhu, Manjinder S

    2013-01-01

    The General Population Cohort (GPC) was set up in 1989 to examine trends in HIV prevalence and incidence, and their determinants in rural south-western Uganda. Recently, the research questions have included the epidemiology and genetics of communicable and non-communicable diseases (NCDs) to address the limited data on the burden and risk factors for NCDs in sub-Saharan Africa. The cohort comprises all residents (52% aged ≥13years, men and women in equal proportions) within one-half of a rural sub-county, residing in scattered houses, and largely farmers of three major ethnic groups. Data collected through annual surveys include; mapping for spatial analysis and participant location; census for individual socio-demographic and household socioeconomic status assessment; and a medical survey for health, lifestyle and biophysical and blood measurements to ascertain disease outcomes and risk factors for selected participants. This cohort offers a rich platform to investigate the interplay between communicable diseases and NCDs. There is robust infrastructure for data management, sample processing and storage, and diverse expertise in epidemiology, social and basic sciences. For any data access enquiries you may contact the director, MRC/UVRI, Uganda Research Unit on AIDS by email to mrc@mrcuganda.org or the corresponding author. PMID:23364209

  2. Communicable and non-communicable diseases among recent immigrants with implications for primary care; a comprehensive immigrant health approach.

    PubMed

    Asgary, Ramin; Naderi, Ramesh; Swedish, Kristin A; Smith, Clyde L; Sckell, Blanca; Doorley, Sara

    2011-12-01

    Data on health status of immigrants and practice recommendations for providers are scarce. We evaluated 99 recent immigrants from developing nations in an immigrant clinic in New York City to assess epidemiology of diseases and to recommend potential screening. Providers received ongoing training. Majority patient was from West Africa and Central America with a mean of 2.1 years in the US. Two thirds were uninsured. Half had positive PPD. Half had prior hepatitis B infection, which was higher in Africans. One quarter had intestinal parasites. Two thirds were overweight; 33% had hypercholesterolemia, 26% were hypertensive, and 25% of women had a Pap smear previously. Eosinophila was higher in African and males (P < 0.05) but didn't predict stool O&P. Recent immigrants were at risk for chronic non-communicable diseases, similar to the US population. Providers should balance their focus on communicable and non-communicable diseases. We recommend practice-based training and on-site comprehensive health services. PMID:21573748

  3. Informing College Students about Venereal Disease: The Mass Communication of a Public Issue.

    ERIC Educational Resources Information Center

    Buckley, John E.

    An information campaign was conducted at the University of Tennessee at Knoxville in cooperation with the student health service to determine the effects of the communication of venereal disease information on the attitudes and behaviors of students. Specifically, the campaign sought to increase students' knowledge of venereal disease and…

  4. Global Foot-and-Mouth Disease Research Update and Gap Analysis: 6 - Immunology.

    PubMed

    Robinson, L; Knight-Jones, T J D; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

    2016-06-01

    This study assessed gaps and priorities for FMDV (foot-and-mouth disease virus) research in the field of immunology. The study took the form of a literature review (2011-15) combined with research updates collected in 2014 from 33 institutes from across the world. Findings were used to identify priority areas for future FMD research. Improved understanding of FMDV immunology facilitates the development of vaccines, adjuvants and diagnostic tests, and will allow better assessment and prediction of vaccine potency and match, with reduced use of animals, particularly large animals, in experimental studies. Continued characterization of the immune systems of several FMD host species has underpinned substantial advances in knowledge of their interaction with FMDV. Recent studies have shed light on the mechanisms underlying formation of the bovine B- and T-cell response; there is also a greater understanding of the significance of non-neutralizing antibodies during FMDV infection and the interactions of antibody-bound virus with immune cells. This knowledge is directly relevant to vaccine development, as well as understanding protection and cross-protection. Despite ongoing research, significant knowledge gaps remain in the areas of neonatal and mucosal immunity. The impact of maternally derived antibody upon the neonate's ability to respond to FMD vaccination has received some attention, but few firm conclusions can be drawn at this stage, and little is known of the cellular response of young animals in general. The mucosal immune system of FMDV-susceptible species requires continued characterization, especially if the potential of mucosal vaccine-delivery systems is to be realized for FMD immunization. PMID:27320167

  5. Global Foot-and-Mouth Disease Research Update and Gap Analysis: 4 - Diagnostics.

    PubMed

    Knight-Jones, T J D; Robinson, L; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

    2016-06-01

    This study assessed knowledge gaps in foot-and-mouth disease (FMD) research in the field of diagnostics. The study took the form of a literature review (2011-15) combined with research updates collected in 2014 from 33 institutes from around the world. Findings were used to identify priority areas for future FMD research. Molecular and genetic technologies, including sequencing, are developing at an increasing rate both in terms of capability and affordability. These advances potentiate progress in many other fields of research, from vaccine development to epidemiology. The development of RT-LAMP represents an important breakthrough allowing greater use and access to molecular diagnostics. It is now possible to determine virus serotype using PCR, although only for certain virus pools, continued progress is needed to cover the global spectrum of FMD viruses. Progress has also been made in the development of pen-side rapid diagnostics, some with the ability to determine serotype. However, further advances in pen-side serotype or strain determination would benefit both FMD-free countries and endemic countries with limited access to well-resourced laboratories. Novel sampling methods that show promise include air sampling and baited ropes, the latter may aid sampling in wildlife and swine. Studies of infrared thermography for the early detection of FMD have not been encouraging, although investigations are ongoing. Multiplex tests have been developed that are able to simultaneously screen for multiple pathogens with similar clinical signs. Crucial for assessing FMDV freedom, tests exist to detect animals that have been infected with FMDV regardless of vaccination status; however, limitations exist, particularly when testing previously vaccinated animals. Novel vaccines are being developed with complementary DIVA tests for this purpose. Research is also needed to improve the current imprecise approaches to FMD vaccine matching. The development of simple, affordable

  6. Association between polymorphism of COMT gene (Val158Met) with Alzheimer's disease: An updated analysis.

    PubMed

    Yan, Weiqian; Zhao, Cheng; Sun, Lu; Tang, Beisha

    2016-02-15

    Previous studies have proposed the association between catechol-o-methyltransferase (COMT) Val158Met polymorphism and the risk of Alzheimer's disease (AD). However, there has been no solid conclusion from those reports because of the limited sample size and/or racial diversity. Here we aimed to give an in-depth and accurate evaluation of this association by performing a comprehensive literature search on websites including PubMed, EMBASE, Alzgene database, Cochrane library and Ovid database. In further meta-analysis we identified 10 case-control studies which contained total 2777 cases and 2829 controls. Summarized odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were assessed to reveal the association. There was no significant association between COMT Val158Met polymorphism and AD susceptibility in all genetic models for the entire population. In the contrast the subgroup analysis stratified by ethnicity revealed significant differences in the Asian population in the dominant (OR=0.66, 95%CI=0.50, 0.87, p=0.004); homozygous (OR=0.66, 95%CI=0.50, 0.89, p=0.006); and heterozygous models (OR=0.65, 95%CI=0.48, 0.87, p=0.004). However, no association was found in the Caucasians population. Similarly to the overall analysis, subgroup analysis of the control population stratified with HWE showed negative results. With the latest comprehensive searching strategy, our updated meta-analysis suggested that COMT Val158Met polymorphism could decrease the risk of AD in the Asian population, but not in the Caucasian or the overall population. PMID:26810551

  7. Monitoring Heart Disease and Diabetes with Mobile Internet Communications

    PubMed Central

    Mulvaney, David; Woodward, Bryan; Datta, Sekharjit; Harvey, Paul; Vyas, Anoop; Thakker, Bhaskar; Farooq, Omar; Istepanian, Robert

    2012-01-01

    A telemedicine system is described for monitoring vital signs and general health indicators of patients with cardiac and diabetic conditions. Telemetry from wireless sensors and readings from other instruments are combined into a comprehensive set of measured patient parameters. Using a combination of mobile device applications and web browser, the data can be stored, accessed, and displayed using mobile internet communications to the central server. As an extra layer of security in the data transmission, information embedded in the data is used in its verification. The paper highlights features that could be enhanced from previous systems by using alternative components or methods. PMID:23213330

  8. Implementing a public web based GIS service for feedback of surveillance data on communicable diseases in Sweden

    PubMed Central

    Rolfhamre, Per; Grabowska, Katarzyna; Ekdahl, Karl

    2004-01-01

    Background Surveillance data allow for analysis, providing public health officials and policy-makers with a basis for long-term priorities and timely information on possible outbreaks for rapid response (data for action). In this article we describe the considerations and technology behind a newly introduced public web tool in Sweden for easy retrieval of county and national surveillance data on communicable diseases. Methods The web service was designed to automatically present updated surveillance statistics of some 50 statutory notifiable diseases notified to the Swedish Institute for Infectious Disease Control (SMI). The surveillance data is based on clinical notifications from the physician having treated the patient and laboratory notifications, merged into cases using a unique personal identification number issued to all Swedish residents. The web service use notification data from 1997 onwards, stored in a relational database at the SMI. Results The web service presents surveillance data to the user in various ways; tabulated data containing yearly and monthly disease data per county, age and sex distribution, interactive maps illustrating the total number of cases and the incidence per county and time period, graphs showing the total number of cases per week and graphs illustrating trends in the disease data. The system design encompasses the database (storing the data), the web server (holding the web service) and an in-the-middle computer (to ensure good security standards). Conclusions The web service has provided the health community, the media, and the public with easy access to both timely and detailed surveillance data presented in various forms. Since it was introduced in May 2003, the system has been accessed more than 1,000,000 times, by more than 10,000 different viewers (over 12.600 unique IP-numbers). PMID:15191619

  9. Prevention of spread of communicable disease by air travel.

    PubMed

    Evans, Anthony D; Thibeault, Claude

    2009-07-01

    Mathematical modeling suggests that travel restrictions are likely to have only a limited effect on minimizing the spread of disease. Nevertheless, medical screening of travelers remains an option to be considered in a risk-reduction strategy. Screening of departing and/or arriving travelers are possibilities, although the World Health Organization (WHO) favors the former as it is normally easier to geographically contain a disease prior to its transmission outside the outbreak area. Apart from airport screening, several other related issues require consideration, including: transmission of disease on board aircraft; transmission of disease in airport terminal buildings; and contact tracing. A major challenge is to ensure adequate resources are devoted to pandemic preparedness planning in the aviation sector, which may not be fully considered in a national preparedness plan. This is because the prevention of accidents occupies most of the attention of regulatory aviation authorities, and public health authorities do not always see aviation as a priority area. Chief medical officers of regulatory authorities may be in a position to facilitate collaboration between the many stakeholders involved in preparedness planning for aviation. PMID:19601500

  10. Molecular mechanisms of cryptorchidism development: update of the database, disease comorbidity, and initiative for standardization of reporting in scientific literature.

    PubMed

    Urh, K; Kunej, T

    2016-09-01

    Cryptorchidism is a frequent urogenital abnormality that may be present at birth (congenital form) or develop later in life (acquired form). It represents 2-4% full-term male births. It has a potential effect on health; defects in testes descent usually cause impaired spermatogenesis resulting in reduced fertility and increased rates of testicular neoplasia, and testicular torsion. In our previous study, we developed a cryptorchidism gene database which consists of 217 genomic variations associated with development of cryptorchidism in seven mammalian species. The number of studies and study approaches in this field are increasing; therefore, update of the database was needed. The search of multi-omics data was performed and the updated database includes 280 genomic variations associated with cryptorchidism in seven species. The catalog has been complemented with additional data including: number of participants (patients/controls), race/ethnicity, clinical data (age period at diagnosis), congenital/acquired cryptorchidism, unilateral (left/right)/bilateral cryptorchidism, disease comorbidity, and disease ontology. Collected data revealed that cryptorchidism has been reported to be co-present with 150 comorbid conditions, including several syndromes, reproductive, cardiovascular, ophthalmologic, dermatologic, mental, and bone disorders, deafness, and cancer. However, updating the database is time-consuming because of the heterogeneity of results and methodology in scientific literature. The field lacks a standardized format for reporting associations between genotype and phenotype which would enable faster development of the database, data integration, sharing, and facilitate biomarker development. Therefore, in this study, we updated a database of cryptorchidism genes and suggested a first step toward standardization of the format for reporting results of original as well as review studies which we suggest implementing into the scientific literature that reports

  11. Communications

    NASA Technical Reports Server (NTRS)

    Stouffer, Donald D.

    1990-01-01

    Communication in its many forms is a critical component for an effective Space Grant Program. Good communication is needed within individual Space Grant College/Consortia, for example between consortium affiliates and the consortium program office. Effective communication between the several programs, NASA Headquarters, and NASA field centers also is required. Further, communication among the above program elements, industry, local and state government, and the public also are necessary for meeting program objectives.

  12. Dopamine depletion affects communicative intentionality in Parkinson's disease patients: Evidence from action kinematics.

    PubMed

    Straulino, Elisa; Scaravilli, Tomaso; Castiello, Umberto

    2016-04-01

    Appropriate communication is at the heart of successful, healthy social interactions in humans. Deficits in social communication are a hallmark of several neurological and psychiatric disorders. Yet, very little research has been devoted to understanding the mechanisms underlying these issues. It has been suggested that dopamine is a candidate neurotransmitter system involved in stimulating communication in individuals that are not highly motivated to communicate. A typical model to study dopaminergic dysfunctions in humans is represented by Parkinson's disease (PD) patients, who show motor, cognitive and motivational symptoms. Our study aimed to investigate the effects of social communication on actions in non-demented PD patients receiving dopamine replacement therapy (Levodopa = l-Dopa) and in neurologically healthy control participants. Patients' ability to modulate motor patterning depending on the communicative intention motivating the action to be performed was evaluated both in "on" (with l-Dopa) and "off" (without l-Dopa) states. In two main conditions, participants were requested to reach towards, grasp an object, and either simply lift it (individual condition) or lift it with the intent to communicate a meaning to a partner (communicative condition). Movements' kinematics was recorded using a three-dimensional motion analysis system. The results indicate that kinematics is sensitive to communicative intention and that l-Dopa treatment has positive effects on translating communicative intentions into specific motor patterns in PD patients. Although the to-be-grasped object remained the same both the controls and the PD patients in an 'on' state adopted different kinematic patterning for the 'individual' and the 'communication' conditions. The PD patients in the 'off' state, instead, were unable to kinematically differentiate between the two conditions. We contend that social and communicative impairments are associated with abnormalities in

  13. First Italian Ebola virus disease case: management of hospital internal and external communication.

    PubMed

    Salce, Lorella; Barbato, Simona; Renna, Daniela; Bianchini, Francesco; Vaccaro, Paola; Mazzeo, Fabio; Gasparini, Annunziatina; Rizza, Claudio; Lanfranchi, Emanuele; Petrosillo, Nicola; Nicastri, Emanuele; Di Caro, Antonino; Capobianchi, Maria R; Puro, Vincenzo; Ippolito, Giuseppe

    2015-10-01

    On November 25, 2014, an Italian physician infected by Ebola virus in Sierra Leone was admitted to the "Lazzaro Spallanzani" National Institute for Infectious Diseases in Rome, Italy. He was the first Italian case and was successfully cured in 38 days. The staff responsible for communication had a critical role ensuring that this challenging mission went smoothly. The Institutional Press Office working together with the press offices of the Ministry of Health was able to provide the high level of expertise necessary within both medical and communication contexts. Communication strategy, tools and procedures adopted before and after the arrival of the patient are summarized. PMID:26485015

  14. An Unequal Burden: Poor Patient-Provider Communication and Sickle Cell Disease

    PubMed Central

    Haywood, Carlton; Bediako, Shawn; Lanzkron, Sophie; Diener-West, Marie; Strouse, John; Haythornthwaite, Jennifer; Onojobi, Gladys; Beach, Mary Catherine

    2014-01-01

    Objective To assess disparities in the quality of healthcare provider communication experienced by African-American adults with and without sickle cell disease (SCD) in the U.S. Methods Poor provider communication was assessed by the Provider Communication subscale of the Consumer Assessment of Healthcare Plans and Systems survey. The SCD sample was obtained from participants in a multicenter observational study of healthcare experiences. The national African-American sample data was obtained from published national estimates. Results The SCD sample was more likely than the national sample to report poor communication in 3 out of 4 communication domains: Listening (22.3% vs. 11.5%, p < 0.0001); Showing Respect (26.1% vs. 9.5%, p < 0.0001); and Spending Enough Time (38.3% vs. 16.2%, p < 0.0001). Differences were consistent in young, but not old, patients and showed some variation by self-reported health status and education. Conclusions The communication difficulties experienced by persons with SCD do not appear reducible to their predominantly African-American race, but may result from more disease-specific factors. Practice Implications Healthcare providers should take particular care in recognizing and demonstrating recommended communication skills with SCD patients as these patients may be particularly vulnerable to, and cognizant of, poor quality interactions. PMID:24935607

  15. Legal aspects of public health: how law frames communicable disease control in Greece.

    PubMed

    Hatzianastasiou, Sophia; Pavli, Androula; Maltezou, Helena C

    2011-11-01

    We reviewed Greek law (legislation, historic Royal Decrees, and modern Presidential ones, 1833-2010) pertinent to control of communicable diseases and compared this body of Greek law with the revised International Health Regulations. Greece authorizes and regulates communicable disease control commensurate with public health risks, and integrates the principles of equality, objectivity, and respect for human rights. Despite strength at the level of principles, Greek law lacks coherence, clarity, and systematization. An inadequate body of regulations means legislation falls short of adequate implementing authority and guidelines; public health authorities often cannot find or understand the laws, nor are they certain about allocation of jurisdictional authority. We identified areas for improvement. PMID:21866179

  16. Fetal Programming and the Risk of Non-communicable Disease

    PubMed Central

    Fall, Caroline HD

    2012-01-01

    The “developmental origins of health and disease” (DOHaD) hypothesis proposes that environmental conditions during fetal and early post-natal development influence lifelong health and capacity through permanent effects on growth, structure and metabolism. This has been called ‘programming’. The hypothesis is supported by epidemiological evidence in humans linking newborn size, and infant growth and nutrition, to adult health outcomes, and by experiments in animals showing that maternal under- and over-nutrition and other interventions (eg. glucocorticoid exposure) during pregnancy lead to abnormal metabolism and body composition in the adult offspring. Early life programming is now thought to be important in the aetiology of obesity, type 2 diabetes, and cardiovascular disease, opening up the possibility that these common diseases could be prevented by achieving optimal fetal and infant development. This is likely to have additional benefits for infant survival and human capital (eg improved cognitive performance and physical work capacity). Fetal nutrition is influenced by the mother’s diet and body size and composition, but hard evidence that the nutrition of the human mother programmes chronic disease risk in her offspring is currently limited. Recent findings from follow-up of children born after randomised nutritional interventions in pregnancy are mixed, but show some evidence of beneficial effects on vascular function, lipid concentrations, glucose tolerance and insulin resistance. Work in experimental animals suggests that epigenetic phenomena, whereby gene expression is modified by DNA methylation, and which are sensitive to the nutritional environment in early life, may be one mechanism underlying programming. PMID:22829248

  17. Multi-morbidity of non communicable diseases and equity in WHO Eastern Mediterranean countries

    PubMed Central

    2013-01-01

    Introduction Non communicable diseases are the biggest cause of death worldwide. Beside mortality, these diseases also cause high rates of morbidity and disability. Their high prevalence is generally associated to multi-morbidity. Because they need costly prolonged treatment and care, non communicable diseases have social and economical consequences that affect individuals, households and the whole society. They raise the equity problem between and within countries. Methods and limitations This annotated bibliography is a systematic review on multimorbidy of non communicable diseases and health equity in WHO Eastern Mediterranean countries. Medline/PubMed, EMBASE and other sources were used to get peer reviewed papers dealing with the review theme. The words/strings used for search and inclusion criteria were: multimorbidity, comorbidity, equity, non communicable diseases, chronic diseases, WHO Eastern Mediterranean and Arab countries. Bibliography with annotations According to the inclusion criteria, 26 papers were included in the present review. Generally, lack or paucity of publications was encountered in themes like headache, cancer and respiratory diseases. Of the 26 contributions selected, twelve dealt with comorbidity of depression and mental disorders with other chronic diseases. Another set of 11 publications was devoted to multimorbidity of diabetes, cardiovascular diseases (CVDs), hypertension, metabolic syndrome and obesity. Considering association of multimorbidity and social determinants, this review shows that female gender, low income, low level of education, old age and unemployed/retired are the most exposed to multimorbidity. It should also be stressed that, geographically, no contribution was issued from North African countries. Non communicable diseases are one of the biggest challenges facing health decision makers in WHO Eastern Mediterranean countries where the multidimensional transition is boosting increases in multimorbidity of depression

  18. PLD3 in Alzheimer's Disease: a Modest Effect as Revealed by Updated Association and Expression Analyses.

    PubMed

    Zhang, Deng-Feng; Fan, Yu; Wang, Dong; Bi, Rui; Zhang, Chen; Fang, Yiru; Yao, Yong-Gang

    2016-08-01

    Alzheimer's disease (AD) is the most common form of dementia. Numerous genome-wide association studies (GWASs) have found several AD susceptibility common loci but with limited effect size. Recent next-generation sequencing studies of large AD pedigrees had identified phospholipase D3 (PLD3) p.V232M as the potentially functional rare variant with causal effect. However, four follow-up replication studies (Brief Communications Arising on Nature) questioned that PLD3 V232M might not be so important in AD. In this study, we re-analyzed all public-available genetic (rare and common variants) and expression data of PLD3, and screened coding variants within PLD3 in probands of 18 Han Chinese families with AD, to clarify the exact involvement of PLD3 in AD. Two closest homologues of PLD3, PLD1 and PLD2, were also analyzed to comprehensively understand the role of phospholipase D members in AD. We found that PLD3 variant V232M was associated with AD risk in overall sample sets (∼40,000 subjects) with a modest to moderate effect size (odds ratio [OR] = 1.53). Our results also showed that common variants and mRNA expression alterations of PLD2 play a role in AD genetic risk and pathology. Although we provided a systematic view of the involvement of PLD3 in AD at the genetic, mRNA expression, and protein levels, we could not define the exact causal or essential role of PLD3 rare variants in AD based on currently available data. PMID:26189833

  19. Brain–Gut–Microbe Communication in Health and Disease

    PubMed Central

    Grenham, Sue; Clarke, Gerard; Cryan, John F.; Dinan, Timothy G.

    2011-01-01

    Bidirectional signalling between the gastrointestinal tract and the brain is regulated at neural, hormonal, and immunological levels. This construct is known as the brain–gut axis and is vital for maintaining homeostasis. Bacterial colonization of the intestine plays a major role in the post-natal development and maturation of the immune and endocrine systems. These processes are key factors underpinning central nervous system (CNS) signaling. Recent research advances have seen a tremendous improvement in our understanding of the scale, diversity, and importance of the gut microbiome. This has been reflected in the form of a revised nomenclature to the more inclusive brain–gut–enteric microbiota axis and a sustained research effort to establish how communication along this axis contributes to both normal and pathological conditions. In this review, we will briefly discuss the critical components of this axis and the methodological challenges that have been presented in attempts to define what constitutes a normal microbiota and chart its temporal development. Emphasis is placed on the new research narrative that confirms the critical influence of the microbiota on mood and behavior. Mechanistic insights are provided with examples of both neural and humoral routes through which these effects can be mediated. The evidence supporting a role for the enteric flora in brain–gut axis disorders is explored with the spotlight on the clinical relevance for irritable bowel syndrome, a stress-related functional gastrointestinal disorder. We also critically evaluate the therapeutic opportunities arising from this research and consider in particular whether targeting the microbiome might represent a valid strategy for the management of CNS disorders and ponder the pitfalls inherent in such an approach. Despite the considerable challenges that lie ahead, this is an exciting area of research and one that is destined to remain the center of focus for some time to come. PMID

  20. [Verbal and gestural communication in interpersonal interaction with Alzheimer's disease patients].

    PubMed

    Schiaratura, Loris Tamara; Di Pastena, Angela; Askevis-Leherpeux, Françoise; Clément, Sylvain

    2015-03-01

    Communication can be defined as a verbal and non verbal exchange of thoughts and emotions. While verbal communication deficit in Alzheimer's disease is well documented, very little is known about gestural communication, especially in interpersonal situations. This study examines the production of gestures and its relations with verbal aspects of communication. Three patients suffering from moderately severe Alzheimer's disease were compared to three healthy adults. Each one were given a series of pictures and asked to explain which one she preferred and why. The interpersonal interaction was video recorded. Analyses concerned verbal production (quantity and quality) and gestures. Gestures were either non representational (i.e., gestures of small amplitude punctuating speech or accentuating some parts of utterance) or representational (i.e., referring to the object of the speech). Representational gestures were coded as iconic (depicting of concrete aspects), metaphoric (depicting of abstract meaning) or deictic (pointing toward an object). In comparison with healthy participants, patients revealed a decrease in quantity and quality of speech. Nevertheless, their production of gestures was always present. This pattern is in line with the conception that gestures and speech depend on different communicational systems and look inconsistent with the assumption of a parallel dissolution of gesture and speech. Moreover, analyzing the articulation between verbal and gestural dimensions suggests that representational gestures may compensate for speech deficits. It underlines the importance for the role of gestures in maintaining interpersonal communication. PMID:25786429

  1. TOWARDS A 'GLOBAL' STRATEGY FOR TACKLING THE GLOBAL BURDEN OF COMMUNICABLE AND NON-COMMUNICABLE DISEASES IN RESOURSE LIMITED SETTINGS.

    PubMed

    Adesina, Adekunle; Hiruye, Abiy; Berhe, Ephrem; Haile, Amanuel; Akinloye, Olugbenga; Abreha, Hagos; Tesfaye, Hagazi; Klaus, Kimberly; Enquselassie, Fikre

    2014-10-01

    The global burden of communicable diseases (CD) and non-communicable diseases (NCD) in low and middle-income countries (LMICs) likely stems from a common substratum of societal and system inadequacies. In order to appropriately control these conditions and to manage the determinants and deterrents of both CDs and NCDs related deaths and disabilities, joint strategies aimed at both systemic and population levels are warranted. Although deficiencies exist within the health systems of LMICs, assets which could be leveraged efficiently to produce desirable outcomes also abound. Significant changes are already taking place through health initiatives within LMICs, opening up opportunities for further success through the involvement of international agencies. The role of these agencies, including donor countries and LMICs' Diaspora, is to strengthen and support the opportunities offered by on-going changes at the country level. There is a need to better understand and support the drivers and processes of positive change within LMICs in order to harness them for more widespread benefit through scale-up efforts. Strategies for addressing CDs and NCDs should be devised and implemented as complementary rather than competing 'sides of the same coin'. PMID:26410991

  2. North Carolina's Communicable-Disease Laws and Regulations Amended in Response to AIDS.

    ERIC Educational Resources Information Center

    Koeze, Jeffrey S.

    1988-01-01

    Describes some of the features of North Carolina's communicable-disease laws and regulations focusing on the problem of the human immunodeficiency virus (HIV) that is the cause of the acquired immunodeficiency syndrome (AIDS). Addresses students and HIV, employees and HIV, and confidentiality. (MLF)

  3. Non-communicable diseases in low- and middle-income countries: context, determinants and health policy

    PubMed Central

    Miranda, J. J.; Kinra, S.; Casas, J. P.; Smith, G. Davey; Ebrahim, S.

    2009-01-01

    Summary The rise of non-communicable diseases and their impact in low- and middle-income countries has gained increased attention in recent years. However, the explanation for this rise is mostly an extrapolation from the history of high-income countries whose experience differed from the development processes affecting today’s low- and middle-income countries. This review appraises these differences in context to gain a better understanding of the epidemic of non-communicable diseases in low- and middle-income countries. Theories of developmental and degenerative determinants of non-communicable diseases are discussed to provide strong evidence for a causally informed approach to prevention. Health policies for non-communicable diseases are considered in terms of interventions to reduce population risk and individual susceptibility and the research needs for low- and middle-income countries are discussed. Finally, the need for health system reform to strengthen primary care is highlighted as a major policy to reduce the toll of this rising epidemic. PMID:18937743

  4. The Impact of Parkinson's Disease on Vocal-Prosodic Communication from the Perspective of Listeners

    ERIC Educational Resources Information Center

    Pell, Marc D.; Cheang, Henry S.; Leonard, Carol L.

    2006-01-01

    An expressive disturbance of speech prosody has long been associated with idiopathic Parkinson's disease (PD), but little is known about the impact of dysprosody on vocal-prosodic communication from the perspective of "listeners." Recordings of healthy adults ("n" = 12) and adults with mild to moderate PD ("n" = 21) were elicited in four speech…

  5. Formulaic Language as a Barrier to Effective Communication with People with Alzheimer's Disease

    ERIC Educational Resources Information Center

    Wray, Alison

    2011-01-01

    Carers recognize that the linguistic problems associated with Alzheimer's disease (AD) can be detrimental to effective communication, but they are often not sure what they can do to help. This article examines the use of formulaic language in AD, including routines, repetitions, and fillers, through the lens of a model of how cognitive and social…

  6. Family Health History Communication Networks of Older Adults: Importance of Social Relationships and Disease Perceptions

    ERIC Educational Resources Information Center

    Ashida, Sato; Kaphingst, Kimberly A.; Goodman, Melody; Schafer, Ellen J.

    2013-01-01

    Older individuals play a critical role in disseminating family health history (FHH) information that can facilitate disease prevention among younger family members. This study evaluated the characteristics of older adults and their familial networks associated with two types of communication ("have shared" and "intend to share…

  7. 75 FR 21577 - Notice of Request for Extension of Approval of an Information Collection; Communicable Diseases...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service Notice of Request for Extension of Approval of an Information Collection; Communicable Diseases in Horses Correction In notice document 2010-9054 on page 20559 in...

  8. 78 FR 58513 - Notice of Request for Extension of Approval of an Information Collection; Communicable Diseases...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-24

    ... Collection; Communicable Diseases in Horses AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... for the interstate movement of horses that have tested positive for equine infectious anemia. ] DATES... INFORMATION CONTACT: For information on the regulations for the interstate movement of horses that have...

  9. 75 FR 20559 - Notice of Request for Extension of Approval of an Information Collection; Communicable Diseases...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-20

    ... Collection; Communicable Diseases in Horses AGENCY: Animal and Plant Health Inspection Service, USDA. ACTION... the interstate movement of horses that have tested positive for equine infectious anemia. DATES: We... for the interstate movement of horses that have tested positive for equine infectious anemia,...

  10. Taipei's Use of a Multi-Channel Mass Risk Communication Program to Rapidly Reverse an Epidemic of Highly Communicable Disease

    PubMed Central

    Yen, Muh-Yong; Wu, Tsung-Shu Joseph; Chiu, Allen Wen-Hsiang; Wong, Wing-Wai; Wang, Po-En; Chan, Ta-Chien; King, Chwan-Chuen

    2009-01-01

    Background In September 2007, an outbreak of acute hemorrhagic conjunctivitis (AHC) occurred in Keelung City and spread to Taipei City. In response to the epidemic, a new crisis management program was implemented and tested in Taipei. Methodology and Principal Findings Having noticed that transmission surged on weekends during the Keelung epidemic, Taipei City launched a multi-channel mass risk communications program that included short message service (SMS) messages sent directly to approximately 2.2 million Taipei residents on Friday, October 12th, 2007. The public was told to keep symptomatic students from schools and was provided guidelines for preventing the spread of the disease at home. Epidemiological characteristics of Taipei's outbreak were analyzed from 461 sampled AHC cases. Median time from exposure to onset of the disease was 1 day. This was significantly shorter for cases occurring in family clusters than in class clusters (mean±SD: 2.6±3.2 vs. 4.39±4.82 days, p = 0.03), as well as for cases occurring in larger family clusters as opposed to smaller ones (1.2±1.7 days vs. 3.9±4.0 days, p<0.01). Taipei's program had a significant impact on patient compliance. Home confinement of symptomatic children increased from 10% to 60% (p<0.05) and helped curb the spread of AHC. Taipei experienced a rapid decrease in AHC cases between the Friday of the SMS announcement and the following Monday, October 15, (0.70% vs. 0.36%). By October 26, AHC cases reduced to 0.01%. The success of this risk communication program in Taipei (as compared to Keelung) is further reflected through rapid improvements in three epidemic indicators: (1) significantly lower crude attack rates (1.95% vs. 14.92%, p<0.001), (2) a short epidemic period of AHC (13 vs. 34 days), and (3) a quick drop in risk level (1∼2 weeks) in Taipei districts that border Keelung (the original domestic epicenter). Conclusions and Significance The timely launch of this systematic, communication

  11. Communication.

    ERIC Educational Resources Information Center

    Online-Offline, 1998

    1998-01-01

    This theme issue on communication includes annotated listings of Web sites, CD-ROM and computer software, videos, books, and professional resources that deal with various methods of communication. Sidebars discuss mythology, photojournalism, sharing ideas on the Web, and songs of protest. Suggestions for class activities are also included. (LRW)

  12. Update on the use of disease-suppressive crops in potato rotations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Numerous soilborne diseases can be persistent, difficult-to-control problems in potato production. The use of disease-suppressive crops, as rotation, cover, or green manure crops, can potentially reduce multiple soilborne potato diseases. Brassica spp. and related plants suppress diseases through mu...

  13. Communication

    NASA Technical Reports Server (NTRS)

    Griner, James

    2010-01-01

    NASA s communication work for the UAS Command and Control area will build upon work currently being conducted under NASA Recovery Act funds. Communication portions of UAS NextGen ConOps, Stateof- the-Art assessment, and Gap Analysis. Preliminary simulations for UAS CNPC link scalability assessment. Surrogate UAS aircraft upgrades. This work will also leverage FY10 in-guide funding for communication link model development. UAS are currently managed through exceptions and are operating using DoD frequencies for line-of-sight (LOS) and satellite-based communications links, low-power LOS links in amateur bands, or unlicensed Instrument/Scientific/Medical (ISM) frequencies. None of these frequency bands are designated for Safety and Regularity of Flight. No radio-frequency (RF) spectrum has been allocated by the International Telecommunications Union (ITU) specifically for UAS command and control links, for either LOS or Beyond LOS (BLOS) communication.

  14. Integration of non-communicable diseases in health care: tackling the double burden of disease in African settings

    PubMed Central

    Temu, Florence; Leonhardt, Marcus; Carter, Jane; Thiam, Sylla

    2014-01-01

    Sub-Saharan African countries now face the double burden of Non Communicable and Communicable Diseases. This situation represents a major threat to fragile health systems and emphasises the need for innovative integrative approaches to health care delivery. Health services need to be reorganised to address populations’ needs holistically and effectively leverage resources in already resource-limited settings. Access and delivery of quality health care should be reinforced and implemented at primary health care level within the framework of health system strengthening. Competencies need to be developed around services provided rather than specific diseases. New models of integration within the health sector and other sectors should be explored and further evidence generated to inform policy and practice to combat the double burden. PMID:25419329

  15. Globalisation and the prevention and control of non-communicable disease: the neglected chronic diseases of adults.

    PubMed

    Beaglehole, R; Yach, D

    2003-09-13

    The growing global burden of non-communicable diseases in poor countries and poor populations has been neglected by policy makers, major multilateral and bilateral aid donors, and academics. Despite strong evidence for the magnitude of this burden, the preventability of its causes, and the threat it poses to already strained health care systems, national and global actions have been inadequate. Globalisation is an important determinant of non-communicable disease epidemics since it has direct effects on risks to populations and indirect effects on national economies and health systems. The globalisation of the production and marketing campaigns of the tobacco and alcohol industries exemplify the challenges to policy makers and public health practitioners. A full range of policy responses is required from government and non-governmental agencies; unfortunately the capacity and resources for this response are insufficient, and governments need to respond appropriately. The progress made in controlling the tobacco industry is a modest cause for optimism. PMID:13678979

  16. Older women's attitudes towards breast disease, self examination, and screening facilities: implications for communication.

    PubMed Central

    Leathar, D S; Roberts, M M

    1985-01-01

    Qualitative research techniques were used in two studies in Edinburgh to explore older women's attitudes and motivations towards breast disease, self examination, and screening, with a view to identifying appropriate strategies for communication. The results indicated that knowledge of breast disease and screening facilities was poor and that many psychological and emotional issues inhibited self examination. Increasing information about self examination and clinics is unlikely to influence uptake unless it is presented together with emotional support rather than through conventional mass media channels. Such support may best be provided by setting breast screening within general health screening rather than emphasising the single disease. PMID:3918709

  17. EXPLORING PARENT-SIBLING COMMUNICATION IN FAMILIES OF CHILDREN WITH SICKLE CELL DISEASE

    PubMed Central

    Graff, J. Carolyn; Hankins, Jane S.; Hardy, Belinda T.; Hall, Heather R.; Roberts, Ruth J.; Neely-Barnes, Susan L.

    2011-01-01

    Focus group interviews were conducted with parents of children with sickle cell disease to explore parent-sibling communication about sickle cell disease. Communication was influenced by attributes and behaviors of the parent, the child with sickle cell disease, and the sibling; extended family, neighbors, friends, and church members or social networks; and available, accessible resources related to the child’s health, child’s school, and parent employment. Outcomes that influenced and were influenced by factors within and outside the parent-sibling dyad and nuclear family included parent satisfaction, parent roles, family intactness, and status attainment. These findings support previous research with African American families and expand our views of the importance of educating parents, family members, and others about sickle cell disease. The findings suggest a need to explore sibling perception of this communication, parent and sibling perception of the impact of frequent hospitalizations and clinic visits on the sibling and family, and variations within families of children with sickle cell disease. PMID:20384476

  18. Prevention of non-communicable diseases in Australia: What role should public health law play?

    PubMed

    Mulvany, Kate

    2015-09-01

    This article explores the role of public health law in the prevention of non-communicable diseases in Australia. The growing urgency to address these diseases is acknowledged and the definition of public health law explored. It is argued that a broad definition of public health law would allow greater recognition of the numerous ways that law can positively influence health outcomes at the population level. Far from substantiating claims of over-reaching state intervention, public health law in the 21st century in Australia should be viewed as a more nuanced and protective strategy in promoting better public health. Adopting this approach offers a way forward towards addressing rising rates of non-communicable diseases, as well as significant health inequities, but it will require greater political will and leadership. PMID:26554201

  19. Framing Strategies to Avoid Mother-Blame in Communicating the Origins of Chronic Disease.

    PubMed

    Winett, Liana B; Wulf, Alyssa B; Wallack, Lawrence

    2016-08-01

    Evolving research in epigenetics and the developmental origins of health and disease offers tremendous promise in explaining how the social environment, place, and resources available to us have enduring effects on our health. Troubling from a communications perspective, however, is the tendency in framing the science to hold mothers almost uniquely culpable for their offspring's later disease risk. The purpose of this article is to add to the conversation about avoiding this unintended outcome by (1) discussing the importance of cognitive processing and issue frames, (2) describing framing challenges associated with communicating about developmental origins of health and disease and offering principles to address them, and (3) providing examples of conceptual metaphors that may be helpful in telling this complex and contextual story for public health. PMID:27310351

  20. Using Social Networking Sites for Communicable Disease Control: Innovative Contact Tracing or Breach of Confidentiality?

    PubMed Central

    Mandeville, Kate L.; Harris, Matthew; Thomas, H. Lucy; Chow, Yimmy; Seng, Claude

    2014-01-01

    Social media applications such as Twitter, YouTube and Facebook have attained huge popularity, with more than three billion people and organizations predicted to have a social networking account by 2015. Social media offers a rapid avenue of communication with the public and has potential benefits for communicable disease control and surveillance. However, its application in everyday public health practice raises a number of important issues around confidentiality and autonomy. We report here a case from local level health protection where the friend of an individual with meningococcal septicaemia used a social networking site to notify potential contacts. PMID:24688599

  1. Using Social Networking Sites for Communicable Disease Control: Innovative Contact Tracing or Breach of Confidentiality?

    PubMed

    Mandeville, Kate L; Harris, Matthew; Thomas, H Lucy; Chow, Yimmy; Seng, Claude

    2014-04-01

    Social media applications such as Twitter, YouTube and Facebook have attained huge popularity, with more than three billion people and organizations predicted to have a social networking account by 2015. Social media offers a rapid avenue of communication with the public and has potential benefits for communicable disease control and surveillance. However, its application in everyday public health practice raises a number of important issues around confidentiality and autonomy. We report here a case from local level health protection where the friend of an individual with meningococcal septicaemia used a social networking site to notify potential contacts. PMID:24688599

  2. [Application of spatial relative risk estimation in communicable disease risk evaluation].

    PubMed

    Zhang, Yewu; Guo, Qing; Wang, Xiaofeng; Yu, Meng; Su, Xuemei; Dong, Yan; Zhang, Chunxi

    2015-05-01

    This paper summaries the application of adaptive kernel density algorithm in the spatial relative risk estimation of communicable diseases by using the reported data of infectious diarrhea (other than cholera, dysentery, typhoid and paratyphoid) in Ludian county and surrounding area in Yunnan province in 2013. Statistically significant fluctuations in an estimated risk function were identified through the use of asymptotic tolerance contours, and finally these data were visualized though disease mapping. The results of spatial relative risk estimation and disease mapping showed that high risk areas were in southeastern Shaoyang next to Ludian. Therefore, the spatial relative risk estimation of disease by using adaptive kernel density algorithm and disease mapping technique is a powerful method in identifying high risk population and areas. PMID:26080648

  3. DNA damage in non-communicable diseases: A clinical and epidemiological perspective.

    PubMed

    Milic, Mirta; Frustaci, Alessandra; Del Bufalo, Alessandra; Sánchez-Alarcón, Juana; Valencia-Quintana, Rafael; Russo, Patrizia; Bonassi, Stefano

    2015-06-01

    Non-communicable diseases (NCDs) are a leading cause of death and disability, representing 63% of the total death number worldwide. A characteristic phenotype of these diseases is the accelerated aging, which is the result of phenomena such as accumulated DNA damage, telomere capping loss and subcellular irreversible/nonrepaired oxidative damage. DNA damage, mostly oxidative, plays a key role in the development of most common NCDs. The present review will gather some of the most relevant knowledge concerning the presence of DNA damage in NCDs focusing on cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, and neurodegenerative disorders, and discussing a selection of papers from the most informative literature. The challenge of comorbidity and the potential offered by new systems approaches for introducing these biomarkers into the clinical decision process will be discussed. Systems Medicine platforms represent the most suitable approach to personalized medicine, enabling to identify new patterns in the pathogenesis, diagnosis and prognosis of chronic diseases. PMID:26255943

  4. Cataract surgery in patients with ocular surface disease: An update in clinical diagnosis and treatment.

    PubMed

    Afsharkhamseh, Neda; Movahedan, Asadolah; Motahari, Hooman; Djalilian, Ali R

    2014-07-01

    In this article we review essentials of diagnosis and management of ocular surface disease in patients who undergo cataract surgery. It is clearly shown that dry eye disease worsens following the cataract surgery in patients with prior history of ocular surface disease, Also new cases of dry eye might appear. Current strategies for the timely diagnosis and proper management of dry eye syndrome in the face of cataract surgery patients are mainly emphasized. To achieve the best outcome in cataract surgery, a healthy ocular surface is crucial. While ocular surface preparation is indispensable in patients with established ocular surface disease, it is also helpful in those with minimal signs or symptoms of surface disease. The current approach begins with early diagnosis and drastic management of ocular surface disease before cataract surgery using a stepwise regimen customized to each patient and disease severity. These measures are continued throughout and after the surgery. PMID:25278791

  5. Communicable disease control programmes and health systems: an analytical approach to sustainability.

    PubMed

    Shigayeva, Altynay; Coker, Richard J

    2015-04-01

    There is renewed concern over the sustainability of disease control programmes, and re-emergence of policy recommendations to integrate programmes with general health systems. However, the conceptualization of this issue has remarkably received little critical attention. Additionally, the study of programmatic sustainability presents methodological challenges. In this article, we propose a conceptual framework to support analyses of sustainability of communicable disease programmes. Through this work, we also aim to clarify a link between notions of integration and sustainability. As a part of development of the conceptual framework, we conducted a systematic literature review of peer-reviewed literature on concepts, definitions, analytical approaches and empirical studies on sustainability in health systems. Identified conceptual proposals for analysis of sustainability in health systems lack an explicit conceptualization of what a health system is. Drawing upon theoretical concepts originating in sustainability sciences and our review here, we conceptualize a communicable disease programme as a component of a health system which is viewed as a complex adaptive system. We propose five programmatic characteristics that may explain a potential for sustainability: leadership, capacity, interactions (notions of integration), flexibility/adaptability and performance. Though integration of elements of a programme with other system components is important, its role in sustainability is context specific and difficult to predict. The proposed framework might serve as a basis for further empirical evaluations in understanding complex interplay between programmes and broader health systems in the development of sustainable responses to communicable diseases. PMID:24561988

  6. General practitioners role in the notification of communicable diseases - study in Malta.

    PubMed

    Gauci, C; Gilles, H; O'Brien, S; Mamo, J; Calleja, N

    2007-11-01

    General practitioners (GPs) have an essential role in notification of communicable diseases. The main aim of the study described here was to assess the GPs' awareness of and attitudes towards the notification system in Malta, with special focus on infectious intestinal disease (IID). A questionnaire collecting demographic data, information on reporting practices, opinions on the existing notification system and suggestions for improvement was sent to 256 GPs working in either private or public health sector. In all, 150 GPs took part in the survey (response rate 58.6%). The responses revealed that Maltese GPs were aware of their obligations to notify communicable diseases but often did not report them, relying on the hospitals or laboratories to do so. The Disease Surveillance Unit (DSU) website and medical school training were the main sources of information on notification. Notification forms were obtained from health centres and usually kept at the place of work. Most GPs reported filling in the forms during the patients' visits. Private GPs tended to notify earlier than GPs working in public health centers. Among IID, food-borne illness was reported more frequently than person-to-person transmitted gastroenteritis and was considered to be of a higher priority with regard to public health importance (p<0.001). The survey highlighted also some areas for improvement, including need of feedback especially by direct communication or a newsletter. PMID:18005655

  7. Men's health: non-communicable chronic diseases and social vulnerability 1

    PubMed Central

    Bidinotto, Daniele Natália Pacharone Bertolini; Simonetti, Janete Pessuto; Bocchi, Silvia Cristina Mangini

    2016-01-01

    ABSTRACT Objectives: to evaluate the relationship between absences in scheduled appointments and the number of non-communicable chronic diseases and to investigate the relationship between spatial distribution of these diseases and social vulnerability, using geoprocessing. Method: a quantitative study of sequential mixed approach by analyzing 158 medical records of male users to relate the absences and 1250 medical records for geoprocessing Results: the higher the number of absences in the scheduled medical appointments, the less were the number of non-communicable chronic diseases and the ones listed in the International Classification of Diseases in single men. There were 21 significant geostatistically cases of glucose intolerance in the urban area. Of these, 62% lived in a region with a social vulnerability rating of Very Low, Medium 19%, 14% Low and 5% High. Conclusion: it was observed that the older the men, the greater is the number of chronic diseases and the less they miss scheduled appointments. Regarding the use of geoprocessing, we obtained a significant number of cases of glucose intolerance in urban areas, the majority classified as Very Low social vulnerability. It was possible to relate the spatial distribution of these diseases with the social vulnerability classification; however, it was not possible to perceive a relationship of them with the higher rates of social vulnerability. PMID:27533266

  8. Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand.

    PubMed

    Trubiano, J A; Cheng, A C; Korman, T M; Roder, C; Campbell, A; May, M L A; Blyth, C C; Ferguson, J K; Blackmore, T K; Riley, T V; Athan, E

    2016-04-01

    The incidence of Clostridium difficile infection (CDI) continues to rise, whilst treatment remains problematic due to recurrent, refractory and potentially severe nature of disease. The treatment of C. difficile is a challenge for community and hospital-based clinicians. With the advent of an expanding therapeutic arsenal against C. difficile since the last published Australasian guidelines, an update on CDI treatment recommendations for Australasian clinicians was required. On behalf of the Australasian Society of Infectious Diseases, we present the updated guidelines for the management of CDI in adults and children. PMID:27062204

  9. Non-infectious granulomatous diseases of the skin and their associated systemic diseases: an evidence-based update to important clinical questions.

    PubMed

    Hawryluk, Elena Balestreire; Izikson, Leonid; English, Joseph C

    2010-01-01

    Non-infectious granulomatous diseases of the skin are a broad group of distinct reactive inflammatory conditions that share important similarities. As a group, they are relatively difficult to diagnose and distinguish both clinically as well as histologically. Many of these disorders have significant associations with systemic diseases that impact the patient's overall prognosis. In this update, we offer a discussion of emerging concepts and controversies in this field, as presented through evidence-based answers to seven important clinical questions regarding palisading and epithelioid granulomata. These questions offer an opportunity to review ten non-infectious granulomatous conditions that have implications for systemic disease: granuloma annulare, annular elastolytic giant cell granuloma, necrobiosis lipoidica, methotrexate-induced accelerated rheumatoid nodulosis, necrobiotic xanthogranuloma, interstitial granulomatous dermatitis, interstitial granulomatous drug reaction, palisaded neutrophilic granulomatous dermatitis, sarcoidosis, and metastatic Crohn disease. Recent clinical, epidemiologic, and laboratory studies have shed some light on these diseases, the association of these conditions with systemic disorders, and their overall prognoses. PMID:20184390

  10. Early Identification and Treatment of Communication and Swallowing Deficits in Parkinson Disease

    PubMed Central

    Ciucci, Michelle R.; Grant, Laura M.; Paul Rajamanickam, Eunice S.; Hilby, Breanna L.; Blue, Katherine V.; Jones, Corinne A.; Kelm-Nelson, Cynthia A.

    2015-01-01

    Parkinson disease (PD) is a complex, progressive, neurodegenerative disorder that leads to a wide range of deficits including fine and gross sensorimotor impairment, autonomic dysfunction, mood disorders, and cognitive decline. Traditionally, the focus for diagnosis and treatment has been on sensorimotor impairment related to dopamine depletion. It is now widely recognized, however, that PD-related pathology affects multiple central nervous system neurotransmitters and pathways. Communication and swallowing functions can be impaired even in the early stages, significantly affecting health and quality of life. The purpose of this article is to review the literature on early intervention for communication and swallowing impairment in PD. Overarching themes were that (1) studies and interpretation of data from studies in early PD are limited; (2) best therapy practices have not been established, in part due to the heterogeneous nature of PD; and (3) as communication and swallowing problems are pervasive in PD, further treatment research is essential. PMID:24166192

  11. Managing Behçet’s disease: An update on current and emerging treatment options

    PubMed Central

    van Daele, P LA; Kappen, J H; van Hagen, P M; van Laar, J AM

    2009-01-01

    Behçet’s disease is an autoinflammatory vasculitis of unknown origin characterized by recurrent oral and genital ulcers, uveitis, arthritis and skin lesions. Additionally, involvement of the gastrointestinal tract, central nervous system and large vessels may occur. The disease is prevalent in countries along the ancient Silk Road from Eastern Asia to the Mediterranean Basin. Many treatment modalities are currently available. The choice of treatment depends on organ involvement and severity of disease. Topical treatment with corticosteroids is often sufficient for mucocutaneous involvement, however for more severe disease with vasculitis or neurological involvement a more aggressive approach is warranted. Newer drugs (biologicals) influencing cytokines and thereby T-cell function are promising with an acceptable side effect profile. Unfortunately, reimbursement of the costs of biologicals for rare disease is still a problem in various countries. In this report we discuss the current treatment modalities for Behçet’s disease. PMID:19536320

  12. Clinical and Pharmacological Aspects of Inflammatory Demyelinating Diseases in Childhood: An Update

    PubMed Central

    Spalice, Alberto; Parisi, Pasquale; Papetti, Laura; Nicita, Francesco; Ursitti, Fabiana; Del Balzo, Francesca; Properzi, Enrico; Verrotti, Alberto; Ruggieri, Martino; Iannetti, Paola

    2010-01-01

    Inflammatory demyelinating diseases comprise a spectrum of disorders affecting the myelin of the central and peripheral nervous system. These diseases can usually be differentiated on the basis of clinical, radiological, laboratory and pathological findings. Recent studies have contributed to current awareness that inflammatory demyelinating diseases are not restricted to the adult age group, but are more common in pediatric age than previously believed. Some of pediatric inflammatory demyelinating diseases carry an unfavorable long-term prognosis but appropriate treatments can improve the outcome. The possibility of physical and cognitive disability resulting from these diseases, highlights the urgent need for therapeutic strategies for neurorehabilitation, neuroregeneration, and neurorepair. This review discusses characteristics of primary demyelinating diseases more frequently observed in childhood, focusing on epidemiology, clinical aspects and treatments. PMID:21119885

  13. Clinical and pharmacological aspects of inflammatory demyelinating diseases in childhood: an update.

    PubMed

    Spalice, Alberto; Parisi, Pasquale; Papetti, Laura; Nicita, Francesco; Ursitti, Fabiana; Del Balzo, Francesca; Properzi, Enrico; Verrotti, Alberto; Ruggieri, Martino; Iannetti, Paola

    2010-06-01

    Inflammatory demyelinating diseases comprise a spectrum of disorders affecting the myelin of the central and peripheral nervous system. These diseases can usually be differentiated on the basis of clinical, radiological, laboratory and pathological findings. Recent studies have contributed to current awareness that inflammatory demyelinating diseases are not restricted to the adult age group, but are more common in pediatric age than previously believed. Some of pediatric inflammatory demyelinating diseases carry an unfavorable long-term prognosis but appropriate treatments can improve the outcome. The possibility of physical and cognitive disability resulting from these diseases, highlights the urgent need for therapeutic strategies for neurorehabilitation, neuroregeneration, and neurorepair. This review discusses characteristics of primary demyelinating diseases more frequently observed in childhood, focusing on epidemiology, clinical aspects and treatments. PMID:21119885

  14. Role of NADPH Oxidase in Metabolic Disease-Related Renal Injury: An Update.

    PubMed

    Wan, Cheng; Su, Hua; Zhang, Chun

    2016-01-01

    Metabolic syndrome has been linked to an increased risk of chronic kidney disease. The underlying pathogenesis of metabolic disease-related renal injury remains obscure. Accumulating evidence has shown that NADPH oxidase is a major source of intrarenal oxidative stress and is upregulated by metabolic factors leading to overproduction of ROS in podocytes, endothelial cells, and mesangial cells in glomeruli, which is closely associated with the initiation and progression of glomerular diseases. This review focuses on the role of NADPH oxidase-induced oxidative stress in the pathogenesis of metabolic disease-related renal injury. Understanding of the mechanism may help find potential therapeutic strategies. PMID:27597884

  15. Role of NADPH Oxidase in Metabolic Disease-Related Renal Injury: An Update

    PubMed Central

    Su, Hua

    2016-01-01

    Metabolic syndrome has been linked to an increased risk of chronic kidney disease. The underlying pathogenesis of metabolic disease-related renal injury remains obscure. Accumulating evidence has shown that NADPH oxidase is a major source of intrarenal oxidative stress and is upregulated by metabolic factors leading to overproduction of ROS in podocytes, endothelial cells, and mesangial cells in glomeruli, which is closely associated with the initiation and progression of glomerular diseases. This review focuses on the role of NADPH oxidase-induced oxidative stress in the pathogenesis of metabolic disease-related renal injury. Understanding of the mechanism may help find potential therapeutic strategies. PMID:27597884

  16. The impact of Parkinson's disease on vocal-prosodic communication from the perspective of listeners.

    PubMed

    Pell, Marc D; Cheang, Henry S; Leonard, Carol L

    2006-05-01

    An expressive disturbance of speech prosody has long been associated with idiopathic Parkinson's disease (PD), but little is known about the impact of dysprosody on vocal-prosodic communication from the perspective of listeners. Recordings of healthy adults (n=12) and adults with mild to moderate PD (n=21) were elicited in four speech contexts in which prosody serves a primary function in linguistic or emotive communication (phonemic stress, contrastive stress, sentence mode, and emotional prosody). Twenty independent listeners naive to the disease status of individual speakers then judged the intended meanings conveyed by prosody for tokens recorded in each condition. Findings indicated that PD speakers were less successful at communicating stress distinctions, especially words produced with contrastive stress, which were identifiable to listeners. Listeners were also significantly less able to detect intended emotional qualities of Parkinsonian speech, especially for anger and disgust. Emotional expressions that were correctly recognized by listeners were consistently rated as less intense for the PD group. Utterances produced by PD speakers were frequently characterized as sounding sad or devoid of emotion entirely (neutral). Results argue that motor limitations on the vocal apparatus in PD produce serious and early negative repercussions on communication through prosody, which diminish the social-linguistic competence of Parkinsonian adults as judged by listeners. PMID:16226803

  17. The Arthropod-Borne Animal Diseases Research Laboratory: Research Program Update and Current Status

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The mission of the Arthropod-Borne Animal Diseases Research Laboratory (ABADRL) located in Laramie, Wyoming, is to solve major endemic, emerging, and exotic arthropod-borne disease problems in U.S. livestock. The ABADRL has three 5-year project plans under two ARS National Research Programs; Animal ...

  18. An update of the role of nutritional therapy in the management of Crohn's disease.

    PubMed

    Alhagamhmad, Moftah H; Day, Andrew S; Lemberg, Daniel A; Leach, Steven T

    2012-08-01

    Crohn's disease is an increasingly global health concern. Currently without a cure, it significantly alters the quality of life of Crohn's disease sufferers and places a heavy financial burden on the community. Recent reports show that the rising prevalence of Crohn's disease is no longer confined to Western countries, with considerable increases seen particularly in Asia. Nutritional problems are often associated with Crohn's disease, most notably in the paediatric population, with underweight and stunting commonly seen at presentation. In addition, linear growth retardation and pubertal delay can also manifest in these younger patients. Therefore, exclusive enteral nutrition has been used as a therapeutic option to treat Crohn's disease, in part to address the nutritional complications of the disease. Exclusive enteral nutrition can improve nutrition as well as induce remission at a rate equivalent to corticosteroids. It is safe particularly with long-term use and can induce mucosal healing, considered the gold standard for therapy, at a rate superior to corticosteroids. Exclusive enteral nutrition has thus become the preferred therapeutic option in many centres for the treatment of paediatric Crohn's disease. This review discusses the role of exclusive enteral nutrition as a therapeutic option for the treatment of Crohn's disease, as well as the latest findings into its mechanisms of action. PMID:22699323

  19. The Arthropod-borne Animal Diseases Unit: research program update and status

    Technology Transfer Automated Retrieval System (TEKTRAN)

    To accomplish the continuing research mission of the Arthropod Borne Animal Diseases Unit (ABADRU) in solving major endemic, emerging, and exotic arthropod-borne disease problems in livestock, the Unit has completed the move to Manhattan, KS. The ABADRU is one of five units at the Center for Grain a...

  20. Infectious Diseases Update. Vol. 1. Current Issues in School and Community Health.

    ERIC Educational Resources Information Center

    Bower, Wilma; And Others

    This booklet, designed to provide up-to-date, accurate information, focuses on selected viral diseases that are potentially serious, often not well understood, and periodically in the news media because of their continued impact on school and community health. General information is provided on viral diseases, the immune system, vaccines, and how…

  1. AN UPDATE OF ADENOVIRAL HEMORRHAGIC DISEASE IN MULE DEER IN CALIFORNIA

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the summer and fall of 1993, a newly recognized disease, adenoviral hemorrhagic disease, caused widespread mortality in black-tailed (Odocoileus hemionus columbianus) and California mule deer (Odocoileus hemionus californicus) in northern California. Greater than a thousand deer were estimated t...

  2. Communicable diseases as health risks at mass gatherings other than Hajj: what is the evidence?

    PubMed

    Gautret, Philippe; Steffen, Robert

    2016-06-01

    Mass gatherings are characterized by the concentration of people temporally and spatially, and may lead to the emergence of infectious diseases due to enhanced transmission between attendees. This is well-demonstrated in the context of the Hajj and Umrah pilgrimages in Saudi Arabia. The goal of this review was to present the available evidence on outbreaks associated with a variety of pathogens, or also the lack thereof, as assessed by thorough surveillance at any mass gatherings with the exception of those in Saudi Arabia. A systematic search for relevant articles in the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Sixty-eight studies were identified. Although outbreaks have not been reported frequently in or after mass gatherings outside the Hajj and Umrah pilgrimages, they have sometimes occurred at Muslim, Christian, and Hindu religious events, at sports events, and at large-scale open air festivals. In this review it was found that the most common outbreaks at these mass gatherings involved vaccine preventable diseases, mainly measles and influenza, but also mumps and hepatitis A. Meningococcal disease has rarely been recorded. Additionally it was found that the transmission of various communicable diseases that may not be prevented by vaccination has been recorded in association with mass gatherings. These were mainly gastrointestinal infections, caused by a variety of pathogens. It was also noted that some outbreaks occurring at mass gatherings have resulted in the international spread of communicable diseases. PMID:26987476

  3. ABO blood group system and the coronary artery disease: an updated systematic review and meta-analysis

    PubMed Central

    Chen, Zhuo; Yang, Sheng-Hua; Xu, Hao; Li, Jian-Jun

    2016-01-01

    ABO blood group system, a well-known genetic risk factor, has clinically been demonstrated to be linked with thrombotic vascular diseases. However, the relationship between ABO blood group and coronary artery disease (CAD) is still controversial. We here performed an updated meta-analysis of the related studies and tried to elucidate the potential role of ABO blood group as a risk factor for CAD. All detectable case-control and cohort studies comparing the risk of CAD in different ABO blood groups were collected for this analysis through searching PubMed, Embase, and the Cochrane Library. Ultimately, 17 studies covering 225,810 participants were included. The combined results showed that the risk of CAD was significantly higher in blood group A (OR = 1.14, 95% CI = 1.03 to 1.26, p = 0.01) and lower in blood group O (OR = 0.85, 95% CI = 0.78 to 0.94, p = 0.0008). Even when studies merely about myocardial infarction (MI) were removed, the risk of CAD was still significantly higher in blood group A (OR = 1.05, 95% CI = 1.00 to 1.10, p = 0.03) and lower in blood group O (OR = 0.89, 95% CI = 0.85 to 0.93, p < 0.00001). This updated systematic review and meta-analysis indicated that both blood group A and non-O were the risk factors of CAD. PMID:26988722

  4. Communications

    ERIC Educational Resources Information Center

    Bailenson, Jeremy; Buzzanell, Patrice; Deetz, Stanley; Tewksbury, David; Thompson, Robert J.; Turow, Joseph; Bichelmeyer, Barbara; Bishop, M. J.; Gayeski, Diane

    2013-01-01

    Scholars representing the field of communications were asked to identify what they considered to be the most exciting and imaginative work currently being done in their field, as well as how that work might change our understanding. The scholars included Jeremy Bailenson, Patrice Buzzanell, Stanley Deetz, David Tewksbury, Robert J. Thompson, and…

  5. Communications

    NASA Technical Reports Server (NTRS)

    Hathorn, S.

    1985-01-01

    An overview of NASA's Thin Route satellite telecommunication project is presented. Thin Route employs applications technology satellites (ATS) in place of more costly commercial multi- transponder telecommunications satellites. This system allows remote and underdeveloped areas to communicate with the outside world for purposes of obtaining medical assistance among other things. The system represents a substantial cost saving over commercial systems.

  6. Non-communicable diseases: is their emergence in industrialized societies related to changes in neuroendocrine function?

    PubMed

    Bickler, S W

    2000-05-01

    This hypothesis suggests that industrialization alters the human neuroendocrine system. The neuroendocrine changes come about because of changes in environmental stimuli. It is further proposed that changes in neuroendocrine function can account for the contrasting pattern of non-communicable diseases in traditional and industrialized societies. The hypothesis is based on subtle clinical differences in traditional and industrialized societies, and the evolving concept of neuroendocrine regulation of physiological processes. Compared to traditional societies, individuals from industrialized communities tend to have lower pain tolerance, slower gastrointestinal transit-time, and a greater chance of having a calcified pineal gland. These changes parallel the increasing incidence of non-communicable diseases in industrialized societies. There is sufficient reason to suspect the variations in pain tolerance, gastrointestinal transit-time and pineal gland calcification represent changes in neuroendocrine function. Programming of the neuroendocrine system by environmental events early in life is one possible mechanism whereby these changes might be effected. Understanding the physiological changes that occur with industrialization, and how environmental stimuli interact with the developing neuroendocrine system might lead to new strategies for the prevention and treatment of non-communicable diseases. PMID:10859694

  7. Survey of general practitioner satisfaction with a district communicable disease control service.

    PubMed

    Lamden, K; Baxter, D; Weighell, J

    2003-04-01

    General practitioners (GPs) have an important role in disease surveillance and control, and are therefore a key target audience for a district communicable disease control (CDC) service. The feedback of surveillance information, and the provision of policies, guidance and specialist advice, are essential functions of a CDC service. This survey was undertaken to assess how well a CDC service was meeting the needs of GPs. Satisfaction with the service was assessed using a questionnaire survey of 166 GPs. The response rate was 42%. GPs reported a high level of overall satisfaction. The service was valued and it influenced GP practice. The service was valued more for responses to requests for information and assistance than for communicable disease control policies. The highest satisfaction was expressed for communication and for immunisation advice. Several areas of need were identified, including the need for surveillance information on antibiotic resistance and for sexually transmitted infections. The survey tool is recommended as a way of auditing standards for Good Public Health Practice, as identified by the Faculty of Public Health Medicine. PMID:12736973

  8. [Constructing an ACP Simulation-Situation Communication Training Program for Patients With Chronic Kidney Disease].

    PubMed

    Chen, Jui-O; Lin, Chiu-Chu

    2016-06-01

    The aging population and changing lifestyles have lead to the increased general risk of chronic kidney disease. Taiwan currently has the highest incidence and prevalence of end-stage renal disease (ESRD) of any country or region in the world. Hemodialysis patients must endure comorbidities and face the uncertainties of death. The best way to achieve a good death is for patients to sign advance care planning (ACP). However, the key factors contributing to low ACP signature rates have been the lack of communication skills and related training among medical staffs. This article explores the dilemma of ACP using an example of chronic kidney disease (CKD) and proposes a theory-based approach to develop a theoretical framework for an ACP simulation-situation communication training program that integrates the simulation situation model, PREPARED model, and scaffolding theory. Readers may use this framework to design ACP simulation-situation communication training programs that conform to their own conditions and then test the effectiveness and feasibility of these programs in clinical settings. PMID:27250964

  9. Completeness and Timeliness of Electronic vs. Conventional Laboratory Reporting for Communicable Disease Surveillance—Oklahoma, 2011

    PubMed Central

    Williams, Jean; Lee, Anthony; Bradley, Kristy K.

    2014-01-01

    Objectives The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages the meaningful use of certified electronic health record technology. A HITECH-compliant core component is nationwide electronic laboratory reporting (ELR) implementation for communicable disease surveillance. In Oklahoma, laboratories with ≥400 positive tests/year for reportable diseases must use ELR. Of 18 such laboratories, two have adopted ELR. We compared completeness and timeliness of ELR reports from these two laboratories with conventional reports from all other Oklahoma laboratories. Methods We retrospectively reviewed confirmed reportable disease cases for January 1–December 31, 2011, excluding tuberculosis, hepatitis, sexually transmitted infections, diseases without laboratory diagnoses, and immediately reportable diseases. Probable reportable tickborne disease cases were included. We compared ELR with conventional reporting (i.e., mail, fax, telephone, and Internet). We assessed data completeness based on eight demographic and two laboratory fields in each disease report and timeliness by percentage of cases reported in ≤1 business day. Results Overall, 1,867 reports met the inclusion criteria; 24% of these reports had been submitted by ELR. Data completeness was 90% for ELR and 95% for conventional reporting. Patient addresses accounted for 97% of the missing data fields for ELR reports. Timeliness was 91% for ELR and 87% for conventional reports. Conclusions Although early in the transition to ELR compliance in Oklahoma, ELR has already yielded improved timeliness for communicable disease surveillance. However, ELR did not yield more complete reports than conventional reporting. Requiring specific demographic data fields for ELR reports can improve the completeness of ELR. PMID:24791024

  10. [Nutritional transition and non-communicable diet-related chronic diseases in developing countries].

    PubMed

    Maire, Bernard; Lioret, Sandrine; Gartner, Agnès; Delpeuch, Francis

    2002-01-01

    It is increasingly recognized that developing countries are undergoing an epidemiologic transition similar to that which occurred in industrialized countries in previous centuries. While infectious diseases are still the main cause of morbidity and mortality, there is a marked increase in chronic non-communicable diseases, particularly in the most advanced developing countries, and these diseases are expected to take the lead in a decade or two. Most of these diseases, above all coronary heart diseases, stroke and diabetes, are related to diet and lifestyles, for example tobacco and alcohol consumption. As a matter of fact, these societies are also facing a growing epidemic of overweight and obesity, due to the frequent energetic imbalance between energy-dense food consumption and reduced daily physical expenditure. This health transition, favoured by demographic changes towards aging populations, is occurring at an increased pace in urban societies widely exposed to the modernization of lifestyle, sedentary occupation, and to lipid- and sugar-rich food, often poor in fibre and micronutrients. Increased world access to cheaper vegetable oil is thought to have triggered off this accelerated and generalized trend, though animal food, rich in saturated fat, and imported or locally-made industrialized food also play a role. While increased national and household incomes facilitate the initial change, as the transition advances poor people progressively become the main victims, as has been observed in the more advanced developing countries. Metabolic imprinting due to intra-uterine and infant malnutrition, which are still common in these societies, is also thought to play a significant role in the increase in the expression of insulin resistance, obesity and chronic diseases when these children are exposed to abundant food and modern lifestyle, later in life. Treatment and secondary prevention of nutrition-related chronic diseases and associated disabilities have an

  11. Ebola Virus Disease (The Killer Virus): Another Threat to Humans and Bioterrorism: Brief Review and Recent Updates.

    PubMed

    Passi, Deepak; Sharma, Sarang; Dutta, Shubha Ranjan; Dudeja, Pooja; Sharma, Vivek

    2015-06-01

    Ebola virus disease (EVD) described as "one of the world's most virulent diseases" by WHO was popularly known as Ebola haemorrhagic fever in the past. It is usually considered a severe and deadly illness when humans are concerned. EVD outbreaks have shown to have a very high fatality rate ranging from 50 - 90% with a reported occurrence primarily seen near the tropical rainforests of remote villages in Central and West Africa. The virus is transmitted to people from wild animals and within the human community through human-to-human contact. Natural host for Ebola virus is not yet conclusively identified but the most probable host appears to be the fruit bats of the Pteropodidae family. Five subspecies of Ebola virus are recognized till date, with Zaire Ebola virus being the most aggressive of all varieties and recording up to 90% mortality. All Ebola forms are highly contagious and hence have been classed as Category A Priority Pathogens by WHO. Severely ill patients warrant intensive support therapy. Medical workers working in affected areas need to undertake extensive measures to prevent contracting the disease. Till date, no particular anti-viral therapy has demonstrated effectiveness in Ebola virus infection. Also, no vaccine for use in humans is yet approved by the regulatory bodies. If Ebola was actually misused as a biological weapon, it could be a serious threat. Idea behind this article is to briefly review the history and present recent updates on Ebola virus, its pathogenesis and possible hopes for treatment. PMID:26266139

  12. Determinants of public phobia about infectious diseases in South Korea: effect of health communication and gender difference.

    PubMed

    Jung, Minsoo; Choi, Mankyu; Lee, Tae-Ro

    2015-03-01

    This study investigated the individual and social determinants of the public's phobia of infectious diseases in South Korea, where collective action was recently fueled by the public phobia over mad cow disease (bovine spongiform encephalopathy [BSE]). Gender-specific multivariate regression was used to compare the public perception of BSE and highly pathogenic avian influenza (HPAI). The analysis results differentiated between the determinants of the phobia for the 2 diseases, BSE and HPAI (N = 1002). As with HIV/AIDS and leprosy, the public fear of HPAI was expressed as a disease phobia that seeks to ensure the social exclusion of infection sources, whereas the fear of BSE was influenced by social and communication factors. Therefore, BSE, unlike previous HPAI, can be rapidly amplified amid the growing distrust in health communication, in which case the social determinants of disease phobia are associated with communicator trust, social values, and political attitude toward diseases rather than disease perception. PMID:23430887

  13. Update on the natural history of intracranial atherosclerotic disease: A critical review

    PubMed Central

    Komotar, Ricardo J; Kellner, Christopher P; Raper, Daniel M; Strozyk, Dorothea; Higashida, Randall T; Meyers, Philip M

    2010-01-01

    Intracranial atherosclerotic disease (ICAD) contributes to a significant number of ischemic strokes. There is debate in the recent literature concerning the impact of the location of stenosis in ICAD on outcome. Some reports have suggested that disease processes and outcomes vary by vessel location, potentially altering the natural history and indications for intervention. Here we have performed a comprehensive, critical review of the natural history of ICAD by vessel in an attempt to assess the differences in disease specific to each of the vascular territories. Our assessment concludes that only minor differences exist between patients with different vessels affected in vessel-specific ICAD. We have found that middle cerebral artery disease confers a lower mortality than vessel-specific ICAD in other intracranial vessels, asymptomatic disease follows a more benign course than symptomatic disease, and that plaque progression or the detection of microemboli on transcranial Doppler may predict poor outcome. Given the expanding indications for treatment of ICAD and rapidly developing endovascular techniques to confront this disease, a thorough understanding of the natural history of ICAD aids the interventional neuroradiologist in determining when to treat and how to predict outcome in this patient population. PMID:21161031

  14. Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease.

    PubMed

    Quimby, Jessica M

    2016-11-01

    Dysregulation of normal kidney functions in chronic kidney disease (CKD) leads to several pathophysiologic abnormalities that have the potential to significantly clinically affect the CKD patient. This article discusses the clinical impact of hypertension, hypokalemia, anemia, dysrexia, nausea/vomiting, and constipation in the CKD patient and therapies for these conditions. These clinical manifestations of disease may not occur in every patient and may also develop later during the progression of disease. Therefore, monitoring for, identifying, and addressing these factors is considered an important part of the medical management of CKD. PMID:27593576

  15. An update on the use of botulinum toxin therapy in Parkinson's disease.

    PubMed

    Mills, Reversa; Bahroo, Laxman; Pagan, Fernando

    2015-01-01

    Botulinum toxin (BoNT) has gained widespread use in a variety of neurological conditions. Parkinson's disease is a complex neurodegenerative disorder manifested by motor and non-motor symptoms that can cause significant disability. BoNT has been used to effectively treat a variety of symptoms related to Parkinson's disease. This review will examine the current therapeutic indications of BoNT use in the following disorders related to Parkinson's disease: cervical dystonia, blepharospasm and lid apraxia, focal hand dystonia, foot dystonia, laryngeal dystonia, oromandibular dystonia, camptocormia, hand and jaw tremor, sialorrhea, hyperhidrosis, dysphagia, constipation, and overactive bladder. PMID:25407133

  16. Ask Dr. Sue--Updates: Infectious Diseases, SIDS, HIV/AIDS.

    ERIC Educational Resources Information Center

    Aronson, Susan S.

    1995-01-01

    Describes new concerns about infectious diseases in childcare settings (tuberculosis, gastrointestinal infections, and lice); sleep position and SIDS; HIV/AIDS issues; and the use of sterilized sand in sand boxes. (DR)

  17. Advanced multimodality imaging of inflammatory bowel disease in 2015: An update.

    PubMed

    Stanley, Emma; Moriarty, Heather K; Cronin, Carmel G

    2016-06-28

    The diagnosis and effective management of inflammatory bowel disease (IBD) requires a combination clinical, endoscopic, histological, biological, and imaging data. While endoscopy and biopsy remains the gold standard for diagnosis of IBD, imaging plays a central role in the assessment of extra mural disease, in disease surveillance and in the assessment of response to medical treatments, which are often expensive. Imaging is also vital in the detection and diagnosis of disease related complications, both acute and chronic. In this review, we will describe, with illustrative images, the imaging features of IBD in adults, with emphasis on up-to-date imaging techniques focusing predominantly on cross sectional imaging and new magnetic resonance imaging techniques. PMID:27358684

  18. Advanced multimodality imaging of inflammatory bowel disease in 2015: An update

    PubMed Central

    Stanley, Emma; Moriarty, Heather K; Cronin, Carmel G

    2016-01-01

    The diagnosis and effective management of inflammatory bowel disease (IBD) requires a combination clinical, endoscopic, histological, biological, and imaging data. While endoscopy and biopsy remains the gold standard for diagnosis of IBD, imaging plays a central role in the assessment of extra mural disease, in disease surveillance and in the assessment of response to medical treatments, which are often expensive. Imaging is also vital in the detection and diagnosis of disease related complications, both acute and chronic. In this review, we will describe, with illustrative images, the imaging features of IBD in adults, with emphasis on up-to-date imaging techniques focusing predominantly on cross sectional imaging and new magnetic resonance imaging techniques. PMID:27358684

  19. Epidemiological aspects of beryllium-induced nonmalignant lung disease: a 30-year update

    SciTech Connect

    Eisenbud, M.; Lisson, J.

    1983-03-01

    The unusual epidemiology of beryllium disease observed in the early studies of beryllium disease led in 1951 to the hypothesis that the chronic form of the disease is the result of an acquired sensitization to beryllium or its compounds. After 30 years, the role of sensitization has been confirmed in a number of laboratory and clinical studies. The unusual epidemiological features first summarized by Sterner and Eisenbud continue to be evident. The early studies also led to formulation of standards that have resulted in effective control of both the acute and chronic pulmonary forms of beryllium disease. No case of acute chemical pneumonitis has been reported among beryllium workers in about 15 years, and the number of chronic cases has diminished greatly despite a marked increase in the use of beryllium.

  20. [IgG4-related disease treatment in 2014: Update and literature review].

    PubMed

    Grados, A; Ebbo, M; Jean, E; Bernit, E; Harlé, J-R; Schleinitz, N

    2015-06-01

    IgG4-related disease is an inflammatory disorder characterized by a polyclonal lymphoplasmacytic tissue infiltrate, with numerous IgG4+ plasmocytes, evolving toward fibrosis. The disease is heterogeneous and affects several tissues and organs synchroneously or metachroneously. Both the fibrosis and the tumor forming characteristics of the disease can be responsible of irreversible tissue damage. For these reasons treatment is usually necessary. A dramatic response is usually observed with steroid treatment but relapses are frequent. Immunosuppressive agents and rituximab are used as second line treatments. We review here previous studies on treatment and suggest general recommendations for the treatment and follow up of patients with IgG4-related disease. PMID:25595874

  1. Metabolic Bone Disease in preterm newborn: an update on nutritional issues

    PubMed Central

    Bozzetti, Valentina; Tagliabue, Paolo

    2009-01-01

    Osteopenia, a condition characterised by a reduction in bone mineral content, is a common disease of preterm babies between the tenth and sixteenth week of life. Prematurely born infants are deprived of the intrauterine supply of minerals affecting bone mineralization. The aetiology is multifactorial: inadequate nutrients intake (calcium, phosphorus and vitamin D), a prolonged period of total parenteral nutrition, immobilisation and the intake of some drugs. The diagnosis of metabolic bone disease is done by biochemical analysis: low serum levels of phosphorus and high levels of alkaline phosphatase are suggestive of metabolic bone disease. The disease can remain clinically silent or presents with symptoms and signs of rachitism depending on the severity of bone demineralisation. An early nutritional intervention can reduce both the prevalence and the severity of osteopenia. This article reviews the pathophysiology of foetal and neonatal bone metabolism, focuses on the nutrient requirements of premature babies and on the ways to early detect and treat osteopenia. PMID:19602277

  2. Pharmacology Update on Chronic Obstructive Pulmonary Disease, Rheumatoid Arthritis, and Major Depression.

    PubMed

    Weatherspoon, Deborah; Weatherspoon, Christopher A; Abbott, Brianna

    2015-12-01

    This article presents a brief review and summarizes current therapies for the treatment of chronic obstructive pulmonary disease, major depression, and rheumatoid arthritis. One new pharmaceutical agent is highlighted for each of the topics. PMID:26596663

  3. B-cell targeted therapies in human autoimmune diseases: an updated perspective.

    PubMed

    Townsend, Michael J; Monroe, John G; Chan, Andrew C

    2010-09-01

    The advent of therapies that specifically target the B-lymphocyte lineage in human disease has rejuvenated interest in the mechanistic biology by which B cells mediate autoimmunity. B cells have a multitude of effector functions including production of self-reactive antibodies, ability to present antigen to T lymphocytes in the context of costimulation, involvement in generation and maintenance of neo-organogenesis at sites of disease, and opposing function through production of both immunostimulatory and immunomodulatory cytokines. In this review, we first discuss the role of B cells in driving autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, systemic lupus erythematosus, and Sjögren's syndrome, and discuss how studies in these diseases have revealed differentially important roles for the multiple B-cell effector functions. These data reveal the complex and interrelated roles of B cells working in concert with other components of the innate and adaptive immune system to drive pathogenesis. We then focus on data from mouse and human in which B cells in the setting of disease have been targeted with drugs directed against CD20, CD22, and the BAFF (B-cell activating factor belonging to the tumor necrosis factor family)/APRIL (a proliferation inducing ligand) pathways. Pre-clinical studies in animal models in addition to and clinical trials targeting B cells have added further to the understanding of the differential roles B cells play in disease both through demonstration of clinical efficacy in the context of B-cell depletion or modulation, and also by failure of B-cell targeting in some diseases and disease patient subgroups. Moving forward, it will be imperative to apply these lessons to new interventional trials to ensure better targeting of the B-cell lineage and concomitantly better selection of patients most likely to benefit from these therapies. PMID:20727041

  4. [Impact of lipid metabolism parameters on the development and progression of coronary artery disease : An update].

    PubMed

    Sinning, D; Leistner, D M; Landmesser, U

    2016-06-01

    Disorders of lipid metabolism play a major role in the development and progression of coronary artery disease. Dyslipidemia therefore plays a central role in therapeutic approaches for prevention and treatment of cardiovascular events associated with coronary artery disease. Epidemiological studies have shown an association between various lipid metabolism parameters, the risk of developing coronary artery disease and progression of a pre-existing disease. In particular, increased levels of low-density lipoprotein cholesterol (LDL-C), reduced levels of HDL cholesterol (HDL-C), as well as high levels of triglycerides and increased lipoprotein(a) [Lp(a)] levels can be taken into account when assessing the risk stratification of patients for primary prevention of coronary artery disease. Lifestyle and dietary changes, intensified statin therapy and possibly the addition of ezetimibe remain the major interventions in both primary and secondary prevention of coronary artery disease, as they improve the prognosis particularly by lowering levels of LDL-C. Recently, genetic studies have contributed to extending our understanding of the relationship between lipid metabolism and coronary artery disease. A causal role for progression of coronary artery disease could be demonstrated for LDL-C, Lpa and triglyceride-rich lipoproteins (TRL), which could not be demonstrated for HDL-C in various studies. Furthermore, the effect of reduction of LDL-C by proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition and by the cholesteryl ester transfer protein (CETP) inhibitor anacetrapib on cardiovascular events is currently being investigated in large clinical outcome study programs. PMID:27215419

  5. Preclinical Models for Investigation of Herbal Medicines in Liver Diseases: Update and Perspective

    PubMed Central

    Tan, Hor-Yue; San-Marina, Serban; Wang, Ning; Hong, Ming; Li, Sha; Li, Lei; Cheung, Fan; Wen, Xiao-Yan; Feng, Yibin

    2016-01-01

    Liver disease results from a dynamic pathological process associated with cellular and genetic alterations, which may progress stepwise to liver dysfunction. Commonly, liver disease begins with hepatocyte injury, followed by persistent episodes of cellular regeneration, inflammation, and hepatocyte death that may ultimately lead to nonreversible liver failure. For centuries, herbal remedies have been used for a variety of liver diseases and recent studies have identified the active compounds that may interact with liver disease-associated targets. Further study on the herbal remedies may lead to the formulation of next generation medicines with hepatoprotective, antifibrotic, and anticancer properties. Still, the pharmacological actions of vast majority of herbal remedies remain unknown; thus, extensive preclinical studies are important. In this review, we summarize progress made over the last five years of the most commonly used preclinical models of liver diseases that are used to screen for curative herbal medicines for nonalcoholic fatty liver disease, liver fibrosis/cirrhosis, and liver. We also summarize the proposed mechanisms associated with the observed liver-protective, antifibrotic, and anticancer actions of several promising herbal medicines and discuss the challenges faced in this research field. PMID:26941826

  6. Escherichia coli in chronic inflammatory bowel diseases: An update on adherent invasive Escherichia coli pathogenicity

    PubMed Central

    Martinez-Medina, Margarita; Garcia-Gil, Librado Jesus

    2014-01-01

    Escherichia coli (E. coli), and particularly the adherent invasive E. coli (AIEC) pathotype, has been increasingly implicated in the ethiopathogenesis of Crohn’s disease (CD). E. coli strains with similar pathogenic features to AIEC have been associated with other intestinal disorders such as ulcerative colitis, colorectal cancer, and coeliac disease, but AIEC prevalence in these diseases remains largely unexplored. Since AIEC was described one decade ago, substantial progress has been made in deciphering its mechanisms of pathogenicity. However, the molecular bases that characterize the phenotypic properties of this pathotype are still not well resolved. A review of studies focused on E. coli populations in inflammatory bowel disease (IBD) is presented here and we discuss about the putative role of this species on each IBD subtype. Given the relevance of AIEC in CD pathogenesis, we present the latest research findings concerning AIEC host-microbe interactions and pathogenicity. We also review the existing data regarding the prevalence and abundance of AIEC in CD and its association with other intestinal diseases from humans and animals, in order to discuss the AIEC disease- and host-specificity. Finally, we highlight the fact that dietary components frequently found in industrialized countries may enhance AIEC colonization in the gut, which merits further investigation and the implementation of preventative measures. PMID:25133024

  7. Spectrum of Smoking-related Lung Diseases: Imaging Review and Update.

    PubMed

    Madan, Rachna; Matalon, Shanna; Vivero, Marina

    2016-03-01

    There is increased awareness of smoking-related lung diseases other than lung cancer and chronic obstructive pulmonary disease. Concurrently, there is general acceptance that there is difficulty in establishing a specific diagnosis of smoking-related interstitial lung disease (ILD), as many patients may not undergo biopsy to facilitate a specific histopathologic diagnosis. Cases that do proceed to biopsy may demonstrate multiple abnormalities, and histologic overlap between different disease processes may confound the picture. This review outlines the key aspects of smoking-related lung disease, including entities secondary to smoking-related lung inflammation such as respiratory bronchiolitis-ILD, desquamative idiopathic pneumonia, and pulmonary Langerhans cell histiocytosis, as well as chronic fibrosing lung diseases strongly associated with cigarette smoke including idiopathic pulmonary fibrosis, combined pulmonary fibrosis and emphysema, nonspecific interstitial pneumonia, and rheumatoid arthritis-ILD. The focus will be on incorporation of clinical findings, key pulmonary function testing parameters, high-resolution computer tomography (HRCT) findings, and pathologic correlates in refining the differential diagnosis and differentiating between the various entities. PMID:26479130

  8. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches

    PubMed Central

    de Noya, Belkisyolé Alarcón; Díaz-Bello, Zoraida; Colmenares, Cecilia; Ruiz-Guevara, Raiza; Mauriello, Luciano; Muñoz-Calderón, Arturo; Noya, Oscar

    2015-01-01

    Orally transmitted Chagas disease has become a matter of concern due to outbreaks reported in four Latin American countries. Although several mechanisms for orally transmitted Chagas disease transmission have been proposed, food and beverages contaminated with whole infected triatomines or their faeces, which contain metacyclic trypomastigotes of Trypanosoma cruzi, seems to be the primary vehicle. In 2007, the first recognised outbreak of orally transmitted Chagas disease occurred in Venezuela and largest recorded outbreak at that time. Since then, 10 outbreaks (four in Caracas) with 249 cases (73.5% children) and 4% mortality have occurred. The absence of contact with the vector and of traditional cutaneous and Romana’s signs, together with a florid spectrum of clinical manifestations during the acute phase, confuse the diagnosis of orally transmitted Chagas disease with other infectious diseases. The simultaneous detection of IgG and IgM by ELISA and the search for parasites in all individuals at risk have been valuable diagnostic tools for detecting acute cases. Follow-up studies regarding the microepidemics primarily affecting children has resulted in 70% infection persistence six years after anti-parasitic treatment. Panstrongylus geniculatus has been the incriminating vector in most cases. As a food-borne disease, this entity requires epidemiological, clinical, diagnostic and therapeutic approaches that differ from those approaches used for traditional direct or cutaneous vector transmission. PMID:25946155

  9. Short communication: Strengthening sub-national communicable disease surveillance in a remote Pacific Island country by adapting a successful African outbreak surveillance model.

    PubMed

    Nelesone, Tekaai; Durrheim, David N; Speare, Richard; Kiedrzynski, Tom; Melrose, Wayne D

    2006-01-01

    Successful communicable disease surveillance depends on effective bidirectional information flow between clinicians at the periphery and communicable disease control units at regional, national and global levels. Resource-poor countries often struggle to establish and maintain the crucial link with the periphery. A simple syndrome-based outbreak surveillance system initially developed and evaluated in Mpumalanga Province, South Africa was adapted for the Pacific island nation of Tuvalu. Eight syndromes were identified for surveillance: acute flaccid paralysis (poliomyelitis), profuse watery diarrhoea (cholera), diarrhoea outbreak, dysentery outbreak, febrile disease with abdominal symptoms and headache (typhoid), febrile disease with generalized non-blistering rash (measles), febrile disease with intense headache and/or neck stiffness with or without haemorrhagic rash (meningococcal meningitis), and outbreaks of other febrile diseases of unknown origin. A user-oriented manual, the Tuvalu Outbreak Manual (http://www.wepi.org/books/tom/), was developed to support introduction of the surveillance system. Nurses working in seven outer island clinics and the hospital outpatient department on the main island rapidly report suspected outbreaks and submit weekly zero-reports to the central communicable disease control unit. An evaluation of the system after 12 months indicated that the Outbreak Manual was regarded as very useful by clinic nurses, and there was early evidence of improved surveillance and response to the disease syndromes under surveillance. PMID:16398751

  10. Pharmacological agents in the treatment of venous disease: an update of the available evidence.

    PubMed

    Gohel, Manjit S; Davies, Alun H

    2009-07-01

    Varicose veins and the complications of venous disease are thought to affect over a quarter of the adult population and the management of these conditions are a major cause of health service expense. Advances in the understanding of venous pathophysiology have highlighted numerous potential targets for pharmacotherapy. This review considers the evidence for pharmacological agents used for the treatment of chronic venous disease. A literature search using Pubmed, Embase and Cinahl databases was performed. The initial search terms 'varicose vein', 'venous ulcer' and 'venous disease' were used with appropriate search limits to identify prospective studies of pharmacotherapy in venous disease. A wide range of venoactive and non-venoactive drugs have been studied in patients with venous disease. The use of micronized purified flavonoid fraction (Daflon) can reduce symptoms of pain, heaviness and oedema in patients with venous reflux and a recent meta-analysis concluded that Daflon improves healing in patients with venous ulceration treated with compression. Pentoxifylline may be a useful adjunct to compression therapy for patients with venous ulceration. Oxerutins and calcium dobesilate may be of benefit in reducing oedema and rutosides may help to relieve the symptoms of varicose veins in pregnancy. The clinical benefits of other medications remain unproven. Although numerous pharmacological agents have been proposed and studied, Daflon has demonstrated the greatest clinical benefits in patients with venous disease. Further research is needed to define the role of venoactive drugs in clinical care and improve our understanding of the pathophysiology of venous disease to help identify new therapeutic avenues. PMID:19601855

  11. Global Strategies for the Prevention and Control of Infectious Diseases and Non-Communicable Diseases

    PubMed Central

    Nakatani, Hiroki

    2016-01-01

    This article on global health reviews the environment surrounding health strategies and plans, as well as lessons learned from the first 15 years of the 21st century, followed by a discussion on the quest for a new paradigm for disease control efforts and challenges and opportunities for Japan. PMID:26947953

  12. Looking Beyond the Terrestrial: The Potential of Seaweed Derived Bioactives to Treat Non-Communicable Diseases

    PubMed Central

    Collins, Kenneth G.; Fitzgerald, Gerald F.; Stanton, Catherine; Ross, R. Paul

    2016-01-01

    Seaweeds are a large and diverse group of marine organisms that are commonly found in the maritime regions of the world. They are an excellent source of biologically active secondary metabolites and have been shown to exhibit a wide range of therapeutic properties, including anti-cancer, anti-oxidant, anti-inflammatory and anti-diabetic activities. Several Asian cultures have a strong tradition of using different varieties of seaweed extensively in cooking as well as in herbal medicines preparations. As such, seaweeds have been used to treat a wide variety of health conditions such as cancer, digestive problems, and renal disorders. Today, increasing numbers of people are adopting a “westernised lifestyle” characterised by low levels of physical exercise and excessive calorific and saturated fat intake. This has led to an increase in numbers of chronic Non-communicable diseases (NCDs) such as cancer, cardiovascular disease, and diabetes mellitus, being reported. Recently, NCDs have replaced communicable infectious diseases as the number one cause of human mortality. Current medical treatments for NCDs rely mainly on drugs that have been obtained from the terrestrial regions of the world, with the oceans and seas remaining largely an untapped reservoir for exploration. This review focuses on the potential of using seaweed derived bioactives including polysaccharides, antioxidants and fatty acids, amongst others, to treat chronic NCDs such as cancer, cardiovascular disease and diabetes mellitus. PMID:26999166

  13. Looking Beyond the Terrestrial: The Potential of Seaweed Derived Bioactives to Treat Non-Communicable Diseases.

    PubMed

    Collins, Kenneth G; Fitzgerald, Gerald F; Stanton, Catherine; Ross, R Paul

    2016-03-01

    Seaweeds are a large and diverse group of marine organisms that are commonly found in the maritime regions of the world. They are an excellent source of biologically active secondary metabolites and have been shown to exhibit a wide range of therapeutic properties, including anti-cancer, anti-oxidant, anti-inflammatory and anti-diabetic activities. Several Asian cultures have a strong tradition of using different varieties of seaweed extensively in cooking as well as in herbal medicines preparations. As such, seaweeds have been used to treat a wide variety of health conditions such as cancer, digestive problems, and renal disorders. Today, increasing numbers of people are adopting a "westernised lifestyle" characterised by low levels of physical exercise and excessive calorific and saturated fat intake. This has led to an increase in numbers of chronic Non-communicable diseases (NCDs) such as cancer, cardiovascular disease, and diabetes mellitus, being reported. Recently, NCDs have replaced communicable infectious diseases as the number one cause of human mortality. Current medical treatments for NCDs rely mainly on drugs that have been obtained from the terrestrial regions of the world, with the oceans and seas remaining largely an untapped reservoir for exploration. This review focuses on the potential of using seaweed derived bioactives including polysaccharides, antioxidants and fatty acids, amongst others, to treat chronic NCDs such as cancer, cardiovascular disease and diabetes mellitus. PMID:26999166

  14. Update on the core and developing cerebrospinal fluid biomarkers for Alzheimer disease

    PubMed Central

    Babić, Mirjana; Švob Štrac, Dubravka; Mück-Šeler, Dorotea; Pivac, Nela; Stanić, Gabrijela; Hof, Patrick R.; Šimić, Goran

    2014-01-01

    Alzheimer disease (AD) is a complex neurodegenerative disorder, whose prevalence will dramatically rise by 2050. Despite numerous clinical trials investigating this disease, there is still no effective treatment. Many trials showed negative or inconclusive results, possibly because they recruited only patients with severe disease, who had not undergone disease-modifying therapies in preclinical stages of AD before severe degeneration occurred. Detection of AD in asymptomatic at risk individuals (and a few presymptomatic individuals who carry an autosomal dominant monogenic AD mutation) remains impractical in many of clinical situations and is possible only with reliable biomarkers. In addition to early diagnosis of AD, biomarkers should serve for monitoring disease progression and response to therapy. To date, the most promising biomarkers are cerebrospinal fluid (CSF) and neuroimaging biomarkers. Core CSF biomarkers (amyloid β1-42, total tau, and phosphorylated tau) showed a high diagnostic accuracy but were still unreliable for preclinical detection of AD. Hence, there is an urgent need for detection and validation of novel CSF biomarkers that would enable early diagnosis of AD in asymptomatic individuals. This article reviews recent research advances on biomarkers for AD, focusing mainly on the CSF biomarkers. In addition to core CSF biomarkers, the potential usefulness of novel CSF biomarkers is discussed. PMID:25165049

  15. Stressed skin? - a molecular psychosomatic update on stress-causes and effects in dermatologic diseases.

    PubMed

    Peters, Eva M J

    2016-03-01

    A pathogenetically relevant link between stress, in terms of psychosocial stress, and disease was first described in the 1970s, when it was proven that viral diseases of mucous membranes (such as rhinovirus and Coxsackie virus infections) develop faster and more severe after stress exposure. Since then, there has been an annual increase in the number of publications which investigate this relationship and break it down to the molecular level. Nevertheless, the evidences for the impact of psychosocial stress on chronic inflammatory skin diseases and skin tumors are hardly known. In the present review, we outline current insights into epidemiology, psychoneuroimmunology, and molecular psychosomatics which demonstrate the manifold disease-relevant interactions between the endocrine, nervous, and immune systems. The focus is on stress-induced shifts in immune balance in exemplary disorders such as atopic dermatitis, psoriasis, and malignant melanoma. The objective of this article is to convey basic psychosomatic knowledge with respect to etiology, symptomatology, and therapeutic options for chronic skin diseases. Particular attention is directed towards the underlying molecular relationships, both from a somatic to mental as well as a mental to somatic perspective. PMID:26972185

  16. Creutzfeldt-Jakob disease: updated diagnostic criteria, treatment algorithm, and the utility of brain biopsy.

    PubMed

    Manix, Marc; Kalakoti, Piyush; Henry, Miriam; Thakur, Jai; Menger, Richard; Guthikonda, Bharat; Nanda, Anil

    2015-11-01

    Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative condition with a rapid disease course and a mortality rate of 100%. Several forms of the disease have been described, and the most common is the sporadic type. The most challenging aspect of this disease is its diagnosis-the gold standard for definitive diagnosis is considered to be histopathological confirmation-but newer tests are providing means for an antemortem diagnosis in ways less invasive than brain biopsy. Imaging studies, electroencephalography, and biomarkers are used in conjunction with the clinical picture to try to make the diagnosis of CJD without brain tissue samples, and all of these are reviewed in this article. The current diagnostic criteria are limited; test sensitivity and specificity varies with the genetics of the disease as well as the clinical stage. Physicians may be unsure of all diagnostic testing available, and may order outdated tests or prematurely request a brain biopsy when the diagnostic workup is incomplete. The authors review CJD, discuss the role of brain biopsy in this patient population, provide a diagnostic pathway for the patient presenting with rapidly progressive dementia, and propose newer diagnostic criteria. PMID:26646926

  17. [Update: standardized CT/HRCT classification of occupational and environmental thoracic diseases in Germany].

    PubMed

    Hering, K G; Hofmann-Preiß, K; Kraus, T

    2014-04-01

    The high-resolution computed tomography (HRCT) coding scheme of the international classification of occupational and environmental respiratory diseases (ICOERD) presented here is an instrument for a standardized semiquantitative description of occupation and environment-linked as well as other pulmonary and pleural diseases. Analogous to the International Labour Organization (ILO) classification, the ICOERD coding scheme should always be used when the CT/HRCT examination is employed for occupational medical investigations or expert opinions. After publication of the guidelines and recommendations on diagnostics and expert assessment of asbestos-linked diseases and silicosis, the application of a standardized investigation program and assessment with the ICOERD classification form are obligatory, at least for the initial assessment. Furthermore, its use in the field of follow-up assessments of occupational diseases should be encouraged in order to guarantee comparability between individual reports (interreader variability) and at least a semiquantitative assessment of disease progression in isolated cases. Because the anatomical structures in projection radiography and CT are not presented identically, a 1:1 transfer of the results of the ILO classification to the CT/HRCT coding scheme is not possible. An overview image of the thorax does not allow overlap-free reproduction of structures, in contrast to CT. These methodological differences can in cases of isolated assessment result in different opinions of projection and CT images mostly by different investigators. In cases of discrepant opinions an integrated report of findings by combination of all information from both procedures is necessary. PMID:24737105

  18. Mutation Update of the CLCN5 Gene Responsible for Dent Disease 1.

    PubMed

    Mansour-Hendili, Lamisse; Blanchard, Anne; Le Pottier, Nelly; Roncelin, Isabelle; Lourdel, Stéphane; Treard, Cyrielle; González, Wendy; Vergara-Jaque, Ariela; Morin, Gilles; Colin, Estelle; Holder-Espinasse, Muriel; Bacchetta, Justine; Baudouin, Véronique; Benoit, Stéphane; Bérard, Etienne; Bourdat-Michel, Guylhène; Bouchireb, Karim; Burtey, Stéphane; Cailliez, Mathilde; Cardon, Gérard; Cartery, Claire; Champion, Gerard; Chauveau, Dominique; Cochat, Pierre; Dahan, Karin; De la Faille, Renaud; Debray, François-Guillaume; Dehoux, Laurenne; Deschenes, Georges; Desport, Estelle; Devuyst, Olivier; Dieguez, Stella; Emma, Francesco; Fischbach, Michel; Fouque, Denis; Fourcade, Jacques; François, Hélène; Gilbert-Dussardier, Brigitte; Hannedouche, Thierry; Houillier, Pascal; Izzedine, Hassan; Janner, Marco; Karras, Alexandre; Knebelmann, Bertrand; Lavocat, Marie-Pierre; Lemoine, Sandrine; Leroy, Valérie; Loirat, Chantal; Macher, Marie-Alice; Martin-Coignard, Dominique; Morin, Denis; Niaudet, Patrick; Nivet, Hubert; Nobili, François; Novo, Robert; Faivre, Laurence; Rigothier, Claire; Roussey-Kesler, Gwenaëlle; Salomon, Remi; Schleich, Andreas; Sellier-Leclerc, Anne-Laure; Soulami, Kenza; Tiple, Aurélien; Ulinski, Tim; Vanhille, Philippe; Van Regemorter, Nicole; Jeunemaître, Xavier; Vargas-Poussou, Rosa

    2015-08-01

    Dent disease is a rare X-linked tubulopathy characterized by low molecular weight proteinuria, hypercalciuria, nephrocalcinosis and/or nephrolithiasis, progressive renal failure, and variable manifestations of other proximal tubule dysfunctions. It often progresses over a few decades to chronic renal insufficiency, and therefore molecular characterization is important to allow appropriate genetic counseling. Two genetic subtypes have been described to date: Dent disease 1 is caused by mutations of the CLCN5 gene, coding for the chloride/proton exchanger ClC-5; and Dent disease 2 by mutations of the OCRL gene, coding for the inositol polyphosphate 5-phosphatase OCRL-1. Herein, we review previously reported mutations (n = 192) and their associated phenotype in 377 male patients with Dent disease 1 and describe phenotype and novel (n = 42) and recurrent mutations (n = 24) in a large cohort of 117 Dent disease 1 patients belonging to 90 families. The novel missense and in-frame mutations described were mapped onto a three-dimensional homology model of the ClC-5 protein. This analysis suggests that these mutations affect the dimerization process, helix stability, or transport. The phenotype of our cohort patients supports and extends the phenotype that has been reported in smaller studies. PMID:25907713

  19. Toward Development of a Fibromyalgia Responder Index and Disease Activity Score: OMERACT Module Update

    PubMed Central

    Mease, PJ; Clauw, DJ; Christensen, R; Crofford, L; Gendreau, M; Martin, SA; Simon, L; Strand, V; Williams, DA; Arnold, LM

    2012-01-01

    Following development of the core domain set for fibromyalgia (FM) in OMERACT 7–9, the FM working group has progressed toward the development of an FM responder index and a disease activity score based on these domains, utilizing outcome indices of these domains from archived randomized clinical trials (RCTs) in FM. Possible clinical domains that could be included in a responder index and disease activity score include: pain, fatigue, sleep disturbance, cognitive dysfunction, mood disturbance, tenderness, stiffness, and functional impairment. Outcome measures for these domains demonstrate good to adequate psychometric properties, although measures of cognitive dysfunction need to be further developed. The approach used in the development of responder indices and disease activity scores for rheumatoid arthritis and ankylosing spondylitis represent heuristic models for our work, but FM is challenging in that there is no clear algorithm of treatment that defines disease activity based on treatment decisions, nor are there objective markers that define thresholds of severity or response to treatment. The process of developing candidate dichotomous responder definitions and continuous quantitative disease activity measures is described, as is participant discussion that transpired at OMERACT 10. Final results of this work will be published in a separate manuscript pending completion of analyses. PMID:21724721

  20. Recognition and management of common acute conditions of the oral cavity resulting from tooth decay, periodontal disease, and trauma: an update for the family physician.

    PubMed

    Edwards, Paul C; Kanjirath, Preetha

    2010-01-01

    This article presents an overview of common and/or significant diseases of the oral cavity that the family physician is likely to encounter, with an emphasis on pathogenesis, recognition, complications, and management. Topics reviewed include the sequelae of dental caries, periodontal disease, and trauma. Prevention and early intervention strategies are emphasized. Recent updates and practical issues for the family physician are highlighted. PMID:20453174

  1. Update on Magnetic Resonance Imaging and Ultrasound Evaluation of Crohn’s Disease

    PubMed Central

    Deepak, Parakkal; Kolbe, Amy B.; Fidler, Jeff L.; Fletcher, Joel G.; Knudsen, John M.

    2016-01-01

    Magnetic resonance enterography (MRE) and abdominal ultrasound are integral parts of multimodality assessments for patients with inflammatory bowel disease. Applications include assessing Crohn’s disease (CD) extent and severity, differentiating CD from ulcerative colitis, detecting CD complications, evaluating response to therapy, and demonstrating postoperative recurrence. Magnetic resonance imaging protocols are being developed that may reduce or eliminate the need for intravenous contrast agents and better differentiate inflammatory from fibrotic strictures. MRE scoring systems have been created to objectively quantify disease activity and response to therapy. By utilizing advanced sonographic imaging techniques, including ultrasound contrast and Doppler assessments, the role of abdominal ultrasonography in the evaluation and management of CD continues to expand. Abdominal ultrasound may function as a low-cost, point-of care assessment tool, especially in CD restricted to the terminal ileum and ileocolic anastomosis. PMID:27231453

  2. Crohn disease and ulcerative colitis in children: an update for 2014.

    PubMed

    Lemberg, Daniel A; Day, Andrew S

    2015-03-01

    Crohn disease (CD) and ulcerative colitis (UC), the two main types of inflammatory bowel disease (IBD), have become increasingly common in Australasian children and adolescents in recent years. Furthermore, CD and UC are seen more often in younger children. These conditions are typically more extensive in children and tend to follow more severe disease courses than in adults. Although many children may present with typical symptoms (such as abdominal pain or bloody diarrhoea), others have atypical features (including oral ulceration, short stature or skin manifestations). In addition, many children with IBD will have altered growth or nutrition, which may compromise normal linear growth and pubertal development. Early identification and full assessment of children presenting with possible IBD are essential to avoid consequences of diagnostic delay and to optimise short- and long-term outcomes. Management of IBD encompasses various options and should be undertaken within a team-based, child and family-focused, multidisciplinary setting. PMID:25039307

  3. Update on Magnetic Resonance Imaging and Ultrasound Evaluation of Crohn's Disease.

    PubMed

    Deepak, Parakkal; Kolbe, Amy B; Fidler, Jeff L; Fletcher, Joel G; Knudsen, John M; Bruining, David H

    2016-04-01

    Magnetic resonance enterography (MRE) and abdominal ultrasound are integral parts of multimodality assessments for patients with inflammatory bowel disease. Applications include assessing Crohn's disease (CD) extent and severity, differentiating CD from ulcerative colitis, detecting CD complications, evaluating response to therapy, and demonstrating postoperative recurrence. Magnetic resonance imaging protocols are being developed that may reduce or eliminate the need for intravenous contrast agents and better differentiate inflammatory from fibrotic strictures. MRE scoring systems have been created to objectively quantify disease activity and response to therapy. By utilizing advanced sonographic imaging techniques, including ultrasound contrast and Doppler assessments, the role of abdominal ultrasonography in the evaluation and management of CD continues to expand. Abdominal ultrasound may function as a low-cost, point-of care assessment tool, especially in CD restricted to the terminal ileum and ileocolic anastomosis. PMID:27231453

  4. Nanomedicines against Chagas disease: an update on therapeutics, prophylaxis and diagnosis.

    PubMed

    Morilla, Maria Jose; Romero, Eder Lilia

    2015-02-01

    Chagas disease is a neglected parasitic infection caused by the protozoan Trypanosoma cruzi. After a mostly clinically silent acute phase, the disease becomes a lifelong chronic condition that can lead to chronic heart failure and thromboembolic phenomena followed by sudden death. Antichagasic treatment is only effective in the acute phase but fails to eradicate the intracellular form of parasites and causes severe toxicity in adults. Although conventional oral benznidazol is not a safe and efficient drug to cure chronic adult patients, current preclinical data is insufficient to envisage if conventional antichagasic treatment could be realistically improved by a nanomedical approach. This review will discuss how nanomedicines could help to improve the performance of therapeutics, vaccines and diagnosis of Chagas disease. PMID:25707979

  5. Nutritional approaches for the primary prevention of allergic disease: An update.

    PubMed

    Rueter, Kristina; Prescott, Susan L; Palmer, Debra J

    2015-10-01

    The dramatic rise in early childhood allergic diseases indicates the specific vulnerability of the immune system to early life environmental changes. Dietary changes are at the centre of lifestyle changes that underpin many modern inflammatory and metabolic diseases, and therefore are an essential element of prevention strategies. Although modern dietary changes are complex and involve changing patterns of many nutrients, there is also an interest in the early life effects of specific nutrients including polyunsaturated fatty acids, oligosaccharides (soluble fibre), antioxidants, folate and other vitamins that have documented effects on immune function as well as metabolism. A better understanding of nutritional programming of immune health, nutritional epigenetics and the biological processes sensitive to nutritional exposures in early life may lead to dietary strategies that provide more tolerogenic conditions during early immune programming and reduce the burden of many inflammatory diseases, not just allergy. PMID:26135523

  6. Update on celiac disease – etiology, differential diagnosis, drug targets, and management advances

    PubMed Central

    Scanlon, Samantha A; Murray, Joseph A

    2011-01-01

    Celiac disease (CD) is an immune-mediated enteropathy triggered by exposure to wheat gluten and similar proteins found in rye and barley that affects genetically susceptible persons. This immune-mediated enteropathy is characterized by villous atrophy, intraepithelial lymphocytosis, and crypt hyperplasia. Once thought a disease that largely presented with malnourished children, the wide spectrum of disease activity is now better recognized and this has resulted in a shift in the presenting symptoms of most patients with CD. New advances in testing, both serologic and endoscopic, have dramatically increased the detection and diagnosis of CD. While the gluten-free diet is still the only treatment for CD, recent investigations have explored alternative approaches, including the use of altered nonimmunogenic wheat variants, enzymatic degradation of gluten, tissue transglutaminase inhibitors, induction of tolerance, and peptides to restore integrity to intestinal tight junctions. PMID:22235174

  7. Ethnic Minorities and Coronary Heart Disease: an Update and Future Directions

    PubMed Central

    Leigh, J. Adam; Alvarez, Manrique

    2016-01-01

    Heart disease remains the leading cause of death in the USA. Overall, heart disease accounts for about 1 in 4 deaths with coronary heart disease (CHD) being responsible for over 370,000 deaths per year. It has frequently and repeatedly been shown that some minority groups in the USA have higher rates of traditional CHD risk factors, different rates of treatment with revascularization procedures, and excess morbidity and mortality from CHD when compared to the non-Hispanic white population. Numerous investigations have been made into the causes of these disparities. This review aims to highlight the recent literature which examines CHD in ethnic minorities and future directions in research and care. PMID:26792015

  8. Exposure to cats: update on risks for sensitization and allergic diseases.

    PubMed

    Dharmage, Shyamali C; Lodge, Caroline L; Matheson, Melanie C; Campbell, Brittany; Lowe, Adrian J

    2012-10-01

    Cats are the pets most commonly implicated in the etiology of asthma and allergic disease. However, systematic reviews have concluded that there is a lack of evidence to support the idea that cat exposure in early life increases the risk of allergic disease. Indeed, it appears most likely that cat exposure is protective against allergic diseases. Recent large prospective studies have shown that living with a cat during childhood, especially during the first year of a child's life, could be protective. However, any advice given to the parents should also incorporate how new acquisition of cats can affect other family members, especially those who are already sensitized. Research is urgently needed to determine whether the suggested impact of acquisition of cats in adult life is modified by the person's childhood pet ownership, to help parents who seek advice on whether or not to get a cat. PMID:22878928

  9. Burden of disease and costs of exposure to endocrine disrupting chemicals in the European Union: an updated analysis.

    PubMed

    Trasande, L; Zoeller, R T; Hass, U; Kortenkamp, A; Grandjean, P; Myers, J P; DiGangi, J; Hunt, P M; Rudel, R; Sathyanarayana, S; Bellanger, M; Hauser, R; Legler, J; Skakkebaek, N E; Heindel, J J

    2016-07-01

    A previous report documented that endocrine disrupting chemicals contribute substantially to certain forms of disease and disability. In the present analysis, our main objective was to update a range of health and economic costs that can be reasonably attributed to endocrine disrupting chemical exposures in the European Union, leveraging new burden and disease cost estimates of female reproductive conditions from accompanying report. Expert panels evaluated the epidemiologic evidence, using adapted criteria from the WHO Grading of Recommendations Assessment, Development and Evaluation Working Group, and evaluated laboratory and animal evidence of endocrine disruption using definitions recently promulgated by the Danish Environmental Protection Agency. The Delphi method was used to make decisions on the strength of the data. Expert panels consensus was achieved for probable (>20%) endocrine disrupting chemical causation for IQ loss and associated intellectual disability; autism; attention deficit hyperactivity disorder; endometriosis; fibroids; childhood obesity; adult obesity; adult diabetes; cryptorchidism; male infertility, and mortality associated with reduced testosterone. Accounting for probability of causation, and using the midpoint of each range for probability of causation, Monte Carlo simulations produced a median annual cost of €163 billion (1.28% of EU Gross Domestic Product) across 1000 simulations. We conclude that endocrine disrupting chemical exposures in the EU are likely to contribute substantially to disease and dysfunction across the life course with costs in the hundreds of billions of Euros per year. These estimates represent only those endocrine disrupting chemicals with the highest probability of causation; a broader analysis would have produced greater estimates of burden of disease and costs. PMID:27003928

  10. Update on drugs used to treat endocrine diseases in small animals.

    PubMed

    Behrend, Ellen N

    2006-09-01

    Drug therapy for the endocrine system is implemented to replace a hormone deficiency or to prevent or reduce the formation or effects of excess hormone. Treatment of endocrine disorders covers diseases of the pituitary, adrenal, parathyroid, and thyroid glands as well as the endocrine pancreas. This article focuses on new therapies currently available for specific diseases. Administration of trilostane for treatment of hyperadrenocorticism and use of insulin glargine, protamine zinc insulin (PZI), and porcine Lente insulin for diabetes mellitus are discussed. In addition, transdermal methimazole therapy for treatment of feline hyperthyroidism and administration of progestins for pituitary dwarfism are considered. PMID:16984828

  11. Select Public Health and Communicable Disease Lessons Learned During Operations Iraqi Freedom and Enduring Freedom.

    PubMed

    Garges, Eric C; Taylor, Kevin M; Pacha, Laura A

    2016-01-01

    History has taught us that the threat of communicable diseases to operational readiness should not be underestimated. The unique operational challenges of a decade at war in Southwest Asia have left us with many new lessons about prevention and mitigation of disease. The successes of military immunization programs demonstrated the successful application of military science to modern combat. Historic maladies such as tuberculosis and malaria continue to challenge our Army health leadership while new challenges with diseases like Q fever and rabies led to questions about our preparedness. These conflicts also brought awareness of issues about the broader deployed community, and the often unique risks that arise when US service members interact more frequently with foreign militaries, local nationals, and third country nationals. Application of these lessons to predeployment training and integration into leadership decision-making will improve our ability to maintain force readiness in future conflicts and adapt Army policy to current evidence and intelligence. PMID:27215886

  12. A Framework to Address Challenges in Communicating the Developmental Origins of Health and Disease.

    PubMed

    Winett, Liana; Wallack, Lawrence; Richardson, Dawn; Boone-Heinonen, Janne; Messer, Lynne

    2016-09-01

    Findings from the field of Developmental Origins of Health and Disease (DOHaD) suggest that some of the most pressing public health problems facing communities today may begin much earlier than previously understood. In particular, this body of work provides evidence that social, physical, chemical, environmental, and behavioral influences in early life play a significant role in establishing vulnerabilities for chronic disease later in life. Further, because this work points to the importance of adverse environmental exposures that cluster in population groups, it suggests that existing opportunities to intervene at a population level may need to refocus their efforts "upstream" to sufficiently combat the fundamental causes of disease. To translate these findings into improved public health, however, the distance between scientific discovery and population application will need to be bridged by conversations across a breadth of disciplines and social roles. And importantly, those involved will likely begin without a shared vocabulary or conceptual starting point. The purpose of this paper is to support and inform the translation of DOHaD findings from the bench to population-level health promotion and disease prevention, by: (1) discussing the unique communication challenges inherent to translation of DOHaD for broad audiences, (2) introducing the First-hit/Second-hit Framework with an epidemiologic planning matrix as a model for conceptualizing and structuring communication around DOHaD, and (3) discussing the ways in which patterns of communicating DOHaD findings can expand the range of solutions considered and encourage discussion of population-level solutions in relation to one another, rather than in isolation. PMID:27449924

  13. An attributional analysis of stigma associated with sexually transmitted diseases and its relationship with communication efficacy.

    PubMed

    Yoo, Jina H; Jang, Suahn

    2012-07-01

    People typically attribute more responsibility to those individuals who are infected with sexually transmitted diseases (STD) than other diseases. This study tested how different routes (i.e., sexually transmitted or foodborne) of transmission have an impact on individuals' general perception on stigma/shame and the attributions of responsibility, when controlling for symptoms/conditions of the hypothetical virus infection. Two hundreds and ninety eight college students were recruited for the study. As predicted, people who were attributed with control over contracting the virus (i.e., sexually transmitted route) were likely to be assigned a greater level of personal responsibility and were more likely to receive blame from others than people who were attributed relatively less control over contracting the virus (i.e., foodborne). The relationship between the attribution of responsibility and communication efficacy was also assessed. The results supported our prediction that there was a significant association between the attribution of responsibility and communication efficacy, in that the perceived controllability of the situation, perceived responsibility for the situation, and blame were all significantly correlated with communication efficacy in a negative direction. Practical applications by evaluating the effectiveness of the actual Merck's Gardasil advertisement were discussed that the Gardasil advertisement appears to reduce the perceived shame and stigma associated with the sexually transmitted nature of the virus by not revealing the true nature of the virus upfront. PMID:22980337

  14. Applying the WHO ICF Framework to Communication Assessment and Goal Setting in Huntington's Disease: A Case Discussion

    ERIC Educational Resources Information Center

    Power, Emma; Anderson, Alison; Togher, Leanne

    2011-01-01

    Purpose: Huntington's Disease (HD) is a fatal, hereditary neurodegenerative disorder that is characterized by a triad of motor, cognitive and psychiatric symptoms that impact on both communicative effectiveness and the treatment techniques used to maximize communicative participation. The purpose of this article is to describe the application of…

  15. CDH1/E-cadherin and solid tumors. An updated gene-disease association analysis using bioinformatics tools.

    PubMed

    Abascal, María Florencia; Besso, María José; Rosso, Marina; Mencucci, María Victoria; Aparicio, Evangelina; Szapiro, Gala; Furlong, Laura Inés; Vazquez-Levin, Mónica Hebe

    2016-02-01

    Cancer is a group of diseases that causes millions of deaths worldwide. Among cancers, Solid Tumors (ST) stand-out due to their high incidence and mortality rates. Disruption of cell-cell adhesion is highly relevant during tumor progression. Epithelial-cadherin (protein: E-cadherin, gene: CDH1) is a key molecule in cell-cell adhesion and an abnormal expression or/and function(s) contributes to tumor progression and is altered in ST. A systematic study was carried out to gather and summarize current knowledge on CDH1/E-cadherin and ST using bioinformatics resources. The DisGeNET database was exploited to survey CDH1-associated diseases. Reported mutations in specific ST were obtained by interrogating COSMIC and IntOGen tools. CDH1 Single Nucleotide Polymorphisms (SNP) were retrieved from the dbSNP database. DisGeNET analysis identified 609 genes annotated to ST, among which CDH1 was listed. Using CDH1 as query term, 26 disease concepts were found, 21 of which were neoplasms-related terms. Using DisGeNET ALL Databases, 172 disease concepts were identified. Of those, 80 ST disease-related terms were subjected to manual curation and 75/80 (93.75%) associations were validated. On selected ST, 489 CDH1 somatic mutations were listed in COSMIC and IntOGen databases. Breast neoplasms had the highest CDH1-mutation rate. CDH1 was positioned among the 20 genes with highest mutation frequency and was confirmed as driver gene in breast cancer. Over 14,000 SNP for CDH1 were found in the dbSNP database. This report used DisGeNET to gather/compile current knowledge on gene-disease association for CDH1/E-cadherin and ST; data curation expanded the number of terms that relate them. An updated list of CDH1 somatic mutations was obtained with COSMIC and IntOGen databases and of SNP from dbSNP. This information can be used to further understand the role of CDH1/E-cadherin in health and disease. PMID:26674224

  16. Prevention and management of non-communicable disease: the IOC consensus statement, Lausanne 2013.

    PubMed

    Matheson, Gordon O; Klügl, Martin; Engebretsen, Lars; Bendiksen, Fredrik; Blair, Steven N; Börjesson, Mats; Budgett, Richard; Derman, Wayne; Erdener, Ugur; Ioannidis, John P A; Khan, Karim M; Martinez, Rodrigo; Van Mechelen, Willem; Mountjoy, Margo; Sallis, Robert E; Schwellnus, Martin; Shultz, Rebecca; Soligard, Torbjørn; Steffen, Kathrin; Sundberg, Carl Johan; Weiler, Richard; Ljungqvist, Arne

    2013-11-01

    Morbidity and mortality from preventable, non-communicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology and design thinking. The purpose of this paper is to summarise the results of a consensus meeting on NCD prevention sponsored by the IOC in April 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within healthcare systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: (1) Focus on behavioural change as the core component of all clinical programmes for the prevention and management of chronic disease. (2) Establish actual centres to design, implement, study and improve preventive programmes for chronic disease. (3) Use human-centred design in the creation of prevention programmes with an inclination to action, rapid prototyping and multiple iterations. (4) Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programmes for the prevention and treatment of chronic disease focused on physical activity, diet and lifestyle. (5) Mobilise resources and leverage networks to scale and distribute programmes of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programmes within healthcare. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad hoc Working Group charged with the responsibility of moving this agenda forward. PMID

  17. Evaluation of the timeliness and completeness of communicable disease reporting: Surveillance in The Cuban Hospital, Qatar

    PubMed Central

    Garcell, Humberto Guanche; Hernandez, Tania M. Fernandez; Abdo, Elmusbasher Abu Baker; Arias, Ariadna Villanueva

    2014-01-01

    Public health surveillance systems should be evaluated periodically, and should involve an assessment of system attributes. Objective: Evaluate hospital-based surveillance of communicable diseases using the elements of timeliness and data quality. Method: Descriptive study was conducted of communicable diseases reported at The Cuban Hospital, Qatar during January 2012 to December 2013. The completeness of notifications were assessed for contact number, address, place of work, and date of symptom onset. Time between the symptoms onset and physician notification, time between physician and Supreme Council of Health notification and time between physician notification and lab confirmation were calculated for each case. Analysis: Percentage of cases with documented essential information and 95% confidence interval (CI) were determined. Mean and standard deviation (SD) of time were calculated. Results: 1065 patients were reported, 75% were male, 80% non-qataries and 91.5% were group 1 (high priority) diseases. Symptom onset date was documented in 91.5% (95% CI, 89.8; 93.2) of cases; contact number in 84.7% (82.5;86.8), with lower frequencies for address (68.1%, 65.3;70.9) and place of work (60.5%, 57.5;63.4). Diagnostic time for tuberculosis was 61.7 days (SD 93.0), acute hepatitis 18.5 days (SD 17.6), typhoid fever 17.0 days (SD 11.6 days), other diseases of sexual transmission 300.2 days, chronic hepatitis 165 days and AIDS 154.5 days. The time of notification to the Supreme Council of Health for group 1 diseases was 1.2 days (SD 1.4). Conclusion: Our results show that the quality of essential data and timeliness is not sufficient to meet the needs of the health system. Additional studies should focus on the evaluation of time delay for diagnosis of high priority diseases. PMID:25320693

  18. Prevention and management of non-communicable disease: the IOC consensus statement, Lausanne 2013.

    PubMed

    Matheson, Gordon O; Klügl, Martin; Engebretsen, Lars; Bendiksen, Fredrik; Blair, Steven N; Börjesson, Mats; Budgett, Richard; Derman, Wayne; Erdener, Uğur; Ioannidis, John P A; Khan, Karim M; Martinez, Rodrigo; van Mechelen, Willem; Mountjoy, Margo; Sallis, Robert E; Schwellnus, Martin; Shultz, Rebecca; Soligard, Torbjørn; Steffen, Kathrin; Sundberg, Carl Johan; Weiler, Richard; Ljungqvist, Arne

    2013-11-01

    Morbidity and mortality from preventable, non-communicable chronic disease (NCD) threatens the health of our populations and our economies. The accumulation of vast amounts of scientific knowledge has done little to change this. New and innovative thinking is essential to foster new creative approaches that leverage and integrate evidence through the support of big data, technology, and design thinking. The purpose of this paper is to summarize the results of a consensus meeting on NCD prevention sponsored by the International Olympic Committee (IOC) in April, 2013. Within the context of advocacy for multifaceted systems change, the IOC's focus is to create solutions that gain traction within health care systems. The group of participants attending the meeting achieved consensus on a strategy for the prevention and management of chronic disease that includes the following: 1. Focus on behavioural change as the core component of all clinical programs for the prevention and management of chronic disease. 2. Establish actual centres to design, implement, study, and improve preventive programs for chronic disease. 3. Use human-centered design in the creation of prevention programs with an inclination to action, rapid prototyping and multiple iterations. 4. Extend the knowledge and skills of Sports and Exercise Medicine (SEM) professionals to build new programs for the prevention and treatment of chronic disease focused on physical activity, diet and lifestyle. 5. Mobilize resources and leverage networks to scale and distribute programs of prevention. True innovation lies in the ability to align thinking around these core strategies to ensure successful implementation of NCD prevention and management programs within health care. The IOC and SEM community are in an ideal position to lead this disruptive change. The outcome of the consensus meeting was the creation of the IOC Non-Communicable Diseases ad-hoc Working Group charged with the responsibility of moving this

  19. Update for the practicing pathologist: The International Consultation On Urologic Disease-European association of urology consultation on bladder cancer.

    PubMed

    Amin, Mahul B; Smith, Steven C; Reuter, Victor E; Epstein, Jonathan I; Grignon, David J; Hansel, Donna E; Lin, Oscar; McKenney, Jesse K; Montironi, Rodolfo; Paner, Gladell P; Al-Ahmadie, Hikmat A; Algaba, Ferran; Ali, Syed; Alvarado-Cabrero, Isabel; Bubendorf, Lukas; Cheng, Liang; Cheville, John C; Kristiansen, Glen; Cote, Richard J; Delahunt, Brett; Eble, John N; Genega, Elizabeth M; Gulmann, Christian; Hartmann, Arndt; Langner, Cord; Lopez-Beltran, Antonio; Magi-Galluzzi, Cristina; Merce, Jorda; Netto, George J; Oliva, Esther; Rao, Priya; Ro, Jae Y; Srigley, John R; Tickoo, Satish K; Tsuzuki, Toyonori; Umar, Saleem A; Van der Kwast, Theo; Young, Robert H; Soloway, Mark S

    2015-05-01

    The International Consultations on Urological Diseases are international consensus meetings, supported by the World Health Organization and the Union Internationale Contre le Cancer, which have occurred since 1981. Each consultation has the goal of convening experts to review data and provide evidence-based recommendations to improve practice. In 2012, the selected subject was bladder cancer, a disease which remains a major public health problem with little improvement in many years. The proceedings of the 2nd International Consultation on Bladder Cancer, which included a 'Pathology of Bladder Cancer Work Group,' have recently been published; herein, we provide a summary of developments and consensus relevant to the practicing pathologist. Although the published proceedings have tackled a comprehensive set of issues regarding the pathology of bladder cancer, this update summarizes the recommendations regarding selected issues for the practicing pathologist. These include guidelines for classification and grading of urothelial neoplasia, with particular emphasis on the approach to inverted lesions, the handling of incipient papillary lesions frequently seen during surveillance of bladder cancer patients, descriptions of newer variants, and terminology for urine cytology reporting. PMID:25412849

  20. An Official American Thoracic Society/European Respiratory Society Statement: Update on Limb Muscle Dysfunction in Chronic Obstructive Pulmonary Disease

    PubMed Central

    Maltais, François; Decramer, Marc; Casaburi, Richard; Barreiro, Esther; Burelle, Yan; Debigaré, Richard; Dekhuijzen, P. N. Richard; Franssen, Frits; Gayan-Ramirez, Ghislaine; Gea, Joaquim; Gosker, Harry R.; Gosselink, Rik; Hayot, Maurice; Hussain, Sabah N. A.; Janssens, Wim; Polkey, Micheal I.; Roca, Josep; Saey, Didier; Schols, Annemie M. W. J.; Spruit, Martijn A.; Steiner, Michael; Taivassalo, Tanja; Troosters, Thierry; Vogiatzis, Ioannis; Wagner, Peter D.

    2014-01-01

    Background: Limb muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD) and it has important clinical implications, such as reduced exercise tolerance, quality of life, and even survival. Since the previous American Thoracic Society/European Respiratory Society (ATS/ERS) statement on limb muscle dysfunction, important progress has been made on the characterization of this problem and on our understanding of its pathophysiology and clinical implications. Purpose: The purpose of this document is to update the 1999 ATS/ERS statement on limb muscle dysfunction in COPD. Methods: An interdisciplinary committee of experts from the ATS and ERS Pulmonary Rehabilitation and Clinical Problems assemblies determined that the scope of this document should be limited to limb muscles. Committee members conducted focused reviews of the literature on several topics. A librarian also performed a literature search. An ATS methodologist provided advice to the committee, ensuring that the methodological approach was consistent with ATS standards. Results: We identified important advances in our understanding of the extent and nature of the structural alterations in limb muscles in patients with COPD. Since the last update, landmark studies were published on the mechanisms of development of limb muscle dysfunction in COPD and on the treatment of this condition. We now have a better understanding of the clinical implications of limb muscle dysfunction. Although exercise training is the most potent intervention to address this condition, other therapies, such as neuromuscular electrical stimulation, are emerging. Assessment of limb muscle function can identify patients who are at increased risk of poor clinical outcomes, such as exercise intolerance and premature mortality. Conclusions: Limb muscle dysfunction is a key systemic consequence of COPD. However, there are still important gaps in our knowledge about the mechanisms of development of this problem

  1. Chronic pruritus associated with dermatologic disease in infancy and childhood: update from an interdisciplinary group of dermatologists and pediatricians.

    PubMed

    Metz, Martin; Wahn, Ulrich; Gieler, Uwe; Stock, Philippe; Schmitt, Jochen; Blume-Peytavi, Ulrike

    2013-09-01

    An effective treatment strategy for chronic pruritus in children with dermatologic disorders should consider the multidimensional aspects of pruritus, the unique challenges associated with treating pruritic skin disorders in the pediatric population, and evidence-based therapies with demonstrated antipruritic benefits and clinically relevant effects on patient/family quality of life (QoL). The Course of Advanced Learning for the Management of ITch (CALM-IT) Task Force is an interdisciplinary group of experts specializing in core aspects of pruritus treatment, integrating pediatrics, dermatology, psychotherapy, pruritus management, and sleep. CALM-IT recently convened to provide updated guidance on managing chronic pruritus associated with dermatologic diseases in pediatric patients, with a special focus on atopic dermatitis (AD) and chronic spontaneous urticaria (csU). This review highlights the updated concepts and best practices, which were built upon international PRACTALL consensus and modified for children and infants with AD and csU. CALM-IT supports the routine use of basic skin therapy and the escalation of topical medications, according to severity and focused on rapid itch control. Anti-inflammatory agents should be appropriate for infants and children (i.e., with an optimized therapeutic index) and have proven antipruritic properties, such as those demonstrated by methylprednisolone aceponate. New experimental findings do not support the use of non-sedating oral antihistamines as adjuvant antipruritic therapy for AD. In csU, oral H1 -antihistamine use is justified, consistent with the distinct pathophysiologic mechanisms of itch underlying AD and csU. All encompassing QoL assessments should consider the burden of both patient and caregiver and should address outstanding unmet clinical needs of pediatric patients. Future research areas include integrated QoL assessments and multidisciplinary treatment programs with pediatric-targeted pruritic therapies

  2. Global Foot-and-Mouth Disease Research Update and Gap Analysis: 1 - Overview of Global Status and Research Needs.

    PubMed

    Knight-Jones, T J D; Robinson, L; Charleston, B; Rodriguez, L L; Gay, C G; Sumption, K J; Vosloo, W

    2016-06-01

    The Global Foot-and-mouth disease (FMD) Research Alliance periodically reviews the state of FMD research to assess progress and to identify new priorities. In this supplement we provide an update of global FMD research, comprising (i) this overview paper, which includes background information with key findings, and papers covering (ii) epidemiology, wildlife and economics, (iii) vaccines, (iv) diagnostics, (v) biotherapeutics and disinfectants, (vi) immunology and (vii) pathogenesis and molecular biology. FMD research publications were reviewed (2011-2015) and activity updates were obtained from 33 FMD research institutes from around the world. Although a continual threat, FMD has been effectively controlled in much of the world using existing tools. However, control remains a challenge in most developing countries, where little has been done to understand the ongoing burden of FMD. More research is needed to support control in endemically infected countries, particularly robust field studies. Traditional FMD vaccines have several limitations including short duration and spectrum of protection, cold chain requirements, and the costs and biosecurity risks associated with vaccine production. Significant progress has been made in the development of novel vaccine candidates, particularly in the use of recombinant vaccines and virus-like particles as an alternative to traditional inactivated whole virus vaccines. Continued investment is needed to turn these developments into improved vaccines produced at scale. Increased knowledge of cellular and mucosal immunity would benefit vaccine development, as would further advances in our ability to enhance vaccine capsid stability. Developments in molecular biology and phylogenetics underlie many of the recent advances in FMD research, including improved vaccines and diagnostics, and improved understanding of FMD epidemiology. Tools for genetic analyses continue to become both more powerful and more affordable enabling them to

  3. Diacylglycerol Kinases as Emerging Potential Drug Targets for a Variety of Diseases: An Update

    PubMed Central

    Sakane, Fumio; Mizuno, Satoru; Komenoi, Suguru

    2016-01-01

    Ten mammalian diacylglycerol kinase (DGK) isozymes (α–κ) have been identified to date. Our previous review noted that several DGK isozymes can serve as potential drug targets for cancer, epilepsy, autoimmunity, cardiac hypertrophy, hypertension and type II diabetes (Sakane et al., 2008). Since then, recent genome-wide association studies have implied several new possible relationships between DGK isozymes and diseases. For example, DGKθ and DGKκ have been suggested to be associated with susceptibility to Parkinson's disease and hypospadias, respectively. In addition, the DGKη gene has been repeatedly identified as a bipolar disorder (BPD) susceptibility gene. Intriguingly, we found that DGKη-knockout mice showed lithium (BPD remedy)-sensitive mania-like behaviors, suggesting that DGKη is one of key enzymes of the etiology of BPD. Because DGKs are potential drug targets for a wide variety of diseases, the development of DGK isozyme-specific inhibitors/activators has been eagerly awaited. Recently, we have identified DGKα-selective inhibitors. Because DGKα has both pro-tumoral and anti-immunogenic properties, the DGKα-selective inhibitors would simultaneously have anti-tumoral and pro-immunogenic (anti-tumor immunogenic) effects. Although the ten DGK isozymes are highly similar to each other, our current results have encouraged us to identify and develop specific inhibitors/activators against every DGK isozyme that can be effective regulators and drugs against a wide variety of physiological events and diseases. PMID:27583247

  4. Diacylglycerol Kinases as Emerging Potential Drug Targets for a Variety of Diseases: An Update.

    PubMed

    Sakane, Fumio; Mizuno, Satoru; Komenoi, Suguru

    2016-01-01

    Ten mammalian diacylglycerol kinase (DGK) isozymes (α-κ) have been identified to date. Our previous review noted that several DGK isozymes can serve as potential drug targets for cancer, epilepsy, autoimmunity, cardiac hypertrophy, hypertension and type II diabetes (Sakane et al., 2008). Since then, recent genome-wide association studies have implied several new possible relationships between DGK isozymes and diseases. For example, DGKθ and DGKκ have been suggested to be associated with susceptibility to Parkinson's disease and hypospadias, respectively. In addition, the DGKη gene has been repeatedly identified as a bipolar disorder (BPD) susceptibility gene. Intriguingly, we found that DGKη-knockout mice showed lithium (BPD remedy)-sensitive mania-like behaviors, suggesting that DGKη is one of key enzymes of the etiology of BPD. Because DGKs are potential drug targets for a wide variety of diseases, the development of DGK isozyme-specific inhibitors/activators has been eagerly awaited. Recently, we have identified DGKα-selective inhibitors. Because DGKα has both pro-tumoral and anti-immunogenic properties, the DGKα-selective inhibitors would simultaneously have anti-tumoral and pro-immunogenic (anti-tumor immunogenic) effects. Although the ten DGK isozymes are highly similar to each other, our current results have encouraged us to identify and develop specific inhibitors/activators against every DGK isozyme that can be effective regulators and drugs against a wide variety of physiological events and diseases. PMID:27583247

  5. Beyond the Definitions of the Phenotypic Complications of Sickle Cell Disease: An Update on Management

    PubMed Central

    Ballas, Samir K.; Kesen, Muge R.; Goldberg, Morton F.; Lutty, Gerard A.; Dampier, Carlton; Osunkwo, Ifeyinwa; Wang, Winfred C.; Hoppe, Carolyn; Hagar, Ward; Darbari, Deepika S.; Malik, Punam

    2012-01-01

    The sickle hemoglobin is an abnormal hemoglobin due to point mutation (GAG → GTG) in exon 1 of the β globin gene resulting in the substitution of glutamic acid by valine at position 6 of the β globin polypeptide chain. Although the molecular lesion is a single-point mutation, the sickle gene is pleiotropic in nature causing multiple phenotypic expressions that constitute the various complications of sickle cell disease in general and sickle cell anemia in particular. The disease itself is chronic in nature but many of its complications are acute such as the recurrent acute painful crises (its hallmark), acute chest syndrome, and priapism. These complications vary considerably among patients, in the same patient with time, among countries and with age and sex. To date, there is no well-established consensus among providers on the management of the complications of sickle cell disease due in part to lack of evidence and in part to differences in the experience of providers. It is the aim of this paper to review available current approaches to manage the major complications of sickle cell disease. We hope that this will establish another preliminary forum among providers that may eventually lead the way to better outcomes. PMID:22924029

  6. Brief chemotherapy (Stanford V) and adjuvant radiotherapy for bulky or advanced Hodgkin's disease: an update.

    PubMed

    Horning, S J; Rosenberg, S A; Hoppe, R T

    1996-01-01

    From May 1989 to August 1995, 94 previously untreated patients with Hodgkin's disease stage II with bulky mediastinal involvement (n = 28) or stage III or IV (n = 66) received an abbreviated chemotherapy regimen, Stanford V, +/-radiotherapy (RT). Chemotherapy was given weekly for 12 weeks followed by consolidative RT to sites of initial bulky disease. With a median follow-up of 3 years, the actuarial 6-year survival is 93% and the freedom from progression is 89%. There have been no relapses or deaths among the 28 patients with stage II bulky mediastinal disease. Eight relapses and three deaths have occurred in the group of 66 patients with stage III-IV disease. The abbreviated chemotherapy regimen, Stanford V, in combination with RT is well tolerated and highly effective therapy for bulky, limited stage and advanced stage HD. Lower cumulative exposure to alkylating agents, doxorubicin, bleomycin and limited use of radiation is expected to improved the prospects for fertility and decrease the risks for second neoplasms and late cardiopulmonary toxicity. PMID:8836420

  7. Depression and Cardiovascular Disease: An Update on How Course of Illness May Influence Risk

    PubMed Central

    Fiedorowicz, Jess G.

    2014-01-01

    Depression constitutes a novel and independent risk factor for cardiovascular disease, which despite extensive support in the literature has been underappreciated. While much of the evidence for depression as a risk factor for cardiovascular disease is based on studies following myocardial infarction, the elevated vascular risk conveyed by depression is not confined to periods following acute coronary syndromes. For that matter, the risk appears across mood disorders with evidence for even greater risk in bipolar disorder. This review summarizes the literature linking depressive disorders to cardiovascular mortality with a focus on how the course of illness of mood disorders may influence this risk. Mood disorders may influence risk over decades of illness in a dose-response to symptom burden, or the persistence of affective symptomatology. This may be mediated through changes in the activity of the autonomic nervous system, the hypothalamic-pituitary-adrenal axis, and inflammatory cytokines. Whether treatment of depression can mitigate this risk is not established although there are suggestions to support this contention, which could be better studied with more effective treatments of depression and larger standardized samples. Directions for future study of mechanisms and treatment are discussed. Regardless of causal mechanisms, persons with depressive disorders and other risk factors for vascular disease represent a neglected, high-risk group for cardiovascular events. In addition to the appropriate treatment for depression, screening and optimized management of traditional risk factors for cardiovascular diseases is necessary. PMID:25163592

  8. Sexually Transmitted Diseases and Young Adults. and Update on AIDS for Teachers and Policy Makers.

    ERIC Educational Resources Information Center

    Yarber, William L.; Newschwander, Gregg E.

    1987-01-01

    Consists of two articles on the topics of (1) sexually transmitted diseases and (2) acquired immune deficiency syndrome (AIDS). Yarber discusses how these topics should be taught to young people, with emphasis on health education as opposed to morality. Newschwander states the facts related to AIDS, including risks of enrolling infected students.…

  9. The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update

    PubMed Central

    Okada, H; Kuhn, C; Feillet, H; Bach, J-F

    2010-01-01

    According to the ‘hygiene hypothesis’, the decreasing incidence of infections in western countries and more recently in developing countries is at the origin of the increasing incidence of both autoimmune and allergic diseases. The hygiene hypothesis is based upon epidemiological data, particularly migration studies, showing that subjects migrating from a low-incidence to a high-incidence country acquire the immune disorders with a high incidence at the first generation. However, these data and others showing a correlation between high disease incidence and high socio-economic level do not prove a causal link between infections and immune disorders. Proof of principle of the hygiene hypothesis is brought by animal models and to a lesser degree by intervention trials in humans. Underlying mechanisms are multiple and complex. They include decreased consumption of homeostatic factors and immunoregulation, involving various regulatory T cell subsets and Toll-like receptor stimulation. These mechanisms could originate, to some extent, from changes in microbiota caused by changes in lifestyle, particularly in inflammatory bowel diseases. Taken together, these data open new therapeutic perspectives in the prevention of autoimmune and allergic diseases. PMID:20415844

  10. Update on poultry viral diseases research conducted at Southeast Poultry Research Laboratory

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The Southeast Poultry Research Laboratory does intramural research for the United States Department of Agriculture on several poultry diseases. Following are some of the research accomplishments from last year. In the area of influenza research, we demonstrated that laying turkey hens inoculated wit...

  11. 2013 update on congenital heart disease, clinical cardiology, heart failure, and heart transplant.

    PubMed

    Subirana, M Teresa; Barón-Esquivias, Gonzalo; Manito, Nicolás; Oliver, José M; Ripoll, Tomás; Lambert, Jose Luis; Zunzunegui, José L; Bover, Ramon; García-Pinilla, José Manuel

    2014-03-01

    This article presents the most relevant developments in 2013 in 3 key areas of cardiology: congenital heart disease, clinical cardiology, and heart failure and transplant. Within the area of congenital heart disease, we reviewed contributions related to sudden death in adult congenital heart disease, the importance of specific echocardiographic parameters in assessing the systemic right ventricle, problems in patients with repaired tetralogy of Fallot and indication for pulmonary valve replacement, and confirmation of the role of specific factors in the selection of candidates for Fontan surgery. The most recent publications in clinical cardiology include a study by a European working group on correct diagnostic work-up in cardiomyopathies, studies on the cost-effectiveness of percutaneous aortic valve implantation, a consensus document on the management of type B aortic dissection, and guidelines on aortic valve and ascending aortic disease. The most noteworthy developments in heart failure and transplantation include new American guidelines on heart failure, therapeutic advances in acute heart failure (serelaxin), the management of comorbidities such as iron deficiency, risk assessment using new biomarkers, and advances in ventricular assist devices. PMID:24774396

  12. AN UPDATE OF TURKEY RESEARCH AT THE NATIONAL ANIMAL DISEASE CENTER

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Approximately 10% of ARS resources in turkey health and 43% of the resources for food safety in turkeys are allocated to NADC. This presentation highlights the accomplishments of the Respiratory Disease Unit including development of PCR assays to differentiate the pathogenic versus commensal Bordet...

  13. Why the communicable/non-communicable disease dichotomy is problematic for public health control strategies: implications of multimorbidity for health systems in an era of health transition

    PubMed Central

    Oni, Tolu; Unwin, Nigel

    2015-01-01

    In today's globalized world, rapid urbanization, mechanization of the rural economy, and the activities of trans-national food, drink and tobacco corporations are associated with behavioral changes that increase the risk of chronic non-communicable diseases (NCDs). These changes include less healthy diet, lower physical activity, tobacco smoking and increased alcohol consumption. As a result, population health profiles are rapidly changing. For example, the global burden of type 2 diabetes mellitus is expected to double by 2030, with 80% of adult cases occurring in low and middle-income countries (LMIC). Many LMIC are undergoing rapid changes associated with developing high rates of NCD while concomitantly battling high levels of certain communicable diseases, including HIV, TB and malaria. This has population health, health systems and economic implications for these countries. This critical review synthesizes evidence on the overlap and interactions between established communicable and emerging NCD epidemics in LMIC. The review focuses on HIV, TB and malaria and explores the disease-specific interactions with prevalent NCDs in LMIC including diabetes, cardiovascular disease, chronic obstructive pulmonary disease, chronic renal disease, epilepsy and neurocognitive diseases. We highlight the complexity, bi-directionality and heterogeneity of these interactions and discuss the implications for health systems. PMID:26103981

  14. Trends and dietary implications of some chronic non-communicable diseases in peninsular Malaysia.

    PubMed

    Khor, G L; Gan, C Y

    1992-09-01

    Non-communicable diseases with dietary implications, ischaemic heart disease, diabetes mellitus and cancers of the breast and colon are discussed in relation to their prevalence and mortality rates in peninsular Malaysia during the past few decades. The mortality rate due to diseases of the circulatory system has more than doubled since 1970, deaths due to ischaemic heart disease being the major cause. The prevalence of diabetes mellitus has risen from 0.65% in 1960 to about 4% currently. The mortality risk for both ischaemic heart disease and diabetes is highest in the Indian compared to Malay and Chinese populations. The Chinese show the highest mortality rate for cancers of the breast and colon. This could reflect, partly, because more people especially in the urban areas are seeking treatment and improved diagnosis. Empirical dietary data indicate an increase in the prevalence of hypercholesterolaemia among urban adults and overweight among urban and rural adults. Aggregate data from food balance sheets indicate increased availability of energy intake from fats and oils, sugar, and animal products, with concomitant decline in available energy from plant products. Continued public health education on the important linkage between diet and disease is called for. PMID:24323170

  15. European Non-Communicable Respiratory Disease Research, 2002-13: Bibliometric Study of Outputs and Funding

    PubMed Central

    Wright, John S. F.; Pallari, Elena; Sullivan, Richard

    2016-01-01

    This study was conducted in order to map European research in chronic respiratory diseases (CRDs). It was intended to assist the European Commission and other research funders to identify gaps and overlaps in their portfolios, and to suggest ways in which they could improve the effectiveness of their support and increase the impact of the research on patient care and on the reduction of the incidence of the CRDs. Articles and reviews were identified in the Web of Science on research in six non-communicable respiratory diseases that were published in 2002–13 from 31 European countries. They represented only 0.8% of biomedical research output but these diseases accounted for 4.7% of the European disease burden, as measured by Disability-Adjusted Life Years (DALYs), so the sub-field is seriously under-researched. Europe is prominent in the sub-field and published 56% of the world total, with the UK the most productive and publishing more than France and Italy, the next two countries, combined. Asthma and Chronic Obstructive Pulmonary Disease (COPD) were the diseases with the most publications and the highest citation rates. They also received the most funding, with around two acknowledgments per paper (in 2009–13), whereas cystic fibrosis and emphysema averaged only one. Just over 37% of papers had no specific funding and depended on institutional support from universities and hospitals. PMID:27111670

  16. European Non-Communicable Respiratory Disease Research, 2002-13: Bibliometric Study of Outputs and Funding.

    PubMed

    Begum, Mursheda; Lewison, Grant; Wright, John S F; Pallari, Elena; Sullivan, Richard

    2016-01-01

    This study was conducted in order to map European research in chronic respiratory diseases (CRDs). It was intended to assist the European Commission and other research funders to identify gaps and overlaps in their portfolios, and to suggest ways in which they could improve the effectiveness of their support and increase the impact of the research on patient care and on the reduction of the incidence of the CRDs. Articles and reviews were identified in the Web of Science on research in six non-communicable respiratory diseases that were published in 2002-13 from 31 European countries. They represented only 0.8% of biomedical research output but these diseases accounted for 4.7% of the European disease burden, as measured by Disability-Adjusted Life Years (DALYs), so the sub-field is seriously under-researched. Europe is prominent in the sub-field and published 56% of the world total, with the UK the most productive and publishing more than France and Italy, the next two countries, combined. Asthma and Chronic Obstructive Pulmonary Disease (COPD) were the diseases with the most publications and the highest citation rates. They also received the most funding, with around two acknowledgments per paper (in 2009-13), whereas cystic fibrosis and emphysema averaged only one. Just over 37% of papers had no specific funding and depended on institutional support from universities and hospitals. PMID:27111670

  17. Barriers to effective communication between veterans with chronic kidney disease and their healthcare providers

    PubMed Central

    Lederer, Swati; Fischer, Michael J.; Gordon, Howard S.; Wadhwa, Anuradha; Popli, Subhash; Gordon, Elisa J.

    2015-01-01

    Background Many patients with chronic kidney disease (CKD) have insufficient knowledge about CKD, which is associated with poorer health outcomes. Effective patient–provider communication can improve CKD patients' knowledge, thereby augmenting their participation in self-care practices. However, barriers to addressing CKD patients' information needs have not been previously characterized. Methods Adults with an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2 or on chronic dialysis or with a kidney transplant were recruited from a Department of Veterans Affairs (VA) nephrology clinic. Semi-structured telephone interviews were conducted to assess patients' CKD information needs and demographic characteristics. A qualitative approach was used to analyze interview transcripts and identify themes pertaining to communication dynamics. Results Thirty-two patients participated. The mean age of participants was 63 years; most were male (94%) and non-Hispanic white (53%). CKD severity groups represented included CKD-3 (eGFR 30–59 mL/min/1.73 m2; 34%), CKD-4 (eGFR 15–29 mL/min/1.73 m2; 25%), CKD-5 (eGFR <15 mL/min/1.73 m2; 16%), end-stage kidney disease on dialysis (13%) and kidney transplant recipients (12%). Several key themes emerged about barriers to patient–provider communication based on patients' reported care at both VA and non-VA facilities, including patients perceived their role as a ‘listener’, reported limited CKD knowledge, did not understand physicians' explanations and were dissatisfied with the patient–provider relationship. Conclusions Several barriers to patient–provider communication prevent patients from meeting their information needs and perpetuate patient passivity. Future research should evaluate whether interventions that empower CKD patients to actively participate in their care increase knowledge and improve health outcomes. PMID:26613037

  18. Obesity and Prevalence of Cardiovascular Diseases and Prognosis-The Obesity Paradox Updated.

    PubMed

    Lavie, Carl J; De Schutter, Alban; Parto, Parham; Jahangir, Eiman; Kokkinos, Peter; Ortega, Francisco B; Arena, Ross; Milani, Richard V

    2016-01-01

    The prevalence and severity of obesity have increased in the United States and most of the Westernized World over recent decades, reaching worldwide epidemics. Since obesity worsens most of the cardiovascular disease (CVD) risk factors, not surprisingly, most CVDs, including hypertension, coronary heart disease, heart failure, and atrial fibrillation, are all increased in the setting of obesity. However, many studies and meta-analyses have demonstrated an obesity paradox with regards to prognosis in CVD patients, with often the overweight and mildly obese having a better prognosis than do their leaner counterparts with the same CVD. The implication for fitness to markedly alter the relationship between adiposity and prognosis and the potential impact of weight loss, in light of the obesity paradox, are all reviewed. PMID:26826295

  19. Multiple myeloma: Updates for pharmacists in the treatment of relapsed and refractory disease.

    PubMed

    Ashjian, Emily; Redic, Kimberly

    2016-04-01

    There have been a number of recent advances in the treatment of patients with relapsed and refractory multiple myeloma. However, despite additional FDA-approved therapies including carfilzomib and pomalidomide as well as clinical trials investigating new combinations of existing treatments, multiple myeloma remains an incurable disease. New therapies currently in the drug development pipeline for relapsed and refractory disease include additional proteasome inhibitors (oprozomib, marizomib, ixazomib), histone deacetylase inhibitors (panobinostat, ricolinostat, quisinostat), monoclonal antibodies (daratumumab, elotuzumab, SAR650984), Bruton's tyrosine kinase inhibitors (ibrutinib), a selective inhibitor of nuclear export, and others. This review will focus on these newly developing therapies as well as the ever expanding role of the pharmacist in supportive care for patients with relapsed and refractory multiple myeloma. PMID:25694345

  20. Diabetic Kidney Disease– A clinical update from Kidney Disease: Improving Global Outcomes (KDIGO)

    PubMed Central

    Molitch, Mark E.; Adler, Amanda I.; Flyvbjerg, Allan; Nelson, Robert G.; So, Wing-Yee; Wanner, Christoph; Kasiske, Bertram L.; Wheeler, David C.; de Zeeuw, Dick; Mogensen, Carl E.

    2014-01-01

    The incidence and prevalence of diabetes mellitus (DM) continue to grow dramatically throughout the world, due primarily to the increase in type 2 DM (T2DM). Although improvements in DM and hypertension management have reduced the proportion of diabetic individuals who develop chronic kidney disease (CKD) and progress to end-stage renal disease (ESRD), the sheer increase in people developing DM will have a major impact on dialysis and transplant needs. This KDIGO conference addressed a number of controversial areas in the management of DM patients with CKD, including aspects of screening for CKD with measurements of albuminuria and estimated glomerular filtration rate (eGFR); defining treatment outcomes; glycemic management in both those developing CKD and those with ESRD; hypertension goals and management, including blockers of the renin-angiotensin-aldosterone system; and lipid management. PMID:24786708

  1. An update on the use and investigation of probiotics in health and disease

    PubMed Central

    Sanders, Mary Ellen; Guarner, Francisco; Guerrant, Richard; Holt, Peter R; Quigley, Eamonn MM; Sartor, R Balfour; Sherman, Philip M; Mayer, Emeran A

    2014-01-01

    Probiotics are derived from traditional fermented foods, from beneficial commensals or from the environment. They act through diverse mechanisms affecting the composition or function of the commensal microbiota and by altering host epithelial and immunological responses. Certain probiotic interventions have shown promise in selected clinical conditions where aberrant microbiota have been reported, such as atopic dermatitis, necrotising enterocolitis, pouchitis and possibly irritable bowel syndrome. However, no studies have been conducted that can causally link clinical improvements to probiotic-induced microbiota changes. Whether a disease-prone microbiota pattern can be remodelled to a more robust, resilient and disease-free state by probiotic administration remains a key unanswered question. Progress in this area will be facilitated by: optimising strain, dose and product formulations, including protective commensal species; matching these formulations with selectively responsive subpopulations; and identifying ways to manipulate diet to modify bacterial profiles and metabolism. PMID:23474420

  2. Leukocyte traffic control: a novel therapeutic strategy for inflammatory bowel disease--an update.

    PubMed

    Cesarini, Monica; Fiorino, Gionata

    2013-04-01

    Adhesion molecules play a key role in the pathogenetic mechanisms of inflammatory bowel disease (IBD), both in Crohn's disease (CD) and ulcerative colitis (UC). In the last decade, some progress has been made in understanding their key role in leukocyte trafficking control in terms of basic research, but evidence of clinical efficacy is lacking. In the last 2 years, new molecules directed against integrins and integrin receptors have been developed and investigated in clinical trials, showing that anti-α4β7 integrin agents can be effective and safe for the induction and maintenance of remission in active CD and UC. Preliminary data show that anti-MAdCAM, anti-β7 and anti-integrin receptor agents are not all effective in IBD. Such results open new perspectives on clinical management of IBD, and new directions in understanding the role of adhesion molecules and leukocyte recruitment both in CD and UC. PMID:23557266

  3. Update on chronic granulomatous diseases of childhood: Immunotherapy and potential for gene therapy

    SciTech Connect

    Gallin, J.I.; Malech, H.L. )

    1990-03-16

    This paper presents a case history and discussion of a man with an autosomal recessive form of chronic granulomatous disease (CGD) of childhood. Because studies indicated that this patient's monocytes increased production of superoxide after in vitro stimulation with recombinant human interferon gamma, he received subcutaneous injections every other day. Steady improvement resulted. The importance of oxidative metabolism has prompted considerable attention to a group of patients with disorders of phagocyte oxidative metabolism, known as the CGDs of childhood.

  4. Vitamin C, gastritis, and gastric disease: a historical review and update.

    PubMed

    Aditi, Anupam; Graham, David Y

    2012-10-01

    The discovery of Helicobacter pylori as the cause of gastritis and peptic ulcers ushered in the modern era of research into gastritis and into acid-peptic diseases and rekindled interest in the role of ascorbic acid in the pathophysiology and treatment of gastritis and peptic ulcer disease. Here, we review historic and modern studies on ascorbic acid and gastric diseases with an emphasis on H. pylori gastritis and its sequelae. The relationship of ascorbic acid and gastritis and peptic ulcer and its complications was extensively studied during the 1930s through the 1950s. Much of this extensive literature has been effectively "lost." Ascorbic acid deficiency was associated with all forms of gastritis (e.g., autoimmune, chemical, and infectious) due in varying degrees to insufficient intake, increased metabolic requirements, and destruction within the GI tract. Importantly, gastritis-associated abnormalities in gastric ascorbic acid metabolism are reversed by H. pylori-eradication and potentially worsened by proton pump inhibitor therapy. Diets rich in naturally occurring ascorbic acid are associated with protection of the gastric corpus from atrophy and a reduction in the incidence of gastric cancer possibly through the ability of ascorbic acid to reduce oxidative damage to the gastric mucosa by scavenging carcinogenic N-nitroso compounds and free radicals and attenuating the H. pylori-induced inflammatory cascade. Ascorbic acid supplementation was possibly associated with a decreased incidence of bleeding from peptic ulcer disease. Pharmacologic doses of ascorbic acid also may improve the effectiveness of H. pylori-eradication therapy. Occasionally, looking back can help plot the way forward. PMID:22543844

  5. Vitamin C, Gastritis, and Gastric Disease: a historical review and update

    PubMed Central

    Aditi, Anupam; Graham, David Y.

    2013-01-01

    The discovery of Helicobacter pylori as the cause of gastritis and peptic ulcers ushered in the modern era of research into gastritis and into acid-peptic diseases and rekindled interest in the role of ascorbic acid in the pathophysiology and treatment of gastritis and peptic ulcer disease. Here, we review historic and modern studies on ascorbic acid and gastric diseases with an emphasis on H. pylori gastritis and its sequelae. The relationship of ascorbic acid and gastritis and peptic ulcer and its complications was extensively studied during the 1930’s through the 1950’s. Much of this extensive literature has been effectively “lost”. Ascorbic acid deficiency was associated with all forms of gastritis (e.g., autoimmune, chemical, and infectious) due in varying degrees to insufficient intake, increased metabolic requirements, and destruction within the GI tract. Importantly, gastritis-associated abnormalities in gastric ascorbic acid metabolism are reversed by H. pylori eradication and potentially worsened by proton pump inhibitor (PPI) therapy. Diets rich in naturally occuring ascorbic acid are associated with protection of the gastric corpus from atrophy and a reduction in the incidence of gastric cancer possibly through the ability of ascorbic acid to reduce oxidative damage to the gastric mucosa by scavenging carcinogenic N-nitroso compounds and free radicals and attenuating the H. pylori-induced inflammatory cascade. Ascorbic acid supplementation was possibly associated with a decreased incidence of bleeding from peptic ulcer disease. Pharmacologic doses of ascorbic acid also may improve the effectiveness of H. pylori eradication therapy. Occasionally, looking back can help plot the way forward. PMID:22543844

  6. Recent Clinical Trials of Pharmacologic Cardiovascular Interventions in Patients with Chronic Kidney Disease: An Update.

    PubMed

    Nataatmadja, Melissa; Cho, Yeoungjee; Fahim, Magid; Johnson, David W

    2016-01-01

    As a consequence of both traditional and non-traditional risk factors, cardiovascular disease is over-represented, and the leading cause of mortality, among patients with Chronic Kidney Disease (CKD). Whilst recommendations for reducing cardiovascular risk in the general population exist, their applicability to the CKD population is questionable due to the exclusion of CKD patients from the majority of contemporary cardiovascular interventional studies. The aim of this review is to critically evaluate the literature regarding pharmacologic cardiovascular interventions in patients with CKD, with an emphasis on studies published since our 2008 review. Interventions discussed include erythropoiesis-stimulating agents (TREAT, U.S. Normal Hematocrit, CHOIR, CREATE, Palmer meta-analysis); statins (SHARP, AURORA, PPP, 4D, ALERT); Fibrates (VA-HIT); Folic Acid (ASFAST, US FOLIC acid trial, HOST); Antihypertensive Agents, Including Angiotensin-Converting Enzyme Inhibitors, angiotensin-receptor blockers, Beta-blockers and Combination therapy (Cice et al, FOSDIAL, Agarwal et al, ONTARGET); sevelamer (DCOR); Cinacalcet (ADVANCE, EVOLVE, Cunningham meta-analysis); Anti-oxidants (SPACE, HOPE, ATIC); Aspirin (HOT study re-analysis); vitamin D analogues (PRIMO); and multidisciplinary intervention (LANDMARK). Unfortunately, there remains a paucity of evidence in this area and a large number of methodologically poor quality studies with negative results. It is possible that these interventions do not have the same positive effect in CKD patients due to differences in the pathogenesis driving cardiovascular disease burden, such as altered bone metabolism and calcific vascular disease. Further well-designed studies with appropriately selected study populations and patient level outcomes are required. Until such time, physicians must consider on an individual patient basis the appropriateness of these interventions. PMID:26497837

  7. Update on Meningococcal Disease with Emphasis on Pathogenesis and Clinical Management

    PubMed Central

    van Deuren, Marcel; Brandtzaeg, Petter; van der Meer, Jos W. M.

    2000-01-01

    The only natural reservoir of Neisseria meningitidis is the human nasopharyngeal mucosa. Depending on age, climate, country, socioeconomic status, and other factors, approximately 10% of the human population harbors meningococci in the nose. However, invasive disease is relatively rare, as it occurs only when the following conditions are fulfilled: (i) contact with a virulent strain, (ii) colonization by that strain, (iii) penetration of the bacterium through the mucosa, and (iv) survival and eventually outgrowth of the meningococcus in the bloodstream. When the meningococcus has reached the bloodstream and specific antibodies are absent, as is the case for young children or after introduction of a new strain in a population, the ultimate outgrowth depends on the efficacy of the innate immune response. Massive outgrowth leads within 12 h to fulminant meningococcal sepsis (FMS), characterized by high intravascular concentrations of endotoxin that set free high concentrations of proinflammatory mediators. These mediators belonging to the complement system, the contact system, the fibrinolytic system, and the cytokine system induce shock and diffuse intravascular coagulation. FMS can be fatal within 24 h, often before signs of meningitis have developed. In spite of the increasing possibilities for treatment in intensive care units, the mortality rate of FMS is still 30%. When the outgrowth of meningococci in the bloodstream is impeded, seeding of bacteria in the subarachnoidal compartment may lead to overt meningitis within 24 to 36 h. With appropriate antibiotics and good clinical surveillance, the mortality rate of this form of invasive disease is 1 to 2%. The overall mortality rate of meningococcal disease can only be reduced when patients without meningitis, i.e., those who may develop FMS, are recognized early. This means that the fundamental nature of the disease as a meningococcus septicemia deserves more attention. PMID:10627495

  8. Best practices in ranking communicable disease threats: a literature review, 2015.

    PubMed

    O'Brien, Eleanor Charlotte; Taft, Rachel; Geary, Katie; Ciotti, Massimo; Suk, Jonathan E

    2016-04-28

    The threat of serious, cross-border communicable disease outbreaks in Europe poses a significant challenge to public health and emergency preparedness because the relative likelihood of these threats and the pathogens involved are constantly shifting in response to a range of changing disease drivers. To inform strategic planning by enabling effective resource allocation to manage the consequences of communicable disease outbreaks, it is useful to be able to rank and prioritise pathogens. This paper reports on a literature review which identifies and evaluates the range of methods used for risk ranking. Searches were performed across biomedical and grey literature databases, supplemented by reference harvesting and citation tracking. Studies were selected using transparent inclusion criteria and underwent quality appraisal using a bespoke checklist based on the AGREE II criteria. Seventeen studies were included in the review, covering five methodologies. A narrative analysis of the selected studies suggests that no single methodology was superior. However, many of the methods shared common components, around which a 'best-practice' framework was formulated. This approach is intended to help inform decision makers' choice of an appropriate risk-ranking study design. PMID:27168585

  9. Balancing and communicating the risks and benefits of biologics in pediatric inflammatory bowel disease

    PubMed Central

    Dulai, Parambir S.; Siegel, Corey A.; Dubinsky, Marla C.

    2013-01-01

    Anti-tumor necrosis factor agents are now considered to be a vital component of the treatment algorithm for pediatric inflammatory bowel disease. Despite the clear benefit of these agents and the re-alignment of treatment goals to achieve early mucosal healing, the decision to initiate therapy is often delayed due to uncertainties regarding risks and benefits. The purpose of this review is to summarize the currently available data regarding anti-tumor necrosis factor agents in pediatric inflammatory bowel disease. Specifically, we review their expected efficacy in both Crohn’s disease and ulcerative colitis, and the likelihood of side-effects associated with these agents. In addition, we address the barriers physicians face when communicating these data and help to identify how pediatric patients and their parents can be more involved in a shared decision making process. Through the creation of a new decision aid (Option Grid), we hope to allow for a more clear line of communication at the bedside when helping patients and parents make these difficult treatment decisions. PMID:23867874

  10. Managing and monitoring chronic non-communicable diseases in a primary health care clinic, Lilongwe, Malawi

    PubMed Central

    Manjomo, R. C.; Mwagomba, B.; Ade, S.; Ali, E.; Ben-Smith, A.; Khomani, P.; Bondwe, P.; Nkhoma, D.; Douglas, G. P.; Tayler-Smith, K.; Chikosi, L.; Gadabu, O. J.

    2016-01-01

    Setting: Patients with chronic non-communicable diseases attending a primary health care centre, Lilongwe, Malawi. Objective: Using an electronic medical record monitoring system, to describe the quarterly and cumulative disease burden, management and outcomes of patients registered between March 2014 and June 2015. Design: A cross-sectional study. Results: Of 1135 patients, with new registrations increasing each quarter, 66% were female, 21% were aged ⩾65 years, 20% were obese, 53% had hypertension alone, 18% had diabetes alone, 12% had asthma, 10% had epilepsy and 7% had both hypertension and diabetes. In every quarter, about 30% of patients did not attend the clinic and 19% were registered as lost to follow-up (not seen for ⩾1 year) in the last quarter. Of those attending, over 90% were prescribed medication, and 80–90% with hypertension and/or diabetes had blood pressure/blood glucose measured. Over 85% of those with epilepsy had no seizures and 60–75% with asthma had no severe attacks. Control of blood pressure (41–51%) and diabetes (15–38%) was poor. Conclusion: It is feasible to manage patients with non-communicable diseases in a primary health care setting in Malawi, although more attention is needed to improve clinic attendance and the control of hypertension and diabetes. PMID:27358797

  11. Anthropometric and behavioral risk factor for non-communicable diseases: a cluster survey from rural Wardha.

    PubMed

    Kumar, Rakesh

    2015-01-01

    Monitoring of risk factors for non-communicable diseases (NCDs) over a period of time would be useful to make an indirect assessment of the actual disease burden. A cross-sectional survey was done among males aged 15-64 years, to study the prevalence of anthropometric and behavioral risk factors of NCDs. Information was collected on the sociodemographical factors, tobacco use, alcohol intake, diet, salt consumption, and physical activity, using a predesigned and pretested interview schedule. Anthropometric measurements were taken. A study found that prevalence of current smoking and use of smokeless tobacco was 14.2 and 54.9%, respectively. Alcohol intake was present in 22.7% of the study population. Per capita salt consumption per day was 14.6 g. A sedentary lifestyle was present among 19% of the men. Prevalence of overweight and obesity was 8.8% and 9.5%, respectively. Our finding suggested that greater surveillance of the NCD risk factors should be initiated as early as possible, in parallel with surveillance for communicable diseases. PMID:25758735

  12. The Law of Communicable Diseases Act and disclosure to sexual partners among HIV-positive youth.

    PubMed

    Christiansen, Monica; Lalos, Ann; Johansson, Eva E

    2008-12-01

    In Sweden, human immunodeficiency virus (HIV) is included among the venereal diseases covered by the Law of Communicable Diseases Act. HIV-positive (HIV(+)) people are required to inform their sexual partners about their infection and adopt safe sex behaviours. However, it is unclear how the law is perceived. This study explores how HIV(+) youth in Sweden perceive the law, handle their sexuality and disclose their HIV diagnosis to sexual partners. Ten HIV(+) women and men between 17 and 24 years of age were recruited from three different HIV infection clinics. These participants were interviewed in depth. The interviews were tape-recorded, transcribed verbatim and analysed according to a grounded theory approach. The core category-cultured to take responsibility-illuminates the informants' double-edged experiences regarding the law and how they handle disclosure to sexual partners. The legislation implies both support and burden for these HIV(+) youth; they feel that they have a great deal of responsibility, sometimes more than they can handle. 'Switch off lust', 'balancing lust, fear and obedience' and 'switch off the disease' are strategies that describe how the informants manage sexuality and disclosure. Young HIV(+) people have a difficult time informing partners of their HIV diagnosis and discussing safe sex strategies. These are challenges that health care providers need to take seriously. HIV(+) youth need better communication strategies to negotiate safer sex. Staff with extended education on sexuality should be a part of HIV health care. PMID:22639678

  13. The Role of Vitamin D in Diabetes and Cardiovascular Disease: An Updated Review of the Literature

    PubMed Central

    Papandreou, Dimitrios; Hamid, Zujaja-Tul-Noor

    2015-01-01

    The dietary reference values for Vitamin D were set primarily considering its role in bone health, but with the discovery of Vitamin D receptors throughout body tissues, new links with other health conditions are now studied, such as for diabetes and cardiovascular diseases (CVD). This paper shall analyze and examine all new research studies carried out, especially in 2013–2015 regarding diabetes mellitus (DM) and cardiovascular diseases (CVD). Vast research has been carried out to establish strong relationship between Vitamin D serum levels, supplementation, diabetes, and CVD. However, the results from researches identified in this paper are disputable. Benefits of Vitamin D adequate levels were recognized from gestational period until later in disease development such as diabetes and/or CVD, but since not all studies are in agreement further investigation is suggested. Researches conducting large randomized controlled trials, exploring range of supplement doses, with variable baseline serum Vitamin D levels, and inclusion of array of associated parameters, are still required to conduct large-scale analysis and draw conclusion as a risk factor. Until then it is possible to conclude that maintenance of serum Vitamin D levels holds advantageous aspects in diabetic and cardiovascular conditions, and people should strive to attain them. PMID:26576069

  14. Important hemoprotozoan diseases of livestock: Challenges in current diagnostics and therapeutics: An update.

    PubMed

    Maharana, Biswa Ranjan; Tewari, Anup Kumar; Saravanan, Buddhi Chandrasekaran; Sudhakar, Naduvanahalli Rajanna

    2016-05-01

    Hemoprotozoan parasites pose a serious threat to the livestock population in terms of mortality, reduced milk yield and lowered draft power. Diagnosis of these diseases often poses a challenging task. Needless to say that impact of disease in health and productivity is huge though a fair economic assessment on the quantum of economic loss associated is yet to be worked out from India. The diagnosis of hemoprotozoan infections largely depends on various laboratory-based diagnostic methods as the clinical manifestations are often inconspicuous and non-specific. Traditional diagnostic methods rely on microscopical demonstration of infective stages in blood or tissue fluids. However, it is laborious, lesser sensitive, and cannot differentiate between morphologically similar organisms. Recent development in the technologies has opened new avenues for improvement in the accurate diagnosis of parasitic infections. Serological tests are simple, fast but lack specificity. With advent of molecular techniques, as DNA hybridization assays, polymerase chain reaction and its modifications ensure the detection of infection in the latent phase of the disease. Nucleic acid-based assays are highly sensitive, free from immunocompetence and can differentiate between morphologically similar parasites. With the advent of newer diagnostics complemented with traditional ones will be of huge help for targeted selective treatment with better chemotherapeutic agents. PMID:27284225

  15. Important hemoprotozoan diseases of livestock: Challenges in current diagnostics and therapeutics: An update

    PubMed Central

    Maharana, Biswa Ranjan; Tewari, Anup Kumar; Saravanan, Buddhi Chandrasekaran; Sudhakar, Naduvanahalli Rajanna

    2016-01-01

    Hemoprotozoan parasites pose a serious threat to the livestock population in terms of mortality, reduced milk yield and lowered draft power. Diagnosis of these diseases often poses a challenging task. Needless to say that impact of disease in health and productivity is huge though a fair economic assessment on the quantum of economic loss associated is yet to be worked out from India. The diagnosis of hemoprotozoan infections largely depends on various laboratory-based diagnostic methods as the clinical manifestations are often inconspicuous and non-specific. Traditional diagnostic methods rely on microscopical demonstration of infective stages in blood or tissue fluids. However, it is laborious, lesser sensitive, and cannot differentiate between morphologically similar organisms. Recent development in the technologies has opened new avenues for improvement in the accurate diagnosis of parasitic infections. Serological tests are simple, fast but lack specificity. With advent of molecular techniques, as DNA hybridization assays, polymerase chain reaction and its modifications ensure the detection of infection in the latent phase of the disease. Nucleic acid-based assays are highly sensitive, free from immunocompetence and can differentiate between morphologically similar parasites. With the advent of newer diagnostics complemented with traditional ones will be of huge help for targeted selective treatment with better chemotherapeutic agents. PMID:27284225

  16. Update of Clostridium difficile-associated disease due to PCR ribotype 027 in Europe.

    PubMed

    Kuijper, E J; Coignard, B; Brazier, J S; Suetens, C; Drudy, D; Wiuff, C; Pituch, H; Reichert, P; Schneider, F; Widmer, A F; Olsen, K E; Allerberger, F; Notermans, D W; Barbut, F; Delmée, M; Wilcox, M; Pearson, A; Patel, B C; Brown, D J; Frei, R; Akerlund, T; Poxton, I R; Tüll, P

    2007-06-01

    Recent outbreaks of Clostridium difficile-associated diarrhoea (CDAD) with increased severity, high relapse rate and significant mortality have been related to the emergence of a new, hypervirulent C. difficile strain in North America, Japan and Europe. Definitions have been proposed by the European Centre of Disease Prevention and Control (ECDC) to identify severe cases of CDAD and to differentiate community-acquired cases from nosocomial CDAD (http://www.ecdc.europa.eu/documents/pdf/Cl_dif_v2.pdf). CDAD is mainly known as a healthcare-associated disease, but it is also increasingly recognised as a community-associated disease. The emerging strain is referred to as North American pulsed-field type 1 (NAP1) and PCR ribotype 027. Since 2005, individual countries have developed surveillance studies to monitor the spread of this strain. C. difficile type 027 has caused outbreaks in England and Wales, Ireland, the Netherlands, Belgium, Luxembourg, and France, and has also been detected in Austria, Scotland, Switzerland, Poland and Denmark. Preliminary data indicated that type 027 was already present in historical isolates collected in Sweden between 1997 and 2001. PMID:17991399

  17. Non-motor Symptoms of Parkinson Disease: Update on the Diagnosis and Treatment

    PubMed Central

    Van Laar, Amber D.; Jain, Samay

    2014-01-01

    Objective To review the prevalence, diagnosis, and treatment of the non-motor symptoms (NMS) associated with Parkinson disease (PD). Methods Narrative review of the literature. Results The NMS of PD are becoming more frequently recognized as having a critical role in the progression of this neurodegenerative movement disorder. The preponderance of PD patients will be diagnosed with one or multiple NMS during the course of the disease, often with many of these symptoms occurring months or even years prior to receiving the PD diagnosis. Despite the high prevalence and impact on disease burden, they often go undiagnosed due to factors including a lack of reporting by patients or insufficient interrogation by their physicians. Further complicating NMS management, only a few treatments have enough evidence to support their use in addressing NMS. Conclusions There is increased recognition of the predominance of NMS in PD, as well as a better understanding that the burden of NMS often supercedes the negative impact seen with motor dysfunction. This has led to significant investigative efforts to identify new or better NMS therapies. Ultimately, it is up to the practitioner to be both knowledgeable of NMS and thorough in patient questioning in order to recognize, diagnose, and address the NMS of PD patients. PMID:15245584

  18. The natural history of coronary artery disease: an update on surgical and medical management.

    PubMed Central

    Whalen, R. E.; Wallace, A. G.; McNeer, J. F.; Rosati, R. A.; Lee, K. L.

    1978-01-01

    The current series represents the total experience of one institution that has treated concurrently a large number of patients with medical or surgical therapy. As previously reported, surgery offers a greater chance for pain relief but no obvious protection from future myocardial infarction. Patients with single artery disease show no difference in survival or future myocardial infarction rate whether treated medically or surgically. Improvement in survival following surgery, determined by univariate analysis of clinical descriptors, in several subsets of patients in the present series has not been confirmed when multivariate analysis techniques are used. If surgical mortality can be further lowered there may well be subsets of patients with coronary artery disease who will outsurvive similar medically treated patients. The current and future natural history of coronary artery disease, whether treated medically or surgically, is not settled by this or any other series because both forms of therapy are rapidly changing and no current series meets valid statistical criticisms. We are in a state of evaluation concerning not only therapeutic approaches, but also the development of suitable statistical methods for determining the efficacy of various forms of therapy. Only by continual modification of therapeutic approaches and the statistical tools to measure their effectiveness can we approach confident conclusions. PMID:617018

  19. Environmental risk factors in Crohn's disease and ulcerative colitis: an update.

    PubMed

    Carbonnel, F; Jantchou, P; Monnet, E; Cosnes, J

    2009-06-01

    Rapid increase in Crohn's disease (CD) and ulcerative colitis (UC) incidence in developed countries, occurrence of CD in spouses and lack of complete concordance in monozygotic twins are strong arguments for the role of environmental factors in inflammatory bowel disease (IBD). Only two environmental factors have an established role in IBD. Smoking is a risk factor for CD and a protective factor for UC; appendectomy is a protective factor for UC. Many other environmental factors for IBD have been investigated. These are infectious agents, diet, drugs, stress and socio-economic factors. They are detailed in this paper. Among them, adherent invasive E. coli, infectious gastroenteritis, oral contraceptives and antibiotics could play a role in CD. To date, three theories integrate environmental factors to pathogenesis of IBD: hygiene, infection and cold chain. Much work remains to be done to identify risk factors for IBD. As exemplified by smoking, research of environmental risk factors of IBD is useful since it may lead to an improved disease course among patients and perhaps, to appropriate prevention among predisposed subjects. Further studies in this field are eagerly awaited. PMID:20117338

  20. Ethnic and Gender Differentials in Non-Communicable Diseases and Self-Rated Health in Malaysia

    PubMed Central

    Teh, Jane K. L.; Tey, Nai Peng; Ng, Sor Tho

    2014-01-01

    Objectives This paper examines the ethnic and gender differentials in high blood pressure (HBP), diabetes, coronary heart disease (CHD), arthritis and asthma among older people in Malaysia, and how these diseases along with other factors affect self-rated health. Differentials in the prevalence of non-communicable diseases among older people are examined in the context of socio-cultural perspectives in multi-ethnic Malaysia. Methods Data for this paper are obtained from the 2004 Malaysian Population and Family Survey. The survey covered a nationally representative sample of 3,406 persons aged 50 and over, comprising three main ethnic groups (Malays, Chinese and Indians) and all other indigenous groups. Bivariate analyses and hierarchical logistic regression were used in the analyses. Results Arthritis was the most common non-communicable disease (NCD), followed by HBP, diabetes, asthma and CHD. Older females were more likely than males to have arthritis and HBP, but males were more likely to have asthma. Diabetes and CHD were most prevalent among Indians, while arthritis and HBP were most prevalent among the Indigenous groups. Older people were more likely to report poor health if they suffered from NCD, especially CHD. Controlling for socio-economic, health and lifestyle factors, Chinese were least likely to report poor health, whereas Indians and Indigenous people were more likely to do so. Chinese that had HBP were more likely to report poor health compared to other ethnic groups with the same disease. Among those with arthritis, Indians were more likely to report poor health. Conclusion Perceived health status and prevalence of arthritis, HBP, diabetes, asthma and CHD varied widely across ethnic groups. Promotion of healthy lifestyle, early detection and timely intervention of NCDs affecting different ethnic groups and gender with socio-cultural orientations would go a long way in alleviating the debilitating effects of the common NCDs among older people. PMID

  1. Prevalence of risk factors of non-communicable diseases in a District of Gujarat, India.

    PubMed

    Bhagyalaxmi, Aroor; Atul, Trivedi; Shikha, Jain

    2013-03-01

    The study attempted to identify the prevalence and distribution of risk factors of non-communicable diseases among urban and rural population in Gujarat, India. Using the WHO stepwise approach, a cross-sectional study was carried out among 1,805 urban and 1,684 rural people of 15-64 years age-group. Information on behavioural and physiological risk factors of non-communicable diseases was obtained through standardized protocol. High prevalence of smoking (22.8%) and the use of smokeless tobacco (43.4%) were observed among rural men compared to urban men (smoking-12.8% and smokeless tobacco consumption-23.1%). There was a significant difference in the average consumption of fruits and vegetables between urban (2.18 +/- 1.59 servings) and rural (1.78 +/- 1.48 servings) area. Prevalence of overweight and obesity was observed to be high among urban men and women in all age-groups compared to rural men and women. Prevalence of behavioural risk factors, overweight, and obesity increased with age in both the areas. Twenty-nine percent of the urban residents and 15.4% of the rural residents were found to have raised blood pressure, and the difference was found to be statistically significant (p < 0.01). For both men and women, the prevalence of overweight and obesity, hypertension, and lack of physical activities were significantly higher in the urban population while smoking, smokeless tobacco consumption, poor consumption of fruits and vegetables were more prevalent in the rural population. The results highlight the need for interventions and approaches for the prevention of risk factors of non-communicable diseases in rural and urban areas. PMID:23617208

  2. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update

    PubMed Central

    Smolen, Josef S; Landewé, Robert; Breedveld, Ferdinand C; Buch, Maya; Burmester, Gerd; Dougados, Maxime; Emery, Paul; Gaujoux-Viala, Cécile; Gossec, Laure; Nam, Jackie; Ramiro, Sofia; Winthrop, Kevin; de Wit, Maarten; Aletaha, Daniel; Betteridge, Neil; Bijlsma, Johannes W J; Boers, Maarten; Buttgereit, Frank; Combe, Bernard; Cutolo, Maurizio; Damjanov, Nemanja; Hazes, Johanna M W; Kouloumas, Marios; Kvien, Tore K; Mariette, Xavier; Pavelka, Karel; van Riel, Piet L C M; Rubbert-Roth, Andrea; Scholte-Voshaar, Marieke; Scott, David L; Sokka-Isler, Tuulikki; Wong, John B; van der Heijde, Désirée

    2014-01-01

    In this article, the 2010 European League against Rheumatism (EULAR) recommendations for the management of rheumatoid arthritis (RA) with synthetic and biological disease-modifying antirheumatic drugs (sDMARDs and bDMARDs, respectively) have been updated. The 2013 update has been developed by an international task force, which based its decisions mostly on evidence from three systematic literature reviews (one each on sDMARDs, including glucocorticoids, bDMARDs and safety aspects of DMARD therapy); treatment strategies were also covered by the searches. The evidence presented was discussed and summarised by the experts in the course of a consensus finding and voting process. Levels of evidence and grades of recommendations were derived and levels of agreement (strengths of recommendations) were determined. Fourteen recommendations were developed (instead of 15 in 2010). Some of the 2010 recommendations were deleted, and others were amended or split. The recommendations cover general aspects, such as attainment of remission or low disease activity using a treat-to-target approach, and the need for shared decision-making between rheumatologists and patients. The more specific items relate to starting DMARD therapy using a conventional sDMARD (csDMARD) strategy in combination with glucocorticoids, followed by the addition of a bDMARD or another csDMARD strategy (after stratification by presence or absence of adverse risk factors) if the treatment target is not reached within 6 months (or improvement not seen at 3 months). Tumour necrosis factor inhibitors (adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, biosimilars), abatacept, tocilizumab and, under certain circumstances, rituximab are essentially considered to have similar efficacy and safety. If the first bDMARD strategy fails, any other bDMARD may be used. The recommendations also address tofacitinib as a targeted sDMARD (tsDMARD), which is recommended, where licensed, after use of at least

  3. The burden of non-communicable diseases in Nigeria; in the context of globalization.

    PubMed

    Maiyaki, Musa Baba; Garbati, Musa Abubakar

    2014-01-01

    This paper highlights the tenets of globalization and how its elements have spread to sub-Saharan Africa, and Nigeria in particular. It assesses the growing burden of non-communicable diseases (NCDs) in Nigeria and its relationship with globalization. It further describes the conceptual framework on which to view the impact of globalization on NCDs in Nigeria. It assesses the Nigerian dimension of the relationship between the risk factors of NCDs and globalization. Appropriate recommendations on tackling the burden of NCDs in Nigeria based on cost-effective, culturally sensitive, and evidence-based interventions are highlighted. PMID:24521570

  4. High-altitude Pulmonary Hypertension: an Update on Disease Pathogenesis and Management

    PubMed Central

    Mirrakhimov, Aibek E.; Strohl, Kingman P.

    2016-01-01

    High-altitude pulmonary hypertension (HAPH) affects individuals residing at altitudes of 2,500 meters and higher. Numerous pathogenic variables play a role in disease inception and progression and include low oxygen concentration in inspired air, vasculopathy, and metabolic abnormalities. Since HAPH affects only some people living at high altitude genetic factors play a significant role in its pathogenesis. The clinical presentation of HAPH is nonspecific and includes fatigue, shortness of breath, cognitive deficits, cough, and in advanced cases hepatosplenomegaly and overt right-sided heart failure. A thorough history is important and should include a search for additional risk factors for lung disease and pulmonary hypertension (PH) such as smoking, indoor air pollution, left-sided cardiac disease and sleep disordered breathing. Twelve-lead electrocardiogram, chest X-ray and echocardiography can be used as screening tools. A definitive diagnosis should be made with right-sided heart catheterization using a modified mean pulmonary artery pressure of at least 30 mm Hg, differing from the 25 mm Hg used for other types of PH. Treatment of HAPH includes descent to a lower altitude whenever possible, oxygen therapy and the use of medications such as endothelin receptor antagonists, phosphodiesterase 5 blockers, fasudil and acetazolamide. Some recent evidence suggests that iron supplementation may also be beneficial. However, it is important to note that the scientific literature lacks long-term randomized controlled data on the pharmacologic treatment of HAPH. Thus, an individualized approach to treatment and informing the patients regarding the benefits and risks of the selected treatment regimen are essential. PMID:27014374

  5. Thyroid disease among the Rongelap and Utirik population--an update.

    PubMed

    Howard, J E; Vaswani, A; Heotis, P

    1997-07-01

    In 1954, 253 Marshallese were accidentally exposed to fallout radiation from the hydrogen bomb, BRAVO. The Marshall Islands Medical Program (MIMP) was established by the Department of Energy in 1955 to monitor and treat radiation-related disease pursuant to this accident. Medical teams from Brookhaven National Laboratory, a federal institution, regularly visit the Marshall Islands to give medical care to the exposed population. The most significant complication of the exposure has been found to be thyroid disease due to the ingestion of radioactive iodides from the fallout. In 1963 the first thyroid nodules were found in Rongelap subjects and in 1969 in Utirik. Non-neoplastic adenomatous nodules were associated with higher doses of radiation and neoplastic nodules developed in individuals receiving lower doses of radiation. Women were more susceptible to the development of palpable thyroid nodules than men. In 1994 the MIMP initiated examination of the thyroid by ultrasound to supplement the clinical examination. One hundred and sixty-four patients were evaluated. No significant differences were found in the incidence of thyroid nodules or the mean nodule count between the three groups of Rongelap and Utirik exposed and a comparison patient population. There was no significant difference in the incidence of thyroid nodules in males vs. females. Five exposed patients were referred for surgical excision of a nodule detected only by ultrasound. These ultrasound findings are unexpected in that females are known to have a higher incidence of thyroid disease than males and we expected that the incidence of ultrasound nodules would be higher in the exposed population. PMID:9199229

  6. Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors: an update.

    PubMed

    Zhang, Wen-Hao; Zhang, Xin-Hua

    2016-01-01

    Phosphodiesterase isoenzymes 5 inhibitors (PDE5-Is) are the first-line therapy for erectile dysfunction (ED). The constant discoveries of nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) cell-signaling pathway for smooth muscle (SM) control in other urogenital tracts (UGTs) make PDE5-Is promising pharmacologic agents against other benign urological diseases. This article reviews the literature and contains some previously unpublished data about characterizations and activities of PDE5 and its inhibitors in treating urological disorders. Scientific discoveries have improved our understanding of cell-signaling pathway in NO/cGMP-mediated SM relaxation in UGTs. Moreover, the clinical applications of PDE5-Is have been widely recognized. On-demand PDE5-Is are efficacious for most cases of ED, while daily-dosing and combination with testosterone are recommended for refractory cases. Soluble guanylate cyclase (sGC) stimulators also have promising role in the management of severe ED conditions. PDE5-Is are also the first rehabilitation strategy for postoperation or postradiotherapy ED for prostate cancer patients. PDE5-Is, especially combined with α-adrenoceptor antagonists, are very effective for benign prostatic hyperplasia (BPH) except on maximum urinary flow rate (Q max ) with tadalafil recently proved for BPH with/without ED. Furthermore, PDE5-Is are currently under various phases of clinical or preclinical researches with promising potential for other urinary and genital illnesses, such as priapism, premature ejaculation, urinary tract calculi, overactive bladder, Peyronie's disease, and female sexual dysfunction. Inhibition of PDE5 is expected to be an effective strategy in treating benign urological diseases. However, further clinical studies and basic researches investigating mechanisms of PDE5-Is in disorders of UGTs are required. PMID:26620458

  7. High-altitude Pulmonary Hypertension: an Update on Disease Pathogenesis and Management.

    PubMed

    Mirrakhimov, Aibek E; Strohl, Kingman P

    2016-01-01

    High-altitude pulmonary hypertension (HAPH) affects individuals residing at altitudes of 2,500 meters and higher. Numerous pathogenic variables play a role in disease inception and progression and include low oxygen concentration in inspired air, vasculopathy, and metabolic abnormalities. Since HAPH affects only some people living at high altitude genetic factors play a significant role in its pathogenesis. The clinical presentation of HAPH is nonspecific and includes fatigue, shortness of breath, cognitive deficits, cough, and in advanced cases hepatosplenomegaly and overt right-sided heart failure. A thorough history is important and should include a search for additional risk factors for lung disease and pulmonary hypertension (PH) such as smoking, indoor air pollution, left-sided cardiac disease and sleep disordered breathing. Twelve-lead electrocardiogram, chest X-ray and echocardiography can be used as screening tools. A definitive diagnosis should be made with right-sided heart catheterization using a modified mean pulmonary artery pressure of at least 30 mm Hg, differing from the 25 mm Hg used for other types of PH. Treatment of HAPH includes descent to a lower altitude whenever possible, oxygen therapy and the use of medications such as endothelin receptor antagonists, phosphodiesterase 5 blockers, fasudil and acetazolamide. Some recent evidence suggests that iron supplementation may also be beneficial. However, it is important to note that the scientific literature lacks long-term randomized controlled data on the pharmacologic treatment of HAPH. Thus, an individualized approach to treatment and informing the patients regarding the benefits and risks of the selected treatment regimen are essential. PMID:27014374

  8. Update on roflumilast, a phosphodiesterase 4 inhibitor for the treatment of chronic obstructive pulmonary disease

    PubMed Central

    Rabe, Klaus F

    2011-01-01

    Phosphodiesterase 4 (PDE4) is a member of the PDE enzyme superfamily that inactivates cyclic adenosine monophosphate and cyclic guanosine monophosphate, and is the main PDE isoenzyme occurring in cells involved in inflammatory airway disease such as chronic obstructive pulmonary disease (COPD). COPD is a preventable and treatable disease and is characterized by airflow obstruction that is not fully reversible. Chronic progressive symptoms, particularly dyspnoea, chronic bronchitis and impaired overall health are worse in those who have frequent, acute episodes of symptom exacerbation. Although several experimental PDE4 inhibitors are in clinical development, roflumilast, a highly selective PDE4 inhibitor, is the first in its class to be licensed, and has recently been approved in several countries for oral, once-daily treatment of severe COPD. Clinical trials have demonstrated that roflumilast improves lung function and reduces exacerbation frequency in COPD. Furthermore, its unique mode of action may offer the potential to target the inflammatory processes underlying COPD. Roflumilast is effective when used concomitantly with all forms of bronchodilator and even in patients treated with inhaled corticosteroids. Roflumilast thus represents an important addition to current therapeutic options for COPD patients with chronic bronchitis, including those who remain symptomatic despite treatment. This article reviews the current status of PDE4 inhibitors, focusing on the pharmacokinetics, efficacy and safety of roflumilast. In particular, it provides an overview of the effects of roflumilast on lung function and exacerbations, glucose homoeostasis and weight loss, and the concomitant use of long-acting beta2-adrenergic receptor agonists and short-acting muscarinic receptor antagonists. LINKED ARTICLES This article is part of a themed issue on Respiratory Pharmacology. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2011.163.issue-1 PMID

  9. Clinical and preclinical treatment of urologic diseases with phosphodiesterase isoenzymes 5 inhibitors: an update

    PubMed Central

    Zhang, Wen-Hao; Zhang, Xin-Hua

    2016-01-01

    Phosphodiesterase isoenzymes 5 inhibitors (PDE5-Is) are the first-line therapy for erectile dysfunction (ED). The constant discoveries of nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) cell-signaling pathway for smooth muscle (SM) control in other urogenital tracts (UGTs) make PDE5-Is promising pharmacologic agents against other benign urological diseases. This article reviews the literature and contains some previously unpublished data about characterizations and activities of PDE5 and its inhibitors in treating urological disorders. Scientific discoveries have improved our understanding of cell-signaling pathway in NO/cGMP-mediated SM relaxation in UGTs. Moreover, the clinical applications of PDE5-Is have been widely recognized. On-demand PDE5-Is are efficacious for most cases of ED, while daily-dosing and combination with testosterone are recommended for refractory cases. Soluble guanylate cyclase (sGC) stimulators also have promising role in the management of severe ED conditions. PDE5-Is are also the first rehabilitation strategy for postoperation or postradiotherapy ED for prostate cancer patients. PDE5-Is, especially combined with α-adrenoceptor antagonists, are very effective for benign prostatic hyperplasia (BPH) except on maximum urinary flow rate (Qmax) with tadalafil recently proved for BPH with/without ED. Furthermore, PDE5-Is are currently under various phases of clinical or preclinical researches with promising potential for other urinary and genital illnesses, such as priapism, premature ejaculation, urinary tract calculi, overactive bladder, Peyronie's disease, and female sexual dysfunction. Inhibition of PDE5 is expected to be an effective strategy in treating benign urological diseases. However, further clinical studies and basic researches investigating mechanisms of PDE5-Is in disorders of UGTs are required. PMID:26620458

  10. Update on the Current Status of Kidney Transplantation for Chronic Kidney Disease in Animals.

    PubMed

    Aronson, Lillian R

    2016-11-01

    Kidney transplantation is a novel treatment option for cats suffering from chronic renal failure or acute irreversible renal injury. Improvement in quality of life as well as survival times of cats that have undergone transplantation has helped the technique to gain acceptance as a viable treatment option for this fatal disease. This article reviews information regarding the optimal time for intervention, congenital and acquired conditions that have been successfully treated with transplantation, recipient and donor screening, immunosuppressive therapy, recent advances in anesthetic and surgical management, postoperative monitoring and long-term management, and troubleshooting perioperative and long-term complications. PMID:27593577

  11. Natural disasters and communicable diseases in the Americas: contribution of veterinary public health.

    PubMed

    Schneider, Maria Cristina; Tirado, Maria Cristina; Rereddy, Shruthi; Dugas, Raymond; Borda, Maria Isabel; Peralta, Eduardo Alvarez; Aldighieri, Sylvain; Cosivi, Ottorino

    2012-01-01

    The consequences of natural disasters on the people living in the Americas are often amplified by socio-economic conditions. This risk may be increased by climate-related changes. The public health consequences of natural disasters include fatalities as well as an increased risk of communicable diseases. Many of these diseases are zoonotic and foodborne diseases. The aim of this article is to provide an overview of the importance of natural disasters for the Americas and to emphasise the contribution of veterinary public health (VPH) to the management of zoonotic and foodborne disease risks. An analysis was conducted of natural disasters that occurred in the Americas between 2004 and 2008. Five cases studies illustrating the contributions of VPH in situations of disaster are presented. The data shows that natural disasters, particularly storms and floods, can create very important public health problems. Central America and the Caribbean, particularly Haiti, presented a higher risk than the other areas of the Americas. Two priority areas of technical cooperation are recommended for this region, namely: reducing the risk of leptospirosis and other vector-borne disease outbreaks related to floods and hurricanes and improving food safety. The contribution of different disciplines and sectors in disaster preparedness and response is of paramount importance to minimise morbidity and mortality. PMID:22718336

  12. Photodynamic therapy and the treatment of neoplastic diseases of the head and neck: an update

    NASA Astrophysics Data System (ADS)

    Biel, Merrill A.

    1994-07-01

    Forty-nine patients with neoplastic diseases of the larynx, oral cavity, pharynx and tracheobronchial tree have been treated with photodynamic therapy with follow-up to 40 months. Those patients with primary recurrent leukoplakia, carcinoma-in-situ, and T1 carcinomas obtained a complete response after one photodynamic therapy (PDT) treatment and remain free of disease. Eight patients with T2 and T3 carcinomas treated with PDT obtained a complete or partial response, but in all cases, the carcinomas recurred locally, many times with overlying normal mucosa. This is due to the inability to adequately deliver laser light to the depths of the tumor bed, despite aggressive use of interstitial implantation. PDT is highly effective for the curative treatment of early carcinomas (CIS, T1) of the head and neck. Further development of devices to measure and deliver light into the depths of a tumor bed are required prior to the use of PDT to effectively treat larger solid tumors of the head and neck.

  13. Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings

    PubMed Central

    Pascual, Sergi; Casadevall, Carme; Orozco-Levi, Mauricio; Barreiro, Esther

    2015-01-01

    Respiratory and/or limb muscle dysfunction, which are frequently observed in chronic obstructive pulmonary disease (COPD) patients, contribute to their disease prognosis irrespective of the lung function. Muscle dysfunction is caused by the interaction of local and systemic factors. The key deleterious etiologic factors are pulmonary hyperinflation for the respiratory muscles and deconditioning secondary to reduced physical activity for limb muscles. Nonetheless, cigarette smoke, systemic inflammation, nutritional abnormalities, exercise, exacerbations, anabolic insufficiency, drugs and comorbidities also seem to play a relevant role. All these factors modify the phenotype of the muscles, through the induction of several biological phenomena in patients with COPD. While respiratory muscles improve their aerobic phenotype (percentage of oxidative fibers, capillarization, mitochondrial density, enzyme activity in the aerobic pathways, etc.), limb muscles exhibit the opposite phenotype. In addition, both muscle groups show oxidative stress, signs of damage and epigenetic changes. However, fiber atrophy, increased number of inflammatory cells, altered regenerative capacity; signs of apoptosis and autophagy, and an imbalance between protein synthesis and breakdown are rather characteristic features of the limb muscles, mostly in patients with reduced body weight. Despite that significant progress has been achieved in the last decades, full elucidation of the specific roles of the target biological mechanisms involved in COPD muscle dysfunction is still required. Such an achievement will be crucial to adequately tackle with this relevant clinical problem of COPD patients in the near-future. PMID:26623119

  14. Nephrology Update: End-Stage Renal Disease and Renal Replacement Therapy.

    PubMed

    Desai, Niraj; Rahman, Mahboob

    2016-05-01

    End-stage renal disease (ESRD) is associated with high rates of morbidity and mortality, and increased health care use. Optimal management of patients with ESRD requires close collaboration among primary care physicians, nephrology subspecialists, and other subspecialists. Critical issues for the family physician include helping patients transition from chronic kidney disease to ESRD, recognizing and managing common issues in patients receiving dialysis or after kidney transplantation, and understanding palliative care for patients with ESRD. Dialysis typically is initiated for patients with a glomerular filtration rate less than 15 mL/min/1.73 m(2) if they are symptomatic due to uremia or if medical management of metabolic conditions is unsuccessful. Kidney transplantation is the optimal form of renal replacement therapy in suitable patients. The choice between hemodialysis and peritoneal dialysis often is based on patient preference and coexisting conditions. Meticulous monitoring of volume status is necessary to achieve and maintain control of blood pressure. Sleep disorders and pruritus are common and can be managed by optimization of metabolic parameters, adequacy of dialysis, and drugs. PMID:27163762

  15. Endothelial dysfunction in cardiovascular and endocrine-metabolic diseases: an update.

    PubMed

    Davel, A P; Wenceslau, C F; Akamine, E H; Xavier, F E; Couto, G K; Oliveira, H T; Rossoni, L V

    2011-09-01

    The endothelium plays a vital role in maintaining circulatory homeostasis by the release of relaxing and contracting factors. Any change in this balance may result in a process known as endothelial dysfunction that leads to impaired control of vascular tone and contributes to the pathogenesis of some cardiovascular and endocrine/metabolic diseases. Reduced endothelium-derived nitric oxide (NO) bioavailability and increased production of thromboxane A2, prostaglandin H2 and superoxide anion in conductance and resistance arteries are commonly associated with endothelial dysfunction in hypertensive, diabetic and obese animals, resulting in reduced endothelium-dependent vasodilatation and in increased vasoconstrictor responses. In addition, recent studies have demonstrated the role of enhanced overactivation of β-adrenergic receptors inducing vascular cytokine production and endothelial NO synthase (eNOS) uncoupling that seem to be the mechanisms underlying endothelial dysfunction in hypertension, heart failure and in endocrine-metabolic disorders. However, some adaptive mechanisms can occur in the initial stages of hypertension, such as increased NO production by eNOS. The present review focuses on the role of NO bioavailability, eNOS uncoupling, cyclooxygenase-derived products and pro-inflammatory factors on the endothelial dysfunction that occurs in hypertension, sympathetic hyperactivity, diabetes mellitus, and obesity. These are cardiovascular and endocrine-metabolic diseases of high incidence and mortality around the world, especially in developing countries and endothelial dysfunction contributes to triggering, maintenance and worsening of these pathological situations. PMID:21956535

  16. Adalimumab for the treatment of immune-mediated diseases: an update on old and recent indications.

    PubMed

    Murdaca, G; Colombo, B M; Puppo, F

    2011-04-01

    Ongoing progress in understanding the pathogenic mechanisms regulating various immune-mediated and inflammatory diseases, as well as the availability of innovative biotechnological approaches, have lead to the development of new drugs that add to conventional treatments. Among these, tumor necrosis factor (TNF)-α inhibitors such as infliximab, adalimumab, etanercept, golimumab and certolizumab pegol, are now available for clinical use. Adalimumab is a fully recombinant human immunoglobulin G1 monoclonal antibody that specifically binds with high affinity to human TNF-α and inhibits its binding to TNF receptors. Adalimumab was approved by the U.S. FDA in 2002 and was granted approval from the European Medicines Agency in September 2003 for the treatment of moderate to severe rheumatoid arthritis and subsequently for the treatment of ankylosing spondylitis, chronic plaque psoriasis, psoriatic arthritis, juvenile idiopathic arthritis and Crohn's disease. In this paper, we will briefly review the structure and biological effects of TNF-α, the old and recent indications of adalimumab, the pretreatment considerations, the reported adverse events and finally, the recommendations for its use in pregnancy. PMID:21573251

  17. Approach to the Patient with Mild Crohn's Disease: a 2016 Update.

    PubMed

    Scott, Frank I; Lichtenstein, Gary R

    2016-09-01

    Mild Crohn's disease (CD) is classified as those patients who are ambulatory, with <10 % weight loss, are eating and drinking without abdominal mass, tenderness, obstructive symptoms, or fever, and endoscopically they have non-progressive mild findings. Initial evaluation of mild CD should focus on assessment for high-risk features requiring more aggressive therapy. In contrast to moderate-to-severe disease, where therapy is focused on mucosal healing, the management of mild CD is focused on symptom management, while exposing the individual to minimal therapeutic risks. Budesonide is the most commonly used medication for mild CD given its safety profile. Assessment of inflammatory markers, in concert with computed-tomography (CT) or magnetic resonance (MR) enterographies and endoscopic studies, should be considered in clinical remission to ensure that mucosal inflammation is not present. Endoscopic inflammation can precede clinical recurrence. Individuals with mild CD require routine vaccination, monitoring for iron-deficiency anemia and vitamin D deficiency, and colorectal cancer screening when appropriate. PMID:27448619

  18. Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings.

    PubMed

    Gea, Joaquim; Pascual, Sergi; Casadevall, Carme; Orozco-Levi, Mauricio; Barreiro, Esther

    2015-10-01

    Respiratory and/or limb muscle dysfunction, which are frequently observed in chronic obstructive pulmonary disease (COPD) patients, contribute to their disease prognosis irrespective of the lung function. Muscle dysfunction is caused by the interaction of local and systemic factors. The key deleterious etiologic factors are pulmonary hyperinflation for the respiratory muscles and deconditioning secondary to reduced physical activity for limb muscles. Nonetheless, cigarette smoke, systemic inflammation, nutritional abnormalities, exercise, exacerbations, anabolic insufficiency, drugs and comorbidities also seem to play a relevant role. All these factors modify the phenotype of the muscles, through the induction of several biological phenomena in patients with COPD. While respiratory muscles improve their aerobic phenotype (percentage of oxidative fibers, capillarization, mitochondrial density, enzyme activity in the aerobic pathways, etc.), limb muscles exhibit the opposite phenotype. In addition, both muscle groups show oxidative stress, signs of damage and epigenetic changes. However, fiber atrophy, increased number of inflammatory cells, altered regenerative capacity; signs of apoptosis and autophagy, and an imbalance between protein synthesis and breakdown are rather characteristic features of the limb muscles, mostly in patients with reduced body weight. Despite that significant progress has been achieved in the last decades, full elucidation of the specific roles of the target biological mechanisms involved in COPD muscle dysfunction is still required. Such an achievement will be crucial to adequately tackle with this relevant clinical problem of COPD patients in the near-future. PMID:26623119

  19. Latest Consensus and Update on Protein Energy-Wasting in Chronic Kidney Disease

    PubMed Central

    Obi, Yoshitsugu; Qader, Hemn; Kovesdy, Csaba P.; Kalantar-Zadeh, Kamyar

    2015-01-01

    Purpose of review Protein-energy wasting (PEW) is a state of metabolic and nutritional derangements in chronic disease states including chronic kidney disease (CKD). Cumulative evidence suggests that PEW, muscle wasting and cachexia are common and strongly associated with mortality in CKD, which is reviewed here. Recent findings The malnutrition-inflammation score (KALANTAR Score) is among the comprehensive and outcome-predicting nutritional scoring tools. The association of obesity with poor outcomes is attenuated across more advanced CKD stages and eventually reverses in form of obesity paradox. Frailty is closely associated with PEW, muscle wasting and cachexia. Muscle loss shows stronger associations with unfavorable outcomes than fat loss. Adequate energy supplementation combined with low-protein diet (LPD) for the management of CKD may prevent the development of PEW and can improve adherence to LPD, but dietary protein requirement may increase with aging and is higher under dialysis therapy. Phosphorous burden may lead to poor outcomes. The target serum bicarbonate concentration is normal range and ≥23 mEq/L for non-dialysis-dependent and dialysis-dependent CKD patients, respectively. A benefit of exercise is suggested but not yet conclusively proven. Summary Prevention and treatment of PEW should involve individualized and integrated approaches to modulate identified risk factors and contributing comorbidities. PMID:25807354

  20. Update on heart failure, heart transplant, congenital heart disease, and clinical cardiology.

    PubMed

    Almenar, Luis; Zunzunegui, José Luis; Barón, Gonzalo; Carrasco, José Ignacio; Gómez-Doblas, Juan José; Comín, Josep; Barrios, Vivencio; Subirana, M Teresa; Díaz-Molina, Beatriz

    2013-04-01

    In the year 2012, 3 scientific sections-heart failure and transplant, congenital heart disease, and clinical cardiology-are presented together in the same article. The most relevant development in the area of heart failure and transplantation is the 2012 publication of the European guidelines for heart failure. These describe new possibilities for some drugs (eplerenone and ivabradine); expand the criteria for resynchronization, ventricular assist, and peritoneal dialysis; and cover possibilities of percutaneous repair of the mitral valve (MitraClip(®)). The survival of children with hypoplastic left heart syndrome in congenital heart diseases has improved significantly. Instructions for percutaneous techniques and devices have been revised and modified for the treatment of atrial septal defects, ostium secundum, and ventricular septal defects. Hybrid procedures for addressing structural congenital heart defects have become more widespread. In the area of clinical cardiology studies have demonstrated that percutaneous prosthesis implantation has lower mortality than surgical implantation. Use of the CHA2DS2-VASc criteria and of new anticoagulants (dabigatran, rivaroxaban and apixaban) is also recommended. In addition, the development of new sequencing techniques has enabled the analysis of multiple genes. PMID:24775619

  1. Myocosis fungoides--an update on a non-mycotic disease.

    PubMed

    Makdisi, Joy; Friedman, Adam

    2013-07-01

    Mycosis fungoides was first described in 1806 by the French physician Jean Louis Alibert in a patient whose skin lesions developed into mushroom-like tumors. Though it is not an infectious disease, it was termed mycosis fungoides (MF) due to its fungating appearance. In 1870, Bazin further described MF, proposing the three classical stages of the cutaneous disease: patch, plaque, and tumor. The term cutaneous T-cell lymphoma (CTCL) was first utilized in 1975 by Lutzner et al to describe a group of malignant infiltrative disorders of the skin including MF and Sézary syndrome. CTCLs comprise a spectrum of extranodal non-Hodgkin's lymphomas that are characterized by primary cutaneous involvement of a dominant clonal T-cell. As molecular biology and immunohistochemistry techniques have become more developed, CTCL has become understood to be a heterogeneous assembly of disorders that vary with regards to clinical course, histopathology, therapeutic considerations, and prognosis. MF, a low-grade lymphoproliferative disorder, is the most common type of CTCL, comprising 54% of CTCLs. It is a rare, extranodal, non-Hodgkin's lymphoma and is an epidermotropic neoplasm composed of CD4+ (helper) lymphocytes Sézary syndrome is a related leukemic subtype of CTCL that presents with diffuse skin involvement as well as circulating tumor cells in the peripheral blood. PMID:23884501

  2. An update on the epidemiology of inflammatory bowel disease in Asia.

    PubMed

    Thia, Kelvin T; Loftus, Edward V; Sandborn, William J; Yang, Suk-Kyun

    2008-12-01

    A rising trend in the incidence and prevalence of inflammatory bowel disease (IBD) in Asia has been recognized for the past two decades. It has been postulated that this phenomenon may be related to the westernization of lifestyles, including changes in dietary habits and environmental changes such as improved sanitation and industrialization. Previously we reported that the incidence and prevalence rates of IBD in Asia were low compared with the West, but there was a notably rising secular trend. In this review, we summarize the recent epidemiological data in Asia, characterize the clinical features, risk factors and genetic susceptibility of Asian IBD patients, and compare these to those of Western IBD patients. In the past decade, the incidence and prevalence of IBD reported across Asia, particularly in East Asia, has continued to increase. Familial clustering is generally uncommon in East Asia but appears to be higher in West Asia. The genetic susceptibilities in Asian IBD patients differ from those of White patients, as NOD2/CARD15 mutations are much less common. The clinical phenotypes and complication rates of Asian IBD resemble the White population in general, but with some differences, including lower surgical rates, higher prevalence of males, and higher prevalence of ileocolonic involvement among East Asian Crohn's disease patients, and a low frequency of primary sclerosing cholangitis among IBD patients in East and Southeast Asia. PMID:19086963

  3. Update on intravenous dipyridamole cardiac imaging in the assessment of ischemic heart disease

    SciTech Connect

    Younis, L.T.; Chaitman, B.R. )

    1990-01-01

    Intravenous dipyridamole is a relative selective coronary vasodilator which, when combined with thallium-201, provides a useful technique to assess myocardial perfusion. The intravenous dipyridamole is administered as an infusion at a rate of 0.14 mg/kg/min for 4 minutes. In the presence of significant coronary artery disease the increase of coronary blood flow is disproportionate between vessels with and without significant coronary lesions, providing the basis for detecting regional differences in flow using thallium-201. The test can be used alone or combined with low level exercise to increase test sensitivity. The test is safe when performed under medical supervision and when patient selection is done appropriately. Most of the side effects induced by dipyridamole infusion are well tolerated by patients and readily reversed with intravenous aminophylline and sublingual nitroglycerin. The average sensitivity and specificity of the dipyridamole thallium scintigraphy test from the major studies are 76% and 70%, respectively. The test is very useful in providing prognostic information in patients who are unable to exercise. A reversible thallium defect after dipyridamole infusion has been shown to be associated with significant mortality and morbidity in patients with documented or suspected coronary artery disease. The use of intravenous dipyridamole has been extended into other modalities of imaging, including 2-dimensional and Doppler echocardiography, to study functional changes in the left ventricular induced by the infusion of intravenous dipyridamole. 52 references.

  4. Mitigation of non-communicable diseases in developing countries with community health workers.

    PubMed

    Mishra, Shiva Raj; Neupane, Dinesh; Preen, David; Kallestrup, Per; Perry, Henry B

    2015-01-01

    Non-communicable diseases (NCDs) are rapidly becoming priorities in developing countries. While developed countries are more prepared in terms of skilled human resources for NCD management, developing the required human resources is still a challenge in developing countries. In this context, mobilizing community health workers (CHWs) for control of NCDs seems promising. With proper training, supervision and logistical support, CHWs can participate in the detection and treatment of hypertension, diabetes, and other priority chronic diseases. Furthermore, advice and support that CHWs can provide about diet, physical activity, and other healthy lifestyle habits (such as avoidance of smoking and excessive alcohol intake) have the potential for contributing importantly to NCD programs. This paper explores the possibility of involving CHWs in developing countries for addressing NCDs. PMID:26555199

  5. Young professionals for health development: the Kenyan experience in combating non-communicable diseases.

    PubMed

    Matheka, Duncan M; Nderitu, Joseph; Vedanthan, Rajesh; Demaio, Alessandro R; Murgor, Mellany; Kajana, Kiti; Loyal, Poonamjeet; Alkizim, Faraj O; Kishore, Sandeep P

    2013-01-01

    Young individuals (below 35 years) comprise an estimated 60% of the global population. Not only are these individuals currently experiencing chronic, non-communicable diseases (NCDs), either living with or at risk for these conditions, but will also experience the long-term repercussions of the current NCD policy implementations. It is thus imperative that they meaningfully contribute to the global discourse and responses for NCDs at the local level. Here, we profile one example of meaningful engagement: the Young Professionals Chronic Disease Network (YPCDN). The YPCDN is a global online network that provides a platform for young professionals to deliberate new and innovative methods of approaching the NCD challenges facing our societies. We provide a case study of the 2-year experiences of a country chapter (Kenya) of the YPCDN to demonstrate the significance and impact of emerging leaders in addressing the new global health agenda of the 21st century. PMID:24262308

  6. Priorities for developing countries in the global response to non-communicable diseases

    PubMed Central

    2012-01-01

    The growing global burden of non communicable diseases (NCDs) is now killing 36 million people each year and needs urgent and comprehensive action. This article provides an overview of key critical issues that need to be resolved to ensure that recent political commitments are translated into practical action. These include: (i) categorizing and prioritizing NCDs in order to inform donor funding commitments and priorities for intervention; (ii) finding the right balance between the relative importance of treatment and prevention to ensure that responses cover those at risk, and those who are already sick; (iii) defining the appropriate health systems response to address the needs of patients with diseases characterized by long duration and often slow progression; (iv) research needs, in particular translational research in the delivery of care; and (v) sustained funding to support the global NCD response. PMID:22686126

  7. [First-line screening guidelines for renal stone disease patients: a CLAFU update].

    PubMed

    Haymann, J-P; Daudon, M; Normand, M; Hoznek, A; Meria, P; Traxer, O

    2014-01-01

    This text summarizes the CLAFU first-line screening guidelines for renal stone disease patients. We have focused on the useful information provided by renal stone analysis and also the identification of relevant stone risk factors detected in a 24-hour urine collection. Indeed, evaluation of water, sodium and protein intake may be easily achieved in a current clinical setting and allows a useful pedagogic tool for patients' advices and follow-up: daily diuresis above 2000 mL, calcium intake between 800 mg and 1 g/day, a moderate daily sodium and proteins restricted diet (<9 g and <1.2 g/kg per day respectively). General therapeutical principles are reviewed, including circumstances requiring specialized management. PMID:24365623

  8. Impulse control disorders in Parkinson's disease: background and update on prevention and management

    PubMed Central

    Leeman, Robert F; Billingsley, Benjamin E; Potenza, Marc N

    2013-01-01

    SUMMARY Given that impulse control disorders (ICDs) have been identified among a considerable minority of Parkinson's disease (PD) patients, these conditions have gained increased clinical and research attention in the past decade. Dopamine-replacement therapies, taken to ameliorate PD symptoms, have been associated with ICDs in PD. Unfortunately, there are relatively sparse empirical data regarding how best to address ICDs in PD patients. Conversely, progress has been made in understanding the clinical, neurobiological and cognitive correlates of ICDs in PD. Some of these findings may inform possible courses of action for care providers working with PD patients with ICDs. The literature on ICDs in non-PD populations may also be informative in this regard. The goals of the present article are to outline important clinical characteristics of ICDs in PD, briefly review relevant neurocognitive and neurobiological studies and discuss possible ways to prevent and manage ICDs in PD. PMID:23606908

  9. An Update on Hidradenitis Suppurativa (Part I): Epidemiology, Clinical Aspects, and Definition of Disease Severity.

    PubMed

    Martorell, A; García-Martínez, F J; Jiménez-Gallo, D; Pascual, J C; Pereyra-Rodriguez, J; Salgado, L; Vilarrasa, E

    2015-11-01

    Hidradenitis suppurativa is a chronic inflammatory disorder that has attracted increasing attention in recent years due to underestimations of prevalence and the considerable impact of the condition on interpersonal relationships, physical appearance, self-esteem, and body image. Although hidradenitis suppurative has a significant psychological impact on patients and can even cause physical limitations when thick scarring results in limb mobility limitation, until very recently little evidence was available relating to its epidemiology, etiology, or pathogenesis. In this review, we highlight the latest advances in our understanding of the epidemiological and clinical aspects of hidradenitis suppurativa. We will also look at the different classification systems for hidradenitis suppurativa and discuss the emergence of skin ultrasound as a promising technique for monitoring the course of this chronic inflammatory disease. PMID:26254550

  10. Update on plication procedures for Peyronie’s disease and other penile deformities

    PubMed Central

    Mobley, Elizabeth M.; Fuchs, Molly E.; Myers, Jeremy B.

    2012-01-01

    Plication techniques are not a panacea for deformities associated with Peyronie’s disease or congenital curvature. However, they do provide certain advantages, both theoretic and real, over competing procedures such as grafting. Depending on the technique, plication procedures have minimal risk of de novo erectile dysfunction, minimal risk of injury to the dorsal neurovascular bundle, and may be used for a variety of angulation deformities, including multiplanar curvature and severe degrees of curvature. A variety of incisions may be used, including the classic circumcision with degloving but also ventral raphe, dorsal penile inversion, and penoscrotal. These may be helpful in preventing postoperative morbidity and in sparing the prepuce if desired. Plication may also be combined with procedures such as penile prosthesis for correction of residual curvature. Lastly, despite its complications, plication techniques are very well tolerated, are relatively simple to perform and result in the very high satisfaction rates. PMID:23205060

  11. Mechanisms of disease: a molecular genetic update on hereditary axonal neuropathies.

    PubMed

    Züchner, Stephan; Vance, Jeffery M

    2006-01-01

    Hereditary axonal peripheral neuropathies comprise a genetically heterogeneous group of disorders that are clinically subsumed under the name of Charcot-Marie-Tooth (CMT) disease type 2 (CMT2). Historically, two classes of CMT have been differentiated: demyelinating forms of CMT (CMT1), in which nerve conduction velocities are decreased, and the axonal CMT2 forms, in which nerve conduction velocities are preserved. Recently, a number of genes that are defective in patients with the main forms of CMT2 have been identified. The molecular dissection of cellular functions of the related gene products has only just begun, and detailed pathophysiological models are still lacking. The known CMT2-related genes represent key players in these pathways, however, and are likely to provide powerful tools for identifying targets for future therapeutic intervention. PMID:16932520

  12. An Update on the Streptococcus bovis Group: Classification, Identification, and Disease Associations.

    PubMed

    Dekker, John P; Lau, Anna F

    2016-07-01

    The Streptococcus bovis group has undergone significant taxonomic changes over the past 2 decades with the advent of new identification methods with higher discriminatory power. Although the current classification system is not yet embraced by all researchers in the field and debate remains over the performance of molecular techniques for identification to the species level within the group, important disease associations for several members of the group have been clarified. Here, we provide a brief overview of the history of the S. bovis group, an outline of the currently accepted classification scheme, a review of associated clinical syndromes, and a summary of the performance and diagnostic accuracy of currently available identification methods. PMID:26912760

  13. Update on Pharmaceutical and Minimally Invasive Management Strategies for Chronic Obstructive Pulmonary Disease

    PubMed Central

    Rafii, Rokhsara; Albertson, Timothy E.; Louie, Samuel; Chan, Andrew L.

    2011-01-01

    Chronic obstructive pulmonary disease (COPD) is a debilitating pulmonary disorder with systemic effects, and it is the fourth leading cause of death in the United States. COPD patients not only develop respiratory limitations, but can also demonstrate systemic wasting, features of depression, and can succumb to social isolation. Smoking cessation is crucial, and pharmacotherapy with bronchodilators is helpful in symptom management. Inhaled corticosteroids may be beneficial in some patients. In addition, pulmonary rehabilitation and palliative care are important components under the right clinical circumstance. This review highlights current guidelines and management strategies for COPD and emphasizes novel pharmacotherapy and minimally invasive (nonsurgical) lung-volume reduction interventions that may prove to be of significant benefit in the future. PMID:21660228

  14. An update on the association of vitamin D deficiency with common infectious diseases.

    PubMed

    Watkins, Richard R; Lemonovich, Tracy L; Salata, Robert A

    2015-05-01

    Vitamin D plays an important role in modulating the immune response to infections. Deficiency of vitamin D is a common condition, affecting both the general population and patients in health care facilities. Over the last decade, an increasing body of evidence has shown an association between vitamin D deficiency and an increased risk for acquiring several infectious diseases, as well as poorer outcomes in vitamin D deficient patients with infections. This review details recent developments in understanding the role of vitamin D in immunity, the antibacterial actions of vitamin D, the association between vitamin D deficiency and common infections (like sepsis, pneumonia, influenza, methicillin-resistant Staphylococcus aureus, human immunodeficiency virus type-1 (HIV), and hepatitis C virus (HCV)), potential therapeutic implications for vitamin D replacement, and future research directions. PMID:25741906

  15. The Economic impact of Non-communicable Diseases on households in India

    PubMed Central

    2012-01-01

    Background In India, Non Communicable Diseases (NCDs) and injuries account for an estimated 62% of the total age-standardized burden of forgone Disability Adjusted Life Years (DALYs). Public and private financing of clinical services to reduce the NCD burden is a major challenge. Methods We used National Sample Survey Organization (NSSO) survey data from 1995-96 and 2004 covering nearly 200 thousand households to assess healthcare utilization patterns and out of pocket health spending by disease category. For this purpose, self-reported diseases and conditions were categorized into NCDs and non-NCDs. Survey data were used to assess how households financed their overall health expenditures and related this pattern to specific health conditions. We measured catastrophic spending on NCD-related hospitalization, defined as occurring when health expenditures exceeded 40% of a household's ability to pay, that is, household consumption spending less combined survival consumption expenditure; and impoverishment when per capita expenditure within the household decreased to below the poverty line once health spending was netted out. Results The share of NCDs in out of pocket health expenses incurred by households increased over time, from 31.6 percent in 1995-96 to 47.3 percent in 2004. In both years, own savings and income were the most important source of financing for many health conditions, typically between 40-60 percent of all spending, whereas 30-35 percent was from borrowing. The odds of catastrophic hospitalization expenditures for cancer was nearly 170% greater and for CVD and injuries 22 percent greater than the odds due to communicable diseases. Impoverishment patterns were similar. Conclusions Out of pocket expenses for treating NCDs rose sharply over the period from 1995-96 to 2004. When NCDs are present, the financial risks to which Indians households are exposed are significant. PMID:22533895

  16. GM1 gangliosidosis and Morquio B disease: an update on genetic alterations and clinical findings

    PubMed Central

    Caciotti, Anna; Garman, Scott C; Rivera-Colón, Yadilette; Procopio, Elena; Catarzi, Serena; Ferri, Lorenzo; Guido, Carmen; Martelli, Paola; Parini, Rossella; Antuzzi, Daniela; Battini, Roberta; Sibilio, Michela; Simonati, Alessandro; Fontana, Elena; Salviati, Alessandro; Akinci, Gulcin; Cereda, Cristina; Dionisi-Vici, Carlo; Deodato, Francesca; d’Amico, Adele; d’Azzo, Alessandra; Bertini, Enrico; Filocamo, Mirella; Scarpa, Maurizio; di Rocco, Maja; Tifft, Cynthia J; Ciani, Federica; Gasperini, Serena; Pasquini, Elisabetta; Guerrini, Renzo; Donati, Maria Alice; Morrone, Amelia

    2011-01-01

    GM1 gangliosidosis and Morquio B syndrome, both arising from beta-galactosidase (GLB1) deficiency, are very rare lysosomal storage diseases with an incidence of about 1:100,000– 1:200,000 live births worldwide. Here we report the beta-galactosidase gene (GLB1) mutation analysis of 21 unrelated GM1 gangliosidosis patients, and of 4 Morquio B patients, of whom two are brothers. Clinical features of the patients were collected and compared with those in literature. In silico analyses were performed by standard alignments tools and by an improved version of GLB1 three-dimensional models. The analysed cohort includes remarkable cases. One patient with GM1 gangliosidosis had a triple X syndrome. One patient with juvenile GM1 gangliosidosis was homozygous for a mutation previously identified in Morquio type B. A patient with infantile GM1 gangliosidosis carried a complex GLB1 allele harbouring two genetic variants leading to p.R68W and p.R109W amino acid changes, in trans with the known p.R148C mutation. Molecular analysis showed 27 mutations, 9 of which are new: 5 missense, 3 microdeletions and a nonsense mutation. We also identified four new genetic variants with a predicted polymorphic nature that was further investigated by in silico analyses. Three-dimensional structural analysis of GLB1 homology models including the new missense mutations and the p.R68W and p.R109W amino acid changes, showed that all the amino acids replacements affected the resulting protein structures in different ways, from changes in polarity to folding alterations. Genetic and clinical associations led us to undertake a critical review of the classifications of late-onset GM1 gangliosidosis and Morquio B disease. PMID:21497194

  17. Chinese Erdheim-Chester disease: clinical-pathology-PET/CT updates

    PubMed Central

    Ding, Huanyu; Li, Yang; Ruan, Caishun; Gao, Yuan; Wang, Hehua; Zhang, Xiangsong

    2015-01-01

    Summary Erdheim-Chester disease (ECD), one type of systemic non-Langerhans cell histiocytosis, has been rarely seen and is characterized by the accumulation of foamy CD68+CD1a- histiocytes. We reported a case of ECD and reviewed the clinical features of 13 cases of ECD reported so far in China. A 53-year-old male was diagnosed with central diabetes insipidus in March 2014, followed by fever, splenomegaly and anemia in July 2014. His initial pituitary magnetic resonance imaging (MRI) revealed the absence of high signal at T1-weighted image in posterior pituitary without any lesion. A further positron emission tomography/computer tomography (PET/CT) images showed elevated metabolic activity of 18F-2-fluro-D-deoxy-glucose (FDG) and low 13N-NH3 uptake in the posterior pituitary, and multi-organ involvement. Biopsy at right femur lesion revealed that granulomatous infiltration of foamy histiocytes and Touton giant cells surrounded by fibrosis tissues. Immunohistochemistry stain was positive for CD68, negative for CD207/Langerin and S-100. The diagnosis of ECD was confirmed and the treatment with pegylated interferon was effective. ECD was a possible immune-related disorder concluding from the IgG4 immunohistochemistry results. We summarized the pathological manifestations for ECD and its differential diagnosis from Langerhans cell histiocytosis (LCH) and Rosai-Dorfman disease (RDD). ECD should be considered by both pathologists and clinicians in the differential diagnosis when central diabetes insipidus is accompanied with multi-organ involvement, especially skeletal system involvement, or recurrent fever. Learning points ECD should be considered when central diabetes insipidus is accompanied with multisystem involvement, especially symmetric/asymmetric bone lesions, or recurrent fever. PET/CT scanning was helpful for locating pituitary lesion, discovering multiple system involvement and indicating the biopsy sites. Conducting proper immunohistochemistry stains was

  18. Nonalcoholic fatty liver disease: Update on pathogenesis, diagnosis, treatment and the role of S-adenosylmethionine

    PubMed Central

    Noureddin, Mazen; Mato, José M; Lu, Shelly C

    2016-01-01

    Nonalcoholic fatty liver disease (NAFLD) is currently the most common liver disease worldwide affecting over one-third of the population in the U.S. It has been associated with obesity, type 2 diabetes, hyperlipidemia, and insulin resistance and is initiated by the accumulation of triglycerides in hepatocytes. Isolated hepatic steatosis (IHS) remains a benign process, while a subset develops superimposed inflammatory activity and progression to nonalcoholic steatohepatitis (NASH) with or without fibrosis. However, the molecular mechanisms underlying NAFLD progression are not completely understood. Liver biopsy is still required to differentiate IHS from NASH as easily accessible noninvasive biomarkers are lacking. In terms of treatments for NASH, pioglitazone, vitamin E, and obeticholic acid have shown some benefit. All of these agents have potential complications associated with long-term use. Nowadays, a complex hypothesis suggests that multiple parallel hits are involved in NASH development. However, the ‘key switch’ between IHS and NASH remains to be discovered. We have recently shown that knocking out enzymes involved in S-adenosylmethionine (SAMe) metabolism, the main biological methyl donor in humans that is abundant in the liver, will lead to NASH development in mice. This could be due to the fact that a normal SAMe level is required to establish the proper ratio of phosphatidylethanolamine to phosphatidylcholine that has been found to be important in NAFLD progression. New data from humans have also suggested that these enzymes play a role in the pathogenesis of NAFLD and that some of SAMe cycle metabolites may serve as noninvasive biomarkers of NASH. In this review, we discuss the evidence of the role of SAMe in animal models and humans with NAFLD and how studying this area may lead to the discovery of new noninvasive biomarkers and possibly personalized treatment for NASH. PMID:25873078

  19. 2012 update on diabetic kidney disease: the expanding spectrum, novel pathogenic insights and recent clinical trials.

    PubMed

    Fernández Fernández, B; Elewa, U; Sánchez-Niño, M D; Rojas-Rivera, J E; Martin-Cleary, C; Egido, J; Ortiz, A

    2012-08-01

    Diabetic kidney disease (DKD) is the most frequent cause of end-stage renal disease in western countries. This implies that current methods based of renin angiotensin aldosterone system (RAAS) targeting for preventing, slowing or promoting regression of DKD are insufficient. Podocyte injury and albuminuria are thought to be key events in DKD. Indeed several DKD stages are recognized based on the magnitude of albuminuria. However, the spectrum of DKD has recently expanded, as lack of significant albuminuria is present in 30% of diabetics with kidney function impairment. This may result from the widespread use of drugs targeting the RAAS. However, it may also indicate that additional pathogenic factors contribute to renal function deterioration despite control of albuminuria. In this regard, double blockade of the RAAS is more effective in reducing albuminuria that blockade of a single component. However, clinical trials assessing double blockade for renal function preservation have been disappointing and raised safety issues. Non-biased -omics approaches have uncovered alternative therapeutic targets, including the cytokine TRAIL, the MIF receptor CD74 and the proapoptotic intracellular protein BASP1. In addition, urinary proteomics has uncovered a peptidomic fingerprint for DKD progression that precedes the onset of microalbuminuria. Studies are underway to validate this fingerprint for early treatment of high risk patients. Recent clinical trials suggest a potential role of bardoxolone methyl to improve renal function in advanced DKD, while trials of avosentan, pirfenidone, sulodexide and pyridoxamine have been disappointing and further data are needed for paricalcitol and vitamin D, newer generation endothelin receptor antagonists and pentoxifylline. PMID:22805616

  20. The role of infant nutrition in the global epidemic of non-communicable disease.

    PubMed

    Singhal, Atul

    2016-05-01

    Non-communicable diseases (NCD) and atherosclerotic CVD in particular, are the most important health problems of the 21st century. Already in every world region except Africa, NCD account for greater mortality than communicable, maternal, perinatal and nutritional conditions combined. Although modifiable lifestyle factors in adults are the main determinants, substantial evidence now suggests that factors in early life also have a major role in the development of NCD; commonly referred to as the Developmental Origins of Health and Disease hypothesis. Factors in utero, early postnatal life and throughout childhood, have been shown to affect NCD by influencing risk factors for CVD such as obesity, diabetes, hypertension and dyslipidaemia. Infant nutrition (e.g. breastfeeding rather than bottle feeding) and a slower pattern of infant weight gain have been shown to be particularly protective against later risk of obesity and CVD in both low- and high-income countries. The mechanisms involved are poorly understood, but include epigenetic changes; effects on endocrine systems regulating body weight, food intake and fat deposition; and changes in appetite regulation. As a consequence, strategies to optimise early life nutrition could make a major contribution to stemming the current global epidemic of NCD. This review will consider the role of early life factors in the development of NCD, focusing on the impact of infant nutrition/growth on obesity and CVD. The review will highlight the experimental (randomised) evidence where available, briefly summarise the underlying mechanisms involved and consider the implications for public health. PMID:27066843

  1. The Law of Communicable Diseases Act and disclosure to sexual partners among HIV-positive youth

    PubMed Central

    Christiansen, Monica; Lalos, Ann; Johansson, Eva. E.

    2008-01-01

    In Sweden, human immunodeficiency virus (HIV) is included among the venereal diseases covered by the Law of Communicable Diseases Act. HIV-positive (HIV+) people are required to inform their sexual partners about their infection and adopt safe sex behaviours. However, it is unclear how the law is perceived. This study explores how HIV+ youth in Sweden perceive the law, handle their sexuality and disclose their HIV diagnosis to sexual partners. Ten HIV+ women and men between 17 and 24 years of age were recruited from three different HIV infection clinics. These participants were interviewed in depth. The interviews were tape-recorded, transcribed verbatim and analysed according to a grounded theory approach. The core category—cultured to take responsibility—illuminates the informants’ double-edged experiences regarding the law and how they handle disclosure to sexual partners. The legislation implies both support and burden for these HIV+ youth; they feel that they have a great deal of responsibility, sometimes more than they can handle. ‘Switch off lust’, ‘balancing lust, fear and obedience’ and ‘switch off the disease’ are strategies that describe how the informants manage sexuality and disclosure. Young HIV+ people have a difficult time informing partners of their HIV diagnosis and discussing safe sex strategies. These are challenges that health care providers need to take seriously. HIV+ youth need better communication strategies to negotiate safer sex. Staff with extended education on sexuality should be a part of HIV health care. PMID:22639678

  2. Ebola Virus Disease (The Killer Virus): Another Threat to Humans and Bioterrorism: Brief Review and Recent Updates

    PubMed Central

    Sharma, Sarang; Dutta, Shubha Ranjan; Dudeja, Pooja; Sharma, Vivek

    2015-01-01

    Ebola virus disease (EVD) described as “one of the world’s most virulent diseases” by WHO was popularly known as Ebola haemorrhagic fever in the past. It is usually considered a severe and deadly illness when humans are concerned. EVD outbreaks have shown to have a very high fatality rate ranging from 50 - 90% with a reported occurrence primarily seen near the tropical rainforests of remote villages in Central and West Africa. The virus is transmitted to people from wild animals and within the human community through human-to-human contact. Natural host for Ebola virus is not yet conclusively identified but the most probable host appears to be the fruit bats of the Pteropodidae family. Five subspecies of Ebola virus are recognized till date, with Zaire Ebola virus being the most aggressive of all varieties and recording up to 90% mortality. All Ebola forms are highly contagious and hence have been classed as Category A Priority Pathogens by WHO. Severely ill patients warrant intensive support therapy. Medical workers working in affected areas need to undertake extensive measures to prevent contracting the disease. Till date, no particular anti-viral therapy has demonstrated effectiveness in Ebola virus infection. Also, no vaccine for use in humans is yet approved by the regulatory bodies. If Ebola was actually misused as a biological weapon, it could be a serious threat. Idea behind this article is to briefly review the history and present recent updates on Ebola virus, its pathogenesis and possible hopes for treatment. PMID:26266139

  3. Association of endothelial nitric oxide synthase gene polymorphisms with coronary artery disease: an updated meta-analysis and systematic review.

    PubMed

    Rai, Himanshu; Parveen, Farah; Kumar, Sudeep; Kapoor, Aditya; Sinha, Nakul

    2014-01-01

    Several association studies of endothelial nitric oxide synthase (NOS3) gene polymorphisms with respect to coronary artery disease (CAD) have been published in the past two decades. However, their association with the disease, especially among different ethnic subgroups, still remains controversial. This prompted us to conduct a systematic review and an updated structured meta-analysis, which is the largest so far (89 articles, 132 separate studies, and a sample size of 69,235), examining association of three polymorphic forms of the NOS3 gene (i.e. Glu298Asp, T786-C and 27 bp VNTR b/a) with CAD. In a subgroup analysis, we tested their association separately among published studies originating predominantly from European, Middle Eastern, Asian, Asian-Indian and African ancestries. The pooled analysis confirmed the association of all the three selected SNP with CAD in three different genetic models transcending all ancestries worldwide. The Glu298Asp polymorphism showed strongest association (OR range = 1.28-1.52, and P<0.00001 for all comparisons), followed by T786-C (OR range = 1.34-1.42, and P<0.00001 for all comparisons) and 4b/a, (OR range = 1.19-1.41, and P ≤ 0.002 for all comparisons) in our pooled analysis. Subgroup analysis revealed that Glu298Asp (OR range = 1.54-1.87, and P<0.004 for all comparisons) and 4b/a (OR range = 1.71-3.02, and P<0.00001 for all comparisons) have highest degree of association amongst the Middle Easterners. On the other hand, T786-C and its minor allele seem to carry a highest risk for CAD among subjects of Asian ancestry (OR range = 1.61-1.90, and P ≤ 0.01 for all comparisons). PMID:25409023

  4. Acute graft-versus-host disease: a bench-to-bedside update.

    PubMed

    Holtan, Shernan G; Pasquini, Marcelo; Weisdorf, Daniel J

    2014-07-17

    Over the past 5 years, many novel approaches to early diagnosis, prevention, and treatment of acute graft-versus-host disease (aGVHD) have been translated from the bench to the bedside. In this review, we highlight recent discoveries in the context of current aGVHD care. The most significant innovations that have already reached the clinic are prophylaxis strategies based upon a refinement of our understanding of key sensors, effectors, suppressors of the immune alloreactive response, and the resultant tissue damage from the aGVHD inflammatory cascade. In the near future, aGVHD prevention and treatment will likely involve multiple modalities, including small molecules regulating immunologic checkpoints, enhancement of suppressor cytokines and cellular subsets, modulation of the microbiota, graft manipulation, and other donor-based prophylaxis strategies. Despite long-term efforts, major challenges in treatment of established aGVHD still remain. Resolution of inflammation and facilitation of rapid immune reconstitution in those with only a limited response to corticosteroids is a research arena that remains rife with opportunity and urgent clinical need. PMID:24914140

  5. Update on the metabolic effects of steroidal contraceptives and their relationship to cardiovascular disease risk.

    PubMed

    Godsland, I F; Crook, D

    1994-05-01

    Evaluation of metabolic disturbances has had an important role in the modification of oral contraceptive formulations toward estrogen-progestin combinations with reduced adverse metabolic impact. An increasing number of interrelationships between metabolic risk factors for cardiovascular disease are being recognized, and a metabolic syndrome of disturbances has been identified with insulin resistance as a potential underlying factor. The insulin resistance syndrome includes hyperinsulinemia and impaired glucose tolerance, hypertriglyceridemia, reduced high-density lipoprotein concentrations, and hypertension. Increased concentration of a small, dense, low-density lipoprotein subtype may also be important. Depending on steroid type and dose, combined oral contraceptives may induce all the features of the insulin resistance syndrome. Reduction in estrogen dose and modification of progestin content have resulted in formulations with no adverse effect on high-density lipoprotein and blood pressure, but insulin resistance and hypertriglyceridemia remain. These are caused primarily by the estrogen component. Therefore modification of the estrogen content of oral contraceptives might result in "metabolically transparent" formulations that could conceivably afford a degree of cardiovascular protection. PMID:8178902

  6. Hereditary motor and sensory neuropathies or Charcot-Marie-Tooth diseases: an update.

    PubMed

    Tazir, Meriem; Hamadouche, Tarik; Nouioua, Sonia; Mathis, Stephane; Vallat, Jean-Michel

    2014-12-15

    Hereditary motor and sensory neuropathies (HMSN) or Charcot-Marie-Tooth (CMT) diseases are the most common degenerative disorders of the peripheral nervous system. However, the frequency of the different subtypes varies within distinct populations. Although more than seventy clinical and genetic forms are known to date, more than 80% of CMT patients in Western countries have genetic abnormalities associated with PMP22, MPZ, MFN2 and GJB1. Given the considerable genetic heterogeneity of CMT, we emphasize the interest of both clinical and pathological specific features such that focused genetic testing could be performed. In this regard, peripheral nerve lesions in GDAP1 mutations (AR CMT1A), such as mitochondrial abnormalities, have been newly demonstrated. Otherwise, while demyelinating autosomal recessive CMT used to be classified as CMT4 (A, B, C …), we propose a simplified classification such as AR CMT1 (A, B, C …), and AR CMT2 for axonal forms. Also, we stress that next generation sequencing techniques, now considered to be the most efficient methods of genetic testing in CMT, will be helpful in molecular diagnosis and research of new genes involved. Finally, while no effective therapy is known to date, ongoing new therapeutic trials such as PXT3003 (a low dose combination of the three already approved drugs baclofen, naltrexone, and D-sorbitol) give hopes for potential curative treatment. PMID:25454638

  7. Acute graft-versus-host disease: a bench-to-bedside update

    PubMed Central

    Holtan, Shernan G.; Pasquini, Marcelo

    2014-01-01

    Over the past 5 years, many novel approaches to early diagnosis, prevention, and treatment of acute graft-versus-host disease (aGVHD) have been translated from the bench to the bedside. In this review, we highlight recent discoveries in the context of current aGVHD care. The most significant innovations that have already reached the clinic are prophylaxis strategies based upon a refinement of our understanding of key sensors, effectors, suppressors of the immune alloreactive response, and the resultant tissue damage from the aGVHD inflammatory cascade. In the near future, aGVHD prevention and treatment will likely involve multiple modalities, including small molecules regulating immunologic checkpoints, enhancement of suppressor cytokines and cellular subsets, modulation of the microbiota, graft manipulation, and other donor-based prophylaxis strategies. Despite long-term efforts, major challenges in treatment of established aGVHD still remain. Resolution of inflammation and facilitation of rapid immune reconstitution in those with only a limited response to corticosteroids is a research arena that remains rife with opportunity and urgent clinical need. PMID:24914140

  8. To Stent or Not to Stent? Update on Revascularization for Atherosclerotic Renovascular Disease.

    PubMed

    Noory, Elias; Sritharan, Kaji; Zeller, Thomas

    2016-06-01

    Renal artery stenosis (RAS) is increasingly encountered in clinical practice. The two most common etiologies are fibromuscular dysplasia (FMD) and atherosclerotic renal artery disease (ARAS), with the latter accounting for the vast majority of cases. Significant RAS activates the renin-angiotensin-aldosterone system and is associated with three major clinical syndromes: ischemic nephropathy, hypertension, and destabilizing cardiac syndromes. Over the past two decades, advancements in diagnostic and interventional techniques have led to improved detection and the widespread use of endovascular renal artery revascularization strategies in the management of ARAS. However, renal artery stenting for ARAS remains controversial. Although several studies have demonstrated some benefit with renal artery revascularization, this has not been to the extent anticipated or predicted. Moreover, these trials have significant flaws in their study design and are hampered with inherent bias which make their interpretation challenging. In this review, we evaluate the existing body of evidence and offer an approach to the management of patients with ARAS in light of the current literature. From the data provided, identification of subgroup of patients, namely, those with a hemodynamically significant RAS in the context of progressive renal insufficiency and/or deteriorating arterial hypertension, seems possible and may derive clinical benefit from ARAS stent revascularization. Appropriate patient selection is therefore the key and more robust studies are required. PMID:27130448

  9. Update on the Pathogenic Implications and Clinical Potential of microRNAs in Cardiac Disease.

    PubMed

    Notari, Mario; Pulecio, Julián; Raya, Ángel

    2015-01-01

    miRNAs, a unique class of endogenous noncoding RNAs, are highly conserved across species, repress gene translation upon binding to mRNA, and thereby influence many biological processes. As such, they have been recently recognized as regulators of virtually all aspects of cardiac biology, from the development and cell lineage specification of different cell populations within the heart to the survival of cardiomyocytes under stress conditions. Various miRNAs have been recently established as powerful mediators of distinctive aspects in many cardiac disorders. For instance, acute myocardial infarction induces cardiac tissue necrosis and apoptosis but also initiates a pathological remodelling response of the left ventricle that includes hypertrophic growth of cardiomyocytes and fibrotic deposition of extracellular matrix components. In this regard, recent findings place various miRNAs as unquestionable contributing factors in the pathogenesis of cardiac disorders, thus begging the question of whether miRNA modulation could become a novel strategy for clinical intervention. In the present review, we aim to expose the latest mechanistic concepts regarding miRNA function within the context of CVD and analyse the reported roles of specific miRNAs in the different stages of left ventricular remodelling as well as their potential use as a new class of disease-modifying clinical options. PMID:26221581

  10. Update on the role of plasmacytoid dendritic cells in inflammatory/autoimmune skin diseases.

    PubMed

    Saadeh, Dana; Kurban, Mazen; Abbas, Ossama

    2016-06-01

    Plasmacytoid dendritic cells (pDCs) represent a specialized dendritic cell population that exhibit plasma cell morphology, express CD4, CD123, blood-derived dendritic cell antigen-2 (BDCA-2) and Toll-like receptor (TLR)7 and TLR9 within endosomal compartments. When activated, pDCs are capable of producing large quantities of type I IFNs (mainly IFN-α/β), which provide antiviral resistance and link the innate and adaptive immunity. While generally lacking from normal skin, pDCs infiltrate the skin and appear to be involved in the pathogenesis of several inflammatory, infectious (especially viral) and neoplastic entities. In recent years, pDC role in inflammatory/autoimmune skin conditions has been extensively studied. Unlike type I IFN-mediated protective immunity that pDCs provide at the level of the skin by regulated sensing of microbial or self-nucleic acids upon skin damage, excessive sensing may elicit IFN-driven inflammatory/autoimmune diseases. In this review, focus will be on the role of pDCs in cutaneous inflammatory/autoimmune dermatoses. PMID:26837058

  11. [Pathophysiology and management of Peyronie's disease in adult patients: an update].

    PubMed

    Alenda, O; Beley, S; Ferhi, K; Cour, F; Chartier-Kastler, E; Haertig, A; Richard, F; Rouprêt, M

    2010-02-01

    Peyronie's disease (PD) is due to a fibrotic plaque forms in the tunica albuginea layer of the penis. It is responsible of penile pain, angulation, and erectile dysfunction. Even though the aetiology remains unknown, the knowledge of the pathophysiology has evolved in recent years. Recent studies indicate that PD has prevalence of 3 to 9% in adult men. During the initial acute phase (6 to 18 months), the condition may progress, stabilize or regress in 20%. Therefore, a conservative treatment approach has been advocated. An initial discussion about evaluation, information, and reassurance is necessary in most cases. The most commonly employed oral therapies include tocopherol (vitamin E), and para-aminobenzoate (Potaba), which have failed to demonstrate efficiency. Intralesional injection therapies with interferon alpha-2B, verapamil are frequently used as a first-line treatment modality, and can provide an improvement in decreasing penile pain and penile curvature. Current literature has shown that extracorporeal shock wave lithotripsy was only active on the pain. Regarding penile curvature, there are discrepancies in the published series. The surgical approach is restricted to men unresponsive to nonoperative therapies (i.e., 10% of patients). In such cases, plication, grafting or even penile prosthesis implantation are conceivable management options. PMID:20142049

  12. Update on the Pathogenic Implications and Clinical Potential of microRNAs in Cardiac Disease

    PubMed Central

    Notari, Mario; Pulecio, Julián; Raya, Ángel

    2015-01-01

    miRNAs, a unique class of endogenous noncoding RNAs, are highly conserved across species, repress gene translation upon binding to mRNA, and thereby influence many biological processes. As such, they have been recently recognized as regulators of virtually all aspects of cardiac biology, from the development and cell lineage specification of different cell populations within the heart to the survival of cardiomyocytes under stress conditions. Various miRNAs have been recently established as powerful mediators of distinctive aspects in many cardiac disorders. For instance, acute myocardial infarction induces cardiac tissue necrosis and apoptosis but also initiates a pathological remodelling response of the left ventricle that includes hypertrophic growth of cardiomyocytes and fibrotic deposition of extracellular matrix components. In this regard, recent findings place various miRNAs as unquestionable contributing factors in the pathogenesis of cardiac disorders, thus begging the question of whether miRNA modulation could become a novel strategy for clinical intervention. In the present review, we aim to expose the latest mechanistic concepts regarding miRNA function within the context of CVD and analyse the reported roles of specific miRNAs in the different stages of left ventricular remodelling as well as their potential use as a new class of disease-modifying clinical options. PMID:26221581

  13. Update on Wnt signaling in bone cell biology and bone disease

    PubMed Central

    Monroe, David G.; McGee-Lawrence, Meghan E.; Oursler, Merry Jo; Westendorf, Jennifer J.

    2012-01-01

    For more than a decade, Wnt signaling pathways have been the focus of intense research activity in bone biology laboratories because of their importance in skeletal development, bone mass maintenance, and therapeutic potential for regenerative medicine. It is evident that even subtle alterations in the intensity, amplitude, location, and duration of Wnt signaling pathways affects skeletal development, as well as bone remodeling, regeneration, and repair during a lifespan. Here we review recent advances and discrepancies in how Wnt/Lrp5 signaling regulates osteoblasts and osteocytes, introduce new players in Wnt signaling pathways that have important roles in bone development, discuss emerging areas such as the role of Wnt signaling in osteoclastogenesis, and summarize progress made in translating basic studies to clinical therapeutics and diagnostics centered around inhibiting Wnt pathway antagonists, such as sclerostin, Dkk1 and Sfrp1. Emphasis is placed on the plethora of genetic studies in mouse models and genome wide association studies that reveal the requirement for and crucial roles of Wnt pathway components during skeletal development and disease. PMID:22079544

  14. Prioritization of intervention methods for prevention of communicable diseases in Tanzania

    NASA Astrophysics Data System (ADS)

    Mayo, A. W.

    poor housing environment (14.5-24.0%). Water quality played the least role in transmission of diseases accounting for only 3-8%. It was concluded that provision of hygiene education, and improvement of water quantity and housing, in that order can significantly contribute to reduction of communicable diseases in the area. Improvement of water quality has potentially the least effect on the number of morbidity and mortality cases.

  15. Risk communication as a core public health competence in infectious disease management: Development of the ECDC training curriculum and programme.

    PubMed

    Dickmann, Petra; Abraham, Thomas; Sarkar, Satyajit; Wysocki, Piotr; Cecconi, Sabrina; Apfel, Franklin; Nurm, Ülla-Karin

    2016-01-01

    Risk communication has been identified as a core competence for guiding public health responses to infectious disease threats. The International Health Regulations (2005) call for all countries to build capacity and a comprehensive understanding of health risks before a public health emergency to allow systematic and coherent communication, response and management. Research studies indicate that while outbreak and crisis communication concepts and tools have long been on the agenda of public health officials, there is still a need to clarify and integrate risk communication concepts into more standardised practices and improve risk communication and health, particularly among disadvantaged populations. To address these challenges, the European Centre for Disease Prevention and Control (ECDC) convened a group of risk communication experts to review and integrate existing approaches and emerging concepts in the development of a training curriculum. This curriculum articulates a new approach in risk communication moving beyond information conveyance to knowledge- and relationship-building. In a pilot training this approach was reflected both in the topics addressed and in the methods applied. This article introduces the new conceptual approach to risk communication capacity building that emerged from this process, presents the pilot training approach developed, and shares the results of the course evaluation. PMID:27103616

  16. Laboratory tests used to help diagnose von Willebrand disease: an update.

    PubMed

    Favaloro, Emmanuel J; Pasalic, Leonardo; Curnow, Jennifer

    2016-06-01

    von Willebrand disease (VWD) is due to quantitative deficiencies and/or qualitative defects in von Willebrand factor (VWF), and is reportedly the most common inherited bleeding disorder. However, diagnosis of VWD is problematic, and is subject to over-, under-, and misdiagnosis. This is due to many factors, including limitations in current test procedures and an over-reliance on these imperfect test systems for clinical diagnosis. VWF is a complex plasma protein with multiple functions, but essentially acts to assist in the formation of a platelet thrombus to stop blood loss from sites of injury. VWF achieves this by several activities, including binding to platelets [primarily through the glycoprotein Ib (GPIb) receptor], binding to subendothelial matrix components (primarily collagen), and binding to factor VIII (FVIII), thus protecting FVIII from degradation and enabling its delivery to sites of vascular injury. Laboratory assessment of VWD entails performance of a battery of tests, some of which aim to mimic in vivo VWF activity. VWD is classified into six separate types, based on quantitative deficiencies [types 1 (partial deficiency) and 3 (total deficiency)] of VWF, or qualitative defects (type 2 VWD), which comprise four 'subtypes'. The current report briefly overviews the diagnosis of VWD, describing the currently available armamentarium of laboratory tests, as well as emerging options for laboratory-assisted diagnostics. Although some methodologies suffer from significant limitations that challenge the accurate diagnosis of VWD, newer methodologies and specific approaches can improve detection of this common bleeding disorder, and the appropriate characterisation and typing of patients. PMID:27131932

  17. Second primary cancer following Hodgkin's disease: Updated results of an Italian multicentric study

    SciTech Connect

    Cimino, G.; Papa, G.; Tura, S.; Mazza, P.; Rossi Ferrini, P.L.; Bosi, A.; Amadori, S.; Lo Coco, F.; D'Arcangelo, E.; Giannarelli, D. )

    1991-03-01

    The risk of second primary cancer (SPC) was evaluated in 947 patients treated for Hodgkin's disease (HD) during the period January 1969 to December 1979. The median follow-up of this series was 10.5 years (range, 9 to 19). Treatment categories included radiotherapy (RT) alone (115 patients, 12%), chemotherapy (CHT) alone (161 patients, 17%), combined RT plus CHT (381 patients, 40%), and salvage treatment for resistant or relapsing HD (290 patients, 30.6%). Fifty-six SPCs were observed, occurring between 1 and 17 years from initial treatment. Among these, secondary acute nonlymphoid leukemia (s-ANLL) was the most frequent SPC (23 cases). Secondary non-Hodgkin's lymphoma (s-NHL) occurred in 5 patients, whereas a secondary solid tumor (s-ST) was observed in 28 patients. The calculated actuarial risk (+/- SE) of developing SPC was 5.0% (+/- 0.9%) and 23.1% (+/- 5.8%) at 10 and 19 years, respectively. Concerning treatment modalities and s-ANLL risk, no cases were observed in the radiotherapy group, whereas CHT plus RT and salvage groups showed the highest actuarial risk. This was, in fact, at 10 and 19 years, 3.1% (+/- 0.9%) and 8.1% (+/- 4.0%) in the former group, and 1.8% (+/- 1.0%) and 16% (+/- 9.0%) in the latter. A statistically significant difference was observed when the CHT plus RT group was compared with CHT and RT groups (P = .04). Concerning the relationships with chemotherapeutic regimens, 12 s-ANLL cases occurred in the mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) plus RT group, and only one case in the group receiving doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) plus RT. A statistically significant difference of s-ANLL actuarial risk was found comparing patients receiving MOPP plus RT to all other treatment groups (P = .04).

  18. Pathogenesis of myasthenia gravis: update on disease types, models, and mechanisms.

    PubMed

    Phillips, William D; Vincent, Angela

    2016-01-01

    Myasthenia gravis is an autoimmune disease of the neuromuscular junction (NMJ) caused by antibodies that attack components of the postsynaptic membrane, impair neuromuscular transmission, and lead to weakness and fatigue of skeletal muscle. This can be generalised or localised to certain muscle groups, and involvement of the bulbar and respiratory muscles can be life threatening. The pathogenesis of myasthenia gravis depends upon the target and isotype of the autoantibodies. Most cases are caused by immunoglobulin (Ig)G1 and IgG3 antibodies to the acetylcholine receptor (AChR). They produce complement-mediated damage and increase the rate of AChR turnover, both mechanisms causing loss of AChR from the postsynaptic membrane. The thymus gland is involved in many patients, and there are experimental and genetic approaches to understand the failure of immune tolerance to the AChR. In a proportion of those patients without AChR antibodies, antibodies to muscle-specific kinase (MuSK), or related proteins such as agrin and low-density lipoprotein receptor-related protein 4 (LRP4), are present. MuSK antibodies are predominantly IgG4 and cause disassembly of the neuromuscular junction by disrupting the physiological function of MuSK in synapse maintenance and adaptation. Here we discuss how knowledge of neuromuscular junction structure and function has fed into understanding the mechanisms of AChR and MuSK antibodies. Myasthenia gravis remains a paradigm for autoantibody-mediated conditions and these observations show how much there is still to learn about synaptic function and pathological mechanisms. PMID:27408701

  19. Pathogenesis of myasthenia gravis: update on disease types, models, and mechanisms

    PubMed Central

    Phillips, William D.; Vincent, Angela

    2016-01-01

    Myasthenia gravis is an autoimmune disease of the neuromuscular junction (NMJ) caused by antibodies that attack components of the postsynaptic membrane, impair neuromuscular transmission, and lead to weakness and fatigue of skeletal muscle. This can be generalised or localised to certain muscle groups, and involvement of the bulbar and respiratory muscles can be life threatening. The pathogenesis of myasthenia gravis depends upon the target and isotype of the autoantibodies. Most cases are caused by immunoglobulin (Ig)G1 and IgG3 antibodies to the acetylcholine receptor (AChR). They produce complement-mediated damage and increase the rate of AChR turnover, both mechanisms causing loss of AChR from the postsynaptic membrane. The thymus gland is involved in many patients, and there are experimental and genetic approaches to understand the failure of immune tolerance to the AChR. In a proportion of those patients without AChR antibodies, antibodies to muscle-specific kinase (MuSK), or related proteins such as agrin and low-density lipoprotein receptor-related protein 4 (LRP4), are present. MuSK antibodies are predominantly IgG4 and cause disassembly of the neuromuscular junction by disrupting the physiological function of MuSK in synapse maintenance and adaptation. Here we discuss how knowledge of neuromuscular junction structure and function has fed into understanding the mechanisms of AChR and MuSK antibodies. Myasthenia gravis remains a paradigm for autoantibody-mediated conditions and these observations show how much there is still to learn about synaptic function and pathological mechanisms. PMID:27408701

  20. APP/PS1 transgenic mice treated with aluminum: an update of Alzheimer's disease model.

    PubMed

    Zhang, Q L; Jia, L; Jiao, X; Guo, W L; Ji, J W; Yang, H L; Niu, Q

    2012-01-01

    There is still no animal model available that can mimic all the cognitive, behavioral, biochemical, and histopathological abnormalities observed in patients with Alzheimer's disease (AD). We undertook to consider the interaction between genetic factors, including amyloid precursor protein (APP) and presenilin-1 (PS1), and environmental factors, such as Aluminum (Al) in determining susceptibility outcomes when studying the pathogenesis of AD. In this article, we provide an AD model in APP/PS1 transgenic mice triggered by Al. The animal model was established via intracerebral ventricular microinjection of aluminum chloride once a day for 5 days in APP/PS1 transgenic mice. Twenty wild type (WT) mice and 20 APP/PS1 transgenic (TG) mice were separately divided into 2 groups (control and Al group), and a stainless steel injector with stopper was used for microinjection into the left-lateral cerebral ventricle of each mouse. The Morris water maze task was used to evaluate behavioral function of learning and memory ability on the 20th day after the last injection. This AD model's brain was analyzed by: (1) amyloid beta immunohistochemical staining; (2) Tunnel staining; (3) apoptotic rates; (4) caspase-3 gene expression. Here, decrease of cognitive ability and neural cells loss were shown in APP/PS1 transgenic mice exposed to Al, which were more extensive than those in APP/PS1 TG alone and WT mice exposed to Al alone. These findings indicate that there is a close relationship between over-expression of APP and PS1 genes and Al overload. It is also suggested that APP/PS1 TG mice exposed to Al have potential value for improving AD models. PMID:22507317

  1. The Movement Disorder Society Evidence-Based Medicine Review Update: Treatments for the Non-Motor Symptoms of Parkinson's Disease

    PubMed Central

    Seppi, Klaus; Weintraub, Daniel; Coelho, Miguel; Perez-Lloret, Santiago; Fox, Susan H.; Katzenschlager, Regina; Hametner, Eva-Maria; Poewe, Werner; Rascol, Olivier; Goetz, Christopher G.; Sampaio, Cristina

    2014-01-01

    The Movement Disorder Society (MDS) Task Force on Evidence-Based Medicine (EBM) Review of Treatments for Parkinson's Disease (PD) was first published in 2002 and was updated in 2005 to cover clinical trial data up to January 2004 with the focus on motor symptoms of PD. In this revised version the MDS task force decided it was necessary to extend the review to non-motor symptoms. The objective of this work was to update previous EBM reviews on treatments for PD with a focus on non-motor symptoms. Level-I (randomized controlled trial, RCT) reports of pharmacological and nonpharmacological interventions for the non-motor symptoms of PD, published as full articles in English between January 2002 and December 2010 were reviewed. Criteria for inclusion and ranking followed the original program outline and adhered to EBM methodology. For efficacy conclusions, treatments were designated: efficacious, likely efficacious, unlikely efficacious, non-efficacious, or insufficient evidence. Safety data were catalogued and reviewed. Based on the combined efficacy and safety assessment, Implications for clinical practice were determined using the following designations: clinically useful, possibly useful, investigational, unlikely useful, and not useful. Fifty-four new studies qualified for efficacy review while several other studies covered safety issues. Updated and new efficacy conclusions were made for all indications. The treatments that are efficacious for the management of the different non-motor symptoms are as follows: pramipexole for the treatment of depressive symptoms, clozapine for the treatment of psychosis, rivastigmine for the treatment of dementia, and botulinum toxin A (BTX-A) and BTX-B as well as glycopyrrolate for the treatment of sialorrhea. The practical implications for these treatments, except for glycopyrrolate, are that they are clinically useful. Since there is insufficient evidence of glycopyrrolate for the treatment of sialorrhea exceeding 1 week, the

  2. A New Wave of Vaccines for Non-Communicable Diseases: What Are the Regulatory Challenges?

    PubMed

    Darrow, Jonathan J; Kesselheim, Aaron S

    2015-01-01

    Vaccines represent one of the greatest achievements of medicine, dramatically reducing the incidence of serious or life-threatening infectious diseases and allowing people to live longer, healthier lives. As life expectancy has increased, however, the burden of non-communicable diseases (NCDs) such as cancer, hypertension, atherosclerosis, and diabetes has increased. This shifting burden of disease has heightened the already urgent need for therapies that treat or prevent NCDs, a need that is now being met with increased efforts to develop NCD vaccines. Like traditional vaccines, NCD vaccines work by modulating the human immune system, but target cells, proteins or other molecules that are associated with the NCD in question rather than pathogens or pathogen-infected cells. Efforts are underway to develop NCD vaccines to address not only cancer and hypertension, but also addiction, obesity, asthma, arthritis, psoriasis, multiple sclerosis, and Crohn's disease, among others. NCD vaccines present an interesting challenge for the U.S. Food and Drug Administration (FDA), which is tasked with approving new treatments on the basis of efficacy and safety. Should NCD vaccines be evaluated under the same analytic frame as traditional vaccines, or that of biologic drugs? Despite the borrowed nomenclature, NCD vaccines differ in important ways from infectious disease vaccines. Because infectious disease vaccines are generally administered to healthy individuals, often children, tolerance for adverse events is low and willingness to pay is limited. It is important to have infectious disease vaccines even for rare or eradicated disease (e.g., smallpox), in the event of an outbreak. The efficacy of infectious disease vaccines is generally high, and the vaccines convey population level benefits associated with herd immunity and potential eradication. The combination of substantial population-level benefits, low willingness to pay, and low tolerance for adverse events explains the

  3. European Society for Paediatric Infectious Diseases consensus recommendations for rotavirus vaccination in Europe: update 2014.

    PubMed

    Vesikari, Timo; Van Damme, Pierre; Giaquinto, Carlo; Dagan, Ron; Guarino, Alfredo; Szajewska, Hania; Usonis, Vytautas

    2015-06-01

    The first evidence-based recommendations for rotavirus (RV) vaccination in Europe were prepared at the time of licensure of 2 live oral RV vaccines (Rotarix, GlaxoSmithKline Biologicals, and RotaTeq, Sanofi Pasteur MSD) in 2006 and published in 2008. Since then several countries in Europe and more globally have adopted universal RV vaccination of all healthy infants as part of their national immunization programs (NIPs). The experience from these NIPs has produced a wealth of post-introduction effectiveness data that, together with the evidence from prelicensure efficacy trials presented in the 2008 Recommendations, support the case of RV vaccination in Europe. The prelicensure safety trials of Rotarix and RotaTeq, each in populations of more than 60,000 infants, did not reveal risk of intussusception (IS), but postvaccination surveillance in several countries, particularly Australia and Mexico, has established that the risk of IS for both vaccines after the first dose might be between 1:50,000 and 1:80,000. Although it may be argued that the risk is acceptable vis-à-vis the great benefits of RV vaccination, this argument alone may not suffice, and every effort should be made to reduce the risk of IS. Considerable evidence, including postvaccination surveillance data from Germany, suggests that the risk of IS can be reduced by early administration of the first dose of oral RV vaccine. The previous European Society for Paediatric Infectious Diseases/European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommendations held that the first dose of oral RV vaccine should be given between 6 and 12 weeks of age; this recommendation is sustained but with an emphasis toward the lower range of the recommended age, that is, preferably between 6 and 8 weeks of age. At the time of the earlier recommendations, experience of RV vaccination in premature infants and other special target groups was limited. It is now recommended with greater confidence than

  4. Neglected tropical diseases among the Association of Southeast Asian Nations (ASEAN): overview and update.

    PubMed

    Hotez, Peter J; Bottazzi, Maria Elena; Strych, Ulrich; Chang, Li-Yen; Lim, Yvonne A L; Goodenow, Maureen M; AbuBakar, Sazaly

    2015-04-01

    The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries also harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). Almost 200 million people live in extreme poverty in ASEAN countries, mostly in the low or lower middle-income countries of Indonesia, the Philippines, Myanmar, Viet Nam, and Cambodia, and many of them are affected by at least one NTD. However, NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. In addition, more than 10 million people suffer from either liver or intestinal fluke infections, as well as schistosomiasis and lymphatic filariasis (LF). Intestinal protozoan infections are widespread, while leishmaniasis has emerged in Thailand, and zoonotic malaria (Plasmodium knowlesi infection) causes severe morbidity in Malaysia. Melioidosis has emerged as an important bacterial NTD, as have selected rickettsial infections, and leptospirosis. Leprosy, yaws, and trachoma are still endemic in focal areas. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is now one of the most common and economically important NTDs in the region. A number of other arboviral and zoonotic viral infections have also emerged, including Japanese encephalitis; tick-borne viral infections; Nipah virus, a zoonosis present in fruit bats; and enterovirus 71 infection. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws. An ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines

  5. Neglected Tropical Diseases among the Association of Southeast Asian Nations (ASEAN): Overview and Update

    PubMed Central

    Hotez, Peter J.; Bottazzi, Maria Elena; Strych, Ulrich; Chang, Li-Yen; Lim, Yvonne A. L.; Goodenow, Maureen M.; AbuBakar, Sazaly

    2015-01-01

    The ten member states of the Association of Southeast Asian Nations (ASEAN) constitute an economic powerhouse, yet these countries also harbor a mostly hidden burden of poverty and neglected tropical diseases (NTDs). Almost 200 million people live in extreme poverty in ASEAN countries, mostly in the low or lower middle-income countries of Indonesia, the Philippines, Myanmar, Viet Nam, and Cambodia, and many of them are affected by at least one NTD. However, NTDs are prevalent even among upper middle-income ASEAN countries such as Malaysia and Thailand, especially among the indigenous populations. The three major intestinal helminth infections are the most common NTDs; each helminthiasis is associated with approximately 100 million infections in the region. In addition, more than 10 million people suffer from either liver or intestinal fluke infections, as well as schistosomiasis and lymphatic filariasis (LF). Intestinal protozoan infections are widespread, while leishmaniasis has emerged in Thailand, and zoonotic malaria (Plasmodium knowlesi infection) causes severe morbidity in Malaysia. Melioidosis has emerged as an important bacterial NTD, as have selected rickettsial infections, and leptospirosis. Leprosy, yaws, and trachoma are still endemic in focal areas. Almost 70 million cases of dengue fever occur annually in ASEAN countries, such that this arboviral infection is now one of the most common and economically important NTDs in the region. A number of other arboviral and zoonotic viral infections have also emerged, including Japanese encephalitis; tick-borne viral infections; Nipah virus, a zoonosis present in fruit bats; and enterovirus 71 infection. There are urgent needs to expand surveillance activities in ASEAN countries, as well as to ensure mass drug administration is provided to populations at risk for intestinal helminth and fluke infections, LF, trachoma, and yaws. An ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines

  6. Communicating with Healthcare Professionals

    MedlinePlus

    ... People Change See More of Resources Communicating with Healthcare Professionals Updated:Nov 16,2015 Adapted from the National ... gained by improving communication between family caregivers and healthcare professionals. Positive outcomes include: Better care for the patient ...

  7. Managing population health to prevent and detect cancer and non-communicable diseases.

    PubMed

    Bryant, Heather; Shin, Hai Rim; Forman, David; Stevanovic, Vladimir; Park, Sohee; Burton, Robert; Varghese, Cherian; Ullrich, Andreas; Sutcliffe, Catherine; Sutcliffe, Simon

    2012-01-01

    The goals of cancer control strategies are generally uniform across all constituencies and are to reduce cancer incidence, reduce cancer mortality, and improve quality of life for those affected by cancer. A well-constructed strategy will ensure that all of its elements can ultimately be connected to one of these goals. When a cancer control strategy is being implemented, it is essential to map progress towards these goals; without mapping progress, it is impossible to assess which components of the strategy require more attention or resources and which are not having the desired effect and need to be re-evaluated. In order to monitor and evaluate these strategies, systems need to be put in place to collect data and the appropriate indicators of performance need to be identified. Session 2 of the 4th International Cancer Control Congress (ICCC-4) focused on how to manage population health to prevent and detect cancers and non-communicable diseases through two plenary presentations and four interactive workshop discussions: 1) registries, measurement, and management in cancer control; 2) use of information for planning and evaluating screening and early detection programs; 3) alternative models for promoting community health, integrated care and illness management; and 4) control of non-communicable diseases. Workshop discussions highlighted that population based cancer registries are fundamental to understanding the cancer burden within a country. However, many countries in Africa, Asia, and South/ Central America do not have them in place. A new global initiative is underway, which brings together several international agencies, and aims to establish six IARC regional registration resource centres over the next five years. These will provide training, support, infrastructure and advocacy to local networks of cancer registries, and, it is hoped, improve the host countries' ability to assess and act on cancer issues within their jurisdictions. Multiple methods of

  8. Artificial Discs for Lumbar and Cervical Degenerative Disc DiseaseUpdate

    PubMed Central

    2006-01-01

    Executive Summary Objective To assess the safety and efficacy of artificial disc replacement (ADR) technology for degenerative disc disease (DDD). Clinical Need Degenerative disc disease is the term used to describe the deterioration of 1 or more intervertebral discs of the spine. The prevalence of DDD is roughly described in proportion to age such that 40% of people aged 40 years have DDD, increasing to 80% among those aged 80 years or older. Low back pain is a common symptom of lumbar DDD; neck and arm pain are common symptoms of cervical DDD. Nonsurgical treatments can be used to relieve pain and minimize disability associated with DDD. However, it is estimated that about 10% to 20% of people with lumbar DDD and up to 30% with cervical DDD will be unresponsive to nonsurgical treatments. In these cases, surgical treatment is considered. Spinal fusion (arthrodesis) is the process of fusing or joining 2 bones and is considered the surgical gold standard for DDD. Artificial disc replacement is the replacement of the degenerated intervertebral disc with an artificial disc in people with DDD of the lumbar or cervical spine that has been unresponsive to nonsurgical treatments for at least 6 months. Unlike spinal fusion, ADR preserves movement of the spine, which is thought to reduce or prevent the development of adjacent segment degeneration. Additionally, a bone graft is not required for ADR, and this alleviates complications, including bone graft donor site pain and pseudoarthrosis. It is estimated that about 5% of patients who require surgery for DDD will be candidates for ADR. Review Strategy The Medical Advisory Secretariat conducted a computerized search of the literature published between 2003 and September 2005 to answer the following questions: What is the effectiveness of ADR in people with DDD of the lumbar or cervical regions of the spine compared with spinal fusion surgery? Does an artificial disc reduce the incidence of adjacent segment degeneration (ASD

  9. Designing a biocontainment unit to care for patients with serious communicable diseases: a consensus statement.

    PubMed

    Smith, Philip W; Anderson, Arthur O; Christopher, George W; Cieslak, Theodore J; Devreede, G J; Fosdick, Glen A; Greiner, Carl B; Hauser, John M; Hinrichs, Steven H; Huebner, Kermit D; Iwen, Peter C; Jourdan, Dawn R; Kortepeter, Mark G; Landon, V Paul; Lenaghan, Patricia A; Leopold, Robert E; Marklund, Leroy A; Martin, James W; Medcalf, Sharon J; Mussack, Robert J; Neal, Randall H; Ribner, Bruce S; Richmond, Jonathan Y; Rogge, Chuck; Daly, Leo A; Roselle, Gary A; Rupp, Mark E; Sambol, Anthony R; Schaefer, Joann E; Sibley, John; Streifel, Andrew J; Essen, Susanna G Von; Warfield, Kelly L

    2006-01-01

    In spite of great advances in medicine, serious communicable diseases are a significant threat. Hospitals must be prepared to deal with patients who are infected with pathogens introduced by a bioterrorist act (e.g., smallpox), by a global emerging infectious disease (e.g., avian influenza, viral hemorrhagic fevers), or by a laboratory accident. One approach to hazardous infectious diseases in the hospital setting is a biocontainment patient care unit (BPCU). This article represents the consensus recommendations from a conference of civilian and military professionals involved in the various aspects of BPCUs. The role of these units in overall U.S. preparedness efforts is discussed. Technical issues, including medical care issues (e.g., diagnostic services, unit access); infection control issues (e.g., disinfection, personal protective equipment); facility design, structure, and construction features; and psychosocial and ethical issues, are summarized and addressed in detail in an appendix. The consensus recommendations are presented to standardize the planning, design, construction, and operation of BPCUs as one element of the U.S. preparedness effort. PMID:17238819

  10. [Reducing non-communicable diseases and health care costs: building a prevention alliance].

    PubMed

    Piccinelli, Cristiano; Pagano, Eva; Segnan, Nereo

    2015-01-01

    In Italy, as well as in most European Countries, the loss of almost 70% of the years of life is attributable to cerebro-cardiovascular diseases and cancers. Whereas the Italian population is expected to grow older, with a significant increase in the burden of chronic non-communicable diseases, the reduction in incidence of chronic diseases and the compression of morbidity are priorities. This is the reason why in Italy the implementation of the National Plan for Prevention and related regional plans becomes necessary, as it can promote the co-operation of multidisciplinary skills in several areas: political, health, economic, legal, sociological. In Piedmont (Northern Italy), it seems useful the creation of a regional Laboratory of prevention,which provides support for the development and implementation of the regional prevention plan, through actions and programmes based on cost-effectiveness analyses. The use of resources in prevention should not be exclusively interpreted as a cost, but as an investment, which, in some cases, can become an avoided cost. Using prevention policies makes it possible to gain years of healthy life and to potentially reduce the cost of healthcare system. The creation of the Laboratory of prevention is a multidisciplinary context, so it is an opportunity to involve the stakeholders in order to achieve the regional health objectives. PMID:26668919

  11. Risk of Parkinson Disease in Diabetes Mellitus: An Updated Meta-Analysis of Population-Based Cohort Studies

    PubMed Central

    Yue, Xuejing; Li, Hehua; Yan, Haiqing; Zhang, Ping; Chang, Li; Li, Tong

    2016-01-01

    Abstract Previous meta-analysis has identified the associations between diabetes mellitus (DM) and the risk of Parkinson disease (PD). However, the results are still debatable. The purpose of this study is to perform an updated meta-analysis to investigate the up-to-date pooling evidence based on published population-based cohort studies and assess the association between DM and the risk of PD. Electronic database including Pubmed and Embase were searched to identify cohort studies published before October, 2015. Studies were selected if they reported the risk estimates for PD associated with DM. We pooled the adjusted effect estimates using random-effects meta-analysis. Funnel plot, Begg, or Egger test as well as Duval and Tweedie trim-and-fill approach were applied to assess publication bias. A total of 7 population-based cohort studies, representing 1,761,632 individuals were included in the meta-analysis. The pooled adjusted relative risk (RR) of PD associated with DM was 1.38 (95% CI 1.18–1.62, P < 0.001). An effect was consistent in female (RR 1.50 95% CI 1.07–2.11, P = 0.019) and in male (RR 1.40, 95% CI 1.17–1.67). The association was similar when stratified by study quality, research region, study design, sample size, published year, diabetes duration, and baseline age. The trim-and-fill approach confirmed the robutness of the result (RR 1.31, 95% CI 1.09–1.57, P = 0.015). Our findings based on population-based cohort studies indicate that diabetes is associated with increased PD risk by about 38%. More large-scale prospective studies are warranted to further clarify this association and its mechanism. PMID:27149468

  12. Risk of Parkinson Disease in Diabetes Mellitus: An Updated Meta-Analysis of Population-Based Cohort Studies.

    PubMed

    Yue, Xuejing; Li, Hehua; Yan, Haiqing; Zhang, Ping; Chang, Li; Li, Tong

    2016-05-01

    Previous meta-analysis has identified the associations between diabetes mellitus (DM) and the risk of Parkinson disease (PD). However, the results are still debatable. The purpose of this study is to perform an updated meta-analysis to investigate the up-to-date pooling evidence based on published population-based cohort studies and assess the association between DM and the risk of PD.Electronic database including Pubmed and Embase were searched to identify cohort studies published before October, 2015. Studies were selected if they reported the risk estimates for PD associated with DM. We pooled the adjusted effect estimates using random-effects meta-analysis. Funnel plot, Begg, or Egger test as well as Duval and Tweedie trim-and-fill approach were applied to assess publication bias.A total of 7 population-based cohort studies, representing 1,761,632 individuals were included in the meta-analysis. The pooled adjusted relative risk (RR) of PD associated with DM was 1.38 (95% CI 1.18-1.62, P < 0.001). An effect was consistent in female (RR 1.50 95% CI 1.07-2.11, P = 0.019) and in male (RR 1.40, 95% CI 1.17-1.67). The association was similar when stratified by study quality, research region, study design, sample size, published year, diabetes duration, and baseline age. The trim-and-fill approach confirmed the robutness of the result (RR 1.31, 95% CI 1.09-1.57, P = 0.015).Our findings based on population-based cohort studies indicate that diabetes is associated with increased PD risk by about 38%. More large-scale prospective studies are warranted to further clarify this association and its mechanism. PMID:27149468

  13. Does a picture tell a thousand words? The uses of digitally produced, multimodal pictures for communicating information about Alzheimer's disease.

    PubMed

    Dobos, Amy R; Orthia, Lindy A; Lamberts, Rod

    2015-08-01

    This study explored the science communication potential of visual imagery by gauging an audience's interpretations of digitally enhanced, multimodal pictures depicting topics from recent Alzheimer's disease research. Guided by social semiotic theory, we created four pictures intended to communicate information about Alzheimer's disease unidirectionally, for an audience who had expressed interest in receiving such information (subscribers to an Alzheimer's disease research newsletter). We then disseminated the pictures to that audience via an online survey, to determine whether respondents received the messages we intended to convey. Our results demonstrated that, without accompanying explanatory text, pictures are most useful for evoking emotions or making loose connections between major concepts, rather than for communicating specific messages based on Alzheimer's research. In addition, participants more often expressed anger and frustration when the meaning of scientific imagery was unclear than when the meaning of emotional-social imagery was unclear. PMID:24867131

  14. Methods to Enhance Verbal Communication between Individuals with Alzheimer's Disease and Their Formal and Informal Caregivers: A Systematic Review

    PubMed Central

    Egan, Mary; Bérubé, Daniel; Racine, Geneviève; Leonard, Carol; Rochon, Elizabeth

    2010-01-01

    Alzheimer's disease is the leading cause of dementia in older adults. Although memory problems are the most characteristic symptom of this disorder, many individuals also experience progressive problems with communication. This systematic review investigates the effectiveness of methods to improve the verbal communication of individuals with Alzheimer's disease with their caregivers. The following databases were reviewed: PsychINFO, CINAHL, EMBASE, MEDLINE, REHABDATA, and COMDIS. The inclusion criteria were: (i) experimentally based studies, (ii) quantitative results, (iii) intervention aimed at improving verbal communication of the affected individual with a caregiver, and (iv) at least 50% of the sample having a confirmed diagnosis of Alzheimer's disease. A total of 13 studies met all of the inclusion criteria. One technique emerged as potentially effective: the use of memory aids combined with specific caregiver training programs. The strength of this evidence was restricted by methodological limitations of the studies. Both adoption of and further research on these interventions are recommended. PMID:20798856

  15. The Influence of Media Communication on Risk Perception and Behavior Related to Mad Cow Disease in South Korea

    PubMed Central

    Park, Jee-Eun; Sohn, Aeree

    2013-01-01

    Objectives The purpose of this study was to ascertain the influence of media communication on risk behavior related to mad cow disease (MCD). Methods Mothers of elementary school students in Seoul were recruited as the survey participants of this study. Results Media reports affected risk behavior related to MCD. Also, knowledge and attitude toward MCD affects risk behavior. Conclusion Risk-related information provided by the media should maintain consistency and objectivity. For effective risk communication, there should be an open communication between the government and public, experts, and related industries, who should all collaborate. PMID:24159557

  16. [Confidentiality in HIV-infection/AIDS--a comment on the Communicable Disease Control Act].

    PubMed

    Frich, J C

    1995-05-10

    The new Communicable Diseases Control Act has come into force in Norway. It makes it compulsory for a physician to warn a third party if it is obvious that a HIV-positive patient, with a high degree of certainty, puts the third party at risk of being infected with HIV. Some philosophers characterize medical confidentiality as an intransigent and absolute obligation, others as a prima facie duty. This article supports the latter view, but the author still argues that strict conditions have to be fulfilled before a physician should consider breaking medical confidentiality: The doctor must try repeatedly to gain the consent or co-operation of the patient involved. Possible negative long-term consequences for the preventive HIV-work support strict medical confidentiality. PMID:7770859

  17. Role of occupational health in managing non-communicable diseases in Brunei Darussalam

    PubMed Central

    Ismail, Pg Khalifah Pg; Koh, David

    2014-01-01

    Like most ASEAN countries, Brunei faces an epidemic of non-communicable diseases. To deal with the complexity of NCDs prevention, all perspectives - be it social, familial or occupational – need to be considered. In Brunei Darussalam, occupational health services (OHS) offered by its Ministry of Health, among others, provide screening and management of NCDs at various points of service. The OHS does not only issue fitness to work certificates, but is a significant partner in co-managing patients’ health conditions, with the advantage of further management at the workplace. Holistic approach of NCD management in the occupational setting is strengthened with both employer and employee education and participation, targeting several approaches including risk management and advocating healthy lifestyles as part of a healthy workplace programme. PMID:25382684

  18. Parkinson's disease psychosis: therapy tips and the importance of communication between neurologists and psychiatrists.

    PubMed

    Martinez-Ramirez, Daniel; Okun, Michael S; Jaffee, Michael S

    2016-08-01

    Parkinson's disease (PD) is a chronic and complex neurodegenerative disorder resulting in a mixture of motor and nonmotor symptoms. Psychosis develops in around 60% of PD patients during and can be one of the most challenging nonmotor symptoms. PD psychosis is considered the single greatest precipitant for nursing home placement. PD psychosis is an independent predictor of increased mortality, and there is no 'ideal' or universal treatment strategy. The treatment approach to PD psychosis should be tailored and individualized for each patient. In this review, we will discuss PD psychosis and provide practical treatment considerations for neurologists, psychiatrists and other healthcare professionals. We stress the importance of real-time communication between members of the healthcare team. PMID:27408981

  19. [Recent trends in and new data on the epidemiology and prevention of non-communicable diseases].

    PubMed

    Boitsov, S A

    2016-01-01

    Mortality from non-communicable diseases (NCDs) in the country varies considerably among its regions and social strata of the population. The main reason for providing inadequate conditions for a healthy lifestyle is that the state and municipal authorities and employers pay insufficient attention to the role of socioeconomic risk factors for NCDs. Only an analysis of the reasons for changing mortality rates allows the correct course of actions to reduce mortality to be chosen and a national plan for the control of NCDs to be worked out. The important mechanisms for improving the prevention of NCDs are to make better cardiovascular risk stratification systems, to introduce telemonitoring the status of the patients followed up, and to interface the prophylactic medical examination of elderly patients with a geriatric service. The design of long-acting drugs is a promising way to increase the patients' motivation to control blood pressure and blood cholesterol levels. PMID:26978602

  20. A system for automated outbreak detection of communicable diseases in Germany.

    PubMed

    Salmon, Maëlle; Schumacher, Dirk; Burmann, Hendrik; Frank, Christina; Claus, Hermann; Höhle, Michael

    2016-03-31

    We describe the design and implementation of a novel automated outbreak detection system in Germany that monitors the routinely collected surveillance data for communicable diseases. Detecting unusually high case counts as early as possible is crucial as an accumulation may indicate an ongoing outbreak. The detection in our system is based on state-of-the-art statistical procedures conducting the necessary data mining task. In addition, we have developed effective methods to improve the presentation of the results of such algorithms to epidemiologists and other system users. The objective was to effectively integrate automatic outbreak detection into the epidemiological workflow of a public health institution. Since 2013, the system has been in routine use at the German Robert Koch Institute. PMID:27063588

  1. Outbreak of meningococcal disease in Rotherham illustrates the value of coordination, communication, and collaboration in management.

    PubMed

    Perrett, K; al-Wali, W; Read, C; Redgrave, P; Trend, U

    2000-09-01

    On New Year's Eve 1998, two teenagers from the same school in Rotherham died of serogroup C meningococcal septicaemia. A third linked case occurred three days later. Over eight days starting on New Year's Eve, a further five cases of meningococcal disease arose across Rotherham district, four of whom were severely ill with serogroup C meningococcal septicaemia. Intense media interest, high levels of public concern, and anxieties caused by several 'false alarm' cases added to the challenge faced by a small health district. This article describes the epidemiology of the incident and policy decisions made, but focuses on the operational aspects of outbreak management (coordination, communication, and collaboration), an area often neglected in outbreak reports. PMID:11014027

  2. Prevalence of non-communicable diseases and their risk factors at a semi-urban community, Pakistan

    PubMed Central

    Naseem, Sajida; Khattak, Umme Kulsoom; Ghazanfar, Haider; Irfan, Awais

    2016-01-01

    Introduction Pakistan is currently facing the double burden of communicable (38%) and non- communicable diseases (49%) according to WHO NCD Country Profiles 2014. About 50% of all deaths are attributed to NCD's. The objective of this study was to determine the burden of non-communicable diseases in semi urban community of Islamabad. Methods We carried a cross sectional study to estimate the burden of non-communicable diseases in an urban setting, a community based cross sectional survey covering 1210 households was carried out over a period of three months. Households were selected through consecutive non-probability sampling, among which adult females and males who were permanent resident of the community were interviewed through a structured questionnaire in urdu language. SPSS version 21 was used to analyze the data. Descriptive statistics were calculated. Results About 38.7% individuals had High BP / IHD, 34.4% had oro-dental health problems, 24.3% were physically disabled and 14.6% had diabetes. Among the risk factors, 48.2% were tobacco user, 13.60% were drug abuser and 1.8% alcoholics. Conclusion We conclude that the prevalence of non-communicable diseases is quite high in the above setting as compared to the National indicators, which demands timely intervention to curtail the existing burden of NCD. PMID:27303569

  3. Time-updated systolic blood pressure and the progression of chronic kidney disease: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

    PubMed Central

    Anderson, Amanda H; Yang, Wei; Townsend, Raymond R; Pan, Qiang; Chertow, Glenn M; Kusek, John W; Charleston, Jeanne; He, Jiang; Kallem, RadhaKrishna; Lash, James P; Miller, Edgar R; Rahman, Mahboob; Steigerwalt, Susan; Weir, Matthew; Wright, Jackson T; Feldman, Harold I

    2015-01-01

    Background Blood pressure (BP) is often inadequately controlled in patients with chronic kidney disease (CKD). Previous reports of the longitudinal association between achieved level of BP and end-stage renal disease (ESRD) have not incorporated time-updated BP with appropriate adjustment for known confounders. Objective To assess the association between baseline and time-updated systolic BP (SBP) with the progression of CKD. Design Observational, prospective cohort study (ClinicalTrials.gov identifier: NCT00304148) Setting Seven US clinical centers Patients Participants of the Chronic Renal Insufficiency Cohort (CRIC) Study (N=3,708) followed for a median (25th, 75th percentiles) of 5.7 (4.6, 6.7) years Measurements The mean of three seated SBP measurements were used as the visit-specific SBP. SBP was time-updated as the mean of that visit and all prior visits. Outcomes were ESRD and the composite renal endpoint of ESRD (dialysis or transplantation) or halving of the estimated glomerular filtration rate (eGFR). Analyses investigating baseline and time-updated SBP utilized traditional Cox proportional hazards models and marginal structural models, respectively. Results SBP was ≥130 mmHg at all study visits in 19.2% of participants, and ≥140 mmHg in 10.6%. The hazard ratio (95% confidence interval) for ESRD among participants with SBP 130–139 mmHg, compared to SBP <120 mmHg, was 1.46 (1.13–1.88) using only baseline data, and was 2.37 (1.48–3.80) using all available time-updated data. Among those with SBP ≥140 mmHg, corresponding hazard ratios were 1.46 (1.18–1.88) and 3.37 (2.26–5.03), respectively. Limitations SBP was measured once annually, and the CRIC Study cohort is not a random sample. Conclusions Among participants in the CRIC Study, time-updated SBP over 130 mmHg was more strongly associated with progression of CKD than analyses based on baseline SBP. Funding The CRIC Study is funded under cooperative agreements from the National Institute of

  4. Political priority in the global fight against non–communicable diseases

    PubMed Central

    Maher, Anthony; Sridhar, Devi

    2012-01-01

    Background The prevalence of non–communicable diseases (NCDs) – such as cancer, diabetes, cardiovascular disease, and chronic respiratory diseases – is surging globally. Yet despite the availability of cost–effective interventions, NCDs receive less than 3% of annual development assistance for health to low and middle income countries. The top donors in global health – including the Bill and Melinda Gates Foundation, the US Government, and the World Bank – together commit less than 2% of their budgets to the prevention and control of NCDs. Why is there such meagre funding on the table for the prevention and control of NCDs? Why has a global plan of action aimed at halting the spread of NCDs been so difficult to achieve? Methods This paper aims to tackle these two interrelated questions by analysing NCDs through the lens of Jeremy Shiffman’s 2009 political priority framework. We define global political priority as ‘the degree to which international and national political leaders actively give attention to an issue, and back up that attention with the provision of financial, technical, and human resources that are commensurate with the severity of the issue’. Grounded in social constructionism, this framework critically examines the relationship between agenda setting and ‘objective’ factors in global health, such as the existence of cost–effective interventions and a high mortality burden. From a methodological perspective, this paper fits within the category of discipline configurative case study. Results We support Shiffman’s claim that strategic communication – or ideas in the form of issue portrayals – ought to be a core activity of global health policy communities. But issue portrayals must be the products of a robust and inclusive debate. To this end, we also consider it essential to recognise that issue portrayals reach political leaders through a vast array of channels. Raising the political priority of NCDs means engaging with

  5. Association of Endothelial Nitric Oxide Synthase Gene Polymorphisms with Coronary Artery Disease: An Updated Meta-Analysis and Systematic Review

    PubMed Central

    Parveen, Farah; Kapoor, Aditya; Sinha, Nakul

    2014-01-01

    Several association studies of endothelial nitric oxide synthase (NOS3) gene polymorphisms with respect to coronary artery disease (CAD) have been published in the past two decades. However, their association with the disease, especially among different ethnic subgroups, still remains controversial. This prompted us to conduct a systematic review and an updated structured meta-analysis, which is the largest so far (89 articles, 132 separate studies, and a sample size of 69,235), examining association of three polymorphic forms of the NOS3 gene (i.e. Glu298Asp, T786-C and 27bp VNTR b/a) with CAD. In a subgroup analysis, we tested their association separately among published studies originating predominantly from European, Middle Eastern, Asian, Asian-Indian and African ancestries. The pooled analysis confirmed the association of all the three selected SNP with CAD in three different genetic models transcending all ancestries worldwide. The Glu298Asp polymorphism showed strongest association (OR range = 1.28–1.52, and P<0.00001 for all comparisons), followed by T786-C (OR range = 1.34–1.42, and P<0.00001 for all comparisons) and 4b/a, (OR range = 1.19–1.41, and P≤0.002 for all comparisons) in our pooled analysis. Subgroup analysis revealed that Glu298Asp (OR range = 1.54–1.87, and P<0.004 for all comparisons) and 4b/a (OR range = 1.71–3.02, and P<0.00001 for all comparisons) have highest degree of association amongst the Middle Easterners. On the other hand, T786-C and its minor allele seem to carry a highest risk for CAD among subjects of Asian ancestry (OR range = 1.61–1.90, and P≤0.01 for all comparisons). PMID:25409023

  6. Optimising and Communicating Options for the Control of Invasive Plant Disease When There Is Epidemiological Uncertainty

    PubMed Central

    Cunniffe, Nik J.; Stutt, Richard O. J. H.; DeSimone, R. Erik; Gottwald, Tim R.; Gilligan, Christopher A.

    2015-01-01

    Although local eradication is routinely attempted following introduction of disease into a new region, failure is commonplace. Epidemiological principles governing the design of successful control are not well-understood. We analyse factors underlying the effectiveness of reactive eradication of localised outbreaks of invading plant disease, using citrus canker in Florida as a case study, although our results are largely generic, and apply to other plant pathogens (as we show via our second case study, citrus greening). We demonstrate how to optimise control via removal of hosts surrounding detected infection (i.e. localised culling) using a spatially-explicit, stochastic epidemiological model. We show how to define optimal culling strategies that take account of stochasticity in disease spread, and how the effectiveness of disease control depends on epidemiological parameters determining pathogen infectivity, symptom emergence and spread, the initial level of infection, and the logistics and implementation of detection and control. We also consider how optimal culling strategies are conditioned on the levels of risk acceptance/aversion of decision makers, and show how to extend the analyses to account for potential larger-scale impacts of a small-scale outbreak. Control of local outbreaks by culling can be very effective, particularly when started quickly, but the optimum strategy and its performance are strongly dependent on epidemiological parameters (particularly those controlling dispersal and the extent of any cryptic infection, i.e. infectious hosts prior to symptoms), the logistics of detection and control, and the level of local and global risk that is deemed to be acceptable. A version of the model we developed to illustrate our methodology and results to an audience of stakeholders, including policy makers, regulators and growers, is available online as an interactive, user-friendly interface at http://www.webidemics.com/. This version of our model

  7. Non-communicable diseases and global health governance: enhancing global processes to improve health development.

    PubMed

    Magnusson, Roger S

    2007-01-01

    This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy. PMID:17519005

  8. The Effectiveness of Interventions for Non-Communicable Diseases in Humanitarian Crises: A Systematic Review

    PubMed Central

    Ruby, Alexander; Knight, Abigail; Perel, Pablo; Blanchet, Karl; Roberts, Bayard

    2015-01-01

    Background Non-communicable diseases (NCDs) are of increasing concern in low- and middle-income countries (LMICs) affected humanitarian crises. Humanitarian agencies and governments are increasingly challenged with how to effectively tackle NCDs. Reviewing the evidence of interventions for NCDs in humanitarian crises can help guide future policies and research by identifying effective interventions and evidence gaps. The aim of this paper is to systematically review evidence on the effectiveness of interventions targeting NCDs during humanitarian crises in LMICs. Methods A systematic review methodology was followed using PRISMA standards. Studies were selected on NCD interventions with civilian populations affected by humanitarian crises in low- and middle-income countries. Five bibliographic databases and a range of grey literature sources were searched. Descriptive analysis was applied and a quality assessment conducted using the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Cochrane Risk of Bias Tool for experimental studies. Results The search yielded 4919 references of which 8 studies met inclusion criteria. Seven of the 8 studies were observational, and one study was a non-blinded randomised-controlled trial. Diseases examined included hypertension, heart failure, diabetes mellitus, chronic kidney disease, thalassaemia, and arthritis. Study settings included locations in the Middle East, Eastern Europe, and South Asia. Interventions featuring disease-management protocols and/or cohort monitoring demonstrated the strongest evidence of effectiveness. No studies examined intervention costs. The quality of studies was limited, with a reliance on observational study designs, limited use of control groups, biases associated with missing data and inadequate patient-follow-up, and confounding was poorly addressed. Conclusions The review highlights the extremely limited quantity and quality of evidence on this topic. Interventions that

  9. Non-communicable diseases and global health governance: enhancing global processes to improve health development

    PubMed Central

    Magnusson, Roger S

    2007-01-01

    This paper assesses progress in the development of a global framework for responding to non-communicable diseases, as reflected in the policies and initiatives of the World Health Organization (WHO), World Bank and the UN: the institutions most capable of shaping a coherent global policy. Responding to the global burden of chronic disease requires a strategic assessment of the global processes that are likely to be most effective in generating commitment to policy change at country level, and in influencing industry behaviour. WHO has adopted a legal process with tobacco (the WHO Framework Convention on Tobacco Control), but a non-legal, advocacy-based approach with diet and physical activity (the Global Strategy on Diet, Physical Activity and Health). The paper assesses the merits of the Millennium Development Goals (MDGs) and the FCTC as distinct global processes for advancing health development, before considering what lessons might be learned for enhancing the implementation of the Global Strategy on Diet. While global partnerships, economic incentives, and international legal instruments could each contribute to a more effective global response to chronic diseases, the paper makes a special case for the development of international legal standards in select areas of diet and nutrition, as a strategy for ensuring that the health of future generations does not become dependent on corporate charity and voluntary commitments. A broader frame of reference for lifestyle-related chronic diseases is needed: one that draws together WHO's work in tobacco, nutrition and physical activity, and that envisages selective use of international legal obligations, non-binding recommendations, advocacy and policy advice as tools of choice for promoting different elements of the strategy. PMID:17519005

  10. An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots, Freckling, and Neurofibromas. An Update. Part I. Dermatological Clinical Criteria Diagnostic of the Disease.

    PubMed

    Hernández-Martín, A; Duat-Rodríguez, A

    2016-01-01

    Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome and probably the one best known to dermatologists, who are generally the first physicians to suspect its diagnosis. Although the genetic locus of NF1 was identified on chromosome 17 in 1987, diagnosis of the disease is still mainly based on clinical observations and the diagnostic criteria of the National Institute of Health, dating from 1988. Cutaneous manifestations are particularly important because café-au-lait spots, freckling on flexural areas, and cutaneous neurofibromas comprise 3 of the 7 clinical diagnostic criteria. However, café-au-lait spots and freckling can also be present in other diseases. These manifestations are therefore not pathognomonic and are insufficient for definitive diagnosis in the early years of life. NF1 is a multisystemic disease associated with a predisposition to cancer. A multidisciplinary follow-up is necessary and dermatologists play an important role. PMID:26979265

  11. Virtual surveillance of communicable diseases: a 20-year experience in France.

    PubMed

    Flahault, A; Blanchon, T; Dorléans, Y; Toubiana, L; Vibert, J F; Valleron, A J

    2006-10-01

    Inserm has developed, since 1984, an information system based on a computer network of physicians in France. It allows for constitution of large databases on diseases, with individual description of cases, and to explore some aspects of the mathematical theory of communicable diseases. We developed user-friendly interfaces for remote data entry and GIS tools providing real-time atlas of the epidemiologic situation in any location. The continuous and ongoing surveillance network is constituted of about 1200 sentinel voluntary and unpaid investigators. We studied their motivation, reasons for either withdrawal or compliance using survival analyses. We implemented early warning systems for outbreak detection and for time-space forecasting. We conducted epidemiological surveys for investigating outbreaks. Large available time and space series allowed us to calibrate and explore synchronism of influenza epidemics, to test the assumption of panmixing in susceptibles-infectious-removed type models and to study the role of closing school in influenza morbidity and mortality in elderly. More than 250 000 cases of influenza, 150 000 cases of acute diarrheas, 35,000 patients for whom HIV tests have been prescribed by general practitioners and 25,000 cases of chickenpox have been collected. Detection of regional influenza or acute diarrhea outbreaks and forecasting of epidemic trends three weeks ahead are currently broadcasted to the French media and published on Sentiweb on a weekly basis. Age-cohort-period models assessed field effectiveness of mass immunization strategies against measles and influenza in the country. Case-control studies with more than 1200 sets of cases of acute diarrheas and their matched controls showed the role of calicivirus and rotavirus as probable major causes of gastroenteritis during recurrent widespread outbreaks in winter in France. An age-specific model for chickenpox showed the probable role of children in disease transmission to their

  12. Theories in Intercultural Communication.

    ERIC Educational Resources Information Center

    Kim, Young Yun, Ed.; Gudykunst, William B., Ed.

    1988-01-01

    Updating an earlier issue of the "International and Intercultural Communication Annual" (Volume VII, 1983), this collection of 13 essays represents the major approaches to the study of intercultural communication, as well as of communication in general. Papers in the collection are: "On Theorizing Intercultural Communication" (Young Yun Kim); "A…

  13. Update to agency for toxic substances and disease registry 2012 report on assessment of biota exposure to mercury originating from Savannah River Site.

    SciTech Connect

    Kuhne, W.

    2015-08-10

    The purpose of this report is to 1) update previous Savannah River National Laboratory (SRNL) assessment reports (Kvartek et al. 1994 and Halverson et al. 2008) on the fate of mercury in the Savannah River Site (SRS) environment and 2) address comments and recommendations from the review of SRS by the Agency for Toxic Substances and Disease Registry (ATSDR) concerning the evaluation of exposures to contaminants in biota originating from the SRS. The ATSDR reviewed and evaluated data from SRS, South Carolina Department of Health & Environmental Control (SCDHEC) and the Georgia Department of Natural Resources (GDNR) concerning the non-radioactive contaminant mercury. This report will provide a response and update to conclusions and recommendations made by the ATSDR.

  14. Towards reframing health service delivery in Uganda: the Uganda Initiative for Integrated Management of Non-Communicable Diseases

    PubMed Central

    Schwartz, Jeremy I.; Dunkle, Ashley; Akiteng, Ann R.; Birabwa-Male, Doreen; Kagimu, Richard; Mondo, Charles K.; Mutungi, Gerald; Rabin, Tracy L.; Skonieczny, Michael; Sykes, Jamila; Mayanja-Kizza, Harriet

    2015-01-01

    Background The burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) is accelerating. Given that the capacity of health systems in LMICs is already strained by the weight of communicable diseases, these countries find themselves facing a double burden of disease. NCDs contribute significantly to morbidity and mortality, thereby playing a major role in the cycle of poverty, and impeding development. Methods Integrated approaches to health service delivery and healthcare worker (HCW) training will be necessary in order to successfully combat the great challenge posed by NCDs. Results In 2013, we formed the Uganda Initiative for Integrated Management of NCDs (UINCD), a multidisciplinary research collaboration that aims to present a systems approach to integrated management of chronic disease prevention, care, and the training of HCWs. Discussion Through broad-based stakeholder engagement, catalytic partnerships, and a collective vision, UINCD is working to reframe integrated health service delivery in Uganda. PMID:25563451

  15. [Integration of mental health and chronic non-communicable diseases in Peru: challenges and opportunities for primary care settings].

    PubMed

    Diez-Canseco, Francisco; Ipince, Alessandra; Toyama, Mauricio; Benate-Galvez, Ysabel; Galán-Rodas, Edén; Medina-Verástegui, Julio César; Sánchez-Moreno, David; Araya, Ricardo; Miranda, J Jaime

    2014-01-01

    In this article, the relationship between mental health and chronic non-communicable diseases is discussed as well as the possibility to address them in a comprehensive manner in the Peruvian health system. First, the prevalence estimates and the burden of chronic non-communicable diseases and mental disorders worldwide and in Peru are reviewed. Then, the detrimental impact of depression in the early stages as well as the progress of diabetes and cardiovascular diseases is described. Additionally, the gap between access to mental health care in Peru is analyzed. Lastly, the alternatives to reduce the gap are explored. Of these alternatives, the integration of mental health into primary care services is emphasized; as a feasible way to meet the care needs of the general population, and people with chronic diseases in particular, in the Peruvian context. PMID:24718538

  16. [Health Communication: Preventing the Spread of Ebola Virus Disease in the Portuguese Spoken African Countries--Methodology KISS & KEYWORDS].

    PubMed

    Santiago, Isabel De; Miguel, José Pereira; Antunes, Francisco

    2015-01-01

    In this work, Health Communication is considered as an important discipline in medicine and health sciences for his role as true determinant of health. We highlight their contribution to health promotion and disease prevention. Thus, the Health Communication Plan (PCS): Preventing the spread of Ebola virus disease in the Portuguese Speaking African Countries - KISS & KEYWORDS methodology is a tool that aims to minimize the risk of infection by Ebola virus in the Portuguese Speaking African Countries and also train for a general improvement of health conditions of the local populations. In the PCS design are especially considered the social and cultural contexts of the target populations, especially the customs, traditions and religion. Health Communication is considered as an Essential Function of Public Health and its main is to provide a population-based approach. The target of communication actions are population groups in addition to the individual communication, target-audiences are people without access to the media, in Guinea Bissau, Cape Verde and Sao Tome and Principe. Under the communication plan uses the methodology, models and practices both by media professionals as health. A proximity approach and cultural mediation, previously identified key facts, are defined objectives; outlines to the Plan in concrete and its implementation methodology (target-audience and following intervention, materials to be used and key-messages and partners to mobilize) following the World Health Organisation standards. PMID:26061502

  17. Nutrient reference value: non-communicable disease endpoints--a conference report.

    PubMed

    Lupton, J R; Blumberg, J B; L'Abbe, M; LeDoux, M; Rice, H B; von Schacky, C; Yaktine, A; Griffiths, J C

    2016-03-01

    scientific evidence does exist to confirm a relationship between the intake of a specific bioactive constituent and enhanced health conditions or reduced risk of a chronic disease. Further, research on the putative mechanisms of action of various classes of bioactives is supported by national and pan-national government agencies, and academic institutions, as well as functional food and dietary supplement manufacturers. Consumers are becoming educated and are seeking to purchase products containing bioactives, yet there is no evaluative process in place to let the public know how strong the science is behind the benefits or the quantitative amounts needed to achieve these beneficial health effects or to avoid exceeding the upper level (UL). When one lacks an essential nutrient, overt deficiency with concomitant physiological determents and eventually death are expected. The absence of bioactive substances from the diet results in suboptimal health, e.g., poor cellular and/or physiological function, which is relative and not absolute. Regrettably at this time, there is no DRI process to evaluate bioactives, although a recent workshop convened by the National Institutes of Health (Options for Consideration of Chronic Disease Endpoints for Dietary Reference Intakes (DRIs); March 10-11, 2015; http://health.gov/dietaryguidelines/dri/ ) did explore the process to develop DVs for nutrients, the lack of which result in increased risk of chronic disease (non-communicable disease) endpoints. A final report is expected soon. This conference (CRN-International Scientific Symposium; "Nutrient Reference Value-Non-Communicable Disease (NRV-NCD) Endpoints," 20 November in Kronberg, Germany; http://www.crn-i.ch/2015symposium/ ) explores concepts related to the Codex NRV process, the public health opportunities in setting NRVs for bioactive constituents, and further research and details on the specific class of bioactives, n-3 long-chain polyunsaturated fatty acids (also termed omega-3 fatty

  18. Preparing for Serious Communicable Diseases in the United States: What the Ebola Virus Epidemic Has Taught Us.

    PubMed

    Varkey, Jay B; Ribner, Bruce S

    2016-06-01

    Ending the West Africa Ebola virus disease (EVD) outbreak required an unprecedented international response. For the United States, participation in the international response to the West Africa EVD outbreak provided an opportunity to learn important lessons in four key domains critical to preparing for future outbreaks of EVD and other serious communicable diseases: (i) safe and effective patient care, (ii) the role of experimental therapeutics and vaccines, (iii) infection control, and (iv) hospital and community preparedness. PMID:27337477

  19. Scenarios, personas and user stories from design ethnography: Evidence-based design representations of communicable disease investigations

    PubMed Central

    Turner, Anne M; Reeder, Blaine; Ramey, Judith

    2014-01-01

    Purpose Despite years of effort and millions of dollars spent to create a unified electronic communicable disease reporting systems, the goal remains elusive. A major barrier has been a lack of understanding by system designers of communicable disease (CD) work and the public health workers who perform this work. This study reports on the application of User Center Design representations, traditionally used for improving interface design, to translate the complex CD work identified through ethnographic studies to guide designers and developers of CD systems. The purpose of this work is to: (1) better understand public health practitioners and their information workflow with respect to communicable disease (CD) monitoring and control at a local health department, and (2) to develop evidence-based design representations that model this CD work to inform the design of future disease surveillance systems. Methods We performed extensive onsite semi-structured interviews, targeted work shadowing and a focus group to characterize local health department communicable disease workflow. Informed by principles of design ethnography and user-centered design (UCD) we created persona, scenarios and user stories to accurately represent the user to system designers. Results We sought to convey to designers the key findings from ethnographic studies: 1) that public health CD work is mobile and episodic, in contrast to current CD reporting systems, which are stationary and fixed 2) health department efforts are focused on CD investigation and response rather than reporting and 3) current CD information systems must conform to PH workflow to ensure their usefulness. In an effort to illustrate our findings to designers, we developed three contemporary design-support representations: persona, scenario, and user story. Conclusions Through application of user centered design principles, we were able to create design representations that illustrate complex public health communicable

  20. Translational informatics approach for identifying the functional molecular communicators linking coronary artery disease, infection and inflammation.

    PubMed

    Sharma, Ankit; Ghatge, Madankumar; Mundkur, Lakshmi; Vangala, Rajani Kanth

    2016-05-01

    Translational informatics approaches are required for the integration of diverse and accumulating data to enable the administration of effective translational medicine specifically in complex diseases such as coronary artery disease (CAD). In the current study, a novel approach for elucidating the association between infection, inflammation and CAD was used. Genes for CAD were collected from the CAD‑gene database and those for infection and inflammation were collected from the UniProt database. The cytomegalovirus (CMV)‑induced genes were identified from the literature and the CAD‑associated clinical phenotypes were obtained from the Unified Medical Language System. A total of 55 gene ontologies (GO) termed functional communicator ontologies were identified in the gene sets linking clinical phenotypes in the diseasome network. The network topology analysis suggested that important functions including viral entry, cell adhesion, apoptosis, inflammatory and immune responses networked with clinical phenotypes. Microarray data was extracted from the Gene Expression Omnibus (dataset: GSE48060) for highly networked disease myocardial infarction. Further analysis of differentially expressed genes and their GO terms suggested that CMV infection may trigger a xenobiotic response, oxidative stress, inflammation and immune modulation. Notably, the current study identified γ‑glutamyl transferase (GGT)‑5 as a potential biomarker with an odds ratio of 1.947, which increased to 2.561 following the addition of CMV and CMV‑neutralizing antibody (CMV‑NA) titers. The C‑statistics increased from 0.530 for conventional risk factors (CRFs) to 0.711 for GGT in combination with the above mentioned infections and CRFs. Therefore, the translational informatics approach used in the current study identified a potential molecular mechanism for CMV infection in CAD, and a potential biomarker for risk prediction. PMID:27035874